PHOTOS: Calgary General Hospital at the moment it was blown to smithereens in October 1998 by Ralph Klein’s conservative government (Photo: City of Calgary). Below: Outgoing Wildrose leader and United Conservative Party leadership candidate Brian Jean, former Alberta Health Services CEO Vickie Kaminski and current AHS CEO Verna Yiu.

Outgoing Wildrose Leader Brian Jean, who is campaigning to lead the province’s far-right Frankenparty, has vowed to lead Albertans back into the health care wilderness where they wandered with Ralph Klein a generation ago.

Alberta is still recovering from that misadventure.

Roughly one half of all Alberta hospital beds were closed during the worst years of Conservative premier Klein’s health care “reform,” between the end of 1992 and 1995. Very few of these beds ever reopened, even though the province’s population has doubled since that health care disaster.

The impact is well understood: years of chronic Emergency Room waits, crumbling infrastructure, stratospheric replacement costs, and now a looming staffing crisis as the Baby Boom generation of health care professionals prepares to retire without the experienced replacements who were driven out of the province by Mr. Klein’s destructive and ultimately ineffective policies.

Nevertheless, in introducing his platform to lead the so-called United Conservative Party, Mr. Jean pledged to make $2.6 billion in instant cuts to Alberta’s public sector by freezing salaries, leaving the jobs done by retiring caregivers and other public employees unfilled, and firing managers, many of whom are in fact front-line heath care workers.

According to Mr. Jean, this is supposed to take place throughout the public sector, but in case you doubted his intent with regard to health care, he singled out Alberta Health Services for special mention in his plans. Remember as well that even if he fired the entire provincial civil service, basically unchanged in size since Statistics Canada compiled these numbers in 2011, he would barely save enough money to keep his promise. So health care inevitably would be a significant target.

Mr. Jean would compound the damage by cutting the government’s revenue base and attacking the rights of working people, other typical discredited economic nostrums of the Republicanized Canadian political right. In addition, of course, there would be more cuts later. Typical of conservative politicians, though, Mr. Jean omitted the details.

This is a man who just days ago was telling a tame Postmedia columnist that “gone are the days when hard-right governments are going to be successful in Alberta.” Well, forget about that! Apparently Mr. Jean got a message from the UCP’s Tea Party base, from his cynical campaign advisors, or both.

Either that, or, worse, he really is the “moderate” in this race. Candidate Doug Schweitzer excoriated Mr. Jean for not going far enough, as has UCP Finance Critic Derek Fildebrandt.

Mr. Fildebrandt, at least, has promised to say precisely where he would make cuts. This may sound like a virtue, but more likely it’s a shrewd calculation that his supporters actually enjoy the prospect of hurting their neighbours, especially those with public sector jobs.

Outgoing Progressive Conservative Leader Jason Kenney, who will announce his candidacy soon, has lately kept quiet about his plans – although he has vowed in the past to repeal every single piece of legislation passed by Premier Rachel Notley’s NDP government, including, presumably, those required by Supreme Court rulings.

If you’re looking for some reasonably balanced thoughts about the money spent on administration in Alberta health care, look no farther than the last two chief executives of Alberta Health Services.

In a letter to the editor of the Edmonton Sun in February 2015, then-CEO Vickie Kaminski, a conservative appointee, pointed out, accurately, that when it comes to directing spending to front-line care instead of administration, no province does better than Alberta.

“Managers only make up three per cent of our AHS workforce,” Ms. Kaminski said in response to a misinformed column by a right-wing Sun columnist. “That includes the lowest-level manager right up to the executive leadership team, including the President and CEO.” She based her arguments on statistics from the respected Canadian Institute for Health Information.

A letter to the Edmonton Journal from Ms. Kaminiski’s permanentv replacement, Dr. Verna Yiu, made the same points in April 2016 in response to another volley of right-wing misrepresentations about the cost of administration at AHS.

As an aside, it seems ham handed for AHS’s communications staff to have used almost identical words in both letters, although the facts had not changed between the two. As is often said in this space, you’re not really plagiarizing if you’re plagiarizing yourself. Just the same, someone should have made the effort to produce a different letter for Dr. Yiu, or to acknowledge that the same points had been made by her predecessor.

