This is part one of a two-part series.
By Paul Caune and Victor Schwartzman
Feb 13, 2012
Late last year one of Canada’s health authorities proved yet again that people with disabilities do not have a practical way to enforce their civil rights.
The George Pearson Centre is a sixty year old nursing home in Vancouver, British Columbia, for adults with disabilities. On November 8, 2011, two top executives of the Vancouver Coastal Health Authority (VCH) met with residents of the institution. The meeting was recorded with the knowledge of the participants.
The minutes of the meeting can be read here:
Dr. David N. Ostrow has been the President and Chief Executive Officer of VCH since March, 2009. He graduated from the University of Manitoba in 1968.
Mary Ackenhusen, the other top executive present, is one of VCH’s three Chief Operating Officers. She has a MBA from Harvard, a degree in Industrial Engineering, and had a “leadership role” with the Fraser Health Authority for ten years.
A short bio of Dr. Ostrow can be read here:
A short bio of Ms. Ackenhusen can be read here:
On the other side of the table from the two executives were twenty-six residents of the George Pearson Centre. Some of them have lived in Pearson for decades. These citizens are the experts on the quality of care at Pearson.
The Pearson Residents Website can be read here: http://www.pearsonresidents.org/
The first thing about the meeting that struck Paul Caune, Executive Director of Civil Rights Now! (http://civilrightsnow.ca/) and a former inmate of Pearson, was that Dr. Ostrow and Ms. Ackenhusen “were breathtakingly patronizing. The entire event must have been extremely humiliating for the residents.”
How the meeting happened
In the summer of 2011, Dr. Ostrow visited Pearson accompanied by Kip Woodward, the Chair of the Board of VCH. At that time Dr. Ostrow was asked to meet the Residents Council. He promised he would. The meeting took a few months to set up, and in November, 2011 Dr. Ostrow returned, this time with Ms. Ackenhusen.
At the beginning of the meeting, Ms. Ackenhusen said: “Something I’d like to start with, something that really David has brought to the organization in
his leadership role, is something we talk about: people first. I know from your comments and knowing what goes on here, you might say we are not living that philosophy.”
Paul Caune says he was stunned. “It was insulting to begin the meeting that way: ‘You might say we are not living that philosophy’?” The people sitting in wheel chairs in front of Ms. Ackenhusen have given VCH a mountain of evidence which proves VCH does not put the people living at Pearson first.
“The residents do not need verbal Valium. They need the freedom to protect their dignity.”
For proof that the people living in Pearson have never been first in anything except bad news go to: http://civilrightsnow.ca/2010/10/george-pearson-centre-isnt-a-prison-says-bcgeu-bs-says-the-evidence/
Paul noted that there were no apologies from either executive for the poor care at Pearson. “Ms. Ackenhusen went on to say: ‘Although I’ve read a lot [about Pearson] and heard a bit here and there and certainly have familiarity with issues here…a lot of what we’ll do today is just listening and trying to understand how we can start to make an impact on these very long standing issues. I’ve read the reports starting back in 2000, which highlights some of the issues, which I believe we’re going to talk about today, so we’ve gone a number of years and haven’t made the impact that you’d like to see.’ Ms. Ackenhusen did not say what specifically the issues were, why VCH hasn’t even started after a decade to make an “impact” on them, and why they are very long-standing.
Paul’s comment: “VCH has been in charge of Pearson for a decade. Reforms could have been made ten years ago. The executives acted as if Pearson has been administered for the last decade by some vague force, nameless, invisible, and obscure to the senses or control of mere mortal men.”
“The very fact ‘issues’ have remained ‘unresolved’ is a fundamental failure; it’s a betrayal of the public’s trust. And that was how the meeting started!
Later on, Dr. Ostrow admits some issues have been ‘unresolved’ since 1980: thirty-one years! That is overwhelming proof that at least in regards to the
citizens incarcerated in Pearson, VCH has does not believe in or act on its People First principle.”
VCH should not be permitted to continue to administer Pearson
Paul notes that COO Ackenhusen said “We [are] doing our best and probably we have a lot of room for improvement; that’s what we’re here for.” Paul thinks that given the failure of VCH to improve Pearson after a decade, and for the safety of the residents, control of the facility should be taken away from VCH altogether.
