Doctors should take the deal, even if it’s ailing

Ontario’s doctors have been without a provincial contract for two years. Should they vote this weekend to approve the proposal the Wynne government has put on the table (and which the Ontario Medical Association recommends), or should they reject it over its perceived weaknesses?

There’s no love lost between the doctors and a province that, a scant few months ago, was selectively attacking doctor salaries in a bid to woo public opinion over health spending. But tactics aside, is the proposal the best the two sides can do, keeping the public’s interest at the forefront? If so, physicians will need to hold their noses and swallow this pill.

For the government, the deal is, above all else, about keeping costs under control and having consistency in future spending. It provides specific annual budgets for general physician services for each of the next four years, starting from $11.58 billion, with a 2.5-per-cent increase annually. That doesn’t mean individual doctors get this raise; in fact there will be cuts to some of what individual doctors can bill — supposedly meaning $200 million in permanent savings.

In the absence of a true overhaul in how Ontarians pay for health care — more private sector involvement, for instance — this plan is likely the best the debt-ridden Ontario government can do.

Critics of the deal — including many doctors — say the province’s planned annual increases won’t keep up with the basic costs of health care, and fear the proposal will drive doctors out of Ontario, further straining wait times and access.

For its part, the OMA says the 42,000 doctors it represents should go for the deal, because it at least gives them a stable amount of money. Though they can strike, doctors usually don’t take labour action; they’re guided by an ethical duty of care. The doctors’ organization, however, would like its protracted negotiations with the province to be subject to binding arbitration. It has launched a Charter challenge to get it, but this won’t be resolved for several years. In the meantime, this deal is a stopgap.

Is it good enough? The proposed accord does make some moves to improve patient access to doctors, encouraging local health authorities to shift staffing for improved primary care, for instance. Still, many of the health challenges in Ontario aren’t about immediate care, they’re about better long-term care and home care. The proposed agreement does not specifically address where physicians fit in with those challenges.

This deal is less than it looks, but doctors should take it, while continuing to press for binding arbitration. Fixing this patient will take a very long time.