The lord giveth and the lord taketh away. When it comes
to physician earnings in Quebec, the lord's name is Dr
Philip Couillard. The minister of health is a just and
fair man with a sterling reputation in the profession
stemming from the excellent work he did at the University
of Sherbrooke both as a neurosurgeon and an administrator.
Since April 2003 he's also been the second most prominent
politician in Quebec after Premier Jean Charest who, it's
believed, he would not be adverse to replacing.
When an ambitious politician wadeth
into unstill waters he should take care to see that
he is wearing his wisdom water wings. Dr Couillard plunged
into the physician compensation debate in his home province
with both feet this week and he's shown himself to be
a strong swimmer.
All year the Department of Health
has been jousting with the specialists over a new deal.
The physicians wanted earning parity with other provinces
and while they likely didn't expect to get it, there
was a good chance they'd come up with something better
than the 8% over four years the government had negotiated
with the civil service last December. The minister had
$600 million in unallocated spending and was ready to
part with some of it to appease specialist demands.
It didn't happen. In the small hours of Tuesday, June
13, the National Assembly, most anxious to put a nasty
session behind them and kick off the summer break, imposed
the 8%/four-year settlement. The specialists lost the
battle and the minister was bloodied by a self-inflicted
wound from the legislative hammer. The Quebec press,
suggesting another day or two of negotiation would have
settled it, had a field day at the minister's expense.
It looked like a lose-lose situation
until late Wednesday when the GPs, whose negotiations
traditionally are tied to those of the specialists,
accepted a new government offer. Despite reservations,
in the longer term the MDs will likely find much to
like in the deal. The provisions with regard to practice
expenses will put more money in their pockets and there's
money in the settlement for chronic care. It's another
proviso, however, that will ultimately score the most
points for the minister politically and with the province's
GP federation as well. The deal removes the cap that
had limited billings in each quarter and had effectively
forced hundreds of practitioners to work only two months
out of every three. In a province where fully one-third
of citizens do not have their own family physician the
change should free up many practices to accept new patients.
In the Montreal area alone fully 300 GPs have been closing
their practice for the final month in each quarter.
— David Elkins, Executive
Editor
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