British Columbia Hansard — Thursday, November 17, 2005

H1117am-02

British Columbia — Debates (Hansard)

First Session, 38th Parliament OFFICIAL REPORT OF DEBATES OF THE LEGISLATIVE ASSEMBLY (HANSARD) Thursday, November 17, 2005 Morning Sitting Volume 5, Number 2 THE HONOURABLE BILL BARISOFF, SPEAKER ISSN 0709-1281

PROVINCE OF BRITISH COLUMBIA (Entered Confederation July 20, 1871) LIEUTENANT-GOVERNOR Her Honour the Honourable Iona V. Campagnolo, CM, OBC FIRST SESSION, 38TH PARLIAMENT SPEAKER OF THE LEGISLATIVE ASSEMBLY Honourable Bill Barisoff EXECUTIVE COUNCIL Premier and President of the Executive Council ............................................................................................................Hon. Gordon Campbell Minister of State for Intergovernmental Relations .......................................................................................................... Hon.

John van Dongen Deputy Premier and Minister of Education and Minister Responsible for Early Learning and Literacy...................... Hon. Shirley Bond Minister of Aboriginal Relations and Reconciliation .......................................................................................................Hon. Tom Christensen Minister of Advanced Education and Minister Responsible for Research and Technology ........................................... Hon.

Murray Coell Minister of Agriculture and Lands.......................................................................................................................................................Hon. Pat Bell Attorney General and Minister Responsible for Multiculturalism............................................................................... Hon. Wally Oppal, QC Minister of Children and Family Development ..........................................................................................................................Hon.

Stan Hagen Minister of State for Childcare ........................................................................................................................................................Hon. Linda Reid Minister of Community Services and Minister Responsible for Seniors’ and Women’s Issues........................................... Hon. Ida Chong Minister of Economic Development and Minister Responsible for the Asia-Pacific Initiative and the Olympics.................Hon.

Colin Hansen Minister of Employment and Income Assistance ...........................................................................................................Hon. Claude Richmond Minister of Energy, Mines and Petroleum Resources .......................................................................................................Hon. Richard Neufeld Minister of State for Mining............................................................................................................................................................Hon.

Bill Bennett Minister of Environment and Minister Responsible for Water Stewardship and Sustainable Communities ...............Hon. Barry Penner Minister of Finance.......................................................................................................................................................................Hon. Carole Taylor Minister of Forests and Range and Minister Responsible for Housing ............................................................................. Hon.

Rich Coleman Minister of Health ......................................................................................................................................................................Hon. George Abbott Minister of Labour and Citizens’ Services .......................................................................................................................... Hon. Michael de Jong Minister of Public Safety and Solicitor General................................................................................................................................Hon.

John Les Minister of Small Business and Revenue and Minister Responsible for Deregulation ...................................................... Hon. Rick Thorpe Minister of Tourism, Sport and the Arts .........................................................................................................................................Hon. Olga Ilich Minister of Transportation...........................................................................................................................................................Hon.

Kevin Falcon LEGISLATIVE ASSEMBLY Leader of the Official Opposition .........................................................................................................................................................Carole James Deputy Speaker ....................................................................................................................................................................................Sindi Hawkins Assistant Deputy Speaker.....................................................................................................................................................................Sue Hammell Deputy Chair, Committee of the Whole.................................................................................................................................................

Harry Bloy Clerk of the Legislative Assembly .........................................................................................................................E. George MacMinn, OBC, QC Clerk Assistant.........................................................................................................................................................................................Robert Vaive Clerk Assistant and Law Clerk .......................................................................................................................................................Ian D.

Izard, QC Clerk Assistant and Clerk of Committees ....................................................................................................................................... Craig H. James Clerk Assistant and Committee Clerk ..........................................................................................................................................Kate Ryan-Lloyd Sergeant-at-Arms............................................................................................................................................................................. A.A.

Humphreys Director, Hansard Services ..................................................................................................................................................Anthony Dambrauskas Legislative Librarian ..................................................................................................................................................................................Jane Taylor Legislative Comptroller...............................................................................................................................................................................Dan Arbic

Party Standings: Liberal 46; New Democratic 33 ALPHABETICAL LIST OF MEMBERS Abbott, Hon. George (L) ..........................................................................Shuswap Austin, Robin (NDP)...................................................................................Skeena Bains, Harry (NDP)....................................................................... Surrey-Newton Barisoff, Hon. Bill (L)...............................................Penticton–Okanagan Valley Bell, Hon. Pat (L) ..................................................................Prince George North Bennett, Hon.

Bill (L) .....................................................................East Kootenay Black, Iain (L) ..................................................................Port Moody–Westwood Bloy, Harry (L).....................................................................................Burquitlam Bond, Hon. Shirley (L).......................................... Prince George–Mount Robson Brar, Jagrup (NDP)..........................................................Surrey–Panorama Ridge Campbell, Hon. Gordon (L) ..............................................

Vancouver–Point Grey Cantelon, Ron (L)................................................................... Nanaimo-Parksville Chong, Hon. Ida (L) ......................................................... Oak Bay–Gordon Head Chouhan, Raj (NDP) ................................................................Burnaby-Edmonds Christensen, Hon. Tom (L) ...................................................... Okanagan-Vernon Chudnovsky, Dave (NDP).................................................Vancouver-Kensington Coell, Hon. Murray (L) ..........................................Saanich North and the Islands Coleman, Hon.

Rich (L)................................................Fort Langley–Aldergrove Conroy, Katrine (NDP) ............................................... West Kootenay–Boundary Coons, Gary (NDP) .............................................................................North Coast Cubberley, David (NDP)................................................................. Saanich South de Jong, Hon.

Michael (L) ........................................Abbotsford–Mount Lehman Dix, Adrian (NDP) ..............................................................Vancouver-Kingsway Evans, Corky (NDP)......................................................................Nelson-Creston Falcon, Hon. Kevin (L) ............................................................

Surrey-Cloverdale Farnworth, Mike (NDP) ....................................Port Coquitlam–Burke Mountain Fleming, Rob (NDP) ...................................................................Victoria-Hillside Fraser, Scott (NDP) ...................................................................Alberni-Qualicum Gentner, Guy (NDP)............................................................................ Delta North Hagen, Hon. Stan (L) ......................................................................Comox Valley Hammell, Sue (NDP) ........................................................

Surrey–Green Timbers Hansen, Hon. Colin (L) .......................................................Vancouver-Quilchena Hawes, Randy (L)............................................................... Maple Ridge–Mission Hawkins, Sindi (L) .................................................................... Kelowna-Mission Hayer, Dave S. (L) ..................................................................... Surrey-Tynehead Hogg, Gordon (L)................................................................... Surrey–White Rock Horgan, John (NDP)...........................................................

Malahat–Juan de Fuca Horning, Al (L)................................................................ Kelowna–Lake Country Ilich, Hon. Olga (L)....................................................................Richmond Centre James, Carole (NDP)............................................................Victoria–Beacon Hill Jarvis, Daniel (L)........................................................North Vancouver–Seymour Karagianis, Maurine (NDP) .................................................Esquimalt-Metchosin Krog, Leonard (NDP)..............................................................................

Nanaimo Krueger, Kevin (L)................................................... Kamloops–North Thompson Kwan, Jenny Wai Ching (NDP)................................ Vancouver–Mount Pleasant Lali, Harry (NDP)..............................................................................Yale-Lillooet Lee, Richard T. (L).........................................................................Burnaby North Lekstrom, Blair (L)................................................................... Peace River South Les, Hon. John (L)....................................................................

Chilliwack-Sumas Macdonald, Norm (NDP)......................................... Columbia River–Revelstoke MacKay, Dennis (L)......................................................... Bulkley Valley–Stikine Mayencourt, Lorne (L)............................................................Vancouver-Burrard McIntyre, Joan (L)...................................................... West Vancouver–Garibaldi Neufeld, Hon. Richard (L) ....................................................... Peace River North Nuraney, John (L)..................................................................Burnaby-Willingdon Oppal, Hon.

Wally, QC (L)............................................... Vancouver-Fraserview Penner, Hon. Barry (L)................................................................ Chilliwack-Kent Polak, Mary (L) ......................................................................................... Langley Puchmayr, Chuck (NDP)........................................................... New Westminster Ralston, Bruce (NDP) ...................................................................Surrey-Whalley Reid, Hon. Linda (L) ..................................................................... Richmond East Richmond, Hon.

