Alberta
Never again! Preston Manning review recommends Emergency Management Agency co-ordinate response to future province-wide public emergencies.
Emergency Review Panel Releases Final COVID-19 Report and Recommendations for the Alberta Government
The Public Health Emergencies Governance Review Panel, led by Preston Manning, delivered its final report to the Government of Alberta, which includes over 90 recommendations for consideration.
The Panel was tasked by Premier Danielle Smith with undertaking a detailed review of the legislation and governance employed during the COVID-19 crisis, and to recommend changes and additional legislation to better prepare the province to meet future public emergencies. The mandate of the Panel was not to conduct an overall inquiry into the government’s response to COVID-19, but strictly to review the statutes that provided the legal basis for the government’s response to COVID-19.
Drawing upon the expertise and research of advisors and contractors commissioned for the study, the Panel arrived at a series of conclusions and recommendations for the Alberta Government to consider.
The recommendations of the Panel fall into three main categories, and included:
- Improving the focus and performance of the administrative and regulatory framework used to respond to provincewide public emergencies, including:
- Strengthen the Alberta Emergency Management Agency (AEMA) through legislative amendments and budgetary provisions to make it the lead government agency responding to and coordinating the response of the Alberta government to future provincewide public emergencies, including health emergencies.
- Develop and maintain a broadly-based Inventory of Scientific Advice and Scientific Advisors that can be drawn upon in the event of a public emergency.
- Mandate by legislation that preliminary, interim and post-emergency impact assessments be conducted in response to any future provincewide public emergencies.
- Reject provincewide school closures as a policy option in responding to a provincewide public emergency, except in the most exceptional of circumstances, and then only for the shortest possible period of time.
- Balancing the protection of Albertans from the harms caused by public emergencies with the protection of their basic rights and freedoms during an emergency period, including:
- Amend the Alberta Bill of Rights and Alberta’s Employment Standards Code and Health Professions Act to protect the rights and freedoms of all Albertans, including workers and healthcare professionals, and the freedom of expression during public emergencies.
- Increasing the overall capacity of Alberta’s healthcare system to respond to surges in demand caused by a public health emergency. Here, the Panel recognized that the government has already taken numerous incremental steps to increase the overall capacity of the healthcare system. The Panel commends those initiatives and recommends additional incremental steps, all compatible with the principles of universality and the Canada Health Act, including:
- Expanding the use of nurse practitioners and licensed practical nurses.
- Reducing or eliminating barriers to labour mobility for healthcare workers.
- Exploring options for attracting more healthcare providers into medical training
- Incentivizing medical graduates to serve in the most needed areas.
- Utilizing pharmacists to their full scope of practice.
- Expanding and improving the organization of home care services.
- Expanding the capacity of the Alberta healthcare system to deal with mental health.
- Expanding and supporting the use of virtual medicine and telemedicine.
- Streamlining system administration.
The panelists include Michel Kelly-Gagnon (President Emeritus of the Montréal Economic Institute), The Honourable John C. (Jack) Major CC KC (Former Supreme Court of Canada Justice), Preston Manning, PC CC AOE (former MP for Calgary Southwest and Leader of the Opposition in the House of Commons), Dr. Jack Mintz (president’s fellow of the School of Public Policy at the University of Calgary and a distinguished senior fellow of the MacDonald-Laurier Institute), Dr. Martha Fulford (Infectious Disease Specialist and Retired Chief of Medicine, McMaster University), and Dr. Robert Tanguay, Psychiatrist and Clinical Assistant Professor of Psychiatry and Surgery at the Cumming School of Medicine).
Quotes
“The COVID-19 pandemic and resulting global turmoil was unprecedented. Alberta, like the rest of the world, had to make decisions quickly and with limited, changing and even conflicting information. It is my hope that by adopting these recommendations, the Government will be better equipped to cope with future emergencies, and that the impacts on Albertans – their personal livelihoods, civil liberties, and mental health can be mitigated to the greatest extent possible.” – Preston Manning, Chair
“For the credibility of the study and our final recommendations, I felt it was important to select panelists and advisors with varied areas of expertise and perspectives on the key issues. For that reason, while there were certainly differences of opinion, I am thrilled that we were ultimately able to arrive at a consensus on the recommendations put forward.” – Preston Manning, Chair
Read the full report here.
