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 from 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.
only Hello DJC and fellow commenters,
I think that one objective is to starve the public health care system of funds so it will be able to provide only a very limited amount of health care. Additional privatization will decrease even further the amount of health care that the public system will be able to deliver because it will have to pay for the profits of for-profit providers. Wait time will be longer in the public system. Danielle Smith hopes that this will drive public demand for more privatized for-profit health care that Albertans will have to pay for out of pocket. I believe that this will result is most health care being unaffordable for the majority of people. And please keep in mind that the Alberta government has deliberately suppressed wages in Alberta. This will mean that even fewer people will be able to afford private health care.
“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.”
WTF does any of that babbling drivel, *mean*?
This is why we’re so pooched. The on site reporters need to ask questions such as, “HOW are you going to “cut through the bureaucracy”? “WHAT bureaucracy needs to be removed?” “What decisions did the hospitals NOT have the ability to make that they will NOW have?”
If the scrum reporters asked the obvious questions then Dixie Dani’s mealy-mouthed waffle would fall apart faster than the Dollar Store folders she waves around.
Oh and for future reference dear DJC readers, the nanosecond you hear the word, “empowering” come from the lips of a politician or a social services worker, steel yourself to be hit by a wave of bullsh*t that would fertilize every wheat field in Manitoba with enough left over for your flower garden.
Buy a snorkel. It’s getting thick.
“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.”
It means you don’t have to get approval to have cousin suzzy hired on to run to the city to get the drugs aunt lori forgot to buy and you can save brother Larry’s farm by making a bank payment every time he changes a lightbulb after hiring him to do maintenance on call.
There …fast, needed and taking care of our own community. It is a UPC trait to milk every cow they find. Health care is an easy one , the more it doesn’t work , the more it is due to federal underfunding and federal interference.
It was not announced at a press conference. There was no opportunity for reporters to ask questions because it was a pre recorded ‘I’d love to sell you some swampland in Florida’ type of sales pitch. They are avoiding any opportunity to be questioned on their actions. And they announce all of this crap (COVID 19 vaccines will cost) once the legislature is in recess. They’re abhorrent. Vote in the by-elections Alberta and make your voice heard!
Jodi-Anne Martin-Hunt: Democracy is not a UCP strong suit. Being a horrible government is.
“WTF does any of that babbling drivel, *mean*?”
Got a snorkel, but Smith stuff is very thick, and sickening!
Oh, FFS. Another tsunami of healthcare upheavals from smith who has NO IDEA how organizations function, so keeps throwing sh*t at walls to see what sticks, if anything. Privatization is her goal.
I have it on good authority that she is going down on this AHS brewing cauldron of crime, deceit, coverups, and criminality. Stay tuned.
Er, for, surely. DJC
Smith, Lestrange and the UPC are hell bent to privatize health care and public education. They don’t care about Albertans, they only care about what’s in it for them. They don’t believe in science, the environment, or future generations of Alberta. They are a one ring shit show!
I just sent a message to Danielle Smith via the official “Contact the Premier” page (link below). I said, in effect, “If you’re worried about a mere $135 million, stop destroying Alberta Health Services, put it back the way it was—and fire Adriana LaGrange.”
Just remember that Smith herself will never see your message. Some anonymous staffer will read it, check off a box for “subject,” then check off a box for either “likes” or “dislikes”—that’s as far as it will go. But they will have to check the boxes, and Smith will see the like vs. dislike numbers.
https://www.alberta.ca/premier-contact.cfm
Over the last several decades, Alberta has went from a fairly decentralized system of hospital boards, to regional ones then to a centralized system and now seems on the way back. We need to clearly understand that fiddling with the system hasn’t solved the problems with health care over the last 30 years and it will not now.
This is because the fundamental problems are not with the system, but how the Alberta government manages health care. They do not provide adequate funding for many thing and they tend to get involved in all sort of questionable micromanagement, like firing the heads of AHS for doubting or questioning the efficiency of their ideological choices and giving good deals to the politically connected.
However, fiddling with the structure is a great way to distract people from the real problems and hold out the false hope that the latest magic structure will solve all the problems. This political trick has been repeated many times over the last several decades and the current government seems to believe Albertans will keep falling for it. They have some more magic beans to yety again cure everything that ails us.
Dave: the most ironic aspect of Smith’s idiotic “plan” to wreck AHS is that, while she was implementing it in 2023, our neighbouring provinces, BC and Saskatechewan (!!!!), were implementing their own plans to ADOPT the AHS model for their own systems! (Sorry, I can’t find the news report. Too much stuff bookmarked, I guess.)
