Tuesday, February 03, 2004

Doctors and government head to June chaos
By Paul Willcocks
VICTORIA - I staggered home in despair after last week's dueling press conferences by government and doctors.
The two sides are fighting about money again. Doctors say the budget for their services needs to increase over the next three years. The government says no.
And since there is no reasonable process for resolving the deadlock, the two sides are heading for a health care wreck in June.
Once again the big losers will be regional centres, which are both the most obvious targets for doctors' job action and the most seriously damaged. If doctors withdraw services from one hospital in the Lower Mainland, there are others just down the road to take up the slack. That's not true in Prince Rupert or the Kootenays.
The two sides are so far apart, and the mistrust so intense, that this dispute has the feeling of a disaster.
I sympathize with Health Minister Colin Hansen. His position is that there is no more money for health care, doctors are already well-paid (they got a 21-per-cent increase over the term of the last three-year agreement) and other government workers have accepted three-year contracts with no increases. Tax cuts and a balanced budget are both, in his view, more important than finding extra money for health care, because they will create economic growth which will eventually fund better care.
Doctors say the last increase was a catch-up, and that if the government wants more operations done to cope with a growing and aging population, it needs to put more money into the budget for doctors. And the BC Medical Association warns that B.C. will lose doctors unless there's a raise.
Hansen says the doctors' proposals would cost about eight per cent a year; the BCMA doctors says are looking for about 3.5 per cent a year, matching an increase just given to Alberta doctors.
The dispute is familiar. The consequences are always damaging. And governments pretty much always lose.
What's painful is that two supposedly mature organizations still haven't managed to agree on a way to resolve disputes without hurting patients.
Hansen's position is that he and the government are in charge, they write the cheques and they'll decide how many doctors are needed and how much money they get. (It is the same position that's led to the Nanaimo emergency room virtual shutdown.) It's the dream role for every manager who wishes for a free hand in running a business or organization.
But it's not realistic. People don't accept the right of the boss to make those decisions. They form unions to increase their clout in the process, or find ways to enhance their individual bargaining power. Doctors - mobile, publicly supported, politically critical to government - have all the tools they need to press their case.
At this point it's the government that has twice agreed to, and then reneged, on processes that were supposed to avoid these kind of disputes.
First the government agreed to binding arbitration, but the Liberals tore up the award when they didn't like the outcome.
This time, the premier signed an agreement which promised see any dispute ultimately go to a conciliator, who would hear both sides, consider the facts and the government's ability to pay, and prepare a recommendation. The government could accept it or reject. Only then would job action happen.
That was supposed to be the deal. But now the government has told doctors in advance that it will reject any deal that provides any extra money. It's a clear betrayal of the commitment to conciliation, another indication that this government is careless about breaking its word.
Conciliation holds political risks for the government. Reject the report - if it's reasonable - and the public will be angry about the resulting disruption. But it holds no economic risks, because government can always reject the report.
Conciliation is what the government promised. And it's the only alternative to chaos.
Footnote: It's also time to consider long-term solutions. The obvious one is to find ways of reducing the level of conflict with doctors without rolling out wheelbarrows of cash. But government could work more aggressively at reducing demand for services, and increasing supply by shifting more procedures to non-doctors and finding innovative ways of producing more doctors quickly.

No more Heartlands, but good news for resource towns
By Paul Willcocks
VICTORIA - Ding, dong, the Heartlands are dead.
Or at least the Liberals' Heartland strategy is dead, mocked mercilessly out of existence by the very people it was supposed to be placate.
The cabinet shuffle marked the official end of the Heartlands' strategy. Last year, the phrase seemed to work its into every government news release. By the time of the shuffle, not a word was heard about it.
But in fact the cabinet shuffle was good news for B.C.'s regions.
First of all, Premier Gordon Campbell blew up the competition, science and enterprise ministry, created after the 2001 election. The ministry has been a flop, unfocused and widely criticized by the businesspeople who were supposed to be its supporters.
In its place, we're back to a ministry of small business and economic development, names familiar from the NDP years. Chilliwack MLA John Les was jumped from the backbench to the job, a big promotion.
What's in a name? Partly, it sends a signal about a government's approach. Competition, science and enterprise didn't suggest much of a role for government. In fact back in 2001, Campbell promised a smaller role for government and different approach to the economy. "We're committed to creating a competitive environment that allows B.C. entrepreneurs, small business and B.C. industries to thrive and to prosper,'' he said. Government wouldn't help make things happen. It would reduce taxes and regulations and stand back while the investment rushed in.
It didn't work. Job growth has been good in the last year; investment hasn't.
A competitive business environment isn't enough anymore. Lots of places have already got there, and are out promoting their advantages. Sadly, if you build it, they will not necessarily come.
The new ministry acknowledges that reality.
It still needs money. The competition ministry has budgeted $3 million for marketing and promoting B.C. this year, a 40-per-cent from last year. Alberta is spending seven times as much. (B.C. has other marketing budgets, like the forest marketing funds. But so does Alberta.)
This isn't just criticism from a grouchy columnist. Tourism BC examined government tourism expenditures as a percentage of industry revenues in B.C. and Alberta, Ontario, Quebec and Nova Scotia. The other provinces spent four times as much. To match the spending level in Alberta, our nearest rival, the Liberals would have to double the tourism budget.
And it's not just tourism. Economic promotion generally has been weak, partly because of budget cuts. The competition ministry budget - or its equivalent - was $69 million when the Liberals took over. Since them it's been cut by 30 per cent, with another cut coming in next month's budget.
That aside, the new ministry is still an encouraging move. B.C.'s regions particularly need help in attracting small business and investment, an area where they have lagged far behind the Lower Mainland. And the economic development ministry should provide leadership across government.
That wasn't the only good news in the shuffle for B.C.'s regions. Campbell created two new junior minister's roles, with Skeena's Roger Harris taking on forests and Prince George's Pat Bell responsible for mining. Harris worked in the industry, and should help push needed reforms forward and ensure progress on key initiatives like the 20-per-cent tenure takeback.
And Bell can bring a needed focus to mining, while Energy Minister Richard Neufeld pushes oil and gas.
Just as importantly, the North now has two stronger voices at the cabinet table. Both Bell and Harris are part of a group of Liberal MLAs from resource communities who could push for more action on rural issues over the next year.
There are still going to be serious problems caused by budget cuts to economic development efforts.
But the Liberals have belatedly acknowledged their poor performance in encouraging investment and growth, and taken a significant step towards improvement.
Footnote: The cabinet is still weighted heavily with guys from the Lower Mainland. MLAs from Victoria, the Lower Mainland and the Okanagan get 22 out of 28 seats around the cabinet table. Women are also in short supply - only six cabinet ministers are women, and only Christy Clark has a key post. Not surprisingly, the Liberals actually trailed the NDP among women voters across the province in the last Ipsos-Reid poll.

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