On Oct. 3, Doctors Nova Scotia (DNS) served the government Notice of Intention to ask the courts to settle two contract issues with the provincial government. Under dispute are government’s use of unapproved contracts for Alternative Payment Plan (APP) physicians and monies owed to DNS for physician’s health and dental and other benefits.
The association has been working to resolve these issues for 12 months. All doctors in the province could be impacted if the contract issues are not addressed.
Ultimately, DNS believes the government is in breach of contract with physicians.
Unapproved APP contract templates
In the past 12 months, the government has unilaterally deviated from the previously negotiated APP contract templates. In some cases, the government started to send “unsanctioned” contracts to physicians for signature (contracts that were not consistent with the approved APP contract templates). In other cases, the government started to ask physicians to sign solely a “deliverables” document with no accompanying contract.
Government took this approach without DNS’s approval or knowledge and, worse, without the knowledge of the physicians who were asked to sign the unsanctioned contracts and/or the deliverables documents.
Both the unsanctioned contracts and the deliverables-only approach expose physicians to unnecessary risk. Physicians could see some of their Master Agreement negotiated benefits refused – such as programs supporting professional liability insurance or continuing medical education, or the 1.5% annual medical services unit rate increase for 2018/19. It is also unclear what process is available to these physicians in the event that they are not in agreement with the government or the Nova Scotia Health Authority (NSHA) about the contract. Where there is no contract at all, government and the NSHA are also exposed to unnecessary risk (since, by way of example, neither the accountability mechanisms nor the notice/termination requirements are clear).
Government refuses to revert to the approved contracts. Doctors Nova Scotia has made every attempt to resolve this through discussion with the Deputy Minister and Minister, without success. Doctors Nova Scotia is now seeking resolution through the courts.
Contact DNS before you sign contracts
Doctors Nova Scotia has been advised that the Department of Health and Wellness (DHW) and the NSHA are having physicians sign unsanctioned APP contracts.
This puts physicians at risk.
In order to protect physicians’ interests, DNS is advising all physicians to contact the Physician Advisory Team before signing contracts and/or deliverables with the NSHA. The team will work quickly to mitigate any risk and ensure there is no disruption in care or physician payments.
Physician Advisory Team Lead and Compensation Manager
Physician Advisor (Zone 1)
Physician Advisor (Zones 2 and 3)
Physician Advisor (Zone 4)
In addition, in the last 12 months the government has not made any payments for physicians’ health benefits as agreed to in the Master Agreement contract. To date, the government owes DNS more than $4 million for these programs. These funds are used to support physicians’ health and dental plan, parental leave and the professional support program.
Without these payments from the government, Doctors Nova Scotia has had to deplete the contingency fund that enables us to maintain these important health programs for doctors. The government has taken exception to the association legally retaining a contingency fund for the benefits programs we administer under our contracts with government.
As part of good governance and a prudent fiscal management strategy, the Doctors Nova Scotia Board of Directors had built up a contingency fund over the course of several years, to ensure that physicians’ benefits are protected from changes in the political and health-care environments.Click here for a FAQs about this issue.
This is the first time in recent history that we’ve had to take such action. We did not arrive at this decision lightly. But we are committed to protecting members’ interests so that you can do what you do best: deliver optimal patient care.
Doctors Nova Scotia aims to resolve these contract issues in order to clear the air with the provincial government. Then, all parties will be able to move on to solve some of the health-care system’s more significant challenges, as outlined in Doctors Nova Scotia’s recent report “Healing Nova Scotia: Recommendations for a Thriving Physician Workforce.”