Sorry, we’re full

Written by Brenda Schimke

Alberta has a problem. Successive conservative governments have attempted to re-shape our health care delivery system into an ‘operations efficiency’ model favoured by the oil industry.

Health care services are now delivered through an arm’s-length corporation, Alberta Health Services (AHS), and governed by a premier-appointed board of directors. The board’s mandate from day one has been cost cutting and operations efficiencies.

A cornerstone principle has been ‘just-in-time staffing’—operate with minimum full-time staff and use part-time to cover peaks and vacations. In a further attempt to save money, minimally-trained, health care aides were introduced to eliminate professional nursing positions. ‘Just-in-time’ inventory also became an important move to save money. Albertans didn’t blink an eye at these trends. In fact, many of us believed this would make our healthcare system better.

The pandemic, however, showed just how wrong we were to think a health care system could be run like an oil company.

If you’ve lived in Alberta as long as I have, you know the routine. When world oil prices are high, oil companies hire like crazy. When world oil prices drop, oil companies lay off employees by the thousands.

I started working with Syncrude in 1974 when there were 50 employees. When I left five years later, there were over 5,000 employees. The ramp up of employees continued for another decade. Syncrude recruiters scoured Canada and the world for every engineer, trades person and labourer they could find. The money offered convinced the masses to move to cold and remote Fort McMurray.

I was at Amoco less than a decade later, when thousands were being laid off as the Beaufort Sea operations were being abandoned—projected returns weren’t good enough when compared to the risks.

We convinced ourselves that we could ramp up and ramp down staffing in the medical world like the oil patch. But today we’re learning a very hard lesson as our medical system has collapsed and the Armed Forces and other provinces are coming to our rescue. It’s kind of humbling, but it’s a good lesson.

Unlike the oil industry, health services can’t simply shut-in assets when oil prices drop. The arrival of patients at hospitals is uncontrollable and medical personnel won’t and can’t just lock the doors and flip on the ‘sorry, we’re full’ neon sign.

Then there’s the reality that medical staffing is a whole different ball game than oil patch recruitment.

Doctors, specialists and nurse practitioners require a lot more education and on-the-job training than the top dog in the oil patch, a professional engineer. Respiratory therapists and registered nurses (RN) take the same number of years to train as engineers, and like engineers, RNs are specialists. An oil company couldn’t safely swap out an electrical engineer for a mechanical engineer’s job anymore than a nurse could transfer from day surgery to the ICU and not cause safety concerns. Different medical units require highly specialized nurses to deal with their specific patient’s care, and must be competent to operate unit-specific, specialized equipment.

The human body is much more complicated than a man-made blueprint!

Unlike an engineer, doctors can’t just be recruited from overseas and then start work in a day or two. It takes years, many exams and lots of money for a foreign doctor to get accreditation in Canada.

So, the moral of the story is that as much as we’ve tried to run AHS under a corporate ‘operations efficiency’ model, the employees—specialists, doctors, RNs, nurse practitioners, respiratory therapists, etc.—are a scarce resource not only in Canada, but throughout the world, and their customers—patients—are human beings desperately wanting to live another day.

 

Brenda Schimke

ECA Review

About the author

Brenda Schimke

Schimke is a Graduate with Distinction from the University of Alberta with a BCom degree. She has lived and worked in Alberta, BC and Ontario.