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McGowan urges voters to reject both conservative parties and, instead, support parties that will "go to the wall" to keep Medicare public

Alberta voters are clearly turning away from the Conservatives, but a massive poll conducted for the Alberta Federation of Labour over the past two days shows that most Albertans don't support one of the main platform promises made by the front-running Wildrose party (click here for poll results).

At the heart of Wildrose's so-called Wait Time Guarantee is a promise to use public funds as seed money to facilitate the expansion of corporate, for-profit health care. Wildrose leader Danielle Smith has said that a Wildrose government would consciously and deliberately encourage the development of a parallel, for-profit health-care sector.

She says such a sector will improve health care by introducing more choice and competition – even though experience and research from around the world (and even right here in Alberta) shows that for-profit delivery of health services costs more and delivers lower quality care.

"We were concerned that in all the enthusiasm to get rid of the Conservatives, who clearly have been in power far too long, Albertans haven't been looking closely enough at what the Wildrose has to say about health care. That's why we decided to do the poll," says AFL president Gil McGowan.

"Well over 26,000 Albertans from all over the province responded to the survey, and the vast majority – 57 per cent – told us that they are opposed to using tax dollars to expand profit-driven health care. Only 15 per cent support the Wildrose idea of funding for-profit care with public money. Twenty-eight per cent were undecided. If we look at just those who have made up their minds on this issue, 79 per cent are opposed to public money going to for-profit health care. What the poll shows is that there is no meaningful support for the Wildrose prescription for health care."

In addition to releasing the poll results, McGowan is also circulating an open letter to Albertans, urging them to reject both of Alberta's conservative parties and, instead, vote for parties that actually believe in Medicare and will "go to the wall to defend it."

"The notion that people should vote for the Conservatives to stop the Wildrose and defend Medicare is ludicrous," said McGowan, explaining the rationale for sending the letter.

"This is the party that brought us Bill 11 and the Third Way. More importantly, if the Conservatives lose, as they seem likely to, then the party will almost certainly move to the right to chase the supporters they've lost to the Wildrose. They will also almost certainly turf Alison Redford and replace her with someone much more conservative. Do you really want to rely on someone like Ted Morton to stand up for Medicare when it's under attack? Frankly, that's a nightmare situation. When the fight to preserve Medicare comes, as it almost certainly will with a Wildrose government, then we need parties and MLAs who will stand up to the Wildrose, not join in the carnage."

The AFL's province-wide survey was conducted April 17 and 18 by the firm Public Polling. 26,487 Albertans from all regions completed the questionnaire, meaning the survey has a very small margin of error (plus/minus 0.6 per cent 19 times out of twenty).

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For more information call:

Gil McGowan, President @ (780) 218-9888 (cell)

Push for competition won't bring two tiers, Smith says

Wildrose Leader Danielle Smith fended off accusations Friday that her party's push for more competitive health care would create a two-tiered system that would see top doctors move to private facilities and wealthy patients receive better care.

Smith said the system already features private operators, including family physicians and clinics that do cataract surgery.

Her party wants to encourage more independent facilities, creating a greater mix of public and private that would create incentives among all providers to reduce costs and bring wait times down, she said.

"If we can have additional choice in our health-care system, it will create best practices that can filter into the public hospital environment so they can become higher performing," she said at Calgary's Fountains of Mission seniors home.

"I look at this as saving our public health-care system. Our priority is to have a public system that works. But in the meantime, we can't afford to have our seniors waiting years for the system to magically get its act together doing the same things it's always done."

Rival parties jumped on the Wildrose position, arguing the health-care system should not be forced to survive in a competitive market.

NDP Leader Brian Mason said he's so concerned by Smith's approach that his party will make the defence of public health care the focus of its election campaign.

"This is going be the thrust and the theme of our campaign from now on. We need to make sure that this election is about health care," Mason said in Edmonton.

"Danielle Smith has thrown down the gauntlet, and we'll pick it up."

