"What don't I like about the Special
Bill? All of it," fumes Dr Louis Morazain, vice president
of Quebec's specialists' federation (FMSQ). The Special
Bill, or Bill 37, which capped the specialists' wages
at about 60% of what their colleagues earn in the rest
of the country, was pushed through in June after negotiations
broke down. Last month the FMSQ, which is suing the
government to challenge the Bill, enjoined its 8,000
members to effectively work to rule until the matter
is settled.
Some say the specialists overplayed
their hand when they rejected an offer of $593 million
in pay increases from Jean Charest's Liberals (the province's
GPs decided to take their 19.5% pay increase offer),
but the FMSQ remains defiant. The federation is holding
out for pay parity with colleagues in the rest of the
country, which it says the government agreed to, then
reneged. The government says it simply can't afford
it. The significantly less generous package imposed
includes the threat of very serious fines should the
specialists violate its terms. "We were just negotiating
when they put forth that bill," says Dr Morazain. "And
this law has fixed doctors' wages for four years at
a level that is totally unacceptable. It's so rigid
and so strict about what we can do to show we're unhappy
with it," he adds. "We can't stop working, we can't
reduce our workload — everything has been subjected
to controls, to lawsuits and to penalties so it's really
odious."
Since negotiating with the province
wasn't getting them anywhere, on October 12 the FMSQ
asked its members not to perform extra evening and weekend
surgeries and to stop performing unpaid tasks such as
teaching and administration. The decision to stop teaching
has proven particularly controversial as it directly
affects the province's much-needed workforce of residents.
Dr Martin Bernier, the president
of Quebec's medical residents' federation (FMRQ), says
his organization's members are sympathetic with the
specialists' goals, but loathe their tactics. "I've
seen a lot of anger," he says. "I got a lot of email
from residents who were quite angry and getting themselves
ready to — I wouldn't say retaliate, but it's getting
close to that. Many feel that they're doing more than
their fair share and if the specialists are going to
stop doing their teaching then maybe the residents ought
to stop doing all this extra work they are doing to
take the pressure off the staff physicians. We told
them upfront that it was very unlikely that the residents
would feel like sacrificing themselves for the monetary
interests of specialists."
For Dr Morazain, the residents
ought to look at the big picture. "First of all, before
we did anything we went to see the residents and consulted
with them and we explained what this was all about to
them," he says. "And while it's important for us, it's
probably more important for them — they'll be our
doctors in a few years and what we're fighting for is
really for them. But of course they'll face some side-effects
from what we're doing and they don't like it —
but that's OK."
"The idea of us having to suffer
now in our better future interests doesn't hold up,"
says Dr Bernier. He and other residents are worried
that if the specialists' protest continues into the
spring, they won't get the evaluations they need to
write their certification exams.
DIVIDE
AND RULE
"We're all experiencing variations on the same theme
with our respective troubles in having 'normal' negotiations
with the government of Quebec," Dr Bernier says. "But
it's unfortunate that we're resorting to using means
that will antagonize these different groups (of health
professionals) towards one another. We're missing the
point and only making it easier for the government to
carry on its business as usual.
"We've warned the FMSQ on that
expected side effect and now we're experiencing it,"
he adds. "I imagine it must be easier for those in power
to face a divided crowd than to face a united front
of 20,000 physicians."
TOE
THE LINE
Quebec's health minister Phillipe Couillard, a former
surgeon, told the press the FMSQ's reaction to Bill
37 was "completely incomprehensible" and that he fully
expected many of the province's specialists to ignore
the federation's dictates.
Dr Morazain says in fact the specialists
are toeing the federation line when it comes to boycotting
unpaid teaching and administration. "The compliance
has been very good," he says. "We've been checking up
on many points in the province and many hospitals and
what we are monitoring on the ground is that everyone
is enthusiastic to do the job that we asked them to
— they're following the orders."
Dr Bernier isn't so sure. He's
seeing less-than-universal adherence to the FMSQ slow-down.
"There's quite a bit of heterogeneity in the way those
measures are applied, some centres are quite 'good'
at following the orders of the FMSQ — Quebec City
in particular — while at McGill they haven't yet
decided what to do."
What sort of message will the actions
of the FMSQ convey? "Quebec doesn't treat its doctors
right — particularly specialists," says Dr Morazain.
Dr Bernier is less-than-sanguine in his appraisal. "I
don't think the population is going to be that receptive
to this kind of pressure," he says.
|
