The Alberta government is commissioning a consultant’s review of its response to the COVID-19 pandemic.
The drawback is plain and has been pointed out: a major consulting firm hoping for future contracts is not likely to come down hard on examples of government shortcomings.
More to the point, the review will focus attention on one matter when other important ones could use real explanation.
Alberta (and Canada as a whole) could more usefully examine why changes to the health system generally seem as difficult to achieve as pipeline construction.
Stories crop up almost daily about the difficulty of getting access to a doctor, even in a walk-in clinic.
Would that be happening if former premier Alison Redford’s idea to create more than 100 family care clinics had been adopted?
Her proposal crashed and disappeared within months. Probably only a few dozen people in the province, if that many, know why.
One could suspect resistance from physician organizations, resistance from Alberta Health Services, unknown concerns raised within the Finance and Health Departments, and private lobbying. Whatever happened to the family care clinics happened out of sight. Albertans might be better off now if the clinics had been created, but hardly anyone knows why they were not.
That’s one thing to look at. There are many others.
A number of health experts and national physician leaders have been commenting on how health care in Canada could be better organized. Some of their ideas sound fairly close to the notion of family care clinics. Nothing ever seems to happen. Why not?
For one thing, a lot of politicians press for private surgery clinics and other forms of privatization at every opportunity. For them, privatization is the answer no matter what the question is. Their other fallback is to call for more immigration by foreign-trained physicians and nurses, which is a way of avoiding real issues. They ignore most other ideas.
Then there’s the tricky matter of physician control. Physicians don’t like the stress they are under now. But they were never eager to hire licensed practical nurses to take on some of the simpler care load even back in the days when primary care networks were first being set up in Alberta. They resist changes to the fee-for-service pay structure. They apparently accept serious bottlenecks in access to residencies, the final stage of physician training. And Alberta is the one province in the country with relatively more specialists than family physicians, a product partly of the way that the medical association allocates public money for physician pay. It’s easy to get the impression that no one wants to take on those and related issues.
Other questions routinely go unanswered, too.
How did Alberta’s chief medical officer get about a quarter-million dollars in extra pay last year? Former finance minister Travis Toews said he never signed off on the payment, but he must have either directly approved or indirectly accepted the policy that authorized such bonuses. Information on why the policy was adopted and how it works should be easy to produce. But provincial politicians know voters have long put up with obfuscation.
The laughable flap over the essay contest on the role of young women in politics is similar. Two UCP MLAs know how a racist and sexist essay was chosen for third prize. The likely explanation is that only five entries were received and two of them could be read as serious criticism of the current government; therefore, the other three had to be the winners. The only question (aside from whether the third-place essay was genuine or intended as satire) is whether the two MLAs nominally doing the judging actually read any of the entries, or whether they left the job to an anonymous political staffer. Once again, the information could be easily produced. But Alberta voters are easily fended off, except when they think they have a complaint against Ottawa.
Mark Lisac watches politics for Alberta Prime Times. He writes novels too, including the recently published Red Hill Creek.
