00:07:23.800Just a few weeks ago, Minister Lagrange announced our government's work to strengthen the primary
00:07:28.460care system to ensure every Albertan has access to a family primary care health practitioner
00:07:34.860when and where they need it. To achieve this goal, we have to ensure that primary health care is the
00:07:40.300foundation of the entire health care system. We know that there's a lot of work to do, but we're
00:07:45.120at a critical time for health care in Alberta. Many people are struggling to find a family doctor
00:07:49.600and those who have them may end up waiting weeks for an appointment. Albertans expect better and
00:07:55.580so does our government. This is why I'm pleased that our government is closing the gap in the
00:07:59.780current funding structure to allow nurse practitioners to open their own clinics,
00:08:04.300take on patients, and offer services based on their scope of practice, training, and expertise.
00:08:10.160It's unfortunate that nurse practitioners have been underutilized in Alberta because they can
00:08:14.320provide an incredible service to Albertans. This past year, we've seen 255 physicians registered
00:08:20.620to practice medicine in our province in addition to these 248 physicians and surgeons have chosen
00:08:26.700to remain in alberta after finishing their training this is so important for alberta
00:08:32.300albertans in need for for important health care services but those hundreds of physicians are not
00:08:38.220all family doctors by creating opportunities for nurse practitioners to open their own offices
00:08:43.740we have the added ability to add more primary care providers for alberta families this would
00:08:48.780represent a significant positive outcome for tens of thousands of patients actually we're just
00:08:52.860talking about it hundreds of thousands of patients in fact we will probably we will stop at nothing
00:08:57.100to ensure that albertans have access to the care they need when and where they need it and that's
00:09:01.980why we're also providing a grant to the nurse practitioner association of alberta for two
00:09:06.140million dollars over three years this investment will help to recruit and prepare nurse practitioners
00:09:11.020as they take on more responsibilities and it will support them as they move to independent practice
00:09:15.820and take on patients nurse practitioners are highly skilled primary care providers with advanced
00:09:21.820training they can assess patients provide diagnosis and treatment order tests and prescribe
00:09:27.260medications they are a key part of the solution to ease pressure on the primary care providers
00:09:32.380and i do want to be clear alberta's government is pulling out all the stops to stabilize and
00:09:36.940strengthen and improve alberta's primary health care system so every single person can have access
00:09:42.700to a family practitioner and get the health care they need when and where they need it.
00:09:47.100Nurse practitioners are ready to lead and government will give them the resources so
00:09:50.700that they can lead. Help is on the way for Albertans frustrated with long delays for
00:09:56.300routine care. Now I'd like to turn things over to Health Minister Adriana Lagrange for more details.
00:10:01.180thank you thank you premier and good morning just recently we committed to several immediate
00:10:14.140actions that will make primary health care the foundation of the health care system addressing
00:10:19.740health workforce challenges is paramount and delivering on this is something i take very
00:10:25.180seriously this is precisely why we are implementing a nurse practitioner compensation model and
00:10:32.780closing this funding gap so that we can add much needed capacity to our primary health care system
00:10:38.860and help more albertans find a regular care provider through the new model alberta health
00:10:44.940will compensate nurse practitioners who want to practice independently take on patients and also
00:10:51.740offer services that reflect the full extent of their training skills and experience the college
00:10:58.540of registered nurses of alberta will be responsible for the regulation of this work and similar to
00:11:04.380other regulated professions all nurse practitioners must meet minimum requirements to practice
00:11:10.620and follow standards set by the regulatory college as premier mentioned we will be providing
00:11:16.460the nurse practitioner association of alberta with a grant of two million dollars over three years
00:11:23.260this funding will help implement the compensation model recruit and encourage nurse practitioners
