This week’s political intrigue, the suspension of Edmonton-Meadowlark MLA Raj Sherman and Stephen Duckett‘s cookie-tantrum, are overshadowing the larger challenges facing our health care system.
The plan proposed by Alberta Health Services top dogs late last week to deal with Emergency Room wait times is a version of a plan already initiated three years ago (known as “full capacity protocol” or “surge capacity” at some facilities).
It works like this: when the number of patients in the Emergency Room hits a magic number, patients are put on stretchers and pushed to wards in the hospital where they are placed in hallways or in rooms (in many cases with patients already admitted). It does not take a health economist or health care professional to understand that pushing patients away from the Emergency Room into hallways is not a solution to this problem. This “out of sight, out of mind” approach may decrease the number of patients physically waiting in the Emergency Room, but it does not do much to actually increase patient care. It also does not deal with the root causes of why Emergency Room wait times have increased in Alberta.
Anyone who has had the misfortune of having visited an Emergency Room will see that there is a serious under-staffing problem. In many hospitals, doctors, nurses, and other health professionals are being run off their feet trying to make up for a lack of proper staffing levels. If new beds are to be introduced, so must an appropriate number of new staffing positions. Patient care will only be improved if there are medical and nursing staff to accompany new beds.
The challenges facing Emergency Rooms go beyond just Emergency Rooms.
It is becoming increasingly difficult to find a family doctor in Alberta. This challenge and limited access to urgent care centres in many communities leaves Emergency Rooms as the only option for many Albertans. When fully operational, the new East Edmonton Health Centre could provide a good model of the kind of accessible family and urgent care that people are currently turning to the Emergency Rooms for.
The reality is that many of the problems faced by our health care system have been created by constant political restructuring of the administration of the system over the past 15 years.
As I wrote last week, stability is something that has been lacking in our public health care system since Ralph Klein became Premier in 1992. Since 1995, the administration of our system has been changed from around 200 hospital and local health boards before 1995 to seventeen, to nine in 2001, and then one centralized province-wide health authority in 2008.
As the health authorities were being restructured in the 1990s, over 10,000 health care staff were laid off or had their jobs downgraded, which has led to much of the staffing issues Albertans are witnessing today.
Current Minister Gene Zwozdesky has tried to put a kinder face on the Health & Wellness portfolio, but the last major restructuring, the creation of AHS took place under the guidance of Minister Ron Liepert in 2008.
In what some political watchers believed to be an extension of a public battle between Calgary Health Region CEO Jack Davis and the provincial government, Minister Liepert dissolved the nine remaining regional health boards and centralized them under AHS (Mr. Davis received a $4 million retirement package when his position was eliminated). Minister Liepert, who was recently criticized by his former parliamentary assistant Dr. Sherman, was not known for his diplomatic skills while serving as Health Minister:
Created only months after the March 2008 provincial election, there was no mention of intentions to dissolve the regional health authorities anywhere in the PC Party election platform. The largest overhaul of Alberta’s health care system was not made in consultation with Albertans, but in closed-door meetings.
Accentuate the positive, eliminate the negative
Couched in nice-sounding words like “European-model”, groups like the Wildrose Alliance argue that the solution is to introduce more private-for-profit involvement in the health care system.
As Albertans saw with the bankruptcy of the Health Resource Centre in Calgary, the flagship for the private health care industry in Canada, introducing more private-for-profit health care is not a viable alternative. I do not believe that this is a solution to improving our health care system. The solution is to fully support and provide stability to a public system that is accessible and accountable to the general public.
While I am disappointed that the Wildrose has taken a negative tone when talking about health care, it has helped remind many Albertans about why they support a public health care system and why it is important to our society.
“Alberta Health Act”
Eclipsed by the past month of health care news is Bill 17: the Alberta Health Act, which is up for third reading this week. This Act is vacuous on details, but as enabling legislation it will allow for more decisions about our health care laws to be made in closed-door cabinet meetings, rather than in the public and open debate on the floor of the Assembly.
As we have learned from the past month and the Alberta Health Services experience, our health care system needs decision makers who are not driven by private agendas behind closed doors, it need openness, transparency, and stability. It needs some TLC.
