July 19, 2024

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Staples: New AHS governor promises health-care change, not revolution

5 min read

Cowell hopes to smooth away systemic choke points that delay patient care but not try to change everything all at once.

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Alberta is getting an experienced emergency administrator to help deal with our emergency in health care.

Dr. John Cowell, a long-time physician and medical administrator, is coming out of retirement to act as a one-person replacement for the Alberta Health Services board. He will be the official administrator, taking over from the board for a short period to work with Premier Danielle Smith, Health Minister Jason Copping, AHS executives and front-line workers to get us through what some are calling the most challenging winter ever faced by Alberta hospitals.

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The idea is to streamline decision-making in this crisis, Cowell told me in an interview, to have a leader who can quickly reach out to everyone from the premier to medical staff.

Cowell hopes to smooth away systemic choke points that delay patient care but not try to change everything all at once.

“Nobody, including the official administrator, is going to try to boil the ocean,” he said. “We are going to work very hard on a very specific set of priorities that are meaningful and will make a positive change.”

It’s evident the emergency care system was already operating at capacity limits in 2018-19 before the COVID pandemic, he said. “Along comes COVID, and if they’re already at capacity, now what? Things get worse. And priorities have to shift from every day demands on the system to now exceptional demands on the system, plus normal. That is what the challenge is.

“Are we out of COVID? I don’t know. We’re in flu and we’ve got RSV and COVID has not gone away … We have to be prepared for all eventualities. Are we prepared for it right now? No. Do we need to do some fast-track changes? Yes.”

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I asked what Cowell thinks of Smith’s critique of too much AHS middle management and not enough frontline workers. He said he’s convinced more hiring of frontline staff is needed.

“I think she has concerns as to why is the system not performing,” he said of Smith. “She’s taken the action with the minister to understand that and solve for it, hence the official administrator. Now it is my task to evaluate that situation and take action based on what I find.”

He was president and CEO of the Workers’ Compensation Board in the 1990s and had this same official administrator role for AHS for one year in 2013-14, when he left his long-time watchdog role as executive director of the Health Quality Council of Alberta, where he often made scathing critiques of health-care problems.

As for his own suitability for the job now, he said, “Why me? Sure, I was on the bench. I’m retired. But I feel compelled that citizens’ needs and health always have to come first. If I have the experience, if I have the will, the stamina, why wouldn’t I step up to the plate?”

He returns to his previous role with fresh insights, having been a patient in a Calgary hospital after crashing his bike and fracturing his left knee in nasty fashion last February during the Omicron wave.

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Cowell, 78, was moving at a slow speed on his bike when he moved to dodge a person who had staggered into his path. His front tire and leg struck a depression and he snapped the bone. He ended up staying eight days in hospital and required surgery.

His own care left him with great admiration for our health-care workers but also was a compelling learning curve, he said. “There are so many things that I realized should have and could have been different. But the common thread was the astonishing care, skill and compassion of my care providers.”

I mention that he doesn’t come across as someone at war with the health-care system, as some politicians can sound at times, including Smith.

“I am not,” he said, “and I can assure you that this minister and this premier is not. They’re all like-minded. They all share the common belief that something has got to be done to improve systems of care. So get on with it.”

His contract is for six months but could be extended. He’s on a similar timeline as Smith, who faces an election in the spring.

How will he do? Cowell has got a solid resume with broad managerial experience. He comes across as a sharp, level-headed and solutions-oriented boss. He also strikes me as non-partisan. He’s got no axe to grind, which is a good place to start in a province traumatized by years of illness, lockdown and division.

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