Paula Simons makes some good points in her column “Alberta Health Services going rogue” but I have a difficult time believing that AHS CEO Stephen Duckett is as “rogue” as her article suggests. While a smart and well-educated man, Mr. Duckett is on the same page as Premier Ed Stelmach and Health Minister Ron Liepert in their haphazard reorganization of Alberta’s public health care system. As a friend of mine described it earlier today, “this could be a problem with make-it-up-as-you-go planning, especially in the disorganized budget mess AHS seems to be in.”
On May 29, 2008, the AHS Superboard and Minister Liepert signed a Memorandum of Understanding that explicitly gave control to the Health Minister to give any direction to the Board, including “priorities and guidelines”, “clinical and operating standards”, and “a provincial service delivery plan”. Central to the memo is the phrase “The Board shall comply with all directions of the minister.” This memo was leaked to Liberal MLA Hugh MacDonald, who then released it to the public.
The appearance of the arms-length AHS Superboard is a convenient political arrangement that has served the current government well during the dissolution of the regional health authorities and centralization that followed. Simply put, Mr. Duckett gets to make the unpopular decisions and the politicians get to make the popular ones.
Convenience aside, when political realities begin to interfere with the internal agendas, action comes from the top – as was witnessed when PC MLA Fred Horne challenged changes that would have seen psychiatric patients be charged for toiletries and snacks at Alberta Hospital Edmonton.
There is little doubt that Mr. Duckett holds powerful executive control over Albertans public health care system, but when reality hits, it is the Premier and the Health Minister who are responsible for the decisions made by AHS. And who are they responsible to?