Alberta flu vaccine clinics to close until further notice
After days of runaway lines and in the face of dwindling supply, the Alberta government put an abrupt halt to its mass immunization program against the H1N1 flu Saturday, promising to launch a new effort next week targeted exclusively at high-risk groups.
The shutdown means vaccine clinics that attracted thousands of people Saturday — and every day since they’ve opened — will remain closed Sunday and until further notice. When they do reopen, only pregnant women, people under 65 with chronic health conditions, children between six months and five years old, people living in remote communities and health care workers will be vaccinated.
“It is important for the public not to panic and respect the priorities for vaccination,” said Dr. Gerry Predy, the province’s chief medical officer of health. “We’re asking people to be calm. There will be more vaccine, and there should be enough vaccine for everybody who wants it.”
The province initially received 600,000 doses of the vaccine. Of those, they doled out more than 300,000 in the first six days of the campaign.
The government had asked for 200,000 more doses for next week. But they’ve have been told they may only receive 90,000 because the manufacturer, GlaxoSmithKline, has fallen behind in production.
Predy said the reduction in vaccine is a national issue, one beyond the province’s control.
Critics, though, say Alberta should have had a targeted vaccination program from the beginning and that launching one now reveals they were poorly prepared for the pandemic.
“This come-one, come-all approach has been chaos,” said David Eggen, the executive director of Friends of Medicare. “This lack of planning has now come back to bite us.”
While some provinces turned the general public away during the initial phase of immunization, Alberta only asked that priority be given to high-risk groups. Clinics did not screen patients or turn anyone away.
“There’s no excuse for this kind of bumbling. It’s not acceptable. People are outraged,” said David Swann, the leader of the provincial Liberal Party.
Swann said he met a 10-year-old boy in a vaccination line at a Calgary mall who couldn’t understand why the vaccine wasn’t being given to those who have the greatest chance of becoming ill. Alberta Health Services should have been turning people away if they did not fit the high-risk criteria, he said.
Predy, though, defended the province’s approach.
“Our pandemic plan was to vaccinate as many people as possible in as short a period as possible,” he said. “In retrospect, we still think it was the right thing to do given the information we had at the time we developed the plan.”
The final day of the mass vaccination campaign was perhaps the most chaotic yet.
In Edmonton, overwhelmed flu clinics stopped accepting new arrivals by 12:30 p.m. as people descended on them in what appeared to be record numbers in advance of an anticipated vaccine shortage.
Lineups at some clinics formed a full five hours ahead of their scheduled 9 a.m. opening.
At the Strathcona County Health Centre in Sherwood Park, some lined up at 4 a.m. to hold spots for themselves and family members.
By 9:15 a.m., there were already nearly 1,000 people in line, many of them wrapped in blankets, shawls and sleeping bags to guard against the fall chill.
Like many in line, Michael Kopp said he was galvanized by talk about an anticipated shortfall of the vaccine.
“When you hear the health minister talking on TV about how they’re going to run out of the vaccine, you just know there are going to be masses of people,” said Kopp, who was there with his wife Carol.
Health Minister Ron Liepert said Friday the provincial government was going through about 50,000 doses of the vaccine a day. Liepert warned the province could run out of the vaccine by this week if public demand continued at its current pace.
Of the thousands who showed up at Edmonton’s Bonnie Doon Mall Saturday, few had shopping in mind.
Those who did were buying snacks for restless children from Tigesti Woldeab, whose Something Good kiosk is in the centre of the mall.
“Business has been pretty good,” acknowledged Woldeab.
By mid-morning, a security guard estimated the crowd to be around 1,500, some facing a five-hour wait.
Security was heavy at some clinics in anticipation of a backlash from those turned away.
“Our staff have had a lot of anger directed toward them, and it’s unfortunate because I think they’ve done a great job,” said Predy. “But we’ve tried to do everything we can to prevent that from happening.”
In Calgary, clinics turned people away for a second consecutive day.
“I am very scared,” said taxi driver Resham Sidhu, a father of three young children, after getting turned away from a clinic. “I drive a cab and I have contact with a lot of people, and then if I catch something, I contact people. Then I come back home and (put my children) at risk, too.”
Val Alvarez — who was turned away for a second time this week in Calgary — said she was frustrated she hadn’t been able to get the shots for her two children.
“They are at the age that where they are saying kids are a priority,” she said. “Well, they’re not a priority if they’re telling us to go home.”
Outside the big cities, flu-shot clinics in Bonnyville and Grande Prairie both reported long lineups Saturday, but there was no indication they had to turn people away.
Predy said the vaccine was disturbed across the province based both on population and on turnout from previous campaigns.
The head of the province’s largest civil service union, meanwhile, wants front-line justice and social service employees put on the vaccination priority list.
Guy Smith, the president of the Alberta Union of Provincial Employees, said corrections employees, probation officers, provincial Sheriffs, child protection workers, youth care workers and nurses in correctional facilities face a higher-than-average risk of contracting the flu.
“These public employees need to be available to keep the system operating in the event of a major health crisis,” said Smith. “If these employees get sick, there will be a shortage of trained people who can do their jobs.”
Predy, though, said prisoners and prison workers don’t fall within the high-risk category.
Eventually, he said, everybody in the province who wants it will get the vaccine. But in the short term, only those who need it most will get the jab.
“We will be turning away people who don’t meet the criteria, so the public needs to be aware of that,” Predy said.
Predy said health workers will work through the weekend to develop a screening plan. Once they do, the clinics will be reopened.
As for the rest of the province, Predy preached patience.
“People shouldn’t panic. This is a temporary shortage,” he said. “We anticipate that within three weeks, we should have a better flowing supply of vaccine.”
Saturday, October 31, 2009
Minister's Advisory Committee Follies
Health-care reform's third man a rookie MLA from Edmonton
Panel co-chair Fred Horne defends decision to dispense with public hearings
By Sheila Pratt, Edmonton JournalOctober 11, 2009
While most Edmonton Tory MLAs prefer a low profile when it comes to health reform, Edmonton backbencher Fred Horne is about to join Health Minister Ron Liepert and Alberta Health Services CEO Stephen Duckett in the spotlight.
Horne, who represents Edmonton Rutherford, is co-chair of the 16-member advisory committee reviewing all major pieces of Alberta health law.
That includes the laws governing hospital services, public health insurance, nursing homes and contracting out to private clinics, to name a few.
The goal is to update the laws to make it possible to move more care out of hospitals and into places like doctors' offices, clinics, pharmacies and primary-care networks, says Horne.
That might also involve looking at whether health-care professionals should expand their duties (scope of practice), he says.
The committee has little more than six weeks to produce a report for Health Minister Ron Liepert that is expected to have far-reaching implications for the direction of health reform.
"It will be an important report that will look to the future," said Horne, adding that Liepert will be making the report public.
The committee may also look at how to provide incentives to encourage healthier living, reduce risky behaviours and build healthier communities, he says.
Thirty-five stakeholders have been invited to meet over four days with the committee behind closed doors to present their concerns on what legislation they'd like to see changed.
Each will have 30 minutes with the committee starting next Thursday and Friday in Edmonton.
The public is invited to fill out an online workbook on the committee's website, says Horne.
"Anyone is free to send in a written submission," he adds.
Horne defended the decision to meet with stakeholders behind closed doors.
"The committee wants a dialogue with stakeholders, so we're not holding public hearings," he says.
"We're looking for targeted information on key pieces of legislation."
Liberal MLA Hugh MacDonald said that's an unfortunate decision, as the public should be engaged in the process.
But MacDonald said he's not surprised there are no public hearings or town hall meetings.
"In the past when they had public hearings, it created an uproar and the public pushed back and they had to back down. They don't want that to happen this time. They're just steamrollering ahead."
Dave Eggen, of Friends of Medicare, said his organization is among those invited to make a presentation.
He would also have preferred an open process, but that's not about to happen, he said.
"Liepert said again this week the time for consultation is over.
"Every Edmontonian should ask their MLA why they supported health cuts in caucus, including the cuts to mental health beds at Alberta Hospital," Eggen says.
Wendy Armstrong, of the Consumers Association of Canada(Alberta), said her group is also pleased to be invited. But it is difficult to respond when the goal of the reform process is so vague, she adds.
"What happened to the days when the government put out a white paper of proposals for the public?"
She notes that Liepert asserted again last week that Alberta voters gave the government a mandate for health reform in the 2008 election. But the consumers association isn't convinced that's the case, especially for radical reform, given that health care was not mentioned in the 2008 election.
© Copyright (c) The Edmonton Journal
Panel co-chair Fred Horne defends decision to dispense with public hearings
By Sheila Pratt, Edmonton JournalOctober 11, 2009
While most Edmonton Tory MLAs prefer a low profile when it comes to health reform, Edmonton backbencher Fred Horne is about to join Health Minister Ron Liepert and Alberta Health Services CEO Stephen Duckett in the spotlight.
Horne, who represents Edmonton Rutherford, is co-chair of the 16-member advisory committee reviewing all major pieces of Alberta health law.
That includes the laws governing hospital services, public health insurance, nursing homes and contracting out to private clinics, to name a few.
The goal is to update the laws to make it possible to move more care out of hospitals and into places like doctors' offices, clinics, pharmacies and primary-care networks, says Horne.
That might also involve looking at whether health-care professionals should expand their duties (scope of practice), he says.
The committee has little more than six weeks to produce a report for Health Minister Ron Liepert that is expected to have far-reaching implications for the direction of health reform.
"It will be an important report that will look to the future," said Horne, adding that Liepert will be making the report public.
The committee may also look at how to provide incentives to encourage healthier living, reduce risky behaviours and build healthier communities, he says.
Thirty-five stakeholders have been invited to meet over four days with the committee behind closed doors to present their concerns on what legislation they'd like to see changed.
Each will have 30 minutes with the committee starting next Thursday and Friday in Edmonton.
The public is invited to fill out an online workbook on the committee's website, says Horne.
"Anyone is free to send in a written submission," he adds.
Horne defended the decision to meet with stakeholders behind closed doors.
"The committee wants a dialogue with stakeholders, so we're not holding public hearings," he says.
"We're looking for targeted information on key pieces of legislation."
Liberal MLA Hugh MacDonald said that's an unfortunate decision, as the public should be engaged in the process.
But MacDonald said he's not surprised there are no public hearings or town hall meetings.
"In the past when they had public hearings, it created an uproar and the public pushed back and they had to back down. They don't want that to happen this time. They're just steamrollering ahead."
Dave Eggen, of Friends of Medicare, said his organization is among those invited to make a presentation.
He would also have preferred an open process, but that's not about to happen, he said.
"Liepert said again this week the time for consultation is over.
"Every Edmontonian should ask their MLA why they supported health cuts in caucus, including the cuts to mental health beds at Alberta Hospital," Eggen says.
