Opposition parties pressure province on Islanders' access to health care

Islanders in need of health care without a primary physician can use walk-in clinics or virtual care, but Green Party MLA Matt MacFarlane wants to know just how accessible the services are to those in need.

"These clinics would be more accurately called 'get up in the middle of the night and stand in line for hours, with no guarantee that you'll actually ever be seen' clinics," he said to Health and Wellness Minister Mark McLane at the legislature Tuesday.

There is a request for proposals going out soon for virtual care, said McLane. He said it won't be a solution but rather another avenue for Islanders to access care.

"We may have one provider, we may two. I'm not really sure on how we'll do it, but again, another entry, another access point for Islanders," he said.

Private company Maple currently provides virtual care to Islanders.

MacFarlane said he recently spoke with the P.E.I. Nurses' Union about the ways nurse practitioners can provide walk-in clinic care.

"One of their asks was to improve the process for nurse practitioners to provide walk-in clinics," he said.

"There's currently no equitable compensation for nurse practitioners who want to provide walk-in clinics, and no clear or easy process for nurse practitioners to access staff or infrastructure to operate a walk-in clinic."

The union's collective agreement expires in March and there have been discussions with the nurse practitioner group, said McLane. 

"I think they're the most eager group in our health-care workforce that continually tells us that they're willing to do more," he said.

There are 14 more nurse practitioners expected to graduate in April and McLane said he's excited to see how the department can maximize their scope.

Further questions on health care on the Island were brought up by Liberal MLA Gord McNeilly. He asked McLane about the April 2023 Health and Wellness mandate letter, in which McLane said the department would:

• Accelerate the roll-out of medical homes by adding 16 more patient medical homes across the province by the end of 2024.
• Incentivize newly created patient medical homes to take unaffiliated patients off the patient registry with a goal of having all Island patients affiliated with medical homes in the next 24 months.

"We've made some, again, some expansions again, we need space in order to do this," said McLane.

He noted space has been leased in Cornwall with the new Access P.E.I. building so Dr. Padraig Casey's patient medical home clinic can expand. 

"Kenlock is expanding, Montague has made steps. So you know we need the space. We've had some, a productive year in hiring. So we'll continue to staff up those patient medical homes," he said.

In October, the Canadian Institute for Health Information report came out showing about one in four Islanders do not have access to primary health-care providers. At the time, Health P.E.I. CEO Melanie Fraser said in a statement to CBC News that she expects the numbers for the province to start improving soon.

"Our commitment to growing primary care through patient medical homes [PMHs] is unwavering," said Fraser. "We've developed efficient procedures to quickly establish new PMHs and ensure widespread access. By 2027, we aim to have every Islander supported by a team of primary-care providers."

As for the patient registry, McLane said the department is spending a lot of time modernizing it over the summer.

"I think with our new electronic medical record system that we have some work to do so that the list is more vibrant and not just a stagnant list," he said.

The department has had discussions with the ethics of managing the list, McLane said.

"I think we need to take another look at how we manage that list," he said.

"Geography and time is still going to be very important and how we consider conditions and maybe somebody's being followed by a specialist that perhaps shouldn't be and should be in the care of a primary care physician."

However, McLane said he would leave that up to the experts.

Population growth, recruitment efforts and capital space also factor into the patient registry, he said.

"Realistically I think there will always be a couple thousand on the list, coming and going, so on and so forth. So again I think we're making strides," McLane said.

The registry is moving in the right direction, he said, and the department has affiliated about 4,800 patients in the last year. Retiring physicians with large panels pose challenges, but he said there has been success in recruiting.