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Doctors in British Columbia will receive slightly higher fees and see new money go to family practices, specialty services and the recruitment and retention of specialists under a new four-year deal with the province.

The B.C. Medical Association, which negotiates on behalf of the province's doctors, announced Tuesday that 92 per cent of the 3,077 members who cast their ballots voted in favour of the agreement.

In its first two years, the deal is worth about $100-million, which represents a funding increase of 1.5 per cent each year. Both sides have agreed to "reopener" talks in 2014 and 2015 to make changes that reflect the province's financial environment.

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But some doctors remain critical of the deal, saying it does nothing to address growing bureaucracy and higher costs in the health-care system.

"I believe the agreement that's been negotiated strikes a reasonable balance," Health Minister Michael de Jong said. "It allows us to collectively continue to work on some of the initiatives relating to family practice, recruiting, retaining specialists and rural-health initiatives."

Voting took place in July and followed an announcement at the beginning of June that the parties had reached a tentative agreement.

Under that deal, doctors' fees will climb by half a per cent this year and in 2013, and the provincial government will pay $27-million more for the increased costs of providing insured services.

The province will also pay an additional $18-million to support and sustain full-service family practices and $18-million to enhance access to specialty medical services.

Recruitment and retention efforts will receive another $14-million, and $10-million will go to enhance the supply and stability of doctors in rural communities.

To address problems of recruiting and retaining specialists, the province will spend an additional $10-million, on top of the $10-million in existing funding.

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The provincial government said $2.7-million will go to support new procedures, and $500,000 will fund shared care between specialists and general practitioners.

"This is a good agreement for the public," said Shelley Ross, president of the medical association.

"It puts money in specific programs that help chronic disease, help mental health, help the frail elderly, looks at getting physicians into the rural areas, looks at getting more specialists into areas where we need them, as well."

Not everyone was happy with the deal, though, including Dennis Karpiak, a former member of the association's board, who said too much money is going to bureaucracy.

"We have in B.C. 11 times the number of bureaucrats per capita than Germany has," he said. "That's quite dramatic."

Dr. Karpiak said he'd like to see that issue addressed because bureaucracy is stealing resources away from real patient care and the system is unsustainable.

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Meantime, Zafar Essak, who also served on the association's board previously, questioned the vote's validity, saying thousands of doctors were not sent ballots because they were not members of the association.

"How can the BCMA claim to negotiate an agreement for all doctors in the province and then not let them all vote?" Dr. Essak asked.

In response, Mr. de Jong said B.C.'s administrative costs compare favourably to other jurisdictions on a national level, but agreed the province can do more.

"To suggest, as some have, that British Columbia is wildly out of step with other jurisdictions is incorrect, in fact, quite the opposite."

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