Health Minister Ron Liepert speaks to reporters at the Alberta legislature Tuesday. (CBC)

The delisting of sex-change surgeries in Alberta is just the start — more services currently covered by medicare in Alberta will be cut later this year, the premier and the health minister said Tuesday.

The Alberta Health Services Board is facing a deficit of at least $500 million and some services will have to go, with more information coming within six months, Premier Ed Stelmach said.

"The minister will take the summer and into fall to work with Albertans and be making further decisions based on what the board has to say," he said.

"These are difficult decisions because it is one budget that is receiving annual increases."

The process started last week when the province released its provincial budget, which projected a $4.7-billion deficit for the 2009-2010 fiscal year.

The government revealed it will no longer pay for two services: chiropractic services, at a savings of $53 million a year, and gender reassignment, or sex change surgeries, which will save Alberta taxpayers $700,000 annually.

The latter move has become particularly controversial. Transgendered Albertans are expected to file human rights complaints about the government's decision on Wednesday, though the complaints are more likely to focus now on the discriminatory nature of the move than on specific cases.

Board of experts to review every procedure

On Tuesday, the government made a surprise concession by committing to fund the 20 people who have started hormone drug treatment but still haven't received approval for the gender reassignment surgery, in addition to the 26 people who are currently on a waiting list.

"It seems to me … to be unfair to have someone believe that certain surgery was going to take place, dug into their pocket for hormonal drugs that were prescribed by [the] medical community and then somehow we don't follow through on it," Health Minister Ron Liepert said.

But any new patients will have to pay for the surgeries themselves, and Albertans can expect to see more of this in the future for other procedures.

Liepert said he wants to put together a board of experts to review every procedure, to decide what should be covered and what can be cut.

"It's worked well in our pharmaceutical approval process," he said. "We have an expert committee that looks at a new drug and says that based on the evidence this should or should not be covered, then makes recommendations to the minister.

"And I'm sort of thinking out loud a little bit and saying why couldn't we do that for the general health-care procedures."

All provinces are trying to keep their health-care spending in line and action needs to be taken to preserve Alberta's public health-care system, Stelmach said.

With files from The Canadian Press