The Alberta government says a Calgary medical clinic that was planning to charge membership fees for faster access to a family doctor has cancelled the approach ahead of its introduction.
In a statement to Global News, the office of the health minister said “The clinic indicated they will not be proceeding with charging fees on August 1.”
The province also confirmed that nurse practitioners are able to charge fees given the fact they are not considered insured services and fall outside of current legislation.
“The legislative framework does not prevent them from doing this – they are like midwives and physiotherapists, for example, who are not insured and can bill privately,” said a ministry spokesperson in a statement.
“However, if Albertans receive nurse practitioner services through a Primary Care Network they are not charged a fee.”
On Monday, the government issued a statement from Health Minister Adriana LaGrange saying: “Should any clinic proceed with the membership fee structure or offer accelerated access to a family physician, an investigation will be conducted.”
“If non-compliance is found, Alberta Health will initiate action, which could lead to withholding payments or court mandated fines that could result in clinics needing to shut down,” she said.
“Albertans do not pay out of pocket for insured health services, such as seeing a family doctor or visiting a hospital — that will not change.”
Last Friday, Alberta Health sent a letter to the Marda Loop clinic, stating it wanted an answer by noon Monday on whether the clinic planned to begin the fee program as promised on Tuesday.
The clinic recently informed patients by email that it would still see patients who do not join the plan one day a week.
The other four days would be reserved for those paying the fees.
Those fees of $2,200 a year for a single adult and $4,800 for a family include other perks, including extended appointments, at-home blood tests, collaborative care from the health team and discounts on skin care and physiotherapy.
Both the province and the federal government said the plan violates the universal access provisions of the Canada Health Act along with related provincial laws.
Premier Danielle Smith said last week that if the clinic proceeded with its fee plan, it would be shut down, fined or have medicare payments withheld.
Clinic owner and physician Dr. Sally Talbot-Jones has not returned repeated requests for an interview.
In the email to patients, she said the fee plan was designed to provide better service. She told CBC last week that the decision was a response to rising clinic overhead costs.
The Opposition NDP, meanwhile, renewed a call for Smith’s United Conservative Party government to act to ensure other clinics are not stepping over the same line by charging fees to effectively allow for faster access to medically insured services.
“If Albertans are to believe Danielle Smith’s claim that she has abandoned her plans to make Albertans pay to see their family doctor, she will launch a full investigation into all clinics engaging in members-only medicine starting today,” said NDP health critic David Shepherd.
Alberta Health has said 13 clinics are charging fees but they are for services not reimbursed by the taxpayer, such as acupuncture treatments and optional surgeries, and are therefore allowed.
Health Canada has advised the province that if it doesn’t remedy the Marda Loop clinic plan, it faces cuts in federal health transfers.
In March, Ottawa clawed back close to $14 million in transfer fees to Alberta due to clinics charging fees in return for access to publicly funded MRI and CT scans. The province disagrees and is disputing the clawback.
Smith made a manifesto promise in the recent provincial election that Albertans would not have to pay for basic medical services such as visits to a family doctor.
She made the promise after the Opposition pointed out that before she became premier, Smith advocated for such measures as paying for doctor visits as a way to keep the system sustainable in the long term.
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Nurse practitioners strike out in own ‘private pay primary clinic’
Global News has also received a copy of a letter from a patient at another Calgary medical clinic facing “concerning changes.”
The letter was from two nurse practitioners at Creekside Medical Clinic.
Karen Parker and Noreen Antonishyn advised patients they would no longer be at the clinic as of July 28, as they were starting their own “private pay, primary clinic.”
The two acknowledged that while the notice “may be distressing” they had basically given all they could to the public system.
The letter stated they had proposed a solution to the province: “the political will to publicly fund NPs in an equal pay for equal work model remains unmet.”
The letter also said it was unclear if they would be replaced. Global News contacted the clinic to find out, but did not receive a response.
University of Calgary legal and medical expert Lorian Hardcastle said that is a concern.
“The province really needs to get a handle on this because primary care is, of course, the foundation of the health care system,” she said.
“We know that there have been strains on the EMS system and emergency rooms for the last couple of years, and those are only going to be made worse if patients don’t have access to primary care.”
Hardcastle said not only does the government need to start actively recruiting more health professionals, it also has to deal quickly with the fact many are leaving for private practice.
“I don’t think the province can really sit on this.
“I think that we’re going to continue to see these private options pop up and the province needs to proactively address those rather than reacting once these patients are receiving letters from these clinics, or they’re seeing advertisements for these clinics.”
“This is an issue that the province needs to be proactive on.”
–with files from Global News’ Tomasia DiSilva