Thursday, September 14, 2017

Caring About the Middle Class Means Caring (and Understanding) About Small Business

Recently (January), I made the leap from government to private sector, more specifically I made the leap to go from helping my husband run our business part-time to helping run it full-time. I can say without a doubt, I work more now than I did then (there's more flexibility, I'm generally happier, but no running a small business isn't an easy road to riches). I think there's a lot of misconceptions out there about these changes and what they will mean for the small business climate in British Columbia. As an economist, and now a small business co-owner, I think these changes are awful public policy driven by some academics who have failed to acquaint themselves fully with the pragmatic reasons these provisions are needed and used and what the real-world impact of these changes will be. I'll happily concede there are problems - but those problems merit a chisel not a shotgun, and the absence of fully understanding the impacts these changes will have is unnerving.

To put my comments on this in context - small business accounts for 30% of the economy across Canada, and some 33% here in BC. It employs more 8 million people, and of those more than half are employed in businesses with less than 20 people. Only 4 in 10 small business have ownership that is majority female. Keep in mind not all small businesses choose to incorporate, but many do, and there are good reasons to encourage incorporation. Most are owned by those who are over 40. A good chunk of them do not enjoy excessive profits and of note - they absolutely cannot use the strategies of large public corporations and I'm not sure that we really want to encourage large public corporations at the expense of small businesses.

What's important to remember, is that when it comes to small business - the tax picture is more complex and simply comparing business owners to employees is unfair. Employees have access to EI (including maternity savings), TFSAs, RRSPs, sometimes pensions, often disability insurance, often maternity leave top-ups, Employment Standards regulations and recourse, minimum wage, over time, etc. Small business owners often put their personal assets on the line to back the operations of their businesses, and at the end of the day must put the needs of their employees, the CRA and their clients ahead of themselves. The small business owner gets paid last and might well lose everything with their venture. It is also important to note that the business owner pays tax twice - a corporate tax (when the money remains in the company), and then personal income taxes (when the money is taken out of the company to fund personal needs - housing, food, clothing, etc.) Further, business owners have based many decisions on what is long standing tax law (more than 40 years) - and unlike individuals, they do not have the luxury of planning for a year, but often must plan for the decades ahead.

So let's say you decide to quit the day job and start a small business. Great! Now reality - what are the odds that you're going to be able to do that, and do it successfully without a supportive spouse? Keep in mind that a small business, and in particular a new small business is a demanding venture. (There's an apt saying, you have the "flexibility" to choose which 18 hours of the day you work). Who will take on the load to make sure you can focus on getting the business going and making it a success? Everything else doesn't stop - the kids still need to get to and from school, people need clean clothes, meals need to be made, bills need to paid (really true if it's the partner's day job that is mitigating the risk). Your long work hours take a toll - and now the government is telling you that you can't "share the income" from the business with the person who likely a) gave consent to start it in the first place. b) put family assets at risk for it. c) is taking on the load of the domestic duties (more so when there are kids involved). As an aside, what do you think will happen to the divorce rate among small business owners when the "sprinkling" provision is eliminated? Now, also a reality of small businesses is that they demand a redirection of resources. In part to mitigate the risk of an unforeseen contingency and in part to finance future growth. Are you going to sink funds into your personal TFSA and RRSP and RESPs - funds that can't be used easily by the business should the need arise, or are you going to be able to put all your money into the business? Under the current rules, the choice to direct funds to the business is defensible and reasonable - under the changes it won't be possible, business owners will have to choose to take the money personally (paying personal tax on it, and then if they do put it into a RRSP, or RESP they may not be able to withdraw it later for business needs). So, these small businesses will have less corporate resources available to fund unforeseen contingencies (some of which can be really expensive!) or future growth. Under the current rules, the business owner could be reassured that the funds in the business could be used later as a form of pension (and taxed when taken), disability insurance (taxed when taken as income), or to fund children's post secondary education (again taxed in the hands of the child). Businesses need this flexibility and ability to plan and pay for life events (note - if a business owner is wanting a family, then need to plan for their own maternity leave including paying to ensure the business can continue during that time) and business needs. On the note of tax fairness - I think it's fair that taxation occur at the "family level" - many benefits are based on "family income" so it makes sense that families be taxed as a family and the removal of income splitting from all families was a travesty of the current government.

