I used to like him; not so much now…

Back in the ’70s when he ran for mayor and we both lived in Toronto, I voted for John Sewell. And when he won, I was a big supporter of his human-scale policies and planning, and enjoyed his youthful vigour and vision. Now, not so much. Sure, he’s a smart, well-spoken, erudite man with a long list of credentials. But he’s also wrong. At least about one issue: our hospital.

Sewell and Collingwood resident Karina Dahlin (former Editor, executive communications, the Hospital for Sick Children, according to LinkedIn) wrote an opinion piece for TVO’s online magazine titled, “Health care gaps: Ontario forcing sprawl by putting hospitals at the periphery.” Sorry, but that’s nonsense.

Both writers are members of the local committee formed to fight the proposed move of the hospital from its near-central location to a new site on the periphery of town. Why Sewell – whose bio states he lives in Toronto – is so involved in Collingwood politics mystifies me.

Sewell was a darling of some former VOTE (Voters Opposed To Everything) members; years ago he was brought in to speak about several issues like planning and growth, mostly in support of their own notions (VOTE, as you know, killed the Admiral Collingwood development which would now be a stunning, income-generating anchor to the downtown had they not interfered).

I’ve written about the hospital in the past (here, here and here for example) – mostly about The Block’s (and the administration’s) ongoing war against the hospital, its development committee and its board. It is a battle between The Block’s idée fixe and the greater good of the community, between personal and public agendas.

While the article makes some good points, it’s not exactly an unbiased and objective look. And in part their argument is based on a faulty association: a big city and a small town. They write:

It is occurring so frequently that it appears to be ministry policy: don’t build a new hospital in the centre of town, only on the periphery. That’s what has happened in Owen Sound, St. Catharines, North Bay, Oakville, Peterborough, Barrie, Cobourg, and other communities.
And there are plans to do the same thing in Windsor, where the two large downtown hospitals are slated to be torn down and a new $2-billion facility built out beyond the city’s airport; in Collingwood, where the downtown hospital would be demolished and a new $400-million facility built among farmers’ fields, beyond what town council calls its “built boundary;” and in Bracebridge and Huntsville, where two hospitals would be demolished and a new one built literally halfway between the communities, in the bush.

We are relatively similar in size to Owen Sound and Coburg, but not to any of the others. Certainly what happens in Windsor or Oakville cannot be reasonably compared. The differences in land values in the core versus those in the outskirts are so much greater in cities that you cannot compare the economics in such communities. Plus they are single-tier municipalities and we are second-tier.

The article is full of such idealistic but inaccurate simplicities. We are told nothing about the circumstances of these communities, their finances, the age or condition of their existing hospitals, their catchment area, local demographics or the reasons for a move. We cannot in good faith judge them even vaguely similar without a lot more information.

Lumping them together for ideological purposes creates no semblance of continuity or commonality. We must know more and judge each on its own merits to make an opinion valid.

And don’t forget a crucial, overlooked factor: The Collingwood General & Marine Hospital is a regional facility. It doesn’t serve merely Collingwood; its role in our collective wellbeing is not defined by the razor-sharp lines of municipal boundaries. If it did, their arguments would carry more weight. Being regional, it serves Blue Mountains, Clearview, Stayner, Wasaga Beach and the rural community – a catchment area with about 100,000 people of whom about a quarter live in Collingwood. Having a hospital in central Collingwood is of no advantage to the majority of the people the CG&MH serves.

However, having it situated closer to the highway, with easier access for emergency vehicles and for the numerous out-of-town residents seems more equitable for the vast majority of people it serves.

Let’s look at the article’s headline: forcing sprawl by putting hospitals at the periphery. Well, that’s not true because sprawl is mostly associated with single-family homes and commercial mall development. Of which there is none in the immediate neighbourhood of the proposed, industrial site and (to the best of my knowledge) no new residential developments, malls or strip malls are planned for that part of town in the immediate future. And there are no farmers’ fields on the Collingwood side (only on the Clearview side because that land is zoned rural).

But even without a hospital, all of this municipality will eventually be developed because Collingwood is identified as a growth node by both the province (Places to Grow Act) and by Simcoe County (official plan). Growth will include a lot of single family dwellings – sprawl, if you will – whether the hospital moves or not. It’s disingenuous to suggest the hospital will be the source of that growth and the attendant sprawl.

The last few provincial policy statements have insisted on core intensification in communities, so I would argue the province is not trying to promote sprawl, but instead to contain it. Smart Growth America says this about sprawl:

“Sprawl is defined as the process in which the spread of development across the landscape far outpaces population growth. The landscape sprawl creates has four dimensions:

• a population that is widely dispersed in low-density development;
• rigidly separated homes, shops, and workplaces;
• a network of roads marked by huge blocks and poor access;
• a lack of well-defined thriving activity centers, such as downtown’s (sic) and town centers;
• a lack of transportation choices other than personal cars,
• and difficulty of walking as a result of housing locations.”

A single hospital in an industrial-zoned area is not by itself sprawl since it does not in any way necessitate a subsequent low density population growth will follow. And it is the municipality’s responsibility to ensure that transit is available to service its hospital in an appropriate manner, not the province’s.

