Doctors believe the Newfoundland and Labrador government is looking to save hundreds of millions in health spending without sharing all of the specifics with key players — including them.
Robert Thompson, executive director of the province's medical association, which represents doctors, calculates the government's savings goal at somewhere between $300 million and $450 million.
"We had never been apprised by government of something this large," Thompson said, calling for the government to share information.
The estimate is based on statements made by the province's Deputy Minister of Health and Community Services, John Abbott.
Health spending in the province is 25 per cent higher than the national average.
Abbott has made it clear he'd like to reduce that number substantially over the next several years.
The Newfoundland and Labrador Medical Association (NLMA) said that could have a dramatic impact on the health-care system.
Thompson told CBC News there appears to be no comprehensive planning process with clear fiscal targets and timelines — or consultation. He also called for some independent review.
Believes deputy minister was revealing government policy
Earlier in December, Abbott told CBC News that every health care service, facility, program and professional group is under scrutiny, that his goal is to lower costs and improve health outcomes.
- Health minister distances himself from deputy, says Abbott 'one voice of many' in health-care debate
Health minister John Haggie later distanced himself, maintaining that his deputy minister's voice is just one of many when it comes to health care reform.
That's not how Thompson sees it.
"Our view is that Mr. Abbott was describing government policy," he said.
Could have started a year ago
Abbott pointed out there are 46 per cent more registered nurses per capita in Newfoundland and Labrador than the Canadian average, and roughly 50 per cent more licensed practical nurses.
He also raised concerns about the productivity of the nursing workforce, and the amount of sick leave that nurses take.
Those comments generated anger, with the Registered Nurses' Union in Newfoundland and Labrador accusing the government of betrayal and bad-faith bargaining.
It's not just the number of nurses that's getting attention.
The health minister told CBC Radio's CrossTalk listeners that over a 10-year period, the provincial health budget doubled. Haggie also said that during the same timeframe, the number of doctors increased from under 800 to nearly 1,200.
Thompson said the NLMA understands the government is facing tough economic times.
He said the association has asked the health minister to work together to make big changes within the health-care system.
"If we'd started a year ago, this plan may actually be done," said Thompson.