From today’s Edmonton Journal – Health Minister Fred Horne plans to introduce legislation to give the government more power over Alberta Health Services:
[ http://www.edmontonjournal.com/news/edmonton/Province+plans+tighten+control+over+billion+Alberta/9814608/story.html ]Province plans to tighten control over $13-billion Alberta health authority
BY KEITH GEREIN, EDMONTON JOURNAL MAY 7, 2014 6:36 AM
EDMONTON – Health Minister Fred Horne unveiled plans Tuesday for a new arrangement with Alberta Health Services that will strip the $13-billion health authority of some of its financial autonomy and bring it more firmly under the government’s control.
Legislative changes introduced this week will for the first time give Horne the power to approve AHS’s annual budget and direct how money is divided among various parts of the health system.
As well, Horne said the province is planning “overarching” new legislation this fall that will redefine the relationship between AHS and the government, and clarify how the health authority is expected to operate.
“I think what this will do is deliver better oversight, but it will also help prevent things like mental health from getting lost in the chasm of acute care (hospital) services, which is the lion’s share of the budget,” he said. “I think that’s something Albertans will welcome.”
Opposition parties said the moves erase all pretence of AHS being an “arm’s length” agency free from political interference.
But Horne said current rules under the Regional Health Authorities Act date to the mid-1990s and don’t fit a health system now being run by one organization.
As an example, he said the act now requires AHS to submit its health plan each year to the minister for approval, but not its budget.
In practice, Horne has typically reviewed AHS budgets before they are released to the public, yet the legislation provides no formal power for him to approve or change it, he said.
“I think most people would agree it doesn’t make a lot of sense to just approve a health plan if you are not going to look at the resources that are allocated to deliver on it.”
He said Alberta has traditionally operated like most of Canada, where each province provides its health authorities a large, single grant to run the system, and lets the authorities figure out how best to use it.
But this year Alberta has already moved to a more “enveloped-based” approach, in which the government prescribes how much can be spent on each part of the health system. For example, the most recent budget released in March gives AHS a limited envelope of $1.3 billion for community care, $1.8 billion for diagnostic and therapeutic services and $3.9 billion for acute care, which actually represents a slight decrease from what was spent the year before.
Horne said the idea is to better ensure resources are going to provincial priorities, which includes a desire to have people treated more often at home or community clinics rather than a hospital emergency room.
Horne’s efforts to exercise tighter control over the health authority date back at least to last June, when he fired the 10-member AHS board in a dispute over executive pay. Instead of replacing the board, he appointed a single administrator to oversee AHS and provide a more direct line of authority to his office.
That was followed by a management overhaul that saw AHS’s contingent of 80 vice-presidents reduced to 10. He has also intervened in specific issues, including a controversy over home-care contracts and plans for a new medical testing system in Edmonton.
NDP MLA David Eggen said the latest changes mean Horne can no longer blame AHS for problems in the health system.
“At what point do we give up this charade of separation between the ministry and AHS?” he said, adding that he would like to see AHS eventually dismantled and the health system directly run by the government.
Wildrose MLA Kerry Towle said the proposed amendments could put too much spending power in the hands of a minister who may not have the right spending priorities.
“So if the minister has a pet project, like 140 family care clinics, he can now do envelope funding for that and pull funding from other places.”
She and Eggen said that instead of centralizing everything in the minister’s office, the health system needs more decision-making at the local level.
Horne said he is in favour of getting more local input. Additional legislative changes introduced this week will see community health councils no longer report to AHS, but rather directly interact with the ministry.
“To get that local community feedback is really important, and it’s something I think we have lost a bit,” Horne said.
A spokesperson for AHS could not be reached for comment.
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