Proposed health care changes would be “devastating” to rural family practice: president of AMA

AHS, AMA and MLA Ron Orr chime in on recent health care announcements

The Alberta government’s proposed changes to regulations around doctor billing and comprehensive primary care, or complex care, have some physicians concerned.

The changes would affect the rates at which doctors can bill and fees for complex care plans.

The government tabled several proposals Nov. 14 and gave the Alberta Medical Association (AMA) until Dec. 20 to respond.

In a letter posted on Nov. 29 on albertadoctors.org, AMA president Christine Molnar calls the recent developments in negotiations with the government, “deeply concerning.”

The United Conservative Party (UCP) is proposing changes to physician compensation and proposing cuts (about 85 per cent) to comprehensive primary care, according to Molnar.

“This is counter to sound health policy, the government’s health platform and the interest of patients, particularly elderly ones, those with chronic and complex conditions, and those living in rural or remote areas of the province,” said Molnar.

“There will be a negative impact on care for thousands of patients.”

Primary care networks and the Medical Home were developed in order to improve Albertans’ access to adequate primary care and family doctors, says Molnar.

“The government proposals threaten to reverse the progress we have made in primary care.”

Ponoka physician Dr. Brendan Bunting signed off on the creation of primary care networks during his term as the president of AMA in 2003, and says he was “very pleased” to have been a part of that initiative.

Dr. Bunting explained during an interview on Dec. 4 that primary care networks offer services that medical practices previously couldn’t by employing people to provide value-added services such as dietitians and nurses and other allied health professionals.

READ MORE: Ponoka family physician retiring after 40 years of service to community

Regarding Bill 21, the termination of contracts and practitioner ID restriction, Molnar says, “these proposals paint a grim picture of the kind of relationship government would like with physicians.”

Molnar’s letter concludes the proposals would be “devastating to rural family practice.”

These proposed changes are coming right on the heels of the announcement of a potential cut of 500 full-time nursing jobs over three years.

READ MORE: Alberta to cut 500 full-time nursing jobs over three years

There has been some confusion around whether decision to cut nursing jobs falls under the UCP’s purview or Alberta Health Services (AHS). The short answer is they are essentially one-in-the-same.

Alberta Health Services delivers medical care on behalf of the Government of Alberta’s Ministry of Health. They are the employer of nurses in Alberta, organized under the United Nurses of Alberta (UNA).

AHS gave advance notice of their intent in a letter to UNA on Nov. 29 and UNA and AHS will head into collective bargaining next year.

The AHS provided Ponoka News with this statement on Dec. 2:

“This is a proactive disclosure of possible initiatives to unions in respect of collective bargaining. While our budget has remained stable, Alberta’s growing and aging population means we need to be more efficient and focused in terms of health care spending.

“Population growth year-over-year has been 1.64 per cent from July 1, 2018 to July 2, 2019. This places increased demand on our health care services and it means we have to do things differently in order to provide care to Albertans. There are additional cost pressures every year of about 2.5 percent.”

As AHS says the disclosure is only a list of potential initiatives and no final decisions have been made, it is unknown yet how health care in central Alberta may be affected.

READ MORE: Kenney: Opposition, unions treating budget cuts like the ‘the apocalypse’

Lacombe-Ponoka UCP MLA Ron Orr says primary care networks aren’t on the list of negotiations so didn’t have a response on that topic, but provided answers on other questions about recent health care announcements and proposals.

According to Orr, the UCP’s proposes to increase the amount of time a physician is allowed to spend with a patient per base rate visit, instead of doctors billing additional fees for complex care, as a “money saving effort.”

Orr says the UCP are undergoing a complete review of Alberta health care services and compensation.

“It’s an old system that needs to be updated.”

Public compensation amounts to one half of Government of Alberta expenses and Alberta pays $119,000 more per doctor per year, which is 25 per cent per capita higher than any other province and 28 per cent higher than B.C. and Ont.

From 2009 to 2017, the volume of services dropped by seven per cent, but the pay per service increased by 37 per cent.

The Alberta government pays $5.2 billion per year for doctor compensation, which has tripled since 2002, making that expense the highest rate of growth for provinces’ health care spending in the country, says Orr.

Orr says the UCP needs to work with their key partners to get the budget under control, and while they aren’t cutting health care spending, they are going to stay within current levels.

There are a total of 11 points currently being negotiated between the UCP and the AMA, and while Orr says the UCP is exploring a new model, “all points are up for discussion” and they will continue to look for ways to improve efficiency.

Regarding nursing positions, Orr says “the reality of anyone actually being fired is highly unlikely,” as the UCP’s plan is to reduce the number of jobs through attrition over three years, meaning they will simply not hire new nurses as they move out-of-province or retire.

