Ontario doctors find it ironic to hear Health Minister Eric Hoskins complaining this week about unilateral action by the federal government, given his own track record with the Ontario Medical Association (OMA).

It was only last week when the Minister delivered his own one-sided “proposal” to the OMA a mere one hour before he called a news conference to “avoid any confusion” about the proposal.

However, he did this without even providing the OMA with any reasonable opportunity to read the proposal, never mind analyze it and consider how to respond. Even the least seasoned negotiator knows that posturing and tactics of this sort are no way to recommence a constructive and responsible dialogue with Ontario’s doctors.

Minister Hoskins should not be surprised that Ontario doctors would regard his public posturing as disrespectful, and his proposal as unacceptable, particularly since (with few exceptions) the proposal is largely the same as the tentative agreement overwhelmingly rejected by Ontario’s doctors last August.

Indeed, removing all the government’s rhetoric about investing in improved health-care access, its latest proposal would actually reduce government expenditures on medical care for patients in Ontario to an overall amount even lower than that in the rejected tentative agreement.

After years of edicts from on high from the Ministry of Health, nothing is now clearer than ever as a result of Minister Hoskins’ actions — we need a fair and independent binding arbitration process that will prevent the government from acting unilaterally, now and in the future.

It is equally clear from the minister’s most recent tactics that, after successive years of cuts imposed by government, Ontario’s doctors have no choice but to consider all options in order to achieve a process to resolve impasses at the bargaining table.

As doctors, we are and always will be concerned first and foremost for our patients. No doctor in this province has ever wanted to be forced into the position of having to consider the withdrawal of services in order to obtain a fair negotiation and dispute resolution process. But, as the disrespect continues and legitimate frustration mounts, what choice has the government left us?

When it comes to all other health-care providers in Ontario (including nurses), and because they provide essential services, legislation recognizes their right to strike must be replaced with the guarantee of a fair and independent binding arbitration process. Indeed, the Supreme Court of Canada has recognized that when workers providing essential services cannot strike their fundamental Charter right to “freedom of association” requires binding arbitration in substitution for striking. Ontario doctors deserve no less.

However, Minister Hoskins apparently believes special rules apply to doctors. He does not want doctors to engage in job action because of the important services we provide to Ontarians. Yet, at the same time he is not prepared to agree to fair and independent binding arbitration. Apparently, Minister Hoskins believes that, when it comes to doctors, and doctors alone, government should be allowed to act unilaterally.

Ultimately, we all know the forum for discussing and debating the substance of the government’s latest proposal is not in the media, but at the negotiating table. But it must be a negotiating table where doctors, and the public, know that, if agreement cannot be reached, the government will not be able to impose its will, but will be required to defend its position before a neutral arbitrator. After years of arbitrary government conduct, that would be far preferable to doctors being forced to consider job action as a last resort to get a place at a bargaining table.

Contrary to the minister’s claim, if anyone is endangering access to care for patients, it is the government’s continued underfunding of necessary medical services, and its refusal to recognize the critical role physicians must be permitted to play as the government’s partner in improving the health-care system. We need a fair bargaining process — that is, a fair and independent arbitration process. We and our patients do not need more posturing and unilateral actions by the government.

Dr. Virginia Walley is president of the Ontario Medical Association.