Health-care unions skeptical about some proposed health system fixes

Alberta Health Services says an out-of-province external review of ambulance response to a fatal dog attack in Calgary. (Ose Irete/CBC - image credit)
Alberta Health Services says an out-of-province external review of ambulance response to a fatal dog attack in Calgary. (Ose Irete/CBC - image credit)

Some health-care union leaders say they're encouraged to hear Alberta's premier recognize the overwhelming pressure workers are under.

However, the leaders are skeptical that firing the Alberta Health Services' board and tasking a new administrator with rapid improvements are destined for success.

Guy Smith, president of the Alberta Union of Provincial Employees, said the provincial government will only achieve its objectives of better wait times for ambulances, emergency care and surgeries if it hires substantially more employees and improves working conditions.

"They need more support, not more upheaval," Smith said of workers in the wake of Premier Danielle Smith dismissing 11 AHS board members.

AUPE has 45,000 members who work for AHS, in roles such as clerical, maintenance, food services, caretaking, licensed practical nurses, health-care aides, and more.

Both Guy Smith and Health Sciences Association of Alberta president Mike Parker met with the premier on Thursday before the announcement of system reforms. They said former premier Jason Kenney had never met with either of them during his three-year reign.

The union leaders are concerned about the government's ability to recruit workers to meet ambitious improvement goals.

Some services, particularly in rural areas, are "just screaming for staff," Guy Smith said. "I don't know where AHS or the minister are actually going to find these staff. They not going to magically appear."

Premier Smith's rationale for appointing a Dr. John Cowell as AHS administrator and dismissing the board was to enable Cowell to rapidly approve decisions that would allow, for example, the expansion of pilot programs province wide, and a restructuring of the province's health authority.

Cowell reports to the health minister and the premier. It's unclear yet if he has specific targets for reducing AHS managers.

"We need to support the exceptional front line staff across our province to do what they do best, and that means reducing bureaucracy and listening to them and to patients," the premier's press secretary, Becca Polak, said in a Friday statement.

Union says some proposed solutions problematic

At a Thursday press conference, both the premier and Cowell said leaders know how to fix some of the problems from numerous previous studies – they just need to be bold enough to act.

Health Minister Jason Copping referred to a pilot project in which patients are transported between local and regional hospitals for medical tests using vehicles with less equipment on board than an ambulance, by staff with less medical training.

Parker, whose union represents 240 health professionals, including paramedics and 911 communication officers, said there are good reasons to transport patients by ambulance, even if they seem stable.

Due to pressures on the health system, people who are still inpatients are increasingly sicker than in the past, Parker said.

"Whoever can supply a vehicle and a person with a driver's licence (will) do what they deem as the most benign transfers," he said. "Well, whose decision of benign? Now we're gambling."

Parker pointed to a case that brought this discussion to the fore in 1995. A two-year-old Indigenous boy died in a taxi in his mother's arms while being transferred between hospitals in Edmonton and St. Paul.

At the time, health officials said a taxi ride was far cheaper than an ambulance. A fatality inquiry found the boy would likely have died no matter how he was transported, but it sparked an examination of how patients are moved.

The problem is a shortage of hundreds of paramedics across the province, Parker said.

Cowell on Thursday also suggested communication officers, who answer 911 calls and dispatch paramedics, could assess on the phone whether the person needs an ambulance, or could call Health Link nurses at 811.

Parker said communication officers are already so stretched, they have to hang up early on callers to handle more incoming calls. They don't have time to ask enough questions to parse emergencies, he said.

Former board member pens scathing letter

Further to his criticisms of the premier in a Thursday interview with CBC News, outgoing AHS board member Tony Dagnone penned an open letter to Albertans on Friday, warning them of risks to health care.

"Her warped stance on COVID, which I remind the Premier 'was and is' a public health issue not a political punching bag, is nothing short of borderline dereliction when the lives of AHS staff and Albertans are at stake," Dagnone wrote.

Dagnone said the performance of Alberta's health-care workers, AHS managers and the board during the COVID-19 pandemic was exemplary. He accused her of spreading and promoting "medical quackery," conspiratorial claims, and questioned who would pursue a health career in a province with an "anti-science premier."

Parker said the letter was vindicating, and showed the AHS board knew just how dire the crisis in front-line care is.

In response, the premier's press secretary, Polak, said the changes are an opportunity to improve the performance of the health system for patients.

"This decision was not personal, this is about better outcomes for Albertans, and we are grateful for the work done by the AHS board," she said.