2004 Legislative Session: 5th Session, 37th Parliament

HANSARD

The following electronic version is for informational purposes

only.

The printed version remains the official version.

Official Report of

DEBATES OF THE LEGISLATIVE ASSEMBLY

(Hansard)

THURSDAY, MARCH 4, 2004

Afternoon Sitting

Volume 21, Number 7

CONTENTS

Routine Proceedings

Page

Introductions by Members

Statements (Standing Order 25 B )

International Women's Day

S. Orr

Assisted-living units for Surrey

seniors

D. Hayer

Epilepsy

G. Trumper

Oral Questions

Police investigation of government

officials

J. MacPhail

Hon. K.

Falcon

Hon. G.

Collins

Police investigation and role of

Bruce Clark

J. Kwan

Hon. G.

Collins

Surgery wait-lists

R. Hawes

Hon. C.

Hansen

Funding for forest fire prevention

and preparedness programs

P. Nettleton

Hon. G.

Collins

Traffic congestion tax

D. Hayer

Hon. K.

Falcon

Mental health in the workplace

Brenzinger

Hon. S.

Brice

Gravel extraction from watercourses

in Hatzic Prairie area

R. Hawes

Hon. G.

Abbott

Reports from Committees

Special Committee of Selection, first

report, fifth session of the thirty-seventh parliament

Hon. G.

Collins

Motions without Notice

Special Committee to Appoint a Merit

Commissioner

Appointment of Special Committee on the Citizens' Assembly on Electoral Reform

Appointment of Special Committee to Review the

Freedom of Information and Protection of Privacy Act

Hon. G.

Collins

Committee of Supply

Estimates: Ministry of Health

Services (continued)

Hon. C.

Hansen

J. Kwan

Brenzinger

R. Hawes

Proceedings in the Douglas Fir Room

Committee of Supply

Estimates: Ministry of Energy and

Mines (continued)

D. MacKay

Hon. R.

Neufeld

D. Jarvis

D. Hayer

J. MacPhail

Hon. P. Bell

Estimates: Ministry of Community,

Aboriginal and Women's Services

Hon. M.

Coell

B. Locke

V. Anderson

D. Hayer

[ Page 9105 ]

THURSDAY, MARCH 4, 2004

The House

met at 2:03 p.m.

Introductions by Members

Jarvis: It is with great pleasure that I introduce a young man whose voice

will soon be echoing through these corridors of the hallowed halls of the

Victoria Legislature. Born yesterday, March 3, at 5:28 p.m. to Linda Reid —

better known as the member for Richmond East — and to Sheldon Friesen, and a

brother to Olivia Reid, was a young man weighing 8 pounds 14 ounces. I'm told he

was 21 inches long. Both the mother and the baby are doing well.

Now, get

this. He will be called Will Nicholas Ivan Donnelly Reid-Friesen. Would you

please make him welcome.

[1405]

Reid: I would like to introduce two constituents who are with us here today.

Both work for the Department of Fisheries and Oceans and are at the Pacific

Biological Station in Nanaimo, and they're here in town attending the

species-at-risk conference. Dr. Jim Irvine is a research scientist with the

conservation biology

section and the father of leg. intern Sara Irvine, and Bill

Shaw is a hook-and-line biologist with the resource management section. Would

the House please make them welcome.

Hon. R.

Neufeld: Wow, two times in a week I get to introduce people from my

constituency. They're here to give some good advice to government: Mayor Steve

Thorlakson from the city of Fort St. John, and Mayor Chris Morley from the town

of Fort Nelson. Would the House please make them welcome.

Lekstrom: As my colleague from the North Peace says, more good news. It's a

pleasure today to be able to introduce two guests in the gallery, friends of

mine and people that work very hard to better the lives of people in northern

British Columbia. Joining us in the gallery is His Worship Mayor Evan Saugstad

from Chetwynd, along with His Worship Wayne Dahlen from Dawson Creek. Will the

House please make them welcome.

Stewart: It's my pleasure to introduce several members of the Société de développement

économique de la Colombie-Britannique that are here in the chamber today

working on francophone economic development issues in B.C: the Société's

director Donald Cyr, project manager Rita Couture, Victoria regional development

director Mario Duguay, administrator Dominique Tregurtha and the director of the

chambre de commerce francophone — the francophone chamber of commerce —

Carole Fontaine-Helter.

Je demande

à l'assemblée de les accueillir chaleureusement.

Would the

House please make them welcome.

P. Wong:

Today in the gallery I have two guests: Mike Cunningham from Victoria and Ginger

Zhu from Shanghai, China — the first time in Canada. They were able to join me

for lunch today and are here to watch question period. Would the House please

make them very welcome.

Trumper: Today has been a busy day for students from my riding. This morning

we had 25 from French Creek school. I ask the House to please welcome 52 grade

5s from Qualicum Beach Elementary School who are here with their teachers, Ms.

Bobbi Coleman and Mr. Roland Marion, plus numerous parents. Please make them

welcome.

Sultan: In the galleries today are two citizens who contribute in a major

way to the efficient and good government of the corporation of the district of

West Vancouver. I refer to Mayor Ron Wood and to Colin Wright, the director of

engineering. Would you please make them welcome.

Statements

(Standing Order 25

b) INTERNATIONAL WOMEN'S DAY

S. Orr:

It is with great pride as a woman that I rise today and remind everyone that on

Monday, March 8 it is International Women's Day. This year Canadians will also

celebrate International Women's Week from Sunday, March 7 to March 13.

International

Women's Day was established in 1977 by the United Nations. This day gives us an

opportunity to reflect on the progress made to advance women's equality, to

recognize the rights and contributions of women in our societies, to celebrate

future steps and to celebrate gains we have made.

[1410]

But still a

very serious women's issue exists, one that disturbs all of us — violence

against women. So I am very pleased to tell you about a large corporate

organization that over the past ten years has taken on this very serious women's

issue and actively campaigned in raising awareness about violence against women.

This organization is called the Body Shop Canada, and to commemorate ten years

of action on this issue, they are planning a Power of Ten campaign and hosting

special events to run in 114 communities across Canada during March. They are

declaring March 8 as a day to speak out against violence against women, and I

commend the Body Shop for taking corporate responsibility on this vile assault

on women. This is a very responsible corporate decision.

On March 8,

International Women's Day, let's remember all those women close to us. Let's

remember those women that the Body Shop and all of us are fighting to help.

Let's remember all women, regardless of nationality, ethnicity, socioeconomic or

political background. Let's all remember to celebrate the efforts

[ Page 9106 ]

that have made this help end inequality. True equality is still not a

reality, but awareness will certainly help towards achieving this goal.

ASSISTED-LIVING UNITS

FOR SURREY SENIORS

Hayer: Last week I was pleased to join the Minister of State for Women's and

Seniors' Services in my riding of Surrey-Tynehead to participate in the

groundbreaking ceremony for 171 new assisted-living units for seniors. This

means Surrey seniors, the very people who helped build our community and this

province, will have increased access to housing and care services close to their

home.

The site is

located at 16028 83rd Avenue in Surrey, just two blocks south of my riding of

Surrey-Tynehead and the Fraser Highway and 160th Street. This complex, Fleetwood

Villa, is being built as a public-private partnership between the provincial

government, B.C. Housing, the Fraser health authority and private partners, the

Lark and Ahmon Groups. The Lark Group, a very experienced Surrey-based company

operated by Larry Fisher, is building Fleetwood Villa, while the family-owned

Ahmon Group will operate the facility. Ahmon Group already operates four

long-term care facilities, so I am certain it will be an excellent stewardship

of care of seniors in my constituency.

Fleetwood

Villa is expected to be open and welcoming Surrey seniors next year. Of the 171

residential spaces being built, 60 of them will be subsidized by the provincial

government through the rent supplement program by the Independent Living B.C.

program.

What makes

Fleetwood Villa even more important to my constituents is that it is being built

right beside Fleetwood Place, a 108-resident care facility on a five-acre campus

for care that is due to open this June. The combination of the two will ensure

plenty of opportunities for Surrey-Tynehead residents and seniors to obtain the

residential care they desire close to their families.

EPILEPSY

Trumper: March is National Epilepsy Month. Epilepsy is a neurological

disorder that affects more than 300,000 people in Canada of all ages and

genders. People with epilepsy endure much physical and emotional hardship. Many

people with epilepsy feel hopeless, isolated, discriminated against and often

ridiculed. Added to the emotional burden are the physical difficulties of having

unexpected seizures and dealing with the sometimes devastating side effects of

medication. People with epilepsy of all ages live in the fear that at any moment

in the middle of daily activities, their brain will short-circuit, causing them

to lose control of their body temporarily.

The

lavender flower is traditionally associated with solitude. The epilepsy ribbon

is lavender, and this is somehow fitting, as often isolation is one of the

primary difficulties facing people with epilepsy and seizure disorders. You will

note that there are some people in the Legislature this month wearing lavender

ribbons to increase visibility of this very important issue.

I might add

that many people with epilepsy are able to live normal, successful lives. I know

a couple of my friends who are leaders in the community suffer from epilepsy,

although many people do not know that. It is important that we do whatever we

can to provide the necessary support to people with epilepsy and that we

encourage further research into treatment and a cure for this condition.

Mr.

Speaker: That concludes members' statements.

Oral Questions

POLICE INVESTIGATION OF

GOVERNMENT OFFICIALS

MacPhail: Up until yesterday the only explanation for the unequal treatment

of David Basi and Bob Virk was that Mr. Basi's job was different. Now the story

has changed.

[1415]

Yesterday

the Minister of Transportation explained to the media that the difference in the

two cases is as follows: "In the one case, they — the Premier's office

— felt that there were serious enough allegations being presented by the RCMP

to terminate, and the other was much less clear. And so it was felt it was

appropriate to put on paid leave until the RCMP investigation was

completed."

Can the

Deputy Premier tell us what the government knows about the RCMP allegations

about David Basi's conduct that warranted his firing?

Hon. K.

Falcon: Actually, the member opposite is correct in the sense that my

comments were inappropriate. I had based them on media coverage that I had

distilled over the last number of months. That was wrong.

Mr.

Speaker: Leader of the Opposition has a supplementary question.

MacPhail: Well, he didn't retract the comments. In fact, he still hasn't

retracted them. Yesterday….

Interjections.

MacPhail: All right.

Interjections.

Mr.

Speaker: Order, please.

MacPhail: Well, in fact, let's acknowledge that he's retracting the

comments, but it still doesn't replace the fact that this is the first minister

who has actually changed the story. The

summary of the warrants

[ Page 9107 ]

makes no distinction between the behaviour of the two ministerial assistants,

and the Premier insists he knows nothing more than what is in the

summary. The

minister has been advised all the way up to the top, along with all of his

colleagues, to be very careful of what they say in public. We know that. That

direction has come from Martyn Brown. We know the Solicitor General briefed the

Premier and his chief of staff the day of the raids on the Legislature. He

obviously told them enough that the chief of staff felt compelled to fire Mr.

Basi immediately.

Can the

Solicitor General please tell the public what evidence he presented to Martyn

Brown and the Premier that warranted Mr. Basi's firing? What is it that the

government is trying to cover up?

Hon. K.

Falcon: Well, to the member opposite, I hate to disappoint her, but I think

it's more a case of a minister in his portfolio for one month that was asked a

question. I based my answer upon a distillation of media coverage that I've read

over the last number of months, and that was wrong. I do withdraw that.

Mr.

Speaker: The Leader of the Opposition has a further question.

MacPhail: Well, I actually acknowledged that. I was going on to the comments

that the Solicitor General has made in public. In fact, the Minister of

Finance's explanation is that his job was different, so they had to fire him.

