Alberta's doctors remain locked in an escalating battle with the province over a new contract, with both sides running advertisements against each other and no new talks scheduled.
Health Minister Fred Horne has now mused about going around the Alberta Medical Association entirely to negotiate directly with doctors and specialists; the AMA, in response, is rallying physicians behind it and openly threatening job action. "Everything's on the table," AMA president Michael Giuffre said in an interview.
Talks collapsed on Nov. 16, when Mr. Horne announced he'd simply impose a unilateral pay plan after 20 months of fruitless talks. His department then ran radio ads laying out their side of bargaining. The AMA responded with newspaper ads this week, saying the government "misled" doctors by offering them an interim deal just before the spring election, and that there's a "difference between intimidation and leadership."
The standoff escalated again Wednesday when Premier Alison Redford waded into the fray, saying it was the AMA that reneged on the interim deal and it's her job "to represent the interests of Albertans. It's the AMA's job to represent the interests of doctors."
Dr. Giuffre said it was government that backed away, and he was caught off guard by Ms. Redford's claim. "I'm surprised," he said. "Now it sounds like they're trying to pull a fast one."
There are several issues at the centre of the debate, Dr. Giuffre said, including physician intimidation, the ongoing reorganization of the health system and plans to review certain fees and do away with some programs designed to retain doctors. The Canadian Institute for Health Information says Alberta's doctors are Canada's best-paid, but Dr. Giuffre said they also have much higher overhead for staff and office space in the booming province.
"When you take into account these things, we're not out of line," he said. "… I think the government would really like to make this unfair negotiation just about money."
That's what Mr. Horne has tried to do, saying the AMA just wants more money, which he can't provide. He said it's up to doctors to return to the table.
"I'll continue to wait and be hopeful," he said Wednesday, dismissing threats of job action. "I don't believe that they would want to harm or restrict access to care in any way, and I will always have faith in that."
Dr. Giuffre has some political allies – in opposition. Wildrose Leader Danielle Smith said "doctors have every reason to feel betrayed by this government." Liberal Leader Raj Sherman, a physician, has said overcrowding, inefficiency and poor patient care matter more to doctors than money. New Democrat Leader Brian Mason urged the sides to sit down with binding arbitration.
It's more than money that has physicians upset, said Jane Ruseski, a health economist at the University of Alberta. "Do they have much to complain about in terms of how much they're paid? Probably not. But it's more of an issue with how the process has unfolded," she said, later agreeing that arbitration or mediation could solve the impasse.
"Each side is now posturing, running ads against one another. That's not particularly healthy for the health-care system. So somebody that can come in there with a level head and see the pros and cons of either situation, would probably be needed," she said.
Doctors from across the province are scheduled to meet Dec. 15.
Mr. Horne's unilateral deal included a one-time bonus and cost-of-living adjustments for the next three years. The interim deal signed before the election gave physicians a raise of inflation plus 1 per cent, Dr. Giuffre said. Physician pay totals $3.4-billion in Alberta, one-fifth of the entire health budget.