This article was published as part of the Healthcare Forum's Healthy Communities Action Kits, Module 4, in 1994
International Copyright 1994 Joe Flower All Rights Reserved
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For Healthy City Toronto to survive political attack in November 1993, we had to use practical political means. We had to convince the mayor, who sits on the City Council, to switch her vote. The project couldn't survive without a political fight.
We did that through the superb support of corporate representatives, community groups, and individual citizens. Almost 40 people spoke before the council's executive committee. Many of them were undisputed pillars of the community, including Bill McCloud, the president of Women's College Hospital. He said, "We have used the model. We have had very successful partnerships with the team. We have put money from the hospital into their projects, including a week-long workshop on violence against women." It was the way that these citizens explained the value of the city's own project that made the difference for many councilors. We went into it one vote short of survival. Their clarity and eloquence had a powerful impact.
The other thing that we had to do to survive was to give a clear commitment that I would leave the project, that it would be headed by someone from inside City Hall. The battle resulted in some nasty personal stuff aimed at me. It was a combination of politics and the process of finessing the mayor's determination to have me out of City Hall without jeopardizing the rest of the team.
Some of the group that founded Healthy City Toronto were, in fact, inside the bureaucracy. The group included both Trevor Hancock at the Board of Health, and Ann Johnson, the chair of the Board of Public Health. Around the time of "Beyond Healthcare conference held in Toronto in 1984 , this group put together a vision statement called "Healthy Toronto 2000." One of the big-ticket items in that statement was the idea of Healthy City Toronto, with its own office and core team.
Jack Layton, a subsequent chair of the Board Of Health, ran for mayor against the current mayor. Even though Jack Layton had not founded the project, the initial implementation was done under him between 1989 and 1991, and was identified with him. So city councilors who were opposite him politically and personally had a political goal out of wiping out anything associated with him.
By the time I arrived at City Hall, the rationalization that many bureaucrats gave to me for their lukewarm support was because it had such a politically unpopular sponsor. The reality was unimportant at that point. The mayor's strongest supporters on the council were taking an intensely personal revenge.
I had been living elsewhere, and when I came back to Toronto in 1991, I was mortified with the changes that I was seeing in the city. At the same time Trevor and the rest of the group were concerned that the Healthy City Toronto office was already becoming bureaucratized, and not doing the real community work. For instance, people being discouraged from working evenings and weekends -- which of course is when many community organizations get together. There were overtime considerations, and concerns over management control.
So they got me to come in. The team was doing substantive work. What I did was validate their work, fire the project manager, and change the model we were working under. The former manager had been trained to control people. I have a very different model. Some people would think they had gone to hell if they have me as a manager, because they need structure. We made the flattest line we could given the limitations of the bureaucracy. We defied the job descriptions that we had been saddled with. It was an honor to work with that team.
When I had been around for a bit, the city department heads and commissioners had an annual golf day. Over a beer, I said, "What do you guys want?"
They said, "We have put a bunch of dough into this, and we aren't sure it's producing what we wanted. In fact, we aren't sure what we want. But we want someone to either turn it around and really show what it can do or shut it down. Give it the best shot, and have the professional honesty to tell us if we don't have a model that works."
Becoming director wasn't a career move for me. We all knew that. That's also why they believed that I could kick butt. I couldn't possibly have done these things without both inside and outside political support and without the excellent core team at the Healthy City Toronto office
But when it came to the fight, there was daylight between the mayor and her supporters. Among other things, she is the first woman mayor, and some of her strongest supporters are definitely anti-woman.
The whole thing played out in the media. The council debate was televised live for hours and hours. A lot of people watched it. At one point the most supportive and courageous councilor said to me, "My God, you're such a lightning rod!" There's no question that it has an emotional cost. By fighting it so openly we secured the survival of the project, but there was also a bureaucratic backlash. I tried to absorb as much of that as possible in order to protect the team. When the project's genesis is within city government, and the livelihood and future of the people on the project is dependent on the government, there has to be someone who can take it on publicly. Bureaucrats are very vulnerable
Trevor Hancock and I agreed on the perfect insider to take it over: Fran Perkins, a nurse-midwife and former president of the Canadian Public Health Association. We convinced her to put her name in. They ended up with six great applicants, highly-skilled insiders, and though we had nothing to do with the selection, Fran got the job. We are just thrilled.
Between the time of the political fight and the time I left, we were able to re-organize the project. A lot of those changes, which we were able to make very quickly, came about because I was not an insider, and did not depend on this for my career. I worked for free for my final three months at Healthy City Toronto. By the time I left, the organizational change was so far into the system that it couldn't be stopped
It's still vulnerable. If a project is bringing about concrete results, it will run into trouble. By definition, it goes against the status quo. All we managed to do was secure the structure of the project.