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It is a message we’ve heard delivered in the past by the premier in no uncertain terms.

Now Adriana LaGrange, heading up health care for the UCP government led by Premier Danielle Smith, sings from the same song sheet.

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In or out. Our way or the highway.

In an interview with Smith around Christmas, the premier spoke of layers and layers and layers of middle managers in Alberta Health Services, an outfit she saw as underperforming for years, pretty well falling short since they were created as a so-called super board 16 years ago.

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Smith campaigned for the UCP leadership vowing to shake up AHS. The old board is gone. The old CEO is gone. Top execs are gone.

Then there are the middle managers. They’re not gone. Yet.

Smith and her government believe some managers are part of the problem and not part of the solution.

Some managers are stuck in their old and now unacceptable ways. Some need to show their value if they want to keep their job.

Those who don’t want to play ball with the Smith government’s overhaul of health care will be shown the door.

LaGrange has been at meetings lately where many attending are front-line health-care workers.

She says every single management position is being given the once-over to see if it’s needed.

“We want to take a surgical approach. We don’t want to take a sledgehammer. We want to keep the really good people.”

As for the others, the not-good people who do exist.

Boy, do they exist.

“Those who are not wanting to move ahead where we need to be in an improved, efficient health-care system, I’m sure there are other opportunities out there in the world for them.

“I’m sure there are greener pastures for them to find.”

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A familiar and polite turn of phrase for take a hike.

A few weeks ago LaGrange mentioned some managers needed to find greener pastures.

The health boss was talking about those who weren’t getting with the new program, the new focus.

“These obstructionists would probably be happier somewhere else,” LaGrange said at the time.

Out well beyond the legislature in Edmonton, the Alberta health minister says workers tell her they are “stymied” by “a heavy bureaucracy.”

“They are frustrated because the bureaucracy doesn’t allow them to do their job at the best of their ability.”

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One manager told LaGrange she had no clear job description and never had an evaluation.

“She felt a bit left out there to her own devices.”

No kidding.

A site manager spoke of needing a new hospital bed because one was broken.

“It had to go up seven levels of bureaucracy to get an approval only to come back down the seven levels after months and months of waiting only to find out the seventh person said no, go ask the hospital foundation to fund it,” says LaGrange.

“That’s ridiculous.”

The health minister finds some things “mind boggling.”

At one Edmonton hospital LaGrange is told of 27 patients who had their treatment but were stuck in hospital beds because they don’t have their taxes done so they couldn’t qualify for other services.

Just at the one hospital there was one patient “languishing in a bed” over 200 days.

“It has taken quite a long time to get to where we are. Obviously the reason for re-focusing is because AHS has lost its way.”

LaGrange adds health-care workers are telling her this sorry state of affairs is not something new.

“It has been an ongoing progression to this point. They saw the deterioration well over a decade ago and it’s just progressively gotten worse.

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“We want accountability. We want people in positions of management to be accountable for the decisions they make. We want to see improvement.”

LaGrange says if the Smith government needs to pivot, it will pivot. If those on the front lines say things need to be done differently the government will react in a serious way.

“We are definitely serious. There are really life and death situations and we have to remember that.”

LaGrange acknowledges there are those who will hear her words and are skeptical, to say the least.

The opposition NDP is out this week telling us once again how public health care is crumbling and how the Smith government is failing.

What does the health minister have to say about that?

She has little time for those she says “complain and are all gloom and doom.”

“If you’ve got something positive to contribute, then be part of the solution.”

rbell@postmedia.com

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