More Manitobans appear to be paying out of pocket for health care services traditionally offered by family doctors and paid for by Manitoba Health.

When nurse practitioner Donna Alden-Bugden makes house calls, or works out of her office, patients can get a prescription, be referred to a specialist, or have an infection treated.

In the last 15 months Alden-Bugden said she went from seeing one patient a week to as many as eight per day. Five clients list her as their primary care provider. 

Visit fees range between $40 and $80 depending on the location and number of patients at an address.

"Sooner or later I knew something was going to happen and it just grew like wildfire," said Alden-Bugden who runs NP Canada Nurse Practitioner House Calls and Clinic.

A loophole in federal health care insurance legislation dating back to the 1980s makes this private fee for service health care possible.

"There is no legislation or regulation under the Canada Health Act that prevents nurse practitioners from working privately,” said a Manitoba government spokesperson in an email to CTV News.

The Nurse Practitioners Association of Manitoba said about 30 nurse practitioners offer some services in private practice. 

“Patients value the holistic and comprehensive approach NPs provide, and now seem to be willing to pay services privately. It is a win-win situation when patients receive the care they want, when they want, and in the place they want. There is no doubt that further healthcare transformation will improve healthcare access and for now there is enough need for both publicly funded and private practice NPs,” said CEO Cindy Fehr in an email to CTV News.

Last weekend a new clinic opened inside Rossmere Pharmacy on Henderson Highway. 

The Manitoba Nurses Union says these private services offered by nurse practitioners erode public ones. It wants nurse practitioner positons added and says everyone should have access to the care they provide.

"We have seen lots of success of nurse practitioners working in long-term care facilities as a primary care provider, we've see lots of success in the access centres, we know they work in the emergency rooms,” said president Sandi Mowat.

Alden-Bugden still works part-time in the public system.

She said most people she visits privately can't physically get to a doctor and believes her service helps keep some people out of emergency rooms.

"I do think unless something changes in the system, the sky is the limit," said Alden-Bugden.

Alden-Bugden said if patients want to pay, it should be their decision.

Winnipeggers gave mixed arguments about this growing private service.

“Sometimes you pay for convenience and I think it's fair,” Melanie Schrim.

“My philosophy says you know we're a community of people, everyone should be treated the proper way not somebody that has funds that can be spent,” said Chris Baetsen.