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Ernst & Young review of Alberta Health Services gives UCP cover to do lots, flexibility to do little

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Alberta Health Minister Tyler Shandro, Alberta Health Services CEO Verna Yiu and Ernst & Young spokesperson John Bethel at yesterday's news conference in Edmonton. Image: Government of Alberta.

We're not closing any rural hospitals, have you got that?

Alberta Health Minister Tyler Shandro strove to make that point perfectly clear at his news conference in Edmonton yesterday on how Ernst & Young, the multinational management consulting firm based in London, England, thinks Alberta Health Services could save nearly $2 billion a year.

No, the United Conservative Party government won't be closing any rural hospitals.

Rural hospitals? None of 'em will be closing.

Shandro even interrupted a question from a reporter who seemed to be asking if any rural hospitals might be closed or … Nope! We're not closing any rural hospitals!

Now, I'm certainly not saying closing rural hospitals would be a sound policy. On the contrary.

Nevertheless, they are among the highest cost items on AHS' list of expenses. So if the UCP is serious about saving $1.9 billion yearly on AHS operations -- which Shandro solemnly promised to plow back into health care -- it's obvious the money's going to have to come from somewhere in the system.

The prevailing view among progressive observers was that the government set up the Ernst & Young report published yesterday to give itself cover to implement its radical privatization agenda, which the highly ideological party made little effort to hide before it was elected.

As the UCP habitually does, critics pointed out, the government set the rules of the contract for the $2-million review so that the consultant's conclusion would be the UCP's obvious preference to dismantle public services generally and public health care in particular -- as much as it can get away with.

"Albertans need to ask," the Alberta Union of Provincial Employees said in a sharply worded news release, "is this Ernst & Young report any better or more reliable than the MacKinnon Report?"

That was a reference to the recent discovery that former Saskatchewan finance minister Janice MacKinnon, chair of the supposedly independent "blue ribbon panel" on Alberta's finances, was using a script hatched in Premier Jason Kenney's office at least some of the time when the panel was supposedly taking its "deep dive" into Alberta's books last year.

That sort of thing may sting at Ernst & Young, which tries to cultivate an image of disinterested authority. That's what you get, though, when you quote discreditable sources like the Fraser Institute, strain credulity with nearly $2-billion of suggested cuts after a hurried eight-month glance at a 110,000-employee, 400-facility, province-wide operation, and reach conclusions suspiciously in sync with MacKinnon's controversial effort.

So none of these criticisms seems unreasonable in light of the UCP's history of using third parties "to provide cover for their true agenda, cuts and privatization of our public services," as the Alberta Federation of Labour put it in a news release.

Still, it wasn't at all clear from Shandro's news conference that the government actually plans to do much at all.

The health minister went to considerable lengths to sound reassuring, praising AHS as an asset to Alberta and saying the government won't make all of the $1.9-billion worth of cuts recommended by the consultant and may do whatever it does over a long, long time.

This is a big change from Premier Kenney's angry springtime-of-repeal rhetoric during last year's election campaign.

In other words, there's been plenty of political flexibility built into the government's response to the Ernst & Young report too.

What gives? Presumably the UCP strategic brain trust has concluded that if selling off public assets like long-term care facilities for a song, contracting out work to low-pay employers or setting up inefficient private surgical clinics for line jumpers arouses too much public opposition among voters, the UCP had better leave itself some room to back off.

As the news conference made clear, they have already dropped the political hot potato of rural hospital closings in the party's electoral heartland.

What do you want to bet that UCP MLAs have been getting an earful about small-town hospitals ever since rural constituents got wind of what MacKinnon was best known for in Saskatchewan -- closing 52 rural hospitals in the name of efficiency?

There was so much flexibility built into the recommendations, indeed, that a cynical observer might have been tempted to conclude chances are good this will turn out to be nothing more than an exceptionally expensive press release.

Apparently prepped within an inch of his life, the normally bumbling Shandro smoothly handed off the occasional tough question from a reporter to AHS CEO Verna Yiu or Ernst & Young spokesperson John Bethel.

Example: What are some of the "procedures of limited clinical value" the consultant thinks could be cut? That's for AHS to decide, Shandro parried, leaving it to Yiu to provide a single acceptable example: maybe some hernia operations.

Pro tip for journalists: Might be worth taking a closer look at this one!

Shandro also carefully tried to avoid giving the impression the government is using the review as a way to get the public on side with its bargaining positions in contract negotiations with public health care unions and physicians -- a practice known in labour circles as "bargaining in the media."

That's a tough trick to pull off when, as United Nurses of Alberta president Heather Smith pointed out in her union's response to the report, AHS "tabled these very proposals" in bargaining for UNA's next collective agreement back on January 15, when the report was already in the government's hands.

Smith suggested the consultant didn't understand how the union's collective agreement with AHS worked when it tried to poke into its intricacies.

For example, complaining union contract language makes it difficult for AHS "to implement innovative staffing approaches to meet demands, especially in rural areas," Ernst & Young seems to have missed the letter of understanding in UNA's current collective agreement with AHS that allows the employer to create rural multi-site positions.

Well, maybe you just don't get that much for $2 million nowadays.

David Climenhaga, author of the Alberta Diary blog, is a journalist, author, journalism teacher, poet and trade union communicator who has worked in senior writing and editing positions at The Globe and Mail and the Calgary Herald. This post also appears on David Climenhaga's blog, AlbertaPolitics.ca.

Image: Government of Alberta

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