What have the UCP been up to since forming government in April 2019? Since forming government, the UCP has relentlessly reminded Albertans they they will deliver on their platform, in which privatization of our public health is clearly underlined. This continues to be of great concern for those of us who believe that health care should be available to all, based on need and not ability to pay.
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AUGUST 12, 2020: ARCHES CLOSURE
Lethbridge is losing its supervised consumption, needle collection, and outreach services effective August 31. This is a devastating loss for the community, and especially those who depend on these life saving services. ARCHES' clients have done nothing to deserve being cast out into the street during a dual health crisis.Last month, Albertans for Ethical Drug Policy sent an open letter to Jason Luan, Associate Minister of Mental Health and Addictions and Tyler Shandro, Minister of Health, urging them to maintain funding and services in Lethbridge. This call has NOT been met.
AUGUST 10, 2020: PRIVATE SURGICAL FACILITY
A new CBC story has revealed that a new private orthopedic surgical facility—the largest ever in Alberta—has been proposed on the site of Ericksen Nissan, next to the Royal Alexandra Hospital in Edmonton, and has already gained the Minister of Health’s “tentative political support.”
Under the proposed terms of this backroom deal, the $200+ million, 5-7 story private surgical facility would be tasked with performing all insured minor surgeries, while the public system would be left with the more complex cases. This deal ensures that the government—meaning every single Albertan—would assume all risk if this privatization experiment does not work out. Just as we did when this same “business model” was tried at the Health Resource Centre in Calgary, which eventually went bankrupt leaving Albertans on the hook for millions of dollars and over 900 surgeries to be brought back under the public system.
AUGUST 5, 2020: CENTRALIZING EMS DISPATCH
Alberta Health Services is removing local emergency medical service dispatch from Lethbridge, Calgary, Wood Buffalo and Red Deer, and consolidating them with existing province-wide dispatch centres. AHS says this consolidation will save the province $6 million per year, as per the recommendation of the EY AHS review. However critics, including Alberta mayors and firefighters, Lethbridge city council, and UCP MLAs, have argued that this move will be less timely, more costly to municipalities, and enable more complications than local integrated dispatch services.
JULY 29, 2020: BILL 30
In the wee hours of July 29, the government passed Bill 30: Health Statutes Amendment Act, after limiting debate to just one hour. Dozens of amendments proposed by the opposition were thrown out. This omnibus bill will make sweeping changes to Albertans’ health care, including repealing or changing 9 pieces of existing health legislation. Albertan patients and health care workers alike have been incredibly vocal in their opposition to the privatization of our public health care system, but the government—who Albertans elected to represent them—weren't willing to hear it. Passing Bill 30 and the privatization it opens the door to is an irresponsible and callous move from this government, especially at a time when Albertans and their families are reeling from the health and economic impacts of COVID-19.
JULY 29, 2020: DOCTORS VOTE NO CONFIDENCE IN MINISTER OF HEALTH
A poll released by the Alberta Medical Association indicated that 98% of the province’s doctors have no confidence in Tyler Shandro in his role as Alberta’s health minister. This follows an ongoing conflict between the government and physicians, which has already resulted in an exodus of doctors (and especially family doctors) from the province. In responding to the poll, the premier and government issues managers have dismissed Alberta’s doctors as an “interest group.”
JULY 16, 2020: DEFUNDING ARCHES SCS
Associate Minister of Mental Health and Addictions, Jason Luan, announced today that the Alberta government would be immediately defunding the supervised consumption service (SCS) in Lethbridge, following an audit which indicated funding had been mishandled. The ARCHES facility has been shut down, and Jason Luan has asked AHS to set up a mobile site in its place, despite the fact that mobile sites have a two-person capacity, while ARCHES sees an average of 800 visits per day - more than any other site in North America. Given that overdoses have been on the rise across Alberta, and given the existing constraints caused by COVID-19, this disruption will no doubt lead to individual and community harms.
► Read the open letter signed by FOM, Change the Face of Addiction, Moms Stop The Harm, and other Albertans for Ethical Drug Policy.
JULY 15, 2020: CPSA TO PROHIBIT DOCTORS' FROM LEAVING
Minister of Health Tyler Shandro has directed the CPSA (College of Physicians and Surgeons of Alberta) to prohibit physicians from leaving their practices’ en masse. This is an unprecedented breach of power from a ministerThe minister’s press secretary has said that this request is “because there is not a large number of actual departures (of doctors) or withdrawals (of services) currently or expected,” despite physicians in over 30 communities across Alberta having already announced their departures.
JULY 10, 2020: PRIVATIZING DISABILITY CARE
Families of Albertans with disabilities in government-operated care facilities received notice from the government that the Community and Social Services ministry were considering contracting out their loved ones care. Families are anxiously awaiting the government's decision, which is expected in September.
