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Government demanding $1 billion in cuts to fees and programs: Ontario doctors

TORONTO – Ontario’s governing Liberals are playing hardball in labour talks with doctors by threatening to impose $1.1 billion in cuts to fees and programs that will hurt patients, the Ontario Medical Association said Tuesday.

The government wants to freeze wages for the broader public sector to eliminate a $15.2-billion deficit, but rejected the proposal by doctors to freeze their fees for two years and find an additional $250 million in savings, said OMA president Stewart Kennedy.

Ontario needs $1.1 billion to pay for the rising cost of serving an aging population and bringing in new doctors, Kennedy said. But the government is threatening to unilaterally cut other fees if doctors refuse to pay for the province’s growing medical needs.

The Liberals plan to table regulatory changes within the next few days that will cut fees in specific areas, Kennedy said.

They include eliminating comprehensive care management fees, which provides family doctors with a monthly fee no matter how many times a patient visits them. They amount to about $300 million a year, he said.

“The government has decided that confrontation is better than collaboration and that politics is more important than patients,” he said.

Premier Dalton McGuinty was willing to make a deal with the NDP so his minority government could survive Tuesday’s budget vote, but won’t negotiate with doctors, Kennedy said.

“It’s disheartening that after eight years of working together to strengthen and improve the health-care system, the government is moving unilaterally to impose fee cuts on doctors,” he said. “Is this negotiating in good faith?”

The Liberals should return to the bargaining table with an independent conciliator to help hammer out an agreement, Kennedy said.

Health Minister Deb Matthews insists the government hasn’t walked away from talks with the province’s doctors and is committed to negotiating a new agreement.

The Liberals have promised to reduce annual growth in health-care spending to 2.1 per cent a year from the current 6.1 per cent to slay the deficit by 2017. To reach that goal, they announced in the March budget that they wouldn’t fund any pay increases for doctors.

The government spends $11 billion a year on doctor’s fees and it doesn’t want to pay for procedures that don’t improve patient outcomes, said Matthews. It also doesn’t want to pay high fees for procedures that, due to technological improvements, can be performed more quickly and efficiently, she said.

While some doctors will earn the same amount of money, others will earn “a little bit less” as a result, she said.

Doctors offered to freeze their fees, but wanted the government to pay for the costs of increasing health-care services, which is under pressure due to an aging population, Matthews said.

They want the doctors to find savings to pay for the increasing use of doctors, so that the government can put any extra money towards home care and community care.

As for the regulatory changes Kennedy said were imminent, Matthews said the government is simply “doing the work required” in case it doesn’t reach an agreement with physicians.

“We’d much rather have the support of the doctors on selecting which of those evidence-based changes to move forward with,” she said. “But if we can’t reach an agreement, yes, we will have to act unilaterally.”

The Liberals have also warned that they’re prepared to legislate wage freeze for the province’s broader public sector — including teachers, nurses and civil servants — if they can’t do it through collective bargaining.

Kennedy said the OMA is looking at its options, but it’s not currently contemplating work-to-rule measures.

“We made an oath when we graduated to take care of our patients,” he said. “We are not going to withdraw services.”