Western Standard - November 09, 2023


ALBERTAļ¼š Improving the health care system


Episode Stats


Length

58 minutes

Words per minute

140.7631

Word count

8,265

Sentence count

244


Summary

Summaries generated with gmurro/bart-large-finetuned-filtered-spotify-podcast-summ .

Transcript

Transcript generated with Whisper (turbo).
00:00:00.000 Thank you.
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00:05:00.000 Well, good morning, everyone.
00:05:20.040 I'm pleased to be here with Adriana Lagrange, Minister of Health, Dan Williams, Minister
00:05:25.760 of Mental Health and Addiction,
00:05:27.760 Minister of Seniors, Community and Social Services,
00:05:30.760 Ed Stelmack, Board Chair of Covenant Health,
00:05:32.760 Cody McIntyre, President of Alberta
00:05:35.760 Professional Firefighters and Paramedics Association,
00:05:37.760 Elliot Davis, Vice President,
00:05:39.760 Alberta Professional Firefighters and Paramedics Association,
00:05:42.760 Sean Charlson, President and CEO of Shepherd's Care Foundation,
00:05:45.760 Dr. Les Schieler, Anesthesiologist,
00:05:48.760 Dr. Susan Prendergast,
00:05:50.760 President of the Nurse Practitioner Association of Alberta,
00:05:54.760 Alberta, Alicia Lobe, the membership director of the Alberta Association of Nurses, Kevin Ferguson,
00:06:01.280 Mayor of the Town of Padoka, and Sandy Edmondson, board member of Alberta Health Services. Welcome
00:06:06.300 to a new day for health care in Alberta. From the very beginning of our government's mandate,
00:06:10.760 improving health care at every level has been the top of our list of priorities, and with delays
00:06:14.920 affecting the whole system, the urgency of the challenge can't be overstated. Wait times for
00:06:20.380 life-saving surgeries, routine care, and mental health treatment are far too long. Alberta's
00:06:24.920 health system isn't working the way it should and the way Albertans deserve. And fixing it is
00:06:29.260 critically important to improving Albertans' quality of life. And improvements must begin
00:06:33.940 with Alberta Health Services, the largest provincially integrated health system in the
00:06:38.460 country. While all Albertans can and should be proud of our frontline professionals, the structure
00:06:43.640 behind them is not setting them up for success. We have seen unacceptable wait times for surgery
00:06:50.320 and emergency rooms.
00:06:52.100 We've seen constant service disruptions
00:06:54.300 and temporary closures at rural hospitals.
00:06:57.100 EMS code reds and response times
00:06:59.260 not meeting targets.
00:07:00.700 Right now, thousands of Albertans
00:07:02.240 do not have access to a primary care provider
00:07:04.500 and so many of our seniors
00:07:05.620 are waiting in hospital wards
00:07:07.360 for access to continuing care
00:07:09.600 longer than in any other province.
00:07:12.120 We can point to the ledgers
00:07:13.200 that show our healthcare spending per person
00:07:15.280 is about the same as the national average
00:07:17.420 and in BC and Ontario.
00:07:18.740 and yet some of our outcomes aren't better and are not improving. For example, Albertans are
00:07:23.920 waiting longer for hip and knee replacements. Only 38% of hip replacements and 27% of knee
00:07:29.320 replacements in our province meet the national wait time benchmarks. And the time Albertans
00:07:33.960 remain in hospital, even after they no longer need hospital care, is four to five days longer
00:07:39.140 than the national average because they lack the supports to return home. The human cost of both
00:07:44.120 patients and their family is immeasurable i'm not satisfied with the current state of our affairs
00:07:50.600 and i know albertans aren't satisfied either right after i became premier we launched our
00:07:55.400 healthcare action plan and i directed dr john cowell to make immediate changes to deliver some
00:08:00.040 quick and needed results we knew that those immediate actions would not fix the entire
00:08:04.840 healthcare system but we needed to take steps forward thanks to that work we've seen some
00:08:09.480 improvements but not enough i've spoken with albertans one-on-one and they've made this report
00:08:14.520 this point to us repeatedly in very personal ways they've told me about surgeries postponed or
00:08:21.320 canceled innovative treatments that are unavailable in our province because of holdups and approvals
00:08:27.000 an entire day's loss to waiting in crowded emergency rooms near a suffering loved one
00:08:32.040 some emergency departments have closed their doors because of a lack of staff
00:08:36.040 which is the exact opposite of why emergency departments exist in the first place. Faults in
00:08:42.040 the healthcare system cause needless pain and anxiety at Albertans most vulnerable times and
00:08:46.840 they put tremendous strain on the frontline professionals who are working every day to help
00:08:51.080 sick and suffering Albertans. When I spoke with frontline health workers, I began to get a sense
00:08:56.920 of how we could truly make a difference, a long-term lasting difference for Albertans healthcare.
00:09:02.520 Without a doubt, we have the best healthcare workers in the country. They're smart, skilled,
