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Premier Smith signals rapid changes in the management of Alberta’s health care system

The extent of the overhaul that Smith says she wants to pursue has yet to be seen but, during the leadership campaign, she said she would fire the AHS board of directors in favor of an interim commissioner.

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Premier Danielle Smith signals her intention to make rapid changes to the management of Alberta’s health care system, raising questions about the scope of the reforms.

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In her first press conference after being sworn in on Tuesday, Smith said she intended to act “very quickly” on changes to both Alberta Health, which sets health policy, and Alberta Health. Services, which provides the province’s health care.

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At the time, she said she was still awaiting an initial healthcare briefing, but her intention is to have a new governance structure in place within 90 days.

  1. Danielle Smith enters Government House before being sworn in as Premier of Alberta on Tuesday, October 11, 2022 in Edmonton.

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Smith also announced plans to replace Chief Medical Officer Dr Deena Hinshaw, saying she will “develop a new team of public health advisers”.

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The extent of the overhaul that Smith says she wants to pursue has yet to be seen but, during the leadership campaign, she said she would fire the AHS board of directors in favor of an interim commissioner.

On Tuesday, she said there was a “management problem” at AHS causing problems in the healthcare system, including pushing frontline healthcare workers out of their jobs as they suffer from a lack of resources. and burnout.

“What happens in a business when it fails to achieve its goals and it fails to follow the direction, you change the direction. And so that’s what we’re going to do, we’re going to change the direction,” Smith said.

But University of Calgary health law expert Lorian Hardcastle says the analogy is problematic.

“The thing that seems to concern Smith the most is the fact that (AHS) couldn’t respond (to the COVID-19 pandemic) by increasing the number of intensive care beds, but they had no control over the number of people trying to access these beds and cannot refuse them like a private company can,” she said.

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“AHS doesn’t just say, ‘That’s how many beds we have, sorry, come back another day.'”

Former CEO of Alberta Health Services, Verna Yiu.
Former CEO of Alberta Health Services, Verna Yiu. Postmedia, file

The new premier’s comments follow several groups representing Alberta health care workers calling for stability in the health care system. hardcastle said Smith’s apparent plan to “clean house” in management and politics could create the opposite impression, underscoring the outcry over the sudden ouster of Dr. Verna Yiu, the former president and CEO of AHS. .

Smith also claimed that “much” of the problem of hospital staffing issues was created by AHS’s mandatory COVID-19 vaccination policy. The health authority announced last August that all health workers would need two vaccines to protect against COVID by Halloween 2021.

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This deadline has been extended twice and a rapid test option has been introduced for some, but in December 2021 AHS said 97% of full-time and part-time AHS staff were fully vaccinated and 99.7% of physicians had at least two shots. There were 1,650 employees placed on leave without pay when they did not comply with the mandate.

AHS rescinded the vaccination requirement last July, and Hardcastle said there was no evidence to support Smith’s assessment of its impact.

“There were health human resource challenges before AHS introduced this vaccine mandate. There is no cause and effect that she suggested.

U of C political scientist Lisa Young said early in Smith’s tenure, it appears health policy is one area where she is not inclined to soften her stance.

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The first important step, she said, is the choice of the Minister of Health. Smith will appoint his cabinet on Oct. 21 and current health minister Jason Copping could remain in the post, but if replaced, whoever takes the job could represent a statement on Smith’s leadership.

There is also uncertainty at AHS, which currently has an interim president and CEO, and a search committee has been searching for a new permanent chief since at least April, when Yiu’s departure was announced.

And there could be additional internal turnover at Alberta Health, raising more questions about who will replace them.

“You could basically take every older person who knows how the healthcare system works and move them quickly,” Young said. “There could be all this turnover at a time when people on the ground are really facing extraordinarily difficult circumstances.”

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