Woes of Northern Ontario Universities: Bad Medicine at NOSM

 

In the wake of the news of the Laurentian layoffs and the provincial government’s unwillingness to assist the situation there in any direct financial fashion, a new disruption to northern Ontario’s universities was announced.  The Ontario Government apparently without consulting with the affected stakeholders is now proposing that the Northern Ontario School of Medicine and the Université de Hearst become independent, stand- alone universities.  The Northern Ontario School of Medicine (NOSM) opened in 2005 and is currently a not-for-profit corporation of Lakehead University in Thunder Bay and Laurentian University in Sudbury.  Obviously, the province is using the current restructuring and chaos at Laurentian to pursue other agendas that include interfering in existing corporate arrangements.  Clearly, it does not have enough on its hands with the pandemic.

 

The creation of NOSM was a long-term effort by many in northern Ontario and since its opening 2005 an ongoing partnership has been forged with university faculty and staff on both campuses, health-care providers, Indigenous communities, community and regional business leaders.  The academic oversight provided by Lakehead and Laurentian has created a unique curriculum that has trained over 600 physicians in a learning model that spans the entire region and conducted research and training relevant to health needs in the north. NOSM has made use of infrastructure – buildings, administration, services and otherwise – on both campuses that have generated substantial cost savings for the government. Given the Ontario government has already stressed university finances by cutting tuition 10 percent and freezing it and keeping provincial grants frozen, why would it continue to stress specific institutions in northern Ontario further by subjecting them to the disruption and costs of tearing asunder something that is working?

 

This development is really quite remarkable, and one wonders if the province is planning to sever the Michael G. DeGroote School of Medicine from its affiliation with McMaster or unilaterally grant the University of Toronto’s Faculty of Medicine independent status also?  Probably not, because those are settled southern schools in the provincial heartland and the core of Ontario civilization which is nestled in a 10-kilometer swath alongside the 401 Highway corridor.  Meanwhile, the Northern Ontario School of Medicine is so far away and therefore is still considered part of Ontario’s colonial administration heritage. The colonialist overtones of this intrusive activity are even more remarkable given that NOSM in particular has a focus on rural/remote and indigenous health and services.  Or, has the provincial government already obtained buy-in from First Nations in Ontario’s North?  There has been silence so far from Alvin Fiddler, the Grand Chief of Nishnawbe Aski Nation who is usually quick to respond to injustice.

 

The provincial government news release calls this action “Steps to Strengthen Postsecondary Education in Northern Ontario.”  How making NOSM with 460 students and Hearst with 160 students separate independent degree granting institutions strengthens the system by adding two tiny universities that will require endless subsidization beyond what they are already getting is considered sound public policy is a good question.  And one imagines that in the case of NOSM, the fact that it was on two campuses was never something that it liked and may even be complicit with the government in getting separate status so they can move to a shiny new campus in one location. After all, even if the province did not consult with Lakehead or Laurentian before announcing their proposal, they must have discussed it with NOSM’s administration, right? I would not be surprised if NOSM’s future new stand-alone home is a nice new mega building and campus in Sault Ste. Marie, home of the current minister of Colleges and Universities.  Who benefits from government policy is always a good question to ask.

 

Costing of Ineptitude in Thunder Bay

 

Well the leaky pipe saga continues in Thunder Bay if one is to judge from the continued entries on the Facebook page of the Leaky Pipe club which now has 3600 members.  For those seeking a quick recap, in an effort to mitigate the environmental effects of lead pipes for an estimated 8,000 households in Thunder Bay, the City of Thunder Bay added sodium hydroxide to water which changed the pH level of the water (reduce its acidity) and therefore helped neutralize the lead content.  However, this additive was put into water going to all homes and it was apparently successful in reducing the amounts of lead.  However, after full extension of the procedure in 2018 following the 2016 pilot it appears that the incidence of pinhole leaks in copper piping of private homes and businesses in Thunder Bay has gone up dramatically. In the worst-case scenarios, not only is there corroded copper piping in the home springing leaks but also the service line goes necessitating repair bills in the tens of thousands of dollars.

 

While there are neighborhood concentrations of affected homes, chats with plumbing and restoration company employees – not to mention the odd nameless municipal worker - indicates the problem is actually more widespread than the City will acknowledge with homes across Thunder Bay affected and indeed even affecting relatively newer homes constructed over the last 10-15 years. It appears this chemical is highly correlated with the corrosive damage and the City of Thunder Bay stopped the additive in February of2020  in response but remains tight-lipped even in the face of the obvious continual plight of homeowners who during a pandemic have also been afflicted with the anxiety and trauma of every morning wondering if they are going to be the next “winners” of Thunder Bay’s leaky pipe lottery.   The fact is that probably all of Thunder Bay’s housing stock has been compromised to some extent and the question is only when things are going to happen.