Voters can't trust Conservative Leader Alison Redford to protect public health care, given the track record of previous Tory premiers such as Ralph Klein and Ed Stelmach, Mason said.

"This PC party, to its very marrow, believes in private health care. All (Redford) will say is that she wants publicly funded health care," Mason said. "What does she mean? She means that we will use taxpayers' money to fund their friends in private business to deliver health care."

Liberal Leader Raj Sherman said he's also worried about the PC and Wildrose platforms.

It's clear both right-of-centre parties don't understand how the health system really works, he said.

Redford denied her party has a hidden agenda for further privatization. Alberta already has a system in which doctors can have their own offices "but that's about as far as we go," she said. The Tories are planning more long-term and continuing care with different types of accommodation, yet every senior will receive the same level of health services in those facilities, Redford said. Earlier this week, she argued the Wildrose approach of encouraging more private delivery and competition goes too far.

"What does competition look like in a system like that? You're going to end up with a system where people are going to find opportunities to create a different set of health services for people that can afford to pay, and people that can't afford to pay are going to end up suffering."

Smith said the Wildrose plan would ensure medical treatments are publicly funded, no matter where they are done.

Private operators wouldn't be allowed any extra billing and would be paid for procedures at the same rate as the cost in a public hospital.

Some health policy experts suggest there would be nothing to stop private clinics from offering patients nonmedical services that could accompany their surgery. This would allow the clinics to make extra money, potentially letting them pay doctors and nurses more than the public system offers.

They also tend to focus on the easiest, cheapest types of procedures, leaving the more complicated and costlier surgery to hospitals, some experts say. They also may not pay union wages.

This leads to concerns such advantages will push the top doctors and nurses to work at independent clinics.

"There's not enough frontline staff as it is. Opening a private, shadow system would only take those limited resources away from public system," said Guy Smith, president of the Alberta Union of Provincial Employees.

His union represents between 35,000 and 40,000 health-care workers in the public sector.

"I think it's a very dangerous move for the Wildrose to do this, but at least they're showing their true colours."

Smith said her expectation is that many health practitioners would wind up working for both public and private operators.

She said a number of doctors want more surgical time than they receive in hospitals and would welcome the opportunity for more. As well, part-time nurses could get additional hours at private facilities.

Political scientist John Church, who studies health-care policy at the University of Alberta, questioned if costs and quality can be controlled under the Wildrose policy.

He also wants to know if it would actually lead to quicker access to a new range of services.

Even if capacity is added, and competition is encouraged through public and private delivery, there's still a limited supply of health-care workers, Church said.

Becoming overly reliant on private operators can be a problem, he added, if the company suddenly goes out of business or other complications ensue.

Edmonton Journal, Sat Apr 7 2012
Byline: Keith Gerein and Marta Gold and Kelly Cryderman

EDMONTON - Health care and education are among Albertans' top concerns heading into the provincial election, while government trust and accountability is another hot topic, particularly for Wildrose party supporters, a new poll indicates.

However, pollster Ian Large of Leger Marketing noted there seems to be no single dominant issue that is commanding voters' attention so far in the race, meaning political parties must score points with multi-pronged platforms.

"Things are looking up, the economy is doing well, people are working, people are satisfied with their personal life, and so the concerns they have are much more general than they would be if say, unemployment was the issue," he said. "It indicates that any party trying to run on a single issue, that's not going to speak to most Albertans. There are a bunch of different things at play here."

The poll, conducted by Leger for the Edmonton Journal and Calgary Herald, asked respondents to name the most important issue facing the province from a list of 12 subjects.

Not surprisingly, health care was the most popular answer, chosen by more than one-quarter of the survey's participants.

However, trust and accountability came in second with 15 per cent, well ahead of taxes, deficit spending, crime, the environment, electricity rates, and other issues that are a central part of some parties' campaign platforms.

The third most popular issue was education at 10 per cent, followed by the economy (nine), cost of living (seven), and energy development (seven). Everything else was five per cent or less.