That covers the passive income and sprinkling provisions that are proposed. Now turning to capital gains. These measures apply more to business succession planning, but what do you think will happen when it becomes much more expensive to pass the family business to the next generation than to sell it to an outside source? Fewer businesses (including family farms) will remain "family businesses" and more will be sold to larger corporate interests. I'll be blunt - we'd love if someday some or all of our children decided to carry on our firm, shouldn't the decision as to whether or not it's "passed along" within the family or sold to an outside interest be at least neutral? What do you think it does for a small business owner, and their approach to their business, when they are thinking that this is something that they are building for their children? If they are sold to large corporate interests, do you think those "shareholders" care about the employees in the same way that the small business owner does? What about caring about their community?

So why does this matter? Because the implications go beyond simple math - it changes the rules of the game entirely, with very little notice. The government has estimated that it will gain $250 million in revenue each year from these changes. If employment in small business is reduced by as little as 5% by these changes, and each of those lost jobs generating $5k in tax revenue (a low estimate) these changes will cost the government more than $2 billion in revenue. These changes mean fewer small businesses starting, fewer small businesses growing, fewer small businesses surviving, fewer small businesses led by women, more family instability among small business owners, and a raft of other consequences. This is bad public policy at its finest and we can stand together for the heart and spine of the Canadian economy - or we can watch this government rip it out and then wonder, why our economy just doesn't perform like it used to.

Thursday, October 6, 2016


It feels oddly real and surreal now.

Now that it has been put into writing.

Now that those words, on that paper have been given, cementing my plans for the New Year.

It feels like leaving home. It feels like saying "yes". It feels like walking out of a maternity ward with a new baby in tow -not quite certain how the future will unfold, but at the same time hopeful and strangely confident that this decision that has been made is most certainly the right one.

The promise of the next chapter in my life, a shifting of weight, and; exhilaration at the prospect of a life in balance, the prospect of the opportunities that now lie ahead.

This is the path not taken. It is overgrown and uncertain - and yet, the path that lies ahead could not be more right for me at this time in my life.

I do not need to know where it will go, all I need to know is that I will grow while I walk it -as a professional, as a mother, as a wife, as a human.

Courage now and gratitude. There is no dress rehearsal.

Saturday, September 24, 2016

An Act of Love

I am on a weekend get away right now - much needed. So much has happened in the months I have not been actively here. Seismic shifts with my husband's business, now fully our business. We helped fight the siting of a sewage treatment plant on what is our front door step. Life with small kids is apt to be, just busy - add a small sliver of time for oneself and then life's true shortage, time, is all the more apparent. Juno's started grade one, and Wyatt is now in his last year of pre-school.

Shifts that I had hoped to make in June had to be postponed. Shifts that would have seen a bit more time here and working on other aspects of Cesarean by Choice had to be postponed. I had to contribute to advocating for where I live, I had to contribute to our business. So I spent and will spend the remainder of my vacation time largely contributing to our business and a bit to helping "Save Clover Point" - thankfully, the efforts to Save Clover Point appear to have succeeded and there is little doubt in my mind that our business will thrive. It's on a good path - it has a great team, they do good work - there is no fear of the hard work that lies ahead. That is the biggest shift, the time and energy I had left after work, after mothering has gone in support of our business and in advocating for where we live in the ways I best know how. But it has meant that this space has needed to take a back seat to the rest of my life. And so, these past few months the Cesarean by Choice Awareness Network on facebook - has been maintained, largely because of the incredible group of women who are there - and indeed it has continued to grow. And so moving from my job, to the work I want to do, fully, truly - might take a while longer.

But it will happen.

We're back on the road to get there - albeit "there" - might be a slightly different spot than what might have been first imagined. "There" now involves a lot more work for our business in addition to the other things I want to do. I'm excited about it though - I'm excited by the prospect of getting to the sweet spot, that place where what I do will align with who I am. I'm excited to leave what often feels like a spin cycle of working motherhood where there isn't quite enough time left over and at the same time, some sadness over that time which feels less meaningful than it could have been.

