Questions remain about Redford’s family care clinic plan

EDMONTON - Premier Alison Redford’s election promise to build 140 family care clinics across Alberta has raised questions about the future of health care delivery in the province, experts say.
Doctors, health policy professors and opposition parties are now waiting for Redford to explain how the new clinics will integrate with existing medical care, how she will measure success, and how she will protect public health care.
“It’s not a cookie-cutter approach,” Alberta Health spokesman Andy Weiler said. “They (family care clinics) are going to be different in each community.”
Weiler said major decisions won’t be made until Redford appoints a new cabinet and a health minister. The government will then decide where the clinics will go, how the pay structures will work and how the clinics will be funded.
“Obviously we want to engage every health care service provider,” Weiler said, adding the province will also survey the approaches taken in other provinces.
Redford has only said the province will transition to the clinics over three years at a cost of $3.4 billion, money that will come from existing budgets.
Family Care Clinics will be open longer – 7 a.m. to 9 p.m. — to take pressure off the emergency rooms. Patients won’t always see a doctor, but the most relevant health practitioner.
Under the new system, money will follow the patient, so clinics will get paid for the services provided. Currently, Primary Care Networks are paid based on the number of patients they have, even if the patients don’t use services.
Sabrina Wong is a professor at the UBC Centre for Health Sciences and Policy Research. She said other provinces are trying similar approaches but nobody knows what works.
“What we have right now is different provinces trying different models of care, and we don’t know what is effective,” Wong said. “Part of the issue is that we don’t have any kind of performance measurement in primary care.”
Wong, who studies ways to measure primary care outcomes, says governments need a system in place to tell them what works.
“It’s no longer going to be one doctor with a shingle. It’s going to be a network. But what is the right combination of different models, that’s the question.”
Linda Slocombe, president of the Alberta Medical Association, said her major concern is that the province will move ahead before properly evaluating the three pilot projects now underway.
“If indeed they’re going ahead, then it’s really important to have a primary care strategy overall for the province,” Slocombe said. “It’s just still unclear exactly what these FCCs will look like, how they will integrate with the primary care that is already being delivered through family physicians and existing Primary Care Networks.
“There’s still a lot of unknowns and questions in my mind, as to what the role of these FCCs actually is.”
David Eggen was recently elected as the MLA for Edmonton-Calder, and was formerly the executive director of Friends of Medicare advocacy group. He worries that doctors and health administrators won’t be able to tolerate more upheaval in the system.
“It’s such a sweeping concept,” Eggen said. “My immediate concern was that we have had so much radical change in health care delivery over these last four years in Alberta, this just seemed like a significant change that came out of the blue.”
kkleiss@edmontonjournal.com