In an unprecedented move, Alberta Health Services and Alberta Health decided to conduct a complete review of the way in which health care delivered by Alberta Health Services is regulated, governed and funded. This involved an analysis of Alberta Health Services structure, programs, services and policies. The review was announced on May 30, 2019. On July 18, 2019, EY commenced work on its mandate to review and advise on “reduction in costs” and “improvement in performance.” Six months later, on February 3, 2020, the EY Report (“Report”) was made public by the Minister of Health.
The Report is over 200 pages long but is, nevertheless, succinct and to the point. This is demonstrated by the fact that the summary is 101 pages long.
It is not an overstatement to describe the report as transformative. The impact on Alberta’s health system is likely to equal that of the Oberg Wagner Report of 1994.
Great change is likely to result from the Report. Alberta Health Services will begin implementing the Report within 30 days and will develop a complete plan for implementation of the Report within 100 days.
While the change will be profound, one change that has been taken off the table is any initiative to break up Alberta Health Services into multiple regional health authorities under the Regional Health Authorities Act.
One reform that can be expected is a rationalization of statutes. Currently, there are over 40 statutes on the subject of health care.[1]
The Report can be divided into four themes:
- People: The Report made 13 recommendations with respect to this theme, on the subjects of workforce, management review and physician optimization.
- Clinical services: The Report made 21 recommendations with respect to this theme, on the subjects of clinical utilization, service configuration and clinical support services.
- Non-clinical services: The Report made 10 recommendations with respect to this theme, on the subjects of non-clinical support services, corporate and back office and supply chain.
- Governance: The Report made 8 recommendations with respect to this theme, on the subject of functional duplication and accountability interface.
There are four significant outcomes that can be expected as a result of the implementation of the Report:
- Patients will have more choice and more information about their health care;
- Patients will experience few, if any, waiting lists;
- Efficiencies will allow more care to be delivered for less money; and
- Health care professionals will be freed up to meet all the health care needs of Albertans and market their excess capacity to the world.
All of this will be achieved without violating any of the following principles of the Canada Health Act:
- Public administration;
- Comprehensiveness;
- Universality;
- Portability; and
- Accessibility
One of the most important findings of the Report is that the highest quality of care is the most efficient in the majority of circumstances.
One of the other significant findings is that partnerships between the public sector and the private sector are in the best interests of patients and the taxpayers who fund the system.
In conclusion, the Report should be read in conjunction with the Premier’s election platform statements on health care. Those statements are at this link.
[1] ABC Benefits Corporation Act, RSA 2000, c A-1; Alberta Evidence Act, RSA 2000, c A-18; Alberta Health Act, SA 2010, c A-19.5; Alberta Health Care Insurance Act, RSA 2000, c A-20; Assured Income for the Severely Handicapped Act, SA 2006, c A-45.1; Charitable Donation of Food Act, RSA 2000, c C-8; Child, Youth and Family Enhancement Act, RSA 2000, c C-12; Crown’s Right of Recovery Act, SA 2009, c C-35; Drug Program Act, SA 2009, c D-17.5; Emergency Health Services Act, SA 2008, c E-6.6; Emergency Medical Aid Act, RSA 2000, c E-7; Family Support for Children with Disabilities Act, SA 2003, c F-5.3; Government Organization Act, RSA 2000, c G-10; Health Care Protection Act, RSA 2000, c H-1; Health Disciplines Act, RSA 2000, c H-2; Health Governance Transition Act, SA 2008, c H-4.3; Health Information Act, RSA 2000, c H-5; Health Insurance Premiums Act, RSA 2000, c H-6; Health Professions Act, RSA 2000, c H-7; Health Quality Council of Alberta Act, SA 2011, c H-7.2; Hospitals Act, RSA 2000, c H-12; Human Tissue and Organ Donation Act, SA 2006, c H-14.5; Income and Employment Supports Act, SA 2003, c I-0.5; Long Term Care Information Act, SA 2018, c L-22; MSI Foundation Act, RSA 2000, c M-24; Mandatory Testing and Disclosure Act, SA 2006, c M-3.5; Mental Health Act, RSA 2000, c M-13; Mental Health Services Protection Act, RSA 2018, c M-13.2; Nursing Homes Act, RSA 2000, c N-7; Opioid Damages and Health Care Costs Recovery Act, SA 2019, c O-8.5; Pharmacy and Drug Act, RSA 2000, c P-13; Protecting Choice for Women Accessing Health Care Act, SA 2018, c P-26.83; Protection for Persons in Care Act, SA 2009, c P-29.1; Protection of Children Abusing Drugs Act, SA 2005, c P-27.5; Provincial Health Authorities of Alberta Act, RSA 2000, c P-33; Public Health Act, RSA 2000, c P-37; Regional Health Authorities Act, RSA 2000, c R-10; Resident and Family Councils Act, SA 2017, c R-16.7; Seniors Benefit Act, RSA 2000, c S-7; Skin Cancer Prevention (Artificial Tanning) Act, SA 2015, c S-7.9; Supportive Living Accommodation Licensing Act, SA 2009, c S-23.5; Tobacco and Smoking Reduction Act, SA 2005, c T-3.8; Voluntary Blood Donations Act, SA 2017, c V-5.