Why didn't they just give him a new job or put him on paid leave, the same as

Mr. Virk? No. They fired him. The

summary of warrants tells us that the B.C.

Rail influence-peddling investigation arose out of a proceeds-of-crime and

corruption investigation. The link between the two investigations is David Basi.

According to the

summary, Mr. Basi was implicated in the first investigation.

The link between Mr. Basi and Erik Bornman and Bruce Clark, whose home office

was searched, was through wiretaps on Mr. Basi's phone. As we explained last

week, the rules of the House dictate that the Solicitor General must consult

with the Speaker before wiretaps can be installed.

My question

to the Solicitor General. Did the Solicitor General consult the Speaker prior to

those wiretaps being installed on Mr. Basi's phone, and when did he inform the

Premier or his staff about the criminal investigation?

Hon. G.

Collins: I'm not aware of any wiretaps, and I don't know where the member is

getting her information from. I don't think it says that in the

summary.

POLICE INVESTIGATION AND

ROLE OF BRUCE CLARK

J. Kwan:

To date, the focus on the warrant

summary has been upon the key government

players associated with the B.C. Rail deal and the lobbyist for Omnitrax. What

hasn't yet been canvassed is the role that Bruce Clark has played in this

situation. He isn't registered as a lobbyist for any B.C. Rail proponent. He

doesn't work for government. We do know that he is the chief Liberal fundraiser

in B.C.

Can the

Solicitor General explain why a Liberal Party fundraiser is associated with a

police investigation into influence-peddling in the privatization of B.C. Rail?

[1420]

Hon. G.

Collins: Mr. Speaker, that question is not in order, and nobody could be

able to answer it even if they did. The individual that the member mentions….

That issue is not under the purview of any member of cabinet.

Mr.

Speaker: The member for Vancouver–Mount Pleasant has a supplementary

question.

J. Kwan:

It's a simple question. It doesn't compromise the investigation, and clearly

the government has had a heads-up on this case for months, given the knowledge

of the wiretaps. Nowhere does the

summary state that the Liberal Party is not

touched on by this investigation. We have only the word of the Solicitor

General, who since has….

Interjections.

Mr.

Speaker: Order, please, hon. members. Let us hear the question. Order.

J. Kwan:

We have only the word of the Solicitor General who, since his initial

high-profile statements on this matter, has clammed up. He clearly knows more

than he's willing to tell about this matter in this House. He won't tell us what

he told the Premier. He won't tell us what he told Martyn Brown. He won't tell

us what he told the Speaker. The only minister who seems to be able to tell

anyone what he knows is the Minister of Transportation, and it seems like

there's a short leash on him now.

To the

Minister of Transportation: can he tell this House what Bruce Clark, a key

Liberal fundraiser, was doing in the B.C. Rail privatization scheme that led to

warrants being served to his home?

Hon. G.

Collins: The allegations and the comments made by the member opposite are a

stretch beyond anyone's imagination. It's quite clear. Probably the Solicitor

General does know more than he's able to tell the two members opposite, or

anyone else for that matter. That's his job. His job is the Solicitor General.

He's doing his job appropriately, properly, and the investigation will bring

those results to the fore when they come.

SURGERY WAIT-LISTS

Hawes: There's an ad running today in the major newspapers from the BCMA,

which decries surgical

[ Page 9108 ]

wait-lists in this province. The ad refers the reader to the BCMA website,

which offers no thoughts at all from the BCMA as to their thoughts for a

possible solution. I suspect somehow these ads are tied to the bargaining that's

now underway between the BCMA and the province.

To the

Minister of Health Services: can you reassure my constituents, who would read

this ad, that you are working on the surgical wait-list problem? And what are

you doing to alleviate it?

Hon. C.

Hansen: We have seen some significant results out of the reorganization of

health care in this province. We've seen an additional 38,000 surgeries and

other major procedures performed last year over the year before. We've seen a

significant increase in the number of British Columbians that are getting access

to hip replacements and knee replacements, which is often the focus of these

debates. On top of that, we are putting more resources specifically into dealing

with wait-lists in this province.

I would

like to put out the challenge to the B.C. Medical Association that they work

with us and support our efforts to make sure that every dollar that we have

available of increased funding in the health budget goes directly into patient

care so that more patients in this province can get access to the care they need

in a timely fashion.

FUNDING FOR FOREST FIRE PREVENTION

AND PREPAREDNESS PROGRAMS

Nettleton: The following public written statement was submitted by the

leader of the B.C. Green Party, Adriane Carr, through the office of the Speaker.

"Filmon's

Firestorm 2003 report recommends that the province act before the next forest

fire season to reduce the risk of catastrophic fires by committing new funding

for fuel management programs, more consistent fire preparedness training and to

restore 27 forest protection branch type 1 crews, the number of crews we had

prior to cuts made in the 1990s. Yet your 2004-05 fire preparedness and forest

health budgets are cut."

This

question is to the Minister of Finance. Can the Minister of Finance provide new

financial resources, and in what amounts, to implement these recommendations

before this summer?

[1425]

Hon. G.

Collins: At the time of the budget, on budget day itself, I was asked that

question by members of the media and stakeholders as well. At the time the

budget was put together, we were not aware of what the recommendations would be

out of Mr. Filmon's report. We now are.

As the

member will be aware from last week's open cabinet, the various ministries

impacted by it are reviewing those recommendations. They'll be putting together

a plan to implement those recommendations. Part of that would be coming to

Treasury Board, possibly, with the request for additional funds over a certain

period of time.

We haven't

seen that yet. But when we do, as I said on budget day, there is room in the

budget plan to accommodate those. We certainly look forward to seeing them and

expect to have as many of them underway as soon as possible. Indeed, I think

there are a number of things in the Filmon report that are already underway.

TRAFFIC CONGESTION TAX

Hayer: My question is to the Minister of Transportation. As I'm sure you are

all aware, driving at times can be difficult in Surrey with the congestion,

leading to driving frustration and fatigue as well as increased costs faced by

the local businesses. As a result of a transportation contingency plan, there

has been some speculation that there could be a congestion fee or tax applied to

parking lots. Given that many people in my riding are commuters to Vancouver,

can the minister please tell this House and my constituents: what is the policy

of the Ministry of Transportation on these new taxes?

Hon. K.

Falcon: I believe the member is referring to the speculation around a

congestion tax. In the city of Vancouver, that was a backup plan that the GVRD

and TransLink were associating with some financing plans. What I can say is that

there will be no new public levy or new congestion tax imposed on the public

prior to a referendum. That is consistent with the new-era commitment we made

here in British Columbia that there would be no new levies or taxes imposed on

the public prior to a referendum.

MENTAL HEALTH IN THE WORKPLACE

Brenzinger: My question is to the Minister of State for Mental Health and

Addiction Services. According to key business leaders across Canada, mental

health is the leading cause of worker disability, and it is striking the most

productive members of the labour force. They suggest that mental health problems

cost the Canadian economy approximately $33 billion a year in lost revenue. Can

the minister tell British Columbians what measures are in place to assist the

public and private sector address mental health issues in the workplace?

Hon. S.

Brice: I am pleased the member has raised this issue in the House, a very

important matter of mental health, and in particular depression in the workforce

— a largely undiagnosed and untreated mental illness. I can advise the member

that through my office, I sit on the British Columbia Business and Economic

Round Table on Mental Health, an organization of businesses dedicated to raising

awareness about mental health issues. Members of that round table are in the

process of raising funds to fund a chair at UBC on depression and have so far

raised $3 million from the private sector.

[ Page 9109 ]

As well,

last year the provincial health services authority held a Bottom Line

Conference. The Premier was the speaker at that, and I know the member for

Surrey-Whalley attended. My office will continue to raise the issue of mental

illness and depression, specifically depression in the workforce.

GRAVEL EXTRACTION FROM WATERCOURSES

IN HATZIC PRAIRIE AREA

Hawes: I have stood many times in this House to try to alleviate or try to

work on the problem of flooding in my riding, particularly in the Hatzic Prairie

area, where creeks and streams are silted in with gravel. DFO has continued to

stop people from cleaning their creeks and streams, causing great danger to both

property and livestock — and at times even lives.

On behalf

of my constituents, can the Minister of Sustainable Resource Management tell my

constituents what progress, if any, is being made with the federal government to

try to alleviate this unsatisfactory situation?

[1430]

Hon. G.

Abbott: I'm glad the member raised the issue. It's an important one.

Annually, there are between 400,000 and 500,000 cubic metres of gravel deposited

as the Fraser River freshet is underway. Of course, it becomes a very important

issue in terms of maintaining that so that we don't have the kind of flooding

that the member and other members from the Fraser Valley region warn of. It's a

very important issue.

I think we

are making some progress in terms of our relationship with the Department of

Fisheries and Oceans. This year DFO has approved 460,000 cubic metres of gravel

to be extracted from the Fraser. Three of those areas are underway — at Big

Bar, Spring Bar and Harrison Bar — all in partnership with first nations.

There's about 255,000 cubic metres there.

We do hope

to continue to improve our relationship with DFO. Clearly, we need an annual

agreement — a five-year agreement, a long-term agreement — with DFO to

ensure that, in fact, we can get those gravel deposits removed on an annual

basis and to ensure that our communities are not subject to unexpected floods

when the spring freshets occur.

[End of question period.]

Reports from Committees

Hon. G.

Collins: Mr. Speaker, I have the honour to present the first report of the

Special Committee of Selection for the fifth session of the thirty-seventh

parliament.

Mr.

Speaker: Please proceed.

Hon. G.

Collins: I move the report be taken as read and received.

Motion

approved.

Hon. G.

Collins: Mr. Speaker, I ask leave of the House to suspend the rules to

permit the moving of a motion to adopt the report.

Leave

granted.

Hon. G.

Collins: I move that the report be adopted.

Motion

approved.

Motions without Notice

Hon. G.

Collins: I seek leave to move three motions.

I seek

leave for the first one first. It's a motion to appoint a select standing

committee to select the B.C. Public Service Agency head and deputy minister

responsible for the agency and to hold office as the merit commissioner.

Leave

granted.

SPECIAL COMMITTEE TO

APPOINT A MERIT COMMISSIONER

Hon. G.

Collins: I move the motion.

[That a Special Committee be appointed to select and

unanimously recommend to the Legislative Assembly, (pursuant to

section 5 of

the Public Service Act, R.S.B.C. 1996, c. 385) the appointment of an

individual to be the BC Public Service Agency head, and Deputy Minister

responsible for the Agency, and to hold office as the Merit Commissioner for

the Province of British Columbia, and that the Special Committee so appointed

shall have the powers of a Select Standing Committee, and is also empowered:

(

a) to appoint of their number, one or more subcommittees and to refer to such

subcommittees any of the matters referred to the Committee;

(

b) to sit during any period in which the House is adjourned, during the recess

after prorogation until the next following Session and during any sitting of

the House;

(

c) to adjourn from place to place as may be convenient; and

(

d) to retain such personnel as required to assist the Committee;

and shall report to the House as soon as possible, or

following any adjournment of the House, or at the next following Session, as

the case may be; to deposit the original of its reports with the Clerk of the

Legislative Assembly during a period of adjournment and upon the resumption of

the sittings of the House, the Chair shall present all reports to the

Legislative Assembly.

The said Special Committee is to be composed of: Mr. Bray

(Convenor), Messrs. Hawes, Hunter and Lee, Mmes. Locke, MacPhail, Orr and

Trumper.]

Motion

approved.

Hon. G.

Collins: I seek leave to move a motion to appoint a Special Committee on the

Citizens' Assembly on Electoral Reform authorized to receive reports from

[ Page 9110 ]

the Chair of the Citizens' Assembly on the progress of the Citizens'

Assembly's work.

