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Adriana LaGrange, minister of health, speaks about health-care reforms as Alberta Premier Danielle Smith looks on during a news conference in Edmonton on Nov. 8.JASON FRANSON/The Canadian Press

A purge of several top executives from Alberta Health Services has set in motion Premier Danielle Smith’s plan to dismantle the organization, signalling a potentially bumpy transition that experts say could place further strain on health care workers.

Last week, Ms. Smith unveiled her government’s plan to divide AHS into four organizations: one focused on acute care, one on continuing care, one on primary care and one on mental health and addictions. On Thursday, the province replaced six executives at AHS, including president and chief executive officer Mauro Chies, who had been appointed permanently to the role just eight months ago. In a statement announcing the departures, AHS said new ideas, voices and leadership are needed to drive change.

The dismissals are the latest in a series of blows to AHS since Ms. Smith took over as leader of the United Conservative Party in October, 2022. She has railed against the health authority for what she has described as mismanagement during the COVID-19 pandemic, including vaccine mandates and other restrictions she opposed. Almost immediately after taking power, she fired the entire 12-person AHS board and replaced it with a single administrator, John Cowell. She also removed Deena Hinshaw as chief medical officer of health.

Ms. Smith recently announced a new AHS board, chaired by Lyle Oberg, a former Progressive Conservative cabinet minister and doctor. The organization’s new directors have been tasked with supporting the transition process, after which AHS will be responsible only for acute care.

Mr. Oberg announced the AHS shakeup on Thursday, and said Sean Chilton, AHS’s former vice-president and chief operating officer for clinical operations and information technology, had been named acting president and CEO.

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Myles Leslie, associate director of research at the University of Calgary’s school of public policy, said the leadership changes could have a chilling effect on AHS workers. But, he said, it will take time to understand how these changes actually impact job responsibilities and patient care.

“If anyone inside AHS hasn’t already figured out – from the dissolution of the original board, to the installation of Cowell, to the installation of this board and six heads rolling – that a new sheriff was in town and change was afoot, they’re awake and aware now,” Dr. Leslie said.

He said the changes add another level of uncertainty for health care staff, who after working through the pandemic are looking for a reprieve.

Gaynor Watson-Creed, assistant dean at the Dalhousie University faculty of medicine and a former deputy chief medical officer of health for Nova Scotia, said what Alberta needs to do is provide evidence-based reasoning for change to its health care system. So far, she said, it has failed to do so.

“If these decisions aren’t based on evidence of their likely effectiveness for whatever problem they think they are trying to solve, then what are they based on?” she asked. “For systems as large, as complex, as costly and as vital as our health care systems, hunches, whims and untested hypotheses should not be – are not – good enough.”

Jasmine Pawa, a health policy expert and past president of Public Health Physicians of Canada, said these changes have been executed rapidly, and the reasoning behind them has been communicated poorly. Because of this, she said, health workers are in some cases worried they might also be shown the door, or that their work will be interrupted. The shift also deals a blow to morale, which was already suffering because of the extreme pressures of the pandemic, she said.

The government has said the overhaul, in its entirety, will take up to two years to complete. Ms. Smith has argued that it will improve patient services, but her government has yet to detail how the restructured health system will address problems, such as overburdened emergency rooms and a shortage of doctors.

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