Dr. Paul Parks, the Alberta Medical Association president, is in the trenches this day in the emergency room in Medicine Hat and he’s busy.
When he finally has a minute your scribbler wants to know what he has to say about Premier Danielle Smith’s latest comments on the state of health care in Alberta.
Over the holidays, eyeballs sizzled over Smith’s words, no matter the political stripe of the reader.
The premier was not holding back. She saw layers and layers and layers of middle managers at Alberta Health Services and saw a problem.
She saw some managers not solving the problems in the delivery of health care.
She saw people wanting more dough for more than a decade to improve care, getting the cash and then care decreasing.
She said her health minister, Adriana LaGrange, will tour the province’s hospitals, go to the front lines and listen to the workers, find the problems and fire the managers who haven’t been solving those problems.
Smith is not afraid to use the word “fire.”
The premier said she’d seen page after page of managers, 40 pages in Edmonton zone alone.
AHS managers who hadn’t seen the eyeballs of patients in a number of years will have to “pick up their game” and “demonstrate their value.”
For Smith there were bosses and bureaucrats preventing front-line workers from helping people, leaving those workers to deal with a worsening situation.
Smith went on to say she gave managers a year to make some progress and they started moving in that direction but then after the election last year they started back-sliding.
Dr. Parks agrees it is critical to do things differently.
He says if you polled docs about whether they thought something major had to change in AHS operations, 70% or 80% would fully agree.
But Parks adds some of the reason the system “is still going, even though we’re on the brink of collapse, is because we have some amazing people in AHS really keeping the ship afloat in an unbelievably difficult situation.”
“The system is really, truly being stressed. It’s so fragile,” says Parks.
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What he hears is the idea of “looking for heads to roll” leads to no managers wanting to “be creative and stick their neck out or pop their head up enough so they’re a target.”
This “paralyzes a lot of key decision makers.”
So, on the one hand, Parks agrees something needs to be shaken up.
“But on the other side, now in a climate where you have the premier saying heads are going to roll do you think there are going to be many in management jumping up and down and making themselves targets even if they have really good ideas?”
Parks says many in the system have frustrations but …
“You can’t just go in and chop off a whole bunch of heads without a real, solid concrete plan as to what you’re going to do to replace them or enable new leaders to fill the void.
“If you’re going to go in and shake up the system then have a plan to replace it when the dust settles.
“We don’t need more chaos.”
Decisions can’t be made and announced with the details left hanging in uncertainty.
Parks urges a sit-down with himself and the new AHS boss and the highest level of the government’s health ministry, among others, to hammer out “an evidence-based and expert-informed plan” to make big changes.
The Alberta Medical Association president wants to make sure two things are crystal clear.
“There are some really good managers who are very constrained by the way Alberta Health Services operates and the way the system currently exists,” says Parks.
“Breaking that logjam and freeing them up to really make local decisions and be creative and really think differently is exactly the goal we share and we want.”
But … there is a but when it comes to finding the good people.
“But coming in with a guillotine and heads will roll is going to make it hard to identify who those people are,” says Parks.
We will see where this goes.
Remember the premier won the leadership of the UCP vowing to fight the Liberal government in Ottawa while, with equal passion, slamming those running the health-care system during the COVID pandemic.
When Smith was asked if what she’s talking about would end up being a big deal her answer is one word.