Most Important Conclusions/Recommendation Per Chapter
- Strengthen, through legislative amendments and budgetary provisions, the Alberta Emergency Management Agency (AEMA) – whose members are specifically trained in emergency management – to make it the lead government agency for co-ordinating the response of the Alberta government to any and all future provincewide public emergencies. (Chapter 2)
- Appoint a Senior Science Officer, with multidisciplinary training and experience, to the AEMA, responsible for developing and maintaining a broadly based Inventory of Scientific Advice and Scientific Advisors that can be drawn upon in the event of public emergencies. (Chapter 3)
- Increase the effectiveness and accountability of the Alberta regulatory framework by increasing its evidence- based decision-making capacity, transparency, consistency, fairness, and self-correctability via feedback. (Chapter 4)
- Reject provincewide school closures as a policy option in responding to a provincewide public emergency, except in the most exceptional of circumstances and only then for the shortest possible period of time. (Chapter 5)
- Mandate by legislation the conduct of impact assessments prior to, during and after promulgation of orders and regulations for adoption in response to a declared provincewide public emergency. (Chapter 6)
- Recognize that public emergencies generate additional and exceptional pressures on governments to limit the exercise of rights and freedoms, and thus amend theAlberta Bill of Rights to specifically strengthen the protection of rights and freedoms under such circumstances. (Chapter 7)
- Increase the protection of the rights and freedoms of workers and healthcare professionals, during public emergencies, in particular their freedom of expression, through amendments to Alberta’s Employment Standards Code and Health Professions Act. (Chapter 8)
- Increase the overall capacity of the Alberta healthcare system, thereby increasing its capacity to meet surges in demand caused by public health emergencies, through the incremental measures proposed, while respecting the principle of universality and the provisions of the Canada Health Act. (Chapter 9)
- On the belief that Alberta can always learn from others, invite representatives from countries having healthcare systems that outperform Canada/Alberta to a Colloquium on 21st Century Healthcare Best Practices to identify the policies, legislation and features of their systems responsible for superior performance. (Chapter 9)
- The recommendations of this report are based on the general consensus of Panel members as to how best to prepare Alberta to cope with future public emergencies. But “preparing for future public emergencies” is an evolving process, subject to unforeseen factors and considerations. Therefore, alternative perspectives and narratives on how to best cope with future emergencies should also be welcomed, appreciated and examined.
Setting the foundation for a refocused health system
Proposed legislation would support the refocusing of Alberta’s health care system to ensure Albertans get the care they need when and where they need it.
On Nov. 8, 2023, Alberta’s government announced plans for a refocused health care system to ensure patients are receiving the care they need, when and where they need it. To achieve this, Alberta’s government will be creating four new organizations, one for each priority health services sector: acute care, primary care, continuing care and mental health and addiction.
If passed, the Health Statutes Amendment Act would enable the government to take the necessary next steps to refocus the province’s health care system. The legislation would ensure Albertans have a system that works for them by prioritizing their need to find a primary care provider, receive urgent care without long waits, have access to the best continuing care options and obtain excellent mental health and addiction treatment.
“We are taking another step toward improving health care by updating legislation and enabling the governance and oversight required to refocus the health system. The critical improvements to transparency and accountability will help support the successful refocusing of the health care system to one that is responsive, effective and reflects the needs and priorities of Albertans today and for future generations.”
The Health Statutes Amendment Act will enable the transition from one regional health authority, Alberta Health Services, to an integrated system of four sector-based provincial health agencies including primary care, acute care, continuing care and mental health and addiction. The agencies will be responsible for delivering integrated health services, ensuring Albertans receive timely access to care, regardless of where they live.
