The president of the municipal hospital system ran into a barrage of criticism from black and Hispanic members of the City Council yesterday as he defended the Giuliani administration's plan to reduce the scope of reconstruction at Kings County Hospital Center and to close a burn unit at Harlem Hospital.
At a budget hearing in the Council Chamber, several lawmakers said they would fight to save the Kings County reconstruction project from being scaled back or delayed further. They also strongly urged the Health and Hospitals Corporation president, Dr. Bruce Siegel, to keep the burn unit open at Harlem Hospital.
With 22 members on the Council, the minority caucus, if it votes as a block, could exert formidable influence on the shape of the city budget, and could make the hospital issue a condition of their cooperation in wider negotiations with the administration on other fiscal matters.
Blue-Collar Job Cuts
Several lawmakers faulted Mr. Siegel for leaving out local Council members when he appointed a task force that is to review the $1 billion Kings County project over the next two months and recommend changes.
Other members suggested the corporation should cut its affiliation contracts with medical schools that provide doctors and nurses, at a yearly cost of about $500 million, before eliminating more orderlies, janitors, food service workers and other laborers. The corporation has eliminated about 1,300 positions in recent weeks to close a budget gap, with about 880 of those from blue-collar ranks.
The municipal hospitals are tremendously important employers in minority neighborhoods, and about 80 percent of their patients are from minorities, many of them uninsured and undocumented. Consequently many black and Hispanic members said they see Mayor Rudolph W. Giuliani's plans as an assault on their constituents, of whom only a small proportion supported Mr. Giuliani in the last election.
"We feel that the poor, and the blacks and the Hispanics, are being asked to take a disproportionate cut in services and whatnot," said Enoch H. Williams, a Councilman who represents parts of Flatbush and is chairman of the Health Committee. "They are not cutting the Police Department. They are not cutting the Fire Department. There are a lot of sacred cows out there that are not being cut. But yet in minority neighborhoods it looks like a vendetta."
Councilwoman Una Clarke, who represents other parts of Flatbush, asked Dr. Siegel rhetorically if the city had put Kings County "on the block of sacrifice because of who we serve?"
"Schools in this city educated children until the majority of the children were children of color," Ms. Clarke said. "The municipal hospitals in this city served the poor until the majority of those who used those services changed."
Dr. Siegel, who is the son of Haitian immigrants, insisted repeatedly that he would not retreat from the hospital's traditional mission to serve the poor. "I am not going to renege on that," he said.
Argument for Redesign
Responding to questions about the Kings County reconstruction, Dr. Siegel said he was committed to building a new hospital. But he said the project should be redesigned and cut back from the sprawling 1,200-bed complex originally planned. For instance, he said the hospital needed fewer prison beds and operating rooms and more clinics that provide basic checkups and preventative medicine.
Despite the added construction costs caused by delays, Dr. Siegel said, it would be more expensive in the long run to push ahead with an unnecessarily large project.
Harlem politicians were angry about losing the burn unit, whose patients will be taken to Bronx Municipal Hospital Center. Councilwoman C. Virginia Fields disputed Dr. Siegel's claim that only 50 percent of the beds are presently filled in the Harlem unit, which costs about $600,000 a year. She said that over the last two years the occupancy rate in the ward has averaged about 75 percent.
Another proposal from Mr. Giuliani that stirred angry words was a plan to turn over 4 of the city's 11 acute-care hospitals to private corporations or independent boards to save money. Several members voiced worries that the poor would not be served if the hospitals were in private hands, including Annette M. Robinson of Brooklyn, Israel Ruiz Jr. of the Bronx and Guillermo Linares of Manhattan.
"I'm numb by this experience," Ms. Robinson said. "I think either I'm under a rock or the administration is under a rock."
