Dr. Ian Arra, Grey Bruce Chief Medical Officer of Health. Photo: publichealthgreybruce.on.ca
BY SOUTHGREY.CA STAFF — Four Municipal Councillors in Grey County are demanding answers of the Grey Bruce Board of Health, regarding the recent disclosure of the Grey Bruce Chief Medical Officer of Health's salary in 2020. The annually-released Sunshine List revealed Dr. Ian Arra's $631,510 in earnings plus $1,690 in benefits for 2020, making him the highest paid Medical Officer of Health among all other Public Health Units in the province.
Owen Sound Councillor John A. Tamming, Georgian Bluffs Councillor Cathy Moore Coburn and Arran-Elderslie Councillors Melissa Kanmacher and Ryan Greig have penned a letter demanding answers of the Grey Bruce Board of Health to explain in greater detail, Dr. Ian Arra's salary as well as a perceived high rate of management turnover since his appointment.
A regularly scheduled Owen Sound Council meeting was held on Monday, March 29. Shortly after the meeting, the Owen Sound Hub published a letter that was reportedly not permitted as an addition to the agenda and later turned over to the Hub.
I was refused permission to read the letter," said Councillor Tamming. "It was addressed to the Board of the Grey Bruce Health Unit and copied to City Council and I thought it should be read out." According to Tamming, Grey and Bruce County clerks have been asked to distribute the letter to all municipal clerks in the region. "We gave them 30 days to respond, so I will follow up in April," said Tamming.
Dr. Arra spoke in response to the letter at the Owen Sound Council meeting last night. John Tamming was unimpressed with some of what the Chief Doctor had to say. "The most offensive thing said by Arra last night in response, was that public criticism of the health unit, his $300,000 bonus and high management turnover, risks lives, and he wishes a flamethrower would destroy my council seat," said Tamming.
Watch Dr. Arra's flamethrower comment below.
With Owen Sound Councillor John A. Tamming's permission, we republish the letter as follows:
Re: Recent Developments at the Grey Bruce Public Health Unit (GBPHU)
We write as elected members of separate local municipal councils. We write on our own behalf and not on behalf of our councils. With others, we are very concerned about recent developments at the Health Unit. We speak both of what the Board paid its chief executive last year and of the very high rate of management turnover since his appointment.
We thank you all, and particularly the front-line staff, for all their diligence and hard work since COVID-19 first entered our region. Nothing in this letter detracts from that. Indeed, we write with their morale in mind as we express our concerns. It is critical to have a strong, vibrant, trusted public health unit as we move forward to defeat the pandemic in our region.
Dr. Ian Arra’s 2020 Compensation: What it Represents
With all of Ontario, we recently learned that in 2020 Dr. Ian Arra, our Medical Officer of Health (MOH), was paid $631,510. This represents:
A 60% increase over his base annual pay of $385,000 in 2019
The highest pay received by any of the 36 Medical Officers of Health in Ontario
$220,000 more than the next highest paid MOH (Middlesex)
$290,000 more than what Toronto paid its MOH, who works for a population of 3.4 million (Grey-Bruce has 160,000 residents)
Almost $200,000 more than what Ontario pays Dr. David Williams, the Chief MOH for the entire province
Reactions and Explanations to Date
This compensation has received national media attention. We have each heard (loudly) from ordinary residents across Grey and Bruce, front line health care workers and those familiar with the internal affairs of the Health Unit.
Remarkably, some councillors and Board members have said that there is nothing to see here, that we should move on and rally together lest public confidence in the Health Unit be shaken.
We respectfully disagree.
That is precisely the wrong course of action and is, frankly, not an option for elected representatives. Through the twin counties, our municipalities are partners with the province when it comes to public health. It is our obligation to seek answers to questions which we or members of the public may have.
It is unfortunate that, with possible health unit mergers still very much on the table, Dr. Arra’s actions and those of the Board have drawn negative publicity. But that is hardly the fault of those who now ask for answers.
