When you sign a contract, there’s always a moment’s pause to think about the chance of misfortune. It’s human nature.

But it’s something altogether different when misfortune visits twice as senior officials of the New Brunswick Medical Society are now finding out. Current efforts to freeze the wages of physicians after reaching a deal is the second time a provincial Liberal government has pulled the tactic since the 1990s. So in late June, the NBMS applied for a court ruling of what society officials called the province’s “rejection of ratified agreements.”

“We have a tentative agreement, it was announced by the minister on Dec. 10, (2008), and we’re waiting for it to be implemented,” said NBMS president and Edmundston-based general surgeon Dr. Ludger Blier. “The events of the last several weeks are, to say the least, deeply troubling to New Brunswick’s physicians and, I suspect, physicians across the country.”

The province’s current Liberal government wants to impose a two-year wage freeze on both fee-for-service and salaried NBMS members after both sides reached a tentative deal proposing an increase of nearly $36 million to the medical services budget this fiscal year.

“From the government’s point of view, the increasing severity of the global recession in early 2009 has since made spending on that scale a virtual impossibility,” stated one news report.

“Tough times call for tough decisions,” added provincial Health Minister Mike Murphy upon announcing the two-page Act to Amend the Medical Services Payment Act. He was forced to do that when the NBMS turned down his request that members voluntarily accept a freeze. “Even with a record-breaking health budget of $2.3 billion, competing priorities mean that savings must be found to ensure the continued, long-term accessibility and sustainability of the public system.”

Competing priorities?
It seems Murphy is part of an inept government run amok. For one thing, which of his many “competing” priorities could possibly compete against health care, perhaps the highest priority for New Brunswickers?

Second, any government failing to see even a glimpse of the economic problems that have been facing Atlantic Canada, Canada at large and even the world for as far back as two years needs to be voted out of office immediately! How can that happen? How could people charged with the responsibility for the care and maintenance of their constituents bungle such a vital part of their mandate so thoroughly as to not be able to see a $741-million deficit barrelling down the road toward the legislature?

It was only last December, when Murphy issued a news release congratulating both bargaining committees on the tentative deal that was reportedly ratified by NBMS members but left unsigned by government.

Amusingly, Murphy said his legislation “exemplifies our government’s commitment to protecting and enhancing access to health services for all New Brunswickers.” Well, he can’t have it both ways: making cuts because of “competing priorities” on the one hand, while “protecting and enhancing” access to health services for all.

Still worse, Murphy added: “We’re not asking physicians to do anything more than we’ve asked cabinet ministers, college instructors, tradesmen, custodians or any other civil servant to do.” Well, for one thing, New Brunswick probably needs fewer cabinet ministers than physicians right now. As for the other groups Murphy mentioned, we wonder if they also had recently reached a tentative deal with the province.

As difficult as it may be to believe, there’s more. . . .Way more! New Brunswick’s gambit opens the way for other governments across the country to try the same sneaky move. In Manitoba for example—another province stretched to the fiscal breaking point—physicians recently ratified by 92% a three-year deal that this year will produce $875-million in fee-for-service and alternate payments. What rebellion there would be if that contract were declared null and void and subjected to “the New Brunswick treatment?”

Luckily, things aren’t as bad for NBMS members as they seem. Murphy’s new legislation technically extends physician wage freezes for another 10 months only because doctors have actually been without a contract since April 1, 2008. Still, it’s the principle: A deal’s a deal . . . except in New Brunswick when it’s totally up to a government that apparently can’t see its hand in front of its face.  

A wage freeze is likely to hurt physician recruitment, even though health ministry officials say 114 “net new physicians” have come to New Brunswick since 2006. “There’s already a perception that we’re not physician friendly,” said Progressive Conservative health critic Margaret-Ann Blaney. “You do something like this, and you’re going to wipe out any hope at all.”

For its part, the Canadian Medical Association has been quiet. To be sure, it’s rare for the CMA to get involved in the affairs of one of its provincial or territorial divisions. Health is a provincial jurisdiction. But the announcement that the group has named a new CEO, after eight months without one, came during the middle of the New Brunswick fireworks.

Still, if ever there were an issue the CMA should and could sink its teeth into, this would be it. Some of its more than 70,000 members are undoubtedly waiting anxiously to see and hear what happens next in New Brunswick and how the CMA responds. With good reason.

Finally, perhaps to take some of the sting out of the bite, Murphy also announced a plan to allow 100 new billing numbers over the next four years. It should be interesting to see if there are any takers . . . or if the program actually gets implemented.

Matt Borsellino is national editor of the Medical Post.