Wendy Armstrong, of the Consumers Association of Canada(Alberta), said her group is also pleased to be invited. But it is difficult to respond when the goal of the reform process is so vague, she adds.
"What happened to the days when the government put out a white paper of proposals for the public?"
She notes that Liepert asserted again last week that Alberta voters gave the government a mandate for health reform in the 2008 election. But the consumers association isn't convinced that's the case, especially for radical reform, given that health care was not mentioned in the 2008 election.
© Copyright (c) The Edmonton Journal
News
The provocateur’s prescription
Hired to fix Alberta’s ailing health system, Duckett opts for ‘shock’ treatment
Published October 29, 2009 by Jeremy Klaszus in News
Back in February, Heather Smith was ready to like Stephen Duckett.
Alberta’s recently created health superboard had just poached Duckett, an Australian health economist, from his government job in the state of Queensland. Smith, president of the United Nurses of Alberta, heard good things about the man who was about to become Alberta Health Services’ new president and CEO — that he was smart, educated and based his decisions on evidence: “A man of learning,” recalls Smith. The nurses union in Queensland gave him a good review. “The message we got back was generally, ‘We’re sorry to see him go,’” says Smith. “I was the one here in our office saying, ‘He may not be bad. Let’s see.’”
Eight months later, Smith has a different view. The nurses have filed a complaint with Alberta Health Services accusing Duckett of “bullying,” spreading “mistruths” and causing “serious morale issues” in the health system. This, after Duckett told media that much “of what a nurse does in a hospital ward could be done by someone else” and made other remarks about disparaging nurses’ coffee breaks. “We have been disappointed,” says Smith.
Liked or not, Duckett has an immense — or, as he puts it on his blog, “incredibly difficult” — job ahead of him. Last year Health Minister Ron Liepert suddenly scrapped the province’s health regions (along with their CEOs) to centralize the system under the Alberta Health Services’ (AHS) banner. Neither the public nor health staff were consulted.
The department, which employs about 90,000, faces a whopping billion-dollar deficit.
Duckett is tasked with making the new behemoth work and building staff and public confidence in the superboard. At the same time, he’s also being asked to cut hospital wait times, improve accessibility, create new health advisory councils and more — all while hacking down the deficit.
If he succeeds, he rakes in $144,000 on top of his annual $575,000 salary. The size of his potential bonus is directly tied to 10 specific goals, ranging from cutting emergency wait times for complex cases (from an existing 16.1 hours to 14 hours) to increasing seniors flu immunization rates (from 58 per cent to 63 per cent). “We have a single hired gun with a promise of a bonus if he does it well,” says Smith.
MAKING HIS MARK
Duckett hasn’t wasted any time making his mark on Alberta’s system. As soon as he was on the job in March, he started furiously restructuring AHS departments. Managers had to reapply for their existing jobs; some were laid off. Staff describe an uncertain and demoralizing work environment.
“The general sense at the staff level is that this has been terribly mishandled, and it appears as though those in charge have no idea what they are doing,” says one AHS employee. (Staff are forbidden from openly speaking their minds to media, as a new code of conduct was written up shortly before Duckett started.)
So far, Duckett has been provocative in his approach — much like the health minister. Duckett has slowed hiring (nurses call it a “freeze”; Duckett calls it putting the “brakes on external recruitment”), shut down hospital helipads for a week based on bad information, cast doubt on the quality of research being done at Alberta universities and announced plans to cut some 300 acute care beds and 250 mental health beds.
He has yet to win over both his own staff and the public. “He burned through a lot of credibility very quickly,” says David Eggen, executive director of Friends of Medicare and a former NDP MLA. Eggen also refers to Duckett as a “hired gun” — he believes that the AHS board hired someone out of country so “he can execute the dirty work and then you can blame him” once he’s gone. “He definitely is not here to win friends and influence people, so far as I can tell.”
(Duckett wasn’t interviewed for this story, despite repeated requests over several weeks for an interview. AHS communications staff said he was too busy, and declined to set up an interview with other health officials, saying Duckett “is the best guy for your interview.”)
Duckett writes on his blog that he’s not here to cut and run, and that he’s been “amazed by the continuing xenophobia associated with my appointment.” His contract is for an “indefinite term.” He writes: “Why would I have left a good job in Queensland, uprooted my family, and bought a house in Edmonton for a job that might only last 12 months? To put the record straight, I have a long-term contract with Alberta Health Services.”
‘100 DIFFERENT BULLETS’
Duckett hails from a country that has a mix of public and private hospitals; about 40 per cent of Australians use private health insurance for routine procedures like eye and joint surgery. This begs the inevitable question: under Duckett, will Alberta see more private care?
Albertans have traditionally been suspicious of Conservative efforts to reform health care. Former premier Ralph Klein’s infamous Third Way, a plan that would have paved the way for more privatization, hit a wall of public backlash. Now, Liepert talks about “finding efficiencies” in the system — in other words, cutting inefficiencies.
“There’s no one magic bullet that’s going to fix the problem,” says Liepert. “There’s going to be 100 different bullets and hopefully if we fire 100 different bullets in the same direction, we’re going to start to see a different alignment of health care.” Critics like Eggen say that Liepert’s vaguely worded “different alignment” involves more privatization.
Duckett is the man responsible for firing Liepert’s bullets. Both his supporters and detractors say he’s got a brilliant mind; as an economist, he loves working with numbers and finding ways to make health systems more efficient. But is the Aussie bent on privatization? “No,” says Vivian Lin, a a former colleague of Duckett’s and the chair of public health at La Trobe University in Melbourne. In fact, she says, the opposite is true. “A lot of people would see him as a very committed person to Labour Party values — so, socialist left…. He has quite publicly opposed attempts to privatize elements of the Australian health system.”
Former colleagues say Duckett is a strong supporter of the public system, though not an ideological supporter. “Basically, Stephen’s view is that the public system is more efficient and more equitable than the private,” says Hal Swerissen, dean of health sciences at La Trobe — a position Duckett himself held until 2006. “It solves the big problems better. It’s not an ideological position in the sense of, ‘Public is better no matter what’…. He would be interested in what is going to be efficient.”
In Alberta, Duckett has much more power than he had in Australia, where state and federal governments share responsibility for health provision (he worked on both levels and in the mid-’90s was the equivalent of deputy minister in the federal government). “Whether you’re at the federal level or the state level, you don’t actually have the levers of the whole health system because each level only has responsibility for one part,” says Lin.
Most Albertans — including Eggen and Liepert — aren’t familiar with Duckett’s previous work. “That’s the job of the headhunter, to do that work,” says Liepert when asked what specifically Duckett did in Australia. (Duckett was selected by a search firm; Liepert interviewed Duckett and, impressed by his “no-nonsense style,” OK’d the choice.)
Before he moved to Edmonton earlier this year, Duckett was in charge of Queensland’s Centre for Health Care Improvement, which was tasked with implementing the state Labour government’s plan to improve patient safety and the “organizational culture” of the health department. Queensland, Australia’s second-largest state, has about four million people. Duckett was about three years into the job when Alberta wooed him away.
Before that, in the ’80s and early ’90s, he worked for the health department in the state of Victoria, where as director of acute health, he introduced case-mix or activity-based funding — a system whereby hospitals are paid for each procedure they do instead of being given a lump sum.
Duckett plans to introduce activity-based funding in Alberta, and has said it will save tens of millions of dollars. In a May speech, he said the activity-based system ensures hospitals receive “fair” funding and live within their means. Switching over “would mean that arguments about overfunding, unfair treatment, favourites etc. would be wiped away and would also reduce the likelihood of service reductions of a budget strategy,” he said.
Eggen is wary of the plan. “I think it’s to open the door to more private contracting and also to, as they say, create this idea of competiton between hospitals, which is patently absurd as far as I’m concerned.”
Liberal leader David Swann — a doctor — says activity-based funding has advantages and disadvantages. “It means that where people are doing good work, efficient work, they get rewarded. The disadvantage is if they just push through people more quickly, it may not be the best work. It may be the fastest work. So giving them more money because they push people through more quickly isn’t exactly what’s needed.”
Swann is unimpressed with the government’s approach to health care. “They’re making ad hoc decisions based on the pressures they’re getting, and the indicators of either human suffering or professional outrage or public anxiety.”
SHOCK STRATEGY
Swann might not be too far off. Swerissen, who worked with Duckett in Australia for about 10 years, says his former colleague intentionally riles up people. “One of the techniques that he uses is to basically shock people a little bit by pointing out the obvious,” says Swerissen. “If you have a situation where one group of professionals is really doing things which are irrational and inefficient, he’s quite likely to say so and then see what reactions he gets.”
It’s done not for the mere sake of provocation, says Swerissen, but with a goal in mind: “He does that a bit to destabilize a situation and then see what emerges, and then he will adapt to the set of circumstances. He uses that as a strategy to get some movement in the system. It’s quite a pragmatic approach that he usually has.”
Unsurprisingly, not everyone in Australia appreciated this. “I think if there was one group that didn’t like him, it was the AMA — the Australian Medical Association,” says Lin. “They think he doesn’t like doctors.” (Contacted by Fast Forward Weekly, a spokesperson with AMA Queensland said: “We don’t comment on Stephen Duckett. We don’t have anyone who’s worked with him directly.”)
Alberta doctors have been wary about the new superboard arrangement and impending cuts. In a June letter, former Alberta Medical Association president Noel Grisdale warned Liepert that trying to “achieve too many savings too soon” might do more harm than good, putting AHS in a position where it “may become identified with reduced access and reduced quality before having a chance to prove itself.”
Current Alberta Medical Association president Chip Doig is diplomatic when asked about Duckett, saying it would be “a little bit unfair” to grade Duckett’s performance so early. Doig is hopeful that cuts won’t hurt either doctors or patients. “We have every expectation from what’s been communicated to us… that cost savings will primarily be achieved through not a reduction in health services, but in other efficiencies.”
‘TOUGH DECISIONS’
So what’s next for Duckett and Alberta health care? Critics — including some within AHS — say there’s no clear plan. “They’re feeling it out as they go along,” says Swann.
Liepert disagrees. “We have the plan, called Vision 2020,” says the minister, referring to a broad health road map put out by the province last December. The plan, which aims for a “patient-focused, co-ordinated and efficient” system, lists five strategic goals, including providing services “in the right place and at the right time” and “matching workforce supply to demand for services.” Part of that includes expanding pharmacists’ and dietitians’ roles as a way of freeing up doctors’ time.
Vision 2020 says it’s “not about the private delivery of health services,” but a “stronger, more efficient and sustainable publicly funded health system.”
Liepert says, “For anybody to say there is no plan, they’re not looking at what’s out there.”
