News Columnists / Frank Landry
Health-care fix will take a little bit of magic
By FRANK LANDRY, Edmonton Sun
In some circles, Health Minister Gene Zwozdesky is known as the Wizard of Zwoz.
That’s because of his apparent ability to make problems vanish with a wave of his magic money wand.
It happened on Feb. 16 when Zwozdesky found $8 million to fund another 2,230 desperately-needed surgeries and medical procedures in high-priority areas.
The so-called “blitz” or “surge” as some call it, was to be carried out over a six-week period, ending this Wednesday.
And though that program is poised to fall 170 surgeries short if its goal, Zwozdesky is gearing up for Round 2.
A plan will be unveiled in the coming weeks to once again boost surgeries
over a period of several weeks ending in June. We know that because Alberta Health Services made the commitment back in February.
It hinged on the availability of operating rooms, surgeons and surgical teams.
But now Zwozdesky also says he wants to expand the next phase of the plan to include more types of procedures.
The original blitz focused on urgent cancer surgery, orthopedic surgery, gynecology, neurosurgery, heart surgery and cataract surgery.
“I don’t want to get into it because I’ll for sure leave something out,” said Zwozdesky, choosing his words carefully.
“You could say it this way, Alberta Health Services has also been considering other surgeries for acceleration where possible. If that’s possible.
“They need to speak with a lot of surgeons and facility operators and nursing supply folks and so on.”
He hinted the expanded list may include more back procedures, among other things.
The plan first is to assess how the initial six-week blitz has gone, Zwozdesky said.
AHS managed to slot an additional 2,060 procedures. Officials said the remaining 170 would be done in April.
Zwozdesky, however, said he was waiting for the final numbers. “That might take us a month or so to do an assessment of,” he said.
“You can’t push so many (procedures) through that you don’t give people a chance to take a little breather.”
Much of the blitz has been pulled off by increasing the hours of existing staff, either through more shifts or overtime.
Critics, meanwhile, say they’re waiting for the government to come out with a long-term surgical plan.
“I welcome shortening the wait list, but I think this kind of on-again, off-again funding is a fundamental problem,” said Liberal MLA Kevin Taft.
“People’s need for hip and knee surgery doesn’t just end because the minister decided not to fund it more.
“One of the things the system needs is stable funding, and we’re not getting it.”
David Eggen, with Friends of Medicare, said he too is looking for a commitment from Zwozdesky to fund more procedures over the long haul.
“Otherwise, you’ll end up on the same boat six months down the road,” Eggen warned.
“Backlogs build up whenever there’s a shortage of beds of surgery time.”
The problem, Eggen said, is that so far, much of this has been reactive response to a huge problem.
“A surge is really an emergency reaction to a problem that’s been building up,” he said.
“There are lots of things that need to be done in a more proactive way.
“We just can’t let things slide and then catch up. You want to build capacity in our acute care centres so you don’t have a backlog at all.”
And that will be the real challenge. Zwozdesky says a long-term surgery plan is in the works.
“But a lot of this is dependent on the availability of facilities, of equipment, of surgeons, of nurses and other staff,” he said.
Zwozdesky likened the situation to completing a Rubik’s Cube. But that’s an easy task compared to mending even a fragment of an ailing health system.
All eyes will be on the Wizard of Zwoz to see if he pulls it off.
frank.landry@sunmedia.ca
Monday, March 29, 2010
Wednesday, March 17, 2010
Zwozdesky freezes ambulance dispatch plan
By Trish Audette and Jodie Sinnema, edmontonjournal.comMarch 17, 2010 9:04 AMComments (73)
StoryPhotos ( 1 )
Alberta Health Minister Gene Zwozdesky.Photograph by: Ed Kaiser, edmontonjournal.comEDMONTON — Health Minister Gene Zwozdesky has frozen the centralization of Alberta's ambulance dispatch systems.
"There are a lot of concerns in rural Alberta," Zwozdesky said Tuesday, after making the announcement at the Alberta Association of Municipal Districts and Counties spring conference.
It has not even been one year since the province moved to replace local medical emergency dispatch centres with three central call centres in Edmonton, Calgary and the Grimshaw area in northwestern Alberta.
Rural communities were the greatest opponents of centralization, which started April 1, 2009. The new system was to cut costs and streamline the running of ground ambulances within Alberta Health Services.
Seventeen of 35 dispatch systems have been centralized.