And yet, the idea of stopping the spin cycle - taking a different approach to my life as I know it. An approach that leaves the "regular paycheque" and the 9am to 5pm and the full pension at age 60 behind, is scary. Indeed, perhaps the largest act of love my marriage has known - is the act of giving permission for me to make this shift in my life at this time in our life. It's an act that says so many things - "I trust you", "I believe in you", "I respect you" - it's an act that is not easy for a spouse to do. I know that - and what lies ahead I do not expect to be easy, but rather I expect it to be worth it.

Love gives wind for wings to fly and heals the wounds that time cannot.

Saturday, June 11, 2016

An Exit, Stage Left

A good friend of mine, a colleague with whom I shared more than a decade of my career, retired yesterday. A small, select group of people - mostly economists, who had intersected his career over the decades had been invited and I felt privileged to be among them. People who had made his career enjoyable, people who had contributed to projects over the years and had assisted in the "good work" that had been done. My colleague, with whom I had enjoyed countless hours of collaboration over coffee over the years was choosing to leave the public service a few months ahead of schedule. Not because there wasn't still good work that needed to be done. Not because he was not willing to do that good work. Not because he disliked the people with whom he worked - but because, but because all of the reasons I had sought to leave the ministry the year prior. A kind of resignation to the reality of the situation at hand and an awareness that retiring was feasible in that context.

It was a pleasant gathering. A reminder of how doing good work, work that makes a difference and working with people who care about that work, who care about evidence informed policy is meaningful. A reminder of the value of coffee with true colleagues. A reminder of the value of remaining focussed on the things that matter. A reminder to do what one can to create the kind of environment and to surround oneself with the kind of people with whom you can collaborate and undertake good work.

That's really the nub of it. When you've had it, being anywhere else - where some critical element is lacking, creates a kind of hunger to find it, somewhere, somehow. To create it or recreate it, somewhere, somehow.

My friend valued his colleagues and his work - he was in the sweet spot for large chunks of his career - and there is something rewarding knowing that I had been (and those others who were in the room, celebrating his career with him) had been a part of the parts of his career where that three legged stool of occupational happiness were realized.

Saturday, May 28, 2016

A Lot to Blog About and No Time to Blog

It feels as though it has been forever since I've blogged here. Life over the past few months has taken a turn for the stressful - and while things were up in the air, I could not blog about it. Before things went from "on track" to "now what" I was looking forward to creating the time and space to get back to the Cesarean by Choice advocacy work - to not only maintaining the Cesarean by Choice Awareness Network on Facebook, but taking it from informal, off the side of my desk endeavour to something more structured. Something that would actively undertake work to help meet the needs of women who choose cesareans. It is part of what I do, that has given me great satisfaction - and nothing has been more rewarding than the certain knowledge that I had helped others in their journeys as women and as mothers. Sadly, it is this work that has been neglected over the past couple of months while dealing with other events. My goal was to go to half time and with half of that half time, making a more formal effort on this front. The dream of having 1.25 days a week to dedicate to advancing this cause, delayed yet again.

The other half of that half time? I was going to spend cultivating the marketing of my husband's law firm and developing an economics consultancy. To that end, it does look like I will get a day. It looks like going to .88 time is in the works - that I will be able to wrest away one day a week from my day job. This falls out from the set of "now what" events. The events that have lead to my husband taking over the firm - and being solely responsible to ensure that its obligations can be met. There are a lot of upsides to that - the team that has been built over the last two years is amazing - the lawyers and staff who work with my husband are a dedicated group of people who are committed to ensuring that the law firm succeeds. The firm is established and has a promising future ahead. However, with the agreement that my husband's partner is to leave the firm, a sizeable chunk of the revenue that was to be expected over the next two years also left. Meanwhile, all of the overhead remains. As a result, there is a need to trim overhead where possible, and look towards more effective marketing strategies to grow the business. To that end, I have become VP of marketing and will in a more formal capacity do what I have been doing informally (I've been managing the firm's twitter account for the past 18 months)- taking on the social media marketing and engagement. It is exciting and the kind of work that has potential to result in enabling my goal of creating time to work on the "work outside of work" that I want to do.

