Thursday, July 9, 2009

Critics are questioning a move by the Alberta Health superboard to dismiss the head of the provincial health laboratory as it struggles to cope with a heavy caseload during an emerging swine flu pandemic.
Dr. Jutta Preiksaitis, medical director of the Provincial Laboratory for Public Health and an internationally renowned expert in infectious disease control, was advised last week that her contract would not be renewed.
Preiksaitis, who recently won an award from the American Transplant Society, has been researching infectious diseases for 26 years.
Alberta Health Services spokesman Mark Kastner would not say why the contract was not renewed, except that it was a human-resources issue and not a cost-cutting measure.
"We haven't eliminated the position," he said.
"There will continue to be a medical director and they will continue to have a similar role."
Preiksaitis is the fifth public health doctor to leave the provincial health service in recent months.
Liberal MLA Kevin Taft said Preiksaitis has been a champion for the provincial laboratory for more than two decades.
"It bodes ill for the health-care system," he said.
"If there is a serious outbreak of H1N1 virus, she is exactly the person you want on the job--not driven out of the province."
Dr. Lynora Saxinger, an associate professor of medicine in the University of Alberta's infectious diseases division, also questioned why Alberta Health Services would make the move when the province is facing an emerging swine-flu pandemic.
"To be quite honest, I am somewhat mystified," she said.
" I think there could probably have been some better timing for a change, or some dialogue as to what the perceived problems were."
She said Preiksaitis was "a very forward-thinking and responsible lab director and we appreciated how she improved care for patients."
Salinger said she was impressed with how well-prepared the provincial laboratory was for the deluge of testing for the H1N1 virus.
"I thought that under her leadership things seemed to be going very well," she said.
Salinger said she was "shocked and dismayed" by the decision not to renew the lab boss's contract.
"Of course, we would all be concerned when someone who we perceive as an ally in making diagnoses in difficult situations has been let go," she said. "She was also interested in expanding our repertoire and our diagnostic abilities and she's a very good virologist--and there are not a lot of good virologists around."
Dr. Geoffrey Taylor, director of the University of Alberta's infectious diseases division, said he was surprised by the move, but pleased that Preiksaitis will continue to do research in his department.
"She's an internationally recognized virologist and at an academic level is highly respected," he said. "The infectious diseases community, the specialists involved in treating people with serious infections in northern Alberta, have always had the utmost respect for Dr. Preiksaitis's leadership at the provincial lab and also for her expertise in virology.
She continues to be a member of our division and we're very happy she will continue and provide that expertise."
Preiksaitis could not be reached for comment.
David Eggen, executive director of the Friends of Medicare, said the decision to replace the lab boss has all the earmarks of cuts in a bid to reduce the projected $1-billion deficit.
"Almost everything that Alberta Health Services is doing now is cuts, and if they try to frame it in any other way, it is misleading," he said.
The province's health superboard is being dishonest by insisting that Albertans won't notice a reduction in services, despite a projected $1-billion deficit facing the health system this year, critics say.
"I think(CEO)Mr.(Stephen)Duckett is being disingenuous, straining his credibility to suggest that his centralization and efficiencies will find $1 billion," David Eggen, executive director of Friends of Medicare, said after the board of Alberta Health Services approved a $10.9-billion budget, up 13.2 per cent from last year. "You wouldn't be able to find those so-called efficiencies without making cuts to essential services. In essence, that's eight per cent of the budget and equates to one in 10 workers."
