Tories vow to add doctors
East Calgary Health Centre opens during shortage
By Jason Fekete, Calgary Herald September 28, 2010 Comments (3)
•Story•Photos ( 1 )•Video ( 1 )
Ken Hughes, Chair, Alberta Health Services Board (left), Ed Stelmach, Premier of Alberta, artist Damon Dessler-Herron, 7, Gene Zwozdesky, Minister of Health and Wellness and Ray Danyluk, Minister of Infrastructure all hold prints of a picture drawn by the youth. Alberta Health Services officially opened the East Calgary Health Centre on September 27, 2010. The new centre brings together numerous health services under one roof to promote community-based care.Photograph by: Lorraine Hjalte, Calgary HeraldThe Stelmach government wants to recruit more physicians and increase the number of medical residency spots in Alberta to address a doctor shortage that's hurting communities and posing staffing pains at some facilities.
Ballooning health-care and construction costs in recent years also have forced the government and Alberta Health Services to either mothball or "shell in" sections of new and expanded health facilities because there's not enough dollars to operate them -- something the province calls its "safe-and-warm process."
The challenge of finding dollars and doctors is being felt at the South Calgary Health Campus, the $1.4-billion facility under construction on the city's southeast edge. Phase 1 of the 228-bed hospital is slated to open in 2012.
Health Minister Gene Zwozdesky said Monday that parts of the province continue to struggle with doctor shortages, especially rural areas, and that government must do more to attract physicians.
"There are some issues that we have to address . . . with respect to the way that doctors are being recruited here and how aggressively they're being recruited," Zwozdesky told reporters Monday at the official opening of the $10.6-million East Calgary Health Centre, a facility offering more than 30 clinics and programs.
"Our overwhelming problem right now, I think, is residency spots," he noted.
"I would really like to put a lot more emphasis on the residency programs."
There are 1,373 physician residency spots available in Alberta in 2010, but the number of students accepted to the province's two medical schools actually decreased this year.
This fall, the University of Calgary faculty of medicine admitted 170 students, down from 180 the year before, while the University of Alberta also trimmed spots.
"It's just no vision, no planning," Wildrose Alliance health critic Heather Forsyth said about the government's challenges finding doctors and staffing facilities. "I just shake my head."
Premier Ed Stelmach vowed Monday his government would continue on a "very aggressive path of training more doctors and nurses."
A few years ago, his government promised to increase by 2012 the number of physician graduates to 295 from 227, registered nursing grads to 2,000 from 1,375 and licensed practical nurses to 1,000 from 559. Last year, the province's postsecondary schools graduated 249 physicians, 1,519 registered nurses and 587 LPNs.
But even if the province attracts more medical professionals, there's no guarantee the government will be able to fully staff its health facilities.
Costly additions to the Rockyview and Peter Lougheed hospitals in Calgary over the past few years created no additional beds in the system because Alberta Health Services couldn't afford to staff both the old wards and new wings.
David Eggen with Friends of Medicare said the government is always trying to look busy on the health-care file but is not properly managing or funding the daily operations to ensure a smooth system.
"They love to cut ribbons but not put the people inside that actually make the facility function," Eggen said.
jfekete@calgaryherald.com
© Copyright (c) The Calgary Herald
Read more: http://www.calgaryherald.com/health/Tories+doctors/3588047/story.html#ixzz1132FYo2c
Thursday, September 30, 2010
Wednesday, September 29, 2010
Red Deer Advocate
Short-staffed? Who knew?
By Greg Neiman - Red Deer Advocate
Published: September 29, 2010 8:35 AM
It shouldn’t be surprising that there’s a staffing shortage at Extendicare Michener Hill, the recently-opened seniors care facility to replace Red Deer Nursing Home and Valley Park Manor. The province has been a net exporter of health workers ever since Alberta Health Services took over the operation of the system in province.
As of a week ago, there were just over 100 workers at Michener Hill, which is expected to have up to 250 at full capacity. According to AUPE, a quarter of the staff at Michener Hill had come from our two aging nursing homes, at the time of their recent vote, which chose AUPE to be their union.
More staff have been hired since that vote and Michener Hill now reports to be at 60 per cent of a full complement of staff.
But 60 per cent is not near enough for Michener Hill to continue to accept transfers from the nursing homes — especially when families learn that much of the shifts being worked are by employees brought in from other Extendicare facilities in the province, and many of them are working double shifts and overtime.
The service is not, as the saying goes, as advertised.
Obviously, this situation cannot be sustained.
The lack of preparation on Extendicare’s part should not be excused. They knew exactly how many patients to expect — they had drawn up a program of transfers well in advance of opening day. They knew that they would quickly be at full capacity, they knew what their staff requirements would be. But those staff are not there.
Why? Were Extendicare managers surprised at the low numbers of staff who agreed to transfer to Michener Hill?
Ask yourself: if you had a family and bills to pay, would you leave your seniority and job security with the public health system to go to a for-profit facility with no seniority — and not even a collective agreement on wages and working conditions in place? Or would you use your seniority and move to a similar job within the public system, bumping casual staff (who could then, in theory, apply with Michener Hill)?
Paulette Bearer described the situation as she cancelled her 97-year-old mother’s move from Valley Park Manor: “I did not expect to find this mess. I live in the States. I know what bad health care is like.”
In the past few days, Health Minister Gene Zwozdesky announced an aggressive recruitment plan for doctors, nurses, practical nurses — all of it. One hopes to high heaven the recruitment plan comes with a plan to actually hire the recruits, but between government and AHS, you can never be sure.
How many health care workers has Alberta paid to train over the past five or six years — who then left for Saskatchewan, the Maritimes or the U.S., because there were no jobs for them here? How many millions of dollars of investment in training them was lost because of the AHS hiring freeze — during a well-demonstrated staff shortage? How many millions is it going to cost to try to lure them back? And why would we spend tax dollars to recruit health workers for seniors, when the only positions available to them are at for-profit corporations? Shouldn’t that be their job?
Albertans were warned something like this would happen. Union reps, staff and advocacy groups like the Central Alberta Council on Aging have said all along that understaffing was the first resort of for-profit health care.
Bearer has first-hand experience of that. “Since I live in the States, I have to deal with that all the time. They understaff, underpay, under-supply. How else are they going to make money?”
Now she’s seeing this on both sides of the border.
Greg Neiman is an Advocate editor.
By Greg Neiman - Red Deer Advocate
Published: September 29, 2010 8:35 AM
It shouldn’t be surprising that there’s a staffing shortage at Extendicare Michener Hill, the recently-opened seniors care facility to replace Red Deer Nursing Home and Valley Park Manor. The province has been a net exporter of health workers ever since Alberta Health Services took over the operation of the system in province.
As of a week ago, there were just over 100 workers at Michener Hill, which is expected to have up to 250 at full capacity. According to AUPE, a quarter of the staff at Michener Hill had come from our two aging nursing homes, at the time of their recent vote, which chose AUPE to be their union.
More staff have been hired since that vote and Michener Hill now reports to be at 60 per cent of a full complement of staff.
But 60 per cent is not near enough for Michener Hill to continue to accept transfers from the nursing homes — especially when families learn that much of the shifts being worked are by employees brought in from other Extendicare facilities in the province, and many of them are working double shifts and overtime.
The service is not, as the saying goes, as advertised.
Obviously, this situation cannot be sustained.
The lack of preparation on Extendicare’s part should not be excused. They knew exactly how many patients to expect — they had drawn up a program of transfers well in advance of opening day. They knew that they would quickly be at full capacity, they knew what their staff requirements would be. But those staff are not there.
Why? Were Extendicare managers surprised at the low numbers of staff who agreed to transfer to Michener Hill?
Ask yourself: if you had a family and bills to pay, would you leave your seniority and job security with the public health system to go to a for-profit facility with no seniority — and not even a collective agreement on wages and working conditions in place? Or would you use your seniority and move to a similar job within the public system, bumping casual staff (who could then, in theory, apply with Michener Hill)?
Paulette Bearer described the situation as she cancelled her 97-year-old mother’s move from Valley Park Manor: “I did not expect to find this mess. I live in the States. I know what bad health care is like.”
In the past few days, Health Minister Gene Zwozdesky announced an aggressive recruitment plan for doctors, nurses, practical nurses — all of it. One hopes to high heaven the recruitment plan comes with a plan to actually hire the recruits, but between government and AHS, you can never be sure.
