Alberta Health Minister LaGrange announces first efforts to fix what ails primary health care

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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 initiatives that come in response to 33 recommendations from advisory panels, first struck last year, under the Modernizing Alberta’s Primary Health Care System (MAPS) initiative.

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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.

LaGrange said Wednesday the government is spending $57 million over three years to help family doctors and nurse practitioners to see an increasing number of patients. Each provider could be eligible for up to $10,000 annually.

Alberta Health is 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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The strategic advisory panel’s final report noted that primary care networks (PCNs) are not funded to adequately hire team members, and the model needs to be expanded.

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LaGrange said there are no changes coming immediately to PCNs, but the government is looking at all the recommendations, with others coming 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’

One key recommendation calls on the province to “align primary health care funding with delivery and accountability under the new provincial governance model.”

Dr. Janet Reynolds, co-chair of the MAPs panel said at the government’s announcement the current governance model is a “little bit cobbled together.”

“The recommendation supports being very clear on what the governance model should be and that funding should follow expectations,” she said.

LaGrange said at the news conference that doesn’t mean practitioners will be threatened with funding cuts if they don’t meet specific standards, but will mean accountability to make sure Albertans can access primary care.

Dr. Reynolds 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.

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“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.

The province is also creating an Indigenous patient complaints investigator that will aim to address concerns raised by Indigenous Peoples after interacting with the health care system, and setting up a community-based Indigenous patient navigator program to support them.

Dr. Tyler White, CEO of Siksika Health Services and chair of the MAPS Indigenous panel, said the commitments are an important first step in improving health equity for Indigenous people, regardless of where they live in Alberta.

“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.

Dr. Noel DaCunha, president of the Alberta College of Family Physicians said the uncertainty of the viability of running a family doctor practice is a growing and serious concern, and discouraging medical students from taking up family medicine.

“We need meaningful responses to this trend with a system re-design,” he said.

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In a reversal from its previous stance against “good faith” billing, the UCP said it now wants to ensure that doctors are paid if patients can’t prove insurance coverage.

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.

The province is expanding online mental health services, and allowing doctors to bill for virtual mental health checks and therapy.

A task force, including the Alberta Medical Association (AMA), College of Alberta Family Physicians and the Nurse Practitioners Association of Alberta, will help inform a new funding model, and has been asked to submit a final report to LaGrange by March.

The Minister said she will likely be signing a memorandum of understanding with the AMA “very soon” to work on a new compensation model.

In response to the announcement, Opposition NDP Leader Rachel Notley said it was merely a “plan to make a plan.”

“There is no immediate help for these families who are in crisis, who are seeking support, who are seeking access to health care.”

More to come…

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