OTTAWA — Alberta Health Minister Adriana LaGrange says it’s only fitting for Canada’s top cattle-producing province to tip over its most sacred cow.
“One thing I’ve heard again and again since taking this job is ‘it’s not working.’ We’re waiting way too long for the care we need,” said LaGrange.
“Now is the time to really look at, okay, how do we implement something that will work for Albertans, and hopefully will be something that will be replicated across Canada?”
LaGrange and Hospital and Surgical Health Services Minister Matt Jones unveiled
new “dual-practice” legislation
last week that will allow physicians in the public system to perform elective procedures like hip and knee replacements and cataract surgeries at private clinics.
She said that the shift to a hybrid surgical model,
already underway in New Brunswick
and Quebec
is informed by a heavy dose of common sense.
“You know, it doesn’t make sense (that) I have to fly out of my province, to a different province to get a medical procedure, and oftentimes the surgeon who’s actually doing that surgery is from my province, and they’re on the plane with me. It’s nonsensical!” said LaGrange.
LaGrange sat down with National Post to discuss next steps, potential roadblocks from Ottawa and changing public attitudes toward private-sector involvement in health care.
She said that one of the biggest changes she’s seen is that Canadians are losing their knee-jerk aversion to “U.S.-style” private care and looking at what ails our system through a more global lens.
“People travel a lot and they go to other countries and ask why can’t we have this here?” said LaGrange.
She pointed out that Canada consistently lags peer countries in wait times, despite being near the top of the table in health spending.
One recent study placed Canada last among
in waiting times for both general practitioners and specialists, with 10 per cent waiting a year or longer to see a specialists.
Top performers Switzerland and the Netherlands, which both allow private surgeries, saw just one per cent of patients wait this long.
“If you look globally, there’s no perfect model, but we have to get to a better functioning model,” said LaGrange
LaGrange said she still believed that universal access to life-saving care was an important national principle and sought to keep the changes compliant with the “spirit and principle of the Canada Health Act.”
“So right off the bat, we’ve said that any cancer surgery, any emergency surgery … will not be able to practice in a flexible capacity,” said LaGrange.
She added that family practitioners would also be excluded from the dual-practice system.
Doctors who opt-in to the system will also need to do a certain quota of surgeries in public facilities.
Dr. Marisa Azad, a specialist at The Ottawa Hospital, said that these prohibitions won’t necessarily stop the leakage of resources into the private system.
“There’s evidence that, when you take a model like this, you’re leaving the more complex procedures—for example, certain cancer surgeries—in the public system, which is going to bog down already limited time and resources,” said Azad.
“Meanwhile, the burnt-out physicians in the public system see surgical colleagues doing these relatively more straightforward osteoarthritis cases, your hip and knee replacements, in the community. They’re working easier hours and making bank,” she added.
“The temptation to flip over to the less demanding, better compensated private system can be intense.”
LaGrange said she’s well aware potential “unintended consequences” that can spring from the dual-practice model, and will spend the next several months developing robust guardrails, in consultation with provincial medical bodies.
“They could include that, for example, that those private surgeries are only done at certain times, such as evenings or weekends,” said LaGrange.
LaGrange said that one major hurdle to the reform
from then federal health minister Mark Holland that warns of penalties for provinces that facilitate so-called “queue-jumping” for non-emergency surgeries by patients who are willing and able to pay out of pocket.
“I can say emphatically that all provinces and territories (are) very concerned about how that interpretation letter could affect people who already have (private) services provided to them,” said LaGrange.
The federal directive, slated to come into effect on Apr. 1, 2026, was a key topic of discussion at
October’s health ministers’ meeting
in Calgary, with federal Health Minister Marjorie Michel
by the end of the year.
Michel’s office said they had nothing new to add on the topic.
Dr. Shawn Whatley, a physician and past president of the Ontario Medical Association, said Michel’s intervention could make or break the Alberta policy.
“it will come down to the (Canada Health Act) interpretation letters. Government gets to define the exception. It is sovereign on this issue,” said Whatley.
National Post
rmohamed@postmedia.com
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