Well, they’re doing it.In both her leadership campaign and the May election, Danielle Smith campaigned on blowing up Alberta Health Services in order to create a new and more efficient entity. She didn’t quite call it that, but it has long been obvious that whatever ‘fixing healthcare’ might mean, radical change would be required. And so with that as an election promise, she was elected leader and then led the party to victory in May.One may agree with her plans or not, but she has been consistent to her word.And something certainly needs to be done. Albertans were not getting the healthcare they were paying for. The familiar metaphor of changing an oil tanker’s course fits well with any talk of reforming AHS.Like tankers, it is enormous, slow and barely responsive to the helmsman’s wheel — hence the replacement of the board last year with a single administrator, in an effort to accelerate decision-making.Also, in the ‘Yes Minister’ world in which it floats, the AHS has in common with bloated bureaucracies everywhere that it tends to reflect the priorities of those who are part of it, rather than the people it is there to serve. Little empires then, in which civil servants work hard at things that don’t actually help the people in Emergency who are trying to help other people with a problem.Occasionally, these priorities may coincide with the public good. But in the search for efficiency and savings, staff reductions and holding the line against grasping unions were always secondary to asking the luckless government of the day for more money.Not surprisingly, the union response to the announcement, delivered by AUPE President Guy Smith, was on message: The “Alberta government should implement wage increases, focus on greater job security and improve staffing levels to support frontline workers and ensure the delivery of quality care to Albertans.”No surprises there, then. It is of course the job of a union to squeeze the employer for as much as it can get in wages and conditions on behalf of its members. The union will do what unions do and on behalf of Alberta’s health workers, the AUPE appears to have been spectacularly successful. As the Fraser Institute reported earlier this year, Alberta’s health workers are among the best paid in the country.However, it is also the job of the employer to push back.In this respect, past Alberta governments have been remiss, either because as in the case of the NDP they were unduly influenced by the unions, or because the Progressive Conservatives always found it easier to raid resource royalties, than to bargain hard. (If the prime minister has his way, this might not be an option much longer.)In any case, the government of Alberta owes it to the poor old taxpayer to resist the squeeze.And so, it was time to do something different.Smith says ‘different’ does not mean privatization. Fair enough; politics is the art of the possible.However, it is much to be hoped that in the process of stripping out the essential functions of health from Alberta Health — continuing care, mental health and addiction, primary care and acute care — the bureaucratic overhead will be reduced and the new ‘silos’ will be leaner and more responsive.Above all the system, however it is constructed, needs to see Albertans not as costs, but as clients. And the measure of an administrator’s success must be how many clients were served, not how many people are under them on the organizational chart.One would have hoped this would have been possible without the wholesale reconstruction of AHS. Apparently it was not, however.Finally, it is perhaps symptomatic of the AHS mentality that has to be expunged, that somebody in a position of trust chose to abuse that trust and leak the government’s planned announcement today, to the Official Opposition yesterday.Don't mistake this person for a whistle-blower. As the document was due to be released within hours, the sole purpose could only have been to embarrass the government and give the Opposition some press.That’s not a civil servant’s job. It is in fact gross disloyalty. That individual must be tracked down and subjected to such disciplinary measures as the system provides.