JULY 9, 2020: BILL 204
On July 8, 2020 MLA Tany Yao introduced Bill 204: Voluntary Blood Donations Repeal Act. This work-shy, mere 3-page bill simply calls for the repeal of the Voluntary Blood Donations Act (2017). It offers no alternative to address our current dependency on US plasma-derived products, and no reason to necessitate this repeal, except to further this government’s never ending quest to privatize our public resources.
JULY 6, 2020: BILL 30
Bill 30: Health Statutes Amendment Act was announced today by Health Minister Tyler Shandro. If passed, the omnibus bill would make sweeping changes to Albertans’ health care, establish the legislative framework for privatization and repeal or change 9 pieces of existing health legislation. Highlights of Bill 30 include:
• The Health Care Protection Act would be renamed to the Health Facilities Act, and would lower the bar for the approval of new private clinics and private surgical facilities. The current Health Care Protection Act (formally known as the infamous Bill 11) resulted from hundreds of thousands of Albertans standing up and protesting against then-Premier Klein’s ongoing attempts to establish a parallel private health care system in Alberta.
• Under the guise of ‘choice’ non-physician corporations would be able to employ doctors — corporations whose ultimate goal is profit.
• The number of public members appointed by the minister to sit on regulatory colleges would be doubled, enabling the government to stack councils with their supporters.
JUNE 22, 2020: VIRTUAL DRUG TREATMENT
The government has announced that they will be providing $4M over four years to expand Alberta's virtual opioid dependency program (VODP). The program is a virtual clinic for clients referred for opioid agonist therapy (OAT). Critics have pointed out that still too few programs exist to fill the gaps between the time that individuals identify their desire to enter this type of treatment and the time that it takes for them to gain access, such as supervised consumption services (SCS).
This announcement comes just months after the government announced they would be ending funding for the intensive opioid agonist therapy program, and mere days after Associate Minister Luan cancelled a planned virtual overdose response program just hours before it was set to start.
JUNE 20, 2020: PRIVATIZING DISABILITY CARE
Families of Albertans with disabilities learned via email that the care of their loved ones is being privatized. The letter, sent by community and social services, informed family members that the government would be exploring “alternative service delivery” when it comes to residential supports in Calgary and Edmonton, with the possibility of contracting out these services to private providers. While COVID-19 has laid bare the longstanding issues in private seniors' care facilities, the government is moving to privatize even more Albertans' care—without consultation from their families. Families are anxiously awaiting the government's decision, which is expected in September.
JUNE 19, 2020: CANCELLED PHONE-BASED SCS
Just hours before it was scheduled to launch, the UCP government cancelled a new virtual overdose response program. Jason Luan, Associate Minister of Mental Health and Addiction said that he has asked AHS to “pause” the project “pending realignment of our addiction and mental health policies.”This AHS-led pilot project follows similar programs across Canada, and would have allowed Albertans to speak to a peer support operator via phone, who would monitor them after substance use and dispatch EMS in the case of overdose.
JUNE 16, 2020: PAID PLASMA
In the coming days, UCP MLA Tany Yao will be tabling a private members bill, Bill 204: Voluntary Blood Donations Repeal Act. With this bill, MLA Yao intends to repeal Bill 3: Voluntary Blood Donations Act, which was put into place to protect and enshrine blood and plasma as public resources under law, and to prohibit them from being treated as a market-based commodity.
Back in March, Friends of Medicare warned that private blood brokers had been lobbying the Alberta government, and attempting to persuade them to repeal Bill 3. While health care workers and communities have been struggling to support each other through the COVID-19 crisis, private blood brokers have been trying to profit off of this dire situation.
JUNE 5, 2020: SCRAPPED HEALTH ADVOCATE JOB COMPETITION
From Ministry of Health documents obtained through a freedom of information request (FOIP), Albertans learned that Tyler Shandro's office asked for recruiters to hold off on posting the competition for Alberta's health advocate position, on the day it was set to go public. The following day, former UCP executive director Janice Harrington was appointed to the role, despite having no background in healthcare or health administration, unlike her predecessors.
In 2019, the Seniors Advocate was rolled into the Health Advocate, and the role was reduced to a single position, now held by Harrington.
MAY 29, 2020: MASK DISTRIBUTION
The government has announced they will be providing 20 million non-medical grade masks to Albertans, distributed via A&W, Tim Hortons and McDonalds drive thrus across the province. Health Minister Tyler Shandro says that 95% of Albertans live within 10 kilometers of one of these locations, but that did not quell the outcry from Albertans concerned about accessibility, especially for those who don't drive. He also said they would be looking at other ways to distribute the masks, but no details for that plan have been provided.
