Medical specialists will drop some pressure tactics

Quebec medical specialists say they will appeal an Essential Services Council ruling that orders them to stop their pressure tactics, even though they plan to conform to several of the ruling's recommendations.

The council ordered specialists to abandon their pressure tactics because they're jeopardizing public safety. The ruling issued Friday night says doctors must:

• Abandon their plans to stop delivering babies in the new year.
• Resume teaching medical students.
• Renew negotiations with the province.

Doctors will abide by the letter of the law and provide essential care to patients, said the provincial federation representing specialists, but will withhold certain services not explicitly outlined by the council's ruling.

Specialists will not take on unpaid administrative duties, and won't do any extra work that contributes to efforts to reduce wait times in hospitals, said Gatan Barrette, president of Quebec's Federation of Medical Specialists.

And while doctors will ensure that medical students graduate, "there will still be consequences to the government's attitude, a government which refuses to negotiate and take into consideration elements like [medical school]," Barrette said in reaction to the ruling.

He couldn't say when specialists would resume teaching upper-year medical students at l'Universit de Montral and l'Universit Laval, where they have failed to complete their external rotations because doctors have boycotted the program.

While the federation determines its course of action, it will most certainly appeal the council's ruling and its jurisdiction, Barrette promised.

"There are points to debate in court, in particular, the council's legitimacy," he told Radio-Canada Monday. "[Teaching] is normally not within the essential council's jurisdiction. We're going to fight them on that," he said.

Specialists ratcheted pressure on the province this fall to draw attention to thegap between their wages and those of their colleagues in other provinces.

In Quebec, the average medical specialist's salary of $233,000 a year is about two-thirds the Canadian average.

Specialists are demanding a 20 per cent salary increase over the next three years. The government has offered a 12.5 per cent increase over a decade, a package worth $370 million.

Quebec welcomes 'new vibe' in doctor talks

The specialists' reaction to the ruling is reassuring and underscores a "new energy" that could help advance negotiations with the province, said Quebec Health Minister Philippe Couillard.

He said he hoped specialists will abandon their pressure tactics and consider negotiations or mediation with the province.

"We want the right agreement," he told reporters at a press conference on Monday. "We're ready for conversations, but I don't know when they will happen."

Some kind of truce before the holidays would be ideal, he added.

"I think it would be a great gift for Quebecers, if we dissipated this worry and tension in the health-care system. We hope for that, and I'm confident the federation will find the tension is toxic, and needs to end," Couillard said in French.

Quebec will only agree to binding mediation if medical specialists accept the province's financial framework for salary negotiations, he added.

Couillard doubted that many specialists would follow the federation's directive for doctors to turn down any extra surgery. Earlier this fall, the province announced new funding for extra surgeries, as part of a plan to reduce wait times for certain procedures.

"I think that it's contradictory that surgeons, who have asked for years to increase their surgery time, would not be interested in doing that," he said.

Couillard warned specialists about pulling tricks to avoid teaching medical students.

"We can't create the perception across North America that our medical faculties interrupt or stop teaching. That is not good for anyone."

Medical schools wring hands

The Essential Service Council's ruling is a step in the right direction, but it may not be enough to save the school year for hundreds of medical students, the province's association of university rectors warned Monday.

"Every day that passes, every missed day in an external rotation, every missed class adds to the risk of losing a school year, which is extremely important," said Dr. Rjean Hbert, president of the Conference of Heads of Medical Faculties of Quebec.

It will be very difficult for students to take certain external rotations again because the waiting lists are so long, said Denis Marceau, president of medical affairs at the Conference of Rectors and Principals of Quebec Universities.

"We're full up already. As you know, we've been asked [by the province] to train more doctors. We have no wiggle room," he said.

Medical schools affected by the specialists' pressure tactics will gauge the situation in various faculties before making any announcements about the school year, Marceau said.