Doctors on Strike

Some strikes no one wins, and a doctors' strike is plainly one of them. Last week, refusing to practice under a socialized medical insurance plan enacted by the Saskatchewan legislature, two-thirds of the province's 900 doctors locked up their offices and went off on vacation. Rather than bow to the government, the doctors gave free emergency care at 34 hospitals --but left behind only one practicing physician for every 3,000 citizens.

The shock of not having the family doctor at the other end of the telephone was abruptly brought home on the first day of the strike. When Mrs. Vicky Derhousoff put her nine-month-old son Carl to bed in their home at Usherville, he was running a fever. Next morning the fever was higher. Peter Derhousoff tried to phone the doctors in nearby Preeceville, was told that both were on vacation. A nurse at the Preeceville Hospital told him to take the baby to Yorkton, 91 miles away. On the road, says Derhousoff, "I began to realize it was a race with death." Three miles from Yorkton, the baby went limp in his mother's arms. Derhousoff tried mouth-to-mouth breathing, but the baby was dead on arrival at the hospital.

No one could say that the baby could have been saved had there been a doctor; a preliminary report showed he had meningitis of a virulent sort. But that did not ease the parents' anguish. "I blame the government," said Mrs. Derhousoff.

Just Like War. Across Saskatchewan, 79 hospitals were left without doctors, and closed for all but first aid during the first two days of the strike. Typical was Nokomis Union Hospital, where patients were told they would have to be discharged. A housewife, Mrs. Al Nagy, found the scene "just like a war. People were standing in groups on all the street corners, talking about it, trying to think of something they could do."

The Saskatchewan plan to which the doctors objected was fathered by former Premier T. C. ("Tommy") Douglas, who, as leader of Canada's only Socialist provincial government for 17 years until last year, pioneered the continent's most far-reaching public health services. In 1946, Douglas inaugurated medical care for 50,000 of Saskatchewan's 925,000 people. The following year, the Douglas government launched Canada's first province-wide hospital insurance plan. The new medicare act is the capstone of Douglas' planning. A country cousin of Britain's NHS, it provides province-wide compulsory insurance covering payments for all medical, surgical and specialist treatment. Unlike the British plan, it does not cover dentistry, glasses or drugs. The cost, $22 million a year, is to be met by annual premiums ($12 for single people, $24 for families), and by increasing sales and income taxes.

The act set up a commission, appointed by the government, and gave it the right to prescribe "the terms and conditions on which physicians and other persons may provide insured services for beneficiaries."

The act required that all doctors conform to the plan, accept a schedule of fees fixed by the government, and not engage in any private practice on the side.

Doctors United. Saskatchewan's College of Physicians and Surgeons denounced the plan as "peacetime conscription," saw in the act "an ingenuous method of controlling doctors and the practice of medicine in a political, economic and legislative sense." So fiercely did they oppose the plan that when Douglas resigned to lead Canada's New Democratic Party last November, his successor, Premier Woodrow Stanley Lloyd, postponed its scheduled start, offered to tone down the administrative commission's powers, and to allow doctors to practice outside the plan. The doctors found the act still "unacceptable."

In the U.S., Dr. J. Bruce Henriksen, who is leading a group of New Jersey doctors against President Kennedy's medicare, applauded the prairie doctors' "fine example." But in both Canada and the U.S., many questioned the doctors' tactics. In Boston, Dr. Richard Ford, associate clinical professor of legal medicine at Harvard, volunteered to fly to Saskatchewan to investigate any deaths "that may be related to professional negligence by delinquent physicians." Dr. Gerhard . T. Beck, 53, left his yacht in Jacksonville, Fla., and flew to Regina to help, declaring: "It is not our professional prerogative to desert our patients."

In the strike's first six days, the doctors and government communicated mainly by trading angry press communiques. Dr. Harold Dalgleish, president of the Saskatchewan College of Physicians and Surgeons, demanded that the act "be withdrawn while doctors are still available who are not fully committed to leave Saskatchewan." But at week's end the doctors had not softened their tone, nor had Premier Lloyd. Said the premier: "This is no longer just a matter of medical care service. It is now an outright challenge to the procedures of constitutional government. If one can envisage this spreading to other groups, then one has a situation of anarchy."

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