First, it was the debate over gambling expansion in 2011.
In June, it was how best to regulate illegal marijuana dispensaries.
Two weeks ago, it was whether city council should approve some form of barrier on the Burrard Bridge to prevent suicides.
The theme linking these major public policy decisions together at city hall is how they were influenced or, at least, informed by the expert opinions and research conducted by Vancouver Coastal Health’s public health and preventive medicine doctors.
Though Vancouver once had its own chief medical health officer in now-retired Dr. John Blatherwick, the move some years ago to create regional health authorities removed the direct connection to city hall. But that changed in 2009 when the newly created Public Health Act required doctors to advise local governments on matters that affected the health of the public.
That’s why Dr. Patricia Daly and Dr. John Carsley of Vancouver Coastal Health have made regular trips to city hall to provide council with research, opinions and recommendations on issues such as gambling, marijuana and suicide.
“They’ve been very receptive and want to hear that independent public health viewpoint on a lot of their decisions, but not all governments do that,” said Daly, who downplayed the health authority’s influence on public policy in Vancouver. “But they’re still making the decisions.”
Vancouver is unique in its acceptance of the health authority’s views since its city manager, Dr. Penny Ballem, is a former deputy minister of health and a trained hematologist. One of its city councillors, Kerry Jang, is a professor of psychiatry at the University of B.C.
Jang recalls that when he and his Vision Vancouver colleagues won government in 2008, there was a need to connect with the health authority to better inform decisions on homelessness, mental health, addictions and other social issues taken on by the administration. That relationship was also important as council embarked on its healthy city strategy, said Jang, noting the city now has a memorandum of understanding with the health authority to work together on public health issues, including implementation of phase two of the Downtown Eastside health plan.
“It’s a very deliberate relationship that we have,” said Jang, pointing out advice from Daly and Carsley influenced his decisions at council on gambling, marijuana and the need for a suicide prevention barrier on the Burrard Bridge. “I take their advice very seriously. It’s data driven, and it’s about providing that extra information that people don’t think about.”
The first real notice of the doctors’ presence at city hall was in March 2011 when Carsley showed up at a public hearing — a visit Vision Coun. Andrea Reimer recalls being “so out of the box at the time” — to recommend council reject a proposal from a Las Vegas company to build a mega casino adjacent to B.C. Place Stadium. Paragon Gaming Inc.’s proposal called for doubling the number of gaming tables and tripling the number of slot machines as it shuttered its Edgewater Casino to build a new facility.
Carsley’s recommendation to sink the proposal was based on research and literature he reviewed on whether the expansion of gambling would create more problem gamblers. Though he found the available information contradictory, he told council that “once you make the decision to go ahead in the hope that one theory is better than the other, you can’t really go back.”
Daly said she and Carsley were pleased that council listened to their advice, given all the views of people who spoke during the several days of hearings.
“That was something that we brought to them,” she said. “They didn’t ask us to comment on this. They hadn’t made the link that this is a public health issue.”
Paragon, meanwhile, is building a new casino but not with the number of tables and slots it wanted.
Carsley’s most recent visit to city hall was two weeks ago, when he recommended council include some form of barrier on the Burrard Bridge to prevent suicides. The majority of council agreed to the recommendation as part of the city’s plan to renovate the crossing, which sees an average of one suicide per year.
NPA Coun. George Affleck, who voted against the need for a barrier, accused the ruling Vision party of using information from public health officials to strengthen its arguments which are based on a “we’re all going to die mentality.”
When asked if information from Daly and Carsley is helpful to council debate, Affleck said he is open to all people speaking at a public hearing and sharing their views on issues. What he’s not open to, he said, is “Vision managing the conversation.”
“[Vision] has found an effective way to argue — to get the things they want done — and will use health as an excuse, as a reason,” he said. “And I don’t think it’s always necessarily the correct reason to make a decision about policy.”
In the marijuana debate, which ended with council passing a series of bylaws to regulate the city’s 90-plus pot shops, Daly told council that marijuana-infused goods — commonly referred to as edibles — should be banned from the dispensaries because of their link to poisonings of children.
Carsley and Daly were also very public about their support for a Yes vote in the recent transportation and transit plebiscite, with Carsley campaigning with Mayor Gregor Robertson. Carsley has also attended press conferences where the mayor has opened new childcare facilities. In 2011, Robertson said he wouldn't lead a charge to get more supervised injection sites in the city unless the health authority deemed it a priority; in his 2008 bid to become mayor, he said in a debate "there is a place for more injection sites" in Vancouver.
Daly explained their roles are more than representing the health authority.
“I work for [the health authority] but I also have that role to independently advise all local governments within the geographic region that I’m responsible for,” she said. “It’s not as if our viewpoints have to be approved by the Vancouver Coastal Health board. We have independent powers under the Public Health Act to provide the best advice.”
@Howellings
