Canada: Public Inquiry Into Preferential Access To Health Services In Alberta

Last Updated: February 18 2013
Article by Nadia Jandali Chao

Allegations of the existence of a two-tier health care system in Canada - one where some people get faster access than others for reasons unrelated to their health condition - have been made for a number of years. A public inquiry currently underway in Alberta investigating allegations of "queue jumping" and related preferential treatment in the health care system (the "Inquiry")1 may provide some credence to those allegations. Until recently, the general consensus on the Inquiry was that it had yet to produce a "smoking gun". However, in recent weeks, the Inquiry attracted significant media attention as a result of witness testimony that lends some support to claims of disparity in access to health care in Alberta.

Background of the Inquiry

By way of background, the Inquiry was ordered by Premier Alison Redford in February 2012 in response to various allegations that some patients in the Alberta health care system were receiving preferential care.2 One such high-profile controversy related to allegations that a public colon cancer screening centre in Calgary (the "Centre") was putting patients referred to it by a certain private clinic, for routine screening, to the front of the line (the "Cancer Screening Allegations"). There were also allegations that politicians were interfering with the health care system and "pushing personal agendas" by using healthcare as an avenue for "political gain".3

The $10 million Inquiry headed by Justice John Vertes is the first of its kind in Canada. Directed to "determine whether improper preferential access to publicly funded health services is occurring," he is to make recommendations, if any is found, "to prevent future improper access."4  Facing criticism that the scope of the Inquiry is too narrow because it does not extend to claims of interference by politicians in health care, nor address the issue of physician intimidation5, Redford has clarified that "the Inquiry can follow the evidence where it leads".6

The Inquiry commenced in December 2012.  It is currently in the evidence gathering stage with witnesses having testified in Edmonton and in Calgary over the last two months. Witnesses have included representatives of Alberta Health Services and the Calgary Health Region (now amalgamated with Alberta Health Services); leaders of the Alberta Liberal Party and Alberta NDP; hospital executives; and the Alberta health minister, the Honourable Fred Horne. Public hearings are scheduled to continue February 19 through to March 1, 2013. The report summarizing the findings and recommendations of the Inquiry is due April 30, 2013.

Recent Testimony

Until recently, no particularly controversial evidence had been put forward at the Inquiry. However, testimony was recently given regarding the Cancer Screening Allegations that attracted considerable attention. Specifically, clerks from the Centre testified that patients who were referred from a private health care clinic (the "Private Clinic") were given urgent priority even if their health condition was not considered high risk.7 The Private Clinic patients would generally receive screenings at the Centre within weeks while non-priority patients often had to wait years.8 The medical director of the Centre, in his testimony before the Inquiry, denied that clerks were told to allow patients from the Private Clinic to jump the queue.9

The Inquiry also recently heard that in 2009 some professional hockey players were able to by-pass five-hour line-ups at public clinics by receiving H1N1 vaccinations through a private session. The private session occurred the day before Alberta Health Services announced a vaccine shortage and began closing flu shot clinics.10


The consequence of a finding of improper preferential treatment in the system is not clear. Currently in Alberta, like many other provinces, there is legislation that prohibits queue jumping.11 However, while there is an implication in the governing legislation that publicly funded medical services should be allocated on the basis of relative need, there is no federal or provincial legislation that dictates how waiting lists are to be structured or wait times allocated.12

One argument that Justice Vertes may have to grapple with is that various (legal) forms of preferential, or inequitable, access to care are already built into the health care system. For example, when a person purchases a diagnostic service at a private facility (either in province where permissible or out of province where not) instead of waiting months for the publicly funded option, and the results demonstrate that some kind of treatment is required, that person has, arguably, been fast tracked towards treatment, as compared to someone who waited for the publicly funded diagnostic test.13  As another example, certain categories of people are excluded from the public health insurance plans, such as workers injured on the job, because they receive funding for health care services from other public sources and, in some cases, those individuals can receive medical care faster than the general public.14  As such, if Justice Vertes concludes that "improper preferential access" exists in the system, it will be interesting to see how that term is defined and whether, or how, it is reconciled with these others types of inequality in the system.


