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Alberta's obsession with re-structuring well being care administration: A short timeline

“Give folks the facility, give them the sources, give them the authority to say sure on the native stage, and we will get a lot better service.”

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Alberta Premier Danielle Smith continues to eye re-hauling well being care, and supplied some particulars this week about her push for extra regional decision-making and a decentralized system.

“I would like managers on the hospital stage,” Smith mentioned on her bi-weekly CHED 630 radio present Saturday.

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“Give folks the facility, give them the sources, give them the authority to say sure on the native stage, and we’re going to get a lot better service,” she mentioned.

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In response to publicly-posted information from Alberta Well being Companies (AHS), staffing shortages are serving to drive all 33 non permanent well being care facility and mattress closures at the moment ailing the province.

Related arguments have been made for many years, however now Alberta’s single built-in authority has copycats throughout the nation. Operational well being care spending within the province is about to price taxpayers at the least $24.5 billion this fiscal 12 months.

Right here’s a quick historical past almost 30 years of the tectonic upheavals, regional competitors for money, workers and management, and the nonetheless unresolved political tensions over well being care in Alberta.


Within the midst of a large deficit-slaying effort and deal with repairing the province’s funds, Progressive Conservative premier Ralph Klein kiboshes greater than 200 native hospital and public well being boards, changing them with 17 well being authorities assigned by geography.

Some argue the “native empires” had been too pricey, and particular person requests for sources had turn out to be channelled by way of politicians who had little concept how you can prioritize them.

On the identical time, critics say the brand new boundaries seemed to be rooted within the politics of the agricultural Conservative caucus extra so than practicality or logic.

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A decade later, these 17 boards are amalgamated into 9 in an effort to make the system extra streamlined and accountable.


The PC authorities beneath Ed Stelmach strikes to dissolve the 9 well being areas, prompting the creation of a single governing authority at Alberta Well being Companies (AHS). It comes after the fierce competitors for sources amongst areas led to various wage and profit gives, and ranging ranges of service, relying on the place you lived.

Well being Minister Ron Liepert spearheads the trouble, with the federal government promising that placing the system beneath one governing umbrella would save administrative prices that may very well be channelled into front-line care — though some later claimed the transfer was about muzzling criticism of the federal government from workers and regional boards.

Well being coverage consultants on the time warn the instability may scare medical professionals away from working within the province, whereas others fear the centralization would create extra forms and fewer native decision-making, leaving rural areas with little say on how companies can be run.

Proponents be aware the unified authority would have be higher in a position to share information, plan extra effectively, enhance economies of scale, and have deliver procurement energy.

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As Alberta Well being Companies’ strikes to offer high medical doctors and managers in its 5 zones across the province the brand new authority to rent workers and purchase tools, Wildrose chief Danielle Smith argues AHS must put much more energy within the hand of medical doctors and nurses.

“Attempting to centrally plan a $10-billion well being system simply isn’t doable,” Smith says.

By 2012, Smith was nonetheless vital of what she referred to as the “unresponsive superboard forms in Edmonton,” saying it ignored native wants following the closure of a rural long-term care house.


In a single high-profile try and reintroduce native governance, PC premier Jim Prentice pitches the concept of organising eight to 10 new operational well being districts. Well being Minister Stephen Mandel mentioned they wouldn’t be just like the earlier 9 well being areas, which he mentioned had been too aggressive and fought for one another for sources.

In Might, a basic election sees Rachel Notley’s NDP sweep to energy, and her authorities quickly publicizes AHS will once more be overseen by a board construction that over the earlier two years had been changed by consecutive directors.

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Coming off the heels of the COVID-19 pandemic, the UCP management race to exchange former premier Jason Kenney in 2022 sparks a fiery debate in regards to the function, construction and administration of AHS.

Operating a management marketing campaign that emphasizes grievances over the dealing with of COVID-19, Smith argues that AHS was too gradual to increase its mattress capability to deal with front-line wants through the pandemic. When she assumes workplace, she fires the board of AHS and replaces it with a sole administrator in an effort to fast-track reforms.


Because the province prepares for the continued re-haul of well being care, Smith tells reporters she is going to preserve province-wide integration for some issues, like main surgical procedure and coronary heart transplants, however including extra administration in native hospitals will improve companies, particularly in rural areas and small cities.

“It’s not about going again to the way in which it was earlier than,” Smith says, including AHS must be centered totally on acute hospital care.

Whereas Smith has made it clear she opposes vaccine mandates, she says that’s not driving the reform. “It’s all about enhancing the system.”

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