Leave

granted.

APPOINTMENT OF SPECIAL COMMITTEE

ON THE CITIZENS' ASSEMBLY ON

ELECTORAL REFORM

Hon. G.

Collins: I move the motion.

[That a Special Committee on the Citizens' Assembly on

Electoral Reform be appointed and authorized to receive reports from the chair

of the Citizens' Assembly on the progress of the Citizens' Assembly's work.

The Special Committee so appointed shall have the powers of

a Select Standing Committee and is also empowered:

(

a) to appoint of their number one or more subcommittees and to refer to such

subcommittees any of the matters referred to the Committee;

(

b) to sit during a period in which the House is adjourned, during the recess

after prorogation until the next following Session and during any sitting of

the House;

(

c) to adjourn from place to place as may be convenient;

(

d) to retain such personnel as required to assist the Committee;

and shall report to the House on the matters referred to the

Committee as soon as possible or following any adjournment, or at the next

following Session, as the case may be; to deposit the original of its reports

with the Clerk of the Legislative Assembly during a period of adjournment and

upon resumption of the sittings of the House, the Chair shall present all

reports to the Legislative Assembly.

The said Special Committee is to be composed of: Mr. Bray

(Convenor), Messrs. Krueger, Lekstrom, and Niijar; and Mmes. Brenzinger,

MacPhail and Reid.]

Motion

approved.

Hon. G.

Collins: I seek leave to move a motion that a special committee be appointed

to review the Freedom of Information and Protection of Privacy Act pursuant to

section 80 of that act.

Leave

granted.

APPOINTMENT OF SPECIAL COMMITTEE

TO REVIEW THE FREEDOM OF INFORMATION

AND PROTECTION OF PRIVACY ACT

Hon. G.

Collins: Just for information, those motions are also in the hands of the

opposition. I move the motion.

[That a Special Committee be appointed to review the Freedom

of Information and Protection of Privacy Act (RSBC 1996 c. 165) pursuant to

section 80 of that Act, and that the Special Committee so appointed shall have

the powers of a Select Standing Committee and is also empowered:

(

a) to appoint of their number, one or more subcommittees and to refer to such

subcommittees any of the matters referred to the Committee;

(

b) to sit during a period in which the House is adjourned, during the recess

after prorogation until the next following Session and during any sitting of

the House;

(

c) to adjourn from place to place as may be convenient;

(

d) to retain such personnel as required to assist the Committee;

and shall report to the House as soon as possible, or

following any adjournment, or at the next following Session, as the case may

be; to deposit the original of its reports with the Clerk of the Legislative

Assembly during a period of adjournment and upon resumption of the sittings of

the House, the Chair shall present all reports to the Legislative Assembly.

That the said Special Committee is to be composed of Mr.

Lekstrom (Convenor), Messrs. Belsey, Bloy, Bray, Hayer, Hunter, Johnston,

Penner, and Wilson; and Mmes. MacPhail, Orr, and Trumper.]

Motion

approved.

Orders of the Day

Hon. G.

Collins: I call Committee of Supply in this House. For the information of

members, we have the ongoing and continuing debate on the estimates of the

Ministry of Health.

Committee A, for the information of members, we'll be calling Committee of

Supply as well. It will be the continuing debate on the Ministry of Energy.

[1435]

Committee of Supply

The House

in Committee of Supply B; J. Weisbeck in the chair.

The

committee met at 2:40 p.m.

ESTIMATES: MINISTRY OF

HEALTH SERVICES

(continued)

On vote 25:

ministry operations, $10,404,260,000 (continued).

Hon.

C. Hansen: Mr. Chair, just prior to our adjournment this morning, the member

asked me about the health benefits office and the process we're engaged in now

where we're seeking a private sector partner to work with us to bring some

technology solutions to the processing of MSP information applications and that

type of thing. She asked if I could give an outline of the process to date, so I

will try to give a quick snapshot of that.

This

actually goes back to July of last year, where we put out a requisition

document. It's known as a joint solutions procurement process, which is a type

of procurement. Initially we had five companies that expressed interest, and we

worked with those five proponents up to the closing date of September 8, at

which time that was narrowed down to four different companies. From September 8

through to November 28 was

[ Page 9111 ]

what we called the proponent qualification phase, where we looked at the

credentials of the various organizations and selected two preferred proponents

to work with in the next phase. As of November we were able to narrow that down

to two preferred proponents.

We are now

into the joint solutions definition phase, which should take us through to

around the end of this month, at which point we are hoping to be able to

identify a final proponent we would work with in terms of the due diligence.

Then, finally, the contract negotiation phase that would be leading up to….

Hopefully, we'd be able to conclude this process by the end of August, at which

time a final contract would be signed.

J. Kwan:

Through that process there were two proponents that were identified. By the

end of March, the minister will…. Sorry, by the end of August, I think you

said. Did you say August or March? It was March. At the end of March, then,

you'll be in a position to select that.

What are

the anticipated savings with this process?

Hon. C.

Hansen: The whole intent behind this particular initiative is not to save

money. In fact, when we embarked on the process, it was primarily motivated by

how to improve service. I think one of the most common complaints that I

certainly hear from constituency assistants around the province who are trying

to provide front-line service to residents is about the delays — the time it

takes to get an application processed through the MSP or for premium assistance,

for example, or the time it takes to get responses to telephone inquiries, just

to get some basic information.

What we set

out to do was to find a private sector partner that could bring some of the new

technology. The approach that has been used in this office up till now has been

primarily paper-based. It is very much out of date in terms of modern business

practices. We had a choice of keeping it in-house. It would have been very

expensive for us to bring in the kinds of computer technologies and software

that would be necessary for us to run this as an in-house program. Yet when we

put that huge investment…. It would have been, if I'm correct, in excess of

$30 million of technology that we would have had to bring in to use just for

this purpose, when in fact we can go out to some of these technology partners,

utilize their equipment that they use for a broad range of applications, and

thereby save the money that would otherwise have had to be spent if we tried to

do all of this new technology as an in-house project.

I'm told

that MSP handles more than 800,000 pieces of paper a year. I think we know that

technology can help streamline that and give faster and better service. I guess

one of the pleasant surprises for us as we've embarked on this process is that

we realized that in addition to the cost avoidance that is there in the future,

we actually are going to be able to see — we anticipate — some operational

savings as well. But that was not the original intent when we embarked on this.

It is primarily to make sure that the public gets better and faster service.

[1445]

J. Kwan:

Does the minister anticipate — and I would presume the minister does

anticipate — that there will be public servants who will be let go as a result

of this process? How many does the minister anticipate in terms of FTE changes?

Hon. C.

Hansen: It is still too early in the process to know exactly what the impact

is going to be on existing staff, because we still have to work through with the

proponent to determine their staffing needs. We anticipate that the proponent

will in fact want to provide employment continuation for many of the staff, but

until we get through that process, we won't know exactly how many. We are also,

obviously, making sure we follow the provisions of the collective agreement with

regard to those staff if there are in fact going to be layoffs or if those jobs

become redundant.

The other

thing that would click in is provisions that are in the collective agreement

around bumping. They would have those rights under those provisions. Also, we're

looking at an early retirement plan that may be attractive to some of those

employees as well.

Right now

we're certainly looking at a range of options to make sure the interests of

those employees get met, but at this point we don't know exactly what the

specific impact is going to be on the employment numbers.

J. Kwan:

On page 13 of the green book it actually provides the FTE numbers in terms of

changes of the health benefits operations. Could the minister explain where

those changes came from and what they are about?

The

Chair: Minister, if you could just hold off on your answer for one moment.

The member has gone to retrieve some information.

[1450]

Hon. C.

Hansen: With regard to the full-time-equivalents that are on page 13 of the

document that the member referenced, what this does is take our existing

staffing level in the health benefits operations of 229…. We anticipate that

once we have completed this transfer or completed this partnership with the new

provider, we will still need in that operation about 23 staff to maintain the

policy initiatives and the contract management functions that would be there.

What we

don't know at this point in terms of the reduction from 229 to 23, which is

going to be 206 individuals, is how many of those individuals will be offered

employment by the new contract provider. We will know that, basically, once we

get through the next stage of our negotiations and discussions with the two

proponents and we select a final proponent and then work with them in terms of

that transitioning. I guess

[ Page 9112 ]

the number that we start with now, which is 229, will be going down to 23

FTEs at the end of it.

J. Kwan:

If the minister doesn't know necessarily what the change is going to be in terms

of the FTEs, why would he then have the projected number of the reduction down

to 23? Where does that…? Okay, the minister seems to know what I'm talking

about.

Hon. C.

Hansen: Once we have concluded our partnership with this new provider, we

know that we will continue to need 23 FTEs in the ministry to provide for that

contract management, the policy directions and the other corporate services that

need to be provided from the ministry itself. What we're going from is an

existing level of 229 to a future staffing level of 23 in that ministry.

We do know

what the FTEs are going to be. What we don't know is how many of those 206 FTEs

are going to in fact have continued employment with the new provider. That's

what we still have to determine. For those that are not continued, we will make

sure that there are programs in place — whether it's early retirement options

or the ability to transfer to other parts of the ministry or other ministries

based on the bumping rights that they may be eligible for under the collective

agreement.

J. Kwan:

Then it could be as high as 206 staff or FTEs that could be let go. Then they

would go through the normal process of collective bargaining rights within the

collective agreement in terms of bumping or whatever — early retirement and so

on. But essentially at the end of the day — I guess, minus early retirement,

however many individuals will fall into that category — somewhere along the

bureaucracy there will be a loss of FTEs.

Hon. C.

Hansen: The only thing we know today is that there are 206 individuals who

are currently employed by the Ministry of Health Services in the health benefits

operations who will not be employed in that particular division two years from

now. Where those individuals will be — whether they will accept early

retirement, whether they will be kept on by the new provider or whether they

will transfer to other positions within the Ministry of Health Services or other

ministries — has yet to be determined, and obviously we'll be working through

that over the months ahead.

[1455]

J. Kwan:

In the bidding process, I guess with the two proponents that are yet to be

selected, whoever they are — the collective agreement, the staff, the 206

individuals that would be impacted one way or another…. Is there language

within the bidding process that deals with the staff?

Hon. C.

Hansen: We don't have the exact bidding document with us here. But I

understand from officials that there is language in the bid documents that flags

the issue of successorship rights to make sure that the proponents are, in fact,

aware of their obligations under B.C. law for successorship rights. That is

something that is specifically flagged in the documents.

J. Kwan:

What quality assurance is in place, or what would the ministry have to

ensure that there is accountability once the successful proponent takes over?

Hon. C.

Hansen: The contract language has obviously not been developed, but there

will be specific contract language developed that will be signed by the

proponent, which ensures a quality assessment process of the work that they do.

There will be specific deliverables. There will be specific indicators of

service standards and service quality that will be written into that contract

because, at the end of the day, that's what this is all about. We want to ensure

that British Columbians get faster and better access to quality service around

their processing of MSP applications, etc.

The other

thing that is also paramount and that will be written into the contract language

is assurances around privacy. Privacy is a number one concern for us in this

file, as it is in others, and we will make sure that the privacy of British

Columbia's health information is certainly kept. It is our number one priority,

and we will not allow for privacy issues to be compromised in any way.

J. Kwan:

No matter who the proponent is, that organization would still be ultimately

responsible to this minister? Therefore, the minister would be answerable to

public complaints relating to that proponent's work. Am I right?

Hon. C.

Hansen: Yes.

[1500]

J. Kwan:

I sort of just skipped over…. In terms of the FTE numbers, it went from 229 to

23. In between, for the '04-05 year, it's 138. The total 206 FTEs — are those

all MSP administration positions?

Hon. C.