Pearson should be abolished, as have been most of the similar giant institutions in Canada, the U.S.A., Australia, the U. K. and Ireland. “After all, VCH
basically admits that decades have passed with the same on-going ‘problems’ and that since VCH gained control of Pearson it has failed completely to correct those ‘problems’. Given the public admission of failure, VCH should relinquish control of Pearson to an organization which cares enough to not talk about principles, but to act upon them.”
Dr. Ostrow stated during the meeting that “We think that you probably know more than we know about what is going on in the world; what the state of the
art is and what are the best kinds of services… We’ve read all the reports, and I think we saw one today going back to 1991 that talked about changes
which hadn’t taken place ten years earlier, so 1980. So we recognize that there are lots of issues that need to get resolved—we want to address as many
of these as we possibly can.
“Dr. Ostrow was paid nearly $400,000 by the people of B.C. during the last fiscal year; he’s been a doctor for forty-three years; and, somehow, he still
does not know that it’s the world-wide consensus among people with disabilities and their families, among social scientists and historians, that institutions by their very nature degrade those incarcerated in them? And he doesn’t know that the “state of the art” is community care with the proper personal supports under the control of the person receiving the support? How could Dr. Ostrow reach the very top of Vancouver’s health care system and not know this? Or, more likely, did he know all this but not care enough to make the changes he claims to want?”
Paul noted the executives did not bring up specific issues themselves. “When Dr. Ostrow said that he ‘recognized’ there are lots of ‘issues’ which need
to get ‘resolved,’ he is referring to ‘issues’ he could have ‘resolved’ anytime he wanted to (he is after all the Chief Executive Officer of the organization
which has absolute control of Pearson). Instead, he has chosen not to, and he’s saying that to the people on the receiving end of those ‘unresolved issues’.”
The “issues” are not secret. They have been described for decades in newspapers, independent reports, on YouTube and even in (we now know due to Dr. Ostrow and Ms. Ackenhusen’s admissions) VCH’s own reports.
For the facts of life at Pearson read
“VCH is supposed to, according to its own values statement, ‘provide outstanding service and respond to needs in a timely and innovative manner.’ Yet Dr. Ostrow admits that VCH has violated those values with regard to Pearson. He says some issues have been unresolved since 1980; in other words, that outstanding service has not been provided, nor have the Pearson residents’ needs been responded to in a timely and innovative manner. The Pearson service delivery model, with a few important qualifiers, hasn’t been innovative since the 1840s—yes the 1-8-4-0s.”
Redevelopment plans—imagine if it was your only home
The Pearson property is part of Vancouver’s Cambie corridor, which is being redeveloped. City of Vancouver have forced VCH to consult with all the populations that will be “impacted” by the redevelopment of the Pearson property. This is the most probable cause of—after a decade of indifference, lying, and stonewalling—VCH’s transparently insincere attempts to appear to be ethical in its treatment of the residents of Pearson.
VCH needs to create a paper trail that they, and all parties concerned with the redevelopment, can use to stymie any allegations of high-handedness from
getting traction in the media or the relevant regulatory bodies. By simply showing up with two executives, VCH apparently believes that is all it has
to do: show up, wave the flag, admit complete failure, and then leave with no specific commitment for change.
During the meeting the two executives did make a commitment to residents concerned about the future of the physical buildings. Residents, if they choose, can remain on site and will not be moved. They also said that the residents would have genuine input into what the redevelopment plans will be.
“However,” Paul says, “neither Dr. Ostrow nor Ms. Ackenhusen have the power to bind their successors to improving anything. So far, nothing they said has even been put in writing. If the Ministry of Health decides, all the residents will be moved somewhere else. It is highly unlikely that Dr. Ostrow and
Ms. Ackenhusen will be in their positions for the entire next ten years. They have no power to make a commitment that will bind their successors and any other players involved in the redevelopment of the Pearson property. It’s easy to make a commitment for the long term in these circumstances to deflect potentially troublesome ‘stakeholders’. Keep the residents calm, don’t tell them anything concrete.
