Opinion: Fix health-care's foundation before adding dual-practice |
Universal health care is only meaningful if people can access it. In Alberta and across Canada, the care itself is excellent once you get into the system, but far too many people wait until they are sicker, older, or in crisis.
Reform is needed. If we want to fix the system, we must focus on the right parts, in the right order.
I’ve been an ER physician for more than 30 years and recently stepped down as board chair of Health Quality Alberta (formerly HQCA), the province’s non-partisan health data agency. I have reviewed Alberta’s performance data closely.
Together, we have lived through two major restructurings. In the 1990s, every province lost hospital beds, physicians, nurses, and health-care staff after cherry-picking from the Barer–Stoddart report.
In 2009, merging nine health regions into one created years of turbulence. The results were the same: instability, declining morale, staff departures, longer waits, unnecessary suffering, and higher costs.
Alberta has now undergone the largest restructuring in its history, dividing Alberta Health Services (AHS) into four new service agencies and new regional health corridors, during a major capacity crisis and amid massive population growth. On top of this, dual practice is being introduced. Supporters and critics are passionate, understandably.
Dual practice — allowing physicians to work in both the public and regulated private systems, is not inherently harmful; many countries use hybrid models effectively. The issue is timing and sequencing.
Reform is not the enemy; disorder is. In a stable system, dual practice can add capacity. In a strained, understaffed system, it siphons away the professionals needed to keep the public system........