Small wonder that city Councillors Robert Pasuta and Terry Whitehead were shocked by the way the Local Health Integration Network gave the go-ahead to Hamilton Health Sciences' plan to convert Mac's ER into a kids-only department.

The councillors, who oppose the change, were watching the proceedings through the eyes of elected officials who are used to assertively questioning and drilling down for more information from support staff.

By contrast, the provincially-appointed LHIN board that gave HHS the green light accepted their staff presentation without asking a single tough question or probing for more details.

Regardless of where you come down on the HHS plan, the apparent lack of penetrating inquiry by the LHIN board should be a cause for concern.

After all, the LHIN's eight-member board is in charge of local health planning and decision-making for about 1.3 million people in the Hamilton-Burlington-Niagara-Haldimand-Brant area.

No doubt they're all well meaning individuals.

But on this issue, with the exception of chair Juanita Gledhill, the board members seemed generally unprepared and out of their depth.

That was driven home with a vengeance when vice-chair Jack Brewer suggested he was basing his support for the plan on the opinions of his golfing pals.

The board left the distinct impression that they were merely rubber-stamping the HHS plan rather than subjecting it to a rigorous assessment.

For example, senior LHIN staffer Marion Emo did a fine job providing an accessible overview of HHS's complex proposal for realigning its delivery of services and programs.

But Emo's presentation skimmed far too lightly over criticisms, including concerns that HHS's community consultations advanced a fait accompli rather than genuinely sought input.

The members of the board all went along for the skate, neither plumbing the validity of the concerns nor the style and approach of HHS's community engagement.

The presentation also gave short shrift to city council's worries that the plan could end up creating complications and higher costs for Hamilton's ambulance service.

That's especially troubling because the board is supposed to base its decisions on community values and preferences, as well as a sound understanding of the issues.

Make no mistake. I'm not saying they made the wrong decision. In fact, I believe the HHS plan is a good one for a variety or reasons.

But the way the board mishandled the decision-making process was both eye-opening and unsettling.

Another example:

Whitehead and Pasuta were justifiably miffed that neither Emo nor Gledhill explained to board members that they had the option of delaying a decision for 60 days in order to collect more information.

Gledhill, in an interview after the vote, insisted the board was well aware of its options and obligations.

Maybe so.

But during the meeting, at least one board member seemed far from certain about that.

Clearly, given the public attention this issue has received, the deferral option should have been explicitly spelled out and analysed to remove any doubts.

In fairness to the board, this is the first time since the LHIN was formed in 2006 that they've had a hot issue to deal with, at least in the Hamilton area.

Perhaps they simply froze and became tongue-tied in the unaccustomed glare of media attention.

Perhaps normally the board does ask and debate the kind of hard questions the public expects from an oversight body.

We can only hope so.

I would hate to think such an important body is as low-functioning as they appeared this time out.

Andrew Dreschel's commentary appears Monday, Wednesday and Friday.

adreschel@thespec.com

905-526-3495