What We Believe
The Alberta Liberal Opposition is committed to a publicly funded and publicly delivered universal health care system that is patient-centred and supports decisions based on evidence, not politics.
With health care spending making up the majority of the budget, the government needs to find safe, innovative ways to improve access to care and patient outcomes, increase accountability, and reduce harm and waste.
We believe that public delivery ultimately provides higher-quality service at a more affordable price since the profit motive increases costs while lowering the level of care for the same amount of funding.
The continuing care system is broken, and Albertans are suffering as a result of failed government privatization policies. We need massive investments into home care and community care to unclog the bottlenecks in the acute care system by transitioning Alternate Level Care patients out of hospitals and back home with appropriate supports.
The current opioid crisis highlights the fact that mental health and addictions are a public health concern, not a problem for the criminal justice system. Those struggling with addictions and mental illness deserve our compassion and support. We have a duty to ensure that those afflicted are able to quickly access the help they need to prevent tragedy long before it happens.
Opioid Overdose Crisis
Alberta is currently in the throes of one of the worst public health crises in recent memory. Opioids are now claiming one life per day: 2016 saw 343 deaths by overdose. While fentanyl remains the largest killer, new and even more deadly varieties such as carfentanil are finding their way onto the streets with tragic results.
Despite the steadily rising number of deaths, the government has failed to show the necessary leadership to effectively address this problem. Concerted action is required to determine the scope of the crisis, report at timely intervals and make the new investments needed to both save lives and save millions of dollars in emergency medical services and police work. Naloxone kits provided free of charge across the province are indisputably saving lives; however, the underlying problem is addiction, which must be addressed with early intervention and timely treatment. While some new resources have been found for harm reduction and replacement therapy, this opioid epidemic demands the breaking down of silos between the Ministry of Health, Human Services, Education and the Solicitor General, so they can coordinate their efforts to the greatest effect.
The first step is to develop a clear and accurate picture of the situation, which can only be achieved by improved reporting of opioid deaths. In British Columbia, where a public health emergency was declared in April 2016, the health authority releases weekly and monthly data tracking illicit drug overdose deaths, the proportion of deaths where fentanyl is detected, non-fatal overdoses requiring emergency service response and/or emergency department care, data disaggregated by age, sex, and region, as well as regular exploration of the contextual factors. This information not only gives frontline practitioners the ability to track the scope of the problem and the progress made in combating it, but also helps them identify individuals at risk so that a fatal overdose can be prevented long before the crisis stage.
The Alberta Liberal Opposition has been an active voice on this issue, calling for a public health state of emergency in the fall of 2016 and keeping sustained pressure on the government both in and out of the Legislature to take action.
The largest line item in the budget, health consumed 46 per cent of the 2016-17 Alberta government’s expenditures; yet Albertans spend more per capita on health care than almost anywhere else in the country. Improving cost and quality of care is possible, but will require transformative change in many different domains.
One area in critical need of attention is the relationship between Alberta Health and Alberta Health Services (AHS). The two bodies must clearly establish distinct roles and responsibilities and improve communications to maximize tactical decisions at the regional level. Miscommunication and politically-motivated ministerial interventions into AHS operations have occurred repeatedly under both NDP and Progressive Conservative governments, and do nothing but drive up costs to little benefit. An excellent example of this is the NDP government’s refusal to allow AHS to partner with private enterprise on services such as laundry and laboratory testing, without demonstrating the business case for their decision. Evidence rather than ideology should be guiding our overstrained health system.
Physician payments have risen well beyond patient benefits, and the Alberta Liberal Opposition supports a move away from the outdated fee-for-service compensation model. Despite medical practices evolving towards preventative and chronic care, the system continues to encourage volume over quality. Under the model, physicians bill the province for specific procedures based on a predetermined negotiated fee schedule; as such, doctors stand to make the most profit by seeing large numbers of patients – spending as little time as possible with each one – and favouring more expensive procedures over simpler, cost-effective ones. Further, fee-for-service discourages team-based care that provides better prevention and treatment of chronic conditions and mental illness (see below), which often relapse and require ongoing assessments and changes in treatment.
While there have been positive steps made towards a better system in the form of Primary Care Networks (PCNs), the project lacks consistent leadership. There needs to be movement towards a shared governance model with more community input and meaningful evaluation based on the needs of the communities served. With appropriate health goals, accountabilities and funding for team-based care, PCN’s could play the pivotal role they were intended to play. At present, however, the political will appears to be lacking in government.
One in five Albertans struggles with an addiction or mental illness – and sometimes both. They often suffer deeply and in secret, locked in battle with their own minds. Too many are afraid to reach out and ask for help, for fear of being dismissed, shunned, or stigmatized; those that do look for aid are given inadequate attention and are too often turned away due to lack of resources and structure to properly reintegrate them into society. Although only 6 per cent of the health budget is committed to mental health/addiction, real change will require more than higher investment.
In June 2015, Alberta Liberal Leader Dr. David Swann was asked to co-chair the Mental Health Review Committee, which after six months of study released their report Valuing Mental Health. The report made 27 recommendations – including timelines on implementation – on how to transform Alberta’s mental health system into one that is patient-centric, co-ordinated between services, and focused on mental illness as a chronic disease rather than a short-term, episodic illness. Another five recommendations focused on addressing the opioid abuse crisis that continues to plague Alberta (see above).
Since the report was presented to the Minister in December 2016, the Alberta government has yet to report any progress on the issue. While several recommendations have been implemented, such as adding new care beds, the report called for transformative change through real leadership, as well as clarity in the roles and responsibilities of the Alberta Health and Alberta Health Services. Front line workers, patients and families are increasingly frustrated at the lack of change. Albertans, especially children, deserve timelier, more effective, team-based care for mental illness and addiction.
Solutions for Tomorrow
Some of the health care policies that the Alberta Liberal Opposition will champion in the legislature include:
- Leadership on providing more information and better co-ordination of opioid abuse treatment and prevention.
- Improve access to mental health services for adults and children, and increase support for the Alberta Mental Health Patient Advocate.
- Take action to reduce emergency department and surgery wait times, and ensure Emergency Medical Services are available to respond to urgent needs.
- Double the funding for public home care and invest in not-for-profit community care.
- Ensure easy access to primary care and multidisciplinary wellness teams with specialty and acute care linkages.
- Enhance regional medical training programs to serve rural communities replace retiring staff.
- Extend Alberta Health Care Insurance coverage to include dental care for lower-income Albertans unable to access basic and emergency dental services due to their unregulated costs.
- Advocate for a national seniors’ pharmaceutical plan.
- Monitor government takeover of private laboratory services.
- Address deferred maintenance of health infrastructure, especially the Misericordia and Rockyview hospitals.
- Bend the cost curve on health care expenditure by controlling salaries, lowering costs and eliminating waste.
- Increase accountability measures for all private, for-profit health care service providers to ensure taxpayer dollars are well-spent and the level and quality of patient care improves.
- Establish an Alberta Wellness Fund with an annual investment of approximately one percent of the total health budget.
- Expand the Calgary and Edmonton Drug Court system to other jurisdictions, and provide funding to enhance further prevention, assessment, and treatment activities.
- Establish Mental Health Courts to effectively meet the needs of offenders with serious mental illnesses and substance abuse disorders.