Good morning, faithful readers. Today’s the day we find out who will be Alberta’s seventh premier in 16 years. More on that tomorrow.
But today, I’m fretting about health care. Danielle Smith, our Premier Presumptive, as quoted in yesterday’s Rick Bell column:
“Alberta Health Services has utterly failed. They utterly failed to manage the pandemic. They utterly failed to increase surge capacity. And now they are utterly failing to provide proper services to people.
“I think there’s an appetite for us to say: Enough is enough. We let the experts make the decisions and they let us all down and they’ve created chaos in society, division in society and now they’ve created chaos in the health-care system.
“You bet. That will be my target.”
This is magical thinking. The assertion that everything in Alberta would have been OK if Alberta Health Services could have produced 1000 ICU beds is wishful thinking. We’ve heard this from Smith before, as well as some of the other leadership contestants, and even the Premier.
What’s wrong with the idea? First and foremost, it implicitly accepts that a much higher death and disability toll from COVID-19 would have been acceptable. Walking away from the ICU unscathed after a bout of COVID is the exception, not the rule. According to the Canadian Institute for Health Information, 26% of COVID ICU patients died in hospital. Alberta already boasts one of the highest death tolls from COVID among Canadian provinces: an approach that filled our ICU beds three times over would have been that much worse. If Smith accepts this price of “freedom” she should acknowledge the trade-off.
Second, blaming AHS experts for Alberta’s COVID-19 outcomes is inconsistent with the factual record. From the fall of 2020 until the winter of 2022, the consistent pattern for the Kenney government was to hesitate as case numbers increased, and only then to act. Recall August and September of 2021, as the Delta variant ran rampant and the government was invisible. It was only when the experts at AHS warned of imminent catastrophe in the health system that restrictions were put back in place and vaccine mandates imposed. The cancelled surgeries and other pressures on the health care system were a direct result of the government’s hesitation to act.
Blaming the COVID-19 outcome and subsequent challenges in the health care system on AHS lets the Kenney government off the hook for its indecisive and insufficent response to COVID-19. It allows those who protested against public health restrictions and vaccine mandates to absolve themselves of responsibility for these outcomes. It targets the very people who have worked so long and hard under exceptionally difficult conditions to keep the health system running.
Assuming Smith wins, she will soon be responsible for the performance of this health care system. The challenges are enormous. Starting from a place of magical thinking and blame shifting is unlikely to produce the kinds of results that Albertans want to see.
Even if restructuring of AHS to decentralize is a sound decision (and I honestly have no idea if it is), should the attention of the AHS leadership be diverted from managing a system breaking under the current strain toward restructuring?
Here’s the nightmare scenario, as I see it. The system continues to struggle with the ongoing pressure of staff shortages and heavy demand through the fall. AHS leadership is distracted by restructuring proposals and political attacks. The campaign to encourage flu and COVID-19 vaccinations is overshadowed by the introduction of legislation guaranteeing the right not to be vaccinated. Pressure on the system increases. And we start hearing even more terrible stories about ambulances that don’t come and people who die unnecessarily.
I hope I’m catastrophizing about this. I hope things don’t get that bad. But if we learned one thing during COVID, it is that leadership matters in an emergency. I hope our new Premier takes the role seriously and is willing to listen to the experts who can get us through this.
I have a hard time understanding your logic. Adding ICU beds would lead to more deaths because people die in the ICU? If that's the case then eliminating ICU beds would save lives? That's nonsense and I'm sure that's not what you meant. The other point that surviving Covid in the ICU is the exception. If 26% of Covid ICU patients die then 74% survive so surviving is the rule and dying is the exception.
There are problems with AHS.. Alberta spends the most on health care while getting some of the poorest outcomes. I'm not sure firing the executive is the answer but neither is the status quo.