Sunday, May 14, 2017

--the dollar bill yo!----------“This will open those doors, because finally there is this commitment that we are all part of the same landscape,” he said.--------------Leaders from each zone will have a seat on a new provincial PCN committee, which will have representatives from Alberta Health Services and Alberta Health, and will be chaired by the deputy minister of health. Van der Merwe said the new model gives primary care advocates better access to the health system’s top leaders, which is important for the province’s efforts to reduce patient traffic at hospitals and treat more people at home or in the community.------------------Under the current funding formula, the government provides $62 a year to a network for each patient in its catchment area — money primarily used to hire other health professionals, such as therapists, nutritionists, pharmacists and nurses, who are shared around the network.----The idea is that patients will receive better care if they have access to a team of health professionals.-----" Van der Merwe said newly announced health transfers from the federal government earmarked specifically for mental health and home care could also be directed to PCNs"-----------------Continuing Care including Long-Term Care is funded 21% less than the national average. Do they intend to reduce this even further? Our voiceless, vulnerable souls in Long-Term are paying dearly because this government regards them as a disposable, discardable liability.

the dollar bill yo!--So let me get this straight. The government of Alberta created the PCNs --primary care networks and gave them more cash to get the team method going. The team method should have been in place without the extra cash but I guess more cash makes the doctors decide to do more.
Oversight was not as good as it could have been and the PCNs were reviewed and unsurprisingly some of them weren't performing as well as wanted. Why would they? No one is following the money trail.
So the next bright idea by the folks at AB Health is to increase the level of complexity and make there be more folks yapping with the deputy health minister who recently has been quizzed about approving $4.2 million for an alternative health program with no deliverables that I can determine. This allotment of cash was made after $10 million was handed over-no questions asked--upfront by the Tories who seemed to feel that there needs to be no oversight of money given for dubious alternative health programs and no sort of ethical review of such use of public dollars.
Mind boggling. What can I say? This story of Tory incompetence gets even worse with the NDP who -according to the doctors may use money allocated to the mental health services for this bright idea of revamping the PCNs.
I don't see how this will work. Unless of course there will be an alternative health program somewhere in this bright idea.

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http://edmontonjournal.com/news/local-news/province-doctors-reach-tentative-deal-to-overhaul-albertas-primary-care-system

Province, doctors reach tentative deal to overhaul Alberta's primary care system

Published on: May 12, 2017 | Last Updated: May 12, 2017 9:00 PM MDT
Dr. Phillip van der Merwe, Chair of the Primary Care Alliance, speaks after Alberta health minister Fred Horne spoke at the announcement of Alberta's Primary Health Care Strategy at the Allin Clinic in Edmonton, Alta., on Thursday, May 1, 2014. Horne announced that nine Family Care Clinics at the event. Twenty-four clinics, of which the nine are part, were initially announced in June 2013. Ian Kucerak/Edmonton Sun/QMI Agency
Dr. Phillip van der Merwe, co chair of the PCN physician leads executive, speaks at a news conference in Edmonton in this file photo from May 2014. IAN KUCERAK / IAN KUCERAK/EDMONTON SUN
Alberta’s $240-million Primary Care Network system is set for a major funding and governance overhaul in the months ahead under an important new deal aimed at providing patients more consistent and comprehensive health care outside the hospital.
The proposed agreement between the province and the Alberta Medical Association — still to be ratified by physicians — is also touted to make PCNs more accountable and efficient, while giving primary care greater prominence in the health system.
“This is a first step that gives Alberta’s health care the best possible chance to succeed,” Dr. Phillip van der Merwe, co-chair of the PCN physician leads executive, said Friday.
Alberta currently has 42 Primary Care Networks, which are collections of doctor’s offices in the same geographic area that work together to care for patients.
Under the current funding formula, the government provides $62 a year to a network for each patient in its catchment area — money primarily used to hire other health professionals, such as therapists, nutritionists, pharmacists and nurses, who are shared around the network.
The idea is that patients will receive better care if they have access to a team of health professionals.
However, reviews of PCNs in recent years found that some networks have not been making wise use of all the money they have received and have been too slow to provide comprehensive care.
Late last year, the province and the AMA finalized a pact to tackle issues related to quality of care and physician costs. Included was a pledge to jointly develop a new governance model and funding system that would allow PCNs to make needed improvements.
Van der Merwe said the current governance model has been ineffective because it requires all 42 PCNs to interact individually with the province like “islands of care.”
The proposed new system calls for PCNs to be organized into five different zones, all of which will be responsible for determining the overall health needs of their patient populations.
For example, a zone with a high incidence of chronic disease might need several nutritionists and pharmacists working in the PCNs, while another zone full of young families would require a different staffing mix.
As well, the new structure will provide an opportunity for PCNs to save money by consolidating services, such as payroll and data management at the zonal level, he said.
Leaders from each zone will have a seat on a new provincial PCN committee, which will have representatives from Alberta Health Services and Alberta Health, and will be chaired by the deputy minister of health.
Van der Merwe said the new model gives primary care advocates better access to the health system’s top leaders, which is important for the province’s efforts to reduce patient traffic at hospitals and treat more people at home or in the community.
“This will open those doors, because finally there is this commitment that we are all part of the same landscape,” he said.
As for a new funding model, van der Merwe said details still have to be worked out. However, the plan is to halt the per-capita formula and instead provide funding based on population health needs. This means zones with higher needs might receive a boost in their grants, while others could receive less.
Van der Merwe said newly announced health transfers from the federal government earmarked specifically for mental health and home care could also be directed to PCNs, provided the new model is approved.
The ratification vote for PCN physicians will take place over the next month, ending on June 13.
kgerein@postmedia.com
twitter.com/keithgerein


