When Ida Goodreau took on the role of CEO for Vancouver Coastal Health (VCH) in July 2002, her appointment was met with a hefty dose of cynicism.
A forestry and pulp-and-paper exec (she was senior VP at Norske Skogindustrier and president of Fletcher Canada’s pulp operations before that) with no prior health-care experience overseeing an authority with 24,500 employees and a $2-billion-plus budget? “Ridiculous,” Jean Smith, then-executive councillor with the B.C. Nurses’ Union, fumed. Five years later, the public scrutiny has yet to abate. Last January, faced with a $40-million shortfall, VCH announced it was closing 36 hospital beds and three operating rooms for the remainder of the fiscal year. Amid public outcry, the provincial govern-ment intervened and Goodreau cancelled the closures. Today Goodreau calmly insists the series of events that had her scraping egg off her face was a media-created maelstrom. The decision had already been made not to shut down services, she says, when the story broke. “What the press picked up was a decision-making process that was happening in the health authority… We had already decided that we would not have to cut back,” she maintains. The debacle, which cost the then-chair of the VCH board his job (Trevor Johnson was replaced by former Teck Cominco boss David Thompson), exemplifies the conundrum of modern health care: responding with a limited budget to the increasing needs of an aging population. Goodreau sidesteps the public-versus-private debate, but concedes we may end up with a situation where “the public health-care system defines what you will get in terms of health-care coverage, but if you want some other things, there might be insurances or other ways of paying for those.” Goodreau delivers all of this with cool composure. But when the subject turns to the condition of the embattled Downtown Eastside, the veteran business exec is suddenly all passion. “We can read articles about, ‘We need to do something about AIDS in Africa,’ and then you look at what’s going on down there and you say, ‘We close our eyes to this?’” She throws her hands up in disbelief. “We know what to do, but the money isn’t there for better housing and for adequate shelters and better treatment. The whole thing… wouldn’t cost more than maybe $100 million.” The situation clearly leaves her feeling conflicted. “When you’re within the health-care system and you say, ‘We’re going to now allocate another 25 or 50 million dollars so we can double the number of knee replacements, but we can’t find enough money to provide adequate shelter for a person on the Downtown Eastside,’” she opines, “that’s where you start to wonder about the trade-offs that a well-informed, pretty politically active community in the city of Vancouver still manages to not see, not pay attention to, not act on.” Listening to those strong words, it’s not hard to imagine the next controversy brewing.