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23 Nov 20:52

Laneway housing of a different kind to come to Vancouver’s West End?

by Frances Bula

Council approved the West End overall plan Wednesday. There was lots of interesting information to mine in that report — the plan for where new towers will go (on the fringes, away from the interior where residents have objected strongly to any new development), the spending plan for new or refurbished community facilities, the little fact that parking has been put back on the main West End streets during rush hours because the space isn’t needed any more for commuters.

But I was intrigued most by the plan to try to add some density in the interior of the neighbourhood by allowing laneway housing — this time, mini-apartment buildings or stacked townhouses — in behind existing towers or low-rise buildings. Can hardly wait to see the first one of those. I wrote my story focusing on that aspect.

 

FRANCES BULA

VANCOUVER — Special to The Globe and Mail

Published

Last updated

Laneway housing has proven to be hugely popular in Vancouver’s single-family neighbourhoods in the past few years.

Now the city wants to try the same idea in its oldest downtown neighbourhood, the already dense West End – but with a twist.

Instead of individual residences, the West End would get mini-apartment buildings and stacked townhouses ranging from 3 1/2 to six storeys facing the lanes on available space at the back of existing lots.


That’s one of the more striking ideas in a massive city report going to council on Wednesday that outlines a plan for adding new residents, business space and community services to the area, which became Vancouver’s first dense downtown community in the 1960s and 1970s.

“The lanes in this area are the widest in the city. It was really apparent we can make them greener and there is an opportunity for infill,” said Vancouver’s general manager of planning, Brian Jackson.

Those laneway buildings could accommodate up to 2,000 of the 10,000 new people anticipated in the next 30 years. The city will require that 50 per cent of the new units be geared to families, with two or more bedrooms.

Like almost every new building proposal or plan for density that has come to the city in the past five years of Vision Vancouver rule on council, the idea has fierce opponents and quiet supporters.

It was in the West End that the first anti-development activist group sprang up four years ago, followed by many others in neighbourhoods around the city. Back then, the issue was two controversial towers proposed under the Vision council’s ambitious policy to give developers incentives to build rental apartments instead of condos.

The opposition forced council to slow down and put a planning process in motion.

That group, West End Neighbours, is encouraging its supporters to oppose the plan that includes the laneway proposal, the result of three years of work, and ask for more time before it is approved.

But relatively few people from that neighbourhood have participated in recent general protests or delegations to council meetings organized by other groups objecting to plans and development proposals in their own neighbourhoods.

Filmmaker Aerlyn Weissman, who has gone to some of the city’s information meetings, said she is dubious about the whole plan, including the laneway housing.

“The alleys are already pretty intensely used – emergency vehicles, parking, garbage trucks. How are we going to infill the alleys and have access to all of the services?” Ms. Weissman said. She also said the idea was sprung on people only in the last few months of consultations, which she said has been a bad pattern for city planners in recent years.

But Christine Ackermann, president of the West End Residents Assocation, said residents and the city have been discussing infill laneway housing for years.

She said the new housing would be a valuable addition, especially because it would have room for families.

In addition to the laneway housing, the West End plan proposes limiting new towers mainly to the Burrard and Georgia corridors marking the border between the West End and the rest of downtown.

It also spells out heights and densities that would be allowed in various zones, how much money would be spent for a new library, pool, community centre and parks, and where new housing would not be allowed.

Unlike the rest of Vancouver, the area would not be permitted under the plan to have condos above businesses in the busy commercial strips. It would largely prohibit new development, except for the infill, from the interior of the neighbourhood.

Mr. Jackson said it was important not to allow a lot of development in the interior because it would endanger the huge amount of low-cost rental if property owners ripped down older buildings to put up taller ones.

Ms. Ackermann said she believes many people support the plan because the city has “made the right choice” by limiting development in the core.

Whether those people will come out on Wednesday in support, she is not sure.

 

17 Aug 20:13

Is a fare increase coming for the prepaid Compass Card? Existing Faresaver has greater discounts

by digitalmonkblog

Faresaver options

TransLink has announced plans to provide up to a 14% discount over cash fares for users of the Compass Card. How will the savings compare over the current discounts for the Faresaver tickets? Will the prepaid stored value Compass Cards still be more expensive?

Discounts are available for Adult One, Two and Three Zone Faresaver booklets. The concession tickets do not have a discount. The Adult Tickets are priced as follows:

10 tickets Regular value Savings
One Zone $21.00 $27.50 23.64%
Two Zone $31.50 $40.00 21.25%
Three Zone $42.00 $55.00 23.64%

Compass Card readerWith cash discounts ranging from 21.25% to 23.64%, the current Faresaver tickets are clearly less expensive than Compass Cards that will only have a maximum 14% discount over Stored Value cash fares. The changeover will result in a fare hike for some users since the Faresaver booklets will be phased out soon, perhaps by January 2014.

