ALBERTA： Improving the health care system
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Summary
Learn English with the Premier of Alberta, Rachel Notley. In this speech, Rachel talks about the challenges facing Alberta s health care system and the need for urgent care in our province, and how to fix them.
Transcript
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I'm pleased to be here with Adriana Lagrange, Minister of Health, Dan Williams, Minister
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Minister of Seniors, Community and Social Services,
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Professional Firefighters and Paramedics Association,
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Alberta Professional Firefighters and Paramedics Association,
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Sean Charlson, President and CEO of Shepherd's Care Foundation,
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President of the Nurse Practitioner Association of Alberta,
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Alberta, Alicia Lobe, the membership director of the Alberta Association of Nurses, Kevin Ferguson,
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Mayor of the Town of Padoka, and Sandy Edmondson, board member of Alberta Health Services. Welcome
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to a new day for health care in Alberta. From the very beginning of our government's mandate,
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improving health care at every level has been the top of our list of priorities, and with delays
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affecting the whole system, the urgency of the challenge can't be overstated. Wait times for
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life-saving surgeries, routine care, and mental health treatment are far too long. Alberta's
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health system isn't working the way it should and the way Albertans deserve. And fixing it is
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critically important to improving Albertans' quality of life. And improvements must begin
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with Alberta Health Services, the largest provincially integrated health system in the
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country. While all Albertans can and should be proud of our frontline professionals, the structure
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behind them is not setting them up for success. We have seen unacceptable wait times for surgery
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and yet some of our outcomes aren't better and are not improving. For example, Albertans are
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waiting longer for hip and knee replacements. Only 38% of hip replacements and 27% of knee
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replacements in our province meet the national wait time benchmarks. And the time Albertans
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remain in hospital, even after they no longer need hospital care, is four to five days longer
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than the national average because they lack the supports to return home. The human cost of both
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patients and their family is immeasurable i'm not satisfied with the current state of our affairs
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and i know albertans aren't satisfied either right after i became premier we launched our
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healthcare action plan and i directed dr john cowell to make immediate changes to deliver some
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quick and needed results we knew that those immediate actions would not fix the entire
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healthcare system but we needed to take steps forward thanks to that work we've seen some
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improvements but not enough i've spoken with albertans one-on-one and they've made this report
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this point to us repeatedly in very personal ways they've told me about surgeries postponed or
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canceled innovative treatments that are unavailable in our province because of holdups and approvals
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an entire day's loss to waiting in crowded emergency rooms near a suffering loved one
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some emergency departments have closed their doors because of a lack of staff
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which is the exact opposite of why emergency departments exist in the first place. Faults in
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the healthcare system cause needless pain and anxiety at Albertans most vulnerable times and
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they put tremendous strain on the frontline professionals who are working every day to help
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sick and suffering Albertans. When I spoke with frontline health workers, I began to get a sense
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of how we could truly make a difference, a long-term lasting difference for Albertans healthcare.
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Without a doubt, we have the best healthcare workers in the country. They're smart, skilled,
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endlessly compassionate people who understand their patients and their practice. And yet when
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they're they are sidelined when it comes to decision making, even though they understand
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the problems and see obvious solutions, they try their best, but they end up being stalled and
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frustrated by a system that lacks focus leadership and governance. The current health system in our
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province limits government's ability to provide system wide oversight on behalf of the people of
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Alberta. It also limits our ability to set priorities and require accountability for meeting
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them. The current Alberta healthcare system is one that has forgotten who should be at the center of
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its existence, patients and the healthcare experts who look after them. We need to bring Alberta's
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healthcare system back to its mission of delivering the healthcare Albertans need
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when and where they need it. We've had recent and extensive consultations with healthcare partners
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and communities during important projects like modernizing alberta's primary health care system
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we've also engaged on areas of emergency medical services mental health and addiction
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continuing care and health care system sustainability everything we've heard has
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helped to inform the development of our plan a plan that i'm pleased to introduce today this is
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all about refocusing our health care system to prioritize patients and empower health care
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workers starting today we're creating an integrated provincial healthcare delivery system that
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concentrates on four priority areas primary care acute care continuing care and mental health and
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addiction we believe that by creating specialized organizations within one provincial system
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we will enable each organization to look after one area of health care only and avoid the scattered
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and uncoordinated approach of the more rigid centralized structure that exists now these
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changes will apply province-wide to avoid the regional fragmentation that existed prior to the
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current system. This focus will help the new organizations better manage performance and
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promote expertise in areas, be faster and more responsive to issues, recognize innovative
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solutions, and make space for local decision making and advice. The newly refocused system
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will be more accountable, ensuring consistent quality care across the province. Patient outcomes
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will be better monitored as a result and all of this will result in a better system not only for
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patients but also for healthcare workers frontline healthcare workers will be a large part of
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organizations that are dedicated to their area of practice providing undivided attention to issues
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and giving workers room to innovate and apply solutions with fewer delays due to bureaucracy
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through this process though this process begins today we understand that restructuring takes time
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and dedicated effort this is why we have named a transition team to guide the process of forming
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these organizations and minister adriana lagrange will have details on these changes and the team
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that will oversee the transition of ahs but i want to be clear about this plan about what it is and
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what it is not i made a public health care guarantee to albertans that means no one will
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ever pay out of pocket for a visit to a doctor or for hospital services and that is not changing
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these reforms have nothing to do with privatization they are also not about cuts alberta's government
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will continue to grow the health care workforce and we anticipate that there'll be no job losses
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to hs staff working in frontline positions who are directly delivering patient care in fact our
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government knows that alberta needs more health care workers and so we'll continue to recruit and
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train more of them this isn't change for the sake of change this is a matter of redirecting alberta's
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healthcare system making it patient-centered seamless and effective it's about giving healthcare
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workers a structure that supports their success and the opportunity to use solutions they know
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will work as quickly and effectively as possible this is change that will mean the right forms of
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care are available for albertans when and where they need them now and for generations to come
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our plan won't lead to change overnight but it will lead to swift and effective reforms that
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Thank you, Premier, and good morning to everyone.
