Premier Danielle Smith and Matt Jones, minister of hospitals, make a health-care announcement in Calgary on Friday.--CP PHOTO JEFF MCINTOSH
zmason@medicinehatnews.com
The Alberta government tabled Bill 11, or the Health Statutes Amendment Act, on Monday. The legislation includes a sweeping set of changes to the province’s health-care system, including the implementation of a dual practice model outlined in draft legislation leaked to the Globe & Mail last week.
The amendment would enable physicians to participate flexibly in both private and public health settings simultaneously, determining on a case-by-case basis which services they bill privately and which services they bill to the government.
Minister of Primary and Preventive Health Services Adriana LaGrange provided more information about the limits of the legislation in a press conference Monday.
At this time, family medicine providers are not eligible to participate in the dual practice model. Further restrictions may be adopted by ministerial order should the legislation pass.
LaGrange says her government’s priority at this time is ensuring every person in Alberta is attached to a primary care provider. As of January, an estimated 600,000 Albertans did not have a family doctor.
Further restrictions may include mandating that surgeons in dual practice must perform a dedicated number or ratio of surgeries in the public system, or restricting the specialties eligible to practice privately.
LaGrange told reporters that dual practice already exists in many other jurisdictions, including several countries in Europe as well as New Brunswick and Quebec.
Earlier this year, Quebec added further restrictions to its dual practice model, requiring new doctors to work in the public system for five years before transitioning to the private system.
Quebec also requires doctors to seek approval from the provincial health ministry before they are allowed to practice in the private system. Their request is approved or denied based on criteria that includes the number of available doctors in a region and the impact on patients.
Under the new legislation, physicians in Alberta will be allowed to choose not to participate in the Alberta Health Care Insurance Plan or participate flexibly by providing one-time notice to the minister of their intent to practice in that status.
New Brunswick is the only jurisdiction to allow physicians to work concurrently in both public and private systems.
A reporter asked LaGrange whether these jurisdictions saw a reduction in wait times and better access to health care.
“We would not do this if we didn’t anticipate that it would mean faster access, access to more services and surgeries, and more timely access, and the ability for more physicians to be able to practice their craft,” she said.
Critics have raised concerns that the dual practice changes violate the Canada Health Act, federal legislation that outlines the right of all eligible residents of Canada to access publicly funded health insurance.
“The Canada Health Act does not preclude private activity,” Jones said at the press conference Monday. “In fact, it already occurs in Alberta and in other provinces. What’s changing here is the flexibility to toggle between public and private on a case-by-case and patient-by-patient basis.”
Jones says the Canada Health Act allows physicians to practice privately, but his government is aiming to reduce red tape that governs a physician’s ability to perform services privately.
“I don’t see how it could not be compliant (with the Canada Health Act) when other provinces are doing it,” said LaGrange.
The province says that to date, Quebec and New Brunswick have not been penalized by the federal government for these models.
Other changes
Bill 11 also contains a number of other changes, including amendments to address over-billing and updates to the regulations governing food inspections and food safety.
Notable changes also include changing co-ordination between public and private drug plans, making public insurance the payor of last resort for Albertans with access to private health insurance plans.
The province is also adding new provisions that will require Albertans to renew eligibility for their health care insurance and outline consequences for failing to renew a health card.
LaGrange told reporters there may be a cost associated with renewal, but that is still to be determined.
