Well, of course he’s running for office.
With a record like his, how could he not?
I refer, of course, to Ken Hughes, the first and so far the only chair of Alberta Health Services, the massive province-wide health board created in May 2008 to … well, it’s never really been all that clear just what AHS was supposed to do.
AHS has managed, one supposes, to realize a few economies of scale — especially among traditionally overpaid top health region executive positions — but at the cost of some pretty fantastic dis-economies of scale.
From the moment the Alberta Tories under then-premier Ed Stelmach and then-health-minister Ron Liepert announced their decision to roll Alberta’s nine regions plus the Alberta Cancer Board, the addictions commission and the mental health board into a single entity, saving money was said to be the reason. But, as far as anyone knows, precious little money has ever actually been saved as a result.
However, that’s the government’s story, and they’re stickin’ to it. As Premier Alison Redford’s current health minister, Fred Horne, said in a carefully phrased news release announcing Hughes’s imminent departure as the chair of the health board, “Ken’s leadership helped AHS to deliver solid results, including over $660 million in administrative savings that has since been reinvested in patient care.”
The real reason for the creation of AHS was likely quite different from saving money. But since no one in a position to know has actually said, Albertans have been left to deduce that the desire to break the political power of the Calgary Health Region’s sometimes outspoken leadership, the need to be seen to be doing something, and the urge to mess up health-care delivery just enough to open the door to privatization all played a role in creating the AHS fiasco.
Instead of savings we got a crisis in Emergency Room wait times, acute-care beds full of patients who needed to be in continuing care, continued efforts to privatize long-term care and no respite from the shortage of health-care professionals that dates back to policy errors committed under Stelmach’s predecessor as premier, Ralph Klein.
The main burden of responsibility, of course, must rest on the shoulders of Liepert and former premier Stelmach, but surely as their chief flunky at what was back in 2008 quaintly known as the “health superboard,” Hughes must shoulder some of the blame.
One waits with interest to hear what Stephen Duckett, the Australian PhD economist who was hired a year after Hughes to be chief executive officer under the chair’s supervision, will have to say about Hughes’s leadership. Duckett, of course, seems to have been hired in part because he was acerbic and undiplomatic, then in November 2010 was fired because he was acerbic and undiplomatic, and has now carved out a niche for himself as an acerbic commentator on Alberta health-care matters.
Hughes must accept some of the blame for that unpopular decision as well, one presumes.
Regardless, we are now informed by the Edmonton Journal that Hughes will likely seek the PC nomination in Calgary-West, a piece of provincial real estate that occupies the same territory as notorious Conservative MP Rob Anders’ federal riding. It is also the Alberta electoral district now occupied by Liepert, who to everyone’s astonishment remains in Redford’s cabinet. However, Liepert has signalled his intention not to run again in 2012, or whenever Premier Redford decides to call an election under her recently passed unfixed-fixed-election-date law.
Hughes is not a stranger to politics. Before his career in health, he enjoyed an undistinguished career as a federal Conservative MP from southern Alberta, and before that as an insurance salesman.
This fall, Hughes took a leave of absence from the helm of AHS to serve on Premier Redford’s transition team. Given all that, it is likely that he hopes to become Redford’s health minister after what the government presumably assumes will be the triumph of the next election.
If so, or even if he just resides in cabinet in some other influential post, don’t expect to see meaningful change to fix the many problems with the single health-board model.
It has been argued in this space that what Alberta really needs is a return to health regions, a structure that sensibly balances economies of scale with unique regional needs. This is because different blends of health services for different regional populations makes sense, delivering better service at a lower cost and responding more quickly to changing needs. This is why, of course, health regions remain the favoured way to deliver health services elsewhere in Canada.
A centralized province-wide board, by contrast, simply can’t respond as effectively as a region could. Emergency Room problems in Lethbridge, Grande Prairie or Red Deer don’t get addressed because we’re busy in Edmonton working on a provincial admissions policy. Even needed short-term solutions, such as opening more continuing-care beds to ease the crunch in emergency departments, take longer when they must be solved by a bloated centralized bureaucracy like AHS.
Not so many years ago — before Stelmach, Liepert, Duckett and, of course, Hughes made their vision of a new health care model for Alberta a reality — we offered world-class medical services to residents of this province.
It will take something more than Hughes occupying a chair in Redford’s next cabinet to make that a reality again.
This post also appears on David Climenhaga’s blog, Alberta Diary.