Primary care networks need closer scrutiny, auditor general says

The Alberta government has no way of knowing whether its primary care networks (PCNs) are working, according to a new report released Wednesday by Auditor General Merwan Saher.

Saher's report saysthe department ofhealth and Alberta Health Services have failed to define clear objectives, performance measures or targets forPCNs, which impedes decision-making about whether to continue, expand or end the program.

"The department and AHS do not have systems to evaluate the PCN program and demonstrate that their current efforts are bringing the province-wide benefits envisioned for this initiative," the report states.

The report says about 80 per cent of Albertans belong to a network, but most haven't been told about it or know which one they've been assigned to. PCNs, in turn, don't know the names of the patients they are responsible for.

"This limits patients ability to engage in decisions about their own healthcare, and impairs PCN program planning and accountability," the report says.

Primary care networks started in 2005. There are 40 in Alberta right now, involving 2,600 family doctors. The province has spent $700 million on them, with another $170 million slated for this fiscal year.

NDP MLA Rachel Notley says she is appalled by the auditor general's findings.

"What this report shows is that this government has essentially spent almost a billion dollars on a project that they never bothered to check whether it was working, at all," she said. "It's grossly irresponsible."

Saher is recommending the government increase its oversight over the clinics and set targets. He also recommends the province tell Albertans what PCN they belong to and what services they can get there.

Health Minister Fred Horne said that he accepts Saher's recommendations. He said that government will keep them in mind as itestablishesthe 140 family-care clinics promised during the election.

"I've had some of these concerns and I have discussed them," he said. "Ultimately, now as minister, it's my responsibility that we deliver on the accountability, and I will do that."

Family-care clinics are similar to primary care networks, but aren't run by physicians. If appropriate, patients who make an appointment may see a nurse practitioner or other health care professional instead of a doctor.

Wildrose Leader Danielle Smith said in a news release that the government should follow up on the auditor general's recommendations before setting up new clinics.

"The government might be fixing what isnt even broken," she said.

"Its reckless and irresponsible to proceed with this massive restructuring without even knowing what the current situation is. We should know whether or not primary care networks are working before overhauling the system."