'It is a mess': How to fix health care dominates P.E.I. election campaign

Corinne McQuillan has been dealing with a full trifecta of P.E.I. health care woes recently.

She just had a surgical appointment cancelled after waiting years, because her surgeon is leaving the province.

She's dealt with long wait times in the emergency room at the Queen Elizabeth Hospital with her infant daughter.

And now, McQuillan's household is losing its family doctor to retirement.

She said she's lost faith in P.E.I.'s health care system.

"Truth be told, it is a mess," McQuillan said.

"I'm just scared for my children.… I have a special needs child. I need to know that if I need to take her to a doctor, that a doctor's going to be there."

'We're just running out of runway here'

The P.E.I. Medical Society is asking politicians campaigning in the provincial election campaign to commit to "urgent action" to prop up a system at risk of collapsing.

The society's president, Dr. Krista Cassell, said years of pandemic pressure and staff shortages have resulted in a health care system "in crisis… and we're just running out of runway here. People are tired, people are frustrated. It's very hard to get your job done every day in this system."

Politicians from all parties have made it clear health care is the biggest issue in the campaign, responding with pages of promises meant to get P.E.I's health care system off life support and into recovery.

Here are some of the commitments they've made.

A medical home for every Islander

There were about 13,000 Islanders on the province's patient registry waiting for a family doctor when the Dennis King Progressive Conservatives came to power in the spring of 2019.

Today there are more than twice that many — more than 28,500, representing one in every six Island residents.

At one of the first stops of the 2023 campaign, King referred to the "doctor for every Islander" promise that helped elect a Liberal government under Robert Ghiz in 2007.

The Liberals never got there and no Island government ever will, King said.

But he promised to get every Islander off the patient registry in the next two years by opening more collaborative medical practices — what the Tories call medical homes and neighbourhoods.

"It's zero in 24 months," King said of his goal for the patient registry. "We want to take everybody off the registry and attach them to a medical home or neighbourhood, because I think what Islanders want is access to service. And that is our ultimate goal."

The idea was actually put forward by the P.E.I. Green Party in its 2019 platform, where the collaborative practices were referred to as medical hubs. The Liberals promised such a system in their platform four years ago as well.

The Greens, Liberals, and NDP are all on board this time around with the idea of expanding collaborative practices.

The Tories say there will be 14 in operation by the end of this month, and if they get re-elected, there will be 30 by the end of 2024.

Concerns on staffing

How to staff those and the Island's existing healthcare facilities is another matter.

The Liberals are promising to expand nurse training programs on the Island, and to increase the supply of nurses and family doctors by offering to pay them more.

"Our salaries are not competitive right now with Atlantic Canada… so people are going to look at that when they're looking at jobs," said Barbara Brookins, president of the P.E.I. Nurses' Union.

The union's contract with Health P.E.I. expired two years ago, and nurses were told recently that negotiations are on hold until a new government can be sworn in, sometime in June.

Liberal Leader Sharon Cameron said one thing that would help with health care recruitment would be to show more respect to health-care workers. 

"The problem with staffing right now is people know the workplace is toxic," Cameron said. 

"They know when people are recruited, some of the commitments [that] get made to them, [they] don't follow through."

Some other promises to boost health care staff recruitment and retention:

• All parties have promised to expedite the licensing of foreign-trained doctors.
• The Tories would also create an associate physician licence to allow foreign-trained doctors to work under a reduced scope of practice.
• The PCs are promising free tuition to resident care workers, licensed practical nurses and paramedics who train on P.E.I. if they work here for two years.
• The NDP would create a provincial travel nurse program, which sounds like a 2022 budget promise from the PCs to create a float pool of 25 nurses (a promise which doesn't seem to have come to fruition).
• The Greens are promising to create a training program for physician assistants, which the Greens, NDP and PCs want to use to help out in areas like emergency rooms.

Parties split on medical school

The PCs and NDP say they would move ahead with plans for a medical school at the University of Prince Edward Island. The Greens and Liberals say they would put those plans on hold, pending some kind of review.

The Greens want a feasibility study — something which doesn't seem to have been undertaken by the province, despite the fact that it has invested tens of millions of dollars in the project.

"Everything here is backwards," said Green Leader Peter Bevan-Baker, because commitments were made before questions were asked and answered.

"We are going ahead, hell-for-leather, with a facility that — we do not know what the full costs are going to be, whether this is the best choice for making our system stronger in the long term….

"At this point in time, it's very, very clear that our health system and the medical personnel in it are not able to support what is being proposed."

University of Prince Edward Island faculty members, Health P.E.I. senior administrators, and the P.E.I. Medical Society have all questioned the commitment to build a medical school at UPEI to train more family doctors, saying the teaching requirements would add too much strain on local doctors already stretched thin.

On a related topic, the Greens, Liberals and NDP have pledged to increase the number of residency spots on P.E.I. to train doctors who studied at medical schools in other provinces. The PCs have promised to create a residency program for emergency physicians.

Expanded virtual care, more walk-in clinics

The Greens, Liberals and PCs are all committing to expanding access to walk-in clinics in the province. Those three parties are also promising to expand access to virtual care, and the Greens and PCs say services like Maple should be free of charge for all residents, not just those without family doctors. (So does the federal health minister.)

NDP leader Michelle Neill has said no public tax dollars should go to private health-care providers, including Maple.

"We can't have that being done with taxpayer, public money," Neill said.

"We need to ensure that those public funds stay in our public system, that they go directly to the front lines for our nurses, our doctors, our PCWs and RCWs… all of those people who work as a team to ensure that all Islanders receive the care they need."

Politics in, or out, of health care

At the end of last year, Derek Key resigned as chair of the board of Health P.E.I. after raising concerns about political interference preventing the health authority from acting at arm's length from government.

The Greens are promising changes in legislation that would create a firewall to make the agency truly independent from the premier's office.

By contrast, the Liberals are promising to make the premier's office more involved in health care by making the premier double as minister of health for the first two years of a new Liberal administration.

The Liberals have also promised to create a separate ministry responsible for mental health.

While there have been many health-care commitments so far in the campaign, few have had price tags attached. As of Monday, no party had yet released a costed platform, and there have been few dollar figures attached to commitments made thus far.