'No tax-cuts... Alberta must stay disciplined'
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Summary
As 2015 winds down, Alberta's premier, Danielle Smith, wraps up the year with a look back at the past three years and a look forward to the new one. She talks about the past, present, and future of the province's health care system and her vision for the future.
Transcript
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Good evening Western Standard viewers and welcome to Hannaford, a weekly politics show of the
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Western Standard. It is Thursday, December the 11th. As 2015 closes out, you could say that it
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has been a tempestuous year for Alberta politics and especially for Premier Daniel Smith. A quasi
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agreement with the Prime Minister over pipelines that may or may not lead anywhere. Separatists
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in her party and out of it who see pipelines as a litmus test of leadership. Where will that go?
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The support was solid at the party conference three weeks ago but there were boos.
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Teachers legislated back to work and in response the Alberta labour movement takes on the government
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with a total of 21 recall procedures initiated already, including that of Premier Danielle Smith.
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And creeping progress on healthcare. When people were hoping for, and to be fair, what was promised
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was quantum improvement three years ago. And of course she is famous now for using
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the notwithstanding clause four times in three years. The miserable weather outside
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MacDougall House here in Calgary could almost seem like a metaphor for the Daniel Smith
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government as the year ends. But what does the Premier think? Let's find out.
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Well, thank you for this, Premier. My pleasure. Good to see you.
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Well, it's good to have you on the show. It was kind of you to do it.
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Madam Premier, may we start with health education and pipelines. Three quick questions in that order.
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Yesterday you announced significant funding for assisted living and one of the purposes was to
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free up acute care beds in hospitals which were occupied by people who needed care but not hospital
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care yeah um all of that is great but i remember our first interview when you had just been uh
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become premier and you said this is what we're going to do we're going to get people out of the
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hospitals and into assisted living and here we are and we're announcing today yesterday that
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we're going to do this again um when are we going to do the grand openings on these things well the
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thing that we had to do is create the authority to make some of these decisions remember when we
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first started AHS controlled everything they were the purchaser the provider the evaluator
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they contracted with themselves contracted with others and we didn't really have line of sight
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into what was happening in the hospitals when Jason Nixon became the minister who was the lead
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on September 1st one of the first questions he asked was how many beds do we pay for in continuing
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care and how many of them are empty and the answer was they didn't know what was happening was that
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they didn't keep track of this if the bed opened up somebody made a phone call and somebody was
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supposed to keep track of it we he ended up having to hire a call center to figure out how many open
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beds that we had we've now since automated that there's going to be a portal that comes out very
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soon so that was one of the changes that needed to be made we were also told that there were about
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460 people who were living in a hospital who needed long-term care. Well, that number turned
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out not to be true. It was closer to 2,000. And so one of the first things that we did is looked
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at our 16 acute care hospitals to find out where the problems were. There were some hospitals in
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the Edmonton area where 40% of the acute care beds were filled with alternative level of care
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patients. We just didn't have that information until Jason went in and started asking for it.
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See, it is the Fraser Institute adage, if it matters, measure it.
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And as a result, we're now down to less than 1,000 in our 16 acute care hospitals.
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We're bringing the Edmonton area down into alignment with focus elsewhere.
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I mean, it's great that you've moved them out of the hospital.
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Do you mean you had these places that they could have gone just sitting empty?
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We had some beds, yeah, that were sitting empty that we were paying for.
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and we've had a we had to to have a conversation with our service providers saying we need to find
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places for these individuals some of them are very complex there were seven people who'd been
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in hospital for a thousand days or more and if we add it up it was a collective 18 years of them
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being in hospitals we had to find dedicated um places for them to support their complex needs
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when we say complex some have a dementia or mental health issues some have addiction issues
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some have anger management issues. Some of them are senior, some of them are not senior. These
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things all have to be dealt with. But our hospitals can't just be a catch-all for a difficult to place
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patient. We've got to find ways to place those patients. We discovered some patients were in
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hospital because the long-term care facility wouldn't take smokers. Well, how efficient is it
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to have nurses and doctors rolling somebody down for a smoke break? Not very. So that's another
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conversation we had to have with our service providers. So those are all things that we needed
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to do is to make sure we were making use of our existing beds, finding ways to pay a proper
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support for those who were complex. And now we just have to build a whole lot more. We're probably
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about 3,000 beds short of those who need long-term care. And when do you think that you're going to
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be able to have those 3,000 beds added to the inventory? There's a couple of things that
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Minister Nixon is doing. One is repairs on existing beds. So there's about 800 that will
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be brought on stream there's another 1500 that are currently in operation so those will come
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on stream this year and then every year uh it's this year like 2025 26 2026 okay yes coming year
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so um then every year after we're going to be investing uh 1500 beds a year until 2030 that's
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the kind that's the kind of pace that we need in order to to keep up but the other part is is the
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is the culture that we're trying to create and the structure we're trying to create is we know
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people want to live at home in their own homes for as long as possible. So let's begin with
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giving the wraparound supports with home care and personal care and renovations. And then let's see
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if we can develop a kinship care program. So maybe they can move in with a daughter or son. And then
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you can move into independent living with assist. And then the continuum goes on to the round-the-clock
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care and so if we can keep people in their own homes as long as possible that that really should
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be something that's going to be beneficial not only for taxpayers but i think more importantly
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for the the person receiving the care themselves so we are well on our way and we just wouldn't
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have been there if we hadn't made some of the structural changes that we did september first
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well let's talk about structural changes uh yesterday i was speaking with a nurse real
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person and not one of these you know people you invent to make a point real person and her question
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was i know we need change but what's it going to look like when it's done why will it work better
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can you explain what it is that danielle smith is trying to do with health well i can say that
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the restructuring is now done and so what rather than have a single authority responsible for
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everything what we're going to now have is that alberta health services will be responsible
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for the facilities they run on our behalf they they run 107 facilities and their job will be
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to improve the patient experience from the moment you walk in the door to the moment you receive
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treatment to the moment that you're discharged their job will also be to maximize the the use
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of their surgical theaters. We've been upgrading our surgical theaters and many of them sit empty.
