Alberta's Opposition NDP has asked the province's auditor general to investigate the procurement process for private surgical facilities, alleging Health Minister Tyler Shandro and other senior government officials have politically interfered in that process through their discussions with one group.
This week, CBC News revealed that a group — which included a developer, orthopedic surgeons and high-powered lobbyists — says it has gained tentative political support from Shandro for its proposal to build and operate a private orthopedic surgical facility near Edmonton's Royal Alexandra Hospital.
The group responded to the government's call for expressions of interest in February.
A recording from one of three presentations made by the group to Edmonton-area orthopedic surgeons in late June was obtained by CBC News. In it, lobbyists described a discussion between one of the group's surgeons and Shandro, who they described as being strongly supportive of the initial proposal and urged the surgeon to follow up with his principal adviser, Ivan Bernardo.
Bernardo "also was very warm to the project and really asked, 'What are the impediments and how can he help remove them?'" lobbyist Elan MacDonald said during the presentation. She said Bernardo was personally overseeing the file.
In a letter sent Tuesday to Auditor General Doug Wylie, NDP health critic David Shepherd said the group's access to Shandro and others shows there is "direct political interference in the procurement process," citing "what appears to be improper contracting procedures being engineered by the Minister of Health and his office."
"I am requesting that the Office of the Auditor General conduct an immediate audit, to ensure that Alberta taxpayers are protected and that our public health-care system is not deliberately undermined through improper procedures," Shepherd wrote.
He asked Wylie to investigate whether Shandro and his office have breached relevant procurement and trade guidelines.
"We are really concerned about what, frankly, appears to be a corrupt procurement process that is happening behind closed doors," Shepherd said in an interview.
Shandro previously declined an interview request. In a statement last week, his press secretary Steve Buick said the minister and his staff regularly meet with physicians and others to discuss improvements to the health-care system. He said Shandro respects the public procurement process and awaits its outcome.
"This project is only a concept at this stage. The minister has not endorsed it," Buick said.
Proposed orthopedic surgical facility
Most of the group's political lobbying occurred weeks before the UCP government of Premier Jason Kenney pushed through Bill 30 in late July. The controversial legislation proposes to cut approval times required for private surgical facilities, allows Alberta Health to contract directly with doctors, and permits private companies to take over the administrative functions of physician clinics.
Critics say the legislation will open the floodgates to private health care in Alberta and that this proposed surgical facility — which, if approved as planned, would perform all non-emergency orthopedic surgeries in the Edmonton area — could mark the beginning of such a shift.
The $200-million facility would be privately financed and managed. The preliminary design is for 270,000 square feet spanning five or seven storeys on the site of the current Ericksen Nissan auto dealership, located on 101st Street near the Royal Alexandra Hospital.
Under the proposal, still in the formative stages, the facility would employ non-unionized staff, run operating theatres up to 23 hours a day, and potentially house other services such as medical imaging and physiotherapy. It would perform, under contract to the government, as many as 10,000 surgical procedures a year, up from the region's current 6,000.
Political lobbying strategy
At the June presentation to surgeons, the group said it intends to seek a contract that would ensure the facility is economically viable as well as make it prohibitively expensive for a future government to shut down.
In his letter, Shepherd expressed concern about this strategy and asked Wylie's office to "proactively engage in an independent cost-benefit analysis of any contract between AHS or the Ministry of Health and the project proponents prior to it being signed, in order to ensure the public purse is protected."
MacDonald and one of the surgeons behind the project also described a plan to keep Alberta Health Services (AHS), which is responsible for delivering health care in the province, "at arm's length" until the proposal has enough political and bureaucratic support that it is effectively approved.
The surgeon, Dr. Paulose Paul, is the AHS Edmonton Zone section chief for orthopedics.
"We really want Alberta Health from the political perspective to be pulling this project through and really be directing down to AHS that this is something that they want to have happen," MacDonald said at the presentation.
Paul told CBC News that AHS is fully aware of the group's proposal. The facility would provide more comprehensive and efficient care, he said, by consolidating surgeries and services now provided in six hospitals across the Edmonton region.
Public health-care advocates, academics and the NDP said research shows private facilities cost more, drive up wait times in the public health-care system and exacerbate staffing shortages.
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