Danielle Smith believes she's found the org chart that saves health care
CBC
If there was a health-care system structure that guaranteed better patient care, lower surgical wait times, and impartial and accountable decision-making, then it would be in place everywhere.
But it's not.
British Columbia has five regional health authorities. Québec has 18. Ontario? It's somewhat complicated.
In 2008, the Alberta government dispensed with years of frustration with the Calgary Health Region's leadership and other tensions by smooshing everything together into Alberta Health Services, which always sounded on its face like the U.K.'s National Health Service, except that regionalization and decentralization have been Brits' watchwords for ages.
AHS was a sufficiently effective and/or non-disastrous model that Nova Scotia and Saskatchewan followed suit with their own amalgamations in the last decade.
It's arguable whether the promised cost savings and efficiencies of innovation ever materialized from this bigger-is-best approach. But now the province that started the centralization trend is embarking on a major disassembling, promising "patient-centred" outcomes, which is somehow different from 2008's pledge to put the "patient first."
Is this the organizational chart that finally cures the strains and aches of Alberta health care?
In the pre-AHS times, continuing care, mental health and hospital/acute care were all integrated within regions (with a specific agency for addictions treatment, for those who remember AADAC). In the new era Premier Danielle Smith is ushering in, Alberta's monolithic superagency is broken into separate organizations by function.
"We believe that by creating specialized organizations within one provincial system, we will enable each organization to look after one area of health care only and avoid the scattered and unco-ordinated approach of the more rigid centralized structure that exists now," the premier said at this week's announcement.
Of course, one person's "scattered" and "rigid" is another person's seamless — just as the UCP premier's emphasis on focus sounds like a new bureaucratic mess to her NDP predecessor.
"This backward-looking UCP plan will stuff patients and providers back into ineffective silos," NDP Leader Rachel Notley said. "Imagine a senior living in a continuing care facility who has to be taken to hospital because of a mental health condition. Under this plan, that poor senior is being tossed between at least three different government agencies."
The New Democrats warn this latest system shakeup will pave the way for health privatization, the warning they tend to give in most months with vowels in their names. While it should be stated that any change may open the door for more for-profit providers, it should also be stated that Smith and Health Minister Adriana LaGrange say that's not afoot in their plans, and their latest federal funding binds them further yet to the Canada Health Act provisions.
True as well: a government can surely overhaul health systems without bundling in privatization, just as a government can privatize without overhauling health systems.
While the premier has long shown past interest in private models and user pay, during the election and her premiership she's shied away from those. But she hasn't much shied away from her animus toward AHS, which appeared to harden in the pandemic; consider that the mass ouster of the agency's board was one of this premier's first actions.