Government’s announcement today about health system reform

November 8, 2023

Dear Members,

You are likely already aware the government has now unveiled plans to “disaggregate” health care services in our province. This restructuring will ultimately see the establishment of four separate crown corporations responsible for various aspects of health care:

• Primary Care
• Acute Care (remaining within AHS)
• Mental Health and Addictions
• Continuing Care

For some time, there have been concerns about the effectiveness and quality of health care delivery in Alberta. We have heard this from members, who have told us that they want government to address suboptimal health care outcomes. We also know that many members support more authentic local decision-making in the health care system.

Nevertheless, it is crucial to approach this restructuring responsibly and carefully to ensure these changes do not have adverse impacts on patient care or lead to longer wait times and poorer access for Albertans. As these new functional organizations are being established, our primary concern is continuity of care for the people of Alberta. We must make sure that patients can navigate this new system seamlessly, without disruptions.

I have told government that physician co-design is vital, and the AMA has a role to play in guiding the path forward. Our health care system is already in a fragile state. The consistent message I have been hearing from physicians across Alberta is that any changes made in our system must involve input from experts on the front lines – the physicians and allied health care workers who are dedicated to patient care. While it is reassuring to see that the government is committed to consultation, we will be working diligently to make sure they get and heed our input.

As government moves forward with their proposed new structure, we will be attentive to the representation rights of physicians working in these other organizations. We will be working to ensure there are answers to questions like: what is the most effective physician representation in a disaggregated system? How will physicians who work in more than one of these entities be compensated? Will physicians have privileges in more than one of these organizations? These and other questions will all require clear answers that support physicians as system leaders.

With respect to the proposed governance structure for primary care, government has told us their new model does not propose operational control over clinics. But this will be another area where physicians will need clarification and reassurance and the AMA will be working with members to ensure family physicians and rural generalists are heard and their input respected.

While the details and impacts are unclear, what is clear is that physician engagement in each of these new organizations will be critical. The AMA will advocate for our voice at the decision-making tables. Physician representation will remain our priority as these new governance structures are stood up. Physician involvement at the ground-level will help to ensure proper functioning and collaboration across these functional domains.

We will be working to ensure that the interests of physicians and our patients are safeguarded during this transformation. Your dedication and expertise are invaluable, and your insights are critical in shaping the future of health care in our province. Together, we can work to ensure that these changes result in a more efficient, effective and patient-centered system for all Albertans.

Regards,

Paul Parks
President, Alberta Medical Association