Leaked documents show Alberta to dismantle health provider, may sell off care homes

Alberta is planning to dismantle its provincewide health provider and may sell off its publicly owned continuing-care facilities, say leaked cabinet briefing documents released by the Opposition NDP.

NDP Leader Rachel Notley says the proposal to break up Alberta Health Services would give complete political control over all health decisions to Premier Danielle Smith’s cabinet.

Notley says it would also bring chaos to the system and open the door to more privately delivered care.

"(The United Conservative Party government) created this crisis, and now they want to blow up our health-care system completely," Notley told Smith and the UCP caucus during question period Tuesday.

"What is wrong with you people?"

Earlier Tuesday, Notley released to reporters photocopies of a computer slide deck outlining details of the government’s promised revamp of the health system.

Notley said the documents were sent to the NDP anonymously.

"Is the premier actually committed to what’s outlined in these leaked documents?" Notley asked Smith during question period.

"One hundred per cent committed," Smith replied.

"We embarked on a process over the last year to try to work within the existing framework to get performance improvement, and we succeeded to a measure," Smith added.

"But we need to do so much more if we're going to be able to make greater progress."

Health Minister Adriana LaGrange told the house that the government would release its health reorganization plan Wednesday.

"I want to be really, really clear. There is absolutely no plan to privatize health care. What we are going to do is strengthen health care right across the province," said LaGrange.

Smith has long promised a fundamental reform of Alberta Health Services, or AHS.

AHS was created 15 years ago and tasked with carrying out health policy and delivering front-line care provincewide, handling everything from hospitals to care homes, mental health and addiction, family physicians and procurement.

Smith has criticized AHS as too top-down and monolithic in its decision-making and said it failed to respond to rising hospitalization rates during the COVID-19 pandemic. Last year, she fired the AHS board and replaced it with a single administrator.

The leaked documents outline a sweeping reorganization of AHS, affecting an estimated 250,000 workers.

Under the new organization, AHS would become one of four agencies that oversee health care tied not to geographic regions, as is currently the case, but to service delivery.

AHS would become the Acute Care Organization, responsible for running hospitals and, for the time being, lab and ambulance services.

Alongside it would be a primary care organization, with a mandate to find a family doctor for every Albertan.

There would be a continuing care organization to oversee and run those facilities. During the reorganization, the government would also look to the potential of selling off AHS continuing care subsidiaries CapitalCare Group and Carewest.

The fourth agency — a mental health and addiction organization — would work directly with the Mental Health and Addiction Ministry to further the broader goal of a recovery-oriented system.

All four agencies would report to an integration council chaired by LaGrange. The council would include Mental Health and Addiction Minister Dan Williams, senior department civil servants and the leaders of the four sub-groups.

A separate committee would handle procurement and other duties, such as legal and payroll.

Notley told reporters the change would create chaos, given the mandates of all four groups would inevitably intersect and overlap in an integrated health-care system.

Smith has promised the new system would empower local and regional decision-making.

The proposal encourages regions to offer up suggestions through advisory committees, but decision-making authority remains with the four new organizations and LaGrange’s umbrella council.

The documents say the government is to start passing legislation in the spring to make the reorganization happen over 18 months to two years at an expected cost of $85 million.

The documents also call for cabinet to pick a new AHS board that would be responsible for winding down AHS operations and determine if AHS should still have a role in ambulance and lab services.

Chris Gallaway, head of the advocacy group Friends of Medicare, said the documents show the province is bent on further disruption at the expense of solving pressing issues such as a shortage of health workers.

"People in this province deserve to know that our public health care is being protected and strengthened, not dismantled and thrown into disarray to fulfil the political whims of the government or premier of the day," said Gallaway in a statement.

This report by The Canadian Press was first published Nov. 7, 2023.