Alberta
IN CASE OF EMERGENCY, READ THIS! ALBERTA’S COVID-19 REPORT
From the Frontier Centre for Public Policy
By Barry Cooper
The report calls for emergency management experts – not doctors or health care bureaucrats – to be in charge when such disasters strike, with politicians who are accountable to the people making the key decisions. Most important, the report demands much stronger protection for the individual freedoms that panic-stricken governments and overbearing professional organizations so readily quashed.
Nobody needs reminding that the Covid-19 pandemic – and the official responses to it – left hardly a person, group or country unaffected. From the lost learning of school closures to the crushed businesses and ruined lives, to the recurring social separation, to the physical toll itself, the wreckage came to resemble recession, social disintegration, war and the ravages of disease all in one. Yet the governments and organizations that designed and oversaw the emergency’s “management” have proved decidedly incurious about delving into whether they actually did a good job of it: what went right, what went wrong, who was responsible for which concepts and policies, who told the truth and who didn’t, and what might be done better next time. Few countries are performing any such formal evaluation (the UK and Sweden being prominent exceptions).
In Canada, the Justin Trudeau government has rebuffed calls for a public inquiry (perhaps a small mercy, as it is hard to envision this prime minister not politicizing such an exercise). Nearly every Canadian province is also ignoring the matter. The sole exception is Alberta, which in January created the Public Health Emergencies Governance Review Panel to, as its terms of reference state, “review the legislation and governance practices typically used by the Government of Alberta during the management of public health emergencies and other emergencies to recommend changes which, in the view of the Panel, are necessary to improve the Government of Alberta’s response to future emergencies.” The Panel’s inquiry fulfilled a promise made by Premier Danielle Smith when she was running for the leadership of the United Conservative Party.
These terms of reference need to be understood because they greatly influenced what followed – both the restrictions on the Review Panel’s inquiries and the broad scope of its recommendations, released in a densely written Final Report (367 pages including appendices) on November 15. The Panel was chaired by Preston Manning, Leader of the Official Opposition in Ottawa some 25 years ago but who more recently became a prominent voice of skepticism regarding the pandemic response, particularly the dismissive treatment of Canadians’ rights and liberties. With this report Manning has driven and led not one but two major pandemic-related reviews, as he was also central in the non-governmental National Citizens Inquiry on Canada’s Response to the Pandemic, which heard wrenching personal testimony.
Despite working under limitations, Manning and his colleagues have rendered valuable and, indeed, unparalleled public services with each effort. Here one must note whom Manning requested for Alberta’s Review Panel. They are in alphabetical order: Martha Fulford, an academic pediatrician at McMaster University with numerous scholarly articles to her credit; Michel Kelly-Gagnon, a businessman and President Emeritus of the Montreal Economic Institute; John C. Major, a former Justice of the Supreme Court of Canada; Jack Mintz, arguably Canada’s most distinguished living economist; and Rob Tanguay, a Calgary-based clinical psychiatrist specializing in treating addiction, depression and pain. Additional specialists prepared several of the report’s 11 appendices.
This is important because the response of Alberta’s NDP and its left-wing media helpers has been to accuse the Panel of mongering conspiracy theories and attempting to legitimize quack pseudo-science. They are using Manning, the founder and longtime leader of the Reform Party of Canada, as a convenient whipping boy. But they are effectively calling the entire panel – including a former member of the nation’s highest court who stood out for his calm and measured approach – a bunch of nutters if not worse. These critics seem to have emitted not one positive thought about any aspect of the Panel Report. That tells you a great deal about them, including that they probably didn’t even read it.
The report also prompted some balanced to favourable coverage, including from several journalists who previously were pro-lockdown, pro-masking and/or pro-vaccine. Edmonton Sun columnist Lorne Gunter, for example, termed the report “sensible and moderate,” noting that it calls for following “all of the credible science.” Gunter’s use of “all” is significant for, he notes, “a lot of what was pitched to the public as definitive scientific knowledge, such as the vitalness of mask and vaccine mandates, school closures, event cancellations and lockdowns was questioned by solid, reputable scientists (not just streetcorner anti-vaxxers and ‘I did my own research’ social-media experts).” Calgary Herald columnist Don Braid, a habitual UCP critic, also sounded impressed.
Alberta had a thoroughly designed, tested and previously deployed emergency plan. It just chose not to use it against Covid-19. This bizarre and gravely damaging decision has still not been explained.
