Since well before her return to politics, Alberta Premier Danielle Smith has carped constantly about how there were too many managers at Alberta Health Services. 

Calgary Sun political columnist Rick Bell (Photo: David J. Climenhaga).

As she said herself a year ago according to Calgary Sun political columnist Rick Bell, who often seems to serve as a semi-official conduit for Ms. Smith’s pronouncements, “it’s no secret I’ve had frustration there is a lot of middle management in Alberta Health Services.”

This is usually delivered with a disclaimer about how much the United Conservative Party loves front-line health care workers. 

There are many reasons to be suspicious of that claim, not least the government’s positions on pay increases for actual front-line health care workers in the midst of Alberta’s current affordability crisis, but many Albertans are happy to go with the flow and take the premier’s word for it. 

Anyway, why let the facts stand in the way of a good yarn? It’s a good story, after all, that Ms. Smith’s political base wants to believe because they, like her, are still furious about COVID-19, seized with conspiracy theories about how there was really no such thing, or attracted by quack cures like that notorious veterinary deworming paste. (For what it’s worth, Ms. Smith denies this is so.) 

Likewise, there are sound reasons to doubt Ms. Smith’s past analysis of the mismanagement of AHS, soon to be known as Alberta Hospital Services, quite possibly as a precursor to more privatization.

Former United Conservative Party premier Jason Kenney (Photo: David J. Climenhaga).

According to the notorious Ernst & Young report, commissioned by the UCP Government under Jason Kenney’s leadership to set the stage for more privatization, management of the organization is lean by Canadian and international standards, the numbers of managers had remained stable for years, and so had their pay. 

Still, Ms. Smith was remarkably consistent about her claim AHS’s middle ranks were bloated with managers who need to be purged – or at least sent back to the front lines, or the regions

Until she wasn’t, that is.  

On Saturday, during the Your Province, Your Premier radio broadcast provided gratis for her by her former employers at CORUS Entertainment, Ms. Smith suddenly revealed that masses of middle managers are OK after all, as long as they’re sowing chaos in the health care system. 

Disorienting? Only if you haven’t been paying close attention as the UCP continues to flood the zone with, er, constantly changing information. 

Asked by the obsequious host about how her project to break up AHS into separate government agencies actually seemed to be leading to a massive boom in management jobs, Ms. Smith responded with a long soliloquy: 

“Look,” she began, “sometimes you need to have decision makers, um, and more than one decision maker. 

“I guess I take a bit of a different view because I come from a world where I’ve looked at how free enterprise works,” she continued, explaining her worldview, “and in free enterprise, the reason you end up with innovation is because you got a thousand different decision makers.

“A thousand different people trying a thousand different things and some things work and some things don’t work. And the things that do work you’re able to do more of, and the things that don’t work you’re able to do less of,” she rambled onward. 

“If you have a single decision maker in a system that is as complex and costly as this, it bottlenecks every single decision, you don’t end up with innovation, and you haven’t ended up with the kind of investment in the right places that we need. 

“So, look, we gotta do something different. It’s gotten worse and worse and worse ever since, um, in the past 15 years, and so, yeah, at some point you gotta realize that this centralized, top-heavy, one-decision-maker, all-things-land-on-the-CEO’s-desk is not the right model, and so we’re gonna try somethin’ different!” 

So let’s get this straight, because AHS has too many managers, in Ms. Smith’s view, she’s going to fix it by … having thousands of managers? 

Now, the premier is not wrong to state that AHS was afflicted by bottlenecks that impeded its ability to act quickly – but in most cases since the UCP came to power in 2019 those bottlenecks originated with political and ideological decisions made in the Premier’s Office. 

One suspects that what’s going on is that Ms. Smith is proposing to replace managers who know how to run a modern health care system with managers who agree with her crackpot economic theories and quackpot medical theories. 

So instead of concentrating everything in the CEO’s office, now we’re going to concentrate everything in the Premier’s Office – where Ms. Smith and her advisors have their ideology to guide them.

Nevertheless, if you were looking for a good career in Alberta, who would have thought health care management would be the ticket? 

Just don’t suggest in your resume that you know anything about public health, immunology, or epidemiology. A certificate as a veterinary technician might help, though. 

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  1. My cat “Fluffy” has a vet that knows more about human healthcare than Dani, or anyone else in the UCP for that matter!

    1. Pogo, your post would still be accurate if you deleted the phrase ‘has a vet that’.

      1. I didn’t want Fluffy to get any big ideas, although it would definitely be an improvement, if she was Minister of health!

    2. We are so glad we escaped the Alberta Advantage in 2004. Back then the privatization of services, interference of educators and most concerning, the wasting of the peoples’ Heritage Trust Fund monies by the long line-up of successively more inane premiers that unthinking Albertans continued to elect was more than enough to flee our home province. Today things are even worse. Thumbs down to the Sovereign Province in a United Canada.