Unstated by either Ms. Kaminski or Dr. Yiu, though, was the fact many lower-level AHS managers do in fact deliver front-line health care, and cuts in those “administrative” ranks will directly and negatively impact the level of care that patients receive from front-line nurses and health care aides.

Regardless, while facts may not count for much in the post-truth environment of the UCP, they should nevertheless be part of the general provincial discussion about what the cuts proposed by Mr. Jean and his cohorts would mean for health care in Alberta.

The brutal cuts proposed by Mr. Jean would mean the same thing as the brutal cuts imposed by Mr. Klein in the 1990s: Worse health outcomes, longer wait times, crammed Emergency Rooms, closed rural and urban facilities, demoralized health care professionals, another lost generation of nurses who take their skills to greener pastures, and a general collapse into the general dysfunction from which we are only now recovering.

Moreover, over the long term, fixing the damage done would cost more than continuing to run the system with a steady hand.

These dystopic outcomes, of course, would be used to justify calls for a more expensive, less fair system of privatized health care – which may, of course, be the whole idea.

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41 Comments

  1. Until the last few days, I had thought Brian Jean was emerging as a voice of moderation, and as a result, ‘electability’ in a general election. Instead he seems to be joining the race to the extreme right.

    In addition to severe cuts, Mr. Jean has also promised a referendum on photo radar and equalization payments. Lumped together, it makes for an interesting analysis of his target demographic.

    1. he not yet clarify how he would save 2.6B so why do you already jump with conclusion?
      Alberta healthcare 34% above average in Canada but have this reflected on quality of service 34% better in comparison to other provinces?
      but we have quite a bunch of public “servants”, who’s salary and absence of accountability, does turn green faced envy in private sector.

      1. Are you aware that the ‘Public Service’ is the same size as it was after the Klein era cuts despite massive population growth? Where do you get the idea that the public services “salary and absence of accountability, does turn green faced envy in the private sector” makes any sense literally and figuratively?

        1. If you read: cbc.ca/news/canada/calgary/alberta’s-sky-high-health-care-costs-make-deficits-hard-to-shake you will find that the conference board of Canada did a study which found Alberta’s healthcare costs are 33% higher than the average in Canada and are indeed the highest in Canada! Now in reading most of the comments on this blog, it would appear that most of you are interested in equality and are against people receiving unjustified higher wages. How do you justify the results of this study? The Conference Board of Canada is non partisan. I guess it is easier to attack Val.

          1. could be i’m mistaken but by reading here discussions one would get strong impression that majority of participants are the present or former civilian servers.
            considering this, their responses on critical approach, rather normal reaction with intention to “save face” than attacks 🙂

      2. Sorry, but who exactly are you comparing? You might be interested to know that deputy ministers in the federal public service make around $300K. So how much do their private sector compatriots make? Well, first you have to define who their equals are in the private sector. Since there are no private sector deputy ministers, the best analogue would be the CEO of a Fortune 500 company (my logic here is that DMs help run a country, which is much greater responsibility than running a company… any company). Given the untold millions the Fortune 500 set makes… even when they run a company into the ground, I think either you are getting a bargain for your tax dollars or someone is grossly underpaid.

        But, really, this isn’t about comparing apples to apples, is it? It’s a scarecrow (a fake, poorly constructed replica of an argument) that is built up to be easily knocked down.

