Alberta doctors have ratified a new four-year agreement with the provincial government.
On Thursday morning, the province said the deal with the Alberta Medical Association focuses mainly on physician recruitment and retention, and rebuilding relationships with Alberta doctors.
“The agreement will ensure that compensation to Alberta physicians remains competitive,” Health Minister Jason Copping said, adding it’s about much more than that. “It’s about working together to serve patients better across our entire health-care system.”
AMA president Dr. Vesta Michelle Warren said the agreement is good for physicians, patients and the health-care system.
“It will allow physicians to contribute to decision-making and provide expertise on what matters for patients,” Warren said.
“It provides increases in line with other settlements, valuable programs, business cost support, fair processes for working together on compensation or other matters and ways to resolve disputes. The agreement will help stabilize physician practices that are struggling with rising costs. Stability is critical to retain and attract physicians.”
Alberta physicians will receive a guaranteed four per cent wage increase over the four-year term of the agreement.
The province has committed $252 million in new spending over the length of the four-year term for communities and specialties facing recruitment and retention issues. The province recognized it is facing challenges ensuring access to family physicians in remote and rural areas.
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“The past three years have been tough, especially in smaller communities, and recruitment of rural physicians is harder than ever,” Copping said. “We need more doctors in the smaller communities across the province and the agreement will be a boost to our recruitment.
“We need to add capacity across the system and keep working towards the goal of better access to scheduled surgeries and other care that we had before COVID.”
“There is a shortage of health-care workers across Canada and even globally, and the competition is going to be fierce,” Warren said. “This agreement will provide stability and that is key to begin to attract more in, and the provisions will help us to remain competitive.”
Lorian Hardcastle, an associate professor in the Faculty of Law and Cumming School of Medicine at the University of Calgary, said while this agreement is an improvement on the tentative deal rejected earlier this year, she doesn’t believe it will do a lot to improve physician recruitment and retention.
“For some people, perhaps having a ratified agreement in place or having a sense of stability might be one checkmark in favour of why they would come to Alberta or choose to leave. But it’s only one factor,” she explained.
“There are other important factors, such as the perception of how health-care workers are treated in the province, the perception of the overall health-care system, a sense that the overall health-care system is a good place to work, is stable. So an agreement is really only part of the puzzle when it comes to recruitment and retention.”
A $40-million lump sum will also be spent on increasing Primary Care Networks over the first two years.
“We need to act urgently to stabilize the system and address the pressures that have increased with the pandemic,” Copping said.
The agreement also includes increased investments to doctor’s fees, with specialties facing greater financial pressures seeing higher rate increases over the first three years of the term. Those specialties include family medicine, neurology, obstetrics and gynecology, pediatrics and psychiatry.
“We need to get more money to family physicians because, quite frankly, that’s the workhorse,” Copping said. “That is where we have the greatest shortages and that’s the bedrock of our health-care system and we need to get that working.”
Higher-earning specialties such as ophthalmology and radiology will still see rate increases, but at a lower rate.
The government has also committed to reviewing caps to daily physician visits, virtual care code enhancements and extending physician support programs to medical examiners.
Alberta doctors voted against a previous tentative deal earlier this year and have been without a deal with the province for more than two years, since then-health minister Tyler Shandro nullified the agreement.
This new agreement includes a commitment from Alberta Health to repeal section 40.2 of the Alberta Health Care Insurance Act, which is what enabled the government to terminate the last agreement with the AMA.
In return, the AMA has agreed to drop the lawsuit it filed against the government without seeking costs.
The AMA and its members would like to see the legislation repealed as soon as possible.
Alberta will have a new premier next week, following the results of the UCP leadership race, which will be revealed on Oct. 6.
Hardcastle said the outcome of that vote will impact the government’s future relationship with doctors.
“There may be a whole lot of instability coming, depending on who is elected,” she said.
“While I think that repealing that provision is a step in the right direction of regaining physicians’ trust, it’s still important for them to know that depending who the next leader… premier is, I worry about the extent to which that person may undercut that promise through new legislation or through issuing directives to the college, or otherwise flexing their regulatory authority.
“It’s far from a done deal in terms of what this will all look like. I think that whoever the next leader is will be far more determinative of that relationship than this agreement will be.”
Warren stressed that the AMA dropping its lawsuit will only happen once the legislation is repealed.
“That’s actually within this agreement,” she said. “My plea to politicians everywhere is, stability is necessary to begin rebuilding and healing and making change. And introduction of more chaos is not helpful.
“Trust is something that is easily broken and is hard to rebuild, and for a lot of physicians out there, it’s the actions that have been taken this year, it’s the actions going forward into the future that really is going to begin to rebuild that trust.”
Copping added that he has spoken with all of the UCP leadership candidates about the agreement.
“I can tell you that they understand the importance of the deal and they understand the importance of doctors in terms of moving forward,” he said.
In a statement, Alberta NDP health critic David Shepherd said he hopes the agreement directs health care on a positive path forward, but added “the scars the UCP have left on this province sill not heal overnight.”
“Albertans went through the worst parts of this pandemic as the UCP actively made the health system worse by attacking doctors,” he said.
“In many ways, this deal simply reverses the decisions made by the same UCP cabinet Jason Copping serves in.”
Alberta Health and the AMA said Thursday that 70.2 per cent of responding physicians voted yes to the new agreement, which was tentatively reached in August. The AMA said voter turnout was 45.8 per cent.
The term of the agreement is from April 1, 2022 to March 31, 2026.