Hansen: These are operational staff in MSP and Pharmacare processing. The

reason you see the step-down in this coming fiscal year is that it is

anticipated this transition will take place partway through the year. The goal

is to go from the 229 to the 23, but it will happen partway through this fiscal

year.

J. Kwan:

What kind of assurance does the minister have that with this new process, with

this new proponent that will take over the responsibilities of MSP services, the

backlogs would be reduced and addressed? The backlogs are significant, even to

date.

Hon. C.

Hansen: The member is right. There is a backlog. That is something that has

been chronic, I think, going back many years. We've seen some attempts in the

past of trying to put in more FTEs to try

[ Page 9113 ]

to deal with the backlog. It doesn't necessarily result in the backlog being

diminished. It's part of what prompted us to look at this solution — to go to

technology, to start using some computer systems to deal with faster processing.

There is and will be built into the contract and the quality standards that we

talked about earlier the turnaround time for applications. Part of what will

also be built in is the time at which we expect that backlog to be dealt with.

The

document inventory has decreased from approximately 230,000 in October 2002 to

approximately 65,000 as of December 2003. I think the backlog isn't as bad as it

has been at certain times, but there's still a lot of documents that we know we

can be providing much faster and at a higher quality of service using some of

these technology solutions.

J. Kwan:

The minister says that built into the process is the anticipation of turnaround

time — or at least projected or expected turnaround time — and the expected

reduction of backlogs at a certain rate. Could the minister advise: what is that

expectation on the turnaround time and the expectation on the reduction of the

backlog?

[1505]

Hon. C.

Hansen: Well, just to compare what the actual was as of April of last year

with the performance target we will expect under this new arrangement…. For

enrolment application, the actual for April of '03 was 16 weeks on average. No,

I shouldn't say on average. The actual is 16 weeks; the performance target is

less than four weeks. For registration maintenance, the actual in April of last

year was up to 24 weeks, and the target is less than four weeks. For premium

assistance transactions, the actual as of last April was 12 weeks, and the

performance target is less than four weeks.

J. Kwan:

So the turnaround time is expected to be four weeks, really, all the way across

for all the categories, and that was in comparison to last April. Just out of

curiosity, what was the worst record so that we actually have a base to go by?

Hon. C.

Hansen: I don't have that in front of me, but I do recall seeing that

charted in a graph that showed the levels of turnaround time. It was actually

about 1999 that was the point at which we saw the worst backlogs. I could try to

get that for the member if she's interested in it, because I know it's a

document I've seen in the past. We just don't have it with us.

J. Kwan:

Don't spend too much time looking for it. That was just out of curiosity because

I know that, as the minister said, it's a chronic situation. I have to say,

actually, that since I've been elected, the worst time for my office, in terms

of people phoning us, just so happened to be last year. We had a record high of

people coming into our office with problems trying to access MSP for one reason

or another. I'm not being partisan here in terms of whether it was any better

when we were in office. I actually don't know the numbers. But I can tell you it

was the worst record for our office and certainly, I think, for my colleague's

office as well — the member for Vancouver-Hastings.

Last year

was the worst ever. We would actually have a pile of people with issues,

problems — can't get their application in or whatever — and then our office

phoning through to try and help process this stuff with the staff on the other

side.

I should

also add that whenever we do contact someone, although it's hard sometimes to

contact someone at the branch with MSP, they're excellent. They do come through

with flying colours. They solve all of the issues just like that. So it's a

matter of actually getting hold of a body and being able to deal with it. I just

want to put that on the record as well.

Now, the

expected reduction of the backlog. The turnaround time is four weeks for all the

categories, and the expected reduction of the backlog…. At what rate does the

minister anticipate the new proponent would be able to process those through?

Hon. C.

Hansen: I think, first of all, when the member talks about the backlogs and

the time it took for people to get through on phone lines and things like that,

that was around the time of the Fair Pharmacare rollout. At least I'm assuming

it was, because I certainly had the same experience in my constituency office. I

think everyone in this House had the same.

The Fair

Pharmacare registration process actually was a pretty phenomenal success story,

except for one element of it, and that was when we had some of the third-party

insurers sending out a message that individuals — everybody, 100 percent of

the population — had to…. There was this deadline, and if they didn't get

their application in by — I think it was the end of April — April 30,

somehow they were going to lose all their benefits and lose all their Pharmacare

entitlements. That was never the case. We tried to counter that message, but

clearly a lot of people were spooked by that and clogged up the phone lines.

[1510]

But at the

end, if you look at how people actually registered, there were just under

400,000 families in the province registered by the website. I think that sort of

speaks to the fact that we are increasingly becoming a computer-literate

province. We need the opportunity to make sure people can take advantage of

those tools. I think this information about the registrations on the public

website underscores the opportunity that is there for us to use technology to

help give better public service.

The other

thing that was quite interesting out of that process was when you look at

seniors' households. There were just under 43,000 that registered using the

public website, so even seniors, I think, are becoming increasingly comfortable

with that option.

To answer

the member's specific question about the time to clean up the backlogs, that is

something, during this due-diligence phase, that we will be working on with the

proponent to look at how quickly their opera-

[ Page 9114 ]

tions can be up and running and how fast they will be able to clean up that

backlog. I don't have a specific answer for her yet, but that is what is

actually unique about a joint solutions procurement process. It allows us to

work through those issues while the contract language is being developed. There

will be clear accountabilities by the time this contract is finalized.

J. Kwan:

I would simply just caution the minister with this. While it is true that there

are more and more people getting access to new technology and computer usage,

and so on and so forth, there are still a significant number of people who do

not have that access. Certainly in my riding, Vancouver–Mount Pleasant, I know

we talk about computers and all kinds of technology advancements, but some folks

in my community don't even have a phone. That's the reality which we live in. So

I simply just want to caution that.

As well, I

know a lot of seniors may not necessarily be using computers themselves, but

they have children and others who could assist them in that process. Of course,

on the flip side of things, there are seniors who don't have access to children

or relatives who could provide that assistance. I just want to provide that

caution there for the minister's consideration.

In terms of

the winning bid, whoever the proponent might be, what…? I fully understand

that the language of the contract with the winning bidder is not yet in place

because you haven't yet chosen the proponent, but I would assume the minister is

planning on ensuring that there's language in that contract, should the

proponent not meet these targets. What accountability measures are in place to

deal with that? Should the proponent not be able to meet the performance

objectives as set out by the government, then what is the next step? Could the

minister just outline that a little bit for this House?

Hon. C.

Hansen: First of all, I agree with the member entirely when she talks about

the need to make sure those without computer access do have access to these

services. I think the technology provides more options, and if those who do have

computer access can take advantage of that tool, then it frees up the other

options for other people. Certainly, we will continue to have the ability for

people to do this over the phone or by mail or whatever other options are there

and necessary.

Yes. There

will be consequences for the provider if they do not deliver on the targets when

it comes to the service expectations. I can't tell the member now exactly what

those consequences will be, but they will certainly be written into the contract

language, and the provider will be held accountable.

J. Kwan:

I think my staff advised the minister that this afternoon I would like to turn

to some hospital issues, particularly some local hospital issues, and then come

back to the service plan. At this point I'd like to just advise the minister

that I would now like to turn to some of the hospital issues, if that's all

right.

[1515]

I'd first

like to focus our attention on Mount St. Joseph Hospital and the foundation

issues. I met with some folks last week with respect to Mount St. Joseph. As I

understand it, the Mount St. Joseph Hospital Foundation, particularly, was

founded in 1921 by a group of nuns to treat Chinese labourers who were not

allowed in what were then called "white" hospitals. Mount St. Joseph

Hospital came to be and continues to be an incredibly important institution not

just in the Chinese community but in the multicultural community. It has, I

believe, over 88 acute care beds, 122 residential care beds and 23 day care

beds. Many people, particularly the elderly, depend on Mount St. Joseph. There

are pieces of the hospital that are now closed and services within it. I'll turn

to that in a moment.

I want to

focus on this issue first. The Mount St. Joseph Hospital Foundation, which is an

independent foundation, was created to support the hospital. It has been

fundraising for some time now to support the hospital. I believe that over the

course of the years they've raised some $13 million to support the hospital.

Currently, they have about $1.3 million in their account. Recently the

foundation has been taken over by the health authority. The foundation directors

have been locked out of their offices.

I wonder if

the minister can explain to this House why the foundation members, whose entire

mandate is to raise funds to support Mount St. Joseph Hospital, were

deliberately disbanded by the government and effectively locked out of their

offices. Why did that happen?

Hon. C.

Hansen: The member is not correct when she says that government did this or

that the Vancouver coastal health authority did this. The Mount St. Joseph

Hospital Foundation, as she correctly indicated, is a totally independent,

not-for-profit society. There is no connection between government and the

foundation. They operate totally independently of government, under the Society

Act.

The other

organization that is supposedly involved in this particular issue is Providence

Health Care, which is also an independent, not-for-profit society in the

province that has its own separate board of directors. Yes, we do have a

contract from the Vancouver coastal health authority to Providence Health Care

with regard to the provision of services at St. Paul's Hospital, Mount St.

Joseph and several others.

I was

certainly approached by one of the parties and asked if I could intervene. I

felt that I could not intervene, because it was basically an issue between two

independent, not-for-profit organizations. They did ask if I could somehow find

a way to help mediate this. While I was looking at what the implications of that

would be, I heard that the parties involved had actually resolved some of their

differences and are going to find a way to work together moving forward.

[1520]

That's

where it stood. My involvement has been very peripheral. It is an issue that

does not involve the

[ Page 9115 ]

Vancouver coastal health authority, nor does it involve the provincial

government.

J. Kwan:

Well, the minister is right insofar as to say they are two independent

organizations. The minister is also right, though, in that where the link does

tie into government is that Providence is funded by the government, and that

funding flows through from Providence to Mount St. Joseph. There is an intrinsic

link in terms of government involvement, in my view, related to that.

Along those

lines then, Mr. Chair, the minister advises that he had engaged in some

discussions with folks. I'm not quite sure who he spoke with. Anyway, he spoke

with some folks about this, and it's his understanding that the matter has been

resolved. Could the minister advise when this discussion took place and with

whom he engaged in these discussions? It is my understanding that as of last

week, unless that discussion took place this week, the matters were not

resolved. In fact, I think the matter is going to court any day now.

Hon. C.

Hansen: The member may have more current information than I do on this,

because as I say, it is something that is very much arm's length from our

operations. I did meet with Dr. Francis Ho, who was the chair of the Mount St.

Joseph Hospital Foundation. I'm trying to think of the dates. I think the first

time I met with Dr. Ho may have been in December. The second meeting was

probably about a month ago. If she wanted more precise dates, I could certainly

get those for her.

J. Kwan:

No, those ballpark dates or time lines will suffice. I was just trying to

determine whether or not the information that I have is now old information, and

therefore the matter has been resolved. Well, if the minister actually met with

Dr. Francis Ho in January or December, then I know that the information I have

is more current, because I met with some people around this issue either last

week or the week before. Was it last weekend? No, I think it was the weekend

before. Anyway, I have to check my calendar on exactly when I met with them as

well, but it was more recent than that.

At that

meeting it was my understanding that the matter has not yet been resolved and

that the matter may appear in the court, actually. Does the minister have no

understanding whatsoever why the foundation board was fired? Does the minister

have no information on that?

Hon. C.

Hansen: As I mentioned, I did have the two meetings with Dr. Ho, and he

certainly presented me with some of the background. At the time, I indicated to

him that I didn't feel I could get directly involved, and certainly I did not in

any way try to offer him any opinion or guidance with regard to those issues.

Given that it is before the courts, it would be inappropriate for me to do so in

any case.

