Respondents tell Alberta government survey they want centralized health system

Albertans who gave feedback during an early phase of the province's health system restructuring work said they are frustrated by a lack of timely access to care and favour a centralized health system, a new report says.

More than 30,000 people took part in public meetings, virtual town halls, and an online survey between November 2023 and June 2024.

Late last week, the government released a report summarizing that public feedback.

Improving job conditions to attract and retain more health-care workers was a recurring theme, in light of the COVID-19 pandemic and global economic downturn, the report says.

"These challenges, which are being faced by every province in Canada, have highlighted the importance of appreciating and investing in the health-care workforce to ensure they feel valued and have the resources, training and support they need to continue providing excellent care to patients," the report says.

Respondents also said rural residents don't have the same access to care as their urban counterparts, and funding models don't reflect the costs rural residents pay out of pocket to access care.

Indigenous participants said their communities lack sufficient health prevention and promotion, experience "ineffective" mental health and addictions services, and encounter bias and discrimination when seeking health care.

French-speaking Albertans said translation services aren't available when they need them during health emergencies.

The feedback process is part of the United Conservative Party government's plan to divide the delivery of health services into four agencies — acute care, mental health and addiction, primary care and continuing care.

In the online survey, respondents wanted better integration, and some of their feedback was summarized as, "Implement a centralized health system," and "Consider a fully integrated health system."

At a news conference Tuesday where she announced that provincial health bureaucrat Kim Simmonds would be the new CEO of Primary Care Alberta, Health Minister Adriana LaGrange said a primary care advisory board recommended the government create an organization with that sole focus.

LaGrange said she is trying to improve health care for Indigenous Albertans by appointing an assistant deputy minister of Indigenous care, hiring more patient navigators, and offering anti-racism training to health-care workers.

"There's a lot of steps that we're looking to address that, but that is what we heard from them — that they do feel that there is racism within the organization," LaGrange said of Alberta Health Services (AHS).

Later, in a statement, LaGrange's office said the government is spending $25 million in two years on services like patient navigators, who can advocate for Indigenous patients. It has also established an Indigenous advocacy council for health care.

Health-care workers worry about negative effects

Dr. Cheryl Barnabe, a rheumatologist and University of Calgary professor, sees patients in both urban and rural Indigenous communities.

She says family doctors leaving or scaling back their practices, along with worsening co-ordination of services, is particularly hard on many Indigenous patients.

A patient with lower financial means who is already sick, after not receiving early or preventative care, is left trying to get to different locations to get diagnoses, medication, mobility aids, and other treatment, she said.

"They are also dealing with the nature of the interaction that does happen in those health services," she said. "It might be one where they're facing bias from a provider. They might be facing microaggressions or racism."

People who have negative experiences will tell their friends and family, creating more reluctance to see health-care workers before their problems become urgent, she said.

Anti-racism training is a great initiative, but it's optional, which makes it less effective, Barnabe said. Although she lauded the value of patient navigators, Barnabe said they, too, have limited caseloads, and are an incomplete solution to what ails the system.

Introducing more private operators into health care also interrupts information and data sharing, leading to inefficiencies, Barnabe said.

Sandra Azocar, a vice-president of the Alberta Union of Provincial Employees, which represents more than 60,000 health-care workers, says the mismatch between Albertans' feedback and the government's decisions shows provincial leaders are not listening to the public.

Azocar says the government hasn't improved working conditions for health-care employees, increased their compensation offers, or made a plan to better recruit and retain workers.

Carving up AHS will see patients fall through the cracks and suffer, she said.

"Instead of finding solutions and addressing the core issues facing our health care, they've decided to blow it up and create a tangled spider web," she said.

The report says the government will use the public feedback "to inform the design and implementation of the refocused health-care system," and that more public engagement opportunities are coming.

LaGrange's press secretary, Jessi Rampton, said in a Wednesday statement the government's decision to tap past cabinet minister Dr. Lyle Oberg to review how patients can have a seamless experience was prompted by the public feedback.

Rampton said the government won't tally the final cost of the engagements until more feedback sessions are done in 2025.