1 Health Services Preferential Access Inquiry, online:

2 "Terms of Reference", Health Services Preferential Access Inquiry, online:

3 "Review of the Quality of Care and Safety of Patients Requiring Access to Emergency Department Care and Cancer Surgery and the Role and Process of Physician Advocacy", Health Quality Council of Alberta (February 2012), online:

4 Supra  note 2, page 3.

5 Shawn Logan, "Wildrose leader Danielle Smith calls queue-jumping inquiry a waste", Calgary Sun (December 11, 2012), online: ; "President's Letter", Alberta Medical Association (February 29, 2012), online:

6 "Queue-jumping inquiry won't be a witch hunt", CBC News (October 15, 2012), online:

7 Transcript Volume 24 (January 15, 2013) of the Health Services Preferential Access Inquiry, at pages 1946-1950, online:

8 Ibid.

9 Transcript Volume 26 (January 16, 2013) of the Health Services Preferential Access Inquiry, at page 2098, online:

10 "H1N1 clinics suspended due to vaccine supply issues", Alberta Health Services (October 31, 2009), online:

11 Health Care Protection Act, RSA 2000, c H-1, s. 3.

12 Transcript Volume 1 (December 3, 2012) of the Health Services Preferential Access Inquiry, at page 76-77, online:

13 Ibid, page 48-49.

14 Ibid, page 44.

The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.

To print this article, all you need is to be registered on

Click to Login as an existing user or Register so you can print this article.

Similar Articles
Relevancy Powered by MondaqAI
In association with
Related Topics
Similar Articles
Relevancy Powered by MondaqAI
Related Articles
Related Video
Up-coming Events Search
Font Size:
Mondaq on Twitter
Register for Access and our Free Biweekly Alert for
This service is completely free. Access 250,000 archived articles from 100+ countries and get a personalised email twice a week covering developments (and yes, our lawyers like to think you’ve read our Disclaimer).
Email Address
Company Name
Confirm Password
Mondaq Topics -- Select your Interests
 Law Performance
 Law Practice
 Media & IT
 Real Estate
 Wealth Mgt
Asia Pacific
European Union
Latin America
Middle East
United States
Worldwide Updates
Registration (you must scroll down to set your data preferences)

Mondaq Ltd requires you to register and provide information that personally identifies you, including your content preferences, for three primary purposes (full details of Mondaq’s use of your personal data can be found in our Privacy and Cookies Notice):

  • To allow you to personalize the Mondaq websites you are visiting to show content ("Content") relevant to your interests.
  • To enable features such as password reminder, news alerts, email a colleague, and linking from Mondaq (and its affiliate sites) to your website.
  • To produce demographic feedback for our content providers ("Contributors") who contribute Content for free for your use.

Mondaq hopes that our registered users will support us in maintaining our free to view business model by consenting to our use of your personal data as described below.

Mondaq has a "free to view" business model. Our services are paid for by Contributors in exchange for Mondaq providing them with access to information about who accesses their content. Once personal data is transferred to our Contributors they become a data controller of this personal data. They use it to measure the response that their articles are receiving, as a form of market research. They may also use it to provide Mondaq users with information about their products and services.

Details of each Contributor to which your personal data will be transferred is clearly stated within the Content that you access. For full details of how this Contributor will use your personal data, you should review the Contributor’s own Privacy Notice.

Please indicate your preference below:

Yes, I am happy to support Mondaq in maintaining its free to view business model by agreeing to allow Mondaq to share my personal data with Contributors whose Content I access
No, I do not want Mondaq to share my personal data with Contributors

Also please let us know whether you are happy to receive communications promoting products and services offered by Mondaq:

Yes, I am happy to received promotional communications from Mondaq
No, please do not send me promotional communications from Mondaq
Terms & Conditions (the Website) is owned and managed by Mondaq Ltd (Mondaq). Mondaq grants you a non-exclusive, revocable licence to access the Website and associated services, such as the Mondaq News Alerts (Services), subject to and in consideration of your compliance with the following terms and conditions of use (Terms). Your use of the Website and/or Services constitutes your agreement to the Terms. Mondaq may terminate your use of the Website and Services if you are in breach of these Terms or if Mondaq decides to terminate the licence granted hereunder for any reason whatsoever.

Use of

To Use you must be: eighteen (18) years old or over; legally capable of entering into binding contracts; and not in any way prohibited by the applicable law to enter into these Terms in the jurisdiction which you are currently located.

You may use the Website as an unregistered user, however, you are required to register as a user if you wish to read the full text of the Content or to receive the Services.

You may not modify, publish, transmit, transfer or sell, reproduce, create derivative works from, distribute, perform, link, display, or in any way exploit any of the Content, in whole or in part, except as expressly permitted in these Terms or with the prior written consent of Mondaq. You may not use electronic or other means to extract details or information from the Content. Nor shall you extract information about users or Contributors in order to offer them any services or products.

