New health omnibus bill clears way for privatization, doctors' contracts

The Alberta government introduced an omnibus bill on Monday aimed at paving the way for an overhaul of the health-care system by allowing more private providers to operate in the province.

Bill 30, the Health Statutes Amendment Act, proposes to cut approval times for private surgical facilities, allow the ministry to contract directly with doctorsand allow private companies to take over the administrative functions of physician clinics.

The changes affecting physicians pay comeafter the government terminated the master agreement with the Alberta Medical Association in February. At the time, the health minister said ending the agreement was a necessary move becausethe province was at an impasse with doctors over how to reduce costs and improve service in the $20.6-billion health system.

If passed, Bill 30 would allow doctors who so desire to move away from the fee-for-service model, where they bill for each patient visit, and instead signcontracts and be paid salaries.

"Doctors can focus on providing care instead of focusing on administration," Health Minister Tyler Shandro said. "Physicians will then have more flexibility to spend time with their patients, especially with those who have more complex issues."

Dr. Christine Molnar, president of the Alberta Medical Association, said alternative relationship plans can be a great option for physicians, depending on the type of practice.

But Bill 21, passed last fall, remains an issue for any physician who signs a contract. The bill gave the government the powerto unilaterally end its master agreement with the AMA in February.

"[Contracts]have an expiration date," Molnar said. "They may have terms but none of it really matters with that bill in force."

Another change proposed in the bill would alter the membership of professional colleges, complaint review committees and hearing tribunals that regulate and discipline health professionals such as physicians and nurses.

Bill 30 would require those bodies to have 50 per cent public membership, up from the current 25 per cent.

Appointments would still be made by the government. Shandro said public members wouldbe added to the 29 boards and colleges; existing non-public positions will not be removed.

Shandro said the change is being made to increase diversity on the boards and make the system more focused on patients.

"Skilled, competent public members are needed to complement the knowledgeable professionals who already sit on these councils," he said. "They will build on each other's strengths and experiences to govern the health system in the public interest."

Diversity amendment

Edmonton City Centre MLA David Shepherd, health critic for the Official Opposition NDP, said he was skeptical about claims the move will make the boards more diverse, particularly since the new public memberswill be appointed by the government.

"Theyare not, indeed, about providing transparency and openness and opportunity for the average Albertan to participate," Shepherd said. "They are about grasping more power for themselves and partisan appointments."

Shepherd says the NDP will propose an amendment to Bill 30 in hopes of enshrining a requirement for diversity of appointments within the legislation.

"If that is truly what the minister is trying to address, then we will help him to do so by providing that accountability and we'll see if he's willing to accept it," he said

The bill also proposes updating who can be appointed to the Hospitals Appeal Board, which the government said in a news release would continue to give it "a strong, qualified group of members to review grievances brought forward by medical staff against hospital boards."

Last week, CBC revealed a racist incident from 2016 at the Queen Elizabeth Hospital in Grande Prairiehad not been dealt with despite complaints from at least three physicians. In response, Shandrolaunched an independent, third-party review.

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The government has already taken the first steps in its goal to reduce wait times by moving more lower-risk procedures such as cataract surgeries to private facilities.

Earlier this year, the province issued a request for expressions of interest to determine how many private contractors wantto performthose publicly funded procedures.

Other changes proposed in Bill 30 include expanding the mandate of the Health Quality Council of Alberta to include "person-centred care."

The HQCA, which currently monitors safety and quality control in hospitals and doctor's offices, would also be tasked with talking to patients, families and caregivers on their experiences with pharmacies and mental health, addiction and rehab facilities.

The bill also affirms Alberta Health Services as the single health authority in Alberta. Covenant Health, which runs Catholic hospitals and long-term care homes in Alberta, would be deemed a "strategic partner and faith-based health-care provider" under the bill.

The government said that will not change the day-to-day operation of Covenant Health.