 

In the end, this is all part of Thunder Bay’s complicated ongoing 25-year water infrastructure saga which has seen the move to one source water supply in the wake of the giardia saga on the south side two decades ago, the rapid increase in water rates to fund all the new infrastructure and maintain the old, the flooding of the new East End water sewage treatment plant – and surrounding neighbours - the introduction of sodium hydroxide to reduce lead in pipes on the cheap, and the removal of sodium hydroxide in the wake of numerous reports of pinhole leaks and more flooding   All of this has also generated several major lawsuits – for flooding in 2012 and now pinhole leaks in 2020.  

 

It is a mess and characteristic of municipal decision making in Thunder Bay given that in an effort to do important things cheaply – the best decisions are not made.  In the case of lead mitigation, the best long-term strategy is pipe replacement by the homeowners.  There should have been a proper financial incentive put in place by the City long-ago to get people to do it but that was probably seen as “expensive.”

 

Instead, despite concerns raised, the City of Thunder Bay went with sodium hydroxide.  While the City of Thunder Bay can argue that they made the decision with the best available information at hand, the province made them do it, and other cities have used sodium hydroxide with no such consequences it remains that something in Thunder Bay has gone horribly wrong. Was it something about the chemistry of Thunder Bay’s water?  Was it the application process when the chemical was introduced?  And what about the response of the City to so much distress?  In the end, even if one can accept that they made a decision based on the “science”, the response to so much resulting misery has been appalling.

 

If one wanted to do a simple summary tally of this penny-wise and pound-foolish approach of the ultimate costs of this entire imbroglio, it would be something like as follows:

 

Lead mitigation on the cheap by adding sodium hydroxide to City of Thunder Bay water:  Annual cost of $264,000.

Potential savings to the 8,000 homeowners with lead pipes by not having to replace their pipe at their own expense or at City of Thunder Bay expense: $40 million.

Potential cost to the City of Thunder Bay of lawsuit from homeowners affected by Leaky Pipes: $350 million.

Potential cost to the City of Thunder of lawsuits yet to come from insurance companies seeking to recoup their costs from all the claims in Thunder Bay: Yet to come.

The value of Thunder Bay’s short-sighted behavior, ineptitude and callousness in dealing with the fallout: Priceless.

By the way, in case you are wondering, I finally got to win big with Thunder Bay's newest lottery this week. 

 

 

 

What Is Federal Health Minister Hajdu Really Up To?

 

Part of the strength of Canada’s political system is its federal structure and the perennial back and forth between Ottawa and the Provinces.  The fact that regional differences are accommodated within a common framework of shared responsibilities is a strength of our system of government and in normal times the endless bickering is really a sign that everyone is still talking.  However, as the recent pandemic has illustrated, during times of crisis the tug of war can be less productive with both Ottawa and the provinces to blame as they engage in short term politics.

 

Here is an old joke.  The UN Secretary-General commissions a report on elephants from all of the member countries.  The United States hands in “How to Raise Elephants for Fun and Profit,” the United Kingdom sends “Should You Invite an Elephant to Tea,” France sends in “The Love Life of the Elephant.” And Canada? Why it sends in “The Elephant: A Federal or Provincial Responsibility.”  That is funny – well at least to some people. “Vaccines: A Federal or Provincial Responsibility?” That is not so funny to anyone given the current spread of COVID-19 variants and the race to vaccinate.

 

So, what’s up with Federal Health Minister Patty Hajdu? All of a sudden, the Federal Health Minister takes to the media with pronouncements that vaccines are having an impact and that the public is anxious about getting their shot but that the provinces (especially Ontario) are not getting the vaccines out fast enough.  Moreover, the Federal Health Minister now plans to monitor that vaccines are being used in a timely fashion after delivery to the provinces and territories and plans to post weekly figures showing how many vaccines have been delivered, and how many have been administered on a province-by-province basis. According to the Health Minister: “I think this is something Canadians want to know. They want to know how efficiently vaccines are getting out the door, and they are also curious when it will be their turn.”

