With Alberta’s overwhelmed public health care system once again teetering at the brink, a memorandum from Alberta Health Services (AHS)’ acting chief financial officer to its “senior leaders” telling them they must find ways to cut costs has surfaced.
So here we go again in Alberta, the poor little rich kid of Confederation, with health care bearing the brunt of our inability to manage our way from a good times one minute to not-so-good the next.
Alas, it’s deficit time at AHS, according to the memo from Michael Lam, who is also the agency’s acting vice-president of corporate services. “AHS is forecasting an operating deficit for the 2023/24 fiscal year,” he warned the managers.
Presumably his “introducing cost management strategies” memo wasn’t intended for public consumption.
At least, you wouldn’t think Premier Danielle Smith and Health Minister Adriana LaGrange, who keep trying to assure us that they have a plan and everything is going to be OK, would want it to be known that AHS managers had been ordered to cut the use of overtime by health care workers and the use of travel nurses contracted from private-sector nursing agencies to keep the system afloat by 10 per cent.
Everyone in the Alberta health care understands the brutal overtime worked by nurses and other health care workers, and the employment of expensive agency nurses paid much higher salaries than staff nurses, are not doing anything good for the system over the long run.
But everyone in health care in Alberta also knows that if we just stop using those Band-Aid measures, imperfect as they are, and expect exhausted staff nurses and other health care workers to pick up the slack instantly, more nurses will leave their profession or move to other jurisdictions and the system in Alberta will be pushed ever closer toward the precipice.
“This is a prescription for driving nurses and other health care workers out of the province and out of the profession,” United Nurses of Alberta (UNA) President Heather Smith said in a statement yesterday. “This is absolutely contrary to what the government says it intends to do to encourage front-line health care services in Alberta.”
UNA’s statement was published in the context of its bargaining for a new collective agreement, but let’s concentrate here on some of the political implications of this situation.
According to Lam’s memo to the AHS senior leaders, the deficit faced by AHS “is largely due to increased vacancies and unplanned absences (e.g. sick leave), both of which result in increased costs and overtime. Action is required to continue to meet our high standard of care and realize a balanced result.”
If by a balanced result he means a balanced budget, that may not be possible if AHS intends to meet its promised high standard of care.
But just as seriously, this places the blame for the state of the health care system exactly where it doesn’t belong – on the nurses and other health care workers who are bailing hard to keep the ship afloat.
It’s not too much overtime and stop-gap measures like hiring agency nurses that are pushing the entire health care system into crisis, it’s the chaos introduced by Smith’s United Conservative Party (UCP) government, which has chosen this moment to simultaneously introduce a senseless massive reorganization of AHS into multiple silos, each with its own expensive bureaucracy, and to all but deny the existence of COVID-19 and other respiratory illnesses that are running wild in Alberta hospitals.
Both policies are driven by the political needs of the government – especially to keep the virulently anti-vaccination and far-right Take Back Alberta faction that now dominates the party and threatens to skid Smith as premier, just as it dumped Jason Kenney, if she fails to do its bidding.
So is Smith’s claim she and Lagrange are about to embark on a tour of Alberta’s hospitals during which they’ll decide which mid-level managers to fire.
If you’re wondering why a lot of health care workers need to take time off sick, look no further than the UCP’s passive aggressive policy of making it hard to understand Alberta COVID statistics and refusing to say a word to encourage Albertans to get vaccinated against COVID, influenza and just about anything else.
So forget about blaming health care workers for sick time and overtime. The UCP Government and Smith in particular, who have concentrated all control of public health care in the premier’s and LaGrange’s offices, own this.
Lam’s memo said that to reduce spending four cost-cutting strategies are being introduced immediately.
- No more recruiting staff for vacant positions except for existing non-management positions in clinically focussed jobs without VP or executive leadership approval.
- “Discretionary spending … must not proceed,” including education for health workers.
- “Portfolios with positive variances must maintain or increase these variances for the remainder of the fiscal year.” (Possible translation: If you haven’t spent all of your old budget, what you did spend is your new budget.)
- A review of all overtime and agency staffing, with every manager asked to “reduce the use of overtime and agency staffing in their areas by at least 10 per cent.”
It’s that last point that will probably do the most damage in the short term.
In the meantime, no one in the government has said anything about the surplus that keeps showing up in AHS’s books, which according to the information on Page 66 of the 2021-2022 AHS annual report is now close to $1.4 billion.
NOTE: In the interests of complete disclosure, I am an employee of United Nurses of Alberta, although this blog is my own thing and expresses my own opinions. I see no reason, though, not to comment from time to time on topics that I happen to know a few things about. DJC
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