N.L. Premier Danny Williams was visibly upset Tuesday when he responded to a question about his handling of labour negotiations with the Newfoundland and Labrador Medical Association. (CBC)

A spirited and sometimes angry Premier Danny Williams fired hard at the Newfoundland and Labrador Medical Association Tuesday, widening a collective bargaining rift involving the province's more than 1,100 physicians.

Speaking in the house of assembly, Williams accused the NLMA of failing to represent some of its own members. He told the house that some physicians accuse the association of using "mob politics" to achieve its ends.

Williams was visibly upset as he argued with New Democratic Party Leader Lorraine Michael, who accused Williams of playing divisive politics with labour negotiations that affect health care in the province.

Only hours earlier, the NLMA had renewed a call for binding arbitration at a news conference in St. John's. The two sides have been negotiating since early 2009.

Association president Dr. Brendan Lewis said Williams — who last month cast the NLMA's contract proposal as excessive — had a closed mind when it came to bargaining.

The premier has been an obstacle to reaching a deal, Lewis said.

In the legislature, Williams read parts of a letter from St. John's plastic surgeon David Jewer, who wrote to the premier on March 27 to say that he and his colleagues had objected to NLMA statements.

"We have been legislated to be members of the NLMA, hence are forced to accept their decisions whether we are in agreement or not," wrote Jewer, who said he was also speaking for other plastic surgeons in the province.

"As we represent a minority in the association, we are subjected to what is essentially mob politics, being outvoted in any decision we object to. Although I am writing on behalf of the plastic surgeons, many other surgeons are of the same opinion."

The association represents all doctors in the province — from general practitioners to specialists and surgeons.

Williams and Jewer know each other personally. The premier's office confirmed Tuesday afternoon that they used to play hockey together.

Williams told the legislature it was important that he bring the surgeon's concerns to light.

"The reason for disclosing this is that the NLMA doesn't have its act together, that they are not united among themselves," he said.

NDP MHA playing 'cheap, dirty politics': Williams

An angry exchange erupted after Michael accused Williams of putting politics before health care.

NDP Leader Lorraine Michael accused Williams of playing a divisive game of politics. (CBC)

"I'm going to ask the premier, when will he stop playing these kinds of games and grandstanding and deal with the issue, which is a crisis in our health care system because of their lack of coming to an agreement with the doctors," Michael said.

Williams threw back a fiery response.

"This is about getting an agreement and bringing good health care to the people of the province — not playing cheap, dirty politics like you do, holier than thou, the member for Signal Hill-Quidi Vidi," Williams said, addressing Michael.

Williams's comments came shortly after his own finance minister offered something of an olive branch to the NLMA.

Tom Marshall said government had prepared a formal written response to the latest proposal from the medical association, one that will address the NLMA's main goal: bringing salaries and fees close to parity with physicians in the rest of Atlantic Canada.

That response will be presented to the NLMA's board on Saturday.

'Brinksmanship is not helpful'

Rob Ritter, the executive director of the NLMA, said the exchange in the legislature was "a bit of a circus." He said Williams's comments will not help resolve problems between the two sides.

Rob Ritter, executive director of the Newfoundland and Labrador Medical Association, described Tuesday's exchange as "a bit of a circus." (CBC)

"He has a particular agenda and he's trying to present his particular perspective," Ritter said in an interview late Tuesday afternoon.

Ritter said that the NLMA proposal actually includes a measure intended to satisfy the plastic surgeons and "deal with exactly the kind of problems that [Dr. Jewer] has raised." He added the NLMA has not been able to talk with the government about its proposal.

Ritter admitted that some subspecialties and disciplines have specific claims, and that the NLMA's bid would be "a hundredfold" more expensive if its proposal had included them.

"The premier can't have it both ways," Ritter said, referring to how Williams has been sharply critical of the NLMA's demands.

"Brinksmanship is not helpful in a situation like this."

Earlier Tuesday, NLMA president Dr. Brendan Lewis said that the association objected to Williams's claim that the association's bargaining proposal was excessive.

"Can't be dealt with. Can't be satisfied. Can't be answered," Williams said of the proposal last month.

The NLMA said Tuesday that a subsequent, terse letter from Williams was the only formal response it had received to date from the government.