Cowed partners bail on worthy project PDF Print E-mail
Monday, 21 April 2008

By Steven Lewis

Barring an about-face by the Saskatchewan government, Station 20 West faces an uphill battle to survive. Its journey from funded project to dream non grata reveals the best and worst about our ambitions for health and community, and our politics.

The project vision — particularly the housing of health-care services, good food store and non-governmental organizations under a single roof — has a powerful intellectual pedigree.

Health care cannot by itself reduce health disparities in populations. It takes community design, development and a comprehensive range of accessible and collaborative services. The non-health-care components are hardly ideology based frills; they are central to what we know about effective inner-city primary health care.

There is as yet no official history of the Station 20 West saga. But the basic anatomy of public policy failure is no mystery. Those who dispute the following account should offer their corrections in public.

A wide range of partners endorsed the project, including QUINT, CHEP, SWITCH, the University of Saskatchewan, the Saskatoon Health Region, the City of Saskatoon, and the Saskatoon Community Clinic.

Successive versions of a business plan have established that the facility would be financially sustainable.

The partnership did not unanimously agree on all aspects of governance and ownership. The community clinic was conflicted: the project would meet its needs for an expanded presence on the west side, but it was used to owning its own facilities and balked at paying rent without an equity position. Notably, the West Side Clinic staff and SWITCH have been steadfast supporters throughout.

The former NDP government parked its $8 million with the health region pending the resolution of the governance and related issues. Obviously it did not park the money firmly enough, because the new government had no problem directing it to be used elsewhere.

How the Saskatchewan Party came to oppose the project is not documented, but there is growing consensus that former MLA Ted Merriman and newly elected MLAs Jocelyn Schreimer and Serge LeClerc were influential critics. Mayor Don Atchison was never a big supporter and, if he is ever up for a fight with Regina, it won’t be over this.

The government has successfully split the partnership. It is in the process of cutting a side deal with the Saskatoon Community Clinic. The U of S has decided to take what the government will give, as long as its educational goals are met. The health region evidently sees innovative primary health care and the replacement of fire alarms as equally worthy.

There is strong consensus that comprehensive and integrated health and health-enhancing services are the best hope to address Canada’s No. 1 health problem — the gap in health status between the well-off and the disadvantaged.

The problem is not vision or knowledge, but commitment and implementation. Station 20 West actually gets it: better health originates in the community and addressing multiple needs in tandem is the only solution to persistent ill health and costly but futile service delivery.

Station 20 West comes with no guarantees of success, but the current approach to primary health care is a proven failure. To those who argue that $8 million is too much to risk, consider that the health-care system in Saskatchewan runs through $8 million in public money every 18 hours, much of it spent to patch up preventable health breakdown.

The responses to the government’s folly are telling. About 2,500 people marched to save the project — a stirring show of community support from a wide range of constituencies. Yet the voices of key institutional partners remain strangely muted. They are afraid of the government and unwilling to speak truth to power.

The dean of medicine and the dean of dentistry have been visionary supporters of Station 20 West since its conception, but their masters have evidently issued a gag order. The city, having provided the land and spent money to clean up the site, now wants to bury the issue, doubtless fearing that standing up would endanger its revenue sharing negotiations. The community clinic has turned its back on its own, its vision and vigour having atrophied since its brave origins in the medicare crisis of 1962.

The government has mis-stepped and these institutions know it. That they are so easily cowed speaks volumes about them and about the state of our polity.

How disheartening that the best primary health care idea to appear in decades has been so swiftly set adrift by those one would expect to champion it to the end. It may be optimistic to expect the health region, the university and the Community Clinic to explain themselves. Perhaps their first encounters should be with the mirror


Steven Lewis is president of Access Consulting Ltd. in Saskatoon and adjunct professor of health policy at the University of Calgary and Simon Fraser University. This piece was originally published as an op-ed in the Saskatoon Star Phoenix.

Last Updated ( Monday, 21 April 2008 )
 
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