On October 31, 2024, Alberta’s Minister of Health, Adriana LaGrange, introduced Bill 26, known as the Health Statutes Amendment Act, 2024 (No. 2) (the “Bill” or “Bill 26”).[1] The Bill, which passed third reading on December 4, 2024[2], proposes significant changes to several of Alberta’s health laws, including the Provincial Health Agencies Act[3], the Public Health Act[4], the Health Facilities Act[5],and the Health Professions Act[6]. Minister LaGrange stated that the Bill will continue the Government’s work to “refocus the health care system, provide clarity on issues that matter to Albertans, and preserve choice for minors identifying as transgender or gender diverse.”[7]
The proposed changes to Alberta’s health legislation would have major impacts on the provincial healthcare system, including:
- Limiting the surgical and pharmaceutical options available to transgender or gender-diverse youth below the age of majority;
- Setting the stage for the winding up of Alberta Health Services as a regional health authority and further health system transformation through the introduction of “provincial health corporations”;
- Authorizing a provincial health agency to enter into agreements with chartered surgical facilities; and
- Modifying the definition of “public health emergency” for the purposes of the Public Health Act.
Amendments to the Health Professions Act
The proposed amendments to the Health Professions Act (“HPA”) would prohibit regulated members from performing surgical procedures to treat gender dysphoria or gender incongruence (as defined in the Bill) on anyone under 18 years of age.[8] The list of prohibited procedures includes breast augmentation, hysterectomy, phalloplasty, vaginoplasty, and other surgical procedures which the Minister may prohibit through regulations.[9]
The Bill would also amend the HPA to prohibit the prescription of certain drugs to minors for the purposes of hormone therapy (including puberty suppression and hormone replacement therapy) to treat gender dysphoria or gender incongruence.[10] The Government of Alberta states that “exceptions would be made for minors aged 16 and 17 with parental, physician and psychologist approval, and for minors who have already been prescribed hormone replacement therapies to treat gender dysphoria or gender incongruence.”[11] These exceptions are not set out within the Bill; rather, a subsequent Ministerial Order would outline the details of any exception(s).[12]
Amendments to the Provincial Health Agencies Act
The proposed changes to the Provincial Health Agencies Act (“PHAA”), and corresponding amendments to numerous other statutes, largely concern the introduction of “provincial health corporations.” This entity has been established as the vehicle to be used to reincorporate the province’s current regional health authority, Alberta Health Services (“AHS”), when it is wound up as a regional health authority and refocussed for the delivery of acute care hospital services. According to the Government of Alberta, the changes to the PHAA “lay the groundwork for [Alberta’s] new health agencies to begin operations.”[13]
A provincial health corporation would be established through regulation, and could do any or all of the following:
- Act in an advisory capacity to a Minister or health authority, agency, corporation or council;
- Deliver or coordinate the delivery of health services;
- Deliver or coordinate the delivery of administrative or operational services related to the health care system; and
- Any other activities assigned to the provincial health corporation by the regulation(s).[14]
The amendments would also add the Minister of Infrastructure to the list of “successors” in the PHAA, and allow for the transfer of real property held by the regional health authority (i.e. AHS), as well as real property, if any, which has previously been transferred to another successor under PHAA section 5.03(1)(b), to the Minister of Infrastructure.[15]
Additionally, the PHAA amendments would relieve provincial health agencies consisting of only one member from the obligation to hold public meetings. Such agencies would, however, be required to publish (or make publicly available) all decisions regarding the business and affairs of the provincial health agency within 72 hours of the decision (subject to exceptions).[16]
Amendments to the Public Health Act
The main proposed change to the Public Health Act (“PHA”) relates to the definition of “public health emergency.” Under the current PHA, a “public health emergency” means an illness, health condition, epidemic or pandemic disease, novel or highly infectious agent or biological toxin, or presence of a chemical agent or radioactive material, which poses a significant risk to the public health.[17] Bill 26 would amend this definition, such that a “public health emergency” would exist where there is an “urgent and temporary occurrence or threat of an occurrence” of one of the enumerated events or illnesses which poses “a significant risk to the public of an increase in disease, injuries, disabilities or deaths in excess of expectations during times of normalcy”.[18] This amendment alters the definition of “public health emergency” within the PHA; however there has been little information or debate on this specific change.
The other proposed amendments to the PHA involve the addition of a preamble, and the introduction of provincial health corporations to certain sections.[19]
Additional proposed amendments
As with the PHAA amendments, the HSAA would introduce the concept of “provincial health corporations” to various other Alberta laws[20], including the Government Organization Act[21], the Freedom of Information and Protection of Privacy Act[22], the Health Information Act[23], and the Labour Relations Code[24].
The HSAA also proposes to amend the Health Facilities Act, which regulates the management and operation of chartered and other non-hospital surgical facilities within Alberta.[25] The amendment would allow a provincial health agency to enter into agreements for insured surgical services provided by a chartered surgical facility.[26] Currently, only a regional health authority can enter into such agreements.[27]
Summary
As detailed above, Bill 26 proposes significant changes to the landscape of health legislation in Alberta, particularly with respect to the future of health care delivery and the treatments available for transgender and gender-diverse youth.
If you have any questions about Bill 26, or how you or your organization may be impacted by these legislative changes, please contact Miller Thomson’s Health Industry Group.
[1] “Bill 26, Health Statutes Amendment Act, 2024 (No. 2)”, 1st reading, Alberta Hansard, 31-1, Day 63 (31 October 2024) at 1848 (Hon Adriana LaGrange) [“1st Reading”].
[2] “Bill 26, Health Statutes Amendment Act, 2024 (No. 2)”, 3rd reading, Alberta Hansard, 31-1, Day 77 (4 December 2024) at 2299-2305, 1969-1977 [“3rd Reading”].
[3] Provincial Health Agencies Act, RSA 2000, c P-32.5.
[4] Public Health Act, RSA 2000, c P-37 [“PHA”].
[5] Health Facilities Act, RSA 2000, c H-2.7 [“HFA”].
[6] Health Professions Act, RSA 2000, c H-7.
[7] 1st Reading, supra note 1.
[8] Bill 26, Health Statutes Amendment Act, 2024 (No. 2), 1st Sess, 31st Leg, Alberta, 2024, s 9 (third reading 4 December 2024) [“HSAA”].
[9] Ibid.
[10] Ibid.
[11] Government of Alberta, “Advancing policies to support the health care system” (2024), online: Alberta <www.alberta.ca/advancing-policies-to-support-the-health-care-system>.
[12] Ibid.
[13] Government of Alberta, supra note 11.
[14] HSAA, supra note 8, s 18.
[15] Ibid.
[16] Ibid.
[17] PHA, supra note 4, s 1(1)(hh.1).
[18] HSAA, supra note 8, s 20 (emphasis added).
[19] Ibid.
[20] See generally HSAA, supra note 8.
[21] Government Organization Act, RSA 2000, c G-10.
[22] Freedom of Information and Protection of Privacy Act, RSA 2000, c F-25.
[23] Health Information Act, RSA 2000, c H-5.
[24] Labour Relations Code, RSA 2000, c L-1.
[25] HFA, supra note 5.
[26] HSAA, supra note 8, s 7.
[27] See HFA, supra note 5, s 0.1(g).
