Alberta Health Services to split into 4 parts

EDMONTON – Alberta’s government said it will “de-aggregate” Alberta Health Services into four entities in a sweeping overhaul that will change the delivery of healthcare for the province. Calling it a “new day for healthcare in Alberta,” Premier Danielle Smith (pictured) said dividing Alberta Health Services (AHS) into new agencies with a narrower focus, to be overseen by a council of politicians and senior government bureaucrats, will improve access to care in a system under strain.

“The current Alberta healthcare system is one that has forgotten who should be at the centre of its existence – patients, and the healthcare experts that look after them,” Smith said at a news conference in Edmonton

The goals of the reform are to reduce emergency room and surgery wait times, improve access to innovative treatments and recruit more staff.

Four new organizations will deliver healthcare services by function – in primary care, acute care, continuing care and mental health and addiction care.

AHS will be the organization responsible for acute care and is likely to get a new name.

Health Minister Adriana LaGrange appointed former cabinet minister Lyle Oberg as the new board chair of AHS. A temporary administrator has been at the helm for a year since Smith fired the previous AHS board.

Smith has criticized AHS as too top-down and monolithic in its decision-making. She has said previously that the health authority failed to respond to rising hospitalization rates during the COVID-19 pandemic. She has also said AHS needs fewer managers and more front-line workers.

The new structure would create several new bureaucratic entities, including the supervising integration council, a procurement secretariat, a centre of excellence for addictions recovery, and revamp 13 groups allowing for local and Indigenous input.

The AHS breakup will take up to two years and has a budget of $85 million.

LaGrange said the government will create the new organization overseeing continuing care by spring 2024, to be closely followed by a new mental health and addictions authority. The new primary and acute care organizations will be unveiled in fall 2024, LaGrange said.

She emphasized patients should move seamlessly through services run or overseen by the four new organizations.

In a technical briefing, health officials were unable to point to another jurisdiction that uses the model proposed by the government, instead saying Alberta is a leader in healthcare.

Steven Lewis, an adjunct professor of health policy at Simon Fraser University and Vancouver-based consultant, said restructuring health systems is rarely the solution when they are underperforming.

He said even with a new agency in charge, it will be difficult to reform primary care until the Alberta Medical Association reaches new agreements with the government on how family doctors are compensated for their work and overhead costs.

Expecting a council of ministers and deputy ministers to foster seamless integration between the new organizations is “extraordinarily naive,” given each new entity will develop its own culture, and may compete for resources and workers, Lewis said.

“I think a lot of this [change] was a concession to the rural base, which always used AHS as the piñata,” he told CBC News.

Alberta Medical Association president Dr. Paul Parks is reserving judgment on the proposed changes until he sees the details of how it will transpire. Doctors must be involved in guiding the transition, he said, and it should be as minimally disruptive to patients as possible.

The government will begin holding town halls and feedback sessions with the province’s 250,000 healthcare workers. The premier said a revamped system should be more responsive to their suggestions. Union leaders said the government should have consulted workers before unveiling its intentions.

“Not one [worker] would have recommended this complicated and expensive reorganization plan,” said CUPE Alberta president Rory Gill.

NDP Leader Rachel Notley told CBC News the new structure will allow the government and new agencies to pick and choose who will deliver services currently performed by public healthcare workers. Notley also questioned how well patients will move through the new system, organized by function, when they have multiple medical issues – such as a elderly, long-term care patient who needs surgery and also has mental health challenges.

Smith’s plan would break apart Canada’s first provincewide health authority about 14 years after the Ed Stelmach Progressive Conservative government created it.