Tories poised for overhaul of Alberta health care

By Don Braid, Calgary Herald September 10, 2013 6:10 AM

Another shakeup of health care — a big one — is thundering our way, with the first hoofbeats expected in a provincial government announcement Tuesday.

Sources say the province will agree to a significant movement of money toward front-line care, and away from the ballooning administration of Alberta Health Services.

It’s likely that a number of vice presidents will soon depart AHS, severance packages in hand.

After watching the AHS head office expand ever since it was created in 2008, the PCs have decided it’s not working as planned, and the time has come to strip out executive blubber.

On Tuesday, the province will release its response to a report on health-care governance, written by Janet Davidson, the AHS official administrator who was appointed in June.

Davidson has already said her review would look at ways to get rid of duplication between AHS and the Health Department.

Davidson herself might help with that. In government, nearly everyone expects that she’ll soon be appointed as the new deputy minister of health.

Last Friday, in a shuffle of deputy ministers, veteran health deputy Marcia Nelson was sent to infrastructure.

An acting deputy took over the department. But indications are that Davidson, who joined AHS after Horne fired the whole appointed board, could soon get the deputy job permanently.

Some provincial people want to cement the command line from government to AHS by having Davidson fill both jobs — as deputy minister, and also as official administrator of AHS.

But that’s thought to be politically difficult, as well as possibly illegal.

Current legislation calls for the health authority to have its own stand-alone governance, either through a board or an administrator.

However the details shake out, it’s clear that the government’s impatience with the growing AHS empire, along with its occasional insensitivity to the public, is at an end.

Political command, as well as involvement in specific health issues, will be more direct and formalized.

The PCs have recently been testing the public’s attitude to direct action by politicians.

The most obvious case was Premier Alison Redford’s face-to-face meeting with disabled people in Edmonton, and her role in reversing an AHS decision to strip them of responsibility for their own home care.

There was no outrage at the premier’s action. In fact, the general reaction was approval.

Health Minister Fred Horne, who works closely with Davidson, provided another example Monday with his disgusted reaction to the appalling case of the senior whose face was allegedly chewed by mice in a Lethbridge care home.

“I must say I was very, very disappointed to learn of this,” Horne said. “I have a tremendous number of questions about what exactly is going on.”

Horne immediately sent inspectors from both AHS and his Health Department to investigate — signalling that AHS, which oversees such facilities, is itself under direct scrutiny.

The Lethbridge Centre is operated by Edmonton-based Covenant Health, a Catholic health-care organization, which runs 18 facilities around the province.

All of that shows, if nothing else, how vast and complex the health-care system has become.

And the AHS structure, for all its bloat, does not have a proper grip.

The only other candidate to provide oversight is the government, which needs to restore the far-more rigorous hold it had on provincial care and standards before the first health regions were created 20 years ago.

And may the government succeed. Please.

Don Braid’s column appears regularly in the Herald

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