Quebec's 7000 specialists, who have been without a contract since March 2002, are pulling out all the stops in their battle with Health Minister François Legault.
“Our main goal is to close the remuneration gap [with doctors in the other provinces],” says Dr. Yves Dugré, president of the Fédération des médicines spécialistes du Québec (FMSQ). It says specialists earn 40% less than colleagues in the rest of Canada. The FMSQ wants $800 million in raises over 3 years; Quebec proposed another year of the old contract, and then offered a $140-million lump-sum payment. The FMSQ has turned it down.
The federation says Legault tried to pin the province's health care woes on MDs. It protested the introduction of Bill 114, which guarantees emergency services, and Bill 142, which dictates the terms of practice for all Quebec doctors. Despite calls to negotiate, Quebec passed a watered-down version of Bill 142. It no longer requires doctors to sign a binding contract of service, but it has the power to dictate where and how specialists practise. “It was as hard to accept as Bill 114,” says Dugré.
In January, Université de Montréal researchers reported that for every FP who leaves Quebec, 3 specialists leave. Between 1996 and 2000, more than 800 left. “French Canadian doctors are leaving Quebec, not only doctors from McGill,” says Dugré, who pegs the current shortage at 1000 specialists.
In November, December and January, the specialists staged 1-day study sessions and suspended all nonessential services to protest the impasse in negotiations. The specialists have stopped all unpaid administrative work, abandoned their teaching duties in undergraduate university courses and refused to work on government committees, whose responsibilities include long-term resource planning.
The FMSQ has implemented a plan to show the government how specialists want to practise, and all 34 member associations have established “ideal” practice standards. For Dr. Michel Jarry, president of the Quebec Association of Cardiologists, that means a “normal” work day, instead of seeing patients in the cardiac catheterization laboratory and doing rounds at Pierre Boucher Hospital in Longueuil from 7 am to 8 pm, without lunch or dinner. “Life has never been so good,” he reports. “We're not rushing patients through the system or straining ourselves to the limit.” — Heather Pengelley, Montreal