The FMSQ's Reaction to the Leitao Budget : An Effort Imposed on Medical Specialists

Montreal, June 5, 2014 – Within the framework of the task undertaken by the Couillard government to balance the budget, medical specialists have pointed out their willingness to voluntarily contribute to the effort of straightening out public finances. The Fédération des médecins spécialistes du Québec (FMSQ) thus responded affirmatively to the government's call by accepting a deferral of sums despite the fact that provisions for these have long been a part of the 2006 and 2010 Agreements.

The willingness of medical specialists to collaborate was demonstrated by intensive negotiations and the presentation of four offers to the government. "We proposed to spread out our Agreement with the government which would result in important savings during the period crucial to reaching the target of a reduced deficit," explained the President of the FMSQ, Dr Diane Francœur. Every one of the FMSQ's proposals was refused by the Minister of Health who instead is asking for the deferral of almost all the investments projected for specialized medicine. "The Minister's proposals to defer these investments as a whole, initially over 15 years until 2029, then over 10 years until 2024, represent a disproportionate effort on the part of medical specialists," continued Dr Francœur. "To keep on postponing the agreed-upon investments, would mean relegating the responsibility for respecting these commitments to future governments."

Having already accepted to spread over 10 years the payment of the sums included in its Agreement, which was signed in good faith, the Federation – already three governments later – wants to avoid relegating to still other governments the costs of investments in specialized medicine agreed upon since 2006.

The Federation considers it would have been preferable, and wholly possible, to arrive at a negotiated agreement before the budget was presented. "Contrary to the deadline specified by the Minister of Finance, we were surprised to hear the Minister of Health declare, on the eve of the budget, that the race we had been running, these last two weeks, was no longer pertinent and that discussions could continue until the stage of analyzing credits," said the President. "We now better understand why, despite our various exchanges, the Minister of Health waited until the eve of the budget to start discussing seriously the parameters looked for. Moreover, we never learnt the exact monetary value of the effort expected from physicians by the government. We found out what it was by familiarizing ourselves with the credits that will be allocated to the department of health and social services for 2014-2015."

The credits, tabled yesterday with the budget, indicate that an amount of $255 million has been cut from Medical Services under Program 4 – Régie de l'assurance maladie du Québec. For the President of the FMSQ, the fact that this sum was included as a budgetary credit certainly does not indicate a willingness to negotiate. "All the amounts that are due to us in 2014-2015 have already been deducted. We are ready to contribute voluntarily to the budgetary effort, but we cannot accept that a result is being unilaterally imposed on us."

Moreover, we notice that the budget announces an intention to limit the growth of healthcare expenses to 3.0% in 2014-2015 and 2.7% in 2015-2016 and forecasts an overall freeze on manpower in the public and parapublic sectors. The FMSQ is of the opinion that, while improvements are certainly possible within the network, pressure on the public system will be substantial. Insisting on the fact that the healthcare system is more than numbers and columns, the Federation invites the government to be prudent. "Before cutting back resources dedicated to direct services and care for patients, the government should look at its levels of bureaucracy and undertake to clean up certain programs that are too generous for our means, like the medically-assisted reproduction program."

In spite of the fact that it was not invited to take part in the pre-budgetary consultations, the FMSQ still presented a white paper (available on the Federation's portal at fmsq.org) on May 23rd to the Minister of Finance. The proposals it contains could generate hundreds of millions of dollars for the government, or even more. The waste and the inadequate management of healthcare institutions, as well as slimming down and eliminating heavy and inefficient structures, are pathways that can generate important savings within the healthcare network alone. The FMSQ intends to keep a very close eye on the government's actions in this respect.

"We do want to help and we will continue to negotiate, but the financial fate of Quebec is not the sole responsibility of physicians," concludes Dr Francœur.

The Fédération des médecins spécialistes du Québec represents close to 10,000 medical specialists certified in one of the 53 recognized medical specialties.