Alberta
Canadians owe a debt to Premier Danielle Smith
From the Frontier Centre for Public Policy
In recent days, Premier Smith has endured criticism from many people about her recent announcements relating to treatments for what is often described as gender transition.
Instead, she deserves praise for decisions that are as important for how they were made as for the gender transition issues that concern her and her colleagues. Her actions on this matter demonstrate how public policy should be developed and explained.
The most important quality of the recent policy announcements by the Alberta government is that they are evidence based.
There is an emerging consensus outside Canada that the evidence supporting pharmacological and surgical procedures to change genders in minors is either very weak or nonexistent.
Sweden, Finland, the UK and Norway have restricted or forbidden the use of these treatments on minors, as have twenty-three American states. Ms. Smith referred to these in her press conference announcing the changes her government is making.
Leaders in other countries have done this after conducting detailed studies including one by the UK High Court of Justice and another by Dr. Hilary Cass, a former President of the Royal College of Pediatrics and Child Health in the United Kingdom
Dr. Cass is an independent expert commissioned to provide advice to the National Health Service on gender treatments. She concluded that “evidence on the appropriate management of children with gender incongruence is inconclusive both nationally and internationally’’.
The second reason the decisions taken by Alberta are important is that they were taken despite ideology advocated by the Government of Canada and the unwillingness of federal officials including the Prime Minster to support their opposition to the Alberta policies with any evidence.
In his initial comments, the Prime Minister made no reference to any of the many studies that have been done describing the dangers of pharmacological and surgical procedures to change the gender of minor children.
He also displayed no understanding of the experiences of other countries on this matter. He did not refer to the Cass report and its seminal conclusions.
The comments by Federal Health Minister Mark Holland lacked any evidence the public could use. He also used offensive rhetoric.
Mr. Holland described the Alberta decisions as being behaviour that is “extremely dangerous to engage in …. which is, I think, playing politics about children’s lives.” He also referred to the “devastation that its going to bring”, referring to the Alberta changes.
Federal communications marked by a factual vacuum and excessive language are not going to help resolve serious differences of opinion on serious issues. They are also not condusive to good relations between the federal government and an important province.
The third and particularly significant reason the recent changes announced by the Alberta government are so important is that they will protect children.
Adolescence, a phase of child development that has been with us for thousands of years, is an important part of everyone’s life.
It is a vital part of what it means to be human. Delaying or blocking it is dangerous, something that many observers have noted but that the Prime Minister and the Minister of Health do not recognize.
Federal leaders need to inform themselves, particularly about the negative impact of puberty blockers on bone and brain development and the lifelong medical attention many transitioners will need because of the pharmacological and surgical procedures used on them to change genders.
The Prime Minister and the Minister of Health should also learn about the increasingly large number of transitioners who regret their transition and later seek to reverse it. Their situation is particularly tragic because many of the negative consequences of changing genders in children cannot be reversed.
Federal leaders also support hiding from parents the decisions children make in schools about the pronouns they use to describe their genders. This is another practice that many feel is harmful and divisive.
The federal perspective on this is unreasonable.
Our species survived over the centuries because the first priority for most parents is their children and most take good care of them.
There is no basis for a lack of trust in them and in the relatively few cases where parents do not provide appropriate care, the child protection laws come into play.
It is particularly important that federal leaders recognize the grave problems that puberty blockers and related surgeries often pose for children who are gays or lesbians.
These children sometimes display some of the attributes of the opposite sex as they grow, and these are often misinterpreted as gender dysphoria. They then get treated for a problem they don’t have, with serious lifelong consequences.
Unfortunately, this happens in many Canadian pediatric hospitals.
There is nothing wrong with these children. They should be allowed to develop and grow in their own way and be who they are. That means no puberty blockers or surgeries to change them.
The fourth reason to respect the new directions on gender issues Ms. Smith and her colleagues have decided upon is the moderation displayed by the Alberta government in putting them forward and communicating with the public about them.
