AHS review implementation must put Albertans and public health care at the forefront

This week marks the 100 days which the Alberta Health Services (AHS) implementation team was given to report back on a detailed plan for which measures recommended in the Ernst & Young (EY) review would be implemented. The COVID-19 response has since put that on hold, but in the meantime, the pandemic has shone a light on the capacity and responsiveness of our public health care system, and has given Albertans pause when it comes to the wrongheaded direction that was recommended in this review.

This report, as Friends of Medicare and many others criticized when it was released back in February, simply served to provide the ideological fodder for this government to start the process of privatizing our health care system by contracting out and reducing health care services available to Albertans. “At a time where our province will be having to make critical financial decisions, Albertans are looking for leadership and a real commitment to our public health care,” says Sandra Azocar, Executive Director of Friends of Medicare. “Once we emerge from this pandemic, the political will to expand our public health will be more crucial than ever.”

With report after report, what is not shared with Albertans is how much contracting out our public health care will ultimately cost to the citizens of this province, nor any comparators of how much it would cost to instead increase in-hospital capacity or build public infrastructure in the interest of the public good.

Seniors’ care is of utmost concern, as the review report recommended the sale of Carewest and Capital Care to private providers as a one-time revenue source. The report suggested that Alberta could see estimated savings “in the hundreds of millions of dollars” through the sale of the two public care providers, but the public has yet to see any real numbers, nor any consideration of the potential impacts the sale would have on working and living conditions at these sites. In light of COVID-19, long-standing issues in our continuing care system have become all the more pertinent; as of May 12, a staggering 85 out of a total 118 COVID-19 deaths in Alberta have been residents of continuing care facilities.

Besides the further privatization of continuing care, the report recommended that AHS convert Long Term Care (LTC) beds into Designated Supportive Living (DSL) beds — in other words, reassess those individuals needing 24 hours care for ‘unscheduled’ medical needs to lower levels of care — is equally specious. This change would mean that residents would be considered to have lower staffing needs, and would remove Registered Nursing from seniors’ care. Staffing has been a long overlooked issue in our continuing care system. LTC in Alberta rarely meets benchmark criteria for minimally acceptable care, and private facilities have the greatest average deficits below minimal care. These deficits put patient health at risk every day, and as we have seen during a health care crisis like COVID-19, this risk surges.

Other recommendations from EY included the privatization of tertiary services including: inpatient food services, housekeeping services, protective services, and laundry and linen services.

They also recommended that the province contract out our medical laboratory services. This is not a new idea — consecutive provincial governments have tried to privatize our lab services for decades, always met with opposition from advocates and lab professionals alike. Alberta’s lab services have been pivotal in our response to the COVID-19 pandemic, administering over 178,000 tests to date, and far exceeding the number of tests administered per capita than any other jurisdiction in Canada. The province's centralized public lab, Alberta Precision Laboratories (APL), has been credited as the primary factor in our ability to test more effectively than any other province, yet plans to further privatize the system continue.

While it is unclear if the work of this implementation team is currently on hold or proceeding as expected, we have the opportunity to reassess those aspects of our health care system that are of critical importance to the care of each and every Albertan — during this pandemic and beyond. This is not the first health care crisis that Alberta has seen, and it will not be the last. Now, we have a responsibility to ensure that once the dust of this health care crisis has settled, our vital public health care system is not left to be squandered and privatized. “Rather than seeking out short-term solutions in the interest of fiscal balance, our government must instead learn the difficult lessons of this pandemic and commit to putting the interests of Albertans first,” states Azocar.

Profit has no place in health care. Friends of Medicare calls on AHS and this government to reconsider the implementation of any recommendation that would see our health care privatized and further eroded.