Government bulks up to face down docs
Has it dawned on Nova Scotia’s government that keeping the doctors we already have is cheaper, smarter and better all ’round than trying to recruit ever more new ones from God-knows-where?
Even if this self-evident truth has somehow managed to penetrate the collective consciousness of the elected and anointed who run the province in no discernible direction, they haven’t shown any sign that they know how to make it so.
Heading into negotiations on a new master agreement between the province and the doctors, the docs – represented by Doctors Nova Scotia (DNS) – hoped for a more positive and conciliatory approach than the last time the two sat down and produced the deeply-flawed – some docs would argue, disastrous – 2016 master agreement.
Unfortunately, the provincial government has proven itself generally disinterested in that most effective style of governance in a democracy – consensus. Reaching consensus allows two or more parties with shared goals to pursue them cooperatively, increasing the chances of success exponentially.
For example, Nova Scotia’s doctors and its government both want the health system to perform better than it does now. Who doesn’t?
The docs want to help, but the government sticks stubbornly to the autocratic notion that it must exert absolute control over all of the system’s moving parts, doctors included. Such control is incompatible with consensus.
From the day it arrived, the Mcneil government has approached every labour negotiation like a carpenter approaches a nail. Civil servants, teachers, nurses and doctors are workforces to be hammered into line at the bargaining table or, failing that, legislated into their rightful, subservient roles.
It’s an approach that got the government its balanced budget, but Nova Scotians lost docs, or their kids lost years to government-sponsored dysfunction in public schools that may, or may not, be behind us depending on who you ask.
Going into the current negotiations – the master agreement sets the fees paid to docs for insured services – the doctors decided to try to change the dynamics. Doctors Nova Scotia suggested to the province that they proceed without lawyers.
If the representative of the province’s physicians sat down in a non-adversarial setting with leaders in the provincial health/ government bureaucracy, they might just reach an agreement that both sides can live with. Or, at least the doctors figured it was worth a try.
Surveying the health-care landscape that its autocratic approach has delivered – a chronic shortage of family docs, disappearing specialists, cancelled surgeries, regional hospitals that can’t even deliver babies safely – this government would obviously welcome the olive branch from DNS, right?
Not exactly. While the government agreed to no lawyers, thus accepting the letter of the DNS proposal, the spirit of the offer was lost on them.
Stripped of its phalanx of labour lawyers, the government nevertheless hired outside help to lead its negotiations, in the person of B.C.’S former deputy minister of health, backed up by a company out of Toronto called Invictus that bills itself as a health-care and data specialist.
“Invictus, who provide expertise in physician data, was engaged by the Department of Health and Wellness to provide objective data, data-analytics, and advice about how physician compensation in Nova Scotia compares with elsewhere, especially the Atlantic region,” the provincial government explains.
The Canadian Institute for Health Information (CIHI) and other sources provide the same kind of information, but it tends to show that Nova Scotia has among the lowest paid doctors in the country. That might explain why the government went shopping for different data going into negotiations with doctors.
The former B.C. deputy is Penny Ballem, a medical doctor and former city manager in Vancouver, where she gained a reputation as a bit of a bully, which was likely the only recommendation the Nova Scotia government needed to hire her without benefit of competition, which is the same way Invictus got its Nova Scotia gig. Fair hiring and purchasing rules become very malleable once the government knows what it wants.
From here, it looks like Doctors Nova Scotia was willing to try to repair the fractured relationship between Nova Scotia’s doctors and the provincial government. That would clearly be in the best interests of Nova Scotians, but apparently those interests take a backseat to whatever the government wants.