Premier Brad Wall’s Saskatchewan Party Government — which all Albertans have been taught by the opposition conservative parties can do no wrong — has decided to amalgamate their province’s 12 localized health regions into a single massive province-wide health region this fall.
Since Alberta conservatives seem to believe everything Wall does practically amounts to earthly perfection — Progressive Conservative uniter-o-the-righter candidate Jason Kenney calls him “the real leader of Western Canada” — it’s fair to wonder what they’ll do now that the Saskatchewan premier has done something a lot of them fervently believe is perfectly wrong.
The health-care administrative model Wall’s party has chosen, after all, was the one created here in Alberta by premier Ed Stelmach’s PC Government. That was the government the Wildrose Party was set up by a largely unknown group of funders to attack as too progressive and push to the right. Just like Saskatchewan now says it will do, the Alberta PCs cobbled together Alberta Health Services in 2008 by amalgamating nine health regions and three province-wide agencies into a single massive entity.
AHS employs approximately 100,000 people and has an annual budget of more than $14 billion, about the same size as the province of Saskatchewan’s budget.
While the AHS model has its defenders, it has generally been excoriated as a massive failure by the Wildrosers in particular — the provincial party Kenney was assumed to support until he threw his hat in the PC ring with a plan to merge the two into a single right wing party much rosier than the PCs are just now. He is favoured to win on the first ballot in March.
Meanwhile, over at Wildrose Headquarters, that party’s health care policy proclaims: “Alberta’s centralized bureaucracy prevents patient care decisions from being made by the professionals actually treating patients.”
“We believe health care should be decentralized to the local level with day to day decisions for staffing, surgeries and procedures made by hospital administrators with their own budgets overseen by local hospital boards,” Wildrose leader Danielle Smith stated in a 2014 speech not long before she decamped to join the PCs. The leader may have been replaced, but the dogma doesn’t seem to have changed very much.
The PC Party, having created AHS, has been more nuanced. But with Kenney likely to lead it down a wild rose strewn garden path, it seems possible he may edge toward the Wildrose position, which is popular with both parties’ bases.
That said, having spent billions of dollars creating AHS in search of savings that have been elusive under eight CEOs in as many years, it seems unlikely any government would spend billions more breaking it back into smithereens.
It seems most likely that, on balance, creating an organization this big was a mistake, but now that it’s been done AHS is too big to be allowed to fail. The NDP under Premier Rachel Notley has clearly shown no interest in a Wildrose-style dismantlement, at any rate.
Now the Wall Government, making exactly the arguments made by Stelmach, is set to copy the AHS model in Saskatchewan.
“If we do this in a proper manner, the average person frankly won’t notice a difference,” Saskatchewan Health Minister Jim Reiter advised a press conference today. Albertans will recall being piously told exactly the same thing.
Postmedia’s Saskatoon Star Phoenix solemnly reported that Reiter “could not immediately provide a dollar figure for the savings or the number of jobs affected.” They need not worry overmuch. It’s been almost a decade here in Alberta and no one really knows those details yet.
Saskatchewan is trying to save money, apparently, because the collapse of world oil prices has pushed their provincial budget into the deficit zone. Funny that, what with the real leader of Western Canada at the helm, a 5-per-cent sales tax and all that good conservative management!
Given our experience in Alberta — notwithstanding the Wall Government’s claims they have learned from was done here — you can count on things unfolding in much the same way there, at least for the first decade or so.
Saskatchewan’s risky ideological health care experiment does have a couple of advantages over Alberta’s scheme, though.
First, they actually did a little bit of planning. The province struck an advisory panel last summer, at any rate, to look into the question, or at least to appear to be looking.
History tells us the AHS idea was cooked up in a single afternoon by Stelmach, health minister Ron Liepert and few other cabinet heavies. Insiders have always assumed the move was done to de-fang the Calgary Health Region’s aggressive senior management, which had been annoying the PC Government by lobbying too effectively.
Second, with a provincial population a quarter of Alberta’s and a provincial budget about the same size as the AHS budget alone, the scale of Saskatchewan’s new single health care agency will be somewhat more manageable.
But what will Alberta’s conservatives, who love to blame everything on the NDP and squishy old Tories like Stelmach and Alison Redford, do now that the real leader of Western Canada is making exactly the same mistake they’re vowing to undo?
Will their heads explode? Will they reverse course and do it the Wall Way? Or will they just pretend nothing has happened? I don’t now about you, but I’m betting they’ll choose door number three.
This post also appears on David Climenhaga’s blog, AlbertaPolitics.ca.
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Image: Wikimedia Commons/DanielPaquet
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