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when it comes to health care in Alberta. As Premier said, we are refocusing Alberta
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Health Services so that we can provide a high-functioning health care system that prioritizes patient
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care and empowers our health care workers. We are beginning this change by listening
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to the health care workforce and to Albertans. Throughout this process, we will rely on the
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expertise of healthcare workers and will work with them to make changes for the
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better. We will also listen to Albertans who use the system every day to ensure
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their experiences and ideas are part of these changes. During this transition we
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will work to minimize disruption to the daily work of healthcare staff and our
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priority will always be and I want to repeat that always be to protect
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frontline jobs. I would like to thank Dr. John Cowell for stepping up to serve as
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the official administrator of Alberta Health Services since last October. Today
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I am announcing a new AHS board which is made up of seven members and I'm pleased
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to announce that Dr. Lyle Oberg will be the chair. Dr. Oberg has years of extensive experience
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as a physician, rural practitioner, and multi-faceted leader. Under Dr. Oberg's leadership,
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this board will guide the changes that will gradually unfold over the next 18 months.
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It is crucial we take the time to get this work right, which is why it will roll out
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in stages over the coming months and years. In addition to the new AHS board, transitional
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boards for the organizations will be named over the coming weeks. The first organization
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to be formed will be the new Continuing Care Organization, which we expect will be ready
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to go this coming spring. The new Continuing Care Organization will seamlessly continue
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the work of transforming the area of continuing care, which is already well underway.
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So this includes work to streamline Alberta's continuing care legislation, developing services
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and supports for home and community care, improving existing continuing care facilities,
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and exploring better options to empower Albertans to live where and how they want to.
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The Continuing Care Organization will be responsible for oversight and coordination
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services and supports, and all operators, including the refocused Alberta Health Services
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as well as Covenant Health, all of these operators will continue to deliver services under contract
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Incidentally, this solves a long-standing issue where AHS both procures and provides
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The establishment of the new continuing care organization will be quickly followed by the
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launch of the new mental health and addictions organization.
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You will get more details from Minister Williams on this organization in just a few moments.
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In the fall of 2024, we expect to unveil the final two organizations, primary care and
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The new primary care organization will be dedicated to the delivery of primary healthcare,
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that is ensuring that every Albertan has access to a doctor, nurse practitioner, pharmacist
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and any other primary healthcare provider that is necessary.
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I know how distressing it can be when you don't have a healthcare professional to turn
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to, whether it's for immediate advice or a regular checkup. Primary care providers should
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be the first stop when health issues arise. But for the many Albertans who do not have
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one, it means their health will go unchecked, which could result in some very serious health
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implications later on. The core mandate of the new primary care organization will be
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to ensure every Albertan is connected to a regular family doctor, nurse practitioner,
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or primary care facility, regardless of where they live in the province.
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As I announced a few weeks ago, we have already begun these efforts to stabilize and improve
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access to primary care in all areas of the province.
