The Decibel - Premier Danielle Smith takes on health care in Alberta

Episode Date: November 22, 2022

Danielle Smith harshly criticized health officials’ response to the pandemic in Alberta during her campaign to become premier – and she promised to change things. She’s now making major changes to health care in the province, firing the entire board of Alberta Health Services and replacing it with a single administrator.Kelly Cryderman, reporter and columnist with The Globe’s Calgary bureau, says Smith is trying to strike a delicate balance – keeping the promises she made while trying to show the rest of the province that she is moderate enough to govern all of Alberta.Questions? Comments? Ideas? Email us at [e-mail]

Hi, I'm Mainika Raman-Wilms, and you're listening to The Decibel. Alberta's new premier, Danielle Smith, has made a major change to the province's health care system. She fired the entire board of Alberta Health Services and then replaced it with one single administrator. Today, Kelly Kreiderman is back on the podcast. She's a reporter and columnist with the Globe's Calgary Bureau, and she's here to talk about what kind of premier Danielle Smith is proving to be. This is The Decibel from The Globe and Mail. Kelly, thank you so much for speaking with me. It's great to have you on the podcast.

Thanks for having me. Before we get into really what happened last week, can you just start by reminding us, who is Danielle Smith and what does she stand for in politics? Danielle Smith is someone who has a long history in Alberta politics, first as a reporter and columnist, and then as a opposition politician. 10 years ago, we actually thought she was going to be the Premier of Alberta. Her Wild Rose opposition party was expected to win that election. And the PCs who were long in government actually ended up winning that election. Daniel Smith returned

to opposition where there was another people look on this as her most her biggest political error, she crossed the floor to the PCs in 2014. When Jim Prentice was leader, it was seen as a betrayal by many people in her party, who saw their party as a resistance or an opposition movement against the governing progressive conservative party. And shortly thereafter, she lost a nomination race and she became a radio host. She says herself she was in the political wilderness for years. So a year ago, we hear that she is interested in running for the UCP leadership if Jason Kenney leaves. And that's the United Conservative Party, of course, right? The amalgamation of those two former parties. Correct. The amalgamation of conservative

parties on the political right in Alberta. And, you know, it was surprising she was going to come back. You know, if you had told me a year ago that Daniel Smith would be our premier now, I would have been very surprised because we hadn't seen a lot of her. There were a lot of people who still had bad feelings for political missteps. But she ran a very focused, very purposeful campaign, and she was able to get the votes of those UCP members who were particularly unhappy with health restrictions, with what they saw as not a bellicose enough tone from Jason Kenney with the federal government. She focused on healthcare reform and, you know, tearing down the system a bit. Daniel Smith describes herself

as a libertarian. A lot of people from outside the province assume she's a social conservative. She's not. She's pro-choice. She's talked about vaccine choice. She has associated it with being pro-choice. When she was sworn in as premier, she didn't use a Bible. It's my understanding she's an agnostic. Having said that, it is certainly part of her political brand to keep social conservatives in the big tent of the UCP. She has talked about the party being an alliance of libertarians and social conservatives. Okay. And you mentioned the Alberta Health Services. This is the big news that was happening last week. And you mentioned the Alberta Health Services. This is the big news that was happening last week. So let's focus in on this.

Smith has made a couple of healthcare decisions recently. She first replaced Dr. Dina Hinshaw as Alberta's chief medical officer, and then she fired the board of Alberta Health Services. Let's just talk about this decision, Kelly. What exactly is that meant to accomplish? Well, that was a key promise from her leadership campaign. And, you know, she repeated many times, you know, she was representing the concern that I heard from many conservatives many times during the pandemic. Why can't we bolster our intensive care unit capacity? Why aren't there the beds? There was this promise for a thousand ICU beds that never came to pass. That is the fault of the elite of Alberta Health Services. And I heard this time and time again, they were incompetent. They made missteps. This is why we

can't get frontline services. This is why we had to have health restrictions. And her focus during the leadership campaign was very much on that, on the idea that AHS management made errors that might have led the way to health restrictions that should have been unnecessary. Can you just help me understand, like, how big of a deal is this move in terms of how healthcare functions in the province? Alberta Health Services is one of the biggest employers in Canada. It's really a different system compared to what I understand is the system in most other provinces where there are very regional health bodies. And, you know, I know that people in AHS often compare themselves

to the National Health Service in the UK because that is the scale of people we're talking about. We're talking about an overall organization for health care. And, you know, so everything really comes down to the governance and administration of Alberta Health Services. And so this is essentially then meant to improve things, obviously, this move on her part. And she's fired the board and replaced the board with one person. Who is this person and what's he going to do now?

