HALIFAX -- Nova Scotia doctors are threatening to take the province to court, saying alleged contract breaches by the Liberal government have eroded the goodwill needed to fix a fragile health-care system.
"We're trying to recruit doctors ... what we need is an atmosphere of trust that allows doctors to say, 'Nova Scotia is a place I can go and I'll be respected,"' Dr. Andre Bernard, chairman of Doctors Nova Scotia, said Monday.
The organization gave the province legal notice Tuesday of a lawsuit asking for over $4 million and a restoration of contract provisions it says were being dropped without its knowledge.
One dispute is tied to agreements with about 200 doctors who get a fixed payment to provide a suite of services, often in rural areas.
The doctors' group said the Health Department recently provided agreements to 16 physicians that dropped clauses recognizing Doctors Nova Scotia as their bargaining agent and cast in doubt a dispute resolution system and liability insurance provisions.
Doctors Nova Scotia says it is also upset that the province isn't agreeing to restore over $4 million it drew from a contingency fund for its health benefits and dental plan.
Nancy MacCready-Williams, chief executive of Doctors Nova Scotia, said over the years, the professional association set aside money for the fund in case the province refused to continue funding its portion. The program includes a health and dental plan, a support program for doctors experiencing stress, family and dependency issues, and a parental leave program.
Randy Delorey, the health minister, said in a news conference that the government viewed the money in the contingency fund as "taxpayers' money" that built up due to an earlier deal with doctors.
The arrangement provided Doctors Nova Scotia with set payments which proved to be higher than the actual costs of the benefits plan, he said.
"I believe this is a dispute with the organization, but not directly with the province's physicians. ... this is a dispute around a surplus fund of taxpayer dollars being held by a third party organization," he said.
Delorey says a new master agreement with Doctors Nova Scotia says auditors from both sides would get together and assess how much of a surplus, if any, should be held by the physicians.
The doctors' group said the province shouldn't have ceased making payments before the auditors had met, but Delorey said that's not the advice his lawyers gave him.
As for the dropped clauses in some of the rural doctors' agreements, Delorey said he had meeting with the doctors' group in August and "my takeaway from that meeting is both sides agreed to sit down and move forward ... and I believe those concerns can be worked out."
The tensions between Doctors Nova Scotia and the Liberal government are occurring at a delicate time for the province's health system, with Premier Stephen McNeil facing criticism over a shortage of family physicians, hospital crowding and long wait times for surgeries.
As of Sept. 1, 35,777 people -- about four per cent of the population -- have registered online or by phone with the Nova Scotia Health Authority's Need a Family Practice registry, indicating they do not have a primary care provider.
The health authority says about 1,700 people on the agency's registry have been accepted by family practices and over 4,400 individuals who have added their names to the registry have had them forwarded to practices.
Meanwhile, Statistics Canada figures from last year suggest the total number of citizens over 12 years of age without a regular medical provider was 83,300, if you include those who haven't signed up on the registry.
That survey estimate doesn't include some remote areas, members of the Canadian Forces and residents of First Nations.
MacCready-Williams said this year should be a time for doctors and the province to work together on solutions, rather than battle in the courts.
"We settled on a contract last year so we shouldn't be having these difficult conversations in terms of trying to implement our contract. We should be in a time of peace and harmony," she said.
Both opposition leaders said Tuesday that the legal dispute is the latest sign the Liberals are doing a poor job overseeing the health system.
"The government should keep its word. When they sign an agreement, the agreement should mean something. This is a calamity for doctor recruitment and retention," said Progressive Conservative Leader Jamie Baillie.
NDP Leader Gary Burrill said "the government simply doesn't have a handle on the matter."