While it may seem a good idea to cut management positions rather than front line health workers this may be another step on the road to centralisation and weakening local input into the health system. The province has already taken a giant step in this direction through having a superboard and eliminating more local boards. Everything will be decided by well paid experts with local areas having no power over their own health care.
Health axe hits 100 Alberta managers
Province's doctors told latest cuts in positions just the beginning in effort to reduce costs
By Jodie Sinnema and Trish Audette, The Edmonton JournalMay 15, 2009 7:53 AMAbout 100 management positions will be cut within the next week as Alberta Health Services CEO Stephen Duckett reveals more details on the health system's organizational structure.
"The structure means fewer people, but that doesn't necessarily involve layoffs," Duckett said Thursday before speaking at a town hall to several hundred doctors. The 100 positions are just a start to reduce costs, he later told doctors. "We're doing it, but we need to do more."
The cuts come on the heels of Royal Alexandra Hospital's plan to cut 15 per cent of its elective surgeries to save money. The cuts will mean longer waiting times for patients needing new hips and knees, hernia operations or cataract removal. Doctors say cancer patients will also have to wait for surgeries.
Duckett told an auditorium full of Edmonton-area doctors, and others hooked up by video conference in Calgary, that he is still determined to meet "ambitious" goals, including reducing the wait for hip replacements to 26 weeks by 2011-12, down from 33 weeks in March 2008. Knee replacement waits should be down to 26 to 35 weeks from about 47 weeks within three years, says a recently released draft strategy.
"I don't think we'll get much improvement in wait times this year," Duckett told the doctors. "I think this year is the year for sustainability, unfortunately, but it's something I'm committed to."
He said he still supports the health region's mission to improve accessibility, quality and sustainability, and is ready to put his annual bonus on the line if that isn't accomplished.
"Living within our means is not something that Alberta Health Services is used to," he said, referring to previous annual deficits in the Edmonton and Calgary health regions. "It became a matter of pride almost to see that you did actually overspend your budget. In fact, as far as I can work out, it was one of the key skill sets of the management in those areas."
Because the new superboard has limited spending this fiscal quarter to the same amount each centre spent last quarter, Duckett said all hospitals will be held accountable the way the Royal Alexandra Hospital was earlier this week.
"I will be looking and monitoring to see that the same discipline is in place everywhere," he said. He said he hopes to keep layoffs to a minimum by slowing external recruitment and instead using current staff to fill positions, and reduce the annual turnover rate of 6,500 employees.
Dr. Mark Joffe, president of the Capital Region Medical Staff Association which organized the meeting, said he expected more heat from physicians during the meeting.
But Joffe said most believe Duckett is the right person to bring needed reform to the health system.
Joffe said he liked the fact Duckett was honest when he responded to one doctor's question by telling the meeting if patients wait longer for care, it won't save the system money.
"He was frank," Joffe said. "It actually costs more in the long term."
Joffe said he wants equal openness from Health Minister Ron Liepert.
"Our minister of health and wellness needs to be more honest and frank about the system," he said.
David Eggen, executive director of patient advocacy group Friends of Medicare, said the province needs to make its health-care plans clear. He obtained an Alberta Health Services medical staff newsletter that said 10 hospitals in central Alberta will be downgraded to urgent-care centres if the government follows a master plan.
Long-term care facilities and general health centres will also be closed, the March 31 newsletter says.
"People need peace of mind," Eggen said. "We want clarity, we want a system that works for people."
The newsletter says the plan was approved by the former David Thompson health region, but not by the new Alberta Health Services super board. It says:
- Hospitals in Rimbey, Ponoka, Lacombe, Innisfail, Castor, Coronation, Consort, Sundre, Three Hills and Hanna will be downgraded to urgent-care centres.
- Long-term care centres in Bentley, Trochu and Breton would close.
- Health centres in Trochu and Castor would close.
- Build new urgent-care centres in Sylvan Lake and East Red Deer, pushing the number of acute-care beds in the area to 995, an increase of 303 beds. The number of long-term care beds would go to 2,600 from 1,400.
"Part of the problem that we're faced with is the government is making a number of ad-hoc decisions behind closed doors," NDP Leader Brian Mason said.
Liberal Leader Dr. David Swann said contemplating cuts to rural health care discourages doctors from practising in smaller places.
Rob Stevenson, spokesman for Alberta Health Services, said the master plan that talks about the closures and changes hasn't been approved by the health superboard, and discussion about it is premature.