University of Lethbridge political scientist Peter McCormick said the focus on accountability was likely driven by a number of recent controversies that have dogged Alison Redford's PC government, including an ethics investigation into a fundraiser held by Asia envoy Gary Mar, a "bullying" letter sent by a Tory MLA to a school board and revelations about a committee that continued to be paid even though it hadn't met for 40 months.

He noted that when survey respondents were asked a slightly different question — what issues would most affect their own vote — trust and accountability slipped to third and education moved up to second.

That's because while health and education play big for voters across the political spectrum, trust and accountability seem to be vital only toWildrose supporters. According to the poll data, 32 per cent of decided Wildrose voters felt it was an issue that affects their choice, compared with much lower concern among those backing the PCs (13), Liberals (16), NDP (21), and undecided voters (13).

"And it's mostly because you are Wildrose that you are concerned about this, rather than because you are concerned about this you are drawn to Wildrose," McCormick said.

"It's on the agenda because the Wildrose has put it on the agenda," said Large. "It's not surprising voters are aware of it, but whether it's important to them remains to be seen."

As for other issues, the environment ranked as the third most important subject for Liberal voters and fourth most important for NDP backers, but was near the bottom for Wildrose voters.

Deficit budgeting was also a concern for the Wildrose, Liberals felt more strongly about the cost of living and PC voters showed high interest in energy development.

Taxes and electricity rates were not vital factors for anyone, even though opposition parties have made those issues key planks in their platforms.

"There's not a bubbling revolution waiting to happen on those things," McCormick said. "Health care, education, and government trust and accountability — that's the closest you can get to finding a combination of issues that will get people going."

The March 22-25 telephone survey of 1,215 Albertans has a margin of error of plus or minus 2.8 percentage points, 19 times out of 20. The margin increases when results are broken down by region or demographic.

Edmonton Journal, Thurs Mar 29 2012
Byline: Keith Gerein

Albertans overwhelmingly want a public inquiry into doctor intimidation - a probe the governing Tories have refused to call - but a slim majority think PC Leader Alison Redford has kept her word on the issue, according to a new poll.

A Leger Marketing telephone survey of 1,215 Albertans, conducted March 22-25 for the Calgary Herald and Edmonton Journal, also found more than half are satisfied with the public health-care system.

Yet, nearly six in 10 Albertans want the option to buy their own coverage from private medical providers.

The survey probed Albertans' attitudes toward health care, a $16-billion provincial system that continues to be the top issue for voters as they head to the polls on April 23.

On the private care question, having the option to pay was more popular among those living in Calgary, or outside the province's two major cities, compared to Edmonton - where just half of voters said people should be able to pay for their own health-care services from private medical providers.

Wildrose party supporters are the most likely to favour private health-care options, followed by PCs. Among those who say they will vote for the Liberals and the NDP, there is significantly less support.

Ian Large, Alberta vice-president for Leger Marketing, said he was surprised by the large number of Albertans who answered in the affirmative. But he noted "we didn't ask 'do you want to pay for private health care,' but 'do you think we should have the freedom to pay for it.'"

John Church, a University of Alberta political scientist who studies health policy, said as the years pass and governments can't satisfy the public over wait lists and access to service, demand will increase for private alternatives.

The private provision of services can be more effective in some instances, Church added. But overall, his research has found a strong public system works best where no one has to produce a credit card to see a doctor.

"That alone is worth any of the other hassles we have to deal with."

Overall, Leger found 57 per cent of Albertans are satisfied with the health-care system - and satisfaction is consistent across the province.

The poll also asked two questions about the public health-care inquiry called by the Redford government last month.

On the heels of a scathing Health Quality Council of Alberta report in February, the Tory government announced a judge-led inquiry will look into "improper preferential access" to publicly funded medical services.

The council's probe found widespread instances of physicians experiencing "intimidation and muzzling" after advocating for patients, but it did not assign blame or identify specifically who did the intimidating.

Concerns about physician intimidation will not be specifically looked at by the panel, unless it is related to queue-jumping. The government is instead setting up two new health task forces, exploring governance issues and the role of the College of Physicians and Surgeons of Alberta.

