Thousands of words have been composed over the past couple of weeks to explain why Villa Caritas, which was approved by the Alberta government in 2009 for development as a 150-bed long-term care facility in West Edmonton, is now opening as a 150-bed geriatric psychiatric facility.
Plenty of literary horsepower has been harnessed to make sense of why what in April 2009 was supposed to be public-private partnership with the Catholic charity Covenant Health that would cost Alberta taxpayers $12 million had by April 2010 turned into a publicly owned geriatric mental hospital that would cost taxpayers $51.4 million.
Likewise, gallons of ink have been spilled to tell us why it makes sense for Alberta Health Services, the province's health care super board, to be closing a geriatric psychiatric facility it already has in East Edmonton to move patients into a new facility in West Edmonton. The new facility, in turn, was thus lost as a long-term care facility that’s desperately to help solve the ongoing crisis in the province’s Emergency Rooms. Still with us?
As the Edmonton Journal observed in a thoughtful editorial on the topic that clearly outlines the chronology of events, "in a province desperate for additional long-term care beds, the board was filling the new building with mental health patients. It was addressing the bed shortage by taking away new beds." The Journal bluntly described the decision as a "debacle."
Former Alberta Health Services CEO Stephen Duckett, fired by the government in November supposedly for eating a cookie at the wrong time in the wrong company, contributed to the deluge of ink with a letter to the editor of the Journal defending the decision as an achievement, not a debacle.
So let's consider what’s likely really going on, and why.
Back in August 2009, Duckett announced a decision to close more than 200 acute psychiatric care beds at Alberta Hospital Edmonton, central Alberta’s main psychiatric hospital. He also announced that a redevelopment of AHE previously approved by the Capital Health Region would be dropped. Both decisions were described as money savers.
However, there’s never been any actual evidence that Duckett's scheme was anything more than a spur-of-the-moment brainwave, scratched out on the back of an envelope. Leastways, no plans, studies or detailed proposals have ever been produced to explain why Alberta Health Services made this decision. Access-to-information requests seeking copies of plans and correspondence leading up to the decision have turned up very little.
Yes, AHE's buildings were growing long in the tooth, which is why the CHR approved the redevelopment. Yet despite the age of its physical structures, the hospital is a fully utilized, desperately needed, world-class psychiatric facility. Upgrading the geriatric psychiatric facility to bring it up to current standards would have cost only $1.4 million.
Notwithstanding vigorous denials by the health bureaucrats behind the decision, the plan to move Alberta Hospital's services "into the community" was viewed by many Albertans as nothing more than a scheme to save money by dumping the mentally ill on municipal social service agencies and the streets.
Accordingly, a huge brouhaha erupted, with a spirited coalition of trade unionists, police officers, physicians, nurses, families, the public and the mentally ill themselves uniting to oppose this plan. The government received literally thousands of letters from concerned citizens demanding AHE be kept open.
The heat from this became so great that in January 2010 Alberta Premier Ed Stelmach relented, shuffling his cabinet to replace the undiplomatic Ron Liepert with Gene Zwozdesky as health minister. Within days, the famously diplomatic Zwozdesky partly reversed Duckett's plan and announced the hospital would remain open after all.
This was the point, however, at which the government also decided to stick with the inexplicable decision to move Alberta Hospital’s geriatric program somewhere, notwithstanding the apparent value of keeping all psychiatric programs together at Alberta Hospital.
Characteristically, after the controversy erupted, the government struck a committee, suspiciously dubbed an “implementation team,” to buy a little time by "studying" the matter. The committee, which included Conservative Edmonton-Rutherford MLA Fred Horne as "Premier Stelmach’s representative," on Jan. 18, 2010, conveniently recommended moving the geriatric psychiatric program to Villa Caritas.
But the answer to the key question in all this remains cloudy: Why did the government stick with the part of Duckett's plan that called for the movement of Alberta Hospital's geriatric psychiatry program to another location when for a variety of reasons that manifestly did not make sense?
While there is an almost total lack of evidence -- proving if nothing else that the government's paper shredders work properly -- the obvious answer is that from a political perspective, the government was afraid of being seen backing down from an ill-considered plan for fear voters would conclude there was no plan at all.
The (lack of) evidence suggests that the government and AHS stuck with the geriatric move to camouflage the weakness of their decision-making process. In other words, this foolish decision was driven by nothing more than pride!
Why Villa Caritas? Well, really, there was nowhere else in the Edmonton area that could accommodate the program in the politically necessary timeframe.
Why did Covenant Health agree to the deal? Because, under the circumstances, the government of Alberta obviously made them a deal so favourable they could hardly say no.
To persuade Covenant Health to convert the facility and change its ownership, the government reimbursed it all the money it had invested, stuck the Alberta taxpayer with the $39.4-million bill, agreed to leave Covenant in charge of the program at government expense and in the process exacerbated the long-term-care bed shortage that is at the root of Alberta’s unsolved ER crisis.
No one should blame Covenant Health for accepting this deal. It's quite reasonable for its executives to operate like the business people they are when a deal this good comes along.
Alberta Health Services and the government of Alberta have no such excuse.
This post also appears on David Climenhaga's blog, Alberta Diary.
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