Privatize some procedures, drop coverage on others: AHS review
By GILLIAN SLADE on February 4, 2020.
gslade@medicinehatnews.com@MHNGillianSlade A government mandated review of Alberta Health Services makes 57 recommendations that could save $1.9 billion annually, says the Ernst & Young report released on Monday. Health Minister Tyler Shandro says any savings will stay in health care. “Every dollar we save will be put right back into the health system to deliver on our promise to improve access and make the system work better for patients. It’s about freeing up administrative resources so we can spend more directly on Albertans’ health care.” A spokesperson for the minister says the savings will provide the additional funding AHS will need to meet future requirements, including additional surgeries to reduce wait times. The Ernst & Young recommendations include addressing AHS salaries, private companies doing some surgeries, certain types of surgery for which there is no clinical benefit not being covered, changes to long-term care and identifying some hospitals that are not being used at full capacity. There are about 36 hospitals that are not meeting priorities, but Shandro says that aspect of the report will not be implemented. “There will be no hospital closures or consolidation of urban trauma centres,” said Shandro. Friends of Medicare says the report is simply the start of private health care. “We don’t know how much contracting out our public health care will ultimately cost the citizens of this province, nor were we provided any comparators of how much it would cost to increase in-hospital capacity or build public infrastructure in the interest of the public good,” says executive director Sandra Azocar. AHS employs 102,717 people, of which 70,139 are full time. It’s the largest employer in the province with about 91 per cent of staff being unionized. The AHS executive team includes 14 full-time staff earning a combined $6.03 million in 2018/19. The report considers the executive-level compensation to be appropriate but says it should be externally assessed periodically. It also says AHS pays “higher than the Canadian average across employee groups.” AUPE, which represents about 50,000 health-care employees, says there was a hidden agenda all along with this review. “It has become abundantly clear to Albertans that this government made up its mind long ago that the solution to everything is to cut services or hand them over to their corporate pals,” said Susan Slade, vice-president. The provincial government awarded the $2-million contract to Ernst & Young to conduct the first review of AHS in its 10-year history. AHS is the provincial health authority responsible for planning and delivering health supports and services with a budget of $15.4 billion. The report suggests 1,300 patients in Long Term Care beds could be moved to Designated Supportive Living instead, or there could be an increase in what Albertans pay for LTC. Public Interest Alberta says those in LTC beds have their pharmaceuticals, medical supplies, and medical equipment covered by the public system. Those in DSL pay for it themselves. If this change takes place “it will mean a significant increase in out-of-pocket costs for Alberta families,” said executive director Joel French. Dr. Verna Yiu, AHS president and CEO, says many of the recommendations were already underway before the review. Since receiving the report an implementation team has already been assembled and by May 13 will provide Shandro with a list of immediate priorities. The report, which cost the government $2 million, also recommends the government change work and pay rules for nurses and doctors, and consider outsourcing food, laundry and other support services to the private sector. More private clinics performing routine surgeries paid for by public health care would save costs, it claims. A spokesperson for Shandro says surgeries at private clinics will cost less, though no details of how much less were available yet. Yiu says there are some procedures that may not result in improved outcomes and for which there is limited clinical value and may not be covered in future. An example would be certain types of hernias. Yiu has noted that the potential gross savings of $1.9 billion is “based on fully adopting every suggested recommendation.” It also does not include implementation costs and other factors. 23-22
