Cutting funding for doctor-delivered flu shots bad decision, says medical association

Health department documents suggest changes were made to the flu shot program to help pay for new HPV vaccinations for boys, but the minister says it's about using health care professionals wisely.

N.L. health minister insists decision based on 'scopes of practice' not costs

The province has stopped paying doctors $17 each time they give a patirent a flu shot. It estimates that will save almost $500,000 annually. (Toby Talbot/Associated Press)

The group that represents Newfoundland and Labrador's doctors says the province has made a bad decision in cutting coverage for flu shots that will result in fewer residents getting the shots, and ultimately increase health care costs.

Emails acquired by the Newfoundland and Labrador Medical Association through an access to information request show the government decided to stop paying physicians $17 each time they give a patient a flu shot  to cover the costs of expanding the human papillomavirus vaccination program last spring to include boys.

"We are looking at eliminating the fee code for influenza immunization." wrote the health department's Michael Harvey on Apr. 3, 2017. 

Harvey is the assistant deputy minister to the department of health's executive director of audit and claims integrity.

"The sense that we have is that this fee code is being used by docs to run "flu shot clinics" and there is an estimate that we could save $517,000 from eliminating it."

"We want to use these savings to pay for the introduction of HPV vaccination for boys," Harvey wrote in an email. 

That decision was confirmed in an email sent to the NLMA weeks later.

"On Thursday, May 4, 2017, the minister will be announcing funding to expand the HPV vaccination program to include school-aged boys. In order to fund this initiative, a decision has been made to no longer fund influenza vaccination clinics held by physicians," wrote the province's deputy minister of health, John Abbott, to the NLMA's executive director, Robert Thompson.

NLMA executive director Robert Thompson. (Jeremy Eaton/CBC)

Doctors say the emails they received through an access to information request show the government expects its decision will result in fewer residents receiving flu shots.

"We are assuming that 75 per cent of individuals who were vaccinated by physicians will come to public health clinics for their immunizations." stated an Eastern Health influenza immunization briefing note dated  April 3, 2017.

The NLMA said the government's decision will ultimately increase health-care system costs.

It said health authorities across the province will need to spend hundreds of thousands of dollars more to vaccinate patients who will no longer receive flu shots from doctors. It also said the province's health system will have to bear the costs of extra emergency room visits and hospitalizations "that will likely occur if flu shot coverage is reduced."

The Canadian Cancer Society has said HPV, or human papillomavirus, is linked to cancer. 

Health minister defends decision

But Newfoundland and Labrador Health Minister John Haggie said saving money had nothing to do with the decision.

"This isn't about cost, this is about scopes of practice. We have a small army of health-care professionals who are trained and competent at giving flu shots. We have a very small group of family doctors whose skill set is in chronic and complex disease management," Haggie said at a news conference Thursday afternoon.

Health Minister John Haggie tells reporters Thursday that government's decision is based on being 'wiser' when it comes to health-care resources and professionals. (Mark Quinn/CBC)

When pressed on his repeated use of the term "scope of practice," Haggie said it's about doing things "wiser."

"Scope of practice is basically a discussion we have had with pretty well every allied health professional and health-care provider, and the NLMA have really led the charge. They want their physicians working to the maximum of their skills — not you know, filling in paperwork or dealing with more mundane tasks that someone else is better trained to do," he said.

Haggie added that Newfoundland and Labrador has a "very robust vaccination program" and there is consideration to extending the flu vaccination season.