  2. Danielle Smith sure knows how to create confusion. For a politician who used to advocate for a smaller government, this isn’t happening, now that she is premier of Alberta. The UCP have a massive government, that has never been seen in Alberta prior. Much like Ralph Klein did, Danielle Smith definitely wants a private for profit healthcare system in Alberta. More naturopathy, which won’t be a cure, is being promoted. The government will have the final say on medical decisions, such as when pandemics come upon us. Doctors won’t be able to do anything. What could possibly go wrong with this? Definitely lots of things will go wrong. More layoffs of nurses could be a possibility too, just like Ralph Klein did. Doctors in Alberta will continue to be treated like garbage, and leave the province. Nurses will have to relocate. More lawsuits will happen, because of the harm people will see, from not getting proper healthcare, and from suffering the effects of a mismanaged future pandemic. Anyone with even the slightest bit of common sense, wouldn’t have supported this.

  3. Let’s start with the fact that Smith is neither an expert in health care or health care management. All she has is a long career in politics and talk radio in which she has honed the skill of sounding like she knows what she is talking about in the moment. Of course, unfortunately some people can be fooled by this and don’t seem bothered that she has the consistency of the wind which blows one way one day and another the next day. Some may have beefs with the current system based on conspiracy theories, so her tear it down approach generally appeals to them.

    In her political career consistency was never Smith’s strength. So its not surprising what she says one day with conviction contradicts what she said previously. For instance she is a former self proclaimed libertarian who now wants to increase the powers of the provincial government over municipalities and post secondary educational institutions. It should already be clear she will say and do whatever suits her purposes at the moment.

    So previously she believed there were too many managers in health care, now she says something different. Just don’t expect her to explain or offer good explanations for the inconsistencies. Our new dear leader, for whatever reasons, has changed her mind and Albertans are expected to go along with this unquestioningly. Our current Premier is not a deep thinker and seems untroubled by her own contradictions so expects us to not give them much thought either.

    1. Middle Dave: Yes. In the garden, growth has it seasons. First comes spring and summer, but then we have fall and winter. And then we get spring and summer again. DJC

  4. Danielle Smith fired the entire board of AHS. She fired the CEO. She stuck in one guy to make all the decisions. Did Smith actually learn, after watching what happened, that she’d made a bad decision?

    1. Excuse me Mike – a bad decision?
      She never makes a bad decision she is a goddess. About time you know that.
      Even when we think she made a bad decision she will change it to whatever is that fits her reality and move on. Whatever destruction left behind does not exist , it is not a fact.
      Danielle Smith is a very psychologically sick person. This UCP is a clear example the nuts took over the asylum.

        1. Political Ranger
          If that comment is for my post, thank you very much.
          So rarely can I do that, unfortunately.
          Being able to express thoughts through words is the greatest challenge.

    2. The best thing she ever did was to fire the entire board of AHS. Now she can add managers who actually do something. She appointed a man she trusts to give her an opinion on how to better run AHS not to be its sole manager for all time and you know that! There are many of us who like thing happening under Danielle’s watch and if she backtracks on some things, that is the wisdom of figuring out a prior decision was wrong. Have you never changed your mind on anything? I love that she appointed as her minister to deal with tent cities and homeless, a man who father founded the Mustard Seed and whose family had been homeless. Maybe comment on that instead.

  5. So Danielle Smith believes more managers means more innovation? I’m reminded of the famous line from “Star Wars: The Last Jedi”:

    “Amazing. Every word of what you just said…was wrong.”

    I’ve seen something of how free enterprise works, too. What I’ve seen is that managers do NOT go haring off on their own to try new ideas.

    Smith’s “a thousand people” probably just means “more than two.” Even so, it’s like she’s never heard of business administration practices—or university degrees. Smith’s fantasy world is a guarantee of chaotic activity and people working at cross-purposes. CEOs don’t like chaos, especially when The Boss has to answer to the Chairman and (horrors) the Shareholders.

    Smith’s yammering about one decision maker in a complex system makes only slightly more sense. You could read this as a criticism of concentrating all decision-making authority in the CEO’s office. That would, in fact, be a bad idea. It’s why large organizations have a CEO; executive vice presidents; department managers; and section (or business-unit) managers.

    None of that has much to do with “innovation.” Making things work better, trying new strategies and new processes, is separate from daily operations. Once you’re (reasonably) sure a new organization is better than what you’ve been doing—that’s when you roll out the New & Improved Management Methods to the entire business. Until then, a smart manager keeps doing business as usual.

    Still… we probably shouldn’t read too much into Smith’s stream-of-unconsciousness word salad. She has a tendency to “think” out loud. Especially when someone asks her to explain her “reasoning.”

    Before she next tries to pontificate on the advantages of breaking AHS and remaking it in her own image, somebody in Smith’s office will hand her a list of talking points. We can be sure that, on the surface, the New & Improved bullet points will appear to make at least a little more sense.

