Danielle Smith takes aim at middle management in Alberta Health Services

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Alberta Premier Danielle Smith is signalling job cuts for managers at the province’s biggest health authority in the next six months as she forges ahead with plans to decentralize its control, at a time when critics accuse her of political interference in the body’s hiring practices.

Ms. Smith has been focused on overhauling the organizational structure of Alberta Health Services since becoming leader of the United Conservative Party last October, moving swiftly after her win to dismiss the authority’s 12-person board and replace it with a single administrator. That change was followed by a string of firings and resignations from senior health leaders, some of whom left their posts in defiance of the Premier’s reform strategy.

During the Western Premiers’ Conference last week, Ms. Smith said Albertans should expect “a lot of change” in the health system over the coming months. Last week, it became clear that her next target is middle managers who she said are causing delays and frustration for front-line personnel.

“It’s no secret that I’ve had frustration that there is a lot of middle management in Alberta Health Services, and it becomes really difficult for those on the front line to find anybody who can get to a yes,” the Premier said to media last Thursday, adding that her government has been looking at ways to restore decision-making to the local level.

“We’re going to have new faces that are going to lead that effort.”

John Cowell is the administrator in charge of carrying out her vision, and Ms. Smith said he is responsible for all work force changes. She said she won’t comment “on every personnel change that he makes” but there needs to be the “right people in the right place” to keep AHS moving in the right direction.

Further layoffs in the health sector could cost the government financially after millions in payouts last year. The largest amount was a package of $660,000 to Verna Yiu, who was removed as president and chief executive officer of the AHS, according to public salary and severance documents.

Ms. Smith has recently faced allegations of political interference in the hiring practices of AHS, which is supposed to be an arms-length entity from the government. More than 100 doctors released an open letter calling for an investigation into a revoked job offer to the province’s former chief medical officer of health, Deena Hinshaw, who was reportedly hired to work in the Indigenous health program.

“It signals to all physicians in this province that their positions are unsafe and could be targeted for political gain,” the letter says. “There is no place for leadership which undermines the decisions, recommendations and sovereignty of the Indigenous Wellness Core, and no place for political interference in health-care delivery.”

The revocation of Dr. Hinshaw’s job offer prompted the resignation of Esther Tailfeathers, who led AHS’ IWC.

In an interview, Dr. Tailfeathers said she was told to stay quiet about the situation after Dr. Hinshaw’s offer was rescinded just days before her start date on June 5. She said people opposed to COVID-19 public health measures, such as masking and vaccine passports, resurfaced to attack Dr. Hinshaw online after an internal memo of her hiring was made public on social media.

“In my childhood, as a result of residential school abuse, something happened to me and I was told to keep it secret and that I couldn’t tell anybody what was happening. I had the same response. I had a gut feeling that this was totally wrong. I had the gut feeling that this was an injury to myself, as well as the other physicians involved in this,” she said.

“Most importantly, this was an injury to my people.”

Dr. Tailfeathers said Dr. Hinshaw had earned the trust of First Nations, Métis and Inuit peoples in Alberta during the pandemic. Their focus at IWC, she said, would have been to form a plan to address skyrocketing rates of drug overdose deaths among the Indigenous population, which exceeds that of non-Indigenous people.

Ms. Smith, a vocal critic of Dr. Hinshaw and pandemic restrictions, had replaced her as the province’s top doctor last November. The Premier deferred questions to Dr. Cowell on the revoked contract, but he has yet to speak publicly or answer requests for comment through AHS, which did not respond to The Globe and Mail on Friday.

Dr. Hinshaw received $20,000 in severance last year, but her public contract shows she is entitled to nearly $182,000.

David Shepherd, one of the Opposition New Democratic Party’s health critics, said the situation with Dr. Hinshaw has set a chill on the very people needed to help improve AHS.

He said there is a “level of delusion and ignorance” on the part of Ms. Smith if she believes a single administrator can reform the system “top to bottom by randomly firing a few people in middle management.”