May 26, 1999
(Health and Community Services)

The following statement was issued today by Joan Marie Aylward, Minister of Health and Community Services. It was also read in the House of Assembly:

I stand today to inform members about an agreement which has been reached with emergency room doctors in St. John's. After some weeks of discussion, a decision has been reached to pay emergency room physicians using a block funding model which provides for base rate compensation of $88 per hour. This requires no new funding and is cost-neutral. These physicians gave up their right to bill on a fee for service basis providing some of the savings required. Additionally, money saved through reduced hours at the Grace Hospital Emergency Room is also available to provide for a second physician during peak hours at the remaining emergency rooms in St. John's.

The Newfoundland and Labrador Medical Association (NLMA) was fully involved in discussions regarding this issue with the Department of Health and Community Services, the Health Care Corporation of St. John's and the emergency room physicians. However, there was some disagreement as to whether or not there was sufficient money to cover the block funding arrangement. This eventuality is covered by a clause in the physician MOU which provides for a mediated dispute resolution process.

The NLMA was in fact informed two days in advance of the decision being taken through a telephone conversation between our medical consultant and the executive director of the NLMA. We followed that up with a letter on May 14 and also copied the NLMA a letter which we sent to the St. John's Health Care Corporation informing that organization of the decision. Emergency room physicians represented by the NLMA indicated agreement with this move.

This arrangement will help to stabilize the system as it provides the doctors with a cost-neutral solution and it allows for additional emergency room physicians during peak times.

Doctors salaries are varied depending on services offered, complexity of cases and volume of work. In St. John's, for example, emergency room doctors at the Janeway Hospital currently, on average, receive more than the $88 base rate. Throughout the province some doctors have received more than $100 per hour depending on their individual situations, the volume of patients, the complexity of service provided and their choice to be paid on a fee for service basis or an hourly rate.

We have received plans for several different compensation schemes from doctors throughout the province and they have also put forward some creative alternate service delivery models. We have said we will be flexible in looking at all offers from our physicians which are cost-neutral and we continue with that commitment to ensure the best possible health services for the people of the province.

1999 05 26         3:40 p.m.