AHS chair criticizes political interference
Minister can issue directive
EDMONTON — The chairman of Alberta Health Services is calling on government officials to keep their hands off the daily management of the health system, saying that a “culture” of political interference has led to too many disruptions in recent years.
Though not calling out current Health Minister Fred Horne, AHS chair Stephen Lockwood told the Edmonton Journal’s editorial board Wednesday that there has been a damaging tendency to micromanage or undermine the work of the health authority.
He said that for the system to succeed, there needs to be a better separation between policy-makers and health operators.
“And there hasn’t been in the past. It’s been way too much interference. It’s been politicized,” he said. “If you (political) guys want to set the policy, OK, but you can’t be interfering in the daily operations.”
Lockwood indicated he and Horne have had a generally productive relationship, saying he doesn’t mind when the minister calls with opinions or questions. In such cases, Lockwood said he contacts the relevant AHS executives with Horne’s request. But if they disagree with the minister’s opinion, Lockwood said he has no problem standing up to Horne.
“I’ll say, ‘Sorry we are not going to do it that way,’ ” Lockwood said. “He, in everything I’ve seen in my short time as the chair, he says, ‘OK, I wish you wouldn’t do that,’ but we (tell him) we have to do what we think is right. We have more of the facts as to the operational impacts than you.
“So you can trust me, you can trust the team, you can direct us or you can replace us.”
Lockwood said that if Horne is impassioned enough about something, he has the power to issue written ministerial directive for which is ultimately responsible. But beyond that, government officials should avoid making demands they are not ready to stand behind, he said.
“If we are being told what to do, but no one is prepared to write it down and direct us, we’re hung out on somebody else’s decision,” Lockwood said. “And I am not going to have my reputation based on the decisions of others they are not accountable for. That’s the only way I can possibly sleep at night, that I’m going to do good or bad based on my decisions.”
Horne said he couldn’t speak to any political interference that had gone on in the past, but that his approach is to try to give AHS as much leeway as possible to make operational decisions. However, he said government is ultimately responsible for the health system and must have the ability to intervene when the situation calls for it.
“The people of the province will always look to their elected representatives to answer for issues in the healthcare system and to pave the way for the improvements they are looking for,” Horne said. “Policy is set at the provincial level and we delegate authority to the AHS board to oversee the delivery system.”
He said he felt Lockwood had a good understanding of AHS’ accountability to government.
Lockwood’s comments came two days after the AHS board approved its 2013-14 budget, and as the health authority gears up for new contract negotiations with the United Nurses of Alberta.
The agency’s plan calls for considerable savings, in part by reducing the number of part-time nurses. Only about 30 per cent of the province’s registered nurses have fulltime positions — the lowest rate in Canada — a situation that drives up costs because benefits and training must be paid for more people.
Furthermore, many parttime nurses earn substantial overtime pay the system can no longer afford, Lockwood said.