Health care frontliners worried about rollout of Primary Care Alberta

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Rollout of the new Primary Care Alberta agency — and the rest of the UCP government’s reorganization and break up of Alberta Health Services into four agencies — is coming at a delicate juncture for health-care professionals.

Some fear chaos is in the wings after Tuesday’s announcement by Health Minister Adriana LaGrange.

Alberta Union of Public Employees vice-president Sandra Azocar said Wednesday the news leaves key questions unanswered for AUPE’s 62,000 members on the front lines of Alberta health care.

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“It’s creating four new levels of bureaucracy within our health care system, potentially different ministries, and how all these four agencies will communicate without having people fall through the cracks will be a task in itself, and so definitely a concern in terms of how these changes will impact delivery of health care,” Azocar said.

Just announced, the Nov. 1 changeover to Primary Care Alberta happens as negotiations are at an impasse at all the health care tables without movement by the UCP government, Azocar said.

“The uncertainty in terms of human resources is huge. We don’t have enough doctors, we don’t have enough frontline workers right now to be able to provide those services. So where are they going to be getting that without actually having dealt with those issues before they make these such huge changes to our health care?”

Azocar said the government took advantage of the anger Albertans feel when they have to wait 12 hours in an emergency room, or when they have to wait years for surgery, or when they don’t have access to a family doctor.

“Instead of dealing with the core issues behind some of these things that we’re seeing in our health care, they’ve gone a completely different direction that is not capturing what Albertans have told them in their review of the health care system — and basically they’re moving incredibly fast in making changes that are going to be impacting one of the most essential services that we provide as a province, which is health care,” she said.

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New physician pay model stalled

The Alberta Medical Association has been in talks with the UCP government for one year.

In November 2023, Premier Danielle Smith and the AMA signed a memorandum of understanding to work on a new agreement.

Then in spring, there was an announcement that they had come up with “the framework for a new model,” but it had to go for a rate review, then back to LaGrange’s desk, and then to Treasury Board.

It still needs to be walked down to the Treasury Board.

Asked how Primary Care Alberta can solve the complex primary care puzzle without a new physician payment model in place, LaGrange said Tuesday she wanted to clarify there was an agreement signed with AMA members two years ago, and it was expected to last four years.

“The negotiations that we’ve been doing on developing the new physician primary care compensation model really is off the regular cycle of negotiations with physicians,” LaGrange said, reminding media of a 2023 infusion of funds to help struggling physician businesses.

“But I also want to remind everyone that just last November, I also dedicated an additional $257 million to stabilize primary care while we were working towards the new model and bringing that forward. And so $157 million of that has been already allocated out to family medicine this year, and there’s another $100 million allocated for next year. So as we continue to support primary care, there’s a lot of work that has to be done with a lot of health care professionals, including primary care physicians, to make sure this new agency gets up and running,” LaGrange said.

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Some $200 million of the stabilization funds LaGrange mentioned were federal dollars, distributed by the provincial government, and the remaining $57 million had been attached to the Modernizing Alberta’s Primary Health Care System initiative in the last budget, AMA president Dr. Shelley Duggan said.

“Yes, we are currently in an agreement that has not kept up with inflation and population growth and, as we all know, the health care system is in crisis. Yes, she is stating a fact, we have an agreement, but it is not doing what we need it to do,” Duggan said.

Specifics to come

Asked Tuesday how staffing would be affected with the new Primary Care Alberta agency, LaGrange said talk of transfers is premature.

“(New CEO) Dr. Kim Simmonds has a lot of work ahead of her to set up the agency and make sure that she’s connecting with the primary care network, with the primary care clinics that are happening across the province. There’s just a lot of work that she’s got ahead of her. So to talk about any transfers is very premature,” she said.

A few specifics were mentioned in a list of long-term priorities, including “funding primary care networks that bring practitioners together to implement provincial initiatives and address regional needs” and “developing chronic disease care models to reduce the burden of chronic disease on patients and the health care system.”

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LaGrange promised more details would be forthcoming on a public-facing website.

“I really believe it’s important for us to be transparent and to be able to share what’s happening and make sure that Albertans know,” LaGrange said.

The health system is being broken up into four organizations — Recovery Alberta (addiction and mental health), Primary Care Alberta, acute care and continuing care, plus a monitoring organization, but LaGrange said integration between them so they function together is key.

“Primary care still needs to be able to intersect very closely with acute care, continuing care and, of course, Recovery Alberta as well,” LaGrange said.

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