Since then, Albertans have complained that they have been receiving multiple packages of masks, being denied masks without purchase, and being denied masks without a car, while health policy experts have questioned the strategy's effectiveness.
MAY 28, 2020: SURGICAL INITIATIVE POSTPONED
The government has delayed it's plans to implement the Surgical Wait Times Initiative, due to constraints caused by COVID-19. The initiative would see publicly funded surgeries performed at private facilities, and while postponed indefinitely, the Minister of Health has stated that they are still committed to the plan.
Friends of Medicare have spoken out against the government's surgical initiative every step of the way, raising issues of accountability, transparency, and the cost to Albertans. This is an opportunity for the government to reverse the costly and risky plan to privatize Alberta's surgical services.
MAY 26, 2020: HEALTH CARE LAYOFFS POSTPONED
The layoffs of more than 7,000 jobs, as outlined in the UCP platform, have been postponed due to COVID-19. Nurses, lab workers, health care aides, and other health care workers now have temporary security until at least September, when bargaining will resume. This health care crisis should drive home to our government how crucial it is that we have a strong, well-resourced, well-staffed public health care system. Instead, these workers, who have been working diligently for Albertans throughout this pandemic, still face uncertainty come fall.
MAY 26, 2020: EXPANDED COVID-19 TESTING
The province is expanding COVID-19 testing, including in seniors' facilities. However, some care homes have already been in outbreak for months, and tests remain voluntary for staff and residents in care, so this response is not strong enough to adequately address the incredibly high rates of infection in these facilities.
MAY 19, 2020: CONTINUING CARE FUNDING
The government announced an additional $170 million for AHS-contracted continuing care facilities, to offset the loss of ‘revenues’ that have resulted from this pandemic. A total of $14.2 million will be provided every month, retroactive to March 15th, and until orders from Alberta's Chief Medical Officer of Health have been lifted. Although the government said there would be a “requirement to report on the use of these funds,” and that facilities will need to “return money not spent on COVID-related purposes,” there was absolutely no indication that this reporting will be made public.
Alberta’s broken continuing care system is the direct result of decades of privatization and a funding structure that creates incentives for both not-for-profits, and especially for-profit providers to underpay their staff and understaff their facilities. While AHS provides ongoing funding to seniors' facilities for staffing care workers, these funds come with no strings attached, and no way to ensure that 100% is spent on those staff. This lack of accountability and transparency has been a disastrous mismanagement of public dollars.
MAY 4, 2020: MILLRISE SENIORS VILLAGE
Alberta Health Services (AHS) has quietly announced that AgeCare Health Services has been tasked with overseeing the management and operation of Millrise Seniors Village in Calgary, effective immediately. According to AHS, a COVID-19 outbreak at the facility was initially declared on April 15th, and on April 17th a health care manager was brought in to support day-to-day operations at the facility. It was not until the weekend of April 25-26 that AHS brought in an additional 20 AHS staff to support staffing levels and ensure infection control.
Rather than following the example of other jurisdictions like Spain, Italy, and BC, which have each made moves to bring their seniors’ care under the public umbrella, they have instead opted to appoint AgeCare, a private company that has received millions of public tax dollars to build facilities and which in turn has profited massively at the expense of Alberta’s seniors and their families
APRIL 24, 2020: RURAL DOCTORS
Health Minister Tyler Shandro announced that rural doctors will now be exempt from the government's newly imposed changes to physician billing. This follows ongoing worries and warnings of doctors' mass exodus from at least 400 communities in rural Alberta due to the new compensation framework that physicians say render their practices unsustainable. The initial announcement excluded 141 rural communities from the list of areas eligible for the new program, which the Shandro now says was in error.
The Alberta Medical Association says this announcement does not do enough to address long-term sustainability in our health care system. Alberta's Rural Physicians (Rural Sustainability Group) was similarly unimpressed. It seems unlikely that this funding alone will be able to begin repair the broken relationship between Alberta's doctors and its government, which began when the long-standing master agreement between the two was unilaterally torn up by the government.
APRIL 20, 2020: COVID-19 HCA FUNDING
New funding is being made available for temporary staffing of health care aides (HCAs) in continuing care facilities for the duration of the COVID-19 pandemic. $24.5 million is being advanced to operators to address immediate cost pressures. A wage top-up of an additional $2 per hour for HCAs will be provided, and up to 1000 paid student practicum positions will be added to fast track certification.
While this funding should be a welcome relief in light of the ongoing COVID-19 crisis and it's disproportionate impact on seniors in care, it does not address the root problems that have been plaguing the continuing care system for decades. And funding is provided with no strings attached, and no accountability to ensure that 100% of funding received is spent on staff, rather than diverted to profits, executive bonuses, and other operational priorities.