00:09:08.440 endlessly compassionate people who understand their patients and their practice. And yet when
00:09:12.920 they're they are sidelined when it comes to decision making, even though they understand
00:09:17.000 the problems and see obvious solutions, they try their best, but they end up being stalled and
00:09:21.800 frustrated by a system that lacks focus leadership and governance. The current health system in our
00:09:26.920 province limits government's ability to provide system wide oversight on behalf of the people of
00:09:31.720 Alberta. It also limits our ability to set priorities and require accountability for meeting
00:09:36.920 them. The current Alberta healthcare system is one that has forgotten who should be at the center of
00:09:41.640 its existence, patients and the healthcare experts who look after them. We need to bring Alberta's
00:09:47.880 healthcare system back to its mission of delivering the healthcare Albertans need
00:09:52.440 when and where they need it. We've had recent and extensive consultations with healthcare partners
00:09:58.120 and communities during important projects like modernizing alberta's primary health care system
00:10:03.640 we've also engaged on areas of emergency medical services mental health and addiction
00:10:08.600 continuing care and health care system sustainability everything we've heard has
00:10:12.920 helped to inform the development of our plan a plan that i'm pleased to introduce today this is
00:10:17.880 all about refocusing our health care system to prioritize patients and empower health care
00:10:22.520 workers starting today we're creating an integrated provincial healthcare delivery system that
00:10:28.280 concentrates on four priority areas primary care acute care continuing care and mental health and
00:10:35.080 addiction we believe that by creating specialized organizations within one provincial system
00:10:40.280 we will enable each organization to look after one area of health care only and avoid the scattered
00:10:46.360 and uncoordinated approach of the more rigid centralized structure that exists now these
00:10:51.000 changes will apply province-wide to avoid the regional fragmentation that existed prior to the
00:10:56.040 current system. This focus will help the new organizations better manage performance and
00:11:00.920 promote expertise in areas, be faster and more responsive to issues, recognize innovative
00:11:06.600 solutions, and make space for local decision making and advice. The newly refocused system
00:11:11.880 will be more accountable, ensuring consistent quality care across the province. Patient outcomes
00:11:17.400 will be better monitored as a result and all of this will result in a better system not only for
00:11:22.120 patients but also for healthcare workers frontline healthcare workers will be a large part of
00:11:29.000 organizations that are dedicated to their area of practice providing undivided attention to issues
00:11:35.080 and giving workers room to innovate and apply solutions with fewer delays due to bureaucracy
00:11:40.440 through this process though this process begins today we understand that restructuring takes time
00:11:45.400 and dedicated effort this is why we have named a transition team to guide the process of forming
00:11:50.840 these organizations and minister adriana lagrange will have details on these changes and the team
00:11:55.720 that will oversee the transition of ahs but i want to be clear about this plan about what it is and
00:12:01.400 what it is not i made a public health care guarantee to albertans that means no one will
00:12:06.600 ever pay out of pocket for a visit to a doctor or for hospital services and that is not changing
00:12:12.920 these reforms have nothing to do with privatization they are also not about cuts alberta's government
00:12:18.760 will continue to grow the health care workforce and we anticipate that there'll be no job losses
00:12:24.120 to hs staff working in frontline positions who are directly delivering patient care in fact our
00:12:31.640 government knows that alberta needs more health care workers and so we'll continue to recruit and
00:12:35.960 train more of them this isn't change for the sake of change this is a matter of redirecting alberta's
00:12:41.000 healthcare system making it patient-centered seamless and effective it's about giving healthcare
00:12:46.360 workers a structure that supports their success and the opportunity to use solutions they know
00:12:51.480 will work as quickly and effectively as possible this is change that will mean the right forms of
00:12:57.320 care are available for albertans when and where they need them now and for generations to come
00:13:02.680 our plan won't lead to change overnight but it will lead to swift and effective reforms that
00:13:07.000 that will make life better for everyone,
00:13:09.160 from patients to doctors to nurses
00:13:11.460 and other healthcare professionals.
00:13:13.240 I want to invite Minister LaGrange
00:13:15.120 to share more details on our path
00:13:17.340 and how we'll deliver the kind of results
00:13:19.320 that Albertans are looking for.
00:13:20.660 Thank you.
00:13:29.180 Thank you, Premier, and good morning to everyone.
