Consolidation versus Regional Control

I've been letting Alberta Health Minister Ron Liepert's reorganization of the Regional Health Authorities into a single minister-controlled monolith stew since it was announced last week.

Initially, I didn't have any real reaction to it, as structurally it's really a return to what we experienced during the 1980s before Ralph Klein came thundering in and shook things up.

Since the mid-1990s when the regional structure was put in place, the issues have not been with the operations of the individual authority organizations. Yes, there have been some moments where problems have emerged, but overall, I don't have any substantial evidence that shows the structure as being problematic.

The real issue has been distinctly related to a lack of action on the part of the government with respect to funding badly needed infrastructure. Over the years, Calgary has experienced numerous hospital shutdowns - the Holy Cross, the General and the Grace come to mind, with very little done to replace the lost capacity. Yes, I'm quite aware of the expansion of the Rockyview, and renovations at the Foothills, but those are quite recent and haven't come close to restoring the available services in Calgary - much less meeting the needs of our growing city today.

Inaction on the part of politicians in Edmonton has created some very embarrassing moments for the government, especially when a regionally focused board has stood up and called the government to task for its failure to provide the funding and other resources necessary for the board to fulfill its mandate.

So, one has to wonder just what Liepert's game really is. I'm going to go out on a bit of a limb here, but I suspect what is really afoot here is Liepert trying to implement something that Ralph Klein always backed away from - mixed public/private health care delivery, with a much greater role for private organizations.

Consider the picture. First off, he has put himself in direct control over both the political/policy side of things in the form of his control as minister of Alberta Health; second he has just made the new "uber-board" that looks after health care delivery directly responsible to him - not to the legislature; not to an arm of the ministry, but to the minister.

This smells like Liepert is setting things up so that he can do whatever he wants with a minimum amount of consultation and protest from the stakeholders until it's too late. It also bears the hallmarks of Stephen Harper's typically secretive, micro-managing approach to things - an aspect of the situation that makes me even more suspicious of the Alberta Government's motives.

I don't know what's next in Liepert's mind, but I suspect it's going to be ugly.