Alberta merges health regions, health agencies into one super board

Jim Macdonald, THE CANADIAN PRESS
EDMONTON - The Alberta government took a major step Thursday to reshape health-care delivery by dissolving nine existing regional health boards and creating a new super board.

"What we are attempting to put in place is a governance model ... that can give us better access (to care) and a more sustainable system," Health Minister Ron Liepert said at a news conference.

It's the latest move by the Alberta government to reform health care. In 1995-96, it got into a fight with Ottawa over extra billing, which cost the province $3.4 million in penalties.

Thousands of people protested in 1998 when the government introduced Bill 11, which allowed for the expansion of private clinics.

Then, in 2006, the Tory government introduced its "Third Way" of health care, proposing to let patients pay for faster access to some procedures and allowing doctors to work in both the public and for-profit systems. But public outcry forced the government to back away from those proposals.

Premier Ed Stelmach said earlier this week that Albertans believe there are too many pencil-pushers in health care, so money saved on administration will go towards treatments.

"We heard a lot about the perception that there's this huge administration in health-care delivery," Stelmach said Wednesday. But Thursday, the premier was vague on how many administrative jobs might be cut.

"We've reduced 127 board members to just five or six on the new board," said the premier, pointing out that total administration costs are less than four per cent of the $13 billion annual health budget.

Government members have been grumbling for years about the million-dollar salaries and benefits for the CEOs of health authorities in Edmonton and Calgary, as well as the dozens of public health-care executives earning between $250,000 and $400,000.

But Capital Health president and CEO Sheila Weatherhill says she's not expecting to see a major reduction in the number of administration jobs in Edmonton.

"There will be some savings because with fewer boards, that will reduce administrative," said Weatherhill. "But the people we have now, we need and we're short of people."

However, Liepert confirmed Thursday that the new governance model will mean that the current CEOs will in effect become chief operating officers, which may require a salary review.

Suzanne Marshall of the Friends of Medicare says with executive salaries in Alberta's health authorities escalating rapidly over the past several years, some of these people may have priced themselves out of a job.

"Those kinds of salaries just boggle my mind," Marshall said in an interview. "I know they are very big and responsible jobs, but those kind of payouts are really questionable."

Former Tory member of Parliament Ken Hughes has been appointed interim chairman of the super board and the interim CEO is Charlotte Robb, who was head of a private diagnostic firm and has also worked in commercial banking.

Liepert also appointed six members to a transitional board, with a larger board and permanent CEO to be announced later.

The new Alberta Health Services Board will also take over governance of the Alberta Cancer Board, the Alberta Mental Health Board and the Alberta Alcohol and Drug Abuse Commission.

The interim board includes Jack Ady, a former Alberta cabinet minister who was board chairman for the Chinook health region, and Pierre Crevolin, a current board member in the Edmonton health region with ties to the Caritas Health Group.

Health governance has followed a winding road in Alberta over the past two decades. In the 1990s the province created 17 regional health authorities to replace dozens of hospital boards across Alberta.

The province then decided to have some health authorities members elected, but elections were later scrapped and the number of health authorities was eventually reduced to nine.

One health economist described the creation of a single board that will report directly to the health minister as a "radical" move.

Retired health economist Richard Plain says this latest change is "one of those great Alberta social experiments" that is happening very quickly and has surprised people of all political stripes.

Liepert says patients will not be affected by the changes and should not change the way they go about seeking treatments. But Marshall says there's bound to be some problems for some patients.

The opposition parties say the government appears to have rushed the changes with very little public consultation.

"They don't know what else to do, they are simply making another decision without clear evidence of where they've been and what it meant and where they're going," said Liberal health critic David Swann.

New Democrat Rachel Notley says the changes will create crisis and uncertainty within the health care system.

The two contentious proposals were to allow doctors to work in both the private and public systems and to let patients pay cash or buy extra insurance to jump the queue on procedures like hip replacements.

© The Canadian Press, 2008