Claude (L)...................................................................Kamloops Robertson, Gregor (NDP) .....................................................Vancouver-Fairview Roddick, Valerie (L)............................................................................ Delta South Routley, Doug (NDP).......................................................... Cowichan-Ladysmith Rustad, John (L) ..............................................................Prince George–Omineca Sather, Michael (NDP)..............................................

Maple Ridge–Pitt Meadows Simons, Nicholas (NDP) ........................................ Powell River–Sunshine Coast Simpson, Bob (NDP).......................................................................Cariboo North Simpson, Shane (NDP) ......................................................... Vancouver-Hastings Sultan, Ralph (L) .........................................................West Vancouver–Capilano Taylor, Hon. Carole (L)..........................................................

Vancouver-Langara Thorne, Diane (NDP) ......................................................Coquitlam-Maillardville Thorpe, Hon. Rick (L)............................................................Okanagan-Westside Trevena, Claire (NDP) .......................................................................North Island van Dongen, Hon. John (L)..................................................Abbotsford-Clayburn Whittred, Katherine (L).............................................

North Vancouver–Lonsdale Wyse, Charlie (NDP) ......................................................................Cariboo South Yap, John (L)........................................................................Richmond-Steveston LIST OF MEMBERS BY RIDING Abbotsford-Clayburn ........................................................ Hon. John van Dongen Abbotsford–Mount Lehman................................................Hon. Michael de Jong Alberni-Qualicum ...............................................................................

Scott Fraser Bulkley Valley–Stikine ................................................................ Dennis MacKay Burnaby North................................................................................ Richard T. Lee Burnaby-Edmonds............................................................................. Raj Chouhan Burnaby-Willingdon ........................................................................John Nuraney Burquitlam............................................................................................

Harry Bloy Cariboo North....................................................................................Bob Simpson Cariboo South................................................................................... Charlie Wyse Chilliwack-Kent ....................................................................... Hon. Barry Penner Chilliwack-Sumas ........................................................................... Hon.

John Les Columbia River–Revelstoke ......................................................Norm Macdonald Comox Valley .............................................................................Hon. Stan Hagen Coquitlam-Maillardville................................................................... Diane Thorne Cowichan-Ladysmith .......................................................................Doug Routley Delta North........................................................................................

Guy Gentner Delta South...................................................................................Valerie Roddick East Kootenay ............................................................................Hon. Bill Bennett Esquimalt-Metchosin ............................................................. Maurine Karagianis Fort Langley–Aldergrove....................................................... Hon. Rich Coleman Kamloops ......................................................................... Hon. Claude Richmond Kamloops–North Thompson..........................................................

Kevin Krueger Kelowna–Lake Country .......................................................................Al Horning Kelowna-Mission ............................................................................Sindi Hawkins Langley................................................................................................

Mary Polak Malahat–Juan de Fuca........................................................................John Horgan Maple Ridge–Mission ......................................................................Randy Hawes Maple Ridge–Pitt Meadows...........................................................Michael Sather Nanaimo ...........................................................................................Leonard Krog Nanaimo-Parksville..........................................................................

Ron Cantelon Nelson-Creston.................................................................................. Corky Evans New Westminster ........................................................................Chuck Puchmayr North Coast .........................................................................................Gary Coons North Island.................................................................................... Claire Trevena North Vancouver–Lonsdale ....................................................

Katherine Whittred North Vancouver–Seymour .............................................................. Daniel Jarvis Oak Bay–Gordon Head.................................................................Hon. Ida Chong Okanagan-Vernon ..............................................................Hon. Tom Christensen Okanagan-Westside................................................................... Hon. Rick Thorpe Peace River North ...............................................................Hon.

Richard Neufeld Peace River South ..........................................................................Blair Lekstrom Penticton–Okanagan Valley...................................................... Hon. Bill Barisoff Port Coquitlam–Burke Mountain................................................. Mike Farnworth Port Moody–Westwood .........................................................................Iain Black Powell River–Sunshine Coast.....................................................Nicholas Simons Prince George North .........................................................................Hon.

Pat Bell Prince George–Mount Robson................................................. Hon. Shirley Bond Prince George–Omineca .....................................................................John Rustad Richmond Centre .......................................................................... Hon. Olga Ilich Richmond East ............................................................................ Hon. Linda Reid Richmond-Steveston ............................................................................... John Yap Saanich North and the Islands..................................................Hon.

Murray Coell Saanich South..............................................................................David Cubberley Shuswap ................................................................................ Hon. George Abbott Skeena ...............................................................................................Robin Austin Surrey-Cloverdale ....................................................................Hon. Kevin Falcon Surrey–Green Timbers.....................................................................

Sue Hammell Surrey-Newton ....................................................................................Harry Bains Surrey–Panorama Ridge...................................................................... Jagrup Brar Surrey-Tynehead .............................................................................Dave S. Hayer Surrey-Whalley ............................................................................... Bruce Ralston Surrey–White Rock..........................................................................

Gordon Hogg Vancouver-Burrard .................................................................. Lorne Mayencourt Vancouver-Fairview.................................................................. Gregor Robertson Vancouver-Fraserview ...................................................... Hon. Wally Oppal, QC Vancouver-Hastings...................................................................... Shane Simpson Vancouver-Kensington ........................................................... David Chudnovsky Vancouver-Kingsway...........................................................................

Adrian Dix Vancouver-Langara.................................................................Hon. Carole Taylor Vancouver–Mount Pleasant .............................................Jenny Wai Ching Kwan Vancouver–Point Grey..................................................... Hon. Gordon Campbell Vancouver-Quilchena ............................................................. Hon. Colin Hansen Victoria–Beacon Hill ........................................................................Carole James Victoria-Hillside................................................................................

Rob Fleming West Kootenay–Boundary ............................................................ Katrine Conroy West Vancouver–Capilano ............................................................... Ralph Sultan West Vancouver–Garibaldi............................................................. Joan McIntyre Yale-Lillooet ..........................................................................................Harry Lali

CONTENTS Thursday, November 17, 2005 Morning Sitting Routine Proceedings Page Committee of Supply............................................................................................................ ................................................... 1913 Estimates: Ministry of Health (continued) K. Conroy Hon. G. Abbott M. Karagianis S. Hawkins C. Puchmayr Proceedings in the Douglas Fir Room Committee of Supply............................................................................................................ ................................................... 1923 Estimates: Ministry of Finance Hon. C. Taylor J. Kwan J. Horgan

1913 THURSDAY, NOVEMBER 17, 2005 The House met at 10:03 a.m. Prayers. Orders of the Day Hon. C. Richmond: In this chamber I call Commit- tee of Supply to continue debate on the estimates of the Ministry of Health, and in

Section A, the Douglas Fir Committee Room, is Committee of Supply estimates debate of the Ministry of Finance. [1005] Committee of Supply ESTIMATES: MINISTRY OF HEALTH (continued) The House in Committee of Supply (Section B); S. Hawkins in the chair. The committee met at 10:06 a.m. On Vote 34: ministry operations, $11,323,248,000 (continued). K. Conroy: G o o d m o r n i n g . I j u s t w a n t e d t o g e t a little bit of clarification on some of the discussion we had last night. What I would really appreciate…. I'm new to this, and on some of it, I would like clarifica- tion.

I wanted just an actual number for the number of net new beds in long-term care in the province. Hon. G. Abbott: I can provide the member with an approximate number. The cha llenge is that there are many projects that are either at completion or near completion. For example, in Salmon Arm, up in my constituency of Shuswap, th ere is a 75-unit Good Sa- maritan assisted-living residential care facility that has some of its units occupied, as I understand now. But it hasn't had a grand opening, so whether we'd count them or not, I'd leave that up to the member to decide. Over all, we are somewher e probably….

In terms of the number since 2001 that we have added or remedi- ated in a substantial way, it would be around 4,500 since 2001. The net number net of closures would probably at this point be somewhere in the range of 300 to 600, again depending on which ones you chose. K. Conroy: Just to clarify, that's just the long-term care beds. The minister had talked about assisted living and long term with his Salm on Arm example. So we're looking at 300 to 600 just in long-term care beds. [1010] Hon. G. Abbott: I'm not sure what the member means by long-term care beds.

There are, as we dis- cussed quite extensively with the Health critic the other night, a range of supports across a continuum, from supportive housing without external supports; to sen- iors supportive housing with supports, where there's regular intervention by home care; to assisted living, where there is access on a regular basis to medical sup- ports plus a hospitality package that includes two meals a day, personal care, and so on; to the highest level of care, which is 24-7 complex residential care. I don't know, when the member says long-term care….

