Under growing pressure from opposition critics, Alberta Health Minister Sarah Hoffman continued to deflect questions about her deputy minister's allegedly inappropriate relationship with a private health foundation that recently received millions of dollars in public funding.

Hoffman's grilling in the legislature Tuesday afternoon followed a formal request from the official Opposition Wildrose for an investigation by Alberta's ethics commissioner into the relationship between Alberta Health deputy minister Carl Amrhein and the Pure North S'Energy Foundation.

In a letter to Ethics Commissioner Marguerite Trussler, Wildrose accountability critic Nathan Cooper, and the party's health critic Tany Yao, asked for a full investigation.

"Albertans want to know that decisions aren't being made within the health department because of personal relationships or cronyism," Cooper said in a news release.

Carl Amrhein

Deputy health minister Carl Amrhein participated in Pure North S’Energy Foundation’s alternative health program. (CBC)

Ten hours after a CBC News request for comment, Alberta Health spokesperson Cam Traynor replied on Amrhein's behalf, saying he "already disclosed his involvement with Pure North to the ethics commissioner when he became deputy minister."

Traynor added that Amrhein will "fully cooperate" with any review by the ethics commissioner.

CBC News has previously revealed close ties between Amrhein and Pure North, a Calgary-based foundation that provides alternative health treatments, including high doses of supplements like vitamin D.

Deputy minister had close ties to foundation

Internal Alberta Health documents revealed Amrhein participated in the Pure North program while deputy minister and met personally with its founder, multi-millionaire philanthropist Allan Markin.

Several sources also told CBC News that Amrhein lobbied Alberta Health for more funding for Pure North while in his previous role as official administrator of Alberta Health Services, the operating arm of the ministry.

While provost of the University of Alberta, Amrhein provided two letters of support for Pure North, one used by  the foundation in its appeal to the government for public funding.

In December 2013, Progressive Conservative minister of health Fred Horne approved a $10-million grant to Pure North against the advice of ministry officials, who had determined the foundation's program was not adequately supported by science, could not prove the health and economic outcomes Pure North claimed, and may cause adverse reactions in participants.

In October 2016, Amrhein signed, on behalf of the ministry, a $4.2-million grant with Pure North for a nurse-practitioner-led primary care clinic. Hoffman has said the clinic will not offer any of its alternative treatments or its funding could be put at risk.

Trussler said Amrhein told her the decision on funding Pure North was made elsewhere and he merely signed the agreement in his capacity as deputy minister, after Hoffman had approved the funding.

Dr. David Swann

Alberta Liberal Leader Dr. David Swann, a former medical officer of health, asked the health minister in the legislature Tuesday if she knew about her deputy's participation in, and lobbying for, the Pure North program. (CBC)

In the legislature Tuesday, Liberal Leader David Swann asked Hoffman if she knew about Amrhein's participation in, and lobbying for, the Pure North program, and if so, when.

Hoffman said she understood Amrhein disclosed his involvement with Pure North to the ethics commissioner.

"If the ethics commissioner wishes to look into this further, we certainly welcome that," Hoffman said, adding later that she could not recall any conversations about Amrhein's involvement with the foundation.

Amrhein, through a spokesperson, earlier said he "fully disclosed" his relationship with Pure North to the ethics commissioner when he became deputy minister in August 2015. Trussler confirmed Amrhein disclosed his participation in the Pure North program but said she could not legally reveal if he had disclosed anything else.

Auditor general asked to review grant

Hoffman's own conduct was also questioned Tuesday. She had previously said she knew nothing about serious health safety issues identified in government documents related to Pure North before she approved the $4.2-million grant to the foundation in October 2016.

But an Alberta Health Services briefing note shows that on Sept. 28, 2016 — a month before her ministry signed the grant agreement — Hoffman's office was told health officials had previously identified the "potential for negative health effects" resulting from the foundation's distribution of high-dose supplements to vulnerable populations.

Swann asked Hoffman what she knew about the health safety concerns before she signed the grant. She ignored the question.

The Wildrose letter to Trussler marks the second opposition request for an investigation related to Pure North. Earlier this month, Swann, a former medical officer of health, asked the auditor general to conduct an audit of the $10-million grant.

No decision has yet been made about whether an audit will be conducted, a spokesperson for the auditor general said Tuesday.

Despite the concerns of public health officials, Pure North points to research studies it says show the program is safe and effective.

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