April 23, 2021
Auditor General’s report sets a clear path to improve wait times via public solutions, not private expansion
The Auditor General’s report, Alberta Health Services Use of Publicly Funded CT & MRI Services, released on April 22nd, shows clearly that AHS has lost control of this important part of our health care system.
The recommendations made by the Auditor General made it clear that AHS and government can, if they choose, utilize unused capacity in public hospital operating rooms and diagnostics, organize access to care more effectively, scale up proven innovations in the public system, and ramp up capacity to improve access to care. Wait list, equity, and timeliness issues were clearly laid out and solutions provided. If unnecessary testing was curtailed, as has been started with MRIs in some provinces, funds could be redirected to needed care elsewhere in our public health care system. Better wait list management, improvements in primary care, and proven innovations in the public system have made a dramatic difference where they have been implemented.
Though AHS has accepted the recommendations made by the Auditor General, it’s clear that this government is not interested in public solutions. In the Diagnostic Imaging, CT and MRI Implementation Plan introduced by Premier Kenney and Health Minister Shandro in March of this year, we see they are opting to take a different direction with this integral part of our health care: under this implementation plan, the Health Contracting Secretariat and their consultants will be responsible for shaping the “scope of service, compensation model options and national benchmarking.”
The AG report did not explore diagnostic exams conducted by private providers, a crucial omission when it comes to understanding the issues that have long plagued this system. A lack of clarity when it comes to the role of the private and public sectors, and incremental privatization via policy/regulatory decisions by provincial governments have worked in conjunction to systematically gut the Canada Health Act a bit at a time.
“Once again, we see how governments have misdiagnosed the problem, and their prescription of ever more privatization has had serious long-term side effects,” says Sandra Azocar, Executive Director of Friends of Medicare. “The real issue is that AHS has totally lost control of the services in this province. How can we hope to fix the system when it’s completely under the thumb of the private market?”
While the report shows that there is sufficient staffing and equipment capacity within our public health care system to improve the wait list for MRIs and CT scans, there has been a lack of commitment from governments to expand the public system, in favour of more private system involvement. As such, it is no coincidence that radiology is the most entrepreneurial of all the specialties in our health care system, a trend that has resulted in hospitals struggling to get on-site coverage and coordinate services. Meanwhile, the public system is required to pay more and more, due to the pressure of the private market next door, where radiologists are free to charge whatever the market will bear.
The most troubling issue emerging from the system that has been created in Alberta is that of equity: “If the wait for an MRI scan is the sole barrier preventing someone from getting on a surgery waitlist, and they can pay for a private scan, they will have access to their publicly-funded surgery before someone in just as much need, but who is less able to pay out of pocket,” says Azocar.
We cannot continue to expand private delivery, which siphons resources from the public system, drives up costs, and results in inequitable access to care. We need to address the wait time issue at the root of the problem, and finally make a commitment to expand and improve our public health care rather than insidiously seeking out more private involvement.