Health-care staff are now being shifted from Alberta Health Services to the provincial health department as the province forges ahead with its controversial and sweeping restructuring plans.
The Alberta government announced its intention late last year to hive off health-care provision into four key organizations, and reduce AHS to the role of a hospital care provider.
So far, 126 AHS staff have been terminated but have been presented with “equivalent” job offers within Alberta Health, according to the province.
A government spokesperson has confirmed the impacted staff are from the departments of capital planning, system planning, continuing care and procurement.
The press secretary to Health Minister Adriana LaGrange said most of them have taken the offers and have begun their Government of Alberta jobs.
“It’s very unsettling,” said Sandra Azocar, vice-president with the Alberta Union of Provincial Employees (AUPE).
“What we have been seeing is memos sent to front-line workers telling them that they have a couple of weeks to make a decision whether or not to stay with the government or take the layoff and recall. And so not very much … consultation is actually happening.”
According to Azocar, the union is aware so far of 39 affected members, most of them general support staff working in administrative roles.
‘Self-inflicted wounds’
A former AHS executive is worried the upheaval is leading to more anxiety among health-care staff at a time when the health system is already under intense pressure. He believes it will further disrupt Alberta’s ability to recruit and retain much needed workers — ranging from front-line staff and support workers to higher level decision-makers.
“We’re experiencing a lot of self-inflicted wounds right now and we don’t need to be experiencing those self-inflicted wounds,” said Dr. Braden Manns, a former interim vice-president of provincial clinical programs at AHS.
Manns said impacted staff have been reaching out to him, given his previous AHS role. Some of them have decided not to take the new job offers, he said.
“People were concerned that their contracts were terminated and that the contract they were being offered was not as competitive as the contract that they had with Alberta Health Services,” said Manns, a kidney specialist and professor of health economics in the department of medicine at the University of Calgary.
“These are the poorly thought through consequences that are going to happen if you move from one organization to another.”
Pay reduction, union claims
Azocar is also worried about compensation.
The transition, she said, amounts to pay cuts for AUPE members, due in part to shorter work days within the Alberta government.
“They stand to lose over 200 hours of pay a year. A lot of them are going to be red circled, which means they’re going to be left in a situation where they don’t get any wage increases unless they’re negotiated,” she said.
According to Azocar, staff could eventually have their salaries reduced through that process.
“When you don’t know if you’re going to show up at work and you you’re told in a month or so you’re going to be somewhere else with a completely different pay scale, with a different contract or whatever, it just doesn’t make it worth your while,” she said.
“Why would they stay working for an employer that basically doesn’t value the work that they do?”
The Alberta government didn’t respond to those specific claims about pay.
Background information provided in an email to CBC News indicates the transitioning staff are given comparable benefits and wherever possible staff are subject to similar terms and conditions. CBC News asked for further clarification but did not hear back prior to publication.
“We are at a critical time when it comes to health care in Alberta,” press secretary Andrea Smith said in a statement.
“Albertans need and deserve a system that works for them, which prioritizes their needs, whether it’s finding a primary care provider, getting urgent care without long waits or getting access to the best continuing care options and supports — and the sooner the better,” the press secretary said.
Centralization concerns
But Manns has his doubts about the restructuring. Health-care delivery, he contends, is typically handled outside of the health ministry.
“Frankly, I don’t think governments know a lot about health care,” he said.
This first round of job shakeups, Manns said, is pulling key staff away from the front lines and up into the government.
“The supports for health-care delivery need to be as close … to the front line as possible,” said Manns.
“The local managers need to understand what’s happening to the number of people they’re looking after. Are there changes to the type of people they’re looking after? They need to plan services for next year. They also need to plan services for five years down the road. So they need those supports at the local level, not at the centralized level of Alberta Health.”
Manns said that despite the political rhetoric, AHS is not bloated with administrators compared with other provinces.
It’s unclear just how many staff will be moved, and how they’ll be divided up, as the province splits health care into the four silos: primary care, acute care, continuing care and mental health and addiction.
Manns believes this is just the beginning of a wave of upheaval to come. And he’s not aware of any evidence these overarching structural changes will actually improve health care for Albertans.
“No other health system has taken this four-sector approach,” said Manns.
“Health-care systems that have great outcomes and lower costs are highly integrated. Splitting a health system up into four sectors does not sound, to me, like a recipe for improving integration.”