The language used has been understated. The changes are lawful in every respect including in relation to the Charter of Rights and Freedom and other legislation.
The evidence has been clearly presented in a way most citizens can readily understand and great care has been taken to deal with those who may have concerns thoughtfully, including allowing time for debate and discussion before the changes are made.
This is a good example of how governments should behave. Federal leaders should show some respect for the approaches taken by Ms. Smith and her colleagues as they dealt with a very complex issue.
The final reason for the importance of the Alberta approach is that it has avoided many of the problems associated with medical practice standards and regulation that are so evident in Canada and which have been a major cause of the difficulties our country faces on gender issues.
Provincial Colleges of Physicians and Surgeons and many regulators elsewhere regulate doctors based largely on prevailing practices by physicians rather than clinical outcomes.
This means that there have been many cases over the years, in Canada and elsewhere, where evidence to support medical procedures has been lacking. Current practices toward gender dysphoria in Canada and some US states are examples.
In these cases, if something is done often enough by enough doctors, that procedure becomes the standard and not clinical outcomes. This often leads to perverse outcomes that everyone ultimately regrets.
In the years to come, unless we change course soon and unless others follow the Alberta path, people will be wondering how the problems summarized in this article developed and why we damaged so many children by an approach defined more by ideology than factual reality.
David MacKinnon is a Senior Fellow at the Frontier Centre for Public Policy
Alberta
Early Success: 33 Nurse Practitioners already working independently across Alberta
Nurse practitioners expand primary care access |
The Alberta government’s Nurse Practitioner Primary Care program is showing early signs of success, with 33 nurse practitioners already practising independently in communities across the province.
Alberta’s government is committed to strengthening Alberta’s primary health care system, recognizing that innovative approaches are essential to improving access. To further this commitment, the Nurse Practitioner Primary Care Program was launched in April, allowing nurse practitioners to practise comprehensive patient care autonomously, either by operating their own practices or working independently within existing primary care settings.
Since being announced, the program has garnered a promising response. A total of 67 applications have been submitted, with 56 approved. Of those, 33 nurse practitioners are now practising autonomously in communities throughout Alberta, including in rural locations such as Beaverlodge, Coaldale, Cold Lake, Consort, Morley, Picture Butte, Three Hills, Two Hills, Vegreville and Vermilion.
“I am thrilled about the interest in this program, as nurse practitioners are a key part of the solution to provide Albertans with greater access to the primary health care services they need.”
To participate in the program, nurse practitioners are required to commit to providing a set number of hours of medically necessary primary care services, maintain a panel size of at least 900 patients, offer after-hours access on weekends, evenings or holidays, and accept walk-in appointments until a panel size reaches 900 patients.
With 33 nurse practitioners practising independently, about 30,000 more Albertans will have access to the primary health care they need. Once the remaining 23 approved applicants begin practising, primary health care access will expand to almost 21,000 more Albertans.
“Enabling nurse practitioners to practise independently is great news for rural Alberta. This is one more way our government is ensuring communities will have access to the care they need, closer to home.”
“Nurse practitioners are highly skilled health care professionals and an invaluable part of our health care system. The Nurse Practitioner Primary Care Program is the right step to ensuring all Albertans can receive care where and when they need it.”
“The NPAA wishes to thank the Alberta government for recognizing the vital role NPs play in the health care system. Nurse practitioners have long advocated to operate their own practices and are ready to meet the growing health care needs of Albertans. This initiative will ensure that more people receive the timely and comprehensive care they deserve.”
The Nurse Practitioner Primary Care program not only expands access to primary care services across the province but also enables nurse practitioners to practise to their full scope, providing another vital access point for Albertans to receive timely, high-quality care when and where they need it most.
Quick facts
- Through the Nurse Practitioner Primary Care Program, nurse practitioners receive about 80 per cent of the compensation that fee-for-service family physicians earn for providing comprehensive primary care.
- Compensation for nurse practitioners is determined based on panel size (the number of patients under their care) and the number of patient care hours provided.
