Bill 10, The Regional Health Authorities Amendment Act (Health System Governance and Accountability) was introduced by government to support system restructuring initiatives in an attempt to centralize and consolidate control in the health care system under the body now known as Shared Health. It is a large bill which contains a number of concerning issues for physicians. Most concerning is that as written, Bill 10 will strip physicians of a fair and transparent dispute resolution process in situations where the government is of the opinion a physician received an incorrect payment from Manitoba Health. In the attached government news release announcing the bill, you will see that physicians are explicitly targeted.
It is important to note Doctors Manitoba and its members do not object to government seeking recompense in the small number of cases where physicians have made errors in billing. Physicians, like all citizens in our community, believe the taxpayers of Manitoba should see value for their money, and any incorrect payment should be duly recovered. We take no issue with that.
History clearly shows, however, that auditors make errors, too. Bill 10 takes away a physician’s right to dispute the findings of an audit, and gives the minister an unfettered ability to collect monies declared by the minister to be owed by a physician. Currently a process exists whereby allegations of incorrect payment proceed through a dispute resolution mechanism, as contemplated in the Physician’s Manual and duly negotiated in the Master Agreement. Bill 10 would override this process, and give the minister complete power to compel repayment, without an opportunity for a fair hearing.
I am appalled by such draconian legislation.
In the early 2000’s, a similar law existed in Ontario, with dire consequences. The court in Ontario ruled the approach was wrong, and a former justice of the Supreme Court of Canada was tasked with reviewing the existing process. Mr. Peter Cory concluded the medical audit system had a debilitating and devastating effect on physicians and the patients they serve. The tyranny of unfair audits had a negative impact on the delivery of heath services, had a serious impact on physician health and wellness and undermined the province’s attractiveness as a place to practice.
Governments across the nation took heed of the recommendations of The Cory Report and amended their protocols to ensure fair processes were in place to resolve disputes.
The Board of Directors and Doctors Manitoba staff have been working with government on this matter since last spring when Bill 10 was initially introduced. We were given assurances verbally, and in writing, that the matter would be addressed. We were informed it was an “oversight” and that fairness would be repatriated into the bill. Indeed, it was on these assurances we agreed to continue our Master Agreement negotiations in the spring and summer of 2019. I am saddened to report these assurances were not honored. Minister of Health, Cameron Friesen, introduced Bill 10 in the legislature on December 2, 2019, and the language regarding the unfettered power of the minister to demand payment remains.
I want to state clearly that Doctors Manitoba senior staff have worked tirelessly with the minister’s office to resolve this issue since last March and as recently as yesterday morning. We have worked very hard to assist the Minister’s office in honouring the commitment made to us prior to the completion of the Master Agreement. We have indicated the willingness to meet anytime, and any place to work on reaching a mutually beneficial agreement. We have reached out dozens of times, provided a number of documents with wording that is fair and meets the needs of government and physicians. Unfortunately, the ball is not in our court. We remain committed and endeavor to meet with the minister’s office without prejudice in the hope of securing a fair, transparent solution. Doctors Manitoba continues to be available anytime of the day or night in an effort to resolve this issue, and we will work every day to ensure your right to fairness is protected.
Today, we are asking all physicians, fee for service and non-fee for service, to unite in opposing this discriminatory legislation. It will affect us all. Recognizing the inclusion of a fair dispute resolution process is an integral part of any allegation against a physician in Manitoba, we ask you make your concerns known to the Premier and to the Minister of Health. Click below to send your concerns.
Inform the Minister of Health and the Premier it is unacceptable to be stripped of your rights to a fair and transparent dispute resolution process. Make your feelings known about the implications of this provision in Bill 10, and request an amendment be made without delay.
If you want more information on Bill 10 and how it will affect you, please do not hesitate to reach out to us at firstname.lastname@example.org.
Dr. Fourie Smith