How many health care workers has Alberta paid to train over the past five or six years — who then left for Saskatchewan, the Maritimes or the U.S., because there were no jobs for them here? How many millions of dollars of investment in training them was lost because of the AHS hiring freeze — during a well-demonstrated staff shortage? How many millions is it going to cost to try to lure them back? And why would we spend tax dollars to recruit health workers for seniors, when the only positions available to them are at for-profit corporations? Shouldn’t that be their job?
Albertans were warned something like this would happen. Union reps, staff and advocacy groups like the Central Alberta Council on Aging have said all along that understaffing was the first resort of for-profit health care.
Bearer has first-hand experience of that. “Since I live in the States, I have to deal with that all the time. They understaff, underpay, under-supply. How else are they going to make money?”
Now she’s seeing this on both sides of the border.
Greg Neiman is an Advocate editor.
Tuesday, September 21, 2010
Friends of Medicare pushing for new health care legislation
10:15pm
Amy Arts
9/21/2010
Health Minister Gene Zwozdesky is in for a special delivery.
The Parkland Institute has put together a report calling for new health care legislation. David Eggen with Friends of Medicare says the three biggest components are improving senior care, creating a provincial pharmacare plan, and reducing wait times.
The concerns were gathered by open houses.
"People are concerned about health care and they want some practical solutions to things that are affecting them on a day to day basis," Eggen explains.
The most recent open house was held Tuesday night in Edmonton. Eggen is hoping for a response from Zwozdesky later this fall. (aa)
10:15pm
Amy Arts
9/21/2010
Health Minister Gene Zwozdesky is in for a special delivery.
The Parkland Institute has put together a report calling for new health care legislation. David Eggen with Friends of Medicare says the three biggest components are improving senior care, creating a provincial pharmacare plan, and reducing wait times.
The concerns were gathered by open houses.
"People are concerned about health care and they want some practical solutions to things that are affecting them on a day to day basis," Eggen explains.
The most recent open house was held Tuesday night in Edmonton. Eggen is hoping for a response from Zwozdesky later this fall. (aa)
Thanks Paul! At least you are honest.
Alberta should reform health care in nudge, nudge, way
By Paul Stanway, For The Calgary Herald September 21, 2010 8:32 AM
A devastating report last week from the Organization for Economic Co-operation and Development (OECD) delivered a very clear opinion on the state of Canadian health care; our vaunted medicare system is one sick puppy.
The world's leading public policy think-tank concluded that across the country health-care costs are gobbling up provincial budgets at an unsustainable rate, while rationing and waiting lists have become "endemic" as governments dither over reforming what we are told is the crowning glory of Canadian liberal democracy.
But of course we already know this. Umpteen reports, studies and commissions have told our federal and provincial governments essentially the same thing: we're paying more and more for health care without significantly improving access to services.
The problem is an antiquated and politicized delivery system, which was designed five decades ago in simpler times and for a smaller, less demanding population. It has struggled to keep pace with medical advances and changing demographics, and it takes no genius to figure out it's not going to respond well to tighter government budgets and the greying of the boomers.
So how have governments responded to these challenges?
Well, in Canada's largest provinces they've adopted a "nudge, nudge, wink, wink" approach, allowing the private sector to quietly supplement the ailing public system. While the governments of those provinces trumpet their undying support of public health care, private clinics are now fairly commonplace in Quebec, Ontario, and British Columbia.
And then there's Alberta, which has adopted a "tell it like it is" approach in the vain hope of an adult debate that would recognize the problems and create a public consensus supporting reform.
And why not? It worked with the fiscal crisis of the early '90s. The Klein government was upfront with Albertans and was widely supported in taking strong action to eliminate the deficit. It was understandable the government would assume the same approach would work with health care.
It didn't. Several clumsy attempts to generate support for health care reforms were successfully derailed by vested interests within the health system and by political and media opposition outside. In the end Ralph just threw his hands in the air and gave up.
But the problems didn't go away and the Stelmach government took a run at them from a new direction. It would re-organize and streamline the administration of health care, as a first step toward modernizing delivery.
That made sense. Nine sets of administration -- with boatloads of executives making huge salaries -- had failed to make the improvements Albertans want. Heck, they had trouble agreeing on the time of day or living within a budget.
Former health minister Ron Liepert was given the daunting task of taking a weed-whacker to this expensive health care undergrowth, and he succeeded in reforming public health administration at near warp speed. Predictably, he was demonized for his efforts -- but I would hazard a guess that few Albertans would actually support the notion that an overfed bureaucracy is the first requirement of an effective public health system.
Fast forward to a new health minister, Gene Zwozdesky, who has been given the task of continuing the overhaul -- albeit with a lighter touch. On the heels of the public consultations released last week by the province, Zwoz's next step is to create a legislative framework for a health system that can better meet evolving demands and put the needs of the patient -- you and me -- at the front of the line.
Because the reality -- as opposed to media myth -- is that Alberta's misnamed Health Care Protection Act is the most restrictive legislation in the country. What it protects is the system, not the needs of the patient: a system in which access is often plugged, and in which customer service is often an alien concept.
Let's get one thing straight. This is not about privatizing public health care. As the Klein government's investigations showed, the potential market for private health care in Alberta is too puny to attract medical entrepreneurs. Besides, if you want it and can afford it you can do a Danny Williams and head to the U.S.
But as the OECD report suggests, expanding the private delivery of public services -- the same system that allows you to see your doctor or go to a medicentre without reaching for your wallet -- has the potential to improve access and cuts costs.
Do you really care if the tech operating an MRI is a provincial employee? Would you care if your Alberta Health card was all you needed to get a hip replacement at a private clinic working on contract for Alberta Health?
Probably not, but this is Alberta. We're typecast as health care villains and any attempt to overhaul our health system is condemned as the end of civilization as we know it: "Americanstyle" privatization with old folks and babies being thrown to the wolves!
If enough Albertans buy that nonsense, it could derail yet another attempt at necessary reform. And as the OECD rightly points out, that really is the road to disaster.
Paul Stanway is an Alberta journalist and former director of communications fo Premier Ed Stelmach. His column runs every
Tuesday.
© Copyright (c) The Calgary Herald
By Paul Stanway, For The Calgary Herald September 21, 2010 8:32 AM
A devastating report last week from the Organization for Economic Co-operation and Development (OECD) delivered a very clear opinion on the state of Canadian health care; our vaunted medicare system is one sick puppy.
The world's leading public policy think-tank concluded that across the country health-care costs are gobbling up provincial budgets at an unsustainable rate, while rationing and waiting lists have become "endemic" as governments dither over reforming what we are told is the crowning glory of Canadian liberal democracy.
But of course we already know this. Umpteen reports, studies and commissions have told our federal and provincial governments essentially the same thing: we're paying more and more for health care without significantly improving access to services.
The problem is an antiquated and politicized delivery system, which was designed five decades ago in simpler times and for a smaller, less demanding population. It has struggled to keep pace with medical advances and changing demographics, and it takes no genius to figure out it's not going to respond well to tighter government budgets and the greying of the boomers.
So how have governments responded to these challenges?
Well, in Canada's largest provinces they've adopted a "nudge, nudge, wink, wink" approach, allowing the private sector to quietly supplement the ailing public system. While the governments of those provinces trumpet their undying support of public health care, private clinics are now fairly commonplace in Quebec, Ontario, and British Columbia.
And then there's Alberta, which has adopted a "tell it like it is" approach in the vain hope of an adult debate that would recognize the problems and create a public consensus supporting reform.
And why not? It worked with the fiscal crisis of the early '90s. The Klein government was upfront with Albertans and was widely supported in taking strong action to eliminate the deficit. It was understandable the government would assume the same approach would work with health care.
It didn't. Several clumsy attempts to generate support for health care reforms were successfully derailed by vested interests within the health system and by political and media opposition outside. In the end Ralph just threw his hands in the air and gave up.
But the problems didn't go away and the Stelmach government took a run at them from a new direction. It would re-organize and streamline the administration of health care, as a first step toward modernizing delivery.
That made sense. Nine sets of administration -- with boatloads of executives making huge salaries -- had failed to make the improvements Albertans want. Heck, they had trouble agreeing on the time of day or living within a budget.
