EDMONTON — Alberta’s health delivery system, which moved from a decentralized to a centralized model three years ago, is now moving back in the other direction.
Dr. Chris Eagle, the head of Alberta Health Services, told reporters Tuesday that a revised leadership model will now see more power devolve to the heads of five health regions.
Eagle said the move was needed to give the regions more flexibility to deal with problems unique to their areas.
“We’ll be able to make the decisions faster that our staff say we really need to be making,” said Eagle who runs the delivery arm of the Alberta Health and Wellness Department.
He said the decentralization is not a radical return to the former way of doing things, but more of a modest restructuring to deliver better service.
He rejected a suggestion the change is an admission the original centralization plan went too far in the first place.
When the Alberta Health Services superboard was created, he said, the department was scrambling to find $1.3 billion in cost savings.
“I don’t know of any other way of easily carving out 15 per cent of a health system’s budget other than centralizing decision-making,” he said.
“Things have changed dramatically now.”
The government now has a stable five-year funding plan that allows the superboard to carry out long-term plans and programs without fear of the funding being pulled out from under it.
The five-year plan, which began in the last budget year, involves funding increases of six per cent in each of the first three years and 4.5 per cent in each of the next two years.
Critics and political opponents of Premier Ed Stelmach have long stated that collapsing the nine health regions and various agencies into one large superboard in 2008 would cause the system to become even more inflexible and thereby cancel out any costs savings and efficiencies.
David Swann, leader of the opposition Alberta Liberals, said frontline staff have seen so many top down expansions, contractions, and modifications of the organizational chart that administrators will have to overcome deeply ingrained cynicism.
“This is simply one of a host of changes folks have experienced over the last 10 years,” said Swann.
“They have no idea when it’s actually going to be meaningful in terms of respect and honour the experience and expertise of the front lines.”
Rachel Notley of the NDP said staff numbed by years of perpetual change in health management must look inwards for any sense of job satisfaction.
“How can you ever truly commit to a (system) when your darn organization is changing every six months, and who you answer to is changing every six months, and the dynamics of it is changing every six months,” said Notley.
“You become paralysed into simply reactive care.”
The core of the restructuring will be the autonomy of the five zones, said Eagle.
He said the zones previously only had partial control over health programs but didn’t, for example, oversee the hospitals.
“The five zones will become the core operating units,” he said.
“Within those zones there will be a single point of accountability, a single leader.
“We become much more focused.”
Danielle Smith, leader of the opposition Wildrose Alliance, said the plan is not so much decentralization as centralization-lite.
Smith said even more control must be delegated to front-line staff, such as doctors and nurses, if there is to be meaningful change and accountability.
She said she doubts that will happen.
“This government under this leader has an ideology that all you have to do is hire a bunch of central planners and they’ll be able to figure it out,” said Smith.
“We see that in the land-use planning model, the health superboard model, and the way they try to micromanage what happens in the municipalities.”