TORONTO -- Some Ontario doctors are urging their colleagues to reject a new fee agreement with the government when they vote on the deal Sunday, even though they've been without a contract for two years.
The four-year deal would increase Ontario's $11.5-billion physician services budget by 2.5 per cent a year, to $12.9 billion by 2020, and gives doctors the power to co-manage the system with the Ministry of Health and Long-Term Care.
It also provides one-time payments in each of the four years of $50 million, $100 million, $120 million and $100 million, which would be reduced if actual expenditures exceed the physician services budget.
The Liberal government last year unilaterally imposed fee cuts for some doctors' services, but the new deal promises no more unilateral cuts over four years.
Doctors were scheduled to have a non-binding vote on the agreement between the Ontario Medical Association and the ministry, the results of which would have been "considered" by the 275-member OMA council as it decided on ratification.
But physicians unhappy with the deal, especially the fact they did not get binding arbitration, got enough signatures on a petition to force the OMA to hold a general meeting and give every doctor a binding vote.
"The vote that will occur as part of the general meeting will provide a binding decision by OMA members on the tentative PSA," said OMA president Virginia Walley.
Groups calling themselves Concerned Ontario Doctors and the Coalition of Ontario Doctors staged rallies and protest marches urging physicians to vote against the deal.
Dr. Keith Meloff, a neurologist, warns the provision for doctors to co-manage the health-care system could make lifer harder for physicians.
"We have to chose between saving money for the ministry -- that is what this deal says -- and saving a life, and I think that is an impossible choice," said Meloff.
Dr. David Jacobs, a radiologist and chair of diagnostic imaging for the OMA, said doctors aren't looking for more money for themselves, but worry the fee agreement could send wait times "through the roof," even though they have more to do with hospital funding than physicians' fees.
"No one is asking for a raise," said Jacobs. "What we're asking for is that the government fulfil its responsibility to fund health care at an adequate level, so that you and I and all the patients in Ontario can be cared for. That's all."
The OMA knows the deal "isn't perfect," said Walley, and that some doctors are angry, especially at what she called the "disrespect" shown them by the government.
"The instability, the unpredictability for their practices, I understand fully must be a dreadful experience for them," Walley said. "And the government has made unilateral actions which in many cases have been very misguided."
The government wouldn't agree to binding arbitration, but both sides agreed the OMA can continue its charter challenge of the issue in court, whether or not the new agreement is ratified, added Walley.
She said the fee agreement "significantly improves on the problems with the government's previous underfunding of growth" in the health-care system, and brings funding stability to doctors after two years of uncertainty.
"Once there was something that looked to our board of directors as potentially acceptable to members, we've taken it to members to get their opinions," she said.
"Most of the people I speak with, that I hear from, are in fact supportive of the agreement and understand the stability it's going to provide for the profession."