So this was last week. And I just want to go back a bit because last week, it was a momentous week. It kind of felt like it was a long time coming. Once the by-election was settled, we finally got action. What her people characterized as her key policy announcement, her first policy announcement as premier, is firing the AHS board, which the 11-member board, which knew the writing had been on the wall for some time. There had been a board member who resigned last month. They knew this was coming. And she appointed Dr. John

Cowell, who is a well known quantity in the province because he held the role, this role of administrator of AHS, he held the role actually in 2013 for a year or two when that health minister and that government thought that Alberta Health Services, this huge body, this huge central authority for health in the province, needed cleaning up too. But a really interesting part of that time is, of course, Daniel Smith was in opposition. She was the Wild Rose leader at that time.

She criticized the progressive conservative government for his appointment at that time, said it was only window dressing. So she criticized his appointment at the time, but now she's appointed him in that role again. Yes, indeed. Wow. Okay, so he's now taken on the role. So used to be an 11 member board. It's now coming down to this, this one person now has is in charge of this. How likely is it that Dr. John Cowell will will be able to actually change things here? That is the multi-billion dollar question, right? He has been given an enormous task, an absolutely huge task. And he's being asked to reform AHS while also being tasked with fixing the front line, fixing ambulance services,

fixing the admission into emergency. He's being given this gargantuan task. Now, the argument from Daniel Smith and Health Minister Jason Copping is having one person with the autonomy to make decisions and move quickly will lead to quick decisions and solutions being found in the healthcare system for frontline services. And Daniel Smith talks about things being better in six months.

They will be better. Sounds like there will be better, but are they giving actual specific ways of how that's actually going to be accomplished? There was discussion of, you know, how could they, there's a problem with having enough ambulances in the province during peak times. So they were talking about, okay, maybe we can have, you know, a lesser health vehicle to transport people who don't have urgent needs, and that could free up ambulances for the most critical cases, or allowing ambulance teams, EMS teams to triage on the spot and decide whether a person needs ambulance services or not.

Those were some of the examples that were given of fixes that could come. But it is those those are examples rather than some kind of wholesome plan, like fulsome plan, I should say. My sense of the whole thing was this is this is thin gruel for what people might have been expecting. If you're firing a whole health care board, there is so much work to be done. Dr. Cowell will be able to hire two assistants. Minister Copping, the health minister, talked about this just being a temporary measure while they do fixes in the healthcare system. But we don't know what the measurements are. We don't know how we're going to be able to quantify that things are better. I

guess, you know, six months from now, Daniel Smith can say wait times have improved in emergency rooms if that is the case. And I think that there's a problem that Albertans as a whole are fearful that Daniel Smith is tearing down a health care system in a very tumultuous time without a clear idea of what is going to be there to replace it. We'll be back after this message. Let's get into some of these concerns then in a little more detail. I want to read you something that one of the previous board members of Alberta Health Services wrote. This is from Tony Dagnoni. He wrote a public letter after being fired criticizing Danielle Smith. So this is what he wrote, quote, That's pretty strong language there. What do you make of his concerns? I think it's the concern that comes from looking at what she has said as a radio host and what she has written in columns.

And even in terms of what she has said since running for the UCP leadership race. She was a radio host. She did talk about therapeutics for COVID. And she was, you know, there was discussion and tweets about ivermectin, which most doctors and health authorities say is an unproven COVID therapy. Of course, there was a lot of vaccine skepticism. criticism so um she has been skeptical of um the mainstream health authorities takes on the pandemic throughout and people will probably remember earlier this fall when she said the unvaccinated were the most discriminated group she's ever seen in her lifetime right and she she said that on her first during her first press conference the day she was sworn in as premier. And that received a lot of criticism. And this is the political tension for Danielle Smith is she was elected by people who do believe that and she has to govern for a province that has more vaccine skepticism and more skepticism about health, health restrictions, perhaps in other provinces, but we're talking very small

percentages. Most of Albertans say we're in favor of a vaccine passport when it had to be implemented during the very bad wave in the fall of 2021. And the political problem for Danielle Smith continually is she won the UCP leadership race and made very specific promises and said she would not pivot. But she now has to campaign and appeal to a broader Alberta electorate. We're heading towards an election in May of 2023. She is up against the very popular Rachel Notley, the leader of the NDP. And it is going to be a campaign based on differences, I think, in policy and pretty stark differences in policies, especially on items like healthcare. Yeah. I want to go back to one thing, one more thing within her policies here. Smith is

