LaGrange should check her facts before blaming AHS managers

By Braden Manns

Health Minister Adriana LaGrange has taken off the gloves, suggesting Alberta Health Services managers who aren’t on board with changes to AHS should find “greener pastures.”

She repeated messages spouted by the premier in the fall — AHS has layers upon layers of middle managers — and she’s going to review every single manager position to see if it’s needed. She’s added in some new concerns she’s heard as well, like having to go up seven layers of bureaucracy to buy a new hospital bed and about 27 patients who “were stuck in hospital beds because they don’t have their taxes done so they couldn’t qualify for other services.”

The minister might want to check her facts before spewing inaccuracies. Frankly, the media should have checked their facts with AHS — though I say this knowing AHS isn’t allowed to speak to media without having their messages approved by the government.

Who cares about facts these days anyways? Facts like that AHS has the lowest spend on administration in Canada — around 2.6 per cent.

This talk of umpteen layers of bureaucracy is tired UCP rhetoric. If you’d asked AHS, you would have found that they implemented a policy over two years ago to provide funding to cover the cost of continuing care in situations like those mentioned for these 27 individuals. So that’s not why these people are still in hospital. It’s more likely there aren’t any continuing care beds for them.

From my past role at AHS, I know that AHS has been raising alarm bells for years about the need for new continuing care beds. New beds are the government’s responsibility and they’ve been stonewalling. No reorg will fix this. Facts can be so inconvenient.

The minister’s message reminds me of the saying “the beatings will continue until morale improves.” Just get rid of managers? I’m assuming you’re talking about the same managers who worked countless hours last summer finding places for patients and residents displaced by the wildfires? The ones taking calls in the evening while at their children’s events when emergency departments are overcapacity? The ones helping patients and families under challenging situations every day?

The problem isn’t managers. If change is slow in the health-care system, it’s because even for AHS — which is meant to have some independence, and the ability to make rapid decisions — the minister feels the need to micromanage every significant decision for fear it might create a PR mess for the government. That’s what leads to gridlock.
If you’re having trouble getting managers on board with your proposed “Health System Refocusing,” perhaps it’s because it’s not clear how the refocus will actually benefit patients or the beleaguered system. I’ve been travelling outside Alberta recently, speaking with other health ministries and systems.

Guess what? Other health ministries actually talk with leaders in the health-care system, the people taxpayers pay to operate it. They exchange ideas in a civil way and solve problems together. What’s more concerning is that people in the ministry (frankly, Albertans as well) take their cues from their leaders, and they are setting a terrible example of the type of collaboration that needs to happen between the ministry and AHS.

When did it become normal to hate on people working in the health-care system? Why is government so intent on creating an environment of fear and intimidation?

I’ll end with a plea to government leaders. Please stick to the facts. Engage in a dialogue with the leaders in the health-care system, including the managers. They have lived experience that can help you. There clearly are issues for patients — long waits, backlogged hospitals and emergency departments — though it’s still not clear that your proposed refocusing will address these issues. When trying to achieve system transformation, good leaders know that it’s critical to capture the hearts and minds of people doing the work. You would be wise to try this.

And yes, there are greener pastures out there, including for our frontline workers and physicians. Our leaders shouldn’t be the ones herding our desperately needed workforce off to other provinces.

Braden Manns is a physician and professor of medicine at the University of Calgary where he holds a research chair in health economics. He was an interim vice-president for Alberta Health Services until he resigned on June 11, 2023.