City council pushes discussion over restructuring Hamilton board of health to next week

City councillors are pushing further discussion on how to restructure Hamilton's board of health to next week, while they figure out if and how they can better integrate community voices into the board.

Local advocacy groups are calling for a change to who sits on the board to include more community members and experts.

At Monday's board of health meeting — the first of the year — Kojo Damptey, executive director for the Hamilton Centre for Civic Inclusion, and Lyndon George, executive director of the Hamilton Anti-Racism Resource Centre, each stressed the importance of a community presence on the board.

"If we have a board of health that doesn't have health experts on the board, how is that going to inform the strategic vision?" asked Damptey.

"With the newly elected board of health, we are here again to call on the board to not wait and move forward with building the board with a vision that includes community members to the decision making table," said George.

The board is currently made of up 16 members — all Hamilton city councillors plus the mayor.

In 2021, local doctors and community advocates, including George, Dr. Natasha Johnson, a pediatrician at McMaster Children's Hospital, and others pushed the city to include medical professionals and people with lived experience on the board of health in a structure similar to boards in Toronto and Ottawa.

In October 2020, Dr. Theresa Tam, Canada's chief public health officer, urged for structural change in public health in a report on an equity approach to combatting COVID-19. She stressed the need to prioritize the perspectives and leadership of people who have experienced stigma and discrimination. 

"Often times it is racialized communities, Indigenous communities calling for transformational change to address these issues," George said in 2021. "It's about having that seat at the table and having your voice being heard."

On Monday, the board said it was waiting for a report back from the Ontario government on how to restructure. It expects that report in April, it said. 

Coun. Ted McMeekin said he wanted to get the restructuring settled soon and let "the province and the various governments know that we're not prepared to waiting another 25 years."

Coun. Brad Clark put forth a motion to create a subcommittee that would include community members while the city waits for that report, but the motion was tabled to allow councillors time "to research the proper language and venue for the motion," Mayor Andrea Horwath said.

Coun. Cameron Kroetsch suggested the board take some time to work with Hamilton's medical officer of health, Dr. Elizabeth Richardson, "to get the numbers correct — how many people will be part of the board of health — so that the motion to put forward a change to the procedural bylaw actually makes sense." 

The process is expected to be discussed again next week. Clark said he wanted input from staff to clarify how to add members of the public as citizen appointees onto the board before council meets on Jan. 25. 

Coun. Nrinder Nann said council also needs to understand why the process is needed exactly.

"We should be clear about why the equity piece needs to be integrated in structurally," she said.

Looking to Toronto, Ottawa

Richardson said it would be easier to create a subcommittee that would act separately and at arm's length from the province.

"Under the current legislative piece, all of council is the board of health for the City of Hamilton, which can't be changed as is."

She said the creation of a subcommittee to deliberate issues related to public health services is within the city's purview and the province recognized it would be simpler moving forward because it would only require changing the City of Hamilton Act rather than also seek changes to additional provincial legislation.

George suggested examining Toronto's board of health, which is made up of six council members, six members of the public and one "education representative."

Ottawa's board of health has 11 members — six councillors and five members of the public.

"Restructuring the board provides a real opportunity to create a decision making framework that critically examines operational decisions from an EDI [Equality, Diversity and Inclusion] lens with accessibility and inclusion principles embedded in the process," said George.