Alberta premier says placing managers in regional hospitals will lead to restarting shuttered services

Alberta Premier Danielle Smith says restructuring Alberta Health Services (AHS) to place more managers in smaller communities will help to restore essential care in regional health centres.

Speaking to reporters after a Thursday appearance at an Edmonton Chamber of Commerce luncheon, Smith said "bad management" has led to disrupted regional health services, such as newly renovated operating rooms sitting unused in Brooks.

"If we had managers at that local facility making decisions for the community about what services should be provided in that community, I'm convinced they would find the people, they'd find the anesthesiologists. They'd find the staffing," Smith said. "That's the reason why you need more management closer to home at each individual hospital."

On its website, AHS lists 33 ongoing "temporary service disruptions," such as no obstetrical care, closed emergency rooms or inpatient bed reductions at hospitals across the province. Some closures have persisted for longer than a year. The rationale listed for most disruptions is "Temporary staff shortage due to illness / leave / vacation / vacancies."

Since she ran for leadership of the United Conservative Party last year, Smith has voiced concerns about AHS management and signalled a restructuring is coming. Last year, she fired the AHS board and replaced members with an administrator. Smith has said AHS has too much centralized management and not enough front-line health-care workers.

On Tuesday, she gave Health Minister Adriana LaGrange a mandate letter asking LaGrange to restructure AHS and decentralize decision making at the organization.

LaGrange questioned whether AHS could be divvied up by function, hinting the organization could be broken up into acute care, long-term care, procurement, and more.

Smith said on Thursday she is not interested in returning to a system of regional health authorities. Those bodies amalgamated in 2008 to become the country's first provincewide health authority.

"Should they be doing midwifery?" Smith asked of AHS. "Should they be micromanaging who is allowed to hire a doctor into a primary care facility? Should they be delivering continuing care, or is that a different specialty that should be under different management?"

The government has not provided a timeline for the restructuring.

Opposition skeptical restructuring will improve service

AHS employs more than 112,000 people and has a budget of about $16 billion per year. It runs 106 acute-care hospitals, five psychiatric facilities, more than 28,000 continuing-care beds, about 3,000 addiction and mental health spaces and is a partner in 40 primary care networks, according to its website. Employees run programs and offer services at more than 900 locations across Alberta.

Before securing the UCP leadership in October 2022, Smith criticized the AHS mandate requiring employees of the organization and its subsidiaries to be vaccinated against COVID-19.

Smith said on Thursday preventing such sweeping employment vaccination requirements in the future was not part of her motivation for seeking to overhaul AHS.

"It's about making sure we've got essential services as close to home for patients as possible, and that's not happening right now," she said.

NDP jobs, economy and trade critic Nathan Ip, who was at the Chamber luncheon, said he's skeptical a restructuring of AHS will fix what ails the health-care system.

"It's a problem of not investing in the front-line health-care workers that we need to, and the precipitous cuts in our health-care system over the past few years," Ip said.

Unions and organizations that advocate for public delivery of health care have said a shortage of health-care workers, challenges recruiting and retaining professionals, and burnout are leading to interrupted services, such as emergency-room closures.

AHS provided CBC News with data earlier this month showing the amount of overtime staff are working has more than doubled during the last three years. More than 14 per cent of registered nursing jobs in the organization were unfilled as of June.

The government has been trying to bolster the health workforce by recruiting employees from other provinces and countries, and creating more training spaces for health professionals in post-secondary institutions.