APRIL 20, 2020: RURAL DOCTORS HOSPITAL SERVICES
Family physicians are predicting an impending health care crisis in rural Alberta, following the government's cuts to physician billing. A survey conducted by the Rural Sustainability Group of more than 300 rural Alberta physicians shows that 47% have, or will be decreasing their hospital-based services by July. Despite calls for the government to halt all health care cuts and billing changes until after the brunt of the COVID-19 pandemic had passed, and to return to bargaining with the Alberta Medical Association, major changes were pushed through on April 1st.
The Ministry of Health has said that all physicians who leave would be replaced to maintain access in rural communities, though no information has been offered as to when, how, or from where new physicians would be recruited.
► See a list of communities that are losing doctor care (via Kim Siever)
APRIL 19, 2020: PPE FOCUS GROUP
Alberta Heath Services is creating a focus group to review new PPE procured in response to COVID-19 amid criticism from health care workers about the quality of new masks. Rather than listening to front-line workers about their issues with the equipment being provided, AHS is allocating precious time and resources amid an ongoing pandemic.
APRIL 18, 2020: REPLACEMENT PPE
New personal protective equipment (PPE) received by front line staff has been criticized for being substandard. Workers say the masks cause skin rashes, nausea, headaches and throat irritation when worn, and slip on the face, putting both workers and patients at risk. The health minister has since defended the quality of the masks, and AHS has responded by removing masks from wrappers and airing them out before they are sent to staff.
The new masks come just a week after the province donated 750K N95 masks to other provinces.
APRIL 11, 2020: PPE DONATIONS TO ON, BC & QC
Alberta donated 750K N95 masks, 7M procedural masks, 50 ventilators, and gloves and goggles, to Ontario, British Columbia and Quebec. In his announcement, Premier Kenney said he is "absolutely confident" that Alberta will not run out of personal protective equipment, and has even promised to mass procure non-medical masks for the public. Meanwhile, just days prior, AHS was considering sterilizing and reusing PPE, including steam cleaning N95 masks.
Days later, Alberta physicians revealed that they were purchasing PPE at a premium and hand delivering them to facilities that were short.
APRIL 1, 2020: MASSIVE HEALTH CARE CUTS
• Seniors taking Driver Medical Exams must now pay out of pocket.
• Referrals by some practitioners for publicly-funded diagnostic imaging is now uninsured.
• Physicians are no longer able to submit Good Faith Claims, preventing them from billing for the care of patients who cannot provide identification or a valid Alberta Health card.
• No more clinical stipends, impacting rural primary care especially.
• Sage Health Services is closing, leaving 500+ seniors without community access to primary care.
MARCH 30, 2020: FOR-PROFIT BLOOD INDUSTRY LOBBY
The Alberta government lobbyist registry shows that a big pharma interest group that represents the private for-profit blood industry (Plasma Protein Therapeutics Association represented by Santis Health Inc), is attempting to persuade the government to repeal the Voluntary Blood Donation Act (2017), which bans for-payment blood clinics in the province.
If the act is repealed, it would ensure that tens of thousands of units of much needed blood plasma are shipped out of the province to global markets, putting the entire Canadian supply chain at risk.
MARCH 23, 2020: PHYSICIAN BILLING CODES
Following weeks of ongoing calls from physicians, the government announced new temporary physician billing codes so that doctors can be compensated for providing virtual care, just as they would for an in-person visit - and at the same rate Telus Babylon already receives. The change is very important in allowing patients to receive care from their family doctor at home, and limiting the spread of COVID-19. However, physicians have expressed concern with the limitations of the billing code, particularly that patients must initiate the virtual appointment.
MARCH 19, 2020: TELUS BABYLON APP
On March 17, 558 Alberta physicians sent an open letter to Premier Jason Kenney, urging them to change billing codes - including telehealth - to better allow them to treat COVID-19, and limit the spread of the virus. Days later, the Alberta government announced a partnership with Telus Health, through which health care is delivered via app, and paid for through an alternative relationship plan (ARP). Rather than implementing public solutions as per recommendations of front-line physicians about their professional needs, and the health needs of Albertans, the government instead chose to unilaterally institute a private service that will further fragment Albertans' access to primary care, and compromise their medical privacy.
MARCH 17, 2020: EXPEDITED BUDGET
Amid an ongoing and worsening pandemic, the government pushed through it's 2020 budget. Despite garnering much criticism for the heavy-handed cuts contained in the austerity budget since it's initial release, and calls from Albertans to reverse cuts in light of the COVID-19 outbreak, the government instead chose to leverage the political, economic, and health uncertainty garnered by the pandemic to expedite the passing of the budget. None of the typical committees for health or other ministry estimates were held, and the budget was passed Tuesday evening.
