TRANSCRIPT OF THE PUBLIC MEETING OF COUNCIL HELD IN THE COUNCIL CHAMBER, CITY HALL, 141 WEST 14TH STREET, NORTH VANCOUVER, B.C., ON MONDAY, FEBRUARY 16, 2004 AT 8:30 P.M.

PRESENT:

COUNCIL MEMBERS STAFF MEMBERS

Mayor B.A. Sharp A.K. Tollstam, City Manager Councillor R.C. Clark B.A. Hawkshaw, City Clerk Councillor R.J. Fearnley S.E. Dowey, Deputy City Clerk Councillor R.N. Heywood D. Sigston, Manager, Lands Councillor C.R. Keating Councillor D.R. Mussatto Councillor B.W. Perrault

Chair: Mayor Barbara A. Sharp

Re: Lions Gate Hospital – File: 3300-07-02 15E 301

The meeting was called to order at 8:39 p.m.

Moved by Councillor Mussatto, seconded by Councillor Perrault

THAT the meeting recess. CARRIED UNANIMOUSLY

The meeting recessed at 8:39 p.m. and reconvened at 10:20 p.m., with the same personnel present.

Mayor Sharp The first presentation this evening is Mr. Ron Erdman.

Mr. Ron Erdman, Chairman, Property Committee, Lions Gate Hospital Foundation Your Worship and Council, my name is Ron Erdman; I am a resident of West Vancouver and I am the representative of the City of West Vancouver to the Lions Gate Hospital Foundation. I am the Chair of the Property Committee on the Hospital Foundation and I served as the co Vice-Chair of the Hospital Foundation. I am a volunteer that has worked with the Lions Gate Hospital Foundation for the last three years and the prior four years as a volunteer with the Burnaby Hospital Foundation. So I am coming to speak before you just for a few minutes tonight solely for the purpose of just giving some background. I have nothing in the way of advice or requests but still think it is important to just lay out no audio with that background I would just like to say that from our perspective we are involved in a not for profit foundation, that has no other interest than raising money. As background, we have a concern, we had a concern with the ownership of these lots last year and formed the Property Committee that I now am running for the purpose of dealing with problems related to liability and running a business that were a concern for us. These do not make a lot of money for the Foundation. Our Golf Tournament in June last year made 25 times more money in one day than these lots made for the Foundation in one year. We have had a relatively low source of income from an intense management activity with liability. We were trying to figure out what to do with it. September/October last year VCH came to us, the Health Board came to us and said they had decided to sell the lots that they owned in Block 52, the northern of the two blocks, where we owned four and if it was of interest to us we could join them in the sale. I guess the point that I wanted to make tonight and this is really the content of this discussion was that a very difficult time and a difficult decision and one that was thought through carefully and with much serious thought by the Foundation. We were very concerned that the Health Authority may take the proceeds from the sale of those lots and use those proceeds to cover whatever costs or deficits might have been an issue for the Health Authority. As people who are here to try and raise money for health care we have, what we consider more or less a non negotiable requirement in regard to our participation in this sale, which was that if we were going to participate or VCH was going sell we thought it was critically important that, that money come back into the community and go back into health care in this community and not be used for anything else. That position was one that caused a lot time and aggravation, a lot of negotiation with VCH.

Our blocks by the way were not bequeathed to us, I think some people, they misunderstand it but they did come from surplus available funds to the hospital some numbers of years ago. So this money in fact has come from health care budgets in the past. We felt it was important having been allocated to the hospital in the past that it stay on the North Shore. So what we did is conclude the negotiation with the hospital where we ensured, by contract, that the money that would come from the sale of those lots held by VCH would be directed entirely back into capital requirements for health care on the North Shore. The other thing that we felt was important was the other lots not offered for sale, Block 52, which continues to be held by the VCH in the block south of the one you are discussing here tonight and part of our requirement in dealing with VCH at this time was that all of the future sale proceeds, should the Health Authority decide at some time in the future to sell those lots, must also go back into health care on the North Shore.

To protect ourselves and insure that there was some reasonable assurance that, that would happen, we entered into a very formal and comprehensive legal contract negotiated with our own hired legal advisors and we have now received and hold what are called duplicate certificates of title for all of the lots in the southern Block 59, so that the Health Authority cannot sell those in the future without our agreement and without our surrendering of those titles to the Title Office and we have advised the Health Authority and have contracted as part of our agreement that we will not release those titles unless we can have

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reasonable assurance that the proceeds of any future sale from Block 59 goes to health care on the North Shore. I guess my purpose, just in summary, I mentioned it would be quick and I am finished, is that we felt that the highest priority to us was to ensure that any proceeds coming from sale of properties in the subject lots and in the future sale of properties from Health Authority held lots adjacent to the hospital, must stay on the North Shore and go into health care. We believe we have achieved that.

We have a legal contract that obliges VCH to ensure that happens, and in return for what they have given us we have agreed to support the sale and that is why you see our name associated with the sale. It is not something that we initiated or something that we are driving but it is something that we have agreed to do in support because we feel that the highest priority to us, in regard to fundraising for health care, has been met by the terms of the agreement that we have negotiated with them. Thank you for your attention and I wanted to be available to answer any questions that people might have.

Mayor Sharp recessed the meeting at 10:29 p.m.

The meeting reconvened at 10:30 p.m., with the same personnel present.

A motion was unanimously endorsed in the Regular meeting of Council this evening to continue the meeting after 10:30 p.m.

Mayor Sharp The next presentation will be from Ellen Pekeles and Janet Woodruff.

Ms. Ellen Pekeles, Chief Operating Officer, North Shore Coast Garibaldi Health Services Your Worship and Council; I am Ellen Pekeles, I am the Chief Operating Officer for North Shore Coast Garibaldi Health Services in Vancouver Coastal Health and joining me is Janet Woodruff, who is our Chief Financial Officer and Vice- President, Systems Development and Performance. Really appreciate the invitation to speak tonight on Lions Gate Hospital, our public health care system, the changes that have occurred and our land sale.

I will speak to our success and challenges in health care on the North Shore and Janet will discuss the systems that are in place to measure and monitor the quality of our outsource work as well as the land sale and we will be happy to answer questions when our presentation is done.

First, to speak of some of our successes, this past Saturday we had an Open House at Lions Gate Hospital and I want to thank the Councillors that actually attended. I think it was a very successful afternoon and some of the areas that we showcased were our new MRI, which is the most advanced technology west of Toronto; it has been in operation since October. There are many ventures that we have undertaken with our Foundation, including our new chemotherapy area, our renovated rehabilitation unit, which desperately needed to be moved

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from our activation building, which is a very old building and needs replacement. We also showcased our digital radiology fluoroscopy table and one of our operation rooms. I think one of the powerful messages in our operation room was just demonstrating what an increase in daycare surgery can do for people. There is lots of discussion about the fact that Lions Gate used to have 350 beds and we now only have 220 beds and beds are really not a very good indicator of what is going on in a hospital. Our activity has been maintained over the past couple of years and because we are performing way more day surgery, than in patient surgery, where at 67% of our procedures are now done as day surgery. In the past if you had your gall bladder removed you would have been in the hospital for a week, now you are in the hospital for a day and that is because the technology is very advanced. We don’t make and incision into your muscle so the recovery is way, way faster and that is good thing, you are not in hospital for a long time so we don’t need the same number of beds to support our activity.

In terms of our wait times in surgery we categorize surgical procedures into three areas; emergency surgery, urgent surgery and elective surgery. Emergency surgery, the clinically acceptable target is to have an emergency surgery within 48 hours and all our procedures that are classified as emergency are done within 48 hours. Urgent surgery the clinically acceptable wait time is 14 days and all our procedures are within that target except for orthopedic surgery where we have a longer wait for surgery. Our target for elective surgery is 90 days and all our procedures are provided within that time, again, except for orthopedic surgery. In the next couple of days we are going to be announcing a strategy to actually invest in our joint surgery where we have a very long wait list, which we are very pleased about.

Another great success has been our Audiology Clinic that opened in February 2003 that was the first one on the North Shore. Clients used to travel to Vancouver and now they can receive that service on the North Shore. We are also very proud of the Women and Youth Clinic that we opened at …… for people in the Squamish Nation that we serve. In mental health we have been able to increase our community housing units by 18.5% over the past four years within the same resources, providing an appropriate range of service with timely access. People have commented that the North Shore used to be the number one health region in Canada, according to MacLean’s Magazine three years in a row and now we have dropped to 17th place. The reason why we have dropped is now the classification includes our Coast Garibaldi area; Sea to Sky, Sunshine Coast, Powell River, Bella Bella and Bella Coola where there is poor health status. So the classification in MacLean’s has changed because of our boundary changes and I think that is quite misunderstood.