So what is actually in the report? Chapter 1’s review of the Panel’s purpose notes it was set up to review the procedures Alberta has to respond to “any public emergency, including a public health emergency,” and how its preparations could be improved, including by broadening and deepening “the role of science in coping with future emergencies.” Its purpose was not to criticize Alberta’s actual responses to the Covid-19 event. While the Covid-19 public health emergency was the initial reason the panel was established, its recommendations would apply more broadly. And while science should be considered central to good public policy, science should not be regarded as consisting of a single narrative. Accordingly, “alternative perspectives” (Report, p. 5) should also be considered.
Alberta Emergency Management Agency
The spring 2020 spectacle of wildly shifting statements from public health officials and political leaders, its blizzard of decrees and edicts, proliferating “mandates,” haphazard changes of direction, imposition of seemingly arbitrary rules, public chaos, and sheer aura of panic – sweat-drenched faces, bulging eyes – might lead any citizen to believe that governments had never planned for or faced an emergency. The promiscuous use of “unprecedented” to describe Covid-19 only added to this feeling. In fact, Alberta had a thoroughly designed, tested and previously deployed emergency plan. It just chose not to use it against Covid-19. This bizarre and gravely damaging decision has still not been explained.
The Final Report’s largely overlooked Chapter 2 discusses improvements to the Alberta Emergency Management Agency (AEMA), making it important on several levels. The Panel recommends AEMA be adequately funded and remain the lead agency in dealing with any future emergency, including any future medical emergency. This alone is huge and hugely welcome. To ensure that individuals who are capable of dealing with emergencies and not just apprehended medical crises are in fact in charge, the Panel recommends several legislative changes to the Emergency Management Act and Public Health Act. Even better.
This sound recommendation rests upon the distinction between emergency management and normal policy decisions made by bureaucrats. The original Alberta emergency plan was developed in 2005 to deal with an anticipated influenza pandemic, and was in turn based on planning initiated across North America following the 9/11 terror atrocity. Alberta’s plan was similar to the approach followed by Sweden in 2020, which despite widespread initial condemnation proved highly successful. Its essential feature was that it was written and was to be implemented by individuals who specialize in emergencies, not by individuals with alleged expertise in the specific attributes of an anticipated emergency such as influenza or Covid-19, what the Panel on page 25 refers to as “subject-matter experts” (a more extensive quote is below).
By way of analogy, societies well-prepared to deal with emergencies do not put a limnologist in charge of an emergency response when riverbanks are unexpectedly breached and cause catastrophic flooding. Nor do they scramble to place a vulcanologist in charge when a volcano erupts and threatens lives and livelihoods. The purpose of putting highly trained emergency professionals in the lead during difficult situations is to remove as much as possible the shock effect from the surprises that emergencies typically bring, especially to normal politicians and conventional bureaucrats who expect normalcy to last forever and who panic when it doesn’t.
The emergency plan Alberta had going into 2020 was designed by David Redman, a former senior Canadian Forces officer whose 27 years of service included combat experience, a vocation that typically deals with unexpected surprises. The problem as the pandemic began was not in any lacunae that the Alberta emergency plan may have contained. Rather, as Redman, who at the time was director of Community Programs for Emergency Management (i.e., coordinating local responses), told C2C Journal in an interview in late 2020, “Governments took every plan they had ever written and threw them all out the window. No one followed the process. [The politicians] panicked, put the doctors in charge, and hid for three months.”
Redman was also emphatic on the question of fear, which is inevitably transmitted by panicked officials. He spent countless hours during the pandemic trying to warn every Canadian premier and many federal politicians that discarding emergency management principles and giving healthcare bureaucrats unprecedented authority was dangerous and would likely lead to disaster. Specifically, he urged healthcare officials and politicians to avoid expressing fear. Instead, he sadly noted in an interview with the Western Standard last week, “They used fear as a weapon. In emergency management you never use fear. You use confidence. You show confidence that the emergency can be handled and present a plan to show how this will be achieved.”
The Government of Alberta made a catastrophic and, as said, never-explained mistake when it turned the province over to a narrowly focused, unimaginative career bureaucrat credentialed only with an M.D. To be fair, this was probably too much for any one person, and Chief Medical Officer of Health Deena Hinshaw was placed in a near-impossible position. The consequences of this decision led to the removal of Premier Jason Kenney, and it is also why nearly the first thing his successor did was fire Hinshaw. That is also why the Manning Panel was commissioned.
So let us agree that the Panel’s recommendations to strengthen AEMA would improve emergency management the next time it is needed. That said, the Panel ignored the fact (or at least declined to state) that, had existing procedures been followed in 2020, things would have turned out much better.