 

Really? A new type of federalism to add to the lexicon: “Watchdog federalism” with the federal government as a large dog that barks constantly but never bites.  After all, the federal government has left the heavy lifting to the provinces when it comes to vaccine delivery aside from negotiating one of the biggest options contracts in Canadian history designed to vaccinate Canadians many times over – eventually.  Why did the federal government not invoke the emergency powers it has under the constitution to invest in its own emergency vaccine production and distribution network?  The UK apparently was able to ramp up production virtually from scratch in nine months – we will get domestic vaccine production in 2027.  The federal government’s reluctance to invoke the emergency act early on to deal with the pandemic in the end was probably political.  After all, it would be the second Trudeau in Canadian history to have invoked the emergency powers of the federal government and how would that play in the next election?

 

It is likely that an election is indeed in the offing.  One wonders if the Federal government’s response to this crisis would have been different if it had been a majority rather than a minority government.  Its actions in dealing with the pandemic always proceeded with a timidity that one could interpret as being more concerned with political optics than getting the job done.  Its lagging behaviour in dealing with the pandemic at the outset was a factor in its spread and Ottawa continues to lag.  It took almost a year for the federal government – which incidentally under the constitution also has the power of quarantine – to set up a quarantining program for returning air travelers and that program is as porous as everything else. Apparently, about of quarter of returning air travelers have been getting exemptions of one form or another.  That probably explains why all three new variants – UK, Brazilian, South African - have gotten a foothold in Canada – the only country to do so.  Furthermore, the delay in March in federally procured vaccine supplies arriving provided a one-month lag in vaccinating ahead of the variants allowing for their foothold to grow.

 

The supply of vaccines has now finally begun to increase. The federal response now? Delivery is a provincial responsibility and they are going to monitor and constantly point out provincial shortfalls rather than do something constructive like send in the military to help vaccinate. Unfortunately, Canadians have the attention span and memory of a fruit fly and if repeated often enough will come to believe that any failures during the pandemic were all the province’s fault – just in time for the next federal election.

 

COVID-19 Case Trends for Ontario and TBD: What a Difference A Month Makes

 Ontario appears to be firmly in the grip of a third wave of COVID-19 that is marked by the spread of the new and more infectious variants.  As Figure 1 illustrates,  and the trend line suggests we are going to surpass the peak of the second wave in terms of daily cases.  

 

Ontario has been reporting close to 3,000 cases a day for the last four days and it does not look to be anywhere near peaking.  On the other hand, the Thunder Bay District appears to have gotten its long second wave finally under control and as Figure 2 shows, the trend is now down.

A month ago, the trends seemed to be completely opposite.  At that time, the Thunder Bay District was trending up pretty rapidly while Ontario as a whole up until two weeks ago still seemed undecided as to whether it was going to trend up or down.  

Of course, Thunder Bay is probably only going to have a brief reprieve because new variants of COVID-19 do not appear to have gained a foothold in the district yet though they have been making an appearance both in the Northwest.  If you check this map provided by the Toronto Star - as of March 30th, Thunder Bay District still appears to be reporting 0 new variant COVID-19 cases whereas the Northwest Health District to our west is reporting 24% new variant cases and the Algoma to our east it is reporting 68 percent.  We are lagging for now but one suspects this is not going to last.  

The only possible salvation is if Thunder Bay District can get ahead of the new variants by vaccinating heavily.  Apparently, the Astra-Zeneca was available at pharmacies as of Saturday but I am not aware if any vaccines were given out during the long-weekend.  Whereas in Thunder Bay, it is normal to have your MRI scheduled at 3 in the morning because of demand and capacity constraints, it would appear that round the clock vaccination during a pandemic is not happening.  That is either because we are incapable of innovating or thinking fast enough or more likely - there is simply not enough vaccine to keep giving shots 24/7. As well, there have been now more than a few anecdotal stories emerging on how it is possible to get a vaccine at the end of the day if you know someone working there.  I suppose what else is new in Thunder Bay, Canada's biggest high school clique masquerading as a large urban center.

Without widespread vaccination quickly, the new variants will gain a foothold here too. Relying on people social distancing and following the rules is not happening. If you have been to a large retailer the last few days, watch how most people going in do not even bother to sanitize their hands.  Compliance with and enforcement of public health measures has been the problem all along in Thunder Bay and beyond.

Yes Councillor! Municipal Costs in Thunder Bay Are Higher But Let Us Explain...