But he doesn’t rule out more private options. “Are we going to the U.S. system? Absolutely not…. Are we going to be selling off our hospitals for profit? No. But we have for-profit provision of seniors care. Doctors are in it for profit. Doctors, they’re not part of the United Way. So there’s all kinds of for-profit health care today.”
As for Duckett, he’s reaching out to AHS staff by asking for their input on ways to save money. Those who come up with the best suggestions will get prizes including two weekend getaway packages and two $500 gift cards — rewards Duckett is pledging will come from his own pocket. “I see part of my job as a leader as being to liberate you to think and act creatively,” Duckett wrote on his blog earlier this month. “And I now want to put my money where my mouth is.”
He’s also asking AHS board members to take a pay cut, but has made it clear that he won’t give up his bonus.
Under Duckett, AHS is also revisiting the much-maligned code of conduct that forbids staff from publicly sharing their opinions. “They seem to be reaching out for at least the impression of consultation now… [to] give a sense of legitimacy to what’s happening,” says Swann.
Meanwhile, health advocates are mobilizing to show their support for Alberta’s public system. Rallies were recently held in Calgary and Red Deer, and more are planned for the coming weeks. “There’s a concern that we’re going to be cutting more services and people will be able to access less,” says Bonnie Malach of Alberta Better Care Calgary, a newly formed coalition of health advocates.
The province, Liepert says, is currently working on next year’s budget. “I don’t know what our funding increase is going to be for health care, but let’s say, as an example, instead of 10 per cent or even six per cent, our increase next year is only three per cent. Well, by golly, there’s going to be some tough decisions around that.”
“What they are, time will tell.”
The provocateur’s prescription
Hired to fix Alberta’s ailing health system, Duckett opts for ‘shock’ treatment
Published October 29, 2009 by Jeremy Klaszus in News
Back in February, Heather Smith was ready to like Stephen Duckett.
Alberta’s recently created health superboard had just poached Duckett, an Australian health economist, from his government job in the state of Queensland. Smith, president of the United Nurses of Alberta, heard good things about the man who was about to become Alberta Health Services’ new president and CEO — that he was smart, educated and based his decisions on evidence: “A man of learning,” recalls Smith. The nurses union in Queensland gave him a good review. “The message we got back was generally, ‘We’re sorry to see him go,’” says Smith. “I was the one here in our office saying, ‘He may not be bad. Let’s see.’”
Eight months later, Smith has a different view. The nurses have filed a complaint with Alberta Health Services accusing Duckett of “bullying,” spreading “mistruths” and causing “serious morale issues” in the health system. This, after Duckett told media that much “of what a nurse does in a hospital ward could be done by someone else” and made other remarks about disparaging nurses’ coffee breaks. “We have been disappointed,” says Smith.
Liked or not, Duckett has an immense — or, as he puts it on his blog, “incredibly difficult” — job ahead of him. Last year Health Minister Ron Liepert suddenly scrapped the province’s health regions (along with their CEOs) to centralize the system under the Alberta Health Services’ (AHS) banner. Neither the public nor health staff were consulted.
The department, which employs about 90,000, faces a whopping billion-dollar deficit.
Duckett is tasked with making the new behemoth work and building staff and public confidence in the superboard. At the same time, he’s also being asked to cut hospital wait times, improve accessibility, create new health advisory councils and more — all while hacking down the deficit.
If he succeeds, he rakes in $144,000 on top of his annual $575,000 salary. The size of his potential bonus is directly tied to 10 specific goals, ranging from cutting emergency wait times for complex cases (from an existing 16.1 hours to 14 hours) to increasing seniors flu immunization rates (from 58 per cent to 63 per cent). “We have a single hired gun with a promise of a bonus if he does it well,” says Smith.
MAKING HIS MARK
Duckett hasn’t wasted any time making his mark on Alberta’s system. As soon as he was on the job in March, he started furiously restructuring AHS departments. Managers had to reapply for their existing jobs; some were laid off. Staff describe an uncertain and demoralizing work environment.
“The general sense at the staff level is that this has been terribly mishandled, and it appears as though those in charge have no idea what they are doing,” says one AHS employee. (Staff are forbidden from openly speaking their minds to media, as a new code of conduct was written up shortly before Duckett started.)
So far, Duckett has been provocative in his approach — much like the health minister. Duckett has slowed hiring (nurses call it a “freeze”; Duckett calls it putting the “brakes on external recruitment”), shut down hospital helipads for a week based on bad information, cast doubt on the quality of research being done at Alberta universities and announced plans to cut some 300 acute care beds and 250 mental health beds.
He has yet to win over both his own staff and the public. “He burned through a lot of credibility very quickly,” says David Eggen, executive director of Friends of Medicare and a former NDP MLA. Eggen also refers to Duckett as a “hired gun” — he believes that the AHS board hired someone out of country so “he can execute the dirty work and then you can blame him” once he’s gone. “He definitely is not here to win friends and influence people, so far as I can tell.”
(Duckett wasn’t interviewed for this story, despite repeated requests over several weeks for an interview. AHS communications staff said he was too busy, and declined to set up an interview with other health officials, saying Duckett “is the best guy for your interview.”)
Duckett writes on his blog that he’s not here to cut and run, and that he’s been “amazed by the continuing xenophobia associated with my appointment.” His contract is for an “indefinite term.” He writes: “Why would I have left a good job in Queensland, uprooted my family, and bought a house in Edmonton for a job that might only last 12 months? To put the record straight, I have a long-term contract with Alberta Health Services.”
‘100 DIFFERENT BULLETS’
Duckett hails from a country that has a mix of public and private hospitals; about 40 per cent of Australians use private health insurance for routine procedures like eye and joint surgery. This begs the inevitable question: under Duckett, will Alberta see more private care?
Albertans have traditionally been suspicious of Conservative efforts to reform health care. Former premier Ralph Klein’s infamous Third Way, a plan that would have paved the way for more privatization, hit a wall of public backlash. Now, Liepert talks about “finding efficiencies” in the system — in other words, cutting inefficiencies.
“There’s no one magic bullet that’s going to fix the problem,” says Liepert. “There’s going to be 100 different bullets and hopefully if we fire 100 different bullets in the same direction, we’re going to start to see a different alignment of health care.” Critics like Eggen say that Liepert’s vaguely worded “different alignment” involves more privatization.
Duckett is the man responsible for firing Liepert’s bullets. Both his supporters and detractors say he’s got a brilliant mind; as an economist, he loves working with numbers and finding ways to make health systems more efficient. But is the Aussie bent on privatization? “No,” says Vivian Lin, a a former colleague of Duckett’s and the chair of public health at La Trobe University in Melbourne. In fact, she says, the opposite is true. “A lot of people would see him as a very committed person to Labour Party values — so, socialist left…. He has quite publicly opposed attempts to privatize elements of the Australian health system.”
Former colleagues say Duckett is a strong supporter of the public system, though not an ideological supporter. “Basically, Stephen’s view is that the public system is more efficient and more equitable than the private,” says Hal Swerissen, dean of health sciences at La Trobe — a position Duckett himself held until 2006. “It solves the big problems better. It’s not an ideological position in the sense of, ‘Public is better no matter what’…. He would be interested in what is going to be efficient.”
In Alberta, Duckett has much more power than he had in Australia, where state and federal governments share responsibility for health provision (he worked on both levels and in the mid-’90s was the equivalent of deputy minister in the federal government). “Whether you’re at the federal level or the state level, you don’t actually have the levers of the whole health system because each level only has responsibility for one part,” says Lin.
Most Albertans — including Eggen and Liepert — aren’t familiar with Duckett’s previous work. “That’s the job of the headhunter, to do that work,” says Liepert when asked what specifically Duckett did in Australia. (Duckett was selected by a search firm; Liepert interviewed Duckett and, impressed by his “no-nonsense style,” OK’d the choice.)
Before he moved to Edmonton earlier this year, Duckett was in charge of Queensland’s Centre for Health Care Improvement, which was tasked with implementing the state Labour government’s plan to improve patient safety and the “organizational culture” of the health department. Queensland, Australia’s second-largest state, has about four million people. Duckett was about three years into the job when Alberta wooed him away.
Before that, in the ’80s and early ’90s, he worked for the health department in the state of Victoria, where as director of acute health, he introduced case-mix or activity-based funding — a system whereby hospitals are paid for each procedure they do instead of being given a lump sum.
Duckett plans to introduce activity-based funding in Alberta, and has said it will save tens of millions of dollars. In a May speech, he said the activity-based system ensures hospitals receive “fair” funding and live within their means. Switching over “would mean that arguments about overfunding, unfair treatment, favourites etc. would be wiped away and would also reduce the likelihood of service reductions of a budget strategy,” he said.
Eggen is wary of the plan. “I think it’s to open the door to more private contracting and also to, as they say, create this idea of competiton between hospitals, which is patently absurd as far as I’m concerned.”
Liberal leader David Swann — a doctor — says activity-based funding has advantages and disadvantages. “It means that where people are doing good work, efficient work, they get rewarded. The disadvantage is if they just push through people more quickly, it may not be the best work. It may be the fastest work. So giving them more money because they push people through more quickly isn’t exactly what’s needed.”
Swann is unimpressed with the government’s approach to health care. “They’re making ad hoc decisions based on the pressures they’re getting, and the indicators of either human suffering or professional outrage or public anxiety.”
SHOCK STRATEGY
Swann might not be too far off. Swerissen, who worked with Duckett in Australia for about 10 years, says his former colleague intentionally riles up people. “One of the techniques that he uses is to basically shock people a little bit by pointing out the obvious,” says Swerissen. “If you have a situation where one group of professionals is really doing things which are irrational and inefficient, he’s quite likely to say so and then see what reactions he gets.”
It’s done not for the mere sake of provocation, says Swerissen, but with a goal in mind: “He does that a bit to destabilize a situation and then see what emerges, and then he will adapt to the set of circumstances. He uses that as a strategy to get some movement in the system. It’s quite a pragmatic approach that he usually has.”
Unsurprisingly, not everyone in Australia appreciated this. “I think if there was one group that didn’t like him, it was the AMA — the Australian Medical Association,” says Lin. “They think he doesn’t like doctors.” (Contacted by Fast Forward Weekly, a spokesperson with AMA Queensland said: “We don’t comment on Stephen Duckett. We don’t have anyone who’s worked with him directly.”)
Alberta doctors have been wary about the new superboard arrangement and impending cuts. In a June letter, former Alberta Medical Association president Noel Grisdale warned Liepert that trying to “achieve too many savings too soon” might do more harm than good, putting AHS in a position where it “may become identified with reduced access and reduced quality before having a chance to prove itself.”
