This is from the Calgary Herald. The article is correct that these plans are often filled with high-sounding phrases that turn out not to have much relationship to what happens. The idea of becoming more efficient by amalgamating health regions seems to periodically gain favor among "experts". Of course it does save money but it also takes away control from local areas and often fails to meet local needs. Control becomes more centred in health "experts" and it is their agenda rather than what local people want that comes to dominate decision making.
The idea of physician assistants seems a good one. Similar positions seem to work out in other countries such as the U.S. The drug purchase scheme also seems a good idea. I believe that Manitoba already uses such a system.
Friday » April 18 » 2008
Is health plan good medicine?
Time will tell if Liepert's vision will improve medical outcomes
Friday, April 18, 2008
Casual observers could be forgiven a yawn over the action plan of Health Minister Ron Liepert, replete as it is with the tired old words of the eternal health-care announcement: "improve health system governance and accountability . . . expand health workforce . . . manage health services to better meet patient needs . . . promote healthy and safe communities."
Yet, droning cliches should not obscure the fact Liepert departed from custom, and set himself a deadline. That's bold.
It means, for example, anybody who has spent years coping with the EMS imbroglio will have certainty about who pays the bill, on or before June 15. And, health-region officials will know where the axe will fall. Alberta's nine health regions will almost certainly be collapsed into fewer administrative units. Some job loss is inevitable: The sooner people know, the better.
Liepert has also given himself less than three months to announce a plan for buying drugs in bulk. True, he doesn't start from scratch: A deal with B.C. allowing two provinces to shop as one is already drafted. Also, the complexities of inter-provincial agreements being what they are, and the dilemma presented by orphan drugs -- very expensive medications for rare conditions -- it is unlikely the plan will yield big savings immediately. More likely is a template agreement covering a few items, to be expanded in due course.
However it gets done, it all helps. Alberta Health spent $1.2 billion on drugs in 2007, almost 10 per cent of its budget, and expects to spend $2 billion in 2009.
To be sure, the plan is fuzzy at the edges. What is a physician assistant, a role to be introduced in six months? Apparently, it's a concept borrowed from the military, a person with more medical knowledge than a nurse, but not quite a doctor. The government is defining it. Meanwhile, Albertans may seek hints of the future in M.A.S.H.
"Develop and deliver provincial health services model to make them more efficient and effective" is also vague. Perennially promised, when does all this efficiency actually get here? And, how will Albertans know?
Perhaps that depends on what Liepert means by "changing the culture of health care."
We take this to be code for adjusting expectations. For example, the number of people lacking a family doctor is often cited as an indicator of system competence. Yet, it may not seem so to a healthy person who has not seen a doctor for 20 years, as long as there's a place for him to go when the day arrives that he must. (And someone more capable than Cpl. Klinger to see to him.)
Perfection is elusive, and we see no future relief from ministers saying how great it's going to be, one day. But, by setting deadlines Liepert has invited Albertans to watch him.
So, his plan should be judged as it unfolds. If he delivers even what specifics he has promised, the system will be better for it.
© The Calgary Herald 2008
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CanWest Interactive, a division of CanWest MediaWorks Publications, Inc.. All rights reserved.