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Alberta

Province says improving primary health care system will take pressure off emergency care

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Strengthening health care: Improving access for all

Alberta’s government is stabilizing and strengthening primary health care across the province so that everyone can access care when and where they need it.

Primary health care is the first point of contact Albertans have with the health care system, and includes health professionals such as family doctors, nurse practitioners and pharmacists.

Last fall, health care leaders, Indigenous partners and experts from across Canada and around the world came together to form advisory panels as part of the Modernizing Alberta’s Primary Health Care System (MAPS) initiative. The panels identified immediate, medium- and long-term improvements to strengthen Alberta’s primary health care system.

Alberta’s government will begin moving forward on the recommendations in the final report to improve access to primary health care for all Albertans. The recommendations will be implemented through a phased approach, with several moving forward immediately, followed by medium- and longer-term improvements that will enhance community-based primary health care across Alberta.

“Today marks an important step in the work I am undertaking to enhance primary care as the foundation of our health care system. The Modernizing Alberta’s Primary Health Care System (MAPS) reports clearly identify the challenges our system is facing, and their release signals this government’s commitment to take immediate and ongoing action to support and stabilize primary health care in our province. I look forward to the ongoing work of implementing needed changes with our health care partners and providers.”

Adriana LaGrange, Minister of Health

Several immediate actions are being taken, all of which are consistent with recommendations from the panels. These actions are critical to ensuring Albertans have better access to health care when and where they need it. Alberta Health continues to work toward implementing recommendations over the medium and long term.

“The MAPS recommendations represent a huge leap forward for our primary health system – strengthening and clarifying governance, community involvement, and recognizing the importance of integrated team-based care that allows Albertans to access primary care from the most appropriate team member at the right time, in the right place. This is how we can ensure equitable access to care across our province.”

Dr. Janet Reynolds, co-chair, MAPS strategic advisory panel

Strengthening primary health care

Alberta’s government is acting immediately on recommendations to improve primary health care and increase Albertans’ access to the medical care they need, including:

  • Creating a primary health care division within Alberta Health.
  • Allocating $57 million over three years to provide family doctors and nurse practitioners with support to help manage their increasing number of patients. Each provider has the potential to receive up to $10,000 annually.
  • Working with the Alberta Medical Association to create a task force to recommend a new payment model for family physicians that encourages comprehensive primary care – where a patient has a regular family doctor who they develop a long-term relationship with and who works with them to ensure all their health care needs are met.
  • Developing a memorandum of understanding with the Alberta Medical Association to collaborate on a transition to a new physician compensation model, modernize primary care governance and enable family doctors to spend more time with patients and less time on paperwork and immediately stabilize primary care.
  • Expanding online mental health services, allowing doctors to bill for virtual mental health checks and therapy, and compensating them for extra time spent with patients virtually.
  • Ensuring doctors get paid if patients can’t prove insurance coverage, reducing administrative burden. This is known as “good faith” claims.
  • Introducing a payment system that will support nurse practitioners to open their own clinics, take on patients and offer services based on their scope of practice, training and expertise. Nurse practitioners have completed graduate studies ensuring that they are properly trained to examine patients, provide diagnoses and prescribe medication.

“We know that a strong primary health care system is foundational for better health care for Albertans, and that starts with access to a family physician and a team of dedicated providers. Primary care requires dedicated planning, resourcing and coordination. We are pleased to join the task force and believe continued collaboration and immediate action will bring us closer to our collective vision.”

Dr. Noel DaCunha, president, Alberta College of Family Physicians

“The Nurse Practitioner Association of Alberta is elated to see the newly released MAPs report, which provides direction for primary care reform and includes the full integration of nurse practitioners. The Government of Alberta is taking a significant and essential step in improving access to primary care for Albertans. This announcement is a win-win for Albertans and nurse practitioners, as it recognizes the valuable contributions of NPs delivering high-quality care for Albertans and their ability to decrease the stress on the health care system. We are excited about the future of primary care in Alberta.”

Dr. Susan Prendergast, president, Nurse Practitioner Association of Alberta

“These actions are welcome news for rural Alberta. Ensuring Albertans have access to health care professionals when and where they need it is essential. This work will help to solve some of the unique challenges for rural Albertans by encouraging health professions to practise in rural parts of the province.”