Current Alberta Medical Association president Chip Doig is diplomatic when asked about Duckett, saying it would be “a little bit unfair” to grade Duckett’s performance so early. Doig is hopeful that cuts won’t hurt either doctors or patients. “We have every expectation from what’s been communicated to us… that cost savings will primarily be achieved through not a reduction in health services, but in other efficiencies.”
‘TOUGH DECISIONS’
So what’s next for Duckett and Alberta health care? Critics — including some within AHS — say there’s no clear plan. “They’re feeling it out as they go along,” says Swann.
Liepert disagrees. “We have the plan, called Vision 2020,” says the minister, referring to a broad health road map put out by the province last December. The plan, which aims for a “patient-focused, co-ordinated and efficient” system, lists five strategic goals, including providing services “in the right place and at the right time” and “matching workforce supply to demand for services.” Part of that includes expanding pharmacists’ and dietitians’ roles as a way of freeing up doctors’ time.
Vision 2020 says it’s “not about the private delivery of health services,” but a “stronger, more efficient and sustainable publicly funded health system.”
Liepert says, “For anybody to say there is no plan, they’re not looking at what’s out there.”
But he doesn’t rule out more private options. “Are we going to the U.S. system? Absolutely not…. Are we going to be selling off our hospitals for profit? No. But we have for-profit provision of seniors care. Doctors are in it for profit. Doctors, they’re not part of the United Way. So there’s all kinds of for-profit health care today.”
As for Duckett, he’s reaching out to AHS staff by asking for their input on ways to save money. Those who come up with the best suggestions will get prizes including two weekend getaway packages and two $500 gift cards — rewards Duckett is pledging will come from his own pocket. “I see part of my job as a leader as being to liberate you to think and act creatively,” Duckett wrote on his blog earlier this month. “And I now want to put my money where my mouth is.”
He’s also asking AHS board members to take a pay cut, but has made it clear that he won’t give up his bonus.
Under Duckett, AHS is also revisiting the much-maligned code of conduct that forbids staff from publicly sharing their opinions. “They seem to be reaching out for at least the impression of consultation now… [to] give a sense of legitimacy to what’s happening,” says Swann.
Meanwhile, health advocates are mobilizing to show their support for Alberta’s public system. Rallies were recently held in Calgary and Red Deer, and more are planned for the coming weeks. “There’s a concern that we’re going to be cutting more services and people will be able to access less,” says Bonnie Malach of Alberta Better Care Calgary, a newly formed coalition of health advocates.
The province, Liepert says, is currently working on next year’s budget. “I don’t know what our funding increase is going to be for health care, but let’s say, as an example, instead of 10 per cent or even six per cent, our increase next year is only three per cent. Well, by golly, there’s going to be some tough decisions around that.”
“What they are, time will tell.”
Sunday, October 25, 2009
Calgary Herald
Health care at 'tipping point,' coalition warns
New lobby group urges province to resist privatization
By Jamie Komarnicki, Calgary HeraldOctober 25, 2009 8:20 AMComments (2)
StoryPhotos ( 1 )
At a downtown Calgary rally Saturday, which drew about 100 people, the Alberta Better Care coalition urged the province to veer away from privatization. The Conservative government has pledged it's committed to maintaining public health care.
"The cuts--privatization, hospital crowding, seniors issues--there's a tipping point," said rally organizer Liza Lorenzetti.
Facing a $6.9-billion forecasted deficit this year and two more years of expected fiscal shortfalls, the province is looking to cut costs on several fronts. The province's medical superboard is also grappling with its own deficit of more than $1 billion.
Alberta Health Services chief executive Stephen Duckett has said the board will offer early retirement packages to nurses and other medical workers in a bid to trim costs. Duckett has insisted staff and other cuts can be achieved along with his goal of substantially reducing wait times.
However, critics argue the province should have planned long ago to deal with health-care funding and infrastructure shortfalls.
"Where was the planning to say Alberta is increasing in population, why don't we increase (services) incrementally alongside?" asked Ted Woynillowicz of Friends of Medicare.
Mark Dicey, a Calgary visual artist, said he's concerned about the province's plans for long-term care.
"We're all getting older," he said. "If the structure is being dismantled, we're all going to be affected in the end."
The new health coalition, which includes seniors advocates, unions and politicians, has several more events planned, including a rally at the Conservative party convention in Red Deer on Nov. 7.
jkomarnicki@theherald.canwest.com
© Copyright (c) The Calgary Herald
New lobby group urges province to resist privatization
By Jamie Komarnicki, Calgary HeraldOctober 25, 2009 8:20 AMComments (2)
StoryPhotos ( 1 )
At a downtown Calgary rally Saturday, which drew about 100 people, the Alberta Better Care coalition urged the province to veer away from privatization. The Conservative government has pledged it's committed to maintaining public health care.
"The cuts--privatization, hospital crowding, seniors issues--there's a tipping point," said rally organizer Liza Lorenzetti.
Facing a $6.9-billion forecasted deficit this year and two more years of expected fiscal shortfalls, the province is looking to cut costs on several fronts. The province's medical superboard is also grappling with its own deficit of more than $1 billion.
Alberta Health Services chief executive Stephen Duckett has said the board will offer early retirement packages to nurses and other medical workers in a bid to trim costs. Duckett has insisted staff and other cuts can be achieved along with his goal of substantially reducing wait times.
However, critics argue the province should have planned long ago to deal with health-care funding and infrastructure shortfalls.
"Where was the planning to say Alberta is increasing in population, why don't we increase (services) incrementally alongside?" asked Ted Woynillowicz of Friends of Medicare.
Mark Dicey, a Calgary visual artist, said he's concerned about the province's plans for long-term care.
"We're all getting older," he said. "If the structure is being dismantled, we're all going to be affected in the end."
The new health coalition, which includes seniors advocates, unions and politicians, has several more events planned, including a rally at the Conservative party convention in Red Deer on Nov. 7.
jkomarnicki@theherald.canwest.com
© Copyright (c) The Calgary Herald
Moving and shaking in Red Deer - Nov. 7th
Movers And Shakers
Edmonton JournalOctober 25, 2009
Here's a quick roundup of a few people shaping politics outside the dome.
- The Upstart: Danielle Smith. With no seat and no byelection in the near-future, Danielle Smith, the new leader of the Wildrose Alliance party, will have to make her headlines away from the legislature this Smith fall.
Smith is planning to host a series of town hall meetings, which should help Albertans get to know her and her policies.
The party's only MLA, Paul Hinman, says he will still hold the government accountable under the dome, but look for Smith to continue hammering away at Premier Ed Stelmach every chance she gets.
- The CEO and His Critic: Stephen Duckett and Dave Eggen.
Since his appointment last spring as president and CEO of Alberta Health Services, Stephen Duckett has routinely been in the headlines.
He may answer to the health minister, but day-to-day he is the most powerful person in Alberta health care. His blog has become a must-read for people following the province's opaque health reforms.
David Eggen will be watching Duckett's moves carefully. Eggen, former MLA for Edmonton-Calder, is now the executive director of Friends of Medicare, where he uses his freedom to regularly lambaste Duckett and the government.
- Unlikely Allies: Gary Holden and Joe Anglin.
One is comfortable in expensive suits and boardrooms, the other is at ease in worn hiking boots community halls. But Joe Anglin, a populist landowner-rights activist from Rimbey, and Enmax CEO Gary Holden find themselves unlikely allies in the fight against Bill 50. The controversial bill, which streamlines the approval process for power lines, was introduced in the spring and will likely pass the legislature this fall.
But not if Anglin and Holden can help it.
Anglin is hosting a series of eight town-hall meetings this fall to whip up (mostly rural) opposition to the bill.
Holden's Calgary-owned utility company is using its own muscle to oppose the bill online and on the airwaves.
© Copyright (c) The Edmonton Journal
Edmonton JournalOctober 25, 2009
Here's a quick roundup of a few people shaping politics outside the dome.
- The Upstart: Danielle Smith. With no seat and no byelection in the near-future, Danielle Smith, the new leader of the Wildrose Alliance party, will have to make her headlines away from the legislature this Smith fall.
Smith is planning to host a series of town hall meetings, which should help Albertans get to know her and her policies.
The party's only MLA, Paul Hinman, says he will still hold the government accountable under the dome, but look for Smith to continue hammering away at Premier Ed Stelmach every chance she gets.
- The CEO and His Critic: Stephen Duckett and Dave Eggen.
Since his appointment last spring as president and CEO of Alberta Health Services, Stephen Duckett has routinely been in the headlines.
He may answer to the health minister, but day-to-day he is the most powerful person in Alberta health care. His blog has become a must-read for people following the province's opaque health reforms.
David Eggen will be watching Duckett's moves carefully. Eggen, former MLA for Edmonton-Calder, is now the executive director of Friends of Medicare, where he uses his freedom to regularly lambaste Duckett and the government.
- Unlikely Allies: Gary Holden and Joe Anglin.
One is comfortable in expensive suits and boardrooms, the other is at ease in worn hiking boots community halls. But Joe Anglin, a populist landowner-rights activist from Rimbey, and Enmax CEO Gary Holden find themselves unlikely allies in the fight against Bill 50. The controversial bill, which streamlines the approval process for power lines, was introduced in the spring and will likely pass the legislature this fall.
But not if Anglin and Holden can help it.
Anglin is hosting a series of eight town-hall meetings this fall to whip up (mostly rural) opposition to the bill.
Holden's Calgary-owned utility company is using its own muscle to oppose the bill online and on the airwaves.
© Copyright (c) The Edmonton Journal
Saturday, October 24, 2009
Fort Macleod Rally at Mr. Berger's Office
People in the southern Alberta community of 3,000 are concerned about privatization of health care.
View larger image
Fort Macleod residents rally outside MLA, Evan Berger's office on Saturday.
Southern Alberta residents rally against health cuts
Updated: Sat Oct. 17 2009 15:37:59
ctvcalgary.ca
Supporters of Friends of Medicare gathered in Fort Macleod on Saturday to criticize the province for cuts to the healthcare system.
A small crowd gathered in front of Evan Berger's MLA office claiming that the Stelmach government and the Health Minister, Ron Liepert, have made no secret that cuts are coming to health care and they say enough is enough.
"It hurts in the pocketbook, cause none of us are really that wealthy that we can afford privatization," said Fort Macleod resident, Nadia Campbell.
The group says the government's constant move toward privatization of health care services is unfair and they want to bring the issue to light.
"We just want to get people more interested and concerned about this because not too far into the future depending on your age, we're all gonna need it, it's gonna affect us whether we like it or not," said Michael Cormican, from Friends of Medicare, "what they're doing, what the cuts are doing is downloading the costs onto the individual and family."
MLA Evan Berger was not present at the rally.
On Friday, 200 nurses protested outside an Edmonton hospital to voice their concerns about planned cuts to health care and a recently announced wage freeze.
