Alberta Danielle Smith addresses the Edmonton Chamber of Commerce yesterday (Photo: Alberta Newsroom/Flickr).

According to Alberta Premier Danielle Smith, apparently all we need to do to find anesthesiologists willing to work in rural Alberta is hand the power to hire them over local hospital managers. 

Former Wildrose Party MLA Rob Anderson, now Danielle Smith’s office manager, long ago on a snowy day in Edmonton (Photo: David J. Climenhaga).

Or something. 

“If we had managers at that local facility making decisions for the community about what services should be provided in that community, I’m convinced they would find the people,” Ms. Smith told a group of doubtless bemused reporters after a luncheon address to the Edmonton Chamber of Commerce yesterday.

“They’d find the anesthesiologists,” she said, according to the CBC’s transcription.* “They’d find the staffing.”

“That’s the reason why you need more management closer to home at each individual hospital,” she rambled on.

Never mind the national shortage of anesthesiologists – the high-paid specialist physicians who administer anaesthetic drugs and keep patients alive before, during, and immediately after surgery – that’s causing delays of surgeries everywhere in Canada.

Robert F. Kennedy Jr., anti-vaxx nut, conspiracy theorist, and now U.S. Democratic presidential contender (Photo: Gage Skidmore/Creative Commons).

And never mind that it’s always been hard to find medical and surgical specialists willing to live outside big cities, let alone one-horse towns on the Canadian Prairies – a fact that elsewhere in her chat with the media, Ms. Smith admits is so. 

Or that there are already managers at every one of those rural hospitals that are cancelling surgeries because they can’t find an anesthesiologist. 

Everyone, and I mean everyone, knows this is bonkers. That includes Ms. Smith. She no more believes that if you hand the problem of finding anesthesiologists over to a local hospital manager, presto chango, the law of supply and demand will be suspended than do the readers of this column.

But stick a mike in her face and she’s likely to blurt out a lot of strange little pearls of wisdom like that, outright contradictions, and even the occasional thing that makes sense.

It’s a measure of her contempt for Alberta voters, I suppose, which some would argue is justified. 

In a short clip posted by Postmedia, Ms. Smith says of her AHS decentralization scheme: “It’s a matter of building a system where you’ve got local decision-makers at each facility, building into a regional system where decisions are made in a region, building into a province-wide system, where everything is integrated.” 

NDP Diversity Critic Lizette Tejada, MLA for Calgary-Klein (Photo: Facebook/ Lizette Tejada).

She sounds convincing throughout. But read that again, slowly, and think about it. It’s a kind of word salad that might be called stream of unconsciousness

I’m convinced that Ms. Smith does this when she’s trying to deceive her listeners about what she really has in mind. 

In this case, what she has in mind isn’t so much decentralization, as being able to use local conditions to justify dangerous and unpopular health care policy decisions and destructive privatization schemes while keeping her United Conservative Party’s anti-vaccine, anti-abortion base sweet. 

Unsurprisingly, there is no press release on the Government of Alberta website about what Ms. Smith had to say to the reporters yesterday, and Alberta Health Services told journalists who bothered to call that they didn’t really have anything to say about it either. Well, you can hardly blame them for that, since they’re already Ms. Smith’s No. 1 whipping boy. 

Indeed, I suspect Ms. Smith would still like to set up a purge of public health managers who led the fight against COVID-19, a topic on which she still entertains bizarre conspiracy fantasies. 

And speaking of COVID conspiracy theories, the executive director of the Premier’s Office, former Wildrose Party House Leader Rob Anderson – best known these days for his Alberta separatist fantasies – is in hot water for tweeting praise for Robert F. Kennedy Jr., a notorious anti-vaxx crank who has launched a Democratic Party presidential primary bid and is well known for remarks characterized as anti-Semitic and racist. 

NDP Diversity Critic Lizette Tejada condemned support for “these baseless, hateful comments from Robert F. Kennedy” – Junior, that is, since his father was a great man. 

