A story published by a community newspaper chain late Monday quotes Alberta premier Danielle Smith telling a United Conservative Party town hall in Drayton Valley how she plans to hand over some public hospitals in rural Alberta to the Catholic Church, which will as a matter of principle refuse to provide certain basic health care services, and use that to scare the bejesus out of AHS administrators.
If you think this is an exaggeration, consider Smith’s words recorded at the Aug. 17 party-members-only meeting and reported by Brett McKay, who owes his employment as rural and municipal reporter by Great West Media to Ottawa’s $59-million local journalism initiative, proving that at least some of the federal funds earmarked for the preservation of journalism in Canada have been well spent.
“When you’re dealing with a monopoly,” Smith told the Drayton Valley meeting about Alberta Health Services, “and they believe that they can deliver any type of care, and there are no consequences, they’re going to continue to deliver bad service.”
Now, let’s not forget that the principal problem with the quality of AHS care has nothing to do with managers maliciously delivering bad service and everything to do with chronic underfunding of health care by the UCP, shortages of medical professionals resulting from past government decisions throughout Canada, and the Smith Government’s massive vanity project to restructure health care along ideological lines.
But how does the UCP now propose to solve the problems it’s created? “Competition is one option” the premier explained to her rural audience. “That’s why we’re offering chartered surgical centres and why we’re offering Covenant.”
Actual evidence indicates that so-called chartered surgical clinics are making things worse and it’s doubtful Covenant Health, owned by the Roman Catholic church, can do much better.
“Contrary to government claims that outsourcing to for-profit facilities increases provincial surgical capacity, data suggest that the expansion of chartered surgical facilities has diverted resources away from public hospitals and, in turn, reduced provincial surgical volumes,” the Parkland Institute reported in a study last year.
Getting back to Smith’s commentary, she said the other option “is the fear of having it taken away. That is going to be a very powerful competitive incentive for the managers to say, ‘Oh my goodness, if we continue to deliver terrible care in Drayton Valley, then somebody else is going to be chosen for the operator.’”
This is dangerous balderdash, but it’s a great line to offer to a rural audience sympathetic to the UCP’s extreme market fundamentalist and socially conservative base when you want to get them to support a program of dismantling public health care that will hurt rural areas far more than the province’s cities.
The premier described frightening AHS hospital managers as an incentive – and it will be, an incentive for the most competent health leaders to leave Alberta and move to better-run nearby jurisdictions, a phenomenon we have already seen among Alberta physicians during the UCP years that began in 2019.
Smith apparently also explained that she sees Covenant Health as a useful replacement for AHS in some communities because the smaller church-owned care provider “has never closed down rural hospitals.”
We have to infer that her reference is to the temporary closings caused by shortages of health care professionals that have plagued rural hospital Emergency Departments operated by AHS, not permanent but politically dangerous closings and consolidations of costly rural hospitals that no government has the courage to touch with a bargepole. Covenant has, in fact, faced the same difficulties as AHS for the same reasons – just not as often because it’s so much smaller.
Well, as Chris Gallaway, executive director of Friends of Medicare, summed it up: “Using Alberta Health Services as a scapegoat for our government’s own failings in health care is an age-old strategy here in Alberta, but Danielle Smith has turned it into a political obsession designed to rally her base against our public health care.”
It’s wrong, though, to suggest Smith’s leaked commentary from Drayton Valley is either a revelation or an announcement.
It has been clear literally for years this was Smith’s plan and, since her ascent to the premiership, UCP policy.
Some of the points covered in Smith’s Drayton Valley town hall were blithely set out in fatuous detail in a non-peer-reviewed paper published under her name by the University of Calgary’s right-leaning School of Public Policy in June 2021.
Despite its obvious flaws of scholarship, the paper was illuminating because it sketched out many of Ms. Smith’s worst ideas in detail in advance of her return to politics. It’s still worth a read for that reason, if only to keep other bad ideas from becoming news stories after it’s too late to stop them.
“Bureaucracies have proven themselves to be terrible at finding efficiencies,” the paper says, a statement the comparative efficiency of AHS proves to be false. “They are geared to grow. The only way to make substantial and significant changes in the way programs are delivered is to allow contracting out, competition and choice.”
At a libertarian conference on “meeting the health care challenge” on Oct. 23, 2021, a few days less than a year before she assumed office as Alberta’s premier, Ms. Smith laid out her plan to sever major public hospitals from Alberta Health Services in more detail.
A video of those remarks was posted on Twitter by the NDP in May 2023, and remains there.
“Alberta Health Services becomes the contractor,” she told her simpatico libertarian audience. “Then we would have the Alberta Health Quality Council do us an auditor function, and tell us whether or not Alberta Health Services should continue running the Lougheed Hospital, or the Rockyview Hospital, or South Campus, or any of the hundred hospitals that they currently run.”
Not yet premier, Smith seemed confident she could find a way to make the Health Quality Council of Alberta do her bidding. Lo and behold, last month Smith, now premier, appointed former Alberta Liberal leader Raj Sherman as chair of the HQCA’s Board – a fact reported here on Aug. 14, but still ignored by mainstream media.
Conveniently, former premier Ed Stelmach, whose government established AHS in 2009, is now chair of the Covenant Health Board and clearly unwilling to object to Smith’s plans.
“If they can’t meet the terms that we want them to, we can do an RFP,” Smith went on in her 2021 speech. “And then the Alberta Health Insurance can give a different contract to a different group of doctors.”
“That is completely compliant with the Canada Health Act,” she boasted.
Now, presumably, there is more compliant health minister and a very enthusiastic premier. And if Ottawa does object, she can always wave her Sovereignty Act at them.
The point is, Smith has told us all before, repeatedly, what she plans to do. Now she’s doing it. No one should be surprised.
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