Addressing Alberta’s health care challenges

As the dust settles from this weeks’ election, the newly formed Notley government must now decide how to begin addressing the challenges facing our health care system. A critical starting point would be assessing how seniors’ health care is delivered in this province.  In many ways, we are ignoring the demands of our elderly citizens, as well as their caregivers. Our new government would do well to start their health care policy work by developing a comprehensive seniors’ health care strategy.

Calls for a seniors’ strategy from both health care providers and the public are not new. The Canadian Medical Association (CMA) has been actively advocating for the federal government to develop such a national strategy. In 2014, a poll commissioned by the CMA showed that 95% of Canadians over the age of 45 identified the need for a national strategy for seniors’ health care. Despite this overwhelming public support, the recent federal budget failed to address this issue. In the absence of federal leadership, Alberta has the opportunity to lead the way in developing a strong, provincial plan for providing quality care to our seniors.

While seniors’ care would improve the quality of care for seniors, the positive impacts of this policy extend well beyond individual care. In our current system many people, most of whom are seniors, remain in the hospital despite being medically stable, as there are not enough supports in the community for them to go home. As a result, our hospitals often find themselves in a “gridlock” situation, where acutely ill patients have to compete for beds with chronically ill individuals who would be better served in a home or community setting for a fraction of the cost.  This results in health care that is more expensive, and does not meet the needs of these patients.

The CMA estimates that, nationwide, we could save $2.3 billion a year if we invested more in continuing and community care.  According to the Canadian Institute for Health Information (CIHI), Alberta spends 33% more than the national average on acute care and 19% less than the national average on continuing care. Clearly, we can and must improve our access to care in the community for seniors.

By not investing more in publicly-funded home and community care services for seniors, the Alberta government has historically been “offloading” the responsibilities and costs of care onto unpaid caregivers – friends and family members. A 2013 report by the Parkland Institute shows that, with seniors increasingly being admitted to assisted living facilities instead of long-term care, families have had to shoulder more of the financial burden for medications, aids and therapy. This can also result in significant inequalities in access to high quality home care due to income.

The good news is that we are a province of innovators who don’t shy away from a challenge. Innovations by Albertan health care providers have already improved the quality and timeliness of services in other parts of our health care system. Perhaps most famously, the Alberta Bone and Joint Institute dropped wait times for assessments to 21 working days from 145. They achieved this by introducing a centralized booking system. ABJI also began using physicians rather than surgeons to assess patients. As a result, 80% of consultations ended in more appropriate, less invasive, non-surgical treatments. By pointing the majority of patients to more appropriate, non-surgical treatments, the wait times for the 20% of patients who did need surgery was reduced from 290 working days to just 37. When we consider the daunting task of developing a seniors’ care strategy, it’s worth remembering that members of our medical community have innovated solutions to other seemingly insurmountable challenges in our system and succeeded. We can do the same for seniors’ care.

Currently, 78% of older Canadians are concerned that they will not have access to high quality home and long term care in their retirement years. As a physician, I share these concerns. Canada needs a clear strategy to ensure that all of our senior citizens, regardless of income, receive high quality health care. With all eyes on Alberta following this week’s election, this is a great time to lead the way on developing long overdue seniors’ care strategies.