Ontario's doctors and the provincial government have reached a tentative deal on binding arbitration that would keep physicians from taking any "strike action" as the two sides work toward a new contract, according to a copy of the framework agreement obtained by The Globe and Mail.
The potential deal marks a significant thaw in the icy relations between Premier Kathleen Wynne's Liberals and the medical profession, which has been without a fee agreement for more than three years.
The Ontario Medical Association announced the breakthrough to its members in an e-mail Thursday, shortly after the OMA's board lent its unanimous support to the plan and less than two weeks after the embattled organization selected a new president and president-elect.
Doctors will vote on the framework agreement next month. If they ratify it, the parties will begin negotiating a new physician services agreement.
The lack of binding arbitration for doctors was considered a major barrier to a new contract.
Ontario physicians have long argued that they are at a disadvantage when talks reach an impasse because there is no mechanism to refer the dispute to a third party for a final say. The Liberal government, meanwhile, had previously expressed concern that an arbitrator could award generous pay hikes to doctors, undercutting efforts to control health spending.
Seven other provinces and territories have some form of binding arbitration for physicians.
"After several years of unilateral government actions against doctors, the OMA and Ontario's doctors have been pressing the government to agree to binding arbitration, in order to ensure we have access to the same fair and independent process afforded to all other essential service providers," Shawn Whatley, the president of the OMA, said in a statement.
The OMA, which represents 34,000 doctors, medical residents and medical students, has for months been exploring the possibility of withdrawing some services for patients if the government refused to agree to arbitration. That option will be off the table if doctors endorse the tentative deal, which says the OMA will not "threaten, condone or encourage" strike action.
The deal wouldn't prohibit doctors from pressuring the government through petitions, letter-writing campaigns, public protests or other forms of advocacy.
The agreement says that, within 30 days of talks commencing, the two sides will try to agree on one person to act as both a mediator and arbitrator, unless the parties decide the roles should be separated. The arbitrator, who will have the final say on a new contract, will be the chair of a three-member arbitration board that will also include panelists appointed by the OMA and the government.
If the two sides can't agree on an arbitrator, the Chief Justice of Ontario will select one, the document says.
The framework agreement also lays out the criteria the arbitration board can use in making its decisions, including the principle that physician compensation be "fair" and "reasonable." The board can also consider "the economic situation in Ontario."
The two sides also agreed that the OMA's Charter challenge to the lack of binding arbitration in Ontario be allowed to continue, despite the tentative deal.
Ms. Wynne, whose government is scheduled to go to the polls next year, called the arbitration agreement an "important milestone," that puts the parties one step closer to a new contract.
"Our priority is to reach an agreement that will allow Ontario's doctors to continue their important work and make sure that people across our province have access to a high-quality, responsive health-care system that is sustainable for generations to come," she said in a statement.
The arbitration framework essentially erases last summer's tentative physician services agreement, saying neither party nor the arbitrator can rely on the terms of an old proposal that two-thirds of doctors rejected.
The No vote touched off months of turmoil within the OMA, and led, ultimately, to the resignation of the group's president and five other executive members, all of whom endorsed the tentative contract.
The rejected deal did not include a promise of binding arbitration.