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Ontario Doctor Deal Achieves Stable Physician Funding And More

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As a member of the Ontario Medical Association's negotiating committee, I find it disappointing to read the misinformation circulating about the tentative Physician Services Agreement (PSA) now before Ontario's doctors.

To say misinformation is to be kind. Some of the information being put out there is just, quite frankly, untrue.

As someone who worked hard to achieve the best possible PSA we could at this point in time (in the context of the limited system resources for health care), I feel it is important to comment.

Doctors told us their top priorities were re-establishing a relationship with the Ministry of Health (MOH) and preventing further unilateral cuts. This agreement achieves both goals. It provides for sustainability, predictability and stability of our physician funding. And it accomplishes much more.

• It guarantees there will be no unilateral action for the next four years;
• It provides an increase of 2.5 per cent in funding for physician services when combined with the one-time funding this increase is enough to meet the demands of our system from an aging and growing population;
• It reverses restrictions around new family medicine graduates joining FHO models of practice;
• It removes sections of Bill 210 with which physicians disagreed;
• It allows us to continue with our Charter Challenge pushing for binding arbitration;
• It mandates the co-management of our health-care system;
• And it sets up real action toward relativity.

The ability for doctors to co-manage the health-care system they are on the front lines of every day is an important achievement. Doctors know where improvements need to be made and where efficiencies can be found.

System sustainability is not a Liberal problem or an Ontario problem, it is a Canadian problem.

Enshrining co-management in the tentative agreement is a significant step and one that I believe is positive for both doctors and patients.

Important details such as access to physicians and after-hours care are written into the document. So too, is patient accountability. The tentative PSA commits to working with the MOH to educate patients on how to steward our system and keep it sustainable. System sustainability is not a Liberal problem or an Ontario problem, it is a Canadian problem. It is in the best interests of physicians, government and patients that our system is sustainable and this tentative agreement is a step towards that.

It is true this tentative agreement is very high-level, which means there are implementation details to be worked out. This was done purposely, so that physicians could work with the Ministry of Health (MOH) to decide, over time, how best to achieve the goals set out in the PSA, without unilateral action by the MOH. It was also done so that physicians who are experts in their particular area of practice can have a say on changes that will directly affect them.

You may have read the 2.5 per cent increase on the Physician Services Budget (the global budget that funds all the necessary care provided by physicians) is not enough to meet the needs of our growing and aging population. When combined with the one-time funding in each of the years that increase rises to 3.1 per cent, which is well above the necessary 1.9 per cent calculation provided by ICES.

It is important to note under the government's unilateral action that doctors have been working under for the past 18 months, less than half of growth is being funded. We moved the government and got them to accept their responsibility to fund the growth in demand on our system. They have also committed to working with us on patient accountability.

If the tentative agreement is rejected, we don't know how deep the cuts will be but there are bound to be more cuts. Could be to the tune of $1 billion (calculated on the MOH 1.25 per cent growth allowance) -- without physicians at the table having a say in where changes will be made. I have heard colleagues say that we can ask to go back to the table; however, the MOH have given us no indication that it is an option.

This agreement provides doctors with the ability to plan for the next four years. It also provides stability while our Charter Challenge, pushing for binding arbitration, works its way through the courts. We believe we have a strong case and that doctors will be granted the right they should have to ensure negotiations are fair. The MOH will not grant this without a Charter Challenge.

Lastly, as a member of the process, but not the OMA governance, I feel the process had integrity.

I urge all physicians to get the facts before they vote on the tentative PSA. This is an opportunity for cultural change in our health-care system. Ontario physicians have the courage to provide leadership at a time when the system needs many fixes.

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