As more detailed health-care promises from UCP leadership candidates trickle out, frontrunners continue to focus their criticism on the provincial health authority and promises of sweeping structural reform.

On Tuesday, Danielle Smith outlined her plan to overhaul Alberta Health Services (AHS), including hiring a new CEO, firing the AHS board in favour of an interim commissioner, and kicking off a facility audit with the aim of increasing capacity.

In three months, Smith promises an audit team will make recommendations on how to “best cut AHS bureaucracy and reinvest those dollars on the front lines” and “decentralize control.”

“Our health-care system is in rough shape and there is no silver bullet; however, the above reforms are critical to saving lives in the short term, and preparing our system for continued improvement as we move forward,” she said in a news release.

Smith isn’t alone in wanting to reorganize AHS.

Former finance minister Travis Toews has suggested AHS needs complete restructuring.

“We have to decentralize their decision-making structure. That structure right now is not only failing Albertans, it’s failing our frontline health-care professionals. And that’s tragic,” he said in late July. He’s since proposed reviewing senior management roles, spending $50 million on rural health-care facilities, boosting rural practitioner incentives, and streamlining the process for credentialling health-care workers.

Former Wildrose leader Brian Jean has promised to “fix AHS” and has targeted tweaking and reviewing the role of the province’s chief medical officer of health in the interests of accountability.

Former transportation minister Rajan Sawhney considered moving back to regional boards during the first leadership debate.

“Alberta Health Services is an inverted triangle. It needs to be flipped. It’s too top heavy.”

Former children’s services minister Rebecca Schulz has promised to simplify AHS’ structure, reducing middle management.

Many candidates, including Jean with his promise of “medical autonomy and bodily autonomy,” have also been preoccupied with the COVID-19 pandemic and vaccine mandates, promising to not repeat the public health measures that were introduced to preserve health-care system capacity.

Steven Lewis, a health-care consultant and adjunct professor of health policy at Simon Fraser University, said some of the frontrunners are making ideological statements that appeal to those voting in the leadership race rather than presenting serious health-care platforms.

Lewis said one of the worst things you can do is cut too much middle management, since the health-care system needs supervision and leadership, and fundamental primary care in the community is generally outside the purview of AHS.

“If you don’t signal your intentions to really focus on primary care, history has shown that you can talk about structure all you want and you can demonize the leadership or the board of AHS, it’s not going to solve your problems — all it’s going to do is create more disruption,” he said, adding that restructuring will take several years to fully implement, and won’t address the root of the problems.

“Primary care is where your system is going to succeed or fail.”

Both Sawhney and Schulz have promised to invest in and bolster primary care networks.

For his part, MLA for Central Peace-Notley Todd Loewen has said the provincial system is broken.

“We have an AHS system that needs a severe renovation,” he said during the July debate.

At an unrelated announcement last Wednesday, Premier Jason Kenney also took shots at AHS, accusing it of failing to respond to political direction to boost health-care system capacity during the COVID-19 pandemic.

However, when he was asked what he thought of proposals to majorly restructure the provincial health authority, Kenney noted it’s been done many times in Alberta, without any progress.

“We could put on a political show here and restructure the whole thing and send everybody running around creating new organizations and new governance structures, instead of focusing on actual outcomes. What we’ve decided to do is stick to our knitting, focus on outcomes as opposed to replaying the endless cycle of structural changes at AHS.”

lijohnson@postmedia.com

twitter.com/reportrix