Former health minister Ron Liepert was given the daunting task of taking a weed-whacker to this expensive health care undergrowth, and he succeeded in reforming public health administration at near warp speed. Predictably, he was demonized for his efforts -- but I would hazard a guess that few Albertans would actually support the notion that an overfed bureaucracy is the first requirement of an effective public health system.
Fast forward to a new health minister, Gene Zwozdesky, who has been given the task of continuing the overhaul -- albeit with a lighter touch. On the heels of the public consultations released last week by the province, Zwoz's next step is to create a legislative framework for a health system that can better meet evolving demands and put the needs of the patient -- you and me -- at the front of the line.
Because the reality -- as opposed to media myth -- is that Alberta's misnamed Health Care Protection Act is the most restrictive legislation in the country. What it protects is the system, not the needs of the patient: a system in which access is often plugged, and in which customer service is often an alien concept.
Let's get one thing straight. This is not about privatizing public health care. As the Klein government's investigations showed, the potential market for private health care in Alberta is too puny to attract medical entrepreneurs. Besides, if you want it and can afford it you can do a Danny Williams and head to the U.S.
But as the OECD report suggests, expanding the private delivery of public services -- the same system that allows you to see your doctor or go to a medicentre without reaching for your wallet -- has the potential to improve access and cuts costs.
Do you really care if the tech operating an MRI is a provincial employee? Would you care if your Alberta Health card was all you needed to get a hip replacement at a private clinic working on contract for Alberta Health?
Probably not, but this is Alberta. We're typecast as health care villains and any attempt to overhaul our health system is condemned as the end of civilization as we know it: "Americanstyle" privatization with old folks and babies being thrown to the wolves!
If enough Albertans buy that nonsense, it could derail yet another attempt at necessary reform. And as the OECD rightly points out, that really is the road to disaster.
Paul Stanway is an Alberta journalist and former director of communications fo Premier Ed Stelmach. His column runs every
Tuesday.
© Copyright (c) The Calgary Herald
Friday, September 17, 2010
UK News First! FOM is international!
A report will be released today by the provincial Government after evaluating months of input received from the public that might possibly help formulate the foundation of new Alberta Health Act.
However, a local promotion group is of the stance that the report’s suggestions made might overlook essential and definitive plans concerning improving health care delivery, and in its place, will come up with absurd set of regulations that will further propel privatization.
David Eggen of Friends of Medicare said that proper plans relating making concrete improvements specially considering wait time trouble, getting easy access to health professionals and hospitals beds was of utmost importance.
People are least bothered about the guiding principles to be offered, but the drawbacks need to be fixed relating the health system.
The Minister's Advisory Committee on Health, which was managed by Conservative MLA, Fred Horne, had reported of the creation of Alberta Health Act when a report was submitted in the month of January.
The committee said that such law must make the complex web of bylaw, simple, and focus on patients’ demands.
The report to be presented today by Horne has been christened as Putting People First’ that will assess the input received from the general public and present 15 suggestions to develop new legal rule.
However, a local promotion group is of the stance that the report’s suggestions made might overlook essential and definitive plans concerning improving health care delivery, and in its place, will come up with absurd set of regulations that will further propel privatization.
David Eggen of Friends of Medicare said that proper plans relating making concrete improvements specially considering wait time trouble, getting easy access to health professionals and hospitals beds was of utmost importance.
People are least bothered about the guiding principles to be offered, but the drawbacks need to be fixed relating the health system.
The Minister's Advisory Committee on Health, which was managed by Conservative MLA, Fred Horne, had reported of the creation of Alberta Health Act when a report was submitted in the month of January.
The committee said that such law must make the complex web of bylaw, simple, and focus on patients’ demands.
The report to be presented today by Horne has been christened as Putting People First’ that will assess the input received from the general public and present 15 suggestions to develop new legal rule.
Braid: Regular Albertans always got it, but Tories did not
By Don Braid, Calgary Herald September 17, 2010 Comments (5)
StoryPhotos ( 1 )
New Democrat Leader Brian Mason says, "People really want concrete improvements to our health-care system, and they don't want a bunch of airy-fairy, abstract principles."
Photograph by: Ted Rhodes, Calgary Herald, Calgary HeraldFor 12 months, government advisory committee members asked what Albertans want for health care.
Politicians and experts visited 23 communities. They held 29 workshops with 1,300 participants. They received 85 written submissions.
And this is what they learned, says Edmonton MLA Fred Horne, who piloted this enterprise.
"Albertans want a health system that puts people first."
The report elaborates this stunning discovery over two sections and 70 pages. Unsurprisingly, it's called Putting People First.
Refining his theme somewhat, Horne adds: "They (Albertans) want to see government put people first."
We get it, Fred. In fact, regular Albertans always got it.
Not many of us ever imagined that the health system should put anything but people first. So far, we don't expect to line up behind horses and dogs.
But it is true, as Horne's own words obliquely concede, that for a long time the Stelmach regime's health-care system did not put people first.
For nearly two years, it put the system first. The government focused on administration and structure, abolishing regions and shaking out management.
And then, when times suddenly turned tough, the new single-region masters decided to cut services and lay off staff.
The people who are supposed to be first began to stack up like cordwood in emergency wards.
Frustration has grown so deep that those waiting rooms are papered with signs warning that abuse of staff will not be tolerated.
I've never seen a sign saying abuse of patients won't be tolerated either. But that's what patients often endure; neglect by an overworked system that does not put people first.
So it's now a powerful indictment, not just a benign observation, for Albertans to say so forcefully that they want people to come first.
Horne and the rest don't even seem to get the implied insult. They're just so darn proud of themselves for listening.
As part of the effort to convince people they come first, there will now be plenty of fine talk about a health charter, a health act and a health advocate.
It's not a bad idea to define patients' rights, as long as there's some real force behind the words.
But this is almost sure to be purely a paper political exercise.
The study adds instantly that the health system and the government should be immune from lawsuits if rights are violated.
And the advocate will report to the health minister, not to the legislature.
It's the same old Tory pattern than has the child and youth advocate, for one, responsible not to children, but to the political minister in charge.
In general, medical people seem to like the people-first rhetoric. It's no surprise; the report reflects their own frustrated goals and values.
But what Albertans really want, one suspects, is far better performance in little practical matters like getting cancer surgery, or catching a doctor's attention when you're in agony in a waiting room.
New Democrat Leader Brian Mason pretty much nailed it when he said: "People really want concrete improvements to our health-care system, and they don't want a bunch of airy-fairy, abstract principles."
That's what the Tories should get on with, once they absorb the mind-altering new insight that a health-care system should put people first.
Don Braid's Column Appears Regularly In The Herald.
dbraid@theherald.canwest.com
© Copyright (c) The Calgary Herald
By Don Braid, Calgary Herald September 17, 2010 Comments (5)
StoryPhotos ( 1 )
New Democrat Leader Brian Mason says, "People really want concrete improvements to our health-care system, and they don't want a bunch of airy-fairy, abstract principles."
Photograph by: Ted Rhodes, Calgary Herald, Calgary HeraldFor 12 months, government advisory committee members asked what Albertans want for health care.
Politicians and experts visited 23 communities. They held 29 workshops with 1,300 participants. They received 85 written submissions.
And this is what they learned, says Edmonton MLA Fred Horne, who piloted this enterprise.
"Albertans want a health system that puts people first."
The report elaborates this stunning discovery over two sections and 70 pages. Unsurprisingly, it's called Putting People First.
Refining his theme somewhat, Horne adds: "They (Albertans) want to see government put people first."
We get it, Fred. In fact, regular Albertans always got it.
Not many of us ever imagined that the health system should put anything but people first. So far, we don't expect to line up behind horses and dogs.
But it is true, as Horne's own words obliquely concede, that for a long time the Stelmach regime's health-care system did not put people first.
For nearly two years, it put the system first. The government focused on administration and structure, abolishing regions and shaking out management.
And then, when times suddenly turned tough, the new single-region masters decided to cut services and lay off staff.
The people who are supposed to be first began to stack up like cordwood in emergency wards.
Frustration has grown so deep that those waiting rooms are papered with signs warning that abuse of staff will not be tolerated.
I've never seen a sign saying abuse of patients won't be tolerated either. But that's what patients often endure; neglect by an overworked system that does not put people first.
So it's now a powerful indictment, not just a benign observation, for Albertans to say so forcefully that they want people to come first.