When I use the term "long-term care," I am talk- ing about that continuum from supported living with medical intervention to residential care. If the member is talking only of residential care, we can try to get her a number. But that's not the model today. The model is a continuum of care. K. Conroy: I appreciate that. I understand the con- tinuum of care. I think we all do. I would appreciate if the ministry would provide for me the exact number of residential care beds, and we can wait for that and get it in writing. I would also like it based on the health authorities — the actual number of long-term care.

We don't need it today, Mr. Mi nister. We can wait and get that in writing — the actual number of residential care beds, the net number that have been created through- out the health authorities. I will wait for that in writing. I'm fine with that. I j u s t w a n t t o m o v e o n . I n m y r o l e I r e c e i v e i n f o r - mation from many families in this province concerning the number of seniors who are in acute care beds in hospitals, waiting for long-term care placement.

What we'd like to know is: is th e minister aware of the num- ber of acute care hospital beds that are currently being occupied by seniors waiting for residential care? Hon. G. Abbott: There are an estimated 25,000 residential care beds in British Columbia today. What we will provide to the member is a breakdown by health authority of the number of residential care beds they have and as much info rmation as we can collect about what the current differential is around what ex- isted in 2001, what exists toda y, which I gather is what the member is looking for — correct? K. Conroy: Thank you.

Now on to my next ques- tion. I'm fine to get that in writing. We'll look forward to those numbers. Again, what I wanted from the min- istry is the number of seniors who are actually in acute care hospital beds awaiting placement in the residential care beds. [1015] Hon. G. Abbott: Perhaps I would first of all ask the member if she would check the record. We went through a lot of these issues the other night, and a lot of this stuff has been put on the record. I don't know how we can better coordinate the efforts here, but we actually had the staff in an d dealt with that.

We don't h a v e t h a t n u m b e r w i t h u s t o d a y , b u t i t i s p a r t o f t h e Hansard record of the debate previously. Generally, what that showed was that we are see- ing a reduction every year and probably every month

1914 B RITISH COLUMBIA DEBATES T HURSDAY, NOVEMBER 17, 2005 over the year, although there would be some varia- tions. But there has been a substantial reduction in the number of so-called bed-blockers — that is, people who are inappropriately in acute care beds when they really should be in alternative-level-of-care beds. Good, we just got the graph here. What the graph shows is that the inappropriate use of acute care beds by what should be ALC clients has dropped from 95 per thousand in 2001-2002 down to about 82, 83 in 2002- 2003, down to the most recent figures, 2004-2005, of about 77 per thousand.

So the number has been drop- ping, and that drop is reco nfirmed by the documented wait times for accessing residential care or assisted- living beds. From acute care beds it's most commonly residential care, but not always. Sometimes assisted liv- ing is the more appropriate venue, depending upon what health issue the individual is dealing with. The drop-over time is reconfirmed by the wait time for ALC. In Vancouver Coastal Health Authority the average is 17 days to wait between identification of a need to actually being able to occupy an alternative- level-of-care bed.

In the In terior Health Authority, which has the longest wait time, it's currently — again on average — 88 days between the identification of need for a long-term care bed and the time at which they would be able to take occupancy of that bed or unit. That is a reduction over time from about one year when our government took office. The member says she's heard from all kinds of peo- ple saying that they don't lik e to wait and that the wait is unacceptable. Fair enough. We want people to have ready access to the level of care they need when they need it. That's the goal.

As we talked about this with the Health critic the other evening or other day or whatever time of day it was, in a perfect system you have a perfect symmetry between acute care beds and their usage and alternative-level-of-care beds and their usage. But there is always some churn between those two bodies of beds, and the churn occurs because there are times when people in acute care beds suffer an in- jury or an illness that, in th e view of their medical care giver, should move them back into the acute care sys- tem.

Alternatively — and I spoke at some length about this — there are lots of cases, as was the case with my father, where he had a series of strokes that incapaci- tated him. This was the late 1990s. There was no resi- dential care bed available to him, so he spent three or four weeks — very unhappy weeks — in an acute care bed waiting for a bed to open up in residential care. He was lucky.

He is a veteran, so he was able to get one of the beds that was dedicated to veterans in Bastion Place in Salmon Arm. [1020] To me, it was probably the most powerful example I will ever need in my life of why we need to have suf- ficient stock in all areas in order to meet that need. Is the system perfect? No, it's not, because they're never in perfect alignment. It would be nice if they were, but they're never in perfect alig nment, because there is a certain amount of churn, and there is still some capac- ity to come on line.

I'm very confident, given the way the wait times have been reduced in recent years, that as the new ca- pacity comes on…. As I think I mentioned to the mem- ber last night, we have 52 projects with shovels in the ground, which will add about another 2,700 units by the end of 2006. As those come on, it will make a dra- matic change in terms of how the health authority can manage that intersection between assisted-living, resi- dential care and acute care beds.

There has been an issue in Salmon Arm — again, I'll use that as an example — at times, with the inap- propriate occupation of acute care beds by people who should really be in residential care or in assisted living or in facilities that are some combination of those two things. As the new Good Sa maritan project comes fully on line, it'll be an addition of 75 beds. I suspect it will pretty much eliminate for Salmon Arm the problem of inappropriate use of acute care beds. But even at that, there may be times when a bout of illness or something like that will have those systems out of perfect align- ment.

That's what happens in the health care system, but we are always working for continuous improve- ment to keep those things as well aligned as we can. K. Conroy: Thank you to the minister. The seniors of Salmon Arm are very fortunate that they have that capacity bein g built in their region. The seniors of the West Kootenay area aren't quite as fortu- nate, as many of them do wait in beds for a consider- able time. The number of beds that have been shut has been substantial, and seniors are having difficulty ac- cessing residential care beds close to home.

I'd like to ask the minister what the ministry's pol- icy is. It's my understanding that when seniors are in extended care facilities that are part of a public general hospital situation, additional fees that are charged are covered by Blue Cross insu rance, for example. When seniors are in private facilities, those additional fees are not covered. I want to know if the mi nistry has addressed what happens to seniors if they are in a public facility and that public facility is closed and they are transferred to a private facility because that's the only bed available in the community.

They would now face the possibility of having to pay the additional fees that they would not have paid before because they were in a public facility. Has the ministry entertained any kinds of poli- cies about that? [1025] Hon. G. Abbott: We're just getting some additional information in respect to the latter question by the member. In relation to her previous question…. Actually, it wasn't a question; it was more a commentary on the Kootenays and the availability there. Just to let the member know: in Cranbrook, 47 beds in Steepleview Care Centre will be replaced by a new 75-bed facility in fall 2006.

At Joseph Creek Village, 25

THURSDAY, NOVEMBER 17, 2005 B RITISH COLUMBIA DEBATES 1915 assisted-living units were opened in September 2003. In Creston, Swan Valley Lodge — 90 beds are being upgraded at an estimated cost of $4.2 million to reno- vate 30 care rooms and install ceiling lifts. At Orchard View Village, again in Creston, 21 assisted-living units have opened. In 2002-2003 enhanced rehabilitation services and an adult day program to include a demen- tia program seven afternoons a week and expanded home nursing services to se ven days a week, volunteer support meal program….

In Fernie-Sparwood, Rocky Mountain Village, a new facility with 50 residential care beds and ten assisted-living units, opened July 2004. In Golden eight assisted-living units are ap- proved, and we hope…. I know there's been some con- fusion around what the mu nicipality and the health authority are working toward s there, but that hope- fully is going to be resolved shortly, if it hasn't been now. In Invermere, Columbia House has been upgraded at an estimated cost of $3.8 million to install ceiling lifts and add 15 new rooms, and it has the capacity to add five additional rooms in th e future.

Additionally, in Invermere, eight assisted-living units have opened at Columbia Garden Village — previously Mere Wood Village. In Kimberley, the Kimberley Special Care Home has been upgraded at an estimated cost of $1.7 million, and 11 assisted-living units will open October 2006. Arrow Lakes: four residential care beds opened at Arrow Lakes Hospital. Castlegar: 15 assisted-living units opened at Castlewood Village, September 2003. Kaslo: five beds added in 2002, and 15 beds at Victorian hospital. And so on. So it's not all bad news in the Kootenays by any means.

Th ere's been a lot of excep- tional work done, I think, by the Interior Health Au- thority. I think the member's latter question was around: whether a facility is owned by the public — i.e., the government — or by a private owner, is there a differ- ence in terms of the rates th at an individual occupying a room in one of those places would pay? [1030] The first thing staff advise is that with the distri- bution of private non-profit facilities to private for- profit facilities, the balance is about the same today as it was through the former government's time in office back in the 1990s — about 50-50.

