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Last Updated: Jul 2nd, 2008 - 20:21:03
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Yet again, Alberta’s health-care system is hurtling into the great unknown with the public being given no clear idea of what the outcome will be and what evidence exists to support the government’s latest big idea.
Thursday, Health Minister Ron Liepert announced the immediate disbandment of the province’s nine regional health authorities, including Chinook, whose board members were thanked for their service and sent on their way. They’ll all be replaced by a single Alberta Health Services Board to be responsible for all health service delivery — including mental health, cancer programs and drug treatment which had been the responsibility of three separate boards.
This new “superboard” will have advice from voluntary community health councils (members appointed by the superboard, itself) which will provide local flavour to the system. The new board will also get input from three new advisory councils reporting on cancer, addictions and mental health.
While the new board oversees the delivery of service, it will be up to Alberta Health and Wellness to set, monitor and enforce policy, standards and programs and manage planning and purchases and measuring outcomes.
All of this upheaval is intended to address the mish-mash of services, priorities and programs that developed with nine different boards calling regional shots and pursuing their own visions of how things ought to be. Both the premier and health minister have said these changes are intended to reduce administrative costs and pour more into direct patient care.
Dispensing immediately with all the political appointees will save some money, but it’s a pittance in the grand scheme. The 2006-07 annual report for Chinook Health pegged the salaries and benefits paid to the board, chaired by Jack Ady, at just $164,000. That figure does not include expenses. (Ady was named to the new transitional board, to be chaired by former Macleod MP Ken Hughes; a new provincial CEO was also named.)
The real dough is found on the list of executives and top administrators in each region, and it’s not clear yet how the move to a single board will result in cutting out layers of bureaucracy.
As Premier Ed Stelmach told the media this week, “The public says, ‘Man, we feel there’s so many people walking around with pencils.’ ”
In Chinook, for example, the annual report shows salary and benefits to “management” at nearly $13.5 million, more than seven per cent of the region’s total payroll. That same percentage holds true down the road in the Palliser region where the 2006-07 annual report shows spending of nearly $8.3 million on “management” salary and benefits.
But how much of that management will be pared and how much will be just shuffled under new letterhead?
The province has not made that clear. And it may never be.
After all, more than a decade after former premier Ralph Klein sent elected hospital boards packing and moved to a regional health model, Albertans have no idea whether regionalization was financially prudent.
What we do know is that by decentralizing so much, the province had no real handle on matters as key as patient safety, as evidenced by the outbreak of infections at a Vegreville hospital that was prolonged for years by jockeying between the health authority and hospital staff. At the time, there were no provincial standards for sterilization and infection control, but one example of the key areas open to regional differences.
We also know the province’s health authorities were not accountable in the least to the public they served. They may have answered to the minister in the face of a crisis, but for the most part, they operated as their own fiefdoms. Disgruntled Albertans looking for someone to answer for health care delivery often wound up calling up their local MLA, who, in fairness, had no authority over the boards or the regional administrators.
Those MLAs will still be left to answer for much of what goes on in health care as decision-making slides further north and deeper into levels of bureaucracy answerable to one person — the health minister.
As the province goes about setting up this new provincial entity that will serve as boss to some 70,000 workers on yet another promise of a more accountable system, it’s going to have to show Albertans how this will be better and more efficient and not just a bigger machine than what is is replacing.
© Copyright by Lethbridge Herald.com
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