Horne and the rest don't even seem to get the implied insult. They're just so darn proud of themselves for listening.
As part of the effort to convince people they come first, there will now be plenty of fine talk about a health charter, a health act and a health advocate.
It's not a bad idea to define patients' rights, as long as there's some real force behind the words.
But this is almost sure to be purely a paper political exercise.
The study adds instantly that the health system and the government should be immune from lawsuits if rights are violated.
And the advocate will report to the health minister, not to the legislature.
It's the same old Tory pattern than has the child and youth advocate, for one, responsible not to children, but to the political minister in charge.
In general, medical people seem to like the people-first rhetoric. It's no surprise; the report reflects their own frustrated goals and values.
But what Albertans really want, one suspects, is far better performance in little practical matters like getting cancer surgery, or catching a doctor's attention when you're in agony in a waiting room.
New Democrat Leader Brian Mason pretty much nailed it when he said: "People really want concrete improvements to our health-care system, and they don't want a bunch of airy-fairy, abstract principles."
That's what the Tories should get on with, once they absorb the mind-altering new insight that a health-care system should put people first.
Don Braid's Column Appears Regularly In The Herald.
dbraid@theherald.canwest.com
© Copyright (c) The Calgary Herald
Alberta going under the knife?
Written by Lethbridge Herald & Canadian Press
Thursday, September 16 2010, 9:55 PM
A proposed overhaul of Alberta’s health-care legislation could include a charter and an advocate to enforce it.
Conservative MLA Fred Horne, who led the team that listened to over 1,000 Albertans in workshops earlier this year, says the charter would recognize the patient as the priority.
But Friends of Medicare, the health system’s non-profit watchdog, predicts no substantive changes will be made in the short term. But after the next provincial election, a spokesperson warns, the government may use the report to justify changes in legislation which could lead to private, U.S.-style medical services.
“What we’re seeing here is another attempt at introducing private health care,” said Shannon Phillips, speaking for the group in Lethbridge.
That’s why the report calls for new legislation cancelling all of Alberta’s existing health-care laws, she suggested.
“It recognizes that amalgamating all the existing legislation may lead to private delivery,” she said after the report was released.
The outcome, she said, could be much the same as former premier Ralph Klein’s “third way” route, previously rejected by Albertans. Now as then, that could hurt Albertans outside the two major cities.
It was rural MLAs who put a stop to Klein’s scheme, she added.
“It wasn’t good then, and it isn’t good now.”
What the report doesn’t reflect, the group notes, is Albertans’ urgent needs for more long-term care, for comprehensive pharmacy coverage, or for more family doctors.
Those needs — and such concerns as the loss of local leadership, after all health regions were dissolved — were voiced during hearings earlier this year in Lethbridge and communities across the province.
Friends of Medicare, seniors’ groups and others raised a range of issues when Horne and his panel visited the city.
Speaking in Edmonton, Friends of Medicare executive David Eggen said appointing an advocate — if the health minister accepts the recommendation — would be a positive step. But little will be done with the report this year, he predicted.
“I think this government is nervous about health care,” he said. “It’s buying time.”
Releasing the report quickly, before the legislature sits in late October, is part of that strategy.
“It makes it look like they’re doing something.”
Writing a charter, Horne said, could put more priority on patients’ needs and less on the issues facing the system. Too often, he said, the focus has been on budgets and the needs of professionals.
“We don’t talk a lot about the needs of the people and the purpose of the system being there to meet their needs.”
Horne said the advocate, who would report to the health minister, would be needed to ensure the charter had some teeth.
“That’s exactly the point Albertans brought up, so we recommended the health advocate have responsibility for the charter. And that role would be to help people, to help point them in the right direction (and) to have their concerns addressed.
The proposals are among 15 that were outlined by Horne. Health Minister Gene Zwozdesky will review them and advise next month which ones he’ll adopt.
The proposed charter, said Horne, would not be used to limit access to care. It would instead promise that all Albertans would have the right to primary care, such as a family doctor. It would also provide mechanisms for people to have their concerns recognized and resolved.
The charter would not be subject to court litigation.
Horne and his eight-member advisory committee heard from 1,300 people across the province over four months. There were also 1,500 web-based surveys and written submissions from more than 80 organizations.
Guy Smith, president of the Alberta Union of Provincial Employees, said he’s optimistic an overhauled health act would enshrine publicly funded and delivered health care. But the devil will be in the details, he warned.
“We really need to proceed with caution about implementing the recommendations of this report,” Smith said in a news release. “Our goal should be to preserve and improve our quality public health-care system, not to provide justifications for introducing more private care.”
Smith’s union is the largest in Alberta at 70,000 members. Most work in health care.
Opposition Liberal Leader David Swann said he respects the work of the committee and those who responded with ideas, but the exercise simply affirmed what everyone already knew.
“As far as I can see, this government continues to dodge and divert and ask for more consultation, not really listening to what many of the experts are saying,” he said.
“It’s time for better management. It’s time for a longer-term commitment to publicly funded, publicly delivered health care.”
Written by Lethbridge Herald & Canadian Press
Thursday, September 16 2010, 9:55 PM
A proposed overhaul of Alberta’s health-care legislation could include a charter and an advocate to enforce it.
Conservative MLA Fred Horne, who led the team that listened to over 1,000 Albertans in workshops earlier this year, says the charter would recognize the patient as the priority.
But Friends of Medicare, the health system’s non-profit watchdog, predicts no substantive changes will be made in the short term. But after the next provincial election, a spokesperson warns, the government may use the report to justify changes in legislation which could lead to private, U.S.-style medical services.
“What we’re seeing here is another attempt at introducing private health care,” said Shannon Phillips, speaking for the group in Lethbridge.
That’s why the report calls for new legislation cancelling all of Alberta’s existing health-care laws, she suggested.
“It recognizes that amalgamating all the existing legislation may lead to private delivery,” she said after the report was released.
The outcome, she said, could be much the same as former premier Ralph Klein’s “third way” route, previously rejected by Albertans. Now as then, that could hurt Albertans outside the two major cities.
It was rural MLAs who put a stop to Klein’s scheme, she added.
“It wasn’t good then, and it isn’t good now.”
What the report doesn’t reflect, the group notes, is Albertans’ urgent needs for more long-term care, for comprehensive pharmacy coverage, or for more family doctors.
Those needs — and such concerns as the loss of local leadership, after all health regions were dissolved — were voiced during hearings earlier this year in Lethbridge and communities across the province.
Friends of Medicare, seniors’ groups and others raised a range of issues when Horne and his panel visited the city.
Speaking in Edmonton, Friends of Medicare executive David Eggen said appointing an advocate — if the health minister accepts the recommendation — would be a positive step. But little will be done with the report this year, he predicted.
“I think this government is nervous about health care,” he said. “It’s buying time.”
Releasing the report quickly, before the legislature sits in late October, is part of that strategy.
“It makes it look like they’re doing something.”
Writing a charter, Horne said, could put more priority on patients’ needs and less on the issues facing the system. Too often, he said, the focus has been on budgets and the needs of professionals.
“We don’t talk a lot about the needs of the people and the purpose of the system being there to meet their needs.”
Horne said the advocate, who would report to the health minister, would be needed to ensure the charter had some teeth.
“That’s exactly the point Albertans brought up, so we recommended the health advocate have responsibility for the charter. And that role would be to help people, to help point them in the right direction (and) to have their concerns addressed.
The proposals are among 15 that were outlined by Horne. Health Minister Gene Zwozdesky will review them and advise next month which ones he’ll adopt.
The proposed charter, said Horne, would not be used to limit access to care. It would instead promise that all Albertans would have the right to primary care, such as a family doctor. It would also provide mechanisms for people to have their concerns recognized and resolved.
The charter would not be subject to court litigation.
Horne and his eight-member advisory committee heard from 1,300 people across the province over four months. There were also 1,500 web-based surveys and written submissions from more than 80 organizations.
Guy Smith, president of the Alberta Union of Provincial Employees, said he’s optimistic an overhauled health act would enshrine publicly funded and delivered health care. But the devil will be in the details, he warned.
“We really need to proceed with caution about implementing the recommendations of this report,” Smith said in a news release. “Our goal should be to preserve and improve our quality public health-care system, not to provide justifications for introducing more private care.”
Smith’s union is the largest in Alberta at 70,000 members. Most work in health care.
