It started in a small way with the arrival of Premier Ralph Klein, a ‘folksy man of the people’. He served up the idea that corporations were efficient and effective and the civil service were lazy and pampered.
That was quickly followed by equating professional associations representing doctors, nurses and teachers, with the ‘union’ label. Union workers had already been deemed the ‘enemy’ of corporate prosperity.
With the dye cast, the majority of Albertans soon became ardent believers that corporations could do everything better than government. Premier Klein was applauded and idolized for slashing budgets and laying off tens of thousands of public servants, nurses and teachers in the 1990s.
However in 2005, Premier Klein moved too quickly to advance private health delivery when his ‘third way’ was soundly rejected by Albertans—but the plan was never shelved!
A significant turning point came in 2008 when Premier Ed Stelmach launched Alberta Health Services (AHS). It was the governance model best able to stealthily deliver more privatization into Alberta’s health care system.
With control centralized in Edmonton and a politically-appointed, business-focussed board of directors, private medical providers began salivating. And the government was exceedingly happy to silence those pesky regional health authorities who spoke directly with patients and front-line providers.
Unbeknown to most Albertans—except the Friends of Medicare—our health care system had become ‘the frog dropped into a vat of cold water’ totally unaware that the fire had been lit.
Decades of ‘adjustments’ to staffing levels was essential to the privatization agenda. Laying off experienced workers; leaving vacant positions unfilled; replacing full-time positions with part-time and casual wherever possible; verbally tearing down the reputations of professional associations; unilaterally tearing up contracts, all helped create the necessary toxic environment.
Privatization advocates now had clear examples of ‘inefficiency’ and ‘dysfunction’ in the public system and like the ‘frog’, the public were generally unaware that the chaos unfolding was according to plan.
Another strategy was for AHS to stop regular maintenance and replacement of equipment and facilities in areas easily privatized—labs, laundry and housekeeping—eventually resulting in the ‘common sense’ decision to lay off 11,000 hospital workers in the middle of a pandemic.
Government finances were bad, existing facilities and equipment needed major upgrades or replacement, and, viola, there were private companies staffed up and equipment-ready to fit the bill.
The AHS board of directors moved quickly to ‘corporatize’ health care, specifically introducing ‘just-in-time’ inventories (which is a proven disaster in a medical emergency); ‘peak efficiency’ (which is a major factor in the ruination of our ambulance services); and ‘management bonuses’.
Management positions ballooned. In 2020, the Canadian Taxpayers Federation reported AHS had a CEO, 11 vice-presidents with a support team of 3,300 managers.
Taxpayer-funded bonuses to high-paid management were, however, a tricky sell. Especially when patient care and wait-times have not gotten better under AHS management—many would argue, it’s worse—and even though the AHS budget had increased from $13 billion to $19 billion since its inception.
The first realization that taxpayers were funding corporate bonuses came in 2013. The media reported the AHS board had given themselves bonuses totalling one million dollars. The government was caught flat-footed and unprepared for ‘this reveal’. In a panic move, they irrationally fired the entire board to make the problem go away.
But it didn’t stop bonuses. The media once again focussed our attention on Dr. Deena Hinshaw, Alberta’s top public health official, who received a jaw-dropping 62 per cent bonus—over quarter-of-a-million dollars—for her efforts during the pandemic.
It was a slap in the face for front-line medical workers.
I would argue Alberta’s top doc owns a significant share of responsibility for aiding and abetting politics over health care. Her deafening silence through the ‘best summer ever’ pandemic crisis was appalling. The ‘richest province in Canada’ let their hospitals and health care workers reach the brink of collapse during the pandemic, and it continues to this day.
On the operational side, Dr. Verna Yiu, president and CEO at Alberta Health Services, was working flat out to save our hospitals from collapse and support overwhelmed doctors, nurses and other health care workers. For doing her job and not pandering to politicians, she was fired.
The AHS board said that Dr. Yiu wasn’t the right leader to bring the health care agenda forward.
Not surprisingly, a short time later Jack Mintz was appointed to the AHS board. He was the advisor to Ernst & Young that produced a report for the Kenney government that recommends even more sweeping privatization measures.
The Alberta public health care system is now that ‘frog’ in water that has reached the boiling point.
The breakdown of the public health care system was gradual and covert, that was the point, and now that we are beginning to understand, the slim chance to reverse course will require, not just a new premier, but a new government.