(Quebec) “Scalded by the slowness of the machine,” the Fédération des médecins spécialisé du Québec (FMSQ) is asking the Legault government to begin negotiations as soon as possible and to accept arbitration from the outset in the event of an impasse.
What you need to know
The 10,000 specialist doctors must renew their framework agreement with Quebec, which is worth five billion dollars per year.
Their federation is growing impatient and is demanding the start of negotiations.
She is asking Quebec to immediately accept recourse to arbitration in the event of an impasse.
The agreement between Quebec and the FMSQ, which governs the $5 billion per year in remuneration for 10,000 specialist physicians, expired a year and a half ago. Negotiations to renew it are dragging their feet. “We’re starting to tap our feet,” says the president of the FMSQ, Dr.r Vincent Oliva.
The stalled negotiations between the government and the Fédération interprofessionnelle de la santé du Québec (FIQ) are fueling his concern. Premier François Legault said that these talks and those with family doctors were “very difficult.” He does not expect to resolve them before Christmas.
PHOTO PATRICK SANFAÇON, LA PRESSE ARCHIVES
The president of the FMSQ, Dr.r Vincent Oliva
Under the circumstances, the FMSQ sent a letter to the Treasury Board this week, a “notice of negotiation,” to request the start of discussions.
“In this notice, we also ask that there be a dispute resolution mechanism, in other words an arbitration mechanism. We want to ensure that these are negotiations that will not drag on, because we see with other organizations that negotiations do not come to anything. Having an arbitration mechanism, in a way, forces the parties to agree because we do not want to go to arbitration. So, it is to ensure that the process will be quick.” This arbitration would be “enforceable,” he specifies.
He maintains that the FMSQ is not making this request because it fears that the government will eventually consider resorting to a special law. The federation is especially “scalded” by the “extremely painful” and “slow” discussions with Quebec concerning various issues over the last few years, he explains.
He accuses the government of not having reinvested in the network the entire $1.6 billion over four years that it sought from the compensation envelope for specialist physicians under an agreement concluded in 2019. Let us recall that this agreement was the result of a compromise: François Legault had then renounced his electoral promise to reduce their compensation by $1 billion per year.
Access to services
On August 27, Quebec submitted an initial offer to the Fédération des médecins omnipraticiens du Québec (FMOQ), which must also renew its framework agreement. The government wants to review the patient care model and entrust other professionals with acts currently reserved for doctors. It intends to “optimize” their $3 billion in compensation, which is not producing the expected results, “before even thinking about discussing” whether or not to grant increases.
After having caught up with its counterparts in other provinces in terms of salaries, the FMOQ now wants to close the gap with Quebec’s specialist doctors.
For its part, the FMSQ refuses to talk about compensation for the moment. “The financial framework is already complex enough as it is, we don’t want to discuss it in public,” says its president. “I don’t want to get involved in a war of numbers. We’ll get there in due time with the government.”
Portrait of the remuneration of a specialist doctor, in 2021-2022*
Average gross clinical payment: $404,593
Full-time equivalent compensation: $458,651
Canadian average full-time equivalent: $462,700
*According to the most recent data from the Canadian Institute for Health Information (CIHI)
The government suggests that a first offer will be made to the FMSQ in the coming weeks. Quebec’s priority: improving access to specialist medical services in order to reduce waiting lists.
Both sides agree on at least this point. “The theme of our negotiation will be access, because we want the population to get value for their money,” says D.r Olive.
The Minister [Christian Dubé] said that patients don’t get value for their money, we tend to agree with that.
The Dr Vincent Oliva, President of the FMSQ
The problem, according to Dr Oliva, it is a bad “organization of care” in the health system which, for example, prevents specialist doctors from performing more operations.
There is thus an “urgency” to renew the contract with the government. “What we want is for doctors to be able to get to work more because there are waiting lists everywhere,” argues Dr.r Oliva: The network continues to deteriorate, and this deterioration has accelerated in recent years. It is not the quality of care that is in question, it is access.
The “preliminary discussions” with Christian Dubé were conducted in a “tone of partnership and collaboration.” And the FMSQ says it hopes it will remain that way. “We hope the negotiation goes well. We don’t want any psychodrama.”