Bill 55 and the End of a Healthcare Era
On May 1st, Bill 55: the Health Statutes Amendment Act, 2025 (“Bill 55”) was introduced to majorly overhaul how healthcare services are governed and delivered in Alberta. The changes, which have since passed all stages of legislative approval, amend over 30 provincial acts of legislation. Bill 55 is part of the Government of Alberta’s broader effort to restructure Alberta Health Services (“AHS”) completely. The legislation is intended to allow for a seamless transition to the new healthcare delivery system upon the final dispersal of AHS’s functions and responsibilities in the fall of 2025.
Fully Ending the Regional Healthcare Model
The Government of Alberta has concluded that the province’s previous model of healthcare delivery under the oversight of AHS is contrary to consistent and effective healthcare delivery. AHS was first established in 2009, consolidating a series of regional health authorities into a single province-wide authority. While many Alberta statutes still reference the former Regional Health Authorities and the AHS, Bill 55 completely removes these references from legislation. Instead, “provincial health agencies” and “provincial health corporations” are the chosen terms through which aspects of the future healthcare system will be labelled.
Provincial Health Agencies
Provincial Health Agencies were defined under the previous Bill 22: Health Statutes Amendment Act, 2024 (“Bill 22”), which are the bodies taking over the governance responsibilities of AHS. Agencies now hold the authority to enforce inspections, reporting rules, and penalties over healthcare operators. A notable difference from the previous structure of AHS is that these agencies will be under the direct supervision of the Minister(s) of Health. The new agencies separate acute care, primary care, continuing care, and mental health and addictions from AHS. Bill 55 will officially transfer remaining employees of AHS, such as medical officers of health and public health inspectors, to their new respective agencies.
Additional nuance to the governance of provincial health agencies arose in the recent bifurcation of the Ministry of Health. Alberta now features a Ministry of Hospital and Surgical Health in addition to a Ministry of Primary and Preventative Health Services, with Assisted Living and Mental Health having been previously moved outside the purview of the Health portfolio. While the constituent fields of healthcare have been separated, Bill 22, and now Bill 55, centralize the decision-making powers over the healthcare system under the provincial government.
Provincial Health Corporations
Complementing the role of the provincial health agencies, provincial health corporations are the new entities entrusted with the operations and delivery of healthcare services, such as hospitals and surgical services. The health corporations will work underneath the health agencies, focusing on day-to-day delivery of services rather than the province-wide governance of healthcare. All provincial health corporations will be defined by legislation and remain under the oversight of government ministries.
Operators and Opposition
The move towards centralizing healthcare under the direct purview of ministries through the agency and corporation model will provide more legal tools to redefine the licensing and funding models of healthcare operators. Despite this, the Government of Alberta has reiterated its intentions to keep healthcare delivery a public service.
Healthcare unions and advocacy groups, including Friends of Medicare and the Alberta Union of Provincial Employees (AUPE), are among the loudest opponents to the changes brought forward in Bill 55. As Alberta’s 2025 Budget shifted the ownership of provincial healthcare facilities to the Ministry of Infrastructure, AUPE leadership has alleged that Bill 55 would allow the Government of Alberta to appoint anyone, including private entities, to become operators of these facilities.
Opposing skepticism has also arisen from the new legal protections extended to operators, expanding those given to AHS during the COVID-19 pandemic response. Bill 55 gives legal protection to healthcare operators and corporations so they can’t be sued for decisions made while delivering care, as long as they were acting in good faith. The legislation broadens this immunity, making it harder to bring legal action against designated operators unless gross negligence or intentional harm can be proven. Critics worry that this places the general public at a disadvantage when it comes to transparency in cases of mistreatment.
Then Minister of Health Adriana LaGrange, who tabled Bill 55, outlined that the changes would not lead to private operations of hospitals in the province, but that it was a necessary step to ensure democratic accountability and oversight. Despite this, opposition to the bill has centred around fears of a move towards healthcare privatization. Increasing political control over the new system may also allow future governments to further restructure healthcare services in whatever direction they see fit, either further or closer to a hybridized public-private delivery model. Dividing and removing the AHS as a single, relatively independent entity increases democratic influence over the province’s healthcare bureaucracy, but also increases the ease of enacting substantial reforms in the future.