The group that represents Nova Scotia's 2,400 doctors has filed a $4.6-million lawsuit against the province, accusing officials of negotiating contracts directly with its physicians, which it claims would be a breach of contract.

Doctors Nova Scotia threatened to launch the lawsuit two months ago in the hopes it would force the province to negotiate a deal. But according to Dr. André Bernard, the organization's board chair, "government officials have been unprepared to do so."

"At a time when our province is struggling to recruit physicians and keep the ones we already have, government's refusal to honour its contractual commitments sends a poor message to doctors," Bernard said in a statement.

The $4.6-million figure represents what Doctors Nova Scotia claims are unpaid invoices dating back to September 2016 for professional support costs and contributions to the organization's health insurance program.

As for negotiating behind the organization's back and directly with physicians, the group said in court papers it would supply proof in due course to back up its claim.

Alternative payment plans

The province's most recent negotiated settlement with Doctors Nova Scotia, dated Sept. 9, 2016, states the group is the sole bargaining agent for physicians in the province.

That includes jurisdiction over alternative payment plans (APP) that have been granted to some general practitioners, nurse practitioners, family doctors, anesthesiologists and obstetricians and gynecologists.

APP is an alternative to fee-for-service compensation and can include a salary. In court documents, the group alleges the Nova Scotia government has "ceased using the APP contract templates … and has been negotiating APPs directly with individual physicians."

"In these instances, either unapproved APP contracts were used, or simply a funding letter with attached performance deliverables and no written contract at all," said Doctors Nova Scotia.

Deterrent to recruitment

Doctors Nova Scotia CEO Nancy MacCready-Williams said the lawsuit might scare off doctors thinking about coming to the province.

"If I was a physician considering Nova Scotia as a place to practise, I might be concerned that, in fact, the contracts that I'm being asked to sign might not be in my best interests," she said. "That's one of the issues that we have in our dispute."

Nancy MacCready-Williams, CEO of Doctors Nova Scotia, says the lawsuit might scare off doctors thinking about coming to the province. (CBC)

"Right now we know that there are many, many Nova Scotians looking for an access to a physician, and if this isn't a warm and welcoming place for physicians, we will continue to have the wait-list that exists now."

Health Minister Randy Delorey said he could not answer questions now that the dispute is before the courts. Instead, his department issued a brief statement: "We were not able to reach a resolution, so we agree the courts are an appropriate avenue to resolve these complex technical issues."

For his part, NDP Leader Gary Burrill expressed disappointment the dispute could not be resolved outside the court process.

"It is disheartening to see the McNeil government put doctors in a position of having to sue the province," he said in an email.