After 3 years under UCP, AHS has lower % of clinical staff

Earlier this year, Alberta Health Services released their 2021–2022 annual report. I was reviewing it and came across the Key Financial Trending section, which includes a table on the AHS workforce.

And I was curious about how this data has changed under the UCP and how that change compares to the change under the NDP.

Until the 2020–2021 annual report, AHS used to include what’s called a Schedule 2 in their report. This would breakdown the number of full-time equivalent (FTE) positions by category (management, nurses, physicians, etc) and how much was paid out in total per category.

They still have a Schedule 2, but it contains completely different information now, so I didn’t think I’d be able to do a story like this. Until now.

So, I went through the last 8 annual reports and compiled employment data on clinical staff, other staff, and management since the 2014–2015 budget year. This covers the last year under the PC government, all 4 years under the NDP, and the first 3 years under the UCP.

The 2022–2023 data won’t be available until the late winter of 2024.

First, let’s look at clinical staff, which are comprised of AHS’ medical doctors, regulated nurses, health technical and professional staff, and unregulated health service providers.

Here we see that the number of clinical staff has increased every year since 2014-2015. During that time, Alberta saw an increase of 14.73% in the number of clinical staff employed by Alberta Health Services. That’s just shy of nearly 7,000 new doctors, nurses and other health service providers.

That works out to under 1,000 new clinical staff per year, or an average increase of 2.1%.

Now, let’s compare the changes in each year.

The largest increase in clinical staff came in the final year of the NDP’s first term. That also happened to be an election year, so I guess it shouldn’t be that surprising that the increase was more than double what it was the previous year and almost double what it was in each of their first two years.

The UCP saw the second and third largest increases in clinical staff. Don’t get too excited, however. The increase over the last two years of this period were primarily temporary and contract workers, as well as more overtime.

The increase in calculated FTEs in 2021-22 was mainly due to the increased number of employees and overtime required to respond to the COVID-19 pandemic. AHS’ workforce grew in 2021-22, with the vast majority being temporary and casual employees hired for contact tracing, Health Link, assessment and vaccination centres, and patient care.

2021–2022 Alberta Health Services Annual Report, p. 46 (emphasis added)

The increase in calculated FTEs in 2020-21 was mainly due to an increased number of employees and overtime required to respond to the pandemic. Over the last fiscal year, AHS’ workforce grew by more than 5,000 employees, the vast majority being temporary and casual employees hired in the second half of the year for contact tracing, Health-Link, immunizations, assessment centres, and patient care. Overtime also increased in the second half of the year contributing to an overall 26% increase from the prior year.

2020–21 Alberta Health Services Annual Report, p. 62 (emphasis added)

Keep in mind that despite these increases, 2020–2021 saw the smallest increase in clinical staff of all 7 years during this period.

During the first year, much of the increase was due to increased hours for workers who had been hired the year before on AHS priority initiatives, as well as some increased overtime at the start of the COVID-19 pandmeic.

The increase in FTEs was primarily due to increased worked and training hours related to AHS’ priority initiatives, including Connect Care, ECC, and CCCP, as a result of higher current year activity and annualized FTEs for staff who were hired during the prior year to support these initiatives. Overtime incurred during the COVID-19 pandemic response in March 2020 further impacted FTEs across all the categories, however, total 2019-20 overtime hours were lower than in the prior year due to AHS’ ongoing efforts to reduce overtime.

2019–20 Alberta Health Services Annual Report, p. 40 (emphasis added)

So, while we did end up with more clinical healthcare workers under the UCP, it seems as though they were forced to staff at those levels, for the most part.

Now, the change in numbers tells only one part of the story. Let’s also look at the change, relative to the previous numbers. After all, if you have a 200 increase from 1,000 is not the same as a 200 increase from 5,000.

Meh. Pretty much tells the same story. Largest increase in the election year, and the second and third largest increases happened under the UCP, who also saw the smallest increase.

But what if we ignored the final year of the NDP administration and just compared the first 3 years of each party, to get a fairer representation. After all, the UCP are probably going to hire a bunch more going into the election year.

During the NDP’s first 3 years in power, they increased clinical staffing levels by 2,388, or about 5.05%. The UCP, however, saw a rise of 3,013, or 5.88%, over their first 3 years in office. That’s barely more than the NDP, and the NDP didn’t have to hire a bunch of people to run testing centres, vaccination clinics, or contact tracing. Had we not seen a 3-year pandemic, we might wonder what the front-line numbers under the UCP actually would’ve been.

Which brings me to my next chart, clinical staff as a percentage of total payroll.

By the end of the NDP’s first term in office, clinical staff made up a larger percentage of total people on the payroll. In contrast, under the UCP, that percentage has dropped for the last two years in a row. In fact, it dropped so much, clinical staff now make up a smaller percentage of total payroll than what we saw in the last year under the PC government.

Okay, but didn’t you just say that the UCP hired more clinical staff than the NDP had? How can they make up a smaller percentage of the total workforce?

Well, the main reason is in the difference between “other staff” hires.

These include support services workers, such as those working in food services, facilities and maintenance, clerical, and administrative support.

Under the NDP, this number grew by 1,226 during their first 3 years in office, or 4.81%. By the time the UCP had been in office for 3 years, AHD had hired over 3,000 of these workers, an 11.13% increase.

In fact, under the UCP, AHS hired more support services workers than they did clinical workers (3,033 vs. 30,013), despite the fact that we were in a global pandemic for most of that time.

Oh, there’s one more reason.

Over the past 3 years, AHS has hired the equivalent of 74 more managers. During the NDP’s first 3 years in power, the number of managers actually plummeted by 127.

In other words, despite the rhetoric you might hear from UCP supporters, the number of AHS managers under the NDP actually declined. The opposite was true under the UCP.