"This is a ten-fold increase in the health deficit from the year before since restructuring," Liberal Leader David Swann said, referring to the much smaller $100-million deficit accrued by the former health regions. "Albertans are going to pay very dearly for this mismanagement. It's clearly going to increase the complication rate, the wait times, the loss of life in the system if they do make those kinds of cuts."
But Duckett, CEO of Alberta Health Services, said cuts to programs, front-line staff or health services will be "the last resort," insisting he will work to find $1 billion in other efficiencies. That includes $250 million this year by combining the payroll departments of the former health regions and cutting 100 management positions, which has already taken place.
That annual savings is expected to grow to $650 million next year and each year after, with$420 million of that coming as a direct result of integrating the former health regions into one. The system will also focus on getting seniors out of expensive hospital beds into long-term or designated care facilities.
The board has to find another$343 million to cover a deficit carried forward from last fiscal year.
"What the board has charged me to do is to look for savings that don't impact adversely on health care, don't impact adversely on health-care access, don't impact adversely on health-care quality but do impact positively on sustainability," Duckett said during a news conference at Alberta Children's Hospital in Calgary. "We've got to look at everything. I'm not going to single out nurses. I'm not going to single out doctors. I'm not going to single out administrative staff. What we've got to do is look at every opportunity for savings, improving efficiencies, improving how we do things." Part of that will be determining why Alberta spends more than the national average on health care, but doesn't have better outcomes, such as longer life expectancy. Duckett will present his results, with strategies on how to reduce the spending difference, to the board in December.
In the meantime, he said spending at hospitals will continue to be limited into the fall, with costs for each fiscal quarter not to exceed what was spent in the last fiscal quarter of 2008-09. That policy has forced the Royal Alexandra Hospital to cancel elective surgeries because of cost overruns. Duckett wouldn't say if other hospitals could also be squeezed, since the situation changes daily. "Every hospital, every facility in the province is being treated equally and we are constantly monitoring against their first quarter spent," Duckett said.
Health Minister Ron Liepert expressed confidence in the board he created to replace the health authorities a year ago. He said government officials will sit down with Alberta Health Services to work out a debt-reduction plan that could include borrowing money to cover the shortfall. "I think we need to give the board and the new CEO and his management team a year or two to start to work through some of these issues," Liepert said, adding that Duckett, an economist who was recruited from Australia, only assumed the job three months ago. "You don't make these changes overnight," Liepert said. "No one ever said there was going to be cost-savings right out of the gate....This is a long-term attempt to get a hold of health-care costs in this province and ensure that while we're getting a hold of health care costs that we're working toward improved patient care and accessibility."
Swann questioned the government plan, given that audited financial statements show severance packages for the bosses of the former health regions cost the system$18 million, with millions more spent on supplemental executive hiring plans. That while the premier has granted raises for himself and MLAs, Swann said.
"This is a government out of control and out of touch with Albertans and their priorities," Swann said. "This government has grossly mismanaged this most cherished service for Albertans. This whole unnecessary experiment over the past year is not only providing poorer services and longer wait times, it is actually sinking us into the deepest deficit in our history."
jsinnema@thejournal.canwest.com
© Copyright (c) The Edmonton Journal
Premier's vow of no tax hikes spurs fear of deep cuts

