Health Minister Fred Horne: The Puppet Master

The Google search engine connecting a reader to the Soapbox spat out this query:  “Is Fred Horne as stupid as he looks?”  Yikes!  That’s bit harsh.  But I must admit the question had crossed my mind (without the reference to Mr Horne’s looks—Ms Soapbox tries to maintain a modicum of decorum on the blog).

Short answer?  No, Mr Horne is not stupid.  Quite the opposite.  He’s a master at manipulating the media to achieve his objectives.  Consider what he’s accomplished over the past month.

The Puppet Master

It started when Mr Horne whipped the public into a pitchfork frenzy over the AHS Board’s decision to pay “bonuses” to senior AHS staff and then sacked the AHS Board for refusing to breach its contractual obligations.

Unbeknownst to us, Mr Horne effectively signed off on the “bonuses” at the same time he was condemning the recalcitrant AHS Board—his Accountability Statement attached to the 2012-2013 Annual Report and Financial Statements indicating payment of $637,000 in at-risk compensation is dated June 19, 2013. 

Apparently his newly appointed Official Administrator managed to do something a flotilla of lawyers were unable to do—she convinced him that the payments had to be made.  (Or, and this is more likely, he knew the lawyers were right but used the bonuses as an excuse to oust the AHS board and pick up some brownie points with the public along the way).   

Mr Horne press released his about-face late Friday, June 21, in the middle of the worst flooding disaster in Alberta’s history.  Well executed from a PR perspective. 

The Puppet Master Goes Silent  

A good public relations consultant knows when to engage the media and when to go to ground.  Mr Horne’s communications team pulled a master stroke when it learned that the AHS accumulated a $106,391,000 surplus for the fiscal year ending March 31, 2013.

Instead of shouting it from the rooftops, the normal PR response to a good news story, Mr Horne said absolutely nothing.  The Financial Statements* simply materialized on the Health Department’s website.

Why the radio silence?

The 2012-2013 Annual Report and Financial Statements

It’s very simple really.  By acknowledging the existence of the $100 million surplus Mr Horne exposes himself to some very difficult questions.

Where did the surplus come from?  Did the AHS discover innovative ways to deliver healthcare?    If so the AHS executives deserved their bonuses and the AHS board should not have been fired.  If not, did the AHS engage in a needless slash and burn program?

Heather Smith, president of the United Nurses of Alberta, articulated her concern:  “If they’re posting a surplus of this size, why are they continuing to cut services to some of the most vulnerable citizens of Alberta?” **

Mr Horne responded in true PR fashion.  The $100 million surplus is negligible, three days of operating costs at the most.  However viewed from another PR perspective, the $100 million will pay for 1000 full time RNs for a full year.***  Over to you Fred.   

Landmines for the Puppet Master

Ms Soapbox’s antenna shot up when it became apparent that the Puppet Master did not want Albertans looking at the “good news” Annual Report (nothing to see here ma’am, move along), so she spent a couple of hours plowing through its turgid prose.  She has many questions.  For example:

In these tough economic times why is Mr Horne’s ministry over budget by $16,040,000?  And why did these overages come out of the two departments focused on strategy?  (p 97). Come to think of it, what exactly did the Department of Policy Development & Strategic Support and the Strategic Corporate Support departments do with $69.2 million?

Given the chaotic state of healthcare in Alberta—privatization by stealth, queue jumping, out of control wait times and flawed governance–why don’t we just scrap these departments and save ourselves the $69.2 million.   That would be enough to hire an additional 700 RNs for another year.

And while we’re on the topic of mega payouts to AHS executives…Who is Andrew Will, Executive VP and Executive Lead Transition, and why was he paid a whopping $1,267,000 last year?  Mr Will’s title suggests that he was in charge of transitioning.  Apparently he “transitioned” himself right out of a job and walked away with $738,000 in severance (p 163).  If Mr Horne was prepared to breach 99 AHS employment contracts to avoid paying $637,000 why didn’t he breach this one as well?

