Health minister quietly took steps to eliminate P.E.I.'s doctor cap last fall

P.E.I.'s health minister quietly did away with doctor complements last fall, opening up less restrictive avenues for the province to recruit new physicians to practice here. 

The complements essentially limited how many family doctor and specialist positions there could be in each region of the Island.

Politicians have defended the caps in the past as a way to try to make sure there were doctors to look after patients in rural districts, rather than having most newly-hired physicians opt to practice in the province's larger urban centres.

But Health P.E.I. has said the complement was making it harder to hire new doctors. For instance, if the complement restricts a certain area to two cardiologists, a third one can't be hired without a lengthy application process to raise the cap. 

Health P.E.I.'s chief medical officer, Dr. Kathie McNally, said the complements were put into place decades ago when physicians operated much differently than they do now. 

"It is a ridiculous thing in this day and age, but when it was put in place it was a different time and place. Physicians at that time were fee-for-service," she said. "It's a different world, and health care is quite different, so we need a different system."

According to Health P.E.I. and Health Minister Mark McLane the complements were maximum numbers, not minimums — basically a cap on the number of doctors that could be hired for each area.

The provincial government tried to eliminate the complements in 2022 with legislation introduced by former health minister Ernie Hudson, but that never came to pass.

Both the opposition Liberals and Green Party raised concerns about the legislation hurting health care in rural communities. 

But in September 2023, McLane found a way around the complements by raising the maximum number of positions. 

He used numbers from a government-commissioned report on health human resource needs, known as the Peachey report, which outlined a need for thousands of new workers over the next 10 years. 

McLane took the number of doctor positions the report said were needed and set the complement numbers 20 per cent higher than that.

For family doctors, for example, the complement had been around 100 positions — it's now set at 186.

It's a workaround until actual legislation can be passed to fully eliminate the complements, which McLane said could come this fall.