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Alberta

Never again! Preston Manning review recommends Emergency Management Agency co-ordinate response to future province-wide public emergencies.

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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:

  1. 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.
  1. 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.
  1. 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.

Alberta

Alberta introducing dual practice health care model to increase options and shorten wait times while promising protection for publicly funded services

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Enhancing access through dual practice

If passed, Bill 11the Health Statutes Amendment Act, 2025 (No. 2), would modernize physician participation rules to give doctors flexibility to work in both the public system and private settings. Dual practice would allow physicians to continue providing insured services through the provincial health insurance plan while also delivering private services.

Alberta’s government has looked to proven models in other jurisdictions to guide the development of a model that strengthens access while safeguarding the public system. Dual practice exists in New Brunswick and Quebec and is widely used in countries with top-performing health systems, including Denmark, the Netherlands, United Kingdom, France, Germany, Spain and Australia.

“For years, governments across Canada have tried to fix long wait times by spending more money, yet the problem keeps getting worse. Alberta will not accept the status quo. Dual practice gives us a practical, proven tool that lets surgeons do more without asking taxpayers to pay more. It means shorter waits, better outcomes and a stronger health system for everyone.”

Danielle Smith, Premier

If passed, this dual practice model would be closely monitored to protect Alberta’s public health care system. The government, for example, would ensure that dual practice physicians maintain separate records for the services they provide, so no public funding subsidizes private services.

Bill 11 would include provisions to restrict participation, which could include:

  • Mandating that surgeons in dual practice must perform a dedicated number or ratio of surgeries in the public system to be eligible to perform surgeries privately.
  • Restricting specialties to public practice if shortages would compromise public care.
  • Potentially restricting private practice to evenings, weekends or to underutilized rural sites, as required.

Alberta’s government remains committed to its public health guarantee: No Albertan will ever have to pay out of pocket to see their family doctor or to get the medical treatment they need. These proposed changes comply with the Canada Health Act.

Alberta’s government is also committed to getting Alberta’s dual practice model right and to taking a thoughtful approach to ensure the best path forward. At this time, family medicine providers will not be eligible to be flexible participants within this new model. The priority is to focus on making sure all Albertans have access to a primary care provider. Additionally, surgeries for life-threatening conditions such as cancer and emergency procedures will remain entirely publicly funded with no private option available.

“Albertans are waiting too long for the health care they need, so we are taking bold and decisive action to shorten wait times, increase access and give Albertans more choices over their own health care. At the same time, we will continue building a strong public health system where no one is denied access to the services they need because of an inability to pay.”

Adriana LaGrange, Minister of Primary and Preventative Health Services

If passed, Bill 11 would create new options for doctors and patients. It would expand Alberta’s health system to provide more care by allowing doctors to treat more patients. Each time a patient chooses to pay for care in a private clinic or a clinic operating on evenings and weekends, for example, resources would be freed up so another patient could receive publicly funded care. This proposed new model would also support physician attraction and retention.

“As dual practice enhances flexibility for Albertans, physicians and medical professionals, safeguards will be established and utilized to protect and grow hospital and public health system capacity.”

Matt Jones, Minister of Hospital and Surgical Health Services

“Albertans deserve choice and timely access to safe care, whether in a private or public setting. With the creation of the dual practice model, we can extend treatment options to patients while helping hospitals focus their resources on the highest-acuity patients.”

Dr. Brett Habijanac, doctor of medicine in dentistry and fellow of the Royal College of Dentists of Canada

“I believe all options to improve access to health care for Albertans should be on the table. Therefore, the government’s dual practice legislation is a welcome option. Appropriate guardrails must be in place to ensure the spirit of the Canada Health Act is maintained.”

Dr. Emmanuel Gye, family physician

Quick facts

  • Physicians would continue to bill the provincial plan for public services and may offer private services separately.
  • Physicians may still choose to work entirely in public or entirely in private settings.

 

Proposed legislation would modernize physician rules, drug coverage, food safety and health cards while improving oversight and administration in Alberta’s health system.

If passed, Bill 11, the Health Statutes Amendment Act, 2025 (No. 2), would amend several pieces of legislation to reflect Alberta’s evolving health needs, strengthen the ability of health care professionals to deliver care and improve accountability and efficiency across the system.

