The president of the Alberta Medical Association says Premier Danielle Smith’s plan to transfer some Alberta Health Services hospitals to third-party operators would add redundancy, red tape, and bureaucracy to Alberta’s health care system and complicate the ongoing staffing crisis.
At a members-only United Conservative Party town hall event in Drayton Valley on Aug. 17, Smith said her government is prepared to take away AHS’s authority to operate hospitals if it isn’t “performing the services we need them to” and that religious operator Covenant Health may be better suited to run facilities in some areas.
Smith said removing AHS as the operator of some hospitals would incentivize improved delivery of care by creating market competition and “fear” among providers.
AMA president Dr. Paul Parks said such major changes should be based on evidence and not “done on a whim.”
“We've been trying to advocate with government for a year, being very, very clear that a lot of the pieces that are critical to stabilize the hospitals right now – our acute care stabilization plan as an example – that all lies with Alberta Health and the government investing and redirecting resources. It would be kind of agnostic as to who is running the hospitals or who is the service provider, when really the critical bottlenecks and issues are around things like workforce and resources and funding models that are all on the desk of Alberta Health and not the actual provider,” Parks said.
Having multiple service providers would require added operational controls, administration, oversight, and coordinating bodies, Parks explained. “I’m just really worried about the added redundancies: more red tape, more bureaucracy, more administrative structure.”
These issues already exist in Edmonton Zone, Parks said, the only zone in the province with two health authorities – AHS and Covenant Health.
“The lack of coordination and issues between those two health authorities make it such that access metrics and outcomes are worse in Edmonton Zone compared to Calgary Zone, as an example.”
In both AHS and Covenant facilities, the main driver of service disruptions has been staff shortages. Pitting the two providers against each other in a competition for staff would worsen workforce issues, Parks said.
“You really don't want multiple authorities competing for the same workforce. You want them to be able to coordinate” and send resources to where they are needed.
Staffing issues have forced the Covenant facilities in Edmonton, the Grey Nuns Community Hospital and Misericordia Community Hospital, to cap the number of patients that are admitted overnight and reduce the number of general internal medicine teams, Parks said. When the hospitals can’t accept more patients, they are redirected to AHS facilities which have to take the “additional transfers and volume and EMS load.”
“Covenant Health has the two hospitals that are struggling the worst for general internal medicine coverage and nighttime coverage for access to their hospitals. But they don't have to transparently report that, whereas AHS does. And so, people don't realize that currently our Covenant Health facilities are not necessarily functioning or operating at as high a level as the AHS ones are in the same city.”
Parks said the health professionals working in Covenant facilities are overstretched and working hard to “provide amazing services. But because of the different health authorities and the issues around coordinating, it's actually the Covenant Health facilities that are struggling the most on those kind of access issues.”
