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BC Doctors Urged to Reject the 2012 Physician Master Agreement

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Vancouver, BC - July 3, 2012 - Z. Essak, MDReject 2012 PMA

Doctors across British Columbia are being asked to ratify a new Physician Master Agreement (PMA) by July 23, 2012 between the Government and the BC Medical Association.

I am a doctor who has read the new agreement and I am urging all BC doctors to look at the agreement and to reject it. The deadline is fast approaching for doctors in BC to vote on this important matter.

I am a member of the BCMA and I served on the BCMA for ten years from 1993 to 2002. I served on the BCMA Board of Directors for five years and on the BCMA President's Committee, the Council on Health Economics and Policy (CHEP), the Deputy Minister of Health's advisory committee and was chair of the BCMA Regionalization Committee examining health care reforms when three critical issues were identified:

  • changes could lead to further growth in administration
  • could negatively impact delivery of patient care
  • medical input to health care was being diminished

The current Referendum package sent by the BCMA to doctors does not include a copy of the agreement but only a Highlights document and a President's Letter recommending members accept the agreement. To see the agreement doctors must download it from the BCMA website or request it through email.

The agreement is a whopping 205 pages. How many doctors will have the time to read such a big, complex document?

Some BCMA Board directors when asked said they received a presentation on the PMA but have not read the agreement themselves? How can they advise their members to accept an agreement they - themselves - have not even read?

Doctors across the province need to reject this agreement for the following reasons:

  1. Excessive growth in administration and bureaucracy
  2. Lack of "fair representation"
  3. Centralization of power and control in our health care system

1. Excessive growth in administration and bureaucracy

Every year the BC Government spends $1.39 billion on health care administration and the administration budget has increased by $303 million (28%) in the last 3 years. Imagine how many doctors and nurses we could have hired with that money?

We are now spending almost as much on administrators and managers as we pay for all physician services. The public is told to believe health care costs are going to continue to rise beyond the ability of government to pay. This is nonsense. It's time to stop this tax train.

Do we really need as many administrators and managers as we do physicians in health care?

Health care providers trying to make changes are faced with red tape and bureaucracy. Doctors are tired of this; we are trying to provide care to patients. This is having a negative impact on health care across the Province. You hear of examples every day.

There are many ways we could make the health care system more efficient if the Government and the BCMA would focus on patient care rather than administration and simply listen to those providing care.

Instead, the PMA increases the funding and size of joint committees and further fuels the growth in bureaucracy on many levels.  Not just in negotiations but also within government, the BCMA itself, Health Authorities and co-management. This is money that should be going to the delivery of patient care.

2. Lack of "fair representation"

In the new PMA, as in previous agreements, the BCMA and the BC Government agree to let the BCMA represent all doctors in the Province whether or not they are members of the BCMA.

The BCMA wants the right to represent all doctors yet makes no effort or allowance to let all doctors vote on the agreement. Only BCMA members can vote. This is not right.

At the very least, the BC Government and the BCMA have a moral if not legal responsibility to ensure all doctors can vote on this agreement whether or not they are members of the BCMA.

Furthermore, the Highlights document does not provide a "fair representation" of the financial aspects of the PMA.

The Highlights document tells of money that will be available but not once does it mention the money not spent during the previous PMA. Money that is being recycled and money that is being held. If the system really worked and was functional the money would have been spent on delivering care and patients would not be waiting so long for care.

The Highlights document also does not mention the funding and increases for the "Committee Structure and Roles" detailed on page 4 of the document.

Under this agreement more health dollars will be diverted into administration, management and bureaucracy. How does this make sense?

3. Centralization of power and control

The new agreement includes further centralization and control in our health care system. All information that is available to the public will be controlled by the Physician Services Committee (PSC). The new agreement essentially muzzles health professionals, requiring permission from the PSC for all communications.

The PSC is headed by Graham Whitmarsh, the Deputy Minister of Health and Allen Seckel the new BCMA CEO who was previously Deputy Premier to Gordon Campbell.

In essence, the public will have no right to know how $4 billion of their tax dollars are being spent.

Doctors will not be able to speak up and raise concerns with the public about health care in this province.

Author Eli Sopow wrote that some organizations in trouble use the 3D defense; Deny there is a problem, Delay doing anything about it, and Discredit or destroy those who speak out.

We see Government doing this and we've seen the same from the BCMA.

It isn't the way to go. British Columbians deserve better.

As doctors we must stand up for patient care and the medical profession and say, enough is enough. We take our oath seriously and refuse to be muzzled by bureaucrats and lawyers.

With the July 23 deadline for Referendum ballots to be returned fast approaching it's time for all doctors in the Province to vote and reject the 2012 Physician Master Agreement.

The 2012 PMA is long-term pain for everyone - patients, doctors, and all taxpayers.



Your Last Call to vote against the Physician Master Agreement

Dear Physician Colleagues,

This is your last call to vote on the Physician Master Agreement (PMA).

If you want your day-to-day struggles of caring for your patients to improve, then say NO to this agreement.

Like many of you, I feel strongly that the current state of our health care system is simply unacceptable, and our association has failed in its mandate to advocate on our behalf for improvements.

Last night, many of us received the message appended below from Drs. Webb and Busser, who ran for positions on the BCMA Board and Executive under the banner of Doctors for a Democratic Future;

They also proposed and led the nearly-successful bylaws referendum on term limits, and complained bitterly about the BCMA Board's undermining of the initiative (e.g. by providing voting doctors with only the Board's opposing view to the change).

It is ironical that these same colleagues are now defending the BCMA Board for sending out the PMA referendum with only the Board's glossy-eyed one-sided views of the agreement. They suggest we hold our noses and vote for the PMA, and focus for now only on reforming the ineffective and undemocratic BCMA leadership structure.

To me, the dysfunctional BCMA leadership structure is the problem and is yet another reason to vote against the PMA, not to vote for it! Why? Because they did not really negotiate effectively for us. This PMA should go back to the drawing board.

The proposed PMA, amongst many other concerns, will further centralize powers within the Physician Services Committee, a body that would have at best two out of six positions filled by doctors. How is this helping to fix the leadership vacuum coming out of the BCMA ?

Let's reject this agreement. The 2007 PMA would still be in full force and effect.

Then we could work on negotiating a better agreement that actually starts to fix the problems we all see as we treat our patients every day.



General Surgeon, Burnaby