President’s Letter: NLMA suspending negotiations to consult with members, government threatening to change Medical Act
Dear Colleagues:
On October 7, the NLMA provided written notice to the Government of Newfoundland and Labrador that we are immediately suspending contract negotiations to consult with our members.
Health Minister John Haggie and Finance Minister Siobhan Coady told the NLMA unequivocally that the provincial government will make zero investment in the physician services budget to help improve the province’s physician recruitment and retention crisis. The NLMA provided the government with a deadline of October 13th to confirm whether its proposals to date are a fair reflection of the government’s negotiations position. As of today, the government has provided no indication to the contrary, which is why we are taking action now.
The NLMA’s contract expired more than four years ago. Since negotiations began in December, the government has failed to table any proposals aimed at solving the recruitment and retention problems of physicians, the family doctor shortage, or the plight of 99,000 unattached patients.
Specialists including family doctors are facing shortages in every region of the province. They are suffering the strain of an under-resourced, over-loaded health system which fails to attract new doctors. Too many members are burning out due to workforce vacancies and an inappropriate on-call burden that is unsustainable and hampering recruitment efforts. We have put forward proposals at the negotiations table to address these issues. The government, however, has flatly rejected them.
We gave the government plenty of opportunity to make serious proposals and to respond to our proposals. However, government has not taken this process seriously. It has wasted time while health care is crashing. They are ignoring the collapse of family medicine and the competitive position of our province.
The NLMA has agreed not to negotiate in public; however, it has made no secret of the fact that to attract new doctors to the province, Newfoundland and Labrador must at least be competitive with the other Atlantic Provinces. Since the NLMA’s contract expired four years ago, the majority of specialties have fallen below the Atlantic average.
Attracting new doctors to fill vacancies in these specialties requires serious effort and investment. However, Minister Haggie and Minister Coady have made it clear that the provincial government has no intention of being competitive with the other Atlantic Provinces. In doing so, the ministers are sending a clear message to any doctor thinking about coming to Newfoundland and Labrador to work and any doctor working here now.
Since 2018, the NLMA has also been calling for a blended capitation payment model for family medicine. Many young family doctors do not want to start a practice in this province under the current fee-for-service model. They want a model that supports interdisciplinary teams and improved quality care for patients.
The Minister of Health has given many media interviews about his support for a shift to a new blended payment model. We thought we were aligned on the need to establish this model in our contract. However, we have not seen credible action from the government on this goal. When asked about the province’s plan to address physician recruitment and retention at a news conference on Tuesday, Minister Haggie stated: “We have staff talking to NLMA staff outside of negotiations on bi-weekly basis, every second day. The material exists, it’s just not in a big binder with ‘The Plan’ written on it in red letters.”
In reality, the Department of Health is not meeting with NLMA to discuss the province’s physician recruitment and retention strategy. Since taking over the heath portfolio, the NLMA has had to repeatedly clarify these types of erroneous remarks from the minister.
The government also has no regard for the existing contract it negotiated in good faith. The NLMA has been forced to take legal action against the government for breaching our contract. We now have three active cases currently before the courts.
Medical Act
As if this weren’t enough, last month the Department of Health advised the NLMA that it intends to change the Medical Act, 2011 legislation to remove the requirement that physicians must be members of the NLMA.
To advance this type of divide and conquer tactic in the middle of our negotiations is unethical and cannot be tolerated. This will not benefit patients in any way, it is an attempt to weaken the NLMA, and it’s an affront to all groups that negotiate and advocate for their members.
The NLMA is launching a series of meetings with its members to discuss the government’s negotiations proposals and next steps to break this impasse. After our consultations we will inform the government and the public about the course we will pursue in the interests of our patients and the public.
Below you will find links to register for our upcoming virtual meetings. It is extremely important that you attend. While we come from many different backgrounds and disciplines, the physicians of Newfoundland and Labrador are dedicated to providing care for all the people of the province. It is important now more than ever that we stand united and in solidarity for our patients.
Member Town Halls:
Please see the links below to register for the upcoming virtual Town Halls. These are confidential briefings for NLMA members, so we would kindly ask that you register for the appropriate meeting depending on your location. If another region’s date/time better suits your schedule, please feel free to register for that meeting instead of your own region.
Eastern Health Region
Tuesday, October 19 at 7:00 p.m.
https://nlma-nl-ca.zoom.us/meeting/register/tZctfuuorjIpGddVlTYeMrLA1RyDc-3qtQuX
Central Health Region
Wednesday, October 20 at 7:00 p.m.
https://nlma-nl-ca.zoom.us/meeting/register/tZMocu2srTgpGNTlA5oktHeP1IvEDnl66_KH
Western Health & Labrador Grenfell Health Regions
Thursday, October 21 at 7:00 p.m. NT
https://nlma-nl-ca.zoom.us/meeting/register/tZYkdeurpj0jG9ezt2G2LF_I_Ku2PXhzupTw