Monday, February 18, 2013



Mayor Rob Ford shouldn't have apologized to Toronto's Medical Office of Health after criticizing him for meddling in issues that have nothing to do with his department.
And the city integrity commissioner should be fired for not understanding that we want rigorous public debate on issues and not namby-pamby Mickey Mouse discussions.
Commissioner Janet Leiper says that when Ford called MOH David McKeown's salary an embarrassment after the mayor got mad at the doctor for approving a $60,000 study that called for, wait for it, lower speed limits on Toronto roads, he had demeaned McKeown's reputation and should be reprimanded.
There is no need to waste money on a study that shows fewer deaths and injuries if speed was slower on our roads because, obviously, we would eliminate all death and injury if we dropped the speed limit to zero. Of course accidents increase when speed does. This is not rocket science, and it certainly isn't a public health issue.
The mayor on his radio show said that he would look into McKeown's salary and "try to straighten things out." He called the report "nonsense."
I didn't realize that our urban health system and hospitals were in such fine shape in T. O.  that the MOH could go off freelancing. What about hospital wait times? What about the fact that the city hands out diet advice that doesn't work because it's wrong. Aren't those issues closer to why we have MOHs in the first place?
I sentence Leiper to watch the wonderful award-winning movie Lincoln for a taste of what is really language that demeans opponents. I sentence Leiper to read any Hansard records of what the greats say when they criticized each other and public officials. I think there is any need for an integrity commissioner in the first place and it is up to council, not paid officials, to monitor its members.
Toronto has had some classic battles between politicians and department heads. Allan Lamport was TTC chairman at war with his own top officials. George Bell, the legendary parks commissioner, had savage arguments in committee with aldermen. The TTC and the parks department were the better for these no-holds-barred debates. But this integrity commissioner wouldn't agree because feelings were bruised when politicians told civil servants to smarten up on the delivery of services.
Once  upon a time, Toronto newspapers always made sure they had a reporter at the city board of health meetings, no matter how strapped they were for staff that day, because of the strange discussions when members wandered off health issues led by the MOH as a failed shepherd. I do recall some interesting stories, like the time the health board said it wasn't really appropriate for funeral workers to collect dead infants from hospitals and transport them back to the funeral home on the TTC in a bag. The Tely ran that one on page one after several editors called me to make sure this wasn't an April Fool's stunt.
What everyone in Toronto knows except for one minor busybody official knows is that a main reason Ford won election in the first place is that a majority of the voters were fed up by the salaries and pay in municipal government and the decline in services. I don't care what the councillors' code of conduct says about private or public criticism of civil servants because what voters expect is for their politicians to demonstrate a rigorous stewardship about how the city is run. And if that includes sounding off on a radio show when some official wanders off into other fields, then that is part of the mayor's mandate. He would have no integrity if he didn't do it.
The bald fact is that too often city commissioners and senior staff survive despite gaffes that would have them fired in the private world within minutes. They demonstrate from the clearing of snow to the timing of traffic lights that they probably would fail in trying to run a one-hoist garage.
I have a good friend in public health who thinks that McKeown could walk on the harbour if he wished. But I also had a good friend in the upper ranks of the city health department who used to roll her eyes at the incompetency and waste that she experienced.
Perhaps I'm prejudiced. I remember a MOH staying silent when a person working for him, who called himself a doctor even though it was only a doctorate in African studies, saying that the city water was not safe for pregnant women to drink.
 I was one of those who persuaded the Metro chairman, Paul Godfrey, to get a $125,000 independent study done of the municipal water supply. It showed that Toronto's water was safer and had less pollutant traces than eight of the bottled waters sold in Toronto stores, including Evian.
I do not recall either the self-promoting socialist "doctor "nor the MOH apologizing or amending.
I remember the head doctor at Runnymedge Health Care Centre telling the board of which I am a member that the MOH was threatening legal action because the hospital was refusing to accept all patients that acute care hospitals wanted to ship to us.
This was when the old chronic care hospital was housed in a century-old elementary school with 100 patients on two floors in the old classrooms with no quarantine capability. Since debilitating hospital infections like MRSA are now so common, the Runnymede doctors were afraid that any infected newcomer would infect much of the hospital in a matter of days.
I moved the motion that we tell the MOH that we were quite happy to go to court against him and that I would be quite happy to publicize the issue in the Toronto Sun.  He backed off.
Ironically, two years ago, after I spent two months in three hospitals, I was shipped to Runnymede for another month to heal and to learn to walk again. I had MRSA and community pneumonia, thanks to the two American hospitals and St. Joseph's in Toronto, but my own hospital now could quarantine me in a private room thanks to the marvelous new building that cost the government and donors almost $100 million. Compared to St. Joseph's, it was heaven compared to what I called hospital hell in a Sun series.
If MOH Dr. Robert McKeown is so hot to trot on $60,000 studies, he could commission one on all the health issues in the city that should be dealt with by his department before it meandered off into transportation issues.
The blunt fact is that Toronto was given a Medical Officer of Health, who is technically independent on health issues from the politicians, because for 150 years, there were serious health issues, starting with floating animal carcasses in the harbour affecting the water supply,  keeping track of venereal disease before modern prescription, battles over fluoridation and inoculations and, of course, the continual struggle against TB and influenza.
Maybe the department has run out of things to do in public health supervision and checking restaurants.  It doesn't appear to be interested in the reality that some days in St. Joe's, there are patients stashed in every hall in Emergency, and there are more paramedics waiting there than there are on duty in great suburban expanses.
I suppose that is a provincial matter. So McKeown must look at other fields to run. Gee, I know a traffic light that doesn't have the proper timing near my house. And he could always check on the humane society and see if it still has that policy of returning all live-trapped animals, even Norway rats,  to the home territory. A great way to fight disease-carrying pests, but then the MOH probably thinks raccoons are cuddly.
I think we want more public criticism of our officials and their salaries and what they do and say and not less. If that runs contrary to any city code of conduct for councillors, then the code is as wrong as the integrity commissioner who is defending conduct that protects officials more than it does the taxpayer.

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