In your use of the Website and/or Services you shall: comply with all applicable laws, regulations, directives and legislations which apply to your Use of the Website and/or Services in whatever country you are physically located including without limitation any and all consumer law, export control laws and regulations; provide to us true, correct and accurate information and promptly inform us in the event that any information that you have provided to us changes or becomes inaccurate; notify Mondaq immediately of any circumstances where you have reason to believe that any Intellectual Property Rights or any other rights of any third party may have been infringed; co-operate with reasonable security or other checks or requests for information made by Mondaq from time to time; and at all times be fully liable for the breach of any of these Terms by a third party using your login details to access the Website and/or Services

however, you shall not: do anything likely to impair, interfere with or damage or cause harm or distress to any persons, or the network; do anything that will infringe any Intellectual Property Rights or other rights of Mondaq or any third party; or use the Website, Services and/or Content otherwise than in accordance with these Terms; use any trade marks or service marks of Mondaq or the Contributors, or do anything which may be seen to take unfair advantage of the reputation and goodwill of Mondaq or the Contributors, or the Website, Services and/or Content.

Mondaq reserves the right, in its sole discretion, to take any action that it deems necessary and appropriate in the event it considers that there is a breach or threatened breach of the Terms.

Mondaq’s Rights and Obligations

Unless otherwise expressly set out to the contrary, nothing in these Terms shall serve to transfer from Mondaq to you, any Intellectual Property Rights owned by and/or licensed to Mondaq and all rights, title and interest in and to such Intellectual Property Rights will remain exclusively with Mondaq and/or its licensors.

Mondaq shall use its reasonable endeavours to make the Website and Services available to you at all times, but we cannot guarantee an uninterrupted and fault free service.

Mondaq reserves the right to make changes to the services and/or the Website or part thereof, from time to time, and we may add, remove, modify and/or vary any elements of features and functionalities of the Website or the services.

Mondaq also reserves the right from time to time to monitor your Use of the Website and/or services.


The Content is general information only. It is not intended to constitute legal advice or seek to be the complete and comprehensive statement of the law, nor is it intended to address your specific requirements or provide advice on which reliance should be placed. Mondaq and/or its Contributors and other suppliers make no representations about the suitability of the information contained in the Content for any purpose. All Content provided "as is" without warranty of any kind. Mondaq and/or its Contributors and other suppliers hereby exclude and disclaim all representations, warranties or guarantees with regard to the Content, including all implied warranties and conditions of merchantability, fitness for a particular purpose, title and non-infringement. To the maximum extent permitted by law, Mondaq expressly excludes all representations, warranties, obligations, and liabilities arising out of or in connection with all Content. In no event shall Mondaq and/or its respective suppliers be liable for any special, indirect or consequential damages or any damages whatsoever resulting from loss of use, data or profits, whether in an action of contract, negligence or other tortious action, arising out of or in connection with the use of the Content or performance of Mondaq’s Services.


Mondaq may alter or amend these Terms by amending them on the Website. By continuing to Use the Services and/or the Website after such amendment, you will be deemed to have accepted any amendment to these Terms.

These Terms shall be governed by and construed in accordance with the laws of England and Wales and you irrevocably submit to the exclusive jurisdiction of the courts of England and Wales to settle any dispute which may arise out of or in connection with these Terms. If you live outside the United Kingdom, English law shall apply only to the extent that English law shall not deprive you of any legal protection accorded in accordance with the law of the place where you are habitually resident ("Local Law"). In the event English law deprives you of any legal protection which is accorded to you under Local Law, then these terms shall be governed by Local Law and any dispute or claim arising out of or in connection with these Terms shall be subject to the non-exclusive jurisdiction of the courts where you are habitually resident.

You may print and keep a copy of these Terms, which form the entire agreement between you and Mondaq and supersede any other communications or advertising in respect of the Service and/or the Website.

No delay in exercising or non-exercise by you and/or Mondaq of any of its rights under or in connection with these Terms shall operate as a waiver or release of each of your or Mondaq’s right. Rather, any such waiver or release must be specifically granted in writing signed by the party granting it.

If any part of these Terms is held unenforceable, that part shall be enforced to the maximum extent permissible so as to give effect to the intent of the parties, and the Terms shall continue in full force and effect.

Mondaq shall not incur any liability to you on account of any loss or damage resulting from any delay or failure to perform all or any part of these Terms if such delay or failure is caused, in whole or in part, by events, occurrences, or causes beyond the control of Mondaq. Such events, occurrences or causes will include, without limitation, acts of God, strikes, lockouts, server and network failure, riots, acts of war, earthquakes, fire and explosions.

By clicking Register you state you have read and agree to our Terms and Conditions