Opinions

Superboard a super bad idea

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A rather unexpected announcement was made last week when Alberta Health Minister Ron Liepert sliced the number of regional health boards from nine to one. The $13 billion "superboard" will be in Edmonton and led by interim chief executive Charlotte Rub. While many argue that this will help reduce administrative costs and therefore increase spending on frontline health care, it does not address the major issues facing Alberta's health care system.

A province-wide board will help in providing an equal standard of health care across the province but that does not mean that they will be improving it. The regional health boards were introduced in 1994 after a collection of 128 hospital boards, 25 public health boards and 40 long-term care boards were facing serious deficits. In2004, the original 17 regional boards were cut down to nine with few nonfinancial benefits resulting.

An open letter to the province by Liepert explained the change will improve health system governance and accountability, add more health professionals, manage health services to better meet patient needs and promote healthy and safe communities. While these are all honorable goals, no information was given as to how they will come about. It's almost as if they've decided to free up the money for an undetermined project. As of yet, doctor- and nurse-shortages will not be fixed by having a superboard located in Edmonton. The decision has no plan to confront surgery wait times.

Rural communities afraid of being forgotten were told the new Edmonton board is setting up smaller voluntary councils. The councils will be situated across the province and report back to Edmonton with recommendations. What is the point of dismantling regional boards only to replace them with less effective groups? Money will be saved on financing the councils but before any action can happen, it will have to go through another level of bureaucracy. Other councils will be set up to deal specifically with cancer research, mental health and drug and alcohol addiction. Decision making is being centralized and then broken up again into different councils-a return to the complicated mess the health minister was hoping to avoid in the first place.

A recent paper published in Canadian Family Physician calls for more cooperation between physicians and local health care executives and administration to direct funding where most needed. Past reduction in regional boards has made this kind of communication more difficult. The superboard may have access to more money, but will also be more disconnected from those who need it.

A centralized board will cut costs for the province and, so far, that's about it. Amputating the regional health boards may be a step in the right direction, but without any plans for the future, Alberta's healing process might be a long one.

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"...this will help reduce administrative costs and therefore increase spending on frontline health care, it does not address the major issues facing Alberta's health care system."

"...doctor- and nurse-shortages will not be fixed by having a superboard located in Edmonton. The decision has no plan to confront surgery wait times."

So, somehow, making more resources available for the frontline delivery of care will negatively affect the frontline delivery of care? And how will pooling of health care infrastructure decrease rural access to health care components such as MRI, cancer care and mental health which they lack now?

"Rural communities afraid of being forgotten were told the new Edmonton board is setting up smaller voluntary councils."

"...more cooperation between physicians and local health care executives and administration to direct funding where most needed..."

But of course more consultation necessarily means less input from stakeholders. How can a government be anything but incompetent when it comes to trying to improve life for its citizens. Pre-emptively proclaiming that such efforts necessarily fail will necessarily make things better for Albertans...

Gauntlet: How does this reorganization affect Alberta students? (It does, but you've failed to notice.)

In your experience as a health management/administration/delivery organization, what specific plans and recommendations do you provide or support?