00:13:32.560 We are at a critical juncture
00:13:35.120 when it comes to health care in Alberta. As Premier said, we are refocusing Alberta
00:13:40.980 Health Services so that we can provide a high-functioning health care system that prioritizes patient
00:13:47.980 care and empowers our health care workers. We are beginning this change by listening
00:13:54.640 to the health care workforce and to Albertans. Throughout this process, we will rely on the
00:14:01.760 expertise of healthcare workers and will work with them to make changes for the
00:14:06.920 better. We will also listen to Albertans who use the system every day to ensure
00:14:13.520 their experiences and ideas are part of these changes. During this transition we
00:14:21.620 will work to minimize disruption to the daily work of healthcare staff and our
00:14:26.840 priority will always be and I want to repeat that always be to protect
00:14:32.280 frontline jobs. I would like to thank Dr. John Cowell for stepping up to serve as
00:14:38.900 the official administrator of Alberta Health Services since last October. Today
00:14:44.020 I am announcing a new AHS board which is made up of seven members and I'm pleased
00:14:50.340 to announce that Dr. Lyle Oberg will be the chair. Dr. Oberg has years of extensive experience
00:14:58.720 as a physician, rural practitioner, and multi-faceted leader. Under Dr. Oberg's leadership,
00:15:07.560 this board will guide the changes that will gradually unfold over the next 18 months.
00:15:14.520 It is crucial we take the time to get this work right, which is why it will roll out
00:15:19.800 in stages over the coming months and years. In addition to the new AHS board, transitional
00:15:27.640 boards for the organizations will be named over the coming weeks. The first organization
00:15:33.660 to be formed will be the new Continuing Care Organization, which we expect will be ready
00:15:38.480 to go this coming spring. The new Continuing Care Organization will seamlessly continue
00:15:45.680 the work of transforming the area of continuing care, which is already well underway.
00:15:52.620 So this includes work to streamline Alberta's continuing care legislation, developing services
00:15:59.440 and supports for home and community care, improving existing continuing care facilities,
00:16:05.660 and exploring better options to empower Albertans to live where and how they want to.
00:16:12.260 The Continuing Care Organization will be responsible for oversight and coordination
00:16:17.560 services and supports, and all operators, including the refocused Alberta Health Services
00:16:24.840 as well as Covenant Health, all of these operators will continue to deliver services under contract
00:16:31.200 with the new Continuing Care Organization.
00:16:34.680 Incidentally, this solves a long-standing issue where AHS both procures and provides
00:16:41.480 services in continuing care.
00:16:45.860 The establishment of the new continuing care organization will be quickly followed by the
00:16:50.340 launch of the new mental health and addictions organization.
00:16:54.200 You will get more details from Minister Williams on this organization in just a few moments.
00:17:00.620 In the fall of 2024, we expect to unveil the final two organizations, primary care and
00:17:07.480 acute care.
00:17:09.480 The new primary care organization will be dedicated to the delivery of primary healthcare,
00:17:14.620 that is ensuring that every Albertan has access to a doctor, nurse practitioner, pharmacist
00:17:20.480 and any other primary healthcare provider that is necessary.
00:17:25.520 I know how distressing it can be when you don't have a healthcare professional to turn
00:17:29.360 to, whether it's for immediate advice or a regular checkup. Primary care providers should
00:17:35.860 be the first stop when health issues arise. But for the many Albertans who do not have
00:17:41.900 one, it means their health will go unchecked, which could result in some very serious health
00:17:46.960 implications later on. The core mandate of the new primary care organization will be
00:17:53.740 to ensure every Albertan is connected to a regular family doctor, nurse practitioner,
00:17:59.900 or primary care facility, regardless of where they live in the province.
00:18:06.840 As I announced a few weeks ago, we have already begun these efforts to stabilize and improve
00:18:11.720 access to primary care in all areas of the province.
00:18:16.040 The recommendations in the Modernizing Primary Care Systems reports made by the expert panels
00:18:21.540 will inform the direction of the new primary care organization and its work
00:18:26.200 will go on to strengthen Alberta's primary health care system. Finally, the
00:18:32.380 new acute care organization will oversee delivery of services in areas including
00:18:37.340 hospitals, urgent care centers, cancer care, clinical operations, surgeries and
00:18:44.100 emergency medical services. AHS will become a service provider much like
00:18:50.140 Covenant Health. Both, along with other contracted emergency service providers,
00:18:55.740 will work with the new acute care organization to continue to improve wait
00:19:00.220 times for emergency care, whether it be on an ambulance call or an emergency
