Alberta
Alberta government should reform hospital funding to help shorten wait times
From the Fraser Institute
By Mackenzie Moir and Alicia Kardos
Other high-performing countries with universal health care (Australia, Germany, Switzerland) use “activity-based funding.” Under this model, hospitals receive funding based on the amount of care they provide.
Earlier this year, the Alberta Medical Association sounded the alarm on “rolling surgical outages,” patients diverted to other treatment sites, and the potential capping of services at major provincial hospitals. Unfortunately, the delays these problems create aren’t new to Albertans, as patients continue to face lengthy wait times.
According to the latest data, Albertan patients faced a median wait time of 33.5 weeks in 2022 for non-emergency medical treatment, a delay that was nearly six weeks longer than the national average, and three times longer than what patients in the province experienced in 1993 (when national estimates were first published).
When broken down, the wait in Alberta includes the first 16.4 weeks it takes for a patient to see a specialist after referral from their family doctor—then a second wait of 17.2 weeks to receive treatment after seeing that specialist. And these figures don’t account for the wait to see a GP in the first place, which is a significant issue in a rapidly growing province where remain without a family doctor.
Of course, we hear the predicable calls for more money. But in reality, spending more won’t get Albertans out of this problem. In a recent comparison of high-income countries with universal coverage, Canada (in 2021) was already one of the highest spenders on health care (as a share of their economy) while having some of the fewest doctors and hospital beds (after accounting for differences in population age among countries).
And when compared to nine other high-income countries in 2020, Canadians were found to have the longest waits for medical care. Specifically, Canadians were the least likely to report waiting under four months for non-emergency surgery (at 62 per cent) compared to higher-performing countries such as Australia (72 per cent), Switzerland (94 per cent) and Germany (99 per cent).
So what’s the solution?
In a word, reform. For example, Alberta could change the way it funds hospitals. Canada’s predominant approach is to provide hospitals a set amount of money each year, regardless of the level of services provided. This means that the money hospitals receive isn’t tied to the actual number of services they provide. This discourages hospitals from providing more care because each patient represents a drain on their budget rather than an opportunity.
In contrast, many other high-performing countries with universal health care (Australia, Germany, Switzerland) use “activity-based funding.” Under this model, hospitals receive funding based on the amount of care they provide. This creates a powerful incentive for hospitals to treat more patients, because each patient represents an opportunity for the hospital to earn more money.
Quebec decided in last year to fund all of its surgical procedures using this model, and now plans to expand the model to all hospital care by 2027/28. The Smith government has also taken some steps that lay the foundation for these types of reforms. This is good news for Albertans, if reform is actually on the way.
Across Canada, despite the availability of solutions, the status quo of long waits persists. Breaking from the past can be hard, but there may be hope on the horizon for patients in Alberta’s beleaguered and poorly performing health-care system.
Authors:
Alberta
Former Chief Judge of Manitoba Proincial Court will lead investigation into AHS procurement process
Deputy Minister of Jobs, Economy and Trade Christopher McPherson has issued the following statement on an independent third-party investigation into procurement and contracting processes used by the Government of Alberta and Alberta Health Services (AHS):
Deputy Minister of Jobs, Economy and Trade Christopher McPherson has issued the following statement on an independent third-party investigation into procurement and contracting processes used by the Government of Alberta and Alberta Health Services (AHS):
“While serving as Acting Deputy Minister of Executive Council, Premier Danielle Smith asked me to establish a credible, independent, third-party investigation into the procurement processes used by the Government of Alberta and AHS and their outcomes.
“I have informed Premier Smith that the Honourable Raymond E. Wyant, former Chief Judge of the Provincial Court of Manitoba, will lead this investigation. I asked Premier Smith to issue a ministerial order to facilitate his work and she has done so. Judge Wyant’s work on this matter begins immediately.
“Judge Wyant was appointed to the Manitoba bench in 1998 before becoming Chief Judge in 2002. Prior to his service on the bench, Judge Wyant worked as a criminal defence lawyer and Crown attorney and was acting deputy director of Manitoba prosecutions at the time of his appointment to the Bench. He has also taught law for many years at Robson Hall at the University of Manitoba.
“Judge Wyant will review the relevant legislation, regulations and policies related to procurement typically used by Government of Alberta departments and agencies, specifically AHS, and their application to the procurement of pharmaceuticals and to services offered by chartered surgical facilities. Questions that Judge Wyant will consider are outlined in the attached terms of reference, and include whether or not any elected official, Government of Alberta or AHS employee, or other individuals, acted improperly during the procurement processes. Judge Wyant will make recommendations to the government for improvement or further action as appropriate.
