What Danielle Smith's 2021 pitch to contract out hospital services is all about

The Alberta NDP raised concerns Wednesday about a 2021 video of UCP Leader Danielle Smith speaking at a conference about potential reforms to the health system, with the NDP characterizing it as a "shocking" revelation that Smith plans to sell public hospitals to private operators.

Even if the UCP points to its "public health-care guarantee" — which states that no Albertan will have to pay out of pocket to see a family doctor or to get medical treatment — what was Smith talking about, and what would it actually mean if implemented?

All of this revolves around privately delivered, publicly funded health care, which has existed for years in Alberta. We'll explain all of that in a moment, but let's get into the details of the video first.

The clip in question starts a little more than 30 minutes into her talk at the FreedomTalk conference in October 2021. Smith turns to a discussion of major hospitals in Alberta.

In the video, she laments the arrangement under which Alberta Health Services operates hospitals but also evaluates their own performance. 

AHS has various performance metrics they are required to report on publicly.

"Guess what they say? They say, we're doing fantastic. Now, think about splitting these roles," Smith said. "You give money to Alberta health insurance. It's a separate entity. It's a government entity, so it's publicly administered."

Smith goes on to pitch the idea that the Health Quality Council of Alberta, a provincial agency focused on improving health service quality in Alberta, could serve as a sort of auditor. 

It would determine whether or not AHS should continue to run hospitals like the Peter Lougheed Centre or the Rockyview General Hospital.

"If they can't meet the terms that we want them to, we can do an [request for proposal], and then the Alberta health insurance can give a different contract to a different group of doctors and a different group of patients and a different entity to run all of our hospitals. That is completely compliant with the Canada Health Act," Smith said.

She also said she had presented her plan to Alberta's health minister, who at that time was Jason Copping, but said the UCP government under Jason Kenney at the time did not act on her suggestions.

At a press conference Wednesday, Kathleen Ganley, the NDP candidate in Calgary-Mountain View, called the video "part of a defined pattern of extreme views" from Smith.

"Danielle Smith thinks you can sneak around the Canada Health Act to sell off our hospitals to private individuals and corporations," Ganley said.

It's important to remember that Alberta already has privatized health care, and has for years. There are various publicly funded, privately delivered options.