Abortion service on P.E.I. would have saved money: report

A proposal to provide abortion services on P.E.I., which a business case showed would have saved the province money, was halted by the health minister, CBC News has learned.

Health Minister Doug Currie refuses request for interview

A proposal to provide abortion services on P.E.I., which a business case showed would have saved the province money, was halted by the health minister, CBC News has learned.

Why exactly is it policy to not save the province money and help local women?

Health PEI investigated last year how an abortion clinic at the Queen Elizabeth Hospital might work, and how that plan gained considerable support from senior health officials, according to documents obtained by CBC News through a Freedom of Information request.

A leaked business plan for a twice-monthly clinic prepared by Health PEI shows the province could have saved $37,000 a year providing abortions on the Island, rather than paying for them to be performed at the Queen Elizabeth II Health Science Centre in Halifax.

Health Minister Doug Currie instructed Health PEI to stop its investigations into establishing an abortion clinic on P.E.I.

In addition, women using the service would also save tens of thousands of dollars.

With the service provided out of province, women have to pay their own travel costs.  In 2013, 153 P.E.I. women went off-Island for an abortion — paying for their own gas, hotel, meal costs and bridge or ferry toll — and spending an estimated $23,000 to $46,000.

One P.E.I. woman who had to travel to the mainland for an abortion agreed to speak to CBC News if her identity was protected. She wants to know what is behind the government policy on abortions.

"Why exactly is it policy to not save the province money and help local women? I just think it's really disappointing. This is not what I would expect from a Liberal government," she said.

"it's just really disappointing to see them so ready to be presented with information that says that women are really struggling and that this is affecting them greatly, and have them find it so easy just to push it, put it on the back burner and forget about it."

She is particularly worried about women on lower incomes who can't afford to pay the travel costs.

"Some people can't make it to Halifax," she said.

"They have children already, they can't pay a babysitter, they don't have a babysitter, they don't have a car.  They don't have means to get to Nova Scotia and stay there."

P.E.I. doctor part of abortion clinic proposal

The Health PEI exploration of an abortion clinic on P.E.I. began with a proposal involving three doctors – two from Nova Scotia and one from P.E.I.

Dr. Rosemary Henderson decided to carry on with evaluating a P.E.I. abortion clinic after orders came from the health minister for the process to be stopped. (CBC)

The proposal went to the medical directors at the Island's two major hospitals: the Queen Elizabeth Hospital in Charlottetown and Prince County Hospital in Summerside.

CBC News has agreed not to name the Island doctor. The doctor is worried being labelled pro-choice could lead to misunderstandings and concerns from patients.

The doctors, including Nova Scotia obstetrician-gynecologist Dr. Robyn MacQuarrie, were proposing two half-day clinics a month.

In May 2013 Health PEI convened a working group, led by Dr. Rosemary Henderson, medical director of the Queen Elizabeth Hospital.

In an email, Henderson acknowledged that they were dealing with a controversial issue, but noted senior health officials were aware of the proposal.

"Dr. Wedge is well aware and OK with public discussion if/when this gets out. [Health PEI] Board was made aware some time ago that we were interested in pursuing this. So far no barriers to proceeding," she wrote.

During a working group teleconference Sept. 30, attended by MacQuarrie and Health PEI CEO Richard Wedge, MacQuarrie told CBC News that Wedge commented that if the province "can offer a service that's reasonable, we're obligated."

"I had been warned not to be too optimistic, but I thought this is a no brainer," MacQuarrie said.

"We've got Health PEI, we've got Richard Wedge on board saying if we can find a service that's reasonable we're obligated and I thought, here we go, this is going to happen. We're going to have a positive impact on the health of women in Prince Edward Island."

Wedge confirms he did express that opinion in the September call. It reflects a public statement he made in 2011 as well.

Premier raises obstacle

Wedge confirmed the proposal did not have road blocks initially, but in December Premier Robert Ghiz, during a year end interview, said the government's policy on abortion would not change. That is, it would continue to fund abortion services off the Island only.

Wedge said in January he got a call from Health Minister Doug Currie saying the project had to stop,

"The minister said there's no point in putting more resources into a project ... that's against government policy," Wedge told CBC News.

so Wedge called the head of the Provincial Medical Advisory Committee. The committee was about to review the plan, following the investigations of the Health PEI working group.

Wedge told the committee's chair, Dr. Rosemary Henderson, to stop the review. Henderson refused. He then told her to keep discussion of the plan out of the minutes, and she again refused.

"Immediately prior to our February PMAC meeting, I got a call from Dr. Wedge, who told me that [Health PEI] has been explicitly told to cease work on the abortion project. I ignored that and took it to PMAC anyway and have finished off my part of it," she wrote.

What is the Provincial Medical Advisory Committee?

While it is established under Health PEI bylaws, the Provincial Medical Advisory Committee is an independent body. It has 11 members: six of those are elected by the province's doctors, dentists, and nurse practitioners; the other five serve as part of their jobs, the executive director of medical affairs for Health PEI, the medical directors of the two main Island hospitals, and two network medical directors appointed by Health PEI.

The committee is meant to provide advice to Health PEI on the operations of health services in the province.

The documents show the committee wanted the public to know it approved the plan, and were not responsible for it not advancing.

CBC News asked Dr. Rosemary Henderson for an interview and was told Dr. Wedge is the official Health PEI spokesperson on this matter. 

The committee completed its review, but Wedge said because the planning process was shut down, executives at Health PEI never reviewed the business plan to know if it actually would save the province money.

When asked by CBC News what he thought about the government's policy on abortion services, Wedge first repeated the government line that the province is not a position to provide all medical services at local hospitals.

"If we had a larger population then we could supply more services on P.E.I., they wouldn't have to travel as far," he said.

"It is not unusual in Canada to travel for medical treatment."

When pressed on abortion services in particular, and the fact that the plan would save both taxpayers and patients money, Wedge had this to say.

"There's a policy in government that says abortions will not be done on Prince Edward Island. And we follow the policy," he said.

"As the CEO of Health PEI, we are required by law to follow government policy … I have personal opinions on it but it's not appropriate to offer personal opinions."

Wedge said if he had been aware of the government policy when the investigation into the proposal first started he might have not "looked down that road," but he said it is Health PEI's job to work through proposals to see if they offer better health care for Islanders.

Government issues statement

Health Minister Doug Currie refused requests for an interview with CBC News about the details of the government's policy.

Official statements on abortion

Dr. Richard Wedge, Nov. 2011

"If a physician applied for privileges to do abortions on P.E.I., and they had the skills, the training necessary to do it, then they could get privileges for that on P.E.I."

Health Department, Jan. 28, 2014

"Due to Prince Edward Island's size and population, it is not possible to provide every medical procedure within our province."

Robert Ghiz, May 26, 2014

"There's a lot of services on Prince Edward Island we do not offer. We believe it's better to pay for them in another province and this happens to be one of the services ... and we believe the status quo is working."

In lieu of an interview the minister's office sent a statement, which was largely a repeat of previous statements by provincial officials on the subject.

"Government is meeting its obligations to offer abortion services on a regional basis, similar to the same way we offer other health services such as cardiac rehab, vascular and pediatric services," it said.

"Islanders have timely access to abortion services and government policy in this area is in compliance with the Canada Health Act. Government has been clear on this position and there are no plans to change the policy."

Dr. Robyn MacQuarrie said the fight to bring abortion services to P.E.I. isn't over.  She said a challenge through the P.E.I. Human Rights Commission is being considered, or there could be a judicial review of the government's position.

with files from Laura Chapin