Alberta Health Services board member resigns in response to premier's plan to replace directors

With thelooming threat of firing hanging over their heads, at least one Alberta Health Services board member has resigned.

In a Oct. 7 letter obtained by CBC News,Deborah Apps says she can't stand by waiting for Premier Danielle Smith to act on a promise to replace the 12-member board of directors with a commissioner whowill report directly to the health minister and premier.

"I fear that the premier-elect's proposals will further destabilize the workplace environment for all health-care workers, adding more uncertainty when frontline staff and those who work tirelessly to lead and assist them require support and thoughtful oversight," Apps wrote in the letter, dated the day after United Conservative Party members voted Smith their new leader.

Smith, who was sworn in as premier on Oct. 11, has pledgedto remove the AHSboard for the organization's response to the pandemic.

At a press conference last week, Smith said AHS failed to ensure there were enough health-care workers on the job when it requiredall employees to be vaccinated against COVID-19.

In December 2021, AHS put 1,650 unvaccinated employees without valid exemptions on paid leave. The organization employs 121,000 people.

AHS expected 750 employees to return in March when it lifted the vaccine mandate.

Changing management

Last week, Smith also said AHS failed to respond to government direction in spring 2020 to vastly increase the number of intensive care unit beds available.

"In a business, when they fail to meet targets and they fail to meet direction, you change the management," Smith said.

Smith told reporters there would be a new governance structure in place within 90 days.

In response to emailed questions, Smith's press secretary, Rebecca Polak, didn't clarify whether the premier is looking at replacing just the boardor senior administratorstoo.

Appointing an administrator to replace the board will allow for rapid decision making, Polak said.

The plan has left health-system experts baffled by the purpose of replacing a board whose members were appointed by the UCP government andhave little involvement in daily decision making.

AHS a 'whipping boy for government,' pastboard member says

Former Alberta Party leader and once Progressive Conservative health ministerStephen Mandel sat on the board from September 2019 to September 2021.

He can't recall the board having any say inhow hospital beds were used or how AHS public health inspectorsenforcedprovincial health orders.

"AHS is really a delivery service for what the government wants to implement," said Mandel, who was also Edmonton's mayor for a decade. "And they become really the whipping boy for everybody because they are the ones who are in front."

Mandel said the board was informedAHS would mandate COVID-19 vaccination for employees. He said it was unclear whether AHS administratorsor the government had made thedecisionbuthe supported it.

AHS board chair Gregory Turnbull declined an interview request.

Apps, the board member who resigned, also declined to do an interview.

Her letter says the board has alsoattracted "outstanding candidates" to fill the vacant CEO role, and the successful candidate should be able to lead without political interference.Mauro Chiesis currently serving as interim CEO.

Dr. Verna Yiu left in April aftersix years as CEOthe longest serving in AHS's 13-year history.

Yiu's new office at the University of Alberta did not respond to an interview request.

A history of instability

AHS has had turbulent leadership since the former Progressive Conservativegovernment amalgamated health region boards in 2009.

In 2013, the then-health minister fired the board over a disagreement about executive compensation. The government appointed a series of four administrators to act in lieu of a board until the NDP government chose a new board in 2015.

The organizationhad six CEOs (including two co-CEOs) in its first six years.

None of this fluxis good for health care, said independent health policy consultant Steven Lewis. Hecalls AHS "the most complex organization in Alberta by an infinite factor."

Lewis said the uncertainty has a huge impact on employee morale, and recruitment and retention of both health-care workers and health-system leaders.

He says frequent leadership changes halts meaningful improvement because AHS doesn't have enough time to work toward its rapidly shifting goals.

Laying blame

University of Alberta political science professor John Church, who co-authored a book this year on Alberta's health-care system, said successive governments have increasingly centralized control of health care under one entity to prevent pushbackfrom local boards.

He said the AHS board now is a government mouthpiece.

"I don't see how you could look at getting a more compliant group of people in place."

Churchsaid the government islooking for a "villain" to blame for its handling of the pandemicand AHS fits the bill.

Pushing out other members of the AHS executive team could also stifle innovation, prevent the system from launching new programs and halt spending on anything non-routine, he said.

Church maintains AHS has been a political football and shield since its inception and remains that way.

Sacking leaders is the last thing AHS needs as it faces pressure from rising COVID-19 and flu cases and a burnedout workforce, he said.

"It's destructive," Church said."And it's actually dangerous to be running a health care system the way that they're trying to run it."