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United Nurses of Alberta says AHS memo to cut costs, reduce OT is ‘irresponsible’

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Alberta Health Services looks to reduce spending
Alberta Health Services is working to cut costs in anticipation of an operating deficit for the 2023/24 fiscal year, but a memo detailing some of the ways it aims to do so has the United Nurses of Alberta voicing some concerns. Morgan Black reports – Jan 9, 2024

Alberta Health Services is working to cut costs but a memo detailing some of the ways it aims to do so has one of the province’s unions worried it’ll impact frontline services.

The United Nurses of Alberta, which represents registered nurses in the province, said it is concerned by a memorandum from AHS acting chief financial officer Michael Lam.

The undated memo instructs the province-wide health care agencies’ senior leaders to reduce the use of overtime and agency staffing by “at least 10 per cent” in anticipation of an operating deficit for the 2023/24 fiscal year.

“In the nursing world, ‘do more with less’ is basically the message that was sent down in the last couple of weeks,” UNA president Heather Smith said Tuesday.

The memo said the following strategies were being implemented immediately:

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  1. Vice president of ELT-leader approval to recruit/fill any vacation position, except for existing non-management positions in clinically focused areas (clinical operations, cancer care, addictions and mental health, correctional health services etc.)
  2. Discretionary spending is frozen. That includes, but is not limited to, travel outside Alberta, travel within the province for non-clinical reasons, purchases of non-clinically-required minor equipment (the memo cited “non-clinically required IT devices”) and office supplies, engaging consultants, education such as courses and conferences, and working sessions, hosting or hospitality or recognition efforts.
  3. Portfolios with positive variances from their budget must maintain or increase the variances for the remainder of the fiscal year
  4. All non-clinical overtime requires executive approval and all areas of AHS are asked to monitor and try to reduce OT and use of agency staffing by at least 10 per cent, “while minimizing impacts to frontline service delivery.”

Smith called the plan extremely concerning.

“If you don’t have people to provide care, then you’re not getting care that you ideally should get and need.”

Smith noted the memo did not go so far as to freeze filling front-line clinical roles like nurses.

“Which is good because in the past we have seen that where, any posting, including direct patient care positions, had to be approved at one point, right up to the CEO at the time, Verna Yiu. But it is putting a restriction on non-clinical hirings.”

University of Calgary health policy expert Lorian Hardcastle said it’s not uncommon for an organization like AHS to make cuts.

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“But you have to balance that desire for savings with concerns around patient care, patient safety, retaining and recruiting health care workers,” she said.

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Hardcastle said it’s an aggressive plan, on top of AHS heading into a significant restructuring that was announced last year by Premier Danielle Smith, that could affect not just morale, but the province’s reputation with job-seekers.

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“What’s going on in Alberta with the restructuring and the potential chaos it brings, the potential instability it brings that may deter someone from wanting to work here.”

Alberta is competing with jurisdictions across the country to recruit and retain health-care workers, Hardcastle said.

“If we’re taking steps that maybe suggests there’s conflict between the government and health-care workers, or we’re taking steps to cut costs and potentially make the working environment more negative, it may be difficult for us to recruit and retain staff.”

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Hardcastle said a focus on cost-saving through staff hours and overtime instead of keeping staff ratios high could lead to quality of care issues.

“Particularly as we transition into colder weather and we can tend to see higher rates of respiratory viruses, there can already be staffing pressures at that time without trying to also find cuts to make,” she said.

The AHS memo acknowledges areas of the health-care system continue to be stressed and the dedication staff has put into keeping the system going “has not gone unnoticed.”

The UNA said the proposed changes send a different message.

“Asking an already exhausted workforce to give even more is quite irresponsible,” Smith said.

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The Alberta NDP called it an attack on health-care workers.

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“At a time when our hospitals are buckling under unprecedented demand, it is outrageous and indefensible for the UCP to demand AHS cut back on the very staff working hard to keep Albertans healthy,” said David Shepherd, Alberta NDP health critic for primary and rural care.

“We stand alongside the United Nurses of Alberta and share their extreme concern regarding the recent memo from Alberta Health Services.

“It is nothing short of a betrayal to those on the frontlines of a healthcare system already stretched to the breaking point.”

The NDP called on the government to reverse course and work on a strategy to retain existing workers and recruit further professionals to the frontlines.

“Costs of care have increased because the UCP has failed to properly invest in public health-care. The only way to decrease costs is doing just that — training, hiring, and retaining the front-line staff we need,” said Luanne Metz, Alberta NDP critic for emergency and surgical care.

“Few, if any, health-care professionals would be enticed to relocate and work in Alberta under such disrespectful conditions.”

Alberta Health says while the memo from AHS leadership requires actions to help limit non-clinical spending, it does not demand staffing cuts be made.

“Albertans expect that AHS puts as much of their funding as possible towards front-line patient care, and that any action to manage spending has limited impact on the quality of health care they receive,” said a statement from ministry press secretary Andrea Smith.

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“Nowhere in the memo does it ‘demand’ staffing cuts, this assertion by the NDP is extremely misleading.”

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