00:11:29.580to participate and provide supports as nurse practitioners plan to set up their clinics
00:11:35.500and work independently we expect the compensation model to begin rolling out in early 2024
00:11:42.780and while its exact structure is still being developed we expect it will apply to full-time
00:11:49.560nurse practitioners who agree to take on certain a certain number of patients whether it be in
00:11:55.120their own independent clinics or within existing primary care practices in addition nurse
00:12:01.800practitioners who opt into the new compensation model will qualify for supports to help manage
00:12:07.780their patient caseloads once those caseloads are established. These supports include $57 million
00:12:14.860over three years to help both nurse practitioners and family doctors manage an increasing number
00:12:24.640of patients. Each provider has the potential to receive up to $10,000 annually. We anticipate
00:12:31.920that the compensation model will be implemented in stages as nurse practitioners become ready
00:12:37.480to participate the model will be implemented for a minimum of five years and then evaluated to see
00:12:43.560what improvements are needed and how we can encourage as many nurse practitioners as possible
00:12:49.000to take part we will work closely with the nurse practitioner association of alberta
00:12:54.360and the college of registered nurses of alberta as the model is put into place i look forward to
00:13:01.240working with them throughout the implementation process and encourage nurse practitioners from
00:13:06.040across the province to participate in this exciting opportunity and we also extend that
00:13:11.800across canada this compensation model represents progress adding critical capacity to alberta's
00:13:19.000primary health care system it is a change that will help more albertans access health care
00:13:24.440in their communities and close to home thank you and now i will ask dr susan pendergast
00:13:30.600president of the nurse practitioners association of alberta to say a few words
00:13:40.280thank you premier smith and minister lagrange for recognizing and supporting the role of
00:13:45.080nurse practitioners in improving access to high quality primary care for albertans
00:13:50.600the nurse practitioner association of alberta is thrilled for the opportunity to support our
00:13:54.840neighbors across the province in accessing a care provider in all health care provide
00:14:00.120environments not just primary care with this announcement and this grant the association
00:14:04.920will be perfectly positioned to ensure that our members are fully prepared to meet the needs of
00:14:09.320albertans in both rural and urban communities there is a large nurse practitioner workforce
00:14:14.840in alberta ready and willing to step up this grant will help nps open primary care clinics
00:14:20.040across the province and quickly improve access to primary care for those without a dedicated provider
00:14:25.720nurse practitioners are full scope health care providers who can assess diagnose order and
00:14:32.900interpret diagnostic tests write prescriptions and manage both wellness and illness or injury
00:14:38.480until now accessing a nurse practitioner has been challenging this announcement ends those
00:14:43.920challenges the npaa looks forward to working with alberta health to get clinics open and to support
00:14:50.120nps and being able to do the work they're trained to do this grant will also support sustainability
00:14:55.200It will also allow us to strengthen relationships with healthcare colleagues and professionals for the purpose of collaborative, comprehensive primary care, and to continue advocacy for NPs and Albertans.
00:15:15.200The NPA and nurse practitioners across the province are energized and ready to get to work.
00:15:21.200In the coming days, the association's focus will be on rolling out strategic plans
00:15:25.620to begin the work of connecting individual Albertans and communities with a nurse practitioner.
00:15:30.960It's the goal of the association that over the next three years,
00:15:34.340more than 300 NPs will successfully launch their primary care practice.
00:15:39.860Albertans can rest assured that they will receive high-quality, comprehensive care
00:15:43.660from their nurse practitioner, no matter where in the province they call home.
00:15:47.620Thank you again for your strong advocacy, premier and minister and your teams.
00:15:52.860We wouldn't be here today without your commitment to addressing the primary care crisis in our province.