All systems were to be on a single system by 2012, but Zwozdesky's announcement puts a hold on the reorganization.
"I'm not looking at reversing any at this stage at all," Zwozdesky said, adding he will be looking at how the system has worked so far.
"What they're supposed to have accomplished is greater and faster access for ground ambulance, and better efficiencies in the system."
Yellowhead County joined the provincial system two weeks ago, but County Mayor Gerald Soroka said there are gaps in service delivery.
"Before, we used to dispatch ambulance and fire at the same time. Now, we are dispatching only fire. That's the disconnect, we don't know where the ambulance is coming from or when it's going to be dispatched," he said.
"I know in our municipality there's a lot of dead-end roads ... . When you're doing a centralized dispatch, it's hard to have a mapping system that covers the entire province."
Zwozdesky's announcement appeared to be yet another reversal of decisions made by Alberta's health superboard.
Soon after being appointed health minister in January, he reversed a decision to close 300 acute-care hospital beds and backed away from plans to shut down 150 mental health beds at Alberta Hospital Edmonton.
Last week, he distanced himself from health board chief executive Stephen Duckett's plans to put "pay for performance" in place as an incentive for hospitals and physicians who provide "superior quality" health care.
Asked about his overturning of board decisions, Zwozdesky said the dispatch centralization is a "policy matter."
"My concern is that people in Alberta, regardless of where they live, feel that they are enfranchised and have access to public health care," he said.
But Dave Eggen, the executive director of the Friends of Medicare, said Tuesday the "flip-flops" look like the government is putting together health policy "on the fly. AHS people must be dizzy from all these flip-flops in the last few weeks," he said.
On Monday, Liberal health critic Kevin Taft grilled Zwozdesky about the confusion created by overturned decisions.
"Who is developing provincial policy on long-term care?" Taft asked.
taudette@thejournal.canwest.com
jsinnema@thejournal.canwest.com
By Trish Audette and Jodie Sinnema, edmontonjournal.comMarch 17, 2010 9:04 AMComments (73)
StoryPhotos ( 1 )
Alberta Health Minister Gene Zwozdesky.Photograph by: Ed Kaiser, edmontonjournal.comEDMONTON — Health Minister Gene Zwozdesky has frozen the centralization of Alberta's ambulance dispatch systems.
"There are a lot of concerns in rural Alberta," Zwozdesky said Tuesday, after making the announcement at the Alberta Association of Municipal Districts and Counties spring conference.
It has not even been one year since the province moved to replace local medical emergency dispatch centres with three central call centres in Edmonton, Calgary and the Grimshaw area in northwestern Alberta.
Rural communities were the greatest opponents of centralization, which started April 1, 2009. The new system was to cut costs and streamline the running of ground ambulances within Alberta Health Services.
Seventeen of 35 dispatch systems have been centralized.
All systems were to be on a single system by 2012, but Zwozdesky's announcement puts a hold on the reorganization.
"I'm not looking at reversing any at this stage at all," Zwozdesky said, adding he will be looking at how the system has worked so far.
"What they're supposed to have accomplished is greater and faster access for ground ambulance, and better efficiencies in the system."
Yellowhead County joined the provincial system two weeks ago, but County Mayor Gerald Soroka said there are gaps in service delivery.
"Before, we used to dispatch ambulance and fire at the same time. Now, we are dispatching only fire. That's the disconnect, we don't know where the ambulance is coming from or when it's going to be dispatched," he said.
"I know in our municipality there's a lot of dead-end roads ... . When you're doing a centralized dispatch, it's hard to have a mapping system that covers the entire province."
Zwozdesky's announcement appeared to be yet another reversal of decisions made by Alberta's health superboard.
Soon after being appointed health minister in January, he reversed a decision to close 300 acute-care hospital beds and backed away from plans to shut down 150 mental health beds at Alberta Hospital Edmonton.
Last week, he distanced himself from health board chief executive Stephen Duckett's plans to put "pay for performance" in place as an incentive for hospitals and physicians who provide "superior quality" health care.
Asked about his overturning of board decisions, Zwozdesky said the dispatch centralization is a "policy matter."
"My concern is that people in Alberta, regardless of where they live, feel that they are enfranchised and have access to public health care," he said.
But Dave Eggen, the executive director of the Friends of Medicare, said Tuesday the "flip-flops" look like the government is putting together health policy "on the fly. AHS people must be dizzy from all these flip-flops in the last few weeks," he said.