About half are where the health authority, or whatever entity exists to serve the public at that point in time, purchases those ser- vices in the private market, or whether it's in a gov- ernment-owned and government-run facility…. The distribution is approximately the same as it was ten years ago and probably about the same as it was 20 years ago. As a government, we have always — and I'm speaking historically here — had some mix of public and private. That continues today.

Again, I assume the former governments, when they were in office and were looking at the allocation of their capital resources, were always looking to try to get the best value — the best, greatest taxpayer benefit — for the expenditure of every taxpayer dollar, just as we do today. I would assume that. Others may want to correct me on that, but that's fine. What is in the best inte rests in terms of deriving maximum public benefit is going to vary at different times in different parts of the province.

I spoke of the facility that is the sort of government-builds, government-runs model up in Vanderhoof, but there are lots of other instances where, because of either competi- tive forces in the marketplace or other issues, perhaps a private non-profit is the best route — a partnership, for example, with Salvation Army. Or it may be in our best interest to purchase a serv ices package from a private sector entity, because of th e competitive nature of the marketplace, or because they want to build a 30-unit facility because they believe that's the long-term viable number of units for their facility.

But in the next five or ten years they are prepared to give us an exceptionally good rate in order to buy a service package from them for perhaps five or ten years. These are the kinds of things that staff do and do very thoroughly and, I thin k, very professionally, in terms of assessing where in the marketplace the best place is for us to invest our dollars. K. Conroy: J u s t t o b e c l e a r , w e a r e n o t i n a n y w a y , s h a p e o r f o r m e x p ressing any negative con- cerns about assisted-living fa cilities in this province. Assisted living is a good thing.

Our concern in the Kootenays is residential ca re: the number of residen- tial care beds that have been closed. I would appre- ciate if the ministry could provide in writing — not today, not in a verbal answer, please — the number of beds in the Kootenays, residential care beds, that have been closed and the number of beds that have been opened. That's residential care beds, not the assisted living. I would appreciate those numbers for the Kootenays. [S. Hammell in the chair.] I think the minister misunderstood my other ques- tion. My other question was really very simple.

It was a question of extra fees that people are charged that in- surance companies cover. All I want to know is…. When a senior is moved from a public facility to a pri- vate facility, through no fault of their own, no choice of their own — the public facility is closed, and the only bed in the area for them, the next available bed, is a private facility — Blue Cross will no longer cover the extra fee the senior is charged. For instance, seniors who are covered by Blue Cross under Cominco in Trail — if they're in a private facility, Blue Cross will not cover that extra fee.

If they're in a public facility, Blue Cross will cover it. Does the ministry have an y kind of policy in place — that's all I'm asking — for seniors who are trans- ferred, through no fault of their own, from a public facility to a private facility? Who now covers that fee, a fee that they had in no way, shape or form planned on paying for and do not have as part of their budget? That's all I wanted to know.

1916 B RITISH COLUMBIA DEBATES T HURSDAY, NOVEMBER 17, 2005 [1035] Hon. G. Abbott: I thank the member for raising the question. It's obviously an important question. In the first instance we're dealing with Blue Cross, which is a private sector entity. It's no t an entity that the govern- ment controls. The issue the member raised, while it's an important one, is not one that we have heard about previously or have encountered. But it is one that would certainly cause us conc ern, so we're prepared to look into it.

If the member could forward to me some examples of where she has seen this problem occur, we would certainly want to do what we can with Blue Cross to remediate this. It does sound like an unfortu- nate situation. Again, we can manage public policy as a ministry, but we can't necessarily force Blue Cross to do any- thing, because they are a private sector provider of insurance and some services not covered by CHA. We welcome the member's submission of more informa- tion to us, and I can assure her that we will take it up with Blue Cross. M.

Karagianis: I do have a few questions for the m i n i s t e r , a s w e l l , t o d o w i t h v e r y s p e c i f i c f a c i l i t i e s . Having worked in the field, however, for the last num- ber of years, I see that

definitions around the levels of care have again somewhat changed. I know that over the last number of years the term "assisted living" was actually not in favour, an d "independent living" was the required terminology to be used. I've heard a number of different references here in the course of these estimates, and so I would ask if the ministry could actually plea se provide for us a defini- tion now of the new language around each level of care — in fact, what that refers to and where the thresholds are, where assisted living becomes complex care or long-term care or whatever the new terminology is.

That would actually help a lot in defining some of the confusion around when a bed is a bed and what level of care we're referring to. That doesn't need to happen at this moment, but at some time if we could, please, have those

definitions. [1040] I n t h e s p r i n g o f t h i s y e a r I r e q u e s t e d , o n b e h a l f o f my constituents, that audits be done on facilities here in the capital region, very specifically Sunset Lodge. My first question is whethe r those audits have been completed and if, in fact, th e results of those are avail- able to the public. Hon. G. Abbott: Let me address the first portion of the member's comments. The comment is an entirely legitimate one. There are a number of different terms that are occasionally used.

Th ey appear to be used in- terchangeably, and there's a certain amount of confu- sion around exactly what the definition of each of them is. For members who would welcome some additional clarification around what we mean by home care, sup- portive seniors housing, assisted living and residential care, I would refer them first to the Ministry of Health website, or Independent Living B.C., for that matter — both are useful — under B.C. Housing. That would be one source.

I understand that the ministry also has a new pamphlet out which goes into some detail in terms of what the different parts of the continuum of care are. Again, we don't have a bias about what's better than another thing.

What we do want to see is a situa- tion where there is a sufficient quantum of different kinds of care, ranging from home care, where people are living independently in their own home and are supported periodically by external supports through home care aides and so on; to supportive seniors hous- ing, where there is layered-on periodic intervention from the health authority th rough health care aides or community nurses and so on; assisted living, where there are those supports plus a hospitality package of meals and personal care; and residential care, for those whose needs are most intensive and who require, gen- erally speaking, 24-7 supports in order to manage.

Our aim, to put it simply, is to have the housing and health supports that are commensurate with need in wherever the location is that the need exists. If you have too large a number of residential care beds and not enough assisted-living beds, for example, you may have people living in residential care who don't require that level of care. Part of the challenge here is not just to ensure we have alternative-level-of-care beds but a proper balance and mix within that area. Staff were just looking for the detail around Sunset Lodge.

I think they have that now, but I want to review it quickly with them, and then I'll come back to you. [1045] Thank you again to the member for her patience in waiting for an answer in respect of Sunset Lodge. Re- gardless of the facility — whatever health authority, whatever location in the province — audits are a regu- lar part of licensing and so on in these kinds of facili- ties. Audits are referred to th e health authority. In the case of Sunset Lodge, Va ncouver Island Health Au- thority has the responsibility.

We understand that li- censing officers from VIHA have met with senior man- agement at Sunset Lodge to review the concerns that have been raised by, I believe, the member and perhaps others as well. Hopefully, those concerns have been resolved. M. Karagianis: Is that information public? Further to that, Sunset Lodge recently, in fact, cancelled a con- tract with Compass and has engaged in a new contract.

A s p a r t o f t h i s a u d i t s y s tem, are the ministry and the minister looking at that new contract, making some comparisons with it and the Compass contract that was previously in place, and au diting the difference be- tween those two contracts? Hon. G. Abbott: As I recall and understand it, the Sunset Lodge is operated by a non-profit society — of course, a very prominent one: the Salvation Army. They are the ones who have the fiduciary responsibili- ties in terms of the management of the facility, so the

THURSDAY, NOVEMBER 17, 2005 B RITISH COLUMBIA DEBATES 1917 licensing management of contracts rests with the non- profit. [1050] What we do, what the government does, is monitor the outcomes. If there are complaints that are regis- tered in terms of food or cl eanliness or other issues, the licensing officers could be dispatched by the health authority to look at those things, but it is not up to government, nor can it be up to government, to deter- mine what relationships the Salvation Army enters into in terms of food contracts, housekeeping contracts or those sorts of things.

It's up to the non-profit provider to determine what's in the best interests of their pa- tients and clients in moving forward. So that's, I think, the best way to characterize that. M. Karagianis: Certainly, I do understand the re- sponsibility that the Salvation Army holds in providing care at Sunset Lodge.

But as a health facility that is un- der the care and responsibility of the health authority, it would be my hope and expectation that the ministry would take a keen interest in the difference in the con- tract that was engaged with Compass when, in fact, that is an organization that provides both food and cleaning services to most of the public facilities in the region. In fact, now we've seen a private caregiver cease this contract because of lack of performance and engage in another contract which may be able to pro- vide better food service and better cleaning service.