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The recommendations in the Modernizing Primary Care Systems reports made by the expert panels
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will inform the direction of the new primary care organization and its work
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will go on to strengthen Alberta's primary health care system. Finally, the
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new acute care organization will oversee delivery of services in areas including
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hospitals, urgent care centers, cancer care, clinical operations, surgeries and
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emergency medical services. AHS will become a service provider much like
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Covenant Health. Both, along with other contracted emergency service providers,
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will work with the new acute care organization to continue to improve wait
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times for emergency care, whether it be on an ambulance call or an emergency
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room wait. All four of the new healthcare organizations will also be focused on
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empowering appropriate decision-making at a local level so we are more
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responsive to the needs of Albertans on the ground. They will be aided in this by 12 new
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advisory councils, which are replacing the existing 12 AHS advisory councils, as well
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as a new Indigenous advisory council. These local advisory councils will represent and
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advocate for regional perspectives, bring forward local priorities, and give input on
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how to continually improve the system overall alignment between the four new health organizations
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will be overseen by an integration council that will also track efficiencies remove barriers
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and improve outcomes this is how four new organizations will continue to operate seamlessly
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within a single provincial health system there will be rigor to this process ensuring that
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patients and the workforce are at the forefront of every decision the ministry of health will
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also change its structure to better align with the new organizations including creating a
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procurement and system optimization secretariat and expanding the role of the health quality
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council of alberta as i said earlier all along this process we will be consulting with the
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healthcare workers who are crucial to the system's success this is a huge undertaking but a necessary
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one there are many facets to this work but all of it will follow seven non-negotiable guiding
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principles and they are one a single functioning health care system with
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specialized areas that focus on delivering the best care that is
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important to a high functioning system to improving patient outcomes by
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ensuring alburns get the best care when and where they need it three creating
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seamless integration and collaboration between all of the new organizations so
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patients will experience a smooth health care journey with appropriate transitions and care
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where needed. Four, supporting a workforce whose own well-being is prioritized, whose expertise
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is leveraged, and whose decision-making is empowered. Five, promoting local decision-making
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by incorporating regional advice. Six, keeping communication transparent and making frequent
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efforts to stay in touch with frontline workers and patients alike and seven fully committing
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to our plans but also remaining flexible to support the ideas and perspectives from our
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frontline workers and from Albertans. I want to emphasize this important piece. Throughout
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this process you will continue to access healthcare how and where you normally would. For a health
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emergency you will still call an ambulance or go to the hospital. Surgeries
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will still happen the same way as they are they are right now. You will still
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visit your family doctor, primary care clinic, walk-in clinic, lab, pharmacist
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and so on for day-to-day healthcare needs and advice. If you or a loved one need
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assisted living you will still access continuing care sites or home care. We
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are committed to this plan because we are committed to Albertans and they deserve the very best
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health care system possible this is exciting this is an opportunity to take care of the system
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and the people that keeps all of us healthy and refocus refocusing is so that we can work not only
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the refocus is so that it will work not only for us but for all Albertans long into the future
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this is so critically important we have to provide for now but we also have to provide for the next
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generations so thank you and i will now invite minister williams to the podium
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well good morning everyone thank you minister lagrange
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As you just heard, the refocusing of Alberta's provincial health system
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will include a renewed focus on mental health and addiction.
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Today's announcement expands on the work we have been engaged in
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over the last four years to build out the Alberta recovery model.
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We have already taken significant steps in increased access and treatment
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and recovery supports by one, adding more than 10,240 addiction treatment spaces
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throughout our province. Two, removing the $1,240 a month user fee to get access to life-saving
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treatment for those in the deadly disease of addiction. Three, by building 11 long-term recovery
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communities through the province, two of which, pardon me, two of which are already open and
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operating. The opening of these facilities will increase the addiction treatment capacity in
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Alberta by more than 50%. We're providing same-day, no fee, no wait list, immediate
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access to evidence-based treatment through the Virtual Opioid Dependency Program. And
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we're expanding options for counselling and mental health supports throughout the province.
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These are just a few of the steps that were already taken to build out the Alberta Recovery
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Model, which is receiving international acclaim, but more work is to be done. The creation
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this model was made possible because of the creation of my ministry, the Ministry of Mental
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Health and Addiction. As part of the provincial refocusing, my ministry will take on a new role
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by overseeing the funding and service delivery of all mental health and addiction services currently
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overseen by the Ministry of Health. My ministry will work closely to oversee the new provincial
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mental health and addiction organization being created. This new organization will be responsible
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for the delivery of mental health and addiction services currently delivered by ahs this includes
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the delivery of a comprehensive continuum of care that includes prevention intervention
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treatment and recovery supports we will also be working closely with the non-profits and charitable
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organizations who provide many mental health and addiction services across our province
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lastly my ministry will work closely to take on a greater role to provide system oversight
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including service planning and capital planning for mental health and addiction services in Alberta.
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These changes will allow us to deliver mental health and addiction services and care more
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effectively for Albertans. We are committed to supporting every Albertan struggling with their
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mental health or suffering from the daily disease of addiction in the pursuit of recovery.
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This will be done by supporting this full continuum of supports that are focused on
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recovery and by removing barriers and expanding services that will support
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across the province for all Albertans. The current AHS senior program officer
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for mental health and addiction, Carrie Bales, will lead the transition toward
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the new mental health and addiction organization. Dr. Nick Mitchell, the
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provincial medical director of addiction and mental health at AHS and Dr.