J. Kwan:

When the minister advises that he attempted to facilitate some sort of mediation

between the two parties, who's on the other side? We know that from the

foundation side he met with Dr. Francis Ho. Who from the Providence side did the

minister meet with? How did that facilitation of mediation take place?

Hon. C.

Hansen: What I said was that there was a request from Dr. Ho to see if I

could…. Since I didn't feel that I could intervene and try to facilitate

discussion between these parties, I would see if it was appropriate for me to

try to find somebody who might. Before I got to that stage of trying to see

whether it was even appropriate for me to do that much, I had heard that these

issues had been resolved.

[1525]

The member

may have more current information that in fact they're not resolved, but the

parties as I understand them are those who were on the board previously and

those who were on the board of Mount St. Joseph Hospital subsequently. Those

would be the two parties to it. There were individuals who served on the board

before who, as a result of a meeting, were no longer serving on that board. Now

there are questions around that particular meeting. I gather that's the subject

of the court case. I have to be careful not to comment in a way that could in

any way be interpreted to prejudice those court proceedings.

J. Kwan:

I'm not clear in terms of what role the minister played. It sounds to me as

though the minister is now saying he played no role, because he was going to

facilitate some sort of mediation, and then he heard from somewhere that the

matter had been resolved. Is that right? At that point the minister didn't

follow up or felt there was no need for any follow-up because he had heard that

the matter had been resolved. If that's the case, who did the minister hear the

information from that the matter was resolved?

Hon. C.

Hansen: I think I want to be really clear that what I offered to do was see

if it was appropriate for me to try to find someone who might help facilitate

those discussions. I didn't offer to intervene. I didn't offer to have anyone

intervene. I simply offered to see if it was appropriate for me as a minister.

I do not

recall where I heard the information that it had been resolved. If the member's

information is accurate, then I may have received inappropriate or inaccurate

information. But once I did have that impression, I didn't pursue the file

because I thought it had been dealt with.

J. Kwan:

Did the minister at any point talk to folks from the Providence side on the

issue or have his staff speak with anyone on the Providence side of the issue?

Hon. C.

Hansen: I certainly didn't, and I'm not sure if staff has.

There is a

letter that I signed. I guess it was on February 25. It was a letter that had

come in from another

[ Page 9116 ]

member of the House regarding this issue. I replied back to him stating

that…. Well, I'll just read you part of the letter. "I appreciate these

concerns. While legal proceedings are underway between the two parties, I must

decline to comment on the specifics that have precipitated this situation."

It goes on to state the fact that there is no relationship with hospital

foundations generally. That would be the sum total of it. I did receive some

correspondence and answered in that vein.

J. Kwan:

Here's what I know about the situation. As I mentioned, the Mount St. Joseph

Hospital is the only hospital in Vancouver east of Cambie. It is the hospital

that was opened in 1921 to serve the Chinese community, because at the time

those of Chinese descent were not allowed to go to what were then termed white

hospitals. The Mount St. Joseph Hospital then came into existence.

I know that

in 2001 Providence Health Care Society owned and managed four Vancouver

hospitals: Mount St. Joseph, St. Paul's, St. Vincent's and Holy Family.

Providence does not own the foundation. The foundation is completely

independent. It was established with a full mandate to fundraise solely for

Mount St. Joseph Hospital.

It is my

understanding that Dr. Francis Ho was explicitly asked by various people to be

the chair of the foundation of which he did become the chair. He's also been a

senior doctor, I should add, at Mount St. Joseph Hospital for at least 30 years

if not longer.

[1530]

On December

4, 2003, people associated with Providence purported to hold a meeting and

assert controlling membership of the foundation. As a consequence of that

meeting, most of the longstanding and committed directors of the foundation were

purportedly terminated and a replacement board was then installed. I've been

advised that the directors, all of whom are volunteers on the foundation, were

terminated on December 4.

Since that

time, as I mentioned, the matter has been brought to the courts. Today is March

4, and I believe that today the matter is being heard. I know that the two sides

were trying to come to some sort of resolution prior to the court date, and as

far as I know, no resolution was found.

When the

foundation board was fired, there were 11 independent directors on that board.

Associated with it, the directors were locked out of their offices in terms of

trying to access any of the documentation or information regarding that. No

resolution. No explanation, it seems to me, was provided to Mount St. Joseph

Hospital Foundation board members about why they were fired. One could only

speculate as to why they were fired, but no information was offered.

Now, I'm

not asking, necessarily, for the minister to intervene. I don't know what

happened in the court today with respect to this matter. But given that the

minister funds Mount St. Joseph, funds Providence, funds all four of those

hospitals — so there is a direct link in terms of accountability there with

respect to that — and given that the foundation's whole mandate is to raise

funds for Mount St. Joseph Hospital, which is a hospital funded by the

government, I would think the minister would have some interest and some level

of responsibility in ensuring that Mount St. Joseph Hospital remains unaffected

with this dispute. The government would have an interest in ensuring that the

foundation, albeit an independent foundation whose purpose is to raise funds to

support a public institution — the Mount St. Joseph Hospital — hopefully

continues on with the good work that it does and is not hampered in any way,

shape or form as a result of this dispute.

So, in the

minimum, one would imagine that it would be appropriate or viable for this

minister to find out why the board members were fired in the first place and

what caused the dispute — to just get some factual information for the

public's consumption.

Hon. C.

Hansen: I would certainly like to acknowledge the tremendous work that Dr.

Francis Ho has done in the community, raising money for the Mount St. Joseph

Hospital Foundation. I think he has certainly made a generous contribution of

his time, money and resources, and he deserves a lot of tribute for that effort.

What I do

know is that there are court proceedings, the essence of which are to determine

whether or not meetings to change directors were appropriate. Beyond that, I

don't feel it's appropriate for me to comment on it. The member says: do I take

an interest in it because it's a hospital foundation? Yes, I do. But because it

is an independent society that is governed under the Society Act — which has

members and bylaws that are totally independent of me and that determine how

they select their board members — it is my job, I believe, to respect the

independence of that organization, given that it has no direct connections to

government. So beyond that, I do not believe it's appropriate for me to comment

on what is, in fact, the subject of court proceedings.

[1535]

J. Kwan:

On the basis of that answer, as far as I understand and if my memory serves me

correctly, the matter is before the courts today. So presumably, by the end of

today some sort of findings would be public and the matter would be out of the

court system. It would no longer be caught up in court proceedings. In that

case, if the matter is not yet resolved, would the minister be prepared to look

into that situation and actually play a role and facilitate the resolution of

this dispute?

Hon. C.

Hansen: Basically, I've told the member everything I know about this

particular file today. The reason I have not delved deeper into this particular

issue is because it doesn't directly affect my ministry, because it is an

independent operation. Generally speaking, if there are issues that I as a

minister can be helpful in trying to resolve, the first obligation I have is

[ Page 9117 ]

to consult staff in my ministry in terms of what my limitations are. I would

certainly look at that when the time comes.

J. Kwan:

As I stated, I believe the minister does have a role to play, because it is

public funds that are being impacted through Mount St. Joseph Hospital, which is

under the umbrella of Providence Health Care. It's true that the foundation does

not fall under the minister's responsibility, because that's completely

separate. Yet it is true that the hospitals — one can, I suppose, make some

sort of argument — are separate as well, except that there is a direct line of

accountability. That is, with the hospitals we're now talking about — whether

it be Providence that has responsibility for the four hospitals or Mount St.

Joseph — the government funds those hospitals directly. Public funds and the

public's interests are at play here, so I would make the argument that the

government does have a role to play.

understand the notion that the matter is in the courts right now, so the

minister does not want to get into the situation because of court proceedings.

But as I understand it, the court proceedings would have ended today, so there

would be an opportunity for the minister to get involved in this. When we come

back to estimates next week, Monday and thereafter, the matter will be out of

the courts — presumably by the end of today — and there will be an

opportunity for the government to intervene.

What I'm

seeking now is a commitment from the government. If the matter is out of the

court proceedings and if it's still not yet resolved, would the minister commit

to playing a role in resolving this matter, particularly in the interests of the

public — because Mount St. Joseph Hospital is a publicly funded hospital, a

hospital that has served the multicultural community since 1921?

Hon. C.

Hansen: I'm not sure what more I can add on top of what I said earlier. I

certainly respect the great history of Mount St. Joseph Hospital and the

tremendous contribution it's made to the community. The foundation is an

arm's-length organization, and it's an independent society. I don't have

anything to do with the appointment of their board. I don't even have anything

to do with the bylaws they have. It operates under the Society Act.

As the

member indicated, yes, they do contribute money to the hospital, which is huge

and obviously very beneficial. But there are lots of organizations, both private

sector and not-for-profit sector organizations, that provide services and are

part of contributing to the delivery of health care services. I still have to

respect the fact that those are independent organizations that do not have

direct relationships with the Ministry of Health Services.

J. Kwan:

Yes, Mount St. Joseph Foundation doesn't have a direct relationship with the

Ministry of Health Services. But Providence does, and so does Mount St. Joseph

Hospital. Providence fired the Mount St. Joseph Hospital Foundation on December

4 without any information to the board members or any reasons offered to them as

to why that has happened.

When that

has happened, it impacts directly on the operations of Mount St. Joseph

Hospital. Why? Because the foundation raises funds directly for the hospital.

That, in turn, directly impacts patient care and directly impacts our community

at large in terms of the delivery of health services.

[1540]

While the

minister says that he can't deal with the foundation's issues — albeit in

spite of the fact that the foundation and the fired chair of the foundation, Dr.

Francis Ho, actually asked for the minister to intervene — I would think

there's a role here for the minister to play, and that is to ask Providence some

questions with respect to this dispute. Providence is funded by this government

directly, and so is Mount St. Joseph Hospital. So if we don't want to go about

it from the side of the foundation, we can certainly, I would assume, go at it

from the side of Providence and Mount St. Joseph Hospital.

All that

I'm asking is for the minister to at least look into this matter. Then when we

come back for estimates debate next week, he might be able to advise this House,

"Yes, I spoke with the folks at Providence, and here's the lay of the

land," and maybe the matter is all resolved. Maybe by the end of today's

court situation it's all resolved, and the minister can update me with that

information. Alternatively, if it is not all resolved, maybe the minister can

say to both sides: "Hey, you know, maybe I can play a mediator role here to

resolve this matter in the best public interests in terms of health care

services delivery."

Hon. C.

Hansen: I can only underscore that all of the hospital foundations in the

province are independent of government — independent societies. Quite frankly,

they don't want government to be interfering in their internal affairs. When

there are any kind of disputes that come to my desk, where somebody asks if I

can intervene and assist in mediation, certainly I will see what I can do.

In this

case, when I was asked if I could intervene or if I could find somebody to help

intervene, it was already at a stage where it was before the courts, which

actually produces other challenges for me as a minister. I have to be careful

not to be interfering in a way that would compromise those proceedings. As the

member says, it's before the courts. Certainly, I think she may be optimistic if

she thinks there's going to be some kind of a decision coming out of this in the

very near future, because often it takes some time for courts to write up their

conclusions. Certainly, in whatever context we're in, I will do what I can to

help, but I have to do that in the context of my obligations as a minister.

J. Kwan:

Well, okay, a couple of things that the minister has acknowledged which are

different from other foundation situations. I'm not asking the minister

[ Page 9118 ]

to intervene in disputes with independent boards and foundations out there

willy-nilly. I'm not doing that at all. The difference here is that the Mount

St. Joseph Foundation board — at least the fired board members, including the

chair — had actually asked the minister for intervention. They welcomed the

intervention. They, too, would like to find out what's happened here and why

they were fired.

I'm not

suggesting that the minister should just sort of go and decide to look into

disputes out there somewhere and decide he'll get involved somehow, so there's

one difference with respect to this situation.