00:19:06.160 room wait. All four of the new healthcare organizations will also be focused on
00:19:12.080 empowering appropriate decision-making at a local level so we are more
00:19:16.660 responsive to the needs of Albertans on the ground. They will be aided in this by 12 new
00:19:23.260 advisory councils, which are replacing the existing 12 AHS advisory councils, as well
00:19:29.580 as a new Indigenous advisory council. These local advisory councils will represent and
00:19:36.460 advocate for regional perspectives, bring forward local priorities, and give input on
00:19:42.320 how to continually improve the system overall alignment between the four new health organizations
00:19:49.840 will be overseen by an integration council that will also track efficiencies remove barriers
00:19:56.560 and improve outcomes this is how four new organizations will continue to operate seamlessly
00:20:04.800 within a single provincial health system there will be rigor to this process ensuring that
00:20:12.720 patients and the workforce are at the forefront of every decision the ministry of health will
00:20:18.880 also change its structure to better align with the new organizations including creating a
00:20:24.320 procurement and system optimization secretariat and expanding the role of the health quality
00:20:30.800 council of alberta as i said earlier all along this process we will be consulting with the
00:20:37.920 healthcare workers who are crucial to the system's success this is a huge undertaking but a necessary
00:20:48.720 one there are many facets to this work but all of it will follow seven non-negotiable guiding
00:20:56.960 principles and they are one a single functioning health care system with
00:21:04.160 specialized areas that focus on delivering the best care that is
00:21:08.540 important to a high functioning system to improving patient outcomes by
00:21:14.420 ensuring alburns get the best care when and where they need it three creating
00:21:20.360 seamless integration and collaboration between all of the new organizations so
00:21:25.520 patients will experience a smooth health care journey with appropriate transitions and care
00:21:30.800 where needed. Four, supporting a workforce whose own well-being is prioritized, whose expertise
00:21:38.920 is leveraged, and whose decision-making is empowered. Five, promoting local decision-making
00:21:46.940 by incorporating regional advice. Six, keeping communication transparent and making frequent
00:21:55.060 efforts to stay in touch with frontline workers and patients alike and seven fully committing
00:22:02.100 to our plans but also remaining flexible to support the ideas and perspectives from our
00:22:08.180 frontline workers and from Albertans. I want to emphasize this important piece. Throughout
00:22:16.100 this process you will continue to access healthcare how and where you normally would. For a health
00:22:22.740 emergency you will still call an ambulance or go to the hospital. Surgeries
00:22:27.480 will still happen the same way as they are they are right now. You will still
00:22:32.200 visit your family doctor, primary care clinic, walk-in clinic, lab, pharmacist
00:22:36.720 and so on for day-to-day healthcare needs and advice. If you or a loved one need
00:22:42.780 assisted living you will still access continuing care sites or home care. We
00:22:49.300 are committed to this plan because we are committed to Albertans and they deserve the very best
00:22:56.180 health care system possible this is exciting this is an opportunity to take care of the system
00:23:03.780 and the people that keeps all of us healthy and refocus refocusing is so that we can work not only
00:23:12.100 the refocus is so that it will work not only for us but for all Albertans long into the future
00:23:17.540 this is so critically important we have to provide for now but we also have to provide for the next
00:23:22.260 generations so thank you and i will now invite minister williams to the podium
00:23:41.620 well good morning everyone thank you minister lagrange
00:23:45.060 As you just heard, the refocusing of Alberta's provincial health system
00:23:48.740 will include a renewed focus on mental health and addiction.
00:23:52.580 Today's announcement expands on the work we have been engaged in
00:23:55.940 over the last four years to build out the Alberta recovery model.
00:23:59.780 We have already taken significant steps in increased access and treatment
00:24:03.940 and recovery supports by one, adding more than 10,240 addiction treatment spaces
00:24:10.180 throughout our province. Two, removing the $1,240 a month user fee to get access to life-saving
00:24:18.020 treatment for those in the deadly disease of addiction. Three, by building 11 long-term recovery
00:24:24.340 communities through the province, two of which, pardon me, two of which are already open and
00:24:29.220 operating. The opening of these facilities will increase the addiction treatment capacity in
00:24:34.280 Alberta by more than 50%. We're providing same-day, no fee, no wait list, immediate
00:24:41.800 access to evidence-based treatment through the Virtual Opioid Dependency Program. And
00:24:46.840 we're expanding options for counselling and mental health supports throughout the province.