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Nathaniel Day, the medical director of addiction and mental health and
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correlational health services at AHS will also be important members of this
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transitional team. Their extensive knowledge and experience will be
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instrumental in guiding the work underway to establish the new provincial
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mental health and addiction organization by mid 2024 as we heard from Minister
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LaGrange. While ensuring stability and continuity of mental health and
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addiction care will be a priority. As you move forward our vision remains the
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same. Anyone suffering from the daily disease of addiction or who has mental
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health challenges deserves an opportunity to pursue recovery and live
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a full life in our society. As Minister LaGrange mentioned, we want to hear
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directly from frontline workers to ensure that their voice helps guide us
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in this government's efforts to refocus Alberta's health care system on Alberta
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and on Albertans. Together we know that we can provide better care for Albertans.
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thank you for your time good morning I'd like to express my gratitude to the
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government of Alberta for listening to the voices of frontline workers although
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there was a slight delay we are pleased to see that the APEC report
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recommendations are being implemented by minister lagrange and premier smith we the alberta
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professional firefighters and paramedic association are hopeful that these changes
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will bring about much needed improvements in the working conditions and the overall health
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and well-being of all pre-hospital care practitioners we look forward to working
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closely with our government in enhancing the lives of all burdens thank you
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good morning everyone i'm sean tirlson i'm president ceo of the shepherd's care foundation
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registered charity that's faith-based i'm here today representing the alberta continuing
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care association as past chair the alberta continuing care association applauds the
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recent health care reforms by the Alberta government and in its commitment to advancing
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health care services for our beloved seniors. These reforms align with our mission of creating
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a sustainable and innovative continuing care sector. We're eager to work in collaboration
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with Alberta Health Services, Alberta Health in providing our expertise, advocating for best
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practices and fostering innovation of our beloved seniors well-being thank you
00:29:41.800
media q a portion of this announcement and just a reminder for media on the line that our last
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two speakers there were cody mcinty the president of alberta professional firefighters so firefighters
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and paramedics association and sean trillson the president and ceo of shepherd's care foundation
00:29:57.800
as well a reminder to media that the participants listed in the news release will be available
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for the Q&A today. That includes Mr. Stilmak, Mr. Davis, Mr. McIntyre, Mr. Charlson, Dr.
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Sheeler, Mrs. Prendergast, Mr. Ferguson, and Mrs. Edmund Stone. We'll be going with one question,
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one follow-up today, and starting off in the room. Hi, Janet French from CBC. Just a question
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for the Premier. You've bemoaned the number of managers that were in Alberta Health Services,
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and now we're looking at this new structure where there's uh an integration council there's four
00:30:31.160
potentially new new or revamped bureaucratic organizations a procurement secretariat how does
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this model align with your goal of putting more resources into the front line as opposed to
00:30:41.480
management well i can i can tell you from what we've seen happen over the last number of years
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is that uh the administration has hollowed out of alberta health and has grown in alberta health
00:30:51.960
services so the process that you'll see and i think that dan williams described it well
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is identifying the experts in alberta health services and pulling them into alberta health
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to give department level oversight so that we can make sure that those that issues are addressed
00:31:07.000
across the entire system so i we've made a commitment we don't foresee any uh front line
00:31:13.960
patient focused uh health professionals being uh we're gonna we're going to to ensure that their
00:31:21.000
jobs are protected but i would say that you're going to see a process of streamlining in the
00:31:25.480
management layers and i'm actually not sure who the second question is for um it's about
00:31:30.760
building hospitals so who would be responsible for building and designing hospitals under this
00:31:36.200
new model and um is it the default assumption that ahs would run any new acute care hospital
00:31:43.080
or would it be open for bidders for different people to run it um well great question and
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capital infrastructure and maintenance now still is determined by Alberta Health. It is informed by
00:31:56.840
AHS heavily at the moment and what we are looking to do is really looking at becoming strategic
00:32:03.640
right across the whole province. While there have been zone plans and AHS has provided
00:32:12.360
plans, they haven't been comprehensive enough. That's my estimation at this point in time and
