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Healthcare fragmentation cause for alarm

Posted on December 27, 2023 by Taber Times

By Vamini Selvanandan

If you were already worried about our province’s health care system, you now have far more cause for concern. And if you weren’t worried before, it is time to feel alarmed. 

On November 8, 2023, the UCP government announced a major restructuring of the health care system in Alberta. They announced plans to create four new provincial organizations to administer health care services in Alberta divided into the categories of Acute Care, Primary Care, Continuing Care and Mental Health and Addiction.

While health systems in other provinces are moving towards integration, our province is taking a huge step backwards by increasing fragmentation. With the creation of Alberta Health Services (AHS) in 2008, Ed Stelmach’s Progressive Conservative government introduced Canada’s first integrated health system. This approach reduced duplication in the system, closed gaps and increased access to services for rural and remote populations. Operating with a single governing body, it created administrative efficiencies, reduced costs and cut bureaucracy. 

Alberta currently has the lowest health administrative costs of all provinces in Canada. Creating four entities to replace one in this restructuring plan will only increase expenses and bureaucracy. The budgeted $85 million dollars is a gross underestimation, and Albertan taxpayers will be paying a lot more for this futile exercise.

There is no doubt that our health care system is in crisis and that AHS needs to address serious issues related to capacity and timely access to care. But, the current proposal for restructuring does not address these issues and will likely make things worse. No plan or funding for recruitment and retention of healthcare workers have been announced. Bringing chaos and instability to the health system takes away from quality patient care as overburdened staff learn new systems and processes. At a time when other provinces, like Ontario and British Columbia, are putting their resources into making working conditions more attractive for health care workers, destabilizing the health care system seriously disadvantages Alberta in recruiting and retaining staff to provide care for Albertans.

Alberta is Canada’s richest province and we can afford adequate investments in healthcare. Instead of policies to subsidize fossil fuel corporations and provide tax breaks for the wealthy, Albertan politicians can use our collective wealth to build more public operating rooms, improve care in nursing homes and invest in health promotion and disease prevention to meet the needs of all Albertans. In this land of abundance, Albertans do not have to live in a constant state of health care scarcity.

Clearly, the intended outcome of restructuring AHS is to concentrate power in the hands of the health minister and premier. The government is poised to take over health care decisions and control over health care workers from AHS. As an agency operating at arm’s length from the government, AHS currently makes decisions that are not politically motivated. But restructuring leaves the health system vulnerable to decisions based on cold calculations of politics and power rather on what is best for the health of Albertans. 

There is however some promise in the proposed changes. In the current state, acute care is prioritized while primary care, continuing care and mental health and addictions services get less attention. Having new organizations dedicated to each of these can lift their profile and should be accompanied by adequate resources for these critical components of health care. 

Also, Danielle Smith’s promise that every Albertan will have access to a family doctor or nurse practitioner is one that we can embrace and hold her accountable for delivering upon.  Her pledge needs to be backed up by action that supports team-based care, provides financial viability for primary care clinics (who operate as small businesses), and allows primary care providers to use their time and energy on patient care rather than paperwork.

We are living in a time of multiple health care crises: ambulance shortages, lengthy emergency room wait times, inadequate staffing and poor work conditions for health care workers and now the destructive restructuring of AHS. These health care crises are not inevitable but a result of political choices, interference and micromanagement. Albertans suffer from a crumbling health care system while politicians making selfish choices, profit and consolidate power.

Regardless of who we voted for, we have a responsibility to hold the current government accountable for providing high quality health care that is accessible, timely and maximizes the value of taxpayer money. We have to demand that health care decisions remain focused on what is best for the health of patients and populations and not on power and political gain. 

We have to insist that Albertans experience health care that is seamless and not risk falling through the cracks of a fragmented system. We need to hold the government accountable for recruiting health care workers and treating them with respect so that they continue to provide excellent care right here in our province. We need to tell our government it is time to stop shuffling the chairs on the deck of a sinking ship and start correcting course. 

Vamini Selvanandan is a rural family physician and public health practitioner in Alberta. For more articles like this, visit http://www.engagedcitizen.ca.

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