“So many players, so many things which can go wrong, which can prevent the commitment from being kept. Who knows what a change in government, provincially or municipally, will do to the redevelopment plans for the Cambie corridor? It’s unfair not to be realistic about that with the residents. Especially since VCH has refused for a decade to meet the reasonable quality of care demands of the residents of Pearson. Most of the residents the executives made the commitment to will be dead by the time the redevelopment, however it turns out, is completed.”
Is this Eden? Will it ever be?
In November 2010 the Pearson Residents Council stated that the Vancouver Coastal Health commitment in 2003 to implement the Eden Alternative philosophy had been broken.
“The GPC Residents Council…believe that the failure to achieve changes that advance the Eden philosophy at George Pearson Centre springs from a failure to adopt and apply an ethical framework for long term care.” A copy of the Residents Council 2010 statement can be read here: http://civilrightsnow.ca/2011/05/were-in-a-prison-here-states-current-resident-of-george-pearson-centre/
A year later, during the November 8, 2011 meeting, the residents expressed the same very serious concerns, and provided very specific examples. It noted that VCH had, despite making a public commitment in 2003 to make Pearson an Eden Alternative Philosophy site, in fact did nothing, ignoring its own commitment.
The Eden Alternative philosophy is the idea of Harvard-educated doctor William Thomas. It is a way to make “long term care facilities” into genuine homes for their residents. For more on Eden go to:
During the meeting, one of the residents’ advocates stated, “Positive caring relationships between staff and residents are not the primary goal [of the
management of Pearson]. Residents are told they cannot refuse a staff member and still receive assistance—even if they feel that the staff member endangers their safety or they feel emotionally abused by that staff member. There are many staff members working here who are inappropriate for a community oriented environment, who have negative attitudes and insist that this is a hospital and not a resident’s home. As far as we know, no matter how much residents complain, staff are never fired or moved from Pearson.”
What was the response? Spin. “I wouldn’t say no progress has been made on the Eden concept,” COO Ackenhusen replied. “But I would say the easy stuff has been done, the garden, the Envisioning Home exercise—so now we are at the hard part, which is the people part.”
However, Ms. Ackenhusen took credit on behalf of VCH for improvements not made by VCH. For example, the community garden created at Pearson was at the initiative of people who are not VCH employees. Ms. Ackenhusen states progress has been made when it is obvious from the executives’ admissions and the residents’ statements that there has been no progress, and in fact no serious work on it at all.
The 2006-2007 Envisioning Home “exercise” Ms. Ackenhusen referenced was research done by a program of the B.C. Coalition of People with Disabilities (http://www.bccpd.bc.ca/) called the Community and Residents Mentor Association (CARMA), which mentors residents of Pearson who want to escape from the institution. The Envisioning Home researchers simply asked the residents what they wanted Pearson to be—this in no way implemented any of the Eden principles, nor was VCH involved.
For more on CARMA go to
In fact, the research, which was based on 2006-2007 interviews with 46 of the then-120 residents, discovered that: “Residents [of George Pearson Centre] understood the need for a routine within GPC but many criticized the inflexibility of it. Residents consistently gave three examples in which the routine challenged the reality of GPC as home: being able to have a bath or shower more than once a week; being able to go back to bed for a rest and then get up again during the day; and having to remain in bed on days when they were to have a bowel routine. Residents wanted a greater degree of control over these aspects of their lives. They described these three things as being pretty basic and that they were really about having some control over your own life. They believed that it was not unreasonable to want to have a shower more than once a week, or if they were feeling like it, to go back to bed for a rest and to then get up again…
“Some residents did not feel able, physically or emotionally, to challenge staff to try and change things. They did not want to upset the status quo. A
number of residents commented it was the ‘squeaky wheel gets the grease’–it was the most vocal residents who had their needs or issues addressed. Residents also discussed their fear of negative consequences if they complained too much or made a fuss.”
Even after the 2008 Envisioning Home report with the above findings (including that some Pearson residents were afraid VCH employees would inflict “negative consequences” on them if the residents used their civil right to free expression) was given to VCH, VCH continued, as recently as the October 20, 2010 Open VCH Board meeting, to publicly assert: “We believe the care at Pearson is good.” Who made this assertion? Ms. Ackenhusen in response to a question Paul asked about Pearson.