So it would be my expectation that VIHA and the minister would take a very keen interest in auditing both the previous contract and this one. We see that so much of our private health care is now dependent on the services provided by Compass, and we have, in fact, not one but two facilities in this region that have now shown a lack of performance by this Compass contract. In fact, Saanich Peninsula Hos- pital has now changed the terms of their food provi- sion contract with Compass as well.

Again, I would hope that the minister and the ministry are taking a keen interest in the performance evaluations of these contracts, are monitoring that and are looking to pro- vide a public audit on that. I would actually ask at this time if the minister would take a personal interest in comparing these two contracts — the previous Compass contract and the new contract that Sunset Lodge has engaged in — and in reporting out to the public on the differential of per- formance in those.

I think we all have a keen interest in seeing whether or not there are some better options than what we are currently experiencing. Saanich Peninsula has managed to change the terms of their food contract. They are no longer rethermalizing. I would ask the minister if this is a move to look at new terms of reference for how food is provided to health facilities across the region and per- haps provincewide. [1055] Hon. G.

Abbott: The member asked a not particu- larly long question but a fairly involved one, so there may be areas of her question that she'll want to do supplementals on, because it is fairly involved in terms of the level of complexity around these things. The member says: do we take a keen interest in these matters? We certainly do. The ministry takes a keen in- terest. The health authority takes a keen interest. Our entrée into this is through licensing, and it's through the service contract that we have with the service p r o v i d e r .

I n t h e c a s e o f S u n s e t L o d g e , i t ' s t h e S a l v a t i o n Army, which is a very well-experienced organization in the provision of care of this sort and has a very strong reputation for both quality and care that is provided by the organization. That's something we respect. What we do on a regular basis are inspections and audits. Those occur on a regular basis, but they can be triggered more frequently should we receive com- plaints about food or cleanliness. They can be triggered more frequently so that we can better understand what's going on in a particular facility.

I n t h e c a s e o f S u n s e t L o d g e , a s w e u n d e r s t a n d i t , they were dissatisfied with the quality of food and housekeeping that had been provided by Compass. They took advantage, I presume, of the conditions for termination which existed in that contract and termi- nated it and have now entered into a new contract. We don't try to micromanage the Salvation Army in terms of who they enter into a contract with. That is up to them. What we monitor are the outcomes. Is the quality of food better? Is the housekeeping better? And so on.

Those are the issues , among other things, that come into our purview through the licensing inspec- tions and the audits that go on. There is an important point around all of this as well. There have never been in the history of this prov- ince the kinds of comprehensive audits of food quality and housekeeping that there have been in recent years through the health authoritie s. In fact, even the infor- mation in respect of thos e food and housekeeping au- dits is posted on the health authority websites. In the case of the Vancouver Island Health Authority, audits are posted on VIHA's website at www.viha.ca.

The member may ask: well, how do those house- keeping audits and food quality audits compare to audits that were done in her former government's days back in the 1990s? The answer to that question is that you can't compare them at all, because there were abso- lutely no audits done in the area of food or housekeep- ing under the former government. [1100] We are adopting a far more rigorous approach to this than has ever been un dertaken before. When prob- lems emerge, we can deal with them under the terms of the contracts we have.

Whether they're with a non- profit service provider or a for-profit service provider, we always have provisions for terminating a contract that's in non-compliance. Again, the system's not per- fect, but it is constructed in a way that lends itself to continuous improvement within that system. M. Karagianis: I would hope that the minister would be very interested in the new contract that Sun-

1918 B RITISH COLUMBIA DEBATES T HURSDAY, NOVEMBER 17, 2005 set Lodge has struck, considering that the Compass Group has now several times over shown lack of per- formance, both at Sunset Lodge and at Saanich Penin- sula Hospital. In fact, Saanich Peninsula Hospital is under the responsibility of VIHA. It is not run by a private organization like the Salvation Army, and they have had their food contract altered because of com- plaints around that.

It would seem to me that the minister would want to examine the new contracts to see whether, in fact, better options are available for the health authorities to provide these services. Given the fact that we've seen complaints from Saanich Peninsula Hospital on the food provision there…. There are continued complaints coming to MLAs. I'm sure the member for Saanich North and the Islands probably receives the same in- formation that I do around the concern for Saanich Peninsula Hospital. Sunset Lodge is just now coming out of the third quarantine this year.

The fa cility has been shut down, and family members were not allowed to go and visit their mothers or fathers or relatives in Sunset Lodge for the past week because of a new quarantine. I would ask the minister, as I did in May, if he would please commit to conducting an independent audit of the health facilities in this region — not a VIHA-stimulated audit bu t an independent audit — given the failure of many of these contracts to fulfil their obligations to the public. Hon. G. Abbott: I do not agree with the suggestion made by the member for an independent audit.

In fact, the licensing officers from the Vancouver Island au- thority are expected to perform their jobs in an inde- pendent manner, and we have absolutely no evidence or reason to think that the professional, well-trained and well-educated licensing officers from the Vancou- ver Island Health Authority would acquit themselves with anything other than professionalism and inde- pendence. If the member has some reason to think that they would not, then she can advise me of it.

We have com- plete confidence in our licensing officers to deliver in- dependent and fully informed reports in respect of what is going on in facilities. Further, I find it just at least modestly offensive that the member suggests that somehow the Salvation Army — which is a very well-experienced, well- respected, well-managed an d excellent organization in every sense — would need to have oversight from the government in terms of the food and housekeeping contracts it undertook. [1105] Clearly, the Salvation Army was dissatisfied with the work of Compass.

I don't know the details of it and wouldn't speculate on it, bu t I do know that the Salva- tion Army took steps to remediate that situation. I think that given their reputation, their obvious man- agement abilities and their experience, we are com- pletely confident that the Salvation Army would take all steps that are appropriate in terms of meeting the needs of the clients they serve. If the member wants to take issue with that, that's fine, but we have confidence in the Salvation Army in what they do.

Further, with our regula r licensing inspections, with regular audits that are done, we will continue to develop a good sense over time of how the new con- tractor is doing in respect to that. In terms of the Saanich Peninsula Hospital, which the member raised, I do want to report this in terms of the audits that have been done. "Saanich Peninsula" — and I'm quoting from a report here — "consistently scored in the high 80th percentile in our joint house- keeping audits, and in the recent third-party independ- ent audit, SPH scored 85.32, above the acceptable benchmark of 85 percent.

With regard to food services, in a patient satisfaction survey done in July, 74 percent of residents stated the meals they receive are accept- able." Obviously, there are 26 percent that are less than fully satisfied, and we need to try to make whatever changes are appropriate to tr y to ensure that a higher percentage of people are satisfied. I think patient dis- satisfaction with hospital food is something that goes back probably about 3,000 year s in history, but we are always looking for ways to improve things.

After some extensive cons ultation, again at Saanich Peninsula Hospital, VIHA is making some changes in respect to on-site food preparation. The new food prepa- ration model will result, they believe, in improved food presentation, taste, appearance and palatability. VIHA and Morrison, the food provider, trialled the new system at SPH before making a decision to im- plement it. The trial involved some of our residents and was monitored by our clinical and dietary staff. The SPH resident family council advocate was also involved in the trial and is supportive of the change.

The trial included a survey where 90 percent of resi- dents told us they preferred the appearance, taste and palatability of the meals prep ared on site. So I think this really shows the responsiveness of VIHA in work- ing on a continuous basis to try to improve the food outcomes and the enjoyment of food by the patients at Saanich Peninsula Hospital. I do know, as well, that across the province health authorities are all engaged in the building of best prac- tices around food preparat ion and presentation.

They share those best practices ac ross institutions within the region, and they share them between the regions as well. While I suppose that we're always in competition with some perfectionist nirvana, that will always be a chal- lenge. But I'm satisfied that health authorities are making their best efforts to improve food and housekeeping qual- ity every day across their health authorities. S. Hawkins: I have a few questions, and I believe I did inform the minister. Th e issue is around cardiac services. [1110] Let me say, first of all, how impressed I am with how PHSA, our Provincial Health Services Authority,

THURSDAY, NOVEMBER 17, 2005 B RITISH COLUMBIA DEBATES 1919 is working to make sure that services for patients across the province are delivered across the province and that patients do get care as close to home as they can. Having been through a personal experience with the health care system, I honestly can appreciate the fact that patients do want to get home or get treated at home if they can.