One of the biggest challenges that we face on the North Shore is our patient flow and I want to acknowledge that is the area where we are focusing all our attention. Currently our target for people who are admitted to an inpatient bed in emergency our target is for people to wait 10 hours. Right now people are waiting 25 hours to get in to an inpatient bed. It is a very complex system and we have spent a lot of time analyzing the causes of the delays for admission and

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we can classify those into three areas. There are diagnostic delays. We have delays in assessment, both by our physicians and our discharge coordinators and for those of you that have ever been in the hospital sometimes a day can go by where nothing actually happens to you. You don’t have a test a doctor doesn’t come and see you and you are wondering why you are actually in the hospital on that day. If you add up those days throughout a year, that translates into 30 beds worth of delays. If we were able to clean up even half that extent of delay we would decrease the gridlock that we have in emergency. Every morning there are 15 to 20 patients waiting for admission so we are very focused on addressing the delays.

Some of the things that we have done in terms of our diagnostic test delays, we are soon to have a new CT scanner, we have extended our hours of CT in the evening, we have opened up our new MRI and we are currently planning a digitalized system for our radiology films, which will also increase our efficiency. Last month we opened up a unit that is called a Hussle Up Bed Unit and a Discharge Lounge. What that means, in the morning, as I said, there are 15 to 20 patients in emergency waiting for admission. We have opened up this unit so we can actually move people out of emergency in the morning to help increase the flow and throughout the day we move those patients to a medical unit and that has dramatically changed just the throughput through emergency. We also have a physician and an administrator now actively involved in discharge rounds and our daily number of discharges has changed, have increased from 2.6 to 3.2. We are on the right road, we understand what the causes of the delays are, and we are starting to fix them.

I just want to speak a few minutes about our financial challenges before handing off to Janet. Our cost pressures in health care are due to greater demand of service due to an aging population, new technology, wage and benefit increases and inflation. Our funding in health care has been frozen for three years. In 03/04 we started off the year with $147million worth of cost pressures out of a $2.1billion budget and it looks like we are on track to eliminate that deficit by the end of the year and we are hoping that in February and March we are actually going to reinvest in some services. Right now 42% of the Provincial Health Budget, Provincial Budget, is spent on health care. Our goal has been in the past year to protect service levels, which we have managed to do. We have the same service level on the North Shore but we have had to make some very tough choices in terms of what core businesses we are in and what core businesses we are not in and we have chosen to outsource some of those services. We are in the business of patient care and our primary goal has been to protect service levels within a frozen budget for three years. As you have heard we have contracted out housekeeping, laundry and security services. We have actually been able to increase our security coverage by one security officer 24/7, which has been badly needed at Lions Gate Hospital. We are currently negotiating with a food vendor.

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I would like to hand off now to Janet who will speak to you on how we are measuring the quality of our outsource work with some excellent results. She will also speak about some of our capital investments, our capital needs and the strategy behind our land sale.

Ms. Janet Woodruff, Chief Financial Officer and Vice-President, Systems Development and Performance, Vancouver Coastal Health Thank you, Mayor Sharp and Councillors, for the opportunity to provide you with an update on Vancouver Coastal Health initiatives. Again, my name is Janet Woodruff and I am Chief Financial Officer as well as Vice-President, Systems Development and Performance for Vancouver Coastal Health. I will cover three issues this evening in my remarks. Firstly I will cover the outsourcing of certain of our non core or support services areas, including housekeeping, laundry and security. Secondly, I will speak to the capital funding that is available to Vancouver Coastal Health and the investments that we are making in the North Shore and then, thirdly, how we can provide with the support of the Lions Gate Foundation much needed capital dollars to support health care in the North Shore by selling non core land assets that are adjacent to the Lions Gate Hospital.

In 2003 we entered into arrangements with third parties to provide services for the provision of housekeeping, laundry and security and that is at 17 sites across the region, including Lions Gate Hospital. The transition to the new service providers was completed in 2003. Currently we are negotiating for the provision of both retail and patient food services with a third party and we have also issued a Request for Proposal for warehousing services. In order to ensure that we meet the needs of our patients and residents each of these services must be provided with the highest quality while being cost effective and to demonstrate our commitment to the quality we have introduced a quality management framework that we believe introduces industry best practices. We utilize measurement criteria for all of these services that are based on quality outcomes, the volume of services that are delivered, the responsiveness of those services and how well they are coordinated with the other hospital unit operations. We have implemented an organization structure that allows us close management of the services and the provision of services from the vendors. There is regular reporting of the activities to our senior executive team as well as our board of directors. We have adopted a very systematic approach to the contracting with these vendors by including provisions in the contracts for the measurement of quality outcomes, both the measurement and the reporting. We post the results of our independent audits, quality audits, on the VCH website so it is available for the public to see how we are performing and how we feel accountable for the quality of those services.

I will just refer you to this graph, this depicts the audit results, the quality audit results for the area of housekeeping and it is showing through time how the performance of our housekeeping service has met different criteria that we measure, both before the implementation and post implementation.

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As you can see for each of the regions within our Health Authority there was some decline before we actually outsourced the housekeeping services. The top line is North Shore where the outsourcing was completed in October of last year and you can see at the point that we outsourced the quality audit measured a performance of 73.6% against 31 difference criteria. Our latest measure in February shows performance at 89%, so we have seen a steady improvement in the quality measure for housekeeping in the North Shore and we expect to see that trend to continue to show some improvement as we continue to measure and complete those audits during our contract term.

With respect to the laundry we do have independent third party test results that we maintain and with respect to the sanitary scores for services provided by Cabriel Laundry we have surpassed all the set standards that have been set in place for them.

With respect to security, Paladin is the third party, that is providing the service and we have been receiving, just recently, the data around the agreed upon quality that is contained in the contract. As Ellen mentioned we have been able to increase the level of security services at our sites and in particular with Lions Gate have the additional one full time equivalent for 24hours, seven days a week.

I will mention that Vancouver Coastal Health is also pursuing opportunities to improve services and efficiencies in addition to work in support services. Examples of some of the kinds of initiatives include the consolidation of our Information Systems and reorganization of administrative functions such as our financial operations. Across Vancouver Coastal we are implementing collaborative business systems software, the PeopleSoft System. When Vancouver Coastal was formed it brought together a myriad of business systems, some of which were in need of replacement, in other areas there were no information systems. In the case of the North Shore there is an SAP system. The work done in the financial investment that was made in that system of $10million was an invaluable precursor to our PeopleSoft implementation and one that we expect will deliver ongoing benefits as we continue to integrate our systems.

I would like to move to the Capital Funds. This particular overhead gives the Councillors a picture of what our capital funding has been from both the Federal and Provincial Government over the past three years. Three years ending March 31, 2004. The capital funds available to support the current needs, they need to be utilized for facilities, development, acquisition of equipment as well as investment technology, but it is all a critical investment for improving our health delivery services. We have in the Province of B.C. received $625million from government funding, of that $167million has gone into Vancouver Coastal Health and more specifically the North Shore has received $33million of that funding. In addition to the government funds received, Lions Gate Hospital has benefited from $10million received from the Lions Gate Foundation, over that same three year period.

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Recently new funding from the Federal Government to B.C. of $200million has occurred and $16million of that has been received by Vancouver Coastal.

The third overhead just highlights some of the recent investments that have been made at Lions Gate Hospital as well as some of the major needs that we see, going forward. Again, these are capital needs for the North Shore. I will just bring your attention to a couple of the items and Ellen mentioned that in the Fall we opened up a new MRI. The investment of both the equipment and the facilities is $4million so quite a significant investment. Another large investment has to do with our renovations in the Chemotherapy Clinic where we have really expanded that environment and enhanced the experience for our patients that are making use of that service.

With respect to major needs going forward, in particular, the land sales we are looking for the proceeds to help support the first three items that are shown on the list that would be the Cedarview renovations, the emergency power generator, as well as the investment in some Radiology Imagining Systems. The capital needs of Vancouver Coastal Health Region do exceed the capital funding from the traditional sources that we have and that applies again to the North Shore. We took very seriously the need to increase the amount of capital funds within the health region so we have adopted a number of strategies to help do that. Some of those strategies include looking at private/public/partnerships and the disposition of non core assets to enable some strategic and sustainment capital investments.