Opposition Liberal Leader David Swann said he respects the work of the committee and those who responded with ideas, but the exercise simply affirmed what everyone already knew.
“As far as I can see, this government continues to dodge and divert and ask for more consultation, not really listening to what many of the experts are saying,” he said.
“It’s time for better management. It’s time for a longer-term commitment to publicly funded, publicly delivered health care.”
Government blows smoke!
Once considered among the foremost advocates for two-tier health care in Canada, the Alberta government has released a report that calls for changes that could reshape the province’s health system into a more public model.
Health Minister Gene Zwozdesky said on Thursday, however, that a new Alberta Health Act the province is developing, and other controversial changes to the health-care system already implemented, include no move to privatize.
“Make no mistake about it: [the AHA] will be in the parameters of the Canada Health Act, and it will reflect one of Albertans' central values – for a single-tiered, publicly funded health system.”
The report released on Thursday, based on citizen feedback and produced by the province, urges in abstract terms that Alberta fundamentally reverse its approach to delivering patient care by “putting people first,” rather than a current model that report stakeholders say prioritizes health professionals and institutions in determining levels of care. Effectively, it says Albertans believe funding and treatment should follow a patient, rather than a patient having to seek it out.
Alberta Health Act Report 2010
If adopted in the new Alberta Health Act, the system envisioned in Thursday’s report would emphasize wellness over treatment – guaranteeing access to primary care, setting up multidisciplinary teams to provide it, developing performance standards, creating a Health Charter and hiring an advocate to enforce it.
Canada is facing a looming funding crisis in health care driven by an aging population and rising costs. The head of the Canadian Medical Association earlier this week urged a total rethink of the country’s health system, and on Thursday praised Alberta’s report.
Mr. Zwozdesky said the province is leading Canada in turning around the health-care model – no province has a Health Act as wide-reaching as that envisioned by Alberta, where health law is currently made up of about 30 individual pieces of legislation.
But critics worry it’s part of an ongoing boondoggle that could lead to more private care.
“The devil’s in the details,” said Liberal Leader David Swann, a physician. “That's one of the challenges I think we'll have to watch closely as [the act] comes to the legislature. Is this another excuse for privatizing?”
While he praised the medical professionals who signed off on the report, Dr. Swann added that “overall, I guess I'd have to say we don't need more laws, we need better management of the health system.”
Some observers say Alberta, which recently invested billions in health-related capital projects and consolidated its health boards, has abandoned its position as a proponent for some privatized care since the departure of former premier Ralph Klein.
The kind of primary care suggested in Thursday’s report could include a broad range of preventive treatment typically not included in public care – funding front-line acupuncture, chiropractors (which Alberta has recently de-insured), and pharmacare-like streamlining of prescription drug access. One stakeholder suggested that even homeopathic care could be considered, though another said he'd oppose that.
No mention was made whether providers would be public or private.
Study author Fred Horne, a backbench MLA who entered politics after a career as a health-care consultant, was left defending his report Thursday amid early coverage suggesting it was too vague. However, he said he was not asked to come up with specifics, but rather report what Albertans want. Access was their top concern, leading to his recommendation of a fundamental shift.
“Pretty much all Albertans I talked to say we have an excellent health-care system. A lot of our issues are just getting in,” Mr. Horne said. “It's up to the minister and the government to really reflect on what Albertans said and come back with a response.”
In his report, which cost just over $1-million to produce, Mr. Horne recommended the AHA augment, and not replace, five existing pieces of provincial health legislation, contrary to what was initially suggested.
Jeff Turnbull, the president of the Canadian Medical Association, praised Thursday’s report, telling The Globe and Mail the report “deals with many of the issues that we feel are important and that physicians across the country feel are important: patient-centredness, putting patients first, a focus on safety and quality.”
William Tholl, who teaches health leadership at Royal Roads University in Victoria and who is one of the authors of the Canada Health Act as well as a past executive director of the CMA, said the report builds on the findings of the 2002 Commission on the Future of Health Care in Canada, which was led by Roy Romanow. And rather than undercutting the Canada Health Act, Mr. Horne appears to want to build on it, Mr. Tholl said. “So, on the face of it, it seems like its going in the right direction.”
He said he was surprised that Alberta, which as recently as 2006 was hoping to expand private care, would take the lead on these types of issues. The province has some for-profit clinics that are publicly funded, and are larger than the most basic form of private, for-profit care: a family doctor’s office.
The report was based on interviews with 1,300 Albertans and was requested earlier this year by Mr. Zwozdesky’s Advisory Committee on Health (which Mr. Horne also sat on). The minister cautioned that the report is not binding, but he will review it before actually tabling the new health act. “The Act is a second step,” he said.
Critics nevertheless worry the creation of a Health Charter could force the government to introduce more privatized care, as it could be liable if it cannot provide services.
“You give people a promise you don’t intend to keep, and lo and behold you have to go private,” said Michael McBane of the Canadian Health Coalition. “In other words, setting it up to fail.”
Mr. McBane said the report was light on details, including “what implications it will have in terms of public versus private care, they are hiding that.”
David Eggen, executive director of Alberta's Friends of Medicare advocacy group and a former New Democrat MLA, said Thursday's report lacks substance and likely won't lead to many changes.
“I just don't see the point of this exercise. Why do you need a statement of principles that's really a faint echo of the Canada Health Act, without having some ulterior motive in mind?” Mr. Eggen said.
A spokesman for federal Health Minister Leona Aglukkaq said Thursday that the her department will review Alberta’s vision for health care. But the report had the support of a number of medical associations, including the College of Physicians and Surgeons of Alberta. Registrar Trevor Theman said the proposed changes are based on the principle that access must be “based on need and not the ability to pay.”
“If they're implemented,” Dr. Theman said, “I think we'll really see a fundamental difference in how health care is delivered in this province.”
The Health Quality Council of Alberta also signed off on the report. Its CEO, John Cowell, said it’s no Trojan horse for privatization.
“It's not about that at all,” Dr. Cowell said. “It's about fundamentally reestablishing a philosophical approach to health care.”
John Church, a professor at the University of Alberta's Centre for Health Promotion Studies, said he supports initiatives to focus on wellness-based care, and a creation of a Health Charter. He noted that since Mr. Klein left office, “we haven't seen a huge explosion in the development of private health care in this province.”
Thursday's report could either be, as skeptics suggested, yet another study that will lead to inaction, or the latest step in Alberta's move to overhaul its health system as a model of public care.
“There are some potentially very positive things the government is looking at doing here, but it will all depend on how they make it operational,” Prof. Church says. “They're certainly saying the right things right now, so we'll wait and see.”
Health Minister Gene Zwozdesky said on Thursday, however, that a new Alberta Health Act the province is developing, and other controversial changes to the health-care system already implemented, include no move to privatize.
“Make no mistake about it: [the AHA] will be in the parameters of the Canada Health Act, and it will reflect one of Albertans' central values – for a single-tiered, publicly funded health system.”
The report released on Thursday, based on citizen feedback and produced by the province, urges in abstract terms that Alberta fundamentally reverse its approach to delivering patient care by “putting people first,” rather than a current model that report stakeholders say prioritizes health professionals and institutions in determining levels of care. Effectively, it says Albertans believe funding and treatment should follow a patient, rather than a patient having to seek it out.
Alberta Health Act Report 2010
If adopted in the new Alberta Health Act, the system envisioned in Thursday’s report would emphasize wellness over treatment – guaranteeing access to primary care, setting up multidisciplinary teams to provide it, developing performance standards, creating a Health Charter and hiring an advocate to enforce it.
Canada is facing a looming funding crisis in health care driven by an aging population and rising costs. The head of the Canadian Medical Association earlier this week urged a total rethink of the country’s health system, and on Thursday praised Alberta’s report.
Mr. Zwozdesky said the province is leading Canada in turning around the health-care model – no province has a Health Act as wide-reaching as that envisioned by Alberta, where health law is currently made up of about 30 individual pieces of legislation.
But critics worry it’s part of an ongoing boondoggle that could lead to more private care.
“The devil’s in the details,” said Liberal Leader David Swann, a physician. “That's one of the challenges I think we'll have to watch closely as [the act] comes to the legislature. Is this another excuse for privatizing?”
While he praised the medical professionals who signed off on the report, Dr. Swann added that “overall, I guess I'd have to say we don't need more laws, we need better management of the health system.”