        1. not sure what deputy ministers in the federal public service has to do with budget allocation in Alberta other than attempt from you to confuse readers.

          nevertheless it seems by alberta’s “progressives” standard they should feel pretty losers.
          what is $300k in comparison to Alberta WCB president Guy Kerr $900k or Jim Ellis president and CEO AER $737k or Brad Klak president and managing director AFS $723k or President and CEO of AHS Dr. Verna Yiu $671k or Richard Masson CEO APM Commission $633k, etc.
          if you like to compare federal and regional levels, you should consider the fact that salary for federal level come from taxation of 18.4 million vs, 2.3 million in Alberta, which makes situation even more ugly,

  2. Managers and senior administrators have important roles to play. Without them, direct-care staff would not have the resources, both human and material, to do their jobs; nor would they have the policy guidance they need to do them well. Direct-care staff need people to sign payroll and hire replacements for those that move, change jobs or retire; they need people to sign purchase orders for consumable supplies and replacement equipment; they need people to lead policy development to ensure best practices in the organization; they need people to look at population and demographic trends to determine changes in service levels in different parts of the province. Large organizations like AHS also need financial monitoring staff to ensure value for money and to prevent misappropriation of public funds, always a risk when dealing with fallible human beings.

    None of the people carrying out the roles I have just described work at the bedside, but all of them are essential to the
    functioning of the system. And, make no mistake, the kind of privatized health care system Mr Jean appears to favour would need all of those same people, and probably many more; if you don’t believe me on this, just look south of the border, where the health care system is burdened with far more administrative overhead than anywhere in Canada.

    1. Thanks for the link, J.E. After I read it I found another link to an item by Jim Storrie. While its content appears to report a new low in politics, it also reports that Brian Jean has recently hired a Rebel co-founder named Hamish Marshall to be his campaign manager. This probably goes a long way toward explaining Brian Jean’s shift to the right.

      Every new, and more extreme, policy these guys announce moves them closer to becoming UCP leader and farther away from winning a general election. Oops, I already forgot about Trump.

      http://edmontonjournal.com/opinion/columnists/opinion-trump-style-vitriol-infecting-alberta-politics

    2. In a July 20,2017 Opinion piece in the Calgary Herald by Chris Nelson titled NDP job strategy could be working for them, Chris discusses Alberta’s job stats since Jan. 2015. We have lost 90,000 energy jobs and replaced them with 78,000 public service jobs in health, education, and public administration. Now that imo is kamikaze economics.

      1. This is a mis-representation; Mr. Nelson clearly states “service jobs” , not “public service jobs”. Perhaps you should have read the comments on Mr. Nelson’s Herald piece, where the difference was plainly pointed out in a reply by Gregory Beneteau, whom I am happy to quote below:

        “1) Jobs in the service sector are NOT the same thing as civil service jobs. In fact, there’s no hiring bonanza going on at either the provincial or municipal level; they’re maintaining current staffing levels and commitments, not increasing them.

        (2) The changing employment landscape is partly the result of demographic changes. For example, as the Baby Boomers age, the province requires more health care workers, which explains the growth in health care hiring. And manufacturing jobs have been going overseas, where labour is cheaper, for decades.

        (3) The loss of oil-related jobs is the result of a cyclical boom-bust cycle, which is one one of the pitfalls of depending on resource extraction to fuel economic growth. The provincial government cannot bring the price of oil (and the jobs that came with it) back to where it was pre-bust. Only time will do that. Laying off people in the public sector in order to balance a budget is counter-productive and solves nothing.”

        1. “as the Baby Boomers age, the province requires more health care workers, which explains the growth in health care hiring”
          ——————————————————–
          even so, Alberta yet still in Canada the province with youngest demographic and you have skipped the main point – no one here objecting against nurses, social service workers but rather why quite significant chunk of public funds, directed for particular public services, ends up in form of reward for top managers and for what?

      2. FARMER B you fail to make the distinction that the bulk of those public sector jobs were in fact federal and municipal hires. The NDP government invoked a hiring freeze on the general public service in 2015. There were no way near 78,000 hires by the provincial government since 2015. BTW Chris Nelson is a tendentious conservative Postmedia scribe, so I wouldn’t put too much veracity into his misleading statements.

        As for the energy jobs lost, you do realize oil prices dropped dramatically during that time period, forcing oil companies to bail on their loyal employees, right?

