Health Minister Dorothy Shephard has no intention of negotiating with doctors or nurse practitioners currently charging patients directly for care, saying her focus is on recruitment and the elimination of the wait list for primary care.
"Every physician and nurse practitioner should be working within the Medicare system," the minister said. "We have 18 vacant nurse practitioner positions that we would dearly love to fill."
In New Brunswick, an increasing number of patients have been forced to seek care outside the public system because they can't get access to a family doctor, or to specialists with long wait lists.
As of Dec. 31, there were 44,226 people registered with Patient Connect New Brunswick which pairs residents with a family doctor.
But Shephard believes that by doing a comprehensive review of the names on the Patient Connect list and by hiring 18 full-time nurse practitioners, she will be able to eliminate that wait list within six months.
"I will hire them today," Shephard said. "And out of those 18 positions, we will take 18,000 patients off the Patient Connect list and connect them with a primary caregiver, a permanent one. That's what we need to have happen. We don't need one-off appointments."
Nurse practitioners argue that long wait list, combined with a new rule introduced by the Blaine Higgs government April 1, which charges medical practitioners for diagnostic or laboratory tests ordered for patients they see outside of the publicly funded system, is making it more difficult for patients who need care.
Shephard said she has no plans to reverse that policy, and is "not going to encourage that people should have to pay for a Medicare service" by providing any public resources to those doctors or nurse practitioners who are charging patients directly for appointments.
Focus is on hiring
In New Brunswick, patients are able to pay between $30 and $50 to see a family doctor or nurse practitioner operating outside of the public system.
Shephard said that's not a solution to the shortage of people who can provide primary care, and it's not something she is going to spend any energy on supporting.
"They're doing one-time appointments," she said. "They may have some followup, but this individual using their service does not have a primary-care provider full time. And that's our goal. Our goal is to ensure that every New Brunswick gets a primary health-care provider."
We're working on a two-tiered system — that's not what we want in New Brunswick. We want dependable, affordable health care. And there's ways to do it. - Minister of Health Dorothy Shephard
Shephard said staff are going through the list of people waiting for doctors and are contacting them by phone and through the mail to determine who is still in need of a primary caregiver.
She said officials have not been able to reach a "significant number," and their names will be removed from the list.
"Then we will have a very clear, concise idea of how many people in this province need a primary caregiver."
Chantal Ricard, president-elect of the Nurse Practitioners of New Brunswick, said her members would like to work within the Medicare system for one of the regional health authorities, but not everyone wants to work full time.
Shephard said she understands that, and is willing to hire part-time nurse practitioners.
Ricard also provided an email exchange with a "talent acquisition specialist" with Horizon Health that began on Feb. 26, when she asked for the postings for the available nurse practitioner positions so she could share with her members and help the province with its recruitment.
She was promised the information in an email dated March 2, but Richard said it never materialized, even after following up as recently as April 9.
Not happy with recruitment
When asked about that, Shephard said she has heard other complaints from health-care providers who want to work in New Brunswick.
"I've also been told that I have family physicians who want to come home to practise here, and they can't even get a call back, she said.
"That's why we've taken recruitment into the Department of Health to lead it, working with our partners at the [regional health authorities] and the medical society and our associations. I have not been satisfied with our recruitment process."
Shephard did not provide any suggestions for those who are currently without a family doctor or nurse practitioner, and in need of care.
"We're working on a two-tiered system — that's not what we want in New Brunswick. We want dependable, affordable health care. And there's ways to do it."