Some observers say Alberta, which recently invested billions in health-related capital projects and consolidated its health boards, has abandoned its position as a proponent for some privatized care since the departure of former premier Ralph Klein.
The kind of primary care suggested in Thursday’s report could include a broad range of preventive treatment typically not included in public care – funding front-line acupuncture, chiropractors (which Alberta has recently de-insured), and pharmacare-like streamlining of prescription drug access. One stakeholder suggested that even homeopathic care could be considered, though another said he'd oppose that.
No mention was made whether providers would be public or private.
Study author Fred Horne, a backbench MLA who entered politics after a career as a health-care consultant, was left defending his report Thursday amid early coverage suggesting it was too vague. However, he said he was not asked to come up with specifics, but rather report what Albertans want. Access was their top concern, leading to his recommendation of a fundamental shift.
“Pretty much all Albertans I talked to say we have an excellent health-care system. A lot of our issues are just getting in,” Mr. Horne said. “It's up to the minister and the government to really reflect on what Albertans said and come back with a response.”
In his report, which cost just over $1-million to produce, Mr. Horne recommended the AHA augment, and not replace, five existing pieces of provincial health legislation, contrary to what was initially suggested.
Jeff Turnbull, the president of the Canadian Medical Association, praised Thursday’s report, telling The Globe and Mail the report “deals with many of the issues that we feel are important and that physicians across the country feel are important: patient-centredness, putting patients first, a focus on safety and quality.”
William Tholl, who teaches health leadership at Royal Roads University in Victoria and who is one of the authors of the Canada Health Act as well as a past executive director of the CMA, said the report builds on the findings of the 2002 Commission on the Future of Health Care in Canada, which was led by Roy Romanow. And rather than undercutting the Canada Health Act, Mr. Horne appears to want to build on it, Mr. Tholl said. “So, on the face of it, it seems like its going in the right direction.”
He said he was surprised that Alberta, which as recently as 2006 was hoping to expand private care, would take the lead on these types of issues. The province has some for-profit clinics that are publicly funded, and are larger than the most basic form of private, for-profit care: a family doctor’s office.
The report was based on interviews with 1,300 Albertans and was requested earlier this year by Mr. Zwozdesky’s Advisory Committee on Health (which Mr. Horne also sat on). The minister cautioned that the report is not binding, but he will review it before actually tabling the new health act. “The Act is a second step,” he said.
Critics nevertheless worry the creation of a Health Charter could force the government to introduce more privatized care, as it could be liable if it cannot provide services.
“You give people a promise you don’t intend to keep, and lo and behold you have to go private,” said Michael McBane of the Canadian Health Coalition. “In other words, setting it up to fail.”
Mr. McBane said the report was light on details, including “what implications it will have in terms of public versus private care, they are hiding that.”
David Eggen, executive director of Alberta's Friends of Medicare advocacy group and a former New Democrat MLA, said Thursday's report lacks substance and likely won't lead to many changes.
“I just don't see the point of this exercise. Why do you need a statement of principles that's really a faint echo of the Canada Health Act, without having some ulterior motive in mind?” Mr. Eggen said.
A spokesman for federal Health Minister Leona Aglukkaq said Thursday that the her department will review Alberta’s vision for health care. But the report had the support of a number of medical associations, including the College of Physicians and Surgeons of Alberta. Registrar Trevor Theman said the proposed changes are based on the principle that access must be “based on need and not the ability to pay.”
“If they're implemented,” Dr. Theman said, “I think we'll really see a fundamental difference in how health care is delivered in this province.”
The Health Quality Council of Alberta also signed off on the report. Its CEO, John Cowell, said it’s no Trojan horse for privatization.
“It's not about that at all,” Dr. Cowell said. “It's about fundamentally reestablishing a philosophical approach to health care.”
John Church, a professor at the University of Alberta's Centre for Health Promotion Studies, said he supports initiatives to focus on wellness-based care, and a creation of a Health Charter. He noted that since Mr. Klein left office, “we haven't seen a huge explosion in the development of private health care in this province.”
Thursday's report could either be, as skeptics suggested, yet another study that will lead to inaction, or the latest step in Alberta's move to overhaul its health system as a model of public care.
“There are some potentially very positive things the government is looking at doing here, but it will all depend on how they make it operational,” Prof. Church says. “They're certainly saying the right things right now, so we'll wait and see.”
Monday, September 13, 2010
Take back private health firm, province urged
Calgary Herald September 11, 2010
Health-care critics staged a rally Friday in front of the Health Resource Centre in an attempt to convince the government to consider incorporating the troubled private health firm back into the public system.
Friends of Medicare executive director Dave Eggen said he wanted to see a cost analysis of making the centre public, as it would serve as a bulwark against the Conservatives' move towards more private health-care facilities.
The centre is embroiled in a legal dispute with Alberta Health Services, which had to intervene to prevent the private health-care provider from going bankrupt earlier this year.
"We want to send a strong message that this experiment for private delivery of public health services is more expensive, it's less efficient and it's certainly insecure as evidenced by this bankruptcy that's taking place now," Eggen said.
"Alberta Health Services had to bail out and take this capacity and put it back into the public system."
© Copyright (c) The Calgary Herald
Calgary Herald September 11, 2010
Health-care critics staged a rally Friday in front of the Health Resource Centre in an attempt to convince the government to consider incorporating the troubled private health firm back into the public system.
Friends of Medicare executive director Dave Eggen said he wanted to see a cost analysis of making the centre public, as it would serve as a bulwark against the Conservatives' move towards more private health-care facilities.
The centre is embroiled in a legal dispute with Alberta Health Services, which had to intervene to prevent the private health-care provider from going bankrupt earlier this year.
"We want to send a strong message that this experiment for private delivery of public health services is more expensive, it's less efficient and it's certainly insecure as evidenced by this bankruptcy that's taking place now," Eggen said.
"Alberta Health Services had to bail out and take this capacity and put it back into the public system."
© Copyright (c) The Calgary Herald
Wednesday, September 8, 2010
Oh, the irony
Free marketers want taxpayers to bail out private health-care firm
By David Eggen, For The Calgary HeraldSeptember 8, 2010
Re: Danielle Smith's August 24 column, Province must intervene to save HRC.
The bankruptcy and bailout of Health Resource Centre (HRC) gives Albertans a rare peek at how private, forprofit delivery of healthcare services actually works -- or, in fact, does not work.
For the first time, court documents and reports from the interim receiver have shone a light on the inner dealings of HRC, giving taxpayers a glimpse of the real cost and real risks of forprofit care.
Let's consider the facts as we know them so far. The HRC senior management team are paying themselves very well on the taxpayers' tab.
The interim receiver's report shows that Alberta Health Services (AHS) views the pay packages for HRC's Chief Medical Officer, Dr. Stephen Miller and HRC's other two executives as "excessive," and have requested that the senior management team revise its compensation.
According to the court documents, "other than an offer from one of the management team to eliminate his car allowance, no proposal has been received." In other words, the HRC executives want taxpayers to cover their high salaries. That's a government handout, not an invisible hand.
We now know that, in addition to almost $3 million in receiver
costs, rent and secured debt, Networc Health, the parent company of HRC, racked up at least $8.4 million in unsecured debt. It owes money to everyone from coffee suppliers to the Workers' Compensation Board.
Taxpayers are also on the hook for a whopping $1.4 million in legal costs. Clearly, HRC expects that Albertans will pay for their shareholder and corporate restructuring in the wake of their financial boondoggles.
When Albertans contracted HRC to conduct orthopedic surgeries, they did not expect to pay for expensive lawyers to re-structure a private contractor.
It is ironic that those who most fervently support the so-called "free market" -- the Wildrose Alliance Party, among others -- are those who are the loudest voices asking for taxpayer handouts for HRC.
Meanwhile, the jury is still out on the health outcomes HRC delivered.
In Alberta, there are unnecessary barriers to finding out how well a for-profit health facility is performing.
While public hospitals and clinics are accredited, inspected and regulated by public bodies, Alberta's Non-Hospital Surgical Facilities, such as the investor-owned HRC, are accredited by the College of Physicians and Surgeons.
