Thanks to Wall government, PAIRS negotiations stalled for over 20 months; parity with Alberta resident physicians recommended

Just over a year ago, the StarPhoenix carried an article about life as a medical intern inside an emergency room as part of National Resident Awareness Day.

Real-life trauma at Saskatoon’s Royal University Hospital is managed largely by residents, especially during overnight care when residents are often on the front line. When patients arrive at the teaching hospital, the first doctor they see is usually a resident. Medical students do not automatically become physicians upon graduation and must spend between two and six years as a resident before becoming an independent physician, the story said.

The following are some of the conditions Saskatchewan interns work under:

▪ A doctor in the third year of training as a resident has an annual salary of $57,207.

▪ A resident doctor in Saskatchewan is allowed to work more than 24 hours once every four days.

▪ Residents are paid $100 to work a 24-hour in-hospital call shift from 8 a.m. Saturday until 8 a.m. Sunday.

▪ Residents have no scheduled rest or meal breaks.

▪ The average resident works 80 hours per week.

▪ A resident walks more than 10 kilometres during an average shift.

The Professional Association of Internes and Residents of Saskatchewan (PAIRS) represent more than 340 physicians in training in the province.

Residents are both employees and students of the University of Saskatchewan. PAIRS negotiate terms of their contract with the university. The Ministry of Health, which funds the contract, has the final say on what the U of S can offer.

The members of PAIRS have been without a contract since December 31, 2008.

The Saskatchewan Party government says physician recruitment and retention is a high priority, and that it values the important role that post-graduate residents play in meeting the needs of Saskatchewan people. At least that’s the message health ministry officials are peddling in briefing notes on the matter.

In response to an access to information request submitted in February, the health ministry recently released six briefing notes totalling fifteen pages. Three of the records were heavily censored. Another eight briefing notes totalling twenty-four pages were withheld in their entirety. Obviously, there are things that the Wall government does not want the public to know.

Despite the extreme secrecy, some details have emerged.

The records show that the Wall government stalled negotiations for more than 20 months.

A briefing note dated September 27, 2010, states that PAIRS and the U of S had not met since March 2009, after PAIRS submitted their proposals to the U of S.

“The PAIRS and the U of S are anxious to resume negotiations. Negotiations have been postponed pending an approved bargaining mandate from Cabinet. The Ministry is in the process of finalizing a Cabinet Decision Item (CDI),” the document says.

Subsequent briefing notes show that the U of S and PAIRS finally resumed negotiations late last year after receiving the Wall government’s mandate.

The U of S and their contracted negotiator, Greg Trew of Claymore Consulting, met with PAIRS on December 15, 2010, where PAIRS provided a counter-offer.

The negotiating teams met again on February 3 and 14, 2011.

A briefing note dating back to April 28, 2010, indicates, “PAIRS has requested wage parity with the SUN agreement; however the University of Saskatchewan is instead recommending parity with Western Canada, specifically Alberta (PARA), which is 11.48% higher Saskatchewan’s 2008 rate.”

Ministry officials say physicians who relocate, tend to move to Alberta or B.C.; therefore, competitiveness is a strong consideration.

A December 20, 2010, briefing note includes a table showing a comparison of salaries for Ontario and Western provinces. Unfortunately, details of the government mandate immediately following are blacked out.

News reports suggest that what the U of S (i.e. provincial government) has been offering doesn’t come close to parity with Alberta.

At a meeting on January 13, 2011, PAIRS members voted overwhelmingly to reject the Wall government’s latest contract offer, which the organization said was no different than the initial offer and did nothing to address the low salaries of residents working in the province.

PAIRS president Dr. Marilyn Kinloch told reporters at a news conference that the government also refused to include retroactive pay in a new contract.

“It’s an absolute mandatory piece of the contract,” Kinloch said. “(Members) will not sign a contract without retroactive pay.”

Kinloch said the two sides have made progress on non-monetary issues, but the employer has refused to budge on salary issues, the StarPhoenix reported.

In the article, Barb Daigle, the U of S associate vice-president of human resources said the university’s strategy is to be competitive with all medical-doctoral schools, not just the one that offers the highest salary. That means the U of S is aiming to rank among the 75th percentile in salary, she added.

However, that’s not what the health ministry briefing notes seem to be saying. These documents clearly show that the U of S is recommending parity with Alberta. Since the cost of living has increased since 2008, the U of S will have to do better than 11.48 per cent in the short-term.

Last year, 26 out of 59 University of Saskatchewan medical graduates stayed in the province for residency programs, which is the lowest rate in Canada, according to PAIRS, the StarPhoenix said. At 34 per cent, Saskatchewan has the highest rate of unmatched residency spots in Canada, PAIRS says. The national average is 10 per cent. [Medical residents reject gov't contract offer (StarPhoenix, January 15, 2011)]

The StarPhoenix editorial board criticized the Wall government’s stance on retroactive pay: “The government’s objection that PAIRS is seeking retroactive pay for persons who no longer are residents or who have moved on to other institutions is an odd rationale, to say the least. Such a justification, if it stands, would reward the government for dragging on the talks for as long as possible, and any settlement would apply only to those specialists-in-training who might take longer to qualify.

“The fact that others put in the long 24-hour-a-day, weeklong shifts at pay rates that can be as low as $10 an hour for serving as front-line doctors in hospitals, seems not be a consideration. Surely, they deserve back-pay if a subsequent contract deems their work to be more valuable, especially since the deal could have been reached while they were on the job except for foot-dragging over issues such as their salaries.” [Fair PAIRS deal needed to beat doctor shortage (StarPhoenix, February 14, 2011)]

According to Daigle, the latest contract offer from the U of S was tabled February 14, 2011. Negotiations are “complex” because of the number of parties involved, she said.

“It’s a challenge when we’re not necessarily the ones making the financial decisions,” Daigle said. “The offer that we tabled on Monday was a best effort to offer to make some progress, in terms of competitive salaries.”

The Ministry of Health declined to comment, referring questions to the university. [Drawn-out talks on contract leave poor impression: medical residents (StarPhoenix, February 18, 2011)]

It’s plain to see that the real road block to a new agreement is the Wall government.

Health Minister Don McMorris told reporters on February 22, 2011, he’s confident negotiations between the U of S and PAIRS will conclude soon.

“Just from my experience in three years as minister of health, it seems like when we get very close is when it gets to be the most tense,” he said. “I would say it’s getting pretty tense right now.” [Pairs’ withdrawal of role ‘unfortunate’: recruitment agency (StarPhoenix, February 23, 2011)]

That was seven weeks ago.

PAIRS members are set to vote on the latest contract offer on April 14, 2011.

In an interview with the StarPhoenix, PAIRS president Dr. Marilyn Kinloch said the negotiating team isn’t making a recommendation to the residents on whether to accept or reject it.

“The negotiations team has decided to remain objective on this offer, present it as is and answer questions,” she said. [Medical residents set to vote on contract (StarPhoenix, April 6, 2011)]

It doesn’t sound promising.