Martin Long, parliamentary secretary for rural health

Strengthening Indigenous health care

Indigenous Peoples face many barriers to access appropriate health care. To support better health outcomes, the government will build more meaningful connections with Indigenous leaders and communities to identify improvements that reflect the unique nature of their communities. Immediate actions include:

  • Creating an Indigenous health division within Alberta Health.
  • Creating a $20-million fund for Indigenous communities to design and deliver innovative primary health care services and projects.
  • Creating an Indigenous patient complaints investigator and Elders roster to investigate incidences of racism during the delivery of health care and provide culturally safe support to Indigenous patients throughout the patient complaint process.
  • Investing in a community-based Indigenous patient navigator program to support Indigenous peoples throughout their health care journey.

“It is unacceptable that Indigenous Peoples continue to face so many barriers when accessing primary health care. It is crucial that all First Nations, Métis and Inuit peoples have equitable access to community-based primary health care that is culturally safe, respects their unique needs and is free of racism. These immediate actions will help us achieve that goal.”

Rick Wilson, Minister of Indigenous Relations

“The panel’s recommendations provide a clear and stable pathway to create a safe, culturally appropriate primary health care system that includes Indigenous people as partners and leaders at every stage of the development, governance and delivery of health care services. The best solutions exist within our respective communities, tailored for our unique needs and priorities. The commitments made today are an important first step toward improving health equity for Indigenous Peoples, regardless of where they live in Alberta.”

Naa Taoyi Piita Wo Taan, Dr. Tyler White, CEO, Siksika Health Services and co-chair, MAPS Indigenous Primary Health Care Advisory Panel

Quick facts

  • Advisory panels were established through MAPS in fall 2022 to identify primary health care improvements in the short term and over the next 10 years.
  • Final reports from the panels were submitted in spring 2023.
  • The strategic advisory panel final report contains 11 recommendations to refocus the system around primary health care with an emphasis on:
    • access to team-based care
    • integration between primary health care and community care
    • a foundation of a coordinated and accountable primary health care system
  • The Indigenous advisory panel final report contains 22 recommendations under five themes:
    • improve health equity for Indigenous Peoples
    • address Indigenous racism in health care
    • build culturally safer primary health care and an Indigenous workforce
    • create system innovation and support community capacity
    • Indigenous ownership, stewardship, design and delivery of health care services
  • Budget 2023 allocated $125 million over three years to implement recommendations from MAPS.
  • The next step will be to further engage with health care partners, including Indigenous communities, to implement these immediate priorities and the broader MAPS recommendations.

Related information

This is a news release from the Government of Alberta.

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Alberta

Yes Alberta has a spending problem. But it has solutions too

Published on

From the Fraser Institute

By Tegan Hill and Milagros Palacios

The Smith government’s recent fiscal update sparked concerns as once again the province has swung from budget surpluses to a budget deficit. To balance the budget, Finance Minister Nate Horner has committed to address the spending side and will “look under every stone” before considering the revenue side, and this is the right approach. Alberta’s fiscal challenges are a spending problem, not a revenue problem.

For perspective, if program spending had grown by inflation and population over the past two decades, it would be $55.6 billion in 2025/26 rather than the actual $76.4 billion. So, while the Smith government has demonstrated important restraint in recent years, total program spending and per person (inflation-adjusted) program spending is still materially higher in 2025/26 than in previous periods.

Alberta’s high spending is fuelling the projected $6.5 billion deficit. Consider that at the alternative spending level ($55.6 billion) Alberta would be enjoying a large budget surplus of $14.4 billion in 2025/26—rather than adding to the province’s red ink.

Despite this, the discussion around deficits often revolves around volatile resource revenue (e.g. oil and gas royalties). It’s true—resource revenue has declined year over year and that has an impact on the budget. But again, it’s not the underlying problem. The problem is successive governments have increased spending during good times of relatively high resource revenue to levels that are unsustainable without incurring deficits when resource revenue inevitably declines. In other words, the fiscal framework for the provincial government relies too heavily on volatile resource revenues to balance its budget.

As a share of the economy, non-resource revenue (e.g. personal income and business income) averaged 12.5 per cent over the last decade (2016/17 to 2025/26) compared to 11.1 per cent between 2006/07 to 2015/16. In other words, Alberta is collecting a larger share of non-resource revenues than in the past as a share of the economy. This statistic alone makes it difficult to argue that the province has a revenue problem.

So, what can the government do to rein in its spending?