The Puppet Master Exposed

Dr Maybaum, a leading patient advocate, has harsh words for Mr Horne and the firing of the AHS Board.  He says that without the AHS Board to act as a buffer “…we now have a situation in which unbridled political interference, lobbying and toadying to cronies can run unchecked in AHS …I cannot underscore and emphasize enough that every Albertan, regardless of political affiliation must wake up to this Orwellian reality.” ****

Albertans can no longer let the government pull the wool over their eyes by manipulating the media.  Mr Horne’s attempt to bury the 2012-13 Annual Report to avoid accountability for massive layoffs in a time of surplus and cover up the gross ineptitude of his ministry is cause for termination.  Let’s call him on it.  It’s time to send an email to Ms Redford Alison.redford@assembly.ab.ca with a copy to Fred Horne fred.horne@assembly.ab.ca  demanding Mr Horne’s resignation.

This is your wake-up call.

* http://www.health.alberta.ca/newsroom/pub-annual-reports.html

**UNA Press Release July 3, 2013 

*** David Climenhaga, commenting on Whitemud Citizens for Public Health Facebook page

****Vital Signs July 2013

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17 Responses to Health Minister Fred Horne: The Puppet Master

  1. Bravo Susan. An excellent piece, exposing so many tough questions. Sadly, no it looks like Horne has gone to ground as you say.

    What a buffoonery, this government’s approach to governing the largest and most vital of portfolios.

    • Thanks Chris! The fact that the AHS is a standalone organization under the wing of the Health Ministry makes it almost impossible to scrutinize at budget time. No transparency, no accountability, just the way the government likes it.

  2. Janet Keeping says:

    This is very useful commentary, Susan. Thanks so much for it. It reminds me that I’d like to know more about how some of the other provinces structure their healthcare systems. I am not aware of equally serious structural problems (outside Ontario) in other parts of the country. And could we not learn a lot more from other countries with healthcare systems roughly similar to ours? This would exclude the US, of course. I am thinking of the more successful European countries.

    • I agree Janet. I also think that Albertans don’t understand how our healthcare system really works and that it would be a useful exercise for us to be educated in (1) what our publicly funded and publicly delivered healthcare system delivers and (2) what is publicly funded but privately delivered. Once we understand our existing system we can compare it to healthcare systems elsewhere to determine how it can be improved.

      Friends who are knowledgeable about healthcare systems both here and abroad caution that we can get ourselves into trouble if we try to cherry pick certain practices from other jurisdictions without fully understanding the context in which such practices have arisen, so understanding the broader context would be part of the exercise.

      It’s a big job but preferable to blindly sliding into privatized healthcare at the hands of the PCs.

      • Janet Keeping says:

        I agree that going along with any movement towards privatized healthcare would be a big mistake. Hence my reluctance ever to see Canadians look south of the border for lessons to be learned.

  3. Well I agree with you Janet about privatization but look how easily the power deregulation was slipped over us by the pc’s and I am afraid the health care is going down the same slippery slope. I have never had to use the health except for one exception when I had my gall bladder removed but it just makes me crinch to see a young couple with a family get saddled with medical bills for the rest of there lifes. I think the problem now a days is the inability of people to pay attention to what is going on in the political sphere on a/c of how busy they are and the political people take advantage of it.

    • Janet Keeping says:

      You make an excellent point, Tom, about people being too busy to keep up with really important developments. There is so much to distract us from the essential.

    • Carlos Beca says:

      I would add that governments are also helping the process with enormous amounts of spin and propaganda created by massive Public Relations departments that in Alberta total something like 250 people. This is not by accident. Since the privatization bandwagon started seriously with Ralph Klein the war on our minds has been cruel and destructive and many people now really believe that everything private is going to be better and cheaper. This is not happening of course and services are deteriorating and in my opinion costing more. The end of all of this is going to be very sad because with better management public services can be effective and cheaper. Furthermore public services, at least those that make sense, keep the money circulating in the province. When we privatize a lot of the profits go out to wherever these companies come from and there is less wealth staying with smaller companies from Alberta. The idea that big corporations do everything better is just a myth. Many are not much better than big government.

