Thread by @Lorian_H

I've been quiet on here as my mat leave soon comes to an end, but can't resist watching today's press conference and tweeting about it!

There are some underlying issues at play that existed even without the recent scandal, although it serves to bring those issues into focus. /1

First, many of us raised concerns with the increasing reliance on chartered surgical facilities back when Kenney supported their expansion. There are concerns with equitable access, quality of care, costs (as the statement of claim highlights), and conflicts of interest. /2

I spoke about these concerns years ago to Smith on her radio show. Unfortunately, the gov forged ahead with chartered surgical facilities without much thoughtfulness around trying to mitigate these issues. /3

Second, grave concerns around the reasons for the CEO's firing aside, the revolving door of health leaders in this province, who have often been scapegoated by the gov for their own failings, is not doing anything to improve the health care system. /4

Instead of dealing with the chaos, the gov is forging ahead with a reorg that 1) is not grounded in evidence, 2) it not targeted at the specific problems facing Albertans (eg access), and 3) may hinder recruitment and retention efforts. /5

As this scandal highlights, there are significant gaps with accountability and transparency in the system. In my view, these gaps are especially problematic when dealing with for-profit entities, as in the case of the chartered surgical facilities. /6

The public interest in transparency outweighs any arguments around the merits of keeping these contracts confidential. Those bidding on surgical contracts should be told that a non-negotiable term of those contracts is transparency around the bidding process, costs, etc. /7

And onto the show...Smith begins by talking about long wait times. This is a distraction. Everyone knows wait times are long but that's not what this issue is about. She claims that these chartered facilities "work" (show us the data, please) and so they wanted to expand them. /8

Calls former CEO's allegations "troubling" and notes they've asked for an expedited auditor general review. Says that AHS alone was responsible for these contracts, which is perhaps an attempt to distract from the allegations of gov interference. /9

Says that contracts have been awarded but not finalized and won't be until relevant parties cleared of wrongdoing. Currently looking for a third party to investigate. In my view, this should be a judge-led inquiry rather than someone hand selected by gov. /10

Tremblay continues as interim CEO of AHS. Smith says they have put in place a "legal conflicts wall", whereby those named in the statement of claim can continue with their reorg of the health system but not be involved in the investigations. /11

Smith says she had nothing to do with procurement decisions. She says that Minister LaG merely made inquiries about delays, received little response, and is critical of AHS for not raising procurement issues at that point. /12

Smith says AHS has been consistently "resistant" to chartered surgical facilities because they want control over all surgeries. This is part of a pattern of scapegoating AHS and ignores legitimate concerns that they may have had with chartered surgical facilities. /13

Turns floor over to Minister LaG...

Says the claims against her are false and those involving others need to be investigated. Says they will "vigorously" defend against allegations. Reiterates that she asked AHS for information about their concerns and didn't receive it. /14

Says that the directive she issued was not about shutting down the review of AHS but was about getting the information she had requested. Says that many similar information seeking directives have been issued. /15

Q: timeline?
A: former CEO raised concerns in summer 2024, LaG says she continually asked for updates of internal review and encouraged third party review.

Smith acknowledges significant price discrepancies between what a surgery costs in different chartered facilities/16

LaG says transparency needed, which is interesting because gov has not been very transparent about chartered facilities. I would love to see the gov publish accessible info about exact costs, a justification for costs variability between facilities, info re surgical volumes /17

Q: Tremblay?
A: not a deputy minister right now, just AHS CEO and administrator
Q: Chief of Staff involvement?
A: Smith says she doesn't speak for him, but suggest that he was asking legitimate questions in light of delays /18

Q: Confidence in LaG?
A: Smith says that these contracts were issued by AHS, some predated Minister, and Minister was only trying to get to the bottom of them. /19

Q: AHS monopoly?
A: Need to split role of purchaser and provider. Conflict for AHS to be negotiating contracts with its competitors.
Q: covid report?
A: reviewing recommendations to decide which to implement/20

Q: timeline for 3rd party review?
A: 4-6 months. Need someone with legal training and need to satisfy the public that it was sufficiently thorough.
Q: public inquiry?
A: suggests existing plans to investigate are sufficient /21

Q: what about gov wrongdoing?
A: again emphasizes that this was all internal to AHS
Q: why trust conflict wall?
A: AHS counsel will be putting together docs, bound by law society /22