A panel reviewing Alberta’s COVID-19 response is calling for legislative changes to ensure the province’s premier and cabinet have the last word in future crises, with help from a new senior science officer.
Former Reform Party leader Preston Manning, who chaired the panel, says a senior science officer could create a roster of experts from medicine, social sciences, psychology and law to advise on decisions and their potential effects.
The report has more than 90 recommendations on how the province can better prepare rules, regulations and its organizational structure.
“The hope is to improve the capacity of the province to respond to any future public emergency — not just health emergencies — but any provincewide emergency,” Manning said.
He said Albertans were negatively affected by the pandemic — their health, of course, but also the economy suffered, unemployment rose, children saw learning and socialization losses. Health workers and teachers were put under enormous strain, he said.
“This report is intended to try to make sure that those stresses and negatives do not occur the next time there’s a provincewide public emergency,” Manning said.
The core recommendation is that all provincewide emergencies are to be directed by cabinet and implemented through the Alberta Emergency Management Agency.
In future pandemics or health crises, Alberta Health Services would be called on to make recommendations related strictly to health matters, but government would make all decisions through the emergency agency.
The report urges the government to spell that out in new legislation.
Lorian Hardcastle, an associate professor in the faculty of law at the Cumming School of Medicine at the University of Calgary, noticed two big themes from the report.
“It recommends that authority for public health decision-making shift from the chief medical officer of health and scientists and into the hands of government. It would be a centralization of power in the hands of government,” she said.
“It pays a lot of lip service to ideology.
“It stresses the importance of individual rights without a lot of discussion of how those individual rights need to be balanced against the collective good and the public interest during an emergency of this type.
“If these recommendations were implemented, it would be difficult for the government to protect hospital capacity, to protect vulnerable people and to curb the spread of infection,” Hardcastle added. “I think the focus on individual rights would make that very hard.”
In a statement Wednesday, Premier Danielle Smith said no decisions have been made yet.
“In January 2023, we established an expert panel to review the legislation and governance practices used by the Government of Alberta during the management of the COVID-19 public health emergency and to recommend changes necessary to improve government response to future health emergencies,” she said.
“Today we received the panel’s report. We thank Preston Manning and the panel for its work and the many Albertans who shared their thoughts and experiences.
“At this time no decisions have been made in response to the recommendations.
“Together with our caucus, we will review and analyze the report and consider the panel’s recommendations as we prepare for future legislative sessions.”
In a news release, the government pointed out that the mandate of the panel was not to conduct “an overall inquiry into the government’s response to COVID-19, but strictly to review the statutes that provided the legal basis for the government’s response.”
Manning encourages Albertans to read the full Public Health Emergencies Governance report and give their feedback.
“The whole intent of this is to get amendments to Alberta’s laws that would better equip the province for the next emergency, whatever that is,” he said.
The panel’s recommendations include:
- Legislate that preliminary, interim and post-emergency impact assessments be conducted in response to any future provincewide public emergencies;
- Reject provincewide school closures as a policy option in responding to public emergencies, except in the most exceptional circumstances, and then only for the shortest possible period;
- Amend the Alberta Bill of Rights and Alberta’s Employment Standards Code and Health Professions Act to protect the rights and freedoms of all Albertans, including workers and health-care professionals, and the freedom of expression during public emergencies;
- Increase the overall capacity of Alberta’s health-care system.
Manning said the panel made its recommendation on school closure policy after looking at evidence and weighing the pros and cons.
“Looking at the impacts of the school closures — and this has been done in other countries as well — that there were these learning losses when you shift from in-school to online, at-home learning. There are socialization losses. In fact, some experts say those are even more serious than learning losses because they’re harder to make up,” Manning said.
“Our conclusion is that the negatives from school closures outweigh the benefits and that ought not to be considered a policy option unless under very unusual circumstances and even in that case, only in the shortest period of time possible.”
On the health system side, Manning said experts stress there must be surge capacity to cope with increased demand.
“During this year, the government has done a number of things in this area. We acknowledge those — we put a list of things the government has already done, incremental changes to the system — and then we list another 10 incremental changes that could be made to increase surge capacity.”
The panel put forward suggestions:
- Expanding the use of nurse practitioners and licensed practical nurses.
- Reducing or eliminating barriers to labour mobility for health-care workers.
- Exploring options for attracting more health-care providers into medical training.
- Incentivizing medical graduates to serve in the most needed areas.
- Utilizing pharmacists to their full scope of practice.
- Expanding and improving the organization of home care services.
- Expanding the capacity of the Alberta health-care system to deal with mental health.
- Expanding and supporting the use of virtual medicine and telemedicine.
- Streamlining system administration.
According to Hardcastle, increasing health-care capacity is just part of the equation. The report doesn’t consider the other part, she says.
