Alberta
Canadians owe a debt to Premier Danielle Smith
From the Frontier Centre for Public Policy
In recent days, Premier Smith has endured criticism from many people about her recent announcements relating to treatments for what is often described as gender transition.
Instead, she deserves praise for decisions that are as important for how they were made as for the gender transition issues that concern her and her colleagues. Her actions on this matter demonstrate how public policy should be developed and explained.
The most important quality of the recent policy announcements by the Alberta government is that they are evidence based.
There is an emerging consensus outside Canada that the evidence supporting pharmacological and surgical procedures to change genders in minors is either very weak or nonexistent.
Sweden, Finland, the UK and Norway have restricted or forbidden the use of these treatments on minors, as have twenty-three American states. Ms. Smith referred to these in her press conference announcing the changes her government is making.
Leaders in other countries have done this after conducting detailed studies including one by the UK High Court of Justice and another by Dr. Hilary Cass, a former President of the Royal College of Pediatrics and Child Health in the United Kingdom
Dr. Cass is an independent expert commissioned to provide advice to the National Health Service on gender treatments. She concluded that “evidence on the appropriate management of children with gender incongruence is inconclusive both nationally and internationally’’.
The second reason the decisions taken by Alberta are important is that they were taken despite ideology advocated by the Government of Canada and the unwillingness of federal officials including the Prime Minster to support their opposition to the Alberta policies with any evidence.
In his initial comments, the Prime Minister made no reference to any of the many studies that have been done describing the dangers of pharmacological and surgical procedures to change the gender of minor children.
He also displayed no understanding of the experiences of other countries on this matter. He did not refer to the Cass report and its seminal conclusions.
The comments by Federal Health Minister Mark Holland lacked any evidence the public could use. He also used offensive rhetoric.
Mr. Holland described the Alberta decisions as being behaviour that is “extremely dangerous to engage in …. which is, I think, playing politics about children’s lives.” He also referred to the “devastation that its going to bring”, referring to the Alberta changes.
Federal communications marked by a factual vacuum and excessive language are not going to help resolve serious differences of opinion on serious issues. They are also not condusive to good relations between the federal government and an important province.
The third and particularly significant reason the recent changes announced by the Alberta government are so important is that they will protect children.
Adolescence, a phase of child development that has been with us for thousands of years, is an important part of everyone’s life.
It is a vital part of what it means to be human. Delaying or blocking it is dangerous, something that many observers have noted but that the Prime Minister and the Minister of Health do not recognize.
Federal leaders need to inform themselves, particularly about the negative impact of puberty blockers on bone and brain development and the lifelong medical attention many transitioners will need because of the pharmacological and surgical procedures used on them to change genders.
The Prime Minister and the Minister of Health should also learn about the increasingly large number of transitioners who regret their transition and later seek to reverse it. Their situation is particularly tragic because many of the negative consequences of changing genders in children cannot be reversed.
Federal leaders also support hiding from parents the decisions children make in schools about the pronouns they use to describe their genders. This is another practice that many feel is harmful and divisive.
The federal perspective on this is unreasonable.
Our species survived over the centuries because the first priority for most parents is their children and most take good care of them.
There is no basis for a lack of trust in them and in the relatively few cases where parents do not provide appropriate care, the child protection laws come into play.
It is particularly important that federal leaders recognize the grave problems that puberty blockers and related surgeries often pose for children who are gays or lesbians.
These children sometimes display some of the attributes of the opposite sex as they grow, and these are often misinterpreted as gender dysphoria. They then get treated for a problem they don’t have, with serious lifelong consequences.
Unfortunately, this happens in many Canadian pediatric hospitals.
There is nothing wrong with these children. They should be allowed to develop and grow in their own way and be who they are. That means no puberty blockers or surgeries to change them.
The fourth reason to respect the new directions on gender issues Ms. Smith and her colleagues have decided upon is the moderation displayed by the Alberta government in putting them forward and communicating with the public about them.
The language used has been understated. The changes are lawful in every respect including in relation to the Charter of Rights and Freedom and other legislation.
The evidence has been clearly presented in a way most citizens can readily understand and great care has been taken to deal with those who may have concerns thoughtfully, including allowing time for debate and discussion before the changes are made.
This is a good example of how governments should behave. Federal leaders should show some respect for the approaches taken by Ms. Smith and her colleagues as they dealt with a very complex issue.
The final reason for the importance of the Alberta approach is that it has avoided many of the problems associated with medical practice standards and regulation that are so evident in Canada and which have been a major cause of the difficulties our country faces on gender issues.
Provincial Colleges of Physicians and Surgeons and many regulators elsewhere regulate doctors based largely on prevailing practices by physicians rather than clinical outcomes.
This means that there have been many cases over the years, in Canada and elsewhere, where evidence to support medical procedures has been lacking. Current practices toward gender dysphoria in Canada and some US states are examples.
In these cases, if something is done often enough by enough doctors, that procedure becomes the standard and not clinical outcomes. This often leads to perverse outcomes that everyone ultimately regrets.
In the years to come, unless we change course soon and unless others follow the Alberta path, people will be wondering how the problems summarized in this article developed and why we damaged so many children by an approach defined more by ideology than factual reality.
David MacKinnon is a Senior Fellow at the Frontier Centre for Public Policy
Alberta
Alberta health care blockbuster: Province eliminating AHS Health Zones in favour of local decision-making!
Hospital Based Leadership: Eliminating the bureaucratic vortex in hospitals
Since Alberta’s government announced plans to refocus the health care system in November 2023, a consistent message has emerged from patients, front-line health care workers and concerned Albertans alike about the flaws of the prior system. Alberta Health Services’ current zone-based leadership structure is overly complex and bureaucratic. It lacks the flexibility and responsiveness needed to effectively support facilities and staff – particularly when it comes to hiring, securing supplies and adopting necessary technologies.
