John Church is an associate professor and is cross-appointed to the Centre of Health Promotion, School of Public Health, and the Department of Political Science, University of Alberta. Neale Smith is research coordinator, Faculty of Health and Social Development, University of British Columbia, Okanagan Campus at Kelowna. The study on which this article is based was funded through an operating grant from the Canadian Institutes of Health Research and a grant from Health Canada. We thank members of the Cross-Provincial Comparison of Health Care Policy Reform in Canada project, which include Harvey Lazar, Pierre-Gerlier Forest, John Lavis, Alina Gildiner, Aaron Holdway, Stephen Tomblin, Tom McIntosh, Claudia Sanmartin, Marie-Pascale Pomey, Élisabeth Martin and Vandna Bhatia. Josh Marko, David Schaaf and Kevin Wipf provided research support for Alberta. The authors also thank the two anonymous reviewers and the journal editor, Barbara Wake Carroll, for their insightful feedback. Last, but not least, they thank the seventeen individuals who agreed to be interviewed for this article.
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Health reform in Alberta: The introduction of health regions
Article first published online: 4 JUL 2008
DOI: 10.1111/j.1754-7121.2008.00016.x
© 2008 The Institute of Public Administration of Canada
Additional Information
How to Cite
Church, J. and Smith, N. (2008), Health reform in Alberta: The introduction of health regions. Canadian Public Administration, 51: 217–238. doi: 10.1111/j.1754-7121.2008.00016.x
Publication History
- Issue published online: 4 JUL 2008
- Article first published online: 4 JUL 2008
Abstract: In 1994, the Government of Alberta passed the Regional Health Authorities Act to abolish nearly 200 existing local hospital and public health boards and replace them with seventeen regional health authorities. Consistent with the larger fiscal agenda, the government's intention was to address health-care system efficiency through larger integrated management and governance structures. In this article, the authors examine why Alberta decided to create regional health authorities for the management and delivery of a significant range of health services. In examining the interaction of ideas, interests and institutions, the authors conclude that the government was partially successful in aligning existing institutional and interest relationships with an emerging political consensus about cost and sustainability of the health-care system.
Sommaire: En 1994, le gouvernement de l'Alberta a adopté la loi intitulée Regional Health Authorities Act (Loi sur les offices régionaux de santé) en vue d'abolir près de 200 commissions hospitalières et commissions de santé publique locales et de les remplacer par dix-sept offices régionaux de la santé. Conformément au programme fiscal plus large, l'intention du gouvernement était d'examiner l'efficience du système des soins de santé grâce à des structures intégrées de gestion et de gouvernance plus vastes. Dans le présent article, les auteurs examinent les raisons pour lesquelles l'Alberta a décidé de créer des offices régionaux de la santé pour la gestion et la prestation d'une gamme importante de services de santé. Après avoir étudié les interactions d'idées, d'intérêts et d'institutions, les auteurs ont conclu que le gouvernement avait partiellement réussi à aligner les relations institutionnelles et les relations d'intérêts existantes sur un consensus politique émergent au sujet des coûts et de la viabilité du système de soins de santé.