Tuesday, April 02, 2002

Uneasy truce with doctors, but no peace
By Paul Willcocks
VICTORIA - It's mixed news for the Liberals.
Premier Gordon Campbell deserves credit for reaching the deal with the B.C. Medical Association, using his personal credibility and powers of persuasion to convince doctors that the government understands and is sympathetic to their concerns.
But it should chagrin Liberals to recognize that the doctors don't think much of the government's integrity. A key element in the temporary truce with doctors was a personal pledge from Campbell that the government wouldn't keep on breaking its written agreements.
The last thing the Liberals needed was a full-scale job protest by doctors. The flashback to the last years of the NDP, as they struggled to deal with protests by northern and rural doctors, would be too vivid.
The specialists who were heading the protest - surgeons, anesthetists and others - have decided to halt the action for 30 days, giving the BCMA and the government a chance to negotiate a lasting peace based on the memorandum of agreement.
There's little new in that agreement. It confirms the extra $392 million for doctors' fees will remain in the budget for the next three years. Doctors had received mixed signals over that issue, but it always seemed to be the government's intention. It also protects extra funding for rural doctors.
And it commits the government to attempt to negotiate some kind of dispute resolution to replace the binding arbitration that the Liberals took away from the doctors with Bill 9. That tough job will be critical for long-term peace.
Campbell says there's no chance the solution will be binding arbitration. That doesn't work, he said again, again blasting former chief justice Allan McEachern for ignoring his mandate. McEachern's award was often murky, but it's inaccurate to say he ignored the question of affordability. He simply came up with an analysis the Liberals didn't like, so the government reneged on its commitment.
It's not going to be easy to ease the deeper anger of doctors.
The province's position is that adding $392 million to the budget for doctors fees is an 11-per-cent increase, about $50,000 for each of the province's 7,800 doctors. That's an increase greater than the earnings of the forestry workers facing layoffs because of the softwood lumber dispute. The government was also prepared to start reminding the public that doctors were big beneficiaries of the tax cuts, to the tune of some $15,000 to $20,000. It hasn't been a bad year for their take-home pay, and if the government took that message to the public it would likely be well-received.
But some doctors are going to argue that they haven't had a real increase in years, and that the $392 million means an increase of about 3.5 per cent a year when averaged over three years, with much of that taken up by increasing use of the system. (Some doctors wrongly believe that the amount will be increased to cover growing demand for service. That's not the government's intention, and once that becomes clear it will be a major issue.)
And based on the ones who were speaking out in Victoria this week, many aren't much concerned about the public's view.
The battle could continue for some time, both inside the BCMA and with the government.
It's still a timely victory for the Liberals, who very much need doctors onside as they move ahead with cuts to health care services across the province. Managing the kind of major change the Liberals hope for, including hospital closings and service cuts, will require planning help and support from doctors. That's at least somewhat more likely now.
And given the inevitable protests, the last thing the Liberals needed was a fight with doctors and growing waiting lists.
Consider it a lull though, not a peace. The hard work of reaching a real truce with doctors still lies ahead.

Paul Willcocks can be reached at willcocks@ultranet.ca

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