Coalition urges doctors to reject Ontario pay deal

As Ontario doctors vote this week and next on the proposed agreement between the Ontario Medical Association (OMA) and the provincial government, a vocal alliance of Ontario physicians announced it opposed the terms of the deal and asked OMA members to reject it.

“After extensive consultation with members of the OMA negotiating team and other leaders, and careful debate at our Board, we have decided to NOT SUPPORT the new deal,” wrote Dr Douglas Mark, the president of the Coalition of Family Physicians (COFP), on Monday in a letter to all Ontario physicians.

The proposed deal, which offers physicians a 12.25% increase in fees over the next four years (not adjusted for inflation), was announced in September after negotiations dragged on for more than five months after the last contract expired on March 31.

The COFP has produced a controversial analysis of the contract, which essentially says what will be seen in reality will be around half of the advertised numbers, and called the raise “sub-inflationary.” “In other words,” Dr Mark wrote, “if this deal is accepted, you will effectively be earning significantly less at the end of its 4-year term than at present.” (Canadian Medicine has reviewed the full proposed contract; our calculations project an inflation-adjusted total increase in fees by the contract’s end, in 2012, of around one-half of one percent, or 0.5825%.)

“A rejection of the proposed deal,” Dr Mark’s letter concluded, “will send a strong message to the government that we demand to be treated fairly and with respect, and we will no longer subsidize its political agenda with underpaid labour... What do you have to lose by voting no?”

'INACCURACY' DEBATE
The COFP’s analysis, however, has come under fire from an influential group of four physicians, three of whom -- Stephen Chris, Chris Pinto and Allan Studniberg -- are former COFP board members; the fourth is Dr Suzanne Strasberg, who was elected to the OMA board after a COFP endorsement in 2003 and who is now the OMA’s president-elect. All four currently serve as OMA board members from District 11.

In a letter to doctors dated Wednesday, October 8, the four doctors strongly counter the COFP’s argument. “We believe that the [COFP] analysis is misleading and inaccurate,” the letter said. The four doctors’ letter corrected the COFP on the 6% of fees it had alleged would not go to physicians, but failed to address the effect of the currently high Canadian inflation rate on the actual size of the contract’s proposed fee increases.

The four doctors’ strong disapproval of the COFP’s decision not to endorse this year’s proposed contract was evident in the letter: they referred favourably to “the COFP of our day,” and wrote, “… it is unfortunate that COFP has chosen to present the information in a misleading manner,” and ended by asking OMA members to read the contract for themselves.

ECONOMIC PRESSURES
In an interview with Canadian Medicine, Dr Mark admitted that he expects the contract to pass. But he disparaged what he referred to as the OMA’s “inaccuracies” in its messages regarding the contract and its “scare tactics” of warning that doctors ought to take this deal to avoid a protracted conflict with the Ministry of Health. “We urge you not to be guided by fear of rejecting this contract -- it already gives us nearly nothing, except the assurance that we will be worse off in four years than we are today,” his letter said.

Dr Mark’s letter contended that “the OMA’s best efforts are simply NOT good enough for the majority of Ontario’s physicians.” He accused the OMA of conceding to the government’s current desire to rein in spending as the economy founders.

In a letter announcing the proposed deal to members on September 15, the association’s president, Dr Ken Arnold, acknowledged, “This has been a difficult negotiation. Government took a very tough stance on a number of our priority issues.”

The OMA refused to comment for this story.

CONTINUED CONFLICT
The COFP-OMA discord is not new. Founded in 1996, the COFP has been a vocal critic of the OMA, even endorsing “Coalition Candidates” in OMA board elections in order to push forward reforms. The conflict reached its height in 2003, when Dr John Tracey, who was then the Chair of the COFP’s Political Action Committee, won the election to become Ontario’s nominee as Canadian Medical Association president, beating out five former OMA presidents. But a surprise “nomination from the floor” during the CMA’s subsequent vote several months later -- which is usually nothing more than a rubber stamp -- resulted in a dramatic victory by defeated OMA past-president Dr Albert Schumacher.

The last set of OMA-Ministry of Health contract negotations, produced an initial rejection from by Ontario doctors in 2004 after the COFP opposed the deal. The COFP also opposed the revised proposal the following year, exhorting doctors not be afraid of what some feared would become an “all out war” with the Liberal government. “Conflict with government is not new,” Dr Mark insisted. Despite the COFP’s efforts, the 2005 proposal passed. Its expiry earlier this year, and the struggle to agree on how to replace it, prompted the current state of affairs.

The COFP has complained about the OMA’s “union monopoly” before, but this month’s war of words has reached new levels of enmity. Dr Mark’s letter earlier this week read, “We can only wonder why the OMA, our government-appointed and supported bargaining agent, has accepted this stance and urged us to accept the new deal... rationalizing that it is the best deal that we can get. It is time to re-examine the relationship of the OMA to government, its guaranteed funding by compulsory collection of our dues... bearing no relationship to performance as our bargaining agent, and the absence of a binding arbitration mechanism for dispute resolution... We need better negotiating and a better deal.”

In response to OMA president Dr Ken Arnold’s request for comments on the proposed deal, Baker & McKenzie lawyer Stewart Saxe, the OMA’s legal advisor, wrote in a letter on Tuesday that he believed the OMA “achieved a result that obtained from the Ministry ‘every nickel’ available.” “The state of the economy must also be considered,” he wrote, “although I believe this is a good deal regardless of the state of the economy.”

Voting on this year’s proposed contract ends October 15.

Photo: Shutterstock

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