The Canadian Medical Association (CMA) is concerned about recent actions by provincial governments in Quebec and Ontario to unilaterally impose measures restricting physicians’ ability to deliver optimal care.
“The new legislation proposed in Quebec and recent actions taken by the Ontario government represent an alarming trend of governments refusing to work together with medical associations to better manage the health care system,” said CMA President Chris Simpson.
In Quebec, legislation introduced last year – Bill 20 – proposes a sweeping series of restrictions on the province’s doctors, including requiring both family physicians and specialists to maintain a minimum caseload of patients and increasing the duties of attending specialists in hospitals. Another bill – Bill 10 – would give sweeping new powers to the health minister. Both bills are now before the provincial legislature.
Family doctors in Quebec would be required to meet specific targets in terms of number of patients seen or face cuts of up to 30% in the capitation fee they receive for each patient.
In Ontario, the provincial government has just imposed a series of measures to limit physician billings, after the Ontario Medical Association (OMA) rejected the most recent government offer in negotiations that have been ongoing since March 31, 2014.
The agreement offer rejected by the OMA included $580 million in fee cuts over two years. The OMA said the offer set an arbitrary baseline for the physician services budget that is more than $80 million below current levels, and funded growth of no more than 1.25% per year despite current growth of 2.7%. The OMA said the government planned to claw back payments to physicians if the budget ceiling was exceeded.
Following the OMA announcement, the provincial government announced that effective immediately it is cutting all fees to physicians by 2.65%.
In addition, the government said it is: eliminating funding for continuing medical education courses; reducing the fee for walk-in clinic visits; eliminating the premium for accepting new patients who are healthy; limiting the number of family doctors in well-serviced areas who can join family health teams.
“The actions in Quebec and Ontario represent a return to the bad old days when provincial governments used bludgeoning tactics against physicians to try to control their health care budgets,” said Simpson.
“The proposed Quebec legislation and measures in Ontario cannot help but have a negative impact on patient care, as well as alienating doctors who want to work to help deliver care more effectively.”
Simpson said the CMA would like to see the governments in Ontario and Quebec return to holding constructive talks with medical organizations about how they can partner to bring forward innovative and constructive solutions to meet the challenges facing health care delivery in all jurisdictions.