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Alberta returns to decentralized health care

By Dean Bennett The Canadian Press   


Seven years after Alberta collapsed its health regions and centralized care in an attempt to save money and improve outcomes, it is moving back in the other direction.

Premier Jim Prentice said Wednesday that decentralization of health care is the way to go, despite earlier decisions by previous Progressive Conservative governments.

“I’m not going to defend what happened in the past. I wasn’t the premier at the time,” Prentice told reporters. “The pendulum is coming back in terms of local input into decision-making to protect the interests of people who live across the province.”


The announcement followed the release of a government report into reforming rural care. Prentice said the government heard a lot from residents “who have felt disenfranchised by the way the system has been operating.”

Health Minister Stephen Mandel said the province will set up eight to 10 new health districts by July 1. Each will be responsible for meeting performance targets and delivering health services.

Each district will receive advice from a local advisory council.

Mandel said the districts will be different from the nine health regions that were consolidated into the Alberta Health Services (AHS) superboard in the spring of 2008.

“The health regions became competitive regions, where one was fighting with the other for services,” said Mandel. “This will be operating districts. It’s much like a business.

“We hope that this will push decision-making down to the local level.”

The reorganization also includes a provincial ambulance service model.

Vickie Kaminski, CEO of Alberta Health Services, said big decisions such as new hospitals, technology improvements and other health infrastructure will still be co-ordinated through AHS.

“We’re also going to keep overall functions in finance and human resources and communications fairly centralized,” she said.

Any costs associated with the transition are expected to be handled within existing resources.

It’s another step in what has been a tortured and twisted path for AHS, which has been responsible for delivering front-line care provincewide.

Since 2008, multiple CEOs have been hired and left, and in 2013 the entire governing board was fired by then-health minister Fred Horne in a dispute over bonuses. It has yet to be replaced.

There have been headlines on wasteful spending and large severance payouts to executives, intimidation of staff and doctors, organizational chaos, administrative turf wars and long lines for surgery and emergency room care.

There have already been previous attempts to reintroduce local governance by dividing the province into five zones to go with 12 other health advisory councils.

NDP Leader Rachel Notley said the latest reorganization is stark proof of Tory administrative bungling, with Albertans paying the price.

“This is an incredible indictment of this government’s record over the last seven years around health-care organization, and reorganization, and reorganization of that reorganization,” said Notley.

Opposition Wildrose Leader Heather Forsyth said she is hopeful, but cynical, that true change will emerge.

“While we are hopeful these new districts will lead to the badly needed improvements in rural care, they sound like another rewrite of a broken script.

“The reality is the core of the problem facing health care in our province remains the same today as it was yesterday: a centralized health model with all the power remaining in Edmonton.”

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