That’s why Alberta’s government is changing to a hospital-based leadership structure. On-site leadership teams will be responsible for hiring staff, managing resources and solving problems to effectively serve their patients and communities. Hospitals will now have the flexibility to respond, freedom to adapt and authority to act, so they can meet the needs of their facilities, patients and workforce in real time.
“What works in Calgary or Edmonton isn’t always what works in Camrose or Peace River. That’s why we’re cutting through bureaucracy and putting real decision-making power back in the hands of local hospital leaders, so they can act fast, hire who they need and deliver better care for their communities.”
“Hospital-based leadership ensures decisions on hiring, supplies and services are made efficiently by those closest to care – strengthening acute care, supporting staff and helping patients get the timely, high-quality care they need and deserve.”
“By rethinking how decisions are made, we’re working to improve health care through a more balanced and practical approach. By removing delays and empowering our on-site leaders, we’re giving facilities the tools to respond to real-time needs and ultimately provide better care to Albertans.”
AHS’ health zones will be eliminated, and acute care sites will be integrated into the seven regional corridors. These sites will operate under a new leadership model that emphasizes site-level performance management. Clear expectations will be set by Acute Care Alberta, and site operations will be managed by AHS through a hospital-based management framework. All acute care sites will be required to report to Acute Care Alberta based on these defined performance standards.
“Standing up Acute Care Alberta has allowed AHS to shift its focus to hospital-based services. This change will enable the local leadership teams at those hospitals to make site-based decisions in real and tangible ways that are best for their patients, families and staff. Acute Care Alberta will provide oversight and monitor site-level performance, and I’m confident overall hospital performance will improve when hospital leadership and staff have more authority to do what they know is best.”
“AHS is focused on reducing wait times and improving care for patients. By shifting to hospital-based leadership, we’re empowering hospital leaders to make real-time decisions based on what’s happening on the ground and respond to patient needs as they arise. It also means leaders can address issues we know have been frustrating, like hiring staff where they’re needed most and advancing hospital operations. This change enables front-line teams to act on ideas they see every day to improve care.”
The Ministry of Hospital and Surgical Health Services, Acute Care Alberta and Alberta Health Services will work collaboratively to design and establish the new leadership and management model with an interim model to be established by November 2025, followed by full implementation by summer 2026.
Quick facts
- Countries like the Netherlands and Norway, and parts of Australia have already made the shift to hospital-based leadership.
- The interim hospital-based leadership model will be implemented at one site before being implemented provincewide.
- Hospital-based leadership, once implemented, will apply only to AHS acute care facilities. Other acute care organizations will not be affected at the time of implementation.
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Alberta
Alberta is investing up to $50 million into new technologies to help reduce oil sands mine water
Technology transforming tailings ponds
Alberta’s oil sands produce some of the most responsible energy in the world and have drastically reduced the amount of fresh water used per barrel. Yet, for decades, operators have been forced to store most of the water they use on site, leading to billions of litres now contained largely in tailings ponds.
Alberta is investing $50 million from the industry-funded TIER system to help develop new and improved technologies that make cleaning up oil sands mine water safer and more effective. Led by Emissions Reduction Alberta, the new Tailings Technology Challenge will help speed up work to safely reclaim the water in oil sands tailing ponds and eventually return the land for use by future generations.
“Alberta’s government is taking action by funding technologies that make treating oil sands water faster, effective and affordable. We look forward to seeing the innovative solutions that come out of this funding challenge, and once again demonstrate Alberta’s global reputation for sustainable energy development and environmental stewardship.”
“Tailings and mine water management remain among the most significant challenges facing Alberta’s energy sector. Through this challenge, we’re demonstrating our commitment to funding solutions that make water treatment and tailings remediation more affordable, scalable and effective.”
As in other mines, the oil sands processing creates leftover water called tailings that need to be properly managed. Recently, Alberta’s Oil Sands Mine Water Steering Committee brought together industry, academics and Indigenous leaders to identify the best path forward to safely address mine water and reclaim land.
This new funding competition will support both new and improved technologies to help oil sands companies minimize freshwater use, promote responsible ways to manage mine water and reclaim mine sites. Using technology for better on-site treatment will help improve safety, reduce future clean up costs and environmental risks, and speed up the process of safely addressing mine water and restoring sites so they are ready for future use.
“Innovation has always played an instrumental role in the oil sands and continues to be an area of focus. Oil sands companies are collaborating and investing to advance environmental technologies, including many focused on mine water and tailings management. We’re excited to see this initiative, as announced today, seeking to explore technology development in an area that’s important to all Albertans.”
Quick facts
- All mines produce tailings. In the oil sands, tailings describe a mixture of water, sand, clay and residual bitumen that are the byproduct of the oil extraction process.
- From 2013 to 2023, oil sands mine operations reduced the amount of fresh water used per barrel by 28 per cent. Recycled water use increased by 51 per cent over that same period.
- The Tailings Technology Challenge is open to oil sands operators and technology providers until Sept. 24.
- The Tailings Technology Challenge will invest in scale-up, pilot, demonstration and first-of-kind commercial technologies and solutions to reduce and manage fluid tailings and the treatment of oil sands mine water.
- Eligible technologies include both engineered and natural solutions that treat tailings to improve water quality and mine process water.
- Successful applicants can receive up to $15 million per project, with a minimum funding request of $1 million.
- Oil sands operators are responsible for site management and reclamation, while ongoing research continues to inform and refine best practices to support effective policy and regulatory outcomes.
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