Finally, I would like to move to our land sales. This overhead indicates where the lots are that we are proposing to sell. They are indicated by the red box. Vancouver Coastal issued a Request for Proposal for the sale of a portion of the lands adjacent to the Lions Gate Hospital. Again, it is the 13 lots that are shown in red on the map. These sales are to support the critical capital needs of the Lions Gate Hospital and I can assure that the dollars raised from these sales will stay on the North Shore in capital investments. The lands are not required for future development of the Lions Gate Hospital. The areas that are marked in blue are lands that we believe are needed for the redevelopment and they are lands that are owned by Lions Gate, at this time. With respect to our Request for Proposal the bids were received in January and the evaluations were completed mid January so we have been working with the top three bidders. We received 15 bids in total and at this time further negotiations are pending the resolution of the City’s deliberation on the potential for rezoning. At this time we can tell you that the potential impact of restricting the rezoning would limit the value that Vancouver Coastal could receive of approximately $4million. So that money, if we are unable to realize that value, it would mean less dollars into the North Shore health care services. Vancouver Coastal is very appreciative obviously of the work of the Lions Gate Hospital Foundation, it has also worked quite closely with us in developing a plan that they believe was in the best interests of the North Shore.

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Finally Block 59, which is on your chart, it is the box on the right hand side in blue that does remain under a joint jurisdiction with the Foundation to ensure that it is used for future health care needs on the North Shore. All of the proceeds with respect to the sale of the lots on Block 52 will be invested in health care on the North Shore. Thank you and that concludes my presentation.

Mayor Sharp Thank you. I know this is going to take longer so I am going to recess the Public Meeting again.

Mayor Sharp recessed the meeting at 10:50 p.m.

The meeting reconvened at 10:51 p.m., with the same personnel present.

A motion was unanimously endorsed in the Regular meeting of Council this evening to continue the meeting after 11:00 p.m.

Mayor Sharp I will call the Public Meeting back into session and the next speaker is Cathy Pinsent from the Hospital Employees Union.

Ms. Cathy Pinsent, Committee for the Preservation of Public Health Care My name is Cathy Pinsent and I am here on behalf of the Committee for the Preservation of Public Health Care. Our committee is made up of workers from Lions Gate Hospital, we are all very long service workers and we all live in the City of North Vancouver. My co-presentator who was supposed to be here with me tonight, John Hodgin, is home very, very ill. We will be speaking tonight on the privatization, service cuts, closures and the sale of lands in relation to Lions Gate Hospital and the North Shore Long Term Care Homes.

Again, just to go back to Bill 29. Bill 29 was the legislation that removed contract provisions that stood in the way of the Liberals efforts to cut services, close beds, facilities and to privatize. Bill 29 is but selling off of health care; one piece at a time. In your documents that I provided to you there is the Vancouver Coastal Health Region intends to privatize, eliminate and alter 32 plus health support services. That list includes: diagnostic lab, diagnostic imaging, plant maintenance, nutrition services, finance, health records, physiotherapy, occupational therapy, speech therapy, telecommunications, purchasing, transcription, etc. If you notice on that document number 14 identifying the 32 plus areas, this list is other.

For the North Shore this will mean services will be privatized, cut or moved off the North Shore. On December 6, 2002 our Committee met with Mayor Sharp, we expressed our concerns about privatization, we talked about long term care and acute care bed closures. Here is what has happened on the North Shore in the last two years. We have lost our media technician at Lions Gate Hospital. Our Print Shop was closed, 1.5 FTE is gone. Deletion of Home Support Workers, 30 FTE’s are gone. Our security has been contracted out; 17 workers

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gone. Linen services have been contracted out; 54 workers gone. Housekeeping has been contracted out; 115 workers gone. Nutrition services has been provided with their notice that they too will be soon fired; 260 workers. Finance will be moved from the North Shore with approximately 37 FTE’s lost. Currently there is a review going on in our lab services that may result in contracting out and are losing our core lab services.

We have six long term care facilities on the North Shore, all have contracted out. Capilano Care, all support staff, others still waiting for confirmation of their care staff will gone; 68 workers gone. Inglewood, all support staff, also waiting to see if their care staff will gone, in the meantime 60 workers are gone. Cedarview, 20 care aides after the facility stopped admissions as they closed 60 long term care beds to make 30 assisted living beds. Kiwanis, all support staff and there is deletions and changes to the care staff. West Van Care, 63 workers, all except the RN’s will be gone by March 29th. Currently this facility is understaffed so god knows what will happen when they contract out. North Shore Private Lynn Valley, 71 care aides, laundry workers and housekeeping out the door by March 29th and why, so the owner can secure a mortgage to build a new complex care assisted living facility. Apparently the workers make too much money and the bank won’t give him a mortgage. Not only the loss of services and bed closures but hundreds of workers that work on the North Shore have lost or will soon lose their jobs with thousands and thousands more fired throughout the Lower Mainland.

Health Services Minister, Colin Hansen, said in an interview “The bottom line for us we need to focus on patient care and delivery of health care needs. Health care workers who provide support services are integral to good care. The Liberal Government and the Health Authority under values the contribution of health support workers and their role as part of the team. Their work is a big part of the business in delivery of health care needs.” So how will privatization affect the patients, residents and clients? Less continuity of care as a result of contracting out, less access to services, the quality assurance, the lower quality care from underpaid and inexperienced staff and contracted out services. We don’t blame any of the workers, they are not trained very well and they lack the manpower, they just don’t have the bodies to do the work. I will just give you a small example. It is a little hard to see because this was a digital camera that we did these on. refers to slides That is the floors at Lions Gate. We could show areas they had the Open House the other day, we could show you some areas that would just repulse you.

They also move these contracted workers around, they don’t stay in the facility for three months because if they stay in the facility for three months the new owners or the company would have to give them a pay increase; so there is no continuity. The man behind talking about the audits, I don’t know who is doing these audits, but I think they should contact me and I could show them the lack of work and the lack of cleanliness that is going on, at particular Lions Gate Hospital. Also privatization is going to be

The Corporation of the City of North Vancouver Public Meeting re: Lions Gate Hospital Page 10 of 32 February 16, 2004 increased wait lists and there is going to be a risk to patient safety and infections.

For the community loss of good union jobs, that support local businesses, e.g. we have hundreds of vendors for our nutrition services, sorry vendors for our nutrition services and as they contract out the services it means these vendors who mostly work on the North Shore will also lose out. Lower wages cannot support a mortgage or high North Shore rents and as I heard earlier tonight $500,000 is okay for a mortgage. Well these people will be making $9 an hour, maybe $10 an hour, so they are not going to be able to live on the North Shore anymore. There is going to be losses of services or facilities, loss of business for local suppliers as multi national companies take over the services; companies like Sedexol, Airmark and Cabriel Linen.

About the support worker that has been laid off, the average age of these workers that are being laid off are in their mid 40’s, the majority of them being women. They are long service workers having dedicated their working lives to their facility. Many of these workers were born at Lions Gate, raised and schooled on the North Shore, married, had children, bought homes or continued to rent and live on the North Shore. There are a number of single parents that were earning a decent living wage and therefore did not become a burden to the system they were able to provide the children with opportunities. As a result of losing their livelihood their children will now be deprived. Many of the workers I am talking about are members of the Hospital Employees Union and just for your information the HEU was founded in September of 1944, it started with 300 tradesmen, orderlies, janitors, dietary, housekeeping and laundry workers; it has grown to 46,000. People just thing HEU are people that go around mopping the floors well they include clerical, patient care workers such as Licensed Practical Nurses, care aides and activity workers. There are lab, x-ray, dental and rehab assistants. There are media, cardiology, pathology and renal dialysis technicians. There are store attendants, bus drivers, computer technicians, analysts and fire and safety officers just to name a few of the classifications. Lions Gate Hospital certified with the HEU on December 3, 1948 the struggles and sacrifices that took place through those years ensured a decent living wage and safe work conditions for all workers but more importantly our victories ensured a public health system for all.

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Privatization is not about restructuring or downsizing about is laying off of workers, privatizing the work and paying the new workers low wages. It is about selling off of public health care. It is about multi national private companies making profits on the backs of the workers. Not one of these companies that takes on the contract are doing it for the love of the patient, it is about how much money they can make; it is all about profits. The new company is not required to hire laid off workers and if they were there is no guarantee that full time work would be offered. These companies pay low wages with minimum to no benefit. This will have an enormous impact on the local economy. The Vancouver Coastal Health Authority purports to promoting wellness and ensuring care, they also plan $175million in cuts, which means more service cuts, more bed closures and more contracting out, this will seriously impact the public. Laying off workers does not promote wellness, it will cause and has caused stress related illnesses, family strains and breakdown of family unit.

