Politicians in the Alberta legislature voted Monday to keep the same referee as they prepared for what is expected to be a raucous spring sitting over proposed changes to health care.

Ken Kowalski, a member of Premier Ed Stelmach's governing Progressive Conservative government, was elected Speaker by a majority of legislature members in the assembly.

"This is an honour that I truly and humbly accept,'' said Kowalski as took the dais and put on the traditional black robe and tricorne hat.

After his win was announced, members gave him a standing ovation as he was ceremonially dragged by Stelmach and opposition Alberta Liberal Leader Kevin Taft to the high-backed, mahogany chair at the head of the chamber.

The mock frog-march is a historical tradition to reflect the myth, which began 15th and 16th century England, that such a sensitive post could bring harm or death.

"Say no, Ken!'' shouted one government member.

It was his fourth consecutive victory and came 11 years to the day after he was first elected to the post.

He defeated Edmonton Liberal Laurie Blakeman, who said she wanted to end the unbroken string of men who have held the post since Alberta became a province 103 years ago.

"I certainly had a lot of feedback throughout Alberta, about why it was important to do that to encourage women that it's possible,'' she said.

Wayne Cao, a Calgary Tory member, was elected deputy speaker.

Vote totals were not released and the balloting is done in secret to reflect the fact the post is a non-partisan one.

The speech from the throne by Lt.-Gov. Norman Kwong on Tuesday formally opens the 27th session of the legislature. It will outline government priorities for the sitting.

Legislature business begins Wednesday and the provincial budget is to come down on April 22.

Also Wednesday, newly appointed Health Minister Ron Liepert is expected to roll out proposed changes to the $13-billion system that now eats up one dollar in three in government spending but still struggles with long wait times and shortages of doctors and nurses.

Liepert hasn't made clear what his reforms will be, but has suggested he may reduce bureaucracy by streamlining Alberta's nine regional health boards.

He wouldn't elaborate Monday or respond to reporters' suggestions that the secrecy means he might be "springing a trap'' on Albertans.

"Why don't we wait til Wednesday rather than fear-mongering on Monday,'' he said.

The opposition noted that Stelmach didn't run on a platform of radical health-care change when his Tories captured 72 seats in the 83-seat legislature last month.

"I think we're going to see a real hot and heavy session, and a lot of it's going to be on health care,'' said Taft.

The solutions are training more doctors and nurses, he said, not privatization or delisting services currently covered by the public system.

Health reform has been a political graveyard, even for Tories such as former premier Ralph Klein, who enjoyed overwhelming majorities and high personal popularity.

A bill under Klein to privatize aspects of the public health system led to protest demonstrations and one near-riot that saw the outside of the legislature vandalized. A second Klein attempt to find a cost-saving middle ground, known as the "Third Way,'' was also scrapped.

Given the session is starting later in the spring due to the election, government house leader Dave Hancock said there's lots of work to do.

"I'm not saying to any of my colleagues that they should plan anything (for vacations) before the end of June and that they should probably clear their agenda for October, November and early December,'' he said.

The government has said its flagship Bill 1 will be to finalize the trade deal with British Columbia to reduce red tape on cross-boundary business and employment issues.

Known as the Trade, Investment, and Labour Mobility Agreement, the deal was struck two years ago and has been followed up by a number of memoranda of understanding.

The deal allows goods and services to travel seamlessly over the boundary and enables business licences and certification programs for professionals to be recognized in both jurisdictions simultaneously.

The deal comes fully into effect a year from now.

NDP Leader Brian Mason has been clamouring for a debate on the deal, saying that while it may open doors, it may also lower standards for workers.

"The concern is it's really a race to the bottom,'' he said.