Alberta's new health care model lacks detail, accountability and prevention methods: experts

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Experts are raising concerns over the province’s new health care model, saying the government needs to provide more clear details on the integration of the various new agencies and address a lack of accountability.

Dr. Louis Francescutti, a professor in the school of public health at the University of Alberta and an emergency medicine physician at the Royal Alexandra Hospital, said in his 32 years of practising things have never been so bad. 

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“Acute care is in a state of disaster. Working in emergency these days — it’s never been so bad,” said Francescutti.

The Alberta government’s new health care model announced on Wednesday will bring in four new agencies and decentralize Alberta Health Services as the province’s main health care provider.

Under the new changes, AHS will focus on acute care and continuing care. It would share that role with two new organizations, one that oversees oversee the delivery of hospital care, urgent care centres, cancer care, and emergency medical services, and another that will coordinate primary health care services and provide transparent provincial oversight.

Two new additional organizations will focus on continuing care and mental health and addiction.

Francescutti said the government’s decision to divide the health care system into four organizations makes sense. But he wants to see the evidence to back up the planning behind the new model and accountability for the system whether it succeeds or fails.

“If they’re going to make any changes of significance, they’re going to have to listen attentively to the people that work in the system and then they’re going to have to deliver on results and, if they’re not prepared to deliver on results, then no one’s going to be accountable and nothing’s going to change,” Francescutti said.

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“They’re trying something new, which is good. Let’s try it. But let’s make sure there’s accountability and please, let’s not forget about prevention because prevention is the key to just about all the diseases,” Francescutti said. 

Francescutti stressed the importance of prevention — which was “glaringly missing” within the announcement of the new model. Preventive care has been largely overlooked within the health care system. Francescutti said that while people cannot change their genetics, preventive care allows for changes toward social determinants of health that impact a person’s well-being — whether it be through proper screening, nutrition or housing. 

David Shepherd, Alberta NDP health critic for rural and primary care, was critical of the new proposed health care model. In an interview with Postmedia, he said while the province’s health care system is in need of reforms, decentralizing AHS and adding new organizations was not the way to go. 

Do we need health care reform? Yes. But that needs to be through investment in the front lines in key areas like primary care and in resources that we know are going to deliver — not in more layers of bureaucracy,” Shepherd said. 

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Elaine Hyshka, an associate professor in the University of Alberta school of public health and Canada Research Chair of health system innovation, said her main concern with the new model is the fear of public health remaining in a state of “purgatory” if decisions regarding the system are pushed off. 

The province is faced with a drug poisoning epidemic which Hyshka said “has never been worse.” According to epidemiological research, only a handful of those who meet the substance abuse criteria seek care but will still come into contact with the health care system.

Fragmentation within the health care system has been an ongoing concern. Hyshka said she hopes there will be a strong focus on integrating mental health services across all aspects of the health care system.

“If we are only saying that ‘this one organization is really responsible for the delivery of all that kind of care,’ it implies that we’re gonna be missing a lot of opportunities where people are presenting in general health services who could be potentially screened and then referred to better care or to addiction, mental health support,” Hyshka said. 

“This is just gonna make that journey more complicated for them. But it’s hard to say for sure because we don’t know all the details.”

— With files from Matthew Black

[email protected]

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