Mike: Saskatchewan did: https://www.saskatchewan.ca/government/news-and-media/2017/january/04/single-health-authority
So has Quebec: https://www.montrealgazette.com/news/article567452.html
So did Newfoundland, in 2023: https://www.saltwire.com/atlantic-canada/five-takeaways-from-nl-health-services-first-year-in-operation-100996954
Nova Scotia established a single health authority in 2015: https://en.wikipedia.org/wiki/Nova_Scotia_Health_Authority
For all intents and purposes, P.E.I. has one too, with the caveat the province has the population of a small city elsewhere in Canada.
I cannot, though, find a story saying B.C. has done the same.
DJC
DJC: Thanks for checking. I acknowledge my error re BC. Still, the fact Quebec and three Maritime provinces saw the advantages of the (former!) Alberta model points up the wilful stupidity of Danielle Smith and the UCP generally. Even Brad Wall thought it was a good idea!
Many years ago, before 1995 or so, virtually every hospital and public health unit in Alberta was its own distinct entity, with a governing board of trustees — usually appointed by municipal councils in the hospital’s service area — and its own Executive Director or CEO. There were a few exceptions — some, like Calgary’s Foothills and Edmonton’s University of Alberta Hospital — were “provincial” hospitals; and way up north, there was this thing called the Northwestern Health & Social Services Board, which ran two hospitals in High Level and Fort Vermilion and public health and home care and some other non-health services in that area, then known as Improvement District No. 24, and now as Mackenzie County. (I know this because NHSSB was my first employer in Alberta). But most hospitals were part of a “General and Auxiliary Hospital and Nursing Home District”.
Then along came Ralph Klein, and the first round of health care regionalization. Seventeen Regional Health Authorities (RHAs) were created, which merged acute care hospital services, public long-term care, home care, and public health into integrated organizations. Each had a Board of Trustees, which were initially provincial appointees but later one-third of each RHA Boards’ Trustees were elected by voters during municipal elections, and each was relatively autonomous in how it did business. So they each did their own hiring and recruitment and procurement and health service planning and so on, and they often even competed for staff during times of labour shortage.
Prominent exceptions to this system were the three provincial health boards: the Alberta Cancer Board (ACB), the Alberta Mental Health Board (AMHB), and the Alberta Alcohol and Drug Abusers Commission (AADAC); and the Catholic hospitals run by what was then called Caritas Health.
Then early this century, while King Ralph was still on his throne, his government decided to merge the 17 Regional Health Authorities into nine larger Health Regions, although the RHA terminology persisted in the legislation. The three provincial health boards and the Catholic hospitals were left out of this merger, and the elections for RHA Trustees were no more, but not much else changed. There had been 17 RHAs, now there were 9.
Some time after Ralph retired from politics, during the government of Premier Ed Stelmach, the then-Minister of Health, Ron Leipert (recently a Calgary Conservative MP), seemingly wrote a plan out on a cocktail napkin and AHS was born. Alberta Health Services merged all nine Health Regions, and this time also roped in the three provincial health boards of ACB, AMHB, and AADAC — but not the Catholic Hospitals, now known as Covenant Health. The stated reasons for this merger included efficiency, collaboration, uniformity of care across the province, and ending competition for staff and making procurement more efficient through economies of scale. I remember being quite vocal at that time that none of the problems cited by government as rationale for this change were insoluble without doing it.
The first few years of AHS’ existence were tumultuous. The first President and CEO, Australian PhD health economist Stephen Duckett, left under a cloud after his infamous “I’m eating my cookie” incident, and later the entire Board was dismissed by the Minister after it refused to renege on a very generous severance provision in a departing senior leader’s contract. The Wildrose Party, then led by Danielle Smith, went into the 2012 election on a health care platform of dismantling AHS and reinstating the RHA system.
But eventually, and specifically after the change of government in 2015, AHS found its footing and it seemed to have stabilized its governance and decision-making apparatus. In the past 10 or so years, it has been touted by such respected authorities as CIHI as having the smallest, lightest administrative overhead of any organization in proportion to its size — which at over 100,000 employees, volunteers and physicians is one of Canada’s largest employers.
Now, however, the new government is not just turning back the calendar to the early 2000s and bringing back Regional Health Authorities. No, they are taking us all the way back to the era of stand-alone, siloed hospital management before the mid-1990s.
It’s not “Back to the Future” — it’s “Forward to the Past”.
Jerry: I didn’t want to change this because I couldn’t find it, Google having erased history, but wasn’t the AADAC the Alberta Alcohol and Drug Abuse Commission? DJC
Yes, that was what AADAC’s acronym stood for (abuse, not abusers). Thanks to Jerry for the history—much as I remember it. This new reorg will have disastrous effects, particularly for hospitals. But make it easier to close smaller hospitals—is that a goal?
