Alberta Premier Danielle Smith replaces health authority board with administrator to usher in reforms

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Alberta Premier Danielle Smith fired the board of the province’s health authority on Thursday and replaced its members with a single administrator whose focus will be on developing a long-term plan for health care reform, improving ambulance response times and decreasing wait times for emergency rooms and surgeries.

Ms. Smith’s successful campaign to become leader of the United Conservative Party, which culminated in her appointment as Premier last month, included frequent attacks on the health authority, Alberta Health Services. She has blamed AHS for the province’s decision to impose pandemic restrictions, such as business shutdowns and vaccine mandates, both of which she opposes. And she has accused it of failing to develop adequate intensive-care capacity. In July, she said AHS was either “completely incompetent” or had “actively sabotaged” the provincial government.

Alberta, like other provinces and territories, is struggling to fix health care systems that are hampered by staffing shortages and long wait times – problems that were exacerbated by the COVID-19 pandemic and compounded by the recent increase in other respiratory illnesses, such as influenza and RSV.

Ms. Smith appointed John Cowell to be the sole administrator for AHS, his second time in the role. Dr. Cowell, a retired health executive, last served as administrator in 2013, after a previous Progressive Conservative government dismantled the AHS board of the day. The UCP government argued at a news conference on Thursday that having a single person in control will increase the pace of change at the organization, because their focus will not be as wide-ranging as that of the larger board.

“I‘m cautiously – well maybe more than cautiously – optimistic that we’re going to see real results in 30 days, 90 days, six months,” Dr. Cowell told the news conference. “Six months for sure is as much time as you need.” He said his first order of business will be to diagnose problems in the health care system. He added that he will be recruiting two people to work with him.

Alberta Health Minister Jason Copping told reporters the appointment of an administrator is a “temporary fix,” and that the government plans to restore the board at “an appropriate time.” One member of the 12-person board, Deborah Apps, resigned last month, saying she could not support Ms. Smith’s plans to overhaul the health care system and its organizational structure.

During the leadership campaign, Ms. Smith committed to launching a review into how hospital bed capacity could be increased. She also promised that recommendations from the same audit team would show how to cut AHS’s bureaucracy and delegate control of health care delivery to local decision makers.

A news release that accompanied Thursday’s announcement said Dr. Cowell would report publicly on his progress in 90 days.

Ms. Smith has also promised to hire a new chief executive officer for AHS. Her predecessor as premier, former UCP leader Jason Kenney, removed the previous CEO, Verna Yiu, and appointed an interim replacement.

Mr. Copping, Dr. Cowell and Ms. Smith described a variety of ways they intend to improve the health care system, such as by fast-tracking ambulance transfers at emergency rooms and increasing surgeries at underutilized hospitals. But their remarks were short on specifics. The Health Minister said the government will increase its health budget by another $600-million next year.

When Ms. Smith was asked about the progress she would like to see over the next few months, she was unable to provide details. She said the government needs to find out the “current status” of AHS and track progress from there. “It will be better than it is today,” she said.

Tony Dagnone, who was among the 11 board members fired this week, said in an interview that, unless Dr. Cowell develops “Godlike powers and the patience of Job,” he will have limited success at reforming the delivery of care, because there is too much government involvement. He noted that Ms. Smith has been critical of public-health measures implemented during the COVID-19 pandemic, and he said she had lobbed “baseless smears” at AHS.

Mr. Dagnone acknowledged that AHS is not a perfect organization, but he said its aim has always been to look after Albertans. He added that he has never before felt the need to criticize a political leader publicly. But he said there is too much at stake right now.

Jennifer Jackson, a professor in the nursing department at the University of Calgary, said the government’s attempts to revamp health care face a key barrier: staffing.

“We do not have adequate staffing to maintain services as they are, let alone expand,” she said, noting that there are currently thousands of nursing vacancies in the province. She said she does not have faith in the UCP’s ability to solve complex problems, such as excessive wait times in emergency departments, when it appears unwilling to take simple public-health measures.

“To take pressure off ER, and thus speed up 911 response times and decrease ER wait times, we need a massive increase in community services, home care and prevention,” Prof. Jackson said. “Given the government’s lack of masking or hand sanitizing – the most basic steps in this idea – I am not hopeful we can deflect people from emergency services.”

Mr. Copping told reporters that the government is continuing to address gaps in primary care and health human resources.

Rachel Notley, Leader of Alberta’s New Democratic Party, dismissed Thursday’s announcement as nothing more than “bad political theatre.” The announcement, she told reporters, will create instability and uncertainty.

“Danielle Smith has absolutely no mandate to create the chaos, the cost and the conflict that today’s announcement may well generate,” Ms. Notley said. She added that the UCP had described the problems in Alberta’s health care system, but had not described a plan to solve them.

“There is absolutely nothing about today’s announcement that should convince a single, solitary person that help is on the way.”