Several leaders of Alberta municipalities are hopeful that changes to the health-care system will mean improved service in rural areas of the province.
“We are really seeing this government listening to rural Albertans,” said Paul McLaughlin, president of the Rural Municipalities of Alberta.
“We do have some complexities. A lot of it’s tied to population, access to services and really just who we are as rural municipalities.”
Premier Danielle Smith was speaking at the fall Rural Municipalities of Alberta convention Thursday.
“We started our work to fix the province’s health-care system one year ago and we were clear then that we were looking for smaller fixes in order to bring some immediate results,” Smith said. “We saw some progress but we knew that there was more work to be done.”
Her address came just one day after the United Conservative government announced big changes to the health-care system, restructuring it into four different organizations with Alberta Health Services being just one of them.
The goal is to reduce wait times and increase access to family doctors.
“This structure will ensure that each area gets the attention it deserves, uses staff more effectively and allow more space for immediate decisions and responses to local conditions,” the premier told municipal leaders.
“Our goal is for the system to be adaptable. So, if your community has specific acute needs in one specific area, the system will be able to shift to meet that local demand — and not because AHS has decided it from on high, but because staff and health-care decision-makers in the region have the freedom to react and to respond.”
Rural Municipalities of Alberta convention on Nov. 9, 2023.
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Alberta Health Services, or AHS, was created 15 years ago, amalgamating disparate health regions into one superboard tasked with centralizing decision-making, patient care and procurement.
Its annual operating budget is about $17 billion. It has 112,000 direct employees with thousands more working in labs, as physicians, and in community care facilities.
Under the proposed new system, Alberta will still have an integrated provincewide health system but with its fundamental structure and decision-making drastically altered.
Smith said solutions should be “common sense” and should come from conditions on the ground, because of what people need and want — “not by wishful thinking or ideology.”
“It’s no secret that we have seen, sadly, constant service disruptions and temporary closures at rural hospitals,” the premier said Thursday. “As a government, we believe that’s unacceptable, and it’s one of the reasons why we are refocusing the entire system.”
McLauchlin admitted the devil is in the details, but municipal leaders are feeling positive.
“A lot of them had concerns that it was going to revert back to the old way it was, which was regionalized, and instead… they said: ‘Hey, that’s got some value and some innovation to it and there’s some ideas around that, that we can actually really move forward on.’”
AHS is currently subdivided into five geographic regions. The new model erases the geographic regions and creates four new subgroups organized not by geography, but by service delivery.
McLauchlin said there were downsides to the centralization of services.
“I’ve got an operating room in the town of Rimbey that’s not being used. There’s pockets of this not occurring in the province. Full capacity, opportunities and really looking at using resources better.”
McLauchlin said spending more money wasn’t helping the underlying issues.
“AHS is what? The fourth largest employer in Canada? There is just no way you can have patient advocacy at the local level when you have all these layers that go up to the top.
“There’s no way you can actually carry that full care message through a system like that.”
McLauchlin said he’ll be watching for the changes to translate to quality-of-life improvements: shorter surgery waits, moving people through the system more efficiently and effectively.
“There’s a number of critical issues,” said Athabasca County Reeve Brian Hall. “The on-going closure of the Boyle Regional Health Care Centre is a big deal. It’s been closed every night — so 12 hours a day — for the last 18 months.
“Through the government’s international nurse program, we’re getting very close to having that back to 24-hours-a-day, seven-days-a-week operation.”
Hall said the major challenge for the county is staffing.
“We’ve got some really good folks working with our municipalities and our partner municipalities in the town of Athabasca and village of Boyle that have had good success with the doctors. The biggest challenge right now relates to registered nurses and that’s been the major challenge in the village of Boyle.
“We’re all hopeful for an improved system and it’s clear that it’s not working ideally with the way AHS is currently structured.
“I haven’t had the opportunity to dig deeply into the changes but it’s important to look to new things cause continuing to do what we were doing is not the answer.”
Under the new plan, there will be a new acute care organization, responsible for running hospitals and, for the time being, lab and ambulance services.
AHS will become a service delivery provider answering to that organization.
Alongside the new acute care organization would be a primary care organization, with a mandate to find a family doctor for every Albertan.
There would be a continuing-care organization to oversee and run those facilities.
The fourth agency, a mental health and addiction organization, would work directly with the Mental Health and Addiction Ministry to further the broader goal of a recovery-oriented system.
— With files from Dean Bennett, The Canadian Press
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