On Monday, Liberal health critic Kevin Taft grilled Zwozdesky about the confusion created by overturned decisions.
"Who is developing provincial policy on long-term care?" Taft asked.
taudette@thejournal.canwest.com
jsinnema@thejournal.canwest.com
Friday, March 12, 2010
Superboard's 'gag order' on cancer centre draws fire
Minister 'not aware of' curb on doctors
By Tamara Gignac, Calgary HeraldMarch 12, 2010
Tom Baker Cancer Centre in Calgary, Alberta on March 10, 2010.Photograph by: Leah Hennel, Calgary HeraldDoctors, opposition parties and even the province's health minister voiced concern Thursday over allegations that Alberta's medical superboard barred oncologists from speaking out about the need to replace the aging Tom Baker Cancer Centre.
The facility ran out of room nearly seven years ago and cancer officials -- including Tom Baker's top doctor Dr. Peter Craighead -- have been warning for years the city desperately needs a new building or wait times for treatment would grow.
This week, however, cancer doctors declined to discuss the matter, saying they were told by Alberta Health Services not to talk to the media.
Such allegations are "very disconcerting," said Alberta
Medical Association president Dr. Chip Doig. "Physicians have a professional responsibility to advocate on behalf of their patients. It's not a leap of logic that that means in certain circumstances advocating for the health-care system more broadly, including through communications with the media."
The fallout of an overcrowded Tom Baker Centre has fuelled a heated debate between Alberta Health Services and the province over whether to replace the facility or exhaust every option to improve capacity.
The Herald contacted several oncologists this week to talk about how space issues at the clinic have affected patient care.
But Craighead, the director of the Tom Baker Centre, said in an e-mail Wednesday that oncologists and medical leaders were "forbidden by AHS to provide the media with any comments relating to capacity or new cancer centre issues."
Any discussion on the matter would require permission from the medical superboard, he added.
The issue sparked questions in the legislature Thursday, with Liberal MLAs asking Health Minister Gene Zwozdesky whether doctors in the province can openly advocate on behalf of patients.
"I'm not aware of any gag order," Zwozdesky said in response.
"I think doctors should feel freely to comment on medical issues and people at Alberta Health Services should feel freely to comment on policy-driven issues."
But the minister acknowledged the issue does warrant further inquiry with superboard officials. "I'd like to find out more about some alleged directive someone from AHS may or may not have given to someone," Zwozdesky told the Herald.
AHS spokesman Don Stewart said physicians are free to comment as they feel appropriate on medical and other issues relating to patient care, including wait times and capacity issues. However, any comments on specific AHS policies and planning decisions should be made by appropriate officials, he said.
The AHS was unable to say whether Tom Baker staff were told not to discuss the issue.
David Eggen, executive director of Friends of Medicare, expressed concern that unreasonable protocols are being imposed on the city's doctors.
The opinion was echoed by Wildrose Alliance MLA Paul Hinman. "When you are kept in the dark and not allowed to speak on things, you know there's something wrong with the system," he said.
tgignac@theherald.canwest.com
© Copyright (c) The Calgary Herald
Minister 'not aware of' curb on doctors
By Tamara Gignac, Calgary HeraldMarch 12, 2010
Tom Baker Cancer Centre in Calgary, Alberta on March 10, 2010.Photograph by: Leah Hennel, Calgary HeraldDoctors, opposition parties and even the province's health minister voiced concern Thursday over allegations that Alberta's medical superboard barred oncologists from speaking out about the need to replace the aging Tom Baker Cancer Centre.
The facility ran out of room nearly seven years ago and cancer officials -- including Tom Baker's top doctor Dr. Peter Craighead -- have been warning for years the city desperately needs a new building or wait times for treatment would grow.
This week, however, cancer doctors declined to discuss the matter, saying they were told by Alberta Health Services not to talk to the media.
Such allegations are "very disconcerting," said Alberta
Medical Association president Dr. Chip Doig. "Physicians have a professional responsibility to advocate on behalf of their patients. It's not a leap of logic that that means in certain circumstances advocating for the health-care system more broadly, including through communications with the media."
The fallout of an overcrowded Tom Baker Centre has fuelled a heated debate between Alberta Health Services and the province over whether to replace the facility or exhaust every option to improve capacity.
The Herald contacted several oncologists this week to talk about how space issues at the clinic have affected patient care.
But Craighead, the director of the Tom Baker Centre, said in an e-mail Wednesday that oncologists and medical leaders were "forbidden by AHS to provide the media with any comments relating to capacity or new cancer centre issues."