View larger image
Fort Macleod residents rally outside MLA, Evan Berger's office on Saturday.
Southern Alberta residents rally against health cuts
Updated: Sat Oct. 17 2009 15:37:59
ctvcalgary.ca
Supporters of Friends of Medicare gathered in Fort Macleod on Saturday to criticize the province for cuts to the healthcare system.
A small crowd gathered in front of Evan Berger's MLA office claiming that the Stelmach government and the Health Minister, Ron Liepert, have made no secret that cuts are coming to health care and they say enough is enough.
"It hurts in the pocketbook, cause none of us are really that wealthy that we can afford privatization," said Fort Macleod resident, Nadia Campbell.
The group says the government's constant move toward privatization of health care services is unfair and they want to bring the issue to light.
"We just want to get people more interested and concerned about this because not too far into the future depending on your age, we're all gonna need it, it's gonna affect us whether we like it or not," said Michael Cormican, from Friends of Medicare, "what they're doing, what the cuts are doing is downloading the costs onto the individual and family."
MLA Evan Berger was not present at the rally.
On Friday, 200 nurses protested outside an Edmonton hospital to voice their concerns about planned cuts to health care and a recently announced wage freeze.
Tuesday, October 20, 2009
Pharmacare Now!
Alberta cuts generic drug costs
Last Updated: Tuesday, October 20, 2009 | 4:29 PM MT Comments11Recommend6CBC News
Alberta has set aside $5 million to provide an allowance for all pharmacies for each prescription less than $75. (CBC)
Prices for new generic drugs will be reduced from 75 per cent to 45 per cent of the brand-name drug price, the Alberta government said Tuesday.
Prices for existing generic drugs will also be reduced starting next April, said Minister of Health and Wellness Ron Liepert.
"Prescription drug costs continue to climb, and we need to bring those costs down for Albertans," said Liepert. "The next phase of our pharmaceutical strategy will reduce the out-of-pocket costs of prescription drugs for all Albertans, allow for quicker access to new drugs and give pharmacists a greater role in patient care."
The first phase of the Alberta Pharmaceutical Strategy was announced in December 2008 and included a drug program for those with rare diseases, a new drug plan for seniors and revised premiums for non-group coverage.
The second phase, announced Tuesday, means Alberta will begin to negotiate product-listing agreements with brand name drug manufacturers, with the aim of reducing drug costs through volume discounts.
Ontario, Quebec, B.C. and Manitoba already use product-listing agreements.
Alberta says it will also introduce a new payment model for pharmacies. A transition plan has been developed to support pharmacies as they shift from just dispensing prescription drugs to providing a wider range of services.
'They have a lot of unfinished business in regards to the drug program, and a lot of places where they can still save a lot of money.'
—Dave Eggen, Friends of MedicareThere will be $5 million in subsidies to pharmacies for dispensing prescriptions valued at less than $75 each.
Dave Eggen, executive director of Friends of Medicare in Alberta, praised the changes in the drug plan, but the government still has work to do.
"They still haven't resolved Phase 1 very well, downloading costs on to seniors, having an extensive program for seniors that some people can't afford. So I think they have a lot of unfinished business in regards to the drug program, and a lot of places where they can still save a lot of money."
Eggen said he would like to see bulk buying of all prescription drugs.
"Bulk buying is a good idea. The missing element here, though, is that the government has a capacity to bulk buy and control the generic drug market much more comprehensively. They can set up a clearing house to purchase most prescription drugs and that gives you a much better negotiation power with the pharmaceutical companies."
Last Updated: Tuesday, October 20, 2009 | 4:29 PM MT Comments11Recommend6CBC News
Alberta has set aside $5 million to provide an allowance for all pharmacies for each prescription less than $75. (CBC)
Prices for new generic drugs will be reduced from 75 per cent to 45 per cent of the brand-name drug price, the Alberta government said Tuesday.
Prices for existing generic drugs will also be reduced starting next April, said Minister of Health and Wellness Ron Liepert.
"Prescription drug costs continue to climb, and we need to bring those costs down for Albertans," said Liepert. "The next phase of our pharmaceutical strategy will reduce the out-of-pocket costs of prescription drugs for all Albertans, allow for quicker access to new drugs and give pharmacists a greater role in patient care."
The first phase of the Alberta Pharmaceutical Strategy was announced in December 2008 and included a drug program for those with rare diseases, a new drug plan for seniors and revised premiums for non-group coverage.
The second phase, announced Tuesday, means Alberta will begin to negotiate product-listing agreements with brand name drug manufacturers, with the aim of reducing drug costs through volume discounts.
Ontario, Quebec, B.C. and Manitoba already use product-listing agreements.
Alberta says it will also introduce a new payment model for pharmacies. A transition plan has been developed to support pharmacies as they shift from just dispensing prescription drugs to providing a wider range of services.
'They have a lot of unfinished business in regards to the drug program, and a lot of places where they can still save a lot of money.'
—Dave Eggen, Friends of MedicareThere will be $5 million in subsidies to pharmacies for dispensing prescriptions valued at less than $75 each.
Dave Eggen, executive director of Friends of Medicare in Alberta, praised the changes in the drug plan, but the government still has work to do.
"They still haven't resolved Phase 1 very well, downloading costs on to seniors, having an extensive program for seniors that some people can't afford. So I think they have a lot of unfinished business in regards to the drug program, and a lot of places where they can still save a lot of money."
Eggen said he would like to see bulk buying of all prescription drugs.
"Bulk buying is a good idea. The missing element here, though, is that the government has a capacity to bulk buy and control the generic drug market much more comprehensively. They can set up a clearing house to purchase most prescription drugs and that gives you a much better negotiation power with the pharmaceutical companies."
People are Angry - Wrong Way!
Health cuts 'ideological choice,' crowd told
More than 500 people attend town hall session organized by Friends of Medicare
By Richard Warnica, Edmonton JournalOctober 14, 2009Comments (32)
The Alberta government has made an "ideological choice" to blow a hole in the public health system -- a move that will raise costs and erode care, a medicare advocate warned an audience of hundreds at a town hall meeting Tuesday.
"We are trying to stop money from flowing out of the system," said David Eggen, executive director of Friends of Medicare.
"The government is completely swimming against the current."
The overflow crowd of more than 500 had organizers scrambling to lay out chairs as Eggen took to the podium.
Lining the walls on either side of the hall, people broke into applause as experts argued that planned health cuts are uninformed, ill-timed and unnecessary.
"Alberta has less excuse than anywhere in the country to cut back," said Dr. Micheal Rachlis, a family doctor turned health policy analyst who spoke after Eggen.
Rachlis called plans to delist services and shut beds a breach in the "spirit of the Canada Health Act," one that won't save any money in the long run.
If the government really wanted to reduce costs, he said, it would expand coverage to include more drug coverage and community care and reform the way doctors and other health professionals are paid, not allow more private delivery.
"I think the best argument against going private is Tony Soprano's," he said: "Fuggetaboutit--you don't need it."
Diana Gibson, research director at the University of Alberta's Parkland Institute, told the crowd that the government is trying to use public relations to make health-care problems disappear.
"It appears with a couple of press releases, we can magic away nursing shortages," she said.
The crowd appeared to be overwhelmingly supportive of the speakers' messages, with some saying they were alarmed by stories of coming cuts and closures.
"I'm concerned by what I'm hearing in the media, but I'm also concerned by what I'm seeing," said Bill Davidson, who runs a boarding house for patients who fly in for treatment from the north. "I'm seeing new places getting built, but not enough staff going into them."
Others were there to protest plans to reduce beds at Alberta Hospital, an acute psychiatric care facility.
"I think it's an outrage that they're closing that mental hospital," said Shirley Lewis.
"I just feel like it's going to spiral into an even worse situation," said Agata Nowinka, a fourth-year medical student who worked at Alberta Hospital this fall.
The government has said it won't close beds at Alberta Hospital until new spaces for treatment are opened in the community. But that doesn't mollify Nowinka.
Acute psychotic patients often need constant intensive care, she said. "That just can't happen in the community. It's like sending your car to be treated by a hairdresser."
Eggen said the government is using the economy as an excuse to do what it wants with the health-care system.
"It's a business choice and an ideological choice," he said. "You blow a hole in the middle of your public health system and private health care will enter."
More than 500 people attend town hall session organized by Friends of Medicare
By Richard Warnica, Edmonton JournalOctober 14, 2009Comments (32)
The Alberta government has made an "ideological choice" to blow a hole in the public health system -- a move that will raise costs and erode care, a medicare advocate warned an audience of hundreds at a town hall meeting Tuesday.
"We are trying to stop money from flowing out of the system," said David Eggen, executive director of Friends of Medicare.
"The government is completely swimming against the current."
The overflow crowd of more than 500 had organizers scrambling to lay out chairs as Eggen took to the podium.
Lining the walls on either side of the hall, people broke into applause as experts argued that planned health cuts are uninformed, ill-timed and unnecessary.
"Alberta has less excuse than anywhere in the country to cut back," said Dr. Micheal Rachlis, a family doctor turned health policy analyst who spoke after Eggen.
Rachlis called plans to delist services and shut beds a breach in the "spirit of the Canada Health Act," one that won't save any money in the long run.
If the government really wanted to reduce costs, he said, it would expand coverage to include more drug coverage and community care and reform the way doctors and other health professionals are paid, not allow more private delivery.
"I think the best argument against going private is Tony Soprano's," he said: "Fuggetaboutit--you don't need it."
Diana Gibson, research director at the University of Alberta's Parkland Institute, told the crowd that the government is trying to use public relations to make health-care problems disappear.
"It appears with a couple of press releases, we can magic away nursing shortages," she said.
The crowd appeared to be overwhelmingly supportive of the speakers' messages, with some saying they were alarmed by stories of coming cuts and closures.
"I'm concerned by what I'm hearing in the media, but I'm also concerned by what I'm seeing," said Bill Davidson, who runs a boarding house for patients who fly in for treatment from the north. "I'm seeing new places getting built, but not enough staff going into them."
Others were there to protest plans to reduce beds at Alberta Hospital, an acute psychiatric care facility.
"I think it's an outrage that they're closing that mental hospital," said Shirley Lewis.
"I just feel like it's going to spiral into an even worse situation," said Agata Nowinka, a fourth-year medical student who worked at Alberta Hospital this fall.
The government has said it won't close beds at Alberta Hospital until new spaces for treatment are opened in the community. But that doesn't mollify Nowinka.
Acute psychotic patients often need constant intensive care, she said. "That just can't happen in the community. It's like sending your car to be treated by a hairdresser."
Eggen said the government is using the economy as an excuse to do what it wants with the health-care system.
"It's a business choice and an ideological choice," he said. "You blow a hole in the middle of your public health system and private health care will enter."
