Medavie will pay the province for any contract outside Atlantic Canada that mimics the health services it now manages in New Brunswick.
Medavie Health Services New Brunswick would pay a one-time payment of 15 cents per eligible patient under a contract signed with another health authority that provides the start-up of home health-care services and a combination of the following services: ambulance/community para-medicine, Tele-Care and home health-care.
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"If we are replicating this system in other provinces, the province will get royalties," said Health Minister Benoit Bourque during the latest edition of the CBC New Brunswick Political Panel podcast.
The payment is referred to as an honorarium in the agreement.
How Medavie operates outside of New Brunswick while managing key health-care services was among the points of contention raised by members of opposing political parties during the lively in-studio debate.
The public got its first look at the polarizing Medavie contract on Monday after it was signed over the Christmas holiday period and then sent for review by the province's integrity commissioner.
The agreement will see Medavie Inc., a private, not-for-profit company based in Moncton, take over management of the extramural care program and the Tele-Care program. Medavie will merge them with Ambulance New Brunswick, which it already runs.
Keep or cancel
The NDP, Greens and People's Alliance have stated, if elected into power, they would scrap the deal.
But canceling the contract without cause may prove costly. A penalty in the terms of agreement says the province can cancel it for any reason but would have to pay Medavie up to $1 million.
The government could walk away without being penalized if Medavie chronically fails to fulfil the benchmarks outlined in the agreement.
Brian Macdonald, a Progressive Conservative health critic, said transparency is needed to show how Medavie is performing compared to the baseline performance pillars set out in the agreement.
"Because, of course, Medavie is going to claim they've improved things," he said.
"We have to be able to as legislators, as the public and as the media challenge that. [...] You can often make statistics say whatever you want them to."
The Opposition has been critical of the contract, but the PCs have said they won't pledge to scrap it. Macdonald, echoing PC Leader Blaine Higgs, said it needs to be tested first.
"The only thing that's worse for the system than this deal is constant change," he said. "And that's what we often find when one government comes in; they just throw out the baby with the bathwater every four years.
"New Brunswick cannot continue to do that on every matter."
People's Alliance Leader Kris Austin chided the PC MLA for that remark.
"I find it quite rich that you have both sides," Austin said.
"You can't say how terrible it is and then say, 'We're going to proceed.'"
NDP Leader Jennifer McKenzie predicted service problems to occur while Medavie strives to hit its targets to trigger bonus payouts.
"You've got people managing the nurses and other professionals who are trying to earn a buck," she said.
"They're being asked to manage the system based on theses bonuses and cost structures. That's where we're going to start to see problems."
Marilyn Merritt-Gray, a member of the Green Party, raised concerns of innovation developed by, for instance, government-funded extra-mural care workers and is used as jointly held intellectual property with Medavie.
She questioned why Medavie should benefit from government-funded innovation.
"These are things that, from a research perspective, need to be kept in the public system," she said.