Opinion: On well being care, native selections result in higher outcomes

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By Krystle Wittevrongel 

When selections are made nearer to residence, they have a tendency to extra precisely mirror the truth on the bottom.

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That is one thing that Premier Danielle Smith and Well being Minister Adriana LaGrange appear to grasp primarily based on the plan they offered to reform Alberta Well being Companies. They’ve even gone as far as to make native autonomy one of many seven guiding ideas for the reform. 

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The plan offered to Albertans talks of splitting Alberta Well being Companies into 4 completely different organizations, every specializing in a selected side of well being care: main care, acute care, persevering with care, and psychological well being and dependancy. Whereas there was limitless tinkering with the system for many years, this reform is the most important since 2008, when then-premier Ed Stelmach centralized the system and merged the regional well being authorities. 

The one downside with this discuss of native autonomy is that primarily based on what was unveiled, it’s arduous to see how native decision-making can be operationalized among the many 12 native advisory councils and Indigenous advisory council to be established. 

Though having completely different specialist organizations is an attention-grabbing concept, it doesn’t clear up the difficulty of extreme centralization within the province’s well being system. We’re not getting rather more regional enter from Fort McMurray, Lethbridge or Grande Prairie by changing one Edmonton headquarters with 4 Edmonton headquarters 

In distinction, empowering completely different areas to make their very own selections would give us a well being system that responds sooner and higher to native wants. Whereas all of us want sooner entry to well being care, not each area faces the identical points.

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A few of these variations may be apparent — you’re extra prone to see snowboarding accidents ending up at hospitals in Banff or Canmore than in Drumheller — however others are much less so. 

For example, sufferers on the Grande Prairie Regional Hospital needed to wait the longest within the province for knee alternative surgical procedure, with 90 per cent receiving therapy inside 191 weeks, in contrast with 97 weeks provincewide. And but, the identical facility is among the many quickest within the province relating to finishing CT scans.

By bringing decision-making nearer to front-line staff, each geographically and hierarchically, unfavourable tendencies may be seen sooner and corrected sooner.

The opposite benefit of decentralization is an improved capability to experiment with completely different options to our health-care woes.

In spite of everything, it’s a lot simpler to implement organizational change in a smaller group than in a single as massive as Alberta Well being Companies, with its greater than 100,000 employees members.

It’s additionally no secret that some points, equivalent to lengthy wait instances, are plaguing emergency rooms in each a part of the province — even if Alberta spends extra per particular person on well being care than many different provinces, together with Quebec and Ontario. 

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By creating a lot of smaller regional models, versus a big conglomerated administrative construction, concepts for small adjustments are extra simply utilized and may doubtlessly generate curiosity and consciousness greater up the ladder.

A great way to visualise it’s that there are far fewer administrative rungs to climb between front-line staff and their native hospital executives than between these staff and AHS executives in Edmonton.

This tends to favour initiative-taking and experimentation on a regional stage. And if experimentation is on the rise in each area, then all the province turns into a laboratory for concepts, the place one of the best strategies may be recognized after which replicated in different places.

Hopefully, when Smith and LaGrange present us with extra particulars, we’ll see extra of that type of decentralization in Alberta’s well being reform. As a result of simply splitting one Edmonton headquarters into 4 dangers doing little or no.

Krystle Wittevrongel is senior coverage analyst and Alberta mission lead at Montreal Financial Institute.

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