You may have noticed your tax dollars hard at work on television these days touting something called “primary health care.” Health Canada is spending about $9.5 million on a national awareness campaign designed, it seems, to coin the phrase without ever really explaining what it means. Meanwhile, without the aid of television ads, Metro residents are about to get a real-life lesson in the meaning of “primary health care,” as one of our local clinics faces a financial crisis that could reduce its ability to provide it.
Last year, Planned Parenthood’s Halifax Metro Clinic on Quinpool Road took a hit when the Metro United Way decided not to renew $44,000 in annual funding for the not-for-profit organization. With some emergency relief funds from Planned Parenthood’s provincial association, the Metro Clinic was able to continue regular operations over the past year, but the financial outlook for the coming year is uncertain. “We run a really lean organization,” says Planned Parenthood Halifax board chair Lisa Tobin. “There’s not a lot we can cut unless we look at cutting services. So far we haven’t had to do that but we just have to wait and see what happens in the future.”
About 9,000 people a year go to Planned Parenthood’s Halifax Metro Clinic for everything from anonymous HIV testing to Pap smears to pregnancy options counselling. Because it employs a multidisciplinary team of doctors, nurses and counsellors to meet patient needs, and because it focuses on patient education in addition to treatment, the Halifax Metro clinic is a model primary health care provider, as touted by Health Canada.
Unfortunately, it’s a model that the health care system in Nova Scotia just doesn’t support. Like any clinic, the lion’s share of Planned Parenthood’s income comes from the many billable services it provides under Nova Scotia’s health insurance system. But Medical Services Insurance (MSI) covers only the bare bones of care. The clinic relies heavily on community donations to maintain its higher standard of primary health care.
At the Metro Clinic, says Tobin, “you get more than a 10-minute appointment. You’ll have a nurse talk with you, share some information about sexual health, then you see the doctor on top of that. There’s a lot of teaching that can happen, a lot of counselling on sexually healthy behaviours.” The trouble is, a half-hour discussion with a nurse on birth control options is not an MSI-billable service. In fact, no nursing services are. That’s where Planned Parenthood’s community donated funding comes in, and where the shortfall will be felt.
The United Way started funding Planned Parenthood’s Halifax clinic in 1980, increasing their contribution over the years to about $55,000 annually. Last year’s cut has set the clinic’s United Way funding back to its 1981 level: about $11,000, designated for the organization’s educational outreach programming. The $44,000 once used to supplement Planned Parenthood’s clinical primary care program (to help pay for the nurses not covered under MSI) is gone.
The reason for the funding cut is unclear. The United Way’s Community Fund is healthy and growing. The trouble is, according to United Way director of community investment Sue Barr, the requests for funding are growing faster. “The demand on money raised in a campaign is ever increasing, and what the volunteers are forced to do is allocate money based on the strongest fit with the United Way funding criteria,” says Barr. United Way funding decisions are made by small groups of volunteers. “They go through a really intensive review process,” says Barr, “including face-to-face meetings with agencies.”
There are no plans yet to cut services at Planned Parenthood’s Halifax Clinic, and executive director Rhonda Phillips is optimistic that there won’t need to be. “We will be talking with the new ministers of Health and Health Promotion and Protection,” says Phillips, although she’s not counting on the provincial government to step up in the short term. Instead, Planned Parenthood will be looking to the community to raise the funds. “We’ve been here for over 35 years, meeting the needs of the community,” says Phillips. “Everyone has either been here or knows someone who’s been here. That’s where we’re hoping that the gap is going to come from.”