I would also argue that replacing the current hospital lands with medium-high density housing is quite the opposite of sprawl. It will intensify the core considerably – a benefit to the community overall.

The authors ask, “…why does the province want us to build them on the edges of our towns instead of at their centres, where people can reach them?” Well, we don’t know what the province wants at all, and the authors merely suggest one possibility (or conspiracy theory). Perhaps the authors should have asked the Minister or anyone in the province for a comment before flying off into ideological space.

Let’s look at accessibility and walkability. How many people walk to our hospital now? or bicycle to it? It’s not on the trail system (which isn’t cleared in winter) so access is along the streets only. Most people require vehicles to get there.

For me, it’s about 2.8-3 km away* and it’s about 1.8 km from town hall. I have bicycled to it on a clement summer day, but never walked. If I was sick or hurt, I wouldn’t (or couldn’t) do either. I suspect few would. Certainly seniors won’t walk there unless they live very close by and only then when the weather isn’t cold, raining or snowing. Our transit system does stop there, of course, as it does in the vicinity of the proposed site (the bus line goes to next-door Georgian College already, so it’s a minor adjustment to extend the route to the adjacent property). Yet the authors write:

In Collingwood, for example, retirement homes, the hospice, and doctor’s offices are all located close to the existing hospital but won’t be close to the new facility. Most patients and their families live in town, not in the fields surrounding the new facility, and there will be little public transit to the new site, so it will be more difficult (and more costly) for those who will need to rely on taxis to get there.

This ignores the large Chartwell development on the west side of town, plus the huge Balmoral retirement village being built nearby. It ignores the thousands of condos that populate the shoreline and Cranberry. It ignores entire west side of town for which the hospital is not immediate and is no more accessible than if it were on the edge of town.

And how do the authors come up with the “most” for their patient count? We are quoted no statistics, no numbers or data to confirm the residence of patients. As I recall from media interviews I did several years ago, and from sitting on the hospital board for two years, most of the emergency patients were from out of town (one of the arguments the hospital has always made for more provincial funding has been the high number of patients from outside the catchment zone). I doubt this has changed. Unless the authors specify where they get “most” from, the term has no credibility.

Face it: we’re a car culture. Sure, I’d like to change that, have a more walkable community, better public transit, but I’m sure you know people (as I do) who won’t walk two blocks to get milk or a paper, regardless of the weather or time of day.** Most people choose to drive and we have to accommodate their vehicles. Our planning laws require a fixed number of parking spaces based on type of usage and size. No matter where the hospital is, a larger facility requires more parking spaces for more staff, more patients and more visitors. A parking lot is not what most people want to look out their home windows and see.

And hospital parking – both fees and availability – has long been a difficult, controversial issue that won’t be resolved easily no matter where it locates to; except that a bigger site will allow for more spaces.

Personally, I’d rather the traffic and the attendant pollution, noise and safety hazards it creates be further away from the core than closer. Having a busy hospital close to the core only contributes to traffic congestion – just walk the hospital zones in downtown Toronto during the work day to see that (which I do whenever we visit there for our mini-vacations).

Emergency vehicles will have less traffic, fewer stop signs and traffic lights to contend with on the edge of town. I’m sure residents near the current hospital don’t enjoy the sounds of sirens and horns when these vehicles approach. The move might be welcomed by them. The authors never asked.

How far away is the proposed new site? It’s about 2.5 km from the current site (1.5 miles) and 3.75-4 km from town hall (2.5 miles). While that may be away from the town’s built up area, it’s not like it’s moving to Mars. It’s a five-minute drive away from the current site (at the legal 50km/h). Even walking, it’s only about 20-25 minutes further.

The authors wrote, “…ministry staff has also told boards they must find a large site, at least 30 acres in size, in order to create a health campus for the next 50 or 100 years.” Again the comment is unattributed to any reliable source, so we don’t know who said it, when, or if it’s merely anecdotal. Or even if it’s just more truthiness.

But it seems fairly sensible to me. After all, the build out is about a decade away. Collingwood is scheduled to grow to 31,000 or more by 2030 and by then the community will look and feel much different. At the same time, our neighbours will have grown and changed. Shouldn’t we be looking at what serves the regional growth best for the future?

Is a hospital in a quiet residential zone the most efficient place, the best site for everyone? I’m not on the committee that determined the new site, so I don’t have access to all their deliberations and data. But I would rather see more housing and small shops and offices there to give some vitality to the community.

Sadly, Sewell and his committee have the ears of The Block, a council group not known for clear thinking or working for the greater good, and adamantly opposed to learning anything new, so council will accept the article and its vague premises without bothering to fact check, and will continue to do everything in its power to stop the move.

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* In comparison, to walk from Bloor Street along Yonge all the way down to Front Street is 2.7 km. Who walks that, aside from homeless people? Pedestrians take the subway, cabs or drive.
** One traffic study done here in the 1990s found that people parking downtown seldom walked more than 200 feet (61m) from their car and if required to walk further, would return to the car and move it closer to their destination rather than walk all the way.