Alberta is proposing new legislation that could affect where doctors work and how much they get paid as well as allow the government more freedom to bring in replacement workers for union jobs.
The amendments are contained in two omnibus bills introduced by Finance Minister Travis Toews.
The bill proposes that the government be allowed to cancel its master agreement with the Alberta Medical Association and would give the province power to compel new doctors wanting to bill the health system to work in rural areas.
“These changes will help government control growth in program spending, eliminate duplication and make government more efficient,” Mr. Toews told the house on Monday as he tabled the bill.
“We have an obligation to future generations to restore Alberta’s fiscal health, and the proposed legislation is an important step we must take.”
Premier Jason Kenney’s United Conservative government introduced a budget last week that reduces spending and promises program and job reviews to get multibillion-dollar budget deficits back in balance by 2023.
The government has been relying on a panel report that said Alberta’s doctors are making far more than other provinces and the main barrier to pay reform is the master agreement.
The panel, chaired by former Saskatchewan finance minister Janice MacKinnon, said that health spending, which makes up more than 40 per cent of the provincial budget, needs to be reduced.
The report also said that physician costs last year were more than $5-billion – about 25 per cent of the health budget – and have grown 300 per cent in Alberta in the past two decades compared with 200 per cent in other provinces.
It said a key driver of the increase is that doctors are paid on a fee-for-service basis, which shelled out $413,000 on average in 2017 – about one-third higher than the national average.
The report also said Alberta has been lagging behind on physician pay reform and that the master agreement with the medical association is difficult to amend.
The current agreement is set to expire on March 31. The bill suggests the government unilaterally end the master agreement if negotiations with the doctors group stall.
Health Minister Tyler Shandro has said the province wants to explore ways to get more physicians to rural areas such as the town of Bonnyville, where there are 600 patients on a waiting list for a doctor.
The bill would allow Mr. Shandro to set limits on dispensing future billing ID numbers to physicians and would tie them to having doctors work in rural areas.
The MacKinnon report also said action must be taken to reduce public-sector compensation, which comprises more than half of the operating budget.
The government said in its budget last week that it will look to attrition to reduce the number of workers.
The province is heading into contract negotiations with major unions and the bill would give the government the option to bring in replacement workers to fill essential services during talks.
Currently, union members must be used to fill essential services.
Last week’s budget did not set aside any money for public-sector salary increases.
It also projects an overall $8.7-billion deficit on $50-billion in spending.
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