00:32:19.000
we really do need to look at the whole province strategically if we do something over here how
00:32:23.320
does it affect over here and that is what we're looking at doing so creating um really building
00:32:28.520
out a capital infrastructure plan that is responsive to the needs of the whole province
00:32:34.280
not just to one organization chelan skalski with ctv news here in edmonton a question either for
00:32:40.680
the premier or the health minister you mentioned it in your earlier remarks the system is from what
00:32:45.240
we are hearing from doctors at a state of collapse patients waiting upwards of 36 hours in emergency
00:32:51.160
rooms um doctors saying it's the worst they've seen it in 15 years what will this plan do to
00:32:56.280
actually help alberta seeking care right now well right now it is going to show that we are looking
00:33:02.200
to change because obviously what continuing doing what we're doing is not working we need to bring
00:33:07.640
in change and we are very focused on making sure that all of these four organizations that we set
00:33:14.280
up are laser focused on improvements on patient care on making sure that those that are in the
00:33:21.320
front lines are able to provide their feedback to us directly and that we're able to implement it
00:33:26.520
so again it's really about you know tomorrow will it change it's taken a long time to get to where
00:33:31.240
we are it's going to take some time to shift but that being said once we get into the new focused
00:33:37.000
areas my anticipation is that we will actually see better outcomes because they will be laser
00:33:42.520
focused on making sure that they address the concerns and the problems that they're seeing on
00:33:47.640
the ground yeah my follow-up again not sure if it'd be best addressed to yourself or the premier
00:33:51.880
just wondering around costs how much do you expect the transition to cost how much do you expect
00:33:57.160
engagement to cost how much do you expect for an operational budget of these new 12 councils
00:34:02.040
as well as the new four organizations that you've created we've set forward an envelope of funding
00:34:06.760
that was based on the 2008 transition it was prorated for inflation etc we don't anticipate
00:34:15.720
that we will require to use all those funds but we did want to make sure that we had funds
00:34:20.280
available to us as a department as a ministry to ensure a successful transition again this is going
00:34:28.120
to be a slow methodical thoughtful journey that we're taking everyone on it is going to start
00:34:35.560
immediately but it's going to take 18 to 24 months we are going to have to set up
00:34:40.360
each one of these organizations make sure that there is seamless transition we
00:34:45.440
want to make sure that the integration council is set up for success that the
00:34:49.540
the procurement and optimization secretariat is also set up for success
00:34:55.600
so we are going to think this through but we don't have a definitive number
00:34:59.980
just yet. Sure. The problem that we've observed in the last year is that all roads lead to the
00:35:08.260
emergency room. If you don't have a family doctor and your child is suffering a high fever, you go
00:35:14.300
to the emergency room. If you're having a mental health crisis, you go to the emergency room. If
00:35:18.460
there's an addiction crisis, you go to the emergency room. If you are a senior who doesn't
0.97
00:35:22.960
have place to go in continuing care, you stay in an acute care bed in a hospital. So by separating
00:35:27.700
these functions out what we are beginning to do and the minister announced this last week is
00:35:33.680
ensure number one everyone has access to a family practitioner so that they always have the ability
00:35:38.640
to see a family doctor or nurse practitioner so that we can avoid having all roads lead to the
00:35:44.840
emergency room there by focusing on continuing care I understand with the continuing care
00:35:49.260
association we may have as much as 30 vacancies in beds so let's make sure that the patients are
00:35:55.060
in the right place, receiving the right level of care. I don't think anybody wants to sit and
00:35:58.440
languish in a hospital room. They want to be in a more home-like facility. So let's make sure
00:36:02.680
that they're in the continuing care homes and we're building enough to be able to meet the
00:36:07.020
future need so that we're also freeing up beds in acute care hospitals. And then with mental
00:36:11.600
health and addiction, as soon as we build out our recovery communities, that also gives
00:36:16.180
an alternative pathway for those who are suffering from addiction crisis to be able to get the
00:36:21.780
treatment that they may need that is not going to be in a hospital environment as well we have five
00:36:25.860
mental health facilities that we're building as well to give that kind of focused care so all of
00:36:30.180
this does take time everything is in process but that's the reason why this structure is is going
00:36:36.180
to optimize care because people will be able to get the the right treatment in the right place at
00:36:41.860
the right time which unfortunately they don't have right now and that's why we're seeing everything
00:36:46.580
overloaded in the hospitals morgan black with global edmonton kind of on that topic we talk
00:36:51.860
about the need for more family doctors more beds more resources i'm just wondering if you could
00:36:55.700
really outline how the reorg addresses the need for where there is not enough you know we talk
00:37:01.700
about primary care finding you a family doctor but how do you find that family doctor if there's not
00:37:07.060
enough in the community well if you if you look at the announcement that the the health minister
00:37:10.980
made a couple of weeks ago this is i think one of the most important aspects is that we're going to
00:37:15.300
to allow nurse practitioners to set up their own practices and bill the province directly.
00:37:20.080
I don't think any province has that kind of model.
00:37:22.820
And so that will allow for, I've spoken with one nurse practitioner in the organization.
00:37:27.180
She began working with a doctor who allows for the billing as a matter of oversight.
00:37:35.020
So if we have our nurse practitioners able to provide that other level of primary care,
1.00
00:37:50.000
that will support doctors with the rising overhead costs.
00:37:52.940
And you've also seen as well that we've announced
00:37:54.740
that our pharmacists are able to provide more primary care.
00:38:00.360
But the objective is that every single Albertan
00:38:14.940
in those engagement sessions change things or influence?
00:38:24.560
because we really wanna hear from the frontline staff.
00:38:33.860
who wants to take part in the engagement sessions.
00:38:44.880
or someone who is struggling with the healthcare system
00:38:49.340
So this will give them an avenue to speak directly
00:38:53.380
to the ministry, to myself as the Minister of Health
00:38:58.820
So I think it's very exciting to give them the opportunity.
