WHEREAS the Rural Physician Action Plan / Health Workforce for Alberta has supported rural Alberta communities with initiatives designed to educate, recruit, attract and retain rural physicians for over two decades, and

WHEREAS the Rural Physician Action Plan / Health Workforce for Alberta is a not for profit organization which receives a grant of approximately $10 million per year from Alberta Health, and

WHEREAS the Rural Physician Action Plan / Health Workforce for Alberta supports rural healthcare by; sponsoring rural students medical education, facilitating and funding rural placement of medical students, assisting physicians with career planning, attracting and retaining physicians and other health providers to available positions in rural communities and supporting research and analysis of rural health care to continuously improve programs, and

WHEREAS decisions currently being made on the 2016 Alberta Provincial Budget and to the Alberta Health Services Ministry budget may negatively impact the programs and services that the Rural Physician Action Plan / Health Workforce for Alberta provides, and

WHEREAS loss of funding to Rural Physician Action Plan / Health Workforce for Alberta will adversely and disproportionately impact rural Alberta,

THEREFORE BE IT RESOLVED THAT the Alberta Association of Municipal Districts and Counties advocate that the Government of Alberta maintain the current provincial funding which is being provided to the Rural Physician Action Plan / Health Workforce for Alberta initiative.

The following information may be found at the Rural Physician Action Plan / Health Workforce for Alberta website: http://www.rpap.ab.ca/

Since its formation in 1992, the Alberta Rural Physician Action Plan (RPAP) has endeavored to address the professional and lifestyle issues confronting physicians in rural practice, as well as those of physicians contemplating rural practice. The common thread over the intervening years has been innovation and adaptive change as circumstances at many levels have evolved.

Over the past 20 years, the focus of our success has centered on proven core programs, including the rural locum program, rural clinical placements for medical students and resident physicians, skills enrichment, and Continuing Medical Education (CME) offerings for practicing physicians.

Much has evolved for the RPAP and its partners, especially in the last 10 years. We have seen the creation in 2000 of the Alberta Rural Family Medicine Network (ARFMN), a unique RPAP – U of A/U of C departments of family medicine partnership with Rural Alberta North (RAN) and Rural Alberta South (RAS) branches. In 2013, we celebrated the 10th anniversary of the graduation of the first class of rural-trained family physicians from these programs.

There has been significant increase in medical school capacity with subsequent new demands placed on the RPAP. Despite that, the RPAP and the two faculties of medicine have positively worked together to establish associate dean and rural/regional positions to advance the rural agenda, including rural medical education distributed learning.

The beginning

As a result of chronic difficulties in physician availability in many rural and remote communities in Alberta, in February 1990 a working group of Alberta Health’s External Advisory Committee on Physician Manpower was established to develop a comprehensive action plan for the recruitment and retention of rural physicians. This plan—“Proposed Action Plan for Addressing Rural Physician Recruitment and Retention Issues”—was approved by the External Advisory Committee in March 1990, and was approved by Cabinet in December 1990.

Developed on the basis of influencing physicians’ decisions about moving to and remaining in a rural Alberta community, the Rural Physician Action Plan, or RPAP as it became known, was originally composed of 16 initiatives, focused on three distinct target groups and was fully operational by 1992.

Growth

RPAP recognized that recruitment efforts alone would not provide long-term solutions to the rural physician shortage in the province and, therefore, it was necessary to reform its education and training initiatives. Beginning in 2000, the RPAP implemented enhancements to its Enrichment Training Program, which included the introduction of the skills broker role, dedicated to arranging CME and other training opportunities for practicing rural physicians.

Physicians who had trained in urban centres, even with the RPAP rural rotations program, were not as interested or necessarily prepared to meet the broad demands of rural practice. In response to this need, the RPAP worked closely with the University of Alberta and the University of Calgary to develop the Alberta Rural Family Medicine Network (ARFMN), a dedicated rural-based, family medicine residency program. In July 2001, the ARFMN accepted its first class of rural family medicine residents.

After focusing its attention on the development of physician recruitment and education initiatives for its first decade, the RPAP identified that physician retention was another important area requiring attention. Initiatives were developed, beginning with a new multi-year retention work plan in 2001, to support and encourage physicians to continue to maintain their interest and commitment to rural practice. This included the development of a rural physician consultant role—to support and encourage the development of recruitment and retention initiatives by physicians, rural communities and the then-Regional Health Authorities. It also included strengthening the Rural Physician Spousal Network (RPSN).

In 2003, the RPAP completed a review of its rural undergraduate medical education initiatives with an aim to increasing the number of rural origin students in medical school and to better support early careerists. A number of new initiatives were created and implemented, beginning in 2004–2005.

Externally evaluated many times since its creation, the RPAP has consistently demonstrated that, on balance, “[it] has been effective in stabilizing the overall level of physicians in rural Alberta since 1991 in the face of major and ongoing changes to the Alberta Health System.”

RMA has no active resolutions directly related to this issue.

Health: Our government takes its duty to be a responsible steward of public money very seriously. As the regular funding cycle for the Rural Physician Action Plan (RPAP) came to a close at the end of March 2016, we are taking this opportunity to review the objectives and outcomes of our rural recruitment and retention strategy, of which the RPAP is one element, to ensure Albertans are getting the best possible results for their investment.

Our government recognizes the challenges that communities in rural Alberta face in attracting and retaining health professionals. We are committed to strengthening our system for rural recruitment and retention and appreciate the feedback we have received from Alberta Association of Municipal Districts and Counties (AAMDC) members on this issue to date.

In 2015/16, Alberta Health invested more than $105 million in rural initiatives and programs to support this work, including $10 million to fund RPAP. Our government has continued funding for the RPAP to September 2016 to allow for the completion of our review.

We want to assure AAMDC members that RPAP will continue to exist.

The Government of Alberta response indicates that RPAP will continue to be funded by Alberta Health and will continue to serve its mandate to the benefit for rural Albertans. This message is consistent with information received by the RMA through other advocacy avenues and the RMA would like to thank the RMA members for their direct advocacy on this issue as well.

In 2017, RPAP was renamed the Rural Health Professions Action Plan (RhPAP) and assigned an expanded mandate to support the recruitment and retention of all health professions in rural Alberta. Additionally, the RMA was offered, and accepted, an opportunity to serve on the RhPAP Board of Directors.

This resolution is assigned a status of Accepted.