Alberta’s health minister has an unconscious habit that emerges when he’s preoccupied.
Tyler Shandro runs his hands through his hair when something is stressing him. It often results in a little tuft defying its original horizontal position, reminiscent of Tintin. When he notices, he quickly pats it back in place.
That routine repeats itself often these days.
The minister is standing beside the large boardroom table in his legislature office, hands clasped, as the hum of staff fills the bureau. Then he reveals another coping mechanism.
Shandro drops a Monty Python joke and the office erupts into boisterous laughter. The minister rears his head back as he joins in.
It’s a side of him the public rarely sees. Between the ongoing pandemic, disputes with doctors and his own personal gaffes, this portfolio and this minister have had a challenging year.
Those challenges aren’t going anywhere.
Shandro, 44, had been health minister for less than a year when Alberta confirmed its first case of COVID-19. The province is now reporting its highest numbers yet, with a seven-day daily average of 485 new infections.
Many political leaders across the country have enjoyed a significant popularity boost in the polls during the pandemic, but not here.
A recent Angus Reid survey found three out of five Albertans think the health file is being managed poorly, and only 56 per cent think the government has done a good job handling COVID-19.
Shandro chalks the dissatisfaction up to the general anxieties felt in the province.
“Throughout the pandemic, as well as dealing with the downturn in the economy, it’s been really tough on families. And so I think that’s a big part of it.”
The pandemic is only one difficult chapter in Shandro’s saga as health minister.
In the past year, he’s sparred with numerous stakeholders, municipal leaders and doctors about changes he’s making in the portfolio. Some of the most recent contentions have been eliminating and outsourcing 11,000 AHS positions and combining EMS dispatch services.
Controversy hasn’t just stemmed from the decisions themselves, but the manner in which they’ve been implemented.
Shandro has been peppered with calls to resign, many connected to the battle over physician compensation changes.
In February, the province tore up its agreement with the Alberta Medical Association (AMA) and imposed a new pay framework. Meetings between the two sides are continuing, despite months of terse exchanges. The minister still hopes a deal is possible, though no one is putting money on when it might happen.
The ministry says it has two goals: Predictability and stability. It’s phrasing Shandro uses effortlessly and repeatedly.
The government says the changes to doctors’ pay will head off $2 billion in cost overruns in the next three years, at a time when the province already has a deficit of $24 billion.
This year’s provincial budget pledged $20.6 billion for health care. The largest portion of that spending, about $5.4 billion, goes to physician compensation.
“I’m quite happy to have that conversation with the AMA so that our doctors can come back and tell us what budget management might look like,” Shandro says.
He has a personal connection to this file as well, as the son of a doctor.
But the AMA is no fan of Shandro. A survey of its members reported that 98 per cent of respondents had no confidence in the minister. The organization has said Shandro’s approach to this dispute has been an impediment to reaching a deal.
Some doctors have threatened to leave the province in protest. At one point, AHS was tracking more than 160 doctors deemed “high risk” to leave. The minister’s office says only about a dozen have followed through so far.
“We continue to see more and more physicians on a year to year basis continue to bill the system, coming to Alberta, because this is a great place to be able to serve patients,” he said.
There are 246 more doctors in Alberta now compared with this time last year, according to the College of Physicians and Surgeons of Alberta. However, it cautioned the full picture of gains and losses won’t be clear for several more months because of how the registration cycle works.
The afternoon sun coming into the office reflects off a set of picture frames, encasing the smiles of his wife and two adolescent sons. He softens immediately as he glances over.
“I scored way above my league,” he says with a smile.
It’s another glimpse at the other side of this minister, who has been called antagonistic on several occasions.
Shandro is more at ease in a familiar setting. A self-described introvert, his office is a refuge from the sustained pushback he receives. He defaults to his ministerial training in public; more careful and deliberate, though still not one to back down from a fight.
He berated a doctor in his driveway after the man posted a meme targeting a company in which the Shandro family has shares.
The minister once threatened to call legislature security on someone.
Another time, he asked AHS for the phone numbers of two doctors who had protested at an event he attended, then called both doctors after hours. Most recently, a Calgary city councillor said he was confrontational during a phone call about EMS dispatch amalgamation.
The minister smirks slightly as the topic is raised. He was expecting this.
Shandro says his responsibility as a minister is answering questions and addressing the concerns of Albertans. He says that’s how he approached those encounters.
“That’s who I am. And I’m not going to apologize for that.”
He remembers the troublesome interactions differently than his counterparts on the other ends of telephones and driveways.
“I know that those characterizations are not accurate of the way in which those conversations went and I’m going to be responsible for what actually happened.”
Between COVID-19, doctor disputes and personal blunders, there hasn’t been a lot of time to devote to what Shandro says is his preferred part of the portfolio: seniors health.
Continuing care isn’t part of the checklist bestowed on him by the premier, but it’s a personal priority for the minister.
“Continuing care was a part of the health system that had so often been overlooked,” Shandro said. “For us to be able to improve continuing care for those residents, I think it’s one of the parts of the job that I’m so excited to be able to continue to work towards.”
He pauses when asked what he wishes he’d done differently as minister.
“I think I’ve been incredibly proud of the work we’ve done to date,” he says.
The UCP government has been busy, tabling bill after bill, keeping the legislature sitting late into the night and checking off election promises.
Many of those choices have had mixed reception. Many of them reside within the ministry of health.
There are still many months before the next provincial vote, but this minister illustrates two broader hurdles to this government’s re-election: Declining popularity and the consequences of decisions made during the pandemic.