MARCH 15, 2020: COVID-19 FUNDING
Premier Jason Kenney announced today that he would be providing an additional $500 million to Alberta's health budget, in response to health costs associated with COVID-19.
This funding however, still leaves Alberta $200 million short of the minimum $700 million necessary just to meet inflation and population growth in 2020. Given the damage that has already been done in the form of funding cuts, staff cuts, and program closures, it is no more than a band-aid over an ongoing and growing problem – even before we take into account COVID-19 health care needs.
MARCH 13, 2020: STAFF CUTS ON HOLD
Health Minister Tyler Shandro has announced that plans to cut the number of front-line health care workers in Alberta would be paused for the duration of the COVID-19 pandemic. While this is absolutely the necessary move to make while our health care system is under additional stress due to this outbreak, the minister's announcement does not provide any assurance to the dedicated health care workers who continue to work tirelessly to ensure our safety during this difficult time, that their workplaces will remain adequately staffed once this pandemic is over.
MARCH 9, 2020: iOAT PROGRAM
Following the release of the SCS review committee report, the Alberta government will be cutting funding for injectable opioid agonist treatment (iOAT) as of March 31, 2021. The program provides doses of hydromorphone to people with chronic opioid dependency under supervision of a nurse. Currently, there are 65 patients in the program, who have one year to transition to other health services after funding ends.
MARCH 5, 2020: SCS REVIEW COMMITTEE REPORT
The committee appointed by the government to review the "socioeconomic impacts" of Alberta's existing supervised consumption services (SCS) has released it's final report, following months of online and townhall consultation with Albertans. Already, the report has been panned as biased or inaccurate by nurses, doctors, academics, criminologists, Edmonton Police Service, and City Councillors, among others. Shockingly, members of this committee chose to undermine the life-saving measures taken at these sites to revive individuals suffering what was referred to as “adverse effects.” To downplay the precautionary interventions of the qualified health care providers on staff at SCS facilities demonstrates ignorance when it comes to responding to an overdose, and calls into question the very basis of this panel.
Premier Kenney made comment in January that SCS may be "closed or relocated" as a result of this panel's findings, but Associate Minister of Mental Health and Addictions Jason Luan has yet to conclusively say whether sites will be closed.
MARCH 4, 2020: SURGICAL WAIT TIMES INITIATIVE
The government announced a $500 million investment as part of the Alberta Surgical Wait Times Initiative, and earmarked just $100 million of this amount to provide capital funding to upgrade and renovate surgical rooms and equipment and expand surgical capacity within the public system. But this announcement posed more questions than answers.
They have yet to indicate how their initiative will improve on the ultimate failure of the Saskatchewan Surgical Initiative, on which Alberta's initiative was modeled. Little clarity was provided as to which surgeries were considered lower or higher risk, and thus would be designated to different facilities, in different communities. And while they indicated there would be a "modest increase" in surgical staff, their budget made clear that staffing would be reduced across Alberta's public sector. Most importantly, we have yet to fully understand the seemingly major role that private surgical facilities will play in this $500 million overhaul of our surgical system.
MARCH 3, 2020: DOCTORS SIGN OPEN LETTER TO MINISTER
Nearly 600 physicians across the province have signed a letter warning that governments' "short-sighted decisions can inflict untold, avoidable harm to Albertans that get injured, sick, need surgery, have a mental health problem, develop an addiction, on the farm or in the city, or have a family member that does." The letter follows letters from the province's ER physicians and psychiatrists, and a petition with nearly 15,000 signatures, calling on Minister Shandro to return to negotiations with the Alberta Medical Association.
As of March 2, Minister Shandro said he is unaware of the letter, and chalked concerns up to "misunderstanding among our health professionals in the province about what has changed."
FEBRUARY 27, 2020: ALBERTA BUDGET
The budget sees a flatlining of the health care budget for 2020, with a spending increase of a mere 0.3% over the next three fiscal years. A minimum of 2.9% additional funding is necessary to keep Alberta's health care spending in line with inflation and population growth each year – the spending freeze through 2023, as outlined in today's budget, will mean fewer public dollars spent in the health care system. In terms of the impact on Albertans, the spending freeze will amount to a 9% reduction in health care spending in the next three years.
• Fewer family physicians and reduced rural care;
• Fewer front-line workers to provide care services;
• Privatization of surgeries and non-medical services like laundry, housekeeping, and food services;
• The reintroduction of the Affordable Supported Living Initiative (ASLI), which will see Albertans subsidize private for-profit facilities in favor of public ones, and the proliferation of the privatization of seniors’ care, and;
• No mention of continued funding to life-saving, evidence-based supervised consumption services.
