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Health care must remain the focus of decentralization

Health Minister to reform the management and structure of Alberta Health Services
FILE - Health Minister Adriana LaGrange received her mandate letter from Premier Danielle Smith which included the goal to reform the management and structure of Alberta Health Services to spread out decision-making to improve front-line care. THE CANADIAN PRESS/Jason Franson

There are pros and cons when it comes to decentralizing Alberta’s health care system, according to those in Red Deer who have had a seat at the health care table.

Michael Dawe, who was an elected member of the David Thompson Health Region Board before it was dismantled in favour of the single Alberta Health Services board, said a more localized health system worked well, was sensitive to local issues, and more efficient than waiting for a massive organization to make decisions.

But he also recalled how disruptive it was to get rid of local authorities.

“As much as I think the end product of a responsive local system is a very powerful thing, be careful what you take apart because rebuilding things is not that easy,” said Dawe, who is a Red Deer city councillor.

This week Premier Danielle Smith’s mandate letter to Health Minister Adriana LaGrange included the goal to reform the management and structure of Alberta Health Services to spread out decision-making to improve front-line care.

The decision sets in motion a reversal of government policy that began almost 30 years ago when then-premier Ralph Klein collapsed more than 200 health boards and agencies into 17 regional health authorities.

Those 17 authorities were later rolled into nine boards and then, in 2008, into the current stand-alone Alberta Health Services, better known as AHS.

In 2015, AHS established operational districts across Alberta, each with a local advisory council which still exist today, to hear from residents and provide feedback.


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Dawe said concentrating on decentralization could take the focus off urgent issues like the doctor and nurse shortage and the expansion of Red Deer’s hospital which is desperately needed.

“(Construction) itself takes a pretty long time. Years have gone by with them saying we’re going to go build it, and years are still ahead in terms of actually getting it built.”

He said change is not bad, but there’s always the risk of disruption and uncertainty for Albertans, including for health care workers and administrators.

“Morale is probably already a big problem right now. Demoralization is the last thing the system needs,” Dawe said.


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City councillor Bruce Buruma said decentralization is an exciting opportunity. Local health care advocates have been saying there is no local perspective within the senior leadership of AHS to provide an understanding of the issues facing Red Deer and Central Alberta.

As a former member of David Thompson Health Advisory Council, Buruma said the council worked on some projects while he was there, but it was strictly advisory so he questioned its effectiveness.

“There wasn’t any decision making. There wasn’t accountability. And I think that’s been one of the challenges around health care. What is the local accountability to meet the real needs that Central Alberta has?” Buruma asked.

He said Central Zone of AHS is huge, stretching from the Saskatchewan border to practically the B.C. border, and having something like a regional board would better serve communities by providing the health care that they need.

Health care is a major consideration when it comes to people deciding where they are going to live, he added.

“This is beyond health care. It’s about the viability of communities. It’s about wellness of communities,” said Buruma, acknowledging the importance of both physical and mental health.

— with files from The Canadian Press

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Susan Zielinski

About the Author: Susan Zielinski

Susan has been with the Red Deer Advocate since 2001. Her reporting has focused on education, social and health issues.
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