To:

Dr. Sarah Newberry
President
Ontario College of Family Physicians

- And -

Dr. Mike Toth
President,
Ontario Medical Association

Dear Drs. Newberry and Toth,

As you both are aware, the current situation between the Ontario Medical Association (OMA) and the Ministry of Health and Long Term Care regarding the Physicians Services Budget continues to be at an impasse. It has now reached the point of litigation, with the OMA rightfully insisting that the Ontario Government respect the Charter Rights of its members. Of course, barring some unexpected event, it will take years for this to work its way through the Judicial System. While this process unfolds however, we know from history that we are faced with declining morale in the medical profession, and the real threat of a net loss of physicians in Ontario, as was witnessed in the 1990’s, under remarkably similar circumstances. As you are both aware, a net loss of physicians, and declining physician morale is ultimately bad for patient care, and real harm will come to the patients of Ontario. Sadly, this fact is currently unappreciated by the Ministry of Health.

In the midst of this, the Ontario Government has been either releasing on hinting that it is going to carry on substantial changes to Health Care delivery in Ontario. It has been referred to in certain circles as a “Transformation Agenda”. This has been hinted at by the release of what’s commonly referred to as the Price Report, and also by the stories in the Toronto Star indicating that CCAC may be rolled into the LHIN’s, and reports in the Globe and Mail suggesting that Health Care will be overhauled. We know none of this is news to you. We also know that you, as leaders of your organizations, will be asked to participate in the implementation process for these changes. Undoubtedly, you will be told that these processes will be implemented with or without your help. Phrases such as “first in gets the win” will be mentioned, along with statements implicating that other professionals (eg Nurse Practitioners) will then guide the process if physicians don’t get involved. There will, as usual, be promises of having “a say” in the way Health Care is “transformed” as physicians voices are "valuable”. There will of course be what are essentially threats that the change will happen without physicians input if necessary and that more harm may come to us as a result.

We the undersigned, feel that in order to protect the Health Care needs of Ontario Residents, the first step has to be the implementation of a fair negotiations process that respects Ontario Physicians Charter Rights. This is absolutely paramount, and in our opinion, there can be absolutely no improvements to Health Care in Ontario until this issue is resolved. Front line patient care depends on having physicians who feel respected, and are therefore engaged. We reject the belief that the “Transformation Agenda” can happen in any way shape or form, without the co-operation of Ontario’s Physicians. We don’t believe government threats that these changes can happen without our input. If they do try, it will be a disaster, and full blame for the failure will be on the government, not us.

To that end, we respectfully request that the both the OMA and the OCFP cease to co-operate with the Ministry of Health in ANY of their Transformation Agenda items. The OCFP recently sent out an email in which it stated "As the OCFP meets at various policy and planning tables on behalf of members, we will continue to reiterate the importance of engaging family physicians.” While we support that it is important to engage Family Physicians, we feel that only applies in a healthy bilateral relationship, which currently doesn’t exist. Similarly, the OMA has a number of positions on government policy and planning tables. We feel the same way about those. Please remove all members from these committees. Please tell the Government on behalf of your members that you will not co-operate in these endeavours until there is a fair process for Physicians Negotiations.

Yours truly,