Health care dominated the lobbying agendas of Alberta’s influencers this year after the provincial government promised to dismantle and decentralize the public health system.
Alberta Health was the target of 135 new lobbying registrations this year, more than any other provincial ministry. Questions about the promised system restructuring have prompted associations of nurses, doctors and other health care workers to lobby the government as their members worry about job security, modernization of health care and the threat of privatization.
The provincial government first shared its plans to decentralize Alberta Health Services (AHS) in November 2023, saying that the restructuring would help ease pressures on a health care system that is already struggling to keep up.
Under the plan, the existing health authority will focus primarily on acute care, while other delivery functions in primary care, continuing care and mental health and addiction care will move to new divisions.
“We believe that by creating specialized organizations within one provincial system, we will enable each organization to look after one area of health care only and avoid the scattered and uncoordinated approach of the more rigid centralized structure that exists now,” said Alberta Premier Danielle Smith during the announcement to restructure AHS on Nov. 8, 2023.
Covenant Health, which is a Catholic health care provider that offers medical services at 17 sites in 12 communities across Alberta, will continue to offer its services in acute care, continuing care as well as mental health and addiction.
Since the announcement to dismantle AHS was made, hundreds of health care workers have been given transfer notices, informing them they will transition from being governed by Alberta Health Services to a newly incorporated agency called Primary Care Alberta.
Donna Wilson, a former nurse and health policy expert at the University of Alberta, said that while she doesn’t support privatization, she is in favour of splitting up AHS.
“AHS was a 20-year experiment to see if it could deliver health care in the province,” said Wilson in an interview. “What happened with AHS is they never controlled the cost of health care. The waitlists grew, the wait times grew and they didn’t modernize the health care system.”
However, Wilson, who ran for office with the Alberta Liberals in 2014, is worried dissolving AHS could pose job security issues for health care workers.
“What I’m really concerned about is the fact that in this shuffling around where you’ve got one health care system now essentially split into four agencies, it looks like they’re actually laying people off,” said Wilson.
Some of the groups trying to influence health policy this year included the Canadian Medical Association, which updated its lobbying registration 11 times this year, the Nurse Practitioner Association of Alberta and the Alberta Medical Association, among other groups.
Kathy Howe, the executive director of the Alberta Association of Nurses (AAN) which represents more than 40,000 nurses in the province, said nurses are feeling anxiety over the changes to the system.
“The big impact that we’re really hearing is just a real increase in stress,” said Howe in an interview. “There is anxiety around some of the changes. People are worried about what’s going to happen to them, whether they’re moving to a new organization or if they’re staring at AHS.”
Despite these anxieties, Howe said the impending change may give nurses the opportunity to work in other divisions that they may not have had a chance to previously.
But as time goes on, Howe said nurses are in doubt about whether the move will improve the system or just create more chaos and uncertainty.
The AAN is currently lobbying the government to create a provincial chief nursing officer to advise the province on priorities in the system. The association is also lobbying to establish a nursing workforce plan to ensure there are enough nurses trained and able to fill the demand.
“We need to get nurses and we need to get health care professionals having more input in these decisions and on the boards,” said Howe. “We’re not seeing nurses in those places. How can you really be making good decisions if those people aren’t involved?”
Insights into Alberta’s influencers
Consultant lobbyists looking to influence the government have to register within 10 days of undertaking to lobby. For organizational lobbyists, the time period to register is longer and registration is only required if they meet a minimum number of hours spent lobbying per year.
But unlike at the federal level, where lobbyists have to disclose phone, in-person or virtual meetings they pre-arrange with government officials, Alberta lobbying rules don’t require lobbyists to disclose any individual communications.
Companies or individuals filed 428 new lobbying registrations between Jan. 1 and Dec. 2, 2024.
Alberta Health narrowly inched out Alberta Jobs, Economy and Trade, and Finance for the title of most-targeted department, according to provincial data.
The premier’s office was targeted in more than half of all of the new registrations filed this year.