Making Proper Use of Science – and Avoiding the Dictatorship of “Experts”
Chapter 3 deals with the place of “science” in public policy. It was self-evident to the Panel that science could help fashion sound public policy responses but could also be used for “political expedience and ideology.” Here the Panel was half-right. On the one hand it advanced a notion of “the scientific method” that dominated science classes a couple of generations ago. According to this account, a researcher develops testable hypotheses that can be modified in light of experimental results. Such was the philosophy of science that I was taught in grade 7 physics.
Its great defect is that it takes no account of what we now call conflicting paradigms or of what German Enlightenment-era philosopher Immanuel Kant called the power of judgment. A pandemic, for example, is not a “fact” but the product of somebody’s judgement. On the other hand, the Panel showed great clarity in asserting that “science is open to the consideration and investigation of alternative hypotheses…and is subject to some degree of uncertainty as an ever-present characteristic of scientific deliberations.” (Report, p. 24)
Before considering how it elaborated the problems of conflicting and alternative hypotheses and of uncertainty, one should note how opponents to both the Panel and UCP government responded to its commonsensical observations. According to NDP Leader Rachel Notley, they were “incredibly irresponsible.” Indeed, she asserted, “What you see is an invitation to normalize conspiracy theories and pseudo-science at the expense of evidence-based medical care.” Notley and CTV went on to attack Premier Smith for embracing “fringe views” – including those found in the October 2020 Great Barrington Declaration, a document written by three of the world’s most respected epidemiologists and subsequently endorsed by, at last count, 939,000 fellow scientists.
One of the Panel-endorsed “fringe views” was that “the number one priority” when a pandemic event is declared should be “protection of the most vulnerable,” (Report, p. 25) which is to say not everybody. Should a particular pandemic’s impact subsequently spread to other social, political and economic relationships, this priority may be modified and adjusted. That sounds eminently responsible, but the NDP wants everybody locked down right from the start.
Still the real question is: who would order the adjustments? The Panel’s answer is forthright, much to the consternation of scientific “experts”: “That a clear and conscious decision be made by elected officials as to the scope of the scientific advice to be sought and that this decision not be left entirely to the subject-matter agency, given that it may have a narrower perspective than that actually required.” (Report, p. 25, emphasis added) As Manning later said: “Political people have to be responsible for the overall direction and management because they’re the people that the public can hold accountable.”
Manning’s determination to avoid having a democracy become a dictatorship of “experts” also reflects a critical aspect of pandemic response: that there are issues far beyond medicine in play, and that the associated decisions are not scientific ones. Weighing risks, for example, is an exercise in logic (a branch of philosophy) and judgment, which depends on inductive reasoning. Assessing costs and benefits of various possible actions is economic in nature. And then, deciding just how much risk to take on and what costs to bear in the pursuit of benefits are questions of ethics. Such things should be undertaken by politicians because, if the people as a whole have a different view of such matters, they can vote in a different government (or, as happened in Alberta, select a decidedly different leader from the same party).
To the experts and their spokespersons, this was an anathema. Lorian Hardcastle, an associate professor in the University of Calgary’s law school and medical school, warned: “We would see ideologically driven response to a public health emergency” that would make it difficult “to keep people alive.” We can characterize the Hardcastle position, which was endorsed strongly during the pandemic by legacy media, the NDP, the “expert” class and the health care bureaucracy, as the “orthodox” doctrine. A health care emergency must be left to the so-called health care experts. Everyone else (including presidents, prime ministers and premiers) should defer to their expertise and do as they are told. The public “conversation” is entirely one-way.
In reality, however, public health does not involve just a single disease but all aspects of the health of a population. Thus, focussing on illness stemming from the SARS-CoV-2 virus was not enough even for so-called specialists because such a focus meant that, for instance, cancer screening was postponed so hospitals would be empty enough to accept the (incorrectly) projected tsunami of Covid-19 patients. Yet cancer is also part of public health, as was the collateral damage from the economic and social effects of lockdowns, school closures and social distancing, none of which the orthodox doctrine considers. Skeptics pointed out all of this throughout the pandemic – and were shouted down as granny-killers.
Alberta
Province announces next step to revamped health care system
Setting the foundation for a refocused health system
Proposed legislation would support the refocusing of Alberta’s health care system to ensure Albertans get the care they need when and where they need it.
On Nov. 8, 2023, Alberta’s government announced plans for a refocused health care system to ensure patients are receiving the care they need, when and where they need it. To achieve this, Alberta’s government will be creating four new organizations, one for each priority health services sector: acute care, primary care, continuing care and mental health and addiction.
If passed, the Health Statutes Amendment Act would enable the government to take the necessary next steps to refocus the province’s health care system. The legislation would ensure Albertans have a system that works for them by prioritizing their need to find a primary care provider, receive urgent care without long waits, have access to the best continuing care options and obtain excellent mental health and addiction treatment.
