Alberta’s 2025 budget is high on rhetoric but low on detail when it comes to plans for the new, “refocused” system of health-care agencies that will replace Alberta Health Services (AHS).
Health Minister Adriana LaGrange speaks at a press release in Red Deer, March 3rd. From the Government of Alberta newsroom Flickr
It’s challenging to draw a direct comparison between the old single agency and the new, still-setting-up set of mini-agencies that are taking its place, so our look at the health section of the budget focuses on four specific issues: the Alberta Surgical Initiative (and “CorruptCare” scandal), agency nursing, vaccines and emergency services.
Budget 2025 is not an optimistic or ambitious document. Premier Danielle Smith’s UCP government projects the economic damage of upcoming tariffs from the United States, courtesy of Smith’s ally President Donald Trump, will be similar in scale to what Alberta suffered during the 2014 fossil fuel recession.
The fiscal plan notes that these economic problems will hit Albertans directly: unemployment is expected to remain higher than it was in 2022/23, at seven per cent.
Budget low on details about Alberta Surgical Initiative
Despite all of the attention on the Alberta Surgical Initiative—or perhaps because of it—the words ‘surgery’ and ‘surgical’ are only to be found in two paragraphs of the government’s strategic plan, neither of which deal directly with the issue of private services, such as those provided by Alberta Surgical Group. The budget does boast $265 million to renovate existing surgical facilities within the public system through the Alberta Surgical Initiative Capital Program.
“Additionally, the initiative focuses on training, recruiting, and retaining high-quality surgical teams to support increased surgical capacity,” the strategic plan claims, without specifying whether those teams exist within the public system or are contracted from private providers.
No mention of agency nursing
Jeremy Appel here at the Report has written several articles recently explaining the ongoing issue with Alberta’s big bill for contract nurses from private staffing agencies. You will not find this topic mentioned directly in the 2025 plans for the health budget. In March 2024, Health Minister Adriana LaGrange acknowledged that t this expense is of concern to even the privatization-thirsty UCP, and as noted in our coverage, overall the use of agency nurses in Alberta has begun to trend down as the staffing pressure from the pandemic has eased: while agency nursing spending peaked at $154.6 million in 2023-2024, AHS projected that spend will have decreased to about $95 in 2024-2025.
The government’s strategic plan does not note any plans to increase the ranks of nurses by improving their pay. Rather, the government argues that it will ease the shortage of nurses by making it easier for nurses from other jurisdictions to migrate and work here. But at the same time, the existing nursing force will be used to ease pressure on primary physicians through the Nurse Practitioner Primary Care Program, a policy change which allows nurse practitioners to deliver many of the services of a family doctor.
Vaccination? Don’t even say the word
In the wake of a viral disease epidemic that killed thousands of Albertans and dramatically compromised the entire health care system for several years, one might expect a government health strategy to mention vaccination programs. This entire topic is glaringly absent from the 2025 budget, though perhaps that’s not a great surprise given the premier’s well-known anti-vaccine position.
COVID-19 is still in circulation and measles and bird flu teeter precariously over the American border, but the Alberta government does not appear to be interested in any expansion of vaccination programs.
Measures to address emergency response problems don’t appear to include improving conditions for workers
Access to ambulances and emergency response services has been an ongoing concern in Alberta for at least the past year. Budget 2025 does not address it fully. The strategic plan notes that the province will invest $60 million more in upgrading the emergency health services (EHS) fleet—that is, purchasing ambulances—but does not make note of any funds for improving worker pay.
While the strategic plan asserts that the EHS fleet upgrade and unspecified measures to “invest in the future of the EHS system” and notes that “these initiatives align with the recommendations from the Alberta Emergency Medical Services Provincial Advisory Committee’s final report,” that final report made far more recommendations, mostly focused on improving working conditions for emergency responders. The budget documents do not address these concerns at all.
While that report does mention fleet expansion once as coming up during consultation, expanding the EHS fleet is not even one of the report’s recommendations.
A more-of-the-same budget
The UCP government is locked in to their plan to fracture AHS into separate bodies and nothing in last week’s budget release suggests any change in course.
The breakup of the agency makes a direct comparison to previous AHS budgets difficult and if there are stealth cuts in this budget, they may take some time to be found. However, the provincial government appears to be staying the course from 2024.
While that course does appear to include a moderate amount of capital spending on new ambulances and facilities, it continues to deny health care workers in Alberta improved pay and working conditions. Without that part of the equation, Alberta will continue to grow more reliant on the private sector to cover its health care needs.