Certainly, around accommodation; costs of living somewhere else or your family travelling somewhere else to look after you; just the cost of meals; the emotional, social, psychological challenges — all of that; not having your community around to support you or your family doctor — all those kinds of things come into play. I know that in the last ten years the minister and I have both talked about how important it is for patients outside the lower mainland to access high-level ser- vices.

So I do want to just talk a little bit about cardiac services, because that's an issue we have talked about for the last few years. I know the ministry has done an excellent job in making sure that the wait-lists have been reduced, and I think that's very commendable. I understand now that the ministry and PHSA have em- barked on a study to look at cardiac services. I believe the Hay Group out of Ontario, from a briefing that I did get from Dr.

Halpenny — I believe it was two years ago; maybe it was a year ago — did indicate that ser- vices for cardiac surgery and where they would be provided were being looked at through this Hay study. I just want to let the minister know that this is an issue that is of great inte rest in my constituency. I know the IHA board, Interior Health Authority board, is onside with providing a good level, a better level, of services for our cardiac patien ts in Interior Health and that the health care providers, families, patients, myself and a lot of the MLAs in the area support this.

I'm wondering if we can just get an update on where we are with the Hay report, if the minister can just briefly tell me where we are with the report and when we might expect to see some recommendations from that study. Hon. G. Abbott: I thank the member for her very important question in respect to cardiac care — specifi- cally in the Interior Health Authority but certainly an issue that's very important in health authorities across the province.

There is currently a review being undertaken by the Ministry of Health and the Provincial Health Services Authority who, as the member knows, have tertiary responsibilities across all of the geographic regions in the province. The PHSA and the Ministry of Health are working with all of the health authorities, including the Interior Health Authority, on that review. The Hay Group is assisting in that process. They're not leading it, but they're assisting it. We anticipate the work that is being undertaken by PHSA and others should be com- plete by early in the new year of 2006.

I should proba- bly make the year clear just in case it could be the new year of some other year, but it's actually 2006. It will address access for patients in the Interior Health Au- thority and other health author ities to cardiac, surgical and other intervention serv ices. So we'll very much look forward to that. Again, cardiac is one of the very important areas from the public perspective and, indeed, from the min- istry's perspective in terms of how well things are go- ing within the health care system.

It's been identified as one of the five benchmark areas in the FMM accord, and it's one of the five areas in which we are construct- ing evidence-based benchmarks across the nation to help guide the formulation of better-informed public policy in respect to wait times for procedures like open-heart surgery or for other angioplasty or other forms of heart surgery. [1115] The wait time for open-heart surgery, I'm happy to report to the member — and this is new information, so her question is very timely — has actually been re- duced from 14.4 weeks in 2001-2002 to now 9.6 weeks in the first quarter of 2005-2006.

That's very good news: a very substantial reduction in the wait time for cardiac surgery. I can also happily note — as this is one of the areas where we are, hopefully, going to be constructing these evidence-based benchmarks in concert with other provinces — that this 9.6 weeks is well within the new benchmark for wait time for open-heart surgery.

I think that is really a tribute to not only the ministry staff that have been working very hard on better man- agement of wait time but to the excellent leadership and staff at the health authorities who have been trying to build stronger models for efficient operating rooms and so on and, of course, to all of the service providers, as well, and the health pr ofessionals who work very hard to ensure that British Columbians receive timely care. S. Hawkins: I appreciate the minister's answer to what the wait time is now. I think that's great. I do know that's been reduced.

My constituents and certainly the people that live outside the lower mainland are also very interested in what options or models, if that's what the Hay study is going to recommend…. I guess I just want some detail around the Hay study. Is it being asked to present some models for how cardiac surgery can be regional- ized in the province? I know we very successfully did that for thoracic surgery, and I understand that's work- ing out very well, especially for our interior patients. I think what we'd like to see is something like that come out of this study. I know there have been previous studies done.

There was one back in 1988 with Keon and Menzies. There was another in 1989; there was another in 1998. I believe — I'm refreshing my memory here — that all of them suggested that we need to have something a little bit more in the interior to deal with patients who wait for days or do have their surgery in the lower mainland and then, unfortunately, don't always have the best transportation to ge t back or caregivers down there to look after them post-surgery.

1920 B RITISH COLUMBIA DEBATES T HURSDAY, NOVEMBER 17, 2005 Again, I guess I'm just asking — and I understand that the study will be out in 2006 and that the ministry and PHS A wil l be work ing on the resu lts o f that: i s it actually going to result in some options or models for future provision? Will there be some consultation on those so that we can look at that and see if they actually fit the needs of our region? [1120] Hon. G. Abbott: The member's question invites a little complexity in terms of the response.

In terms of where open-heart surgery is currently provided in this province, there were about 1,948 open-heart procedures completed in th e seven-month period be- tween April 1 and October 31, 2005. Just over a quarter of those…. Actually, the larg est hospital in terms of number of procedures was St. Paul's, at 597. Vancouver General had 502, Royal Jubilee had 435, and Royal Co- lumbian had 414. That's for open-heart surgeries.

I'm advised that by and la rge, open-heart surgeries are being performed, relatively speaking, on a less fre- quent basis and often now are displaced by angioplasty as an alternative to that. One of the important issues that is being considered within the bounds of the dis- cussion underway that we've referenced previously is whether we can have stand-alone angioplasty centres without having the standb y cardiac surgery, open- heart surgery, etc. That's an important issue here. The conclusions have not been reached on that.

Certainly, with the expert clinical evidence that is being gathered through the discu ssion that's underway, cur- rently led by PHSA and the ministry, we will be as- sembling all the expert clinical evidence that comes to bear in terms of whether we should be moving forward w i t h a d i f f e r e n t o p t i o n o r a d i f f e r e n t m o d e l , a s t h e member expressed. So there will be options and mod- els considered in this report.

W h i l e w e u n d e r s t a n d t h a t t h e r e i s n o f o r m a l c o n - sultation being anticipated around this, we would cer- tainly expect, as with most things, that as the health authorities consider whether some expansion or change in the existing mode l is appropriate, they will certainly be hearing from a range of people within their regions about whether that's a good idea or not. In terms of open-heart surgery, as well, and the relative centralization of this in the lower mainland and southern Vancouver Island, transportation then becomes an issue. The member is absolutely right.

You know, for patients in the in terior, having a centre in Kelowna would be welcome fr om a transportation-cost perspective and, obviously, a family perspective and in a range of other areas. I do appreciate the member's advocacy in respect of whether she would welcome it, and certainly she would. I guess if I was wearing a different hat, I might as well. But of course, I'm a dispassionate Minister of Health at this point in time and make decisions only on the basis of the evidence that is assembled for me.

I'm pleased that the evidence is being assembled, and as I noted earlier to the member, we hope that sometime relatively early in the new year, we will have that evi- dence finalized in the form of a report. S. Hawkins: Thank you, minister, for that, and thank you for raising the issue of cardiac surgery and angioplasty. [1125] Let me just say: you raised the issue of stand-alone angioplasty, and I totally agree. I've done a little re- search on that. If you are going to do a stand-alone angioplasty unit, I suggest that could perhaps be done in an area where cardiac surgery is already concen- trated.

If we're looking at dispersing some of these ser- vices across the regions, perhaps Kelowna would bene- fit by having cardiac surgery and angioplasty together, because with angioplasty sometimes there can be a problem, and you need that backup cardiac surgery. I look forward, minister, to talking to you about this in a little more detail. I know there are other mem- bers that have questions. I just wanted to raise the is- sue, because I was wondering if that was the kind of stuff that was being considered in the ministry and PHSA's deliberations. You have confirmed that it is.

I know the position of caregivers and families in the region, and certainly myself, is that we not have just a stand-alone unit but that we also have cardiac surgery with an angioplasty stand-alone unit. I will look for- ward to discussing this with you further. C. Puchmayr: Recently, there was an announce- ment of the closure of 87 residential care beds at Queen's Park Hospital. Thos e were contracted out to other facilities in the Tri-Cities.

It's to create the subacute rehabilitation program in New Westminster to provide some of the services, actually, that were provided at the now-demolished Saint Mary's Hospi- tal. The Woodlands site, which is the site for a future project through, I guess, Good Samaritan Canada, an Alberta-based organization…. Actually, when the city of New Westminster negotiat ed with the government on that site, part of the negotiation was to earmark a large

section of that — I believe it's about four or five acres — for Fraser Health strictly for P8, which is pub- lic institutional lands. I notice that there's going to be a replacement of, I believe, 59 units of assisted living on that site. My ques- tion is: why wouldn't the su bacute care rehab program be constructed on that site, rather than disrupting and creating emotional duress for the patients and families that were on the third floor at Queen's Park Hospital, who have had to adjust, some with dire consequences, to this move? Some were there for many, many years. [S.