That's not good enough for most Albertans.

According to the Leger poll, 71 per cent of Albertans said the government should hold an inquiry into the intimidation of doctors that was found in the council's report.

At the same time, exactly half of respondents said they believe Redford lived up to her promise to hold an inquiry - given during last year's PC party leadership race - by calling a probe into health care queue-jumping last month. Eighteen per cent say they don't know, while almost onethird say Redford did not live up to her word.

"She probably needs to be concerned about that," Large said. "Enough Albertans don't think we've heard the end of the discussion."

Earlier this month, the Alberta Medical Association took out full-page ads in Alberta newspapers, urging the government to call a full inquiry.

The ads have received hundreds of responses and the issue has gained traction, said AMA president Dr. Linda Slocombe.

"I think we have the public awareness around the issue," Slocombe said.

The Leger poll has a margin of error of plus or minus 2.8 percentage points, 19 times out of 20, although regional margins are higher.

Calgary Herald, Thurs Mar 29 2012
Byline: Kelly Cryderman, with files from Jamie Komarnicki

CALGARY — Liberal Leader Raj Sherman kicked off his party's campaign in Calgary on Tuesday with charges that the intimidation of health-care workers extends far beyond doctors.

Sherman sat side-by-side in a news conference with nurse Terri Reuser, who said she paid a price for raising concerns about the deterioration of care and the mistreatment of elderly patients with dementia in a long-term care facility in Black Diamond.

The problems began in 2006, when the facility was under the Calgary Health Region and became worse after the formation of Alberta Health Services in 2008, Reuser said.

Problems such as bedsores and infections became more prevalent, she said.

Reuser alleges that a staff member had twisted the arm of an elderly patient behind her back to make her go to bed. The woman fell and required stitches to her head.

Another patient was slapped by a staff member, she said.

Reuser said she raised concerns about the problems to the facility administration and was "interrogated, bullied, just made to feel incompetent."

"I was shunned."

She wrote a letter to AHS and was told an investigation would be launched, but Reuser said she has never been told what resulted.

Sherman said the situation is part of a much greater problem with the system under the PC government, pointing to a Herald story last week that showed there have been 1,000 confirmed cases of elderly and disabled Albertans being abused in provincially funded facilities over the past seven years

He said Reuser's story is a piece with last month's Health Quality Council of Alberta report that found half the doctors who responded to a survey felt they had been stopped from advocating for their patients. About 20 per cent said they'd experienced "active harmful obstruction."

"It's beyond the bullying of doctors," said Sherman, an emergency room physician. "We have more than 30,000 nurses in this province and we as doctors can't do our job without all the nurses and the health staff. These are the angels of the health system who are right beside us. . . . Nurses are bullied as well as are all front line staff. And this is unacceptable in this province."

The Liberals are calling for the doubling of funding for home care and an additional $180 million for the construction of new, long-term care facilities.

Progressive Conservative Leader Alison Redford said the government hasn't denied the allegations of intimidation in the health system and is taking steps to deal with the issue.

A situation affecting seniors such as the one described by Reuser is a "tragedy," Redford said.

"We have to make sure that there are as few of those as possible," she said. "Unfortunately sometimes in the health are system there are circumstances that arise that really do lead to really unfortunate situations. What we have to do is make the system better. . . . We have to make sure that they're reported and we have to make sure we don't let them happen again. That's actually solving the problems."

In 2010, the governing Tories proclaimed the Protection of Persons in Care legislation to make it against the law not to report abuses.

Door-knocking later with former party leader David Swann in the trendy Hillhurst neighbourhood of his Calgary-Mountain View riding, Sherman is hoping the Liberals can add to the party's four seats in the city with a split between the front-running conservative parties.

Early polls have shown the long-governing Tories and the Wildrose party in a dead heat.

"Our chances are very good. There is a perfect 50-50 split on the right wing and there are a lot of progressive Calgarians. . . . I believe we can make big inroads," he said.

