New bill would concentrate medical officers of health under Alberta government control

A new bill continuing the reorganization of Alberta's health system has some government critics worried that all public health leaders will report to politicians.

The Health Statutes Amendment Act, or Bill 55, would continue a redistribution of responsibilities and health-care workers started last year by moving all public health functions out of Alberta Health Services (AHS).

Medical officers of health and public health inspectors currently working for AHS would become government health employees, should the bill pass.

Front-line programs such as newborn screenings, communicable disease control, well-baby clinics, routine immunizations, and health prevention and promotion programs would move to a new agency, Primary Care Alberta.

"We're really going to take a more concerted effort to make sure that we have more concentration on public health, in terms of, how do we do more preventative and information sharing across the whole province," Health Minister Adriana LaGrange said at a news conference Thursday.

Health officials did not know how many employees would be switching employers as a result of the proposal. The government would negotiate agreements with affected workers in the Health Sciences Association of Alberta, United Nurses of Alberta and Alberta Union of Provincial Employees.

Bill 55 also proposes numerous housekeeping changes to support the divvying up of health services into five new agencies, including a shared services organization to handle human resources and information technology.

Risk of scientists beholden to politics

Dr. James Talbot, a former Alberta chief medical officer of health (CMOH) and adjunct public health professor at the University of Alberta, says currently, the provincial CMOH and deputy officers have to "walk that tightrope" between politicians' demands and what evidence says would best protect communities.

"It's a step backwards," Talbot said of moving other medical officers of health into the ministry — should they choose to transfer. "I don't think this government is particularly trusted by people who work in public health to uphold the values that are important to public health, starting off with the importance of science to guide decisions."

In an interview, Talbot questioned whether medical officers of health will be guided by evidence or forced to respond to politicians who may be reluctant to compromise individual freedoms for collective safety. Medical officers of health may also be reluctant to be employed by a government that platforms people with fringe views, he said. 

NDP health critic Sarah Hoffman said she worries the province may lose some of the experts now working as medical officers of health for AHS.

"There is definitely a culture of fear and control in the public service right now," Hoffman told reporters at the legislature. "Telling these folks who've had more independence that now they report up through the deputy to the premier, I think is not the right culture for folks who are supposed to be giving advice based on evidence, and not based off somebody's political ideology, ambition or interference."

Health minister says information sharing will improve

In the news conference Friday, LaGrange said the proposed changes are informed by dozens of feedback sessions health officials held with members of the public, including health-care workers, across the province.

"A major topic of discussion was how to position public health within the refocused system to sustain its critical functions and enhance consistency and coordination," LaGrange said.

LaGrange characterised the change as administrative, saying it will streamline operations because medical officers of health already report to the CMOH.

Hoffman, who was the NDP health minister from 2015 to 2019, disagrees, saying the officers share information with their provincial counterpart, but do not report to them.

Lorian Hardcastle, a University of Calgary health law professor, said the further concentration of control over public health within the provincial government is likely to concern many people.

She said it comes on the heels of a 2023 bill that put final decisions during public health emergencies in politicians' hands, not the CMOH.

"Many people would point to the government's silence on the measles outbreak as sort of evidence that the government is more concerned about politics and appeasing voters, and pandering to the voting base than it is about public health," Hardcastle said.

On Thursday, LaGrange also defended her government's response to rising numbers of people contracting measles, saying the 193 cases reported to Alberta Health so far this year are in clusters, and not a provincial outbreak.

Alberta's former CMOH, Dr. Mark Joffe, told doctors in a webinar last week that the spread of measles in Alberta is a "failure of leadership," as some vulnerable people do not know it is preventable.

Joffe stepped out of the role last month after declining to renew his contract.