Economist forecasts deficit of more than $7 billion

By Darcy Henton, Edmonton JournalJuly 9, 2009


Premier Ed Stelmach's declaration that there will be no tax hikes during his reign has some people bracing for brutal cuts to programs and services if the faltering economy does not quickly turn around.
While the premier suggested most provincial government departments can stand a "haircut," some groups fear the governments could be forced to axe programs or cut or freeze wages to balance the books.
Economist Jack Mintz said the financial picture is likely going to be worse than the forecasted$4.7-billion deficit. That's because natural gas prices are two dollars less than the budget estimate. For every 10 cents the price falls below the estimate, $126 million is lost.
"I wouldn't be surprised if we're looking at a deficit of more than $7 billion," he said. "There's more downside than upside risk."
Mintz, who teaches at the University of Calgary, said this year's deficit alone could eat up nearly half of the province's savings.
Liberal MLA Hugh MacDonald said the government will have to conjure up some magic to balance the budget without tax hikes. The Liberals tried unsuccessfully to introduce amendments that would have cut nearly $50 million from the budget.
"The government is not going to find $2 billion under a mattress somewhere," Alberta Federation of Labour president Gil McGowan said. "If they want to balance their budget with cuts alone, there will be deep cuts and they will have a huge impact. "
McGowan said such cuts may balance the books in the short term, but will cripple programs for years.
"It's bad news for those who represent public-sector workers and it's bad news for all Albertans. A return to Klein-style cuts is not in anyone's best interests."
Alberta Treasury Board president Lloyd Snelgrove predicted earlier this week that if tax increases were off the table, there would have to be a cut of at least 15 per cent to health care, education and social programs, and infrastructure spending would have to be cut 30 per cent. But Snelgrove was much more optimistic
Wednesday after the premier made his declaration there would be no tax increases.
"We have to really sharpen our pencils," Snelgrove said. "We need to go back. We'll be sending targets out to the different departments sooner than later."
He said the government was "spending a little too much," but it now had to be careful it didn't cut too deeply. "We don't want to swing the pendulum past the point where we do damage to what in many cases are very good systems."
The Canadian Taxpayers Federation says cuts can be made without destroying programs.
"This is the biggest spending government in Canada, next to Newfoundland, on a per-capita basis," said Alberta director Scott Hennig.
"I don't think other provinces live in constant chaos just because they don't spend as much as we do."
Grant MacEwan political studies expert Chaldeans Mensah said Stelmach is taking a big risk with his vow not to increase personal or corporate taxes. In the short term, the promise will shore up the premier's support among fiscal Conservatives, with a leadership review looming this fall, Mensah said.
"In a sense, he has boxed himself into a corner and he has to be hopeful that economic conditions improve," Mensah said. "This will be a very telling moment for Ed Stelmach. He has set the stage for what will be a clear basis for judging him and making a very definitive judgment on his performance."
NDP MLA Rachel Notley called the vow "a blatant political ploy."
She added that Stelmach's decision to reverse the liquor taxes in the April budget that would have brought in $180 million was "incredibly irresponsible and thoughtless."
David Eggen, executive director of the Friends of Medicare, said Stelmach is "playing a dangerous game" and every cut he makes to social programs will be measured against his decision to reverse the tax on liquor. "He is lowering alcohol taxes when seniors will be paying more for prescriptions next year," he said. "It seems like he doesn't have his priorities straight."
dhenton@thejournal.canwest.com

Tuesday, June 30, 2009

Billion dollar health deficit hanging over our heads

