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Danielle Smith’s anti-expert crusade will crash Alberta’s health-care system

New Alberta Premier Danielle Smith has already pledged to replace Dr. Deena Hinshaw, the province's chief medical officer of health. Photo by Chris Schwarz/Government of Alberta via Flickr (CC BY-NC-ND 2.0)

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In advance of Donald Trump’s inauguration in 2017, the New Yorker ran one of its signature back-page cartoons poking at the anti-elite fervour that helped propel him to office. “These smug pilots have lost touch with regular passengers like us,” says a man standing up from his seat in front of a sea of raised hands. “Who thinks I should fly the plane?”

It’s a picture that says at least a thousand words about the perils and problems with populist leadership, and one that should be particularly resonant — and terrifying — for Albertans right now.

That’s because in conversation with Derek Fildebrandt, a former Wildrose Party MLA and publisher of the latest iteration of the Western Standard, Premier Smith made it clear that when it comes to health care and the pandemic, her government would be listening to the passengers instead of the pilots. "I think that the experts let us down, so I'm not interested in taking any advice from them,” she said.

Those experts, to be clear, are at Alberta Health Services, the government organization, which manages the province’s hospitals and health-care facilities that helped steer the province through the first two years of the COVID-19 pandemic. Smith has already pledged to fire the entire board of directors, replace chief medical officer of health Dr. Deena Hinshaw and seems determined to press ahead with even bigger changes in the months to come. “It's going to be a bit bumpy for the next 90 days,” Smith said Thursday in a speech to the Edmonton Chamber of Commerce. “I know that it's perilous to try to reform an area this big this close to an election, but we must do it.”

There were undoubtedly some mistakes made over that period, as Alberta’s health-care system nearly buckled under the weight of unvaccinated patients and a government that seemed determined to wait as long as possible to implement public health measures. But Smith’s biggest complaint seems to be that AHS doctors and other medical experts didn’t look hard enough at crackpot theories around hydroxychloroquine and ivermectin — failed treatment options she pushed hard as a pundit at the time. “I don’t want to have a scientific committee advising me that isn’t prepared to look at therapeutic options in the middle of the pandemic,” she told Fildebrandt.

Alberta Premier Danielle Smith has said that when it comes to health care and the pandemic, her government will ignore the experts and instead listen to ordinary people. @maxfawcett writes for @NatObserver #COVID #pandemic #Alberta #abpoli #opinion

The truth is that the scientific committee advising her predecessor, Jason Kenney, looked hard at her preferred treatment options and found them wanting. In an October 2021 analysis of the medical merits of ivermectin, the government’s COVID-19 therapeutics working group concluded that “there continues to be insufficient evidence of benefit.” It also noted that the drug’s manufacturer, Merck, had stated there was “no scientific basis for a potential therapeutic effect against COVID-19” and “no meaningful evidence for clinical activity or clinical efficacy in patients with COVID-19.”

This was in the wake of a joint statement released a few weeks earlier by the Alberta College of Pharmacy and the College of Physicians and Surgeons of Alberta that stated: “There is no evidence that prescribing and dispensing ivermectin is beneficial but there is certainly significant risk of patient harm when ivermectin is used in the prevention and treatment of COVID-19.” But apparently for both then-pundit and now-Premier Smith, the work of those experts pales in comparison to what Dr. Facebook is saying.

It gets worse, though. In her talk with the Western Standard, Smith again brought up one of the conservative movement’s most popular whipping horses: the World Economic Forum. She suggested AHS “signed some kind of partnership with the World Economic Forum right in the middle of the pandemic; we’ve gotta address that. Why in the world do we have anything to do with the World Economic Forum? That’s got to end.”

What she appears to be referring to is an invitation from 2020 for AHS to join the “Global Coalition for Value in Healthcare.” That coalition asks its members: “How can we eliminate the US$3.2 trillion of annual global health spending that makes no or minimal contribution to good health outcomes?” For a government that’s supposed to be interested in finding efficiencies and cutting red tape in the health-care system, this would seem to be an unalloyed good. But for someone who routinely flirts with conspiracy theories like Smith, it’s apparently yet another reason to take a knife to the province’s already wounded health-care system.

This reflexive enmity towards experts, and particularly those working in Alberta’s health-care system, isn’t going to end well for anyone — including Smith. Expertise doesn’t confer immunity against being wrong, just as the COVID-19 vaccine doesn’t make you incapable of getting sick. But its presence does dramatically reduce the odds of something catastrophic happening, and that’s something a political leader is supposed to care about.

Remember, Alberta is in a pitched battle for health-care talent with every other jurisdiction in Canada. Does anyone seriously think that doctors and nurses are going to want to come to a province where its leader is openly contemptuous of the expertise they spent years building? And if Alberta can’t attract those doctors and nurses, how is it going to improve health-care service delivery, which Smith states is one of her top priorities? Those are questions that an expert could help her answer — if only she was willing to listen.

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