Calgary Herald, Wed Mar 28 2012
Byline: James Wood

NDP Leader Brian Mason rolled out his party's health plan to open 1,500 new long-term-care beds, spend $100 million more on home care and cover basic dental costs for children under 18.

The New Democrats would also cap seniors' drug costs at $25 in total, instead of $25 for each prescribed drug needed. They would maintain the cap on seniors' living costs and hire "hundreds" of doctors over the next four years.

Mason said these aren't "extraordinary promises," but ways to bring down waits for emergency care and strengthen medicare.

"Come election time, every party says they are the champions of Alberta health care, but Alberta's New Democrats are always there, election time or not," Mason said, calling the NDP health platform the party's top priority.

"Medicare is suffering in Alberta because of years of mismanagement and attempts at privatization."

Mason said the PCs rolled out their plans for the Third Way after the 2004 provincial election. After the 2008 election, the government appointed Ron Liepert the bad-cop health minister who set up Alberta Health Services after firing CEOs of the former provincial health regions.

"I think this is likely to happen again," Mason said. "I think people are learning a lesson: You can't trust the Progressive Conservative Party on health care because they won't tell you the truth during the election."

Premier Alison Redford continues to flirt with privatization by saying she'll get rid of the cap on the maximum amount seniors can pay for living expenses, said Mason.

"Alison Redford's answer is American-style health care," he said. "We want to improve and expand public health care."

How much the NDP health plan would cost won't be released until later this week.

"In our view, medicare is sustainable through commitment and innovation," Mason said. "The government doesn't spend its money wisely in the health-care system."

Edmonton Journal, Wed Mar 28 2012
Byline: Jodie Sinnema

Critics predict increasing backlog in ERs

New figures from the province's health authority show the wait for nursing home beds has worsened this year despite the fact Alberta Health Services has increased the number of long-term care spaces.

While a document that AHS provided to the Herald this week laid out a 150-bed reduction in 2012, an official said Thursday they have actually added 152 spaces across the province with round the clock nursing.

Roman Cooney, AHS' vice-president of communications, said the authority has opened 470 nursing home beds and closed 318 spaces so far this fiscal year.

"These beds are continually being refurbished to meet higher standards," Cooney said in an e-mail.

"In addition, over the next three years, we will open 150 additional net new long-term care beds."

Despite the increase in spaces this year, AHS figures show the queue of ailing seniors stuck in hospital or struggling at home while they waited for a nursing home bed grew by 14 per cent to 215 people in the first 10 months of this year.

The AHS figures show the situation is especially dire in Calgary where there were 95 people waiting in January for a vacancy.

Opposition parties predicted Thursday the backlog in Alberta's hospitals and ERs will worsen unless the government opens more nursing home beds to accommodate those seniors in the queue.

"It's complete incompetence," said Liberal health critic Dr. David Swann, "that is jeopardizing the health of our seniors and contributing to the crisis in our hospitals."

While AHS' plan would hold the number of nursing home beds at or slightly be-low 15,000 for the next three years, the authority is hoping to open 3,000 additional supportive living spaces over the same period which offer less nursing care, require residents to shoulder the cost of drugs and medical supplies, but which cost the health-care system less.

New Democrat seniors critic Rachel Notley said the plan aims to force sick seniors to shoulder a larger share of their health-related costs and live in facilities that may offer them an inadequate level of care.

"It's unfair, but it's also absolutely penny wise and pound foolish," Notley said.

"These patients will end up in much more expensive ER and acute care beds because they are the last resort."

Facility operators said the situation is worse than AHS' figures reveal because many of the 1,279 seniors on the waiting list, who the authority says are suited for supported living spaces, actually need to be in a nursing home.

"People are being placed there who don't belong and we're struggling to care for them with inappropriate and insufficient staff," said Bruce West, executive director of the Alberta Continuing Care Association.

"The government may have a vision of people aging in place and what supportive living can be but that's not what's available right now."

To deal with the current bed shortage, West said the province should designate at least 25 per cent of the new beds it is opening each year as long term care spaces.

