Since well before her return to politics, Alberta Premier Danielle Smith has carped constantly about how there were too many managers at Alberta Health Services (AHS).
As she said herself a year ago according to Calgary Sun political columnist Rick Bell, who often seems to serve as a semi-official conduit for Smith’s pronouncements, “it’s no secret I’ve had frustration there is a lot of middle management in Alberta Health Services.”
This is usually delivered with a disclaimer about how much the United Conservative Party (UCP) loves front-line health care workers.
There are many reasons to be suspicious of that claim, not least the government’s positions on pay increases for actual front-line health care workers in the midst of Alberta’s current affordability crisis, but many Albertans are happy to go with the flow and take the premier’s word for it.
Anyway, why let the facts stand in the way of a good yarn? It’s a good story, after all, that Smith’s political base wants to believe because they, like her, are still furious about COVID-19, seized with conspiracy theories about how there was really no such thing, or attracted by quack cures like that notorious veterinary deworming paste. (For what it’s worth, Smith denies this is so.)
Likewise, there are sound reasons to doubt Smith’s past analysis of the mismanagement of AHS, soon to be known as Alberta Hospital Services, quite possibly as a precursor to more privatization.
According to the notorious Ernst & Young report, commissioned by the UCP government under Jason Kenney’s leadership to set the stage for more privatization, management of the organization is lean by Canadian and international standards, the numbers of managers had remained stable for years, and so had their pay.
Still, Smith was remarkably consistent about her claim AHS’s middle ranks were bloated with managers who need to be purged – or at least sent back to the front lines, or the regions.
Until she wasn’t, that is.
On Saturday, during the Your Province, Your Premier radio broadcast provided gratis for her by her former employers at CORUS Entertainment, Smith suddenly revealed that masses of middle managers are OK after all, as long as they’re sowing chaos in the health care system.
Disorienting? Only if you haven’t been paying close attention as the UCP continues to flood the zone with, er, constantly changing information.
Asked by the obsequious host about how her project to break up AHS into separate government agencies actually seemed to be leading to a massive boom in management jobs, Smith responded with a long soliloquy:
“Look,” she began, “sometimes you need to have decision makers, um, and more than one decision maker.
“I guess I take a bit of a different view because I come from a world where I’ve looked at how free enterprise works,” she continued, explaining her worldview, “and in free enterprise, the reason you end up with innovation is because you got a thousand different decision makers.
“A thousand different people trying a thousand different things and some things work and some things don’t work. And the things that do work you’re able to do more of, and the things that don’t work you’re able to do less of,” she rambled onward.
“If you have a single decision maker in a system that is as complex and costly as this, it bottlenecks every single decision, you don’t end up with innovation, and you haven’t ended up with the kind of investment in the right places that we need.
“So, look, we gotta do something different. It’s gotten worse and worse and worse ever since, um, in the past 15 years, and so, yeah, at some point you gotta realize that this centralized, top-heavy, one-decision-maker, all-things-land-on-the-CEO’s-desk is not the right model, and so we’re gonna try somethin’ different!”
So let’s get this straight, because AHS has too many managers, in Smith’s view, she’s going to fix it by … having thousands of managers?
Now, the premier is not wrong to state that AHS was afflicted by bottlenecks that impeded its ability to act quickly – but in most cases since the UCP came to power in 2019 those bottlenecks originated with political and ideological decisions made in the Premier’s Office.
One suspects that what’s going on is that Smith is proposing to replace managers who know how to run a modern health care system with managers who agree with her crackpot economic theories and quackpot medical theories.
So instead of concentrating everything in the CEO’s office, now we’re going to concentrate everything in the Premier’s Office – where Smith and her advisors have their ideology to guide them.
Nevertheless, if you were looking for a good career in Alberta, who would have thought health care management would be the ticket?
Just don’t suggest in your resume that you know anything about public health, immunology, or epidemiology. A certificate as a veterinary technician might help, though.
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Nick Seebruch, editor
