http://www.canada.com/health/story.h...dc6&page=2

Ontario pledges to push ahead with reforms despite doctors rejecting deal

Gillian Livingston
Canadian Press


November 21, 2004


TORONTO (CP) - The Ontario government is adamant it will push ahead with its agenda to improve health care despite a sound rejection of a proposed landmark deal by the province's doctors.

But without the doctors immediately on side the prognosis for the government's health-care goals, such as sending more physicians into underserviced areas, doesn't look good, said one political observer.

"You have to have the doctors to put it in place," said Nelson Wiseman, a political scientist with the University of Toronto.

The agreement with the doctors, which was negotiated over the past nine months and overwhelmingly rejected on the weekend, is only "part of a plan, not the entire plan," said a senior Liberal source.

"Our plan doesn't change," the source said. "Plan B is the same as Plan A."

The province's goals to reduce wait times, alleviate the doctor shortage and manage the runaway health-care budget remain the same regardless of the rejection, the source said.

The deal was just "a means to an end," the source said.

The Ontario Medical Association rejected the deal Saturday after nearly 60 per cent of the more than 15,000 doctors who voted turned down the proposed four-year, $6.9-billion agreement.

The government lauded the deal as a first, one that dealt with key priorities as it rewarded doctors who worked in team settings, or in rural or underserviced areas, and helped cut wait times for top medical procedures.

It provided monetary increases in the range of four to 35 per cent, depending on what kind of medicine a doctor practised, but most increases came near the end of the agreement.

In the face of the rejection of the much-touted proposal, Health Minister George Smitherman expressed his disappointment but stressed the deal had been accepted by the OMA's negotiating committee.

"We will not be thrown off course - not even a little," Smitherman said at a news conference Saturday.

"We remain fully committed to our comprehensive plan to improve Ontario patients' access to the highest quality health care."

Smitherman also reiterated there was a lack of cash in the kitty for doctors.

Dr. Mark Prieditif of the Ontario Association of Radiologists disagreed, citing a new agreement for more federal health-care dollars and cash from the province's new health premium.

"I wouldn't expect anything magical to happen in the next few weeks. It's going to take awhile, I think, for both sides to get things together," he said.

Still, the government "is quite determined to proceed along the lines of what's in this deal," Wiseman said. "Whether the government can pull it off is another matter."

He questioned whether another round of negotiating would bring doctors much more, and suggested the province might end up imposing a deal in the end if more negotiations aren't successful.

"It's not as if (the government) has extra money lying around," he said.

Imposing a deal would be "a big mistake," said Dr. Douglas Mark of the Coalition of Family Physicians, a group that publicly opposed the deal.

"It's bad for doctors, bad for patients, and bad for family practice," he said.

Smitherman's press secretary, Eva Lannon, said the minister would meet with OMA president Dr. John Rapin soon to examine what further steps the province and the organization would take in a bid to get a deal.

Sources said a meeting could come as early as this week.

Whether the province would go back to the table to renegotiate the deal by either making minor changes or overhauling it "is still to be decided," the Liberal source said.

If there are more negotiations, it would likely be with a new OMA negotiating team, a source familiar with the association said.

The government has to find out the chief reasons doctors rejected the deal and why they were at such odds with the negotiating team, the government source said.


In dismissing the deal Saturday, Rapin said doctors were concerned that most financial increases were at the back end of the four-year deal with no inflationary increases at the start, and complained it didn't improve the province's competitiveness.

The OMA says Ontario is ranked seventh in the country for the amount it pays its doctors.

Rapin stressed though doctors were not looking to go on strike to back demands.

"We cannot go on strike," Mark said. "That's the essential thing, because it would hurt our patients and it's morally and ethically not what physicians want to do."

© The Canadian Press 2004

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