Police, firefighters, paramedics and other provincial doctor associations all use binding interest arbitration to ensure that if there is ever an issue during negotiations, there is a built-in mechanism to keep the process fair -- for both sides. The one essential service missing from this list are Ontario's doctors.
So when Ontario Premier Kathleen Wynne and Health Minister Eric Hoskins released a joint statement promising to look at binding arbitration to the Ontario Medical Association (OMA), physicians across Ontario were shocked -- and more than a little wary.
Minister of Health and Long-Term Care Eric Hoskins, June 24, 2014. (Photo: Aaron Harris/Reuters)
Negotiations between the OMA and the Liberal government fell apart in 2015. Usually when negotiations hit an impasse, it means lockout or walkout. Neither is a possibility for physicians, because when government and physicians fight, patients get caught in the crossfire. So binding arbitration exists to keep things peaceful and fair.
Instead, the government resorted to cuts and bizarre regulations. Funding cuts of seven to 30 per cent meant individual clinics had to cut services including in-office labs, flu shot clinics, staff and equipment upgrades to stay afloat. In some cases, clinics closed. Nonsense regulations made it impossible to start new family medicine practices. Nonsense laws like Bill 41 played an expensive game of musical chairs with bureaucracy.
Throw in the usual political shenanigans, bad-mouthing doctors in the media, fake contracts and failed negotiations arising from back-room dealings -- you have a recipe for distrust, acrimony and frustration. So it's been a while since doctors and government have had a normal relationship.
Canada scores last when it comes to waitlists, and it's only getting worse.
The Liberals want to talk. But is it genuine?
This will be the fourth go-around between doctors and government. With elections around the corner and bottom-of-the-barrel approval ratings, it's no surprise that the Liberal government is on a peace-keeping mission. Sooner or later, though, we all go to the doctor or the hospital; at that moment we become patients and not voters. At that moment we view health-care spending in a whole new light.
Like any sane person, I want a fair contract. But beyond that, I see a health-care system failing the very people who depend on it and the people who work in it. Call me crazy, but the doctor-government relationship must change. Government has to come to terms with the concept that looking after health-care workers means looking after patients when it comes to policy. We need a government playing ball instead of posturing on the sidelines.
The Liberals ignored patient, caregiver, physician and front-line worker input when drafting Bill 41, the Patients First Act. Three months in and LHINs are hiring new vice-presidents, funding bureaucracy instead of patient services. We as a population need to look into the not-so-distant future when we will need the health-care system that we are creating today.
(Photo: Shayne Ppl via Getty Images)
The Commonwealth report released yesterday showed the reality patients and doctors live on the front-lines: waitlists are spiraling out of control. Canada scores last when it comes to waitlists, and it's only getting worse. With 40 per cent of the Canadian population and one-third of all practicing physicians, Ontario is driving these statistics.
Talking to my colleagues, I see the people behind the statistics. Even in Toronto -- resource-rich Toronto -- doctors talk of seeing patients diagnosed with brain cancer waiting nine weeks for surgery or patients diagnosed with kidney cancer waiting two months for surgery. More and more, patients start a waitlist with a treatable medical condition only to reach the front of the line and discover that it's too late.
We need a grown-up conversation and genuine change.
Here's an example given by a student-doctor: a 40-year-old mom diagnosed with gallstones was slated for surgery. The first time her surgery was cancelled, it was because it was bumped by a cancer case. So she went back in line and waited. The second time her surgery was cancelled, it was because the operating room ran over-time. So she went back in line.
The third time her surgery was cancelled, it was because the hospital ran short of funding and had to postpone all non-life threatening cases to the following year. The next time the student-doctor saw this woman was in the ICU where she had been hospitalized with gallstone pancreatitis. She died a week later.
The health-care system is in crisis. The usual political stunts and theatre are getting old. We need a grown-up conversation and genuine change. I don't know which attitude the Liberal government will bring to the table. But I'm watching. We all are.
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