Hawkins in the chair.] My question is: could not that program be built on the land that the city of New Westminster has put aside through the provincial government — through BCBC, I believe — and the transition be dealt with in that manner?

THURSDAY, NOVEMBER 17, 2005 B RITISH COLUMBIA DEBATES 1921 [1130] Hon. G. Abbott: I thank the member for his ques- tion. Even though it's a fairly involved and specific one, I think we have some reasonably good answers here in respect of what's being attempted and what's being served. I guess the underlying poin t is one we have talked about a number of times in recent debates — although never, obviously, in the context of this specific institu- tion — a n d t h a t i s h o w w e n e e d t o h a v e s u f f i c i e n t quantities of both residential care and acute care beds.

Where we can enhance the number of acute care beds in facilities in an expediti ous way, we try to do that. That would be the case here. The Queen's Park Care Centre or QPCC, and Royal Columbian Hospital or RCH, are involved in a redes- ign to create a 25-bed convalescent care program, a 20- bed subacute rehabilitation program at QPCC and a 20- bed acute medical program at RCH, thus creating pro- grams more appropriate to each facility and enhancing overall care for seniors.

In the redesign, 87 beds on the third floor of QPCC, as the member noted, will be con- verted from residential care to provide space for these two new programs, which in total will comprise 45 beds. The addition of the new 25-bed convalescent pro- gram means there will be a net increase of 17 beds aimed at meeting seniors' ne eds within Fraser north, and the redevelopment of the Woodlands site adjacent to Queen's Park is anticipated to include some assisted- living units as well, further enhancing seniors' options.

In terms of the third floor itself, we can note that because we need to free up space for these programs, all residents on the third floor will need to be moved, but we will accommodate these moves within QPCC itself wherever possible or move residents to a different facility, perhaps closer to fa mily. There are, we gather, a number of instances of that, where the residents would happily be located closer to their families, if that has been the preference expressed by the residents.

Residents and their families will be meeting with a team at QPCC to discuss the moves, and a detailed care and relocation plan will be developed for each resident, even those moving within QPCC. The actual number of moves is likely to be fewer than the beds involved, due to normal attrition rates. While I'm appreciative of the member's question and his suggestion that it would be better to do some- thing elsewhere and just leave everything as it is at these facilities, that is not the informed view of Fraser Health.

They have looked into this and clearly feel that the greater public benefit, a greater patient benefit, would be served by the kinds of changes they have proposed here. It's obvious from what we know of this that they intend to do it on a very careful and thought- ful basis, and we look forward to them doing that successfully. C. Puchmayr: I j u s t w a n t t o g o o n r e c o r d t o s t a t e that there is not a move available to the second floor. The second floor is virtually full as it is.

I think the let- ters to the patients and to the families did state that wherever possible, the accommodations would be made. My instructions are that that isn't possible with all, so there are some issues with that. I would really like to discuss this with th e minister or the ministry after the estimates. [1135] K. Conroy: I want to move now into the Commu- nity Care and Assisted Livi ng Act, with some things around regulations in this sector. I was really pleased to see, when the act was in troduced, that there are ac- tually going to be regulation s in this sector.

One of the interesting things in the act is the formation of resident and family councils in facilities. Although they're encourag ed, it's not mandatory. What I would like from the ministry, just in light of the time — we only have so much time left here today — is to get an answer in writing as to if the ministry is aware of the actual number of facilities that have active councils that are working in the facilities in the prov- ince. If we could receive that in writing, I would appre- ciate that.

I am also understanding the role of the assisted- living registrar, who has been appointed to protect the health and safety of seniors in public and private assisted-living facilities…. I think this is a great re- source. We were wondering what actual resource dol- lars are committed to this office. Hon. G. Abbott: We don't have that precise figure here, but we're happy to provide it to the member. It's probably in the ballpark of $200,000 to $250,000, but we will advance the precise figure to the member — along, of course, with the other information we've promised her. K.

Conroy: I'll look forward to the information. Within this office, I'm wondering how many com- plaints have been received by the registrar. How are they acted upon once they 're received? When they're acted upon, what are the pena lties or outcomes of the complaints when the complaints have been received? [1140] Hon. G. Abbott: We don't know the precise num- ber of complaints that have been registered with the office, but that information may come in as we con- tinue this discussion.

The pr ocess, though, is a fairly straightforward one and is actually quite consistent with how these issues are managed, for example, by the health authorities as well. Typically, the office is triggered by a complaint. Often, that complaint might come from a family mem- ber or a friend who sees something and feels aggrieved about it, so the complaint would be registered with the office. If a complaint is registered, the officer investi- gates. She would look at whether the conditions pre- sent in the facility would in any way jeopardize the health or safety of a patient or client in the facility.

1922 B RITISH COLUMBIA DEBATES T HURSDAY, NOVEMBER 17, 2005 The model would then see the registrar work with the operator to try to remediate those conditions which, in her view, held so me jeopardy for the health or safety of the client. Hopefully, those would be remediated through the proc ess of discussion with the operator, but in the final an alysis, should the operator be unwilling or incapable of remediating the conditions that jeopardized the health and safety of the patient…. In that case, it is within the purview and authority of the registrar to lift the licence and registration of the facility.

They thereby would lose their opportunity to provide care needs for those patients. K. Conroy: I'm not sure if this information is avail- able, but if it is, I would like, in writing, the number of facilities that have actually had their licences removed. If that's possible, I'd like to access that. One of the other things that come up in my discus- sions with people across the province is the issue of food and facilities. It was mentioned briefly this morn- ing. I'm sure all of us who've visited seniors facilities know that quite often the me al is the highlight of the day for them.

They look fo rward to breakfast, lunch and dinner with anticipation, and the food is an issue. It's an issue across the province. I've had calls from all different parts, where it continues to be an issue. We've been through the whole issue of rethermalized food in the Interior Health Authority region.

Appar- ently, packaged food is an issue in the lower mainland, and it carries on being an issue across the province. [1145] My question, in light of th is, is not to get into a dis- cussion around whether or no t food is an issue but to ask: what kind of standard s does the ministry expect health authorities to have in place with respect to the nutritional quality they're pr oviding to seniors in the residential facilities? Hon. G. Abbott: I appreciate the member's concern with respect to food in facilities across the province. We certainly share that conc ern.

That is why for the first time in history we have undertaken comprehen- sive audits across facilities, across health authorities to measure the quality of food being provided in facilities across the province and to set benchmarks and really demand continuous improvement in that as we move forward. The member, I suspect, knows or should know that food has been an issue for a long, long time in hospitals and related facilities. In fact, one suspects that the first food complaints were probably initiated just about the day the first hospital opened, and they have been pretty much continuous ever since.

Certainly, those that work in the system would advise of that. So how do we move forward to try to ensure that we have better food from a nutritional perspective, from a hot and cold and preferred temperature per- spective, from a quality and safety perspective? Well, I think there's lots of good wo rk being done in that re- gard, and technology is going to be a part of that. It is not possible to advance in this area without some ref- erence to the new technology that can assist.

I know that the times I've had meals at hospital facilities, we've gone through some of the issues around thermalization and rethermalization and so on, and there has been a lot learned in respect of that in recent years. This is new technology, whether we like it or not. Unless we want to be sort of 21st-century Lud- dites, we need to find ways to build best practices out of the new technology we have.

I'm very satisfied that the health authorities are trying to come to grips with building best practices around food management within their authorities and then moving on to sharing those best practices across the health authorities. Thermalization and all the new technologies and so on is something that's happening on an international basis. It's not just happening in Brit- ish Columbia. This is international, and we need to learn from it and, on a continuous basis, be improving those outcomes. I'll welcome the member's next question. K.

Conroy: No one wants to be accused of being a Luddite, but I've talked to some of the seniors, and I think they'd like to go back to the good old- fashioned way of cooking in those hospitals where they weren't dealing with rethermalized food. But that will be an ongoing issue we will continue to discuss and take up. [1150] One of the things I wanted to talk about this morn- ing is standards around staff-patient ratios. I'm very well aware and well-acquainted with the licensing acts through the early childhood education field and have lived and managed under those licensing regulations for some 20 years.