Sunday, October 11, 2009
Health Cuts Supported by all Tory Members
Health-care reform's third man a rookie MLA from Edmonton
Panel co-chair Fred Horne defends decision to dispense with public hearings
By Sheila Pratt, Edmonton JournalOctober 10, 2009
While most Edmonton Tory MLAs prefer a low profile when it comes to health reform, Edmonton backbencher Fred Horne is about to join Health Minister Ron Liepert and Alberta Health Services CEO Stephen Duckett in the spotlight.
Horne, who represents Edmonton Rutherford, is co-chair of the 16-member advisory committee reviewing all major pieces of Alberta health law.
That includes the laws governing hospital services, public health insurance, nursing homes and contracting out to private clinics, to name a few.
The goal is to update the laws to make it possible to move more care out of hospitals and into places like doctors' offices, clinics, pharmacies and primary-care networks, says Horne.
That might also involve looking at whether health-care professionals should expand their duties (scope of practice), he says.
The committee has little more than six weeks to produce a report for Health Minister Ron Liepert that is expected to have far-reaching implications for the direction of health reform.
"It will be an important report that will look to the future," said Horne, adding that Liepert will be making the report public.
The committee may also look at how to provide incentives to encourage healthier living, reduce risky behaviours and build healthier communities, he says.
Thirty-five stakeholders have been invited to meet over four days with the committee behind closed doors to present their concerns on what legislation they'd like to see changed.
Each will have 30 minutes with the committee starting next Thursday and Friday in Edmonton.
The public is invited to fill out an online workbook on the committee's website, says Horne.
"Anyone is free to send in a written submission," he adds.
Horne defended the decision to meet with stakeholders behind closed doors.
"The committee wants a dialogue with stakeholders, so we're not holding public hearings," he says.
"We're looking for targeted information on key pieces of legislation."
Liberal MLA Hugh MacDonald said that's an unfortunate decision, as the public should be engaged in the process.
But MacDonald said he's not surprised there are no public hearings or town hall meetings.
"In the past when they had public hearings, it created an uproar and the public pushed back and they had to back down. They don't want that to happen this time. They're just steamrollering ahead."
Dave Eggen, of Friends of Medicare, said his organization is among those invited to make a presentation.
He would also have preferred an open process, but that's not about to happen, he said.
"Liepert said again this week the time for consultation is over.
"Every Edmontonian should ask their MLA why they supported health cuts in caucus, including the cuts to mental health beds at Alberta Hospital," Eggen says.
Wendy Armstrong, of the Consumers Association of Canada(Alberta), said her group is also pleased to be invited. But it is difficult to respond when the goal of the reform process is so vague, she adds.
"What happened to the days when the government put out a white paper of proposals for the public?"
She notes that Liepert asserted again last week that Alberta voters gave the government a mandate for health reform in the 2008 election. But the consumers association isn't convinced that's the case, especially for radical reform, given that health care was not mentioned in the 2008 election.
© Copyright (c) The Edmonton Journal
Panel co-chair Fred Horne defends decision to dispense with public hearings
By Sheila Pratt, Edmonton JournalOctober 10, 2009
While most Edmonton Tory MLAs prefer a low profile when it comes to health reform, Edmonton backbencher Fred Horne is about to join Health Minister Ron Liepert and Alberta Health Services CEO Stephen Duckett in the spotlight.
Horne, who represents Edmonton Rutherford, is co-chair of the 16-member advisory committee reviewing all major pieces of Alberta health law.
That includes the laws governing hospital services, public health insurance, nursing homes and contracting out to private clinics, to name a few.
The goal is to update the laws to make it possible to move more care out of hospitals and into places like doctors' offices, clinics, pharmacies and primary-care networks, says Horne.
That might also involve looking at whether health-care professionals should expand their duties (scope of practice), he says.
The committee has little more than six weeks to produce a report for Health Minister Ron Liepert that is expected to have far-reaching implications for the direction of health reform.
"It will be an important report that will look to the future," said Horne, adding that Liepert will be making the report public.
The committee may also look at how to provide incentives to encourage healthier living, reduce risky behaviours and build healthier communities, he says.
Thirty-five stakeholders have been invited to meet over four days with the committee behind closed doors to present their concerns on what legislation they'd like to see changed.
Each will have 30 minutes with the committee starting next Thursday and Friday in Edmonton.
The public is invited to fill out an online workbook on the committee's website, says Horne.
"Anyone is free to send in a written submission," he adds.
Horne defended the decision to meet with stakeholders behind closed doors.
"The committee wants a dialogue with stakeholders, so we're not holding public hearings," he says.
"We're looking for targeted information on key pieces of legislation."
Liberal MLA Hugh MacDonald said that's an unfortunate decision, as the public should be engaged in the process.
But MacDonald said he's not surprised there are no public hearings or town hall meetings.
"In the past when they had public hearings, it created an uproar and the public pushed back and they had to back down. They don't want that to happen this time. They're just steamrollering ahead."
Dave Eggen, of Friends of Medicare, said his organization is among those invited to make a presentation.
He would also have preferred an open process, but that's not about to happen, he said.
"Liepert said again this week the time for consultation is over.
"Every Edmontonian should ask their MLA why they supported health cuts in caucus, including the cuts to mental health beds at Alberta Hospital," Eggen says.
Wendy Armstrong, of the Consumers Association of Canada(Alberta), said her group is also pleased to be invited. But it is difficult to respond when the goal of the reform process is so vague, she adds.
"What happened to the days when the government put out a white paper of proposals for the public?"
She notes that Liepert asserted again last week that Alberta voters gave the government a mandate for health reform in the 2008 election. But the consumers association isn't convinced that's the case, especially for radical reform, given that health care was not mentioned in the 2008 election.
© Copyright (c) The Edmonton Journal
Wednesday, October 7, 2009
Listing boat "Pauses" before sinking
Gov't 'pauses' bed closings
By Jodie Sinnema, edmontonjournal.comOctober 5, 2009Comments (101)
StoryPhotos ( 6 )
More Images » Alberta Health Services announced in August that 100 to 150 beds would be closed over the next three years at Alberta Hospital edmonton, part of which is shown above. reaction to the announcement has been strongly negative, with concerns coming from parents, police, health professionals and edmonton Mayor The head of Alberta Health Services admitted Tuesday the consultation process about bed closings at Alberta Hospital wasn't broad enough to quell the fears of psychiatrists.
"The consultations we've done so far have been essentially internal," CEO Stephen Duckett said in an interview Tuesday, the same day 14 psychiatrists at the hospital wrote a letter lambasting Alberta Health Services for plans to close 246 beds without proper consultation.
"Our level of consultations hasn't been sufficiently specific or probably at high enough a level," Duckett said.
"Our plans aren't firm yet and because our plans aren't firm, people can have uncertainty, and with uncertainty, rumours are able to be developed."
In response to a public outcry and multiple rallies against the plans that will move many mental health patients into city hospital wards, Premier Ed Stelmach announced the formation of an "implementation team" to get expert input on the issue.
"What he was looking for was an opportunity for a bit of a pause and a little more thought about the transition we're trying to achieve from solely an institutional-based model to a more of a community based-model," said MLA Fred Horne, who will serve as the premier's representative on the committee. "It's the right move and the premier's obviously very committed to it."
Psychiatrists, support workers, other health professionals who work in Alberta Hospital and advocates for patients with mental illnesses will be on the committee, as will Doug Knight, president of the Alberta Union of Provincial Employees, who has been a vocal opponent of the bed closures planned for Alberta Hospital.
Until now, Alberta Health Services has said it consulted with psychiatrists and others in the mental health community before deciding to close the beds and move mental health patients to city hospitals and other community settings once the appropriate care is in place.
Psychiatrists say they weren't consulted.
"Alberta Health Services is proceeding at breakneck speed to dismantle years of quality psychiatric services at Alberta Hospital Edmonton with potentially disastrous results for patients and families," doctors wrote in a letter to Stelmach and Albertans on Tuesday. "In what is becoming an alarming social experiment by AHS, the psychiatrists at Alberta Hospital Edmonton would like to express grave concern for the safety of our patients, and the future of compassionate care for the severely mentally ill in Alberta."
RELEASE PLANS
The psychiatrists called for a stop to the hasty process of bed closures and a "genuine" consultation process to figure out the long-term plan. They also said Alberta Health Services must release its plan for the hospital's 275-acre grounds once acute psychiatric and geriatric patients move out.
"Do not sell this beautiful land off the backs of the mentally ill," the doctors wrote.
Duckett said he wants to hear directly from the psychiatrists and workers rather than hear about their concerns through the media or through unsubstantiated rumours.
He said there is no plan to dispose of the large chunk of land the hospital sits on.
He also disputed claims that the patients will be moved by December-- a much faster turnover than staff first thought. "We've said our timeline has always been two or three years," Duckett said.
Duckett disagreed with concerns that the committee might not have much power.
"You just look at the members of this committee to realize that there are people there with a long history of supporting people with mental illness, and they're not going to be shut up by feel-good measures," Duckett said.
Changes to the health system will still be made, since the province has already decided to move away from institutionalized care to care within the community, at least when it comes to Alberta Hospital. Those buildings are old and irreparable, Duckett said, unlike the Ponoka facility for the mentally ill, which he called a "lovely" upgraded centre.
"There is no question about the policy direction that's been decided here," Horne said. "The theory behind the committee is to see how we can add value to the work that is already underway by Alberta Health Services. I just encourage people to give this a chance."
Knight said he's happy to sit on the committee, but while he agreed some Alberta Hospital patients could be better served in the community, he said all the beds must remain open for others who need specialized care given by teams of trained pharmacists, nurses, doctors and aides.
PATIENTS ON STREETS
"I still don't think those beds should be closed," said Knight, whose aggressive campaign to keep the beds open has included TV commercials featuring psychiatrists and professionals in law enforcement saying that closures will mean more mental health patients on the streets and in jails. "I am hoping this (committee) is a result of them starting to listen to not just the AUPE but others in support of us."
David Eggen, executive director of Friends of Medicare, said the formation of the committee is a sign the government is realizing its mistakes.
"Mr. Stelmach is backpedalling," Eggen said. "I think they got caught and now they're in full damage control. They hit a nerve that they didn't expect and they're looking for a way out of this mess."
By Jodie Sinnema, edmontonjournal.comOctober 5, 2009Comments (101)
StoryPhotos ( 6 )
More Images » Alberta Health Services announced in August that 100 to 150 beds would be closed over the next three years at Alberta Hospital edmonton, part of which is shown above. reaction to the announcement has been strongly negative, with concerns coming from parents, police, health professionals and edmonton Mayor The head of Alberta Health Services admitted Tuesday the consultation process about bed closings at Alberta Hospital wasn't broad enough to quell the fears of psychiatrists.
