TORONTO – A group of doctors is disappointed with a tentative agreement the Ontario Medical Association has reached with the province, saying it won’t keep pace with the pressures of the health system.
Under the tentative four-year deal, which has not yet been released but was obtained by The Canadian Press, the government will increase the physician services budget – currently about $11.5 billion – by 2.5 per cent each year.
But Concerned Ontario Doctors, an advocacy group for physicians, says at least 3.1 per cent is required “to maintain the bare minimum in health care,” and this deal amounts to a cut to existing patient services.
“It would be complete hypocrisy to agree to a contract that agrees to wilful underfunding of the system when we’ve been protesting that for months,” said Dr. Nadia Alam. “It makes no sense to us that the OMA is actively endorsing this contract.”
The physician services budget is to be “co-managed” by the doctors and the government, and also contained in the deal is an agreement that if doctor expenditures stay within budget, the government will make payments of $50 million, $100 million, $120 million and $100 million in each of the four years, respectively.
But if they exceed the physician services budget in any year, it will come out of those payments.
OMA president Dr. Virginia Walley said that funding pushes the budget’s growth rate to three per cent.
The agreement also sets out $200 million in “permanent reductions in fees of physician payments,” the OMA said in a confidential memo sent to the province’s doctors that was also obtained by The Canadian Press.
Walley called the two reductions of $100 million – in 2017-18 and 2019-20 – “adjustments” to the physician services budget.
“It will probably mean a redistribution of resources, but it will be focused, as I say, on patient needs,” she said.
Alam said the deal does not factor in various unplanned pressures on the health system.
“They’re trying to impose an artificial control over something that’s much bigger than physicians as a group,” she said. “They’re not giving any leeway. This is the line that they’ve drawn.”
The agreement says the government agrees to add more funding to the physician services budget if it decides to provide a new or expanded service to Ontarians or if “there is an unforeseeable event beyond the control of either party that materially impacts the (budget) to increase overall expenditures.”
The deal is set for a ratification vote on Aug. 6, and Concerned Ontario Doctors is suggesting physicians reject the deal.
The tentative deal includes a clause to jointly “update” doctors’ fees, which have been a major source of acrimony since the government imposed fee cuts last year.
Walley said that the agreement provides some stability and gives physicians the opportunity to work with government “in a constructive, co-operative way.”
“I think once they have a chance to look at it and to look at the balance of what’s being provided for them and their practices and for their patients going forward, I’m confident that they’re going to support this agreement,” she said.
The OMA had publicly said it was seeking binding arbitration, which Alam said many doctors were disappointed not to see. An OMA court challenge against the government for binding arbitration will continue.