The other thing that has been on my plate - is that I have been engaged in the neighbourhood efforts to Save Clover Point. I have been running the twitter account @SaveCloverPt - and doing what I can to support that cause.

Hoping to being able to blog here more often in the months to come.


Monday, April 4, 2016

Yes, My Panties Are in a Bunch

So I've started blogging over at: - in opposition to a Sewage Treatment Plant plan at Clover Point Park. A Plant that will literally be on my front door step, and less than 100 meters away from my home.

Tuesday, March 8, 2016

Detour Ahead

We were at the point where I was going to go to half-time this coming June. We were at the point where we were going to put in motion plans to build our new house. We were at that point where I was going to start doing more "work outside of work" - more writing, more work in support of cesarean by choice, more work in support of my husband's business (social media marketing, miscellaneous analysis, etc.), more work in support of my daughter's school's PAC, work to do more independent consulting, and a better balance for me.

All of that must now wait again - relegated to the side of my desk once again.

At least the work I am doing at work has improved substantially. At least my marriage is as strong as ever. The kids are healthy. I'm healthy. My husband is healthy. We have what matters most. At least this is happening now, rather than in a few years when the damage would have been far worse (and while the situation is bleak, it could be far worse). In the long-run, we will be stronger. In the short term, it is stressful. In the short term, it is uncertain. In the short term, things that seemed within reach just a month ago are now going to have to wait.

We will get through this. That is the one thing I am certain of - that the now is merely a setback. That we will learn, we will build, we will get to where we're going. It isn't what is best for us financially right now that matters (particularly if that means sacrificing a core value) - what matters is building a business and protecting it, fostering the right team to provide services that meet the needs of clients, services that enable them to focus on recovering as best as possible and maintaining those services through this transition - fostering a sustainable business means that there are sacrifices that need to be made now. Sometimes, in order to grow, you must identify the areas that need to be pruned.

Resiliency and optimism are a powerful combination.

Monday, February 8, 2016

A Lovely Detour

October 2014, I was painfully aware of the need to make shifts if I were to get to a place where I would be happy with what I did, who I did it for and how I did it and the balance between my work life and my outside of work life. I dropped alcohol from my diet, joined a boot camp and set about trying change my workplace for the better with a collaborative “deck the halls with art” project. It was clear that if I could not change where I was, I needed to change where I was. There was also a kind of clarity around what I genuinely wanted to do and I felt as though I was making strides in the right direction.

By May 2015, I had dropped 20 pounds and had navigated into a secondment at a different Ministry. Now, 8 months into that secondment, with promise of my position formally transferring over in the near future – I have learned a lot and have enjoyed the work I’ve done. However, I am again looking at where I am at and where I wish to be. I’ve regained 15 of the 20 pounds lost (note: I did reintroduce moderate alcohol consumption and got a bit lazy diet and exercise wise). While I am doing good work, in a good environment – there is still something lacking and a feeling of there just not being enough hours in the day to do work at work, as well as the work outside of work. My life lacks balance. I am still not in that “Sweet Spot” where what I do truly resonates with who I am and what I wish to achieve. It is, as I thought it might be, moving from one ministry to another but remaining with government; I am happier but not happy. It has been a lovely detour – and it is nice to know now, that I will not be leaving out of some kind of desperation, but rather out of genuine desire to live a different kind of life. I long to get back on the path I first envisioned, a path filled with the work outside of work with the hope of making a life while finding some way to also make a living.

So if I know the destination – then, is it merely a matter of taking steps once again towards that destination? First step get back to getting healthier (back to developing good habits and dropping some less than good ones). Once again alcohol has made the “no drink” list. Once again the kitchen scale has come out to measure. Once again, I’m logging into MyFitnessPal. Once again, I have found another boot camp that works with my schedule. I look forward to again mounting my bike and ditching the car for my daily travels. Having seen what I can do before – I’m confident that I’ll again be running the TC 10K, and if I stick with it, can be in better form for my 40th birthday (now just three short years away), than I have ever been.

