Alberta Premier Danielle Smith delivered on her long-promised shakeup of Alberta Health Services yesterday, firing the 11 members of the province-wide agency’s Conservative-appointed board and naming John Cowell as its sole administrator.
Alert readers will recall that Dr. Cowell was appointed sole administrator of AHS in September 2013 by Conservative premier Alison Redford after her health minister, Fred Horne, lost confidence in the agency’s Conservative-appointed board.
As far as anyone can tell, the medical doctor and former head of the Health Quality Council of Alberta fixed nothing during his yearlong first rodeo at AHS.
It’s likely that when Dr. Cowell’s current indeterminate appointment as sole administrator comes to an end, he will have accomplished the same thing.
Dr. Cowell’s appointment axiomatically illustrates the health-care strategy of Alberta’s Conservative governments at least since 1992, when Ralph Klein became premier:
“Nothing we have done to fix the problems in health care has worked for years! Let’s do the same thing again this year!”
Well, to be fair, Dr. Cowell, Health Minister Jason Copping and Premier Smith haven’t proposed blowing up a major urban hospital as Mr. Klein did. Yet.
Premier Smith boldly promised at her news conference yesterday that as a result of her shakeup at AHS Albertans will quickly see “faster EMS wait times, decreased Emergency Room wait times, and reduced surgical wait times.”
No such thing will happen before the next election, of course, although misleading claims may be made.
Why? Well here is a small example: What is the simplest thing the government could do to immediately reduce wait times in Emergency Rooms during the current triple wave of respiratory infections? Answer: Mandate the indoor use of face masks.
Beyond the current premier’s ideological blinders, the problems facing the health care system are too big, too systemic, too international, and too steeped in the market fundamentalist philosophy that dominates Conservative political parties to be fixed in a few weeks, if they can be fixed at all.
The uncertainty and chaos introduced by the United Conservative Party’s bull-in-a-china-shop approach to health care management are likely only to make things worse.
Never mind that Dr. Cowell himself acknowledged back in 2013, soon after he was appointed the first time as sole administrator, what AHS really needed was stability. That hasn’t changed either.
During Dr. Cowell’s tenure in his latest posting, though, expect Alberta’s health care system to remain in the perpetual state of crisis it has been in at least since Mr. Klein was premier – with the sole exception of the short period between 2015 and 2019 when Rachel Notley’s NDP was in power.
This is not to say that all was well in health care during the NDP government. On the contrary, many of the systemic problems that bedevil health care throughout Canada today, exacerbated by the lingering effects of the pandemic and an international shortage of nurses, continued between 2015 to 2019.
What was different was that the system was governed with stability, not “creative destruction,” in mind. The result was order, and incremental progress, not a rapid descent into chaos.
Alberta was also fortunate after 2016 that AHS was under the steady hand of the capable, sensible, and respected Verna Yiu.
Dr. Yiu was fired by Ms. Smith’s predecessor, Jason Kenney, and her health minister, Mr. Copping, who held the same portfolio in the Kenney Government.
Dr. Yiu had been targeted by the extremist anti-vaccine fringe of the UCP base for requiring front-line health care staff to be vaccinated against COVID-19 during the gravest health care crisis in a century.
Premier Smith was among the many noisy voices on the far right calling for her head.
Ironically, Mr. Kenney was soon pushed out himself by the same mob, which chose Ms. Smith as Alberta’s premier-without-a-mandate.
It is interesting to note, as University of Calgary political scientist Lisa Young reminded us yesterday afternoon in what she called the “obligatory political scientist ministerial responsibility tweet” that the Alberta Government has now fired the CEO of AHS, chief medical officer of health Deena Hinshaw, and the AHS board (which they appointed). And yet “the minister stays in place.”
In case you missed it, the principle of ministerial responsibility holds that ministers are accountable not only for their own actions as the heads of government departments, but also for the actions of their subordinates.
Well, not in Alberta, apparently.
Here, that job will be left up to voters.
A few months after Mr. Cowell left his post at AHS in 2014, Alberta’s first NDP government was elected in May 2015. Under health minister Sarah Hoffman, the NDP restored the AHS board in the fall of 2015. Dr. Yiu was appointed in June 2016. Things ran relatively smoothly until 2019.
Those looking for more parallels in history will note that the next Alberta provincial election is scheduled to take place on May 29, 2023.