Now the Alberta government is on the hot seat after allegations of grossly inflated contracts for chartered surgical facilities (CSFs) came to light. A recent investigative report by The Globe and Mail has created quite a stir. It questions the rationale behind the province’s increasing investments in private health care, while public facilities are still reeling from the impacts. Athana Mentzelopoulos, the former chief executive of Alberta Health Services (AHS), said she first faced political interference. She testified that this pressure made her approve excessive contracts for CSFs. The Parkland Institute published a report describing the latter, underscoring the huge growth in provincial spending. For the upcoming fiscal year 2023-24, spending on private surgical facilities has almost tripled to $55.8 million.
Though funding for private health facilities skyrocketed, public health infrastructure received only nominal increases in investment. This new shift in focus has fueled passionate arguments both ways. Now the effectiveness of ASI, the Alberta Surgical Initiative, launched by the current United Conservative Party (UCP) government in December 2019, is under examination. To reduce the backlog of wait times, the ASI funded 80,000 extra surgeries over four years. They’ll do this by increasing use of private facilities under contract.
Unfortunately, despite their ongoing national Urban Agenda, wait times for these important—often life-saving—surgeries have only increased. In 2023, lung cancer patients waited an average of 31 days for surgery, a significant rise from 21 days in 2019. In a mirror image, wait times for breast cancer surgery jumped to 22 days from 17 days over the same period. Earlier this month, the Canadian Institute for Health Information shared a disturbing trend. Since the ASI’s launch, median wait times for nine of eleven priority procedures have gone up. Remarkably, knee replacements wait times jumped by 27 percent.
In their defense, the Alberta government claims expanding capacity through private facilities will ultimately lower wait times. Critics have blasted these facilities for siphoning away valuable staff and resources from public hospitals. This loss cripples the hospitals’ ability to do high margin, high value add, urgent, needed procedures.
"Paying for-profit providers a premium rate simply diverts staff from hospitals to the for-profit sector," he said.
"For-profit providers are being paid inflated prices to deliver the easiest, most profitable procedures at the expense of our public hospitals," said Andrew Longhurst, a health policy researcher and the report’s author, in an interview.
This was the thinking behind a report from the Parkland Institute. It found that the province has yet to add surgical capacity or decrease wait times, contrary to what the ASI promised the province would achieve.
"The consequence to that is what we’re seeing in cancer surgical care. You’re seeing those wait times balloon … and they have very real effects on people’s lives."
When the UCP government initiated the ASI, they did so with a daring mission. They set a goal for these independent providers to perform 30 percent of all surgeries by 2023, effectively doubling their share from 2019. We see private facilities continuing to drain talent and resources from public ones. This begs the question of how realistic it is to set these targets without compromising the quality of public health care, though.