Any discussion on the matter would require permission from the medical superboard, he added.
The issue sparked questions in the legislature Thursday, with Liberal MLAs asking Health Minister Gene Zwozdesky whether doctors in the province can openly advocate on behalf of patients.
"I'm not aware of any gag order," Zwozdesky said in response.
"I think doctors should feel freely to comment on medical issues and people at Alberta Health Services should feel freely to comment on policy-driven issues."
But the minister acknowledged the issue does warrant further inquiry with superboard officials. "I'd like to find out more about some alleged directive someone from AHS may or may not have given to someone," Zwozdesky told the Herald.
AHS spokesman Don Stewart said physicians are free to comment as they feel appropriate on medical and other issues relating to patient care, including wait times and capacity issues. However, any comments on specific AHS policies and planning decisions should be made by appropriate officials, he said.
The AHS was unable to say whether Tom Baker staff were told not to discuss the issue.
David Eggen, executive director of Friends of Medicare, expressed concern that unreasonable protocols are being imposed on the city's doctors.
The opinion was echoed by Wildrose Alliance MLA Paul Hinman. "When you are kept in the dark and not allowed to speak on things, you know there's something wrong with the system," he said.
tgignac@theherald.canwest.com
© Copyright (c) The Calgary Herald
Wednesday, March 10, 2010
Report cites medical mix-ups
Calgary Herald; Canwest News ServiceMarch 10, 2010
An independent investigation into four serious medical mistakes within 54 days at Alberta Children's Hospital, including two non-fatal medication overdoses, suggests poor communication and improper use of equipment triggered the problems.
But the full 58-page report was not made public Tuesday by Alberta Health Services due to confidentiality concerns. It's unclear how many of the report's 85 recommendations have been adopted.
The report, conducted by the Health Quality Council of Alberta, was commissioned last spring to look into the four errors that occurred on the same unit at the Alberta Children's Hospital in February and March 2009.
"The four instances were unrelated," said Dr. John Cowell, chief executive of the council, an independent agency that promotes patient safety.
"It was coincidental that they all happened within a couple of weeks of each other in a single area of the hospital.
"As it turned out, though, they were completely separate and isolated incidences."
In the executive summary of the report, which was released Tuesday, it noted that there were different reasons for each case -- although there were some systemic problems identified by the investigation.
The errors were: a two-year-old received five oral medications through an intravenous line instead of through a tube to the stomach; a four-year-old was given a 15-fold overdose of a narcotic; a six-year-old child had an accidental overdose of a drug to suppress the immune system; and a nine-day-old infant received the wrong breast milk.
None of the children died.
© Copyright (c) The Edmonton Journal
Calgary Herald; Canwest News ServiceMarch 10, 2010
An independent investigation into four serious medical mistakes within 54 days at Alberta Children's Hospital, including two non-fatal medication overdoses, suggests poor communication and improper use of equipment triggered the problems.
But the full 58-page report was not made public Tuesday by Alberta Health Services due to confidentiality concerns. It's unclear how many of the report's 85 recommendations have been adopted.
The report, conducted by the Health Quality Council of Alberta, was commissioned last spring to look into the four errors that occurred on the same unit at the Alberta Children's Hospital in February and March 2009.
"The four instances were unrelated," said Dr. John Cowell, chief executive of the council, an independent agency that promotes patient safety.
"It was coincidental that they all happened within a couple of weeks of each other in a single area of the hospital.
"As it turned out, though, they were completely separate and isolated incidences."
In the executive summary of the report, which was released Tuesday, it noted that there were different reasons for each case -- although there were some systemic problems identified by the investigation.
The errors were: a two-year-old received five oral medications through an intravenous line instead of through a tube to the stomach; a four-year-old was given a 15-fold overdose of a narcotic; a six-year-old child had an accidental overdose of a drug to suppress the immune system; and a nine-day-old infant received the wrong breast milk.
None of the children died.
© Copyright (c) The Edmonton Journal
Tuesday, March 9, 2010
Braid: Duckett yet to catch up with Tory shift
By Don Braid, Calgary HeraldMarch 9, 2010 6:33 AM
If health care changes any faster than this, we'll all need a prescription for motion sickness.
On Monday, Premier Ed Stelmach suddenly said a new cancer clinic for Calgary is one of his priorities.
And Health Minister Gene Zwozdesky staged an epic slapdown of health superboard CEO Stephen Duckett.