    1. Mike J Danysh: I personally believe that Danielle Smith is going to end up creating more problems here. When she will be asked to clarify what she meant, she might use her excuse that she misspoke. She still has a loyal fan base who will come to her defense, no matter what. That might only last for so long, because I also think that Danielle Smith will not survive a full term as premier of Alberta. She will resort to some mumbo jumbo speech, in front of the media. I don’t know what she will do next, outside of politics.

  6. Governance by ADHD … maybe as well rename the UCP to that, because explains far too much. When it comes to naming the crises and the respective solutions, Queen Danielle tends to be all over the place usually. Heath care professionals are overpaid, then they’re scarce, then they have to be called to Alberta, then they are sent away … During Tyler Shandro’s tenure as Minister of Health, the chaos and the mayhem that occurred was not driven by sound decisions. Rather, it was driven Shandro’s bizarro notions of whatever Kenney wanted him to do. One suspects that after Shandro was booted as MLA, he likely will not be able to find employment operating a monkey grinder, let alone as the monkey. Now, Sleepy LaGrange is there and she doesn’t seem to know anything beyond pro-life. True to form, the UCP loves putting idiots in charge, with the hope that they break everything. But don’t worry, because Smith will distract with another distraction ego trip that proves she actually has big ideas. You’re welcome, Alberta.

    1. A “monkey grinder”?
      That sounds terribly cruel. And you definitely wouldn’t want to be the monkey in such a situation.

  7. We know that Danielle Smith will say a lie when she starts her answer with “well, look….”

  8. It could be that if all those middle managers were fired, they might share their views on what goes on in health care. If they remain employed, they keep their mouths shut
    As health care deteriorates in Alberta may see many who moved there for less expensive housing leave because they can not obtain health care.
    My take on Dani is, she is as good as the last person she spoke to.

  9. 1. The behavior exhibited by the lobbyist/radio talk show host is an overt manifestation of seeds of intellectual self doubt and its accompanying confusion/chaos/inconsistency/dispersion/ect. and their spilling , or irruption into public consciousness, i.e. a concrete example of the corrosive nature of double think on individual, private consciousness. [Where it is assumed that, “Doublethink means the power of holding two contradictory beliefs in one’s mind simultaneously, and accepting both of them.”] Further, it was long ago noted that the fundamental characteristic of the unhappy conscience and its inherent instability is that it is divided within and against itself, becoming tangled up in its own contradictions.

    2. AHS bottleneck?

  10. True story red tape or too many managers Looking for incontence supplies for husband Called old social worker of 6 mts ago our file closed. Given a phone number not sure who community ?.. called have to be placed on a nurses call number list Someone will call to tell us when they will call have to be available from 8 to 4 when the call comes Can’t have the nurses direct contact number gave up . Phoned complaint line nice nurse can’t find information either Told me to phone seniors advocate that seemed too ridiculous also we don’t have one with UCP ?. So gave up. Neighbor told me to go to my family doctor GP luckily I have a GP waited for appt to open with dr Dr did not have time to look through forms to get right form. He just sent a general form to home care Nurse A phoned to do a pre assessment on phone. Told of both of our urinary issuses Told I would have to see a urologist as surgery as other options needed to be looked into incontience supplies last option. I thought I heard wrong I said what can’t my GP refer and surgery comes before incontience supplies Nurse A snippy I don’t make the rules then after I apologized plus plus. Told me tha someone would come to do a bowel and bladder assessment It would be another nurse and just my husband gets the B and B assessment I don’t qualify Then came the look at the calendar and find a day that we can be at home fr 8 to 4 or 9 to 5. Picked a day with no outside appts On that day say May 31 a second nurse will call to tell us when she will come This is true The problem is I can’t have my adult child with me that day or any day unless takes a precious vacation day we have learned the hard way that you need a 3 rd person there because we have had unkind experiences with previous social workers and nurses from home care. So my neighbour will sit in with us. All the nurses are RN s because I have asked That’s a lot of money Anyway that’s the red tape or too many managers / people to get incontience supplies. I hope we get the supplies while I want 6 mts to see a urologist excuse sp and computer skills. Thx

  11. Somehow I don’t see Dotty Dani lasting to term’s end. She spins faster than a one arm bandit’s cherry display. Chaos results wherever she puts her hand. Like Trump everything she touches turns to cow manure. Even her own party will recognize she is well beyond her level of competence. At this point, the Unlimited Crap Party best find a new leader. Hint: the NDP now has more members in Calgary than Edmonton. The storm to wash this pestilence away is gathering, and the UCP is rotting from the head down. I am betting the demise of the United Crap Party is developing.

  12. Never thought I would see the day when a politician would abuse their power to sow such chaos. To find her model we need to look no further than the Republican candidate for US president.

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