What needs doing
Asked the other day why the Martha's Vineyard Commission is hunting for alternative sites for a new Island hospital, one commission member said it is because the commission represents the interests of Islanders. In general, that is not so, unless one defines those interests very narrowly as having exclusively to do with land use, slowing growth, and preventing change. Even in this important work, the MVC is deservedly regarded as expensive, self-indulgent, myopic, whimsical, and harrowing by many of those poor souls who have been forced to seek its approval of their development plans.
On the other hand, if one considers that a regional planning and land use regulatory agency ought to represent the interests of Islanders by studying professionally and in depth such issues as health care needs and the costs associated with meeting them, economic and business development, the potential value of expanding regionalized services, or the future utility of the Steamship Authority if it continues to be organized as it is today, then the MVC has, in its 32-year history, not done much to earn its keep.
And, we don't have in mind multi-year master planning efforts. Master planning, everyone knows, aggregates lots of information, much of it not very meaningful for future decision making, plus a lot of opinions and forecasts, but then it has little bearing on the future it was intended to influence.
If it chose to do so, the MVC could take actions that would benefit the interests of its constituents. Here's an example. Instead of making a wacky, whimsical search for a new site for the hospital, whose leadership doesn't want a new site and doesn't think a new hospital on a new site is remotely affordable, what might be valuable is an inquiry into the sort of health care system Martha's Vineyard requires. After all, what the hospital is proposing is a new hospital, something its leaders believe it needs.
On the other hand, if the community - here, read the MVC, using professional help - were to consider what it needs in the way of cradle-to-grave health care services, what that might cost, and what it might look like, well, the result of that careful thinking might be something other than what the hospital has in mind. And, the price tag might be different, more or less. But the key is that the community, represented by the MVC, would have considered carefully what is, after all, the community's problem, namely health care needs. A hospital of some sort would certainly need to be fitted into the ultimate conclusion, but it might not be the hospital that the private, non-profit Martha's Vineyard Hospital has imagined for itself. After all, this plan for a new hospital is hardly an Island effort, financed as it will be in the end almost exclusively by wealthy summer residents. What would the health care answer be, if Islanders considered the question? And, if they drew the plan, would they be willing to pay some of the bill?
Or, here's a more circumscribed inquiry. Is the hospital's analysis correct about the cost of a new facility, either on its current site or another? Would Windemere be included if a new site were chosen? Do we need Windemere? Why not analyze, with the assistance of professional consultants, the work that the hospital has done in developing its current plan? What are the assumptions that underlie the project as it has been described to us? How can we look for new sites for the hospital without knowing how authoritative the pricing of the current plan is, how realistic is it is to think the money can be raised, or whether something important, such as Windemere, will need to be scrapped to improve traffic congestion over the Lagoon Pond Bridge?
These are questions the MVC would be hard at work answering, if it actually represented the important interests of Islanders.