- Nurse practitioners have completed graduate studies and are regulated by the College of Registered Nurses of Alberta.
- For the second consecutive year, a record number of registrants renewed their permits with the College of Registered Nurses of Alberta (CRNA) to continue practising nursing in Alberta.
- There were more than 44,798 registrants and a 15 per cent increase in nurse practitioners.
- Data from the Nurse Practitioner Primary Care Program show:
- Nine applicants plan to work on First Nations reserves or Metis Settlements.
- Parts of the province where nurse practitioners are practising: Calgary (12), Edmonton (five), central (six), north (three) and south (seven).
- Participating nurse practitioners who practise in eligible communities for the Rural, Remote and Northern Program will be provided funding as an incentive to practise in rural or remote areas.
- Participating nurse practitioners are also eligible for the Panel Management Support Program, which helps offset costs for physicians and nurse practitioners to provide comprehensive care as their patient panels grow.
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Alberta
Province considering new Red Deer River reservoir east of Red Deer
Central Alberta reservoir study underway
Alberta’s government is moving forward a study to assess the feasibility of building a new reservoir on the Red Deer River to help support growing communities.
Demand for water from communities and businesses is increasing as more families, businesses and industries choose to live and work in central Alberta. The Red Deer River supplies water to hundreds of thousands of Albertans across the region and expanding water storage capacity could help reduce the risk of future droughts and meet the growing water demands.
Alberta’s government has now begun assessing the feasibility of building a potential new reservoir east of Red Deer near Ardley. A two-phase, multi-year study will explore the costs and value of constructing and operating the reservoir, and its impact on downstream communities, farmers and ranchers, and businesses.
“Central Alberta is a growing and thriving, and we are ensuring that it has the water it needs. This study will help us determine if an Ardley reservoir is effective and how it can be built and operated successfully to help us manage and maximize water storage for years to come.”
Reservoirs play a vital role in irrigation, drought management, water security and flood protection. Budget 2024 allocated $4.5 million to explore creating a new reservoir on the Red Deer River, at a damsite about 40 kilometres east of the City of Red Deer.
Work will begin on the scoping phase of the study as soon as possible. This will include reviewing available geotechnical and hydrotechnical information and exploring conceptual dam options. The scoping phase also includes meetings with municipalities and water users in the area to hear their views. This work is expected to be completed by December 2025.
“Reliable water infrastructure is essential for Alberta’s growing communities and industries. The Ardley reservoir feasibility study is a vital step toward ensuring long-term water security for central Alberta. As we assess this project’s potential, we’re supporting the sustainability of our economic corridors, agricultural operations and rural economy.”
“Water is essential to the agriculture industry and if the past few years are any indication, we need to prepare for dry conditions. A potential dam near Ardley could enhance water security and help farmers and ranchers continue to thrive in Alberta’s unpredictable conditions.”
Once that is complete, the feasibility study will then shift into a second phase, looking more closely at whether an effective new dam near Ardley can be safely designed and constructed, and the impact it may have on communities and the environment. Geotechnical and hydrotechnical investigations, cost-benefit analyses and an assessment of environmental and regulatory requirements will occur. The feasibility phase will also include gathering feedback directly from Albertans through public engagement. This work is expected to be completed by March 31, 2026.
Quick facts
- The Ardley dam scoping and feasibility study will be undertaken by Hatch Ltd., a Canadian multi-disciplinary professional services firm.
- Once the feasibility study is complete, government will assess the results and determine whether to pursue this project and proceed with detailed engineering and design work and regulatory approvals.
- Alberta’s government owns and operates several large reservoirs in the South Saskatchewan River Basin that help ensure sufficient water supply to meet demand from communities, irrigators and businesses, while also maintaining a healthy aquatic environment.
- Water stored at Gleniffer Lake, the reservoir created by Dickson Dam, helps supplement low winter flows along the Red Deer River and helps ensure an adequate water supply for Red Deer and Drumheller.
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