Opposition parties say a report from the auditor general this week on primary care networks (PCN) should be a red flag for the government’s future plans on healthcare.
Auditor general Merwan Saher released a report this week indicating the government simply had no idea how well the networks were working, because it wasn’t asking the questions.
“It is a bit like conducting the experiment and not recording the results. We have no evidence that they are working superbly or that they are working poorly, but the real point is the government doesn’t have the evidence,” he said.
Saher said the government doesn’t know if PCNs are improving access, if they are hiring more health professionals and bringing them into the system, because it isn’t tracking any of that information.
Saher’s report raises concerns about the government’s latest model for primary care, the family care clinic. Three pilot clinics are already operating and the government hopes to eventually have 140 in place.
Primary care networks are groups of family doctors who work together and bring in other health-care professionals, like nurses, nurse practitioners, nutritionists and mental health workers.
Family care clinics would be similar, but the other health professionals could bill the province directly. The government has also promised they would have extended hours and be more accessible.
While he did not set out to examine family care clinics or any of the plans to create them. Saher said he saw an obvious parallel with the problems with PCNs.
He said the government has to set up clear guidelines and expectations for family care clinics and track them to make sure they are achieving what they are supposed to.
“If you don’t do that, as I think I have already said, you have no basis for making decisions going forward.”
Health Minister Fred Horne admitted it was clear the government was not properly measuring the PCN experiment.
“The systems and process were not in place that should have been in place to ensure that we were delivering consistently across Alberta what we said we would deliver in each PCN.”
He said the government would be taking in his recommendations and would work to make sure family care clinics had better guidelines and accountability measures built in from the beginning.
“Government is ultimately accountable for the delivery of care.”
Opposition politicians were less confident in the government’s ability to bring in family care clinics, considering they didn’t know what primary care networks were delivering.
“If you are going to completely upend the system and propose something brand new, like family care clinics, you have to know what it is you are replacing,” said Wildrose leader Danielle Smith.
NDP health critic Rachel Notley said the government seems ready to make exactly the same mistake again. She said it is unclear how the province plans to integrate the two models.
“The province has to decide whether it is going to have the new family care clinics work alongside PCNs or instead of PCNs,” she said. “In either case there is so much information we don’t have about what did or did not work with PCNs.”
Liberal leader Raj Sherman said he raised concerns about accountability with PCNs when he was in government and expected the auditor general’s report.
He said the family care clinics were announced without talking to physicians and without any real engagement with other health professionals.
“It starts off with no clear direction and she is destroying the relationship with the physicians,” he said. “The government should take a step back and be objective about everything.”