EDMONTON — Albertans shouldn’t notice any reduction in services when they show up at hospitals in the province despite a projected $1 billion deficit facing the superboard that manages public health care across the province, says Health Minister Ron Liepert.
Liepert told reporters at the legislature that government officials will sit down with Alberta Health Services to work out a debt-reduction plan which could include borrowing money to cover the shortfall.
The health minister also maintained he still has confidence in the board he created to replace Alberta’s regional health authorities a year ago.
“I think we need to give the board and the new CEO and his management team a year or two to start to work through some of these issues,” Liepert said, noting that Alberta Health Services CEO Stephen Duckett, an economist who was recruited from Australia, only assumed the job three months ago.
“You don’t make these changes overnight, but I am confident that given a year or two you’re going to see a more efficient health-care delivery system in this province,” he said.
Liepert also stressed that the rising cost of health care is an issue in other provinces of Canada and jurisdictions around the world.
He said that while he expects that a single provincial board will eventually be more efficient than the nine regional health authorities, it won’t happen overnight.
“No one ever said there was going to be cost-savings right out of the gate,” he said. “This is not an overnight solution that we had embarked upon. This is a long-term attempt to get a hold of health-care costs in this province and ensure that while we’re getting a hold of health-care costs that we’re working toward improved patient care and accessibility.”
Duckett refused to talk about possible program cuts to hospitals and health programs, instead insisting that he will work to find spending efficiencies to help cover the projected deficit.
“We’ve got to look at everything,” said Duckett told a press conference at Calgary’s children’s hospital. “My first priority is to look for efficiencies.”
Cuts to programs are “the last resort,” Duckett said. Instead, the health superboard says it will save $250 million this year by combining payroll departments and other administrative departments from the nine former health regions, plus the Alberta Cancer Board and AADAC, into one. It will also focus on getting seniors out of expensive hospital beds into long-term care facilities.
That annual savings is expected to grow to $650 million next year and each year going forward.
If necessary, the health region will also consider borrowing money to make up the shortfall, but not until Duckett brings a formal debt reduction plan to the board. As part of that plan, Duckett will also have to report why Alberta spends more than the national average on health care, but doesn’t have better health outcomes such as longer life expectancy.
The projected $1.1 million deficit is on top of another $343 million deficit carried forward from the last fiscal year.
Friends of Medicare executive director David Eggen said the announcement of a projected deficit was “a body blow to public health.”
He said that if the government embarked on cuts to balance the books it would have to chop one out of every 10 health-care professionals and he urged Premier Ed Stelmach to find other options.
“We’re very concerned and we hope Mr. Stelmach won’t just cut and run on this — that we actually get some long-term planning to make sure health care is there when everybody needs it,” he said. “Albertans tell us time and time again they want a public health-care system strengthened. They don’t want private health care as a default and they sure the heck don’t want $1 billion taken out of the health-care system.”
NDP MLA Rachel Notley said she is worried the governing Conservatives will use the deficit as an excuse to contract out more health-care delivery to the private sector.
“The government is basically making a decision to try to create a crisis in order to create an appetite for cuts and ultimately bring in more privatization,” she said. “If Premier Stelmach had this agenda 18 months ago when he was running for office he had an obligation to tell Albertans about it — and he didn’t.”