00:16:13.300i believe the creation of a compensation model for nurse practitioners is great news
00:16:18.740for rural alberta as the parliamentary secretary for rural health i know only too well about the
00:16:24.180inability for rural albertans to see a family doctor when they need to or at all because there's
00:16:28.980no doctor to see this leads to emergency room visits and pressures on the entire health care
00:16:34.580system my hope is that the compensation model we are talking about today will give rural albertans
00:16:40.820more access to care in their own communities i strongly encourage nurse practitioners to consider
00:16:46.100our rural communities and the opportunities they offer as they look to set up their own
00:16:50.020independent clinics or join existing primary care teams i know from the meetings i have taken with
00:16:56.420municipal leaders since my appointment that the opportunity and the need is there today's
00:17:01.460announcement is yet another tool alberta's government is is using to address health care
00:17:05.700staffing shortages and to strengthen primary health care it will help ease pressures on the system
00:17:12.020it means more health professionals will be providing primary health care to albertans close
00:17:16.820to home it's a good day for health care and a good day for health care in rural alberta
00:17:22.820thank you very much thank you we'll now go into questions here we'll start off in the
00:17:28.660room before going to the phones everyone in the room we'll go to emmanuel then lisa and
00:17:33.620then janet and then over to the phones yeah for mr lagrange um during your ahs performance announcement
00:17:41.380you said that you wanted to ensure that every albertian had access to either an np or a family
00:17:47.220doctor how far are we from that goal right now well we're working towards um getting more and
00:17:53.220more physicians and more and more as as the announcement is uh that we just announced today
00:17:59.140that we're working to get more nurse practitioners as well so we know that right now there's roughly
00:18:05.780about seven hundred six to seven hundred thousand people that are unattached so we need um to step
00:18:12.020up in a big way we have heard that we have approximately 255 new physicians that have come
00:18:19.620to alberta that have registered to practice in alberta just in the last four months alone
00:18:24.820that's great news but not all of them are family practitioners as the premier indicated
00:18:31.060and as susan has indicated dr bander guest has indicated there is the potential for
00:18:38.340roughly about 300 or so new nurse practitioners to set up their own practice so that that will
00:18:44.260certainly add to the availability of everyone having an a primary care home but we know more
00:18:51.460has to be done so we're working very very hard on that can i ask something so we we do know that the
00:19:00.420average patient load for a family practitioner is about 900 patients so if you do the math on what
00:19:07.220minister lagrange was saying if we have 700 000 people that are unattached that gives you some
00:19:12.340range for the number of combination of doctors and nurse practitioners that we need to recruit
00:19:17.060into the system in order to ensure that everybody has coverage now some of those nurse practitioners
00:19:22.180and family doctors will take on more patients we've heard from uh from dr pendergrass that there
00:19:27.220is one of her nurse practitioners currently working in a clinic that has 2200 patients
00:19:31.540so there there is a range but that should give you some idea of where we're going so if you
00:19:36.180have 300 nurse practitioners coming in um hopefully a significant number of those new doctors that are
00:19:42.900are registering here also taking on family practice we're getting pretty close to narrowing
00:19:46.820that gap well we're going to work very closely with the association and the college of nurse
00:20:04.260practitioners to make sure that we come up with a fair model so that is part of the what the two
00:20:09.620million dollars will work towards is that we will work together on what is a fair model so that is
00:20:15.780to be determined but we hope to have that model up in place by um by january of this upcoming year
00:20:23.8602024 and lisa did you have any uh yeah just to follow up on that the new compensation
00:20:30.660while i mean can you give us more details about that because the support the case about supports
00:20:35.300that was already announced so what we're talking about here is this compensation model rolling out
00:20:39.380in january but it's still to be determined like you're still working on it correct there's many
00:20:45.380logistics that we have to work through and so we're working very closely with the association
00:20:49.780to make sure that that the model that we come up with will be fair and equitable for nurse