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Why was none of this possible under the model that you inherited?
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I think lack of focus perhaps because you had AHS who was also managing Covenant Health and AHS
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was managing 50 different charter surgical centers and AHS was determining whether or not we would
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have international medical grads and AHS was running the public health system and AHS was
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running long-term care. So it's a focus issue. So now they will be focused on
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running the 107 facilities that are under their purview and we will have
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under our primary and preventative care, we'll be making sure that everybody is
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attached to a family doctor. That's going to be a separate area so we can do
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international recruitment to make sure we have enough doctors and nurses so that
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everybody has a family practitioner. The long-term care will be a separate entity
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and mental health and addiction will be a separate entity.
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what are the new incentives that are going to make the individuals uh i mean there was a sorry
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story you told me earlier about the the beds being available but nobody thought to pick up the phone
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and let anybody know clearly somebody was was was not on top of their job okay we have a new
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structure yeah what are the incentives that are going to keep officials well the notion that we
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have is funding following the patient to the facility that's best able to give them the
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treatment and one of the reasons we know this will work is when we look at our charter surgical
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facilities and there's 50 of them we pay them based on the surgeries they do right and as a
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result they've gone from doing 40 000 surgeries when we first started to 65 000 surgeries at the
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same time ehs has just gotten back to the level of surgeries that we started doing you know that we
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were doing in 2019 even though they've had three and a half billion dollars more so everyone is
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now going to be paid on the basis of the surgeries that they do especially on the elective side
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and we think that that's going to increase the number of surgeries that are done i'll tell you
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an example of what i think will happen in practice um if you want to go look at the humber river
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model it's a public hospital in ontario and what they realized is that if they gave a surgeon
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two operating room suites in the same eight-hour block they could get way more production out of
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those operating room suites because a lot of what happens in hospitals is downtime you go and do your
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surgery then you sit back and wait for 45 minutes until the surgery until the operating room is is
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re-established with the the patient in there and then you go in so our typical unlike what the
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dentists do completely go back from forth between the rooms so and i'll tell you what happens so
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normally you might get four surgeries done in a surgical time block in a public hospital in
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Alberta right now. Humber River, they did 14 in the same eight-hour time block. So that's the kind
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of thing we're trying to incentivize, is that if you can do more surgeries in a more efficient way,
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find a way to restructure your staff, find a way to restructure how you manage your operating rooms,
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then we want to reward you for it. That's going to make a big difference.
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Okay, got it. Education. One of the big problems is clearly that there's a lot of people who don't
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speaking just being pushed into the classrooms and then the door closes and you've got one teacher
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there and it's very hard to teach correct why don't we stream people well we're having that
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conversation now um one of the things i'd say about uh what we've learned about the complexity
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issue is that we have a number of kids who are in the classroom who have very high needs
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aggression issues or very high medical needs and so we know that there are specialized classrooms
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in a lot of different school systems where those kids are getting smaller classrooms more one-on-one
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maybe we need to do more of that but we we when we looked at the data what we discovered is that
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the number of kids who speak english as a second language has doubled in uh the last three years
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it is now up to 96 000 students in a school system of of eight of 750 000 kids and so the good news
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about English language learners is it's one of those things that with the right resources,
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somebody can become well-spoken in English. So we have to find new ways to make sure that those
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kids get connected with resources. I can give you an example. We had a large number of Ukrainians
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who came in the immediate months following the Russian invasion of Ukraine. And many of them
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found themselves in the school system. I met a couple of young girls, one who'd been here six
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months, one who'd been here nine months, and they were able to give a presentation about a business
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idea, a junior achievement, after being here for a very short period of time. But you have to put
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the dedicated resources in so they can develop that ability in English, so that they can then
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go on to be integrated into a classroom. So I think what you'll see in the new year, as we've
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identified that that is the biggest part of the pressure in our classrooms, we will have some
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dedicated resources for that. Okay, all right, let's talk pipelines for a moment. Yesterday in
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British Columbia, the court ruled that B.C. legislation has to conform to UNRIP and UNRIP
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the United Nations Declaration on the Rights of Indigenous Persons. All their legislation has to
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conform to that. That puts an awful lot of leverage in the hands of Indigenous B.C. leaders.
