UCP CANCELS PAY CONTRACT, IMPOSES RADICAL CHANGE
Doctors feel betrayed by unexpected move but government says it’s the best option
The UCP fired its heaviest artillery at Alberta doctors Thursday, cancelling their funding contract, cutting a key pay element and enabling 10 more changes through a cabinet order in council.
Doctors were fearful some of this would happen, but stunned by the extent of it.
They will immediately challenge the contract cancellation in court, said Dr. Christine Molnar, president of the Alberta Medical Association.
“They have chosen to tear up a viable contract before the end of term.
“I believe this is the first time this has happened in Canada. A first for Alberta. A sad day for health care.
“We had offered a short-term saving of three per cent, around $150 million. We had informed them that another offer was to be delivered tomorrow (Friday).
“This is a betrayal of the process that we entered into in good faith. As a result of their actions, physicians feel betrayed.”
Molnar said she was not told Thursday’s announcement was coming, despite having spoken to Health Minister Tyler Shandro as recently as Monday.
The UCP says that even after changing the fundamental rules — also giving Shandro all power to set doctors’ fees — further offers from the doctors are welcome. Doctors will be paid despite the contract cancellation.
After Thursday, physicians will greet those claims with deep skepticism.
The government also cut $3 million from the AMA’S annual payment for administering benefit programs funded by government.
Once again, the UCP shows it’s much less concerned with the feelings of stakeholder groups than it is with its funding targets.
They say this package is the only way to keep doctor compensation stable at $5.4 billion a year. Otherwise, they argue, the charges could balloon by a further $2 billion.
But the draconian changes pose a risk to the supply of family doctors and specialists.
With the new rules, they will not feel protected from capricious cuts.
Only in recent years has the province overcome a shortage that plagued patients for a decade. Family doctors — and specialists such as radiologists, who will also face fee reductions — may begin to leave again.
The UCP doesn’t believe this will happen, because doctor pay will still be high by national standards. They also feel the U.S. is not the lure it once was.
But the physicians have been saying for weeks now that many will depart, retire early or discard services for which they are no longer paid.
Molnar calls some of the changes “an attack on family physicians.”
One major measure is a cut from $18 to $9 for time spent with a patient after 15 minutes of consultation — the stipend for dealing with patients with complex needs. The rest of that payment will disappear next year.
In government there’s a conviction that many doctors are charging this fee as soon as they hit 15 minutes. It’s a claim every doctor I’ve spoken to rejects. They consider the allegation a phoney excuse for a pay cut.
Looming over all of this is the abrupt cancellation of the doctors’ master agreement.
This breathtaking move is a clear signal to other groups — especially public-sector unions — that the government is willing to radically change the rules and simply fight the inevitable lawsuits.
The government will also strip the AMA of power to veto fee changes, giving full authority to the minister, a step the doctors have feared since enabling legislation was passed last fall.
The UCP feels this power rightfully belongs to the government, not the doctors. But physicians worry Shandro will simply cherry-pick fees he considers too high.
The UCP calculates that most people don’t care about the detail of how public-sector groups are funded, or even how much. In that, the Kenney government may be largely correct.
But Albertans do care about service, especially in health care.
The UCP continues to claim wait times and other measures will improve even as the system is disrupted.
The doctors — and soon, the nurses — will pay for this now. If service erodes, the government will pay later.