Tuesday, June 04, 2002

Liberals better learn - quickly - from doctors' dispute
By Paul Willcocks
VICTORIA - Never get into a fight with a person who may someday stand over your naked, unconscious body with a knife.
That's the first lesson the Liberals should take away from this battle with doctors.
People need to trust their doctors. So while they may grumble about the BC Medical Association, they're going to think well of the person who cures their child's ear ache.
And that means that in almost any public relations battle between doctors and government, the doctors will always win.
Lesson number two is similarly basic.
The tactic of trying to drive a wedge between a bargaining unit - the BCMA - and the people it represents almost never works.
I know, as a former business guy who handled labour negotiations. Several times I thought that if the employees were just told how sensible my position was, and how poorly they were being served by their union reps, they would pressure the union to come to the table. But it never worked.
Health Minister Colin Hansen and the rest of the Liberal strategists should know that by now. Any attempt to encourage splits in the doctors' ranks simply served to make doctors madder and more determined.
The third lesson isn't any more complicated. Once you show people you can't be trusted, it's hard to reach a deal. That is of course what the Liberals did by promising to accept a binding arbitration report on the doctors' settlement, then ripping it up when they didn't like the result.
The government says that former chief justice Allan McEachern ignored his terms of reference, the complaint of every dissatisfied party to an arbitration. The government could have taken that complaint to court; instead it broke trust with doctors as it did with so many others.
I'm a little hesitant to move to lesson four. It's always difficult to assess how negotiations went if you weren't at the table.
But the Liberals need to examine what went wrong here, because from the outside it looks as if the deal could have been reached two weeks ago if the government had bargained more effectively.
A key issue in this battle was how future disputes would be resolved. Doctors wanted some form of binding settlement consistent with the Canada Health Act. The government first said no, then introduced the deal-breaking requirement for an essential service plan. That was one of the critical elements that lead doctors to break off talks.
But the final settlement dropped the government's demand for essential service guarantees and looks much like what doctors would had agreed to almost two weeks ago.
Another deal-breaker was the length of the contract. The government wanted it to last until 2005; doctors said 2004. And the final settlement accepted the doctors' position. (The Liberals can be forgiven a little anger over this one, since the BCMA - apparently without paying attention - had agreed to the longer term in the March memorandum of understanding signed with the premier.)
On financial issues, both sides made small changes, but the deal was there
at least two weeks ago.
The issue isn't whose position was right. It's just bad bargaining to dig in your heels, creating two weeks of mounting chaos in the health care system, if you're actually prepared to give on the issues.
The biggest lesson is both simple and incredibly complex.
The government has less than two years before this agreement expires, less than two years before the whole mess is visited on the province once again. There will still be a doctors' shortage in two years, B.C physicians will still be angry and mistrustful and the government will still be short of money, setting the stage for another war on patients.
It's not enough to talk about rebuilding relationships.
The underlying problem is that our demand for increasingly expensive medical services is almost limitless.
And at some point, we're going to have to decide together what we are no longer prepared to pay for.

Paul Willcocks can be reached at willcocks@ultranet.ca