00:39:05.480
from the front lines, that they have great ideas
00:39:08.340
that just aren't being listened to on how we could change
00:39:36.120
so that it works for Albertans, for the Albertans, instead of having a more administrative system,
00:39:42.120
more complex, where Albertans can't have access to the care they deserve.
00:39:49.120
And then, what will change in the lives of patients?
00:39:53.120
If Albertans will be in the hospital in one year, what will change?
00:39:57.120
The way Albertans access their care, it will not change.
00:40:01.120
But we will have a system that is now focused on Albertans.
00:40:09.280
So we will have no resources that can be re-entered towards the front lines.
00:40:17.440
But the way people will access their services will not change.
00:40:25.920
The questions were simply, why are you doing this?
00:40:28.480
what is it you're doing? And the answer was simply, similar to the Premier and Minister
00:40:33.200
of Health comments, that we're refocusing our healthcare system in a way that's going
00:40:36.820
to better serve Albertans to a system that's less complex, less administrative, and more
00:40:40.760
of those resources go to the front lines. And then the follow-up system was, what will
00:40:45.420
be the difference, say, in a year's time? And my answer was simply, the way that Albertans
00:40:49.820
access the system won't change, but you will see more and more of the resources focused
00:40:55.900
on those frontline services thank you and we'll go over to the phone lines now operator could you
00:41:02.540
put through our first caller please thank you rick bell calgary son um good good morning um
00:41:12.460
since my memory has not completely left me um i'd like actually a former premier
00:41:19.020
Stelmack to come to the podium if he could. And my question is, I remember back in the 2008
00:41:27.660
election there was discussion about changing the health care system toward what we then called a
00:41:34.860
Super Board, which of course was Alberta Health Services. What are your thoughts today now that
00:41:42.940
there's a you know major overhaul of that whole system into in 2008 record
00:41:52.180
was a good decision to consolidate procurement human resources management
00:41:59.220
of our hospitals across Alberta information systems to be the same
00:42:03.940
across Alberta and at that time the system worked well since 2008 as we
00:42:16.040
progressed there were many more changes in Alberta we heard today from the
00:42:20.460
Minister and also from the Premier as to the refocusing on areas that have
00:42:27.500
really increased in the band addictions mental health in 2008 yes we did have
00:42:34.880
some issues but not anywhere similar to what we have today in emergency rooms
00:42:40.700
across the province where a lot of the visits to the doctors in emergency are
00:42:47.420
off a mental health issue homelessness the numbers are incredible even with
00:42:55.180
With all of the work that went in, we see the numbers increasing.
00:42:59.220
We have some local mayors here from White Court, from Pinocchio, that have people, homeless
00:43:12.900
The other area on procurement and infrastructure is one that the government will peel apart
00:43:21.100
and be much more efficient in the way that hospitals are planned and built and make sure
00:43:26.620
that they're in the right places as well. So a lot has happened since I think it was
00:43:33.740
May of 2008 when we made the announcement but I'm fully supportive of the plan that
00:43:39.900
was introduced today. We're very optimistic that we will see positive results. It's bold
00:43:46.860
But it is strategic and we will see better access for all Albertans.
00:43:56.540
And I have a supplementary question for, thank you very much, Premier Stelmeck.
00:44:02.620
I have a supplementary question for Premier Smith.
00:44:08.080
If you could summarize it succinctly, when you look back, what is it about AHS ultimately
00:44:24.340
What is it about the way AHS operated that really didn't measure up to the expectations
00:44:34.980
is it about the ahs that just wasn't working as well as it should well i think what i look at at
00:44:43.940
ahs what i think it should be is alberta hospital services that's what people should be thinking of
00:44:49.300
is are they delivering the very best hospital acute care services and are they creeping into
00:44:55.780
other areas that really should be overseen by other entities that's what this is is all about
00:45:01.780
is figuring out how we can get mental health in the proper structure for decision-making primary
00:45:08.980
care proper structure as well as continuing care for the proper structure that's one part
00:45:13.540
the other part is that ahs became all things it is a policy making body it is the recipient of
00:45:21.940
the lion's share of funding it is a service provider it contracts out to its competitors
00:45:27.780
and then it evaluates its performance and those functions need to be separated that the policy
00:45:33.860
making function is an alberta health function the decision on how to fund is an alberta health
00:45:39.140
function and so what this does is it puts alberta health services as a service provider and doesn't
00:45:44.020
put them in that conflict position where they're deciding whether to keep services from themselves
00:45:49.060
or contract them out to covenant health or contract them out to a doctor-run surgical
00:45:53.620
center so that's i think going to be the fundamental change is that alberta health
00:45:57.940
services is going to be focused on delivering the very best hospital care and then we're going to
00:46:02.980
be able to to build out the the better functionality in those other areas thank you and operator could
00:46:10.820
you put through our next caller please thank you don brade calgary herald thanks for taking my call
00:46:19.460
Well, I deeply regret that Bell asked the question I had for Ed, and it's interesting
00:46:26.900
to see him back to the podium after all these years.
