When Optics Tell a Different Story, Part 1

A lack of diversity plagues hospital decision making in Windsor-Essex Part 1

Decision making for the new Windsor Essex hospital system rests in the hands of a small group of elite and politically connected power brokers. This group bears little resemblance to the region's increasing ethnic and socio-economic diversity. Elected and unelected officials have created a tightly controlled power structure to promote the deeply flawed exurban development plan. Their top-down approach and highly selective messaging are designed to satisfy a homogenous, mainly middle class suburban and rural audience. This strategy has not only created a deepening divide in the community; it has served to bury the voices and healthcare needs of tens of thousands of residents. Especially affected are those on fixed incomes, those with impaired mobility, and those who are dependent on public transit for their transportation needs. However, this small group of decision makers - among them Windsor mayor Drew Dilkens and Windsor Regional Hospital (WRH) CEO David Musyj -- wish you to believe otherwise...

For example, Mayor Drew Dilkens recently declared his commitment to diversity when he wrote in a Facebook post, "It is important to talk with people who can make us see the world differently." Indeed. He had participated in a June 19, 2020 online panel with local Black, Caribbean and African leaders. The panellists discussed "barriers to justice and equality and opportunities for Windsor to be the most inclusive, respectful, loving and connected community possible."

Mayor Dilkens' stated desire for inclusivity echoes WRH CEO David Musyj's promise from a May 2015 CBC interview: “...the most inclusive, transparent, fullsome process that will result in the best decision for the location of the new hospital. What we have been told is that we have put together such a process up this point by trying to get the community involved.”

Perception is Reality

Optics (and actions) that tell a different story Completely contrary to these laudable stated goals, the decision making process for the planned new regional hospital system has been tightly dictated by a small group with little of the racial, economic or cultural diversity that characterizes the Windsor-Essex population.

"Currently there are over 170 ethnicities and 70 spoken languages making Windsor the fourth most ethnically diverse city in Canada."                         -- City of Windsor, Cultural Mapping Community Stories

1.  A Narrow, Privileged and White Demographic

One glance at the members of the WRH site selection committee confirms an astonishing lack of diversity. Six of them are current or former WRH Board members. They share an abundance of high profile professional backgrounds and prominent board appointments, representing a narrow, privileged and largely white demographic.

One of the members professed a desire to speak for the Francophone community. While that's admirable, who represents BIPOC (Black, Indigenous, People of Colour) or newcomers to Canada, and those who live in the region's most densely populated neighbourhoods (clustered near Windsor's downtown and the city's west end)?

Another member went on to become the president of the Essex Riding Association of Maxime Bernier's People's Party of Canada (PPC), known for its hardline stance on immigration and refugees, as well as its denial of human contributions to climate change. Openly racist social media posts by the Essex candidate caused this riding to come under fire during the 2019 federal election.

Who speaks for the particular challenges of those who are wheelchair bound or dependent on public transportation to get around? Are any of the committee members single parents, perhaps with limited resources and several children? Or is anyone on the committee disabled, with no family support system to rely on? Was this committee ever capable of truly understanding, predicting and planning for the entire community's future needs?

2.  The Men Wielding The Most Power More disturbingly, our regional diversity isn't reflected among those steering the hospital planning through the municipal and provincial approval and oversight processes. These men are the ultimate decision makers. These spokespeople and process gatekeepers have the loudest and most persistent presence in the local media. They are the power brokers who directly speak for the "entire" community at the Ministry of Health and in Queens Park.   But do these men truly represent everyone?

From the top, in clockwise direction: David Musyj, co-chair of the new hospital steering committee and CEO of Windsor Regional Hospital, Gary McNamara, Mayor of Tecumseh and Warden of Essex County,Tom Bain, Mayor of Lakeshore and former Warden of Essex County, Glenn Ackerley, Fairness Advisor, Drew Dilkens, Mayor of Windsor, Dave Cooke, co-chair of the new hospital steering committee and former chair of the Erie St. Clair LHIN.

3.  A "Father Knows Best" Approach To Communication The Windsor Essex Economic Development Corporation (WE EDC) recently hired the lobbyist firm Crestview Strategy ("We make, change, and mobilize public opinion") to "stage" a taxpayer-funded "grassroots" campaign. This approach perpetuates the monolithic top-down PR style (complete with bait and switch tactics) that characterizes nearly a decade of hospital planning and decision making:

"...now we’re providing a platform for a more co-ordinated and effective message.”            -- Stephen MacKenzie, CEO, WE EDC, describing his organization's six-figure taxpayer funded campaign to manipulate residents into supporting the exurban hospital plan.