FEBRUARY 20, 2020: TERMINATION OF AMA CONTRACT
Health Minister Shandro announced that his government would be terminating the long-standing contract between the Alberta government and the Alberta Medical Association (AMA), and, as per the MacKinnon Report, using “legislative options” to make changes to physician compensation. The government is implementing a new physician funding framework as of March 31, 2020, and physicians will be encouraged to move to a Clinical Alternative Relation Plan (ARP) payment model. This decision to unilaterally end its long-standing master agreement with Alberta’s doctors represents a dangerous precedent in the manner in which this government is willing to push forward their agenda.
They also outlined 11 consultation proposals that will not only negatively impact the financial bottom line for family physicians, but also for Albertans themselves. Some of changes include: Seniors' Driver Medical Exams will now be paid out-of-pocket, as will referrals for diagnostic imaging from practitioners like chiropractors, audiologists and physiotherapists; physicians will no longer be able to submit good faith claims for patients who can't provide ID; an end to clinical stipends, impacting rural care especially. Already, Alberta doctors are anticipating that they will have to close their practices or even leave the province due to the changes imposed by this government.
FEBRUARY 3, 2020: AHS PERFORMANCE REVIEW
Ernst & Young (EY), was contracted for $2 million to conduct a review of Alberta Health Services, with a focus on economics, rather than best health outcomes for Albertans. They released a report containing 57 recommendations that could result in an estimated $1.9 billion savings, though Health Minister Shandro indicated that not all recommendations were feasible, or would be implemented.
The recommendations outlined in this report ultimately have the potential to turn over our resources, health care dollars and staff to private companies that will be subsidized by public health care dollars, rather than put towards improving our existing public health care system.
JANUARY 31, 2020: SURGICAL SERVICES
AHS released a Request for Expression of Interest (REOI) for surgical services in Alberta. The request follows a government announcement of a new initiative to contract out surgical services. The REOI was not limited to hip, knee, and cataract surgeries as areas that will see further privatization, but also listed several potential procedures as areas of expansion for private surgeries, including gynecology and general surgeries, ie. hernia repair, mastectomy, and cholecystectomy.
We know that private delivery of surgical services costs more than public delivery, and we know that contracting out means that public loses our right to see what AHS pays for services from private suppliers, and is denied any input on how to provide or change services. Yet, the government is doubling down on their costly, risky plan to privatize Alberta's surgical services.
JANUARY 21, 2020: SUPERVISED CONSUMPTION SERVICES
DECEMBER 12, 2019: ALBERTA SURGICAL WAIT-TIMES INITIATIVE
In a press conference, Health Minister Tyler Shandro announced the government’s plan to reduce surgical wait times in Alberta. The minister confirmed that the planning for the surgical initiative was informed by the Saskatchewan Surgical Initiative (which ultimately failed to solve wait-time issues in Saskatchewan) but was unable to clarify the lessons that this government is taking from its failure. The announcement came with no monetary figures, no timelines, and no details, but made it clear that they would be increasing contracts to Non-Hospital Surgical Facilities, providing public funding to private practitioners.
NOVEMBER 29, 2019: FIRST CUTS TO FRONT LINE STAFF
On Black Friday, Albertans learned of the impending loss of well over 5,100 front-line health care jobs and another 2,500 public sector jobs, via the release of letters addressed to union officials from Alberta Health Services and the Government of Alberta. United Nursed of Alberta estimate the loss of 750 registered nurses and registered psychiatric nurses in the next three years. More job losses are anticipated following the commencement of the government’s review of Alberta Health Services (AHS). These announcements came alongside notice that AHS will be considering future contracting out initiatives, and the privatization of emergency, non-emergency and hospital transfer ambulance services.
NOVEMBER 14, 2019: PHYSICIAN BILLING
The UCP proposed that physicians stop billing for patients without valid Alberta health cards. This change would disproportionately impact vulnerable Albertans, and individuals experiencing homelessness in particular. Other proposed changes would alter the rates at which doctors can bill, including cutting funding for complex care plans, and restricting doctor pay for 25-minute visits to the same as for 15-minute visits. They have also proposed that the Alberta Medical association charge seniors for their mandatory renewal driving tests. Bill 21: the Ensuring Fiscal Sustainability Act will also limit the number of physicians allowed to practice in a given area of the province, as well as the number of physicians allowed per practice type or specialty.
Family doctors in particular, and especially rural doctors, have expressed worry about the impacts this would have on their ability to provide the care that their patients need. The Alberta Medical Association has called the proposed changes "troubling."
NOVEMBER 7, 2019: BILL 207
Peace River MLA Dan Williams introduced Bill 207: Conscience Rights (Health Care Providers) Protection Act. The bill passed first reading and was referred to the Standing Committee on Private Bills and Private Members Public Bills. Although the Charter of Rights and Freedoms already protects doctors and health care providers’ ability to refuse to provide health services or procedures to which they morally object, Bill 207 sought to allow health providers to refuse to even refer patients to an alternate health provider. This bill would impact Albertans' access to legal health care services, especially reproductive rights, medical assistance in dying (MAID), and LGBTQ2S+ health care - and particularly for individuals in rural areas.
