While stakeholders are raising concerns about health-care workforce planning as staff shortages and service gaps continue following provincial restructuring, some confusion seems to exist on who in the government is responsible and what they are doing about it.--CP FILE PHOTO
zmason@medicinehatnews.com
Throughout the province’s health-care refocusing, stakeholders have continued to raise alarms about a lack of co-ordinated workforce planning.
Amid all the changes currently affecting the province’s health-care delivery, it is difficult to discern where responsibility for ensuring that staffing needs are met across the province lies.
In an interview with the News last month, Justin Wright, Cypress-Medicine Hat MLA and Parliamentary Secretary for Rural Health, deferred a question about workforce planning to Minister of Hospital and Surgical Health Services Matt Jones.
Jones had previously told the News that responding to workforce shortages like the one Medicine Hat experienced in September, leaving the hospital without on-call obstetricians for three days, was the jurisdiction of his ministry. Jones said his ministry would collaborate with the hospital service provider – in this case, AHS – to address the shortage.
However, Minister of Primary and Preventative Health Services Adriana LaGrange told the News in October that workforce falls under her jurisdiction.
In a statement to the News last week, LaGrange’s press secretary Maddison McKee confirmed that the general responsibility for workforce issues belongs to that ministry.
“Workforce planning is shared across ministries, employers, regulators and service providers. The Alberta Health Workforce Oversight Committee, led by PPHS and made up of multiple ministries and sector partners, oversees implementation of the strategy,” said McKee.
For specialized services like obstetrics, McKee says PPHS and HSHS work together with the Oversight Committee to identify gaps and ensure appropriate recruitment.
“As in other provinces, no single individual is responsible for hiring and assigning every health-care worker. What matters is that we have a co-ordinated system and that we are growing the workforce to meet demand,” said McKee.
Wright also pointed inquiries to Parliamentary Secretary for Health Workforce Engagement Chelsae Petrovic. Petrovic told the News she couldn’t identify any persons responsible for province-wide workforce planning, and pointed to the Health Workforce Strategy.
The strategy, released in 2024 and predating the refocusing which stakeholders say has disrupted workforce management, outlines an intention to create mechanisms for a co-ordinated approach but otherwise contains no substantive information regarding workforce planning.
“I don’t think we’re at a place where we have a co-ordinated workforce plan,” said Brian Wirzba, president of the Alberta Medical Association, in an interview with the News. “I would not say we’ve not actually even started that work in earnest.”
Wirzba says there have been discussions with the health ministries about workforce challenges and issues, and a loose agreement to collaborate on addressing them. But, he says, preliminary talks were disrupted when the government touchpoint for the AMA left the government, and talks haven’t resumed since that position has been filled.
At a rural media roundtable in October, Minister of Assisted Living and Social Services Jason Nixon told reporters the AMA resisted the refocusing because they were defending the old system.
“While we will continue to work very closely with the AMA, what cannot happen is the status quo. The position of the AMA was that we were to do the status quo. That wasn’t working for Albertans,” said Nixon.
Wirzba told the News that has never been the AMA’s position.
“The AMA understands that there were problems with the old system. Albertans were not getting the degree of care that they deserve. So no, it’s not the status quo.”
Wirzba said innovation and optimization are certainly welcome, but that the province’s refocusing has largely proceeded without input from stakeholders, including the AMA.
“Our focus is always on the patient journey. And we’re very concerned about the integration of these different pillars and how that’s actually going to work.”
Wirzba says one doctor could plausibly work in all four pillars of the new system. Without careful integration around workforce planning, that one physician could be counted four ways to distort key data informing workforce decisions.
He says there is so little information available about workforce planning that it’s impossible to know whether that is the case.
“We don’t even know if they’re counting the numbers that they have,” he said.
LaGrange told the News in October her ministry had conducted a heat map of the province determining what services were needed and where. That data is not publicly available.
Health-care professionals are concerned Alberta’s Bill 11 may exacerbate pressures on a strained workforce. The legislation would allow some physicians to practice concurrently in both the public and private system.
Wirzba says Alberta’s health system capabilities are not robust enough to support the model the province has proposed, and the biggest reason for that is workforce availability.
“If you look at OECD averages, Alberta is at 2.4 physicians per 1,000 people, whereas some of these other countries, they might be at 3.5 to even 4.5 per 1,000, depending on the country.”
With better access to primary and preventative care, these systems have a better likelihood of delivering, Wirzba says. Even so, he says other jurisdictions that introduced more private pay have seen their public systems take a hit.
Wirzba says LaGrange has assured him the AMA will be involved in setting the actual policy that governs the dual practice model proposed in Bill 11.
