VICTORIA — When the NDP government and B.C. doctors concluded a three-year deal on the weekend, it was not without a significant disagreement about how the terms should be reported.
Doctors of B.C., bargaining agent for 12,000 provincial physicians, advised members the deal would provide “average monetary increases of 8.8 per cent over three years on the current compensation base.”
There was also this detail: “All physicians who earned a minimum income of $75,000 in any of the past three years will receive a one-time payment of approximately $7,500 following ratification of the agreement. This payment is in recognition of recent increases in business costs.”
The putative increase of 8.8 per cent, plus the payment of $7,500 upon ratification, were both a cause of consternation on the government side when reported.
The John Horgan government’s bargaining mandate for the current round of public sector contracts was two per cent a year over each of three years, or 6.1 per cent compounded.
Nurses, other health care workers and most unionized public servants had already signed on to the sustainable services mandate, as it was known. None received anything like the $7,500 payment to doctors.
Consequently, when Keith Baldrey of Global TV obtained a leaked copy of the doctors’ version of the settlement late last month, New Democrats were quick to offer a briefing on why the then-still tentative deal was not comparable to other public sector contracts.
For one thing, doctors were independent contractors and Doctors of B.C. was less a union than a professional association.
Nor was the alleged 8.8 per cent increase a fair representation of a many-faceted settlement that tackled the shift away from fees for service to primary care clinics and physicians on salary.
The $7,500 payment, far from being a signing bonus, was granted in recognition of higher office costs for doctors, especially rents in urban centres.
Beyond that background briefing, the New Democrats said little, not wanting to get between bargaining agent and members while a ratification vote was underway.
On Saturday Doctors of B.C. announced the results.
“The 2019 physician master agreement was ratified in the referendum of members that concluded at midnight,” announced CEO Allan Seckel. “A total of 3,961 votes were cast with 96.8 per cent accepting the proposed agreement.”
The turnout represents a mere third of the member physicians. But I’m told that is actually on the higher side for B.C. doctors, most of whom leave the voting to others.
While the bargaining agent was content to leave it at that, the government used the opening to put the settlement into its preferred perspective.
Not surprisingly, there was no reference to a monetary increase of 8.8 per cent over three years, which was only an average and “not across the board,” as even Doctors of B.C. admitted.
Neither was there any mention that doctors were in line for one-time payments of $7,500 over the next six months, supposedly to cover increased business costs.
Never mind that Doctors of B.C. estimates most of its member physicians will be in line to receive the money whether they work on salary, share expenses in a clinic, or maintain a stand-alone practice.
“The agreement meets government’s sustainable services negotiating mandate for bargaining and reflects the desires and commitment of all the parties to work within that mandate,” insisted the press release from the ministry of health.
“Most physicians are independent contractors. Their services are paid for through fees, contractual arrangements and other incentive programs negotiated in the physician master agreement.
“Unlike other public-sector employees” — ahem — “physicians are typically responsible for the overhead costs associated with operating their practices (including) information technology, medical equipment, clerical support and office space.”
In short, don’t make any comparisons, tempting as that might be. Particularly for the B.C. Teachers’ Federation, which is currently in negotiations and making no secret of its expectations of an increase beyond “two, two and two” on grounds that its members are the lowest paid in Western Canada.
That said, the government emphasized how the agreement attempts to address the changing face of medicine, from team-based care to increased reliance on primary clinics.
“New physicians have told us they want their focus to be on patients, while many retiring family doctors are unable to find new physicians to take over their practice and the administrative burden that comes with it,” Health Minister Adrian Dix was quoted as saying.
“This agreement charts a new way forward by supporting doctors to work in partnership with other health professionals and gives patients the team-based care they need.”
There followed an itemized breakdown of all the payouts — from more money for rural programs and after hours services to increased support for family practices and specialist services.
Underscoring the shift away from fee-for-service, the deal only provides for a general increase of half a percentage point a year in that area.
All in, the New Democrats say the total lift in funding for physician services (including overhead) by the third year of the deal will be $331 million, up from $4.156 billion last year, for an increase of 7.3 per cent.
Which is less than the highball estimate from the doctors, but more than the government’s bargaining mandate for pretty much everyone else.
But if there are any teachers out there who are reading these numbers, I expect the government would sooner they just forget it.
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