The College's 2009 annual report shows a high number of reportable incidents at private clinics -- such as infections, admissions to hospital, severe illnesses, and even deaths. In 2009, private clinics like HRC had 111 "reportable incidents" -- or two per week. Unfortunately, taxpayers can't access any more information than that. Where the incident occurred or during what type of procedure is all hidden from the public.
At the very least, forprofit clinics delivering publicly funded services should be subjected to the same accreditation and inspection regime as public facilities, including more rigorous reporting requirements.
HRC was given all the advantages government could provide.
It was paid well out of the public purse to perform surgeries. According to then Premier Ralph Klein in 2005, surgeries contracted out to private facilities including HRC were costing on average 10-per-cent more than those performed in public facilities. As anyone who has studied basic business classes knows, 10 per cent is a decent profit margin. Private delivery of health care simply means taxpayers are subsidizing profits for corporate, investor-owned businesses. Albertans have done their share for HRC and its investors. Enough is enough.
To improve our healthcare system, Alberta should look at best practices from other jurisdictions.
In Manitoba, the Pan-Am clinic started out as a private business and was later absorbed into the public system. Its profits are now invested back into the public facility and the clinic is internationally known as a centre of innovation and excellent health outcomes.
Alberta Health Services is doing the right thing in absorbing the Health Resource Centre back into the public system.
It recognizes that its arrangement with this for-profit facility has not proven to be economically efficient, nor has it turned out to be a reliable way to deliver orthopedic surgeries in Calgary.
AHS is doing the right thing by terminating its contract with a business that is clearly on shaky ground.
Albertans should not even consider further bailouts, handouts, or other special favours for HRC.
The evidence is in, and this experiment with for-profit delivery should come to an end before it costs us millions more.
David Eggen is executive director of Friends of Medicare in Edmonton.
© Copyright (c) The Calgary Herald
Free marketers want taxpayers to bail out private health-care firm
By David Eggen, For The Calgary HeraldSeptember 8, 2010
Re: Danielle Smith's August 24 column, Province must intervene to save HRC.
The bankruptcy and bailout of Health Resource Centre (HRC) gives Albertans a rare peek at how private, forprofit delivery of healthcare services actually works -- or, in fact, does not work.
For the first time, court documents and reports from the interim receiver have shone a light on the inner dealings of HRC, giving taxpayers a glimpse of the real cost and real risks of forprofit care.
Let's consider the facts as we know them so far. The HRC senior management team are paying themselves very well on the taxpayers' tab.
The interim receiver's report shows that Alberta Health Services (AHS) views the pay packages for HRC's Chief Medical Officer, Dr. Stephen Miller and HRC's other two executives as "excessive," and have requested that the senior management team revise its compensation.
According to the court documents, "other than an offer from one of the management team to eliminate his car allowance, no proposal has been received." In other words, the HRC executives want taxpayers to cover their high salaries. That's a government handout, not an invisible hand.
We now know that, in addition to almost $3 million in receiver
costs, rent and secured debt, Networc Health, the parent company of HRC, racked up at least $8.4 million in unsecured debt. It owes money to everyone from coffee suppliers to the Workers' Compensation Board.
Taxpayers are also on the hook for a whopping $1.4 million in legal costs. Clearly, HRC expects that Albertans will pay for their shareholder and corporate restructuring in the wake of their financial boondoggles.
When Albertans contracted HRC to conduct orthopedic surgeries, they did not expect to pay for expensive lawyers to re-structure a private contractor.
It is ironic that those who most fervently support the so-called "free market" -- the Wildrose Alliance Party, among others -- are those who are the loudest voices asking for taxpayer handouts for HRC.
Meanwhile, the jury is still out on the health outcomes HRC delivered.
In Alberta, there are unnecessary barriers to finding out how well a for-profit health facility is performing.
While public hospitals and clinics are accredited, inspected and regulated by public bodies, Alberta's Non-Hospital Surgical Facilities, such as the investor-owned HRC, are accredited by the College of Physicians and Surgeons.
The College's 2009 annual report shows a high number of reportable incidents at private clinics -- such as infections, admissions to hospital, severe illnesses, and even deaths. In 2009, private clinics like HRC had 111 "reportable incidents" -- or two per week. Unfortunately, taxpayers can't access any more information than that. Where the incident occurred or during what type of procedure is all hidden from the public.
At the very least, forprofit clinics delivering publicly funded services should be subjected to the same accreditation and inspection regime as public facilities, including more rigorous reporting requirements.
HRC was given all the advantages government could provide.
It was paid well out of the public purse to perform surgeries. According to then Premier Ralph Klein in 2005, surgeries contracted out to private facilities including HRC were costing on average 10-per-cent more than those performed in public facilities. As anyone who has studied basic business classes knows, 10 per cent is a decent profit margin. Private delivery of health care simply means taxpayers are subsidizing profits for corporate, investor-owned businesses. Albertans have done their share for HRC and its investors. Enough is enough.
To improve our healthcare system, Alberta should look at best practices from other jurisdictions.
In Manitoba, the Pan-Am clinic started out as a private business and was later absorbed into the public system. Its profits are now invested back into the public facility and the clinic is internationally known as a centre of innovation and excellent health outcomes.
Alberta Health Services is doing the right thing in absorbing the Health Resource Centre back into the public system.
It recognizes that its arrangement with this for-profit facility has not proven to be economically efficient, nor has it turned out to be a reliable way to deliver orthopedic surgeries in Calgary.
AHS is doing the right thing by terminating its contract with a business that is clearly on shaky ground.
Albertans should not even consider further bailouts, handouts, or other special favours for HRC.
The evidence is in, and this experiment with for-profit delivery should come to an end before it costs us millions more.
David Eggen is executive director of Friends of Medicare in Edmonton.
© Copyright (c) The Calgary Herald
Thursday, September 2, 2010
Superboard denies crippling private health clinic
Private facility faces money troubles
By Jamie Komarnicki, Calgary Herald September 2, 2010
A series of meetings, phone calls and e-mails detailed in court documents filed by a for-profit clinic describe the flurry of negotiations between the Health Resource Centre and Alberta Health Services attempting to lock in more than triple the number of surgeries originally agreed upon.
The landmark agreement once heralded by the two parties has developed into a legal battle that's put scrutiny on health service delivery in Alberta.
In an affidavit sworn Tuesday, Health Resource Centre chief operating officer Bernie Simpson claims the clinic's current financial difficulties were caused by AHS delaying and eventually reneging on its commitments to boost the surgeries HRC performs.
He also contends the private surgical facility provides hip and knee replacements for about 40 per cent less than it costs the public system.
The health superboard swiftly disputed a number of the HRC claims in the court documents.
AHS officials declined an interview Wednesday, but issued a statement saying the HRC court filings contain "numerous statements which Alberta Health Services believes are inaccurate and misleading." They promised to dispute the claims -- which have not been proven -- in court.
"AHS has honoured all of its commitments under the existing contract ... AHS believes that any suggestion that AHS has not bargained in good faith or honoured its contractual obligation is inaccurate and misleading."
The private negotiations were thrust into the public realm when AHS intervened to ward off bankruptcy proceedings against the company that runs HRC, which provides about 1,000 publicly funded joint surgeries a year.
The surgical agreement between the two parties states the health authority isn't obligated to provide a minimum number of procedures annually to HRC.
According to Simpson, shortly after the parties entered into the December 2006 surgical services agreement, the former Calgary Health Region asked the centre to increase its capacity to be able to do 3,500 procedures.
In the court document, he acknowledges the situation left HRC "vulnerable" but claims the centre relied on an amicable relationship with the CHR and notes the two parties were "required to negotiate in good faith the pricing and other terms associated with the requested expansion of capacity."
The surgical centre eventually began plans to expand, entering into a 10-year lease agreement to take up space in a new centre being built by Cambrian.
Simpson outlines a series of negotiations between HRC and health authorities over a period of 21/2 years to expand the private centre's surgical capacity so it could perform at least 3,500 procedures for the province.
In April 2009, HRC officials began discussions with AHS, Alberta's new provincewide superboard that had taken over the CHR, to "document the new arrangement between AHS and HRC," Simpson claims.
"Despite working together for over 21/2 years to expand HRC's surgical capacity, making commitments to HRC, approving HRC's transition to the Cambrian facilities . . . AHS waffled and then reneged on its commitments to HRC," Simpson claims.
"It appears to HRC that far from dealing with it in a collaborative manner involving mutual respect, trust and good faith, AHS is now bent on destroying HRC," he alleges.
