2016-KohutRachelBy Rachel Kohut

During the final weeks of my internship at the Legal Network, I got the chance to witness Toronto City Council pass three supervised injection sites. It was an enlightening experience to say the least, and definitely not what I was expecting. What was supposed to be an hour at City Council watching the motion pass, quickly turned into a whole morning.

Research, community consultations and careful planning had been thoroughly undertaken before these three proposed sites were brought before city council, with these recommendations ultimately brought forward to City Council by the Board of Health. Day of, the Medical Officer of Health for City of Toronto was present for any lingering questions. Turned out, there were many. I was admittedly a bit shocked that so many people had so many lingering questions, and that many of them were seemingly entirely off point. It was as if they only skimmed a few documents the night prior. All of a sudden, the conversation became about methadone treatment, instead of about safe injection sites.

Toronto City Council Chambers
Toronto City Council Chambers

Three Councillors voted against the proposed supervised injection sites: Giorgio Mammoliti, Christin Carmichael Greb and Stephen Holyday, as they were not swayed by the arguments presented to the Council Chamber. They questioned the efficacy of the sites, further arguing that the sites would be ‘enabling’ and ‘dangerous’. Mammoliti made a motion to change the location of the sites to hospitals, pharmacies and medical clinics to make them more safe. This was rejected by Council.

This last minute hail mary pass that caught me off guard. There were many other opportunities to raise these concerns beforehand, whether at community centres where consultations were held, or at discussions with the Board of Health. Why weren’t these concerns raised them, particularly given the technical nature of the subject matter?

Interestingly, once Mammoliti’s motion was tabled, he didn’t stay in his seat for long. He immediately shimmied to the top of the chamber, where the press was eagerly waiting to question him. But the discussions in the lower part of the Council Chamber didn’t stop. In other words, Mammoliti wa voicing his plight about the safety and efficacy of supervised injection sites to various news outlets at the top of the Chamber, while those in the lower part of the Council Chamber who were elected to represent the voice of Torontonians were continuing the discussion.

It quickly became apparent that this was a last minute media ploy more than anything, which got me thinking about the role of the press. Everyone has the right to know what is happening at City Council and media plays a big part in communicating discussions to the public. But did it really have to be that second?

Medical Officer of Health for City of Toronto, Dr. David McKeown, answering questions from councillors.
Medical Officer of Health for City of Toronto, Dr. David McKeown, answering questions from councillors.

What further struck me about this process was the role of the Medical Officer of Health in the discussions. Having previously worked at the Chief Public Health Office at the Public Health Agency of Canada, I am aware that the role of medical officers in decision- and policy-making is often murky at best, but it is hard to disagree with the fact that they are brought in for their technical medical knowledge and opinion.

As I watched David McKeown thoughtfully and patiently fielded questions from councillors who obviously didn’t read up on supervised injection sites, and what it meant for the city, I could only imagine what was running through his head. Maybe he was just as frustrated as me to witness councillors not seizing the opportunities to become better informed when they are presented, and instead turning around to create opportunities for public confusion and personal gratification. This moment for clarification rapidly spiralled into a moment of public health education 101, with science struggling to hold its own for a moment in the mix.

Thankfully the motion passed and if all goes well in Toronto’s application for a federal exemption, the city will soon have three supervised injection sites. But wow, what a whirlwind to get there.