Amid the clamour of pro and con forces, a new voice has been added to the marathon public debate at city hall over the proposed downtown casino expansion, one that could tip the balance against the project.
In a surprise development, Vancouver medical health officer John Carsley has sided with those opposed to the large new facility.
Citing his public health duties, Dr. Carsley said there is too much risk that the planned tripling of gaming opportunities by owners of the current casino will lead to an increase in problem gamblers.
"I'm a public health physician, and this is what they pay me for," Dr. Carsley said in an interview Wednesday, following his presentation the previous evening at city council's ongoing public hearing on the matter. "Problem gambling is clearly a public health issue."
Dr. Carsley called on city council to reject the expansion of gaming capacity, despite his admission that the evidence is not clear on whether the large new casino actually will boost the number of problem gamblers.
"There is no certainty that it will cause an increase, and no certainty that it won't," he said. "But from a public health point of view, we prefer to advise caution. Even a small increase in problem gambling will affect a large number of people. It poses a potential risk."
Dr. Carsley was the last speaker on Tuesday night, and councillors were so intrigued by his presentation they asked him to return for further questions when hearings resume on Monday.
So far, only about 30 of the 160 registered speakers have had their say on the proposed half-billion-dollar development adjacent to BC Place, one that has emerged in recent weeks as a pivotal issue in the future of Vancouver.
The project includes a casino with 1,500 slot machines, two large hotels and numerous restaurants.
Former NPA mayoral candidate Peter Ladner, who has been in the forefront of opposition to the proposal by Las Vegas-based Paragon Gaming, said he believes momentum is beginning to shift against the development.
"We've got all these ministers, the criminologists, we've got cops, community groups, the arts groups and now the health people," said Mr. Ladner. "I mean, who's left?"
He said the project represents a major step in changing the character of Vancouver for the worse. "It's bringing a huge casino into the heart of the city, right by a large public sports centre," he said.
In a rare consensus, both business and union members have spoken out in support of the Paragon development, pointing to the jobs and boost to the economy it is projected to provide.
Paragon president and owner Scott Menke agreed that the company's plans "are getting into a bit of a bad situation" as opposition mounts, but he had nothing but praise for Dr. Carsley's intervention.
"He was very open and honest about how inconclusive all the [problem gambling] studies are," Mr. Menke said. "It was refreshing to see a public official come forward and have that kind of open dialogue."
The BC Lottery Corporation, however, which is involved with Paragon in the proposed casino expansion, firmly rejected Dr. Carsley's conclusion that the development should be rejected because problem gambling might increase.
"We know from our experience and our research that … expansion of a casino does not contribute to an increase," BCLC media relations manager Seumas Gordon said in an e-mailed statement.
Dr. Carsley said he understands that the proposal will provide economic benefits.
"It's an unfortunate position to be in, because epidemiologists like evidence, and it is not definitive. But you have to make a professional judgment," he said. "When you're dealing with an important disease, it's the standard public health approach to conflicting evidence. You advise the course that is prudent."
Asked whether he was nervous about weighing in on such a vital issue, with so many investment dollars at stake, Dr. Carsley said he felt anxiety but no guilt. "I'm clear in my own mind that I am following the right course," he said.
Editor's note: Vancouver's medical health officer is Dr. John Carsley. Incorrect information appeared in an earlier version of this story, this version has been corrected.