Alberta headed for chaos in health care
It’s now glaringly obvious that Danielle Smith is willing to go to extraordinary lengths to put Alberta’s public health-care system under her thumb; retribution for vaccine promotion and other public health measures adopted during the pandemic.
Her rural base abhorred vaccines, vaccine passports, restaurant closures and masks and they blamed Alberta Health Services for imposing them. They denounced Chief Medical Officer of Health Deena Hinshaw, even though former UCP premier Jason Kenney and his cabinet had authorized those measures.
The heavy hand of retribution comes in the form of new legislation tabled last week that breaks up Alberta Health Services and its 110,000 employees into four separate organizations; acute care, continuing care, mental health and addictions and primary care. The former provincewide, integrated system was already delivering those services (except for primary care) to 4.5 million people.
It’s hard to know how this will all work out for patients and health-care workers because the new system has never been tried before — anywhere.
Health Minister Adriana LaGrange says the current system is too “fragmented and needs to be refocused.” But dividing it up into four separate fiefdoms seems to fragment it even more. How will a hospital patient waiting for a long-term care bed connect with those providers when they have been moved to a separate agency? Will a patient with an addiction who is suffering severe withdrawal be treated at his addiction recovery facility or a hospital emergency department?
Alberta’s wholly integrated public health-care system was considered so successful that other provinces are adopting the model. Why would a premier mess with that when a shortage of hospital beds and health-care workers is already compromising patient care?
Dr. Braden Manns, who was vice-president of provincial clinical excellence at Alberta Heath Services until he resigned a year ago, is hopeful that the new agency designed to focus on primary care will improve communication and planning between the province’s family doctors and the government.
But he is concerned that a return to a segmented system won’t necessarily mean better patient care, despite the government’s promises. “One of the main things that you’re trying to achieve (in health care) is integration of care … but it’s hard for me to see how pulling these other two parts (continuing care and mental health and addiction) off of Alberta Health Services will lead to more integration of care,“he said during an interview.
Manns suggests that the UCP government is downsizing Alberta Health Services because it became too powerful and difficult to control.
Control of everything, everywhere has become a key theme of Smith’s government. So overriding decisions that should be left in the hands of health-care administrators and medical professionals is par for the course.
For example, creating a separate agency — called Recovery Alberta — for mental health and addictions allows the government to prioritize its approach to addiction treatment, which spurns harm reduction and safe supply — no matter what the experts say — in favour of residential facilities that focus on getting people to abstain from drugs or alcohol.
Last June, Smith’s heavy hand of interference was personally experienced by Manns when, he says, she vetoed the hiring of Deena Hinshaw, Alberta’s former CMOH, by an AHS Indigenous health unit after it had been approved by Manns and other AHS executives. Manns and the head of the Indigenous unit both resigned in protest. Smith denied the claim.
There was more interference last fall when the government directed Alberta Health Services not to use the words “COVID-19” or “influenza” or mention the benefits of vaccination in its seasonal vaccination advertising. Vaccine uptake plummeted and Alberta recorded the highest number of deaths from influenza in 15 years.
“The decision (to break up AHS) has already been taken,” said Manns. “Now it’s a question of controlling the damage and making sure that patients don’t fall through the cracks.”
Unfortunately, Smith is better at creating chaos than controlling chaos.
Alberta’s wholly integrated public healthcare system was considered so successful that other provinces are adopting the model. Why would a premier mess with that when a shortage of hospital beds and healthcare workers is already compromising patient care?