She demanded Mr. Anderson remove his commentary about them. But, really, he should be required to leave it right where it is, so that voters can be reminded of what he said in the future. 

Apparently Mr. Anderson missed the part where Mr. Kennedy, who got his start as an environmental lawyer before veering off into COVID and anti-vaccine nuttery, called oil from Alberta’s bitumen “the dirtiest oil in the world.”

*There are noticeable, but not significant, differences between the CBC’s and Postmedia’s transcription of Ms. Smith’s post luncheon remarks. I wasn’t there. So I flipped a coin and went with the CBC’s. I provided my own transcription of the quote from the Postmedia video clip. There appears to be no public copy of a recording of the premier’s remarks to the Chamber, from which media accounts also provided no quotes. DJC

Join the Conversation


  1. As long as they operate under the same budget constraints, AHS will have difficulty attracting health care professionals and specialists to rural Alberta.

    Unfortunately the UCP already has quite a history of being cheapskates, such as when their previous leader and previous Health Minister got into a war with doctors and other health care professionals to cut their compensation. A lot of this was unwisely targeted at rural health care professionals.

    While this war has died down, the damage has been done, with a lot of health care workers in rural Alberta retiring or moving and a lot of distrust of the UCP by those remaining.

    So I feel decentralization in itself will do little to repair the damage or attract more health care workers to rural Alberta. The government will both have to show them the money and win some trust back. This is something that will be difficult for a party that has a history of being parsimonious and somewhat hostile to health care workers and professionals.

  2. There seems to be a hostility emanating from progressive circles (or what passes for it) these days to anything local. Gone are the days of “local people working together to find local solutions” etc. The local yokels must take their direction from above because, you know, we know best.

    RFK Jr. an anti-Semite? Come man! His father was assassinated in 1968 by Sirhan Sirhan because of his support for Israel. His alleged anti-Semite remarks were taken out of context. The Democratic Party smear machine is in full swing . So alarmed at the prospect of another Kennedy entering the national political stage they are considering digging up the bones of Lee Harvey Oswald.

    Worth reading is a recent interview RFK Jr gave to the online Jewish magazine Tablet.

    1. Ronmac, also worth reading or watching as I did, NBC news; where RFK jr’s family are calling him out on both his covid “theories ” and his anti-semitic remarks. As well as using the family name for his own self interests.

      Just out of curiosity; where you state that–” the local yokels must take their directions from above because, you know, we know best”. Are you saying that the yokels should listen to Danielle advocating ivermectin/ hydrochloriquin because she knows best ; or that they shouldn’t listen to her because she’s at the top and therefore doesn’t know what’s good for them because they’re locals ??

        1. POGO– Thanks for that, I didn’t know she had done a duet with Tony. 2 thumbs up!! But unfortunately, along with Jann , “local Alberta girls makes good” won’t be recognized by the ‘walk back Alberta ‘ group. All that hostility coming from the anti-progress groups, you know!

          FYI and entertainment, in case you missed it; on Twitter–Jann’s comment about Danielle and the ‘little green man’ was quite….. precise .lol

  3. Kennedy is fascinating from the little I have heard him say since his run for office. He comes out with some actually sensible policy statement and then descends back into complete kookiness.

    Seems like a good candidate for office in the USA. /s

    1. Tbh I think he’s useless at best and captured at worst. Can’t remember if it was his daughter or his daughter in law who was a field agent for the CIA, but the quotes he has on that subject alone should cause anyone expecting him to present positive change to give their head a shake. Whichever faction of deep power he truly represents remains to be seen but he is no more an outsider candidate than Trump was.

    1. In truth, by 2028, it won’t matter how many health workers we have. Global warming will kill us all by then.

      Getting back to 2023, why do we insist on focusing on the shortage of doctors (which is real) but we never talk or mention the over-abundance of patients. What if we had half as many patients in hospital, wouldn’t that help? Oh, which patients you ask? Why Covid cases of course. Imagine how much better the public healthcare would be if there were no covid cases clogging up the system. Mandate masks, it would cost nothing and would help take the strain of the hospitals.