Step two – scale back work at work to make more room for work outside of work. The plan is half-time as soon as feasible. It looks like that will happen in the next 3-4 months. That might be enough, that might bring enough balance between the work at work and the work outside of work. At the least it will create a much better balance.

Step three – get back to growing and engaging in work outside of work. There is nothing more satisfying than knowing that you have helped someone else - that you have made their life a bit better. The work I do outside of work, does that. So finding ways to contribute to this world that resonate with who I am and helps others is profoundly important to me - being able to focus on what matters, matters. This is the part that excites me. The part that has the potential to bring purpose back to what I do. The part that fills my soul – for life is short, and I wish to love what I do and find a way to work a life worth living.

Thursday, January 7, 2016

What will you fill your life with?

Of all the resources that are scarce, time is perhaps the most valuable. I have not been blogging much lately, far less than I'd like. Not for lack of material, but rather for lack of time. Life has filled my hours with mothering, and work, and more work and mothering and being a wife. Things I'd like to get done get shoved, postponed - the car goes without an oil change for a couple months past due, the house isn't nearly as organized as I'd like, I'm not as on top of a variety of things as I would like (Christmas cards, what Christmas cards?) - but the mission critical things are getting done. The bills are getting paid. Work is in a much better spot than it was. The kids are being read to, fed, dressed and to school on time. The Cesarean by Choice Awareness Network on Facebook continues to flourish as a community of support. My husband has been able to focus on building the business - and in time we will get to where we need to be.

I would like to take a step back, to find a few hours to think about what the future might look like - to identify and set aside time to do the things I'd like to do. To identify the things that will bring me joy - and to find ways to have those things fill more of my time. To identify the things that are not bringing satisfaction, and to find ways to have those things take less of my time.

More blogging seems to be in order.

Saturday, December 26, 2015

To What Was, What Is and What Will Be - Farewell 2015

Every year, without fail, between Christmas and New Years my mind turns to the year that was, and the year that is to come. Almost always, there is a combination of thankfulness for all that has been learned (particularly true in the most challenging years), for my family, for friendships and hope for the year that is to come. I think about the sorts of things that will move me towards my goals - personal goals, professional goals and purpose goals. I think about what has held me back, and if there is anything that can be done about those things.

In recent months I haven't been blogging as much as I would have liked - not because there has not been anything to write about (indeed there has) but rather because lack of time, leads to a kind of neglect. Indeed, there have been numerous posts began, but never finished - on work, on maternal request cesareans, on the health system, on Parent Advisory Councils and the education system and on life. Posts have been begun, stale-dated and never posted - and I have missed blogging. The space where ideas are let loose publicly - the exercise of writing, both for my own understanding and to share my ideas with others. I hope to do more blogging again in the year to come.

On the work front, I am once again, reasonably happy. Once again, I find myself working for someone who is the kind of leader I would hope to be. Someone who truly values the abilities of his staff (and understands what those abilities are), gives meaning to work, and fosters a good work climate. Once again I am engaged - and for that I am thankful. Yet, I find myself thinking that less would be far more - and so in the year to come, I am hoping to move away from a full-time schedule so that I can make more room for work outside of work - the work on the this blog, the Cesarean by Choice Awareness Network, the work I do for my husband's firm, for writing and mothering & life. Simply put, there's 24 hours in a day, and in order to find balance and perhaps do more that means more, I must adjust - I must make time and space for that work outside of work. It appears at last, that that opportunity will come to pass in the year to come.

I am incredibly thankful to be in a position where that is possible - where I will be supported to find a better balance, and I am incredibly hopeful for what that means in the year to come. I am incredibly thankful for the people and circumstances in my life that has made the year ahead possible. Indeed, looking back at 2015 - the foundation has been laid for an incredible 2016.

To 2016 - and beyond, wishing all the best - health, happiness, friendship, love, hope and success.

Monday, October 19, 2015

Election 42 - Go Vote!

