Ernst & Young has been reviewing the operations of Alberta Health Services, in a Dec. 30, 2019 story. (File photo by Advocate staff)

’Significant changes:’ Alberta eyeing major reforms to health system in 2020

EDMONTON — Alberta’s medical system is getting prepped for some major surgery in 2020, and Health Minister Tyler Shandro says it starts in about two weeks with the release of a report expected to be the blueprint for change.

“We committed to getting wait times down, so now we’ve got to figure out a way to do it. That’s going to be the No. 1 thing,” Shandro said in a year-end interview.

The report, by Ernst & Young, has been reviewing the operations of Alberta Health Services, which is the day-to-day service delivery component of Shandro’s health department.

It will address roles and responsibilities, come up with ways to find savings, reinvest savings and review the relationship with private facilities contracted out to do work paid for by the public system.

“That (report is) going to, I think, recommend some significant changes in the relationship between AHS and the ministry,” said Shandro.

It will likely also be just the first act in a drama featuring a government turf battle with doctors, a wage and job fight with nurses and other health workers, and the launch of Shandro’s plan to make the province a national leader on meeting surgery wait-time targets by adding surgeries and using more for-profit clinics.

Alberta is spending $20.6 billion on health this year, eating up more than 40 per cent of the operating budget.

A government-appointed panel, led by former Saskatchewan health minister Janice MacKinnon, has said rising health costs need to be addressed and that Alberta is comparatively getting substandard outcomes for the money it pays.

Alberta’s physicians take in $5.3 billion a year, and Shandro has already initiated changes outside of negotiations for the master agreement set to expire next March with the Alberta Medical Association.

The province has asked the AMA for feedback on changes it plans to make starting in the new year, including extending the amount of time a doctor must consult with a patient — to 25 minutes from 15 minutes — before an add-on fee kicks in.

Shandro says the change is needed to make those consultations more effective, but some doctors have said that will force them to cut other consultations to as little as 10 minutes, potentially compromising care, in order to recoup the funds needed to keep their practice going.

Shandro said he’s heard those complaints, but says they suggest the current payment method, called fee for service, doesn’t work and supports his argument that a new remuneration plan is needed.

Dr. Christine Molnar, head of the AMA, has said some of the proposed changes should be part of the master agreement negotiations, while Shandro’s department insists it has the statutory power and will use it.

“The consultation is an end-run around negotiations for many of the proposals that legitimately belong at the negotiating table and must remain there,” Molnar said in an open letter to members Dec. 9.

Shandro also faces challenges on the labour front, with unions promising a fight after the government sent letters suggesting as many as 5,000 job cuts over the next three and half years as part of restructuring, including 500 full-time nursing jobs.

The Opposition NDP, meanwhile, has also called Shandro’s plan to use more for-profit clinics to reduce wait times the thin edge of the wedge to American-style care, where patients pay out of pocket or through private plans to get medically necessary procedures.

Not so, said Shandro. He said the delivery method may change, but not the cost.

“I have zero interest in forcing anybody to pay for medically necessary services,” he said.

He said Alberta already has clinics and family doctors running their own offices while doing work paid for by the province.

The goal, he said, will be how to find the right mix of care, as is done in Europe, to get more work done to free up bed space in hospitals and get more surgeries done in hospitals by, say, adding extra shifts and finding specialists to staff them.

“This is a complex system,” he said.

“Every time you touch anything in the system, there’s going to be ripple effects everywhere.”

This report by The Canadian Press was first published Dec. 30, 2019.

Get local stories you won't find anywhere else right to your inbox.
Sign up here

Just Posted

Cilantro and Chive was voted in the top three in no less than 13 different categories in the 2020 Best of Lacombe Readers Choice Awards. Photo by Megan Roth/Lacombe Express
Cilantro and Chive opening in Red Deer

There will now be two Cilantro and Chive locations. The restaurant announced… Continue reading

B.C. Liberal leader Andrew Wilkinson, B.C. NDP leader John Horgan and B.C. Greens leader Sonia Furstenau. (Black Press Media)
VIDEO: One day until B.C. voters go to the polls in snap election defined by pandemic

NDP Leader John Horgan’s decision to call an election comes more than a year ahead of schedule and during a pandemic

Alice Kolisnyk, deputy director of the Red Deer Food Bank, says the agency expects an increase in demand as the COVID-19 pandemic continues. Every new subscription to the Red Deer Advocate includes a $50 donation to the food bank. (Photo by BYRON HACKETT/Advocate Staff)
Support the food bank with a subscription to the Red Deer Advocate

The community’s most vulnerable members are always in need of a hand,… Continue reading

Mariah Bell of the United States competes during women’s freestyle program in the International Skating Union Grand Prix of Figure Skating Series Saturday, Oct. 24, 2020, in Las Vegas. (AP Photo/David Becker)
Canadian Keegan Messing earns bronze at Skate America in Vegas, Chen wins gold

Messing earns 266.42 points at Skate America in Las Vegas

In this Oct. 7, 2020 photo, chef Sohla El-Waylly prepares Swedish meatballs during a taping of “Stump Sohla,” in New York. El-Waylly became a familiar face on YouTube as a standout on Bon Appetit’s test kitchen channel. But during the nationwide racial reckoning following the police killing of George Floyd, she was among members of the test kitchen who accused the channel’s owner, Conde Nast, of discriminatory practices. She departed Bon Appetit in August after failed negotiations. Her new show is her own, pushing her to deploy her talent, charm and encyclopedic culinary chops to solve challenges. (AP Photo/Mary Altaffer)
‘Babish’ expands as pandemic boosts YouTube cooking shows

Daily views of videos with “cook with me” soaring

FILE - Oprah Winfrey arrives for the presentation of Stella McCartney’s ready-to-wear Fall-Winter 2019-2020 fashion collection in Paris on March 4, 2019. Winfrey is setting aside her usual book club recommendations and instead citing seven personal favorites ranging from James Baldwin’s landmark essays in “The Fire Next Time” to Mary Oliver’s poetry collection “Devotions.” She is calling her choices “The Books That See Me Through,” works she values for “their ability to comfort, inspire, and enlighten” her. (AP Photo/Michel Euler, File)
`The books that see her through’: Winfrey suggests seven

Mix of fiction, poetry, non-fiction and spirituality

NDP Leader John Horgan celebrates his election win in the British Columbia provincial election in downtown Vancouver, B.C., Saturday, Oct. 24, 2020. THE CANADIAN PRESS/Jonathan Hayward
John Horgan says he will work across party lines to find ideas that work for B.C.

VICTORIA — British Columbia’s election results show a divided province with Liberal… Continue reading

President Donald Trump gestures from the top of the steps of Air Force 1 at Andrews Air Force Base, Md., Wednesday, Oct. 21, 2020. When people in the United States talk about moving to Canada to escape four more years of Donald Trump, it’s usually either a punchline or a pipe dream. THE CANADIAN PRESS/AP-Susan Walsh
Move to Canada? A pipe dream for some Americans is a parachute for Canadian expats

WASHINGTON, Wash. — When people in the United States talk about moving… Continue reading

The Cogeco logo is seen in Montreal on Thursday, October 22, 2020. THE CANADIAN PRESS/Paul Chiasson
Five things to watch for in the Canadian business world in the coming week

TORONTO — Five things to watch for in the Canadian business world… Continue reading

Most Read