Alberta Premier Alison Redford has struck a deal with doctors, ending a lengthy feud between the cash-strapped province and the country's top-paid physicians.
To finalize a memorandum of understanding on a seven-year contract, the province offered a lump-sum bonus while backing off program cuts and a key election promise, the introduction of family-care clinics. In return, the doctors agreed to a three-year pay freeze as the province looks to rein in costs amid falling oil prices. Doctors took modest increases in the final four years of the deal.
"I deeply appreciate the physicians' willingness to be flexible and to be accommodating," Ms. Redford said at Monday's announcement in Calgary, where she was joined by Health Minister Fred Horne and Alberta Medical Association president Michael Giuffre.
Doctors will accept the "short-term pain" of a fee freeze to help drive reform in the health system, Dr. Giuffre said, adding Monday's memorandum of understanding is "back-end loaded" for doctors.
"I think this is a story that's going to evolve over time to show we can improve the system, that we're looking for efficiencies with government, that we'll be side by side at various aspects," he said.
The deal dates back to 2011, when the last deal expired, and ends in 2018. It includes raises of zero per cent for the first three years (saving the province $455-million, Mr. Horne said), 2.5 per cent for the next two and cost-of-living increases for the final two. The one-time bonus of $68-million, payable this year if the deal is ratified, amounts to about 2 per cent. Previous proposals didn't include the bonus, Dr. Giuffre said.
Ms. Redford's family-care clinics (FCCs), a key election pledge, were once meant to replace primary-care networks (PCNs), which are doctor-run, in delivering front-line treatment. Physicians objected to this. Monday's deal now envisions "PCN 2.0," though what that means is unclear. "I'm not sure if it excludes the FCC concept, but certainly is more of a broader concept," Dr. Giuffre said.
Ms. Redford, speaking at the legislature Monday evening, nonetheless pledged FCCs weren't being abandoned and the government will open "up to" the 140 clinics it had promised. She hopes to overhaul funding models to create FCCs while developing existing PCNs.
"You bet you're going to get family-care clinics. We're sticking to our commitment," she said, before stressing the length of the deal. "It gives us peace to be able to move on and actually build sustainable health care in a way that's, I think, unique in Canada right now."
The government also agreed to back off cuts to programs offering bonuses for physician retention, high business costs and doctors working in rural northern areas.
The deal, which will expire if not ratified this month, signals an end to bitter negotiations. Doctors had recently threatened to sue, while the province sought to circumvent the AMA and try to strike individual deals with certain groups of physicians. The new deal recognizes the AMA's authority and means "there's no longer this divide and conquer stuff," Dr. Giuffre said.
The deal comes as Ms. Redford's polling numbers have dropped, and as she continues to fight several battles with labour groups, including nurses and provincial employees. A tentative teachers' deal, meanwhile, has yet to be ratified by all school boards. All this comes as the Premier prepares for her annual party leadership review this fall, where a low approval rating could force her departure. The doctors' deal, if ratified, will also ensure labour peace past the next provincial election, due in 2016.
The opposition wondered why a deal took so long. "It seems like they overpromise, underdeliver and create an unnecessary amount of turmoil before finally being dragged, kicking and screaming, to an agreement," Wildrose Party Leader Danielle Smith said.
Liberal Leader Raj Sherman, a physician himself, said "the Premier clearly blinked" in her battle with doctors, while NDP Leader Brian Mason praised the AMA for standing up to the "bully" government. Mr. Mason warned the doctors' agreement may impede ratification of the less-generous teachers' deal.