Public Statement from the O’Brien Institute for Public Health on the restructuring of Alberta Health Services

Nov. 21, 2023

The O'Brien Institute for Public Health’s Centre for Health Policy is actively monitoring the conversation around the recent announcement by the Alberta provincial government regarding the restructuring of Alberta Health Services (AHS). While acknowledging the government's intent to refocus health care delivery across Alberta to be more adaptable to community needs, it is imperative to approach this restructuring with careful consideration to prevent adverse effects on access to services and quality of care.

The reforms will limit AHS’ role, concentrating policy-making and budget functions within the government. AHS will become one of multiple entities delivering acute care under a new organization. Three additional organizations will handle primary care, continuing care, and mental health and addictions.

As we navigate these shifts in our healthcare landscape, the O'Brien Institute calls for regular, robust evaluations of the restructuring, grounded in patient experience and including a transparent communication plan to share the results and any course corrections needed. Such evidence-based approaches are key in Learning Health Systems, and toward ensuring that the restructuring remains rooted in best practices and demonstrable successes.

For whatever reforms are eventually enacted, the Institute is invested in informing the optimization of Alberta’s health systems, acknowledging both the challenges ahead and the potential for positive transformation.

We hope that the changes will bring about positive outcomes and address Alberta’s longstanding healthcare challenges while ensuring the system's overall resilience. However, we caution against oversimplifying the healthcare issues facing Alberta by attributing them solely to AHS. Doing so overlooks the complex nature of issues such as wait times, overcrowded ERs, struggles with recruitment and retention of staff, and a lack of primary care, which also necessitate increased resources provided by Alberta Health.

The government's recent announcement also omitted any reference to empirical evidence substantiating the assertion that a more compartmentalized service delivery model would effectively address the prevailing challenges within our health system. This absence of evidence leaves a critical gap in understanding how the proposed changes align with proven strategies for enhancing healthcare outcomes.

As we navigate these shifts in our healthcare landscape, a thorough examination of evidence-based approaches is key to ensuring that our health system's evolution remains rooted in best practices and demonstrable successes.

Drawing on extensive research done by the Centre for Health Policy into effective and sustainable healthcare delivery, we urge the Government of Alberta to carefully consider specific areas throughout the restructuring process:

  1. Preservation of province-wide integration: We advocate for maintaining the province-wide integration that AHS has fostered, ensuring a continuum of care and learning from successful initiatives like the Strategic Clinical Networks.
  2. Effective integration of the four re-organized entities: We encourage the integration of the new continuing care and primary care organizations with the AHS acute care organization, for the seamless provision of comprehensive health services across the continuum of care. We agree that mental health and addictions is a critical topic to include, and we emphasize the need for thoughtful and collaborative integration of this new organization with the three others, considering the interconnected nature of these services.
  3. Health equity integration across the four pillars: We stress the importance of prioritizing health equity in integration efforts across all four pillars to address disparities in health outcomes and access to care among diverse populations.
  4. Public health as a priority: We call for a comprehensive strategy for a unified provincial public health system, ensuring preparedness for future public health crises and enhancing overall population health.

As more details of the planned restructuring emerge, we emphasize the importance of evidence-based decision-making, citizen engagement, and a focus on improving patient outcomes. The citizens of Alberta deserve a resilient, responsive healthcare system centered on their needs.

The Centre for Health Policy is committed to evidence-informed decision-making. We stand ready to convene non-partisan experts to address issues not explicitly covered by the restructuring, such as short-staffing and financial sustainability. We look forward to optimizing the restructuring for the improved health and well-being of all Albertans.

Dr. Kirsten Fiest, PhD, scientific director, O’Brien Institute scientific director

Dr. Katrina Milaney, PhD, associate scientific director, population health, O’Brien Institute

Dr. Jamie Day, PhD, administrative director, O’Brien Institute