An update on Alberta’s Bill 26: Health Statutes Amendment Act

Alberta’s Bill 26 seeks to continue the government’s restructuring of healthcare in Alberta and introduces prohibitions on the treatment of minors for gender dysphoria.

On December 5, Bill 26, the Health Statutes Amendment Act, 2024 (NO. 2), received royal assent. With some exceptions, its provisions will come into force upon proclamation, expected early 2025.

The bill enables the Alberta government to continue its dramatic restructuring of Alberta’s health sector by amending the Provincial Health Agencies Act to permit creating provincial health corporations, establishing procedures for patient complaints, and amending laws applicable to subsidiary health corporations, community health councils or provincial health boards to apply to provincial health corporations.

It also amends the Health Professions Act to prohibit certain treatments and surgery for minors suffering from gender dysphoria and amends the Public Health Act to revise the definition of “public health emergency.”

The Provincial Health Agencies Act – introduction of “provincial health corporations” and complaints process

The first Health Statutes Amendment Act, 2024 replaced Alberta Health Services with provincial health agencies. Currently, four provincial health agencies have been established based on sectors. Alberta Health Services is now responsible for acute care, and there are provincial health agencies for primary care, continuing care, and mental health and addiction.

Bill 26 continues this re-structuring, and will amend the Provincial Health Agencies Act to permit creating “provincial health corporations,” to:¹

• Act in an advisory capacity to ministers, existing health authorities, provincial health agencies, regional health authorities, other provincial health corporations, subsidiary health corporations or community health councils;
• Deliver or coordinate the delivery of health services and services related to administering and operating the health care system; and
• Carry out other activities assigned by the regulations.

Provincial health corporations are to be established by the responsible minister in accordance with the regulations.² Similar to provincial health agencies, they will be an agent of the Crown.³ The terms of governance for the provincial health corporations, including their purpose, powers, duties, responsibilities, functions, jurisdiction and management are to be addressed through regulations.⁴

Bill 26 will also require provincial health agencies, regional health authorities and provincial health corporations to establish and maintain a process for resolving complaints by, on behalf of or in the interests of patients, in accordance with the regulations.⁵

In short, the bill authorizes the relevant ministries to establish new “provincial health corporations” to deliver the health services within that ministry’s defined areas of responsibility. However, most of the details about what corporations will be created and how they will function have been left to regulation. To date the government has not published regulations, and has not indicated when any will be published. Accordingly, the full scope and impact of these structural changes to Alberta’s health sector still remains to be seen.

The Health Professions Act – prohibitions on treatments for gender dysphoria

Bill 26 amended Alberta’s Health Professions Act, to add definitions for “gender dysphoria,” “gender incongruence,” “minor,” and “sex reassignment surgery,”⁶ and to prohibit sex reassignment surgery on a minor.⁷ This prohibition came into effect upon royal assent, December 5, 2024.

The bill also prohibits prescribing a Schedule 1 drug within the meaning of the Pharmacy and Drug Act, or any other drug identified in the regulations, to a minor for the purposes of hormone therapy, including puberty suppression and hormone replacement, for the treatment of gender dysphoria or gender incongruence, except for in accordance with an order of the minister.⁸

The minister may make orders under the Health Professions Act authorizing the prescription to a minor for the purpose of hormone therapy, including puberty suppression and hormone replacement therapy, for the treatment of gender dysphoria or gender incongruence, and respecting any such authorization, including any terms, conditions or limits that apply to an authorization.⁹ The Government of Alberta advised that a ministerial order will outline exemptions for minors aged 16 and 17 with parental, physician and psychologist approval, and for minors who have already been prescribed hormone replacement therapies to treat gender dysphoria and gender incongruence.

The Government of Alberta noted it expects self-governing regulatory colleges under the Health Professions Act to be responsible for enforcing the prohibitions through their unprofessional conduct discipline process.

The Public Health Act – revising the definition of “public health emergency”

Bill 26 amends the Public Health Act to revise the definition of “public health emergency” to include “an urgent and temporary occurrence or threat of an occurrence” of the enumerated events or illnesses “that poses a significant risk to the public of an increase in disease, injuries disabilities or death in excess of expectations during times of normalcy.”¹⁰ This amendment came into effect upon royal assent, December 5, 2024.

The amendment was in response to the Public Health Emergencies Governance Review Panel’s report, which recommended the definition be amended to provide additional clarity.

The author would like to thank Kristen Verwey, articling student, for her contribution to preparing this legal update.