Second,

where there is a direct link to health services and the delivery of health

services to British Columbians is that Providence, which has responsibilities

for these four hospitals…. These hospitals and Providence are funded by the

government, directly by this minister, so there is a direct link in terms of

accountability with respect to that.

Providence

took action to fire a foundation which raises funds for one of the hospitals

that's publicly funded by this government, which serves the public. Therefore, I

think that logically there is an argument to be made there.

[1545]

Maybe I'm

optimistic, and maybe the matter will be tied up in courts forever and a day,

but maybe not. As I understand it, the court date is today. Presumably, after

the hearings today a decision will be forthcoming, but in the meantime —

however that plays out — if the matter is not resolved, I don't know where

things will go.

Maybe

there's an opportunity, then, for the government to intervene, for the minister

to intervene. Not necessarily to pick sides — that's not what I'm suggesting

— but to help resolve the matter in a way that is in the best interests of the

public, keeping in mind that Mount St. Joseph is a public and publicly funded

hospital that serves a very unique population, and that is the multicultural

community. It would be, I would think, in the best interests of the government

to ensure that the hospital has its maximum funding opportunities — whether it

be from government sources or from foundation sources — and to not lose those

opportunities. I would think there's a role here for the government to play.

That's all that I'm asking — for the minister to make some sort of commitment

that he will look into this matter and play what role he can to help facilitate

the resolution of this dispute.

Hon. C.

Hansen: Once this is no longer before the courts, I'd be pleased to do that.

J. Kwan:

Thank you very much. That is much appreciated. I'm sure that would be good news

for members of the public and particularly those of the Chinese community who

have been very, very concerned about this matter. They're very worried about the

outcome of this situation. They're worried that the members who served on the

foundation will perhaps simply walk or that maybe the foundation would not be

able to raise the kinds of funds that they have historically to support the

hospital. Of course, on the other side — the hospital side — people are very

worried that if those sources of funding — aside from government funding —

are not available, that might impact the services of Mount St. Joseph Hospital.

Nobody wants to see their services decline, so I appreciate the minister's

commitment on that.

Okay, that

deals with the foundation issue. Let me now turn to services within Mount St.

Joseph Hospital, because the other piece that greatly concerns me and many

community members is that there's been downsizing activity in Mount St. Joseph

Hospital. First of all, let me begin with the gynecology services, which have

been downsized at Mount St. Joseph Hospital. I have received a petition — sort

of like a petition. It's kind of like a letter/petition thing, with….

Hon. R.

Thorpe: Letter/petition thing?

J. Kwan:

I'm not quite sure what to call it. Anyway, let's just call it a petition.

That's the intent behind this document. I'm going to call it a petition, and 117

people signed it when they heard the news very quickly that the gynecology —

the women's — services for Mount St. Joseph were shutting down and were being

moved to St. Paul's Hospital in March of this year. That situation has happened.

The closure of the women's services for Mount St. Joseph has happened.

First of

all, could the minister advise: why did that happen? Why did the government

allow for the closure of this service, which is a very unique service? As I

mentioned, Mount St. Joseph was established in 1921 with its original goal to

serve the Chinese community, because the Chinese community had no other access

to any other hospital because of discrimination issues. Since that time, Mount

St. Joseph has really built its reputation and services, based on providing

excellent care and service and solving language and cultural barriers for the

multicultural community. It is, I would say, a unique hospital in all of British

Columbia that has this kind of expertise.

[1550]

Yet the

government allowed for the women's services — at least this one component….

There are other components which I'll turn to in terms of the downsizing of that

hospital, but they allowed for this to take place. What kind of evaluation took

place with respect to the downsizing of the women's centre services at Mount St.

Joseph, and how did the government let this happen?

Hon. C.

Hansen: There were actually several reviews done — including the

gynecological services planning report to what was then the Vancouver-Richmond

health board, which was done in May of 2001, and the surgical services planning

project report to Vancouver coastal health in December of 2002 — which

recommended that the gynecological services at Mount St. Joseph be transferred

to St. Paul's Hospital.

J. Kwan:

On what basis were those recommendations made?

[ Page 9119 ]

Hon. C.

Hansen: What was driving the change was what was seen as a duplication and

inefficiency in the way the services had been structured, which led to the

consolidation. I'll read these two paragraphs here: "Part of the

implementation plan for this consolidation will ensure that Mount St. Joseph

continues to provide basic gynecological support at Mount St. Joseph. Planning

has been underway since October 2000 to address issues regarding hospital-based

gynecological services in Vancouver. The primary challenge is that critical

services are spread across numerous organizations, resulting in a lack of

critical mass at any one site."

J. Kwan:

Well, I understand in part what the minister is saying. It's for

cost-efficiencies that this situation was allowed to take place. Therefore, what

the minister said was that duplication in efficiencies had led to the

consolidation. Effectively, that nice language means the closure of the Mount

St. Joseph gynecology department and the services associated with it.

The issue,

of course, is that Mount St. Joseph is very different from other hospitals in

that it provides for multicultural, multilingual services. Other hospitals, in

my view, do not have the extensive level of personnel, perhaps, in dealing with

that multicultural community. The hospital was set up explicitly to deal with

the multicultural community, and that is now lost.

[K. Stewart in

the chair.]

I know, Mr.

Chair. I speak Cantonese myself, and I can tell you, when it comes to…. I know

I don't speak the language that well, but I can tell you that when it comes to

technical terms, especially around medical terms, it is very difficult to learn

that language and be able to explain to people what you really mean. That skill

set is particularly valuable, and I don't mean just for the Chinese community. I

just happen to mention the Chinese community because that is my own natural

heritage, and I know that's part of the service that Mount St. Joseph had

provided. I know that in other communities as well, they have that expertise and

those kinds and levels of skills there. Now that's all lost.

[1555]

Even when

we talk about duplication of services and about efficiencies, the information

I've received with respect to the Mount St. Joseph gynecological department is

that the population base in terms of the people which they serve in their local

population had actually increased by nearly 40 percent. Is the minister saying

that in the name of efficiency…? Is he also saying that Mount St. Joseph

didn't have the demand in the hospital in terms of the demand for their services

to keep it open and that therefore it should be shut down?

Hon. C.

Hansen: A couple of things in response to the member's point. First of all,

one of the things that has changed fundamentally in how we structure specialist

services in the province is the requirement that we pay for on-call coverage. We

have to be very careful in where we establish those call groups, because

basically for every call group, it's $220,000 a year, I think.

For a level

1 call it's…. We have to fund the on-call payments depending on the particular

level of call that has been determined for that particular group. Level 1 is

$223,000. Level 2 is about $125,000. Regardless as to what particular

classification they're put into, we do have to fund that.

One of the

things that has necessitated is some consolidation of where specialists work out

of, because now that call money gets divided up among the specialists working in

that particular call group. There's good reason for it. It's to make sure they

don't go through burnout, so that they're not on call for too much time and

actually get some time to relax and some time with their families. That has been

a fundamental change in basically how call groupings have been structured around

the province.

The other

thing that this shift does is allow us to bring together gynecology and

obstetrics at St. Paul's. There are some real synergies there that allow those

specialists to work together and to have more of a team approach to providing

care.

I guess the

final point I'd like to make is that I recognize the importance of us delivering

culturally sensitive health care in the province. It is an issue, I think, that

is growing in importance in the province, and we have to be able to respond to

it. My goal is to make sure that every one of our health facilities in the

province is culturally sensitive and can recognize the importance of those

differences people have that we need to respond to.

The

practitioners who could speak Mandarin or Chinese or other languages,

potentially, at Mount St. Joseph won't disappear. They will still be able to

provide service to their patients at a new location. My hope and expectation is

that we will continue to be able to provide culturally sensitive services and

still be able to provide those services in the venue that allows for that kind

of efficiency and cost savings overall.

[1600]

J. Kwan:

I would like to ask the minister a number of questions around this situation.

First of all, let me just break it down with this. The minister advises that

there is synergy at St. Paul's Hospital. I don't want to dispute that. St.

Paul's Hospital, in my own personal view and experience, is a great hospital. I

delivered my baby girl there, and they were exceptional. The folks who assisted

me every step of the way were just fantastic in their service provision —

whether it be the nurses, the doctors, the people who deliver the food or who

kept the place clean. I did make a mess; there's no doubt about it. They were

just absolutely exceptional. They are experts, certainly, in their own right.

At the same

time, because of the increase in demand at Mount St. Joseph Hospital for a

unique set of services, according to the physicians that worked there…. They

advised that in fact they need more people in the hospital providing those

services rather than

[ Page 9120 ]

saying they don't have enough demand to keep the services at that location.

Second,

I've been advised by physicians at St. Paul's that they actually cannot

accommodate all of the obstetric requirements of the gynecological surgeons of

Mount St. Joseph Hospital, because the demand there is also huge. Given that, it

would seem to me that at both hospitals the demands are high. They have their

unique sets of skills.

Why would

we choose an option that is what the minister calls consolidation and what I

call downsizing and shutting down one set of expert services? Why would we do

that? Why would we not build on both of them and let their own expertise

flourish in their own areas? When you consolidate, you actually run a great risk

of losing that expertise and losing the capacity to service the community,

especially when the demands are enormous on both sides.

I'm not

suggesting for a moment that the physicians will disappear, although some of the

doctors at Mount St. Joseph have told me they would not go to another hospital.

In fact, they would not do that because they don't feel the environment would be

the same, and the level of service they would like to see provided would not be

met. Therefore, they would not go.

[1605]

Hon. C.

Hansen: It's an advantage to have a deputy minister who is also the former

CEO of Women's Hospital to help me with some of the background on this issue.

She has pointed out to me in our discussions here that when we go through this

kind of a consolidation, we can in fact expand capacity. As you bring groupings

of specialists together, you actually get the ability to care for more patients

at the end of the day, and that is certainly what is expected out of this

particular consolidation.

The other

things she has pointed out to me are that the gynecological operating room

surgical interventions are decreasing, and more of the procedures are being done

in clinical settings. There are certainly new advancements in terms of

procedures in how to treat issues that do not necessarily require the acute care

hospital environment. When you start bringing all of these together, the net

effect of this consolidation is that we will be able to meet additional

capacity, but it's also in a changing environment in terms of how gynecological

services are provided.

J. Kwan:

What happens, then, when emergency gynecological services are required at Mount

St. Joseph? Given that the gynecological department is now no longer there, what

happens in that situation?

Hon. C.

Hansen: As I think I indicated earlier, there will continue to be basic

gynecological support at Mount St. Joseph Hospital. If there was an emergency,

then the patient would be transported to St. Paul's Hospital. I think you've got

to look at that in the context of if there is an emergency at Mount St. Joseph,

you want to make sure there is 24-hour-a-day, seven-day-a-week coverage, and

that comes back to the whole issue of the on-call coverage. You need to make

sure patients can have access to the care they need in an emergency situation.

By consolidating the care at St. Paul's, we can be certain that there will be

24-hour-a-day, seven-day-a-week coverage. Given the new fee structures for

on-call payments, that's where it makes sense.

I was in

error when I listed out the level 1, level 2 call rates earlier. The level 1

rate is $225,000 per call group per year, or $616 per day, for being on call.

The level 2 is $165,000 per call group, or $452 per day, to cover physicians

being on call.

J. Kwan:

Based on the minister's logic then, in terms of efficiencies and so on, given

that the gynecological department has closed because it does not provide for

seven-days-a-week, 24-hour-a-day service…. Because Mount St. Joseph does not

provide for emergency services in the evenings — that is for all services, not

just gynecological services — is it logical to assume, then, that the plan is

to shut down Mount St. Joseph altogether and to consolidate them with other

services because they're not serving seven days a week, 24 hours a day?