"The consultations we've done so far have been essentially internal," CEO Stephen Duckett said in an interview Tuesday, the same day 14 psychiatrists at the hospital wrote a letter lambasting Alberta Health Services for plans to close 246 beds without proper consultation.
"Our level of consultations hasn't been sufficiently specific or probably at high enough a level," Duckett said.
"Our plans aren't firm yet and because our plans aren't firm, people can have uncertainty, and with uncertainty, rumours are able to be developed."
In response to a public outcry and multiple rallies against the plans that will move many mental health patients into city hospital wards, Premier Ed Stelmach announced the formation of an "implementation team" to get expert input on the issue.
"What he was looking for was an opportunity for a bit of a pause and a little more thought about the transition we're trying to achieve from solely an institutional-based model to a more of a community based-model," said MLA Fred Horne, who will serve as the premier's representative on the committee. "It's the right move and the premier's obviously very committed to it."
Psychiatrists, support workers, other health professionals who work in Alberta Hospital and advocates for patients with mental illnesses will be on the committee, as will Doug Knight, president of the Alberta Union of Provincial Employees, who has been a vocal opponent of the bed closures planned for Alberta Hospital.
Until now, Alberta Health Services has said it consulted with psychiatrists and others in the mental health community before deciding to close the beds and move mental health patients to city hospitals and other community settings once the appropriate care is in place.
Psychiatrists say they weren't consulted.
"Alberta Health Services is proceeding at breakneck speed to dismantle years of quality psychiatric services at Alberta Hospital Edmonton with potentially disastrous results for patients and families," doctors wrote in a letter to Stelmach and Albertans on Tuesday. "In what is becoming an alarming social experiment by AHS, the psychiatrists at Alberta Hospital Edmonton would like to express grave concern for the safety of our patients, and the future of compassionate care for the severely mentally ill in Alberta."
RELEASE PLANS
The psychiatrists called for a stop to the hasty process of bed closures and a "genuine" consultation process to figure out the long-term plan. They also said Alberta Health Services must release its plan for the hospital's 275-acre grounds once acute psychiatric and geriatric patients move out.
"Do not sell this beautiful land off the backs of the mentally ill," the doctors wrote.
Duckett said he wants to hear directly from the psychiatrists and workers rather than hear about their concerns through the media or through unsubstantiated rumours.
He said there is no plan to dispose of the large chunk of land the hospital sits on.
He also disputed claims that the patients will be moved by December-- a much faster turnover than staff first thought. "We've said our timeline has always been two or three years," Duckett said.
Duckett disagreed with concerns that the committee might not have much power.
"You just look at the members of this committee to realize that there are people there with a long history of supporting people with mental illness, and they're not going to be shut up by feel-good measures," Duckett said.
Changes to the health system will still be made, since the province has already decided to move away from institutionalized care to care within the community, at least when it comes to Alberta Hospital. Those buildings are old and irreparable, Duckett said, unlike the Ponoka facility for the mentally ill, which he called a "lovely" upgraded centre.
"There is no question about the policy direction that's been decided here," Horne said. "The theory behind the committee is to see how we can add value to the work that is already underway by Alberta Health Services. I just encourage people to give this a chance."
Knight said he's happy to sit on the committee, but while he agreed some Alberta Hospital patients could be better served in the community, he said all the beds must remain open for others who need specialized care given by teams of trained pharmacists, nurses, doctors and aides.
PATIENTS ON STREETS
"I still don't think those beds should be closed," said Knight, whose aggressive campaign to keep the beds open has included TV commercials featuring psychiatrists and professionals in law enforcement saying that closures will mean more mental health patients on the streets and in jails. "I am hoping this (committee) is a result of them starting to listen to not just the AUPE but others in support of us."
David Eggen, executive director of Friends of Medicare, said the formation of the committee is a sign the government is realizing its mistakes.
"Mr. Stelmach is backpedalling," Eggen said. "I think they got caught and now they're in full damage control. They hit a nerve that they didn't expect and they're looking for a way out of this mess."
Sunday, October 4, 2009
Capital Health execs handed $300,000 gift
Ex-CEO approved bonuses following health region amalgamation: AG report
By Trish Audette, Edmonton Journal; With files from Darcy Henton and Richard WarnicaOctober 3, 2009
After the province announced plans to amalgamate the nine health regions into one superboard last year, the CEO of Edmonton's Capital Health approved retention bonuses for 15 executives that totalled $300,000, according to the auditor general's latest report.
Sheila Weatherill paid $20,000 bonuses to each executive, even though eight of the 15 were then let go during the amalgamation. None of the retention payments were
-Oilsands spat could cost $100 million / A3
recovered and, according to the report, no documentation clearly outlines why such payouts were made.
Auditor General Fred Dunn said Friday he is frustrated and "somewhat disappointed" that the theme of nearly all his annual reports since 2002 has been the government's failure to enforce its own rules.
Dunn, who will retire in February, released his final report Friday.
Putting a spotlight on compensation packages handed out to outgoing health executives, the multimillion-dollar gap between bitumen royalties received and expected, and the need to enhance communications contract rules, Dunn's audit looked at whether the government meets its own objectives and taxpayers get value for their money.
He said some compensation payments made in the health sector in the last year could be called "friendly parting gifts," and there is a need for more consistent and effective monitoring across the board.
"It becomes very inefficient inspecting the same problems over and over again, and you find no change in approach or attitude."
In a 350-page report, Dunn urged the government to better guide public agencies in keeping track of severance packages, bonuses and other achievement pay.
But Dunn's lengthiest recommendations were aimed at Alberta Health Services.
"This has been a very difficult audit," Dunn said, adding it was essentially the first time all nine health regions --now amalgamated into single entity-- have been audited at once.
He compared the health authorities to "regional fiefdoms" that handed out "gold-plated" retirement packages to top executives.
Mathematical errors and relying on the wrong employment contracts led to AHS miscalculating three executive severance packages last year, and paying out about $41,000 more than was necessary.
Alberta Health spokesman Andy Weiler said the department, and Minister Ron Liepert, had no role in approving severance packages.
"What has to be remembered here is the auditor general's audit for 2008-09 is looking at a system in transition," Weiler said.
AHS vice-president of corporate services, Mike Conroy, would not comment on past practices, but said the $41,000 overpayment is being pursued and $2,000 has already been recovered.
Liberal Leader David Swann said he was outraged by what appears to be a "total disregard of management principles.
"It's clear that this government either doesn't know how to, or doesn't care to, put in place serious measures to set up contracts that are clear and enforceable."
NDP Leader Brian Mason said the government's overall lack of oversight is serious. "Every public official responsible for spending public money should treat the money as if it was their own. They should treat it as if it comes out of their pocket, and it's clearly not been happening."
The auditor general's office also discovered no single organization is responsible for securing the province's online health records. For as long as three months last year, no one in the department double-checked who was accessing online patient information.
With no systematic review of who looks at health records, Dunn said patient information could be compromised.
Weiler said no breaches of privacy were ever recorded, and Alberta Health and Wellness constantly revisits its system of securing patient files.
But David Eggen, the executive director of Friends of Medicare, said Dunn's report shows a shoddy handling of a year in transition.
Starting a new superboard from the ground up should open the door to increased efficiency, Eggen said. Instead, Dunn's recommendations -like a suggestion AHS come up with long-term business plans--point to an "astounding" lack of planning.
Premier Ed Stelmach said on Friday the government will accept Dunn's recommendations on streamlining compensation systems.
Dunn said Friday the University of Calgary failed to provide him with information about executive compensation. By dodging his office's request for the president's contract, U of C made have tried to deceive the legislature, he said.
taudette@thejournal.canwest.com
© Copyright (c) The Edmonton Journal
Ex-CEO approved bonuses following health region amalgamation: AG report
By Trish Audette, Edmonton Journal; With files from Darcy Henton and Richard WarnicaOctober 3, 2009
After the province announced plans to amalgamate the nine health regions into one superboard last year, the CEO of Edmonton's Capital Health approved retention bonuses for 15 executives that totalled $300,000, according to the auditor general's latest report.
Sheila Weatherill paid $20,000 bonuses to each executive, even though eight of the 15 were then let go during the amalgamation. None of the retention payments were
-Oilsands spat could cost $100 million / A3
recovered and, according to the report, no documentation clearly outlines why such payouts were made.
Auditor General Fred Dunn said Friday he is frustrated and "somewhat disappointed" that the theme of nearly all his annual reports since 2002 has been the government's failure to enforce its own rules.
Dunn, who will retire in February, released his final report Friday.
Putting a spotlight on compensation packages handed out to outgoing health executives, the multimillion-dollar gap between bitumen royalties received and expected, and the need to enhance communications contract rules, Dunn's audit looked at whether the government meets its own objectives and taxpayers get value for their money.
He said some compensation payments made in the health sector in the last year could be called "friendly parting gifts," and there is a need for more consistent and effective monitoring across the board.
"It becomes very inefficient inspecting the same problems over and over again, and you find no change in approach or attitude."
In a 350-page report, Dunn urged the government to better guide public agencies in keeping track of severance packages, bonuses and other achievement pay.
But Dunn's lengthiest recommendations were aimed at Alberta Health Services.
"This has been a very difficult audit," Dunn said, adding it was essentially the first time all nine health regions --now amalgamated into single entity-- have been audited at once.
He compared the health authorities to "regional fiefdoms" that handed out "gold-plated" retirement packages to top executives.
Mathematical errors and relying on the wrong employment contracts led to AHS miscalculating three executive severance packages last year, and paying out about $41,000 more than was necessary.
Alberta Health spokesman Andy Weiler said the department, and Minister Ron Liepert, had no role in approving severance packages.
"What has to be remembered here is the auditor general's audit for 2008-09 is looking at a system in transition," Weiler said.
AHS vice-president of corporate services, Mike Conroy, would not comment on past practices, but said the $41,000 overpayment is being pursued and $2,000 has already been recovered.
Liberal Leader David Swann said he was outraged by what appears to be a "total disregard of management principles.
"It's clear that this government either doesn't know how to, or doesn't care to, put in place serious measures to set up contracts that are clear and enforceable."
NDP Leader Brian Mason said the government's overall lack of oversight is serious. "Every public official responsible for spending public money should treat the money as if it was their own. They should treat it as if it comes out of their pocket, and it's clearly not been happening."
The auditor general's office also discovered no single organization is responsible for securing the province's online health records. For as long as three months last year, no one in the department double-checked who was accessing online patient information.
With no systematic review of who looks at health records, Dunn said patient information could be compromised.
Weiler said no breaches of privacy were ever recorded, and Alberta Health and Wellness constantly revisits its system of securing patient files.
But David Eggen, the executive director of Friends of Medicare, said Dunn's report shows a shoddy handling of a year in transition.
