ST. JOHN'S, N.L. — Peter Jackson
The Telegram
@pjackson_nl
Doctors and the province’s health minister are so far apart on contract negotiations, they can’t even agree whether they’re negotiating.
The Newfoundland and Labrador Medical Association (NLMA) held a news conference earlier in the week slamming Health Minister Dr. John Haggie for constantly ignoring their advice and proposals over the past few years.
It’s the third time the NLMA has gone public with concerns in the past six weeks, although Tuesday’s event went beyond complaints about the reopening of health services during the pandemic and painted a broader picture of dissatisfaction with the relationship.
“This is all around negotiations,” Haggie told The Telegram the following day. “We’re in formal negotiation with the NLMA.”
Except they’re not.
And Haggie conceded formal collective bargaining has not yet begun.
“We’re pretty well ready to start,” he said. “We’re actually in negotiations on a variety of topics, from virtual care through other interests that were related to COVID, for example.”
Haggie said most of the issues being brought up relate to matters that would be included in a collective agreement, but he would not go so far as to say the organization is simply posturing.
“I think they are concerned about the economic environment. They’re concerned about their issues, and I think this is part of the lead-in to negotiations where we do actually collectively bargain,” he said. “We certainly haven’t got to the collective bargaining phase, but we have been involved with (regular) discussions about monetary issues.”
The minister frequently touts progress on transitioning from primary care to a team-based system.
But NLMA president Dr. Charlene Fitzgerald says the public shouldn't believe him.
“We cannot stand by any longer without making clear that this is false,” she said Tuesday. “Family physicians are still waiting for the program that enables them to bring their hundreds of thousands of patients into primary health-care teams. It just does not exist. The foundational piece has not yet been designed and agreed upon.”
Haggie disagreed.
“I would not accept the premise of that,” he said. “We have family health networks set up through the family practice renewal committee. They are instrumental locally in having needs-based meetings. These are run by local groups of family practitioners. There was a very successful one before COVID based in Eastport in the Central region.”
He also took issue with the claim he is brushing off the NLMA's concerns, saying that in the past week, senior officials have been consulting with the association almost daily.
“I certainly wouldn’t say they’ve been ignored,” the minister said. “They may not have been responded to in quite the way that the medical association would have liked.”
A key issue in any contract talks will be fees for service, and Fitzgerald said this province’s fee structure is often cited by graduating medical students as a reason not to stay in the province.
She said the province only manages to reach about half of its goal of retaining about 30 medical graduates annually.
“New medical graduates tell us the current fee-for-service payment model is outdated and inconsistent with the way new doctors are being trained today,” she said. “And the current payment model does not easily support integrating registered nurses and nurse practitioners into family practices to increase access for patients.”
Meanwhile, Haggie couldn’t offer a timeframe for formal negotiations, which are now about three years overdue.
“I don’t think casting blame is necessarily going to get us too far in getting it off the ground and getting it started,” he said.
In a statement Thursday, the NLMA again pressed for talks to begin.
“The NLMA has repeatedly and publicly called on the minister of health to start negotiations, to no avail,” it read.
Peter Jackson is a Local Journalism Initiative reporter covering health for The Telegram