00:24:51.980 These are just a few of the steps that were already taken to build out the Alberta Recovery
00:24:56.140 Model, which is receiving international acclaim, but more work is to be done. The creation
00:25:02.300 this model was made possible because of the creation of my ministry, the Ministry of Mental
00:25:06.140 Health and Addiction. As part of the provincial refocusing, my ministry will take on a new role
00:25:11.340 by overseeing the funding and service delivery of all mental health and addiction services currently
00:25:15.900 overseen by the Ministry of Health. My ministry will work closely to oversee the new provincial
00:25:22.700 mental health and addiction organization being created. This new organization will be responsible
00:25:28.140 for the delivery of mental health and addiction services currently delivered by ahs this includes
00:25:33.260 the delivery of a comprehensive continuum of care that includes prevention intervention
00:25:38.780 treatment and recovery supports we will also be working closely with the non-profits and charitable
00:25:45.100 organizations who provide many mental health and addiction services across our province
00:25:50.220 lastly my ministry will work closely to take on a greater role to provide system oversight
00:25:56.140 including service planning and capital planning for mental health and addiction services in Alberta.
00:26:01.900 These changes will allow us to deliver mental health and addiction services and care more
00:26:07.500 effectively for Albertans. We are committed to supporting every Albertan struggling with their
00:26:12.940 mental health or suffering from the daily disease of addiction in the pursuit of recovery.
00:26:18.780 This will be done by supporting this full continuum of supports that are focused on
00:26:23.420 recovery and by removing barriers and expanding services that will support
00:26:27.500 across the province for all Albertans. The current AHS senior program officer
00:26:33.440 for mental health and addiction, Carrie Bales, will lead the transition toward
00:26:37.460 the new mental health and addiction organization. Dr. Nick Mitchell, the
00:26:41.780 provincial medical director of addiction and mental health at AHS and Dr.
00:26:45.900 Nathaniel Day, the medical director of addiction and mental health and
00:26:50.540 correlational health services at AHS will also be important members of this
00:26:55.580 transitional team. Their extensive knowledge and experience will be
00:26:59.320 instrumental in guiding the work underway to establish the new provincial
00:27:02.680 mental health and addiction organization by mid 2024 as we heard from Minister
00:27:07.420 LaGrange. While ensuring stability and continuity of mental health and
00:27:11.420 addiction care will be a priority. As you move forward our vision remains the
00:27:17.120 same. Anyone suffering from the daily disease of addiction or who has mental
00:27:22.220 health challenges deserves an opportunity to pursue recovery and live
00:27:26.540 a full life in our society. As Minister LaGrange mentioned, we want to hear
00:27:31.840 directly from frontline workers to ensure that their voice helps guide us
00:27:35.880 in this government's efforts to refocus Alberta's health care system on Alberta
00:27:40.160 and on Albertans. Together we know that we can provide better care for Albertans.
00:27:45.260 thank you for your time good morning I'd like to express my gratitude to the
00:28:02.780 government of Alberta for listening to the voices of frontline workers although
00:28:07.880 there was a slight delay we are pleased to see that the APEC report
00:28:11.720 recommendations are being implemented by minister lagrange and premier smith we the alberta
00:28:20.280 professional firefighters and paramedic association are hopeful that these changes
00:28:25.720 will bring about much needed improvements in the working conditions and the overall health
00:28:31.400 and well-being of all pre-hospital care practitioners we look forward to working
00:28:37.960 closely with our government in enhancing the lives of all burdens thank you
00:28:53.160 good morning everyone i'm sean tirlson i'm president ceo of the shepherd's care foundation
00:28:57.720 registered charity that's faith-based i'm here today representing the alberta continuing
00:29:01.800 care association as past chair the alberta continuing care association applauds the
00:29:07.080 recent health care reforms by the Alberta government and in its commitment to advancing
00:29:11.880 health care services for our beloved seniors. These reforms align with our mission of creating
00:29:18.280 a sustainable and innovative continuing care sector. We're eager to work in collaboration
00:29:24.120 with Alberta Health Services, Alberta Health in providing our expertise, advocating for best
00:29:30.840 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
00:29:47.160 two speakers there were cody mcinty the president of alberta professional firefighters so firefighters
00:29:52.440 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
00:30:02.680 for the Q&A today. That includes Mr. Stilmak, Mr. Davis, Mr. McIntyre, Mr. Charlson, Dr.