The Health Statutes Amendment Act establishes roles for an oversight minister and sector minister. The Minister of Health will take on the role of oversight minister, responsible for setting the strategic direction of the overall health system. A sector minister will be responsible for a specific health services sector. For example, the sector minister for Recovery Alberta is the Minister of Mental Health and Addiction. On the recommendation of the oversight minister, additional health service sectors may be established and designate a minister responsible for that newly created sector.
Enhanced government oversight will help Alberta’s government to better direct resources to the front lines where they are needed the most, improve patient care overall and support health care professionals.
“Mental health and addiction have been growing issues within our society and need to be prioritized within our health care system. Amid an addiction crisis, a refocused health system will allow for mental health and addiction services to get the attention, oversight and focus they need. Recovery Alberta would allow for improved mental health and addiction care across the province as an important part of an integrated health system.”
“Refocusing Alberta’s healthcare system is a crucial step towards ensuring that we can deliver a framework that prioritizes accessibility, accountability, and patient-centered care. By streamlining operations, improving oversight and fostering collaboration, we are setting a strong foundation for a healthcare system that is better equipped to address the diverse needs of each of our communities.”
The legislation will enable the minister of health to transfer employees or classes of employees from AHS to the new sector-based organizations, once established. During the transition period, AHS will be enabled to continue operating as a regional health authority. Employee transfers will be seamless, maintaining existing bargaining relationships and collective agreements. This will ensure stability for the workforce, unions and government as the health system refocus is implemented. There will be no job losses for staff who transition into the new organizations.
Amendments to be made to existing legislation
The Health Statutes Amendment Act includes amendments to the Regional Health Authorities Act and the Health Information Act, which have not been updated since the 1990s.
As part of these amendments, the name of the Regional Health Authorities Act will change to the Provincial Health Agencies Act. The amended Provincial Health Agencies Act will remove outdated references to allow the transition from a single regional health authority to a unified, sector-specific provincial health system. This will clarify the scope and accountabilities of provincial health agencies and health service providers going forward.
The amendments will also place responsibility on the provincial health agencies for operational planning and oversight of clinical service delivery across the province. This will enable provincial health agencies to set priorities in the provision of health service delivery. The agencies will also be tasked with sharing information and collaborating closely to support seamless patient care as the transition to the refocused health care system takes place.
Alberta’s government is committed to ensuring that patient information continues to remain safe and secure through this transition. Amendments to the Health Information Act will be introduced to support the new health system refocus and to support the establishment of the Canadian Centre of Recovery Excellence. These amendments will allow the Ministry of Health, the Ministry of Mental Health and Addiction, the four new provincial health agencies, the Health Quality Council of Alberta and Canadian Centre of Recovery Excellence to have the authority to use health information for health system purposes.
If passed, the Health Statutes Amendment Act will enable Recovery Alberta, the mental health and addiction provincial health agency, to begin operating in the summer of 2024. The primary care, acute care and continuing care provincial health agencies are expected to be established in the fall.
Quick facts
- Consequential amendments are changes made to existing legislation due to new legislation being passed. These amendments are necessary to ensure legislative alignment with the proposed amendments to the Regional Health Authorities Act.
- To support the Regional Health Authorities Act amendments and ensure alignment, 43 other acts are being consequentially amended – for example, to replace references to “regional health authority” with “provincial health agency” where necessary.
- AHS will remain a key provider of health services, and in fall 2024 will transition to focusing on the provision of acute care services.
- Alberta’s government introduced the Canadian Centre of Recovery Excellence Act which, if passed, will establish the Canadian Centre of Recovery Excellence (CoRE) as a public agency that would support the Government of Alberta, including Mental Health and Addiction, and Recovery Alberta in advancing the Alberta Recovery Model.
Related information
- Establishing the future of Alberta health care
- Refocusing health care in Alberta
- Recovery Alberta
- Canadian Centre of Recovery Excellence
- Bill 22: Health Statutes Amendment Act, 2024
Related news
- Refocusing on patient-centred care (Nov. 8, 2023)
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