00:20:56.340practitioners do you have any estimate of how much that that model will cost alberta health
00:21:03.380i mean if you're taking like like was said you know 80 of the potential billing codes that
00:21:11.220family physician can build a promise for and moving over to we're actually not going yeah
00:21:18.340i mean how much is this going to cost over to help we're not looking at a fee for service
00:21:22.340we're looking at a a different model with nurse practitioners and also i look at it as how much
00:21:29.140will it save the health care system when when we look at the fact that a lot of people when they
00:21:35.380don't have a primary care provider they end up going to emergency rooms or they let their health
00:21:42.420care get to a critical stage so that by the time they get to needing like they get to an emergency
00:21:50.900room then they need more care so i really believe this will actually save the health care system
00:21:56.660dollars the average billing of a doctor is in around that 300
00:22:05.380and uh sixty thousand dollar range um but it's it is hard to um to to put an exact number on that
00:22:16.100amount um you know because there's there's many factors like obviously doctors make more than
00:22:24.100that but they also have clinics that they have to support their administrative costs they have
00:22:28.420staffing costs so if you're looking at net that is an average but again um i don't want to be
00:22:35.380too specific because obviously there's lots of doctors uh practicing uh various um various uh
00:22:42.660specialties as well so i i don't want to be specific on that particular amount but
00:22:47.460that's a kind of a rough estimate in in that range thank you yeah also have compensation
00:22:54.820questions if you're not looking at fee for service are you looking at alternative relationship plan
00:22:59.620or can you describe what the alternative to fee for service is it is exactly what you're talking
00:23:05.780about an alternative relationship of sorts so we are looking to see what what makes sense
00:23:13.540and how we can in fact make sure that nurse practitioners are compensated for their skill
00:23:20.340set their knowledge the work that they're doing the panel that they will be looking after also
00:23:26.340if they're setting up their own clinic as we provide for physicians there's dollars available
00:23:33.380for the actual administration costs etc primary care networks have a different compensation model
00:23:40.580so we're going to work with the association to make sure that we get the right model that works
00:23:45.140for them i wanted to hear from susan what um estimate time estimate you think it might
00:23:50.500realistically take for some of your colleagues to apply go through these scoops you know alone
00:23:57.380set up a practice when could we actually see clinics opening by the people who are really
00:24:02.340gung-ho for this thank you for that question um it depends on how uh many you know many days and
00:24:10.500weeks i suppose it takes to formalize the process of of an expression of interest to
00:24:14.660the alberta health and to the nurse practitioners association but we already have several nps that
00:24:20.740have indicated that they're ready to go setting up a clinic is actually very easy i've done it
00:24:26.900in the past as as have several of my colleagues the issue is just making sure that we have the
00:24:32.340infrastructure set up for nps to make this sustainable over the long term realistically
00:24:38.100if we can get that infrastructure set up we should have clinics opening in january february
00:24:43.140thanks janet and we'll go over to the phone lines now operator could you put through our
00:24:47.620first caller please jonathan bradley western standards hello uh my third question is for
00:24:55.940minister lagrange so with uh this with the healthcare problems operators experiencing
00:25:03.860one issue is with labor shortages what do you intend on doing to enhance recruitment of nurse
00:25:10.980practitioners so part of the two million dollars that we just announced today um is working with
00:25:19.060the association and with the college of nurse practitioners to really um incentivize and and
00:25:25.380look at how we can recruit more nurse practitioners i know we have graduate roughly about 150 nurse
00:25:31.300practitioners a year in alberta that being said many of them take the course from out of province
00:25:38.980and so we we just want to make alberta the most attractive place to come and work
00:25:44.180and setting up a new compensation model having the ability to expand the post-secondary
00:25:52.020programs that's something that we're also actively investigating and working towards
00:25:58.340those will all add into the ability to have more nurse practitioners
00:26:02.340come and practice in alberta okay and i have a follow-up question on an off-topic matter for
