Stephen Rees's blog

Thoughts about the relationships between transport and the urban area it serves

Posts Tagged ‘Regional Health Authority

The Need for Improved HandyDART Service

with 4 comments

Once upon a time I worked for Translink and the HandyDART file seemed to reside almost permanently on my desk. If I can recall any one summarizing emotion about that it would be intense frustration. The problems then were only too apparent, and the willingness to do anything about them was almost non-existent. I would like to be able to say that since I left more able minds were employed and things got better. But they haven’t: they have got a great deal worse. And mostly because everyone involved in the decision making process prefers to ignore demographics.

The story makes the front page of today’s Vancouver Sun, but my own resolution to not link to paywalled sites can be maintained since there is also coverage at the Vancouver Media Co-op. And my friend Eric Doherty, who is the author of the report, has made the whole thing available on line at his own web site as a pdf. I recommend that you read the whole thing.

The points made by the report are telling. The need to use Handy DART rises steeply with age, and the population “over 70 in Metro Vancouver has increased by two and a half times that of the general population” in the last five years. This is nothing new – the same effect can be observed over a much longer period. But during that time HandyDART service has not been increased. Indeed it has been cut, in part due to a misguided belief on the part of the former Translink Commissioner Martin Crilly that taxis would be cheaper. He formed that opinion after hiring his old friend and former colleague Glen Leicester – who was previously Translink’s Vice-President of Planning who presided over the years of inaction on the same issues when he was my boss. He now operates as Shirocca Consulting of North Vancouver and his usual methodology is very selective comparison with other Canadian cities using CUTA data.

The headline statistic is the rapid increase in the number of trip refusals – 4,900 times in 2008, 13,400 times in 2010 and 37,700 times in 2012 – obtained by an FoI request. It is also pointed out in the report that trip refusals actually understate the problem. “Trip denials do not show the full extent of unmet demand people won’t attempt to book trips they know will be denied.”  That’s actually a tweet I made which slightly edits what Eric wrote to fit the Twitter 140 character limit.

Privatising the service did not help at all. Previously Translink contracted with a number of smaller operators – mostly societies run by people with disabilities, with one company on the North Shore which must have had one of the most quixotic mission statements as it could not have ever turned a profit. At no time in the years I was involved was there any suggestion that this arrangement was especially problematic, although the re-organisation and concentration of health services by the province was making the need for cross-boundary trips increasingly problematic.

I do not understand why an American based for profit organization needed to be brought in – and they have not performed well. And – just in the interest of full disclosure – MVT in the US is run by Kevin Klika who was once a brother-in-law of mine.

Once of the real changes I have noticed in recent months is that the Health Authorities have at long last woken up to the health impacts of our dysfunctional transportation system. They have sent representatives to at least two of the recent pubic meetings about the future of transit in the region. Perhaps this is being driven by the work of Larry Frank at UBC. But the concern expressed so far has been restricted to the general health of the population at large (see yesterday’s post for Larry’s take on that) and none at all about how the geographic concentration of outpatient services has put such a strain on the sector of the population that needs it most. It needs to be understood that when you are over 70, you are much less likely to be in employment or full time education, so the only trips you can qualify for on HandyDART are those of a medical nature. That must be borne in mind too when you look at trip refusal rates.

The failure of Translink to meet the essential needs of the most vulnerable sector of society is egregious, but in large measure it can be laid at the refusal of the Health Authorities to work cooperatively with Translink. Their view seemed to be that transporting patients was not any of their concern. As long as it could be downloaded onto the patient then their own statistics and financial data would look better. They were, after all, only following the example of other service providers – such as retailers. By choosing to build bigger facilities, and seeking “economies of scale” more of the distribution/collection problem could be downloaded to customers. IKEA, for instance, not only expects you to travel a long way to its stores, it expects you to take care of delivery and final assembly – unlike most other furniture retailers. Of course, Health Authorities do not face much competition – so the pressure has simply been from politicians who only think that public services ought to be run like businesses.

HardyDART is much more a social service than a business and its shameful neglect of its responsibilities has to laid at the feet of these same politicians. And, I am sorry to say, at those of a number of senior officials only too willing to do their bidding and not stand up for their mandate.

Written by Stephen Rees

November 20, 2013 at 11:43 am