Sweeping changes to come for Alberta's health-care system in 2024

Premier Danielle Smith is set to take scalpel and bone saw to Alberta's $17-billion health delivery system in 2024, while simultaneously scrambling to keep and find more family doctors.

One goal can't wait on the other, Smith said in a recent year-end interview.

"We won't be able to solve the front-line problems without doing a massive reorganization," said Smith.

"Our nurses are getting burnt out after two years and leaving our system. Paramedics last about five years on average. Doctors have reduced their private practice and not enough are going into primary care.

"That's a management problem, decisions that either don't get made or get pushed off, or bad decisions get made. And that has a huge impact on morale."

Smith's United Conservative Party government is expected in the spring sitting to begin passing laws to make good on her plan to dismantle Alberta Health Services, the centralized body that oversees health delivery on everything from acute care to community care.

AHS is to be replaced by four agencies, while being reduced to the role of service provider in acute care.

The model has raised concerns that the four areas — primary care, acute care, continuing care, and mental health and addiction — could fail to be integrated and put care at risk.

In the meantime, Smith said work continues to find more family doctors while keeping the ones the province has from closing up shop.

Alberta, like other provinces, is facing an acute shortage of family physicians, a problem that has a disastrous knock-on effect through the health system as more patients without primary care seek aid in crowded emergency departments.

Just before Christmas, Smith announced $200 million over two years to help primary care physicians keep their practices open.

In the meantime, the province and the Alberta Medical Association are hammering out a new pay model to reflect growing cohorts of patients, inflation, higher business operating costs and more comprehensive care. The care takes into account the face-to-face time with patients as well as the time before and after patients are seen.

It's an ambitious agenda of policies announced by Smith this year. She is also: steering a debate over leaving the Canada Pension Plan; arguing with Ottawa over energy boundaries; rolling out a new blueprint on green electricity projects; and implementing a promised tax cut.

As well, Smith has promised the six-month moratorium on large green electricity projects will end this spring as her government explores new rules to ensure these projects can be cleaned up after they are done.