"The health minister said he's flexible, that the new spaces coming on stream are built to offer a range of care," he said.

"Let's deal with the crisis now and add the RNs that are needed to ensure seniors get the prompt medical attention they need."

A recent health quality council report found up to eight per cent of the province's hospital beds were clogged with patients who should be in nursing homes or supportive living facilities.

Dr. Paul Parks, the past-president of the Alberta Medical Association's emergency medicine section, said the long waits in the province's ERs won't get shorter until the hospital backlog is cleared.

Parks said he has struggled to get reliable and consistent figures from AHS or the province about the number of nursing home beds in the province.

Health Minister Fred Horne said a few weeks ago that there were approximately 14,550 beds, while Seniors Minister George Vanderburg stated recently there were only 14,092 beds.

If AHS' 152 new beds are added to their stated capacity of 14,550 at March 31 last year, there should be 14,702 beds open today. Cooney did not reply to a request by e-mail to confirm that number.

"The bottom line is we have roughly the same number as we did two decades ago, but there's another 1.3 million people in the province and that population is aging fast," Parks said.

"I can't fathom how that is going to work."

Long-term care beds in Alberta

- People waiting for nursing home beds based on assessed medical need:

Calgary Herald, Fri Mar 23 2012
Byline: Matt McClure

CALGARY — Wednesday's surprise pay deal between the province and the doctors raises an obvious question: has the government bought their silence during the coming election campaign?

"The answer is no," says Linda Slocombe, the plain-talking Calgary family doctor who is president of the Alberta Medical Association. "Our positions are the same. There will be ongoing advocacy before, during and after an election on issues we feel are important to Albertans.

"We still feel strongly about a health care inquiry into doctor intimidation."

Slocombe said some advertisements are being prepared right now for the AMA. She wouldn't say if they'll be political stunners like the recent one that started, "Just How Sick is Alberta's Health Care System?"

The full-page ads went on to complain about intimidation, the lack of a full inquiry into the issue, and the government recently imposing "political control" through a unilateral, one-year pay decree.

That was dangerous stuff to appear just before an election. The Progressive Conservatives still have wobbly knees at the memory.

"Doctors can be pretty damned intimidating themselves," one says ruefully.

So there's no doubt that this deal, which somehow wasn't possible for two long years, suddenly came together because an election call is only days away.

The government needed to calm the doctors, who in turn applied maximum pressure just when the PCs were most vulnerable. They are wily adversaries who understand each other very well.

None of that changes the fact that doctors have been intimidated, are correct about the inquiry, and never again want to be prevented from advocating for patients.

But the lack of a pay deal was one of their main issues, and that's solved now. They will "advocate," but I doubt they'll attack government with as much force as they did in early March.

Health Minister Fred Horne and Finance Minister Ron Liepert now have to scramble to find $181 million in additional pay, most of which isn't in the budget passed Tuesday night.

The irony here is that the Tories created new spending within 12 hours of passing a budget with promises of stable allotments.

The main thing for patients is quality medicine, and this deal advances the cause by providing stability and better funding in some key areas, especially primary care.

One area that obviously needs help is senior care, following the Herald's revelation that over seven years there were more than 1,000 cases of Albertans being abused in provincial facilities.

These are proven cases, not just complaints. The average of 142 a year is far too high, even in a system with 40,000 residents.

Remember, these are people under direct professional, publicly funded care. If they aren't safe from abuse, who is?

In the legislature, Tory responses to questions about this issue were pathetic.

Without acknowledging any problem, deputy premier Doug Horner accused the Liberals of insulting health workers just by raising the issue. This old tactic is long past its spoil date.

Dr. Chris Eagle, the CEO of Alberta Health Services, at least said he finds the cases "very disturbing" and takes them seriously.

Finally, the PCs are being justly blasted for delaying the release of a regular AHS report card on health-care performance.

This measure of crucial wait times has fallen into the government hands for "review." But the PCs say this has nothing to do with the election.

If you fall for that, you'll also believe there's no link between politics and doctors raises.

