Author of the article: Don Braid • Calgary Herald
Publication date: Sep 14, 2022 • 9 hours ago • 3 min read • 25 comments Nurses prepare to treat a patient with COVID-19 in the intensive care unit at the Peter Lougheed Center on Nov. 14, 2020. Photo courtesy of Leah Hennel/AHS

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This is the longstanding standard in Alberta health care. UCP politicians are now in the blame phase. For reasons both ideological and political, but rarely medical, leadership candidates threaten to paralyze the system once again with sweeping changes. Danielle Smith, especially, seems to be driven by rage at pandemic wrongs in her libertarian character. She wants to sack the AHS board (the one appointed by the government she hopes to lead) and install an administrator who will report directly to her. He vows to cut the ranks of the administration. Yes, what a thought. A politician with a penchant for fringe medicine running the health system. Many Albertans have legitimate quibbles with AHS. Last Saturday, a 14-year-old hockey player was immobilized for 45 minutes after being hit from behind.

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EMS was overwhelmed. A Global News report says no help came until an off-duty firefighter took to the fire to respond. Abominable. But is the government responding to this and many other problems with yet another massive reshuffle? This would ensure years of paralysis and dysfunction. A mass board layoff had taken place before, in 2013, when then-Health Secretary Fred Horne scrapped the whole batch of management pay bonuses. There was little or no health care benefit. In fact, almost everything these candidates require has been tried before. Two hundred hospital boards became 17 health authorities, which then became nine, which later became one – today’s AHS supersystem that was advertised as a magical money saver.

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Now, almost all candidates want to turn back the clock. Which of the previous systems that didn’t work would they prefer? Smith is also promising to cut management, despite UCP’s own evidence that the management team is not bloated. In 2019, consultant Ernst & Young (EY) was awarded a $2 million contract by then-Health Secretary Tyler Shandro to take a deep dive into the entire system. The massive 220-page report was submitted on December 31 and made public on February 3, 2020, just as the COVID pandemic is packing its first punch. The study found no swelling in the management ranks. Managers make up about 3.2 percent of AHS’ total workforce of more than 100,000. This is no different from other health systems or large private companies.

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Total executive pay has remained fairly flat over the previous five years, rising from $361 million to $373 million. EY found some opportunities to reduce management numbers. There are areas where management is ineffective. In this group there are disparities in pay. But AHS executive pay is “adequate” and in some cases well below compensation for leaders who only manage parts of systems in other provinces. In short, the management team is neither bloated nor overpaid, although it could be better organized and developed. In 2021, UCP commissioned another third-party study as an initial response to the pandemic. The report by KPMG cost $475,000 and ran to 126 pages. He said the province’s unified health authority had created “significant structural advantages” in dealing with COVID-19.

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None of these detailed studies found a case for massive reorganization of the system. Neither does Premier Jason Kenney, who won election on a promise to reduce wait times for ERs and surgeries. The UCP campaign made no mention of an overhaul of the system. Kenney concluded then, and still believes, that none of a long series of radical changes since the 1990s had solved the problems. Don’t try another twist now, he says. Far better to focus on improving wait times, access to surgery and EMS capacity. But today’s candidates are in the political heat. They are targeting UCP members, some of whom blame AHS for both the handling of the pandemic and the current crisis. They seek support by fueling anger towards a vital organization already badly hurt and demoralized by a monumental crisis. This is the way to destroy health care in Alberta, not restore it. The winning candidate will not have a mandate to seriously overhaul health care. That can only be won by voters in next May’s general election. Until then, the government — and the next premier — should just fix the problems that really matter to Albertans. Get an ambulance for this kid. Don Braid’s column appears regularly in the Herald Twitter: @DonBraid

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