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Alberta may be under 'new management,' but we’re getting the same old bait and switch!

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Jim Prentice & Stephen Mandel

Unelected Premier Jim Prentice and his appointed Health Minister Stephen Mandel held a news conference in Edmonton yesterday afternoon to demonstrate they're doing something decisive about Alberta's embarrassing "bed blocker” problem and, no doubt, aid both their by-election campaigns on Oct. 27.

"Bed blocker" is an uncomplimentary term for patients who belong in long-term care, but end up in acute-care beds because there's nowhere else suitable to put them. It implies that they are somehow at fault for their plight, when in fact it's successive Progressive Conservative governments that have been closing long-term care beds and encouraging their replacement with expensive private-sector alternatives generally referred to as "continuing care" or "assisted living spaces."

This has been going on since Ralph Klein was premier. Now, however, we have another politically embarrassing health care meltdown at a rather delicate moment for Prentice's PC "new management."

And it's not exactly a secret that the government’s determined emphasis on assisted living and cuts in long-term care beds has contributed directly to the huge backlog in hospital acute care wards, which in turn has increased wait times in Emergency Wards.

An embarrassing story in the Calgary Herald over the long weekend illustrated how this process works, and included new Alberta Health Services CEO Vickie Kaminski musing about how keeping the elderly poor from being admitted to acute care hospitals might be the answer.

She asked: "Is there a role that we can be to be able to provide better treatment options in the emergency departments so that they don't just get admitted?"

Perhaps the government had a moment of clarity and realized how that sentiment might go over with the public if the message started to sink in.

That would explain the timing of yesterday’s news conference, which had a large supporting cast including Kaminski herself, recently demoted Seniors Minister Jeff Johnson and Alberta Medical Association President Richard Johnston. The Greek chorus was provided by the Wildrose Party's seniors' critic, Kerry Towle, and the Alberta New Democrats' and Liberals' candidates in Edmonton-Whitemud, Professors Bob Turner, MD, and Donna Wilson, RN, PhD.

But the message from the premier and health minister to the gathered media -- which turned out in considerable numbers at the newser in the lecture theatre of the Royal Alexandra Hospital, notwithstanding a weekend Ebola scare in Edmonton -- was less than clear, and short on details.

The PC candidates for Calgary-Foothills (Prentice) and Edmonton-Whitemud (Mandel) solemnly informed the media that the government would "open 464 continuing care spaces that are currently unfunded or unstaffed through the reallocation of existing resources." (Emphasis added.)

Why that particular number was not fully explained. Presumably, it's what they managed to come up with on short notice.

They also vowed at some indeterminate future date to "assist" some of the 700 patients said to be in acute care who really ought to be in long-term care "through $60 million in targeted Affordable Supportive Living Initiative funds," and to reserve about 20 per cent of the beds freed up for exclusive use by Emergency Departments.

"We're taking concrete steps to relieve pressure on Alberta's hospitals by considering the flow of the overall system and effecting changes to help those who most need continuing care options," Prentice said in his news release. (Emphasis added again.)

I'm afraid I'm not at all certain precisely what the premier had in mind with the bit about the flow of the overall system, other than, "calm down, people, everything is taken care of. Don't forget to vote on Oct. 27."

Regardless, the important thing was that this sounded decisive enough. Plus, Prentice made the point of telling reporters they were looking at a "hands on" health minister in Mandel, the kind of decisive guy who can get stuff done in a big fat hurry. (I thought the previous incumbent, Fred Horne, was pretty hands on too and decisive, especially when it came to dealing with Alberta Health Services Board members who were insufficiently co-operative. But there you go.)

On closer examination, however, Prentice and Mandel seemed to be playing the same old bait and switch game of confusing "continuing care" (a murky term that could mean anything, private or public) with "long-term care" (a specific term set out in legislation and regulation that means a defined level of care).

The differences can be very important with registered nurses on staff, essential supplies and medicines, physician services, physiotherapy and transportation all provided in long-term care, and either unregulated or sold as high-cost extras to residents in other levels of care included under the mushy term "continuing care."

In other words, on the basis of what was actually said between the lines of yesterday's news conference, the Prentice Government remains as committed as was the Redford Government, the Stelmach Government and the Klein government to the privatization of seniors' care.

Since committing to continuing-care beds is exactly what got us into the current mess in the first place, it's hard to see how these changes are going to make things better.

The government's news release, in Prentice's preferred technocratic style, provided us with an impressive chart outlining how many beds will be opened, approximately when, and in what parts of the province.

But it seems almost certain that the government remains committed to making them the wrong kind of beds.

So at the end of the news conference, when the premier raced off to another engagement and Mandel hung around to skillfully field reporters' questions, it wasn't entirely clear underneath which walnut shell the bean was resting.

And it may be working, at least if the reports are true there's a new public opinion survey out there suggesting Prentice and the hitherto troubled PCs are enjoying a nice honeymoon bounce with the public, polling only a point or two behind the Wildrose Party.

We'll have a better idea of what this really means on Oct. 27, when we learn the results of the by-elections in Edmonton-Whitemud and Calgary-Foothills, as well as in Calgary-West and Calgary-Elbow, disgraced premier Alison Redford's old riding where Prentice's appointed Education Minister Gordon Dirks is running.


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

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