00:46:31.000
By asking, what, I guess, you know, it was very controversial at the time.
00:46:43.740
And could you identify where it started to go off the rails?
00:46:47.700
you think a little bit with ahs as well obviously a very close and interested observer that's for
00:46:54.180
premiers down that of course did you want to come in and answer he he said he missed hearing from
00:46:58.900
rick bell so i'm sure he missed hearing from you too don i'll turn it over to him
00:47:06.980
i think just the the size of the the organization and as the premier sort of eloquently described
00:47:15.540
how the function changed from being operating hospitals, the intention and design in 2008,
00:47:26.980
to where they had this incredible role across Alberta and fingers into everything from hospital
00:47:35.220
construction to policy budgeting to me and I'm going to be very frank the
00:47:44.220
decision-making in this province in terms of budgets infrastructure and
00:47:51.120
policy is made by government it's made by elected people and we drifted away
00:47:59.340
from that and I think that Don will give you a pretty good indication of where
00:48:07.560
and why these changes have come about thank you and for the premier sorry for
00:48:21.660
the premier is a follow-up premier it seems to me is it a fair summary to say
00:48:26.940
that what's happened here is that AHS is being seriously trimmed so it's one of
00:48:32.700
just four agencies that all report directly to Alberta Health. That
00:48:38.940
certainly implies a great demand to staff up big-time in Alberta Health and
00:48:45.120
at Mental Health and Addictions to deal with all this. Could you do your comments on that?
00:48:51.480
And also are you considering changing the name of AHS to Alberta Hospital
00:48:55.620
services that would make it very clear oh i'll leave the name change up to the the new board
00:49:01.300
and to the to the minister on that but i would say it's sort of one step further is that ahs will be
00:49:08.020
one service provider reporting up to acute care which is one of the the agencies they're not going
00:49:14.020
to be at the top of that pillar and they're not going to be at the top of all of the pillars so
00:49:18.660
under acute care provision we'll of course have the um covenant health we will have alberta
00:49:24.180
health services and we'll have the the doctor run surgical centers as well under there and
00:49:30.340
they will all report independently up to the acute care organization that reports directly to the
00:49:35.860
minister but keep in mind i mean ahs i believe runs 106 of our facilities and so they are
00:49:43.540
obviously the most significant uh provider of acute care services and i i suspect that will continue
00:49:49.860
Thanks, Don. Operator, can you put through our next caller, please?
00:50:01.460
Thanks for taking my call. There was a crisis in our hospitals during COVID
00:50:07.620
surrounding not having enough acute care beds for all the COVID patients, which greatly limited
00:50:13.220
the government's options. How will these changes if we were to have another situation like that
00:50:18.980
with a new virus new pandemic how would how are the changes that you're putting in place better
00:50:25.620
able to address something like that where you know for instance the government was promised
00:50:31.380
about a thousand beds and they could only deliver about 170 as i recall at one point which was not
00:50:36.580
nearly enough how will this new system better work uh in that kind of scenario we've already begun
00:50:45.380
i mean surge capacity was one of the the big objectives when dr john cowell came in i if i
00:50:51.300
remember my notes correctly we've increased the amount of acute care beds by 171 and we've also
00:50:57.140
increased the amount of icu staffed beds by 50. so we're moving in in the right direction i suspect
00:51:03.700
the biggest change will come from a facility by facility audit to see how many patients should be
00:51:11.620
in an alternative arrangement, either in a long-term care facility or a continuing care facility or at
00:51:18.740
home supported by home care. I think what we have observed is that several of our wings of our
00:51:25.300
hospital, several wards, several floors have been turned over to continuing care provision.
00:51:31.540
And we have a whole variety of alternative care providers who could provide alternative arrangements.
00:51:37.780
So I don't want to prejudge how many beds that will be. I think at the at the moment it had been identified as over 500 individuals who are waiting for placement in long term care.
00:51:48.080
And it may be more than that. I also know that there are wings of hospitals and floors and operating rooms that have either been decommissioned or never brought into service.
00:51:59.200
So when the minister talks about optimization, that's going to be the challenge of the board is to go through facility by facility and make sure all of the areas are optimized.
00:52:12.080
And then, of course, we have a recruiting task ahead of us.
00:52:15.280
We have to graduate more health professionals to be able to make sure that we're staffed up and recruit more of them from abroad.
00:52:21.180
But we we have to get a better handle on just how much capacity we do have and how much more we can we can create.
