The P.E.I. government promised free virtual care for all. But will it actually happen?

Four months after the Progressive Conservative government's election promise to make virtual health care free for all Prince Edward Islanders, it's still not clear when it will actually happen, or how it will work. 

A government spokesperson directed CBC News to Health P.E.I. for details on the plan, calling it "the entity that will lead implementation."

The agency's CEO, Dr. Michael Gardam, says it will likely take a couple of years of planning and doctor recruitment to make it feasible.

"To be blunt, I don't think it's possible right now because none of these virtual platforms have enough doctors that would be able to suddenly provide it for everybody on the Island, whenever they wanted it," said Gardam. 

For the past three years, virtual care through the Maple platform has been free for Islanders on the wait list for a family physician or nurse practitioner. There are currently 31,120 people on that list.

But other people using Maple on P.E.I. have to pay out-of-pocket, unless they're covered through private or work insurance plans. 

Gardam worries that if all Islanders had the cost covered through public health care, some P.E.I. physicians would use it as an incentive to stop seeing patients and go virtual. 

"We've already had that happen on the Island. A few of the doctors that have left Health P.E.I. in the last couple years have gone to do virtual care full time," said Gardam. 

"If you're a fee-for-service doctor and you don't have to pay for any overhead, and you can do this from your dining room table, you can make more money. So these are things that need to be worked through, so that we don't inadvertently take away from one area and bring it to another area."

According to Maple's CEO, Dr. Brett Belchetz, there are currently 97 doctors and nurse practitioners "set up on Maple and eligible to provide medical care to patients in P.E.I."

Belchetz agrees that number would need to increase to meet the demand if the P.E.I. government made virtual care through Maple free to all Islanders. 

But he doesn't think that would reduce access to in-person care. 

"There are lots of practitioners out there across the country who work full schedules. They're in a clinic five days a week for lengthy hours. But they have extra capacity at different times... It could be evenings. It could be weekends," he said.

"I would love to extend that messaging out to all the providers on the Island and make them aware this is something that's flexibly available to them."

Maple's CEO also thinks looser licensing rules for doctors would help improve access to virtual care. 

In May, the four Atlantic provinces launched a new framework that lets doctors around the region work in any of the four provinces for one yearly fee, without additional licensing requirements.

But doctors and nurse practitioners outside the region, who don't have a P.E.I. licence, can't provide virtual care to Islanders. 

"The more the government is open to saying, 'We will bring in providers from elsewhere in Canada,'... the more likelihood that not only can we open up the program, but open up the program so that everybody can get a quick, available appointment when they need it," said Belchetz. 

The P.E.I. government hasn't provided any details about how a free virtual health-care program would work, or how it would meet the demand given the staffing challenges. 

In its budget address in May, the province announced plans to invest $2.4 million "to expand access to virtual care." The province didn't say whether that meant free virtual care, or provide any timelines.