  4. I believe the Premier is engaging in a form of “Gish galloping”. Named after the creationist Duane Gish, it refers to the technique of overwhelming people with a litany of arguments without regard for the strength or accuracy of any of them. It may be stream of consciousness but it can also be an effective technique, popular in the alternative medicine crowd Ms Smith clearly has sympathy for and doubtlessly developed on her radio show, to convince people that you must know what you’re talking about by saying a lot of stuff.

    1. An opponent of those who use this technique advised, focus on individual claims only and prepare intensively.

    2. You? Yes you! Deserve a song! What you’ve described is what has been advocated as fair game political tactics in the USA since I don’t know, Lee Atwater? All the way to Steve Bannon maybe? Flood the zone with counter factual shit! Dani? She’s at best a dim shill. At worst, well, shall the future unfold? As some may like it. We’ll see!

  5. “If we had managers at that local facility making decisions for the community about what services should be provided in that community, I’m convinced they would find the people,”

    Think of how a local manager could sell a community in rural Alberta! What an impression it would make on a prospective anestsiologiest when they learn how the locals behaved during Covid, refusing to get vaccinated, refusing to wear masks and refusing public health restrictions! What medical professional wouldn’t want to be in a community like that?

  6. Strange but true ,no surprises,
    RDRH skipped over again ,MLA LaGrange examples what she thinks of her community,using RDRH as basecamp of squirrels

  7. And who needs a stinkin’ anesthesiologist anyways? Here, just bite down hard on this stick of jerkey, like gramps did back when that mule got him. Worked then, it’ll work now, and dang cheaper too.

  8. My understanding is that AHS has the lowest administrative costs of health boards in Canada, which doesn’t quite fit Premier Cray Cray’s narrative. How long before she can force up costs and use that as another arrow in her quiver of nonsense?

  9. She wants to make the rural COVID deniers who support her happy. If and when the next COVID wave hits “local decision makers” can ban masking and let COVID rip in the rural hospitals. And then they will ship the people who are most sick out to the urban centres and blame their deaths on ivermectin deficiency.

  10. My line of work brings me into the world of supply chain management/logistics daily and yes, sometimes the benefits of local decision making are clear. But I’m talking about items such as gloves, sanitizing products, office supplies etc; cost savings can sometimes be enormous. That said, what Cherokee Dani is proposing is fantasy, pure and simple. Just meant to please the rubes, er, I mean low-information UCP voters.

    On another note, I see that the CBC is still disabling comments on all Smith-related stories (such as the one linked above), just as I pointed out here a few days ago. Coincidence between that and the previously threatened lawsuit? I think not.

  11. I’m pretty sure that it was not that long ago that the UCP solution was to get rid of managers, that there were far too many of them.

    I guess this is another full circle event or maybe it is squaring the circle.

  12. All of this giving the local managers decision making powers is a total red herring, just like most of what spews from Smith’s mouth. It is clear trying to tackle AHS as a whole is not working to the end the UCP wants. The new strategy is to divide and conquer. Attacking the top down structure of the large organization makes it difficult to push ideas down the line, whereas leaning on little managers will be much easy for Smith to push her stupid unpopular ideas.

  13. Reminds me of my old boss who used to wander around saying, “You people are a dime a dozen.” A colleague kept a nickel in his pocket waiting for the day he would quit, with the words, “Here, have a half dozen on me.” I wasn’t there when it happened because I had already left. Moral of the story: skilled workers are not widgets. You can’t buy a discount carton of anaesthesiologists at the store and plug them in. Telling people they’re not valued is never an effective HR policy. Word gets around about employers like this.

  14. ” . . . the executive director of the Premier’s Office, former Wildrose Party House Leader Rob Anderson – best known these days for his Alberta separatist fantasies – is in hot water for tweeting praise for Robert F. Kennedy Jr., . . .”

