Alberta’s For-Profit Surgery Initiative Faces Growing Criticism

Alberta’s health-care system is under scrutiny as concerns mount over the effectiveness of its for-profit surgery initiative. Despite the government’s push to expand chartered surgical facilities (CSFs), insiders reveal that the strategy may be compromising patient care in public hospitals.

Dr. Ken Cheung, a Calgary anesthesiologist with 25 years of experience, expresses a deep-seated discomfort with the current trajectory of Alberta’s health-care policy. He describes himself as a “conscientious objector” to the mandate that directs medical professionals to work in private surgical facilities. Alongside a colleague, Cheung has managed to avoid these facilities by trading shifts, but he acknowledges the moral implications of supporting a system that may undermine public health.

Under the leadership of the United Conservative Party (UCP), Alberta has seen a significant increase in surgeries performed in private CSFs, with plans to fund an additional 50,000 procedures over the next three years. This initiative aims to alleviate surgical wait times, yet an investigation by The Tyee highlights troubling trends. Dr. Braden Manns, a former vice-president of Alberta Health Services (AHS), notes that while some wait-lists for simpler surgeries have decreased, those for complex cases, including cancer surgeries, have grown longer.

The investigation reveals that a climate of fear permeates the health-care system, with many professionals hesitant to speak out due to potential repercussions. Interviews with former senior AHS executives indicate widespread mistrust of data and advice within the UCP government. This skepticism has led to a dismantling of AHS, raising concerns about the future of public health management in Alberta.

Critics argue that the expansion of private surgical facilities has diverted essential resources away from the public system. A report by the Parkland Institute, authored by researcher Andrew Longhurst, indicates that the increase in CSFs has exacerbated staffing shortages, particularly among anesthesiologists and nurses. According to Longhurst, the total number of surgeries performed in public hospitals has declined since the pandemic, undermining the very goals of the surgical initiative.

Minister of Alberta Primary and Preventative Health, Adriana LaGrange, has dismissed findings from the Parkland Institute, labeling it as biased. She contends that CSFs are vital for improving patient care and reducing wait times, despite growing evidence suggesting otherwise. The Tyee has also acquired unpublished research indicating that while CSFs have marginally reduced wait times for less complex procedures, the impact on more intricate surgeries has been detrimental.

The Alberta Surgical Initiative, launched in 2019, aimed to alleviate chronic wait times by increasing the use of private surgical facilities for various procedures, including orthopedic surgeries. However, the focus has shifted predominantly towards low-acuity surgeries, with critics warning that this has left the public system to manage a backlog of complex cases.

As the UCP government continues to prioritize its for-profit model, insiders express concern about the implications for patient care. With a chronic shortage of anesthesiologists in Alberta, the government’s directive to prioritize staffing for CSFs has created tension within the medical community. Anesthesiologists often prefer working in private facilities due to less stressful cases and higher pay, leaving public hospitals increasingly understaffed and overburdened.

The lack of a coordinated approach to surgical scheduling has also compounded the challenges. Former Alberta Medical Association president Dr. Paul Parks notes that the absence of citywide scheduling led to significant friction, particularly as anesthesiologists gravitated towards CSFs. This has resulted in critical surgeries in public hospitals being postponed or delayed.

Despite warnings from former AHS executives regarding the adverse effects of expanding private surgeries, the government has largely ignored these concerns. The executives reported that the initial data from the Alberta Surgical Initiative indicated significant issues, including increasing wait times for cancer surgeries.

The government’s insistence on expanding private surgical operations has raised ethical questions within the health-care community. Many health professionals argue that the current model prioritizes efficiency and volume over patient welfare, creating a system where those with less urgent needs may receive faster care than those requiring critical treatment.

In response to the growing criticism, the UCP government has faced calls for greater transparency regarding the costs associated with private surgeries. Former executives have highlighted discrepancies in pricing, noting that procedures in CSFs can be as much as 50 percent more expensive than those performed in public hospitals.

As Alberta navigates this controversial landscape, the future of its health-care system hangs in the balance. Health care professionals and policy experts continue to advocate for a more equitable approach that prioritizes patient care and addresses the systemic challenges currently facing the public health sector.