This is the blog I did not want to write. I’m not a lawyer, I’m a doctor and a pretty average one at that. I’m lucky because former Chief Justice, the Hon. Warren K. Winkler, Q.C. writes in a pretty straightforward way. I only had to get my dictionary out once.
What I really didn’t want to do was to get in an argument about what Justice Winkler says and does not say. We should be getting down to work to improve healthcare in this province and quit wasting time on semantics.
For your reference, here is a link to the full report.
In the Legislature and during various news interviews, the Premier and the Minister of Health refer to Mr Winkler as an ‘umpire’. They imply that he was on their side and that they are free to do whatever they want as a result. As recently as Sept 23 2015, the Minister of Health explained on Metromorning why he was making cuts to physicians’ fees by citing the Winkler report.
So I re-read the report. I thought that I might have missed the spot where it says “the Minister of Health has won complete and total victory and the Ontario Medical Association should offer unconditional surrender”. Thankfully from my point of view no such language was used
Admittedly the overall tone of the report favours the Government’s position more than the OMA’s. But it’s not as black and white as the Government makes out either.
The most important comment has been ignored by the Government.
Mr. Winkler comments “that without systemic changes to the health care system” the Government and the OMA may be on a collision course that makes a physician services agreement impossible.
The report offers 2 suggestions as to how to make those systemic changes. He recommends two groups do some work and come back with solutions. These groups should take time to research and reflect and consult with stakeholders “especially the public”.
The first is a Task Force on the Future of Physician Services and the second is a Minister’s Roundtable on Health System Transformation. No terms of reference is included in the report but 2 groups who owe their life to a Physician Service Agreement would require substantial representation from both groups.
I haven’t seen a Government announcement about either of these groups. Have you?
I guess the Government is ignoring the parts of the umpire’s report that are distasteful to them.
Justice Winkle does recommend that the OMA “reconsider its rejection of the Ministry’s Proposal” and he urges “the Ministry to not resile from its final offer”.
This is where I broke out the dictionary. From Webster’s “to return to a prior position”.
The OMA may have reconsidered its rejection of the final offer but it clearly rejected the terms of the final offer.
Just as clearly the Government has resiled and it has resiled in many ways.
First and foremost it has rejected the notion of forming the Task Force on Physician Services and the Minster’s roundtable. I’ll go through a couple of other examples.
The final offer apparently was for a three-year term and the third year was to see them find $32.7 million in savings and to add in a $117 million payment to physicians to offset the cost of practice. Where did that go?
The Government proposed saving $580 in year 2. Instead they have unilaterally cut fees across the Board in January and made 9 other focused cuts including making it almost impossible for new graduates to join Family Health Teams. They have also made and additional $280 million in accross the board and targeted cuts effective October 1. Were all of those cuts in the final offer? No they were not.
Finally the Minister has been widely quoted as saying that the current dispute he has with doctors is a ‘paycheck issue”. But Justice Winkler emphases is in his report that between the parties “their primary and mutual concern was the continued provision of the best quality of physician services to Ontarians”. That doesn’t sound like a paycheck issue to me.
I resent the Government cherry picking Mr. Winkler’s report. It’s shameful that they do so in the Legislature and its shameful that they do so in public.
Re-read the Concilliator’s Report and decide for yourself.
Scott Douglas Wooder, MD
These are my own views and have not been previewed by the OMA.