In TransLink’s Tariff changes FAQ for July 2013 there’s the following Question & Answer:

Will transit rates be changing?

No. TransLink’s base rates are not changing at all. We’re discontinuing some discounts, thereby making rates more equitable for users across the system.

The Compass card changeover will result in an increase in some of the rates as many users do not merely pay the “base rate” or full cash fare for a single trip. There are a number of different Compass card options. The ‘Stored Value’ operation of the card is a method for adding cash to the card. Credit is deducted whenever the card is used. The Compass Card can also have a Monthly Pass loaded onto it. The fares with a Monthly Pass should remain unchanged. TransLink maintains that the discounts for Faresavers were historically less than at present as the rationale for having only a 14% discount for Compass Cards over cash fares.

It’s also important to note that Compass Cards with stored value will always have the full price of a 3 zone journey deducted when someone begins a trip on transit. This is regardless of whether the journey is on a single zone vehicle, such as the 99-B Line bus, or if it’s a two zone journey such as the 620 Tsawwassen Ferry route. In theory if the user ‘taps’ out their Compass Card at when they disembark then they’ll only be charged for the zones they’ve travelled through. Of course, if there’s a malfunction in the reader, or if the user forgets to tap out, then the fare will be charged for a 3 zone journey. Surely TransLink can limit a cash deduction to 1 zone or 2 zones when vehicles travel through fewer zones?

A number of details have been recently released about the upcoming transit system changes. Please see our previous posts for more information: Bus cash fares will not provide Skytrain entry under Compass Card system, new TransLink petition and TransLink announces fare changes for upcoming Compass Card, Beta program.

FareboxTicket dispenserCompass Card bus reader  Faresaver cardFaregates at Commercial Drive Compass SignCompass Vending Machine


26 Jul 05:24

BC doctors need unbiased info on prescription drugs

by Vaness Brcic

As a family physician, I need to be sure that each medication I prescribe has good evidence behind its use for my patient’s diagnosis, concurrent medical conditions, and demographic. This isn’t as straightforward as it sounds, because good evidence isn’t always easy to find.

In an often polarized culture of illness and suffering in which some patients take pride in avoiding medication use and others desperately search for a cure, it’s important for patients and physicians to have real conversations about risks and benefits. With increasing access to a motley collection of online information, my job of critical appraisal and patient education is growing ever more important. In this context it’s important to know where physicians get their information.

To complement Clinical Practice Guidelines of varying utility, my go-to sources are three academic organizations I know of in Canada (Bugs and Drugs based in Alberta, RxFiles based in Saskatchewan, and the Therapeutics Initiative at UBC) with no affiliations to the pharmaceutical industry, whose mandates are to provide unbiased and up-to-date information to physicians on appropriate and safe prescribing. BC’s own Therapeutics Initiative (the TI), funded by the provincial government, is on the chopping block. We should demand that it be sustained. Let me explain why.

As a family physician, the Therapeutics Initiative does more than provide me with gold-standard prescribing information that I pass on to my patients. It promotes regular, face-to-face learning opportunities for health providers of all stripes to critically think about medication prescription. When I leave their sessions, I do so with a feeling of relief that I am better equipped to practice evidence-based medicine, and confidence in the therapeutic options I can offer patients henceforth. On a policy level their work impacts my practice too. The Therapeutics Initiative provides the government with the unbiased facts needed to choose worthwhile drugs for our provincial Pharmacare plan, and avoid adopting drugs with dangerous side effects, or with inflated or unproven efficacy. They don’t study cost-effectiveness of medications, only safety. So my patients covered by Pharmacare (or those whose extended benefit plans cover Pharmacare benefit medications only) know that they are getting drugs that are safe, and that work. However such organizations, beneficial on both a clinical and policy level, are rare in the landscape of pharmaceuticals. Let me give you a sense of the landscape.

If I follow the path of least resistance to prescribing information, I get a free lunch, and a one-on-one update from a pharmaceutical company rep who delivers a glossy hand-out with a narrow view of data that always has their drug coming out on top. Although medical schools don’t always excel at enforcing conflict of interest policies, I was taught to keep away from these slick and persuasive encounters. So that’s what I do. It requires resistance. Drug reps are everywhere.

The next easiest option is the CPS manual: a massive blue book that is a familiar sight in most doctors’ offices. Every year I get it in the mail, for free. I go to my PO Box and dutifully sign “Return to sender.” And every year they send it again. Why? Its content is supplied by the drug manufacturers; it’s no more than a hefty accumulation of the information provided in the glossy pamphlets mentioned above. At a recent seminar organized by the Therapeutics Initiative, the Canadian Medical Protective Association cautioned me that if I prescribe based on this information, errors in my prescribing that harm patients would not be defendable in court, because this information is not filtered through the academic lens required to identify safe prescribing practices.

