Alberta Premier Danielle Smith speaks with media as he arrives for a meeting of Canada’s Premier’s on Feb. 6, in Ottawa.Adrian Wyld/The Canadian Press
Premier Danielle Smith’s special appointee in charge of reforming the province’s health authority has delivered a statistical review outlining recent improvements rather than a detailed plan to act on the Premier’s promises to decentralize health care and cut bureaucracy.
John Cowell, Alberta Health Services’ administrator, on Monday produced a short report highlighting changes in the system between his appointment in November, 2022, and January. When pressed about Ms. Smith’s promised report to reform the health care system, Dr. Cowell said he will present a one-year business plan and a three-year health plan in the coming weeks.
Alberta, which on Monday became the seventh province to strike a bilateral deal with Ottawa on health care funding, will unveil its provincial budget Tuesday. Ms. Smith has said more money will be directed toward the Health Department. She made overhauling AHS a key campaign promise when running for leader of the United Conservative Party and the future of health care will be a key point of contention in Alberta’s next election, scheduled for May. But while Monday’s report shows early signs of improvement, the government has yet to expand on its vision of the health care system.
“This 90-day update was to give some confidence to people that the decision-making is going in the right direction,” Ms. Smith said Monday.
She added: “There does still need to be a shoring up of the management capacity at the facility level and there does still need to be a rationalization of what kind of decisions are made centrally versus what kind of decisions are made on a site-by-site basis.”
During her successful UCP leadership campaign, Ms. Smith vowed that within three months of taking office, a commissioned report would outline how to streamline AHS management, give more power to local decision makers, permanently reduce emergency room wait times, and increase overall health care capacity.
But after taking office and replacing the 12-person AHS board with Dr. Cowell, Ms. Smith walked back that promise. Instead, she committed that Dr. Cowell would report within 90 days of his appointment on progress related to improving ambulance response times and decreasing wait times for ERs and surgeries.
The administrator’s 16-page report outlined improvements to front-line staffing, patient flow, and ambulance, ER and surgery wait times between November, 2022, and January, in addition to continuing actions. It did not provide comparable year-over-year numbers.
Among the listed successes, the report states 114 full-time equivalent nursing staff have been added to emergency department teams and the frequency of red alerts – where no ambulances are available for calls – is coming down in Alberta’s two largest cities.
“When I started at AHS in November, I was told that this was a system in crisis and a broken organization,” said Dr. Cowell. “I’m here today, however, to tell you that AHS is not in crisis and is not broken. This report, to me, backs up that statement.”
He said COVID-19 continues to pose a challenge to the health system, as do other infectious diseases, and more needs to be done to bring the system “up to full capacity and full performance.” But he said Albertans should have renewed confidence in AHS.
Ms. Smith’s leadership campaign centred on disdain for AHS and its role in imposing COVID-19 pandemic restrictions. She accused the authority of failing to develop sufficient intensive-care capacity and said its vaccine mandate led to staff shortages. At one point, Ms. Smith said AHS was either “completely incompetent” or had “actively sabotaged” the provincial government.
Meanwhile, Alberta and the federal government announced an agreement in principle on health care funding. The four Atlantic provinces, Manitoba and Ontario had previously announced bilateral deals, after Canada’s premiers earlier this month accepted Ottawa’s offer to increase health care spending by $46-billion over 10 years.
Ottawa will spend $24.18-billion over 10 years to fund Alberta’s health care, the federal government said in a statement. This includes $2.92-billion for a new bilateral agreement focused on “shared health care priorities” and an immediate $233-million to address “urgent needs, especially in pediatric hospitals and emergency rooms, and long wait times for surgeries.”
Ms. Smith said the majority of the funding will come through the Canada Health Transfer, noting this means it comes with “no strings attached.” The Premier said she, along with the provincial ministers for health, and mental health and addiction, recently highlighted Alberta’s work on reducing wait times in emergency departments and its approach to mental health and addiction, to federal cabinet ministers. Alberta’s mental-health and addiction strategy emphasizes recovery programs over harm reduction policies such as safe supply of drugs through prescriptions.
“While important details still need to be discussed, we are confident Alberta will be provided sufficient policy flexibility under the agreement to deliver in areas of shared interest,” Ms. Smith told reporters.
The Premier, who like her provincial counterparts said Ottawa’s financial offer falls far short of their collective request, said Monday’s funding is a productive first step.
“The extra funding will be used toward health care action already under way,” Ms. Smith said. The Premier said the deal equated to $518-million “new dollars, this year, that we weren’t anticipating.”
Alberta on Tuesday will present its 2023-24 budget and Ms. Smith has signalled more money for the Health Department, which accounts for the majority of the province’s spending. The Health Department will spend over $22-billion in fiscal 2022-23, followed by education at around $8.4-billion.
The budget’s revenue is expected to ring in around $70-billion, thanks to hefty oil and gas royalties. Ms. Smith has indicated a willingness to spend more of this surplus than Jason Kenney, her predecessor, as the province prepares for the May election.