“We are taking another step toward improving health care by updating legislation and enabling the governance and oversight required to refocus the health system. The critical improvements to transparency and accountability will help support the successful refocusing of the health care system to one that is responsive, effective and reflects the needs and priorities of Albertans today and for future generations.”
The Health Statutes Amendment Act will enable the transition from one regional health authority, Alberta Health Services, to an integrated system of four sector-based provincial health agencies including primary care, acute care, continuing care and mental health and addiction. The agencies will be responsible for delivering integrated health services, ensuring Albertans receive timely access to care, regardless of where they live.
The Health Statutes Amendment Act establishes roles for an oversight minister and sector minister. The Minister of Health will take on the role of oversight minister, responsible for setting the strategic direction of the overall health system. A sector minister will be responsible for a specific health services sector. For example, the sector minister for Recovery Alberta is the Minister of Mental Health and Addiction. On the recommendation of the oversight minister, additional health service sectors may be established and designate a minister responsible for that newly created sector.
Enhanced government oversight will help Alberta’s government to better direct resources to the front lines where they are needed the most, improve patient care overall and support health care professionals.
“Mental health and addiction have been growing issues within our society and need to be prioritized within our health care system. Amid an addiction crisis, a refocused health system will allow for mental health and addiction services to get the attention, oversight and focus they need. Recovery Alberta would allow for improved mental health and addiction care across the province as an important part of an integrated health system.”
“Refocusing Alberta’s healthcare system is a crucial step towards ensuring that we can deliver a framework that prioritizes accessibility, accountability, and patient-centered care. By streamlining operations, improving oversight and fostering collaboration, we are setting a strong foundation for a healthcare system that is better equipped to address the diverse needs of each of our communities.”
The legislation will enable the minister of health to transfer employees or classes of employees from AHS to the new sector-based organizations, once established. During the transition period, AHS will be enabled to continue operating as a regional health authority. Employee transfers will be seamless, maintaining existing bargaining relationships and collective agreements. This will ensure stability for the workforce, unions and government as the health system refocus is implemented. There will be no job losses for staff who transition into the new organizations.
Amendments to be made to existing legislation
The Health Statutes Amendment Act includes amendments to the Regional Health Authorities Act and the Health Information Act, which have not been updated since the 1990s.
As part of these amendments, the name of the Regional Health Authorities Act will change to the Provincial Health Agencies Act. The amended Provincial Health Agencies Act will remove outdated references to allow the transition from a single regional health authority to a unified, sector-specific provincial health system. This will clarify the scope and accountabilities of provincial health agencies and health service providers going forward.
The amendments will also place responsibility on the provincial health agencies for operational planning and oversight of clinical service delivery across the province. This will enable provincial health agencies to set priorities in the provision of health service delivery. The agencies will also be tasked with sharing information and collaborating closely to support seamless patient care as the transition to the refocused health care system takes place.
Alberta’s government is committed to ensuring that patient information continues to remain safe and secure through this transition. Amendments to the Health Information Act will be introduced to support the new health system refocus and to support the establishment of the Canadian Centre of Recovery Excellence. These amendments will allow the Ministry of Health, the Ministry of Mental Health and Addiction, the four new provincial health agencies, the Health Quality Council of Alberta and Canadian Centre of Recovery Excellence to have the authority to use health information for health system purposes.
If passed, the Health Statutes Amendment Act will enable Recovery Alberta, the mental health and addiction provincial health agency, to begin operating in the summer of 2024. The primary care, acute care and continuing care provincial health agencies are expected to be established in the fall.
Quick facts
- Consequential amendments are changes made to existing legislation due to new legislation being passed. These amendments are necessary to ensure legislative alignment with the proposed amendments to the Regional Health Authorities Act.
- To support the Regional Health Authorities Act amendments and ensure alignment, 43 other acts are being consequentially amended – for example, to replace references to “regional health authority” with “provincial health agency” where necessary.
- AHS will remain a key provider of health services, and in fall 2024 will transition to focusing on the provision of acute care services.
- Alberta’s government introduced the Canadian Centre of Recovery Excellence Act which, if passed, will establish the Canadian Centre of Recovery Excellence (CoRE) as a public agency that would support the Government of Alberta, including Mental Health and Addiction, and Recovery Alberta in advancing the Alberta Recovery Model.
Related information
- Establishing the future of Alberta health care
- Refocusing health care in Alberta
- Recovery Alberta
- Canadian Centre of Recovery Excellence
- Bill 22: Health Statutes Amendment Act, 2024
Related news
- Refocusing on patient-centred care (Nov. 8, 2023)
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