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Did Alerta Attemipt to Cut Health Care Costs Too Quickly?

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Did Alerta Attemipt to Cut Health Care Costs Too Quickly? POLITICS * POLITIQUE Did Alerta attemipt to cut health care costs too quickly? Richard Cairney ing government. It recommended amalgamated with the Royal Resume: Le projet du premier that Grey Nuns close its acute-care Alexandra; and the city's laborato- ministre Ralph Klein de reorgani- beds and become a replacement site ries, radiology and imaging services ser les etablissements de sante en for Alberta Hospital Edmonton, the would be administered centrally. Alberta a ete diversement ac- city's dilapidated psychiatric facil- The massive Edmonton protest cueilli. Si tout le monde trouve ity. over the rumoured closure of Grey louable la reduction des depenses But local community associa- Nuns was followed by emotional re- gouvernementales, on s'inquiete tions weren't going to let that hap- sponses in Calgary, where residents de plus en plus du fait que le pen without a fight. They rallied are angry about recommendations gouvernement en fait trop, trop residents to express their concerns, for regionalizing that city's health rapidement. Le gouvernement and after an estimated 15 000 area care. The report containing the rec- provincial examine actuellement residents turned out to protest the ommendations, written by a com- des recommandations visant la rumoured closure of the hospital, mission headed by former provincial centralisation de la plupart des which runs Edmonton's second treasurer Lou Hyndman, urged the services hospitaliers et leur assu- busiest emergency room, the province to close the Alberta Chil- jettissement a des <<super-con- province blinked. It allowed Meyer dren's Provincial Hospital its seils>> regionaux; l'objectif fi- and her counterparts to work on beds would be absorbed into the nancier est de reduire de plus de new plans to redefine the hospital's Foothills Hospital. It said acute-care 700 millions de dollars les role. beds should be concentrated at the depenses de sante au cours des [Physicians were also hit hard Rockyview and Foothills hospitals quatre prochaines annees. by the cuts. As this issue went to and Peter Lougheed Centre, and the press, the government announced Bow Valley Centre should be trans- that payments to doctors will be cut formed into a community-health fa- A s far as Corky Meyer is con- by $60 million this year. It has also cility with a small emergency unit cerned, the Grey Nuns Hos- banned doctors from outside the and possibly a women's health care pital in southeast Edmonton province from setting up practices clinic. Another recommendation died on Good Friday, 1994. in Alberta by refusing to let them called for the closure and sale of the That's the day the Millhurst bill medicare as of July 1. Ed.] Grace Hospital Women's Health Community League president fin- Residents are still mulling over Centre. (Oddly, that inner-city hospi- ished reading a report on the re- other recommendations in the Atkin- tal and the property it sits on are gionalization of Edmonton's health son report that would leave Edmon- owned by the Salvation Army, not care services. Prepared by Ottawa ton with three full-fledged hospitals: the province.) consultant Dr. John Atkinson, the University of Alberta, the Royal The proposals and protests have report had been commissioned by Alexandra and the Misericordia. The caused chaos in both cities, and the Premier Ralph Klein's deficit-bust- number of obstetric beds will be situation changes almost daily. In cut in half, to 102; the Charles Cam- Edmonton, Grey Nuns may now Richard Cairney is an editor with Alberta's sel Provincial General Hospital maintain its active-bed status; Cal- St. Albert Gazette. would close, with its staff and beds garians have protested the closure of <- For prescribing information see page 1915 CAN MED ASSOC J 1994; 150 (I 1) 1857 the children's hospital, but may have and they send you to the city." in from farming centres north of the left the Grace to go down in flames. The government's plans mean city. Under regionalization, the Stur- The protests crystallized reac- that each region will have hospitals geon General Hospital now joins the tion to sweeping changes in Al- specializing in different disciplines, Edmonton region. Patients living berta's health care system. The and everything from laboratories and north of the city can come to St. Al- province is, essentially, reinventing imaging to accounting, food services bert even though it is a separate health care delivery by trimming the and laundry will be centralized. The health region, but the streamlined fat from an extravagant hospital- same principles will apply in urban system in which different facilities building binge that occurred when and rural areas. Regional "super- specialize in different disciplines