BOYLE — Temporary and rolling hospital closures throughout Alberta have been the subject of much attention in recent years, especially within the last week following the publication of Premier Danielle Smith’s statement indicating Alberta Health Services (AHS) may be replaced as operator of select underperforming facilities.
“If our operator isn’t performing the services we need them to we’re going to take (the hospital) back,” said Smith during an Aug. 17 UCP town hall in Drayton Valley.
She pointed to Catholic healthcare provider Covenant Health as a potential third-party operator to replace AHS in certain facilities, a name drop which, along with the rest of her statement, raised the eyebrows of experts and critics across the province.
But Boyle Mayor Colin Derko, and residents of the village and surrounding area, have been dealing with nightly closures of the Boyle Healthcare Centre’s emergency department for more than two years. Although he’s unsure of what the correct path forward is for the facility, Derko was adamant: “Something needs to change.”
“I don’t know what the answer is,” he said. “I trust the fact that’s what (the government) is making their decisions on, on the premise that something needs to change to get better, because it’s not getting better the way it’s being done.”
Smith explained the transfers are a next step in the restructuring of AHS and will introduce healthy competition back into a single-provider market as a solution to underperforming hospitals.
“When you’re dealing with a monopoly, and they believe that they can deliver any type of care, and there are no consequences, they’re going to continue to deliver bad service.”
Smith added the competition, introduced by way of chartered surgical centres and new third-party hospital operators, will also inspire fear in current hospital management, motivating operators to provide better healthcare delivery.
Experts such as Lorian Hardcastle, associate professor at the faculty of law in the University of Calgary’s Cumming School of Medicine, have noted a change in facility operators likely won’t solve staff shortages and lack of physician coverage driving temporary closures, and could even have an opposite effect on hospital staffing numbers.
“There may also be some providers who aren’t interested in continuing to work at a facility if Covenant takes over, and so it’s not clear that this is going to help recruitment and retention, and it might make it worse,” said Hardcastle.
But Derko said he remains cautiously optimistic that opening the door to alternative options for the Boyle hospital could bring the delivery of rural healthcare back to its roots.
“We need to be more involved, because decisions are being made for us by people that have no clue, and not to their fault,” said Derko. “Our healthcare system, it’s become an empire where nobody is responsible for anything and nobody can make a decision.”
Doyle noted managers and board members running the hospital used to live in the community and made connections to the locals and residents receiving care.
“It seems that’s what we went away from, and that’s where we ended up having problems,” he added. “I’m not exactly sure what I’m in favour of, but I am 100 per cent in favour of making a change where we have more control, more say.”
Athabasca-Barrhead-Westlock MLA Glenn van Dijken agreed with Derko’s sentiments, echoing the need for more regional input when it comes to provision of healthcare, and the switch from small business to a more corporate style of delivery.
“I’ve seen the system go from essentially, community care and delivery to where now it's big business delivery, and I think there’s a happy medium between those two that will help bring solutions, especially in rural Alberta.”
van Dijken said all stakeholders in the system, including front line workers, the local community, and municipalities should be involved in the restructuring and betterment of healthcare in the province.
“We’re seeing stress throughout the system throughout Canada, but sometimes finding solutions takes conversations, and I believe that having the willingness to structure some conversations around it will bring us to solutions.”
He noted the Premier’s comments about using fear to motivate AHS management were focused on holding the operators of facilities accountable for their actions.
“Front line service providers, really in my opinion, have nothing to fear, when they’re getting the job done,” said van Dijken. “Moving forward, don’t be in fear of accountability, but take it as an opportunity to influence change to improve delivery.”
Alberta Medical Association president Paul Parks voiced his opinion on Smith’s plan, saying the transfer of facilities will only bog the system down further and cost taxpayers more money.
“I'm just really worried about the added redundancies: more red tape, more bureaucracy, more administrative structure,” said Parks, who also noted competition between providers would create more staffing issues for all parties.
“The critical bottlenecks and issues are around things like workforce and resources and funding models that are all on the desk of Alberta Health and not the actual provider,” he added.
Faith-based care concerns
Hardcastle noted the introduction of faith-based care into more of the province’s hospitals would limit Albertan’s access to care. As a Catholic organization, Covenant staff are not allowed to administer services such as abortion, emergency contraceptives, and medical assistance in dying.
When asked if rural Albertans should have to choose whether faith dictates the medical care they receive, van Dijken said both AHS and Covenant Health must provide the level of care guaranteed in the Canada Health Act.
Abortion is included in the Canada Health Act under the broad definition of “insured health services.” Although no law restricts or criminalizes abortion, it is not specifically mentioned in the Act.
“It’s more about actually getting delivery than going into the nuances of whether or not the Covenant health system has been able to service Albertans properly,” said van Dijken.
“I think the local community is more focused on getting a system in place that they can rely on, that is going to be there when they need it in critical care times as opposed to diving into the nuances of what services are available.”
But Alberta NDP health critic Dr. Luanne Metz, said the loss of ‘nuances’ in service described by van Dijken would put many rural Albertans in a challenging position.
“It will be devastating for these communities if they lose access to a whole avenue of health care that is provided to other Albertans, and that may be reproductive health care as well as medical assistance in dying, which (Covenant) also does not support,” she said.
With files from Brett McKay, LJI reporter
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