Friday, June 26, 2009

Lethbridge Friends of Medicare Rally - 250 people!

Text of speech from Virgil Grandfield at rally for St. Michael's and Medicare, 25 June 2009.
First, I would like to thank the Friends of Medicare and all other organizations and individuals who have answered our call today for help in defending senior care as health care in this province. We are grateful for the work you do to support and defend Universal Health Care every day in this city and province and country.I would also like to thank the many citizens of Lethbridge who have called my home these past weeks, especially those seniors – our super citizens - who call me every day to share their views, and often their pain, on these issues. It was one of our super citizens, Miss Madeleine Brown, a retired schoolteacher and long-time resident of Lethbridge, who - at lunch breaks on days I worked as her gardener just a few blocks from here – taught me to cherish the privilege and responsibility of local citizenship. Miss Brown studied and debated every issue as seriously and passionately as if her vote was always going to be the one deciding the election and fate of her world. It was this attitude of hers, more than any number of votes, that changed her world, I believe. Miss Brown died three years ago, but I believe her attitude and spirit of citizenship lives on in this group assembled with us today. I got a call from Miss Brown's ghost this week - a Mrs. June Lee, another super-citizen - phoned to say that her ire was really up over the deregulation of senior care and that she was bringing some of her super citizen friends to our rally today. Mrs. Lee, I want you to know your phone call was the first moment I really felt we are going to win this fight.Most nights, I read the bible to my father, a retired minister with Alzheimer's who is now in hospital awaiting placement in a dementia facility. The other night, in the third verse of Hebrews Chapter 3 we came across a bit of ancient wisdom which I think our government and maybe our society has forgotten: “He who hath built the house hath more honour than the house.” Our seniors, our retired schoolteachers, our farmers and builders and ministers, our super citizens, built this country. They suffered the winters, cleared the land, plowed the fields, hoed the beets. They paid the taxes that built this building behind me, and some even actually put brick on brick for it. They raised the children who work in it now as adults, they packed their lunches, made them do their homework, and sent them to universities and colleges, which they also built. They built the roads you drove on to get here today, they planted these lawns on which you stand, these trees under which you rest. On top of everything, they built and gave to us, our Universal Health Care System, which is the envy of the world. Now, in the last decade, but especially in the last weeks and months, this government of this the luckiest of all generations is telling us we can't afford to keep our seniors in the public system which they, our super citizens, built. This luckiest of generations is cashing in its inheritance and selling its own best generation out to privateers. They pretend to take in and give refuge to the generation that actually built the house, and then allow strangers to sublet that same house to them at a profit. Why do they, the oil-soaked politicians and profiteers and rentiers of this - our luckiest, wealthiest generation - why do they say we the public can no longer afford to care completely for our builders? Why are they quietly redesigning health care criteria like bean counters in order to quickly move 80 per cent of seniors from holistic, public long term nursing care into a doublespeak system that reclassifies senior care as for profit residence and services with some public health delivery? Why do they talk as if eggs exist separate from their shells. As if we drink our milk from the floor. As if families won't eventually realize that they are paying more for less. As if seniors won't recognize this counterfeit and know that they are being sold out? As if they won't wonder at this dishonour? As if they won't say, “Why us?”There is an F. Scott Fitzgerald story about a fellow named Benjamin Button who is born into this life as an old man. As Benjamin ages, he grows younger and younger until as he approaches his death, he becomes a toddler who has no vocabulary or memory but of the present. In the story, Benjamin's nurse cares for him constantly and tenderly, moment-to-moment, until, as an infant, he closes his eyes forever. My father has Alzheimer's dementia. In a sense, because his brain is dying, he is also aging in reverse. He is dying as a sweet boy, and eventually, an utterly helpless, speechless infant. Why would we afford him any less care than Benjamin's Button? Why would we treat any senior, any of our builders – even those who age and die more normally - as less of a treasure to us than a child I must tell you a story now to give you a more intimate window into this debate between public long term health care for seniors and this government's quiet, dishonest deregulation scheme for seniors. Last week, a super citizen came to the door of my home and introduced herself as a volunteer at St. Michael's and as someone who is upset with the government of Alberta. She said her life partner, a Mr. Doug Richardson, suffering from a host of medical problems, was classified for placement to a deregulated assisted living facility here in the city a few years ago. On a Sunday last Spring, this woman said she notified care attendants at the facility that her life partner was breathing heavily and might need to go to hospital. She told me the staff of this assisted living facility said they were not qualified to assess Mr. Richardson. The woman continued to raise her concerns, until on the Thursday, a blood test was done, and an ambulance called. The next morning, Doug Richardson died of an undiagnosed bladder infection because he was not in a proper long term care facility supervised by a Registered Nurse. Unlucky Mr. Richardson was deregulated to death by the luckiest generation in history, in the richest place on earth. Mr. Richardson's widow now believes so strongly in publicly administered and regulated senior care, she works for free in this beautiful building behind me, turning her anger to action and spending the balance of her years not in seeking what is owed her but in giving what is needed. She has standards many of us can't totally relate to anymore. Not politicians, nor bean counters, nor bonus seekers, not profiteers, not salary negotiators, nor soft-handed speechmakers. Only a builder could understand her pride and sense of ownership and responsibility in what she has built and what she daily gives the reflected glory of her honour. This Universal Health Care system, including especially senior care, belongs to those who need it and those who built it. No one has a right to take it away from them, by deregulation, by selfishness, by third way, quiet way, my way or the highway. Doug Richardson was every woman's life partner and his widow is everyone's widow. My father is everyone's father. Miss Brown was everyone's great aunt. Mrs. Lee is everyone's mother and ring leader. We will not become a society which dishonours any of them or lets any of one of our builders die before their appointed time. We will not allow fast talkers, whitewashers and quick counters play this way with the truth and our builders' lives and the treasure they have left us. We sons and daughters and families, we Friends of Medicare and associated parties and organizations, we the people of Lethbridge and Alberta, and not least of all, Mrs. Lee and her band of super citizens – we all here are drawing a line and taking a stand for seniors and medicare at St. Michael's, and sending out the call to our fellow citizens to defend and honour our builders. In the words of the prophet Isaiah, from one of my father's favourite passages of scripture: “Cry aloud and spare not... Lift up thy voice like a trumpet!”