Everyone should listen to this excellent question – w excellent points that the Premier didn’t bother to answer...

But let's break this down, shall we?

TLDR: when Premier says “they” she is deflecting cuz “they” = GOVT
1/13

https://x.com/thebreakdownab/status/1987607384077025547?s=61

Actual concerns raised: Privatized delivery will just drive our critically short workforce out of the hospital (fact), while there are empty ORs in a lot of our major hospitals (fact), and CHAOS in the current system that needs to be addressed (fact).
2/13

Real ED Case in AB 🧵 :

Elderly couple 91 and 92yo, living in their own home caring for each other. Slowly declining, as one has worsening dementia, and they can no longer live on their own anymore.
No beds to place them in continuing care from the community
1/5 Brought to the ED by 2 EMS crews, with no acute medical issues, but they need to be admitted to hospital to wait placement.
They are confused and anxious, and will be STRANDED in an ED for days, and then in a hospital for WEEKS/MONTHS... STRANDED because LTC spaces rare
2/5

Let's run through just ONE example of what will enfold with govt's new TESTING PRIVITIZATION PLAN
Simplifying in broadstrokes a common example:
Take a 35yo female with heavy pelvic bleeding and irregular menses, who has no FM doc.
🧵 1/10
buff.ly/wf7leEA - pays for a lab test and Hemoglobin is low (not critical though so no reimbursement)
- pays for an ultrasound that shows a mass (don't know what it is so no reimbursement)
- pays for an MRI (looks like a complex fibroid, but still needs a biopsy, so no reimbursement)
2/10

Albertans are witnessing the deathblow to fair and equitable HC access right here, and all without even a discussion to see if there is a mandate for govt to do this.
This is not hyperbole or fearmongering.

Let's pick 10 quick highlights🧵:
1/15
buff.ly/dzaXRPF 1 - Govt is NOT creating any new capacity here, they are simply splitting the queue for all lab/DI/screening into private and public pay streams.
2 - There is no new workforce to deliver the new stream (that could develop in decades??? while the public system is starved?)
2/15

RURAL ED CLOSURES - REAL AB Case #3
- patched through a bystander call from 911 dispatcher to online doc, significant trauma from an ATV accident
- literally not a single EMS crew in the vicinity, local ED closed, all resources actively transporting patients
1/5 - trying to talk a bystander (not first responder) through what to do over the phone for an extended period of time
- trying to involve RCMP, forestry, all other resources as known significant delay for any EMS crew to be able to respond
2/5

RURAL ED CLOSURES - REAL AB Case #2

- Pt in their 40s, witnessed cardiac arrest
- EMS responds and begins resuscitation
- Only mins from nearest Hospital, but the ED is CLOSED
- Adjacent Hospital ED Closed too
- EMS crew NOT aware of ED closures
1/7 - EMS calls hospital staff for help - crew in significant distress because there is nowhere to take this patient
- Local nursing staff tries calling physicians in the community
- One provider is 25 minutes away
- Resuscitation terminated pre-hospital - "no receiving site"
2/7

RURAL ED CLOSURES - REAL AB Case #1
- ABs are not aware of how frequently rural EDs are closed, and the impact on the people in these communities.
- the ever-worsening stats are meaningless
- it's important to put a human face on what's happening.

Anonymized Actual Case #1:
1/7 Before giving example cases...
Here's a refresher of a recent post on the growing issue across AB:


2/7 buff.ly/FIHAlkb

ED RURAL CLOSURES are happening more and more across AB.

Let's look at some of the issues, before talking about some real cases:

- the frequency of rural ED closures is growing - often with little to no warning for the community
- large areas of AB are left uncovered - pts may not be aware and self-present with emergency conditions
- EMS crews are often unaware and show up to closed locations as well
- growing reliance on Virtual ED (VED) which can ONLY care for the less sick (CTAS 3-5), and refuses to provide any care/advice to CTAS 1-2

Let's talk further "refocusing" and the new corridors
5 ZONES will be converted to 7 CORRIDORS - with futher dispruption and chaos added
Each of the current zones have medical leaders trying to coordinate care within/between zones... who will do this in new corridors?
1/6
Currently there are no plans for:
- Corridor medical leadership (multiple service providers in each corridor with NO overall operational control)
- coordination between zones
- what this will mean for provincial services that cross corridors
- what it will mean for pts
2/6

Hey Alberta! Get ready for this. The Premier has stated she wants to sell off our hospitals to private operators... and he govt has set up all the legislation so that this WILL happen...Maybe we should be aware of at what cost 🧵 :
1/4buff.ly/XMoqtKl How about the cost of lives: 13% increase in DEATHS!
Why - cuz they want to maximize profits so they cut corners and cut staff numbers.
This Study shows how they do this: 11.6% less staff, and 16-18% less operating funding = substandard care and more people die
2/4

WOW! There appears to be conflicts of interest all over the place... but given that govt refuses a Public Inquiry, will we ever find out?

