Author of the article: Ralph Coombs
EDMONON JOURNAL / OPINION
Publishing date: Apr 09, 2022 •
Publishing date: Apr 09, 2022 •
Dr. Verna Yiu, CEO and president of Alberta Health Services, speaks during a COVID-19 update on Oct. 12, 2021. PHOTO BY IAN KUCERAK /Postmedia file
The dismissal of Dr. Verna Yiu from her post as CEO of Alberta Health Services raises serious questions. By all accounts, she served as a consistent and steady influence on the Alberta health-care system throughout her time in the position.
Why the firing? Columnist Don Braid suggests that it may be preparing the way for another round of reforms. Given the spotty record of previous Alberta “reforms,” one might assume Yiu’s discomfort.
I have come to believe that a government’s intent for health-care delivery is as important as the manner in which the system is configured. Most Canadians view health care as a public good, a moral enterprise, a right of citizenship that should be based on a one-payer system, publicly governed and portable across provincial boundaries.
Health-care managers commonly show a distrust of “contracted-out services” as such is not seen to add sufficiently to the overall strength of the team. Unquestionably, the patient is safest and the care more successful when everyone on staff sees themselves as a caregiver with a personal duty owed to the one in the bed.
There are others who believe health care could be viewed as just another commercial commodity, to be bought and sold, controlled largely by market forces and staffed by any means that brings the best price. But health care is complex and very, very personal and does not lend itself easily to free enterprise principles. Canadians have shown they want a system that will provide timely, contemporary and accessible care to those who are sick or injured.
Also wanted is a robust public health system, with actions and interventions to guard the overall health of communities. Equity is seen as fundamental and the system must be based on need, not income. Two-tier systems have been rejected as un-Canadian and wasteful of short resources.
The dismissal of Dr. Verna Yiu from her post as CEO of Alberta Health Services raises serious questions. By all accounts, she served as a consistent and steady influence on the Alberta health-care system throughout her time in the position.
Why the firing? Columnist Don Braid suggests that it may be preparing the way for another round of reforms. Given the spotty record of previous Alberta “reforms,” one might assume Yiu’s discomfort.
I have come to believe that a government’s intent for health-care delivery is as important as the manner in which the system is configured. Most Canadians view health care as a public good, a moral enterprise, a right of citizenship that should be based on a one-payer system, publicly governed and portable across provincial boundaries.
Health-care managers commonly show a distrust of “contracted-out services” as such is not seen to add sufficiently to the overall strength of the team. Unquestionably, the patient is safest and the care more successful when everyone on staff sees themselves as a caregiver with a personal duty owed to the one in the bed.
There are others who believe health care could be viewed as just another commercial commodity, to be bought and sold, controlled largely by market forces and staffed by any means that brings the best price. But health care is complex and very, very personal and does not lend itself easily to free enterprise principles. Canadians have shown they want a system that will provide timely, contemporary and accessible care to those who are sick or injured.
Also wanted is a robust public health system, with actions and interventions to guard the overall health of communities. Equity is seen as fundamental and the system must be based on need, not income. Two-tier systems have been rejected as un-Canadian and wasteful of short resources.
Today, we find access to medical services widely impaired. This did not happen overnight. Shrinkage of capacity began in the early 1990s when the Klein government declared the system unaffordable and uncontrollable. Reform was demanded. Despite evidence that Alberta spent less of its GDP on health care than any other province, health funding took a big hit. Local governing boards were scrapped in favour of centralization.
In Calgary, the Calgary General Hospital was torn down, the Holy Cross Hospital was sold and the Salvation Army Grace Hospital closed. Hospital capacity shrank by half. Calgary’s population went on to double without corresponding increases in capacity. Waitlists grew. Herald headlines displayed “Welcome to Hospital Hell: a 14-hour wait in an emergency ward;“ and “Hospital patients dying for help: staff claim ER waits sometimes fatal;” “Alberta’s health care army in no shape for a surge: capacity in the event of an epidemic, major disaster or even a multiple-vehicle crash was doubtful.” Doubts rose. Was it wise to have a single authority control the funding, directly delivering the services, setting the standards, evaluating its own work and reporting principally to itself? Did not this run the risk of overly politicizing health care?
Alberta’s deficit in health-care capacity adversely affects all Albertans. Are we alone? Not so states The Commonwealth Fund report, Mirror, Mirror 2021: Reflecting Poorly, which ranks health-care systems in 11 peer countries, including Canada and the United States. Canada was awarded the 10th position just ahead of the United States in last position. The Organization for Economic Co-operation and Development lists a larger sample of like countries and ranks Canada no better.
So, Yiu is to be fired at a time when very real issues indicate that what is needed is a dramatic increase in both physical and caregiver capacity in existing facilities if there is to be a realistic hope in dealing with the enormous waiting list of deferred surgical and diagnostic procedures.
And, COVID-19 is not done with us yet. Alberta has aging facilities that have needed substantial upgrades for decades, if not total renewal. Yet, what the UCP appears to be offering is more cuts to AHS and the funding of more privatization. Something is wrong with this picture.
Ralph Coombs was CEO and president of the Foothills Provincial General Hospital from 1973 to 1990. He is past president of the Alberta Hospital Association and the Association of Canadian Teaching Hospitals. He served as chairman of the board of directors of the Alberta Catholic Health Corp.
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