Alberta moves ahead with hospital-level decision-making amid ongoing health care overhaul
Alberta is continuing its sweeping overhaul of the health system by shifting decision-making power from regional zones to individual hospitals, a move the government says will improve care but that some experts warn could deepen confusion around the province’s evolving health care structure.
Under the new model, Alberta Health Services’ current zone-based approach will be dismantled. Hospitals will instead be managed by on-site leadership teams responsible for hiring, managing resources and responding to patient needs. The province says this decentralized approach will reduce delays and better support local care delivery.
Premier Danielle Smith has framed the changes as a common-sense correction to a system she says has become too bureaucratic. “What works in Calgary or Edmonton isn’t always what works in Camrose or Peace River,” she said in the government’s announcement. But the shift comes on the heels of several other structural reforms, including the creation of new provincial health agencies, and may add another layer of uncertainty for both patients and providers.
The government is modeling the changes on systems in countries like Norway and the Netherlands. The transition will begin with a pilot site this fall, with full provincewide implementation expected by summer 2026. The new framework will apply to AHS-run acute care hospitals only, leaving other care providers under the existing structure for now.
Acute Care Alberta, a new oversight body, will monitor performance and set expectations for individual hospitals. AHS will continue to operate the sites but with a narrower focus on performance standards and accountability under the hospital-based model. Interim AHS president Andre Tremblay said the approach will allow local leaders to respond more quickly to on-the-ground issues, such as staffing gaps or operational inefficiencies.
While the province insists the change will lead to more efficient care, it remains unclear how it will integrate with other recent reforms, including the launch of Primary Care Alberta and separate organizations for continuing and mental health care. The health system is still adapting to these earlier changes, and some stakeholders worry that adding another layer of restructuring could further delay improvements to front-line services.
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