Doctors Nova Scotia concerned about private health clinic in Halifax

The introduction of a private health-care clinic in Halifax is a signal to the province's public system that it needs to take vigorous steps to improve, a spokesperson for Doctors Nova Scotia says.

'They see a need and they are stepping in to fill it when the public system can't do it'

Kevin Chapman, director of partnerships and strategy for Doctors Nova Scotia, says the association has questions about how a new private clinic in Halifax operates. (CBC)

The introduction of a private health-care clinic in Halifax is a signal to the province's public system that it needs to take vigorous steps to improve, a spokesperson for Doctors Nova Scotia says.

The professional association that represents about 3,500 or so physicians in Nova Scotia met Saturday to discuss the issue, said Dr. Kevin Chapman.

"It was an enthusiastic discussion, I can say that," he said. 

The Unified Health Community Triage Centre, which opened in August, underlines the ongoing lack of access to primary health care for many in Nova Scotia, he said.

"I don't want to say I applaud this clinic. I am quite concerned about the introduction of private care. But they see a need and they are stepping in to fill it when the public system can't do it and we need the public system to be able to do it."

Unified Health Community Triage Centre opened in west-end Halifax in August. Its ability to provide laboratory tests and diagnostic imaging was questioned by Doctors Nova Scotia at a meeting Saturday. (Unified Health Community Triage Centre photo)

Doctors Nova Scotia has some specific concerns about the clinic, Chapman said.

"At least on the surface, it seems to create a two-tiered system ... for medically insured services.  One of the concerns is, is this a slippery slope in the erosion of a publicly funded health care system?" 

The association is drafting a series of questions for both the clinic and the Nova Scotia Health Authority to find answers to questions such as who oversees the delivery of services at Unified Health. 

"Physicians are governed by the college of physicians and surgeons, the Nova Scotia Health Authority is responsible for delivering care across the province in its facilities. We don't have an understanding of what that oversight [for the clinic] might be," Chapman said.

The clinic's access to diagnostic services, such as laboratory tests and x-rays, is another concern for Doctors Nova Scotia.

Lots of questions

"If an individual comes in and needs diagnostic tests, are those done through a private clinic or are they done through a public clinic? Will the patient be charged for those? We had a lot of discussion around that," he said.

"The bottom line is, there were lots of questions. At the end of day, we certainly see this clinic trying to provide services that are needed. Access to primary care certainly is a challenge in Nova Scotia, but our focus would be on strengthening the public system rather than trying to concurrently put a private system in place."

Nova Scotians can currently get a type of triage through 811, where they speak to a nurse or nurse practitioner, Chapman pointed out.

"It is essentially the same kind of thing where they may just talk to me about over-the-counter kinds of [medications] or refer me to a walk-in clinic or emergency room. It is recognized that the system does need a gateway with so many unattached patients."

The profit motive is another concern, where naturopathic and other non-traditional treatments are attached to Unified Health, that are not insured through the public system, he said.

"It's the same reason why physicians aren't allowed to prescribe and sell medications at the same time."

More access to locums

Meanwhile Doctors Nova Scotia wants changes made to licensing regulations that make it difficult for physicians to practise outside their own provinces, a major barrier to finding locums to fill in for other doctors.

"Ideally a locum, in a perfect world ... we would pay to fly them down here, we would pick them up at the airport, we would taken them to the clinic, they would practise, we would pick them up, take them back to the airport and they would fly home," Chapman said.

A locum working group including members of Doctors Nova Scotia and the Nova Scotia Health Authority was reconvened about a month ago to deal with some of the administrative obstacles.

"I think we have to get to a place where we find nine ways to say yes, before we have to say no. We make it easy for someone to come. If you've been practising in Canada, and you're licensed by New Brunswick, I think we need to work with our college (of physicians and surgeons) to facilitate that more easily ... portability across the country has to be easier. "