Hon. C.

Hansen: Certainly in the ministry there is no such plan.

J. Kwan:

Then why was gynecology picked as a service that should shut down in terms of a

specialty service? What numbers does the minister have in terms of the demand

both for Mount St. Joseph Hospital in this area and for St. Paul's — in

gynecology as well as obstetrics?

[1610]

Hon. C.

Hansen: As I mentioned earlier, there were two reviews. One was the

gynecological services planning report that was done in May 2001. The other is

the surgical services planning project report that was done in December 2002,

which recommended the transfer of these services. If the member would be

interested, I'd be pleased to provide her with copies of those reports.

J. Kwan:

Yes, I'll be very interested in both of those reports. For the purposes of

the discussion here, what the minister advised from those reports was that there

was a need to deal with duplication and a need to deal with efficiencies, which

then led to the consolidation.

I would

like to know, in more than just these broad terms, how that came about in terms

of this evaluation, because the information that the minister just gave in this

House, according to his deputy, is that the gynecology services at hospitals

have actually declined. However, I have received information that actually

contradicts that from physicians, who advise me that there is an increase,

particularly for the ethnic community, because people are looking for those

kinds of skill sets and that kind of expertise to provide those kinds of

services. Anyway, I would like to actually get the fac-

[ Page 9121 ]

tual data around that so it is not just hearsay — what I heard, what you

heard. Not that I don't trust the information of your very able deputy, but I

would just like to get that factual information as well.

Hon. C.

Hansen: I think the best way I can respond is to provide the reports,

because I think that is where that kind of detail is provided. We will endeavour

to get that to the member as soon as we're able to.

J. Kwan:

Yes, I appreciate that, and when I get the reports I'll read them in full.

But for the purposes of the estimates today, does the minister know, or does he

not have the information before him? Maybe that's the problem, so therefore we

can't really engage in a discussion in trying to get the facts. Or maybe he does

have the information?

Hon. C.

Hansen: No, I do not have that level of detail with me in the chamber.

J. Kwan:

Then perhaps I'd like to come back to this after I get the reports and when

the minister has the reports before him, and then we can engage in that

discussion at a later time. So then aside from the data itself, which I think is

actually vital for information, is the decision to shut down Mount St. Joe and

move those services to St. Paul's…? Who made that decision? Why not, as an

example, the other way around?

Hon. C.

Hansen: This is a process that was actually initiated originally by what was

then the Vancouver-Richmond health board and continued under the auspices of the

Vancouver coastal health authority. It involved representatives from all of the

facilities in the health authority, and it was basically as a result of their

review and a review of the reports that the recommendations and the decisions

were made.

[1615]

J. Kwan:

That doesn't answer the question. Presumably, the minister is ultimately

responsible for the decisions of the health authorities, and the health

authority's decision is to shut down Mount St. Joseph Hospital's gynecological

department and to expand, I guess, or consolidate those services to St. Paul's.

Presumably, the minister who is responsible for the health authorities signed

off on that — or at least he doesn't seem to have disputed that — and

allowed for this to happen. So there must be valid reasons, outside of:

"Well, somebody did some report, and so therefore it was done." There

must be some sort of valid reason why that option was chosen and not, as I

mentioned, the other way around.

Did anybody

look into the possibility, in terms of switching that decision the other way

around?

The

Chair: We'll just have a five-minute recess.

The

committee recessed from 4:16 p.m. to 4:25 p.m.

[K. Stewart in the chair.]

On vote 25

( continued ).

Hon. C.

Hansen: The member, prior to that break, was asking about who in fact makes

the decision around this kind of relocation, and the short answer is the health

authority. We have given them the responsibility to organize the health care

delivery system in a way that meets patient needs in the most cost-effective way

possible and that delivers the maximum amount of patient care with available

resources. That means that sometimes consolidations are necessary in order to

get the best-quality patient care for the amount of financial resources that are

available.

This is one

of the initiatives that they have taken. They don't come and ask me for

permission on every single one of their decisions. I just rely on them to make

sure that they do it based on good evidence and good research. I do hold them

accountable for their outcomes, as set out in the performance agreements.

The other

thing I'd like to point out is that while there have been some services that are

being moved from Mount St. Joseph, there are other services that are being moved

to Mount St. Joseph as a result of the reorganization.

I think

this kind of initiative by the health authorities is totally within their

mandate, and it is within their purview to make these decisions. Unless somebody

can show me that it is not based on good methodology or good evidence, I

certainly give them the latitude to make these judgments.

J. Kwan:

The health authorities are accountable to the minister, and so the decisions of

the health authorities ultimately are the responsibility of the minister. So the

closure of the gynecological department of Mount St. Joseph decision ultimately

is a responsibility of the minister as well.

The

minister says that he accepts the information from the health authorities on

their evaluation for that action to be taken. For the minister to accept not

just the end result of what they're doing…. But has the minister accepted

their rationale for this? And what is that rationale? That's what I'm trying to

get at, because I'm not clear on how they arrived at that decision, other than

they think that it's the best thing they could do for health care service

delivery. I mean, those are very vague and noncommittal terms. Anyone can say

that. But what are they using to back up their decision?

Hon. C.

Hansen: I did set that out for the member earlier in this discussion as to

what that rationale was. I also am aware of the process that they went through,

in terms of the reviews that were done and in terms of the expertise that came

to the table to consider those particular reviews and to assist in making this

decision. I know that some of the best experts and officials have put their

minds to this, and this is the recommendation that has come forward.

I accept

the fact that I am ultimately accountable for these decisions. But based on the

process that they

[ Page 9122 ]

have gone through at arriving at this decision, I am certainly prepared to

support them.

[1630]

J. Kwan:

The only rationale that the minister has offered to date is what he called….

There were evaluations done, and in fact they found duplications and

efficiencies that were required, and therefore it led to the consolidation. One

could make the argument that if duplication and efficiencies were issues, you

could easily have reverted the decision of consolidating the services. Instead

of from Mount St. Joseph to St. Paul's, it could have gone the other way around.

What evidence did the minister receive that supported this decision for it to go

the way it did — that is, to shut down Mount St. Joseph and to consolidate its

services in St. Paul's Hospital?

Hon. C.

Hansen: The review was done by expert clinicians. What I want to make sure

is that we base our decisions in terms of health care delivery around that kind

of clinical expertise. I am not going to base decisions around purely political

motives. I'm not going to inject a political lens on how we best meet the needs

of patients in the province.

When I have

a group of expert clinicians that come together to review two substantive

reports that were put together, and they put that against the lens of delivery

of quality service to patients — the need for a 24-hour-a-day coverage,

including the on-call coverage we talked about earlier; the need to get best

value for every single health care dollar we spend in the system; and optimizing

the use of our resources, not only our human resources but our capital resources

as well — that is the lens with which we have to evaluate these decisions.

When I look

at a decision like this, I am anxious to make sure that they have done their due

diligence. I am comfortable that they have done so in this case.

J. Kwan:

I'm not suggesting that there should be political interference necessarily, nor

am I suggesting that the government should just make decisions without factual

information. But it appears to me that the minister does not necessarily know

what that factual information is. That's what I'm trying to canvass with the

minister.

What is

that factual information? He says there were studies done. He doesn't have the

studies before him. He didn't have the facts and figures in this House when I

asked for them so as to determine, in fact, if the gynecological services at

Mount St. Joseph, as an example, had actually gone down in demand and therefore

required the consolidation. He doesn't have that information before him.

Yet he can

sit here and attempt to berate me about political decisions versus clinicians'

information and decisions. Given that the minister is responsible for these

decisions, one would have assumed that the minister would have some background

information around them other than to say: "Some reports were done by some

people that I'm sure have expertise, and therefore I just accept those

decisions." If that's how the minister operates, then there's cause to be

concerned.

Let me try

again here. Maybe if the minister advises that he doesn't have the information

before him and therefore these kinds of questions relating to these decisions

should be deferred for another day, I'd be happy to do so. But it's not good

enough. It's not good enough during the estimates debate, when community members

have written — certainly to me as the MLA for Vancouver–Mount Pleasant, as

the opposition member, and to my colleague the member for Vancouver-Hastings —

about their concerns around these decisions. They want to know explicitly how

that happened, what the data behind it was, especially when physicians who are

involved are saying: "I have contrary information and data that say

otherwise."

Mr. Chair,

you'll pardon me if I don't just accept what the minister is basically saying:

"Trust me. Studies were done. Experts did them, and therefore it's the

right decision." It's not good enough for me, that kind of explanation.

Hon. C.

Hansen: First of all, I apologize to the member if she felt that I was

berating her. I certainly did not intend to have that come across that way.

[1635]

have offered to provide those reports to her. I did not know she was going to

specifically be raising Mount St. Joseph Hospital this afternoon. If we had

brought in all of the reports and all of the statistics and all of the

background documents with regard to all of the issues in health care, quite

frankly, it would fill this chamber, and we wouldn't have any room to sit in

this room. We do bring along a significant amount of information to try to help

us with this estimates process. I do apologize that I don't have that level of

detail at my fingertips in this chamber as it pertains to one particular program

at one particular hospital, but as I mentioned to the member, we will endeavour

to get that to her.

J. Kwan:

Then it would seem to me that it would be wise to defer questions around Mount

St. Joseph, at least pertaining to this aspect here, so that we could have a

legitimate debate about these issues. I accept that the minister doesn't have

all of his information before him. I accept that. But I was under the impression

that while the minister may not have all the details in terms of the data and

numbers and so on, he does have the general parameters of why these decisions

were made — more than generalities that say efficiencies and duplication. I

was expecting that, but I'm wrong. I will defer these questions with respect to

the gynecology department closure.

Now, am I

right to assume…? There are other departments that have closed at Mount St.

Joseph. The most recent one that I learned of is the diabetes centre at Mount

St. Joseph. That has now closed, which was unfortunate news, I must say. It is

much like the gynecological services that Mount St. Joseph provided. The

[ Page 9123 ]

diabetes centre provided excellent informational sessions to people with

diabetes and language-appropriate advice with respect to the kinds of foods

people should take. Dietitians provided advice to individuals with diabetes and

so on.

That

service is now also gone, as I understand it. It has closed. If it hasn't

closed, it's in the process of closing, but I believe it has closed. Again, the

decisions that led to that — are they also in this other report, or is there

some other report? Maybe the minister has the information as to why the diabetic

services at Mount St. Joseph Hospital were terminated.

Hon. C.

Hansen: Again, I want to come back to the role of the health authorities. It

is their job to make these decisions as to where services can most appropriately

be provided. I don't have any specific detail around any changes to the diabetic

service that may have been provided at Mount St. Joseph Hospital, but it may

well be that the health authority is making decisions as to where those can be

most appropriately provided. That is their mandate. They're empowered to do

that.

If you go

to the performance agreements we have with the health authorities…. We hold

them accountable, but I don't micromanage them. I don't tell them how to do

their job. I just hold them accountable at the end of the day that we get better

quality health care for the available dollars that we have for health care

delivery in that particular health authority.

I would

like to just expand on the comment I made earlier about services moving to Mount

St. Joseph Hospital. I don't hear the member complaining about that. There are,

for example, expanded elder care ambulatory services, including 15 geriatric

medicine beds, an additional 20 geriatric psychiatry beds, geriatric psychiatry

and medicine out-patient programs, six additional surgery beds, consolidated

ophthalmology programs — all initiatives where this change has moved programs

to Mount St. Joseph Hospital.

The bottom

line is: is there change happening in terms of health care delivery in Vancouver

coastal health authority? Yes, because we're trying to redesign a health care

system so that in fact we can get better-quality care and more capacity for the

available financial and human resources that we have.