In the past when the hospital was in negotiations with the Union regarding essential services the workers, services and the bed counts became so important. They were concerned about the prevention and I quote, “of immediate and serious danger to life, health and safety.” They wrote “Lions Gate Hospital is the only acute care hospital on the North Shore serving North and West Vancouver. The hospital is extremely busy as demonstrated by the occupancy rate. In addition, Lions Gate Hospital and its patients who require major surgery and emergent procedures, which cannot be carried out in Pemberton, Squamish, Whistler, Sechelt and Powell River communities.” In 1992 we had 336 acute care beds, this morning I counted 200 beds. Recently the authority announced the closure of 6West, a surgical unit, because they state more surgeries are going to daycare, less ….. are better and more money will be going to the OR, there are less inpatients staying. However, with more daycare surgeries it will mean more pressure on the families or on the patient if there is no family to rely on it. It also means the Health Authority saves money as the family will be the caregivers or you will be required to hire help. Meds, dressings etc will be purchased by the patient or their family, home visits will be limited. The consequence of this decision, chances of infection will increase and there will be an increase in re admissions because of early discharges.

I find it interesting that we hear $10million for the SAP, to date I cannot get an accurate figure from this Health Authority even though we have requested over and over again. $10million was the original guesstimate that they put in place. They went live April 1, 2001 and just recently in the spring the Pemberton and Whistler went live. Again, we probably guesstimate it is probably closer to $18million that they have put in and of

The Corporation of the City of North Vancouver Public Meeting re: Lions Gate Hospital Page 12 of 32 February 16, 2004 course they are going to scrap that now and the Vancouver Coastal Health Authority is going to implement PeopleSoft at a minimum, minimum cost of $25million.

Last fiscal year there was 34 non union severances packages in the authority that were paid out and the same time more directors, managers and our management project teams were being hired or shuffled around the different health authorities. Overtime costs were outrageous as managers in the target areas refused to hire staff giving the impression that these departments were unable to meet their budgets. In five years the North Shore has seen four different logos; costs unknown. Name changes e.g. Human Resources is now called Employee Engagement, so what is the dollar amount attached to that? The Health Authority hiring of media personnel, we believe the Chief Operating Officer should be accountable and be able to address public concerns about decisions made by this authority.

We question why the Health Authority would not challenge the government about spending millions and millions and millions of dollars on health care ads instead of putting their money into health care. Are they worried they won’t get their bonuses or worse being fired for not fulfilling the governments’ wishes? Code gridlock, heard earlier, it is a daily announcement heard over the PA system. Too many patients in emergency, it means hurry up doctors discharge your patients, we need the beds. The authority, as you have heard, has introduced HUB it stands for hussle up bed with a discharge lounge in it. This is a patient shuffle; if you don’t see the patients in emergency it doesn’t mean there still isn’t a problem.

We are unable to confirm the rumours for the contracting out of food services, whether patient food will continue to be prepared on site or prepared out of the facilities, perhaps out of the Province. Same for the medical transcription, we know currently that some workers work on contract from home, paid by the line. But the recent rumour is it will be contracted out of the country. We want to know why the authority did not accept a $20million concession package that was employee proposed. This would have kept our experienced, well trained staff and nutrition services and also kept these services public. We want to know why the authority is signing 10 year contracts with multi national for profit companies instead of ensuring our services remain public. We want to know why the authority and the private facility owners will not negotiate with the contract companies to ensure that our workers go with the work or they have the right to first refusal or as part of the negotiating is to make

The Corporation of the City of North Vancouver Public Meeting re: Lions Gate Hospital Page 13 of 32 February 16, 2004 sure these companies will pay their workers a decent living wage instead of poverty wages.

We are concerned about the lack of infection control at our facilities and obviously lack of training for the contracted out services. We have concerns about rewarding employees not to call in sick, so how does that promote wellness? That is right, you come to work sick and infect all the patients! Recently we had a Norwalk virus outbreak in Evergreen House. One of the recently hired contract staff was advising everyone that it was okay in Evergreen that she could go to work because she was not infectious because she had had the flu shot. That is great but that shot is not going to help her or her patients from not contracting the Norwalk virus.

The selling off of the property past discussion and morals. About 13 years ago, this is actually a photograph that we just took of the actual model they had in the lobby of Lions Gate Hospital …… As you can see the plan was to renovate and build on all that property that they are going to sell off. The other information I have and I would be happy to make copies for you after, is a document that I received on November 5, 2001. Basically it talked about the need for a new facility on the Lions Gate Hospital site. It talked about demand for new beds, outdated program space, deficiency in the building infrastructure. What we are advised is that the acute tower and the northern expansion are poorly made, they are not earthquake proof and they talked about different ways they are going to rebuild, like tear down the buildings, build new buildings and using that site. So we find it rather suspicious and odd that they wouldn’t think about the future of Lions Gate Hospital. Our question is why did the authority, how did the authority acquire this land? We understand a lot of it was willed and if it was donated what were those wishes. Were those wishes to sell it off or use it to expand our community hospital? Again, as I said, we are the only acute care hospital on the North Shore, serving both North and West Vancouver.

We have the closing of long term care beds and again that is going to be more cost to the family ………………….or lets them balance the budget on the backs of our seniors. On April 5, 2002 there was a new assessment process that was introduced supposedly to end wait lists to our long term care facilities. However, with these new rules of assessment they restrict many who can’t remain in their own home or can’t be assessed for assisted living or pay for assisted living or for private care. What this means is that hundreds of our frail seniors and people with disabilities will no longer be eligible for long term care. The impact of assisted living will mean more and more low income seniors will be left on their own or their families will be responsible. The costs for private care assisted living are well beyond the means of most moderate and low income individuals so basically only those who can pay will get care. The bottom line,

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the authority and the private facility owners would rather contract out, close beds, eliminate services or make profits on opening assisted living beds. Contracting out services will not save the authority dollars. David Hanley and Executive Director for Value Inn, which is the group that is contracting out services for the authority, said in an October 17th meeting “the Value Inn Group looks for lower costs while still expecting the same quality.” Well, simply you are going to get what you pay for. The population now on the North Shore is approximately 175,000 and climbing. We also have an increasing aging population that will require many, many services and of course we have concerns about our fired workers who will be forced to leave the North Shore. Lions Gate Hospital is our community hospital, seniors must be protected. Dedicated workers should not be fired so that companies can make profits from our tax dollars.

In closing we are requesting the following: that on behalf of our health care workers of the North Shore we appeal to the Mayor and the Councillor’s to advocate for us. We request your assistance in our fight to keep public health services in tact by appealing to the BC Government, Health Authority and the private facility owners to stop the privatization. We want to thank you for passing the motion in relation to the privatization and we would request that you forward these to all the municipalities and encourage them also to endorse. I just have a few more pictures I would like to put up if I may?

Refers to photos This is what 6West looks like right now so for surgical beds either the rooms are looking like that or they are being used for offices and first aid. break in tape these are just examples of some of the vendors that we use for nutrition services. So as I said when they contract out that service all these local businesses will also lose. I will just show you a series of three pictures which is our old linen department. This is how bad it is, this is what is left of our laundry after the so called quality contractor removed the equipment. They left a duct hanging from the ceiling in an unsafe manner, openings in slab uncovered and the rest of the area in a messy unsafe condition. Again concerns of safety in relation to the contracted out services, there is lack of training, the individuals aren’t taught about awareness. These are chemicals that you see that are just left out in the hall, most of them aren’t marked. There is no training if there should be a fire at the facility, what they should do to protect the patients etc. Thank you for your time.

Mayor Sharp I am now going to go on to the representations from the public and I do note that I have a speaking list here. It has taken almost an hour on the three presentations so I am going to be very strict with the members of the public. It is a quarter after eleven, at a maximum of five minutes each it will be at least a half an hour if you take five minutes and you will not be allowed to go beyond it. So if you have a canned speech I suggest you cut it down to five minutes real quick. The first person that I have to speak is Sylvia MacLeay.

Representations from the public:

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Ms. Sylvia MacLeay, 5479 Greenleaf Lane, West Vancouver My name is Sylvia McLeay; I live at 5479 Greenleaf in West Vancouver. I am here because I am representing the Council of Senior Citizens organizations and I am going to focus my remarks on that area.

Seniors as you probably are well aware are prime users of the health care system and have every reason I think to be very concerned. They want good health care when they need it and in that respect, like everybody else that I know. I would say that seniors feel that a tacit agreement that they thought they had with the people in the country has been broken. They think that they worked their working lives that they raised their families that they paid their taxes that they made their contributions to medicare and they assumed that when they retired they would have a medicare system.

Changes that have happened since this Liberal Government that we have come into power, the Provincial one, have in fact attacked that. We are now paying a huge amount of money out of our pockets for medicare. Pharmacare has gone up astronomically and seniors, many seniors, are finding they don’t have enough funds to pay for this. There are a few wealthy seniors but most seniors aren’t wealthy. When people retire they generally have a lower income than they did when they were working and if you retired 30 years ago, as 15% of my membership has, and my membership is about 52,000 people across B.C. you retired with a pretty small amount of money. It was indexed in most cases and it didn’t have a …. and it hasn’t increased.

