Smith and UCP begin selling health care overhaul to supportive rural leaders, skeptical professionals

Alberta's premier told a ballroom full of rural leaders "I love you all" Thursday morning as she received a standing ovation at the Edmonton Convention Centre.

Danielle Smith had just spent roughly 30 minutes at a microphone in front of councillors, mayors and reeves at a Rural Municipalities of Alberta (RMA) gathering.

She skewered the federal government over the carbon tax, stood behind her six-month ban on renewable energy projects and sold her plan to completely restructure health care.

"I’ve actually never felt more heard by a government than this government that we have right now," RMA president Paul McLauchlin told the crowd.

"You guys are really the heart of this province, and I just love you all. So thanks for the work that you do," Smith said to applause.

A major theme of her speech was the health care shakeup announced the day before.

The changes will see Alberta Health Services split up with four organizations each taking responsibility for acute, primary, continuing care, and mental health and addiction.

"You’re going to get more accountable, more flexible health care networks with no changes to public healthcare or any cuts to frontline services," Smith promised in her speech.

Rural communities across the province are facing similar health care concerns, including a shortage of doctors and nurses leading to closed facilities, long wait times for paramedics and difficulty accessing specialized treatment.

"Solutions should be determined by common sense, by conditions on the ground, and by what the people affected really need and what they want, not by wishful thinking or ideology," Smith said.

The premier appears to have found an ally in McLauchlin, and some others at RMA, who feel the current health system simply isn't working properly.

The RMA president believes AHS is too large and the changes will lead to more decisions being made at the local level.

"This isn’t talking about eliminating the issues, it’s talking about taking the problem-solving machine closer to the problem," McLauchlin said.

'IT’S NOT ADDRESSING THE ISSUES': NDP

But the NDP Opposition is not joining the applause, insisting the restructuring of health services does nothing to attract more staff to small communities.

"It's about blowing up public healthcare," agriculture and forestry and rural economic development critic Heather Sweet told reporters.

"It’s not addressing the issues that we’re hearing from municipal leaders in rural Alberta about the fact that they have no access to doctors, that there are no registered nurses and no nurses available in their local community."

The province was also met with skepticism and a lot of questions from health-care workers during the first of a series of town hall meetings.

"Have you engaged with patients in the development of this model?" one asked.

"The notification said many staff will stay under AHS. Who will not?" another wondered.

Health Minister Adriana LaGrange insists the plan will create less bureaucracy.

"One of the guiding principles of the healthcare refocus is to prioritize healthcare workers' well-being and listen to their expertise," she wrote in a statement.

But the vice-president of United Nurses of Alberta is worried the changes will bog down an already struggling system.

"Layering on additional bureaucracy during this critical time will likely lead to a delay in the kind of action we need," Danielle Larivee said.

Larivee, also a former NDP MLA, worries the plan could result in workers leaving Alberta and says it does nothing to help patients in the short term.

"The health care system is not guaranteed to be there for you and your family when you need it. We desperately need action," she said.

'TRUST IS ALMOST ZERO': AMA

Alberta Medical Association president Dr. Paul Parks said more staff is needed, and fast.

"Words are only worth so much. Now we have to show some action, now we have to actually really do some work together," he said of the province's plan.

"Morale is really low. Fatigue is really high. And trust is almost zero."

But there is no funding for more doctors or nurses in the province’s health care reforms, instead a plan to enhance the role of nurse practitioners (NPs).

"We are going to allow NPs to set up their own practices and bill the province directly. I don't think any province has that model," Smith said on Wednesday.

The president of the Nurse Practitioners Association of Alberta is excited for the new role NPs will play but wants clarity around pay.

"We've been advocating for quite a long time to allow nurse practitioners to support Albertans in accessing proximity care," said Dr. Susan Prendergast.

There are currently 853 NPs working in the province with up to 100 graduating in the spring.

NDP leader Rachel Notley said more frontline staff is needed but worries how the province will attract them.

"Quite frankly, saying to healthcare workers across the country, 'Hey, come to Alberta, we have no idea how this is going to work,' isn’t putting our best foot forward," she said.

The province will hear from more health-care workers with the next town hall scheduled for Tuesday.

With files from CTV News Edmonton's Jeremy Thompson and Chelan Skulski and CTV News Calgary's Bill Macfarlane and Tyson Fedor