Stephen Lockwood, the chair of Alberta Health Services, took the defiance a step further by suggesting Premier Alison Redford's government is suppressing financial details of his organization.
He also criticized government's Tuesday announcement to review the governance of all boards, starting with AHS.
"We're talking about autonomy and integrity," Lockwood, speaking from Calgary, told reporters on a conference call after the board affirmed its decision made earlier this year to pay out the $3.2 million in bonuses for the fiscal ending March 2013.
"It's about the ability of AHS to operate independently from government, and our ability to make operating decisions that we believe are in the best interests of providing quality health care.
"For us to govern effectively, there must be separation between us and government."
He noted bonus pay is eliminated going forward.
Just hours earlier, Horne issued a public statement urging the board reject the bonuses, given that the government is tightening its belt and that doctors and teachers are dealing with wage freezes.
"I think Albertans have had a lot to say about this. I know our premier has. I know our cabinet colleagues have," Horne said outside a cabinet meeting in Lethbridge.
"I have taken the step today of issuing a directive to Alberta Health Services requesting that they revisit this decision and advise me of the outcome."
The board's decision illuminated the long-standing, fuzzy line where the authority of Alberta Health Services, or AHS, ends and the authority of the health minister begins.
AHS was created as an arm's-length agency to deliver day-to-day care in hospitals and clinics to ensure the best decisions are made free of political influence or partisanship.
However, the board still must ultimately answer to the health minister; if the board answers to the public through the minister it's not independent, but if it's truly independent then it becomes a panel of unelected people spending $37 million a day with no accountability.
Opposition Wildrose Leader Danielle Smith said taxpayers are now reaping the result of that dysfunctional construct.
“Health Minister Fred Horne has officially lost control of Alberta’s public health-care system," said Smith.
"The decision by Alberta Health Services to ignore his weak directive to reconsider pay-at-risk for executives shows a fundamental failure of leadership and calls into question just who is calling the shots in the health-care system."
Smith said Horne has no choice but to rescind the bonuses or fire the board.
“There is simply no way the unelected and unaccountable health superboard should be able to hold millions of tax dollars hostage by awarding undeserved bonuses to executives," said Smith.
Also on the conference call, Lockwood addressed the new review of AHS governance — he called it redundant.
He said a government report was completed on that late last year but never released.
"We've been through that process," said Lockwood.
"We don't need to spend more taxpayers' money studying governance. Release the paper that has already been done."
He also suggested the government is delaying the release of financial data from AHS.
"We've been directed to defer release of our annual report and our financial statements. I wonder why that is," said Lockwood.
He said in the 2012-13 year AHS recorded a $100 million surplus, but wasn't allowed to release it.
"In my view, good governance and best practice would include releasing documents like that," he said.
The government has indicated it will respond to the AHS decision on Wednesday morning.
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