Methinks the minister doth protest too much.

OK, I didn’t count. But Health Minister Fred Horne, Alberta Health Services Chief Executive Officer Dr. Chris Eagle and Janet Davidson — we’ll get to who she is in just a moment — kept insisting at their press conference yesterday that the massive restructuring they’d just announced at AHS didn’t mean they were reinventing the entire health-care system in Alberta.

In fact, I think every one of them used that phrase — which I’m pretty sure officially makes it a talking point.

“I certainly wouldn’t see it as a major overhaul,” soothingly observed Davidson, the health-care trouble-shooter and consultant who until yesterday was effectively the sole governing officer of the fifth largest employer of Canada. She was parachuted into that post in June by Horne when he fired the province-wide health agency’s supposedly independent board for disobeying his order to refuse $3.2 million in politically embarrassing bonuses to executives.

At the time, Horne instructed Davidson to review the governance structure of AHS — and yesterday’s announcement was the apparent result of that look-see. Davidson also concluded that the board was right and the executive bonuses had to be paid, but she must have been sufficiently diplomatic not to be send packing back to her Vancouver Island home.

“We do have a good system, but I believe it can be significantly better,” explained Davidson, who moments before had been promoted to be Horne’s Deputy Minister of Health, the top civil servant in the most expensive department in the Alberta government.

“It certainly is not a wholesale reinvention of the health-care system,” added Horne, who earlier in the day had announced AHS was firing five of the health system’s top officials and said it was about to eliminate the jobs of 70 of the 80 or so remaining vice-presidents and senior vice-presidents in the $17-billion health authority. As one reporter cheekily observed, this amounted to something like an 800-per-cent reduction in VPs.

All or most of them may be kept around to do something, of course — whether or not they’re called vice-presidents while they do it. Meanwhile, the five who went over the side yesterday — the chief operating officer, the chief medical operating officer, and the senior VPs of communications, the Edmonton Zone, and priorities and performance — will get to split a generous $2.1 million in severance pay.

If the system needed such a dramatic shakeup, why wasn’t something done before? queried one of the throng of reporters that packed into a tiny 29th-floor boardroom in the downtown Edmonton Telus Tower. “… Changes of this magnitude, you can’t do every five minutes either,” huffed Eagle, who may momentarily have forgotten his talking point.

Nor was the shakeup going to bring back health regions, thank you very much, said the health care power trio, who were moving and shaking things with such a vengeance yesterday they brought back a couple of health, uh, territories. The two health-care areas will be based in Calgary and Edmonton.

Way back in 1990s, when premier Ralph Klein’s government brought in the system of health regions, there were 17 of the things, with really big ones in Calgary and Edmonton. Later, in the early Zeros, that was reduced to nine, with really big ones in Calgary and Edmonton.

With 17 regions or nine, though, the system had the advantage of administering high-cost, high-volume services in the high-population areas, and keeping the Progressive Conservative party’s rural Tory heartland happy with their own health authorities. Problems could be deflected by the government, which could blame the regions.

After Ed Stelmach became premier in 2006, though, he quickly became disillusioned with that system, likely mainly because the health regions in Calgary and Edmonton were getting too big for their britches. This was especially so when the CEO of the Calgary region, who had backed another leadership candidate, wouldn’t play nice with the government on funding.

That led to the creation of Alberta Health Services, the massive single province-wide health authority, in 2008 — wherein lies Horne’s problem today.

The Progressive Conservative government of his boss, Premier Alison Redford, can hardly admit that Stelmach and his health minister Ron Liepert messed up spectacularly when they created an entity as enormous as AHS — especially when the PCs have been bragging for years now about all the money-saving economies of scale they discovered as a result.

At the same time, when they faced political crises arising from long Emergency Room waits, allegations doctors were being intimidated, spectacular executive expense accounts, claims VIPs were getting preferential treatment and public outrage at the number of generously compensated executives, including those 80-plus vice-presidents, it turned out that AHS couldn’t exactly turn on a dime.

Things just went from bad to worse until Horne fired his entire rebellious board of directors in June and brought in Davidson to shuffle the deck chairs on the Titanic.

And now we have something very much like really big health regions in Calgary and Edmonton — which, though perhaps not in quite the way Horne meant, can nevertheless be taken as evidence not much actually has been reinvented.

Regardless, one has the feeling that this latest reshuffling won’t please all that many of complainers. Will rural voters, already warming to the far-right Wildrose opposition, conclude there really are just two health regions, both serving big cities? And will anybody be persuaded, the next time something at AHS goes spectacularly wrong, into thinking it’s not Horne and the PCs who are personally to blame?

And even if voters can be convinced yesterday’s reshuffle was a small step in the right direction, as NDP Leader Brian Mason conceded after the official presser, many of them will still wonder why, as he said, “it’s taken the government five years to clean up Ron Liepert’s mess!”

Well, it takes time to do things right, I guess. And while 70 or so vice-presidents will be gone, surely the brain trust of Horne, Davidson, Eagle and Dr. John Cowell, the well-connected former head of the Health Quality Council of Alberta who will replace Davidson as the AHS Administrator, should be able to come up with something that works.

After all, their titles notwithstanding, they all seem likely to see eye to eye for some reason while they do essentially the same job.

Given that, it’s a safe bet Alberta Health Services will ever again be run by a board of public-spirited citizens!

This post also appears on David Climenhaga’s blog, Alberta Diary.

David J. Climenhaga

David J. Climenhaga

David Climenhaga is a journalist and trade union communicator who has worked in senior writing and editing positions with the Globe and Mail and the Calgary Herald. He left journalism after the strike...