Questions over Alberta Health ministry directives to remove influenza and Covid-19 specificity from seasonal vaccination advertising campaigns dominated a media availability with Alberta’s Premier and Minister of Health on Dec. 21.
Premier Danielle Smith announced that pass-through funding, provided by the Government of Canada to the Government of Alberta from a bilateral agreement signed earlier in the day, would be used to stabilize funding for primary care physicians to improve access to primary care.
That funding, amounting to $200 million per year, represented the bulk of the $285 million per year in the agreement given to the province through the federal government’s Working Together to Improve Health Care in Canada plan.
“We are in discussions with the Alberta Medical Association on a new family physician payment model to support comprehensive care and ensure that doctors are seeing more patients and we need to have and we expect to have the outlines of that within a few months. Still, family physicians need help now,” said Premier Smith.
“Details will be announced as soon as they’re finalized. But I want family physicians to know that relief is on the way and soon.”
The provincial government is creating a new primary care organization separate from Alberta Health Services. They hope to have that organization running by the end of 2024.
Minister of Health Adriana LaGrange said that a task force consisting of her ministry and the Alberta Medical Association was working towards short-term stabilization actions to address key pressures in the current health system, like physician retention, payment models, and rising costs for doctors to run clinics.
“Ultimately we want to better support family physicians and their teams to have a viable practice that improves their quality of life and which also meets all of the care needs of their patients,” she said.
Dr. Paul Parks, president of the Alberta Medical Association said that steps taken towards providing stabilization for physicians was an essential first step out of several promised to doctors by Minister LaGrange.
“Today’s funding is an unprecedented infusion of financial support for the clinics and practices where most Albertans obtain the health care in both urban and rural settings, and it is consistent with recommendations of Alberta doctors for a three-phased approach,” Dr. Parks said.
Those phases, he said, were the stabilization of family physicians and rural practitioners in Alberta, followed by a need for increased support to provide life-long patient care for Albertans, and the move away from a pay-per-service to a more comprehensive payment model for doctors.
Questions of ministry interference in AHS vaccination advertising raised
Following allegations that Alberta’s Ministry of Health directed Alberta Health Services to remove references to influenza and Covid-19 from this year’s advertising campaign—a story first published by the Globe and Mail on Dec. 21—both the Premier and Minister of Health denied any impropriety.
At issue, were indications via documents provided via freedom of information requests that the Alberta Health ministry directed Alberta Health Services to remove references to those vaccines, and to limit information on vaccine effectiveness in the ad campaign.
Premier Smith, when asked directly whether this was the “sort of micromanagement” that could be expected from ministries into how Alberta Health Services is run, said that AHS would be transitioning into an acute care-only provider.
“There are a lot of functions that we’re moving back into the department,” said Premier Smith, referring to the Alberta Health ministry.
Minister LaGrange claimed that because Alberta was now in an endemic phase, and not in a pandemic phase of Covid-19, that all respiratory viruses had to be “treated in the same manner.”
“So, the language and the documentation and the communication has to be in alignment. We’ve done the same with our website to make sure that we are covering all of the respiratory viruses that are out there,” Minister LaGrange said.
According to statistics provided by the Government of Alberta to the end of Dec. 9, there have been 1097 hospitalizations and 34 deaths from influenza, versus 2,647 hospitalizations and 306 deaths from Covid-19. Provincial data on RSV shows few cases, and no data was available on hospitalizations or deaths, if any.
Premier Smith, when asked about low levels of vaccination in the province, said that vaccinations are not any lower than in other provinces —and remain a private medical matter to be discussed between a patient and their physician.
She said that the province is spending roughly the same as they have in years past on the advertising campaign, approximately $500,000.
“People need to understand that all of these viruses put people at risk, and so people need to talk to their doctor about what vaccinations they need and how to best protect themselves. That was the message in the campaign. That is the message in the advertising. That was our message as a government, and we’ve been spending the same amount of money as previous years in advertising that message.”
The Premier denied that they had deemphasized the amount of support given to vaccinations, citing quotations made by Minister LaGrange and Dr. Mark Joffe made in a single press release sent on Thursday, Sept. 28 at 4:30 p.m., as counter-evidence to that claim.
“I think that the message was pretty clear,” she said.
Alberta Health Services sent out a press release Thursday reminding Albertans to get immunized, following the conclusion of the government’s media availability.
Talk to your doctor the message, but not clear who will have a doctor to talk to
Dr. Parks said that the lack of people getting vaccinated is a concern to physicians.
“Vaccines work. They really, truly work. I want to put this in perspective out there that what we need is more Albertans being vaccinated because it works in it helps to protect those people, but it helps to protect the system,” he said.
“I’ll give some examples. We’re seeing two-year-olds out there now that are getting influenza and having encephalitis which is an infection of the brain that may actually be life-threatening, and if they survive, they may never be normal again. We’re seeing adults that are going to have maybe need heart transplants from influenza because they’ve done so much damage to their heart.
“I’m a physician, not a politician.”
On the message of whether Albertans should get vaccinated, Premier Smith said that she’s a politician, not a doctor, and that everyone should talk to their doctor about the right choice for them.
She passed the question of which doctor would be available to speak to, given that some 700,000 Albertans do not have a family physician, to Minister LaGrange.
“One of the reasons for this very announcement is the fact that we have roughly about 700,000 people in the province that do not have a primary care provider. So that makes that conversation about immunization and about other health issues that they may be facing a difficult conversation,” she said.
“It’s going to have to be a multi-pronged approach until people feel comfortable once again to go to their provider and get that immunization that’s so required. But again, you’re hearing firsthand from a doctor who’s seeing it live in his hospital what the results are. So of course we’re going to do everything possible that we can.”
Across Canada, the number of Canadians who have received an updated booster shot for Covid-19, up to Dec. 3 of this year, was 14.6 per cent according to Health Canada.
Alberta, Nova Scotia, and New Brunswick lagged the national average with 14.3 per cent, 14.2 per cent, and 13.1 per cent.
Alberta’s neighbouring provinces of B.C. and Sask. have had 23.1 per cent and 16.5 per cent vaccinations of their populations for the same period.
