Alberta’s For-Profit Surgery Strategy Draws Criticism from Doctors

Concerns are mounting over Alberta’s expanding for-profit surgery initiative, with medical professionals claiming it is undermining public healthcare. Anesthesiologist Dr. Ken Cheung, who has served at Calgary’s Foothills Medical Centre for 25 years, has voiced strong objections to the provincial government’s policy that mandates staff to work in private chartered surgical facilities (CSFs). “I feel like I’m a conscientious objector,” Cheung stated.

Under the United Conservative Party (UCP) government, the number of surgeries performed in private facilities has surged, with the government recently announcing funding for an additional 50,000 procedures over the next three years, supposedly to alleviate surgical wait times. Cheung and another anesthesiologist, who chose to remain anonymous, have avoided working in CSFs by swapping shifts with colleagues, expressing their discontent at being compelled to support a system they believe damages public healthcare.

A recent investigation by The Tyee highlights a troubling trend: while the waitlist for some minor surgeries has decreased, those requiring complex interventions, particularly for cancer patients, have increased. “Alberta Health didn’t seem to care who gets surgery,” remarked Dr. Braden Manns, a former vice-president of Alberta Health Services (AHS). “They care about how many surgeries get done in a year.”

Concerns from Within the Medical Community

To gather insights, The Tyee spoke with several healthcare professionals, including four former senior AHS executives. Many expressed fears of retaliation, citing a pervasive atmosphere of apprehension within the provincial health system, exacerbated by high-profile dismissals of AHS leadership. The government is currently dismantling AHS, which for over a decade managed Alberta’s public healthcare, and replacing it with multiple agencies, a move many experts deem unnecessary and chaotic.

According to those interviewed, a fundamental distrust exists between senior government officials and health data. One former executive noted that despite presenting data to the government, they were often met with skepticism and ideological bias against AHS. “They didn’t trust AHS, they didn’t trust us, and they didn’t want to listen,” shared a former senior AHS executive.

Research conducted by the Parkland Institute echoes these concerns. In a report by health researcher Andrew Longhurst, evidence suggests that the expansion of private surgery has diverted essential resources and staffing from the public healthcare system, leading to increased wait times for critical surgeries. The number of operations performed in public hospitals has reportedly dropped since the onset of the pandemic.

Impact on Patient Care and Resource Allocation

Despite the government’s claims that CSFs have successfully reduced wait times, evidence points to a more complex reality. A forthcoming study based on internal AHS data indicates that while CSFs have marginally improved access for “low-acuity” surgeries, they have simultaneously exacerbated wait times for more complex cases, resulting in “potential inequalities in access.”

When the UCP government initially introduced the Alberta Surgical Initiative in 2019, experts warned that CSFs would prioritize less complicated surgeries, ultimately straining public hospitals tasked with handling more complex cases. Currently, CSFs account for over 20 percent of insured surgical procedures in Alberta, a figure that can rise to 30 percent in urban areas. Yet, wait times for critical cancer surgeries continue to exceed acceptable standards.

Critics argue that the government’s aggressive push for private surgeries has not been substantiated by evidence from other jurisdictions with similar public-private models. In provinces like Quebec and Ontario, studies reveal that surgeries in for-profit facilities often cost significantly more than those performed in public hospitals, raising questions about the economic viability of Alberta’s approach.

The political directive to expand private surgical capacity has led to scheduling conflicts within the healthcare system. Anesthesiologists often prefer working in CSFs, where cases are generally less complex and financially rewarding. However, this preference has created staffing shortages for public hospitals, complicating the allocation of resources needed for critical surgeries.

As the situation evolves, many healthcare professionals are left questioning the sustainability and ethical implications of Alberta’s healthcare strategy. The push for privatization has not only created disparities in patient access but has also strained the morale of those working within the public system.

The government’s commitment to prioritizing volume over patient care raises significant concerns about the future of healthcare in Alberta. As officials continue to navigate this contentious landscape, the voices of healthcare professionals underscore the urgent need for a reevaluation of strategies that prioritize profit over patient well-being.