PAC Member Blog

It was recommended that we begin a blog on the PAC website. It could encompass observations about events and trends, and perhaps eventually answer questions and direct people to information. 

See below for the first entry from PAC member Lisa Newman:

The parkette at the end of my street has always been a welcome green oasis for us central city residents. Several shade trees, a concrete table with a permanent chess-board top and three park benches were all the amenities needed to give respite from the city's noise and bustle. I am not sure who decided it was necessary to tear up our little parkette completely but I suspect it was a central, bureaucratic decision made without input from people who actually use these parks; similar construction has made several other downtown parks inaccessible.

The renovation of our parkette has gone on for many months now, and we have been deprived of its use, as large fences and earth-moving equipment along with a portable toilet now inhabit that space. The work has apparently been contracted out to several different private firms: some days we see a few workmen there, but most days it is empty. The drawing posted on the fence shows a design that seems little improved over the previous, natural parkette and uses many hard materials (stone, brick, concrete) not much different from city buildings and protruding shelves for gussied-up flower boxes which for most of the year will not have any blooms, due to our cold Toronto climate.

What does this have to do with healthcare, you ask?

It struck me the other day, as I once more walked disconsolately by our abandoned parkette, that the decision-making process for this renovation had a lot in common with similar top-down processes in health care, especially because there has been no input from the users of the service and poor coordination among the implementers of the vision. This has all the earmarks of an 'expert' decision made by people who do not have to live with the consequences of their grand scheme. We are familiar with this in healthcare: it is provider-centered rather than patient-centered planning. And the change in this case was not driven by the expressed needs of local park users; rather, it seems to me that the parks department may have been responding to an imperative to spend their budget before it disappeared. The result: a lot of uncoordinated effort to produce a suboptimal result. It could have been improved (as our healthcare could) by seeking out input from the actual users of the service.