I am usually a decided voter long before I enter the polls. This year I was a decided voter, until I was not. Until my preferred candidate withdrew from the race, after the nomination deadline – leaving me yet again, undecided, except for clear knowledge of who I would not vote for. I brought both my children with me – my daughter for the second time, and my son for the first time. I entered the gym of my daughter’s school and approached the table where I was directed to present my voter registration card and ID. The election worker neatly crossed my name off with a ruler and handed me a ballot. I proceeded to the box, and unfolded the ballot. I checked to ensure it was as it should be – unmarked. I then made a choice, my pencil alternating between two of the candidates before I clearly marked an X beside one. I folded my ballot again and put it into the box - narrating the process for my daughter.

Her name was still on the ballot – there was no prominent notice of her withdrawal at the polling station I attended. Momentarily, I entertained the idea of marking my “X” there despite knowing that she had withdrawn. I felt remorse and a degree of anger – after all, her reason for withdrawal was that comments she had made on facebook had been taken out-of-context and paraded about. It was not anything that she had done in the course of her work, nor in the course of her public duties – but rather her private life that had put an end to her political career. Further, it was comments made years before she was a candidate – comments that may not have even reflected her current beliefs. Comments that should have been given the same amount of deference as comments made at a dinner party.

And yet, she withdrew.

I still wanted to vote for her – for her party – in some measure because of what had happened. I wanted to vote for her, because, I believe people have a right to their personal lives – even and perhaps especially those who run for office. I wanted to vote for her, because, I believe people should be able to “live out loud” – and that their careers, their actions in public – should speak much louder than what they might have said or wrote in their private lives (including on facebook with the intended audience of friends and family). I believe that people continue to mature – that the views once held, change over time – and that what matters, truly, is a willingness to grow and learn from one’s experience. Her name was the one I wanted to mark my “X” beside – even though she withdrew.

If only she had not withdrawn. If only the party had stood behind her in some measure. If only…

Because, those who express themselves are at least willing to have their views challenged. They are at least willing to let it be known what they believe, and often why. The candidates with facebook pages are not the ones to be feared – rather, it is, the candidates who live their lives in guarded fashion who are worthy of skepticism. Those who dare not speak what they think, because of the political repercussions – for they are not willing to have their ideas challenged. Do not be fooled, guarded candidates still hold personal beliefs and opinions, but unlike those who post to facebook, they are not willing to have those beliefs challenged.

If we want a transparent government, we could start by supporting those who live their lives transparently.

Saturday, October 3, 2015

Do Stand Alone Birth Centres Make Sense? Do they ensure quality care?

St. Paul's hospital in Vancouver is being redeveloped. As part of those plans, is a stand-alone birth centre that will be supported by midwives and family practitioners. It is a non-hospital facility. It is intended for low-risk births not expected to have complications.

As a non-hospital facility it will not offer epidurals. As a non-hospital facility it will likely have a high-rate of transfers to the hospital facility adjacent to it - to facilitate either pain relief or surgical delivery when necessary. It is largely conceived with the idea that births that do not involve interventions - will save money, and that the best way to avoid interventions is to remove birth from hospital facilities and have births attended by practitioners who do not view birth as being inherently in need of intervention for low-risk women.

Designing maternity care services with the view to limit the use of intervention is not going to deliver quality care to BC Women or their babies, but rather is going to increase the number of mothers who ultimately have poor experiences of care and longer term consequences as a result of that care. The harm caused by failing to intervene in a timely way when it is needed versus the harm caused by intervening too soon is an order of magnitude worse. A mother who leaves with empty arms or who will be caring for a profoundly disabled child for the rest of her life, has suffered a far greater harm than a mother who might have had a cesarean sooner had she been giving birth in a fully integrated, hospital based maternity ward.

Further it segregates care in a way that is likely to lead to lesser quality care. When family practitioners and midwives who deliver maternity services are segregated from OBGYNs it often leads to less collaboration in care - fewer opportunities to discuss their patients and develop professional relationships that benefit their patients. At it's worse, it can lead to situations where women and babies die because OBGYN's are seen as rivals rather than colleagues.

