Sunday, April 04, 2021

How the Alberta doctors' contract dispute could impact the UCP government now and in the 2023 election

Ashley Joannou 
4/2/2021

© Provided by Edmonton Journal (left to right) Health Minister Tyler Shandro and Premier Jason Kenney take part in a press conference where they provided an update on the distribution of COVID-19 vaccines through participating community pharmacies, in Edmonton Thursday March 18, 2021. The press conference was held outside the Shoppers Drug Mart at 5970 Mullen Way.


Tuesday’s decision by Alberta doctors to vote down a proposed master contract with the provincial government has thrown the already contentious relationship back into the fire.

After taking more than a year for the government and the Alberta Medical Association to reach the deal that doctors quashed, both sides are on their way back to the bargaining table. Political watchers say the longer the dispute drags on, the more it could influence other government contract negotiations on the horizon — and the 2023 election.
What are the obstacles?


Fifty-three per cent of doctors who voted said no to the deal.


The proposed contract gave Health Minister Tyler Shandro final say on budgetary decisions, University of Calgary health law professor Lorian Hardcastle, who has seen the rejected deal, said. While doctors understood the minister would have significant power, she said “a lot of people were concerned specifically how he would use that discretion.”

That mistrust has grown over the past year and throughout the pandemic. It began in February 2020 when Shandro ended the province’s master agreement with doctors and unilaterally imposed billing and compensation changes, in the name of fiscal responsibility and aligning Alberta’s costs with those of other provinces. Many of those changes were rolled back.

Doctors have said the numbers the government uses is not their take-home pay and does not account for overheard costs of running an office.

Shandro has also faced criticism during the conflict for his behaviour away from the bargaining table. In March 2020, he shouted at a doctor in his driveway over a social media post, and in April 2020 he contacted doctors on their personal phones.

Over the past year, some doctors have either left or threatened to leave the province, and the association sued the government over the ripping up of the contract.

Hardcastle believes the deal could have been ratified if it was being managed by someone other than Shandro.

Premier Jason Kenney has backed his health minister throughout the fight and on Wednesday said Shandro has his “full, 100 per cent confidence” amid calls to shuffle him out of his post.

Melissa Caouette, a political strategist and vice-president of business development and government relations at Edmonton’s Canadian Strategy Group, said the government may be reluctant to change the face of their negotiations mid-stream.

“I think that it could be interpreted that switching the person who’s dealing with those is sort of a signal that they’ve changed their mind on their stated desire to bring public sector compensation in alignment with other provinces, which is still a goal for them,” she said.

Duane Bratt, a political scientist at Mount Royal University, said Kenney could also be afraid of what shuffling Shandro out would signal to other negotiating groups.

“The next labour people are going to go well, if I’m the ATA, and I don’t agree to a deal with (Education Minister Adriana) LaGrange, is Kenney going to shuffle her out?” he said.

© Jeff McIntosh/The Canadian Press/File Alberta Health Minister Tyler Shandro has been at odds with doctors since he ended the master agreement for physicians in Feb. 2020.


More than one health-care bargaining table

Doctors aren’t the only ones in the medical community negotiating with the government.

Shandro also announced last year that he was scrapping the government’s deal with radiologists. The recently extended contract now ends in September.

Last month, Alberta’s largest nurses union, the United Nurses of Alberta, rejected a proposal to delay bargaining until June, which the government blamed on the pandemic.

Caouette said the loss to doctors makes those negotiations even harder for the government.

“Physicians are supposed to be the easiest historically to have these conversations with,” she said.

“I think that other groups are going to see what’s happened here, see (that) they can drag the fight on for a long time and I would imagine that some of those folks are going to hope to drive those conversations on and make this an election issue.”

Hardcastle said she could see having multiple organizations negotiating with the government at the same time embolden those groups to push and ask for more “because they’re not the only ones pushing back.”
Election 2023

With the government midway through its four-year term, Caouette said the doctors’ contract could be at risk of becoming an issue in the 2023 election.

“I think if it does persist, if there isn’t an agreement, it is going to have worse of an impact on the government than it does on physicians, especially if we are still in a state of heightened public health concern with the pandemic,” she said.

The striking down of the contract comes as the UCP government’s popularity slides.

In March, researchers with the University of Alberta and the University of Saskatchewan’s Common Ground project found that UCP support has swung significantly and directly to the NDP for the first time since the party was formed in 2017.

The poll found NDP support at 39.1 compared to 29.8 per cent for the UCP. Researchers noted that two other polls in the field at the same time also had the NDP significantly ahead.

Health care and education are two key areas voters care about come election time, Caouette said, and any uncertainty in those files leads to uncertainty amongst the electorate.

In rural Alberta — a key region for the United Conservative Party’s base — the link between physicians and their community may be stronger than in urban environments, she said.

“If we are in a situation where family physicians in rural Alberta are making a decision to leave, or perhaps scaled down or shut down their practices because of economic concerns, it’s definitely going to be something that the base is worried about,” she said.

To date, the government has denied doctors are leaving the province, saying its numbers show a net increase.
Now what?

While there’s no hard deadline for when a new contract has to be in place — doctors could continue with the status quo indefinitely — the uncertainty of working without one could have an impact on the province’s health-care system.

“It’s uncertainty for perhaps new graduates who may look at what’s happening and say, ‘I would like to work in another part of Canada versus Alberta.’ It is uncertainty for existing physicians who might be having some of the same thoughts as well,” Caouette said
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© David Bloom (left to right) Health Minister Tyler Shandro and Premier Jason Kenney adjust their face masks as they take part in a press conference where they provided an update on the distribution of COVID-19 vaccines through participating community pharmacies, in Edmonton Thursday March 18, 2021.

When it comes to getting back at the table, Hardcastle said the government seems unlikely to budge on two specific issues in the proposed contract that irked doctors: the end of binding arbitration, and the placing of a cap on physician compensation that would allow the government to withhold payment if the budget were exceeded. But there may be wiggle room with other points, such as potentially more consistent virtual care funding or a stronger grant program, she said.

When asked whether the government might try and impose a contract on doctors as they continue to butt heads at the bargaining table, Hardcastle said the status quo already gives government significant power.

Bratt believes that reading between the lines of the MacKinnon Report — commissioned by Kenney in 2019 to examine Alberta’s finances — offers a path where the government could impose contracts using Canada’s notwithstanding clause.

The report does not explicitly make that suggestion. It concedes that the “Supreme Court of Canada decisions on collective bargaining have limited the power of governments to set aside or impose collective agreements.”

However, it says legislative mandates can be used not as an ongoing way to conduct collective bargaining but “in exceptional circumstances such as the current situation in Alberta where the government has committed to balance the budget by 2022/23.” Since the pandemic, the government has backed away from that timeline.

The report later mentions that Saskatchewan used the notwithstanding clause in 1986 to overturn a court decision on labour relations.

“And so you negotiate” Bratt said. “If that doesn’t work, then you impose. And if it goes to the courts, well, we’ll take it to the courts. And if the courts ruled against us, then you use (the notwithstanding clause)."

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