When I finished medical school, I dedicated a year to public health research. I first naively accepted a job at a research firm that promised high pay and great learning opportunities. My first assignment was to use my MD credentials to “convince my colleagues” to take part in a Phase IV marketing study that was having a hard time recruiting physician offices to participate. The study would provide free medication to patients, and study the acceptability of the drug to patients. I didn’t see the benefit to patients of this study, besides access to free samples that might bias their perspective on acceptability, but I had to pretend. I couldn’t do it. My second assignment was to design a study that would show that a drug could be useful for some indication – anything, so that it could sell in North American markets after not being approved for its same use in European markets. “You must be able to find an indication for this drug in Canada,” they said to me. I quit this job after one week.

These stories represent the challenge that physicians face in finding bias-free evidence for good prescribing. We are mired in this challenge, and we depend on academic groups like the Therapeutics Initiative for the academic lens through which we are professionally obligated to look for safe, evidence-based prescribing practices. I don’t want to berate pharmaceutical companies for providing my patients with medications that can extend and improve their quality of life. But I admonish the practice of finding as many patients as possible to sell drugs to, whether or not the evidence exists for the use of the medication.

Given that the pharmaceutical industry tries its hardest to build cozy relationships with doctors, so too have they been cozying up to the BC government. And although the government denies withdrawing funding and support for the TI, that is exactly what is happening. The government has been slowly eroding funding for the TI over the last 2 years, including defaulting on the contract that promised TI funding through June 2013. UBC has filled the gap for the last nine months, but the future of the TI is grim with a lack of financial support, even though funds would be recovered many times over by avoiding the prescription of unproven or dangerous drugs and the complications that result.

My first responsibility as a physician is to do no harm. But the reality is that harm is done both by adverse reactions to prescription medication, and also lack of access to needed medications. The true science of medicine is getting the right medication to the right patient. That is what the TI does.

Patients who are suffering are easy targets for miracle solutions, and that’s the exactly the picture that drug manufacturers try to paint of their medications. That’s what happened when Pfizer paid $2.3 billion in fines for civil and criminal allegations that they illegally promoted drugs for use that wasn’t supported by medical evidence. Similarly, arthritis sufferers were enlivened to try something new in Vioxx until it was clear that the medication was causing deadly heart attacks and strokes. This disaster caused Merck to pull the drug from the market after concealing the magnitude of the risk in their initial research. Prior to the withdrawal of Vioxx, the TI correctly forecasted this risk, recommending that it not be adopted as a Pharmacare benefit and protecting many BC residents from these devastating side effects.

But let’s not dwell in fear. Many medications are beneficial to patients. But we need to know what kind of benefit they offer. How much of a benefit? A benefit for what type of patient? The seller is not the right person to ask. The right person to ask is an impartial academic organization like the Therapeutics Initiative that looks at relative versus absolute benefits, and harms, of medications. This helps doctors to see what we actually know, and how that differs from what the drug companies are trying to show.

There are several reasons why I need this reliable, impartial evidence – especially in a culture in which more medical attention, and thus intervention, is often sought. When my patients are hoping for a cure for their pain and suffering, it is difficult for them to evaluate the risks and side effects of a treatment. Our yearning for a cure for arthritis, MS, cancer, and many other devastating health problems causes us to look more favorably towards benefits of medications, and less to risks; it’s what doctors and patients both want to hear. That’s also why medical journals publish studies that show positive results, not negative ones.

Another reality of medical practice is that many of the drugs coming onto the market, such as those for cholesterol and diabetes, are for the prevention of future complications. In these situations, patients can suffer more from the side effects of the medication than from the condition itself. Evidence is also constantly shifting about how aggressively we need to treat these conditions in the first place. Other new medications, such as those for depression or anxiety, are competing with multiple drugs already on the market that treat the same condition, and shockingly few studies compare them head to head. In addition, one in ten Canadians can’t afford to pay for prescription drugs. In the context of growing income inequality in BC, I must also ensure that a new medication for my patient is worth the money spent on it instead of on food, rent, or other necessities.

Given irrefutable pharmaceutical industry bias that saturates our information sources, physicians and governments need organizations like the Therapeutics Initiative to make safe decisions about pharmaceuticals. Yet the government is cancelling funding for the TI as they simultaneously take no more than superficial steps towards reducing the exploding costs of pharmaceuticals in this province. It is time we stop blaming seniors for escalating health care costs in Canada and acknowledge that rising pharmaceutical costs are the leading cause of health system unsustainability. And then let’s do something about it. Let’s get the patients who we know will benefit access to the medications they need through a national pharmacare strategy that can save us up to $10 billion dollars annually. It’s about using smart evidence and safe practices to do what works in health care: getting patients the drugs that work while avoiding harm, and saving money.