The report on private surgical services is out:


/1open.alberta.ca/dataset/35ee3f… Report notes: "Unlike a public inquiry, this investigation did not have the power to subpoena or hear testimony under oath". Some people declined to be interviewed or answer questions. Also no cross-exam for credibility and some seemed to fail to give honest and complete info. /2

Bill 55, introduced in the AB legislative assembly today, is the latest step in the reorg of the health system.

On the plus side, we finally hear about what is happening with public health, which was very notably absent from earlier announcements about the reorg. /1 Some public health functions (immunizations, newborn screening, health promotion, communicable disease control) will go to the new primary care org. Other functions (policy, inspections, surveillance) will go to AB Health. Medical officers of health will move to CMOH's office. /2

The UCP will introduce Bill 53 today, the Compassionate Intervention Act, which would allow for the compelled treatment of individuals struggling with addiction. While we await the text of the bill, a couple of thoughts.../1 There are obvious Charter issues, with any forced medical treatment engaging the right to life, liberty, and security of the person. It will then be up to the gov to justify that infringement on individual rights. It is not clear what evidence they would rely on to do so /2

I've been quiet on here as my mat leave soon comes to an end, but can't resist watching today's press conference and tweeting about it!

There are some underlying issues at play that existed even without the recent scandal, although it serves to bring those issues into focus. /1 First, many of us raised concerns with the increasing reliance on chartered surgical facilities back when Kenney supported their expansion. There are concerns with equitable access, quality of care, costs (as the statement of claim highlights), and conflicts of interest. /2

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

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

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

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

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

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

Much anticipated decision in Ingram v Alberta (CMOH) is out! This case addresses the legality of covid public health orders. A summary and some thoughts... /1 As discussed ad nauseam during covid, this decision clarifies that the authority to issue public health orders is that of the CMOH and not cabinet. Despite this, Hinshaw repeatedly said that she was merely an advisor, thereby improperly delegating her power to cabinet. /2

Catching up on the Smith/Copping presser...
Smith commends front line staff and scapegoats AHS. Appoints administrator to replace AHS board. 4 priorities: EMS response times, ER waits, surgery waits, develop long-term reforms through consultation with health professionals. /1 Copping also commends front line staff and talks about the need for more capacity (doesn't address preventing people from needing hospital services in the first place). Claims a temporary administrator is preferable to board because they can work on these issues full time. /2

Hot off the press! The Court of KB releases its decision in the school masking case. Some thoughts to follow... /1 The applicants challenged the chief medical officer's order rescinding masking in schools and the Minister of Ed's direction that schools not impose their own masking requirements. /2

Some health related thoughts as we wait for the UCP leadership coverage to begin...

The candidates have mused on the future of AHS. These musings range from finding efficiencies to blowing the whole thing up in favour of decentralization. /1 While the idea of finding efficienties is, of course, a good thing, the Ernst&Young report from a few years ago was a lesson in what not to do (eg lack of consultation on proposed changes, problems with implementation). /2

The agreement between the Alberta Medical Assoc and the province will or will not be ratified today. It is, undoubtedly, a better deal than the previous proposed agreement. There are a number of political/policy concerns that transcend the agreement itself. Some thoughts.../1 The new UCP leader will be hugely important...more important than the agreement itself. Some candidates are much more likely than others to try to work with the agreement itself, whereas others will forge ahead with dramatic (not in a good way) health system transformation.../2

Powerpoint to cabinet on loosening covid rules has been disclosed. At times, the gov tried to normalize our approach by pointing to other countries. These examples are concerningly cherry picked. Also concerning was gov's desire to rush to reopening before other provs. /1 Cabinet weighed 3 approaches. # 1 significant easing. Striking is how prominent a role non-medical factors played in decisions (e.g. importance of AB being first to open, which is more about politics and optics than science). #2 moderate easing/2

Watching the presser. Perhaps the last one for a while?

Copping starts by talking about the availability of rapid tests. More coming to pharmacies, will be gone from AHS sites. It seems weird to talk about testing when, soon enough, isolation won't even be a requirement. /1 Copping talks about being past peak and the "heavy cost" of restrictions. Says that the risk to hospitals was not as significant as some expected. Field hospitals closing. /2

This gov is determined not to let anyone have public health protections. First, Kenney said he's looking into stopping municipalities from having vaccine passports. Then, LaG told schools they can't have restrictions. Now this:

https://twitter.com/demetriosnAB/status/1491549863426895877

And, as with the letter sent by LaG, what is this "it is my expectation" shit. Are you issuing a ministerial order or aren't you?

Interestingly, the only group that can have public health protections are businesses, who Kenney said can continue to collect proof of vax...

Kenney presser!
Claims they have come up with a "careful and prudent plan".
Lists reasons for this decision: past peak, improved numbers (hospitalizations, water, etc), other jurisdictions changing rules, "damage" of rules. Fails to list the real reason: his political career. /1 Keeps going on about "damaging restrictions." I'm unclear what the damage of some restrictions (e.g. masks) are. He talks about effects on children, domestic violence, economic hardship, etc. /2

Today's presser...

Kenney thanks people for getting vaccinated. Thanks people for following gathering rules (which he said they wouldn't follow).

1053 in hospital, 73% unvaccinated. 242 in ICU, almost 90% unvaccinated.

Verification app now available. /1 Copping notes plateau in numbers, which he attributes to the exemption program (the program that the gov fought against implementing despite evidence to the contrary). He explains the app in a painfully detailed manner reminiscent of Kenney's epidemiology lecture last summer. /2

Questions:
Q: Accountability? Resignations? Inquiry?
A: We are trying really hard. We will think about accountability later (he's hoping we will forget) /1
#ResignKenney Q: Pattern of resisting intervening, mocking experts, and finally impose measures when there are no options. Why don't you learn? 🔥
A: Shockingly, he brags about our shitty response. Talks about the problems with restrictions. Claims they made "best efforts" to vaccinate /2