Liberals' stubbornly vague answers on Medavie contract frustrate Higgs

For the second straight day, New Brunswick's Liberal government offered vague answers on what it would take to cancel the controversial extramural care contract being finalized with Medavie Inc.

Premier Brian Gallant is pointing to performance targets that Medavie must achieve under the agreement, including an increase in home-care visits by nurses and a decrease in emergency-room visits by extramural patients.

But Progressive Conservative Opposition Leader Blaine Higgs was frustrated when he tried to find out whether the province can tear up the deal if Medavie falls short of the targets.

"What does that mean if they don't meet these targets?" he said. "Does it mean the contract is in jeopardy or does it just mean they don't get a bonus? We can't get any information. We can't get any details about what it means."

Less money

Health Minister Benot Bourque said the targets, known as "key performance indicators," would mean less money for Medavie.

"There's a total amount that is part of the contract, and if they do not achieve the full KPIs, then there is a penalty," he said. "They will receive less money if they don't achieve the full scope of what we are hoping they will achieve within the KPI's."

In the next breath, Bourque said failing to meet the targets could also allow the province to walk away.

"If we are not satisfied with the level of performance, we can pull out. Either party can pull out. If the KPIs aren't met, then we need to revisit the contract."

But the minister wouldn't say whether the actual contract language allows a cancellation based on the targets not being met.

"It has to do with the level of satisfaction," he said. "If they are clearly sub-par, then we really need to revisit the contract."

Gallant added to the ambiguity when he said in question period the consequence of not meeting the targets "is what is being negotiated."

He did not say missing them could lead to cancellation.

Terms being finalized

The province and Medavie are now finalizing the terms of the agreement, which will see the company take over management of the extramural program on Jan. 1.

The PC opposition calls it "privatization" and "the next step to American-style health care."

Medicare will continue to fund the program, and employees will remain public-sector employees, but management of the home-care program will be in the hands of Medavie.

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Higgs spent a second straight question period trying to pin down the details of the contract, which the Liberals say they will only release after it has been signed.

Higgs said he wants to be able to cancel the agreementif he becomes premier next year, but can't promise to do that without knowing if the contract allows it.

Numerous targets to meet

Medavie will be required to improve home-care visits, increasing them by 15 per cent, and ensuring that patients see someone within one day of a call instead of within three days.

They must also increase doctor referrals to the program by 20 per cent and provide enough care to bring down the number of extramural patient visits to the emergency room by 15 per cent.

The contract is worth $4.4 million per year, with $2.6 million to cover the administration of the services and $1.8 million if Medavie achieves the targets.

When it was announced in August, Medavie CEO Bernard Lord referred to the $1.8 million as an incentive.

"If we don't meet the standards, we don't get paid," Lord said. "The employees still get paid. The nurses, all the health professionals, they still get paid, but we don't get paid."

He said that incentive puts the province in a position "to enforce these standards."

Incentive or penalty

But Friday, Bourque referred to the $1.8 million differently as a "penalty" that Medavie would lose if it doesn't meet the targets.

He also said some of the $1.8 million could be paid if Medavie achieves some of the targets.

"It's based on a scale system. So if they partially achieve it, they will get part of the amount. If they fully achieve it, they receive the total amount."

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Bourque was also vague on when Medavie would be rated on hitting the targets. The contract takes effect Jan. 1 but he said there will be "a transition period" of two or three years before the extramural program is completely transformed.

He couldn't say when the province will measure the targets and decide how much of the $1.8 million the company will get.

The Liberals say with a rapidly aging population, New Brunswick has to adjust its health services quickly to meet growing demand for programs used by seniors, such as extramural.

"We have to be ready," Bourque said.