Calgary Herald, Thurs Mar 22 2012
Byline: Don Braid

Tories accused of throwing money around before election

Days before an expected election call, the Tory government ripped up its physician salary hike imposed weeks ago and instead offered the province's 7,200 doctors a sweeter, $181-million compensation agreement.

Alberta's health minister said the tentative deal will help provide stability in the medical system, but opposition critics accused the PC government of trying to snuff out an outspoken physician advocacy campaign on the eve of a provincewide vote.

But Alberta doctor representatives vowed Wednesday not to back down from their increasingly vocal fight for a public inquiry into the intimidation of physicians who've advocated for patient care.

"These last-minute, Hail Mary negotiations have nothing to do with keeping us quiet," said Dr. Lloyd Maybaum, president of the Calgary and area medical staff association.

"There's no bloody way it's going to keep us quiet."

Last week, the province's five medical staff association presidents accused the government of stonewalling on physician issues.

And Maybaum called upon Albertans to bring in a "tsunami of change" and demand a health inquiry on physician intimidation.

The new physician salary proposal, which comes after doctors have been without a contract for more than a year, includes a 2.5 per cent fee increase each year for two years, retroactive to April 2011. The province's primary care networks will see per patient funding up $12 to $62.

The parties will continue working on a long-term agreement between Alberta Health Services, doctors and the provincial government.

If that can't be reached by March 31, 2013, the proposal gives physicians a cost of living hike in the third year. The tentative deal also provides a limited arbitration process on fees for insured services and some physician benefit programs.

Asked about the timing of the deal, Health Minister Fred Horne told reporters the agreement in principle is the product of discussions that have been taking place for months.

"I think it's what Albertans expect of government - they expect us to have a good relationship and a sound foundation in terms of our work with doctors," the minister said.

The new proposal comes just three weeks after the government imposed a controversial one-year, $93-million salary deal - including a two per cent fee increase - on doctors without negotiating.

Wednesday's tentative agreement, which must still be ratified by the AMA and the government, supersedes those terms.

Liberal Leader Raj Sherman, an emergency room physician, said the government is obviously running scared.

"They're desperate and they are trying to cut deals with everybody on the eve of an election."

Wildrose House Leader Rob Anderson said the agreement smacks of electioneering.

"They're throwing money around like crazy right now," Anderson said. "I think it will be difficult to buy the silence of doctors. They're pretty passionate about getting their tsunami of change."

Alberta Medical Association president Dr. Linda Slocombe said the agreement could provide some stability for doctors who have been in compensation "limbo" for more than 12 months.

It will also help build a strong working relationship with the government, she added.

"We have been working on this for a long time," Slocombe said.

"The timing is what it is."

The Calgary family physician said the doctors' association is still committed to its vocal advocacy efforts, which included recent full page newspaper ads calling for a full public inquiry on doctor intimidation.

"Those sorts of advocacy initiatives will be ongoing, before, during and after the election," she added.

Last month, an independent report by the Health Quality Council of Alberta found more than half of all doctors surveyed said they'd been intimidated or bullied in the past year.

A few felt they were pushed out of the province or had their hospital privileges threatened after speaking out about the state of Alberta's $16-billion health-care system.

The government acknowledges the problem, but insists such cases do not need to be aired in a public forum, but rather the medical system must build a "just culture."

On the salary front, doctors and the government have been trying to work out a contract since the former eight-year agreement expired March 31, 2011.

With the 2012-13 budget already passed by the legislature on Tuesday, Alberta's health minister may have to ask Treasury Board to help fund the new doctors' deal.

Finance Minister Ron Liepert said the money promised to doctors may not increase Alberta's budget deficit if there is a revised quarterly update reducing the red ink forecast.

"I wouldn't jump to the fact that it will increase the deficit," he said. "It will increase the project spending."

Liepert said he assumed Health Minister Fred Horne will come to Treasury Board seeking the money, which was not included in the budget.

Likewise, Premier Alison Redford said she didn't expect the physician costs to impact the deficit in this year's budget.