    Apparently Mr. Anderson is another individual with two university degrees that has the ability to reinforce (blindly or deliberately as the case may be) the necessary cognitive biases that offer up the required foundational support for the chosen ideological tribal mythologies. It seems to be the case that the chosen examples used to defend the ideological ‘tribal faith’ more often than not turn out to be mere charlatans using trickery, deception, and intellectual dishonesty in order to artfully control, manipulate, and hypnotize their selected audience. The choice by Mr. Anderson, it appears, is not one of happenstance, or coincidence; since, both the beliefs and actions of RFK Jr. consistently echo and reflect those of the current Alberta political talk show corporate lobbyist. That is:

    1. “Let’s establish at the outset that Robert F. Kennedy Jr. is someone who lies constantly . . .”

    2. “But the fact that Kennedy is completely wrong doesn’t mean it will be obvious that he’s wrong, especially to those with limited statistical training.”

    3. “Kennedy, like other antivaxxers, is good at presenting pseudoscience, and pseudoscience is effective because it’s “pseudo”—it looks like science, and non-experts find it hard to differentiate between it and the real thing.”

    4. “. . . promoting deadly lies should be disqualifying from public office, . . . But as we know, the fact that someone spouts easily-disproved nonsense is no guarantee that they will not attain a huge following.”

    5. “Kennedy is clearly trying to run as an outsider, claiming to be taking back control of the party so that it serves the interests of voters rather than “elites.””

    6. “Kennedy clearly knows how to speak the language of the populist outsider.”

    7. “The danger of Kennedy is that he uses populist rhetoric to make people think he will change things. But thinking Kennedy will shake things up in a good way is probably as misguided as thinking that Donald Trump would “drain the swamp” or give us a good healthcare plan—things he promised but failed to deliver on.”

    8. “That, combined with his delusional faith in the free market, ought to be the final nail in the coffin of his candidacy for anyone who is even the slightest bit serious about addressing the existential issue of climate.”

    9. “In a way, we are in a similar situation to 2016, when, as Chris Hedges put it, “our failed democracy vomited up a con artist who was a creation of the mass media.””

    10. Ect., ect.

    Somehow it all sounds so very drearily familiar in a banal repetitive sort of way, decade after decade, as in the same old political PR legerdemain directed at the same audience of starry eyed suckers, rubes, and gulls.

  15. Danielle Smith is out to sabotage the public healthcare system in Alberta, just so she can find a way to privatize it.

  16. Anesthesiologists have always been thin on the ground outside the two big metro areas. That’s why hospitals in smaller cities and rural communities have often used family physician anesthetists instead.

    For example, for most of the time I worked at Grande Prairie’s Queen Elizabeth II Hospital as an ICU nurse, there were no true anesthesiologists practising there. Surgical anesthesia was provided by family physician anesthetists.

    This situation evolved in the first years of this century, as more anesthesiologists began to move to the city, and now there are no family physician anesthetists at the new Grande Prairie Regional Hospital — one of whom, Alika Lafontaine, is President of the Canadian Medical Association.

    But outside this regional referral centre, in the small town hospitals that do provide surgery — Peace River, for example — family physician anesthetists still prevail. One of the most common surgeries performed in those small town hospitals is caesarean section, which is most commonly an urgent or emergent procedure.

    But whether a family physician provides anesthesia services is primarily the decision of the physician, who has to do special training beyond basic medical school to provide this care. Certification in Family Practice Anesthesia is provided by the College of Family Physicians of Canada:

    So if & how hospitals’ “local management” can influence this process is a mystery …

  17. Somehow I see an image of Danielle Smith at the podium patting the top of her head, rubbing her belly and hopping on one foot whilst saying, “Donkeys live a long time. None of you has ever seen a dead donkey…”

    Now, that, at least, is not impossible.