00:52:27.940
but that's the direction we need to go. One of the things that Dr. Cowell told me
00:52:31.620
is the problem is if you always are operating at 100%, when you do end up with a patient surge,
00:52:38.660
like we do every single respiratory virus season, now you're burning out your staff
00:52:42.520
because you're asking them to operate at 115%. And in the case of COVID, that carried on
00:52:47.260
for over two years. And so we have completely burnt out our frontline staff. What we have to do
00:53:00.880
so that when a surge comes, they're able to scale up
00:53:03.420
and we're able to create better working conditions.
00:53:06.920
is that you can't have your staff running flat out
00:53:10.740
especially when unanticipated pressures come on the system.
00:53:23.640
My follow-up question is we have some major trends going on just not in Alberta but across North America where people are getting major diseases like cancer, diabetes, cardiovascular disease in greater numbers and at younger ages than ever before.
00:53:40.140
we have just general trends where the population is becoming less healthy over time and some
00:53:46.700
physicians and other medical people are talking about a great need for preventative care coming
00:53:52.020
to the forefront that our systems are designed for acute care but we do a very we do a poor
00:53:57.340
terrible job in preventive medicine how will these changes that you're envisioning address
00:54:03.000
that particular issue so great question and something that we really have to focus on
00:54:09.320
And when I made the announcement on primary care, on modernizing Alberta's primary care
00:54:14.280
system, it's really from the lens of how do we keep people out of hospital?
00:54:23.820
And part of what I've always advocated for is early intervention, early diagnostics.
00:54:31.640
Having everyone attached to a primary care provider so that they can be seen when something
00:54:38.720
happens within their body that they feel needs to be addressed, the sooner they can get in to see
00:54:44.280
their family physician or a nurse practitioner or a pharmacist or whoever that primary care
00:54:49.680
professional is, the sooner we can start them on a journey to diagnosis. And I know for myself,
00:54:57.440
I was diagnosed with eye cancer in 2012. It was an optometrist who had the insight to see that,
00:55:05.500
you know what what he's seeing isn't quite normal and so he sent me on to an ophthalmologist who
00:55:10.300
then tracked me for a number of years who then said you know what this needs to go to the next
00:55:14.860
level we need that for every single individual in this province and so that's what we're working
00:55:20.620
towards is really improving the system so we catch things early and help people stay as healthy as
00:55:25.980
possible and stay out of the hospital and we have time for just one more question here operator
00:55:31.980
could you put through our last caller please thank you guys elena smith globe and mail hi
00:55:38.460
thanks for taking my question i think this one would fall to premier smith uh i'm just wondering
00:55:43.020
so the system like in the acute care pillar of this new system would there be room for a competitor
00:55:49.340
to alberta health services to operate well currently uh there are a number of service providers
00:55:55.420
including Covenant Health. Covenant Health as well as Alberta Health Services have been operating
00:56:02.000
in the acute care space. We've also had chartered surgical facilities run by physicians that have
00:56:08.640
been operating for decades now, and we're seeing more of that happening. So it really is ensuring
00:56:16.480
that those that are providing service right now continue to provide service, but they will have
00:56:20.940
an organizational structure overseeing them that really is focused on all of
00:56:25.820
acute care and providing good guidance up to the ministry and follow-up Lana
00:56:36.060
and then sorry can you hear me for my follow-up question yes yep oh sorry um
00:56:43.260
I just to clarify on that first question I'm really talking about hospitals
00:56:48.200
specifically. So I know there's AHS, there's Covenant, is there room for more basically
00:56:53.540
for their competitive, you know, kind of control of hospitals. But my second question, in addition
00:56:59.380
to that clarification, is just in terms of empowerment, we keep talking about empowerment,
00:57:04.580
empowerment of, you know, regional areas of Alberta, empowerment of frontline workers.
00:57:09.420
I'm wondering what exactly, what decisions exactly are frontline workers or regional
00:57:15.180
areas from these regional boards going to make what are their decision-making processes so to
00:57:20.300
your first question on acute care acute care right now is being provided by ahs by covenant health by
00:57:26.780
chartered surgical facilities so it will continue to be publicly funded health care right across
00:57:33.340
this province and so there is no privatization of health care so i want to be very very clear on that
00:57:39.580
no privatization it is publicly funded public health care that we're talking about on your
00:57:46.860
second question in terms of the regional so right now there are ahs 12 advisory councils regional
00:57:55.020
advisory councils my understanding is that they could provide better input that would inform change
00:58:01.900
because what i hear even from doctors and nurses right on the front lines is that oftentimes they
00:58:07.500
They bring their suggestions, their ideas forward, but they're not acted upon, not listened
00:58:12.900
And so these new restructured 12 advisory councils, actually 13, including a new Indigenous
00:58:21.440
Advisory Council, will actually provide direct input to the Integration Council.
00:58:27.840
It will provide direct input to each one of these organizations, and ultimately it will
00:58:32.300
provide direct input to the Ministry of Health and myself.
00:58:36.380
perfect and that'll wrap up today's announcement thank you everybody for