Premier Danielle Smith reveals plans to transfer some Alberta hospitals away from AHS

During a UCP town hall event in Drayton Valley, Premier Danielle Smith outlined the next steps in her government’s plan to restructure Alberta's healthcare system. This includes potentially removing Alberta Health Services (AHS) as the operator of certain hospitals and transferring these facilities to other operators, such as the Catholic healthcare provider Covenant Health.

Smith explained that the government is creating a framework where it retains ownership of healthcare facilities but leases them to AHS. The government is also prepared to withdraw AHS's authority to operate hospitals if necessary. "If our operator isn’t performing the services we need them to, we’re going to take [the hospital] back," Smith stated at the town hall on August 17.

The next phase of this strategy involves evaluating how many hospitals currently managed by AHS can be reclaimed by the government. However, Smith acknowledged that this approach wouldn't apply to all hospitals.

Smith believes this strategy will enhance healthcare delivery and reduce service disruptions in rural hospitals by introducing competition and fear as motivating factors. "When you’re dealing with a monopoly, and they believe they can deliver any type of care without consequences, they’re going to continue to deliver bad service. That’s why we’re offering chartered surgical centres and Covenant," she said. She added that the fear of losing operational control would serve as a strong incentive for managers to improve services.

Smith cited the government’s ongoing efforts in La Crete, where hospital authority is being transferred to Covenant Health, as an example. She noted that Covenant Health has a track record of maintaining rural hospitals without closures and suggested that different operators might be needed in smaller communities to ensure consistent care.

Smith emphasized that these changes would be gradual and that the government would seek a mandate from Albertans to proceed with them.

Lorian Hardcastle, an associate professor at the University of Calgary’s Cumming School of Medicine, expressed concerns about the proposed changes, arguing that switching hospital administrators would require significant time and money and might not address the underlying issues causing temporary closures. "It seems to be more of what we’ve already seen—change for the sake of change—not with a view to improving access or quality," Hardcastle said.

She also questioned the assumption that Covenant Health would be better suited to run rural hospitals, pointing out that this claim lacks factual support. Hardcastle noted that Covenant Health has faced emergency department closures at some of its facilities due to staffing shortages, just like AHS.

Moreover, Hardcastle raised concerns about the implications of transferring hospitals to a religious operator like Covenant Health, which does not provide certain services such as emergency contraception, abortion, and medical assistance in dying.

Alberta NDP health critic Dr. Luanne Metz echoed these concerns, warning that losing access to these services would be detrimental to rural communities. Metz criticized the ongoing changes in Alberta’s healthcare system, suggesting they have led to budget cuts for AHS while increasing spending on restructuring and consultants. She argued that the government is unfairly blaming AHS for issues while controlling its operations behind the scenes.

Metz also cautioned that changing hospital operators could add instability, making it harder to attract healthcare professionals, and hinted that this move could signal further privatization of the public healthcare system. "I think this is part of a move towards privatization, not just a story about Covenant versus AHS. It’s a way of introducing other providers," she said.

Metz further challenged the effectiveness of existing private healthcare initiatives in Alberta, noting that chartered surgical facilities have not led to an increase in surgeries and could worsen rural healthcare.

A spokesperson for the Minister of Health’s office stated that the ongoing efforts to refocus Alberta’s healthcare system include transitioning AHS to focus primarily on acute care services. Both AHS and Covenant Health will continue to play essential roles in delivering acute and continuing care to Albertans, with the government committed to maintaining key healthcare partnerships to provide the best care possible.