This morning I led a small HSAA delegation to meet with the Minister’s Advisory Committee on Health (MACH), which is doing a comprehensive review of Alberta’s health legislation. The committee, chaired by MLA Fred Horne, is meeting with ‘stakeholders’ to gather input. (UNA, CUPE and AUPE were also part of this consultation meeting, and The unions were in full agreement on virtually all issues.)
We emphasized to the committee the HSAA position on health care that supports not only the principles of the Canada Health Act(universality, accessibility, comprehensiveness, portability and public administration), but also the public provision of care. At the same time, we stressed that while we prefer public delivery, we take the position that the people doing the work deserve union representation just like every other worker, and that we will not hesitate to bring them into our union if they currently work for a private provider. And we will certainly fight to follow them to a private provider if services are contracted out!
A key concern is that a new Act may simply be a broad ‘enabling’ statute, that provides some very broad strokes, and then allows the Minister to fill in the detail with regulations. Regulations can be changedwithout any debate in the Legislature, and potentially without either notice or consultation. Given statements by government and AHS CEO Stephen Duckett, it is clear that further privatization has not been ruled out, in spite of the HRG bankruptcy.
A lesson to learn – for-profit companies buy a building at firesale prices, then get contracts to do surgeries for more money than it costs in the private system, and do not have to provide the emergency care when things go wrong. Their shareholders earn dividends, the leaders earn big salaries, and when the thing goes belly up, we the taxpayer get to pay even more to ensure that patients get their surgeries. Does this make sense for your tax dollar?
I also raised the ongoing staff shortages, the fact that positions either drop off the face of the earth when they become vacant, or get bottlenecked in the Kafka-esque ‘vacancy management process (which may now be named something else). Shifting anyone to the private sector does not provide more services in total, in fact it may lead to less access.
Long-term care was raised by several participants. I reminded the committee that changing a name (continuing Care to ‘Assisted Daily Living”doesn’t make a long term care patient more independent, it just switches costs of care to their pockets.
We also spoke about the desireability to ensure that all professionals work to their full scope of practice, and that we shouldn’t necessarily need to see a physician to get a referral. In this iday of computers and ‘help lines’, we should surely be able to develop some decision making tools that will take us directly to the most appropriate professional. At the same time, UNA Vice President Bev Dick urged that in shifting care to other disciplines, we need to look at the whole picture, rather than fragmenting tasks just to download them to less expensive workers.
This consultation follows a similar meeting on Tuesday with Lloyd Snelgrove, President of the Treasury Board, about the next budget. Here we again emphasized public helath care, but also urged the Treasury Board to consider the longer term when planning budgets, and to look at the revenue side of the ledger, and to avoid the mantra of tax cuts at any cost. We get the public services we need by paying our taxes. Interestingly, even a representative of the oil industry made this point, though he wanted the government to consider a sales tax to fund public services.
I know of at least two members who have been confirmed to participate in the “MACH” meetings, and would encourage every one of you to provide your perpsectives. Simply go to the Governmetn of Alberta’s web site and follow the icon to ‘Your Alberta Health Act’
Wishing you a fine weekend, now that the sun is shining (at least for the moment!).
Elisabeth