The ethnicity and professional backgrounds of the four people in the video testimonials posted in June 2020 to promote WE EDC's "interactive grassroots campaign" certainly don't represent the reality of Canada's fourth most diverse city:

From the top left, in clockwise direction: Karl Lovett, International Brotherhood of Electrical Workers Local 773 Joe McParland, Forward 42 Karen Riddell, WRH Vice President, Critical Care, Cardiology, Regional Stroke, Trauma and & Clinical Support Services Kevin Marshall, WRH Director, Facilities & Capital Planning

Stay Tuned! In Part 2, we'll look further at those influencing the push for the County Road 42 new hospital location. We'll also discuss ways greater diversity in decision making can be immediately achieved -- without resorting to tokenism -- and without negatively affecting the provincial funding for our new hospital.

Outsourcing local "grassroots" support… ... to a nationwide lobbyist

New questions about transparency and fiscal stewardship emerged on June 3, 2020, when the WindsorEssex Economic Development Corporation (WE EDC) announced it has engaged Crestview Strategy, a well-known Ottawa (and Toronto) based lobbying firm specializing in government relations, to promote the County Road 42 hospital plan.  The price tag? Six figures.

Last week’s launch of a slick new campaign, attempting to promote the County Road 42 location for Windsor’s proposed new hospital, unintentionally highlights major failures in the City’s and Windsor Regional Hospital’s management of the proposal. According to the June 3, 2020 Windsor Star:

Stephen MacKenzie, WE EDC’s CEO, publicly acknowledged how far off track the project is when he stated it “hasn’t moved forward one step, even one baby step.” Why has the project not progressed? Could it be for the same reasons that the Windsor Region Society of Architects noted in their March 2018 Mega‐Hospital Site Review Report to Windsor City Council?

“Without a strong planning case justifying the selection of a site so contrary to the policies, the selected site cannot be endorsed as good planning for the City of Windsor.”

According to The Windsor Star, Crestview's campaign is “aimed at harnessing grassroots support to help raise the profile and speed up provincial funding for the long-awaited mega-hospital project.” [emphasis added] Yet the company's website promotes something completely different:

"Crestview Strategy effectively represents the interests of corporations, not-for-profits and industry associations to achieve results with governments around the world."

Crestview Strategy is an international communications agency with multiple Canadian offices and one in Washington, D.C., though none in Essex County. Many of the professionals listed on the agency's website have deep ties to Queen's Park or Parliament Hill. Is Crestview unfamiliar with the problems propagated and escalated by hospital management who, in pursuit of shiny new buildings, are unable to fix what's wrong with the local healthcare system? Do they know about the ethical and societal issues revealed by the flawed, nearly decade-long hospital planning process?  Incredibly, the marketing campaign states on social media that Windsor Regional Hospital (WRH) is "no longer fit for use.” How is this possible when a new hospital  - no matter where it's built - is still years away? How can both of WRH's two local campuses be in such disrepair yet score 99.8% in the 2019 national accreditation process?

As far back as 2016, the City and WRH acknowledged a new hospital won’t be ready for use until at least 2026. Fewer than 15 years after major building additions and capital renovations at WRH's two campuses, Crestview's campaign exposes that our hospital infrastructure has been so poorly managed that it’s unusable five years before a replacement was ever planned to open.

What happens to those who need hospital services now? We need a WRH management team who are capable of properly planning for our current and future hospital needs. From the start, hospital leaders knew how long this project would take. They have a responsibility to provide adequate healthcare services for the more than five years before we have a new facility.