Duckett had said the clinic won't be among his board's capital projects for this year.
Zwoz shot back that nobody but the premier can say what's on that list before it's complete.
Then Stelmach called the Calgary clinic a priority.
The city should take him at his word. If he keeps it, the centre will be on the new list of capital projects to be finalized by early April.
But a funny thing is happening in health care.
On the surface, at least, the politicians now appear to be endorsing the things people want. It's the health board that looks obstructionist.
Doctors have been crying out for a new cancer clinic for seven years. The most vocal was Dr. Peter Craighead, director of the Tom Baker Cancer Centre, who has said many times the old clinic desperately needs replacement.
Craighead doesn't talk like that any more, though -- at least, not publicly.
All calls to the doctor are shunted to the health superboard's public relations people.
Nobody will say Dr. Craighead isn't allowed to talk; but somehow, this previously outspoken advocate never phones back.
Instead, after a columnist waits a few humble hours watching ER reruns, he will get a call from somebody like Mike Conroy, the health board's executive vice-president of corporate services.
Conroy does not repeat Dr. Craighead's urgent message about a new clinic. Not at all.
He says that province-wide, "bringing projects together is a very significant piece of work. Those capital projects are still under consideration."
Asked if the new Calgary clinic should get the green light, Conroy says, "I haven't yet seen the data to allow us to make that type of decision."
As for cancer care in Calgary, "our wait times for access to radiation treatment compare favourably with other jurisdictions in Canada."
You might ask what on earth is going on here. The answer is buried deep in the Byzantine crypt of Alberta health-care politics.
Duckett's health board is still doing exactly what it was told to do for the last two years -- trying to strip out politics and make tough decisions across the entire system.
Alas for Duckett, the agenda has changed and he hasn't caught up. Or maybe he doesn't want to.
The Tories are now desperate to win back popularity. There is no surer route than cutting wait lists and championing local health care.
As their hands-off policy switches to direct management, the things they asked Duckett to do suddenly look like meddling in policy.
His decision to leave the cancer centre off his wish list is one example. That's interfering with the biggest thing politicians do -- approving construction and taking credit.
Another Duckett offence, it seems, is using his blog to promote "pay for performance funding."
Hospitals and possibly professionals would get more money for superior performance.
Zwozdesky was very cool Monday about this post, saying he and the CEO have to be "on the same page."
The rest of us, as usual, are just trying to figure out the page number.
But if an overdue cancer centre for Calgary falls out of the new Tory prayer book, that would be fine.
dbraid@theherald.canwest.com
Tories kick the Duckett
Premier, health boss clash over future of cancer centre
By Jason Fekete, Calgary Herald March 9, 2010 6:46 AM
Ed Stelmach says a new Calgary cancer centre "is a priority" for his government and, despite the claims of the medical superboard, may be included in the province's health capital plan slated to be released by the end of the month.
The political battle over the facility is the latest clash between the Stelmach government and Alberta Health Services on health-care delivery in the province, sparking more questions about who's in charge of the $15-billion system.
Both the premier and Health Minister Gene Zwozdesky took issue Monday with comments from Alberta Health Services president Stephen Duckett, who told the Herald that a new cancer treatment facility -- to replace the aging and overcrowded Tom Baker Cancer Centre -- won't be included in the government's list of priority capital projects.
The Tom Baker facility ran out of room nearly seven years ago, but Duckett said last week that the medical superboard won't ask for provincial money to replace the cancer centre with a new facility until it exhausts every option to improve capacity.
On Monday, the premier and health minister stepped in, saying the project list hasn't been finalized.
---
Rather, Stelmach said lower-than-expected construction costs on other projects have generated savings that he wants to use on priority facilities like a new Calgary cancer centre.
"There's a number of projects that were temporarily put on hold because of the rapid drop in our revenue stream, but because of savings in other areas, we're looking at the priorities," Stelmach told reporters in Edmonton. "And, of course, this is a priority with respect to health facilities."
Duckett, however, told the Herald the focus for cancer treatment is reducing the wait times and increasing capacity by 15 per cent at both the Tom Baker and the Cross Cancer Institute in Edmonton. With that plan in mind, he said a replacement Calgary cancer centre hasn't been added to this year's capital budget list, expected to be released by the province later this month.
"Basically the list stays the same," Duckett said last week. "We're trying to get things on the list done, not the things that aren't on the list yet."
