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Alberta Health Services chair to politicians: Do as I say, not as I do!

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Stephen Lockwood

The newish chairman of the board of Alberta Health Services, this province's massive public health agency, was in the media yesterday advising elected representatives to keep their paws off day-to-day operations of the health care system.

A culture of political interference is creating big problems, Stephen Lockwood complained to a local newspaper, and Something Must Be Done. Probably a lot of Albertans nodded their heads in agreement with this without thinking too carefully about what Lockwood was actually saying.

"If you guys want to set the policy, OK, but you can't be interfering in the daily operations," Lockwood told Alberta's politicians, as channelled by the Edmonton Journal. (The italics, however, were added by me.)

And if you don't like it, added the Okotoks trucking company executive and lawyer not long after the AHS budget was released, "you can direct us or you can replace us."

Well, OK … I guess.

But isn't that exactly what Lockwood is doing?

Let me explain. Alberta Health Services has a president and chief executive officer -- a physician by the name of Chris Eagle -- who is paid considerably more than half a million free-floating Canadian Credonias every year to operate the massive $13-billion-plus agency, which is a branch of the provincial government in all but name.

Eagle was appointed, it is true, when the guy previously in that job started to annoy some of the same elected politicians that Lockwood is unhappy about.

Back in November 2010, that fellow, an Australian PhD economist by the name of Stephen Duckett, finally committed a major blunder with an oatmeal-raisin cookie and the politicians who had hired him and then grown tired of him had the opportunity they'd been looking for to skid him all the way back to the Antipodes. Nowadays, safely back in Australia, Duckett happily works for a policy think tank and receives reams of positive media coverage.

Eagle's job, like that of Duckett before him, is to run the day-to-day operations of Alberta Health Services within the budget he is given by the board, which in turn gets its funding from the government.

Meanwhile, Lockwood was jumped up last fall by essentially the same Progressive Conservative politicians from mere membership on the board to its chairmanship. This was really done to replace former chair Ken Hughes, who had quit to run in the spring of 2012 for Premier Alison Redford's government. Hughes was successful, by the way, and is now Redford's energy minister. (There was also briefly an interim chair, someone named Catherine Roozen.)

The job of the board, all members of which are appointed by the government, is to set the policy of Alberta Health Services.

Therefore, as Lockwood says of the government, the same may be said of the board: it has no business interfering in the day-to-day operations of AHS. That's management's job.

Let me say that again. The board of AHS has no business running the day-to-day operations of the organization, and Lockwood as the chairman has no business acting as if he is the CEO -- which he appears almost every day to do by acting as the chief spokesperson for the organization and involving himself in matters as picayune as parking at individual hospitals.

That, by the way, is why it shouldn't be a problem for the chair of the board to be a political appointee from the trucking industry, a Q.C., or both, instead of a doctor of medicine or, say, health care economics. That's because the chair's principal jobs are to chair board meetings and contribute to the creation of general policy at those meetings -- jobs that don't require medical or health administrative expertise.

But it's pretty obvious that Lockwood is making CEO type decisions about daily AHS operations.

So Lockwood may be right when he suggests that, in the words of the Edmonton Journal’s reporter, "for the system to succeed, there needs to be a better separation between policy-makers and health operators."

But he needs to remember that his job is as a policy maker, not that of a health operator, and that dictum surely ought to apply to him as well.

On the other hand, if Lockwood is acting as the CEO, we have a right as the people footing the bill for all this to wonder what we're paying Eagle $590,000 plus bonuses to do.

And maybe it's just me, but I keep asking myself where the heck Eagle is in all this.

I mean, seriously, can you imagine Duckett keeping his mouth shut if Hughes had tried to sideline the entire management of AHS and personally run the province's health system. Not likely!

Beyond that, if the choice really is as Lockwood describes it, are we better off having things run by politicians who are directly accountable to us at least once in a while, or by political appointees who are not?

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

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