Alberta
Province announces next step to revamped health care system
Setting the foundation for a refocused health system
Proposed legislation would support the refocusing of Alberta’s health care system to ensure Albertans get the care they need when and where they need it.
On Nov. 8, 2023, Alberta’s government announced plans for a refocused health care system to ensure patients are receiving the care they need, when and where they need it. To achieve this, Alberta’s government will be creating four new organizations, one for each priority health services sector: acute care, primary care, continuing care and mental health and addiction.
If passed, the Health Statutes Amendment Act would enable the government to take the necessary next steps to refocus the province’s health care system. The legislation would ensure Albertans have a system that works for them by prioritizing their need to find a primary care provider, receive urgent care without long waits, have access to the best continuing care options and obtain excellent mental health and addiction treatment.
“We are taking another step toward improving health care by updating legislation and enabling the governance and oversight required to refocus the health system. The critical improvements to transparency and accountability will help support the successful refocusing of the health care system to one that is responsive, effective and reflects the needs and priorities of Albertans today and for future generations.”
The Health Statutes Amendment Act will enable the transition from one regional health authority, Alberta Health Services, to an integrated system of four sector-based provincial health agencies including primary care, acute care, continuing care and mental health and addiction. The agencies will be responsible for delivering integrated health services, ensuring Albertans receive timely access to care, regardless of where they live.
The Health Statutes Amendment Act establishes roles for an oversight minister and sector minister. The Minister of Health will take on the role of oversight minister, responsible for setting the strategic direction of the overall health system. A sector minister will be responsible for a specific health services sector. For example, the sector minister for Recovery Alberta is the Minister of Mental Health and Addiction. On the recommendation of the oversight minister, additional health service sectors may be established and designate a minister responsible for that newly created sector.
Enhanced government oversight will help Alberta’s government to better direct resources to the front lines where they are needed the most, improve patient care overall and support health care professionals.
“Mental health and addiction have been growing issues within our society and need to be prioritized within our health care system. Amid an addiction crisis, a refocused health system will allow for mental health and addiction services to get the attention, oversight and focus they need. Recovery Alberta would allow for improved mental health and addiction care across the province as an important part of an integrated health system.”
“Refocusing Alberta’s healthcare system is a crucial step towards ensuring that we can deliver a framework that prioritizes accessibility, accountability, and patient-centered care. By streamlining operations, improving oversight and fostering collaboration, we are setting a strong foundation for a healthcare system that is better equipped to address the diverse needs of each of our communities.”
The legislation will enable the minister of health to transfer employees or classes of employees from AHS to the new sector-based organizations, once established. During the transition period, AHS will be enabled to continue operating as a regional health authority. Employee transfers will be seamless, maintaining existing bargaining relationships and collective agreements. This will ensure stability for the workforce, unions and government as the health system refocus is implemented. There will be no job losses for staff who transition into the new organizations.
Amendments to be made to existing legislation
The Health Statutes Amendment Act includes amendments to the Regional Health Authorities Act and the Health Information Act, which have not been updated since the 1990s.
As part of these amendments, the name of the Regional Health Authorities Act will change to the Provincial Health Agencies Act. The amended Provincial Health Agencies Act will remove outdated references to allow the transition from a single regional health authority to a unified, sector-specific provincial health system. This will clarify the scope and accountabilities of provincial health agencies and health service providers going forward.
The amendments will also place responsibility on the provincial health agencies for operational planning and oversight of clinical service delivery across the province. This will enable provincial health agencies to set priorities in the provision of health service delivery. The agencies will also be tasked with sharing information and collaborating closely to support seamless patient care as the transition to the refocused health care system takes place.
Alberta’s government is committed to ensuring that patient information continues to remain safe and secure through this transition. Amendments to the Health Information Act will be introduced to support the new health system refocus and to support the establishment of the Canadian Centre of Recovery Excellence. These amendments will allow the Ministry of Health, the Ministry of Mental Health and Addiction, the four new provincial health agencies, the Health Quality Council of Alberta and Canadian Centre of Recovery Excellence to have the authority to use health information for health system purposes.
If passed, the Health Statutes Amendment Act will enable Recovery Alberta, the mental health and addiction provincial health agency, to begin operating in the summer of 2024. The primary care, acute care and continuing care provincial health agencies are expected to be established in the fall.
Quick facts
- Consequential amendments are changes made to existing legislation due to new legislation being passed. These amendments are necessary to ensure legislative alignment with the proposed amendments to the Regional Health Authorities Act.
- To support the Regional Health Authorities Act amendments and ensure alignment, 43 other acts are being consequentially amended – for example, to replace references to “regional health authority” with “provincial health agency” where necessary.
- AHS will remain a key provider of health services, and in fall 2024 will transition to focusing on the provision of acute care services.
- Alberta’s government introduced the Canadian Centre of Recovery Excellence Act which, if passed, will establish the Canadian Centre of Recovery Excellence (CoRE) as a public agency that would support the Government of Alberta, including Mental Health and Addiction, and Recovery Alberta in advancing the Alberta Recovery Model.
Related information
- Establishing the future of Alberta health care
- Refocusing health care in Alberta
- Recovery Alberta
- Canadian Centre of Recovery Excellence
- Bill 22: Health Statutes Amendment Act, 2024
Related news
- Refocusing on patient-centred care (Nov. 8, 2023)
Alberta
Alberta Next Panel calls for less Ottawa—and it could pay off
From the Fraser Institute
By Tegan Hill
Last Friday, less than a week before Christmas, the Smith government quietly released the final report from its Alberta Next Panel, which assessed Alberta’s role in Canada. Among other things, the panel recommends that the federal government transfer some of its tax revenue to provincial governments so they can assume more control over the delivery of provincial services. Based on Canada’s experience in the 1990s, this plan could deliver real benefits for Albertans and all Canadians.