Julie Ali · 
I am concerned about the comment here:

http://edmontonjournal.com/.../province-doctors-reach...

" Van der Merwe said newly announced health transfers from the federal government earmarked specifically for mental health and home care could also be directed to PCNs"

***
I was under the impression that the mental health money would be used only for mental health services. Now are we going to have this money directed elsewhere as PCN services disguised as mental health services?

How will this pass the smell test for the federal government? Or does no one at any level of government care how the money is spent and what the deliverables are?

The mental health system in Alberta is in chaos. Accessing services, psychiatrists and supports is difficult. Mentally ill citizens cannot advocate for themselves and are the last in the line asking for help. It's troubling that our government continues to fail the mentally ill by reinventing PCN services with mental health money allocations. Will Mr. Trudeau's government ensure that the money directed for mental health services will indeed be used for this purpose?

I am also surprised that there is no mention of similar increases in funding for the continuing care system. What is the continuing care system in Alberta? The Cinderella sister?

The PCN system seems like the ugly sister in my opinion. I am not convinced that creating these PCNs do anything more than result in more money spent for frills that aren't improving patient health. For example a doctor in a PCN has a nurse practitioner working in her team as well as a dietician. Well how does this improve health of patients? We are paying for three staff instead of one. Previously the doctor would do all the work. Is Alberta Health creating the PCNs for the purpose of saving taxpayers money by delegating some physician labour to the other professions?

I don't see the value of having the extra non-physician staff when it seems more efficient to have the doctor doing the work even if it costs more. I don't believe that the nurse practitioner can do the same quality of work as the doctor but we are told that this is the case. Sure it might be cheaper to have a nurse practitioner to see the patient but is this good for the patient?
LikeReply13 mins
Wendy Rudiger · 
So glad this is FINALLY being looked at. Wow. 4 decades of NOTHING and in 2 years this government has done amazingly! !
LikeReply9May 13, 2017 10:39am
Frank Hogan
Alberta's PCN system has only been in place 12yrs.
Sarah Hoffman announced in 2015 there wouldn't be a $75M cut then did it anyway.
It was about this time my family Doctor as well as many others chose to leave the province.
Somehow the Pc's and a 40yr reign are to blame.
UnlikeReply2May 13, 2017 5:22pm
Ellen Bourgeois · 
Wow talk about uninformed. NDP troller? They will thankfully be out in 2019. I can't wait!!
LikeReplyMay 13, 2017 5:28pm
Wendy Rudiger · 
Worked in the PC reign of healthcare terror for almost 30 years as an RN. so yes. I am informed and have experienced too much (especially during the DE Klein years. The Public has no idea.
LikeReply6May 13, 2017 5:55pm
Frank Hogan
30 years!
Sounds like a fantastic career to most.
I'm sorry you didn't have a chance to choose a different career path or move away from the "PC reign of healthcare terror" for 3 whole decades. It's a darn good thing everything is going to be all hearts and flowers now.
LikeReply123 hrs
Pierre Jacques
Frank Hogan, Ellen Bourgeois, talk about right wing trolls!!! I can't wait until 2019 when the AB NDP gets a second majority govt...boy will you be pissed....we lived with the pc nightmare for 44 yrs...we're used to it, but you!! YOU COULD NOT EVEN TAKE 4 YRS!! 😂😂😂 hey but if you don't like Alberta now maybe you should move out because i hear there are lotsa work opportunities in SK !! 😉
LikeReply222 hrs
Bill Adams · 
Ellen Bourgeois yes cant wait to get the super corrupt PCs back!
LikeReply1 hr
Julie Ali · 
Pierre Jacques I don't think it is nice to call each other names. It's important to look at the facts. Why for example is the government of Alberta considering using directed funds from the Federal Government that is for mental health services for funding the PCNs as per this information? I thought the money for mental health services would be directed for this purpose and not for other uses.

http://edmontonjournal.com/.../province-doctors-reach...
" Van der Merwe said newly announced health transfers from the federal government earmarked specifically for mental health and home care could also be directed to PCNs"
LikeReply26 mins
Julie Ali · 
I am surprised by your comment. What exactly has the government done? I mean there is still underfunding of the continuing care system. Folks are still waiting for surgery. We have line ups in the emergency. I don't see any difference with the NDP folks in power.

