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Alberta

Province announces next step to revamped health care system

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9 minute read

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.”

Adriana LaGrange, Minister of Health

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.”

Dan Williams, Minister of Mental Health and Addiction

“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.”

Jason Nixon, Minister of Seniors, Community and Social Services

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.

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Alberta

Alberta extracting more value from oil and gas resources: ATB

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From the Canadian Energy Centre

By Will Gibson

Investment in ‘value-added’ projects more than doubled to $4 billion in 2024

In the 1930s, economist Harold Innis coined the term “hewers of wood and drawers of water” to describe Canada’s reliance on harvesting natural resources and exporting them elsewhere to be refined into consumer products.

Almost a century later, ATB Financial chief economist Mark Parsons has highlighted a marked shift in that trend in Alberta’s energy industry, with more and more projects that upgrade raw hydrocarbons into finished products.

ATB estimates that investment in projects that generate so-called “value-added” products like refined petroleum, hydrogen, petrochemicals and biofuels more than doubled to reach $4 billion in 2024.

Alberta is extracting more value from its natural resources,” Parsons said.

“It makes the provincial economy somewhat more resilient to boom and bust energy price cycles. It creates more construction and operating jobs in Alberta. It also provides a local market for Alberta’s energy and agriculture feedstock.”

The shift has occurred as Alberta’s economy adjusts to lower levels of investment in oil and gas extraction.

While overall “upstream” capital spending has been rising since 2022 — and oil production has never been higher — investment last year of about $35 billion is still dramatically less than the $63 billion spent in 2014.

Parsons pointed to Dow’s $11 billion Path2Zero project as the largest value-added project moving ahead in Alberta.

​​The project, which has support from the municipal, provincial and federal governments, will increase Dow’s production of polyethylene, the world’s most widely used plastic.

By capturing and storing carbon dioxide emissions and generating hydrogen on-site, the complex will be the world’s first ethylene cracker with net zero emissions from operations.

Other major value-added examples include Air Products’ $1.6 billion net zero hydrogen complex, and the associated $720 million renewable diesel facility owned by Imperial Oil. Both projects are slated for startup this year.

Parsons sees the shift to higher value products as positive for the province and Canada moving forward.

“Downstream energy industries tend to have relatively high levels of labour productivity and wages,” he said.

“A big part of Canada’s productivity problem is lagging business investment. These downstream investments, which build off existing resource strengths, provide one pathway to improving the country’s productivity performance.”

Heather Exner-Pirot, the Macdonald-Laurier Institute’s director of energy, natural resources and environment, sees opportunities for Canada to attract additional investment in this area.

“We are able to benefit from the mistakes of other regions. In Germany, their business model for creating value-added products such as petrochemicals relies on cheap feedstock and power, and they’ve lost that due to a combination of geopolitics and policy decisions,” she said.

“Canada and Alberta, in particular, have the opportunity to attract investment because they have stable and reliable feedstock with decades, if not centuries, of supply shielded from geopolitics.”

Exner-Pirot is also bullish about the increased market for low-carbon products.

“With our advantages, Canada should be doing more to attract companies and manufacturers that will produce more value-added products,” she said.

Like oil and gas extraction, value-added investments can help companies develop new technologies that can themselves be exported, said Shannon Joseph, chair of Energy for a Secure Future, an Ottawa-based coalition of Canadian business and community leaders.

“This investment creates new jobs and spinoffs because these plants require services and inputs. Investments such as Dow’s Path2Zero have a lot of multipliers. Success begets success,” Joseph said.

“Investment in innovation creates a foundation for long-term diversification of the economy.”

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Alberta

Alberta government must restrain spending in upcoming budget to avoid red ink

Published on

From the Fraser Institute

By Tegan Hill and Milagros Palacios

Whether due to U.S. tariffs or lower-than-expected oil prices, the Smith government has repeatedly warned Albertans that despite a $4.6 billion projected budget surplus in 2024/25, Alberta could soon be in the red. To help avoid this fate, the Smith government must restrain spending in its upcoming 2025 budget.

These are not simply numbers on a page; budget deficits have real consequences for Albertans. For one, deficits fuel debt accumulation. And just as Albertans must pay interest on their own mortgages or car loans, taxpayers must pay interest on government debt. Each dollar spent paying interest is a dollar diverted from programs such as health care and education, or potential tax relief. This fiscal year, provincial government debt interest costs will reach a projected $650 per Albertan.

And while many risk factors are out of the government’s direct control, the government can control its own spending.

In its 2023 budget, the Smith government committed to keep the rate of spending growth to below the rate of inflation and population growth. This was an important step forward after decades of successive governments substantially increasing spending during good times—when resource revenues (including oil and gas royalties) were relatively high (as they are today)—but failing to rein in spending when resource revenue inevitably declined.

But here’s the problem. Even if the Smith government sticks to this commitment, it may still fall into deficit. Why? Because this government has spent significantly more than it originally planned in its 2022 mid-year plan (the Smith government’s first fiscal update). In other words, the government’s “restraint” is starting from a significantly higher base level of spending. For example, this fiscal year it will spend $8.2 billion more than it originally planned in its 2022 mid-year plan. And inflation and population growth only account for $3.1 billion of this additional spending. In other words, $5.1 billion of this new spending is unrelated to offsetting higher prices or Alberta’s growing population.

Because of this higher spending and reliance on volatile resource revenue, red ink looms.

Indeed, while the Smith government projects budget surpluses over the next three fiscal years, fuelled by historically high resource revenue, if resource revenue was at its average of the last two decades, this year’s $4.6 billion projected budget surplus would turn into a $5.8 billion deficit. And projected budget surpluses in 2025/26 and 2026/27 would flip to budget deficits. To be clear, this is not a far-fetched scenario—resource revenue plummeted by nearly 70 per cent in 2015/16.

In contrast, if resource revenue fell to its average (again, based on the last two decades) but the Smith government held to its original 2022 spending plan, Alberta would still have a balanced budget in 2026/27.

Bottom line; had the Smith government not substantially increased spending over the last two years, Alberta’s spending levels today would align with more stable ongoing levels of revenue, which would put Alberta on more stable fiscal footing in the years to come.

Premier Smith has warned Albertans a budget deficit may be on the way. To mitigate the risk of red ink moving forward, the Smith government should show real spending restraint in its 2025 budget.

Tegan Hill

Director, Alberta Policy, Fraser Institute

Milagros Palacios

Director, Addington Centre for Measurement, Fraser Institute
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