also very publicly opposed mask mandates and vaccine mandates there. But she said last week that people are welcome to wear masks if they want, but didn't recommend that people wear them. What does this perspective on health care mean for how the province is going to be handling things, especially in this upcoming winter when we're hearing about the surge in respiratory viruses? There's COVID and influenza, RSV. What does all this mean for the months ahead for the province? I think this is a really important point because I think, again, she is elected with a group of people who is not in favor of mask mandates. And her tone is very different on masks than, say, I would say the tone from medical officers of health, say in Ontario. But if you boil down to the concrete terms of what her government is doing versus other provincial governments in terms of mandates, it's not different at this point.

That is the interesting part of it. Her tone on masks is very different. You know, we have the chief medical officer of health in Ontario is recommending masks. He is not mandating masks. We had BC say definitively, we are not going to mandate masks from their chief medical officer of health. And I feel like an interesting side of this to me is Daniel Smith's tone on healthcare is very different,

but the actual concrete policy right now between policies between the provinces is not different at this point. very different. But the actual concrete policy right now, policies between the provinces, is not different at this point. I think there is concern in all the provinces that there is not public appetite for mask mandates again. This is a really interesting point, though, because it sounds like she's doing a little bit of a political dance here, where in terms of the actual policy, it's not straying too much from other provinces, but the rhetoric around it is maybe more catering to, as you say, that base that elected her. Right. And you know, this was a question I had for Daniel Smith when it looked like she was going to

win the UCP race. I said, are you going to pivot? Are you going to make yourself more electable to a broader Alberta politics? She's like, I'm going to double down. And I think, you know, we're going to see a really interesting dynamic between the provinces going forward where, because the healthcare systems in all provinces are so under the gun that, you know, there's going to be comparisons made between waiting lists for surgery, comparisons made between recruiting healthcare workers. And that's all going to factor in how into bigger things like how the federal government approaches the provinces in giving them new healthcare funding. Is the federal government going to be interested in giving the provinces more money if they're going to use that money

to compete for healthcare workers amongst one another? Yeah. I'm glad you brought up the federal government, Kelly, because I want to ask you about this too, because all the stuff that we're talking about in Alberta, this is happening within the context of bigger health care funding discussions between the federal government and the premiers of various provinces. What's been going on there? OK, so we have a situation where the premiers are united in asking the federal government to boost health transfers from an amount. They say right now the health transfers pay for 22% of healthcare costs. They want that to be boosted to 35%. Federal government counters that the premiers are not taking into account

a whole host of tax credits and other transfers that are made for healthcare. And the health transfer is essentially money the federal government gives provinces to provide health care then. Absolutely. And the idea that this historically was set up on a 50-50 agreement and has since the weight has moved to the provinces in an unfair manner.

But I think what is interesting is even a province like British Columbia, which is very politically different than Alberta, their stance on health care funding and what the federal government should be contributing isn't very different from Alberta's. Yeah. Just lastly here, Kelly, given all of this kind of the big picture and then also the narrower picture in Alberta as well, what do you think we'll see Daniel Smith do as premier in the coming months? You know, she has a very big job ahead of her. We are six months away from a provincial election. And she is the premier, she is part of the governing party. The economy is doing decently in Alberta, despite the inflation pressure, she should be in fairly good shape.

But instead of her leadership, giving the party a bump, you know, taking over from Jason Kenney, who was a very unpopular premier, it hasn't. And some polls show even that her party has less support under her leadership. And I think there is a big question in Albertans' minds about her judgment and her ability to guide the province when it comes to the big issues like healthcare and inflation. And she has to exceed expectations. Calgary is going to be a battleground and Calgary is not the same as rural Alberta when it comes to ideas about fighting Ottawa or when it comes to ideas about health restrictions. And I think she has to stay true to what she has promised and keep the people who support her on side while also appealing

to a broader electorate. And that's very difficult. And I say this completely without snark. The benefit that she has is that she has low polling numbers and that expectations are low right now because she has ability to exceed expectations if she does a few things right. Kelly, this is all really interesting context to hear. Thank you so much for taking the time to speak with me today. You're so welcome. So happy to be here. That's it for today. I'm Mainika Raman-Wilms.

Our producers are Madeline White, Cheryl Sutherland, and Rachel Levy-McLaughlin. David Crosby edits the show. Kasia Mihailovic is our senior producer. And Angela Pichenza is our executive editor. Thanks so much for listening, and I'll talk to you tomorrow.