Health Care

Renew Health Care

You’ve heard the expression ”at least I have my health.” Many people are justifiably worried about the state and effectiveness of our current health care system. Instead of decisions being made by people who are much closer to local patients, the PC government has turned it over to the control of a bunch of managers and central planners in Edmonton.  Our system has lost its connection to average Albertans, and in the process, many bad decisions are being made and public and health care worker confidence is being undermined.

We need to push for a return to local decision making and accountability. Instead of forcing a patient and their doctor in Taber to ask permission for necessary treatment from someone in Edmonton, we need to empower local health officials and bring back local health boards. The principle is simple: the closer the accountability is to the people who receive service, the quicker decisions can be made or changes can be implemented.

Funding will follow

There is a serious flaw in our health care system, lump-sum funding gives hospitals and other providers a block of funding. It’s up to them to provide services as they see fit. Funding doesn’t directly follow a patient when they seek treatment; a patient has to hope the service is offered in a timely fashion, if at all.

Alberta has the best education system in the country. This came about because in our system, the funding follows the student. Choice is the most important piece of the system. With choice has come accountability and competition. Badly run schools lose students and well run schools gain students. This is how our health care system should be modelled. Patients should be able to take their Alberta Health Card to any approved health care provider and receive the treatment they need.

The provincial government should work on moving billions of dollars in funding away from centralized bureaucracies and back to frontline doctors and nurses in our health system. This means moving funding directly to providers, where doctors, nurses, and patients know best where it is needed.

Each patient in every area should be given full per capita funding. With full funding, Lethbridge would have had radiology for cancer treatment years ago because it was necessary and there were enough patients in need. Bureaucracy delayed the delivery of critical care.

Centralization/Local Needs

The government seems to think that 50 or 100 managers in Edmonton can make the best health care decisions for nearly four million Albertans. I disagree. I have respect for experts; one of them is my doctor. I place my trust in front-line workers, people that are best placed to understand the situation at hand. I think the further away you are, like an out of place referee, the worse your decisions will be.

We’ve moved from local hospital boards to regional health boards to the grand Alberta Health Services. I think we need to return to our roots, to the local doctors and administrators who have a real sense of what a community wants and needs to best provide for their patients.

We’ve lost flexibility in our communities. Edmonton and Calgary are going to have very similar needs. Medicine Hat and Grande Prairie will have theirs. We cannot provide every single world class service in every municipality; I am not asking for it to be so. Small, medium and large communities, whether urban or rural, have different needs. Population size can be fooling without context. St. Albert and Medicine Hat are very similar in size, yet St. Albert is part of the greater Edmonton area while Medicine Hat must provide for the surrounding region.

Hospital Districts

I believe in bring health decisions back to the community level. We should create what are called Hospital Districts. Each district would have 400,000 or so people in it with a full scope of practice. If full per capita funding followed every person in the province each district would have all the funding they need to care for their citizens. If a region thought it was better to have certain procedures performed out of their district, because of specialisation, scale and other professional considerations, they could do so.

For larger cities you could take the Hospital District model or you could take a regional approach. It would make sense for someone from St. Albert or Sherwood Park to travel into Edmonton for specialist treatment; they are suburban cities with many commuters. A city like Grande Prairie or Lethbridge will have to take a different approach.

I just don’t believe in top-down approaches in general, whether it is education or health care. I think most issues are local issues. Your school, police or hospital are all local. We need to empower people who make the real life and death decisions.