Structural review greeted with optimism, caution
An optimistic but cautious reaction has followed the latest shakeup at Alberta Health Services.
Gerald Ingeveld, chairman of the David Thompson Health Advisory Council, said the council is encouraged by the talk of more public and community involvement, and site-based decision making.
On Tuesday, Alberta Health and Wellness released the AHS organization and structure review that was ordered following the firing of the AHS board in June.
A number of changes were recommended. They are geared to giving better support health-care providers, including moving from 80 senior executives to 10 across the province.
Among the highlights, the report found the system top-heavy, not the best model to support front-line staff and confusing to navigate.
Former David Thompson Health Region board member Michael Dawe is hopeful the latest shuffle works. But he said, based on past performances, he isn’t convinced. Dawe said there have been many changes and restructuring that resulted in more chaos, more disconnect from the communities and dysfunctional decisions.
He said the old structure with local boards had its shortcomings but they were rooted in communities.
Dawe said he would like the pendulum shifted back to where there’s genuine community input.
“This whole idea of everybody having to be responsible either directly or almost directly to the minister as opposed to the public we serve, I think we have to re-insert public accountability,” said Dawe.
“The best way we do this is that you are selected from your communities. That focuses your mind on what the people in your community want. If you answer to the minister, then your primary concern is what the minister thinks,” Dawe said.
Dr. Chris Eagle, CEO of AHS, said the report was only released yesterday so it will take time to turn the report into action of bringing greater focus to front-line services.
Eagle said there will be a review of titles, organization layers and compensation over the next few months. He said the report highlighted the concerns in clear messages that made it easy to identify the themes and start the hard work of moving forward.
“You cannot run a service like Alberta Health Services without having very, very strong public engagement and community engagement,” said Eagle. “One of the weaknesses has been that AHS has been a large organization and people were not making those connections. I think this underscores very, very strongly that we need to have our zone leads, service leads very much seeking public involvement in how their services are changed and how they are delivered.”
Ingeveld said Alberta is a big province and some of the decision-making needs to be moved from the centre of the province and brought out to the regions.
Ingeveld said he is “a little concerned that this is the next shake up of AHS. And they have had a lot. It always takes time for the frontline people to adjust to change.
“However, if it works out that it ends up being more personal involvement on the ground, then it will be a change for the better.”
The province’s Health Advisory Councils are expected to meet with Health Minister Fred Horne in the next week couple of weeks. Ingeveld said hopefully they will hash out some details and determine a clear understanding of the council’s roles.
“The hinting has been we will be more involved,” said Ingeveld. “That really excites us because that’s why we volunteered. We want to be involved so we are encouraged by that.”
Brenda Corney, chairperson of Friends of Medicare Red Deer chapter, said she hopes the province reaches the goal of supporting frontline staff. She said re-organization of the structure was necessary because it was top-heavy with administration.
Five senior positions were eliminated on Tuesday and the majority of the senior positions will be re-aligned.
“I hope the things that happen in the next little while will show that goal is attainable,” said Corney. “I think it’s important. It’s a good thing to say. It’s a good thing to do. But we will have to wait to see the results.”
Changes to the overall structure include dividing the province into north and south zones, with each portion led by a vice-president, a chief operating officer and a medical director.
The former organization was divided into north, south, central, and Calgary and Edmonton zones.