The 500 full-time positions would be under one per cent of AHS’s total nurses and is less than the AHS’s current rate of normal turnover, which is 1.2 per cent.

The initiative’s purpose is to reduce costs and expenses, which is what the UCP was elected on, says Orr.

Get local stories you won't find anywhere else right to your inbox.
Sign up here

Just Posted

Alberta chief medical officer of health Dr. Deena Hinshaw updates media on the Covid-19 situation in Edmonton on Friday March 20, 2020. nbsp;Alberta is reporting it's highest daily number of COVID-19 cases, with 364 new infections. THE CANADIAN PRESS/Jason Franson
Alberta confirmed 323 COVID-19 cases Tuesday

Central zone active cases at 145

Jay “Chef” Scotian poses for a photo in his new location in Sylvan Lake. Eat Coast Market and Grill will be holding a “Donations for Donairs” fundraiser for Haley Wile on Oct. 24. Photo by Megan Roth/Sylvan Lake News
Sylvan Lake business fundraising for local woman paralyzed in car accident

Haley Wile was in a serious car accident which left her paralyzed from the waist down

Brady Durkin. Photo Submitted
Young Sylvan Lake golfer places in the Top 10 in the country

Brady Durkin finished the National Championship tournament in 8th place recently

Health Minister Tyler Shandro and Dr. Deena Hinshaw, the chief medical officer of health, receive flu shot. Photo via Government of Alberta
COVID-19: One more death in central zone

Ponoka County on province’s watchlist

Many rural municipalities were concerned about a proposed reduction to their industrial revenues, but Alberta’s Municipal Affairs minister has come up with an alternative solution. (Photo contributed)
Province and rural municipalities agree on a plan to support Alberta’s energy industry

Creating new wells or pipelines would result in a three year ‘tax holiday’

Conservative member of Parliament Pierre Poilievre speaks during a press conference on Parliament Hill in Ottawa on October 19, 2020. THE CANADIAN PRESS/Sean Kilpatrick
Liberals say Tory effort to set up COVID-19 committee will be a confidence matter

The Tories were originally proposing an ‘anticorruption’ committee

(The Canadian Press)
Alberta-raised Cree actor lands role in Disney’s live-action ‘Peter Pan and Wendy’

Tiger Lily is featured in Disney’s 1953 animated “Peter Pan” film

Natural Resources Minister Seamus O’Regan responds to a question during Question Period in the House of Commons Tuesday February 4, 2020 in Ottawa. The Alberta government is welcoming news that Ottawa has approved an expansion of the Nova Gas Transmission Ltd. gathering system in Alberta — while condemning federal delays that it says cost this summer’s construction season. THE CANADIAN PRESS/Adrian Wyld
Alberta welcomes federal approval of gas pipeline expansion while criticizing delay

Pipeline division owned by Calgary-based TC Energy Corp. will now be required to restore 3,840 hectares of caribou habitat,

This 2020 electron microscope image made available by the National Institute of Allergy and Infectious Diseases shows a Novel Coronavirus SARS-CoV-2 particle isolated from a patient, in a laboratory in Fort Detrick, Md. THE CANADIAN PRESS/AP-NIAID/NIH via AP
At least 49 cases of COVID-19 linked to wedding in Calgary: Alberta Health

McMillan says the city of Calgary has recently seen several outbreaks linked to social gatherings

Alberta Premier Jason Kenny and government house leader Jason Nixon chat before the speech from the throne delivered in Edmonton, Alta., on Tuesday, May 21, 2019. Alberta politicians are to return to the legislature Tuesday with a plan to discuss up to 20 new bills — many of which are focused on the province’s economic recovery. THE CANADIAN PRESS/Jason Franson
Alberta legislature to resume Tuesday; focus to be on economic recovery

Opposition house leader Heather Sweet said the NDP will focus on holding Premier Jason Kenney

A passer-by walks past a COVID-19 testing clinic in Montreal, Friday, Oct. 16, 2020. THE CANADIAN PRESS/Ryan Remiorz
Canada ‘yet to see’ deaths due to recent COVID surge as cases hit 200,000

Much of the increase in case numbers can be attributed to Ontario and Quebec

robbery
UPDATE: Suspect identified in early morning shooting

Rimbey RCMP had responded to a complaint of an armed robbery at the Bluffton City General Store

Executive Director of Agape Kate Halas (left) receives $1000 from Sgt. Eric Christensen (right) on behalf of Agape. Photo/ Shaela Dansereau.
Former Wetaskiwin Peace Officer wins provincial award; gives back to Wetaskiwin community

Eric Christensen has won the Alberta Association of Community Peace Officers Award of Excellence.

Agriculture Minister Devin Dreeshen (Alberta government photo)
Big boost for Alberta college agriculture research

The $2-million agreement to benefit Lethbridge College’s applied research team

Most Read