AMA calls on Alberta to declare health-care crisis as surgery, ER and ambulance wait times increase

The Alberta Medical Association (AMA) is calling on the province to acknowledge the backlogs and challenges frontline workers are facing by declaring a health-care crisis in Alberta.

"There needs to be action at the highest level," AMA president Dr. Paul Parks said.

"We've been struggling with massive challenges around capacity and workforce staffing challenges, and I think over time, things have just slowly degraded to the point where literally small tweaks and little small changes to a standard operating procedure are not going to fix things."

Parks says Alberta health-care system needs a massive overhaul, saying that currently, "all roads lead to the Emergency Department," and system-wide problems are decreasing the quality and timeliness of care.

He adds that staffing issues are also a major concern to AMA members, as there is difficulty managing the influx of the roughly 10,000 newcomers arriving in the province each month.

Parks says, in some cases, access to long-term care can hit 20 to 30 per cent over capacity, which also adds to wait times.

"So the hospital beds for acute (care patients) are blocked by patients that just need to go into continuing care, because that capacity doesn't exist for them. They're stuck in the hospitals," Parks said.

"The burnout levels for staff are epic, they’ve never been this high and moral injury is a real issue as so many health-care workers struggle because they can’t provide safe and timely care like they want."

The situation has become so dire, that staff at the Red Deer hospital were hanging tarps with duct tape just to create more space for assessments.

Alberta NDP Health Critic Luanne Metz says the solution is to build more hospital spaces, and in this case, an expansion of Red Deer’s hospital, which was supposed to begin in 2021.

"That’s what it has come to here in Red Deer, a city that has long been ignored by the UCP when it comes to public healthcare," she said.

"No more excuses and no more delays. Even then, that expansion will take years to complete, so we’re also demanding a more permanent emergency space within the hospital. We should actually be supporting primary care, not just repeating promises to do so."

Despite the struggles, Alberta’s wait time for emergency care are still better than what other provinces are seeing.

According to a September 2023 report from Canada's Drug and Health Technology Agency (CADTH), Alberta has a median wait time of two-and-a-half-hours in comparison to six in Ontario and upwards of 12 hours in Prince Edward Island.

SURGERY WAIT TIMES SEEING NO IMPROVEMENTS

Albertans in need of joint replacement surgeries are experiencing lengthy wait times for the procedure.

The average wait time for knee replacement in Alberta was 99.6 weeks in April of 2023, according to provincial data, but increased to 101.8 weeks by October 2023.

Hip replacement surgery wait times have seen little change, sitting at 78 weeks in April 2023 and 77.3 weeks in October 2023.

James Heron says his father-in-law in Calgary used to be a healthy and active person, but started having trouble with his hip last spring.

Heron says what was once a minor nuisance has since reduced his father-in-law's mobility significantly, and a scheduled surgery isn’t in the cards for him anytime soon.

"We all figured it would just be a matter of time until they put him in for surgery. Months passed, we reached out to the specialist and doctors and were told we had to wait longer," Heron said.

"It took until this week to get any update on the surgery – six or seven months later. We have been informed he is on the list for surgery in the next 22 to 24 months.

"His quality of life and mental health is suffering and we feel like there has been little to no communication or help coming from anyone with the ability to help." 

UNA ‘EXTREMELY CONCERNED’ BY AHS PLAN TO CUT OVERTIME, AGENCY STAFFING

The United Nurses of Alberta (UNA) says it is "extremely concerned" by a plan from AHS to cut overtime and agency staffing by at least 10 per cent in an effort to save costs.

The group was informed that AHS is forecasting an operating deficit for the 2023/24 fiscal year through a memo sent to them by AHS CFO Michael Lam.

Una quotes the memo as saying the deficit is "largely due to increased vacancies and unplanned absences (e.g. sick leave), both of which result in increased costs and overtime."

"Action is required to continue to meet our high standard of care and realize a balanced budget."

According to UNA, the memo outlines four strategies senior managers should implement immediately, which include:

• Approval by a vice-president or executive leadership team member to recruit for any vacant position except for existing non-management positions in clinical areas;
• An end to discretionary spending on travel, non-clinical equipment, office supplies and the like;
• No more spending by areas that have not spent their full budget for the year, and
• 10 per cent cut to overtime and agency staffing.

UNA President Heather Smith says between the overtime and the staffing cuts, it's a prescription for driving nurses and other health-care workers out of the province and out of the profession.

"This is absolutely contrary to what the government says it intends to do  to encourage front-line health care services in Alberta," she said.

Smith says she finds it troubling that a premier who refuses to disclose if she has been vaccinated, and whose officials are suppressing information about the spread of COVID-19 and other respiratory illnesses, "in effect blames health care workers for taking sick time for the problems in the system."

WAIT TIME DATA 'ONLY A SNAPSHOT': ALBERTA HEALTH MINISTER

Alberta Health Minister Adriana LaGrange says the Alberta Wait Times Reporting (AWTR) database presents “only a snapshot” of the data and is not entirely complete.

The figures for hip and knee surgeries don’t report the median time, but rather the 90th percentile of wait times which refers to the worst 10 per cent of people who have to wait that long.

The province says its Alberta Surgical Initiative (ASI) dashboard uses a “ready to treat” timeline (date from being given all clear for surgery to the actual scheduled date), which is the national standard, and what Alberta is using as a benchmark.

It says the ASI model results in varying numbers for wait times for knee and hip replacements as follows:

Province-wide hip replacements

• Using AWTR: 65.8 weeks
• Using ASI/ median: 21.7 weeks.

Province-wide knee replacements

• Using AWTR: 77.3 weeks
• Using ASI/ median: 26.3 weeks.

Despite these numbers, several Calgarians have reported to CTV News that they have waited months longer than expected or even opted to travel to other provinces for private, more expensive surgeries paid out-of-pocket.

As for EMS response times, LaGrange’s office says they are down compared to November 2022 in metro and urban areas from 10.1 minutes to 7.8 minutes, marking a 29 per cent improvement.

In communities with more than 3,000 residents, the median response time also fell from 9.6 minutes in November 2022 to 7.9 minutes in November 2023, while rural community response time improved from 17.8 minutes to 15.8 minutes in that same time period.

In addition, the province also pointed to a new Angus Reid survey on satisfaction with health-care delivery by province which indicates that 37 per cent of Albertans say their government has done a “good” or “very good” job in handling health care.

This is up nine per cent since 2022 and is the highest level of satisfaction in the country.

“We appreciate the work of our frontline workers in the many improvements of healthcare delivery,” read a statement from LaGrange’s office.

“We know more needs to be done to improve our healthcare system and to support our frontline. That’s why we’ve launched our refocusing plan and will continue to work on better outcomes for Albertans.”