If you’ve ever wondered why Albertans keep asking their government for one thing but end up with something completely different it’s because the battery on your *stealth alert* device is running low. How do the PCs use stealth to push through policies that might not sit well with the public? Let’s do a case study: the use of Family Care Clinics to open up healthcare delivery to the private sector.
Imagine the breathless headline—Alberta Health & Wellness and Alberta Healths Services strengthen Primary Care Networks by creating Family Care Clinics! Huh? Would it help if I told you that you wanted these Family Care Clinics and Redford’s Tories are patting themselves on the back for delivering them to you? No, then we’ll take it one step at a time. I’ll add a *stealth alert* where appropriate.
Primary Care Networks (PCNs) were created in 2003 when the Alberta Medical Association, the government and the 9 regional health authorities, now all rolled up into Alberta Health Services (affectionately referred to as the Superboard) signed an 8 year agreement governing doctors’ pay.
PCNs were billed as an innovative new model that delivered healthcare by a team of professionals—doctors, nurses, nurse practitioners, pharmacists, mental health workers, psychologists, etc—for a fee of $50 a head for every patient in the PCN.* Patients and doctors quickly adopted the PCN model and now there are 40 PCNs in Alberta.
*stealth alert* Everything was fine until Dec 2011 when Health Minister Horne dropped the Family Care Clinic bomb—billed as “an innovative new” model to deliver healthcare to Albertans. Doctors were stunned. The public was confused. Details were non-existent. When Dr Slocombe, President of the Alberta Medical Association, pressed Minister Horne for more information she was told that “…neither the locations nor the operational details were known”.** There’s no need to worry your pretty little head about that my dear.
*stealth alert* Ms Redford told the Legislature “Family care clinics will include doctors, licensed practical nurses, and other health practitioners who can provide support to moms and dads who want to make sure that they can get access for their kids not in an emergency room at 11 o’clock at night but in their own community”.***
That made FCCs sound like a solution to ER overcrowding but didn’t answer the critical question: How are FCCs different from PCNs? And how will the government ensure that FCCs don’t cannibalize the family practices supported by PCNs.
It took more than 3 months of playing cat and mouse with the government to confirm that (1) both FCCs and PCNs provide healthcare through the same team of healthcare professionals, (2) both FCCs and PCNs give patients direct access to other health professionals without a doctor’s referral,** and (3) both FCCs and PCNs provide extended access to healthcare.
*stealth alert* Then on Mar 7, 2012, the political fog cleared and the true purpose of FCCs was revealed. While defending the Health Department budget, Mr Horne mentioned in passing that the pilot FCCs are owned and operated by the government, however “…opportunities do exist…for the FCCs to be community owned in the future and to be physician owned. That is a distinct difference from the current [PCNs].”****
Premier Redford and Minister Horne have been talking about FCCs for 3 months, both in the press and at the Health Care town hall meetings. Not once did they mention that the only “distinct difference” between the existing Primary Care Networks and the Family Care Clinics was the fact that FCCs could be privately owned and operated.
*stealth alert* In fact Horne’s response to very pointed questions about FCCs at the town hall meetings was this: (1) FCCs are not private delivery models but rather publicly funded models to deliver healthcare to smaller communities and (2) FCCs will enhance PCNs, not cannibalize them.
The proof is in the pudding. On Mar 23, 2012 Mr Horne announced the opening of a FCC in Calgary (not exactly a “smaller community”). It opened right next door to a PCN, forcing the PCN to close its doors. (One down 39 more to go). The PCN which cost $1 million to operate will be replaced by a FCC which costs 5 times as much. The response of the AHS…? Oops. “It was never our intent when we planned this clinic for the [PCN] to move out”.*****
*stealth alert* To add insult to injury, Premier Redford is on record as saying “Family care clinics are what Albertans want.”** I don’t know about you, but I’m drawing a blank when it comes to asking the government to use Family Care Clinics to drive Public Care Networks out of business, at 5 times the cost to the tax payer!
Premier Redford extols the value of transparency and authenticity in government. However her actions do not line up with her words. No surprise really, that’s what “stealth” is—a secretive act designed to make detection difficult if not impossible.
WARNING: You’ve entered the political fog, when you step into the voting booth on April 23, please ensure that your *stealth alert* device is on and fully charged.
*This was increased to $62 a head in Ms Redford’s effort to head off the bad PR created by the doctors’ insistence on a public inquiry into physician intimidation. Albertans were relieved when the AMA didn’t roll over in return for the $12/head increase.
**AMA President’s Letter Dec 23, 2011
***Hansard, Mar 20, 2012, p 665
****Hansard, Mar 7, 2012, 383
*****Calgary Herald, March 23, 2012, B1.