The government has begun a “provincewide response”, including diverting less critical patients away from ERs, but the primary issue remains unaddressed: the system needs reform. The government has made some very good announcements about forthcoming changes, but they need to be expedited.
Albertans are not getting timely access to primary and scheduled care. As a result, many of them may end up in the ER for lack of better options – or simply because they waited so long that a previously elective condition becomes an emergency.
Consider data from the Canadian Institute of Health Information that shows almost 16 percent ER visits in Albert are for conditions that could be managed in primary care. The answer is not to simply turn these patients away to free up overloaded ERs, but to improve access to family doctors so they don’t end up there in the first place.
Another example comes from the Fraser Institute, which estimated a 38 week wait for scheduled care. While some can face these long waits without serious consequences, many may experience deterioration and end up in the ER. In fact, SecondStreet.org found that at least 240 patients died while waiting for scheduled treatment for various surgeries in the province the last time data was tracked (2022-23). Again, the solution here is to provide timely surgery to pre-empt spillover into overwhelmed ERs.
Unfortunately, hospitals also struggle with a significant load of patients who don’t need acute inpatient care, but cannot be safely discharged into more appropriate settings like long-term care homes. Alberta has reportedly reduced the number of so-called “bed blockers” by 20 percent, but the problem largely persists.
While the immediate provincial response must prioritize critical cases in ERs, there needs to be a parallel plan to avoid a ballooning backlog of less urgent patients who may overwhelm emergency rooms in the future.
How can this be done?
First, every non-critical patient whose treatment is postponed beyond clinical benchmarks should be offered treatment in private facilities – within Alberta’s borders, or beyond. This would bring Alberta in line with the European Union that offers patients the same choice. While the obvious long-term solution is to also build more capacity (doctors, nurses, beds, etc.) in Alberta, the government must use all clinical capacity regardless of ownership.
Next, the premier must fast-track her promise to shift hospitals to activity-based funding [aka ABF or patient-focused funding]. This is an excellent commitment, one that could significantly help patients, but it needs to be expedited. One of the reasons why some hospitals may not have enough resources to treat patients is because governments provide them with a cheque at the beginning of the year and hope for the best. Most other countries have shifted to funding hospitals based on the volume of patients they serve and complexity of their cases.
If Alberta had used this model, hospitals encountering a surge in patient demand would have receive additional funding to treat that patient. Conversely, a hospital serving fewer patients would see less funding. This approach would also help ensure health care funding is spent on services for patients – such as doctors and nurses’ salaries – rather than bureaucracy.
Premier Smith previously suggested such a shift was on the horizon, but it is yet to be implemented.
Finally, Alberta must enact legislation requiring patients to be immediately informed of their both their expected wait, as well as clinically acceptable wait times for their condition. This would ensure patients are aware of the realistic probability of receiving timely care, and empower them to plan alternative pathways. Similar legislation (known as Debbie’s Law) is being considered in Manitoba and British Columbia, and Alberta could take leadership in empowering patients with the information they need to make life-saving decisions.
While Smith has signalled a willingness to consider much needed reforms in Alberta (and indeed delivered some), she must act now with clarity and speed. Unfortunately, the Premier and her patients are simply running out of time.
Bacchus Barua is the Research Director at SecondStreet.org, a Canadian think tank.
This column was originally published in Juno News on February 4, 2026.
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