Lastly, it segregates women, new mothers from one another. It is one more way in which one mother can goad another - where how a woman gave birth is advertised merely by where she chose to give birth. It is one less thing for mothers to have in common when they meet at the neighbourhood park or coffeeshop.

If quality care is the goal, collaboration between those who provide maternity services is key. If quality care is the goal, timely care is paramount. If quality care is the goal - how maternity services are structured must be integrated, not segregated. Women should be empowered to make the choices that best meet their needs - and not coerced into making the choices that best meet the needs of the system.

What is the goal? Quality care or to save money?

Thursday, July 30, 2015

Victoria's Plan for Topaz Park Deserves a Public Policy Darwin Award

This past week Victoria’s mayor and Victoria’s city council passed a motion 8 to 1 to consider establishing a designated tenting area in Topaz Park for Victoria’s homeless population. Since then, there has been a public outcry about the proposal –because a “designated temporary tenting area” by another name is a “tent city”.

At first blush, it would seem to be a quick and inexpensive fix to the problem. The homeless need shelter, a tent provides shelter and a designated tenting area has to be better than random encampments throughout the city – doesn’t it? Why not use a city park to provide land for the shelters of the homeless?

It really is rather incredible, that a problem as intractable and pervasive as homelessness has such an easy fix. After all, if the problem was as easy as a “temporary tenting area” why has it not been tried before? (Never mind that the “tent cities” that sprung up at the Cridge Center, St. Ann’s Academy, Beacon Hill Park in the past were unmitigated disasters that cost nearly a half-million in policing costs – but those were “tent cities” not formally “designated temporary tenting areas”).

After all – what could go wrong with congregating a population that has a high incidence of addiction, mental health struggles, and various other problems in a public park? What could go wrong with failing to provide showers and food and adequate washroom facilities (never mind the intensive counselling and assistance many of these people would need to actually end their struggle with homelessness)?

So will the city be on the hook when the surrounding neighbourhood finds that property crimes skyrocket? Will the city be on the hook when a child is injured by a needle discarded in an adjacent play area? What about when one of the residents of the “temporary tenting area” assaults another? After all, such problems are foreseeable – does the city not have a responsibility to ensure the health and safety of the residents of the “temporary tenting area” and the neighbourhood around it?

On further thought, not only is a “temporary tenting area” a very bad idea, it is a complete non-solution to the problem while creating a multitude of other problems – both for the homeless and for the surrounding neighbourhood. Further, if a “temporary tenting area” is established at Topaz park then, what park is next?

This idea deserves a "Public Policy Darwin Award" - for taking a serious problem and making it worse.

Wednesday, July 22, 2015

Sun Peaks Hit and Run Leaves Groom-to-Be in Serious Condition

There’s a bride-to-be who was less than 6 weeks away from what was supposed to be her wedding day. This time was supposed to be the start of a new life together – filled with planning and anticipation. This time was supposed to be the time when she should have been imagining the years ahead, of hoping and dreaming about their future together.

This past weekend, their dream turned into a nightmare. While at Sun Peaks, her fiancé was celebrating the upcoming nuptials with close friends. On the walk back to where he was staying, at about 3am on Sunday July 19, 2015, he was struck by a truck and sustained severe injuries.

The bride-to-be is now sitting by her fiancĂ©’s side in a Kamloops hospital room. Praying, pleading for his health; he is in serious condition. The bright future that laid ahead for the couple, just a few days ago – now seems incredibly uncertain. The months ahead will be focussed on recovery and healing – coping as best as possible.

The prospect of the future is made even more uncertain as the person responsible for his injuries remains at-large. The driver of the truck that struck him did not remain on the scene and has not come forward – making a tragic and heartbreaking situation an order of magnitude worse.

It is hoped that the damage will be mitigated. That he will recover as best as possible from his injuries. That the person responsible will come forward, or that information will lead to his/her identification and that he/she will be held accountable. The family has posted a $10,000 reward for information that leads to the driver responsible being held accountable.

