Hamilton votes: Six health care issues to consider at the ballot box

Hamilton's soon-to-be-elected city council will face tough decisions regarding ongoing health issues exacerbated by the pandemic.

COVID thrust a number of long-standing challenges into the spotlight and onto the agenda of the city's board of health.

As Hamiltonians head to the ballot box on Oct. 24, the health care system is more strained than ever with some of the pressure points affected by future decisions of council.

The municipal election gives residents the chance to have their say on the direction city council will take.

Diversity in decision-making

A battle has been brewing over whether Hamilton's board of health should include more diverse and expert voices.

Currently, the board is limited to the mayor and 15 city councillors. However, some doctors and community advocates have been calling for change for more than a year.

Ottawa and Toronto both have unelected citizens on their boards and some would like to see Hamilton restructure to bring more medical expertise and diverse voices to the decision-making table.

Those advocating for an overhaul say the current structure risks overlooking systemic barriers that can affect the health of racialized and Indigenous residents, people with disabilities, or those in vulnerable circumstances, such as homelessness.

On the other side, some councillors are uncomfortable with adding unelected citizen representatives to the board, which oversees public health services.

The board voted in July to ask the province for information about the feasibility of changing its makeup.

It will be the next council that makes this decision," Coun. Brad Clark said at that time.

Ambulance delays

Paramedics are at the epicentre of unprecedented strain in the health care system.

The average time it takes to off-load patients at increasingly overcrowded emergency departments was significantly up in the first half of the year compared to 2021.

At the same time, call volumes have been increasing - the union that represents Hamilton paramedics says it goes up by at least four per cent every year.

Adding to the squeeze is that the city has an insufficient number of ambulances, Ontario Public Service Employees Union (OPSEU) Local 256 said in June.

The result is high numbers of Code Zero" events - when there is one or no ambulances left to respond to calls. Hamilton had 140 Code Zero events between January and June.

All of these factors can lead to ambulances taking longer to get to life-or-death calls where every second counts.

The city has been working with local hospitals and the province on this long-standing problem but so far no overarching solution has been found.

Opioid crisis

Opioid overdose deaths in Hamilton soared to 166 probable or confirmed cases in 2021 compared to 127 in 2020 and 106 in 2019.

The city is on track for another increase in 2022 with 55 probable or confirmed opioid-related deaths in the first three months of the year.

Another sign the crisis is getting worse is a nearly 62 per cent increase in the number of times paramedics responded to suspected opioid overdoses in 2021. Ambulance calls went up to 914 - 76 a month - last year compared to 565 or 47 per month in 2020.

Meanwhile, Hamilton has just one safe consumption site while a long-planned second location has struggled to find a home. The city claimed it wasn't able to line up a space after considering 29 locations.

Instead, council endorsed the AIDS Network's proposal for a site on Barton Street East, but it has faced opposition and become an election issue in Ward 3.

City councillors also asked the federal government in August to grant an exemption in law so illicit drugs for personal use could be decriminalized in Hamilton. Toronto has made a similar request while Health Canada has already granted an exemption to British Columbia for three years starting Jan. 31.

However, support for decriminalization was not unanimous on council and came with a call for stiffer penalties for the production and distribution of illicit drugs.

Vaccine mandates

Council has been deeply divided over COVID vaccine mandates for city workers.

At the peak of the brutal Omicron-driven wave in January, council voted to fire workers who weren't vaccinated by May 31.

In April, councillors narrowly voted to suspend the policy for existing workers based on the recommendations of staff.

But a week later, final approval of the decision failed on a tie vote, which meant the vaccine mandate was back with an extended deadline until Sept. 30.

Council flip-flopped again in August, voting to suspend the policy and give a reprieve to 264 workers facing termination.

Suspending the policy means it can be brought back at any time. So, a newly-elected council could face this issue again, particularly as COVID is forecast to start increasing this month and peak in December.

Public health backlogs

COVID has left public health with staggering backlogs as key services were cut back or stopped altogether for two and a half years.

Thousands of Hamilton students are estimated to be behind on school-age vaccines, 23,000 kids missed dental screening during the pandemic and hundreds of health inspections are needed at tattoo parlours, nail salons, low-risk food premises and pest control.

Meanwhile, public health is significantly short-staffed and struggling to recruit in a global competition for health-related human resources. At the same time, the department's current staff faces burnout after years of pandemic work.

The department is also trying to put a greater emphasis on health equity after the pandemic revealed major divides in vaccination rates and infection among certain groups locally and provincially. In fact, public health plans to take lessons learned from COVID to develop and implement a health equity strategy.

In addition, public health faces some significant funding crunches as key programs paid for by the province are short of cash due to budget freezes or increases that don't cover inflation.

It will leave the new council with some difficult choices on how to get public health programs back on track while COVID continues to take up significant resources.

Ongoing pandemic

COVID is not over yet.

Managing the pandemic will still be part of the next council's job. However, it could be much different than past waves as the expectation is that lockdowns and many public health measures have come to an end.

Councillors will be elected in the midst of what is expected to be a fall wave. The predicted rise in cases comes as the health-care system is already dealing with unprecedented overcrowding, staff shortages and backlogs. Finding ways to protect Hamilton's hospitals during the fall wave could be one of the first challenges the next council faces.

In addition, uptake of COVID shots has been less than expected, resulting in Scarsin Forecasting twice increasing its estimate of how many Hamiltonians will be hospitalized with COVID in this fall wave. Getting more Hamiltonians boosted could be key to protecting the city as the pandemic continues.

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