Alberta public health system losing staff, funding as province increases spending on private facilities
Alanna Smith
[url]https://www.theglobeandmail.com/canada/alberta/article-alberta-public-health-system-losing-staff-funding-as-province/[/url]
Private surgical facilities in Alberta are starving the public system of staff and funding to perform priority procedures, according to a new report that concludes the province has yet to increase surgical capacity or reduce wait times as pledged.
The 20-page analysis, published Wednesday by the Parkland Institute, showed provincial spending on private surgical facilities increased nearly three-fold to $55.8-million in 2023-24 from $20-million in 2019-20. By comparison, spending in public facilities increased marginally.
During the same time period, the average cost of outsourced procedures nearly doubled, while wait times jumped for priority procedures, such as cancer surgeries, which are only performed in the public system. In all, roughly 16,500 more procedures were performed over those five years in Alberta, but the increase was “exclusively” in private facilities.
“For-profit providers are being paid inflated prices to deliver the easiest, most profitable procedures at the expense of our public hospitals,” said Andrew Longhurst, a health policy researcher and the report’s author, in an interview.
“The consequence to that is what we’re seeing in cancer surgical care. You’re seeing those wait times balloon … and they have very real effects on people’s lives.”
The Alberta government has been under fire over its deals for chartered surgical facilities (CSFs) since The Globe and Mail reported ([url]https://www.theglobeandmail.com/canada/alberta/article-alberta-ousted-health-services-ceo-amid-probe-into-medical-contracts/[/url]) allegations, now contained in a wrongful dismissal lawsuit, of government interference into health contracts last month. Athana Mentzelopoulos, the former chief executive of Alberta Health Services (AHS), alleges she faced political pressure to sign inflated contracts for CSFs.
CSFs are privately-owned centres where surgeons perform operations paid for by the public health care system. Two private facilities at the centre of Ms. Mentzelopoulos’s allegations were negotiating rates more than double what a competitor was charged, The Globe previously revealed ([url]https://www.theglobeandmail.com/canada/alberta/article-alberta-surgical-companies-with-contracts-under-scrutiny-linked-to/[/url]) after obtaining an AHS pricing document. The price comparison also showed that the proposed fees surpassed what it cost AHS to perform the same surgeries.
The United Conservative government has argued that private facilities add capacity and can help reduce wait times. Critics say CSFs can play a role in surgical care but run the risk of scraping crucial resources, such as anesthesiologists, from the public system.
Mr. Longhurst noted in his report that the public and private facilities are pulling from the same limited staffing pool. He said most public operating rooms in Alberta are not currently funded and staffed to perform surgeries during evenings or weekends.
“Paying for-profit providers a premium rate simply diverts staff from hospitals to the for-profit sector,” he said.
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Health Minister Adriana LaGrange, in a statement on Wednesday, dismissed the report.
“The use of chartered surgical facilities has played a key role in reducing wait times and improving patient care, yet these successes are often dismissed or downplayed in favor of an ideological stance that does not reflect the actual progress we’ve made,” she said.
The UCP government, under former premier Jason Kenney, announced the Alberta Surgical Initiative (ASI) in December, 2019. The aim was to meet wait-time targets and fund an additional 80,000 surgeries over four years by expanding contracts with private facilities. The UCP said it wanted independent providers to perform 30 per cent of all procedures by 2023, double that of 2019.
That goal has not been reached. About 22 per cent of all surgeries performed in Alberta last year were scheduled in CSFs, according to government data. The provincial dashboard also shows that 42.5 per cent of patients are waiting for surgeries outside of the recommended target, as of February.
Mr. Longhurst’s report shows median wait times for nine of 11 priority procedures tracked by the Canadian Institute for Health Information have increased since ASI was introduced. Lung cancer patients in 2023 waited on average 31 days for surgery, up from 21 in 2019. Over the same period, wait times for breast cancer surgery rose to 22 days from 17.
There were also longer wait times for prostate, bladder and colorectal cancer surgeries. Cancer surgeries are performed exclusively in public hospitals.
Cataract and hip surgeries – both of which are partly outsourced to CSFs – were the only two procedures that saw median wait times decrease, by 31 per cent and 1 per cent. Knee replacements, one of the main procedures outsourced to private facilities, saw a 27-per-cent increase in wait times.
The report also highlights that government spending on private facilities outpaced funding for public operating rooms.
“Public hospitals have been put in the untenable position of serving a growing and aging population with fewer resources,” the report says. “While the Alberta government seems committed to deepening the role of investors in Alberta’s health system, this approach is proving costly for both the government and patients.”
