Alberta reform delays doctors' contract negotiations
Alberta Medical Association (AMA) president Dr Darryl LaBuick admitted the province's recent decision to condense its nine health regions into one will affect ongoing trilateral contract negotiations between the AMA, the government and the RHAs. The doctors' contract expired March 31. But Dr LaBuick nevertheless endorsed the government's plan, applauding its focus on patient care.
Other AMA members, however, are concerned the new reforms will further delay negotiations. Alberta's March election and cabinet shuffle already halted the long-running process, says AMA negotiating committee member Dr Glenn Comm. "For me this is a sign of disrespect — showing where we are on the totem pole of their concerns." |
He's only been Alberta's health minister since March, but Ron Liepert took one look at the province's health authority set-up and knew he wanted to overhaul the whole thing.
The system's structure, which includes nine regional health authorities (RHAs), has been "studied to death," he said. He promised no more reviews, studies or commissions — it was time for action. His solution: one province, one health authority.
"It was becoming more and more apparent there were barriers in the system to streamline patient care," Mr Liepert told NRM. "It seemed the system was designed around the region, not the patient."
Needless to say, his unilateral action upset many in the health sector. The government's abrupt change has sparked a debate in Alberta about how healthcare should be administered, mirroring a similar debate across the country.
ALBERTAN PLANS
Alberta's reform will ensure consistently applied standards across the province, Mr Liepert says. "We had situations where folks had care provided differently on one side of the road than the other. Care should be equitable."
Criticism has been abundant. "There needs to be a massive and quick infusion of new people into the healthcare workforce in the province of Alberta," says Alberta Liberal deputy leader and health critic Dave Taylor. "Just rearranging the board governance system doesn't address that — it's like rearranging the deck chairs on the Titanic, when in fact somebody should be grabbing the wheel and changing course."
Steven Lewis, a Saskatoon health policy consultant, was lukewarm to Mr Liepert's reforms in an essay published online last month by Longwoods Publishing. "The Alberta solution is nothing if not Canadian: when in doubt, restructure," he writes. "[But] structural reform does not guarantee improved access, better quality or greater efficiency." He adds that if Alberta took the time to fix all the other problems in the system their current reforms might make sense. But he suspects no such fix is in the cards.
REFORM TREND
Across Canada, the trend towards health regionalization reform appears to have reached its zenith.
New Brunswick announced plans in March to move from eight regional health authorities to two. Manitoba recently commissioned an external review of its regional health authority structure; the results, released in February, were largely positive but made 35 major recommendations for improvements. Prince Edward Island and Ontario also redesigned their health authorities over the last few years.
The experts have been weighing in. In a paper delivered last month at The Change Foundation's meeting in Toronto, Ken Fyke, a former deputy minister of health in BC and Saskatchewan, wrote: "Regionalization is a good idea, badly done."
In Saskatoon, on June 2 and 3, policy experts attending the National Healthcare Leadership Conference seemed nervous about governments' trend towards centralization, says Mr Lewis, a panellist at the conference. "I think everybody was a little bit disoriented by the Alberta move. There was a general mood of uncertainty about the future of regionalization."
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