There is a growing concern amongst opposition parties and advocacy groups that the recent decision to centralize the province’s health boards will do little to address the current problems the healthcare system faces and may be one step closer to opening it up to privatization.

On May 15, Health Minister Ron Liepert announced the dissolution of the province’s nine remaining health regions as well as the Alberta Cancer Board, Alberta Mental Health, and the Alberta Alcohol and Drug Abuse Commission. All will be replaced by the newly created Alberta Health Services Board (AHSB), which will oversee the province’s healthcare needs. In the 1990s, the government replaced dozens of hospital boards with 17 health regions, and five years ago they further whittled the number down to nine.

It is a decision seemingly made without any evidence that a centralized health board would improve Albertans’ quality of care, accessibility, or cost-effectiveness, says Liberal MLA David Swann. “For us to reach 2008,” he says, “and suddenly be faced with yet another restructuring in five years from the last one, without evidence that the previous ones were either better or worse in those three areas of evaluation—quality, access, cost-effectiveness—begs the question: What are these folks basing their management on? He adds that if the government isn’t making its decisions based on evidence, then they must be based on either ideology or the pressure to act impulsively in the midst of a crisis.

When asked what evidence the government based its decision to centralize the province’s health regions on, Alberta Health and Wellness spokesperson Howard May replied, “I don’t know how to answer a question based on the word evidence. How can you have evidence of this working unless you have another province as a control group?”

Swann’s sentiment are shared by the nonpartisan advocacy organization Friends of Medicare (FOM), which says the decision to centralize the health boards is not about good governance. Rather, by keeping the healthcare system disrupted and in disarray, the government is opening it up so that corporate business can take over. “I think there is an ulterior plan, and that is to privatize,” says Ted Woynillowicz, president of FOM’s Calgary chapter. “Our huge concern is that they’ve brought these people in who don’t have any background in healthcare and they seem to be more about business and privatization.” 

The government has replaced the 127 recently pink-slipped board members with a transitional provincial board made up of a chair and six members appointed by the minister of health and wellness. Former Tory MP and insurance lobbyist Ken Hughes was appointed as interim chair, and Charlotte Robb, former CEO of Dynalife Diagnostics (formerly Dynacare Kasper Medical Laboratories), now sits as the new interim CEO.

According to the Health Sciences Association of Alberta (HSAA), a union that represents 16,000 health professionals across Alberta, it may be too early to tell what is going to happen, but they do have some concerns about the restructuring. “There’s a very heavy private sector representation on that board,” says HSAA president Elisabeth Ballermann. “Not only Ken Hughes and Charlotte Robb, but if you go down the list pretty much everyone has a significant private-sector perspective.”

It’s not the first time the HSAA has dealt with Robb. In 2006, the HSAA filed a complaint with the Alberta Labour Relations Board against Dynacare Kasper Medical Laboratories accusing the company of violating its employees’ right to unionize while Charlotte Robb was CEO of the company. “It’s interesting at the time she pleaded an unawareness of labour relations practice with regard to unionized labour relations,” says Ballermann. “Given that she brings no more knowledge, as far as I know, that does beg the question of how they intend to deal with their unionized employees. At the same time, the chair of the board doesn’t do the day-to-day labour relations, but they certainly set the tone.”

The key difference in this situation, says Ballermann, is that healthcare workers in the province are already unionized and well aware of their rights, and will not be easily intimidated—though there would be “grave concerns” should there be an abrogation of employees’ rights. 

While the government and media often report on Alberta’s spiraling healthcare costs, which currently sit at $13 billion a year, Woynillowicz says a decade and a half of neglect, cutbacks, and hospital closures on top of tremendous growth in both population and inflation all but ensured the need for the government to pour billions into a starved healthcare system. “Sure, it’s going to cost more right now because they’re playing catch-up,” he says. “For all those years there’s been no spending, and there’s actually been a reduction. If you take a look at the per-capita costs, it has been remarkably steady for the last two decades, and they haven’t really grown that much.”

Both Swann and FOM say that with nine different health regions (and subsequently nine different approaches) now dissolved, the government is able to distance itself from each region and take the province in whatever direction it sees fit, be it public or private. “All the evidence from around the world is that privatization may lead to improved access in the short term, but it worsens access, worsens quality, and costs more in the long term,” says Swann. “So they’re not listening to the world evidence, they’re not creating their own local evidence. They seem to be following their ideology of ‘private is better than public’ on everything.”

There is also concern that the restructuring process will add even more stress to healthcare providers at a time when many are already burnt out. A 2002 survey of 1,161 medical students, residents, and working and retired physicians conducted by the University of Lethbridge, the Alberta Medical Association and Dr. G.N. Kiefer found nearly half (48.6 per cent) were in an advanced phase of burnout. According to the same study, the average Canadian worker burnout rate is between 38 and 42 per cent. With the province’s doctors and nurses stretched to their limit and hospitals are packed with patients, says Swann, all it would take is a flu epidemic or similar disaster to be the proverbial straw that breaks the camel’s back. “I think we’re in a crisis headed for a catastrophe, really,” says Swann. “We’re already stretched to the limit especially in our major centres.” 

Swann says the current structure isn’t perfect, but it does allow for those working on the frontlines the opportunity to bring forth their concerns to management and for policies to be changed. “It’s a more responsive system,” he says. “This will simply make it much tougher for professionals and for patients, frankly, to be heard about problems in the system.”