"As we move ahead into next year, it could have a slight impact, but with the surpluses we're projecting, it's always a matter of balancing as we go forward."

Calgary Herald, Thurs Mar 22 2012
Byline: Jamie Komarnicki and Darcy Henton

The province plans to reduce the number of nursing-home spaces this year, despite new figures that show a rising number of Albertans are still stuck in hospital or at home waiting for a bed to become vacant.

Doctors are worried delays in the province's emergency rooms could worsen and facility operators are concerned ailing seniors will suffer poor care if Alberta Health Services cuts 150 spaces with round-the-clock nursing.

"I'm baffled as to how we're going to eliminate the bottlenecks in our hospitals at the same time as we're cutting long-term care beds," said Paul Parks, past-president of the Alberta Medical Association's emergency medicine section. "I'm very afraid we're on the cusp of another crisis in our ERs."

Bruce West, executive director of the Alberta Continuing Care Association, said AHS seems determined to push seniors with complex medical needs into less-expensive supported-living spaces, which may not provide adequate care.

"My concern is these patients will end up back in acute-care hospitals because they won't get the care they need," West said.

"There appears to be a disconnect between the government's philosophy and the front-line reality that we have a lot of very sick seniors."

The provincial health authority released figures this week that show the number of seniors waiting for a nursing-home bed increased 14 per cent to 215 patients during the first 10 months of the current fiscal year.

More than 25 per cent of the 473 patients clogging the province's hospitals in January were waiting for a long-term care bed.

Just over nine per cent of the 1,021 seniors struggling to manage on their own around Alberta were also in the lineup to be ad-mitted to a nursing home.

The situation is dire in Calgary, where 55 hospital beds are occupied by seniors waiting for a nursing home space and another 40 seniors are coping on their own waiting for a vacancy to come open.

An AHS official said long-term care beds are being closed so they can be refurbished.

David O'Brien, the authority's vice-president of seniors' care, said normal turnover in nursing homes means space will be found for patients on the waiting list.

O'Brien said that, over the next 12 months, AHS is adding 1,000 supporting-living spaces - beds not equipped or staffed to handle residents with unpredictable behaviour, intensive rehabilitation needs or who require 24/7 nursing care - because that level of care is adequate for the vast majority of seniors in the queue.

"We're building supportive living as fast as we can," O'Brien said, "because that's the level of care Albertans want and need."

But a study published last year suggests more than a quarter of the patients the province is placing in supportive living beds may be unsafe because there is insufficient staffing and care for their complex medical needs. As a result, they were twice as likely as nursing home patients to end up in hospital or visit an ER.

O'Brien says changes have been made since the study was done to improve care at supportive living facilities by providing on call nurses who can deal with ill patients and nurse practitioners who regularly review a client's condition.

A recent report from the Health Quality Council of Alberta fingered the long list of seniors being warehoused in overcrowded hospitals for average stays of six weeks as one of the key causes of chronic, excessive waits of seriously ill patients in Alberta's ERs.

Dr. John Cowell, the council's top executive, said the province needs to reduce occupancy in its major hospitals to 85 per cent and develop accurate predictions of its growing need for both nursing home and supportive living beds to clear the backlog.

"It's critical that AHS match its resources to its needs," Cowell said, "and the numbers of people on the waiting list for long term care have me concerned that's not happening."

AHS documents show the health authority plans to hold the number of nursing home beds fairly constant through 2015 at just under 14,500 and add another 3,000 supportive living spaces to the system, but neither the health authority nor the government could provide figures this week to show whether the new capacity will match the needs of an aging population.

Health Minister Fred Horne said he hopes to have a new fore-casting model up and running later this year that will allow his staff to plan up to two decades into the future.

In the meantime, Horne said the level of care available in many of the new spaces being opened can be adjusted upwards, if that's what is required to match patient needs and to empty acute care beds.

"We have the flexibility," he said.

Calgary Herald, Thurs Mar 22 2012
Byline: Matt McClure