People power

Local autonomy is returning to communities nearly three years after the nine regional health authorities were scrapped and the Alberta Health Services superboard was created

Local autonomy is returning to communities nearly three years after the nine regional health authorities were scrapped and the Alberta Health Services superboard was created.

Alberta Health Services unveiled a revised leadership model on Tuesday that transfers more decision-making in five zones for hospitals and community centres. When the regional health boards were disbanded in 2008, there was outcry about losing local input on health care.

Kerry Bales, central zone vice-president for Alberta Health Services, said there has been feedback from communities about the centralization of decision-making in AHS. But he said centralization was necessary given all the changes that needed to happen.

“At the same time, it hasn’t actually facilitated the type of local decision making to get things done,” said Bales.

“It could be things as small as the ordering of equipment to actual program decisions or decisions that would have outcomes for client care.”

Bales said the intent of the realignment is to allow for those decisions to be made within the local communities and within the zone and not constantly channelled through to a central decision-making process.

Physicians will also have more input.

“It’s really designed to put the emphasis back on the clinical focus on the patient care,” said Bales.

“And a piece of that is making sure there is more involvement and engagement with the local staff and the local physicians. It will allow for greater autonomy again at those local levels to start making those day-to-day decisions that need to be made. Things people that perceive to have been counterproductive to the work that they have to get done on a daily basis.”

Five senior vice-president roles will be created, one for each zone, who will report to a chief operating officer (COO). The senior VPs will be hired internally and AHS will hire a COO externally.

The existing 85 vice-presidents will keep their jobs but their roles are likely to change.

The new senior VPs will be responsible for all health outcomes for their zone.

David Thompson Health Advisory Council chairman Bruce Buruma said the shift will strengthen the roles of the advisory councils.

In 2009, the 12 advisory councils replaced the 59 community health councils to gather local feedback on health service delivery.

“I think there’s a part when you look back historically on health care: There was a strong level of local input,” said Buruma. I think there was a feeling of local ownership and community. There’s value in having a provincial system but I think there was a connection people had with their local hospitals and wanting to meet those needs. This is probably putting a bit more element into it.”

Gord Bontje, the former local Alberta Health Services board member who quit in protest over the firing of the former AHS CEO Stephen Duckett last fall, said the new structuring and the addition of senior vice-presidents is good news for patients.

“Making operational decisions closer to the patient, closer to the problem and closer to the solution,” said Bontje. “. . . Putting simple things like decisions around the purchasing and the hiring and so forth closer to the front lines can only be healthy.”

Bontje said he hopes the next step is connecting funding to the receiver of the service.

“So much energy was dedicated when I was there toward activity-based funding,” he said. “That is ultimately going to give us the control we need.”

Changes at the senior level are expected to be completed by the end of May, and the completion of the realignment within nine months.