Alberta Premier Danielle Smith doesn’t have a coherent plan for running public health care yet, but yesterday she revealed that, just like her hero Donald J. Trump, she has a concept of a plan.
In a news release poetically headlined, “Eliminating the bureaucratic vortex in hospitals,” Ms. Smith announced with gee-whiz enthusiasm that “we’re cutting through bureaucracy and putting real decision-making power back in the hands of local hospital leaders, so they can act fast, hire who they need and deliver better care for their communities.”
Cool! It’s less clear, though, how this audacious scheme to make everything better by returning Alberta to a system in which each of the province’s 106 public acute care hospitals, five public psychiatric hospitals, and maybe even its myriad public health care centres and clinics have real decision-making power is supposed to work. In fact, it’s as clear as mud.
This, I’m pretty sure, is because there is no plan. There’s a concept of a plan, barely, and someone in the provincial Department of Health is going to have to figure out the real plan. Alberta’s Health Department, by the way, is confusingly known as Alberta Health, but isn’t the same as Alberta Health Services, the province-wide health care agency that the UCP is busy dismantling because it offended the party’s MAGA principles during the pandemic.
As Chris Gallaway of Alberta’s Friends of Medicare explained yesterday’s announcement, even though the premier says the scheme will implemented by next summer, what we saw “contained few details as to the rollout, nor how the government expects the creation of potentially hundreds of new hospital-based leadership teams all reporting to Acute Care Alberta and Alberta Health Services will reduce complexity or bureaucracy.”
What will the org chart look like? Who can say? “The Ministry of Hospital and Surgical Health Services, Acute Care Alberta and Alberta Health Services will work collaboratively to design and establish the new leadership and management model with an interim model to be established by November 2025, followed by full implementation by summer 2026,” the release promises.
Well, don’t worry, whatever those anonymous boffins come up with, it’s going to be great! Maybe the greatest ever!
“Hospital-based leadership ensures decisions on hiring, supplies and services are made efficiently by those closest to care,” the news release quoted Matt Jones, the minister of hospital and surgical health services, saying with enthusiasm that almost equalled Ms. Smith’s.
And that’ll strengthen acute care, support staff, and help patients “get the timely, high-quality care they need and deserve,” continued Mr. Jones, who may or may not be the ranking health minister in the United Conservative Party’s new four-member health care junta. Well, five if you count the premier, which you really should because she’s the one making all the decisions.
According to the news release, “Alberta Health Services’ current zone-based leadership structure is overly complex and bureaucratic.” Well, running a provincial health system is certainly complex and requires a certain level of bureaucracy. But how having a minimum of 607 separate bureaucracies is going to make things less complex and bureaucratic is, once again, not explained. (Hint: It won’t.)
AHS’s zone structure “lacks the flexibility and responsiveness needed to effectively support facilities and staff,” the news release continues, “particularly when it comes to hiring, securing supplies and adopting necessary technologies.”
Just take a look at the AHS zones that will be eliminated and the “corridors” that will replace them and the differences will be … not obvious.
“By removing delays and empowering our on-site leaders, we’re giving facilities the tools to respond to real-time needs and ultimately provide better care to Albertans,” said the health care junta’s Thing 2, or maybe Thing 4, Minister of Primary and Preventative Health Services Adriana LaGrange, in the release.
Mind you, where these local leaders will find the qualified health care workers they want to hire is not explained.
Which brings us, literally, to the money question: Alberta is the poor little rich kid of Confederation, always broke when we’re not bragging about how rich we are and telling other provinces how to set their priorities.
In fact, we’re so poor right now that we have to take money away from disabled Albertans, charge senior citizens for their COVID shots, and introduce co-pays to cover the cost of their drug plan that was so good a year ago we were refusing to sign on to Ottawa’s pharmacare program!
So where is all the money going to come from to set up this cumulatively massive multitude of new bureaucracies in every town and village in Alberta? And where’s the money going to come from for all those local hospital bureaucrats to hire the people they need, secure the supplies they require, and adopt the technologies they think are necessary?
Well, not the province of Alberta. Which gets us to the vortex of the whirlwind that Danielle Smith intends to send spinning through Alberta’s health care system.
Mr. Gallaway explains: “In April, the government transfered the titles of hundreds of health care facilities to be directly under the ownership of the provincial government through Alberta Infrastructure. This was quickly followed by the announcement of a new Activity-Based Funding model for acute care, a return to a voucher system which prioritizes competition over ensuring quality of care.
“In May, Bill 55: Health Statutes Amendment Act made many significant changes to Alberta’s health care system, including allowing the government to appoint entities ‘other than a provincial health agency or provincial health corporation’ to operate hospitals.”
“This signals steps to further privatize Alberta’s health care services, including our public hospitals,” he concluded.
In other words, it’s all about privatization. And the money, Dear Readers, is going to come from you.