Following much opposition from Friends of Medicare, other advocacy organizations, the official opposition party, and medical professionals, the bill was shut down at committee level. However, after MLA Mike Ellis tabled the committee's final report, MLA Dan Williams indicated that he wished to speak to the motion for concurrence, and so debate was scheduled for December 2. This debate was interrupted by a tragic incident outside the legislature, in which a man took his own life to bring attention to the issue of MAID access.
Instead of reopening debate once the house resumed, the bill was left to fail on the order paper.
NOVEMBER 4, 2019: MENTAL HEALTH AND ADDICTIONS ADVISORY COUNCIL
The UCP appointed a new 23-member panel to address access to mental health and addictions services. The panel replaces the NDP-appointed Minister’s Opioid Emergency Response Commission, which the UCP claims was too focused on a harm reduction approach. One of the panel's co-chairs is Pat Nixon, father to two sitting UCP MLAs.
Meanwhile, the existing supervised consumption site review panel has yet to report to the government. The findings of the report, expected by year's end, will inform the government's decision about whether or not to continue to fund Alberta's existing sites beyond March 2020.
OCTOBER 28, 2019: ALBERTA PRECISION LABS (APL)
Existing leadership of Alberta Public Laboratories was suddenly removed and the name changed to Alberta Precision Laboratories. The name change and the removal of the word ‘public’ signals a move towards privatization in Alberta's medical labs, as is consistent with the recommendations of the McKinnon Report. The future of lab services in this province continues to be uncertain.
OCTOBER 24, 2019: BUDGET 2019
Budget 2019 saw a slight increase in spending in health care in 2019, and a flat-line in health spending for the following three years. The 1% increase in 2019 far from meets inflation and population growth (3.5%), and over 4 years the spending freeze will amount to a 15% reduction in health care spending.
Some notable changes:
• The South Edmonton Hospital has been delayed four years
• The Child and Adolescent Mental Health building has been delayed indefinitely
• Assured Income for the Severely Handicapped (AISH) will no longer be indexed to inflation, impacting more than 66,000 recipients
• The reintroduction of ASLI means that privatization is ramping up in the continuing care sector
• $11 million cut from ambulance services
• Changes to the Alberta Seniors Benefit Drug Program could mean up to 46,000 people will lose their drug coverage
OCTOBER 17, 2019: EXPANDING LPN SCOPE
Health Minister Tyler Shandro revealed that the government would be widening the practicing scope of licensed practical nurses (LPNs). With an appropriate utilization strategy, an expansion to the role of LPNs could alleviate under-staffing in care settings and optimize the continuity of patient care, however, with the release of the provincial budget, the government confirmed that this move is intended to "lower the number of Registered Nurse (RN) funded hours per weighted resident day." Despite their assertion that this will have "no impact on residents’ quality of care," the government has the responsibility to establish an effective workforce strategy that includes the right mix of health care professionals in a variety of care settings, so that Albertans can be assured that staffing decisions are based on best patient outcome, not on budgets.
OCTOBER 15, 2019: LAWSUIT AGAINST OPIOID MANUFACTURERS
The Alberta government announced it would be joining BC a class-action lawsuit against opioid manufacturers, and seek to recoup health care costs connected to opioid over-distribution. Meanwhile, Albertans wait to see what measures the government will be taking to reduce the number of lives lost each day due to the overdose crisis, and to see what their Opioid Response Strategy will entail.
OCTOBER 11, 2019: LAB EQUIPMENT FUNDS ON HOLD
OCTOBER 10, 2019: VEGREVILLE SUPPORTIVE LIVING WORKERS LAID OFF
After all 53 workers at the Vegreville Century Park supportive living centre learned they would see their employment terminated, the Health Minister made clear that he would not be intervening. The Health Minister's press secretary, Steve Buick, said in a statement: "He sympathizes with the staff and understands the new operator intends to hire mainly from the existing staff, and that there are other jobs available in Vegreville and area, so he hopes most or all the staff will have jobs at the end of the transition."
In early October, BC-based private operator Optima Living, issued layoff notices to the workers following the decision to contract their work out to Pro-Vita, a privately-held company also based out of BC. Optima Living receives receives operational funding from Alberta Health Services to hire and retain staff, and will now be contracting out staffing to save money for shareholders. Starting November 1, the employees have the opportunity to re-apply for similar positions, but at $8 to $10 an hour less than what they were previously making.
