POLITICS KILLED CRACK-PIPE PROGRAM: WORKERS

Strip Council Of Public Health Responsibilities, Officials Urge

Health and social support officials working with homeless and
addicted people are urging the provincial government to strip Ottawa
city council of its responsibilities as a board of public health.

The officials say after city council killed the municipality's
crack-pipe program, it's clear politics are getting in the way of
rational decision making aimed at improving public health, and that
council can no longer be trusted to act in the city's best interests.

The officials say there was clear evidence the program was working to
help stem the spread of HIV and hepatitis C amongst the city's drug
users, but that it was so unpopular with the general public, many
city councillors and the mayor voted to kill it instead of risking
turning off voters.

"When it comes to health care decisions like this, they are literally
life and death, so there's no room for politics," said Michelle Ball,
education and health promotion co-ordinator at the Ottawa Aids
Committee, who dispenses crack pipes and is leading a charge to keep
the program running.

"I just don't think politicians can be health care providers. They
have no health care experience. Many are business men and women, and
they are making critical health care decisions like this while trying
to maintain the support of voters. It just doesn't work. It's bound
to backfire, and it did in this case."

Wendy Muckle is the executive director of Ottawa Inner City Health,
the primary health care provider for Ottawa's homeless and addicted.

She says the province should turn responsibility for public health
decisions to the Champlain Local Health Integration Network, a
provincial body whose mandate is to "plan, coordinate and fund health
services" in the area.

She said the main focus of city councillors and mayors is to make
choices designed to garner enough votes to get re-elected. She says
this is largely incompatible with the world of health decision
making, which often requires unpopular choices to be made that are in
the public's interest.

She said the decision to cancel the program is a "perfect example of
what's flawed in the current system."

"Leadership in this area is about doing tough things even when they
are politically unpopular, and the council failed this test miserably."

She said it doesn't make sense to have the network responsible for
public health and leave the decision making to city council, and it
would be better to cut city council out of the picture.

"These decisions should be about saving lives, but in this case, that
goal got overrun by politics, and it's dangerous to allow this to
continue happening," Ms. Muckle said.

Mayor Larry O'Brien's chief of staff, Walter Robinson, said the
officials are free to lobby the province for the change, but that
council made a democratic decision and it shouldn't come as a
surprise because Mr. O'Brien's belief for some time has been the
program wasn't working.

He said the mayor is concentrating on getting a new drug treatment
facility up and running to help people kick their addictions.

"The mayor wants a permanent solution to help people end their
addictions to crack and crystal meth," Mr. Robinson said. "That's
what he wants, and that's what he's working towards along with the
chief of police and the minister of health promotion."

By a 15-to-seven vote on Wednesday, city council killed the
controversial two-year-old program, which saw crack pipes, mouth
pieces, and screens given to users on demand at a cost of $7,500 per
year to the city. The provincial government funded the balance of the program.

The program's goal was to stop the spread of HIV and hepatitis C in
Ottawa's drug using population, the majority of whom smoke crack.
Ottawa is currently going through a boom in crack smoking, users here
have the highest rate of hepatitis C infection in Canada, and the
rate of HIV infection among users is near the top.

The city's chief medical officer of health, Dr. David Salisbury,
repeatedly told council that the program was working, saving lives,
saved millions in future medical expenses, and was good for public
health in Ottawa before it was cancelled. He added that scientific
evidence backed up these claims, and an internationally recognized
study of the program concluded it was working.

Kanata South Councillor Peggy Feltmate, who voted to keep the
program, regretfully agrees with the officials that the province
needs to look at taking away responsibility for public health from council.

She said the decision to kill the program was politically motivated,
and it shows council is not living up to its role as a board of health.

"Obviously, we're not up to the task," she said. "When people are
ignoring the clear advice of our chief medical officer of health,
there's a huge problem."

The timing of the health and social agencies call for council to be
stripped is good.

The province is responsible for administering health-care matters,
including the makeup of boards of health. Two provincial acts state
local councils are responsible for establishing health boards.

But the Ministry of Health is currently reviewing the situation to
see if the responsibilities should be taken away from municipal
councils and given to the local health networks.

Results and recommendations coming from the review were expected some
time ago. Calls to the provincial ministry weren't returned yesterday.

The review is being done to see if uniform guidelines for boards of
health are needed. In the province, different cities and
municipalities have different make ups of boards of health.

In Toronto, it is made up of city councillors, doctors, other medical
professionals and citizens. Ottawa is one of the few municipalities
to have its council double as a board of health.