00:30:08.520 Sheeler, Mrs. Prendergast, Mr. Ferguson, and Mrs. Edmund Stone. We'll be going with one question,
00:30:14.200 one follow-up today, and starting off in the room. Hi, Janet French from CBC. Just a question
00:30:19.640 for the Premier. You've bemoaned the number of managers that were in Alberta Health Services,
00:30:25.480 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
00:30:36.440 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
00:30:46.520 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
00:30:56.360 is identifying the experts in alberta health services and pulling them into alberta health
00:31:01.560 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
00:31:49.480 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
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.
00:37:33.360 She's got 2,200 patients.
00:37:35.020 So if we have our nurse practitioners able to provide that other level of primary care,
00:37:40.100 that's going to allow for more access.
00:37:42.220 We're also recruiting more doctors.
00:37:44.420 The minister is working with Dr. Paul Parks,
00:37:46.820 the head of the Alberta Medical Association
00:37:48.360 to create a new funding model
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.
00:37:57.160 So it's going to be a combination
00:37:58.920 of all of those three factors.
00:38:00.360 But the objective is that every single Albertan
00:38:03.240 will have access to a family practitioner.
00:38:06.420 And then follow our secondary question
00:38:08.180 will be talking about the engagement sessions.
00:38:10.220 I believe it starts with AHS tomorrow.
00:38:12.120 So to what extent will what you hear
00:38:14.940 in those engagement sessions change things or influence?
00:38:18.880 I recognize it's a years long process.
00:38:20.880 So to what extent will that change things?
00:38:23.040 Well, to a great extent,
00:38:24.560 because we really wanna hear from the frontline staff.
00:38:27.440 This is an exercise in really listening
00:38:30.940 to our frontline workers and to every Albertan
00:38:33.860 who wants to take part in the engagement sessions.
00:38:36.240 I know I hear daily about situations,
00:38:39.820 whether it's from a frontline worker
00:38:41.520 or from an everyday Albertan, a mom or a dad
00:38:44.880 or someone who is struggling with the healthcare system
00:38:48.320 as it currently exists.
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
00:38:56.920 and influence change.
00:38:58.820 So I think it's very exciting to give them the opportunity.
00:39:01.380 It really is empowering the workforce.
00:39:03.300 And I've heard so often from the workforce,
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
00:39:12.120 and positively change.
00:39:15.840 Manuel Prestovet, Radio-Canada.
00:39:17.220 Minister Williams in French.
00:39:19.420 Yes, Sarah.
00:39:20.340 Yes.
00:39:23.940 In fact, I just wanted to tell you in French,
00:39:27.520 why do we do all this reform?
00:39:29.300 Why is it necessary to do all this reform?
00:39:31.700 Because we reorient the system
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.
00:40:16.480 That will change.
00:40:17.440 But the way people will access their services will not change.
00:40:22.160 Thank you.
00:40:23.280 Can you summarize in English?
00:40:24.480 Oh sure.
00:40:25.040 Because we don't have simultaneous questions.
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
00:43:07.260 people even in small rural communities.
00:43:10.500 That requires a refocus.
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.
00:44:01.620 Well, thank you.
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
00:44:22.380 at its core?
00:44:24.340 What is it about the way AHS operated that really didn't measure up to the expectations
00:44:32.260 you say Albertans have and that you have?
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.
00:46:29.180 I think he misses, he said he missed.
00:46:31.000 By asking, what, I guess, you know, it was very controversial at the time.
00:46:37.160 You know, you've integrated all the regions.
00:46:39.620 There's a huge uproar.
00:46:40.720 There's a lot of public controversy about it.
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?
00:49:57.540 Thank you. David Staples, Edmonton Journal.
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
00:52:53.640 is create enough of a capacity buffer,
00:52:57.940 have the hospitals operating at 85%
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.
00:53:05.340 So that's where we're going to,
00:53:06.920 is that you can't have your staff running flat out
00:53:09.900 all the time,
00:53:10.740 especially when unanticipated pressures come on the system.
00:53:15.100 And so we are going to be working on improving
00:53:18.180 that capacity at the hospitals.
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?
00:54:19.200 How do we do early diagnostics?
00:54:20.700 I'm a rehab practitioner by profession.
00:54:23.820 And part of what I've always advocated for is early intervention, early diagnostics.
00:54:29.280 How do we improve that system?
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
00:58:11.900 to.
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
00:58:40.380 thanks everyone