“This legislation represents a new era for health care in Alberta. By putting patients first and supporting providers, we are improving transparency, flexibility and access. With modernized physician rules, stronger drug coverage, enhanced food safety and better health information sharing, Albertans will have world-class care.”

Adriana LaGrange, Minister of Primary and Preventative Health Services

Protecting drug coverage for Albertans

If passed, amendments would improve coordination between public and private drug plans, ensuring taxpayer-funded programs are used efficiently and remain available for those who need them most.

Private plans would become the first payer for individuals who have them, with public programs acting as a safety net. The legislation would also protect older Albertans by ensuring employers cannot reduce or terminate health benefits for employees aged 65 and older who remain actively employed.

“People shouldn’t be punished for getting older – it’s that straightforward. With this legislation, we’re protecting Albertans by ensuring employers can no longer kick folks off their health benefits when they need them most.”

Jason Nixon, Minister of Assisted Living and Social Services

Ensuring consistent billing and remuneration practices

Alberta’s government is also proposing amendments to the Alberta Health Care Insurance Act to ensure health care providers and clinics are not engaging in improper billing practices and making inappropriate claims. The proposed amendments would strengthen accountability and transparency while generating cost savings by introducing penalties for systemic non-compliance.

Strengthening food safety in Alberta

If passed, amendments to the Public Health Act and related regulations would strengthen food safety across all establishments by improving training for staff, increasing transparency of inspection results and giving inspectors new tools for oversight and investigation.

The changes would also update the Food Regulation, Food Retail and Food Services Code, Institutions Regulation and create a new Public Health Investigator Regulation, ensuring consistent standards, better reporting and increased public confidence in Alberta’s food safety system.

“Enhancing food safety in Alberta is an important step to making sure Albertans have the safeguards and protections in place to keep them healthy and well. If passed, these amendments to the Public Health Act will ensure food establishments are following best practices and that enforcement measures are in place to support proper food safety.”

Dr. Sunil Sookram, interim chief medical officer of health

Improving health cards and information sharing

If passed, the legislation would create a new process for health card renewal, prevent card misuse and allow cards to be seized or suspended if tampered with. The changes would also permit information sharing with the ministries of Technology and Innovation and Service Alberta and Red Tape Reduction to support continued efforts to modernize health cards.

Amendments to the Health Information Act would support a more integrated health care system and seamless patient experience to help improve care for Albertans who are accessing the system.

It would also add new authority to enable health foundations to better connect with patients to support innovation and advancement of care in their community in an appropriate manner, in accordance with the requirements set out in regulations.

“Albertans generously support enhancements to health care delivery, innovation and research in their communities each year. We look forward to working with our health partners across the continuum to better communicate with grateful patients. With these changes, we will join other Canadian jurisdictions in connecting patients with health foundations in their community while ensuring the strongest protection of Albertans’ private health data.”

Sharlene Rutherford, president and CEO, Royal Alexandra Hospital Foundation

Advancing a new era of health care

If passed, proposed amendments to the Alberta Health Care Insurance Act and the Provincial Health Agencies Act would support operational changes to implement previously announced objectives like transitioning Alberta Health Services to a hospital-based acute care service provider.

The proposed amendments would also result in the repealing of the Hospitals Act, as all hospital governance and operational provisions would be moved into the Provincial Health Agencies Act.

New dual practice model to increase access and choice

The Health Statutes Amendment Act, 2025 (No. 2) includes proposed amendments to the Alberta Health Care Insurance Act that would modernize how physicians participate in Alberta’s publicly funded health insurance plan. The changes would introduce a new dual practice model, giving physicians greater flexibility to provide care in both public and private settings while maintaining safeguards to ensure Albertans continue to have access to publicly funded health services.

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Alberta

Premier Smith explains how private clinics will be introduced in Alberta

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Premier Smith and Hospitals and Surgical Health Services Minister Matt Jones laid out Alberta’s new dual practice model for surgeons. This change will let doctors perform more surgeries, cut wait times, keep talent in Alberta, and move patients through the system faster, all while protecting publicly funded care.

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