Court deals blow to local doctor recruitment
Decision up to provincial body, not community
EDMONTON • Alberta Health Services acted within its authority when it refused to sponsor an African doctor’s move to the town of High Prairie, a judge has ruled in a case with potential ramifications for other communities looking to recruit foreign physicians. In making his decision, Court of Queen’s Bench Justice Michael Lema dismissed the application of a High Prairie clinic that had been stymied by Alberta Health Services in its attempt to hire a Nigerian-trained family doctor to help handle a busy patient load.
The health authority argued that although the individual clinic may have been swamped, the community as a whole was adequately served by family doctors at the time.
The authority eventually decided to sponsor the Nigeria-schooled physician, but for a position in Westlock, 280 kilometres south of High Prairie.
“AHS has the power … to direct resources where, in its view, they are most needed,” Lema wrote in his July 30 ruling. “The applicants have not shown that the sponsorship request here was declined for an improper purpose.” The case is believed to be the first legal challenge to rules that came into effect in May 2015, when Alberta Health Services was given sole authority to sponsor internationally trained doctors seeking to join the Alberta workforce.
Such physicians must have a sponsor to receive a skills assessment that is necessary to practise medicine in the province.
For several years prior to May 2015, the health system relied on a more open process that allowed clinics, medical schools and even individual physicians to act as sponsors for an international doctor.
However concerns started to develop that too many foreign physicians were being recruited to Alberta — particularly by urban walk-in clinics — without regard to provincial need or cost to the government.
As such, the rules were changed to give sponsorship supremacy to the health authority, which declared such decisions would be made on a “community-need basis.” In High Prairie’s case, clinic operators Dr. Robert Laughlin and Dr. Pamela Edwards insisted that need was obvious considering their office was open seven days a week with evening hours, and still had to turn away 20 to 30 patients each day. They told court the town of 2,500 people served a substantial population in the surrounding region, and the workforce planning tool used by the health authority underestimated these numbers. As well, the doctors argued Alberta Health Services’ denial of their sponsorship request was self-serving because it was designed to put their clinic out of business to benefit the rival clinic in town owned and operated by the health authority. Laughlin alleged health services had engaged in a pattern of discriminatory behaviour, which included other sponsorship denials and the clinic’s failure to lease space in High Prairie’s new $228-million hospital. Lema rejected all of the arguments, ruling there was no evidence that Alberta Health Services’ actions were improper.
“The applicants have not shown that AHS’s population figures for High Prairie and its catchment area were
AHS HAS THE POWER … TO DIRECT RESOURCES WHERE, IN ITS VIEW, THEY ARE MOST NEEDED.
off-target in any way or, in any case, that AHS’s decision to decline their sponsorship request was unreasonable for turning, to any degree, on those figures,” he wrote. The outcome of the case is likely to be of interest to other communities, particularly rural and remote communities that have been clamouring for more health professionals and often rely on doctors schooled in other countries.
Doctors at the High Prairie clinic, 370 kilometres northwest of Edmonton, could not be reached for comment on whether they plan to appeal the decision. The NDP government and the Alberta Medical Association are continuing to work on a physician resource framework for the whole province that would determine how many doctors and specialists are needed in Alberta and where they should be located.