        1. See Neo Geo’s response below. It would seem Chris Nelson’s error was even more egregious than that. DJC

          1. A quick review of Alberta’s 2015 budget and 2017 budget shows some interesting numbers: AHS-2015 $13.4 billion, AHS-2017 $14.7 billion a 9.7% increase over 2 years. Physician compensation 2015 $4.6 billion 2017 $5.2 billion a 13% increase. Drugs ans supplemental 2015 $1.8 billion, 2017 $2.2 billion, a 22% increase. Overall health spending in these 3 areas increased from $19.8 billion in 2015 to $22.1 billion in 2017 a 11.6% increase over 2 years. This certainly doesn’t say anything about employment numbers but shows a continued above inflation growth in health spending.

            As for Neo Geo’s response in his first point he said there was no increase in hiring, in his second point he said hiring increased because of the need for more health workers to service the aging baby boomer population, contradicting himself.

            Interestingly enough, I don’t believe the solution lies in cutting both spending and taxes. Anyone who can do math should realize Alberta’s over 15 billion dollars of debt in one year when capital spending is included cannot be fixed by cutting less than 3 billion in spending and then reducing revenue by cutting taxes. It should also be noted you can’t fill this hole by increasing corporate taxes which bring in roughly 4 billion a year now, when the NDP raised corporate tax fron 10% to 12% revenue actually decreased due to the downturn in the economy.

            First of all our healthcare costs need to be brought more in line with the rest of Canada. We don’t have superior outcomes in Alberta so there is no justification for the higher cost. On the revenue side, I apologize for continually talking about a sales tax, but our government revenue requires diversification, either we cut spending by 20% or we bring in a sales tax. We need to work towards a balanced budget so that our resource revenues can be saved for our future generations to benefit from. I suspect few on here will agree but have a good day just the same:-)

          2. One more thought, just read an interesting article in the national post about Quebec’s improving economic fortunes. In it there was an interesting quote from Quebec’s finance minister Carlos Leitao: “It’s not a big revolution what we did. We realized that spending was growing at a faster pace than revenues. If you do that on a consistent basis, your going to end up with a ballooning deficit. We said we would restrain the rate of growth in program spending and allow revenues to keep growing at three percent per year.” Quebec is projecting a 2.5 billion dollar surplus. A couple thoughts here. $70 billion in revenue of which $10 billion is equalization payments. Makes life a little easier. $36.6 billion spent on health or roughly $4500 per capita. In Alberta $5150 per capita on health spending. Older average age in Quebec. Again have a good day:-)

  3. “A letter to the Edmonton Journal from Dr. Verna Yiu”
    ====================================================
    i guess it’s hard to find anything decent if you use her to support your point of view.
    sure, she’s exemplary conscious and patriotic local top manager.
    only she seems prefers to keep her $568,321 salary and don’t like to settle for “humble” $100K and redirect remaining $468K to hire 8-9 additional nurses.
    what a hypocrisy.

    1. You have no idea of what it costs to hire a nurse, so perhaps you need to be more careful about presumptuous commentary.

      1. Latka figures a nurse should pull down $50k per. Don’t want them to have jumped-up nurses tooling around in new Elantras like they own the place.

      2. so you believe $500+k absolutely justified salary for humble public “servant”?

        in regard of “costs to hire a nurse”, nationwide it’s $61k – $76k for registered nurse.
        Alberta $67k – $84k
        as of april 2016 undergraduate nurse – $ 27 per hour which translates to average $40K before tax.

        1. Dear Val,

          First off, we don’t refer to workers in the public service as “servants.” They are called employees, or simply workers.

          Second, obviously $500K is excessive pay for a “humble” public employee. But, let’s not forget that it’s the previous Conservative government who set the salary scale so high.

          Lastly, it seems $500K is just about right for cronies appointed by Conservatives.

          This is the kind of thing Rachel Notley is trying to fix, so we should be praising her and not blame her for past Conservative excesses.

