PCs still not happy with Liberal answers on Medavie contract

New Brunswick's new health minister is spending his first few months on the job defending a health services contract with Medavie that may be turning into a political vulnerability for the Liberal government.

Benoit Bourque spent more than five hours last Friday fielding questions about the agreement during a legislative committee hearing in Fredericton.

He gave detailed answers about the contract's performance targets and the legislation that will allow the deal to take effect.

None of it worked.

"There's just so much unknown," saidOpposition Progressive Conservative MLA Ross Wetmore after the marathon session spent questioning the minister.

"If it's a good deal for New Brunswick, we'll stand behind it, but the government hasn't come forward with enough information."

The contract, which will take effect Jan. 1 but has not yet been signed, will turn over management of the extramural care program and Telecare to Medavie, a not-for-profit company that already runs the provincial ambulance service.

• Medavie CEO defends takeover of extramural management

Mario Levesque, a political scientist at Mount Allison University, said the lack of a clear rationale for the outsourcing is a huge political risk as the Gallant government prepares for an election in September 2018.

The Liberals say the three programs Medavie will oversee have to work together efficiently as the provincial population gets older and requires more home-based care.

But Levesque says the government has not explained clearly why the existing extramural program can't do that.

"What's not running well? What's the hiccup?" he said.

Extramural popular, and seniors vote

"I'd like to see where it's been a problem, I guess," Levesque said. "'Give me some examples' is what I'd ask the government."

He said research he conducted last year amongpeople with disabilities in Shediac, Bathurst, and Grand Falls showed a high level of satisfaction with the extramural program, now run directly by the provincial government.

"They just raved about the program," he said. "They said it was phenomenal, it was where they got all the resources. 'Without that, we don't know what we'd do.' They loved how it was coordinated. It was easy to work with. It was their lifeline to government services."

• Victor Boudreau defends moving extra-mural program to Medavie

Bourque and fellow cabinet minister Lisa Harris, the minister for seniors and long-term care, held nine public meetings around the province to answer questions about the contract.

Bourque also asked a francophone seniors' group for permission to make a presentation at a series of public sessions it organized. The group refused, saying it didn't want Bourque taking over their meetings.

Levesque said it looks like the Liberals have again provoked senior citizens as they did in 2015 with changes to nursing home fee structures they later abandoned.

"That's one group you don't pick on," he said. "They have a lot of power and they vote. They vote like crazy. They're the ones that vote in the highest proportion."

Minister explains targets

Bourque's lengthy appearance at the legislative committee last week included a detailed explanation of how the Medavie contract's key performance indicators, or KPIs, will work.

The company can win an extra $1.8 million per year on top of a $2.6 million base payment if it hits five indicators.

They include increasing extramural visits to patient homes by 15 per cent and reducing expensive emergency-room visits by extramural patients by the same amount.

The 15 per cent increase in extramural visits would equal about 90,000 more visits, based on the current number of 600,000, Bourque said.

For $4.4 million, "that's quite a sweet deal, I have to say."

The bonus payments will be prorated, meaning Medavie will collect a percentage of the money as it achieves a percentage of each KPI.

But once the company fully hits the indicator, the province will negotiate a new, higher target. The bonus payment will revert to zero so that it must be earned again.

"Once Medavie hits 15 per cent, it's not 'done,' 'check,' and they get the bonus year after year just for hitting the target," Bourque said. "So Medavie keeps looking to improve on that performance indicator."

No open door, minister says

Bourque also defended his legislation from criticism by the Vitalite Health Network. The bill lets the cabinet draft regulations to broaden"extramural" services, which Vitalite says could allow the province to outsource other parts of the system.

Wetmore echoed that concern at Friday's hearing.

"That's opening the door to a number of things," he said. "The private management is going to start to encompass more and more parts of the health system."

Bourque said the government doesn't want to "reduce [extramural] to one definite, closed definition" in case new services are created in the future. But he said the point is not to privatize management of more services.

"The rest is not changing," he said."Inferring an erosion of the system I'm going to say it, it's false."

The health department said Monday extramural physiotherapy and occupational therapy services for children, both named in the bill, will remain with regional health authorities and won't come under Medavie.

On Nov. 10, the department told CBC News it was still being "worked out" whether they'd move to Medavie.

Bourque said the two RHAs were aware as early as February 2016 of the changes the province wanted, and never presented an alternative proposal on how they could do it.

"The RHAs do not have that type of capability when it comes to home care that Medavie has," he said. "Only Medavie can address all five KPIs with the amount we are bringing to the table."

'More of the same'

Despite Bourque's lengthy defence of the bill, Levesque says the agreement is perilous for the Liberals.

He compares it to a decision under the previous PC government to outsource a provincial program that provides and maintains wheelchairs for low-income New Brunswickers.

"This is more of the same," he said.

After the contract went to the Canadian Red Cross, which had no experience with the program, many participants complained they were forced to wait weeks or months for their wheelchairs.

Bourque is scheduled to continue defending the legislation during another session of the committee on Tuesday.

Wetmore said the government should release the full text of the contract before it's signed, something the Liberals say they can't do.