      • Bang on Carlos. This notion that the private sector is more efficient than the government is misguided. I’ve worked in a number of large corporations and have seen the pendulum swing from out-sourcing to in-sourcing many many times. It always starts well. The private provider promises to deliver services more efficiently than the company ever could, but over time the quality of the services erode as the private provider struggles to make his profit margins or moves on to an even more lucrative contract and the corporation gets stuck with the “B” team. The corporation is caught between a rock and a hard place because it’s not happy about the decrease in quality but has lost the expertise to provide the services itself. It’s one thing to talk about the lack of quality service for, say, an outsourced IT department. It’s quite another when the poor service impacts our most vulnerable citizens.

        Having said all that the only way the government can provide public services efficiently is if it stops wasting our tax dollars–like I said, just what exactly did the two “strategic” departments in Fred Horne’s ministry do with the $69.2 million we gave them last year?

    • I agree Tom. The fact that the government can privatize health services by de-listing covered services with the stroke of a pen makes it even more difficult to catch the government at it. I understand that 30% of our healthcare services are now uninsured. Services like physiotherapy, eye care and drug coverage used to be publicly funded to a much higher degree than they are today. Now they’re funded by private insurers, generally as part of an employer benefit package. This is the US model and as Janet says, is not something we want to replicate in Alberta.

      Janet, what can we do about disengaged voters? I’ve heard a number of explanations for why voters tune out, including cynicism or a lack of hope that change is possible, the lack of a charismatic leader, being distracted by everyday life, thinking everything is good and not realizing that it’s slowly slipping away. I’m glad that notwithstanding the challenge there are people like you who are prepared to take up the challenge and move us forward.

  4. carlos beca says:

    The Puppet Master ! It is impossible to find a better description.

    With a victorious smile he announced yesterday that it is now impossible to reverse the silly Home Care decision. That is what they wanted anyway and did it stealth as they always do. These people are so dogmatic that they cannot stand a discussion about anything. Furthermore he does not care at all what anybody thinks or wants to discuss. To a person with a dogmatic mind that is totally irrelevant.

    • You nailed it Carlos. The modus operandi of this government appears to be (1) do the legwork for a major policy decision without any meaningful public involvement (the home care decision and the $5 billion commitment to take up 100,000 bbd on the TCPL East pipeline are two recent examples), (2) sign the contracts with the corporations, (3) announce the new policy to the public when it’s too late to do anything about it and (4) deny that this is a form of corporate welfare. A shocking breach of the democratic process…but a clear example of ideological pig-headedness as you so correctly point out.

      • Janet Keeping says:

        Good observations and examples, Susan. I think part of the problem is that successive PG governments have been on policy development cruise control. I’ll never forget the day I picked up Oilweek magazine (I had to peruse it weekly for my job at that point) and saw in the same issue that 1) the province’s energy policy group had been disbanded (because the end of history had been reached, I suppose) and 2) climate change was emerging as an issue with the potential to explode in importance. This was at least 20 years ago. Climate change has continued to grow in significance (as have so many other issues, such as the growing gap between rich and poor) and the provincial government has continued to decline in competence. Albertans have become used to inept governance. It’s the job of all who appreciate the long-term implications of this apathy for our democracy to try to turn it around.

      • Well said Janet (especially the “end of history part”:)) I’m on board for ending the 40 history of PC rule in this province. Let’s keep these conversations going and start to focus on what we can do to within the constraints of this miserable “first past the post” system to force a dramatic change in government at the next election.

      • Janet Keeping says:

        That is our reality, isn’t it? We can’t change first past the post until the government is changed.

  5. Carlos Beca says:

    Janet even after the government is changed it will be a tough job to change this electorial system. I have been with Fair Vote Canada since its foundation and we have acomplished very little. The tide seems to be growing but we are a difficult people when it comes to change unless it is to favor inequality and celebrity lifestyle. Somehow we are buying into the American ‘we are all milionaires in waiting’ type philosophy.
    I loved your end of history bit. Hard to believe that was another bandwagon. I just wished it would be that easy to get into something like ‘the end of mediocre PC government’.

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