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Speech: Reflections on 20 or So Eventful Months

Speech: Reflections on 20 or So Eventful Months

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Published by: jmarkusoff on Dec 31, 2010
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12/31/2010

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 Reflections on 20 or so eventful monthsSpeech byDr Stephen DuckettFoundation President and Chief Executive OfficerAlberta Health ServicestoAlberta Health Services Senior Leaders6 December 2010
 
1Id like to thank you all for joining me here to mourn, celebrate and move on. We live in differentrealities. Mine is a future primarily outside AHS, yours within. Our realities overlapped for 20 shortmonths, a time when we achieved an enormous amount which is to be celebrated. But also a time cutshort and for me it is appropriate to mourn the might-have-beens, and the agenda that I hope will becontinued. But we all also need to move on, to the next stages of our lives. Many of you are goodfriends and I hope I can catch up with you from time to time, to share laughs and adventures. But manyof you dont know me well. And I want to take this opportunity to give you a better understanding of who I am, what I did and why.
 
Im going to give a formalish talk, partly to avoid too many tears! What I want to do tonight is say mypiece, not in real time youll be pleased to know. Because of my former role Ive been constrained inwhat I can say, especially so this year. Im a free person now and can reflect on our achievements andmissed opportunities more directly.So to begin at the beginning.
Joining Alberta Health Services
I was appointed in January 2009, Ive told some of you the trials and tribulations of the short-listingvideo interview on the Friday (Australian temperature at +40, the other end of the line in Calgary at -40),the 2 day drive back to Brisbane from my holiday, the haircut, the flight, arriving in Calgary on theMonday night and an hour or so later being rotated around three tables at dinner with the board. Aforetaste of the pace at which I would be working in AHS.Another aside. In the interview I was asked if Id any media experience. I answered yes but I didntexpect thered be much exposure in this job. The Board basically rolled around laughing and I realizedId made yet another mistake in the interview.Although the internet age means people can find out a lot about who you are, I wanted to make myvalues clear, so thered be no risk that Id be asked to do things I wouldnt want to do. Given thegovernments previous history on Medicare
1
, in my first meetings with Ken Hughes as Board Chair andMinister Liepert in that interview week, I told them that I would not do anything that would underminethe Canada Health Act. They both accepted that position and honoured it. I see myself as a friend of Medicare with a small f. The capital F folk go much further and want to end private delivery, puttingalmost all physician practices out of business
2
. Not a position I can support.So shortly after the announcement of my appointment, but while I was still in Australia, I got this phonecall from Ken Hughes and Don Sieben, chair of the Audit and Finance Committee, telling me that theyd just become aware of the need to do a significant financial correction, dimensions still unclear butcertainly north of $1B. Imagine my feelings. I thought I was going to a well endowed health system!
1
http://www.thecanadianencyclopedia.com/index.cfm?PgNm=TCE&Params=M1ARTM0012159
2
To be precise, according to their website(http://www.friendsofmedicare.org/default.asp?mode=webpage&id=52) they are opposed to a parallel system of for-profit delivery, with no mention of any exclusion for physician practices.
 
2Anyway, an interesting introduction to AHS and one which gives the lie to those who said I wasappointed simply to do budget cuts. Ive said subsequently to Ken Hughes that I should sue them formisrepresentation in not informing me about the financial situation as part of my recruitment. Inreturn, he pointed out that for misrepresentation to have occurred they would have had to know howbad the problem was when they appointed me. And they didnt of course as the oil and gas pricecollapse was just occurring.But then I arrived here. Lorinda, Joyce and others had taken the trouble to speak to my former staff inQueensland to find out my likes and dislikes. To make things easy for me. To make me feel welcome.And that set the tone for me inside Alberta Health Services. This has been probably the most supportiveorganization I have ever worked in. You have all been welcoming. Tolerating my quirks, Australianisms,different sense of humour. But really caring for me in the tough times, and weve had a few. For therecord when I say you, I dont only mean you, the leaders in this room, but you, the others with whomIve worked at all levels of the organization, and the Board too.There was less tolerance outside AHS. The media created a Stephen Duckett I didnt recognize,portraying me as a one-dimensional budget cutter, a portrayal that still continues
3
. Yet my main workand achievements in Queensland had been about access and quality, the other two goals of AHS!
P
aradise lost?
An early challenge I faced was the issue of AHS legitimacy. When I arrived there were still many (insideand outside AHS) who lamented the demise of the predecessor entities, and they looked back on thegood old days when everything was perfect. Everything AHS did was bad and not up to the standard of the previous region, board, Commission. But as Ive said in previous presentations
4
, all was not rosy.Alberta spends more per capita (adjusted for age and sex) than other Canadian provinces, and gets less.Male and female Albertans have a shorter health adjusted life expectancy than the Canadian average.Albertans who get cancer dont live as long as people from Ontario.All this using data from before AHS was formed.Investment decisions have over-emphasized acute provision at the expense of seniors care. In contrastto other provinces, Alberta reduced per capita spend on non-acute facilities over the last decade. Is itany wonder that our acute facilities had to become
de facto
seniors housing, contributing to thesystemic problems that have created the problems in emergency care?And emergency department performance in both Edmonton and Calgary has been getting steadilyworse over the last decade, achieving the eight hour standard for admitted patients about 60% of thetime in the first few years of the decade to around 25% now. Neither level acceptable of course.
3
 http://www.edmontonjournal.com/health/interim+Alberta+health+board+boss+will+focus+better+service+engaging+staff/3890943/story.html
4
Most notably to this forum, the Board, zone planning days for the Calgary, Edmonton and North Zones and at aUniversity of Alberta conference (http://www.economics.ualberta.ca/boom_and_bust_again.cfm)

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