Battle reignited over whether more diversity is needed on Hamilton’s board of health

The possibility of changing Hamilton's board of health to include more diverse and expert voices is being looked at once again.

The board voted Wednesday to ask the province for information about the feasibility of adding unelected citizens to its membership. Currently, the board is limited to the city's 16 members of council. However, some doctors and community advocates have been calling for change for more than a year.

I don't see this as something to be afraid of," said Coun. Nrinder Nann. I do caution being afraid versus being informed in our decision-making."

But other councillors warned seeking the information would be like opening Pandora's box." Coun. Tom Jackson said it, scares" him to think the province could end up appointing members to the board - how the citizens would be chosen has not been determined.

If it ain't broke, don't fix it," said Coun. Maria Pearson. I think we are opening up Pandora's box and it's going to change that whole democratic process ... I'm just very leery at this time to even open that door."

However, medical experts and community advocates detailed in March 2021 and June 2021 how they believe the current structure of the board risks overlooking systemic barriers that can affect the health of racialized patients, people with disabilities or those in vulnerable circumstances such as homelessness. They wanted to ensure community voices were heard on a board that reflects the city's diversity and has some medical expertise.

We went through a year ago ... of folks coming in and delegating to public health on the restructuring - many of whom were doctors or certainly within the health-care profession - suggesting ... that we needed to take a look at an alternate set up for our board of health," said Coun. Judi Partridge. None of us are experts in the health-care industry."

But the calls for change haven't swayed some of the councillors, who pointed to the pandemic response as proof the board works well.

I'm not interested in going down that road," said Coun. John-Paul Danko. I'm not sure what the problem is that we're trying to solve. We just had two years of the worst public health crisis of the past century. Overall, I think the response ... was exemplary and overall highly successful."

Nann countered that Ottawa and Toronto, which both have members of the public on their boards, responded to COVID just as well as Hamilton, if not better.

Toronto and Ottawa set forward some practices during the pandemic ... that enabled both of those cities to get their vaccine rollouts out in a way that targeted those communities that needed deeper investment and deeper resourcing," said Nann. They were resourced as a board of health to come out of the gates a little quicker on some of that work, where we didn't have that same resource capacity here in Hamilton."

Regardless, Danko and Jackson had issues with some elected councillors being replaced by members of the public on a restructured board.

I take my responsibility so seriously," said Jackson. I just think that diminishes what the voters have said every four years."

Danko added, I'm very uncomfortable with the idea of unelected, unaccountable citizen representatives."

Both felt advisory committees were the proper place for community voices to be heard. They also warned similar calls for change on other standing committees of council would follow if board of health was restructured.

But Nann again pointed to Toronto and Ottawa where no such changes have taken place to other committees.

At the end of the day, Coun. Brad Clark emphasized the motion he brought forward was only for information to help the board clearly understand what would be required to restructure the membership.

We're not making a decision ... to change the governance structure," he said. We're simply asking the province to tell us about the feasibility."

With a municipal election coming on Oct. 24, Clark said time has run out for the current councillors to restructure the board anyway.

It will not be this board of health that makes this decision," he said. It will be the next council that makes this decision."

As a result, he said it's important to get them the facts they'll need to make an informed choice.

I find it troubling that some are ready to catapult this motion out the door when all this motion does is it brings back all of the information that is needed for the board of health to make a determination," he said.

The motion passed with Clark, Nann, Partridge, Pearson, Coun. Arlene VanderBeek, Coun. Esther Pauls, Coun. Russ Powers, Coun. Jason Farr and Coun. Brenda Johnson voting for it.

Voting against was Danko, Jackson and Mayor Fred Eisenberger.

The issue may end up being moot in the end as the province announced restructuring before the pandemic that would see Ontario's 34 public health units merged to as few as 10 to 14.

Hamilton would be affected if the province was to go forward with that piece," medical officer of health Dr. Elizabeth Richardson told the board. At this point in time we don't know ... what the direction may be."

Joanna Frketich is a health reporter at The Spectator. jfrketich@thespec.com