The Tom Baker ran out of capacity in 2003 and cancer officials-- including Dr. Peter Craighead, the city's top cancer doctor -- have been warning for years that Calgary desperately needs a new facility or wait times for treatments would grow. While Duckett indicated the wait for a new facility would continue, the health minister delivered a different message Monday.
"No one should be speculating yet as to what is or what isn't on the project list," Zwozdesky said. "I haven't finished developing it yet."
The minister also said he isn't too happy with a recent blog post from Duckett that said Alberta will pursue a "pay for performance" funding model that sees hospitals and physicians receive additional financial support for "superior quality or health-improving performance."
Zwozdesky said he approves of offering some sort of incentives for health professionals who excel at their jobs, and recognized there's room for activity-based funding (which sees dollars follow the patient, rather than simply allotting block funds).
But he stressed "health care is not a business" and that he doesn't necessarily agree with how the superboard president envisions a pay-for-performance system would function.
"This would be one of those examples where we have to work a little harder to get on the same page, and we will," he said. "The same with the Tom Baker."
David Eggen, executive director of Friends of Medicare, said the battle over a health-care funding model and new cancer centre for Calgary is the latest "disconnect" between a government responsible for crafting policy and a health board charged with delivering care.
"You can't apply this business model to health care," Eggen said about a pay-for-performance system. "The government will proceed with this model at their own peril."
Earlier this year, Zwozdesky ordered the province's medical superboard to halt its planned closing of nearly 350 acute-care hospital beds in Calgary and Edmonton.
The latest tussle between the province and Alberta Health Services has opposition parties and public health advocates questioning who's ultimately accountable for a system that's gobbling up nearly 40 per cent of the provincial budget.
"It's pretty clear that confusion reigns in the health-care system," said Liberal health critic Kevin Taft. "It's not clear to anyone who's in charge. It's certainly not clear to the minister."
Taft believes the problems stem from the Stelmach government imploding the former regional health authorities and creating one Edmonton-based superboard.
The fallout of an overcrowded Tom Baker centre, he noted, has been to deliver cancer services at other facilities around Calgary, including the Holy Cross Centre.
Taft said he's very worried about the health of patients and staff at the Holy Cross, which is the subject of a class-action lawsuit over asbestos contamination.
"I just don't think it's a place where health services should be delivered," he said.
Former premier Ralph Klein promised nearly five years ago $1 billion to build or expand cancer facilities in Calgary and Edmonton. But his government did not follow through on the 2005 promise.
jfekete@theherald.canwest.com
© Copyright (c) The Calgary Herald
By Jason Fekete, Calgary Herald March 9, 2010 6:46 AM
Ed Stelmach says a new Calgary cancer centre "is a priority" for his government and, despite the claims of the medical superboard, may be included in the province's health capital plan slated to be released by the end of the month.
The political battle over the facility is the latest clash between the Stelmach government and Alberta Health Services on health-care delivery in the province, sparking more questions about who's in charge of the $15-billion system.
Both the premier and Health Minister Gene Zwozdesky took issue Monday with comments from Alberta Health Services president Stephen Duckett, who told the Herald that a new cancer treatment facility -- to replace the aging and overcrowded Tom Baker Cancer Centre -- won't be included in the government's list of priority capital projects.
The Tom Baker facility ran out of room nearly seven years ago, but Duckett said last week that the medical superboard won't ask for provincial money to replace the cancer centre with a new facility until it exhausts every option to improve capacity.
On Monday, the premier and health minister stepped in, saying the project list hasn't been finalized.
---
Rather, Stelmach said lower-than-expected construction costs on other projects have generated savings that he wants to use on priority facilities like a new Calgary cancer centre.
"There's a number of projects that were temporarily put on hold because of the rapid drop in our revenue stream, but because of savings in other areas, we're looking at the priorities," Stelmach told reporters in Edmonton. "And, of course, this is a priority with respect to health facilities."
Duckett, however, told the Herald the focus for cancer treatment is reducing the wait times and increasing capacity by 15 per cent at both the Tom Baker and the Cross Cancer Institute in Edmonton. With that plan in mind, he said a replacement Calgary cancer centre hasn't been added to this year's capital budget list, expected to be released by the province later this month.
"Basically the list stays the same," Duckett said last week. "We're trying to get things on the list done, not the things that aren't on the list yet."