It might be useful for Alberta Health to actually listen to the citizens who voted for them and got them to government. We're not happy about the problems in the continuing care system and we want action. Or will families have to go to media and report on the failures of the folks at AB Health and AHS to get their voices heard?

It's useful to have actual deliverables to back up the praise. I have no praise for Alberta Health or AHS. I think there is a lot of waste of staff hours and citizen cash. A great deal of chatter goes on and no actual work to change the problems. I would assume that this is due to a lack of leadership from the executive teams at both the ministry of health and at the health authorities.
LikeReply9 mins
Mark Wilson · 
God at BFS
"Hi, i'm from the government and i'm here to help"
LikeReply3May 13, 2017 9:45am
Brenda Flinkman Olson · 
Primary care offers awesome programs and services..❤️
LikeReply223 hrs
Julie Ali · 
And they are costing us a ton of cash. It might be useful to see the value for the money spent. In addition it might be useful to see why so much money ($14.2 million) is being spent on alternative health programs by AB Health as noted here:
http://www.cbc.ca/.../liberal-leader-david-swann-calls...

Wildrose accountability critic Nathan Cooper said the auditor general should review both grants awarded to Pure North. Like Azocar, he said the government must investigate safety concerns raised about the Pure North program.

"Patient safety is obviously the number one priority," Cooper said. "And health dollars should be spent based upon the best science available.

"So that is the responsibility of the health minister to ensure that that is happening," he said. "And if that isn't happening, we definitely need to be taking steps to correct that."
LikeReply6 mins
Dan Belisle · 
More bureaucracy and management.
UnlikeReply1May 13, 2017 1:46pm
Julie Ali · 
I tend to agree with you. Wherever government adds money we have more layers of bureaucrats without deliverables.
LikeReply25 mins
Gwen MacNeill
Great news with more checks and balances in mind?
LikeReply1May 13, 2017 10:56am
Julie Ali · 
I doubt that AB Health will have more checks and balances for the PCNs when we have two health ministers approving major money for an alternative health program.

First we had the PC Health minister sign off on $10 million upfront to this foundation:

http://www.cbc.ca/.../liberal-leader-david-swann-calls...
CBC News reported last month that Alberta Health gave Pure North a $10-million grant to expand its program, which featured high doses of vitamin D and the removal of mercury dental fillings, ultimately to 7,300 mostly low-income seniors.

Internal government documents show former Progressive Conservative health minister Fred Horne approved the funding against the advice of ministry officials.

The officials determined the Pure North program was not adequately supported by science, could not prove the health and economic outcomes it claimed, and may cause adverse reactions in participants. The foundation focuses on vulnerable populations such as the homeless, addicted and elderly, and operates free clinics in such places as homeless shelters and on Indigenous reserves
*****
Then we have the NDP folks sign off on yet more cash.

http://www.cbc.ca/.../alberta-health-carl-amrhein-pure...
In October 2016, Amrhein signed, on behalf of the ministry, a $4.2-million grant with Pure North for a primary-care clinic in Calgary staffed by nurse practitioners
*********
What were the reasons for these disbursements when the foundation has not (in my opinion) provided any evidence of the value of these expenditures? Meanwhile the Auditor General of Alberta has not investigated the value for the money (if any).
LikeReplyJust now
Edward Redshaw was feeling disgusted.
Copy of my most recent E-Mail to Keith Gerein at the Edmonton Journal and copied to the Premier, Health Minister, Alberta Health Services, Advocates, CEOs and others.
Disgraceful.
Dear Keith:
Re: Your article in today's (May 13, 2017) Edmonton Journal "Province, doctors teach tentative deal on new primary care model".
Two important quotes"
"Alberta's $240 million Primary
Care Network (PCN) system is set for a major funding and governance overhaul in the months ahead"
" Van der Merwe said newly announced health transfers from the federal government earmarked specifically for mental health and home care could also be directed to PCNs".
I am beyond disgusted with this government. They proceed from one disgraceful action to another. This is an even further low than their previous one regarding people with Dementia at home.
Acute care in Alberta is already funded 35% higher than the national average and yet they are going to pour even more funding into this bottomless pit. Why don't they spend the money to open up some of the procedures, such as MRIs they have closed to public use or to reduce waiting times for specialists? With this new system they are going to generate even more clients for these already backlogged needs.
To add insult to injury they intend to siphon off funding from the federal transfer funds which were not earmarked for that purpose. Continuing Care including Long-Term Care is funded 21% less than the national average. Do they intend to reduce this even further? Our voiceless, vulnerable souls in Long-Term are paying dearly because this government regards them as a disposable, discardable liability.
Dante in his Inferno said that the hottest place in hell is reserved for those who remain silent in times of moral crisis. Perhaps those who fit into this category might, by digging deep, find the courage to speak up and encourage others to do the same. Assure their employees that they will not lose their jobs or be sued if they join this cause. This would reduce the space allocation in hell.
Something has to be done. The Health Minister and Alberta Health Services have to be informed of the error of their ways and their thinking redirected.
Trying to Keep the Faith in my fellow man and woman.
Edward S. Redshaw.
Sent from my iPhone

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