Alanna Smith
[url]https://www.theglobeandmail.com/canada/alberta/article-alberta-public-health-system-losing-staff-funding-as-province/[/url]
Private surgical facilities in Alberta are starving the public system of staff and funding to perform priority procedures, according to a new report that concludes the province has yet to increase surgical capacity or reduce wait times as pledged.
The 20-page analysis, published Wednesday by the Parkland Institute, showed provincial spending on private surgical facilities increased nearly three-fold to $55.8-million in 2023-24 from $20-million in 2019-20. By comparison, spending in public facilities increased marginally.
During the same time period, the average cost of outsourced procedures nearly doubled, while wait times jumped for priority procedures, such as cancer surgeries, which are only performed in the public system. In all, roughly 16,500 more procedures were performed over those five years in Alberta, but the increase was “exclusively” in private facilities.
“For-profit providers are being paid inflated prices to deliver the easiest, most profitable procedures at the expense of our public hospitals,” said Andrew Longhurst, a health policy researcher and the report’s author, in an interview.
“The consequence to that is what we’re seeing in cancer surgical care. You’re seeing those wait times balloon … and they have very real effects on people’s lives.”
The Alberta government has been under fire over its deals for chartered surgical facilities (CSFs) since The Globe and Mail reported ([url]https://www.theglobeandmail.com/canada/alberta/article-alberta-ousted-health-services-ceo-amid-probe-into-medical-contracts/[/url]) allegations, now contained in a wrongful dismissal lawsuit, of government interference into health contracts last month. Athana Mentzelopoulos, the former chief executive of Alberta Health Services (AHS), alleges she faced political pressure to sign inflated contracts for CSFs.
CSFs are privately-owned centres where surgeons perform operations paid for by the public health care system. Two private facilities at the centre of Ms. Mentzelopoulos’s allegations were negotiating rates more than double what a competitor was charged, The Globe previously revealed ([url]https://www.theglobeandmail.com/canada/alberta/article-alberta-surgical-companies-with-contracts-under-scrutiny-linked-to/[/url]) after obtaining an AHS pricing document. The price comparison also showed that the proposed fees surpassed what it cost AHS to perform the same surgeries.
The United Conservative government has argued that private facilities add capacity and can help reduce wait times. Critics say CSFs can play a role in surgical care but run the risk of scraping crucial resources, such as anesthesiologists, from the public system.
Mr. Longhurst noted in his report that the public and private facilities are pulling from the same limited staffing pool. He said most public operating rooms in Alberta are not currently funded and staffed to perform surgeries during evenings or weekends.
“Paying for-profit providers a premium rate simply diverts staff from hospitals to the for-profit sector,” he said.
More stories below advertisement
Health Minister Adriana LaGrange, in a statement on Wednesday, dismissed the report.
“The use of chartered surgical facilities has played a key role in reducing wait times and improving patient care, yet these successes are often dismissed or downplayed in favor of an ideological stance that does not reflect the actual progress we’ve made,” she said.
The UCP government, under former premier Jason Kenney, announced the Alberta Surgical Initiative (ASI) in December, 2019. The aim was to meet wait-time targets and fund an additional 80,000 surgeries over four years by expanding contracts with private facilities. The UCP said it wanted independent providers to perform 30 per cent of all procedures by 2023, double that of 2019.
That goal has not been reached. About 22 per cent of all surgeries performed in Alberta last year were scheduled in CSFs, according to government data. The provincial dashboard also shows that 42.5 per cent of patients are waiting for surgeries outside of the recommended target, as of February.
Mr. Longhurst’s report shows median wait times for nine of 11 priority procedures tracked by the Canadian Institute for Health Information have increased since ASI was introduced. Lung cancer patients in 2023 waited on average 31 days for surgery, up from 21 in 2019. Over the same period, wait times for breast cancer surgery rose to 22 days from 17.
There were also longer wait times for prostate, bladder and colorectal cancer surgeries. Cancer surgeries are performed exclusively in public hospitals.
Cataract and hip surgeries – both of which are partly outsourced to CSFs – were the only two procedures that saw median wait times decrease, by 31 per cent and 1 per cent. Knee replacements, one of the main procedures outsourced to private facilities, saw a 27-per-cent increase in wait times.
The report also highlights that government spending on private facilities outpaced funding for public operating rooms.
“Public hospitals have been put in the untenable position of serving a growing and aging population with fewer resources,” the report says. “While the Alberta government seems committed to deepening the role of investors in Alberta’s health system, this approach is proving costly for both the government and patients.”
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