Vol. 20, No. 1
January 15, 2015
OMA Board Unanimously Rejects Government Final Offer, Ministry to Impose Further Cuts to Medical Services
Today, the OMA Board of Directors unanimously rejected a final offer from the Ontario government that would cut an additional 4% in medical services, and place an arbitrary ceiling on the physician services budget, which would cap the number of services physicians are able to provide to our patients.
The government’s final offer, submitted late Wednesday evening, included:
· $580 million in cuts over two years, including
- $259 million through 9 specific cuts in physician payments, the majority of which impact family practice;
- $50 million in system savings;
- Increasing the current 0.5% payment discount to 1% on all physician payments;
- Further additional increases to the payment discount by specialty of practice.
· A 1.4% one-time payment in year 3.
The Ministry warned the OMA that if we did not accept this punitive offer, it would pursue unilateral action against physicians immediately. We have received details of this arbitrary action and are assessing its potential impacts.
The OMA and the physicians of Ontario have worked hard to build and maintain a positive relationship with government. We have negotiated in good faith to improve the health care system for our patients. In 2012, Ontario’s doctors did our part and contributed more than $850 million in fee concessions and health system savings. To impose a further $580 million in cuts to medical services and payments is unwarranted and destabilizing.
The government’s position will lock in system underfunding for future years and subject physicians to open-ended liability for growth in the utilization of medical services that is beyond our control. It will limit training opportunities in primary care, mental health, and many other specialties. Also, the government’s pattern of heavy-handedness toward doctors, and unwillingness to negotiate reasonable agreements with the profession, will make Ontario an undesirable place to practice.
The OMA will be active in the media and other venues to ensure that the public and our patients understand the truth and the real impacts of the government’s final offer and its arbitrary measures.
We anticipate the government will claim to have offered the profession a modest raise based on the language in its proposal — this is disingenuous and misleading. In fact, government plans to set an arbitrary baseline for the physician services budget that is more than $80 million below current levels, and fund growth of no more than 1.25% per year, despite the current growth of 2.7%. This difference will be funded through cuts to physician payments. Also, the government intends to claw back from physicians through reconciliation any expenditure that exceeds its arbitrary budget.
While we have rejected the government’s final offer, and it has been withdrawn by the Ministry, the OMA Board considers it vital that we share the government’s proposal with all members. We know that members will have many questions, and we will work to ensure that you get the information and answers that you need in a timely and effective manner.
The OMA will undertake an extensive member education campaign to provide all details of the rejected government offer, as well as the Ministry’s unilateral cuts. We are organizing a series of face-to-face meetings and teleconferences across the province.
OMA Council will meet in the near future to review these developments and plan how we intend to move forward championing our patients and supporting our members in the face of the government’s cutbacks.
The OMA has been negotiating with government for more than a year. These talks have been difficult. Since the outset, the government focused exclusively on cutbacks and balancing its budget. We concluded the first round of negotiations in August and were unable to reach an Agreement. We then moved to facilitation, and subsequently conciliation with former Chief Justice of Ontario Warren Winkler. Here too, we were unable to reach a deal. Justice Winkler submitted his report to the parties on December 11. In his report, he suggested the OMA should reconsider the government’s offer, and we did.
The OMA called a meeting of physician leaders, which was held December 20. More than 150 physicians from across the province attended. The Board outlined the negotiations timeline, the government position, and the results of our facilitation and conciliation process. We detailed the challenges at the negotiations table and the significant gap between both sides. We circulated the offer on the table from government at that time and we shared Justice Winkler’s then-confidential report, which will be available on the OMA website. We set out the positives and negatives of the government position, and reviewed the Winkler recommendations and the critical elements not referenced in the final conciliator’s report. Physician leaders provided valuable perspective to inform the final stage of the negotiations process.
The OMA and Ministry reconvened for a brief final round of negotiating that concluded January 9, with the government tabling its final offer on January 14. Today, the OMA Board met to review that offer. After careful consideration of the potential impacts of the proposal, threatened unilateral action, and the valuable input from more than 150 physician leaders who attended the December 20 meeting, the Board voted unanimously to reject it.
This offer will not improve quality of care, nor will it improve public access to medical services. In fact, we know the opposite will result. In the face of this arbitrary action, the OMA and Ontario’s doctors, on behalf of our patients and our partners in the health care system, intend to candidly and aggressively inform the public and all stakeholders about the truth of the government’s offer and the real implications for health care.
I urge all members to stay focused on our patients and avoid divisive actions or any actions that will compromise patient care. We need to monitor the impacts of the government’s measures on the system and our ability to practice. We need to work together as a profession and with our partners in the system to assess our relationship with government, and establish our collective strategy going forward.
I want to thank all members for your tremendous patience during the past year. The Board recognizes that these developments will be frustrating for physicians and have significant implications for your practice and your patients. We have made every effort to convince government that heavy-handedness is not the solution, however, it is clear the government is entirely focused on fiscal targets and not patient care.
The OMA will be communicating regularly with you in the coming days. Documents will be posted on the OMA website and the site will be updated on a continuing basis (www.oma.org).
Once again, I encourage all members to maintain focus on patient care and professional unity as we assess the current circumstance, and let’s work together to address this challenge collectively on behalf of our patients and our colleagues.
Dr. Ved Tandan