Leslie: I believe selling them or giving them away to private corporations is the principal goal. DJC
Actually that was just a typo that I didn’t catch before posting.
Just over a week ago, Danielle Smith said Albertans have “the lowest living standards in the world”. Not low enough for her liking! She’s determined to take us all on a serfin’ safari. Not until every Albertan is bankrupted by a stay in privatize hospitals will Dear Leader be happy. Have a baby, pay for it for the rest of your life. Break a leg, yada yada.
She’s enriching the oligarchs. Hockey tickets are child’s play. This is the plan. The rest is details.
Enriching oligarchs and stealing Federal $200.00 disability from the poor. A star student for Trump.
Once again, Danielle Smith shows her competence.
After WW2, the US Army tried to evaluate the effectiveness of generals who commanded combat forces.* They wanted to learn what personality traits were shared by the successful commanders. The slightly tongue-in-cheek classification system identified four traits, in four combinations:
1. Smart and energetic
2. Smart and lazy
3. Stupid and lazy
4. Stupid and energetic.
NB: “smart” and “stupid” are RELATIVE terms, applied to a small and select group. You do not, repeat, NOT, get command of thousands of men and billions of dollars’ worth of equipment if you can’t tie your own shoes.
The first three classes each have their uses. The fourth is considered a disaster. These guys were more likely to make bad plans, and then charge ahead regardless of casualties.
Now: which class do you think Smith and LaGrange fall into?
*I apologize for not providing a source. I read this a long time ago, and can’t remember where I found it. Furthermore, I’m not now, and never was, a soldier. I apologize in advance to any veterans who may be insulted by my poor grasp of military issues.
https://www.oxfordreference.com/display/10.1093/acref/9780191826719.001.0001/q-oro-ed4-00012327 DJC
I’m thinking I need an account at the U of A to do literature searches. This idea must be as old as armies. Thanks again.
Mike: No worries. My head is full of factoids like this, sometimes fully remembered, sometimes partly, sometimes incorrectly … wait! was that Shakespeare, or the Bible? DJC
Oh, and about that claim Smith made that doses were “wasted.” Here’s a bit of background. Note the publication date: 21 December, 2023.
https://www.cbc.ca/news/canada/calgary/danielle-smith-globe-and-mail-vaccines-adriana-lagrange-1.7067051
Given Smith & LaGrange have a well-known prejudice against vaccines, would anyone care to bet that 2024’s “please vaccinate” campaign was at least as bad as what’s described here?
Mike J Danysh: If Pinocchio had a mother, her name would be Danielle Smith.
The premier appears skeptical, having seen not a single leech nor any evidence that anyone’s humors are being balanced.
I am so sick of these kleptocratic idiots filling their pockets with tax dollars while they gleefully burn down what at one time actually was a world class healthcare system.
All the other words I have for this are swears. Where is the federal government ?
Shared with Public
PLEASE READ …WE NEED YOUR HELP AND SUPPORT!
THE U.S. HAS A COMMANDER IN CHEIF, ALBERTA HAS A PREMIER (SMITH) IN THEIF. EVERY PROVINCE WAS GRANTED $200.00 DISABILITY, ONLY ALBERTA HAS CLAWED BACK THAT $200.00.
SMITH IS A THEIF AND EATS, MEETS, AND OPERATES JUST LIKE HER BUDDY TRUMP: STEAL FROM THE POOR AND ENRICH YOURSELF AND YOUR FRIENDS AND DONORS.
THIS IS HEART BREAKING, ESPECIALLY FOR PEOPLE LIKE MY PRECIOUS CHRISTIAN. DO WHATEVER YOU CAN DO TO EXPOSE THIS EVIL PREMIER ((JUST SPENT $280,000.00) ON CARPET).
PLEASE SHARE FAR AND WIDE, AND HELP US AND THE MOST NEEDY WHO HAVE NO CARPET.
SMITH IS A THEIF!!!
BLESS YOU ALL WHO HELP AND CARE!
TENET: Sorry about that, because it shows how cruel the UCP are. The UCP’s boondoogles are far more, and much more pricey than that one. Billions of dollars have often been flushed down the drain.
Thank you, and seniors like me, who care for a person with a disability will have to pay for Covid vaccines now… by elections will prove who we are.
Smith came a long way from flipping burgers.
You just balanced my humours, no leeches necessary!
Danielle Smith’s idol is Ralph Klein. One of them anyways. She wants private for profit healthcare, just like he did. Great comments from everyone.
“Empowering” seems to be a real buzz word with this group. So far I only see “Enriching”.