Bait and switch, paid for by unsuspecting taxpayers How much taxpayer money has now been spent opposing and suppressing CAMPP’s legitimate concerns since the residents group formed in 2014? For more than six years, local officials have alternated between publicly demeaning and diminishing CAMPP as “just a few naysayers” and spreading fear that CAMPP is a powerful force preventing Windsor Essex from getting adequate modern healthcare. Which is it? Fundamental to Crestview's marketing campaign is a bait and switch approach. Bypassing (actually, completely ignoring) the community’s considerable concerns about location and focusing messaging on supporting a new building is questionable. It has always (and only) been the County Road 42 hospital location that’s contentious. However, local power brokers hope this agency will dupe the public with this shell game tactic to achieve their at-any-cost goal: building an ex-urban hospital at County Road 42 and closing the two accessible, current hospital campuses. Is hiring a large, international corporate communications firm a signal that genuine grassroots support is lacking for their plans?   Or is it simply a Hail Mary conveniently funded by local tax dollars without the need for City Council approval?  Why has the publicly funded WE EDC hired Crestview Strategy to foment grassroots support now - while we await the decision of the Divisional Court?   What happened to the (supposedly) organic local group  - - 42 Forward  - - that arrived in 2019 out of nowhere, fully formed and funded, complete with branded merchandise and a special, advertorial edition of The Drive magazine? Why does the creation of “grassroots” support for the proposed hospital location have to now be subcontracted to an even larger and more professional entity - to one of Canada's premier government lobbying firms?   Data and transparency If over the last 6+ years there was truly so much local “grassroots” support for the location, then why outsource promotion in a six-figure taxpayer-funded online “push” advertising campaign and media blitz to discover IF it exists? How many basic and much needed local infrastructure and other improvements could be made using those same public tax dollars? Where is the data to prove most residents desire or prefer the County Road 42 location? Only Windsor tax dollars (not those of other Essex County communities) will be used to pay for the hundreds of millions of dollars in infrastructure and ongoing maintenance costs for the-as-yet undeveloped Sandwich South future hospital location. The full extent of these costs (which would largely be avoided if the hospital is built closer to the heart of the city) has never been transparently disclosed to the public. How do local residents - especially those disabled, elderly, public-transit dependent or financially strapped -  feel about the future loss of WRH’s Metropolitan and Ouellette acute care hospital campuses if the new hospital is built on County Road 42? WRH trumpets having conducted 70 public consultations. However, information about these “consultations” is scant. There's no data showing who attended these events, the specific meeting agendas or what public sentiment was displayed. CAMPP supporters attended many of these meetings and noted the format always followed the same script: Questions from residents concerned about a greenfield hospital on the edge of Windsor were consistently brushed aside. Attendees were routinely told these meetings were not about the hospital location. Presentations and "discussions" were limited to the features of the plan years before the location - Sandwich South -  was ever officially approved for development by Windsor City Council. Council approval was obtained in a mind-boggling nine-hour meeting on August 13, 2018 during which 37 of the 45 attending delegates voiced factual concerns about the proposal. Of the 8 remaining delegates supporting the proposal, 7 were developers, representatives of developers, or landowners. Only one delegate who favored the proposal was a resident without any apparent financial interests in the location. More than 20 written submissions expressing negative concerns about the site were also presented to Council during that meeting. Yet, despite the overwhelming public opposition, the development of Sandwich South (presumed to be anchored by the future hospital) received a green light.

A convenient vehicle for taxpayer-funded outsourcing WE EDC is a not-for-profit organization that receives its core funding from the nine Windsor-Essex municipalities. Its focus is to “develop and execute strategies to retain, expand, attract and help new businesses start up in the Windsor-Essex region.” The organization posts the minutes of its Board meetings on its website, but we found no mention of the new marketing campaign. The new hospital is not a new business and there is no indication that the consolidation of the existing two hospital campuses will ever lead to any meaningful net employment increase after the completion of construction. WE EDC does, however, promote the projected creation of "13,000" local construction jobs over 3 years to justify the project. These are temporary jobs and each is assumed to be a one-year contract:

In KPMG's October 2015 Economic Impact Assessment Study, the reader is told that 14,698 Full-Time Equivalent (“FTE”) positions (13,000 of which would be local) are expected to be realized over the course of an assumed three-year construction period. A footnote clarifies that an FTE is assumed to be equivalent to one full-time position that is held for one year.  The study doesn't mention that the construction jobs will be created regardless of where the hospital is located.

We wrote about WE EDC in our March 1, 2020 eblast. The organization’s Board has close connections to Windsor-Essex municipal leadership. Current City of Windsor Mayor Drew Dilkens, and Tom Bain, Warden of the County of Essex, have served on the WE EDC Board for many years. Presumably, funding the Crestview Strategy contract through WE EDC was an effective (though blind) way to legally bypass Windsor's Purchasing Bylaw 93-2012. This way taxpayer money could be used to once again attempt to create an illusion of public support without the risk of funding being denied by Windsor's current City Council - - - for an ill-conceived and controversial project, that in a rational world should never see the light of day. It was a covert strategy that didn't require any of the usual public scrutiny or council debate -- or oversight -- that the municipal procurement process normally requires. Is this the proper way for elected officials (and their hired help) to conduct business? How is this in the public's best interest?