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Health policy experts say ‘the uncertainty persists’ after AHS changes

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Health policy experts and political watchers say the provincial government’s latest plan to reform health care under a temporary administrator has big question marks ahead.

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When Dr. John Cowell was named official administrator of Alberta Health Services Thursday, it was a callback to a moment nine years earlier, when he stepped into the same role shortly after then-health minister Ron Liepert dismissed the AHS board.

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University of Alberta political science professor John Church, who recently co-wrote a book about Alberta’s health system, said Friday the last time the board was ousted, “It created four years of chaos, basically.”

The province’s consolidated health authority was created in 2008, amalgamating nine separate health regions into one. Since then, Church said the head of AHS has only lasted, on average, a little more than a year, until Dr. Verna Yiu took over in 2016. She served in the role up until she, too, was ousted in spring 2022, more than a year before her contract was up. A search for a new permanent AHS CEO is still underway.

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Cowell, flanked by Premier Danielle Smith and Health Minister Jason Copping, received a mandate Thursday to focus on decreasing wait times in emergency rooms and for surgeries, improving EMS response times and consulting with front-line workers to develop long-term reforms.

“It’s not like the priorities he’s been given are not priorities that have been given to every decision-making leader in the health system,” Church said.

“Alberta Health Services has been working on this stuff, and it does take time. They were starting to get traction under Verna Yiu because they actually had stable leadership.”

BC-based health policy analyst Steven Lewis said the AHS board acts as another layer between the health authority and the government, and eliminating those people is a clear statement that the province is taking more direct control. Copping said Thursday that the move is meant to foster “immediate changes” and the board will be restored later down the road.

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“This looks decisive. It looks like, ‘We’re going to get things done at breakneck speed,’” Lewis said.

I think that’s a pipe dream because these are very difficult problems to solve.”

University of Calgary political scientist Lisa Young said without specific benchmarks to measure the new administrator’s success, it will be difficult to track how well the new plan works, with a provincial election looming next May.

“They carefully avoided setting any specific targets. And when you think about what the health system will look like six months from now — will (ER) wait times be better? Sure, because we won’t be in the middle of the fall respiratory illness wave,” she said.

Politically, Young said that Smith now has something to point to showing she’s moving ahead on promises she made during her leadership campaign.

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“Whenever a reporter or the (NDP) Opposition asks her, ‘What are you going to do about whatever bad thing happened in the health system this week?’

“She can say, we have taken action, it was swift and decisive.”

Church added little will improve without work to improve health-care services available in the community, so people can get services they need without deteriorating to the point that they end up in an ER. In September, Copping rolled out several primary care advisory panels, which are due to report back with suggestions next spring.

Church and Lewis both said they’ll be watching closely for what unfolds that looks different compared to work that’s already happening.

“Instability has surrounded the governance of AHS for a long time now, and I’m sure it’s affected morale,” Lewis said.

“The uncertainty persists. And do organizations generally function better when there’s a lot of uncertainty? No, they don’t.”

— With files from Lisa Johnson


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