If Alberta doctors ratify a proposed new agreement with the provincial government, the province pledges to reverse a controversial legislative change, say documents obtained by CBC News.
Neither the Alberta Medical Association (AMA) nor the province has spoken publicly since a late-Friday announcement the parties had reached a tentative agreement after nearly three years of tense relations.
An information package sent to doctors from the AMA and obtained by CBC News outlines the terms of that proposed agreement.
Included is a promise that if the government gives up its power to unilaterally rip up a contract with doctors — as the UCP government did in February 2020 — the AMA will drop a lawsuit against the province.
“The AMA lawsuit will only end once this legislation has been passed following agreement ratification,” the documents say.
The United Conservative Party government imposed a new agreement on doctors in April 2020 that changed how they are paid for their work and cover their expenses.
An attempt to negotiate a new agreement failed in March 2021 when Alberta doctors voted to reject the offer.
The AMA president at the time said a sticking point was the inability to take unresolved issues to binding arbitration. Doctors were also upset the government said it would withhold some of their pay if the province went over its annual budget for doctor’s billings, set at $5.5 billion this year.
The information obtained by CBC says doctors won’t be held responsible if their billings exceed that value.
It says the four-year agreement includes one per cent billing rate increases each year from 2022 to 2025 and a one per cent lump sum payment in 2022-23.
A new committee will attempt to negotiate doctors’ billing rates after 2025. Those rates could rise or fall depending on rates in other provinces, the documents say. The AMA and the government will negotiate compensation for the fourth year of the agreement. Either side can call for mediation and binding arbitration if they hit an impasse.
“This four-year agreement gives time for rebuilding relationships between physicians and Alberta Health,” the document says. “The agreement provides a structure for the parties to work through challenges, issues and disagreements that may emerge.”
Some terms to be negotiated later
The proposed new agreement would continue the stipends for doctors who work in Alberta Health Services facilities, such as hospitals, for two years. In 2019, the government proposed ending those stipends.
On March 31, 2020, the government stopped paying doctors when medical staff couldn’t identify an Alberta Personal Health Number for the patient. These are called “good faith claims,” and critics said the change could hurt vulnerable and impoverished people without health care cards.
The proposed deal now says doctors can bill for some good faith claims, retroactive to April 2022, through an application process.
The government also capped the number of patients most doctors could see per day to 65, which it said was for safety reasons.
The agreement would commit a committee to conducting an expedited review of that policy within 60 days of ratification.
The deal would also punt other points of contention before joint committees and panels, pushing resolution further down the road. That includes decisions about how much doctors should be paid for virtual mental health care, and how to handle future stipends for specialists working in hospitals.
Neither the government nor the AMA was answering questions about the proposal on Monday.
In a public letter Friday, AMA president Dr. Vesta Michelle Warren said the organization’s board strongly recommends that doctors vote in favour of the offer. Voting starts Tuesday and runs until Sept. 28.
“We share the same goals of stabilizing the health system including the physician practices that are part of infrastructure and targeting other areas of concern,” Warren said in a joint statement with Health Minister Jason Copping on Friday.