The Tom Baker ran out of capacity in 2003 and cancer officials-- including Dr. Peter Craighead, the city's top cancer doctor -- have been warning for years that Calgary desperately needs a new facility or wait times for treatments would grow. While Duckett indicated the wait for a new facility would continue, the health minister delivered a different message Monday.
"No one should be speculating yet as to what is or what isn't on the project list," Zwozdesky said. "I haven't finished developing it yet."
The minister also said he isn't too happy with a recent blog post from Duckett that said Alberta will pursue a "pay for performance" funding model that sees hospitals and physicians receive additional financial support for "superior quality or health-improving performance."
Zwozdesky said he approves of offering some sort of incentives for health professionals who excel at their jobs, and recognized there's room for activity-based funding (which sees dollars follow the patient, rather than simply allotting block funds).
But he stressed "health care is not a business" and that he doesn't necessarily agree with how the superboard president envisions a pay-for-performance system would function.
"This would be one of those examples where we have to work a little harder to get on the same page, and we will," he said. "The same with the Tom Baker."
David Eggen, executive director of Friends of Medicare, said the battle over a health-care funding model and new cancer centre for Calgary is the latest "disconnect" between a government responsible for crafting policy and a health board charged with delivering care.
"You can't apply this business model to health care," Eggen said about a pay-for-performance system. "The government will proceed with this model at their own peril."
Earlier this year, Zwozdesky ordered the province's medical superboard to halt its planned closing of nearly 350 acute-care hospital beds in Calgary and Edmonton.
The latest tussle between the province and Alberta Health Services has opposition parties and public health advocates questioning who's ultimately accountable for a system that's gobbling up nearly 40 per cent of the provincial budget.
"It's pretty clear that confusion reigns in the health-care system," said Liberal health critic Kevin Taft. "It's not clear to anyone who's in charge. It's certainly not clear to the minister."
Taft believes the problems stem from the Stelmach government imploding the former regional health authorities and creating one Edmonton-based superboard.
The fallout of an overcrowded Tom Baker centre, he noted, has been to deliver cancer services at other facilities around Calgary, including the Holy Cross Centre.
Taft said he's very worried about the health of patients and staff at the Holy Cross, which is the subject of a class-action lawsuit over asbestos contamination.
"I just don't think it's a place where health services should be delivered," he said.
Former premier Ralph Klein promised nearly five years ago $1 billion to build or expand cancer facilities in Calgary and Edmonton. But his government did not follow through on the 2005 promise.
jfekete@theherald.canwest.com
© Copyright (c) The Calgary Herald
Sunday, March 7, 2010
Nurses' contract negotiations 'to set new standard for future'
Will create template for other health professionals: expert
By Jodie Sinnema, Edmonton Journal March 6, 2010
Representatives of Alberta's 24,000 registered nurses are set to begin contract negotiations with Alberta's health superboard that could have wide-reaching implications beyond the health profession, observers say.
Proposals are changing hands Monday with meetings set through March and April.
"The nurses have historically set the standard not only for health services but public services in general," said David Eggen, executive director with Friends of Medicare.
"These negotiations will have implications for the doctors and for health professions and even other public servants."
The contract for registered nurses and registered psychiatric nurses expires March 31. The contract for doctors on March 31, 2011.
"The outcome is going to set a new standard for the future," said Trish Reay, a business professor at the University of Alberta.
"I do think this is a very important negotiations that are coming up."
The last time the registered nurses were at the bargaining table was 2007, when they received five-per-cent annual raises for three years.
The deal made senior nurses the best paid in Canada, and also gave lump sum payments to nurses at every level to keep them in the then-overheated Alberta economy.
Physicians received similar wage hikes in their contract.
"It's certainly different than in 2007," said Heather Smith, president of the United Nurses of Alberta. "In the previous round, I think the employers and the union were rowing in the same direction in understanding there was a huge workforce supply issue that needed to be addressed."
Where once the province insisted it faced a severe shortage of nurses, the health authority then declared it had an oversupply, in part because of lower-than-expected turnover.
"This environment is a little bit different," Smith said.
"We still don't know how many jobs have disappeared since last May and we're not sure if there's the level of commitment to building the health-care workforce and building our capacity to deliver services in the public realm."
She said there will be a wage proposal put forward, but staffing is a key priority to ensure there are enough and the right mix of nurses to provide safe and quality care.
"I'm optimistic that there is a will to really address the needs and make health care better here in the province," Smith said. "I want to be optimistic that there's calm and thoughtful intent with respect to our negotiations."
