Blended public health committee to be floated during consultations on reform

A committee made up of councillors and community experts alike will be floated for feedback as the city explores potential changes to Hamilton's public health governance model.

The hybrid body - designed to bring health professionals and equity-seeking voices to the table - would advise and help shape policy for city council.

What I hear from the community, and I think they've been loud and clear for two years, is we want to have some input on the board of health process," Coun. Cameron Kroetsch said.

The existing board of health is made up of Hamilton's 16 council members. Despite having the same membership, its decisions are ratified at council meetings.

This week, council backed Kroetsch's motion to present the proposed blended public health committee during upcoming consultations on the question of reform.

That committee would have six council members, six community members with interests or expertise in health, and an education representative. A selection committee would pick the members.

Among the preferred skills for potential applicants is an understanding of principles including diversity, equity and inclusion; anti-racism; anti-oppression, and health equity."

The city's consultation efforts on the reform question are expected to start in the summer and to be summed up in a staff report with recommendations before council in the fall.

The city is able to strike a public health committee in house.

But restructuring the existing board of health into an autonomous or semi-autonomous body to include community members would require provincial approvals - a wild card, especially in terms of timing, Kroetsch pointed out.

We're doing this because it's all we're able to do in the short term. That's why I'm trying to push it forward."

Hamilton's exploration of a new public health governance model has been complex and protracted, with advocates calling for reform drawing inspiration from mixed-membership boards in Ottawa and Toronto since the last term of council.

In a recent Spectator op-ed, Natasha Johnson and Anjali Menezes, both McMaster medical experts with focuses on equity, diversity, inclusion and anti-racism, reiterated that call.

The pandemic highlighted known and avoidable inequities in access and health care outcomes that disproportionately impact Black, Indigenous and other racialized people," they wrote.

But the status quo: a system where elected officials along with one physician decide the fate of our communities ...(without diverse community representation) is designed to fail diverse and marginalized communities."

Some councillors have embraced the push for change, but others have expressed reticence to ceding seats on the board to non-elected representatives.

In February, in a 9-7 vote, the new council opted to direct staff to conduct consultations on board governance, rather than an immediate restructuring, which Kroetsch and others had pursued.

Staff were directed to report back with options, including a public health committee, and continue exploring a semi-autonomous board.

On Wednesday, Coun. John-Paul Danko, who floated the motion leading to February's approval, said the prescriptive model in Kroetsch's proposal offers a good starting point" for the city's upcoming feedback efforts.

Likewise, Mayor Andrea Horwath, who in February urged due diligence" in exploring a new model, praised efforts to establish a path forward" on the governance question.

It was complicated. There was no doubt. But I think we've gotten to a really great place."

But Lyndon George, executive director of the Hamilton Anti-Racism Resource Centre, said he has mixed feelings" about Wednesday's outcome.

George commended Kroetsch for doing an excellent job," but overall, community members long urging change have been shut out.

What I saw there was this wasn't a priority for some on the board."

Councillors expressed the need for time to mull reform, but racialized communities, who were disproportionately affected by the pandemic, for instance, don't have that luxury, George explained.

That, to me, is the part that I don't think got across."

Teviah Moro is a reporter at The Spectator. tmoro@thespec.com