Critics worry the Alberta government's latest health-care reforms, which included the elimination of 12 CEO positions, will lead to privatization and a loss of expertise to other parts of Canada.
The job losses are the latest move in the government's attempt to create a single health superboard, by dissolving nine regional boards in favour of the centralized Alberta Health Services Board.
Donna Wilson, a professor of nursing at the University of Alberta in Edmonton, said the loss of top level talent could hurt Alberta's health-care system.
"We did this back in 1993, '94, '95 when we set up regionalization to start with, and that was a huge mistake at the time because you lose such tremendous, talented people. You lose people that can plan, that are good at planning, getting changes made," she said.
The CEOs who lost their jobs were the heads of the nine regional health authorities, the cancer board, the mental health board, and the Alberta Alcohol and Drug Abuse Commission. Three of the executives will move to different positions, while the other nine will not be working with the new Alberta Health Services Board.
Wilson said the elimination of the CEO positions could create a ripple effect. She worries that additional job cuts might encourage middle and lower level managers to quit, meaning the province would lose even more health-care expertise.
"There's such a shortage of good management people in health care elsewhere, any one of those people now could leave," she said.
The Friends of Medicare, a lobby group that has fought attempts to privatize Alberta's health care in the past, also has concerns about changes in the health-care system.
"There may be privatization behind it, which may not favour the patients, might favour the patients that can pay ... more private clinics and those type of things might arise out of this," said Calgary's Mel Teghtmeyer, a member of the Friends of Medicare.
Teghtmeyer is also "highly concerned" about the lack of public participation in the new centralized board.
"We see the superboard empowering themselves, and not much empowerment left to the community. [We are] highly concerned about that," he said.
Superboard structure similar to HMOs, says prof
John Church, an associate professor at the University of Alberta's school of public health, said the single board structure reminds him of the for-profit Health Maintenance Organizations (HMOs) in the United States.
"As long as it's publicly managed and publicly funded I think we probably don't have a lot to worry about," he said. "But it's possible that at some point the government could decide that they're going to contract out for the management of the system and I think they would still be within the Canada Health Act in doing that."
Church added a single decision-making body could now decide to contract out hip and knee surgeries like they are doing now in Calgary.
"They could now look at doing that across the entire province and there wouldn't be any barriers that were there because of regional boundaries."
The structure of the new board will include a CEO responsible for urban health care, and another to handle health care in rural areas, a move criticized by Edmonton Liberal MLA Laurie Blakeman.
"I think that Alberta is an urban province and I'm tired of having this government treat the urban population as though we're second class," she said. "I think they're trying to hold on to their rural voting base, but frankly I think that's very unfair to people that live in urban areas."
The single health board officially takes over on April 1, 2009.