Susan McGillivray, vice-president of labour relations and human resources for Alberta Health Services, said negotiations will be driven by four principles: to engage nurses, to keep Alberta competitive, to optimize worker skills and to make sure Alberta has as many nurses as needed in the right places.
"We're hoping for good discussions and to work collaboratively to reach an agreement that's really focused on improving patient care and allowing nurses to spend more time with patients," McGillivray said.
Reay said the strained atmosphere between nurses and Alberta Health Services appears to have eased slightly since February's budget, when the government covered the $1.3-billion deficit of the health authority and gave another six-per-cent funding increase for operations.
But she said registered nurses are being pressured by talk that some could be replaced by cheaper licensed practical nurses.
"That's a pretty threatening place for the nurses to be," Reay said.
"My guess is the United Nurses are going to be reasonable in their discussion about wages. They're going to be looking to preserve the number of nurses that are employed."
She believes public support will be strong. "The public believes nurses are worth it. Essentially, people like nurses and they think they do incredibly important work."
Eggen said the public will be watching. "(These negotiations are) very important
to perhaps rebuild some of the morale and confidence that's been lost in the health-care professions over the last couple of years," Eggen said.
"Health-care professionals have been through the ringer in this province and it's time to try to fix that."
jsinnema@thejournal.canwest.com
Will create template for other health professionals: expert
By Jodie Sinnema, Edmonton Journal March 6, 2010
Representatives of Alberta's 24,000 registered nurses are set to begin contract negotiations with Alberta's health superboard that could have wide-reaching implications beyond the health profession, observers say.
Proposals are changing hands Monday with meetings set through March and April.
"The nurses have historically set the standard not only for health services but public services in general," said David Eggen, executive director with Friends of Medicare.
"These negotiations will have implications for the doctors and for health professions and even other public servants."
The contract for registered nurses and registered psychiatric nurses expires March 31. The contract for doctors on March 31, 2011.
"The outcome is going to set a new standard for the future," said Trish Reay, a business professor at the University of Alberta.
"I do think this is a very important negotiations that are coming up."
The last time the registered nurses were at the bargaining table was 2007, when they received five-per-cent annual raises for three years.
The deal made senior nurses the best paid in Canada, and also gave lump sum payments to nurses at every level to keep them in the then-overheated Alberta economy.
Physicians received similar wage hikes in their contract.
"It's certainly different than in 2007," said Heather Smith, president of the United Nurses of Alberta. "In the previous round, I think the employers and the union were rowing in the same direction in understanding there was a huge workforce supply issue that needed to be addressed."
Where once the province insisted it faced a severe shortage of nurses, the health authority then declared it had an oversupply, in part because of lower-than-expected turnover.
"This environment is a little bit different," Smith said.
"We still don't know how many jobs have disappeared since last May and we're not sure if there's the level of commitment to building the health-care workforce and building our capacity to deliver services in the public realm."
She said there will be a wage proposal put forward, but staffing is a key priority to ensure there are enough and the right mix of nurses to provide safe and quality care.
"I'm optimistic that there is a will to really address the needs and make health care better here in the province," Smith said. "I want to be optimistic that there's calm and thoughtful intent with respect to our negotiations."
Susan McGillivray, vice-president of labour relations and human resources for Alberta Health Services, said negotiations will be driven by four principles: to engage nurses, to keep Alberta competitive, to optimize worker skills and to make sure Alberta has as many nurses as needed in the right places.
"We're hoping for good discussions and to work collaboratively to reach an agreement that's really focused on improving patient care and allowing nurses to spend more time with patients," McGillivray said.
Reay said the strained atmosphere between nurses and Alberta Health Services appears to have eased slightly since February's budget, when the government covered the $1.3-billion deficit of the health authority and gave another six-per-cent funding increase for operations.
But she said registered nurses are being pressured by talk that some could be replaced by cheaper licensed practical nurses.
"That's a pretty threatening place for the nurses to be," Reay said.
"My guess is the United Nurses are going to be reasonable in their discussion about wages. They're going to be looking to preserve the number of nurses that are employed."
She believes public support will be strong. "The public believes nurses are worth it. Essentially, people like nurses and they think they do incredibly important work."
Eggen said the public will be watching. "(These negotiations are) very important
to perhaps rebuild some of the morale and confidence that's been lost in the health-care professions over the last couple of years," Eggen said.
"Health-care professionals have been through the ringer in this province and it's time to try to fix that."
jsinnema@thejournal.canwest.com
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