Starting a new superboard from the ground up should open the door to increased efficiency, Eggen said. Instead, Dunn's recommendations -like a suggestion AHS come up with long-term business plans--point to an "astounding" lack of planning.
Premier Ed Stelmach said on Friday the government will accept Dunn's recommendations on streamlining compensation systems.
Dunn said Friday the University of Calgary failed to provide him with information about executive compensation. By dodging his office's request for the president's contract, U of C made have tried to deceive the legislature, he said.
taudette@thejournal.canwest.com
© Copyright (c) The Edmonton Journal
Friday, October 2, 2009
Canadian Press
Friends of Medicare suspects Alberta is hiding user fees and extra billing
(CP) – 18 hours ago
EDMONTON — The group Friends of Medicare is turning up the heat on the Alberta government to disclose whether patients are subject to extra billing or user fees.
Group spokesman David Eggen said a federal report issued each year outlining health-care payments across Canada does not clearly identify extra charges to patients.
"Now, more than ever, we need to know what's going on," Eggen told a news conference Thursday.
"We know there's different clinics opening up. Clinics that are pushing the boundaries of the Canada Health Act."
But a government spokesman rejected the advocacy group's allegations.
"Alberta does not allow user fees on any insured services," said John Tuckwell, spokesman for Alberta's Health Ministry.
Eggen said it appears the federal government is not asking for specific information on user fees and the province doesn't feel obliged to tell. He describes that as a failure to protect citizens from these types of payments.
The Canada Health Act requires that the federal government reduce transfer payments to provinces that allow these extra fees.
"Alberta was penalized back in 1984 for allowing extra billing," said Eggen. "The financial and political pressure exerted by reducing transfer payments resulted in the Alberta government backing off."
Friends of Medicare has hired a lawyer to send letters to the federal and provincial health ministers demanding they fulfil their responsibilities to protect the public health-care system.
Copyright © 2009 The Canadian Press. All rights reserved
(CP) – 18 hours ago
EDMONTON — The group Friends of Medicare is turning up the heat on the Alberta government to disclose whether patients are subject to extra billing or user fees.
Group spokesman David Eggen said a federal report issued each year outlining health-care payments across Canada does not clearly identify extra charges to patients.
"Now, more than ever, we need to know what's going on," Eggen told a news conference Thursday.
"We know there's different clinics opening up. Clinics that are pushing the boundaries of the Canada Health Act."
But a government spokesman rejected the advocacy group's allegations.
"Alberta does not allow user fees on any insured services," said John Tuckwell, spokesman for Alberta's Health Ministry.
Eggen said it appears the federal government is not asking for specific information on user fees and the province doesn't feel obliged to tell. He describes that as a failure to protect citizens from these types of payments.
The Canada Health Act requires that the federal government reduce transfer payments to provinces that allow these extra fees.
"Alberta was penalized back in 1984 for allowing extra billing," said Eggen. "The financial and political pressure exerted by reducing transfer payments resulted in the Alberta government backing off."
Friends of Medicare has hired a lawyer to send letters to the federal and provincial health ministers demanding they fulfil their responsibilities to protect the public health-care system.
Copyright © 2009 The Canadian Press. All rights reserved
News Alberta
No extra-billing info
By KERRY DIOTTE, SUN MEDIA
Last Updated: 2nd October 2009, 1:41am
Email Story Print Size A A A Report Typo Share with:
Facebook Digg Del.icio.us Google Stumble Upon Newsvine Reddit Technorati Feed Me Yahoo Simpy Squidoo Spurl Blogmarks Netvouz Scuttle Sitejot + What are these? A health-care lobby group suspects the province and the feds might be turning a blind eye to extra-billing fees in Alberta and have sent letters from its lawyer to the federal and provincial health ministers expressing concern.
However, Alberta Health spokesmen deny there's anything sinister happening.
"Under the law, our governments have a duty to protect Albertans from extra-billing and user charges and we are asking them to do so," said Friends of Medicare executive director David Eggen.
He said the most recent annual report from Health Canada regarding the Canada Health Act is lacking information and makes his group suspicious Albertans could be getting dinged for extra health-care fees that aren't allowed under the act.
"The report's section on Alberta does not identify extra-billing or user charges at all," said Eggen.
"In the summary tables, the columns referring to private for-profit facilities and the payments to physicians show entries of 'not available.'
"If Albertans are subjected to extra-billing or user fees, it should be reported here," Eggen says. "There is no way of determining, from the information provided, the extent of extra-billing and user charges in Alberta."
Eggen says he's concerned about reports some Calgary clinics collect a type of membership fee of "between $3,000 and $15,000 that might get people faster access to a clinic.
"We want to see what the government is monitoring," he said. "If you don't have anything to look at, you don't have any idea of what's going on.
"The practice appears to be that the federal government does not ask about extra-billing or user charges, and the Alberta government does not tell. It's don't ask, don't tell," said Eggen.
Health ministry spokesman John Tuckwell was puzzled by the concerns, saying the health report being cited doesn't detail billing information in that category in other provinces either and extra-billing for insured services is also illegal under Alberta law.
"If any Albertan feels they are being extra-billed for insured services, they should contact us," he said.
Tuckwell said clinics that charge certain user fees can't charge them for medically insured services. The Canada Health Act outlaws extra-billing for insured services.
In 1984, Alberta and the feds were locked in a dispute over extra-billing and the province's transfer payments from the feds were reduced, said Eggen.
KERRY.DIOTTE@SUNMEDIA.CA
No extra-billing info
By KERRY DIOTTE, SUN MEDIA
Last Updated: 2nd October 2009, 1:41am
Email Story Print Size A A A Report Typo Share with:
Facebook Digg Del.icio.us Google Stumble Upon Newsvine Reddit Technorati Feed Me Yahoo Simpy Squidoo Spurl Blogmarks Netvouz Scuttle Sitejot + What are these? A health-care lobby group suspects the province and the feds might be turning a blind eye to extra-billing fees in Alberta and have sent letters from its lawyer to the federal and provincial health ministers expressing concern.
However, Alberta Health spokesmen deny there's anything sinister happening.
"Under the law, our governments have a duty to protect Albertans from extra-billing and user charges and we are asking them to do so," said Friends of Medicare executive director David Eggen.
He said the most recent annual report from Health Canada regarding the Canada Health Act is lacking information and makes his group suspicious Albertans could be getting dinged for extra health-care fees that aren't allowed under the act.
"The report's section on Alberta does not identify extra-billing or user charges at all," said Eggen.
"In the summary tables, the columns referring to private for-profit facilities and the payments to physicians show entries of 'not available.'
"If Albertans are subjected to extra-billing or user fees, it should be reported here," Eggen says. "There is no way of determining, from the information provided, the extent of extra-billing and user charges in Alberta."
Eggen says he's concerned about reports some Calgary clinics collect a type of membership fee of "between $3,000 and $15,000 that might get people faster access to a clinic.
"We want to see what the government is monitoring," he said. "If you don't have anything to look at, you don't have any idea of what's going on.
"The practice appears to be that the federal government does not ask about extra-billing or user charges, and the Alberta government does not tell. It's don't ask, don't tell," said Eggen.
Health ministry spokesman John Tuckwell was puzzled by the concerns, saying the health report being cited doesn't detail billing information in that category in other provinces either and extra-billing for insured services is also illegal under Alberta law.
"If any Albertan feels they are being extra-billed for insured services, they should contact us," he said.
Tuckwell said clinics that charge certain user fees can't charge them for medically insured services. The Canada Health Act outlaws extra-billing for insured services.
In 1984, Alberta and the feds were locked in a dispute over extra-billing and the province's transfer payments from the feds were reduced, said Eggen.
KERRY.DIOTTE@SUNMEDIA.CA
Thursday, October 1, 2009
Alberta’s compliance with medicare in ‘a huge fog’: Eggen
By Trish Audette, edmontonjournal.comOctober 1, 2009 1:02
David Eggen, executive director of Friends of Medicare, announcing an aggressive campaign to urge the government to stop cutting funds from the health structure in Alberta.Photograph by: Larry Wong, Edmonton JournalEDMONTON — Public health activist David Eggen demanded Thursday that the province reveal how much Albertans are paying in user fees and “extra billing.”
Pointing to Health Canada’s most recent Health Act annual report, for 2007-08, the Friends of Medicare executive director said Albertans’ out-of-pocket payments haven’t been adequately reported in years, if ever.
“There’s a huge fog over the Alberta section of the annual report to the Canada Health Act,” Eggen said. “We have to get the numbers. We have to know what’s being spent on extra billing.”
The Friends of Medicare accuse the federal government of failing to look for the amount of money spent -- listed as unavailable in the report, which can be found online here — and they accuse the provincial government of failing to tell.
This week, the organization sent letters, through an Edmonton-based law firm, to federal Health Minister Leona Aglukkaq and provincial Health Minister Ron Liepert demanding better explanation of the audit process.
“Given the vital importance of the Canada Health Act to providing health services equitably to all Canadians, and the importance of controlling extra-billing and user fees, we request you ensure adequate information is available to enforce the Act,” the letter to Aglukkaq says.
Eggen said he hopes the issue can be resolved “amicably,” and stopped short of outlining what action would be pursued if both levels of government ignore the letters.
taudette@thejournal.canwest.com
By Trish Audette, edmontonjournal.comOctober 1, 2009 1:02
David Eggen, executive director of Friends of Medicare, announcing an aggressive campaign to urge the government to stop cutting funds from the health structure in Alberta.Photograph by: Larry Wong, Edmonton JournalEDMONTON — Public health activist David Eggen demanded Thursday that the province reveal how much Albertans are paying in user fees and “extra billing.”
Pointing to Health Canada’s most recent Health Act annual report, for 2007-08, the Friends of Medicare executive director said Albertans’ out-of-pocket payments haven’t been adequately reported in years, if ever.
“There’s a huge fog over the Alberta section of the annual report to the Canada Health Act,” Eggen said. “We have to get the numbers. We have to know what’s being spent on extra billing.”
The Friends of Medicare accuse the federal government of failing to look for the amount of money spent -- listed as unavailable in the report, which can be found online here — and they accuse the provincial government of failing to tell.
This week, the organization sent letters, through an Edmonton-based law firm, to federal Health Minister Leona Aglukkaq and provincial Health Minister Ron Liepert demanding better explanation of the audit process.
“Given the vital importance of the Canada Health Act to providing health services equitably to all Canadians, and the importance of controlling extra-billing and user fees, we request you ensure adequate information is available to enforce the Act,” the letter to Aglukkaq says.
Eggen said he hopes the issue can be resolved “amicably,” and stopped short of outlining what action would be pursued if both levels of government ignore the letters.
taudette@thejournal.canwest.com
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