A premier says she wants to decentralize Alberta Health Services “to enhance local decision-making authority,” 15 years after centralizing the province-wide public health agency under a single administrator who now only answers to her.
What’s wrong with this picture?
According to Danielle Smith’s mandate letter to Health Minister Adriana LaGrange, this will “create a more collaborative working environment for our health care workers by incentivizing regional innovation and increasing our ability to attract and retain the health care workers we need.”
How likely is this to work as advertised, d’ya think?
We don’t know yet, of course, whether this will be a full-blown catastrophic effort to drag Alberta Health Services back to a future that most resembles the 1950s south of the Medicine Line, or just some ideological window dressing to keep the UCP’s anti-vaccination, anti-public-health, anti-abortion, anti-everything base happy.
Probably a bit of both.
The mandate
There’s not actually a lot to go on in the mandate letter. It’s mostly a repeat of the one she sent to her last health minister, Jason Copping, before the voters in Calgary Varsity released him back into the wild on May 29.
That is to say, it accurately identifies many of the problems causing the crisis in health care, and tells the minister to do something about them.
Easier said than done. It provides no hint about how she might actually go about the task.
The letter also mentioned Smith’s big promise of a $300 health spending account, which so far hasn’t held up under scrutiny. The letter reads “working with the Minister of Technology and Innovation, who is lead, to explore the feasibility of creating an Alberta health spending account to support improved health outcomes for Albertans.”
Sounds more like face-saving than a serious plan.
Potentially disastrous
The Canadian Press called the Etch-A-Sketch outline of the UCP’s plans contained in the letter “the go-ahead to decentralize the entire health-care delivery system.”
If so, it’ll be a catastrophe. But it’s said here, that’s a big if.
There’s not much point asking Premier Smith nor Minister LaGrange about it – that would just be an invitation to more gaslighting. Indeed, speaking on a friendly right-wing radio station Tuesday, LaGrange said that “all of this will involve structures, and it’s too early to say what those will look like. I don’t want to presuppose where we will go, but rest assured, we are going to be making some change…”
Well, a bit of administrative decentralization would certainly provide political cover.
That’s important for a government that wants to privatize public health services, restrict access to reproductive health services, get revenge on public health officials for their response to COVID-19, and do some union-busting – all of which would be significantly unpopular.
Then there are the two other goals: incentivizing regional innovation – other than ideological hobbyhorses like abortion services and vaccinations – and recruiting health care workers Alberta desperately needs. Well, real decentralization would have the opposite effect.
Another major restructuring of health care in Alberta is absolutely the last thing the system needs. It’s already in crisis. Everybody who knows anything about health care keeps saying over and over.
Most likely, it would be an absolute catastrophe.
The legacy of Alberta’s public health services
But Conservative provincial governments in Alberta have been trying to reform health care for decades. Pretty much the only effort that actually worked was the creation of AHS, rolled out in 2009 under Progressive Conservative premier Ed Stelmach.
It had a bumpy start, but lo and behold, it eventually ended up with the lowest administrative costs for health care in Canada.
So of course, the UCP has been asking “Why not mess with it?” ever since they came to power.
“This mandate letter is released at a time when Albertans are witnessing the UCP government’s health care privatization schemes fail before their eyes.,” said Friends of Medicare Director Chris Galloway in a news release, responding to LaGrange’s letter.
“Privatized food in hospitals is a disaster, privatized labs are failing to deliver, and privatized surgeries are only worsening wait times and reducing capacity. As these privatization schemes continue to pull more workers from our public system, our health care short-staffing crisis is only getting worse with dozens of facilities across the province facing repeated temporary closures,” Galloway stated.
NDP Health Critic David Shepherd observed, “this mandate letter basically provides a comprehensive list of all of the UCP’s failures in the health care system.”
Whatever the government does next, whether it’s the worst case or merely a less worse case, it’s reasonable to expect that it will have the same lack of success.
But it most likely will turn out that some things really are too big to dismantle – and that AHS is one of them.
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Nick Seebruch, editor
