Globe Editor: Danielle Smith has a scary fix for health care

Open this photo in the gallery:

Alberta Premier Danielle Smith has introduced a new tool to improve the performance of her province’s hospitals: fear.

His views, as revealed in Aug. 17 in a members-only meeting with the United Conservative Party loyalist in Drayton Valley, Alta., is to outsource the operation of struggling hospitals currently run by Alberta Health Services to a third party.

Alberta has long allowed private clinics to perform certain surgeries, and Ms. Smith said she intends to turn some AHS hospitals over to Covenant Health, a faith-based health care provider that operates hospitals in Alberta. 11 and other services. He said this could create competition.

“When you’re dealing with a monopoly, and they believe they can provide any type of care, and there are no consequences, they will continue to provide poor service. And competition is one option. .That’s why we offer chartered surgery centers and why we offer the Alliance,” Ms. Smith said.

But another is the fear of dispossession. That will be a very strong competitive incentive for managers to say, ‘Oh my goodness, if we continue to provide terrible care at Drayton Valley, then someone else will be appointed for the driver.’ ”

The idea of ​​introducing market-like competition and fear in providing public services is undoubtedly appealing to many of the UCP’s voters.

Alberta’s health care costs are higher than the Canadian average, but it still suffers from the same problems as lower-spending provinces: long wait times for surgery, overcrowded emergency rooms , shortage of family doctors, overworked hospital staff. lack of mental health support…

Ms. Smith has directed public anger over these shortcomings at Alberta Health Services, the government agency that receives the lion’s share of the province’s health budget.

AHS is one of the largest health care centers in Canada. It has the power to provide health care in Alberta — or did, until Ms. Smith announced last year that her government would break it up into four systems — primary care, acute care, continuing care and mental health – and leaving. Only serious care in the hands of AHS.

Ms Smith now says she wants the government to take back ownership of the 106 hospitals that AHS runs and lease them to the agency – thereby creating a situation where the government can use its money as a weapon of terror.

Could this save taxpayers money and ensure better services? There is absolutely no guarantee of that, and Ms. Smith has given no evidence for it.

But there are concerns that the protected health system could mean some patients will find themselves having to deal with four separate officers.

It is also troubling that Ms. Smith said the hospitals could be transferred to Covenant Health, a Catholic care provider that does not allow employees to provide abortions, birth control and assisted dying, procedures that Canadians have the right to do it.

Early abortions in Alberta are usually performed in AHS-funded clinics, not hospitals, and MAID is available through health care services, clinics or patients’ homes. However, it is possible that outsourcing hospitals to Covenant Health could reduce Albertans’ access to the care they need – which, in a word, would amount to inefficiency.

The big issue, however, is that the government will raise money as a threat against an incumbent that the prime minister of the day doesn’t like very much.

It can prove costly to transfer the operations of a perceived underperforming hospital to another organization, only to discover that the issues that caused the alleged inefficiencies actually existed in the care system. Canadian health in general – things like shortage of doctors and nurses, low government funding. , elderly people etc.

That is the crux of the matter. Health care services are struggling across the country, and no provincial government has come up with a magic bullet. And Smith would be wise to try to understand the common causes of the current crisis and deal with them.

But it’s a lot more difficult than calling the provincial health officials careless, then offering a simple solution.