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Just at a time when you have a memorandum of understanding with the Prime Minister about
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pipelines that even he fell short of saying well if we say it goes it goes you know everybody has
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to be on side i know you still believe in in the in the pipeline but why there seems to be so much
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working against it well i can tell you i've been critical of um judges rulings and how it's upended
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a lot of uh of uh of the uh legislative agenda that we've wanted to do and i've had to use the
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the notwithstanding clause a few times. I noticed with great interest that Premier David Eby is now
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saying how outraged he is at the decisions coming down on the court that has upended his private
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property and land titles legislation, as well as his mineral investment regime. So he is going to,
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it sounds to me, like do some either modifications to the legislation or challenge that in court.
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So I think we're all beginning to see that from time to time, judges don't always make
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a decision that's in sync with the people, and then they're not always right. So I'm going to
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watch to see how that unfolds. But when it comes to Indigenous resource development, one of the
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things I would point out in British Columbia is it was actually the Indigenous communities that
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led the development on LNG. I know we had a hard time getting coastal gasoline built,
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but in the end, the reason why LNG Canada and Solisms and Wood Fiber and others are being
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proposed is because there's indigenous proponents to it so we think that that's a good common ground
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to start from and so my indigenous relations minister has been going to bc quite a lot and
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having a number of meetings to begin the engagement if we find the right port and i have to tell you
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i mean i just saw an interview with the prince rupert port authority saying that prince rupert
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is probably the safest port in canada because it's right on the water deep water very little
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navigation, straight run to Asia in 8 to 10 days. I think that that is a good starting point. If
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we're talking about safety and talking about the way in which we can get our products to market
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on an established port, and we've got to work with the nations in order to have a joint ownership.
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So you still believe we'll get a pipeline out of all of this?
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I wouldn't have signed the MOU if I didn't think so. But in the meantime, we also got rid of the
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emissions cap. We also got rid of the clean electricity regs. Those were the two things
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I've been advocating against for the past three years. We had national advertising campaigns
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and it's already demonstrated that it's having an impact on investment decisions. You've got
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Enbridge, you've got Trans Mountain, you've got South Boat, all talking about new projects to
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increase the amount of egress for pipelines. You've also got Capital Power talking about how
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the clean electricity regs are gone. They want to do a major investment in natural gas power
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generation, which will fuel AI data centers. So those two things alone, I think, are going to
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make a huge impact in our investment climate. And then just have a little bit more work to do
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to work out the technical specs for the pathway and route on the pipeline to the BC coast,
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but I'm confident that we'll be able to. Maybe so, because for some members of your party,
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that getting a pipeline is a sort of a litmus test on leadership. One last thing before we go.
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to say to that, though? So if we get 400,000 barrels from Enbridge Mainline, if South Bow
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does another 650,000 barrel line, if Trans Mountain expands 360,000 barrels, if we get oil
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by rail to Sydney, Nova Scotia, if we end up with a pipeline going to Churchill so that we're able
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to export, I would look at all of that as success. And it's going to take a little bit longer to do
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the BC pipeline but what we needed to do is create an environment where all of those projects would
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go ahead and that's what I'm hoping that we'll see in the coming months. I notice to end on a
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frivolous note that the Canadian Taxpayers Federation gave you a big thumbs up. They have
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a naughty and nice list that they publish every year and apparently the fact that you've used
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the notwithstanding clause and saved Alberta taxpayers $2 billion puts you on their nice
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list. I don't think anybody would disagree with that. Now, the thing is to stay on the nice list.
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So for 2026, a tax break for Alberta taxpayers? Well, we're looking at it. We did our tax break.
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We accelerated our tax cut this year, so $750 for each individual, $1,500 for a family.
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But I can tell you, we have a $7.5 billion deficit that we're looking at, because the
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reality is that our budget needs $74 oil to balance.
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For every dollar that WTI is short, it's $750 million to our Treasury.
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So that's a big problem that we've got to deal with.
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We're starting to deal with it because we're investing the income from the Heritage Fund
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into the fund so that it can grow to $250 billion
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we're not going to be able to balance our budget
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about how we're going to get back into balance.