We are very concerned. We are concerned about the quality of care, the long waiting lists when we need care, we are concerned about being sent home from the two care procedures and not having any support. Nurses do not apparently come as far as I can figure out all the time and give the support that people need at home. Home support for people who need help to get in and out of the bathtub or in and out of bed if they are in a wheelchair just isn’t there because they budgets for that have been cut to such a degree that they now allocate time in fifteen minute hunks. You might get like two fifteen minute pieces of home support if you are a frail elder in a week. I am afraid that won’t keep your house clean and it won’t give you very many baths a week and it won’t help to clean to fridge and it won’t let you live they way you would like to. Seniors would like to live on their own as long as they can, just like I assume everybody here would but they will need some home support and they are not getting much of that. Assisted living is a nice idea for one stage in the progression of what a person’s health might become as they age but it is not the B’all and end’all. Many people won’t have the good luck to die in their sleep and they will probably need some long term care and they will need some palliative care and we are making big cuts there; cuts that don’t make any sense.

I would just like to say a couple of words about the fact that I think most seniors are very interested in fiscal responsibility. They would like to see our system efficient and well run but not at the cost of being unable to provide quality care

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and that is what I think seniors all see as happening right now. We see longer waiting lines, we see people who can’t get the care they need, when they need it. I hear stories regularly of people who actually have had their life significantly shortened by the inability to get the care that they need when they need it.

Privatization is not, as far as the seniors are concerned, the way to go. P3’s never worked in England, in Britain, they didn’t work on the continent of Europe and they won’t work here. It hasn’t apparently come through to our government that in fact when people go into private business they have a motive; it is called make a profit. They will give you a loss leader or like the credit cards they will give you a good interest rate for a while but then the price will go up. That is what happened elsewhere and it will happen here. I am very disturbed at the idea that Lions Gate is planning to sell land. They are not making any more land; you noticed. The land that is around Lions Gate should be reserved for expansions that may be needed either in the hospital itself or another health care facility that we may need. To sell that land in my view is short term gain and it will be long term pain later on.

I would just suggest to you the deal that we had in Lions Gate previously and I have just gone through a situation where my husband died in Lions Gate less than a year ago.

Mayor Sharp 15 seconds.

Ms. MacLeay Okay. We need a combined effort of all the workers in the hospital to make a really good place. Privatized workers who have been told not to help patients for any reason and to call 911 are not like the workers that we have had in the past.

Mayor Sharp That is it, thank you.

Ms. MacLeay That is what we need. Thank you.

Mayor Sharp The next speaker is F.R. Macintyre and I am going to caution people that if you are going to applaud I am going to adjourn. Not here, okay, Sheila Paterson.

Ms. Sheila Paterson, 1038 Banbury Road, North Vancouver Your Worship and Councillors I have no statistics, I have no graphs, I just have some quotes and they will take two minutes.

In a single interview Premier Campbell gave to the Hospital Employees Union in November 2000, just a few months before the last election, he stated his intentions for publicly run health care as follows, “My plan is to make sure that people get the care they need where they live and when they need it.”

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Asked if he favoured public/private development model or a not for profit one he replied “I favour not for profit because when you deal with not for profit in communities you are actually building communities as well as health care.”

Since coming to office the government has required that all new health infrastructure projects must be partnerships with for profit corporations. When Mr. Campbell was asked of a 48 year old hospital housekeeper who has finally, after decades of struggle, come up to the average wage for B. C. does she have anything to worry about in terms of privatization from a Gordon Campbell government. His response “I say no, no, what she is going to find is that people in British Columbia and my government are recognizing the value of the work she does.” Just to be sure HEU asked Mr. Campbell directly if he was going to privatize non medical services like food, housekeeping and laundry. He replied “oh no, I think we should be providing these things through the public health care system. I found when I was Mayor of Vancouver that the workers in the City 9 times out of 10 were providing way better value than private sector workers.”

Well either the Premier has changed his mind completely about the value about not for profit health care or he was well aware that public health care and decent wages for working people have long been well established human values and would not be politically astute for him at that time to state his intention to trash them just before the voters went to the polls. This is a consummate betrayal of public trust. Thank you.

Mayor Sharp Chris Dorais is the next speaker. That was four minutes just so you know, it goes quicker than you realize.

Mr. Chris Dorais, 524 East 21st Street, North Vancouver It does go quick and thank you Your Worship and Councillors for the opportunity to speak. I would like to thank the public for staying for two hours to hear this important issue, which is important to everybody in North Vancouver. For those of you who don’t know me I am Chris Dorais, I live in the City of North Vancouver on East 21st Street. I sit on the North Vancouver School Board in North Vancouver and I also work for the Hospital Employees Union. I am not here before in either of those roles and nor have I been asked by anyone to come and make a presentation to Council this evening.

I am here as a very concerned citizen in our community. A very concerned citizen with what is going on. I have had three children born at that hospital up the street and I have worked in the health care system for ten years in North Vancouver prior to working for Hospital Employees Union. I worked in long term care and I worked at Lions Gate Hospital and I can tell you what I think about what is going on right now.

You heard a fancy presentation from the Health Authority and these bureaucrats have done a fine job of putting up graphs and putting up numbers and telling you what good is happening in health care. Well let me tell you health care is not

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about graphs, it is not about numbers, it is not about dollars, it is about patients, it is about residents and it is about people who provide care for those people in many different ways, whether you are a housekeeper, a food service worker, a laundry worker or you are a nurse aide or a care aide or you are a licensed practical nurse, everybody is part of the team. That is what I saw in my 10 years of experience in health care. In my experience in 10 years I saw that housekeeper that went home and knit something for residents who didn’t have family. I saw them; knitting scarves and knitting sweaters and bringing them to the residents that didn’t have families. I saw that food service worker that took the time to go after their shift and go shopping for residents who couldn’t get out of the building. I saw food service workers at Lions Gate Hospital who went and saw after shift somebody going from the psyche unit who shouldn’t have been out of the psyche and took time, at their own time, to go and coax that person and go back to the psyche unit. Those are the real people in the health care system and those are the people that are making a difference and this Health Authority has absolutely no regard and they carrying out the governments’ agenda with no regard. What are they doing, they are replacing those dedicated people who have worked in this community for 30 years some of them and dedicated their lives to the patients and residents in this community, they are taking those people and throwing them out on the street replacing their decent paying jobs with jobs at $9 or $10 an hour, which you and I both know nobody can live in this community at that rate of pay. Shame on them. Shame on them for doing that.

I would again like to thank Council for bringing this important forward because it is an issue the community needs to be talking about. I would like to remind you about one thing that has been mentioned already that these contracts aren’t going to local businesses. These contracts are going to international corporations. The money is being taken directly out of the pockets of people that work in our communities and is going into the pockets of shareholders around the world and that is the direction this Provincial Government is taking us in and it is sad. I offer one warning to the Lions Gate Hospital Foundation who said they had a legal contract about lands the sale of lands in North Vancouver; health care workers thought they had a legal contract. They thought that they were going to be respected in this Province and they haven’t been so take heed of that. Thank you.

Mayor Sharp Thank you. The next speaker is Fred Muzin.

Mr. Fred Muzin, President, Hospital Employees Union Thank you Your Worship and Councillors. I am the President of the Hospital Employees Union and I am not going to repeat a lot of very compelling information you have received tonight. It took Roy Romano 18 months and at the end of 18 months he said that health care in this country was sustainable and what the vast majority of Canadians wanted. We talk about these contractors well you know at the District meeting Dr. John Blatherwick said they are all American. Well they are not, Sedexol is French, Compass is British, Airmark is

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American and Cabriel that had the laundry on Vancouver Island that walked away 10 years ago because they couldn’t make enough money has now been given a 10 years contract. The Pilbury Laundry could have underbid, it is a public facility, high quality, the most efficient on the continent, they were not allowed to bid. So this has nothing to do about saving money and you really wonder when is the health board going to be held accountable. If all these contracts are such good public investment why are they all secret? Where is the transparency? You wouldn’t accept that kind of performance by this City Council why do we accept it from our health boards.

It was very interesting in the presentation from Ms. Pekeles when she is talking about the cost drivers in the system. She seems to forget the most expensive one which is the cost of pharmaceuticals; that is what is driving it. It is not wages, it not what they are investing in, the demand for services, it is pharmaceuticals, that has been well documented. The number one cost driver in this government has delisted drugs, has moved the cost onto individuals and so our per capita drug cost has increased. Those were very conscious decisions.