00:26:11.460so a little while ago it was mid last week uh regular tasks like regional schools trustee
00:26:18.740monique lagrange was removed her position after violations related to sharing a meme comparing
00:26:27.540pride month to indoctrination what do you think about that well i have i've said that the only
00:26:33.060time you should ever make reference to the nazi flag is when you're talking about actual nazis
00:26:38.100it's an inappropriate comparison to use it it undermines the horrible experience that jews had
00:26:43.380during the holocaust and it's inappropriate so she has to take responsibility for her actions
00:26:48.260and the board made a decision and that is an independent process that that we allow under
00:26:52.900the school act great thank you jonathan we'll go to our next caller operator could you please put
00:26:58.500them through please rick bell calgary sun uh question for premier smith uh good morning
00:27:06.340premier um yesterday in saskatchewan uh the scott moll government had a news conference
00:27:14.020talking about the clean uh electricity regulations expressing their frustration
00:27:19.940releasing a letter that they sent to the federal environment minister and the letter
00:27:26.660and their press conference echoed almost exactly the same concerns that you have articulated about
00:27:36.260about those regulations being unconstitutional unattainable etc um so i'm interested because
00:27:44.420you haven't had a good news uh press conference saying that you and the environment minister for
00:27:50.420the feds both are on the same page i would like to know uh how are the talks going between
00:28:00.340alberta and the feds with regards to the clean electricity regulations because of course the
00:28:06.820clock is ticking on this whole file well we're getting pretty frustrated because they they've
00:28:14.260had a supreme court loss now that says that they cannot use their federal power as a pretext to
00:28:19.540invade provincial jurisdiction and they're acting like that supreme court case didn't happen they
00:28:24.180had another loss on the issue of plastics which was also an unconstitutional overreach and
00:28:29.220unreasonable and instead of accepting the court's judgment you're going to drag it out again so we've
00:28:33.940got a lawless federal government and when you have a lawless federal government then you've got to
00:28:38.180assert that the constitution matters we've got the supreme court behind us we're continuing to press
00:28:42.660that matter they haven't dropped it yet uh but i can tell you we are are just like um uh premier
00:28:48.580mo getting increasingly frustrated uh the way they're behaving on this we we think that there
00:28:52.900is a resolution so a line to get to 2050 on emissions reductions targets that's the position
00:28:58.660that we continue to put forward and that's what we're going to do in alberta quite frankly we
00:29:02.500We know that that's achievable, we know we have the constitutional jurisdiction and we know that they're acting in a way that's outside of their boundaries.
00:29:17.540So what, why are they not willing to compromise?
00:29:23.480but they don't believe you've articulated in the past many many times that you're willing to use
00:29:31.480all legal measures to fight for the constitutional rights of the province
00:29:37.240is it a case of they don't care or they don't think you'll do anything or like what is the
00:29:45.160situation here when the Alberta government has been very clear about how far you're willing to go
00:29:52.520what is it about with the feds that they just don't seem to either get it or they don't care
00:29:58.880and they're just proceeding on with what they want to proceed on i'm shocked by it quite frankly
00:30:04.760i mean imagine a province getting a constitutional judgment against them and saying yeah whatever
00:30:09.660we're just going to keep on doing what we're doing anyway that's what the feds are telling
00:30:12.660us it's outrageous really and so we're we're continuing to press the matter we've told them
00:30:17.580we are simply not going to implement their targets of 2035. We continue to hope that they're going to
00:30:23.300align with us around 2050. I can only imagine that you've got, for some reason, they believe
00:30:30.440that Stephen Guibault should be setting the entire policy for the government in the face of everything
00:30:35.880showing them that these reckless policies are causing their support to erode. Everybody knows
00:30:41.460that the reason why the grocery bills are going up, the reason why it costs a lot of money to
00:30:45.940fuel up with gas and diesel the reason why it's going to cost money in home heating this winter
00:30:50.760is because of their carbon tax because of their reckless policies so it's a very easy point for
00:30:56.880us to make if you think things are bad now they're going to be five times worse if we continue going
