Nearly a decade of sustained pressure has stretched Alberta health care resources paper-thin, leaving workers and administrators struggling to provide quality care. Alberta Premier Ralph Klein launched his campaign to undermine public health care as soon as he took office in 1993. The trail he blazed has created a crisis that paves the way for privatization.
Health care spending under Alberta Premier Don Getty holds steady. In 1986, per capita spending is $1,360. In 1992 per capita spending, adjusted for inflation, is $1,393. Ralph Klein is a cabinet minister in the Getty government.
Klein becomes premier. He immediately begins delivering the message that health care spending is out of control, a campaign that Gillian Steward and Kevin Taft call a campaign to distort information and mislead the public. Klein hammers relentlessly on this theme, using it as the justification for deep cuts.
The Klein government makes deep cuts to health care. Per capita spending, adjusted for inflation, drops to $1,325 in 1993 and plummets to $1,156 in 1995 an 18 per cent cut. Acute care spending is cut by 30 per cent. In three years Alberta went from Canadas second highest level of spending per person on health care to the countrys second lowest.
The results rock the health care system. Half the hospital beds in Calgary and Edmonton close, creating longer waiting lists and crowded emergency rooms. There are now only about 1.75 hospital beds per 1000 people in Edmonton and Calgary down from 4.7 per thousand in 1993. Calgary and Edmonton lose 4,400 health care workers; the province has 8,300 fewer registered nurses. Health care services such as labs and laundry are contracted out and privatized.
The Alberta government creates 17 regional health authorities, including the Calgary Regional Health Authority (CRHA). Health authority board members are appointed, in spite of a government committees recommendation that two-thirds of board members be elected. The CRHAs first board chair is John McCaig, a Calgary businessman who reinforces and deepens the corporate connections to public health care.
Under McCaigs leadership, the CRHA closes the Holy Cross, Grace and former Calgary General (Bow Valley Centre).
Calgary laundry workers at the Bow Valley Centre, CUPE members, go on an illegal strike over laundry contracting out. The contract is one of the CRHAs first major private sector deals.
A federal-provincial dispute erupts over extra billing for cataract surgeries performed by Albertas Gimbel clinics. The resolution furthers privatization and funnels more money into private pockets. Klein extends health coverage to include the facility fee in dispute a fee that runs as high as $1,200. The federal government signs a Working Understanding with the province, a document that promises to [e]nsure a strong role for the private sector in health care, both within and outside the publicly funded systems.
Calgary health care corporation Health Resources Group is incorporated (see pg. 20). Soon after, HRG leases space at the newly-closed Grace Hospital, profiting from public infrastructure. An HRG brief states the Grace is an outstanding, purpose-built hospital building in excellent physical condition. It has longstanding credibility as a well respected, compassionate hospital. Capitalizing on its good fortune, HRG sinks $4.5 million into lavish renovations and equipment, and begins lobbying the CRHA for contracts. HRG knew they would get a good reception when they came calling; as the same brief states, [p]rior to regional governance in Alberta, the viability of opening a private acute care facility of the size and scope of the HRG organization would have been impossible.
The CRHA closes and then blows up the Calgary General Hospital (Bow Valley Centre). Steward and Taft write that [t]he dust and grit from the implosion of thousands of tones of bricks and mortar could be seen all over the city. Kleins orchestrated chaos is building to a crescendo.
In a fire sale of epic proportions, Holy Cross is sold to Enterprise Universal Inc. for $4.5 million after undergoing more than $35 million in renovations (see pg. 22).
Bill 37, Kleins first attempt to legalize private hospitals, is withdrawn after widespread public protest.
The CRHA announces a $20 million deficit. Former provincial treasurer Jim Dinning is appointed CRHA chair. Later the same year, Dinning announces the health authoritys deficit has mushroomed to $52 million.
The dots were beginning to connect at an alarming rate. As Steward and Taft write, Mr. Dinnings career had come full circle. He was the architect of the deficit elimination program which imposed severe funding cuts to public health careNow Mr. Dinning, as chair of the CRHA, appeared to be the architect of the scheme to fix the damage.
In March, Klein introduces Bill 11, legislation allowing private, for-profit hospitals. The bill passes in May in the face of unprecedented opposition.
The College of Physicians and Surgeons approves standards regulating major surgery at private clinics, giving the green light to for-profit hospitals to apply for approval.
In October, the first election of board members to regional health authorities takes place. The province still holds many of the cards, and most of the major gutting and forced restructuring is already complete.
The Mazankowski report advocating further privatization of public health care is released.
HRG wins approval from the College of Physicians and Surgeons to perform joint replacements requiring overnight stays taking a big step towards becoming Albertas first for-profit, private hospital. All that stands between HRG and hospital status is the provincial health ministers rubber stamp.