Harvard faces critics in housing, health

The dual issues of community housing and community health may surface again this Spring as it becomes clear Harvard will be unable to meet its commitment for 1100 units of new housing in Boston by Jan. 1, 1973; and officials of the Affiliated Hospital Center reveal a 46 per cent cut in outpatient services at the proposed medical complex.

The Harvard Corporation is publicly committed to construction of 1100 units of low and moderate cost housing in the Mission Hill section of Boston, adjoining the Affiliated Hospital Center.

Tenants living on property owned by Harvard have been told repeatedly since last Spring new housing will be available for relocation when eviction begins on Jan. 1, 1973.

With 22 months left before the deadline, plans for construction of what may turn out to be the only new low-cost housing to be built in Boston during the next two years are at a virtual standstill.

The Harvard Corporation has directed a reorganization of the staff for dealing with community housing and has named another "blue-ribbon" committee, headed by medical school associate dean Dr. Sidney Lee, to examine the university's relations with the community.

The staff reorganization centers around appointment of a person over Edward N. Gruson, until now in charge of new housing construction; and Henry Cutler, Harvard's manager of real estate.

Harvard is having difficulty filling this key position; negotiations with at least two persons with community housing experience have broken down.

The crucial first issue that must be resolved is the role, if any, of community residents in determining what kind of housing will be built. Negotiations between community representatives and their advisor, John Sharratt, and appropriate Harvard officials have not really gotten underway.

John Sharratt is serving as advocate and advisor for the tenants living on Harvard-owned property in negotiations with the University. The tenants sought to have his salary paid by Harvard, since they had no funds to buy his services. Harvard refused, arguing that if the university provided the funds, Sharratt's allegiance would be to the university not the tenants. However, Harvard then prepared a grant application to the Permanent Charities Fund seeking money to hire Sharratt on behalf of the tenants. Permanent Charities approved the grant and is making funds available to pay Sharratt.

In the meantime, central issues such as where the housing will be built, what the rents will be, what the mix of one, two, three and four bedroom apartments will be, and what portion of the 1100 units will be reserved for community residents remain unresolved and largely undiscussed between Harvard and the community.

No contracts have been signed with architects or developers and with eviction only 22 months away there is growing concern among tenants, students, and some Harvard faculty that the university is laying the foundation now that will force it to renege on its commitment for new housing by Jan. 1, 1973.

The health issue may turn out to be an even more bitter struggle since the university has made no commitments and thus far has maintained the posture that delivery of health services in the community is none of its affair, with responsibility resting solely on the Affiliated Hospital Center.

The original plans for the Affiliated Hospital Center called for construction of an ambulatory care center with resources to provide for 250,000 out-patient visits per year.

In the face of severe money problems, this plan has been abandoned, according to Stanton F. Deland, president of the board of trustees of the A.H.C.

Current plans call for an out-patient facility in the existing Peter Bent Brigham Hospital with resources for 135,000 patient visits each year.

The three hospitals involved in the A.H.C. complex-Peter Bent Brigham, Boston Hospital for Women, and the Robert Breck Brigham-currently handle 90,000 out-patient visits per year.

The proposed 135,000 visits in the new complex are a projection of anticipated growth among the persons presently being served by the hospitals.

There is no provision in current plans for a significant increase in size of the population to be served on an out-patient basis in the new complex.

The primary source of service to the community is the out-patient resources of the new complex. With continuing financial difficulties, this was cut 46 per cent and the plans for a new ambulatory care center serapped.

The in-patient, acute care portion of the new medical center's resources was cut back 15 per cent from 900 beds to a currently proposed 770 beds.

In the face of these cuts in resources for community care, there is growing concern among residents, students and some of the younger faculty that the A.H.C.'s alleged commitment to in-creased community service is only talk.

However, Richard Wittrup, who replaced Brown as executive vice president, stresses that planning for community health care delivery is still underway and has a top priority. Wittrup reports further plans in this area can be expected in the next six to eight weeks.

There is reason to believe the A.H.C. is considering turning 100 beds of the current Peter Bent Brigham into a community hospital and establishing a network of community clinics in the areas to be served.

Harvard's attempts to remain uninvolved in the issues of community health as they relate to plans for the A.H.C. are beginning to crumble.

In recent weeks citizen groups from Jamaica Plain and Roxbury have met with the Associate Dean of the Medical School for Urban Affairs, Dr. Stephen Miller, to press demands for primary and ambulatory care in the community.

Harvard's Center for Community Health and Medical Care has been work with the A.H.C. staff on organization of ambulatory services.

Last week, Dr. George Thorn, Hersey Professor of the Theory and Practice of Physics and chief of medicine at the Peter Bent Brigham Hospital, met with the staff of the center for community health.

Many observers view this meeting as the beginning of a growing involvement by the Harvard center in the community care plans of the A.H.C.

It is clear that what care is delivered to the citizens of Roxbury and Jamaica Plain will come in large part from staff members of the A.H.C. who hold Harvard appointments from professors on down.

There is mounting evidence that distinguished members of the Harvard medical faculty are dissatisfied with the plans of the A.H.C. for delivery of medical care to the Boston community:

The executive vice president of the A.H.C. and professor of health administration, Ray Brown, resigned last Spring with little publicity and no public discussion of the reasons surrounding his departure only two years after being brought here to put the A.H.C. on its feet:

A nationally recognized expert in community health, Dr. Charles Lewis, was brought to Harvard and named Professor of Social Medicine. Dr. Lewis studied the proposals for community health delivery at the A.H.C. and was critical of what he found at that time. He told A.H.C. officials last Fall there was no viable plan for community health activity as part of the A.H.C.

Dr. James Shapiro, one of three Harvard researchers to receive national publicity for determination of the structure of the gene, has droop his research activities to concentra on problems of health delivery. D? Shapiro will devote his efforts the year to helping "correct the inequiti?? in the current plans of the A.H.C.

The dean of Harvard Medica? School, Dr. Robert H. Ebert, has been unable, thus far, to participate in raising funds for the A.H.C. Dea? Ebert stressed that his fund-raising activities must be based on program particularly programs for community care. To date the programs of the A.H.C. have not been well enough defined to permit his participation.

Dr. Ebert is in a difficult position in publicly criticizing the plan for community health delivery at the A.H.C. since the president of the board of trustees of the A.H.C., Stanton Deland, is a member of the medical school's visiting committee, and the chief fund raiser for the A.H.C., Thomas D. Cabot has long-time ties to the Harvard Corporation.

Dr. Leonard W. Cronkhite, general director of the Children's Hospital Medical Center, has been critical of the plans for community health services at the A.H.C. and has made a presentation of other options which might be implemented by the proposed complex. He has seen no evidence, thus far, of interest on the part of the A.H.C.

There is growing evidence that Harvard will not be able to remain aloof from the plans for community health care at the A.H.C., and will have to assume a portion of the responsibility for failure to meet the health needs of community residents in Roxbury and Jamaica Plain in the 70's in the event no changes are made in the current plans of the A.H.C.