Medicine Hat News
Thursday, November 13, 2003
Deal should have patients in mind: Docs
By DAVID FREEMAN
Doctors hope that the end result of an historic eight-year agreement reached between the province, health regions and physicians this weekend will be used to improved services for patients.
According to Dr. Noorali Bharwani, a physician in Medicine Hat, the deal is a step toward reforming the health system, but he is taking a wait and see attitude.
“I don’t know how the patients will benefit,” he said. “When patients can’t see a family doctor for a month, there’s something wrong.”
Alberta Health and Wellness and the Alberta Medical Association, along with representatives of the provincial health authorities, agreed on the eight-year deal that will see a fundamental changes in the way the three entities work together to improve patient care.
On the top of the list of changes is making the health regions equal partners in the process.
“This is the first time those who are responsible for managing the region are equal partners with those who deliver front-line services,” said Christianne Dubnyk, a spokesperson for Alberta Health and Wellness.
Representatives for the Palliser Health Region could not be reached for comment before press time.
According to Dubnyk, no labour deal in Canada has ever been eight years before. The agreement will last until March 31, 2011 and is retroactive to April 1, 2003, which was when the last agreement ended.
“[It’s] the amount of time needed to fundamentally change how the three parties interact,” she said.
“Previous terms [with the AMA] were two years. That’s simply not long enough. It’s safe to say this is new territory,” Dubnyk continued. “We definitely need time to work things out.”
The Master Agreement has four main agreement components designed to see a co-operative effort in reforming health care in this province.
The most dynamic aspect of the deal is the Primary Care Initiative agreement. It will see a co-operative effort between doctors, health region officials and the province to develop plans for each health region to identify specific needs and assign specific costs to address problems in each region.
The Local Primary Care Initiative will be entered into by physicians and the region, said Dubnyk. They will then come up with a business plan assessing the needs of the community and receive up to $50 per patient in funding if accepted by the Primary Health Care Committee and a Master Agreement Committee.
Part of the business plan will be assessing the use of other health care professionals in each region, such as nurses.
“Until we see how the agreement affects nurses and other primary health care providers, we can’t take a strong stance here,” said Jeanne Besner, president of the Alberta Association of Registered Nurses.
“The AARN supports reform of primary health care,” she continued, adding that the AARN hoped the local Primary Care Initiatives would have a collaborative approach.
“We definitely feel we need to be involved and feel physicians want us involved,” she said.
The Physician’s Services agreement, the second part of the deal, will see a modest rise in fees for physicians over the course of three years, 2.7 per cent in the first year followed by increases of 2.9 and 3.5 per cent.
“The money’s never enough for everybody,” said Bharwani, though he emphasized that he is happy with the compensation package.
He said that when doctors aren’t compensated properly, “Your performance goes down, and in the end patients suffer.
“What patients are complaining about right now is a shortage of doctors,” he continued. “Will it attract more physicians to our province? We’ll have to wait and see.”
There is also a Physicians On-call Program agreement which will see improved access to specialist and rural physicians.
Finally, the Physician Office System Program agreement will see the automation of the paper-based physician’s offices and link their files to an electronic health record. The electronic record will allow physicians immediate access to a patient’s prescription history, allergies and laboratory tests resulting in a more accurate diagnosis and treatment.
The agreement will see $1.45 billion spent in the first year, $1.52 billion in year two and $1.65 billion in 2006. The agreement has two financial re-openers in 2006 and 2008.
The largest portion of the budget will go toward the Physician Services Agreement, $1.34 billion in year one followed by $1.4 billion and then $1.49 billion in years two and three.
The Primary Care Initiative will see $20 million, $20.5 million and $59.5 million over the course of the next three years. And the Physician On-call agreement will see infusions of $68.9 million, $71.4 million and $75.3 million in the first three years.
“It may sound big, but in practical use there may still be some shortfalls,” concluded Bharwani regarding the dollars being announced.
Alberta Health and Wellness has said from the start that the amount of money isn’t as important as the way the money is spent and what is targeted.
Doctors across the province will have the details of the agreement explained to them by representatives of the AMA in the coming two to three weeks before a ratification vote scheduled for Dec. 12. The AMA tour will be in Medicine Hat on Dec. 2.
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