Premier Danielle Smith fires Alberta Health Services board, appoints administrator

Dr. John Cowell will report to Health Minister Jason Copping

Image | Dr. John Cowell

Caption: Dr. John Cowell has been appointed administrator of Alberta Health Services. (CBC News)

Alberta's premier spread mistruths about Alberta Health Services' handling of the COVID-19 pandemic and has a naive view of how difficult it is to recruit health-care workers, a now-fired AHS board member said.
Former senior health administrator Tony Dagnone was reacting to Alberta Premier Danielle Smith's removal of 11 AHS board members on Thursday. She has replaced them with an administrator, Dr. John Cowell, who will serve in the role for at least six months.
Dagnone, who has served as CEO of the London Health Sciences Centre in Ontario and Saskatoon's Royal University Hospital, was appointed to the AHS board in 2021.
"She seems to like shooting from the hip," Dagnone said on Thursday of Smith's decision. "She doesn't believe in being informed before making these huge, huge decisions that have an impact on the health of Albertans."
Dagnone said the board was months away from signing a new CEO to lead Alberta Health Services after the government and board removed Dr. Verna Yiu from the role in April.
Recruiting a top-notch CEO will now be far more difficult, Dagnone said.
The premier and Health Minister Jason Copping said at a press conference they chose Dr. John Cowell as a short-term administrator to allow for rapid decision making. It will allow the $15 billion organization to pivot more quickly and address multiple crises.
In 2013, Cowell served a one-year-term as AHS administrator after the Progressive Conservative government fired the board. He has also been CEO of the Health Quality Council of Alberta and a corporate leader in the private sector.

Firing AHS board was a party leadership promise

Replacing the AHS board was one of Smith's UCP leadership campaign promises. Once voted party leader in October, she said she intended to act within 90 days.
Knowing Smith's plans, one board member tendered her resignation last month.
Smith has tasked Cowell with reducing wait times impacting access to ambulances, emergency rooms and surgery. The government also wants him to consult health-care workers to devise longer-term system reforms. There are yet undisclosed milestones he must hit, in addition to writing reports within 30 days, 90 days and six months.
Copping said the government could be willing to invest additional funding to achieve those goals if Cowell recommends them.
Although critics have for years accused politicians of meddling with AHS, Smith said her goal is to quickly approve good ideas, such as a patient transfer service that could free up ambulances.
"This really is not meant to be disruptive," she said of the leadership overhaul. "Not meant to radically switch gears. It's meant to accelerate things that we already know should be implemented, can be implemented, and are underway in the pilot phase."
Cowell will report to Health Minister Jason Copping.
Unlike board members, who serve in the roles part time, Cowell will be a full-time government employee. Copping's press secretary did not answer a question on Thursday about Cowell's pay.
Cowell said he feels optimistic he has the political support necessary to make meaningful and rapid improvements.
"I really do hope that I'll be able to make an effective contribution to making health care stronger and a better experience for the patient," he said.

'There so much at stake here': outgoing board member

Smith ran for party leadership on promises of dramatic health system reforms, including firing the boards of AHS and the College of Physicians and Surgeons of Alberta. She has already replaced the province's chief medical officer of health.
Smith has said AHS failed to ensure there were enough health-care workers on the job during the COVID-19 pandemic when it required all employees to be vaccinated against the disease in late 2021.
Numbers from the organization show about 900 workers did not return to work after the vaccine mandate was lifted. AHS employs 121,000 people.
Smith has also said AHS neglected to create enough intensive care unit spaces in hospitals earlier on during the pandemic. After she was sworn in as premier, Smith said AHS "manufactured" the shortage of health-care workers.
Dagnone says that kind of rhetoric leads to some misinformed patients abusing exhausted health-care workers.
"When I witness the real stress on health-care providers and hear the premier going rogue … on public health measures, and then she resorts to criticizing AHS, someone has to step forward and really call her out," Dagnone said.

Image | Lorian Hardcastle

Caption: University of Calgary health law associate professor Lorian Hardcastle said a dramatic leadership change at AHS could be destabilizing for the health-care system. (Submitted by Lorian Hardcastle)

University of Calgary health law associate professor Lorian Hardcastle said switching AHS board members over time to bring in people with a mix of skills would be prudent.
"But I'm not sure this kind of dramatic change is going to be of any benefit," she said. "And in fact, I think it risks destabilizing the system."
The board's corporate memory is now lost, and Cowell will have to rapidly get up to speed, Hardcastle said.
NDP Leader Rachel Notley said the crisis in health care is due to a shortage of active health-care workers who are further demoralized and disenfranchised by the government's approach.
"The dismissal of the AHS board today is nothing short of bad political theatre," Notley said.
Smith also terminated former chief medical officer of health Dr. Deena Hinshaw this week, and replaced her with AHS vice-president Dr. Mark Joffe.
Smith said her choices thus far of known health-system leaders for key roles should reassure health-care workers that she's not looking for a drastic changes.
In 2013, former premier Alison Redford's health minister also fired the AHS board of the day after members clashed with the government over executive pay.
Four administrators, including Cowell, acted in place of a board until the NDP government appointed new members in 2015.