“We do need to improve on our ability to have surge capacity in an emergency. However, the other side of that equation is that government has to do its part to limit demand for that capacity.
“When hospitals are struggling, they can’t just be made to continue to find an endless number of beds to meet demand. The government has to do its part to try to curb the spread of the disease so more and more beds aren’t needed.”
Manning’s panel recommendations urge reforms and changes to Alberta’s Bill of Rights, along with other laws, to ensure personal freedoms are better protected in a crisis. If liberties must be curtailed, it calls for mandated cost-reasonable fast-tracked court challenges.
It urges the government to work with health regulatory bodies to ensure medical professionals are not unreasonably curtailed from speaking their minds should they disagree with government or regulatory policy in a health crisis.
It calls for more transparency in government decisions, along with mandated reviews.
Hardcastle thinks the emphasis on transparency is positive.
“During COVID, we often didn’t know who was making decisions, why they were making them. But these recommendations would push the government towards more transparency around why it’s implementing particular measures, which I think would be a good thing,” she said.
The report also urges changes to the Employment Standards Code to provide for leaves of absence for non-compliant employees during a public health emergency.
“If the employer, for example, makes continued employment or re-employment conditional on the employee conforming to a health order or regulation, and even says: ‘We’ll fire you if you don’t comply,’ we tried to change that or recommend changing that,” Manning explained. “Firing somebody is a permanent thing to deal with a temporary situation.”
In July, a Court of King’s Bench judge determined the province ran afoul of its Public Health Act when then-chief medical officer of health Deena Hinshaw improperly deferred some of her public health COVID-19 decision-making authority to cabinet.
Justice Minister Mickey Amery introduced a bill earlier this month to explicitly grant that authority to cabinet.
Hardcastle says that decision — and the report — align with others this United Conservative government has made recently.
“For example, there’s been announced a restructuring of Alberta Health Services and the health-care system that would put more power in the hands of government. Bill 6 has been introduced in the legislative assembly, which would shift power in a public health emergency from the chief medical officer’s hands to the hands of cabinet.
“It seems this is a government that plans to be very hands-on when it comes to public health and the health-care system more generally,” she said.
Smith launched the Public Health Emergencies Governance review in January and appointed Manning to chair the panel. He was given the ability to pick the other panel members, subject to approval by the premier.
The other panelists were Michel Kelly-Gagnon, John C. (Jack) Major, Dr. Jack Mintz, Dr. Martha Fulford and Dr. Robert Tanguay.
The panel’s budget is $2 million, and Manning is to be paid $253,000.
This is the second time Manning has been involved in a COVID-19 inquiry.
Last November, he announced plans for a citizen-led and funded cross-country inquiry into the effects of Canada’s response to the pandemic.
Polak said Manning would step aside from his role at the National Citizens Inquiry to avoid any conflict of interest.
Manning and Smith have been critical of government-imposed health restrictions such as masking, gathering rules and vaccine mandates during the pandemic.
Smith has questioned the efficacy of the methods and their long-term effects on household incomes, the economy and mental health. She has promised health restrictions and vaccine mandates will have no role in any future COVID-19 response in Alberta.
Opposition NDP Leader Rachel Notley called the panel’s report “incredibly irresponsible.”
She said it is an “invitation to normalize conspiracy theories and pseudo science at the expense of evidence-based medical care. So that’s very, very concerning to me.
“That is not good news for Albertans. That’s not good news for our safety and and the quality of our health care,” Notley added.
The NDP leader said the recommended amendments to Alberta’s Bill of Rights are “about putting the right of individuals over the right of the community as a whole.
“So that you could literally have somebody assert that right to refrain from getting a vaccination and then walking on in to an intensive care unit full of people with extremely compromised immune systems and doing their thing because: ‘That’s their right.'”
Hardcastle thinks independent inquiries and their recommendations can be valuable.
“But I think the focus of this report ultimately makes it money not well spent.
“While some of the recommendations are important and should be implemented, a lot of it is just ideology and pushing a particular view point of the pandemic,” she said.
Pointing to inquiry reports that followed SARS and the tainted blood scandal, Hardcastle said the Manning report isn’t unbiased.
“I think those reports did a much better job of being objective in their tone, objective in who they included in their composition, in terms of what experts they consulted. And this report really doesn’t do this. This report almost seemed to have conclusions before it actually did its investigation.”
Since the recommendations have not been implemented, Hardcastle says now is a good time for Albertans to read the report and let their MLAs know which suggestions they support and which they don’t.
And, on Wednesday, Manning defended against implications that he came into this assignment with a bias.
“The scientific approach is you look at the evidence first and then you come to your conclusion,” he said.
–With files from Dean Bennett, The Canadian Press
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