If you can’t use your civil right to free expression in your own home to describe your quality of life in your own home because you’re afraid the government will hurt you if you do, then you’re not living in a free and democratic society. The Envisioning Home report can be read here:
(Please carefully study the illustrations in the report of the Residents’ vision of a real home. Posters of these illustrations hang on the walls of one
of the long hallways of Pearson. Civil Rights Now! Board member David Marley has said, “Those posters should be on the walls of the CEO’s office, in front of his face every day.”)
Implementing Eden was VCH’s idea. Even on VCH’s own terms, it failed. And VCH can’t even manage an apology, much less a commitment to act.
Staff problems are no problem
Paul notes another clear example of why the administration of Pearson should be taken away from VCH. He notes that Dr. Ostrow said during the meeting, “When Mary says we absolutely believe in the concept of people first—what we mean is that our first and foremost goal is to serve you and help you with your lives. But we recognize that we can’t do that unless the people who work for us are happy and fulfilled and trained appropriately and doing what is best for them. We all have experiences going into a store where you have a surly staff and miserable people working there and they don’t serve you well and they don’t serve themselves well.”
Paul’s philosophy teacher would call the last quoted statement a false analogy. If you go to a store and get crappy service you don’t back. If you get
crappy service at Pearson and survive, you get told by a bureaucrat you’ve paid nearly $400,000 a year, “I’ve been CEO for over two years and I’ve chosen to let the decades-old unresolved issues I’ve inherited remain unresolved.”
Paul sees this as writing-off complaints about staff. “If you live in a place where even if you think a staff member is dangerous you have no choice but
to receive service from them, then you’re not living in a place that’s first and foremost goal is to serve you and help you with your lives. If VCH genuinely wanted to help citizens with disabilities with their lives they wouldn’t force them into Pearson.”
More citizens are being incarcerated
The population of Pearson, which used to be over 300 and had gone down to 120 a few years ago, is now up to 126. Residents claimed at the meeting that the effects of the population increase are “becoming clear”.
Residents have to train “new staff almost daily, which is exhausting. New staff is unfamiliar with residents, rushed through training, and major mistakes
are made. Residents feel crowded—some of those who have private rooms are losing them, and with that they are losing the space for the few personal items they have that make this feel like a home. Interpersonal conflicts are increasing as residents have no choice in sharing a room with incompatible roommates. The OT and PT departments are already stretched to the limit, and it is important to note that residents already dream of having more of these services available. Those who wish for more rehab can’t get it here.”
The response from COO Ackenhusen was: “These are one of these tough decisions that I had to make, in my responsibility for all the health services in Vancouver; I have the hospitals as well. So as you can probably guess, there is a trade off between the individual space you have as a resident of George Pearson versus the needs of others who need the same type of care. They are basically languishing without the rehab services that you enjoy—in a hospital bed on a waitlist for George Pearson, which is increasing long. We don’t really know why it’s getting longer, why there are more folks with the needs that
make them good candidates for Pearson, but there are. That’s why we’ve increased the census, it’s not something we wanted to do.”
With a few flashes of self-pity Ms. Ackenhusen stated VCH will increase the overpopulation of Pearson indefinitely regardless of the fact that this is diminishing the quality of life of current Pearson residents. She offers no explanation for why VCH has allowed the situation to deteriorate so badly—if VCH did not want to increase the population of Pearson, why did it? She did not indicate VCH explored any other alternatives to further diminishing the quality of life of Pearson residents.
A few seconds after being informed by the experts, the people who actually live in Pearson, that because of over-crowding, “the OT and PT departments [at Pearson] are already stretched to the limit…those who wish for more rehab can’t get it here”, the Harvard MBA Ackenhusen stated people on a waitlist for Pearson are “languishing without the rehab services [Pearson residents] enjoy”.
This is VCH’s idea of “People First”? First how? First in line to be ignored by VCH? The evidence forces us to conclude the Vancouver Coastal Health
Authority puts the voters with disabilities trapped in George Pearson Centre last.
Coming Up: Part Two: An “epidemic” of theft; the deafening silence; how to talk to bureaucrats