It had all the makings of not just a good news story for the Ontario Liberals, but a great news story.
The doctors, with whom they’d been in mortal combat for the past two years, surprisingly came to a tentative agreement with the province on July 11, removing one of the most intractable political problems from Premier Kathleen Wynne’s to-do list.
As with most agreements, there was good news and bad news for both sides. The government liked the fact that the Ontario Medical Association had agreed to a four-year package that essentially held the line on physician compensation at $11.584 billion per year.
Some doctors liked the notion that they could earn extra income if they found additional savings in health care costs. And, of course, after having had their last “agreement” unilaterally imposed by the province in 2012, the docs preferred to come to a negotiated settlement this time around, as that would be infinitely preferable to a rumoured $300 million in further cuts to their compensation if no agreement was forthcoming this time.
But the initial hosannas have proved to be illusory. Almost instantly, the agreement came under fire from various factions of the OMA, and for different reasons. Some more militant members of the profession don’t support the agreement because there’s no pay increase included. Most doctors haven’t effectively had a raise in a decade, and many have had their fees for services clawed back by the government, which is desperately pulling out all the stops in hopes of balancing its books by the next fiscal year (coincidentally, an election year). Health care funding has shot up to more than $50 billion from $29 billion in 2003-04, and a quarter of that is paid out in compensation to physicians.
Other doctors don’t like the agreement because they say it builds in financial incentives to provide less patient care – potentially, they say, a pretty stark violation of their basic professional mission, namely to provide the best possible care they can.
What has transpired is a virtual mutiny within the OMA, possibly leading to something that hasn’t happened in 25 years – a petition forcing a general membership meeting, thereby preventing a vote on the tentative agreement.
Currently, doctors are scheduled to vote between July 27 and Aug. 3 in a non-binding referendum on the deal, after which the OMA’s 250-member council will decide on Aug. 6 whether to ratify the agreement. Some doctors have expressed concern that the council will ignore the results of the membership’s vote.
But on Friday afternoon, a group of dissenting doctors held a rally outside the Toronto offices of the ministry of health, and delivered a petition to the OMA demanding a full-scale general meeting of the association membership, which would take weeks to pull together. If that happens, it would suspend the authority of OMA’s council. Most significantly, that means any voting on the new tentative agreement would be stopped dead in its tracks at least until the general meeting, which, of course, is the point behind the mutiny.
According to OMA bylaws, signatures from five per cent of the membership are required to prompt the board of directors to give notice of a general meeting. The OMA’s legal beagles initially rejected the petition, saying that it contained only 2,007 valid signatures. They said because the OMA’s membership is 42,091, a total of at least 2,105 signatures of members in good standing would be necessary. (Until last week, common knowledge pegged the membership at about 33,000.) No problem, the doctors replied, and resubmitted the petition with another 1,000 signatures they collected quickly.
The OMA’s lawyers are still eyeing all the petition signatures to ensure they’re legitimate. If they are, all bets are off on whether this agreement can survive. The OMA leadership held a conference call Sunday afternoon to review its options in the event it has to call a general membership meeting.
Such a development would prove to be somewhat embarrassing for the OMA leadership, on whom there would be considerable pressure to step aside. And it could get even stickier for the government, which had fervently hoped to have all this put to bed before the next election.
That’s why they call these things tentative agreements. Because every now and then, you just never know when several thousand doctors will decide to draw a line in the sand.
Update, 11 a.m.: Concerned Ontario Doctors issued a press release saying the OMA has conceded that the petition is valid and that all OMA council activities are suspended until a general meeting is held. The member referendum will be delayed.
Clarification: This post has been edited to clarify that the general meeting of members only suspends the OMA council’s authority with respect to matters to be addressed at the meeting. The OMA continues to operate for all other purposes.
May we have a moment of your time?
Our public funding only covers some of the cost of producing high-quality, balanced content. We depend on the generosity of people who believe we all should have access to accurate, fair journalism. Caring people just like you!
Get Current Affairs & Documentaries email updates in your inbox every morning.