Government employee compensation typically accounts for nearly 50 per cent of the Alberta government’s operating spending. From 2019 to 2024, the number of provincial government jobs in Alberta increased by 46,500. Over that period, total compensation for provincial government jobs jumped from $24.2 billion to $29.5 billion. Put differently, government compensation now costs $5.3 billion more annually than pre pandemic. The government should reduce the number of government jobs back to pre-pandemic levels through attrition and a larger program review.

Business subsidies (a.k.a. corporate welfare) is another clear area for reform. Business subsidies consume a meaningful share of each ministries‘ annual budget costing billions of dollars. For example, in 2024/25, grants were the second-largest expense for the ministry of environment at $182.0 million and the largest expense for the ministry of arts, culture and status of women at $154.2 million. For the ministry of energy and minerals, grants totalled $166.3 million in 2024/25. With more than 25 ministries, the provincial government could find meaningfully savings by requiring that each to closely examine their budgets and eliminate business subsidies to yield savings.

The Smith government’s recent fiscal update rung the alarm bells, but to fix the province’s fiscal challenges, one must first understand the underlying problem—Alberta has a spending problem. Fortunately, there are some clear first steps to tackle it.

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Alberta

Maritime provinces can enact policies to reduce reliance on Alberta… ehem.. Ottawa

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From the Fraser Institute

By Alex Whalen

Nova Scotia’s Finance Minister John Lohr recently took the rare step of publicly commenting on the province’s reliance on transfer payments from Ottawa. For decades, the Maritime provinces have heavily relied on federal transfers, and the equalization program in particular, to fund provincial budgets.

Ottawa collects taxes from across Canada and then redistributes money to different provinces and/or individual Canadians through various programs, including equalization. The MacDonald Notebook recently reported that Lohr told a Halifax Chamber of Commerce audience “we’re very aware that we are very dependent on transfer payments from other parts of the country… we can’t continue to take that for granted… we have the resources here.”

Lohr makes an important point. Consider equalization, a federal program that, in effect, provides payments to provinces with weaker economies and a lower ability to raise tax revenues, with the goal of ensuring all provinces can deliver comparable services at comparable tax rates.

Premiers in other provinces have often lobbied for changes including reform or outright elimination of the program. In fact, Newfoundland and Labrador (backed by Alberta, British Columbia and Saskatchewan) is currently challenging the program in court. These provinces believe the program is unfair given how equalization payments are calculated on an annual basis. And this is a serious political concern because at some point these provinces could force reforms to equalization that would result in reduced payments to recipient provinces.

Such a move would have a major impact on provincial finances in the Maritimes. In 2024/25, Prince Edward Island, New Brunswick and Nova Scotia are the three provinces most dependent on equalization funds, ranging between $3,718 per person in P.E.I. to $3,252 per person in Nova Scotia. Equalization represents between 19.4 per cent and 21.9 per cent of provincial revenue in these provinces. Put differently, without this federal transfer program, these provinces would lose roughly one-fifth of their revenue. Only Manitoba comes close to this level of reliance on equalization.

But why should the Maritime provinces wait to have reform forced upon them? Moreover, it shouldn’t be a goal to be a long-term recipient province for the same reason one wouldn’t want to be a long-term welfare recipient. Regardless of what Alberta and Saskatchewan wants, we in the east should want to be off equalization for our own reasons. Strengthening provincial economies in the Maritimes would raise living standards and incomes, while strengthening provincial finances and reducing reliance on programs such as equalization.

So, what can be done?

First, the Nova Scotia government’s recent shift in policy to permit more natural resource development in areas such as mining and natural gas is a strong first step. The province is sitting on billions of dollars in economic opportunity in this sector, while the sector’s wages tend to be among the highest of any industry. Other provinces should follow suit and develop their natural resource sectors.

More broadly, governments in the region should trim their bloated bureaucracies to make way for broad-based tax relief. The Maritime provinces have the largest governments in Canada, with government spending (at all levels—federal, provincial and local) exceeding 57 per cent of provincial economies. A consequence of this large government sector is some of the highest taxes in North America (across all types of taxation). Reducing the size of government to national-average levels would make room for substantial tax relief that would boost growth in the region.

Long-term dependence on federal transfers does not need to be a given in the Maritimes. With the right policy environment in place, the governments of Nova Scotia, P.E.I. and New Brunswick can strengthen their economies while reducing reliance on the rest of Canada. On this front, Minister Lohr is on the right track.

Alex Whalen

Director, Atlantic Canada Prosperity, Fraser Institute
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