Minister of Health Tyler Shandro, removes his mask during an announcement in Calgary, Alta., Wednesday, Oct. 7, 2020. Alberta Health Minister Tyler Shandro says he regrets recently downplaying and dismissing the bitterness of a year-long fight with physicians over pay and working conditions. THE CANADIAN PRESS/Jeff McIntosh

Alberta physicians reject new master agreement with provincial government

EDMONTON — Alberta’s doctors have rejected a proposed new master agreement aimed at resolving a year’s worth of acrimony over pay and working conditions with the provincial government.

The Alberta Medical Association said 53 per cent of physicians rejected the deal while 47 per cent supported it.

“The overall vote turnout was 59 per cent — which is considerably higher than for recent agreements,” AMA president Dr. Paul Boucher said late Tuesday in a news release.

“I know this was a difficult decision for many. Members debated the merits and possibilities of the (agreement) at length and with passion.

“Our first priority will be to engage with the membership. We heard many themes over the last three weeks, but we need to hear more about the challenges members saw with the (agreement) and the barriers to voting yes.”

Health Minister Tyler Shandro in a statement said, “While this result is disappointing, it does not erase the meaningful collaboration and mutual understanding that was gained throughout this process.

“Our government will seek to further renew our relationship with the AMA in the weeks and months to come as we work together to ensure Albertans continue to benefit from quality health care.”

The AMA represents 11,000 physicians.

The two sides have been at loggerheads since early 2020 after Shandro unilaterally cancelled the master agreement with the association and implemented new fees that doctors called heavy-handed, unfair, and liable to force some family practices to close.

In response, doctors began withdrawing services, the association sued the province, and the two sides swapped angry attacks on social media — all occurring as COVID-19 swept through the province.

The two sides eventually returned to the table and hammered out a tentative agreement that was presented to rank and file members on Feb. 26 to vote on.

Political scientist Duane Bratt said the level of bitterness in the debate raises the question of what role physicians trust in or antipathy for Shandro played in the vote.

“To go against what your own representatives negotiated is a slap in their face and it’s a vote of non-confidence,” said Bratt, with Mount Royal University in Calgary.

“So my gut tells me this was not about the details in this agreement. This really was: We’ll support the current agreement — but not with the current minister.”

Details of the agreement have not been made public. Each side said they didn’t want to influence doctors during the vote.

However, some details of the deal obtained by The Canadian Press specify that the collective baseline pay for doctors would remain static at about $4.6 billion a year over the four years of the deal.

It would be retroactive to 2020 and subject to spending needed to speed up surgeries to reduce wait times.

Last month, the province introduced a budget that set physician compensation at $5.4 billion for the upcoming year, rising to $5.5 billion by 2024.

The proposal does not make any reference to doctors being able to have access to third-party arbitration. It would give the medical association the right to invoke non-binding mediation on key issues. But if that didn’t work, the document suggests the government would have final say.

Arbitration was cancelled by the province when it threw out the master agreement last year. The AMA has previously cited arbitration as critical given that, for ethical reasons, doctors can’t walk off the job to gain leverage at the bargaining table.

The AMA’s lawsuit accuses the government of breaching collective bargaining rights and negotiating in bad faith.

Shandro has said fundamental changes to physician pay and work arrangements are needed to keep health care viable in the long term.

As voting wound down in the last two weeks, Shandro extended numerous olive branches to the doctors, including a promise to never resurrect hotly contested changes to patient billing rules, called complex modifiers.

Shandro also issued a public letter to all doctors saying he regretted downplaying their frustrations and anger over the dispute and hoped to move forward together in a spirit of reconciliation.

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