I was never particularly impressed with the AHS “Superboard” concept that was instituted in 2009 - it got some thing right (like centralizing procurement), but it also had the effect of gutting the ability for the system to respond to local needs. It effectively turned major decisions into political fodder - suddenly matters like building new facilities became political footballs, with little or no regional input into matters like requirements.
After an initial period of utter chaos, which arguably lasted through 2012 or 2013, AHS started to find its feet and initiated programs like Primary Care Networks which went a long ways towards smoothing out access in the system, and in particular communication between family physicians and specialists.
Today, AHS is far from perfect, but it has done a lot to rebalance the system and introduce more local responsiveness to issues.
What was rolled out by the Danielle Smith-led UCP government yesterday is a recipe for disaster. We don’t have a lot of details yet, but the basic structure effectively creates a series of “silos” that will inevitably make communications between groups much, much worse. Vertical silos like what has been proposed are almost inevitably going to create walls between organizations that prevent meaningful knowledge sharing and collaboration.
Second, when I see this kind of structure trotted out in the corporate world, it almost always means that things are being lined up to be sold. Once the walls go up, and mutual collaboration is severed, it’s relatively easy to sell off pieces and make huge profits on the sale. Corporate “mergers” tend to go one of two ways: The acquired entity is assimilated into the larger organization and its core functions become part of the larger whole; or, the acquired entity remains an all but separate business of its own that feeds a few % of its profits into the parent corporation - until such times as the parent company decides to skim a profit by selling it off.
The UCP structure for health care in Alberta seems to be designed with an orientation towards the latter. Create a bunch of isolated vertical silos that can then be dismantled.
Given the lack of detail, lack of risk management planning, and the complexity of trying to dismantle AHS into this new structure, the government’s self-assigned budget of some $120M is almost laughably small. Having been a project manager myself, I look at that and go “you’re going to restructure a $45B organization that cheaply? - yeah keep kidding yourselves.”.
When - or if - a more detailed plan is made available, I will look at it. But, at the moment, I take one look at this, and my first thought is “this is a completely unrealistic plan that will be detrimental to the well-being of Albertans”. I have little doubt that the real goal of this is to sell off as much as they can to US interests before the next election. After that, Albertans will find themselves stuck with the same affordability dilemma that so many in the US face: Do I pay my rent or my healthcare premiums?
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