Federations such as Canada typically work best when governments stick to their constitutional lanes. Indeed, one of the benefits of being a federalist country is that different levels of government assume responsibility for programs they’re best suited to deliver. For example, it’s logical that the federal government handle national defence, while provincial governments are typically best positioned to understand and address the unique health-care and education needs of their citizens.
But there’s currently a mismatch between the share of taxes the provinces collect and the cost of delivering provincial responsibilities (e.g. health care, education, childcare, and social services). As such, Ottawa uses transfers—including the Canada Health Transfer (CHT)—to financially support the provinces in their areas of responsibility. But these funds come with conditions.
Consider health care. To receive CHT payments from Ottawa, provinces must abide by the Canada Health Act, which effectively prevents the provinces from experimenting with new ways of delivering and financing health care—including policies that are successful in other universal health-care countries. Given Canada’s health-care system is one of the developed world’s most expensive universal systems, yet Canadians face some of the longest wait times for physicians and worst access to medical technology (e.g. MRIs) and hospital beds, these restrictions limit badly needed innovation and hurt patients.
To give the provinces more flexibility, the Alberta Next Panel suggests the federal government shift tax points (and transfer GST) to the provinces to better align provincial revenues with provincial responsibilities while eliminating “strings” attached to such federal transfers. In other words, Ottawa would transfer a portion of its tax revenues from the federal income tax and federal sales tax to the provincial government so they have funds to experiment with what works best for their citizens, without conditions on how that money can be used.
According to the Alberta Next Panel poll, at least in Alberta, a majority of citizens support this type of provincial autonomy in delivering provincial programs—and again, it’s paid off before.
In the 1990s, amid a fiscal crisis (greater in scale, but not dissimilar to the one Ottawa faces today), the federal government reduced welfare and social assistance transfers to the provinces while simultaneously removing most of the “strings” attached to these dollars. These reforms allowed the provinces to introduce work incentives, for example, which would have previously triggered a reduction in federal transfers. The change to federal transfers sparked a wave of reforms as the provinces experimented with new ways to improve their welfare programs, and ultimately led to significant innovation that reduced welfare dependency from a high of 3.1 million in 1994 to a low of 1.6 million in 2008, while also reducing government spending on social assistance.
The Smith government’s Alberta Next Panel wants the federal government to transfer some of its tax revenues to the provinces and reduce restrictions on provincial program delivery. As Canada’s experience in the 1990s shows, this could spur real innovation that ultimately improves services for Albertans and all Canadians.
Alberta
Ottawa-Alberta agreement may produce oligopoly in the oilsands
From the Fraser Institute
By Jason Clemens and Elmira Aliakbari
The federal and Alberta governments recently jointly released the details of a memorandum of understanding (MOU), which lays the groundwork for potentially significant energy infrastructure including an oil pipeline from Alberta to the west coast that would provide access to Asia and other international markets. While an improvement on the status quo, the MOU’s ambiguity risks creating an oligopoly.
An oligopoly is basically a monopoly but with multiple firms instead of a single firm. It’s a market with limited competition where a few firms dominate the entire market, and it’s something economists and policymakers worry about because it results in higher prices, less innovation, lower investment and/or less quality. Indeed, the federal government has an entire agency charged with worrying about limits to competition.
There are a number of aspects of the MOU where it’s not sufficiently clear what Ottawa and Alberta are agreeing to, so it’s easy to envision a situation where a few large firms come to dominate the oilsands.
Consider the clear connection in the MOU between the development and progress of Pathways, which is a large-scale carbon capture project, and the development of a bitumen pipeline to the west coast. The MOU explicitly links increased production of both oil and gas (“while simultaneously reaching carbon neutrality”) with projects such as Pathways. Currently, Pathways involves five of Canada’s largest oilsands producers: Canadian Natural, Cenovus, ConocoPhillips Canada, Imperial and Suncor.
What’s not clear is whether only these firms, or perhaps companies linked with Pathways in the future, will have access to the new pipeline. Similarly, only the firms with access to the new west coast pipeline would have access to the new proposed deep-water port, allowing access to Asian markets and likely higher prices for exports. Ottawa went so far as to open the door to “appropriate adjustment(s)” to the oil tanker ban (C-48), which prevents oil tankers from docking at Canadian ports on the west coast.
One of the many challenges with an oligopoly is that it prevents new entrants and entrepreneurs from challenging the existing firms with new technologies, new approaches and new techniques. This entrepreneurial process, rooted in innovation, is at the core of our economic growth and progress over time. The MOU, though not designed to do this, could prevent such startups from challenging the existing big players because they could face a litany of restrictive anti-development regulations introduced during the Trudeau era that have not been reformed or changed since the new Carney government took office.
And this is not to criticize or blame the companies involved in Pathways. They’re acting in the interests of their customers, staff, investors and local communities by finding a way to expand their production and sales. The fault lies with governments that were not sufficiently clear in the MOU on issues such as access to the new pipeline.
And it’s also worth noting that all of this is predicated on an assumption that Alberta can achieve the many conditions included in the MOU, some of which are fairly difficult. Indeed, the nature of the MOU’s conditions has already led some to suggest that it’s window dressing for the federal government to avoid outright denying a west coast pipeline and instead shift the blame for failure to the Smith government.
Assuming Alberta can clear the MOU’s various hurdles and achieve the development of a west coast pipeline, it will certainly benefit the province and the country more broadly to diversify the export markets for one of our most important export products. However, the agreement is far from ideal and could impose much larger-than-needed costs on the economy if it leads to an oligopoly. At the very least we should be aware of these risks as we progress.
Elmira Aliakbari
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