Alberta revamps health care system, creates separate units

The big overhaul will not impact how an average Albertan will access health care, officials insisted. For example, in a health emergency, patients will still go a local hospital or those who require continuing care services will still receive those in care homes or through home care.

Premier Danielle Smith said the changes will allow the United Conservative Party government to set goals for the entire health care system.

“The current health system in our province limits the government’s ability to provide system-wide oversight on behalf of the people of Alberta,” Smith said during a news conference.

“It also limits our ability to set priorities and require accountability for meeting them.”

Smith explained the unified system will prioritize patients.

“The current Alberta health care system is one that has forgotten who should be at the centre of its existence: patients and the health care experts who look after them,” she said.

It will take at least a year to implement the new system and the four new agencies will not launch until 2024.

Timeline of Alberta’s plans to revamp the health care system. (CHAT News graphic)

Minister of Health Adriana LaGrange acknowledged the transition will take some time but hailed it as an important step forward.

“This is a huge undertaking but a necessary one,” LaGrange said as she revealed a set of guiding principles that included improving patient outcomes, supporting the workforce and ensuring transparent communication.

LaGrange said the new framework addresses concerns over the state of the health care system she said was “not working” by addressing various aspects of care more efficiently.

“We are very focused on making sure that all of these four organizations that we set up are laser-focused on improvements, on patient care, on making sure that those that are on the frontlines are able to provide their feedback to us directly,” LaGrange said.

The minister also emphasized the restructuring protects taxpayer-funded health care.

“I want to be very, very clear on that: no privatization, it is publicly-funded public health care that we’re talking about,” she said.

The transition begins immediately.

The government will start holding town halls with AHS on Thursday and engagement efforts with Albertans will kick off in early December. Province-wide workforce engagement will begin mid-January, the government said.

NDP MLA David Shepherd, flanked by frontline health care workers, criticized the Alberta government’s health care plans.

“We believe health care does need reform but through investment in the front lines,” Shepherd, who represents Edmonton-City Centre, said.

“But Danielle Smith’s plan to concentrate more power over health care in the premier’s office is going to cause chaos in our clinics and hospitals.”

Shepherd referenced apparent leaked documents released by the Opposition party that show the ruling UCP were aware of risks associated with the new structure, saying that the premier failed to address those concerns on Wednesday.

“What Danielle Smith described this morning will make health care slower, harder to find and more fragmented and siloed. It means inferior health care for Albertans.”

‘BOUND TO FAIL’

The government’s overhaul of the health care system is moving ahead despite repeated calls by the Alberta Union of Public Employees for a collaborative approach and consultation, the union said in a statement.

“Over the past 30 years I’ve seen these types of reforms and without union and worker involvement they are bound to fail,” AUPE President Guy Smith said.

“This is going to have a massive impact across sectors and will hurt an already fragile health care system being chipped away by the UCP’s privatization scheme.”

AUPE is asking health minister LaGrange to commit to keeping unions informed, involved and heard.

It called on the government to implement wage increases, focus on greater job security and improve staffing levels to support front-line workers and ensure the delivery of quality care to Albertans.

More than 82,000 AUPE members, including 49,000 in health care, will enter collective bargaining in 2024.

HOW WILL THE NEW SYSTEM WORK?

The four new organizations will be mandated to enhance local decision-making, officials said.

The new structure will include 13 advisory councils — including one Indigenous council — that will represent regional perspectives and advise the new units.

Graphic released by the Alberta government showing the new structure for health care in the province. (Government of Alberta)

Key to the new format will be the system’s integration council. It will be led by the health minister and include participation from across the structure as it focuses on supporting the health care workforce.

Smith’s government said the new structure will allow the system to be more responsive to patient needs, support local decision-making and regional advice, relieve those working in acute care through the specialized units and better leverage the experience of employees.

“Danielle Smith has repeatedly talked about more local control in health care as cover for her transformative changes to the system, but today’s announcement does nothing but tweak local advisory councils, it’s not about local input into health care,” said Chris Gallaway, executive director of Friends of Medicare. “Instead what we are seeing is a destructive plan for restructuring and causing more chaos in our public health care system. Albertans should be very concerned about today’s announcement.”

“Blow it up and sell pieces off, that seems to be the strategy underway with this morning’s announcement,” said Gallaway. “You think this government would have learned their lesson after their disastrous decision to split our lab system into two pieces and their subsequent failed privatization of the community labs to Dynalife, but here we go again.”

“We’ve seen nothing about getting the new hospitals for Red Deer or South Edmonton built, nothing to help retain the health care workers currently in the system, nothing about training or recruiting more doctors, nurses and other health care professionals into the system,” said Gallaway. “When asked about building needed hospitals and acute care beds, or fixing widespread short staffing, the Premier and Health Minister relied on buzzwords and vague promises of restructuring over the next year and a half. It’s clear they don’t understand the current crisis or the solutions we need.”

Meantime, United Nurses of Alberta says it sees nothing in the breakup of Alberta Health Services and the restructuring of the administration of public health care announced this morning by the provincial government that will address the principal crisis that concerns most nurses – chronic understaffing and overwork caused by the shortage of nurses.

While UNA has long acknowledged genuine deficiencies in the management of health care services by AHS, there is nothing in today’s announcement that will address that problem, said Heather Smith, President of UNA, which represents more than 30,000 Registered Nurses and Registered Psychiatric Nurses, the majority of them employed by AHS.

“The wrong diagnosis always creates the wrong treatment,” Smith said. “The government has diagnosed the problem in Alberta’s health care system as being the structure of AHS. A far more serious problem is the shortage of nurses and other medical professionals, as well as beds and capacity. Let’s not throw out the baby with the bathwater!”

“The treatment announced by the government today is going to make the problem worse,” she predicted. “It seems likely the chaos in the health care system will be a roadblock to the retention and recruitment of nurses,” Smith said.

She asked: “Who is going to move to Alberta to work in health care when they don’t even know what agency or organization they will be working for?”

The most important points made by UNA’s leaders to Minister Adriana LaGrange and Premier Danielle Smith in recent conversations, including one formal meeting with the health minister, was “please don’t do anything to destabilize AHS,” she concluded. “That is exactly what they have done.”

In the meantime, UNA says it has many unanswered questions about how the reorganization will impact members and their jobs. “We will aggressively seek answers to these questions and communicate them to our members,” Smith said.

“Today’s announcement is a significant change for our members and Albertans. We will be taking some time to gain a better understanding of what the government has planned, but we heard some important commitments today,” says Mike Parker, President, Health Sciences Association of Alberta.

“We appreciate the clarification that the government is committed to increasing front-line health-care professionals and they are not planning on any job losses.

“However, we need to know what this plan will do for retaining our health-care professionals and recruiting more. We will judge this government on how this plan addresses the critical staffing shortage. Albertans and our members cannot wait 18 to 24 months for results. Improving retention and recruitment of health-care professionals cannot wait while management is re-organized.

“Commitments were also made to involve front-line health professionals during the transition and in the new model. That’s us, we are involved from the 911 call to out-patient care.

“As always, HSAA is ready to work with government to make improvements to the health system as long as the premier keeps her commitment that this is not about privatization. Publicly funded and delivered health care will produce the best outcomes for Albertans and patient care must be placed above all other considerations.”

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by Eli J. Ridder | @EliRidder

Alberta revamps health care system, creates separate units

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