So we have workers that have been contracted out that are desperate for work, they are absolutely desperate for work and it amazes me to hear that their best practices, I don’t know if any of these people ever actually wonder around the facility. We have lots of evidence because we have people that actually work there. Biomedical waste is being scooped out of bags with bare hands to balance out the load, repeatedly. Six bags of patient’s personal laundry in long term care, that are incinerated because somebody can’t read the tag. People going into rooms where there are infectious diseases and not knowing the difference. Contract cleaners vacuuming up vomit, these disaster stories that the public is simply is not hearing, the deterioration in their public health care system because of this confidentiality and the fact that there is no whistleblower protection in this Province. It is disgraceful what is going on.

Cathy Pinsent talked about the turnover of staff and you see the hospital administrators cannot instruct the staff from the contractors because then they will run into problems with maybe the union saying that they are direct employees, so if you need any of these services you have to call a contractor, maybe on a phone bank thousands of miles away to call back the facility and tell them to get a cleaner or a food service worker over to where the real problem is because the cannot give them direct orders.

Where is the concern of the health board for what is called the social determinence of health? We have a government that attacks seniors, it is absolutely shameless. They attack the disabled. They now have their little foray into welfare that they also don’t know what they are doing and so we have the question, is there really commitment to a public health care system because all these administrators are paid off the public purse and rather than attacking, privatizing and trying to destroy the health care system maybe it is about time the acknowledged and recognized the public investment in the skills and the abilities

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of people that have committed their whole working life to having a public health care system the Canadians are willing to pay for. They want it efficient but these people are not going to come up with solutions because they don’t listen to the people actually providing the services and so we really need a lot of accountability in this Province and it is about time that Council’s and the people of this Province and this country absolutely demanded accountability and a sustainable public health care system. Thank you.

Mayor Sharp Thank you. The next speaker is Betty Griffin.

Ms. Betty Griffin, 208 – 156 West 21st Street, North Vancouver, representing the North Shore Council of Canadians Good evening Mayor and Council. Thank you for giving us this opportunity to speak to you. My name is Betty Griffin; I represent the North Shore Chapter of the Council of Canadians. We have 2,000 members and supporters on the North Shore. We were very pleased and commend both your Council and the Council of North Vancouver District for endorsing the senior citizens’ resolution opposing any privatization in our public health care system.

Next speaking to the issue of Cedarview Lodge I went there today and it will break your heart to see that wing black, closed up and one poor woman was desperately trying to get down the first floor because that was where her room had been but they had to shift her to an upper floor. She had no idea where she was going. I spoke to the worker there and she said, oh yes renovations are proceeding, and here are 60 beds, 60 rooms being turned into little two room, I don’t know sitting room and a bedroom for 30 people who are not as incapacitated as those 60 people, each having one little room. Where is the logic in this? It is absolutely ridiculous, not one penny should have been spent on that. My husband had the greatest of care in Cedarview and he died there and it would break your heart to see what has happened to that facility.

Regarding our hospital lands this was news to me and looking at maps and trying to find out who owns what lands. How come Vancouver Health Authority suddenly owns this, they weren’t around three or four years ago, where did these lands suddenly come from? Something smells.

We support the recommendations that you have on your agenda tonight regarding Lions Gate Hospital and we would just like to ask you to consider striking a citizens public health committee to examine the state of the whole North Shore facilities and report back to Council as soon as possible and then keep a watching brief on future events. Thank you and we support the previous half a dozen speakers who have spoken so eloquently tonight. Thank you.

Mayor Sharp Thank you. Are there any other members of the public who wish to speak on this issue? Please come down and give your name and address for the record.

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Mr. Ken Hovden, 377 Tempe Crescent, North Vancouver Hello my name is Ken Hovden and I live at 377 Tempe Crescent, North Vancouver. I am not a very eloquent speaker really but I just kind of wanted to say I work, I am a Food Services Supervisor at Lions Gate Hospital and I have been there for 23 years. I don’t have anybody, I am not representing the Union, I am representing the workers who have worked there for many years. I have worked there for 23 years and the majority of our senior people have been there 20, 30, 25 years. 9 years ago in 1992 we combined two kitchens together to make one, we went to a cold plating system called Cook/Chill, this went on for six months with workers hanging from the ceilings while we are trying to prepare our food and everything and the day after, the day that it was implemented I had lost my job, I went to laundry, I was going to be a laundry worker but I was called into the kitchen because of this catastrophe that happened. Basically, in a nutshell, the food that was brought in did not work in the system that we were using and there as utter chaos for five years. In six years we had 13 managers, so who is running the department during these 13 managers? It certainly wasn’t the Manager’s they didn’t know what was going on. So it is these long term people who have worked there for many years.

Now recently it was brought to us from some militants that we should do an illegal strike like to support, try to save our jobs, but we don’t support holding patient’s hostages and especially the people at Evergreen House. About two weeks later I saw the BC Ferries hold the Province of BC hostage by shutting down the ferry system. Two weeks after that I saw the Doctors in Nanaimo, the Doctors if you can believe it, who are supposed to be the epitome of health care, they were on strike for more money. We didn’t believe that we should hold people hostage, patients, so we didn’t, we lose our jobs but we are going to walk out with dignity because the last day that we are on the job we will do the best like we have always done. I just want to say this in support of all the long term workers in Lions Gate Hospital that we are out of there, nothing is going to save us but we will do the best for our last day. Thank you very much.

Councillor Fearnley left the meeting at 11:39 p.m.

Mayor Sharp Are there any other members of the gallery who have questions or comments at this time? Seeing none I will go to members of Council. Councillor Mussatto!

Discussion by members of Council:

Councillor D.R. Mussatto Well Your Worship it is a long night but I really do feel that I have to say a few things about this because this is near and dear to everybody’s heart here and you know it is going to be near and dear to everybody some day who get sick and have to go to the hospital.

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Comments that I hear over and over again is “I didn’t know it was like this until I get there”, until they have a need for the hospital or until they have a loved one in there, they have no idea. Life is so busy these days I guess I can’t really blame them but these people here are from their hearts. They are not just worried about their jobs. What I hear in the stories tonight they are talking about the people that need care at Lions Gate Hospital. We all know that we needed to do change in health care. We are not sitting in a vacuum here. We knew that there had to be change to the system; it wasn’t sustainable. The cost of health care was rising about three times the rate of inflation, we know that, we are not stupid. But what has happened Your Worship is that changes are being made without consultation, without partnerships, without education. They are being made unilaterally and I almost feel sorry for the people here tonight Ms. Pekeles and Ms. Woodruff and the rest of the people because they are almost between a rock and a hard place Your Worship because they have been told this is how much money you are getting, go and make the system work, you are not getting a penny more. That is coming from their bosses, which is the Provincial Government, so they are almost having to deliver on a message. I would challenge them to stand up and say, no, that is not the case. But I think that is. I think they are having to be the messengers of a very difficult system here Your Worship and that is wrong, that is totally wrong. There should be an avenue for these people to say no we are not going to do this, we are going to try a different model and we need some more money to try to make this partnership, this change happen.

You know Your Worship it is all about dialogue. It is all about the Japanese culture; it is about the process we go through to reach the end point. The end point at the end doesn’t really make a difference it is the process we go through. The Vancouver Coastal Health Authority has a $2.1billion budget and how much public consultation input is involved in that; almost none. And they haven’t got much staff to do that, they probably don’t have the education to go and do that. They are faced with having to make these changes unilaterally and that is wrong and we have heard all the speakers come out tonight and say that the process they are going through is wrong. The gentleman that just spoke, Mr. Hovden, I have never met him before, I don’t think I have ever seen him, he is saying, this is the dedication. They are working to their last day, they are losing their jobs and they are going to do the best they can. To me that says that we have to work with the workers.

From what I understand HEU had come forward, they had come forward with a proposal to try to trim $20million in savings in an area where the health board could trim $30million, so they could make an extra $10million. To me that is an amazing thing and when you start working together in partnerships you can achieve a lot more than just $20million in savings. Your Worship the problem is that the health board is working on the ideological study. Deloitte & Touche, they have companies come in and do assessments of how many beds we should have in terms of the number of people for our population here and we should have X amount of emergency beds and ICU beds and long term care beds, which we call assisted living beds now and we have too many in the population.

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The problem is, is that the demographics weren’t looked at. The age of the population is not looked at and when you start comparing it to Alberta and other parts of Canada and the United States, you will find that we are a little bit unique on the North Shore. We are an aging population and we can’t just fit that model. I know that there are inherent problems with the data that they have used to make these assumptions.

Your Worship Cedarview Lodge is a tragedy. The Provincial Government had said that there was going to be 5,000 new assisted care beds in the Province, so then why are they closing 60 beds at Cedarview Lodge to make 32 assisted living beds? Where is the math in that? There is going to be a reduction in beds. They are not in the delivery of housekeeping and food services and those types of things but Your Worship those people are going to suffer. I know as an ambulance paramedic, I go into these houses and I see these people who don’t get these services, they don’t have the families, they don’t have the support system, they are going to pay a price. How do you do an assessment on that type of thing, how do you measure that until they die? I don’t know Your Worship, I really don’t know.

