“We have to do more with less. That will apply across the board. It will have to apply to the very good work [of the child advocate], it will have to apply to my office, it will have to apply to the auditor general’s office. That’s the way it’s going to be.” Jim Prentice defending cuts to the Child Advocate’s Office and the Auditor General’s Office, Feb 11, 2015
Would someone please tell Mr Prentice that he’s not the President of the United States?
Unlike President Obama, Mr Prentice does not have a unilateral right of veto and cannot revoke the decision made by an independent all-party Standing Committee to restore $546,000 to the Auditor General. If he did, he wouldn’t have to frog march the independent all-party Standing Committee into a meeting next week to “reverse” their decision. It would stand without further action on anyone’s part.
And while we’re on the topic, would someone please tell Mr Prentice that an all-party standing committee should include representation from the Wildrose Official Opposition. Remember them? There have been no Wildrose MLAs on the committee since the Wildrose defected to the Tories last December but the committee has been making budgetary decisions willy-nilly ever since.
A CEO’s perspective
Mr Prentice is acting like the CEO of a $40 billion enterprise, and making a mockery of Alberta’s democratic system in the process. Unfortunately even in CEO-mode, he’s botched it.
Consider how a CEO would conduct what in corporate-speak is referred to as “right sizing”.
When CEOs take an axe to their organizations they draw a “line in the sand”—I want 9% cuts across the company, or else!
And that’s what Mr Prentice did, right? Wrong.
When Mr Prentice said that the 9% cuts were going to apply “across the board” he wasn’t being entirely truthful. Yes, he hammered the Child Advocate investigating children’s deaths while in government care and the Auditor General investigating the government’s misuse of taxpayers’ dollars; but Alberta Health Services will get more resources, not less—Mr Prentice hired an executive search firm to find 10 or so part-time board members to oversee its activities.
If he pulled this stunt in the private sector, he’d lose his job. Here’s why.
The byzantine world of healthcare
First, a quick primer on the byzantine mess that passes for healthcare delivery in Alberta. (NOTE: this is not a knock on healthcare workers who go above and beyond the call of duty to keep the system from imploding altogether).
Healthcare is provided by two entities: the Department of Health led by the Health Minister Stephen Mandel (let’s call them “The Government”) and Alberta Health Services, a governmental agency run by CEO Vickie Kaminski and her team of highly paid vice-presidents (let’s call them “The Agency”).
The Agency was “advised”* by a board of directors until June 2013 when the former Health Minister, Fred Horne, summarily fired the lot of them (long story involving fat bonuses and severance contracts) and replaced them with three official administrators in rapid succession (bit players, ignore them).
The Agency has been ticking along without a board ever since. Interestingly nobody noticed.
The Tory government justifies the parallel universe in healthcare delivery by saying The Government is the strategic arm of healthcare delivery, responsible for policy, strategic direction, global budgets and doctors’ compensation while The Agency is the delivery arm that puts it all into effect.**
Got it. Government = policy. Agency = delivery.
Before a smart CEO resurrected The Agency board of directors he’d ask himself why The Agency with its high priced CEO and executive team needs two entities to give it policy direction—The Government and the board. Wouldn’t this increase the risk of crossed wires and create greater confusion?
Mr Prentice’s response is it’s “unacceptable” for Alberta’s multibillion-dollar health budget to be overseen by “just one person”. Hence the need to appoint “a board of respected Albertans…to keep an eye on what is happening in the system.”***
Oh please! What Mr Prentice really said was that Health Minister Mandel can’t be trusted with the job, but it’s perfectly acceptable for “just one person”, Mr Dirks, to oversee the $8 billion education budget, or Ms Klimchuk to oversee the $4 billion human services budget, or indeed, Mr Prentice himself to oversee the $40 billion dollar provincial budget without the assistance of an outside board “to keep an eye” on things.
If Mr Prentice doesn’t trust his hand-picked Health Minister to manage his $18 billion budget with all of the assistance available to him from his colleagues in Cabinet, his deputy ministers, associate deputy ministers, staff, and countless high-priced consultants then he doesn’t deserve the job and should be sacked.
A smart CEO would make an additional observation.
Healthcare makes up 40% of the budget. When the Tories centralized healthcare in 2000 healthcare was 22% of the budget. Perhaps healthcare costs are rising not because Albertans pile into Emergency Departments at the first sign of a sniffle or old folks don’t have the good grace to kick off quickly and free up an acute care bed for someone else, but a policy/structural problem that merits more thought.
A smart CEO would call off the executive search team because even the Dream Team isn’t going to fix this problem any time soon.
Either way it’s a disaster
Mr Prentice decided that in order to prepare an austerity budget he cannot be bound by the rules of parliamentary process. Instead he will act like a private sector CEO, and in his words, “that’s the way it’s going to be”.
Unfortunately he’s made a hash of it.
*Regional Health Authorities Act Section 17(1)
**Hansard, Apr 13, 2011, p 645
***Edmonton Journal, Feb 11, 2015