AHS plans to axe 1 in 10 contract health workers

In a memo recently circulated to Alberta Health Services senior leaders by Michael Lam, the agency’s chief financial officer and acting vice-president of corporate services, told these managers that he expects that agency staffing levels in all areas have to be reduced by at least 10%.

I have included a copy of the memo, which was provided by the United Nurses of Alberta, at the end of the article.

Lam starts off his memo by warning the senior leaders that AHS is forecasting a budget deficit for the 2023–2024 fiscal year, which ends at the end of March.

He immediately tells them that “Action is required to continue to meet our high standard of care and realize a balanced result”, and then lists four strategies to reduce spending so they can reach that goal.

Because the solution to a balanced budget is always reduce spending and never increase revenue.

Anyhow, the fourth strategy is the one I’m going to focus on in this article.

We’re reviewing all organizational initiatives to determine if they should be slowed or paused, as well as management strategies around the use of overtime and agency stalling. All non-clinical overtime requires Vice President or ELT leader approval, and all areas are asked to monitor and implement strategies to reduce the use of overtime and agency staffing in their areas by at least 10 per cent, while minimizing impacts to frontline service delivery.

It’s that last part that I’m referring to: “reduce the use of overtime and agency staffing in their areas by at least 10%”.

Agency staffing refers to health care workers who AHS contracts out when they need more workers but haven’t hired enough.

When I first read it, I thought they just wanted to reduce overtime by 10%, which I thought was great. After all, overtime is often accumulated because services are understaffed, so potentially this could mean that Alberta could see an increase in healthcare workers.

But when I read it a second time, I noticed that they wanted to reduce overtime by 10%, as well as reduce “agency staffing” by 10%.

And remember, that’s a minimum. They welcome higher cuts to overtime and staffing.

So, now I’m confused.

As I stated, the easiest way to reduce overtime is to increase staffing levels. If you have more people available to cover shifts, then you have less of a need to ask someone to work more hours than scheduled.

But if they’re asking “all areas” to reduce agency staffing levels by at least 10%, how will that work? If having insufficient numbers of workers is the primary driver behind overtime, then wouldn’t having even fewer workers increase the need for overtime?

How can you fire 1 in 10 contract workers, thereby increasing pressure on the other 9 to take on more hours, yet also expect there to be less overtime? Are you going to close down emergency departments or something? Oh, wait.

Because the only way I can see AHS managers being able to reduce overtime while also firing workers is to reduce service delivery.

Alberta nurses have spoken out against this directive from AHS leadership in a statement they published on their website earlier this week.

David Harrigan, labour relations director for United Nurses of Alberta, in a letter to Leland McEwan, the executive director of labour relations for AHS, compared this reduction to overtime and staffing level to “lighting a match in a powder keg”.

Harrigan warned McEwan that if AHS follow through with these actions, it will lead to “more burn-out and sick time among front-line staff and will undermine efforts to retain and recruit front-line health care employees”.

UNA President Heather Smith echoed Harrigan’s apprehensiveness, calling the proposed actions “a prescription for driving nurses and other health care workers out of the province and out of the profession”

Smith also shared my doubts about whether the pay and job cuts can occur “while minimizing impacts to frontline service delivery”, which is what Lam asked the senior managers to do, as indicated in the quote I included earlier in this article.

“It’s all very well to talk about minimizing impacts to front-line services, but this simply cannot be done while cutting emergency staffing and overtime by 10%.”

UPDATE: An earlier version of this story implied that the cut was to all healthcare workers. I’ve since updated it to make it clearer that the staffing cuts are directed at contracted workers.