Anyone with information is asked to call Lambert and Williams Law Corporation at 250-589-2174 – information that leads to a criminal or civil conviction of the driver will be considered for a $10,000 reward. Police are seeking anyone with information about this hit and run as well.

Sunday, July 19, 2015

Pushing Back for the Best Choice - Cesarean by Choice in Canada Deserves Respect, Compassion - Not Mocking

Canadians, and Cesarean by Choice moms in particular, should be outraged at what is considered to be appropriate behaviour by research institutions and hospitals in Ontario. A website has been created - - and supported by the University of Ottawa, McMaster University, the Canadian Institute for Health Research, the Canadian Health Services Policy Research Foundation, Markham Stoufville Hospital, and Queensway Carleton Hospital. It is deeply offensive and mocks patients while purporting to "Push for the Best Choice".

The content of the webpage is as follows:

Caesarean section (CS) is an efficacious option for birth, but is not without risks to mothers and their babies, including maternal mortality, infection, hemorrhage, maternal or fetal injury, increased recovery time postpartum and difficulty breastfeeding. Given these risks, it is problematic that CS birth currently accounts for more than 28% of all births in Ontario in 2010/11, which is nearly double the 15% target recommended by the World Health Organization.

I should note that vaginal birth (VB) is also an efficacious option for birth, but is not without risks to mothers and their babies, including maternal mortality, infection, hemorrhage, maternal or fetal injury, increased recovery time postpartum and difficulty in a wide variety of areas. But this article completely neglects the risks of vaginal delivery - and then proceeds to declare the prevailing rate of cesareans as problematic, while trotting out the WHO's zombie statistic that was quietly retracted in 2009 as having no evidence to support it only to be brought back to life this past year, despite having questionable evidence to support it. There is no "ideal cesarean rate" - and despite wide criticism this number continues to pervade popular media and policy circles alike.

The common perception that this large and increasing proportion of CS births is attributable to maternal requests for CS does not reflect the available evidence, particularly in a Canadian context. Maternal factors that are more likely to contribute to the increase in CS birth include increased maternal age, use of assisted reproductive technology, incidence of obesity and gestational diabetes. While these maternal factors are likely attributable to changes in sociodemographic and health status in developed countries, of particular concern are the obstetrical practice changes that have led to an increased use of technological intervention during birth. Such interventions (including increased use of labour induction, augmentation, epidural analgesia, and electronic fetal monitoring) are associated with an increased risk CS, even in cases of otherwise low-risk birth.

I agree that maternal factors (changes in the incidence of medical indications for CS) likely contribute to the higher rates that are observed in Canada. However, the article then goes on to criticize the use of technology in birth. What the article fails to consider is what happens in the absence of that technological intervention. More stillbirths (rare, but the incidence of still birth increases after 39 weeks), more neonatal asphyxia, more 3rd and 4th degree tears (and likely more pelvic organ prolapses subsequently), more PTSD as a result of extreme and uncontrolled pain... but, I guess all of that is justified to achieve a higher rate of vaginal delivery. Given the choice between many of these outcomes and undergoing a cesarean - many women would choose the cesarean and the use of technology as it best meets their needs.

Despite evidence of effective individual strategies to curb inappropriate childbirth interventions that focus on either patients, maternity care providers, or hospital policies, little is known about the cumulative effect of a multifaceted strategy to reduce CS birth.

Inappropriate by whose standard? Is it inappropriate to respect patient autonomy? Is it inappropriate to avoid the worse set of outcomes by minimizing their risk and increasing the risk of cesarean? Inappropriate to provide adequate pain relief? Little is known about the cumulative effect of a multifaceted strategy to reduce CS birth - but it is absolute foolishness to think that such a strategy is going to come without some harm. Maternity care needs to focus on what really matters, and that is not "mode of delivery" - it is healthy and happy outcomes that best meet the needs of individual mothers and babies.

As a final slap in the face, a cartoon accompanies the article (below) - a complete caricature of a doctor and a patient making a medical decision. Under the cartoon is the disturbing statistic - 10 percent of mothers (without prior cesarean) would choose it, fewer than 2 percent of mothers actually have a cesarean as a result of maternal choice.