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Tuesday, January 12, 2010

not as rogue as you would believe.

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?


Anonymous said...

I'm not sure Liepart felt the convenience of the situation, while defending H1N1. Nor do I think Duckett enjoys being the whipping boy of both the opposition and the governing party. As such, it might just be the perfect symbiotic relationship.

Are you surprised by the elected officals retaining control over an out-of-control bloated administration? Isn't that the point of government?

What exactly do you want?

Anonymous said...

Mr Liepert's part of the deal is his outrageous pay. He'll endure five years of Albertans hating him and return to Australia a much richer man. Hardly a bad deal, if you can get it.

As for the first poster, Dave is just pointing out that the political masters can't honestly claim Dr Duckett is acting outside of their expectations or control. They have the ability to change any aspect of AHS in a heartbeat, so if they don't they are explicity condoning the current course of action.

Steph Laskoski said...

Duckett is certainly anything but "rogue." I attended the Press Gallery's Christmas Party this year, and who should be standing at the door, greeting guests, but Mr. Duckett. That shifted my whole perspective of his role as an "independent" quite significantly.