Doctors, health advocates warn Alberta's budget falls short as costs rising
Health spending expected to hit $24B this year
There are growing concerns the Alberta government's plans for health-care spending, detailed in the latest provincial budget, will do little to address front-line pressures or improve access to care.
Total health spending is expected to hit $24 billion this year, with 3.5 per cent increases planned in each of the following two years, climbing to $25.7 billion by 2027-28.
"We are really struggling in our acute care hospitals," said Dr. Paul Parks, an emergency room physician in Medicine Hat and past president of the Alberta Medical Association.
"We just did not see anything in that budget that's going to immediately tackle and deal with how difficult it is to deliver safe and timely care in our hospitals."
Jennifer Zwicker, the director of health and social policy at the University of Calgary's School of Public Policy, said the budget reflects the government's previously stated priorities and restructuring push.
However, she said details about how progress can be measured were limited.
"An increase of this magnitude probably just doesn't even keep up with population growth and inflation considerations," she said.
Health Minister Adriana LaGrange acknowledged on Monday the budget was tabled during a time of uncertainty.
"It is a tough budget all around," she said at a news conference in Red Deer.
According to LaGrange, the province budgeted a 5.3 per cent increase overall in health-care spending.
"It really does look at making sure that we are resourcing our health-care system to meet the demands that we have."
Spending on administration grows
Spending on health administration is rising. The province estimates it will hit $544 million this year with increases to $573 million next year and $604 million in 2027-28.
That comes as no surprise, according to Parks, given the government's health system overhaul and creation of four new agencies to oversee acute care, primary care, mental health and addictions as well as continuing care.
Acute Care Alberta and Primary Care Alberta fall under the health portfolio.
"We're seeing more and more layers of bureaucracy and more and more layers of administration. And just to put it very simply, those numbers have to go up," Parks said.
"And there's worry that they're even underestimated in the budget."
Lorian Hardcastle said the true cost of the restructuring remains unclear.
"I don't think we've seen a lot of transparency from the government of what this health system transformation is going to cost. And I don't think it's clear from this budget," said Hardcastle, an associate professor in the faculty of law and the Cumming School of Medicine at the University of Calgary.
In the lead up to announcing Alberta's health system overhaul, the government took aim at Alberta Health Services for being too top heavy.
Hardcastle said she expects administrative costs to increase in the long run with the creation of new agencies.
"And not just costs going up, but costs going up without corresponding value to the public in terms of improved access, improved quality of care, better integration of services, et cetera," she said.
Meanwhile, LaGrange said administration has not been added through the restructuring process.
"We are continuing to work to make sure that we do streamline our levels of administration … particularly within the ministry of health," she said.
"Were going to keep looking at how we can make things much more efficient and redirect resources to the front lines."
Other health advocacy groups and unions — including the Health Sciences Association of Alberta and the Alberta Union of Provincial Employees, which are in contract negotiations — have also raised concerns about the provincial budget.
"Where's the workforce planning?" asked Chris Gallaway, executive director of Friends of Medicare, after the budget release last week.
"We should be laser focused on retention, on recruitment, on a plan for training to meet a growing population need.… That means we need beds and we need health-care workers."
Physician compensation
In a statement on Monday, the Alberta Medical Association (AMA) said it welcomes funding increases for primary care, mental health, addictions and continuing care.
But, according to the AMA's calculations, physician compensation and development is $600 million less than what's needed to keep up with patient care demand.
"What's going to give? What's their plan? How are they going to address that? And it's not clear to us right now," said Parks.
The Alberta government said it plans to spend approximately $7 billion on physician compensation and development this year.
"That is the highest it's ever been in Alberta's history," said LaGrange
"We will continue to work with the AMA to make sure that we are addressing the issues, but we also need to make sure that we are sustainable in the province."
Spending on physician compensation will grow to $8.1 billion by 2027-28.
"This includes $15 million for recruitment and retention of physicians who practice full-time in underserved areas, a $12-million increase for the existing Rural Remote Northern Program, and $12 million annually for physician support programs," the government's fiscal plan says. It also notes the new primary care physician compensation model is expected to help with recruitment and improve access for patients.
The AMA also said the budget is "silent" on a proposal it submitted in the fall of 2023 to stabilize acute care.
The group estimated $308 million is needed to recruit and retain acute care physicians and address hospital strain.
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