Mrs. MacLeay has talked about seniors wanting the system to efficient and well run but not at the expense at quality health care and that is the critical issue. People don’t want to see cuts if it is going to affect their health care. The bottom line is Your Worship, here we are we are seeing a revolution in health care. A revolution, a change that we have never seen before and it has to involve everybody; it just can’t be done unilaterally. I urge the Council to look at the motions we have got to continue to support these motions and almost hold out a hand to the health board and say, listen we have got to work with you. We have got to start working with you in terms of making these changes. It is going to be painful, it is going to be tough, it is going to push you to areas you have never been before but we cannot continue to make these unilateral changes in health care without seeing very dire consequences in the future Your Worship. We have got to all be in this boat together and make changes together, so I plead with them to work with the municipalities, the unions, the workers, with everybody to come up with something that is going to work for all.

Mayor Sharp Councillor Keating!

Councillor C.R. Keating Thank you very much Your Worship. Well given the hour I certainly won’t go into detail. I think I, like other members of Council, and the people presenting tonight have heard a variety of different horror stories about what is going on in health care in the Province of British Columbia and the Vancouver Coastal Health Authority today.

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My wife works in that system, both as private practitioner of medicine but also within what used to be the Vancouver Richmond Health Board and I know that people in units are now being told, aides to people are being told not to clean up messes because there is another unit to do that and there is an emergency situation. So the living conditions for people in the health care, mental health care sector are just quite simply going down.

I don’t want to get into all those kind of details now, given the hour, Your Worship. I think one of the questions that we have to ask ourselves here because we, as a Council, have advanced motions and we are talking about this issue in a public meeting tonight is, why are we concerned? I think Your Worship for a couple of reasons. Health care on the North Shore used to have a heck of a lot more public input. There used to the Union Board of Health, there used to be Council representatives on the Health Board, there used to be much more regular forums of input. Now that all disappeared several years ago and it continues to disappear, so now what we have is a situation Your Worship in which profound changes are taking place in the health care delivery on the North Shore and I don’t think North Shore residents are adequately represented. I think we, as the court of last resort for so many issues, in politics, in this Province, at the municipal level, we hearing about it now and we are holding those kinds of public hearings that absolutely need to be held now.

Another reason we ought to be concerned Your Worship I think many people were given the dubious treat of being here for a couple of public hearings about rezoning applications and certainly one of the issues that we, as a Council, are concerned about Your Worship is absolutely affordability. Who can live in this community? We try to do it through the mechanisms that we have at our disposal Your Worship, which is trying to create more density, appropriate density, diversity of options but the fact of the matter is it is like pushing a big boulder up hill Your Worship, if good living wage jobs disappear and are replaced by $9 and $10 jobs. So this is about our community. It is about whether or not people who have lived here for years as decent good citizens can continue to live here or they have to be forced off to other areas. So I think it is ultimately one of our great concerns what is going on here Your Worship.

I guess the other reason we are here Your Worship is that I think there is a lot of land ultimately at stake and I think that is why we are seeing for the first time in the last four years I have been on Council Your Worship a lot of concerns suddenly from the Health Authority about what the opinion of North Vancouver City Council is. I guess Your Worship ultimately there is a plan from the Vancouver Coastal Health Authority to sell off some lands along with the Lions Gate Hospital Foundation and to drive it back into capital projects Your Worship. For me, I guess Your Worship, I ask what would the effect of permitting the rezoning from its current institutional use to a residential use. What would be the effect of that be if our Council simply blithely went along and said yep you can change that use, you can change it to residential and you can sell it off. Well from where I sit Your Worship I think the effect of that would be to say the kinds of changes, that have occurred without consultation and are destroying our

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community in certain respects, are in fact changes that we agree with and we think are A okay from our corner. Well Your Worship I don’t think they are A okay. I think something needs to happen here. We need to stand up as a Council and say we don’t like the changes that are affecting our community.

As for Councillor Mussatto I have to say I have some sympathy for the members of the VCHA Board and for the executives of the North Shore health delivery region in this regard. I think they have been put into a box. A lot of the terms that they are dealing with is a Health Board and, as Executives, they can’t change and the government has said there is going to be no increased funding for health care over three years. Well as one of the presenters mentioned tonight we have a population that is growing and is aging and if you think you can service that growing, aging population with the same budget today, that you did three or four years ago well then somebody had been dipping in the medical marijuana; it is just not going to happen Your Worship. So they have been put in a box on that. They have also been put in a box by a government that instead of fulfilling its promise to create 5,000 new long term care beds, decide instead well we are going to change the definition of what a long term care bed is and who gets into a long term care bed and that will solve the problem.

On other issues Your Worship I think choices were there to be made Your Worship by the local Health Authority and by local executives. As Councillor Mussatto suggested HEU and others came to the Health Authority and said here is a way that we can save money and work together and from what I read in the press and from what I know there is just really not an adequate response to that. The choice was to go for another kind of system based upon the private health, for a private health care delivery model. There was a decision to enter into long term contracts with these private contractors that was a conscious decision that did not have to made, it was a choice to be made. I guess at the end of the day Your Worship I guess the question becomes, is the Vancouver Coastal Health Authority a champion of the community or is it an agent of the Provincial Government and I guess that is fundamentally the choice that is going to be revealed by the decisions that are made. I certainly hope that they are the champions of the community and that we can find a way to reach out to the community and to find a broad consensus that yes, this is the way we have to go and maybe we have to say to Minister Hansen that no we cannot live and in a public way we say we cannot live with those things. But, Your Worship, at the end of the day I don’t think any of that thing is going to happen if this Council rolls over and allows lands, which the health region wants to sell for its own interests, to be rezoned to the highest bidder of residential. There is another interest here, there is a very symbolic moment about what happens in this and from where I sit I will gladly have an open mind at a public hearing, but from where I sit right now I am disinclined to vote in favour of any such rezoning. It is a political reason; absolutely it is a political reason. I want somebody in Victoria to say well yeh people are cheesed off and maybe we have got to listen.

Mayor Sharp Councillor Clark!

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Councillor R.C. Clark Your Worship it saddens me greatly to hear this state of Lions Gate Hospital and the health system. I have heard rumours of this but when people stand in front of you and talk about, and show very graphically, the state of Lions Gate it concerns me greatly. Bob Smith was referenced, I was on the hospital board, which believe or not was a very functional board, it certainly provided for local input. There was a community of interest, it was a community hospital, it was managed by a community hospital board and there were no problems with communication. If there was a problem you walked through the CEO’s door. There was always a Manager; it was just a better more open system.

Now I am sure HEU and the rest will point to faults during those times as well but I think I would suggest to them that we have gone downhill, not even sideways; it is very much downhill. Slash and burn seems to the flavour of the day over in Victoria on a host of ministries not the least of which is health care, and it appears it hasn’t worked elsewhere. This is news to me. I thought health authorities and things in Europe were proven commodities, perhaps I am hearing now for the first time, the other side of the equation. Certainly I know there is a problem just from my own Council viewpoint.

I first read about the plan by the health region to sell the lands which are under discussion here, I read that first in the newspaper. Now I understand there was a communication and maybe some of it got lost but certainly for me to do that when that piece of land is so integral and important to not only the hospital but to this community. If that isn’t going to be hospital land then it is a glorious opportunity for us to do something for mental health housing for affordable housing to set a tone in that whole Grand Boulevard central kind of a place. Obviously Council is the body which decides what planning and what uses ultimately go there so why wouldn’t it have occurred to somebody at Coastal Health to maybe consult with us, sit down with us, they know we are players in Lower Lonsdale, we have set a tone at being very active in the real estate market and driving development in this community, in the way which we want, with taxpayers dollars as well as the planning function. That kind of got me off side with the whole process right off the bat and I must admit that I am still not on side.

I guess my big concern here is we have heard a lot and really a lot of this is outside of this Councils’ jurisdiction, which I am sure in not news to anybody in the audience. I guess what I am coming to now is where do we go from here? Are we relegated to being just sort of protestors? Can we not show up at the meeting which is on February 18th, later this week, and actually contribute in a meaningful fashion? I am going to turn it around, at least initially, on the Coastal Health people. You have heard the flavour of the discussion, I gather this isn’t the first time a Council on the North Shore has made these kind of points, I turn it around to Ms. Pekeles and to the Board, which she ultimately is responsible to, there is obviously a problem on the North Shore, what are you going to do about it? Thank you.

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Mayor Sharp Councillor Heywood!

