Braid: Health budget defies logic

By Don Braid, Calgary Herald

Stephen Duckett, president and CEO of Alberta Health Services, sits alongside AHS vice chair Catherine Roozen during the AHS public board meeting June 29 at Rockyview Hospital.

Alberta Health Services' budget released last week promises great improvements this year -- but relative to what, exactly?

In many cases, the comparisons are with 2009-10, the worst year for Alberta health care since the government blew up and closed Calgary hospitals in the 1990s.

The gains predicted for 2010-11 begin at the lowest point of a dismal cycle, making them seem more impressive than they really are.

For instance, the provincewide system is supposed to get 36 new mental health beds this year.

That gain, hardly overwhelming to start with, follows a year when the entire province gained only two mental health spaces.

So the improvement over two years is 38 beds, or 19 a year; no big deal at all.

Similarly, the budget trumpets a spending increase of $28 million for home care in 2010-11.

But in 2009-10, the home care budget actually fell by $10 million. So the real gain in the current year is $18 million, not $28 million.

The budget is riddled with such signs that this year's spending hikes will barely allow the system to survive existing shortages, let alone overcome them.

The biggest mistake ever made in Calgary health care -- the physical destruction of hundreds of acute care beds in the 1990s -- still haunts the hospitals. And there's no sign this budget will finally set this right.

The city had 1,897 acute care beds in 1994. Sixteen years later only 133 new beds have been added, even though the population grew by 327,000.

Alberta Health Services now says up to 700 seniors who need long-term care are waiting in acute care hospital beds across the province, including 244 in Calgary. They block others from admission.

So what's new? This problem has been known and publicly discussed for at least five years.

Once again, the health-care bosses are promising a surge of continuing care construction to empty out those acute care beds.

That's part of the answer, obviously; but numbers suggest that even with a seniors complex on every corner, a shortage of acute care beds will still be with us.

Really, how can Calgary's gain of 133 acute care beds in 16 years be enough, even if every long-stay senior leaves the hospitals?

And how does the provincial problem repair itself when the entire provincial system gained only 83 acute care beds in 2009-10?

The math defies logic. So does the habit of refusing to open beds already built, like those at the Peter Lougheed. There's no firm promise on when, or if, they'll finally be in service.

Stephen Duckett, the system CEO, doesn't make any secret of the severe shortage of acute care beds. The consequence, he says, is that "our emergency departments are overcrowded with too many people waiting too long for care."

But the answer, as always, is to build more of another kind of bed.

Some solutions could eventually come with more acute space in the new south hospital and other facilities under construction. But that's still years off. Meanwhile, even with a spending bump of more than $1.5 billion, they're still plugging holes in 2010-11.

dbraid@theherald. canwest. com

This article was published in the Calgary Herald on July 6, 2010. Read the full article on the CagaryHerald.com website.