Panel calls for ‘transformation’ of health system
From physician pay to nurses’ duties and the role of hospitals, Alberta’s entire health system needs a complete overhaul, according to the Mackinnon panel.
In a frank conclusion, the panel wrote Alberta has “no choice but to bring spending on health in line with (other) provinces in order to balance the budget.”
“There are no quick fixes to curb increasing costs in health care. The system needs a major transformation,” it wrote.
The panel, headed by former Saskatchewan finance minister Janice Mackinnon, was tasked with examining the state of Alberta’s finances and proposing solutions to what Finance Minister Travis Toews deems a “spending problem.”
Health care comprised four of the panel’s 26 recommendations, perhaps not a surprise considering the sector eats up 42 per cent of Alberta’s operating budget.
The solution, according to the panel? Restrain health care spending while finding other ways to deliver services.
PRIVATE CLINICS RECOMMENDED
The panel urged Alberta to look beyond its borders, engaging doctors, nurses and other health practitioners to establish a system with shorter wait times for surgeries and treatment.
It also said the health system funding should better reflect the situation in British Columbia, Ontario and Quebec, which spend between $800 and $1,000 less per-capita.
NDP acting leader Sarah Hoffman slammed the comparisons with other jurisdictions.
“I was the health minister when I looked at those other jurisdictions ... B.C. spends less on drugs, that’s true. They do that because they don’t have a seniors drug plan,” Hoffman told reporters in Edmonton.
“Saskatchewan spends less because they privatized a number of things and have two lineups — one for those who pay out of pocket and one for everybody else.”
University of Calgary economist Ron Kneebone said the comparisons are fair game.
“When it comes to health care and education, Alberta’s pretty comparable to other provinces about the need but we spend a whole lot more, and I think that’s fair game to make those comparisons,” he said in an interview.
To help rein in costs, the panel recommended private or non-profits deliver day procedures and other services, rather than relying on hospitals.
That alternative delivery model should extend beyond health, the report noted, though the panel didn’t expand on what other services should go to the private sector.
Mike Parker, president of Health Sciences Association of Alberta, the union of health-care professionals, said he’s concerned by a shift towards privatization.
“We’ve been watching this across the country ... where they are defunding our public sector work and offering up privatization that appears to have, on the surface, some kind of a cheaper model,” Parker said in an interview.
“But let me tell you something — syringes still cost the same whether you’re public or private. It’s the attack on the workers you’re seeing here directly.”
Despite a good chunk of ink devoted to the ballooning costs of hospitals, the panel didn’t go so far as to recommend closures, as happened to 52 rural facilities in Saskatchewan in the 1990s, when Mackinnnon was finance minister of that province.
She said Alberta’s health-care system is spending more money for poorer results compared to other jurisdictions.
“You have to make those changes — fewer hospitals, more clinics, fewer doctors, more nurse practitioners, using private clinics,” Mackinnnon said at a Tuesday news conference in Calgary.
The recommendations were not just about making change — the panel wants an independent organization to review the results and report back.
The report’s focus on health echoed Premier Jason Kenney’s message during the election, in which he repeatedly pointed to the system as a sector ripe for change, and more private options as the road his government will take in Alberta.
“We were clear during our election campaign that we were not going to reduce spending in education or health care, but in fact look for efficiencies, look for alternative ways of delivering service,” Toews said during the news conference.
‘CONSIDER LEGISLATIVE OPTIONS’ FOR DOCTOR PAY
Along with a shakeup of how health care is provided, the panel wants to see changes around doctor compensation.
As the second-highest expense in health care, the report suggested incentives for physicians to switch to an alternative payment plan.
The physician compensation agreement between the province and Alberta Medical Association should be renegotiated, the panel recommended.
If that fails, it urged the government to “consider its legislative options” around doctor payment.
It also urged the government to widen the scope of practice for health-care practitioners, including licensed practical nurses (LPNS).
“Significant savings can be achieved without affecting the quality of health care if Alberta follows the example of Ontario and allows LPNS and nurse practitioners to perform duties consistent with their scope of practice,” the panel wrote.