  18. Hello DJC and fellow commenters,
    It seems to me that the provincial government and other provincial governments can take some steps such as increasing the number of seats in medical schools. As far as I know, part of the problem is that the federal and provincial governments may not agree on the funding. I think that was the situation which resulted in Dalhousie offering places, including residencies, to 59 Saudi students. The cost to Dalhousie of losing these students was going to be about $5.9 million. It is, no doubt, a nuanced situation, but it seems to be one that should be resolved by enabling more Canadians to take medical degrees while assisting other countries by having some of their doctors trained here. There is also a benefit to Canada, especially hospitals, because residents provide medical services at a much lower cost than fully licensed MDs
    Apparently, there are also Canadian students who have completed medical degrees at reputable universities in other countries, but they are unable to find residencies in Canada. I am not exactly sure how the matching service works or if creating residencies in Alberta would enable some of these Canadian graduates from non-Canadian universities to complete their residency here and then be licensed to practice in Canada. Do any of your commenters have an insight into this ? Thanks.
    Poaching doctors and others who are qualified in related fields from other countries, usually poorer countries, who have paid the cost of training their citizens is not ethical.

  19. The key take aways? Sing from the hymn book. *sighs* Oh and when we tell you? Beat up on public healthcare, unions, LGBTQ people and yourself! Why? Because, if you aren’t with us you’re against us! That gives us license to make your lives a misery!

  20. We live in the age of supply side economics. Demand got lost long ago and who wins and who loses is assigned by corporate entitlement. The word “entitlement” essential services, increasingly in control of entitled cronydom members. It’s arbitrary from meaning of words to requisites of democracy.

  21. Dave this comment is particularly insightful and needs to be repeated—

    “In this case, what she has in mind isn’t so much decentralization, as being able to use local conditions to justify dangerous and unpopular health care policy decisions and destructive privatization schemes while keeping her United Conservative Party’s anti-vaccine, anti-abortion base sweet.”
    “In this case, what she has in mind isn’t so much decentralization, as being able to use local conditions to justify dangerous and unpopular health care policy decisions and destructive privatization schemes while keeping her United Conservative Party’s anti-vaccine, anti-abortion base sweet.”

  22. Having local managers make hiring decisions in hospitals these days is a good way to ensure corruption, favoritism, unqualified staff, and lots of law suits.

    Leaving hiring of anestesiologists to a local hospital is just a sure way to ensure no qualified anestesiologists. Local people usually won’t know any anestesiologists, doesn’t attend their conferances, doesn’t know the people within the industry, doesn’t know the game rules around the job, etc.

    As some one told me a long, long time ago, the person most likely to kill you in an O.R. is the anestesiologist.

    At one time, when I was young, local hospitals in B.C. had board of directors who determined a lot of things. One was: you guessed it, deciding whether the hopital would perform abortions. Hospital AGMs became battle grounds and the province took over the running of Vancouver General Hospital. Our local hospital usually had two slates running, pro choice and anti choice. Didn’t matter what they knew about medicine, running a hospiital, fund raising, etc.
    One parental units “job” was to go to all AGMs. and vote “choice”. Hiring medical staff for a small hospital can not adequitely done locally. The jobs people are being hired for are too complex for a lay person to deal with.

    I’m sure Smith her statement will create some buzz in communities. locals who aspire to hire will be lining up.

  23. In the end, the expansion of AHS management, supposedly to better manage resources, will be nothing more than another boondoggle designed to reward a lot of failed UCP candidates and MLAs.

    Kenny did the same thing in the aftermath of the 2019 election, so why not do it again?

  24. So we aren’t hiring more medical professionals, we’re hiring “managers”, whose only qualification (presumably) is their support for the UCP. Whatever happened to cutting “red tape” or reducing “bureaucracy”???

    Pork-barrel politics at its finest. !!!

  25. I politely asked my surgeon if he minded me administering my own anesthetic. He said, “Sure. Knock yourself out.”

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