[1640]

J. Kwan:

The minister says he doesn't micromanage health board decisions, health

authority decisions. I'm not necessarily asking the minister to micromanage

their decisions. The minister admits that he's accountable for health board

decisions. Therefore, he must answer, in my view, questions around their

decisions. The public has the right to ask these questions. The opposition

members, on behalf of the public, have the right to ask these questions. The

minister has the responsibility to provide these answers. It is for the public

to decide, through that debate, whether or not the government, the minister and

the health authorities made the right decisions. It's for them to make that

judgment.

I know the

minister may like the opposition or the public to accept out of hand what the

minister or the health authority says are the right decisions. But for the

opposition to do their job prudently in terms of holding the government

accountable, I have to go a little bit deeper than that, rather than just

saying: "Okay, if you say so. If that report you have says so, so be it,

and then we'll move on." No, that's not how it's going to work. It is going

to need more than that, at least for my own satisfaction and for the

constituents I represent — for their satisfaction — in terms of these

decisions.

Whether or

not these decisions are made in the best public health services delivery

interest remains to be seen. It remains to be seen. The background,

documentation and knowledge base of this minister in supporting the health

authority's decisions will have to be canvassed in this House, and judgments

will then follow from it. That's why I'm asking these questions.

I do want

to turn to the enhanced services that exist with Mount St. Joe. I will turn to

that, but right now my focus is on the service cuts. That's the line of

questioning I'm going on.

Am I right,

then, with respect to the diabetic services at Mount St. Joseph Hospital? Am I

right to assume that was also part of the study undertaken by the health

authorities to make the decision to shut down the diabetic centre services? If

the minister tells me, "Come back to me next week around that, and I'll

have more information for you," I will accept that, and I will come back.

I'm not trying to be difficult. There are a number of services that have been

cut. People are very concerned about it. People have phoned my offices, and I

have committed to them that I will ask these questions in the estimates process

of the minister. That's what I'm trying to do here.

Hon. C.

Hansen: I appreciate the fact that the member is seeking a level of detail,

and I have to apologize that I don't have that level of detail at my fingertips

here in the chamber. I do accept my responsibility to be accountable for even

the details, but I just can't do it instantly. I certainly would endeavour to

try to get back to her with regard to diabetic services.

To answer

her one question — was it covered in the two reports I mentioned earlier?—

the answer is no. One of those reports was specifically around gynecological

services, and the other report was around surgical services planning. In neither

case would that reflect directly on diabetes care. I will endeavour to find out

more information about diabetes services at Mount St. Joseph.

If she is

seeking this level of detail with regard to other files, if she would like to

provide us with a bit of a heads-up in advance, we'll certainly try to have that

information in the chamber so that we can avoid having to take questions on

notice, and I can perhaps give her more timely answers.

[1645]

J. Kwan:

Fair enough, fair enough. I will ask these questions around the diabetic

centre along with the

[ Page 9124 ]

gynecological questions next week some time, when the minister has that

information and I've received the reports.

If there

are reports associated with work undertaken to determine the closure of the

diabetic centre for Mount St. Joseph Hospital, I would appreciate that as well.

If I can get that background information, then we can obviously have a much more

fluid debate in this House.

Now, the

other area which Mount St. Joseph Hospital had to shut down was their children's

ward. It was called the…. What's that famous actor's name?

Interjection.

J. Kwan:

The Jackie Chan Centre, I think. The Jackie Chan children's ward, I think it

was called. That, too, had shut down. It was substantively funded by that famous

actor, Jackie Chan, and then it had shut down. Again, I'm not quite sure why,

how that came to be, what led to that decision, etc.

The

minister, if he doesn't have that information…. That's okay. We can have that

discussion next week as well, along with those other services that have shut

down. All I need to know then, if that's the case, is: should we defer questions

around the Jackie Chan children's ward — I think it's called — for Mount St.

Joseph Hospital, which was closed?

Hon. C.

Hansen: I'm advised that that particular program at Mount St. Joseph was

underutilized. I think we also have to recognize that at Children's Hospital we

have a tremendous facility that is really a centre of excellence around

children's care. Because the one at Mount St. Joseph was underutilized and it

was seen to be desirable to consolidate those services under the Children's

Hospital, where there are very extensive programs, that consolidation was

undertaken.

J. Kwan:

Underutilization. What was the utilization rate at Mount St. Joseph

Hospital?

Hon. C.

Hansen: I don't have that data with me, but we'll endeavour to get it.

J. Kwan:

The evaluation to close the children's ward at Mount St. Joseph because of

underutilization, as the minister says…. Who undertook that work to make that

determination? Was it the health authority themselves or…? I don't know; maybe

they contracted it to somebody else to look into that situation. Does the

minister know what process took place around that?

Hon. C.

Hansen: The children's health services at Mount St. Joseph were funded from

the provincial health services authority, which also has responsibility for

Children's Hospital. The review was undertaken by PHSA.

What they

were looking at was how best to provide those services going forward. I

understand that that particular evaluation is something that went back certainly

more than three years and resulted in this consolidation. The programs didn't go

away; the programs were shifted from Mount St. Joseph and consolidated at

Children's Hospital.

[1650]

J. Kwan:

The closure of the children's ward at Mount St. Joseph Hospital was a fairly

recent event, actually. The minister advises that the information, the data,

collected to make that determination was at least three years old. Maybe I

didn't hear the minister correctly, so maybe the minister can advise when that

data was collected.

Hon. C.

Hansen: What I was saying is that the review actually goes back more

than three years, but it was an ongoing process, so they would be using the most

current data that would be available at any point in time. When they started

looking at how to best provide child health services and the potential need for

consolidations, it was over a fairly long period of time, but they were using

the most current data that would be available at any point during the years that

the review was ongoing.

J. Kwan:

Is it possible for the minister to provide the opposition with a copy of this

review that determined the need to close Mount St. Joseph Hospital's children's

ward because of underutilization?

Hon. C.

Hansen: It's not a document per se. The review is something that would have

involved clinical experts looking at how best to provide those child health

services. If the member is interested, I could certainly get a briefing note

from the provincial health services authority to explain the rationale behind

this particular move.

J. Kwan:

Yes, that would be helpful. Again, it's not just for my own information but, I

think, for the public's information as to how that decision was arrived at.

Then, for the community to decide whether or not that was the right decision,

that would be important.

Given that

a number of services have closed at Mount St. Joseph Hospital, may I ask the

minister what is happening with this new wing of the hospital that used to be

the children's ward? I believe it was called the Jackie Chan children's ward. Is

it just sitting empty? What are the plans for this space that is now no longer

being utilized?

Hon. C.

Hansen: I don't have that detail in terms of how that particular space is

being utilized. I do know there are additional services that have been moved

into Mount St. Joseph Hospital. Whether or not they've gone into that particular

part of the building, I don't have that information.

J. Kwan:

Maybe when we deal with the other closure elements of Mount St. Joseph Hospital,

the minister could find out for me what the intention is here

[ Page 9125 ]

with respect to these empty spaces that donors through the foundation…. The

hard work of volunteers of the foundation raised these moneys, and donors

earnestly believed that their donations would go towards this cause. Therefore,

this structure was built, and then — lo and behold — not long after, they

find that the service they thought they had donated towards is no longer there

and the structure is just…. Well, I don't know what it is being used for.

[1655]

That's

troubling, I think, for a lot of people — not only for the community which

accesses that service, but it's also troubling for the foundation that worked

hard to raise these moneys, as you can appreciate, and then for the donors

themselves. They sit there and think: "Okay. I donated a bunch of money to

provide for the hospital here only to find out that the service has been closed

down." The foundation that is trying to raise the money loses a lot of

credibility, the community loses the service, and the donors are sitting there

wondering: "Why am I donating these moneys to these things that end up not

being used?" That's not a fortunate scenario for anyone, I think. It would

be useful if the minister can advise what's happened to these spaces and

supports that have been put in place for Mount St. Joseph Hospital.

Let's turn

to the additional services that the minister put on record a little while ago. I

missed some of them. If the minister can advise what additional services now

exist at Mount St. Joseph, and if he could run through the list for me and the

extent to which the additions had been put in place….

Hon. C.

Hansen: I don't have a comprehensive list of all the things that may have

been moved to Mount St. Joseph, but these are actually services I read out

earlier — services transferred from St. Vincent's Hospital to Mount St. Joseph

Hospital and St. Paul's Hospital. The ones that were transferred to Mount St.

Joseph specifically are elder care ambulatory services, including 15 geriatric

medicine beds, 20 geriatric psychiatry beds, geriatric psychiatry and medicine

out-patient programs, six additional surgery beds and consolidated ophthalmology

program.

J. Kwan:

There has been discussion about expanding Mount St. Joseph, and there has also

been discussion about closure of Mount St. Joseph. The minister had just advised

in this House a little earlier that there are no plans to close down Mount St.

Joseph Hospital, so I don't have to canvass any more about that. There are no

plans to close Mount St. Joseph Hospital.

With that

knowledge, then let me explore the concept of expanding Mount St. Joseph,

because people were under the impression that the government had wanted to

expand Mount St. Joseph. They naturally got very worried about it because

services within Mount St. Joseph — such as the gynecological department, the

children's ward, the diabetic centre, etc., — ended up shutting down. And

people were thinking that was kind of a strange way of expanding things. The

things that have been expanded, in terms of the beds and so on, hadn't given

people a level of comfort that in fact the plans were not to shut down Mount St.

Joseph.

Can the

minister enlighten me through this House of the plans for expansion of Mount St.

Joseph beyond what the minister had advised in terms of those beds?

Hon. C.

Hansen: I think what is key for me to point out is that the provincial

government does not own this facility. It's owned by Providence Health Care,

which is in turn owned by the Sisters of Providence. Providence Health Care owns

and administers a network of Catholic facilities in the Vancouver coastal health

authority, of which Mount St. Joseph Hospital is one.

[1700]

I am aware

that within Providence Health Care they are trying to look forward in terms of

what the future vision would be for Providence Health Care well down the road.

We have certainly been supporting them in a feasibility study that they're doing

to look at what some of that future vision might look like.

Beyond

that, from the ministry's perspective, it is not our role to plan for expansion

or change with regard to any of those Providence sites. It is really incumbent

upon their own board to do that future visioning and then for us to work with

them in terms of how the services they deliver are integrated into the rest of

health care delivery not just in Vancouver coastal but indeed provincewide. In

the case of St. Paul's, for example, that is a facility that provides some very

important provincewide programs.

The short

answer to the member's question is that we don't have any specific plans within

the ministry for expansion, but Providence Health Care, which is the owner of

the facility, is embarking on a future visioning project.

J. Kwan:

Did the minister say the government participated in a feasibility study in terms

of the future vision of what Mount St. Joe would look like? Did I hear him

correctly on that?

Hon. C.

Hansen: Providence Health Care, which owns Mount St. Joseph Hospital and

several other facilities in Vancouver, is embarking on a future visioning

process to look at what role Providence Health Care should play in the future.

We have provided them with some specific financial assistance to fund a

feasibility study to look at what that future vision might look like. Our

participation in it is to provide some funding to enable that feasibility study

to be done.

J. Kwan:

Has the feasibility study been completed?

Interjection.

J. Kwan:

No, it hasn't. When will it be completed, and will the minister get a copy of

that completed study?

[ Page 9126 ]

Hon. C.

Hansen: I understand that the completion of the feasibility study is still

months off. It is, as I understand it, a very complex process, because it's not

just looking at the internal challenges within Providence, but it's also looking

at how that integrates with the rest of health care delivery. On top of that, it

has to anticipate years forward, decades forward, in terms of what those health

care needs would be. It is a fairly complex and involved process. When it is