The previous head of Alberta Well being Providers Athana Mentzelopoulos tried to warning the federal government in regards to the potential influence of chartered surgical amenities on the provincial health-care system months earlier than she was fired, CBC has discovered.
Mentzelopoulos earlier this month filed a $1.7 million wrongful dismissal swimsuit alleging she confronted authorities stress to log off on commitments for brand spanking new chartered surgical amenities (CSFs).
A type of was an approval of a contract extension for one vendor, Alberta Surgical Group (ASG), regardless of considerations she had that the prices have been excessive in comparison with different contractors.
In a draft letter obtained by CBC Information and referenced in her assertion of declare, Mentzelopoulos wrote that “AHS stays dedicated to supporting CSFs and their position within the well being system and acknowledges the worth that they bring about together with further surgical capability and improved entry for scheduled surgical procedures.”
However she additionally famous there are challenges as nicely.
She mentioned that along with chartered surgical amenities costing greater than the general public system, there was concern they may siphon off essential workers from hospitals.
“These disruptions can have unfavourable penalties for sufferers and communities, limiting well timed entry to emergent, pressing and medically advanced surgical procedures akin to most cancers, common surgical procedure, orthopedic and vascular surgical procedure,” she wrote.
The Oct. 1 letter was emailed to Darren Hedley, who on the time was affiliate deputy minister of well being.
The letter was addressed to Well being Minister Adriana LaGrange however Mentzelopoulos, in her electronic mail, steered that it must be despatched to then-deputy well being minister Andre Tremblay. CBC Information has not verified whether or not LaGrange or Tremblay considered the letter.
Mentzelopoulos wrote that “[chartered surgical facilities] proceed to demand greater pricing than the equal comparable price inside AHS and with different surgical suppliers.”
She added health-care workers might select to work in these personal amenities over the general public system as a result of they’ll supply greater incomes, extra versatile schedules and fewer on-call necessities.
A restricted workforce and funds will enhance the possibilities of “acute care service disruptions” throughout the province, she wrote.
Mentzelopoulos made a number of suggestions, akin to making certain chartered facility pricing “not exceed the validated AHS inside prices” and that funds “not be supplied for companies that don’t happen.”
On Oct. 18, weeks after the letter was shared with Hedley, LaGrange issued a directive ordering the provincial authorities to take over contract negotiations with chartered amenities.
‘Acknowledged the chance’
Mike Parker, president of the Well being Sciences Affiliation of Alberta, reviewed Mentzelopoulos’s letter and mentioned it raised pink flags.
“As an worker at the moment, because the CEO of AHS, she acknowledged the chance in all of this dialog. She was doing her due diligence and reporting that threat into the ministry,” Parker mentioned.
“Public health-care is for the sufferers and personal surgical amenities are for the income and they don’t see eye to eye of their fashions.”
Stirling Bryan, a well being economist at College of British Columbia, mentioned the message of Mentzelopoulos’s feedback within the letter are “truthful.”
“We’re in a workforce disaster, that some individuals say, in health-care in Canada at this level,” he mentioned, including there’s a restricted provide of employees.
“Undoubtedly within the short-term a minimum of, there can be some adversarial penalties.”
Nevertheless, he notes that publicly-funded personal provision of health-care acts as a stress valve for the health-care system.
“We’ve got lengthy wait lists and other people see this as a chance, probably, to truly relieve ready lists by having further capability for surgical procedures and for delivering care within the personal sector to enrich the companies which might be supplied within the public sector,” Bryan mentioned.
He mentioned the procedures within the personal system are sometimes dearer than the general public system however he mentioned that it permits for extra operations to be completed, thereby easing wait lists.
Nevertheless, Bryan mentioned personal surgical procedures must be approached with warning.
“It is a short-term repair that should not be seen as one thing that may clear up a systemic drawback that now we have within the system,” he mentioned.
When requested in regards to the considerations within the letter at an unrelated press convention Monday, Alberta Premier Danielle Smith mentioned the general public system is nicely resourced.
Worth comparability
Within the letter, Mentzelopoulos additionally features a desk that compares AHS costing for hip, knee and shoulder substitute surgical procedures with personal suppliers like ASG and Clearpoint.
Whereas a hip substitute would price $4,044 with AHS, it will price $8,303 at ASG and $3,622 at Clearpoint.
The desk reveals a shoulder substitute would price $4,833 with AHS, $11,243 at ASG and $3,875 at Clearpoint.
A knee substitute would price $4,036 with AHS, $8,510 at ASG and $3,276 at Clearpoint.
Rose Carter, a lawyer representing ASG, mentioned the corporate’s contract with AHS comprises a confidentiality clause that prohibits it from disclosing something associated to the contract
“Thus, ASG is unable to publicly defend itself,” Carter mentioned in an electronic mail.
She as an alternative pointed to numbers from Canadian Institute for Well being Info (CIHI).
“ASG’s numbers are beneath these beforehand reported within the press,” Carter mentioned.
When requested in regards to the distinction in pricing, Smith disputed Mentzelopoulos’s numbers, saying that she depends on numbers from CIHI.
That knowledge, which incorporates inpatient prices, reveals the imply price of a hip substitute in Alberta in 2021-2022 was $10,737.
The AHS knowledge, in response to the letter, excludes prices lined by the well being authority, akin to implant gadget prices, scientific lab companies and diagnostic imaging.
When pressed on the contrasting figures, Smith mentioned Mentzelopoulos’s numbers have been incorrect.
“When AHS claims that they’ve a decrease price construction and so they solely embody half the fee, I am sorry, there isn’t any credibility to that,” Smith mentioned on Monday.
“We will not be making up numbers with Alberta Well being Providers as a way to make it appear to be chartered surgical amenities are extra expensive.”
When requested whether or not her authorities can be okay with paying extra for surgical procedures in personal amenities, Smith mentioned she “would hope not.”
“The notion behind chartered surgical centres is strictly that, that they’re supposed to have the ability to supply surgical procedure at a decrease price. And so, I assume, that is the query is, what’s the precise price?” she mentioned.
Bryan, the well being economics professor, additionally examined the chart and referred to as the personal price of a process double what it’s within the public system “a little bit stunning.”
He mentioned, with confidentiality agreements usually a part of contract signing, it’s tough to determine what the value differentials are.
“I might be alarmed at that kind of differential if this was seen as a long-term repair for the health-care system and for the supply of elective surgical procedure in an Albertan or Canadian context,” he mentioned.
He mentioned that non-public contractors for health-care “inevitably” depart provincial governments in susceptible positions due to fiscal constraints in health-care.
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