Alberta’s UCP government is creating two new divisions within its health ministry and making changes to help doctors and practitioners see more patients.
The moves establish assistant deputy ministers and dedicated staff to work in both primary care and Indigenous health and are among 10 commitments in response to 33 recommendations from two advisory panels, first struck last year, under the Modernizing Alberta’s Primary Health Care System (MAPS) initiative.
Health Minister Adriana LaGrange told Postmedia in an interview Wednesday those areas didn’t have the dedication they needed.
“Primary care is what keeps people out of hospital, and keeps them well, so we want to make sure that we give it the proper focus,” she said.
The government is spending $57 million over three years to help family doctors and nurse practitioners with administrative support so they can see more patients, with each provider eligible for up to $10,000 annually.
It’s also creating a $20-million fund for Indigenous communities to develop and run their own primary health care services and projects. The specifics come after this year’s budget earmarked $125 million over three years for initiatives put forward by the MAPs advisory panels.
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While the strategic advisory panel’s final report noted that the primary care network (PCN) model needs to be expanded, LaGrange said there are no changes coming immediately, but the government plans to commit to more recommendations in phases.
“I would call this a framework, and then we need to put the meat on the bones of this framework.”
‘Investment needed throughout the whole primary health care system’
Dr. Noel DaCunha, president of the Alberta College of Family Physicians, said at the government’s Wednesday news conference in Calgary the uncertainty of the viability of running a family medicine practice is a serious concern, and is discouraging medical students from taking it up as a speciality.
“We need meaningful responses to this trend with a system redesign,” he said.
Dr. Janet Reynolds, co-chairwoman of the MAPs panel, said primary care represents less than 20 per cent of all health care spending and needs to be increased. But she said an exact number is yet to be determined.
“There’s acknowledgement with the launching of the MAPs initiative and the report that there’s investment needed throughout the whole primary health care system,” she said.
Dr. Paul Parks, president of the Alberta Medical Association (AMA), told Postmedia following the announcement it’s positive the government is acknowledging that family medicine and primary care are in crisis.
“(But) it’s not near enough, it’s a very small step, and we really need something very significant, and very quickly, to stabilize family medicine practices, to allow them to move to a longitudinal funding model,” he said, adding that critical piece was missing on Wednesday. But the hope is the AMA can work with the minister.
LaGrange said she will likely be signing a memorandum of understanding with the AMA “very soon” to work on a new physician compensation model.
Parks emphasized that family doctors are the “heart and foundation” of primary care.
“They are going to need to make a major investment in family medicine,” he said, adding that it’s positive that the government recognized the importance of addressing unique Indigenous health challenges.
The province is creating an Indigenous patient complaints investigator that will aim to tackle concerns raised by Indigenous Peoples after interacting with the health care system, and it is setting up a community-based Indigenous patient navigator program for support.
Dr. Tyler White, CEO of Siksika Health Services and chairman of the MAPS Indigenous panel, said the commitments are an important first step in improving health equity for Indigenous people.
“I’m encouraged that we have this pathway and runway to be able to be creative and be able to support these urgent needs,” he said.
The province said it now wants to ensure that doctors are paid if patients can’t prove insurance coverage, often called “good faith” billing.
A new payment system is being promised to support nurse practitioners in opening their own clinics and taking on patients, but the government did not provide specifics or a timeline for when that might be rolled out.
A task force will help inform a new primary care funding model, and has been asked to submit a final report to LaGrange by March.
Opposition NDP health critic for primary and rural health care David Shepherd said in a statement he saw little from the UCP that will provide tangible help to recruit or retain family doctors, or improve access to care.
“More Albertans than ever before can’t find a family doctor, but the UCP just keep pushing papers around their desk. They announced the creation of another panel with reheated instructions to study actions they’ve been discussing and promising to take for years, including a new primary care compensation model.”
Shepherd did note he was glad to see the release of the Indigenous panel’s report and will be watching closely for action on addressing systemic racism.