Alberta Rolls Out Controversial Dual-Practice Model for Doctors
Alberta is implementing a new dual-practice model under Bill 11, allowing eligible specialists to work in both public hospitals and private clinics. While Premier Danielle Smith argues this will reduce wait times, critics and data from other provinces suggest the move may exacerbate inequalities and fail to improve public access.
Alberta has begun rolling out a controversial "dual-practice" model as part of Bill 11, which allows eligible doctors to work in public hospitals while also providing care in private clinics. The initiative, which started this month, applies only to specific practitioners; family physicians are not eligible to participate. Approximately 400 doctors in Alberta have expressed interest in joining the program.
Proponents of the legislation, including Premier Danielle Smith, argue that the model will increase surgical capacity and help reduce wait times for elective procedures such as hip replacements. However, the plan faces significant opposition. More than 20 Canadian health organizations have called on the federal government to review the legislation, warning that it could violate the Canada Health Act and create a two-tiered system based on ability to pay.
Critics point to data from other jurisdictions to question the effectiveness of expanding private care. In Ontario, where the healthcare system remains largely public, 84 per cent of patients receive hip replacement surgery within the six-month national benchmark. In contrast, Quebec, which has more than 800 doctors who have opted out of the public system to operate privately, sees only 54 per cent of public patients meeting the same benchmark. Currently, 63 per cent of public patients in Alberta receive these surgeries within the national standard.
Experts caution that dual practice can create conflicts of interest and may incentivize longer wait times in the public sector. A 2024 study focused on Australia found that pushing private care to relieve the burden on public hospitals had limited impact, reducing public hospital wait times by less than half a day on average. International data suggests that expanding private care often exacerbates inequalities rather than solving public access issues.
While Nova Scotia saw its percentage of elective surgeries delivered within the benchmark rise to 77 per cent after implementing centralized waitlists and extended operating hours, the path forward for Alberta remains contested. Patients like Cheryl Stewart continue to face long waits for public surgery, highlighting the potential disparity between those who can afford private options and those who cannot. As the model takes effect, observers will be watching closely to see if Alberta’s approach aligns with the success seen in provinces maintaining strict public compliance or mirrors the challenges faced in Quebec.