SEPTEMBER 3, 2019: BLUE RIBBON PANEL REPORT
The UCP appointed Janice MacKinnon to chair the Blue Ribbon Panel, and to look into our province’s expenditures. The panel was given a very narrow mandate to examine expenses but not revenues, and was tasked with recommending a path to a balanced budget by the year 2022-23, without raising taxes. The panel released its report on September 3, and the recommendations included massive cuts to public services, which will directly inform the UCP's upcoming budget.
In the area of health care, the panel recommended "transformational change in the way health care services are delivered and health care professionals are compensated." Most concerning was the recommendation that the government expand the role of private health care in Alberta.
JULY 9, 2019: CONTINUATION OF ASLI
On July 9th, 2019, without media releases or formal statements, Health Minister Shandro announced on Twitter that the Affordable Supportive Living Initiative (ASLI) will continue under the UCP government. His announcement was made with a photo op at the Silverado Seniors Village, owned by Park Place Seniors Living. The ASLI program allows the government to provide up to 50% of funding for construction costs, followed by operational costs to run these facilities. Tax payers do not own the buildings, and once the contracts expire tax payers will need to buy the building back at the market price.
JUNE 28, 2019: BILL 9
Introduced Bill 9: Public Sector Wage Arbitration Deferral Act, enabling the government to delay wage arbitration for thousands of public sector employees, including many of the province's front-line health care workers. The government's decision to impose Bill 9 on all public sector workers not only violates their charter rights and breaks a legally binding contract with the employer it also undermines the importance of the vital work they do every day on behalf of all Albertans.
JUNE 26, 2019: BILL 203
Following Friends of Medicare's presentation to the Standing Committee on Private Bills and Private Members' Public Bills on Bill 203: An Act to Protect Public Health Care, the committee — comprised of 4 NDP and 7 UCP MLAs — voted to keep the bill out of full debate in the legislature. The bill would have protected our public health care system by prohibiting two-tier medicine, extra billing and any other form of private payment in relation to insured services, and would have banned queue jumping via cash payments.
This was possible because of a new Standing Order implemented by the UCP government, which allows government MLAs sitting in a position of majority to determine what bills presented by the opposition will proceed forward. As we saw in the case of Bill 203, these 7 MLAs now have the power to decide on behalf of 4 million Albertans whether we have the right to hear our legislators discuss proposed legislation that would impact each and every one of us. In the case of Bill 203, committee members' unwillingness to allow it to proceed to the Assembly for a fulsome debate on the importance of strengthening public health care in this province brings clarity to the direction that we can expect this new government to take.
JUNE 8, 2019: CONVERSION THERAPY
The government failed to take action to ban conversion therapy in Alberta, including refusing to reinstate the Conversion Therapy Working Group, or to commit to supporting their recommendations. Health Minister Tyler Shandro’s office has said that they “don’t think there’s a need to address [conversion therapy] specifically because it’s not a valid health service,” despite the fact that over 250 complaints have been made to Alberta Health from Albertans who have been subjected to the practice.
MAY 31, 2019: SUPERVISED CONSUMPTION SITES
Funding for proposed supervised consumption sites in Medicine Hat, Red Deer, and Calgary is suspended pending “socio-economic analysis” of the impact of the existing sites. The review has halted the development of the three proposed sites, and its results could impact the continued funding of existing sites across the province. Meanwhile, the government has not made clear what is in store when their “comprehensive approach” to substance addiction and misuse is eventually rolled out. What is clear is that Alberta is in the midst of an overdose crisis – a staggering 10,300 Canadians lost their lives between January 2016 and September 2018, with Alberta trailing only British Columbia in rate of overdose deaths. As of February of this year, the 3 existing supervised consumption sites in Edmonton alone have reported 420 overdose reversals and 15,335 referrals to other services and supports.
MAY 30, 2019: AHS REVIEW
As part of their election promises, the UCP said they would be commissioning a performance review of Alberta Health Services, with the intention of finding savings “on the administrative front,” despite the fact that AHS has the lowest administrative costs in Canada. On May 30 they began the review, with the final report on the $15.2 billion public health care agency due December 31. The real savings would be found if we looked at how much of our public health has been contracted out from under the public umbrella especially in home care and seniors’ care.
APRIL 22, 2019: EDMONTON LAB HUB PROJECT
As one of their first moves as government, prior to even being sworn-in, the UCP announced that the $590 million lab hub project would be put on hold until they have the opportunity to “review the project.” Then-Premier elect Jason Kenney claimed that this project “will do nothing to improve patient services,” a claim which is both inaccurate, and patently disrespectful to laboratory workers and the vital work they do for Albertans. Reporting from the Edmonton Journal showed that our current lab system is outdated and overwrought, and without a plan in its stead, this halt to what was to be a major expansion for our public laboratory services puts Albertans’ health care in jeopardy.