 

Thunder Bay spends one of the highest per capita amounts of major Ontario cities.  Moreover, it has chosen to prioritize three things: general government, police, and fire services.  Indeed, of 27 major Ontario municipalities, Thunder Bay spends the most per capita of its tax levy supported operating budget on these three things as illustrated in Figure 1.  Indeed, nearly 60 percent of Thunder Bay’s operating tax levy is spent on these three items.  Naturally, what it also implies is that there is less to spend on everything else and in fact, while Thunder Bay spends one of the highest amounts per capita and the most on general government, police and fire, it actually spends a lot less on everything else compared to these other cities.

 

 

 

Now, if I were a Thunder Bay city administrator tasked with addressing  the above statements in response to a query by a municipal councillor, I would naturally respond by saying that yes indeed, councillor, the numbers are higher but they really do not tell the entire story because in Thunder Bay ‘general government’ is a broader and more encompassing term of innumerable complexities compared to other municipalities that are located in more densely populated and less policy challenged parts of the province.  As well, I might even venture that perhaps Thunder Bay includes costs in general government that other cities do not as part of its own diverse and unique circumstances reflecting its special position as a northern municipality with serious social and economic issues of the utmost seriousness that in the fullness of time must be very seriously addressed.

 

Of course, that begs the question as to why the composition of the numbers that have been used in the above comparisons - which come from the BMA Municipal Report – would be so different given that they are supposed to be constructed and provided to allow for some type of standardized comparisons?  Needless to say, at this point as a City Administrator I would probably respectfully argue that these are complex questions beyond the pale of the councillor's valuable time given their plethora of pressing duties and ultimately requiring further study by knowledgeable and qualified individuals with intimate knowledge of local realities.  If pressed for details on the composition of general government spending in Thunder Bay, I would certainly take the request into consideration and get back at some future date as providing the data requires substantial resource expenditures given its all-encompassing complexity.

 

So, we are left to our own devices. In addressing the higher costs of certain municipal expenditures in Thunder Bay, perhaps we can focus on something more specific and better defined rather than something as amorphous as ‘general government’.  Why not policing or fire?  Figure 2 provides a first ranking of policing by presenting the number of police officers per 100,000 population obtained from Statistics Canada for 15 major Ontario centres in 2019 (with Hamilton only available up to 2017).  It turns out that Thunder Bay does not have the highest numbers of officers per capita of these 15 cities. It is tied with Windsor at about 205 officers per capita.  

 

 

 

No doubt there are extenuating circumstances as to why Windsor has so many officers. -perhaps there is more crime in border cities with a lot of casinos.  Thunder Bay is a border city – well almost – but it is very close to the border.  And we have a casino too.  Lo and behold, Thunder Bay, also has a lot of crime so we must be like Windsor after all.   And as for Ottawa which has so many fewer officers, it is the seat of government and also has innumerable other security forces such as our military and the RCMP which allow the municipality to spend less on policing.  If only Thunder Bay could be blessed with a Canadian Forces base or perhaps a branch office of CSIS, we would be a more secure place.  Moreover, Ottawa is inhabited largely by peaceful civil servants and government sector workers so it must be a more law-abiding town, right?  But wait, Thunder Bay has over 30 percent of its employment in the broader public sector – not as high as Ottawa but still very high by provincial standards - so why no spillover into crime statistics?

 

 

 

Of course, the number of officers may be correlated with cost but perhaps policing resources in Thunder Bay are abundant because we pay officers less and therefore, we are getting more bang for our buck?  Well, Figure 3 looks at the cost of policing for these same 15 major Ontario centres using cost measures from the BMA 2020 Municipal Report.  The cost measure is what is available – the cost of policing in terms of dollars spent on policing per $100,000 of tax assessment.  Using this measure, Thunder Bay comes in third place – behind Windsor and Timmins – at $439 per $100,000 of taxable assessment.  Put another way, in Thunder Bay, if you have a $250,000 home, you are probably paying close to $4,000 in property taxes on that home.  Of that amount, $1098 (2.5 times 439) is going to pay your share of police services – about 28 percent of your taxes.  In other words, in Thunder Bay, one-quarter of the tax levy goes to provide policing services. A good question is how this might compare to other cities but good luck conveniently getting the data for that.

 

Are there good reasons why we spend a lot on policing in Thunder Bay. Yes, councillor, maybe.  Or, maybe not. However, relying on the City of Thunder Bay to make the case rather than a more impartial source probably results in a predetermined answer. It still does not change the fact that we are at the top of the list both in terms of policing numbers per capita and in costs as measured by the publicly available data.  Does that mean we need do nothing about it? No. We can always do better.  That does not mean spending more on policing, it means finding ways to achieve current outcomes with less money.