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Alberta

Province announces next step to revamped health care system

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9 minute read

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.”

Adriana LaGrange, Minister of Health

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.”

Dan Williams, Minister of Mental Health and Addiction

“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.”

Jason Nixon, Minister of Seniors, Community and Social Services

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.

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Low oil prices could have big consequences for Alberta’s finances

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From the Fraser Institute

By Tegan Hill

Amid the tariff war, the price of West Texas Intermediate oil—a common benchmark—recently dropped below US$60 per barrel. Given every $1 drop in oil prices is an estimated $750 million hit to provincial revenues, if oil prices remain low for long, there could be big implications for Alberta’s budget.

The Smith government already projects a $5.2 billion budget deficit in 2025/26 with continued deficits over the following two years. This year’s deficit is based on oil prices averaging US$68.00 per barrel. While the budget does include a $4 billion “contingency” for unforeseen events, given the economic and fiscal impact of Trump’s tariffs, it could quickly be eaten up.

Budget deficits come with costs for Albertans, who will already pay a projected $600 each in provincial government debt interest in 2025/26. That’s money that could have gone towards health care and education, or even tax relief.

Unfortunately, this is all part of the resource revenue rollercoaster that’s are all too familiar to Albertans.

Resource revenue (including oil and gas royalties) is inherently volatile. In the last 10 years alone, it has been as high as $25.2 billion in 2022/23 and as low as $2.8 billion in 2015/16. The provincial government typically enjoys budget surpluses—and increases government spending—when oil prices and resource revenue is relatively high, but is thrown into deficits when resource revenues inevitably fall.

Fortunately, the Smith government can mitigate this volatility.

The key is limiting the level of resource revenue included in the budget to a set stable amount. Any resource revenue above that stable amount is automatically saved in a rainy-day fund to be withdrawn to maintain that stable amount in the budget during years of relatively low resource revenue. The logic is simple: save during the good times so you can weather the storm during bad times.

Indeed, if the Smith government had created a rainy-day account in 2023, for example, it could have already built up a sizeable fund to help stabilize the budget when resource revenue declines. While the Smith government has deposited some money in the Heritage Fund in recent years, it has not created a dedicated rainy-day account or introduced a similar mechanism to help stabilize provincial finances.

Limiting the amount of resource revenue in the budget, particularly during times of relatively high resource revenue, also tempers demand for higher spending, which is only fiscally sustainable with permanently high resource revenues. In other words, if the government creates a rainy-day account, spending would become more closely align with stable ongoing levels of revenue.

And it’s not too late. To end the boom-bust cycle and finally help stabilize provincial finances, the Smith government should create a rainy-day account.

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Alberta

Governments in Alberta should spur homebuilding amid population explosion

Published on

From the Fraser Institute

By Tegan Hill and Austin Thompson

In 2024, construction started on 47,827 housing units—the most since 48,336 units in 2007 when population growth was less than half of what it was in 2024.

Alberta has long been viewed as an oasis in Canada’s overheated housing market—a refuge for Canadians priced out of high-cost centres such as Vancouver and Toronto. But the oasis is starting to dry up. House prices and rents in the province have spiked by about one-third since the start of the pandemic. According to a recent Maru poll, more than 70 per cent of Calgarians and Edmontonians doubt they will ever be able to afford a home in their city. Which raises the question: how much longer can this go on?

Alberta’s housing affordability problem reflects a simple reality—not enough homes have been built to accommodate the province’s growing population. The result? More Albertans competing for the same homes and rental units, pushing prices higher.

Population growth has always been volatile in Alberta, but the recent surge, fuelled by record levels of immigration, is unprecedented. Alberta has set new population growth records every year since 2022, culminating in the largest-ever increase of 186,704 new residents in 2024—nearly 70 per cent more than the largest pre-pandemic increase in 2013.

Homebuilding has increased, but not enough to keep pace with the rise in population. In 2024, construction started on 47,827 housing units—the most since 48,336 units in 2007 when population growth was less than half of what it was in 2024.

Moreover, from 1972 to 2019, Alberta added 2.1 new residents (on average) for every housing unit started compared to 3.9 new residents for every housing unit started in 2024. Put differently, today nearly twice as many new residents are potentially competing for each new home compared to historical norms.

While Alberta attracts more Canadians from other provinces than any other province, federal immigration and residency policies drive Alberta’s population growth. So while the provincial government has little control over its population growth, provincial and municipal governments can affect the pace of homebuilding.

For example, recent provincial amendments to the city charters in Calgary and Edmonton have helped standardize building codes, which should minimize cost and complexity for builders who operate across different jurisdictions. Municipal zoning reforms in CalgaryEdmonton and Red Deer have made it easier to build higher-density housing, and Lethbridge and Medicine Hat may soon follow suit. These changes should make it easier and faster to build homes, helping Alberta maintain some of the least restrictive building rules and quickest approval timelines in Canada.

There is, however, room for improvement. Policymakers at both the provincial and municipal level should streamline rules for building, reduce regulatory uncertainty and development costs, and shorten timelines for permit approvals. Calgary, for instance, imposes fees on developers to fund a wide array of public infrastructure—including roads, sewers, libraries, even buses—while Edmonton currently only imposes fees to fund the construction of new firehalls.

It’s difficult to say how long Alberta’s housing affordability woes will endure, but the situation is unlikely to improve unless homebuilding increases, spurred by government policies that facilitate more development.

Tegan Hill

Director, Alberta Policy, Fraser Institute

Austin Thompson

Senior Policy Analyst, Fraser Institute
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