Alberta doctors reject tentative agreement following year-long dispute with UCP government

Alberta doctors have voted against a tentative agreement with the provincial government.

The Alberta Medical Association said 59 per cent of its 11,000 members turned out for the vote, and 53 per cent voted against the agreement.

A simple majority was required for it to pass.The AMA had tentatively approved the deal, subject to the member vote thatwrappedon Tuesday.

The lack of resolution follows a year ofbad blood between the province's physicians and the United Conservative government, a fight that began inFebruary 2020when Health Minister Tyler Shandro unilaterally ended the AMA's master agreement and imposed a new physician compensation framework.

The move sparked public outcry, a lawsuit, accusationson both sides of bad-faith bargaining,and doctors withdrawing servicesin protest.

Shandro confirmed the vote was unsuccessful in a statement late Tuesday evening.

"While this result is disappointing, it does not erase the meaningful collaboration and mutual understanding that was gained throughout this process," the health minister wrote, thanking AMA's president and board for their efforts.

"The momentum gained over the past few months will not be lost. Our government will seek to further renew our relationship with the AMA in the weeks and months to come as we work together to ensure Albertans continue to benefit from quality health care."

a health-care system without an agreement between physicians and government becomes chaotic."- AMA President Dr. Paul Boucher

AMA President Dr. Paul Boucher said he knows the vote was a difficult decision for many and involved passionate debate.

"It was encouraging to observe that while there was disagreement about the best choice, there was always consensus about the things that unite us. Everyone recognizes the significant challenges we will face in the next few years, such as the fragile economy, changes arising from new health legislation and a potential third wave of COVID-19 as the care deficit caused by the pandemic continues to grow," Boucher wrote in a letter posted to the association's website.

Details of the agreement have not been made public, but CBC News previously obtained a leaked copy of the tentative agreement, which would haveset the current physician services budget at the2018-19 level of $4.6 billion and allowed the government to withhold payments from doctors if overspending was expected.

• Tentative agreement would allow Alberta to withhold doctor pay to balance physician budget

Doctors would also have given up the right to third-party arbitration, previously considered to be critical leverage in bargaining given that physicians can't hit the picket line for ethical reasons.

Dr. Christine Gibson, a family doctor in Calgary, wrote on Twitter that she voted against the agreement for a variety of reasons, from worries it aligned with moves toward privatizing health services to concerns patient care would suffer if pay was withheld.

"We've been told cruel things about us in the toughest year of our jobs, and had nothing but vitriol and obstruction until this past month. Like the cycle of abuse. So we said no," she said.

Edmonton Dr. Kim Kelly wrote on Twitter that it's the first "no" she recalls in her career of more than 20 years as a doctor in the province something she chalked up to as broken trust between the two parties.

Duane Bratt, a political science professor at Mount Royal University, said the level of bitterness in the debate raisesthe question of what role physicians trust in or antipathy for Shandro played in the vote.

"To go against what your own representatives negotiated is a slap in their face and it's a vote of non-confidence," said Bratt, with Mount Royal University in Calgary.

"So my gut tells me this was not about the details in this agreement. This really was: We'll support the current agreement but not with the current minister."

Olive branches

As voting wound down in the last two weeks, Shandro extended numerous olive branches to the doctors, including a public lettersaying he regretted downplaying their frustrations and anger over the dispute and hoped to move forward together in a spirit of reconciliation.

Boucher said he has reached out to the health minister and will meet soon to begin discussions on priorities like ensuring Alberta has an adequate supply of physicians, and ensuring a new contract will provide equitable accessfor patients and fair treatment for physicians.

"The challenges facing the health-care system remain and we need to get to work on concrete strategies to evolve our system toward stability and pursue sustainability in the only way it can be achieved: through quality care for our patients," he wrote.

"This would be an easier task with an agreement, but regardless, we need to re-establish Alberta as a good place to practice as for the problems that need attention, these will only be addressed properly by working together. Eventually, we will need an agreement; a health-care system without an agreement between physicians and government becomes chaotic."