Health minister given mandate to review, reform Alberta Health Services

Alberta’s health minister will review what functions Alberta Health Services performs, saying there are questions about whether the provincial health authority has become too large.

Adriana LaGrange says review will consider compartmentalizing AHS by function

Health Minister Adriana LaGrange
Alberta Health Minister Adriana LaGrange says the time for studying health system reforms is done, and she is expected to make changes based on previous recommendations for improvement. (Jo Horwood/CBC)

Alberta's health minister will review what functions Alberta Health Services performs, saying there are questions about whether the provincial health authority has become too large.

"It was originally intended to just look after acute care," Health Minister Adriana LaGrange said in an interview with CBC News in Calgary on Tuesday.

"But now it looks after acute care. It looks after primary care. It's looking after continuing care. It's also a service provider. It's also developing policy. All of these areas were beyond the scope it was originally intended for."

Premier Danielle Smith released a hefty four-page health mandate letter on Tuesday, six weeks after LaGrange was sworn in as minister.

After four years as education minister, LaGrange is now charged with addressing health care recruitment and retention challenges across Alberta, including rural access to obstetricians, midwives and family doctors.

The premier also asked LaGrange to be willing to "reform the management and structure of Alberta Health Services (AHS) to better decentralize decision-making and resources to the front lines and local communities."

Smith's letter says the health system must welcome innovation and incentivize the best patient care.

In 2008, the Progressive Conservative government of the day created AHS by merging all regional health authorities and a handful of provincial health agencies.

It was the first provincewide health authority in Canada. More than 125,000 employees now work for AHS or one of its wholly owned subsidiaries.

Since pursuing the United Conservative Party leadership last year, Smith has said she wants to reform AHS to allow local leaders to act more quickly to start new programs or respond to local problems.

On Tuesday, LaGrange said she doesn't want to presuppose the outcome of this reorganization, nor did she give a timeline for when the government would make restructuring decisions. 

LaGrange ruled out the idea of hiring a consultant to conduct another analysis of the organization.

In 2020, the UCP government released the results of a $2-million AHS review performed by Ernst &Young, which recommended measures it said could save nearly $2 billion per year.

LaGrange said the time for studies is done, and the government will instead act on previous recommendations. However, closing or consolidating rural hospitals, as the EY review recommended, is not on her to-do list, LaGrange said.

Health-care union leaders, meanwhile, have raised concerns about restructuring a system that is already under strain from high patient demand, growing government expectations and a shortage of workers.

"Our health-care workers need stability and investment in the work they do every single day," Health Sciences Association of Alberta president Mike Parker said on Tuesday. "Not conflict between a public health guarantee and alternative models. Not this unknown nebulous of decentralization."

Mike Parker HSAA
HSAA president Mike Parker has concerns about restructuring a system that is already under strain from high patient demand. (HSAA website)

Although the UCP government has been outsourcing some functions of the health system to private companies, Smith has said no Albertan will have to pay out of pocket for insured health services, such as a family doctor visit.

NDP primary and rural health critic David Shepherd said the government's pledge of decentralizing decision making is ironic, given Smith fired the AHS board and installed an administrator to speed up change.

"It's a bit laughable that she's suddenly now saying she wants to be more regional, collaborative and empower local healthcare workers and others," Shepherd said. "I don't think our system would be helped by creating additional red tape, additional boards."

When asked, LaGrange didn't say whether splitting AHS back into regional boards was a possibility.

Minister to fix 'unacceptable' lab delays

Smith has also asked LaGrange to resolve "the unacceptable lab services delay challenge" as patients, particularly in Calgary and southern Alberta, are sometimes left waiting more than a month for routine tests.

During the last year, AHS has outsourced more lab testing to Dynalife, a company that was already running community labs in Edmonton and parts of northern Alberta. Privatizing more of the service was one of the EY report's recommendations that was supposed to save money.

However, patients who depended on routine or timely tests sometimes spent hours waiting in emergency rooms instead to get their tests done on time.

LaGrange wouldn't say what solutions the government is considering, but that officials have made it clear to Dynalife they expect the company to scale up its staffing and improve service.

"Albertans deserve the best lab services available," she said. "And right now that's not happening."

She did not say what the consequences would be for Dynalife, should they continue to fail to meet expectations.

Dynalife deferred questions to Alberta Health.

HSAA represents around 3,000 lab workers across the province in both public and private labs.

Union president Parker said the service Dynalife provides has eroded because the company now needs to skim off profits for shareholders.

"How do you make those profits? It's in cutting of resources, time, scheduling, workers," he said.

Parker was happy to see the premier address worker concerns such as employee shortages in the mandate letter, saying unions have been pointing out the problem for years.

Among the rest of LaGrange's to-do list is containing to try reducing surgical and emergency room wait times, addressing a taxed EMS system, and strategizing how to recruit and retain workers, especially in rural Alberta.

She'll also implement UCP election promises to expand disease screening for newborns and bolster women's health research.


Janet French

Provincial affairs reporter

Janet French covers the Alberta Legislature for CBC Edmonton. She previously spent 15 years working at newspapers, including the Edmonton Journal and Saskatoon StarPhoenix. You can reach her at janet.french@cbc.ca.

With files from Emily Fitzpatrick