The explanations received to date from the chair of your Board, Ms Sue Paterson, have not been satisfactory. Let us review them:
We are told that in 2020 Dr. Arra was working the job of two people, since he did not have an Associate Medical Officer of Health (AMOH). We note:
i) This is simply not accurate. We understand that Dr. Arra was out of the country during part of the late winter of 2020, after which he presumably
quarantined for several weeks. During that absence, the Board relied on his acting AMOH, Dr. Linni Li. Dr. Li remained with the Health Unit until mid-2020, when she joined those others who had left (see below). Other physician consultants were hired at that point, again, sharing the load.
ii) Even if Dr. Arra was bereft of an associate for part of the year, such should not trigger a doubling of his income. We note in this regard that the public health unit of Hastings-Prince Edward, with an identical population to ours and with no AMOH at all, paid its MOH $282,000 last year, less than half of what was paid Dr. Arra.
iii) Finally, as detailed below, working 24/7 for a year is not a metric of managerial competence and, indeed, when coupled with the loss of key staff, may suggest the very opposite. Communications, testing, contact tracing and vaccinations can and should be the purview of senior managers, not the CEO.
Ms Paterson also rather glibly asks how one can “put a price on lives”. That is not a serious argument. Why stop then at a doubling of his salary? Why not move to seven figures? Surely Board oversight of his remuneration does not go out the window because COVID can take lives. Are lesser paid MOHs not saving as many lives?
We are told by Ms Paterson that Dr. Arra acted in a “visionary” manner for his use of hockey arenas as vaccination sites and because he obtained four deep freezers. We choose not to comment.
We were also told that these monies were a special injection of overtime funds made available by the province specifically to help out health units with overtime. We question whether the Board in fact was compelled to pay out such monies to Dr. Arra. We ask why such funds were not either declined (salaried persons do not usually receive overtime) or distributed more widely among staff. Other Medical Officers of Health reported their actual numbers of overtime hours. As of the date of this letter, to our knowledge, our Board has not released this same data. Our citizens pay local taxes that go towards our local Health Unit, and they also pay provincial taxes. Either way, this payment is coming out of their pockets. Per the cliché, there is only one taxpayer.
Managerial Turnover at the Health Unit
The ultimate strength of any health unit is the quality and experience of its people. On first glance, something seems seriously “off” at our Health Unit.
Staff turnover at any organization is natural. As well, there had been an effort to prune the size of the Health Unit for budgetary reasons.
But since Dr. Arra’s appointment, such turnover has been substantial and unprecedented. Dr. Arra joined as acting MOH in October, 2018 and, once he passed some exams, assumed the full title in January, 2019. In a little more than two years under his management, many non-unionized positions have been vacated. The positions that have seen turnover include senior management and others:
Acting Associate Medical Officer of Health/Physician Consultant
Part-time Physician Consultant
Human Resources Managers (two)
Contract Epidemiologist (contract not renewed)
Director of Operations and Program Development
Three Public Health Managers
There has been turnover at less senior levels as well, including health data analyst. Doubtless, some left on good terms. Others, not so much.
But for a relatively small public health unit, this loss of management and other staff raises the issue of organizational dysfunction. It certainly erodes the institutional memory essential to navigate these pandemic waters.
The loss of senior and experienced staff is of particular concern given that Dr. Arra is new in this vocation and only recently completed his certifications. He has never before managed a health unit.
Questions for the GBHU Board
As a first step to restoring public trust, we respectfully request that the Board respond to the questions below. We anticipate that the Board will rely on privacy concerns to argue that it cannot respond to some of these queries.
But nothing prevents Dr. Arra from voluntarily agreeing to release this information. His actions have triggered all of this and we trust he will do just that. This is public money being spent. Further, the integrity and morale of the health unit deserves that gesture from him. In addition to written answers, we ask for copies of relevant documents which ground those replies, including Board minutes, contracts and correspondence.
We ask for fulsome answers to these questions from the Board, while reserving the right to request an investigation down the road. Under the circumstances, we see no reason why answers cannot be provided within 30 days.
It brings us no pleasure to write this letter. One of us (Councillor Moore Coburn) worked with pride for a quarter of a century with the Health Unit. Another (Councillor Tamming) toured the health unit many months ago with Dr. Arra, and was so impressed with both his deep understanding of epidemiology and the systems he had put in place that he publicly praised him in writing.
Thank you for your kind attention to this matter. We assume you want what we do – a healthy organization that is transparent with the public it serves.
We look forward to your response.
John A. Tamming
Councillor, City of Owen Sound
Cathy Moore Coburn
Councillor, Municipality of Georgian Bluffs
Councillor, Municipality of Arran-Elderslie
Councillor, Municipality of Arran-Elderslie
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