Do ABs even care how their money is spent while the system degrades?
1/7
buff.ly/y4AL4wG So 2 independent Audits:
First: ASG contract followed "sole source contract" rules... but very narrow focus, so 2nd ordered
2nd: look into potential conflict of interest... while looking into it the govt says: stop everything, also CEO fired, also Board fired
2/7

Let's talk about LWBS = Left Without Being Seen

Look at the graphs - anyone can immediately see the trend.

Post pandemic it just keeps getting worse. Let's break this down as everyone should care as it will impact you or a loved one at some point 🧵 :
1/10
This is public data from HQA - it's two quarters behind, but same trend continues and this fall will be horrendous for ED Access Block (= inability to get safe and timely care in the HC system)


Key points:
2/10buff.ly/Zzme8kn

It's been over 8 months since govt fired the AHS CEO and the entire AHS Board... ostensibly to make things better, and to give govt more direct control over the HC system.

An acting CEO and no Board, and things are demonstably worse on all acute care fronts.
1/6 No oversight.
No arms length from govt - it's all govt all the time...
Endless firings, and basically any of those with HC expertise and clinical experience that are still around are just waiting to get fired (why quit and get no severence for your lifelong service?)
2/6

Let's talk about AB's HC workforce, a 🧵 :
The graph is for all of Canada, but this trend continues and is getting worse in AB.
Many reasons but key ones:
- "refocusing" has eliminated any ability for our province to do workforce planning. NO COORDINATED work being done
1/7 - there are so many orgs now, and all with "acting" appointed temporary leads, that one hand has no idea what the other is doing
- HCWs can work in mulitple orgs in our siloed HC "system", and so the orgs are finding themselves competing against each other for same supply!
2/7

Some concerns from former AHS CEOs sworn affidavit 005 - Some issues re CSFs🧵:
- Let's break down some specific concerns raised by the former AHS CEO around CSFs in AB.
- I will talk about CSFs in general... details about specific CSFs are opaque and hidden
1/12 One important note: there is nothing innately wrong with the idea of doing select surgeries in chartered facilities. The key issue is ensuring proper coordination, oversight, safety reporting, transparency, and accountability.
Ensuring they work for the public!
2/12

Some concerns from former AHS CEOs sworn affidavit 004 - HCW Intimidation and Silencing🧵:
- pg 16
- concerns raised of govt being punitive and silencing "critics"
- this should be very alarming when a former AHS CEO raises this concern.
1/10
- if it proves to be true that actual screen shots of this behaviour exist, and from people still in positions of power over HCWs, all ABs should be very worried.

What I can speak to from firsthand knowledge:
- almost daily HCWs tell me they are terrified to advocate
2/10

Regarding "refocusing' - which should be nominated for the euphemism of the year award - ABs should pause and reflect on what is happening w the disintegration of our HC system 🧵:
- first off "disintergration" is used intentionally w respect to what's happening
1/8 - govt is both blowing up the system and breaking down any and all INTEGRATION
- they are creating silos, redundant bureaucratic orgs, and moving clinical HC dollars to support more admin and bureaucrats

But what is really important is the HOW they are doing it:
2/8

Some concerns from former AHS CEOs sworn affidavit 003 - Refocusing🧵:
- pg 19
- Some concerns about the chaos of "refocusing"...
- There really was no plan, Premier said blow-up AHS, so they blew it up and then set consultants and bureaucrats to create "anything"...
1/6
Some key concerns:
- NDAs have been used wantonly by this govt - the right hand can't even talk to the left hand...
- people could be on multiple refocusing committees and not be able to share info between the groups!
- AHS couldn't inform HCWs
- everyone flying BLIND
2/6

Some concerns from former AHS CEOs sworn affidavit 002 - Surgical Coordination🧵:
- from page 12
- It is critical to understand that payments for surgery in AB all come out of the EXACT SAME POT.
1/9
- doing more low acuity surgeries in community, w same or less funding = something has to give
- we know from objective data what gave: life and limb saving surgeries, bowel and transplant surgeries, and cancer surgeries... all wait times went up for them.
2/9

Some concerns from former AHS CEOs sworn affidavit 001🧵:
- from page 23
- Concern: govt did not budget HC for pop growth and inflation
- this is factual, and very important to understand
- the Premier even confirmed this during her budget announcement
1/10 Why is this important:
- our pop is BOOMING, and inflation is making it more expensive to provide HC
- govt isn't even doing its most basic duty = ensuring/insuring HC is adequately funded from yr to yr ("insuring" intentional as they are the health insurance provider!)
2/10

"Kyle Warner, press secretary to Hospital Services Minister Matt Jones, said only two hospitals saw one in five patients leaving the ER early"

Both hospitals are in Edmonton... and this is full on admission of UTTER FAILURE
🧵
1/6
buff.ly/L7rPhAJ At times the RAH LWBS numbers are higher than 1 in every 4 patients seeking care... read that again: they are seeking care and RECEIVE NONE.

Aggregrating the top 16 EDs to dilute the provincial avg is mere distraction... Pts only ever present to ONE ED at a time.
2/6