Alberta Premier Danielle Smith’s 2024 was a year of following through on her promises — from health-care reforms to support for the oil and gas industry — even as her opponents fought her ideas.
In a year-end interview at the legislature in early December, Smith reflected on a few pressing issues.
The Alberta government’s next steps, she said, will be revealed in the provincial budget, set to be tabled on Feb. 27.
This interview has been edited for length and clarity.
International relations
After U.S. president-elect Donald Trump threatened a 25 per cent tariff on Canadian goods, you supported his concern that the Canada- U.S. border is too porous to drugs and migrants. Can you elaborate on your position?
The issue we face in Western Canada is clearly the drug overdose problem, and it’s gotten even more acute post-COVID-19. Product is coming in from British Columbia and then finding its way down into the United States through Alberta, or precursors are coming into Alberta and then finding their way back into the United States.
We identified this problem years ago. Mike Ellis, my public safety minister, had already begun the process of training up a team of sheriffs that could be deployed for border patrol and addressing the fentanyl issue. It just seemed like, yup, this is a problem. That’s a problem for us. It’s a problem for the Americans. Let’s solve it.
Protecting Alberta from outside interests
You have expressed concerns about Ottawa imposing on Alberta’s jurisdiction; some people perceived Trump’s tariff messaging in the same vein. How are you protecting Alberta’s interests from foreign governments?
We’ve made no secret about our disappointment with the federal approach to addressing the issue of drug overdose and crime. They brought through a bill that created a revolving door of criminals and we’ve been working on trying to get that tightened up. It hasn’t worked.
We also vehemently oppose their approach on safe supply. We don’t think that the way that you get people off drugs is to put more high-powered opioids into the market.
I’m glad that the federal government is now beginning to see that there are consequences to the policies that they’ve adopted. Now they have to align with the things that we want to do to preserve our trade relationship — which is the most important trade relationship, probably, on the planet.
What I think we can do in Alberta is talk to the Americans about how we jointly benefit from our cross-border trade. We can use oil and gas as a point of leverage to say, because of this strong relationship, all Canadian goods should be tariff-free.
Reforming the health-care system
You’re restructuring Alberta Health Services with a goal of improving care. How did you get to the idea of restructuring AHS by function?
It came from looking into the system and trying to figure out what is the core business that Alberta Health Services is supposed to be delivering. And the answer was, everything. And if everything is your core business, then it’s really hard to get a focus.
We just kept finding little problems that were occurring because there wasn’t dedicated interest in each of these different aspects of health care. We wanted Alberta Health Services to focus on hospitals. They should deliver the very best acute care because they manage the bulk of our hospital facilities.
So, who’s going to deal with the doctors and the nurse practitioner contract, and pharmacy? A lot of that was already in the [provincial health] department. But some of those functions had to be brought into the new entities.
The plan would create four agencies responsible for primary care, acute care, continuing care, and mental health and addiction. Do other jurisdictions divide it up that way? What did they achieve?
A lot of hospitals have become the only door that people can enter into our system.
If Alberta Health Services manages everything, all of that comes into the hospital. And so you have people who have very complex needs, [such as] seniors with mental health issues, maybe even addiction issues. This is the most expensive bed that they’re in — a $2,500-a-day bed.
Patients need to have care in the right place, by the right practitioner. And that’s why we’re dividing it into the four service provision areas. I think that our staff within Alberta Health Services will be much happier in returning the hospitals to their original function, which is that acute care function.
Listening to Albertans
Your supporters love that you take the time to listen to them. How do some of their concerns go on to become government policy?
Since I completed my economics degree, I got into property rights advocacy, then became a business advocate, advocacy journalist, as well as a talk show host and TV show host. And you just talk to hundreds of people who have good ideas.
Our process is to listen to everyone. We believe that the private sector creating good jobs is good for everybody because it creates tax revenue for us to care for the most vulnerable.
Premier Danielle Smith says convincing Americans of their dependence on Alberta oil and gas is the key to staving off U.S. president-elect Donald Trump’s tariff plan. In a year-end interview, Smith also says she’s restructuring Alberta Health Services in an effort to keep people who don’t need urgent care out of hospitals.
We recently announced our [artificial intelligence] data centre policy. That was something that I wasn’t even talking about two years ago. People kept asking us whether there would be an appetite for this. My minister put together a working group of seven or eight other ministers to figure out the different pieces of it — municipal taxes, energy, electricity, gas, water and cooling location — and it culminated in a policy.
When you hear from enough people that there’s an issue that needs provincial attention, we give it the attention, so that we can get the best answers and move quickly on implementing them.
