Bloated and dysfunctional

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President, Alpine Insurance and former Conservative MP; Director, Cathton Holdings and the Allard Foundation; former PC MLA and past Chair of Chinook Health Region; Past president, TSX Venture Exchange; Partner, Bearisto, Lehners, Ketchum Engineering; President and CEO, SAIT Polytechnic; Chartered accountant; Senior partner, Andreachuk Popovitch Barristers and Solicitors; President and CEO, Laebon Developments; Partner, Ahlstrom Wright Oliver and Cooper LLP; Executive vice-president, Quantia Communications (New Jersey); Executive director and CEO, Indian Oil and Gas Canada; President and CEO, Stantec; Executive director, Li Ka Shing Knowledge Institute (Toronto); Vice President, Syncrude Canada.

The names aren’t listed, but the positions indicate the expertise that was chosen by then-Health Minister, Ron Liepert, to lead Alberta Health Services into the new millennium – publicly funded health care run like a business.

This structural change in 2008 was instrumental in bringing “big business” culture into the health care delivery system. The season of huge salaries and benefits, rich severance packages and performance bonuses or the more sanitized version, “pay at risk”, had arrived.  Patients were now consumers and cutting costs and earning bonuses became more important than employee or customer satisfaction.

The initial idea of moving 50 per cent of the provincial government’s budget (amount spent on health care) to an arm’s length organization was ill-conceived and naive. It was argued at the time that a health care system had to be kept away from political interference. What an oxymoron! The health care system is politics because it’s funded by taxpayers. It’s not a business or it would have shareholders and elections for directors.

Thankfully Health Minister, Fred Horne, seems to have caught on somewhat and is in the process of returning the responsibility and accountability for AHS back to where it was and back to where it belongs – the Health Ministry, the Minister of Health, the Government and the taxpayer.

Liepert’s great experiment to pass the buck, failed miserably on all fronts – patient care, wait-times, accountability, efficiency, effectiveness, fiscal responsibility and front-line employee satisfaction. The damage left in the system is huge.

Health Minister Fred Horne used a weak argument to fire the AHS Board, but that being said, they needed to go. They were running the organization without regard for health and wellness, clients, taxpayers, or front-line workers.  They were just supporting and expanding a mammoth bureaucratic organization. It was like watching Wall Street gurus at work – the guys on top slicing off the biggest portions for themselves and the people on the bottom and the clients (patients) getting the scraps.

I can’t get my head around 80 vice-president positions. Is it any wonder that Janet Davidson, when reviewing the Health Service’s management structure, found it confusing and that people were unsure of who had responsibility.  Eighty vice-presidents!

Of course, Davidson’s scathing revelations weren’t a surprise to anyone who worked or knew someone who worked in the system.  It didn’t come as a surprise to anyone who was on a wait list, or had tried to access care through the emergency wards, or had to support a loved one caught up in the system.

It came as no surprise to Brian Mason, Leader of the NDP, or Raj Sherman, leader of the Liberal Party. For years they have been arguing to an unreceptive audience that AHS was dysfunctional, unaccountable and its top-heavy management structure was wasting millions of dollars that could have been spent on the front-line.

Horne recently fired five of the 80 vice presidents, and, of course, taxpayers shelled out more severance pay—this time to the tune of $2.1 million.

Seventy ex-VP’s have been “re-profiled” to positions that more directly support front-line staff. Give us a break!

Management is management; this re-profiling makes no sense unless those demoted VP’s have had their salaries reduced according (which we all know they haven’t) and have been moved into front-line support positions where the true needs are. Such as helping with lifting, feeding and bathing patients, or cleaning bed pans, making beds and scrubbing down rooms or assisting with routine maintenance jobs.

Horne says the people who make decisions about how health care is delivered need to be closer to the people they serve. The better answer would have been that there needs to be a lot fewer people making decisions and more people actually doing the work.

AHS is managerially bloated and dysfunctional. To eliminate five senior vice-presidents is a teeny, tiny step forward, but re-profiling 70 vice-presidents is not going to change much of anything.

If Health Minster, Fred Horne, is truly committed to emphasizing patients and front-line staff, he’s got a lot more firings ahead of him . . . unfortunately!

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