‘Failing to deliver’: Alberta’s surgical outsourcing leading to increased costs and wait times: report

A new report suggests Alberta's outsourcing of surgeries is increasing wait times and costs. For patients stuck on those long waiting lists, it's a real pain.

The wait list for Albertans needing hip, knee and shoulder replacement surgeries is growing and the outsourcing of procedures to for-profit surgical groups is leading to higher costs in the province, according to a new report.

Parkland Institute’s report, dubbed Operation Profit: Private Surgical Contracts Deliver Higher Costs and Longer Waits, analyzed public data on wait times and spending.

The report’s lead author says the cost of publicly funded, private surgeries has jumped by 79 per cent since 2019, but wait times have gone up over the same time period.

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“We’ve seen wait times for nine of 11 priority procedures tracked by the Canadian Institute for Health Information, including knee replacements and all cancer surgeries—those median wait times have increased since the inception of the Alberta Surgical Initiative,” said Andrew Longhurst, a health policy researcher.

“So, it’s delivering higher costs and longer wait times, to put it simply.”

The provincial government launched the Alberta Surgical Initiative in 2019 in an effort to increase the number of procedures by outsourcing some surgeries to private partners.

“The provincial government has spent about $154 million over the last five years. These are fees paid to private, for-profit, investor-owned facilities to pay for the surgeries,” Longhurst said.

“And there’s been quite significant increase in the for-profit facilities and really a marginal increase in funding for public operating rooms.”

Longhurst says it’s also resulting in a shifting of staff from the public health-care system to the private sector.

LaGrange responds

Late Wednesday afternoon, the Minister of Health declined an offer to go on-camera, but her office provided the following statement:

“I’m not surprised to see the Parkland Institute continue their work acting as the NDP’s unofficial research arm,” it said.

“This report selectively highlights data that supports ideological narratives while overlooking the practical, evidence-based solutions implemented by Alberta’s government.

“The use of chartered surgical facilities (CSFs) has played a key role in reducing wait times and improving patient care, yet these successes are often dismissed or downplayed in favor of an ideological stance that does not reflect the actual progress we’ve made.

“For the 2024-25 fiscal year, we are targeting a record number of 310,000 surgeries, up from 304,595 surgeries completed in the previous fiscal year. In fact, 2023-24 represents the highest volume in five years, with cancer surgery volumes up in every one of the most recent four quarters.

“Regarding cost, CSF contracts from 2024 were negotiated at a rate of $6,950 per hip surgery and $6,950 per knee surgery. Whereas, CIHI data determined the average cost of delivering knee surgery in hospital in Alberta to be just over $9,600, and over $10,500 for a hip surgery.

“Alberta’s government is also concerned that AHS’s internal costing for surgeries delivered in AHS facilities is unreliable as they do not appear to include overhead, administration, or capital maintenance when calculating the costs of their own surgeries.

“It is obviously not valid to compare only operating costs in hospital to the cost of services in a new purpose-built CSF.

“Any claim based on such a comparison is misleading.

“We are currently considering changes to the acute care funding model that would increase transparency and accountability and ensure a more sustainable and transparent funding model for acute care in Alberta.”

You can read the full report below: