Now that we have a new Conservative Party leader, let's have a closer look at his health policy platform...
"[R]especting the fact that healthcare is a provincial responsibility" and the feds "should not be telling the provinces how to run their systems." Concern that this is code for allowing provinces to explore privatization and feds may not enforce the Canada Health Act.
"Augmenting international recruitment of healthcare workers." While Canada does need to work on recruitment, this doesn't even acknowledge the concerns with recruiting workers away from countries with fewer resources than Canada. See WHO Code of Practice: who.int/hrh/migration/…
"Diversifying our supply chains for critical supplies" like drugs and PPE. Depending how the gov goes about this, this could be a good thing. Drug shortages/shortages of raw ingredients have been a problem in Canada for years. For a brief discussion: theconversation.com/how-coronaviru….
"Speeding up the approval of new medications and health technologies, so that Canadians get access to life-saving innovation." This is an important issue but would have to be done properly or we risk sacrificing safety for quicker access. See eg: jamanetwork.com/journals/jamai…
"Convening a Royal Commission on the Pandemic within 100 days of taking office." Post-COVID review is obviously important, but this may duplicate efforts that will have already occurred by then. If a review is already complete, he should instead focus on implementing reforms.
Working with provs "to strengthen support for mental health across Canada." Whether this is a good thing depends on what the feds do. For example, we don't need Alberta's approach to addictions making its way to other provinces.
I will stay in my lane and won't comment on environmental, immigration, gun control, etc. policies. However, others have raised concerns in these and other areas, which affect health and the social determinants of health.
Protect "the conscience rights of all health care professionals whose beliefs...prevent them from carrying out or referring patients for services that violate their conscience." Removing the duty to refer is concerning and may significantly limit access to abortion and MAiD.
Reform the Not Criminally Responsible designation to protect public ensure "those who commit heinous acts do not escape justice or walk free after a short period of time." This may risk criminalizing mental illness and not taking rehabilitation goal of criminal law into account.
Toughen "penalties for elder abuse and broadening the definition to ensure that mistreating or failing to care for vulnerable seniors is a criminal offence." This is a very incomplete solution to the problems in long-term care.
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Watching the press conference on "refocusing" the health system (ie breaking it up into 4 organizations).
Primary Care Alberta will start its work today. AHS replacement called Acute Care Alberta will begin work in early spring (later than originally announced). /1
She says Albertan's deserve improved access. Unclear how this will improve access, as they have not presented any evidence for this model and new bureaucratic structures don't tend to speed things up.
AHS & other acute care providers will be accountable to Acute Care AB. /2
Transition team comprised of AHS execs & Dr. Chris Eagle ("external special advisor").
Primary Care AB's initial work will be to implement corporate policies and processes, develop operational plans and set vision, mission & performance targets./3
Bill amending the Alberta Bill of Rights introduced. New provisions:
Right for individual with capacity not to be subjected to or coerced into receiving medical care, treatment, or procedures without consent unless likely to cause substantial harm to themselves or others. /1
Right to freedom of expression, broadening the scope of Albertans’ rights protected beyond written and spoken language to include other expressive activities.
Right to acquire, keep and use firearms in accordance with the law.
Expanded property rights. /2
Currently applies to laws but would now apply to all provincial gov action, including policies and programs, and to organizations that operate under extensive government control, such as municipalities, police services, and some activities of hospitals. /3
Bill 22 (Health Statutes Amendment Act) now tabled. Broadly, will enable transition from Alberta Health Services to 4 new organizations, each responsible for a different silo of the health system (it remains unclear why gov is moving away from an integrated model) /1
4 agencies (primary, acute, continuing, mental health & addiction) will deliver or arrange delivery (contract out?) services, evaluate & adjust to meet needs, implement ministerial plans, ensure integrated transfers within & between sectors (will be a huge job!). /2
Minister of Health will be "oversight minister" and set strategic direction and sector ministers will be responsible for each of the 4 sectors /3
Manning report on covid has dropped. Notably, the panel's mandate wasn't to look broadly into the management of covid, but more narrowly to look at governance in a public health emergency. /1
I'm not going to disparage any specific person, but it is fair to say that the panel's composition seems designed to reach particular conclusions on the issues. /2
Report immediately mischaracterizes who makes decisions in a pub health emergency by putting Cabinet at the top of the list and saying cmoh is merely "highly relevant". Although that's what happened during covid, the law is quite different (for now...see bill 6). /3
Watching the presser on changes to the health system...
Smith highlights challenges with staffing and surgical wait times, but unclear how their proposed reforms will fix any of this. Says that current system lacks accountability and falls short on putting patients 1st /1
Delivery system will now focus on 4 areas, each with their own organization: primary care, acute care, continuing care, mental health & addiction. Calls current AHS structure "scattered" and "rigid". Will apply province-wide to avoid pre-AHS regional fragmentation. /2
Smith says this new model will be more responsive to issues, better able to mange performance, more accountable, more adaptable to innovation, and responsive to make space for local input. Unclear how the new model will facilitate these goals. /3
Gov announced forthcoming changes to the Public Health Act today that will give cabinet greater power over decisions during a public health emergency. Some thoughts... /1
First, clarity over the role of the CMOH was much needed. This should have been fixed much, much sooner when it became clear that what was happening during covid (i.e. cabinet making decisions) was out of step with the law (i.e. CMOH making decisions). /2
Two questions required attention. First, who ought to make decisions during a health emergency (CMOH, cabinet, combo)? And second, how much independence should the CMOH have (e.g. a bureaucrat reporting to the Minister of Health or able to disclose recommendations publicly)? /3