          1. Athabascan: This is meant respectfully, but as a former civil servant and for many years a public sector trade unionist, for several reasons I don’t hold with the prevailing view, which you have stated here, that public employees ought not to be called “civil servants.” The term is an honourable one, usefully more specific than public employee, and widely understood to mean direct employees of the government, as opposed to health care workers and the like employed by publicly funded agencies. Civil servants are servants of civil society, not of their bosses, with whom they the have a modern employee-employer relationship, as opposed to a master-servant relationship. So there’s nothing wrong, again in my view, with being a servant in this context. As for why anyone would object to the civil portion of the term “civil service,” I don’t understand. It speaks well of our society that the distinction between civil and military is not a big issue with citizens, but it should remain part of our consciousness as long as we enjoy the rule of law. If there is a legitimate objection to the civil part, one is perfectly free to refer to the pubic service and public servants. It is my own view that the market fundamentalist right has effectively exploited this change in terminology, arrived at for the most honourable of reasons, because it has created the sense public servants don’t serve anyone, and are just employees cashing undeserved paycheques. I am not criticizing the use of the terms “public employees” (quite useful, if much broader) or “workers” (honourable, though tainted with the instinctive McCarthyism of the Alberta right), only defending the terms “civil service” and “civil servant.” DJC

          2. “This is the kind of thing Rachel Notley is trying to fix”
            ——————————————————————
            sure it’s seems like good intent but what is real outcome?
            Dr. Verna Yiu $568,321 in fact are old news from 2016 disclosure
            in 2017 she advanced to $671k and that’s two years after start of crusade by Ms. Notley against wasteful use of public money.
            b.t.w. she was appointed during NDP governing thus don’t qualify as PC appointy.

            pretty much similar happens with another “servants”, particularly ones, who’s duty to monitor and interact O&G industry on behalf of provincial government. it looks like the more cheaper the oil – the more fatter their paychecks.

    2. But how come when their were machinists and boilermakers and well-service people (with their per diems and vehicle and tool allowances) making more than these nurses (and don’t forget those private sector bonuses and other perks), that was all right? The argument I heard was that they were entrepreneurial and when times were good they got amazing wages and when times were lean they took their chances. And if people in the public sector didn’t like it they should shut up and get real jobs. Now that times are tight a lot of what I hear is that the everyone should be brought down to the lowest level. Doesn’t seem right to me.

      1. i guess your knowledge about value added sector of economy and monetary and perks compensation based on tales from acquaintances of your acquaintance 🙂

        1. MsEdmonton’s point is that people choose the private sector and the risk that entails. Sometimes that risk pays off and they get paid much more than public servants. Sometimes it doesn’t and they get paid less (or get laid off). The point is, oil sector workers go in with their eyes wide open (or should). You take your risks in life, and right now, in Alberta, the decision to work in the public sector is paying off. In a few years, it won’t pay off as much as it will in the private sector. What I and Msedmonton object to is the hypocritical, faux victim stance from many conservatives that the loss of jobs in the oil patch is someone else’s fault (Notley, Trudeau, Kathleen Wynne, greedy Quebecers, overpaid public servants… whose pay has not changed) and not the fault of both external forces and people’s own choices. As someone else said, just as there are no atheists in foxholes, there are no Any Rand fans in unemployment lines.

        2. Touché. But then again, that didn’t stop you from wading in to give advice on the best way to manage the healthcare system and hire nurses.

  4. Brian Jean is delusional if he thinks he’ll be the leader of the Unite the White party.

    The reality is he’ll end up being Kenney’s lapdog, just like McKay was for Harper.

    Dear Mr, Jean,

    Kenney’s intention is to oust YOU. Maybe you are OK with that. If that is so, don’t pretend this will be an honest race for the leadership of this frankenparty.

  5. Most revealing will their position be on lab testing.

    Recently AHS annouced plans to buy out the private laboratory testing company Dynalife and transfer its services back to the province when the current contract expires in 2022.

    Alert readers will recall last year current Health minister Sarah Hoffman cancelling a $3-billion contract with Australian company, Sonic Healthcare, awarded by the previous PC government. Sonic was supposed to have taken over from Dynalife, a highly controversial move at the time. Some wondered why would the province be outsourcing services to an outside foreign company, especially one that needed to pay stock dividends to its shareholders.

    More recently an Australian public watchdog group Grattan Institute put out a report claiming the Austrailian gov’t was paying too much for services provided by Sonic Healthcare and patients needed to be protected from added fees. It was a hot button issue in Australia’s election.

