Editor:
Last Wednesday I attended “Let’s Talk: Invitation to Community Information Session on Obstetrics in the Bow Valley Corridor,” co-sponsored by Covenant Health and Alberta Health Services.
The session was a response to community concerns raised about the recent contentious decision to close the birthing unit in Banff Mineral Springs Hospital and centralize such facilities in Canmore.
From the point of view of public participation, the Let’s Talk event was a fiasco. It was a disappointment for community members who came to express their concerns about the decision to close obstetrics in Banff, and an opportunity lost to engage public input by those sponsoring the event. The apparent attempt to mollify community opposition had the opposite effect, making a bad situation worse, in my opinion.
I’m not a medical doctor, but I do have a doctorate in community and regional planning. Community engagement and public consultation are areas of my expertise. My work is mainly in the natural resources sector, but the lessons are analogous. From what I saw, Alberta Health seems behind the resource sector. It reminded me of the disastrous forestry information sessions we used to see 10-15 years ago.
I told as much to Patrick Dumelie, president and CEO of Covenant Health. Whatever the evening’s intention, the result was to alienate people further. Community members came prepared to speak at the invitation to Let’s Talk, yet were consistently shut down when trying to share their point of view.
The information session was set up in a rather one-way fashion with audience members only allowed to ask questions. If community members appeared to share point of view the facilitator cut them off, demanding the process be respected and a question posed.
Coupled with the fact that over 100 people showed up with only 30 minutes allotted for questions, it gave the appearance there was little interest in hearing what people had to say. It looked more like an attempt to stifle dissent than obtain input. Thus, community members left even more disgruntled and determined to fight a decision in which they felt they had no voice.
Given what I witnessed, I found rather incongruous, even insolent the comments of Mr. Dumelie in a followup news item citing him as saying “there was nothing that Covenant or AHS officials heard that would prompt them to reconsider…” (Calgary Herald, Feb. 14). This gives the impression the event was somehow structured for community members to give input. It was not. Whatever the intention, the meeting was structured and conducted in a manner that curtailed authentic audience participation.
My hand was raised for 30 minutes throughout the session, but I didn’t get a chance to speak. Like others in attendance, I had prepared for the opportunity by reading public health literature and studying reports. Several research papers suggest rural hospitals maintain obstetrics to sustain community health and quality of life.
One of the most compelling is the “Joint Position Paper on Rural Maternity Care,” approved by the Council of the Society of Obstetricians and Gynaecologists of Canada, the Canadian Association of Midwives, the Canadian Association of Perinatal and Women’s Health Nurses, the College of Family Physicians of Canada, and the Society of Rural Physicians of Canada.
I had also scrutinized the Community and Rural Health Planning report for the Bow Valley Corridor (AHS and Covenant Health 2012) and discussed this with an AHS official. There was little on obstetrics. This community engagement process was closed-door by invite only. Various public health stakeholders were included but one of the most important was left out: those who would be using or denied service. The greatest tragedy is that pregnant women seem the most politically marginalized in all this.
The whole affair gives the impression of a decision made prior to community engagement, of using the process to justify a decision rather than make it. The result will limit the range of choice for women and their families with regards to health care in the Bow Valley.
I am not convinced this limiting of choice will improve delivery of obstetric and family medicine and believe it may lead be a decrease in the quality of health care posing a risk to community sustainability. It’s hard to avoid the conclusion that this was a politically-motivated decision made behind closed doors. Lesson from the resource sector: notification does not constitute consultation.
David Lertzman,
Canmore