government tills were full. Faced boards" will take over the 17 areas could mean trouble. with the legacy of a decade of deficit June 1 as hospital boards and health "If you live in High Level and budgeting and mounting debt, the units disband. you have a brain tumour, you are Alberta Tories have embarked on a If one thing can be agreed upon happy to see the expert at the Uni- radical redesign of health care that in Alberta, it is that the next few versity of Alberta," said Gray, a past will see some hospitals go out of steps taken in health care are critical, president of the Alberta Medical As- business, while others form strategic but the lighting along the path is sociation (AMA) and former chair- alliances that will eradicate duplica- poor. From his office in the Edmon- man of the CMA Board of Directors. tion of services, wipe out the ton suburb of St. Albert, where Grey "But if you are having a baby, you province's 27 health-unit districts Nuns built the province's first health want something within a reasonable and form 17 regional "superboards" care facilities a century ago, Dr. distance. to oversee hospitals and public Alan Murdock expressed uncertainty "I have patients who do not health. about the future of Alberta's public- drive in the city of Edmonton. I have In the process, the province health programs. As chief medical some from faraway places like plans to cut health care costs by officer of the Sturgeon Health Unit, Athabasca and Westlock who come more than $700 million over the a body that provides public-health to St. Albert for their health care next 4 years; much of that is ex- services to 100 000 people living they aren't going to drive to down- pected to come from the hospital re- north of Edmonton, Murdock will town Edmonton." organization. oversee the final days of the 40- Other patient-care problems Although everyone favours year-old unit. He isn't confident that could emerge as hospitals lose their sound economic planning, many patient needs will be met after he emergency rooms and intensive-care consumers, doctors and administra- locks his office door for the last time units (ICUs), Gray noted. "You can- tors feel the government is doing too on June 1. not run a hospital without an inten- much too soon, and some argue that "Outside of budgets, Bill 20 sive-care unit, and the cornerstone of patients will pay the price. "Without doesn't give me much feeling of our hospital is an excellent ICU. If a doubt, patient care will suffer," support," Murdock said. "What the they take that away and the emer- said Edmonton protest leader Meyer. government wants to do and what it gency room away, then all of the "If this hospital closes, where will is doing are going in absolutely op- people who come to the hospital those 60 000 emergency room ad- posite directions. Bill 20 [the region- from the north will have to go fur- missions go? The city's other emer- alization legislation] is totally silent ther." gency rooms are already Uammed], on any responsibility for regional Gray and several colleagues and now we're going to throw health authorities in promoting or also work in clinics north of the 60 000 more people at them?" improving health in communities. city, and make house calls. He The Atkinson report suggested [The] major focus should be not just thinks the province's plans provide that some type of emergency room on maintaining and improving pa- for more of these services, with operate at the Grey Nuns to handle tient care, but [also on promoting] home care and community-health the estimated 180 000 people health across the community and in centres replacing in-patient treat- who live in the hospital's catch- schools. Successive health ministers ment wherever possible. But the ment area. "I look at that and I have talked about this for years, but province will make a mistake if it say 'Great. Another damned medi- when we see the legislation it is to- tries to reduce the importance of fa- centre . .,' " Meyer said. "You go tally silent." cilities such as the Sturgeon General there with anything serious and they A few blocks away from Mur- Hospital, he said. "I can tell you take one look at you and send you dock's office, Dr. Neil Gray, a past right now that in 10 years we will to the hospital." chief of staff and chairman of the go back to centres like [we have Rural Albertans will feel the new Sturgeon General Hospital now at] St. Albert's, providing basic effects as well, she insisted: "I don't Medical Advisory Committee, won- surgery, basic internal medicine and want to slam small-town hospitals, dered what the future holds for pa- a lot of the outpatient programs we but anything worse than a sliver tients, particularly those who drive have now, with nurses, doctors and 1858 CAN MED ASSOC J 1994; 150 ()IL) LE le, JUIN 1994 physiotherapists making house calls dict what patient care will be like ing...
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