Episode 27: When is Alberta’s next election? And will Don Iveson be the next Prime Minister of Canada?

Mr Hastman: re health care spending cuts that “protect the front lines” … we hear this same mantra from conservative politicians and pundits over and over again, but when they actually get their hands on the public purse, it is direct patient/client care that suffers.

You see, as direct care staff, we rely on all those managers and mid-level directors for all sorts of things we can’t do ourselves. Hiring, mentoring and scheduling our co-workers, to both replace staff attrition—because people move, have babies, get sick, retire, die, win the lotto & move to Fiji—and to expand staffing levels when necessary, are management functions without which we are inevitably left short-handed. Ensuring we have the necessary support services, from equipment and supplies, to maintenance, to utilities to run care facilities, is a necessary management function. Paying us, since after all highly-qualified health care professionals are not volunteers: gotta have management to do that.

Setting evidence-based Policy, to ensure care processes are based on the best available evidence, is another key management function. So is financial oversight: any organization the size of AHS needs strong financial controls to prevent either inadvertent or intentional misspending. Same applies to quality assurance, infection prevention & control, and patient safety programmes. None of these directly touch the average patient, and yet you don’t want to run a health care system without them.

So, you can’t just go through the gigantic org chart—which was, let’s not forget, the brainchild of Mr Ron Liepert—with a scythe, and expect to keep a quality health care system. You have to do it with a scalpel, and at the end of the day, the savings will be negligible.