“Appointed under the Government Organization Act, Judge Wyant will operate independently of government. The Government of Alberta will provide Judge Wyant with access to all relevant documents held by its departments and AHS, as well as facilitate interviews with relevant individuals.
“Judge Wyant has been given a budget of $500,000 to undertake this important work, including to retain legal and audit assistance at his discretion. He is being paid $31,900 per month, which is the same remuneration rate as the Chief Justice of the Alberta Court of Justice.
“To ensure additional independence, Service Alberta and Red Tape Reduction will hold the budget for this third-party investigation.
“Judge Wyant will deliver an interim written report by May 30, 2025. A final written report and recommendations will be delivered by June 30, 2025, and it will be posted on alberta.ca.”
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Alberta
Province announces funding for interim cardiac catheterization lab at the Red Deer Regional Hospital
Alberta’s government is partnering with the Red Deer Regional Health Foundation to expedite the delivery of life-saving cardiac services to central Alberta residents.
Alberta’s government is partnering with the Red Deer Regional Health Foundation to expedite the delivery of life-saving cardiac services to central Alberta residents.
Alberta’s government is committed to ensuring that Albertans have access to the health care they need, including life-saving cardiac care and lab services, no matter where they live. For those in central Alberta, the Red Deer Regional Hospital Centre plays a critical role in providing that care, which is why the $1.8-billion Red Deer Regional Hospital Centre redevelopment project includes two state-of-the-art cardiac catheterization labs.
While the project is expected to be completed by 2031, the government recognizes the urgent need for cardiac services for the 450,000 Albertans from Red Deer and surrounding rural communities. If passed, Budget 2025 will provide $3 million in startup funding and ongoing funding to cover the operational costs for an interim cardiac catheterization lab at the Red Deer Regional Hospital Centre.
“Every Albertan should have access to the health care services they need close to home. Albertans living in the Red Deer area have long advocated for a cardiac catheterization lab and I am pleased to support a project that we know will help save lives.”
A cardiac catheterization lab is a dedicated space where specialized teams can carry out diagnostic tests that examine and evaluate heart function to aid in the diagnosis of cardiac health concerns and treatment of coronary artery disease. The lab will be equipped with specialized imaging equipment to allow for cardiac procedures primarily including ablation, angiogram and angioplasty.
The interim cardiac catheterization lab will be located within the existing Red Deer Regional Hospital Centre in a space currently being used as a physician’s lounge. Preliminary design plans are already in place and construction is expected to begin by fall 2025.
The Red Deer Regional Health Foundation has committed to funding the capital cost of the project, which is expected to be about $22 million.
In October 2024, the foundation announced the signing of a memorandum of understanding with Alberta Health Services to fast-track the opening of a cardiac catheterization lab at Red Deer Regional Hospital Centre.
“We are incredibly grateful for the generosity of the Donald and Lacey families, whose support is bringing life-saving cardiac care closer to home for the benefit of all central Albertans. Together with all our health care partners, their commitment to advancing health care will make a lasting impact on countless lives for years to come.”
The foundation’s work is made possible by the generosity of donors, supporters and champions across the region. To support the development of the interim cardiac catheterization lab, the foundation announced a $10-million donation from the John Donald family.
“I am pleased to support the development of cardiac services in central Alberta, something we’ve long advocated for. This initiative will provide essential care to our community and ensure that more lives are saved closer to home.”
By prioritizing the development of an interim cardiac catheterization lab, patients will have access to critical services about three years earlier than expected. The interim cardiac catheterization lab is expected to be operational in early 2027.
“Developing this lab will allow us to treat more cardiac patients closer to home and support them in their recovery. Enhancing our cardiac services will also support our efforts to recruit and retain the talented professionals needed to care for our region’s patients.”
Being able to meet the needs of the province’s rapidly growing population is a top priority for Alberta’s government.
Quick facts
- The $1.8-billion Red Deer Regional Hospital Centre redevelopment project will upgrade several services throughout the hospital site, including:
- an additional patient tower
- six new operating rooms
- a new medical device reprocessing department
- two new cardiac catheterization labs
- renovations to various areas within the main building
- a newly renovated and expanded emergency department
- a new ambulatory clinic building to be located adjacent to the surface parkade
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