    So the question that needs asking will the UPC roll back those NDP plans and privitize lab services. More to the point, will it reinstate the Sonic Healthcare contract.

  6. I am not sure how Mr. Jean plans to balance the budget with his $ 2.6 billion in cuts, given the deficit is far larger than that. It is a mathematical mystery to me, unless he actually means to cut something like $2.6 billion each year for several years. However, that was not clear to me from what he said.

    I suppose we should be thankful, this is the first hint of real policy from the right. I feel Mr. Jean’s low ball estimate of the cuts, is just a ruse to reassure unsuspecting voters that the cuts do not need to be brutal. However, some in his party are already saying his plan is too modest. I am sure if Mr. Jean gets a chance to implement his plan, the cuts will somewhere along the line change from modest to brutal. Either that or the deficit will not be eliminated or safely after the election he will conclude that a sales tax is not such a bad thing after all. I think brutal cuts will be the most likely option, with the misleading message “this will only hurt a little bit, you will barely feel it” being used to entice voters to support much more slashing than they are comfortable with.

    Big picture – Alberta’s energy revenues are about 10 billion a year lower than in the Klein era, so we have a deficit now. Its really quite simple. It is not due to government over spending or poor management as the right wing likes to pretend. It will take either brutal cuts or new taxes to get rid of that deficit in the short term. Those that pretend otherwise are not being honest with Albertans.

  7. It is really easy for Brian Jean to make these comments when he is not in power.

    I cannot help but wonder why he is not spending more time on his own constituency issues. Health care and hospital facitlities in Ft. Mac. are in crisis. ALberta Health’s lastest plan to send a desperately needed pedeatrician….they are sending one up who is 7 months or so pregnant….then she will take time off. Mothers who deliver prior to 30 weeks cannot deliver in Ft. Mac…they need to go to Edmonton. Most WANT to go to Edmonton.

    So Brian…would you cut health care in Ft. Mac to balance the budget? Why not ask some of your constituents…especially those with young families???

    Mr. Jean is such a hypocrite. He needs to work and stick up for the folks who elected him. If he cannot do his day job he should resign so that he can focus his full attention on becoming an also ran, Jason Kenneys gofer, or an apologist for the far right wing nut cases in his party.

    Health care in Ft. Mac is in critical condition. It needs attention Mr Jean. And more that just your assistant sitting in her offfice.

  8. Costs for AHS executive staff and managers are too high. I support Mr. Jean’s future moves to cut managers and other staff both in government and all the ABCs (agencies, boards and commissions). While this might sound irresponsible to public sector workers it is actually being responsible and realistic. We can’t keep going into debt forever; we know this as families and so why should government be exempt from the same frugal practices of spending only as much money as what comes in?

    Private sector workers have no sort of permanence or luxuries like those present in the public sector. So why may I ask should we be working for the folks in the public sector? It’s time to provide reasonable returns for labour in Alberta. In this matter I am not speaking about the poorest as I think an increase in the minimum wage is required.

    What I am saying is that the elite are being unfairly compensated for no good reason that I can determine. Some of the managers have no deliverables that I can determine no matter where they are placed–in government, AHS or Covenant Health. Please don’t say that the CEOs at AHS and Covenant Health earn their salaries–I am pretty sure they can do the same work at lower salaries. And if they won’t, then hire folks who will.

  9. Wow, he intends to fire a lot of people who were appointed by previous right wing governments, many for their political connections!

    Since the economy is 70% consumer spending, the government might save money but business will suffer for lack of buyer demand.

    I thought business people were conservative supporters. Maybe not when they realize they are a secondary target.

    1. Sadly, many Alberta business people appear not to be able to see the trees for the forest. DJC

  10. May be the whole idea ? There’s no maybe, privatization has been the main idea from the very start. Defund, create discontent, then say the systems broken and people agree when you axe it.

  11. Slight correction to the story. I was an employee at the Calgary General Hospital when it was demolished on October 4,1998.

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