Simpson points to a March 26, 2010 letter signed by AHS head Stephen Duckett offering a new contract expiry date of March 31, 2016 and a volume of 2,733 procedures; the letter, filed as an exhibit with the affidavit, also offers an AHS prepayment of $5 million to help HRC cover some of its costs, with the amount to later be recovered through the extended contract.
On April 1, 2010, Cambrian filed a bankruptcy application against Networc. On April 30, AHS asked the court to appoint an interim receiver to supervise HRC.
In the AHS statement Tuesday, officials said: "No agreement was ever reached to increase the maximum number of surgeries to be permitted under the existing contract nor has any evidence of such an agreement -- between the former Calgary Health Region (CHR) and HRC -- ever been submitted to the court by HRC."
AHS moved to protect the interest of patients when the superboard became aware of bankruptcy proceedings against HRC, according to the statement.
The health board also said it would be increasing the number of surgeries performed in Calgary hospitals to make sure there is no disruption to surgical volumes due to the HRC situation.
In his affidavit, HRC's Simpson argues his facility provides better, more affordable services for Albertans needing joint surgery. He describes Alberta Bone and Joint Health Institute figures that say the number of days a patient spends in hospital is 120 per cent higher at public facilities than at HRC, for comparable surgeries.
The institute also provided figures that, when adjusted for implant, lab services, estimated capital and sub-acute care costs for a direct comparison, suggest an AHS total hip replacement costs $16,826, or 40 per cent more than one performed by HRC for $12,019. An AHS knee replacement for $14,619 costs 37 per cent more than an HRC procedure for $10,654, the document claims.
Wildrose Alliance caucus leader Danielle Smith said such figures suggest the province should do a better job not only maintaining the private contract, but running its own public hospitals.
The court allegations damage the province's credibility in attracting private investment to the economy, Smith added.
"No doubt this has shone the light on some pretty bad practices in the health region and Alberta Health Services," said Smith.
HRC wouldn't have gone ahead with the new lease if they hadn't had a "reasonable assurance" their main customer -- AHS -- approved the deal, she contended.
An Edmonton health policy analyst argued the case demonstrates some of the pitfalls of contracting out to private companies.
"When we contract out, the public purse is very vulnerable to the business decisions of the company we're contracting out with," said Wendy Armstrong, a member of the Alberta chapter of the Consumers' Association of Canada.
She said that lack of transparency around such deals is a concern.
According to David Eggen of Friends of Medicare, the legal brouhaha should cause the province to "think twice before entering into this sort of agreement."
" This HRC issue has increased the public's awareness about the dangers of contracting surgical services to private companies," Eggen said.
The group is organizing a rally outside the Calgary HRC building on Sept. 10 to urge the Stelmach government to hold back on such private contracts.
jkomarnicki@theherald.canwest.com
© Copyright (c) The Calgary Herald
Private facility faces money troubles
By Jamie Komarnicki, Calgary Herald September 2, 2010
A series of meetings, phone calls and e-mails detailed in court documents filed by a for-profit clinic describe the flurry of negotiations between the Health Resource Centre and Alberta Health Services attempting to lock in more than triple the number of surgeries originally agreed upon.
The landmark agreement once heralded by the two parties has developed into a legal battle that's put scrutiny on health service delivery in Alberta.
In an affidavit sworn Tuesday, Health Resource Centre chief operating officer Bernie Simpson claims the clinic's current financial difficulties were caused by AHS delaying and eventually reneging on its commitments to boost the surgeries HRC performs.
He also contends the private surgical facility provides hip and knee replacements for about 40 per cent less than it costs the public system.
The health superboard swiftly disputed a number of the HRC claims in the court documents.
AHS officials declined an interview Wednesday, but issued a statement saying the HRC court filings contain "numerous statements which Alberta Health Services believes are inaccurate and misleading." They promised to dispute the claims -- which have not been proven -- in court.
"AHS has honoured all of its commitments under the existing contract ... AHS believes that any suggestion that AHS has not bargained in good faith or honoured its contractual obligation is inaccurate and misleading."
The private negotiations were thrust into the public realm when AHS intervened to ward off bankruptcy proceedings against the company that runs HRC, which provides about 1,000 publicly funded joint surgeries a year.
The surgical agreement between the two parties states the health authority isn't obligated to provide a minimum number of procedures annually to HRC.
According to Simpson, shortly after the parties entered into the December 2006 surgical services agreement, the former Calgary Health Region asked the centre to increase its capacity to be able to do 3,500 procedures.
In the court document, he acknowledges the situation left HRC "vulnerable" but claims the centre relied on an amicable relationship with the CHR and notes the two parties were "required to negotiate in good faith the pricing and other terms associated with the requested expansion of capacity."
The surgical centre eventually began plans to expand, entering into a 10-year lease agreement to take up space in a new centre being built by Cambrian.
Simpson outlines a series of negotiations between HRC and health authorities over a period of 21/2 years to expand the private centre's surgical capacity so it could perform at least 3,500 procedures for the province.
In April 2009, HRC officials began discussions with AHS, Alberta's new provincewide superboard that had taken over the CHR, to "document the new arrangement between AHS and HRC," Simpson claims.
"Despite working together for over 21/2 years to expand HRC's surgical capacity, making commitments to HRC, approving HRC's transition to the Cambrian facilities . . . AHS waffled and then reneged on its commitments to HRC," Simpson claims.
"It appears to HRC that far from dealing with it in a collaborative manner involving mutual respect, trust and good faith, AHS is now bent on destroying HRC," he alleges.
Simpson points to a March 26, 2010 letter signed by AHS head Stephen Duckett offering a new contract expiry date of March 31, 2016 and a volume of 2,733 procedures; the letter, filed as an exhibit with the affidavit, also offers an AHS prepayment of $5 million to help HRC cover some of its costs, with the amount to later be recovered through the extended contract.
On April 1, 2010, Cambrian filed a bankruptcy application against Networc. On April 30, AHS asked the court to appoint an interim receiver to supervise HRC.
In the AHS statement Tuesday, officials said: "No agreement was ever reached to increase the maximum number of surgeries to be permitted under the existing contract nor has any evidence of such an agreement -- between the former Calgary Health Region (CHR) and HRC -- ever been submitted to the court by HRC."
AHS moved to protect the interest of patients when the superboard became aware of bankruptcy proceedings against HRC, according to the statement.
The health board also said it would be increasing the number of surgeries performed in Calgary hospitals to make sure there is no disruption to surgical volumes due to the HRC situation.
In his affidavit, HRC's Simpson argues his facility provides better, more affordable services for Albertans needing joint surgery. He describes Alberta Bone and Joint Health Institute figures that say the number of days a patient spends in hospital is 120 per cent higher at public facilities than at HRC, for comparable surgeries.
The institute also provided figures that, when adjusted for implant, lab services, estimated capital and sub-acute care costs for a direct comparison, suggest an AHS total hip replacement costs $16,826, or 40 per cent more than one performed by HRC for $12,019. An AHS knee replacement for $14,619 costs 37 per cent more than an HRC procedure for $10,654, the document claims.
Wildrose Alliance caucus leader Danielle Smith said such figures suggest the province should do a better job not only maintaining the private contract, but running its own public hospitals.
The court allegations damage the province's credibility in attracting private investment to the economy, Smith added.
"No doubt this has shone the light on some pretty bad practices in the health region and Alberta Health Services," said Smith.
HRC wouldn't have gone ahead with the new lease if they hadn't had a "reasonable assurance" their main customer -- AHS -- approved the deal, she contended.
An Edmonton health policy analyst argued the case demonstrates some of the pitfalls of contracting out to private companies.
"When we contract out, the public purse is very vulnerable to the business decisions of the company we're contracting out with," said Wendy Armstrong, a member of the Alberta chapter of the Consumers' Association of Canada.
She said that lack of transparency around such deals is a concern.
According to David Eggen of Friends of Medicare, the legal brouhaha should cause the province to "think twice before entering into this sort of agreement."
" This HRC issue has increased the public's awareness about the dangers of contracting surgical services to private companies," Eggen said.
The group is organizing a rally outside the Calgary HRC building on Sept. 10 to urge the Stelmach government to hold back on such private contracts.
jkomarnicki@theherald.canwest.com
© Copyright (c) The Calgary Herald
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