Alberta isn’t fixing healthcare. It’s abandoning it.
“Every system is perfectly designed to get the results it gets.”
— Dr. Paul Batalden
The Alberta Government has a fiduciary duty to provide effective healthcare for every Albertan.
Fiduciary duty is not an abstract, academic concept. It’s the legal and ethical requirement to act in the best interests of the people you serve.
As a pediatrician, that standard is the price of admission into the profession. I am morally and legally accountable for the wellbeing of the children in my care.
Governments carry the same obligation. And in Alberta, they’re failing to meet it.
The Canada Health Act requires provinces to ensure reasonable access to medically necessary care. The Alberta Health Act requires care to be accessible, accountable, and appropriately staffed. But the holes in Alberta’s system are now so large they cannot be described as anything other than system failure.
Don’t think things are that bad?
Consider a typical pediatric case of mine. A four-year-old boy, “Noah,” is flagged by daycare staff for language delay and behaviour issues. For six months, his parents cannot find a GP willing to take him. Finally, a walk-in referral gets him on a pediatric waitlist — mine.
Clinicians are already working at full capacity, but government messaging implies that waitlists are a reflection on a lack of work ethic from doctors, rather than a lack of system support.
My next open appointment is in a year. During that year, the school, lacking educational assistants, reduces his attendance to three hours a day “for safety.”
At our first visit, autism is suspected, but will take another year to confirm. Early intervention is essential. But public access to autism therapies is bottlenecked to one under-resourced agency, FSCD, whose case workers are overwhelmed.
The family waits another two years to have a file opened.
Funding approvals take months. Even with funding, many therapy providers don’t take public cases because compensation is abysmal. Private therapy can cost tens of thousands per year, which most parents don’t have.
The steeper cost Noah and his parents are forced to pay is the loss of three critical years: his behaviours worsen, he’s excluded from school, his parents burn out and both take career hits.
Noah’s development becomes harder to adjust with every delay in care. The lifelong trajectory of his entire family is permanently altered.
His story isn’t bad luck. When a government designs a system that predictably produces these outcomes, the harms are a result of unfulfilled obligations that only a responsible government can fulfill.
The collapse is not limited to pediatrics. Alberta’s own reports show the same system-wide pattern year after year: chronic staff shortages, unsafe delays, and waitlists stretching into years. Ignoring these warnings is a breach of basic obligations.
The proposed “solution,” privatization, requires deliberate political contortions. To sell it, the UCP must simultaneously acknowledge system failure while avoiding the deeper truth: that through these recent years of accelerated collapse, it held the power, resources, and the obligation to prevent this failure.
Two-tier healthcare is not a fix. It is an off-ramp from fiduciary duty. It reframes life-altering delays in care as a “choice” and converts government failures into revenue streams for insurers and for-profit clinics.
Families are being asked to pay twice. Once through taxes, and again through out-of-pocket fees, premiums, and the brutal math of what they can and cannot afford. Those who can’t pay will be left in the hollowed-out shell of what remains — usually to wait.
Despite its fiduciary duty, the UCP has presided over and accelerated this degradation. And it now asks Albertans to pay again for services they have a legal right to receive.
This is not innovation. It is not modernization. It is not stewardship.
This is dereliction.
The Small Voice is a practicing pediatrician in Alberta who writes pseudonymously. Their identity and credentials have been verified by Canada Healthwatch.