00:31:01.640down this path and i i i'm mystified as to why they think that this is a winning issue for them
00:31:06.960in the face of every single month they get lower and lower results in the in the polls but all i
00:31:11.940imagine is that somehow they think that minister gibault's position is a popular one i can tell
00:31:16.820you it's not and it's going to lose them the election if they don't change course thanks rick
00:31:21.540and we have time for two more questions so operator could you put through our next caller please
00:31:27.300morgan black global news hi question for minister la grange please uh so you talked earlier about
00:31:33.140the need uh to keep more health workers in alberta uh family doctors and otherwise i'm wondering if
00:31:37.780the hope of this announcement would also ideally take pressure off family doctors and encourage them
00:31:43.460to stick around oh absolutely making sure that they have other team members that they can rely on
00:31:50.500that are funded that also can be an integral part of their team certainly will will help to alleviate
00:31:58.500some of the pressures that our family doctors are seeing also the um as i said earlier there's
00:32:06.100so many people that are unattached right now do not have a primary care provider that having
00:32:12.660nurse practitioners who are able to take some of that burden off of physicians will will certainly
00:32:19.140help the system as a whole again primary care needs to be the foundation of our whole health
00:32:26.260care system and to date it hasn't been it's been somewhat fragmented we really need through the
00:32:32.980maps work that we've been doing is really refocusing the whole healthcare system that
00:32:38.980this actually has to be our foundation so we want to strengthen that foundation through doctors
00:32:44.180through nurse practitioners and other primary care providers as part of a team
00:32:52.340thanks minister and then the other question is for miss prendergast i'm just wondering is there
00:32:56.100anything in this scope that a nurse practitioner could not do in their practice compared to what
00:33:00.900a family doctor could do um our scope of practice is uh similar to a family physician as i mentioned
00:33:07.220we can assess diagnose order interpret tests prescribe any medication and manage both wellness
00:33:14.580and disease some of our nps also work in acute care and have expanded skills there so a very
00:33:23.620different type of um approach perhaps but a similar scope thank you morgan and we'll take
00:33:32.100our last question now operator could you put through the last caller please yes rob ptv
00:33:39.860morning thanks for taking my question uh i guess i vote for uh premier smith
00:33:44.500the first one being uh your reaction to the federal fall economic statement
00:33:48.580well there's um what we're looking for from the federal government is some commitment to to follow
00:34:00.140what we're doing with carbon capture utilization and storage and providing support for those
00:34:06.000industries that want to invest in it they've been talking about it for the last couple of years
00:34:09.620they talked about it more yesterday and so it looks like they're getting closer to giving some
00:34:14.360detail around that we'll be announcing our detail around our program next week
00:34:18.580And we're really hopeful that they keep their commitment to put some legislation in place before the end of the year so people know what that framework is.
00:34:27.540It would be nice to go to COP28 with an understanding of what the investment climate looks like in Canada for this important new innovation.
00:34:38.260Considering in the U.S., the Inflation Reduction Act is really creating a boom in investment down there.
00:34:45.780So I'm glad that they re-announced what they intended to do, but I think what I would like to see before we go to COP is some of the details of what that looks like.
00:34:57.420Thanks, and one more question for you, Premier Smith.
00:35:00.000We're hearing that the province is creating its own PCUS incentive program.
00:35:04.880Just wondering what you can tell us about it and any idea of when it will be announced.
00:35:13.880i have to i'm going to be leaving for dubai on november 20th 30th so it'll it'll be before we
00:35:19.400go away we're just pinning down the date it'll be next week but we'll we'll send out a press release
00:35:22.840when we pin down the actual date perfect thank you for that jessica that's all the time we have
00:35:43.880Canadian Shooting Sports Association, without the CSSA, our gun rights would have been taken
00:36:11.880Long, long ago, these guys are on the front lines helping to draft smart and intelligent firearms regulations and legislation in Canada, and more importantly, educating the public about how we keep guns out of the hands of the wrong people.
00:36:26.280To become a member, it's absolutely worth every penny.