Nova Scotia

Proposed contract for Nova Scotia's doctors 'doesn't solve the big problems'

Nova Scotia's doctors will begin voting this week on a proposed contract that maintains the status quo but "doesn't solve the big problems" facing the health-care system, according to doctors who are recommending the deal.

Despite concerns, tentative deal called 'the best that can be accomplished'

Nova Scotia doctors will vote on a proposed contract starting on June 11. (CBC)

Nova Scotia's doctors will begin voting this week on a proposed contract that maintains the status quo but "doesn't solve the big problems" facing the health-care system, according to doctors who are recommending the deal.

Doctors Nova Scotia recently sent the proposed contract to physicians across the province and CBC News has obtained a copy.

Doctors Nova Scotia president Dr. Michelle Dow and past president Dr. David Milne wrote that solving the big problems in health care "would require significant investments in new, innovative care models and service-delivery options, which your negotiations team pursued but was unable to secure."

"To be frank, the contract you are about to review doesn't solve the big problems facing our health-care system."

'Best that can be accomplished'

Despite the concerns, Dow and Milne recommend the contract is accepted.

"In the current economic and negotiating environment, your negotiations team and the board of directors believe that this deal is the best that can be accomplished."

The offer to doctors is similar to what Nova Scotia's government is offering other health-care unions: a four-year deal with no increases in the first two years and increases of one and 1.5 per cent in years three and four, respectively.

Some new money and few increases for services

There would be additional increases for some doctors on alternative payment plans such as family doctors and anesthesiologist, and there is new money within the clinical and academic funding plan to hire new doctors "based on requests that aligned with government priorities."

The contract would be retroactive to April 1, 2016 and expire on March 31, 2019.

There is $14 million in new money for services such as providing care over the phone and methadone management. Fees are also increasing for home visits, nursing home visits, maternity and newborn care.

The government will pay 90 per cent of doctors' liability premium above the deductible. Doctors who were forced to dig into their own pockets when fees jumped last year will be reimbursed if the contract is ratified.

Signalling the government's health-care plan

Certain terms of the deal appear to signal where the provincial government wants to go with health care.

The remote practice on-call program will be scaled back in the next two years and cancelled on April 1, 2018 — a move opposed by Doctors Nova Scotia.

Fees for walk-in clinics would also be reduced.

"Doctors Nova Scotia has steadfastly opposed this move, noting that while continuing care may be best for patients, in the absence of timely access to family physicians, walk-in clinics provide an important, necessary service to Nova Scotians," reads the message to doctors.

Incentive programs changed to fees

Doctors in the province currently get incentives to use electronic medical records, take on unattached and orphaned patients and work in collaborative practices.

The contract proposes turning that incentive-based system — currently capped at $13 million — into one based on fees.

"The transition to fee-based initiatives allows these investments to be uncapped (which means government bears the risk of cost increases as a result of higher uptake) and makes the funding easier to protect in future negotiations," the doctors wrote.

Voting takes place between June 11 and June 27, and neither the province nor Doctors Nova Scotia is commenting until after the vote concludes.

The contract needs more than 50 per cent approval to be accepted.

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