The Alberta government is hoping to speed up the queue for Albertans waiting for surgery by introducing Bill 11 — legislation that would allow some doctors to work in both the public and private health-care systems simultaneously.
According to the Alberta Surgical Initiative Dashboard, as of September, about 83,000 Albertans are on a surgery wait list.
That’s a roughly 4,000-person jump compared with September 2024, and a roughly 6,900-person jump from September 2023.
Of those on a list, about 43 per cent waited longer than the recommended target times.
The governing United Conservative Party tabled Bill 11 in late November.
Weeks later, experts are still divided on what this plan will do.
Nadeem Esmail, health policy director at the Fraser Institute, believes the province is taking a step in the right direction.
He says some surgeons are willing to work more and want to earn extra pay, and are waiting for access to surgical rooms.
Allowing them to work in private facilities would help the health-care system by boosting resources.
“The idea that this will somehow starve the public system of resources misunderstands what’s happening on the ground in Alberta today,” Esmail said.
Esmail says physicians have left Alberta in the past for more flexible working conditions.
He believes Bill 11, the dual-model system, would be an appealing idea for nurses who have left and could attract unemployed physicians.
Esmail says this model would also encourage competition and create better service.
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“Currently, the government health care provides a single uncontested standard of care. There is no one in Alberta delivering better health care. Patients who want to see care for themselves are having to leave the province or leave the country,” Esmail said.
“Having an option at home encourages the public system to do a better job and look after public patients when there is a clear alternative doing a better job right next door.”
Esmail says this model would be beneficial to the patient, too, as they now have a choice.
“Allowing Albertans to purchase care that the government system is unwilling or unable to provide is going to give them an important option to look after themselves,” he said.
On a national level, Esmail says other developed countries offer a universal health-care system as well as a private system.
A 2023 Commonwealth Fund report showed that Canada has the highest number of people waiting between two months and a year for a procedure. Esmail says even if some developed countries have high wait times with a dual model, they are shorter than Canada’s wait-lists.
However, University of Calgary health economics professor Dr. Braden Manns says Europe has twice as many doctors per capita as Canada.
He says there are not enough physicians currently in Alberta’s public system, let alone working in both.
“This isn’t a problem of not having operating rooms in Alberta. It’s a problem of not having anesthetists and not having enough staff,” Manns said.
“We will not do more surgeries in the public system until we can recruit more anesthetists, train more nurses who can work in the operating rooms and that will take years to do — and with the population growing, I don’t see that happening any time soon.”
Manns says the more private expansion occurs, the longer the wait times will be in the public system.
He points to a recent study done by Newcastle University in the United Kingdom that compared cataract surgery expansion over a 20-year timeline in England and Scotland.
In England, for every one per cent expansion of the private sector, wait times in the public system increased by two per cent.
Scotland kept private facilities at a minimum, even buying a private hospital and moving it into the public system. That move ended up reducing wait times.
Manns says it isn’t fair that only people who can afford care can get it faster.
“Some patients wait two years to get their surgery, while a similar patient in the same city who lives on the same street but seeing a different surgeon might get their surgery done in three months,” he said.
Manns adds that the dual model will be a burden to the current workforce.
However, Primary and Preventative Health Minister Adriana LaGrange says it would not be a burden because the dual model is optional.
“No one is forced to do it. Obviously, it’s voluntary. If you have capacity and you want to do it, that is what will happen,” LaGrange told reporters.
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