Nelson: Health care will make or break Prime Minister Smith

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It’s hard to tell if Premier Danielle Smith is brave or just plain stupid.

In the end, it doesn’t matter much. Either way, his political future is tied to the albatross that is health care in this province.

Alberta is not alone when it comes to a dysfunctional health care system. The combination of ever-increasing demand and inadequate supply is straining social infrastructure across the Western world, something that will worsen as the population ages, and there fewer workers are close to choosing. (The large number of newcomers to our province will exacerbate that need.)

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And although everyone understands the need for change, few are ready to risk the consequences. “First, do no harm” is not just a phrase for doctors, it is also a phrase that resonates throughout the health care organization.

Therefore, the response from those running this amazing system is to endlessly cry “it’s a disaster” and demand more money. Exactly how much, they never say, because that will come with responsibilities attached. So, like the famous Oliver Twist, they just want more, even though the current annual provincial budget stands at $26.2 billion. There are not five million of us here in Alberta. That’s a lot of money to spend.

Smith believes his government can go some way to fixing this. In fact, when he came to power, it would be done in 100 days. That was just madness on steroids.

So, after first firing its board and splitting Alberta Health Services into four separate divisions, now we hear his government is considering removing AHS’ control over rural hospitals deemed underperforming well. Other operators, such as Catholic care provider Covenant Health, will be asked to take over and introduce competition into the system. (Given the religious nature of the movement, don’t be surprised if abortion becomes an issue. As if we weren’t divided enough.)

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“The next step is to see how many hospitals that AHS currently operates that we can take,” the Prime Minister told the party delegation at the recent town hall in Drayton Valley.

You certainly can’t blame Smith for sitting on his hands. AHS has been watching him since he left, fueled by anger among supporters who helped him win the championship, and now he’s under fire in the upcoming leadership test. For these people without better things to do, the restrictions imposed by the health authority during the COVID epidemic are still in place. It’s time to pay.

Yet the important question remains: Will these changes, as radical as they may seem, make a difference to what is important to Albertans? Will they make the system more efficient? Will they attract doctors and nurses to the front? Will the surgical waiting list be reduced?

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If it’s just a matter of strength, Smith would have a fighting chance. But that won’t get him very far at this point, because no matter how he rearranges the deck seating, it’s still the same class on this Titanic.

There are more than 110,000 AHS employees, making it the largest employer in the province. And everyone knows exactly where they sit in the Holy Grail of documentation, the organization chart.

Trying to force change, however necessary, from outside such a large, interconnected organization is next to impossible. You need strong internal allies, and those will be hard to find when “first, do no harm,” is still the clarion call for their position.

It is doomed to failure.

And because Smith makes it an important part of his platform, this does not give him his political future. But at least he’ll go down swinging.

His opponents will mourn the disaster, as they demand more money.

Chris Nelson is a regular writer.

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