Physician job action nothing new
Ontario may have been the site of the latest extended dispute between doctors and government, but similar standoffs have occurred throughout Canada for more than 30 years and disputes are seldom far from the surface in different parts of the country.
The first full-blown strike took place in Saskatchewan, the home of medicare, during an organized protest against the introduction of public health insurance. In 1962, 90% of Saskatchewan doctors walked off the job and were replaced by doctors imported from Britain. The strike lasted 23 days.
In 1970, some specialists walked out in Quebec to protest the introduction of public health insurance. Ontario's most recent action began to boil up in 1996 after the provincial government announced it would cut its 9-year-old practice of subsidizing malpractice-insurance dues. In an effort to reverse the decision, obstetricians, who generally pay the highest insurance dues, threatened to stop delivering babies.
By the fall of 1996, obstetricians and orthopods had stopped accepting new patients, and they were later joined by some general surgeons and family physicians. The job action culminated with 1- and 2-day partial withdrawals of medical services.
The government eventually backed down and partially restored the subsidy. Last winter Justice Charles Dubin released a report on the malpractice issue that urged governments to continue carrying a portion of malpractice insurance costs, but not before further clashes erupted between the province and its doctors over pay issues.
The job action ended in January 1997, with the province eventually agreeing to spend $150 million to top up doctors' salaries and reduce clawbacks imposed on their billings by the previous government.
This latest confrontation came 10 years after Ontario doctors clashed with the then Liberal government over the issue of extra-billing. That often rowdy 25-day dispute, marked by highly publicized protests on the front lawn of the legislature, involved about 40% of the province's physicians.
Quebec has also been the scene of recent tension, in this case because of public-sector cutbacks. Last December, Quebec doctors staged a 1-day study session to protest the cuts. A proposed 6% fee reduction was postponed from January until July of this year. Quebec doctors also withdrew services during disputes in 1982, 1987 and 1991.
In Winnipeg, meanwhile, 5 of 7 hospital emergency rooms were shut down in 1993 and 1995, for 10 and 30 days respectively. Staff emergency-room physicians and pathologists withdrew services to protest pay levels and working conditions.
