The Government of Alberta’s per person health care spending is among the highest of all the provinces, and health care consumes more than 40 per cent of the provincial budget. That proportion continues to increase every year. Clearly, this is not a sustainable approach. It’s a public policy challenge that needs to be addressed immediately or health care expenditures will begin to erode other essential public services such as education, social services, policing and first responders and environmental protection.
People in this constituency have made it clear to me that being able to access the health care they want and need when they want and need it is a critical priority for them and their families. The problem is, despite massive annual increases in health spending, the system often fails to meet the needs of Albertans. Waiting lists are at all-time highs, patients are left languishing in emergency rooms for hours and sometimes days, finding a family physician is increasingly difficult and many seniors find it impossible to secure the care they need.
The provincial government’s centralization of health care has been a disaster; from dismantling emergency medical services delivery in rural communities, to bullying and disempowering front line health care professionals, to destroying the quality of food in local hospitals and long-term care facilities, while they have squandered millions of dollars on executive salaries and bonuses, despite chronic underperformance and missed targets. The superboard bureaucracy has for the most part become unresponsive to local needs.
The latest report from Alberta’s independent Auditor General (AG) confirms this failure. The AG, Merwan Saher, brought to light the abysmal government management of Primary Care Networks (PCNs) across the province. PCNs began operating in Alberta in 2005 yet, alarmingly, Saher said the government has never done a thorough, ongoing study to determine whether PCNs are working for Albertans, and if any improvements need to be made. The idea is that PCNs allow family physicians to work in partnership with Alberta Health Services and other health providers to improve integration of care, encourage innovation and increase service capacity and access.
Forty PCNs currently operate throughout Alberta — while more are in various stages of development — and about 80 per cent of eligible family physicians work in PCNs. The government will fund PCNs to the tune of $170 million this year, and overall, PCNs have received a total of $700 million since they began operating. But the government doesn’t know whether they are delivering the best health care services that we deserve. PCNs seem like a good model. In fact, the PCNs in this constituency appear to working quite well according to the professionals involved, but the lack of measurable information about their performance and outcomes is staggering.
The AG said the government set five objectives for the PCNs years ago, but never developed targets and measures to determine whether objectives are met. The government has not provided any precise parameters around the geographic zones PCNs are supposed to serve; no consistent standards for the 24-hour service they are supposed to provide; no expectations for what skills the mandated multidisciplinary teams must possess; no guidance on which chronic diseases the PCNs should focus, how to treat them and no requirement to follow basic clinical standards or guidelines, despite chronic disease management being a key component of PCN service delivery. Health care professionals report confusion about which PCN they should operate in, and others don’t understand the rationale for which patients belong in PCNs in which they do participate.
Incredibly, on top of this, Premier Redford announced in the spring election campaign plans to create 140 new “Family Care Clinics.” As far as anyone understands, they are intended to perform essentially the same services as Primary Care facilities, but totally under the auspices of the Alberta Health Services superboard.
When the premier made this irresponsible Hail Mary election promise, both the Alberta Medical Association and the College of Family Physicians warned that more major restructuring of the health care system could be disastrous and that the three trial Family Care Clinics that currently exist need time to operate before going down a road to set up 137 more with no consultation with health care professionals. Unfortunately, it has been this government’s pattern to centralize operations into cumbersome bureaucracies at ever increasing cost with no consultation and no confirmation that Albertans are actually going to get the care and services they need.
Albertans deserve better. We need to work with front line health care workers to ensure health care decision making is local, responsive, measurable, effective, and patient-centred, and that wait times for specialists, procedures and emergency room care are significantly decreased. As your MLA, I will continue to push the government to make Alberta’s health care system work for you and your family.