Councillor R.N. Heywood Thank you Your Worship. It is quite illuminating to hear all of the information that we have heard tonight and it is hard to put it into a bigger picture context. I think that the people at the health region have a very difficult job on their hands. I guess there is one thing I don’t quite understand, I have heard and reading some of these ads in the paper that is saying that $2billion more has gone into health care in the last two or three years than was going into health care before that. Then I hear that there is no increase in the budget for the health region so I wonder where that $2billion went? I am interested in that aspect of it.

I think the issue when you hear about people losing their jobs and people that have been employed for a long time it is a very difficult thing. I have been through situations like that. I worked in private sector areas where people were laid off and a lot to do with helping people find other employment and it wasn’t a particularly fun time, so I have a lot of direct experience of going through that. On the other hand you look at the health region, aside from the politics of it all, which you can have different views around this room but if you look at it as an organization of 27,000 people with huge infrastructure systems, processes, departments, people and all of this providing a range of services, a complex range of services and at the same time while they are doing that the technology is changing at a rate that almost boggles the mind and the costs of these services are changing at a rate that almost boggles the mind and the community demographics are changing that almost boggles the mind and, even if you take away all the politics, I think that people in the cold light of day would have a tough time to run this system efficiently and with the added pressure on the taxpayers all over this country in terms of the amount of taxation we have, the levels of government we have and the resistance to increasing taxes and we also know that there is a limit and whether we like the idea that we are in a global community or not, doesn’t really matter; it is there. We have to compete on the world stage or we won’t sell our products outside the boundaries of this Province, so the economy of this Province is incredibly important. When we look at that we have to be competitive. We can’t carry tax rates that render us non competitive with other parts of the world, we just won’t sell our products it is as simple as that. So there is an absolute limit on the amount of tax people can pay and I think of all of us as taxpayers we don’t pay huge increases in tax.

The governments are all faced, regardless of what political stripe they are, they are all struggling with how to provide the maximum service. The previous government in this Province brought about the health region concept with the idea of trying to save money so it is not all about party politics. Part of it is, I concede that, but it is not all that. I think there is a very difficult job here in terms of trying to adapt this organization to this changing dynamics that is going on. I look at, you know switchboard operators that used to be by the 100’s across the country, and they are all gone now with the changing technology and

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the telephone system. You look at stenographers that existed by the score in every office, typing up all the dictation of work for people, and I am picking on women’s jobs. The same happened in men’s jobs as well. There has been a lot of change and I think the health region is facing the same kinds of change and I hope the health region does put its priority on medical service. I think they have got some very difficult choices to deal with there.

The other point that I think that I would like to touch on is the lack of consultation with the municipality where this is very critical and as has been said by other speakers here that we have got down this road with changes and cuts and selling of land without the right amount of consultation in the community. I certainly endorse that idea and we need to do something different about that. In terms of the real issue which brought all of us here is about the land sale that is why we are here. The other has all been added, we are here about the land sale and the issue there I agree with Councillor Clark we need to look at the options that, that land presents break in tape do that and I hope that proceeds well.

Mayor Sharp Councillor Perrault!

Councillor B.W. Perrault Yes, thank you Your Worship, well much of what I was going to say has been said and in view of the hour I am going to be very brief.

First of all Lions Gate Hospital is a vital part of our community. It is an important part of our community, both as a health care provider and as an employer. I understood at one time Lions Gate was the largest employer in the City, so yes, it is important to us. All the sub-services and people who are connected with the nutritional services, etc. at the hospital that definitely is another important ingredient in our community.

As a former member of the Lions Gate Hospital Foundation many years ago I chaired a fundraising drive so I am well aware of the Foundation and the good work that it has done in the community and the various pieces of equipment that it has been able to provide. I know it has advanced well beyond that when I hear the figure of $10million that it has raised for the purchase of equipment and I commend the people who are here from the foundation.

This is a tough question when you have got seniors on the one hand who are very concerned about no home support systems. I am not talking about having someone in to clean their house. I am talking about someone who comes in to change their bandages and to help them bathe etc. Those are the kinds of home support systems that seniors need if they wish to remain in their homes and I know a lot of those services have been cut and we do have an increasing number of people who are aging in our population and we have to be concerned about that.

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I did hear somebody else say with regard to the lands that these were willed. My memory and I haven’t got complete recollection of this but I think that, that is not quite accurate. There might have been one or two but as I recall those lands were purchased by the hospital when they came up for sale and I think that was a smart thing to do. Whether or not the 13 lots that the Coastal Health Authority says that they can sell off, whether or not that is a good idea, I don’t really know. I think we need a lot more information on that and that is why we have people in property management, here in the City. I think we need to go back, we need to have an analysis done of that and I also listen, when I listen to the Coastal Health people talk, it is a tough act. There budget has been frozen for three years. How do you meet the increasing needs of an aging population when you have a budget that has been frozen for three years? How do you meet that need? I don’t know that selling off property is the right answer but I don’t pretend to have all the answers on that. Then when I hear the other statistic that 42% of the Provincial budget goes to health care that is a very big number.

I think what has happened tonight is we have heard from people in the health care community, we have heard from them and I am sure all of us feel very sympathetic to the health care workers because many of them have families and have lived in this community and the uncertainty is never good for anyone nor for their families. However, I am also mindful of the community and we have always taken a great deal of pride in our community hospital and what we have heard tonight certainly isn’t going to inspire any confidence in people nor in people who may have to go in for surgery. I am putting that out there. I think that people who are listening to this are going to feel very uneasy about what has been said. I don’t pretend to have all the answers and I don’t pretend to know all the facts but I think that there is perhaps a balance here that we need to achieve. As health care providers I can understand and empathize with the people who are going through that uncertainty but I also know that health care, the needs have increased, the technology is different, all these other things, pharmaceuticals, everything is costing more money and I am not sure that privatization is the right way to go.

As has been said, they are in the business for money and most of the non profit societies are there for the good of the people so I think we need a very careful analysis done of that. It is a very essential service to our community health care and I think that we need to have some analysis done before we can make any further decisions.

Mayor Sharp One thing we need to be really clear on is that we are not the Provincial Government so we are not responsible for health care but what I heard out of this evenings talk was a couple of things that people are looking for. They want the Mayor and Council to advocate for health care and certainly I would think that the Council is certainly prepared to advocate for good accessible health care. That is kind of like motherhood and apple pie really but I really don’t know to what extent we can do that within our limitations of what local government can do.

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Certainly I also heard some possibility of striking up a committee but if we don’t have any ability to do anything about anything when it comes to health care I guess that Council will have to have a discussion on just how far they want to go down that path. Certainly we are concerned a lot about the health care in our community and just what direction it is taking and we are not happy with the direction that it seems to be taking and that includes the issue surrounding the employment issues and the quality of life and affordability and all the rest of it, that goes along with that. Because if you have people that are working in your community and they are paid reasonably well or decent wages, livable wages, then they can afford to shop and live in your community and that certainly is what sustainability is all about and we want to be a very sustainable community. So we want to have the economics, we want to have the environment, we want to have the social sites, we want the jobs as well. Those are definitely concerns for us so we will certainly have some more discussion on this but not too much more this evening. It is actually not evening any more it is now morning and there has been a lot said.

I don’t know if you have some form of recommendation maybe to have some of the issues taken tonight into consideration and come back to Council?

Mayor Sharp Councillor Mussatto!

Councillor Mussatto Your Worship I think you are right on with that. I think what we should do, looking at the hour, is that we refer this to the next Council Meeting for some discussion in terms of recommendations. Council has pretty much already got the handle of where we are going and I know Councillor Clark has a motion there that needs to be discuss and I know Councillor Fearnley wanted it deferred so he could have some discussion as well. I would move that we discuss this at the next meeting Your Worship.

Mayor Sharp Are you seconding that Councillor Keating?

Councillor Keating Yes Your Worship.

Mayor Sharp Do we need to discuss about whether we defer it to the next meeting or not? Then I will call the question, all those in favour, contrary, carried unanimously.

Recommendation:

Moved by Councillor Mussatto, seconded by Councillor Keating

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THAT consideration of any action regarding “Lions Gate Hospital” be deferred to the next regular meeting of Council scheduled for Monday, February 23, 2004.

CARRIED UNANIMOUSLY

Mayor Sharp A motion to adjourn in is order. Councillor Mussatto!

Councillor Mussatto I am Your Worship.

Mayor Sharp Councillor Heywood!

Councillor Heywood Second.

Mayor Sharp All those in favour, contrary, carried unanimously.

Moved by Councillor Mussatto, seconded by Councillor Heywood

THAT the meeting adjourn.

CARRIED UNANIMOUSLY

The meeting adjourned at 12:10 a.m. on February 17, 2004.

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