One of the interesting things that I found missing in this act is the lack of appropriate lev- els of staffing for patient population. When I looked at the act, in fact, it was around a responsible person being involved in the care of sen- iors, and there were no specific staff-to-client ratios. How are staffing levels determined in the facilities, and how are professional staffing levels determined — as in RNs, LPNs — in the facilities? The Chair: Minister, noting the hour. Hon. G. Abbott: Thank you, hon. Chair, for noting the hour. I was so caught up in these debates that one has the time simply flying by. H.

Lali: Filibustering your own estimates. Hon. G. Abbott: Don't confront me with the truth like that, member. That is so harsh. Let me note, just to begin here, Madam Chair, the registrar's budget for the CCALA, the assisted-living registrar. I had grossly underestimated her budget. Her budget is, in fact, $420,000 per year, not the $200,000 to $250,000 I had estimated. I'm sure she recoiled in hor-

THURSDAY, NOVEMBER 17, 2005 B RITISH COLUMBIA DEBATES 1923 ror on hearing the lower figure and advised me of same. The registrar of assisted living has received 50 complaints this year. I presume that's probably calen- dar year: 50 complaints to date. That answers a couple of the questions the member had posed earlier on. In residential care facilities, the appropriate mix of registered nurses and licens ed practical nurses is an ongoing issue, and I don't believe we have all of the answers around that.

It is a matter that is still under study and discussion, and there are some different kinds of models in terms of staffing arrangements that we should be looking at. [1155] I think one of the opportunities we've talked about earlier in these estimates that may have some applica- tion here is the building of collaborative teams where each of the participants ca n bring their skills and their appropriate scope of practice to bear. That would be one of the things we want to look at.

In terms of sort of that scope of practice and educa- tion and training, those are the kinds of issues that tend to be addressed by the respective colleges — under a college of nurses and all of that. That's where a lot of that discussion lies, as opposed to us always trying to determine that. In term s of how we look at what is occu rring in a facility, we wouldn't go in and be necessarily prescrip- tive about how many RNs or how many LPNs or how many care aides…. Rather, the licensing officers, when they go into residential care facilities, are looking at the question: are the patients getting good care?

That would be what they look at. If there is a problem in the quality of care that is being received in a residential care facility or an assisted living facility, then that might beg, among other questions, whether the staffing ratio was appropriate or not. I know there has been some tension around this issue, and some of that continues. Perhaps some of it is inevitable. But again, I do hope that as we move for- ward, we can build more collaborative models where, in fact, the relative skills that people can bring to a team are embraced and that this becomes as much an opportunity as it is a challenge.

The expectations that the health authorities set out for facilities, whether they're non-profit, public or for profit, are set out in the service contracts that they put together with the facility operators — whether they're non-profits, private or public — and those tend to be the general guide in terms of what we expect from outcomes. Noting the hour, Madam Chair, I move the commit- tee rise, report progress and ask leave to sit again. Motion approved. The committee rose at 11:57 a.m. The House resumed; Mr. Speaker in the chair.

Committee of Supply (Section B), having reported progress, was granted leave to sit again. Committee of Supply (Section A), having reported progress, was granted leave to sit again. Hon. C. Richmond moved adjournment of the House. Motion approved. Mr. Speaker: This House stands adjourned until two o'clock this afternoon. The House adjourned at 11:58 a.m. PROCEEDINGS IN THE DOUGLAS FIR ROOM Committee of Supply ESTIMATES: MINISTRY OF FINANCE The House in Committee of Supply (Section A); H. Bloy in the chair. The committee met at 10:10 a.m. On Vote 29: ministry operations, $46,571,000 . Hon. C.

Taylor: Good morning, everyone. It's my pleasure today to introduce the estimates for the Minis- try of Finance, fiscal year 2005-2006. Before I begin, I would like to introduce the people who are with me today or, at least, some of them. Many of you, of course, know right beside me is Dep- uty Minister of Finance Tamara Vrooman. She's not going to like this, but I will say that the Globe and Mail profiled Tamara earlier this year as one of Canada's top 40 under-40 achievers. She will now not speak to me for the rest of the morning. Interjection. Hon. C. Taylor: Yes, unlike the rest of us, she is under 40.

Tamara is an example, as are all of the people who are here, staff of the ministry, of the strength of the public service in Brit ish Columbia. We're very, very fortunate to have people like Tamara and oth- ers who have chosen to work in the public service. Nick Paul is the assistant deputy minister, deputy secretary to Treasury Board, and he is overseeing not one but effectively two budgets this year. He has been a v e r y b u s y m a n . A l s o w i t h u s i s a c t i n g c o m p t r o l l e r general, David Fairbotham. That is from the Finance side.

From public affairs, of course, our new deputy minister, Linda Morris, is with me on my left. Denise Champion, right behind me, is director, operation and human resources, and also Cheryl, who wears many

1924 B RITISH COLUMBIA DEBATES T HURSDAY, NOVEMBER 17, 2005 hats. Cheryl Wenezenki-Yolland is EFO of Ministry of Finance, and Cheryl is directly behind me. I'm proud to be able to wo rk with these senior staff. I'm proud of the many talented and dedicated people that I have the privilege of working with in the minis- try. It's a ministry with a very long history of achieve- ment. It's a ministry key to government achieving our five great goals. All of us are committed to improving literacy, leading healthier lives, supporting people at risk, improving our enviro nment and creating more jobs.

Reaching those goals takes focus, discipline and a very strong foundation. Th at foundation includes maintaining a balanced budget, a tax and regulatory climate that supports a strong and vibrant economy, effective financial and resource management and re- porting, and leadership in innovative business and people practices. Those are the goals of the Ministry of Finance. Now I'd like to talk about those goals, all of which position the province to achieve the five great goals of government. Our first goal, as I said, is to maintain a balanced budget. And why?

Well, be cause balanced budgets create the financial discipli ne necessary to ensure the decisions we make today are affordable now and in the years ahead. Balanced budgets result in proper long- term planning so that our spending does not outpace our revenue. They're also an important signal to the world that we have our financial house in order in Brit- ish Columbia. We balanced the budget in 2004-2005 as prom- ised, with a record $2.6-billion surplus and record debt paydown.

That paved the way for another bal- anced budget in February of this year, one that in- cluded a series of tax reductions for lower- and middle-income British Columbians and increased funding for health and education. In September we introduced the first of what will be five balanced budgets in this mandate. The first one, the September budget update, built further on February's budget by focusing on all of our seniors. We renewed the seniors supplement, which will benefit about 40,000 low-income seniors.

We doubled our annual investment in the Shelter Aid for Elderly Renters, or SAFER, program, to pro- vide more support for low-income seniors who rent. We provided funding to update existing seniors health facilities and stre ngthen and modernize the full range of services for seniors. We know that we can provide those supports now and that we can continue to provide them in the future because of the prudent management and long-term planning that has become a hallmark of this ministry. Our second goal is to maintain a tax and regulatory climate that supports a strong and vibrant economy.

Today, in contrast to a few years ago, B.C. is an eco- nomic leader. We outpace al l other provinces in job creation. Our unemployment rate is the lowest in nearly a quarter of a century. People are moving back to B.C., and our business community continues to grow. Now we must focus on keeping our economy strong. We know that taxes are an important factor in businesses starting, staying and growing in our prov- ince. We are continually reviewing British Columbia's tax system to keep our taxes competitive and fair.

We have reduced taxes for individual British Columbians and also for the businesses that create jobs in our com- munities. [1015] Our tax reductions since 2001 have included a 25- percent reduction in personal income taxes, so that B.C. now has the lowest tax rate in Canada, in the bottom two tax brackets. This year we introduced the B.C. tax reduction to reduce or eliminate provincial income taxes for about 730,000 British Columbians. We increased the thresh- olds to qualify for MSP premium assistance. We im- proved the first-time-homeb uyer's program, and we reduced the PST to 7 percent from 7½ percent.

Last month, in addition to improving our support for low-income seniors, we took steps to enhance B.C.'s economic competitiveness. We reduced the general corporate income tax rate to 12 percent from 13.5 per- cent to benefit all sectors of the economy. We also pro- vided a tax incentive for the commercialization of life- science patents to build on B.C.'s growing stature as a centre for biotechnology rese arch and development. I think that anyone who saw the headlines in the paper yesterday sees that that notion is being reinforced and recognized across the country.

In addition to these tax measures, we have created a more favourable regulatory climate by cutting red tape and modernizing the governance of financial insti- tutions in the real estate se ctor. All of these measures support our great goal of creating more jobs per capita than anywhere else in Canada by making B.C. an even better place to work and do business. Our third goal is effective financial and resource management and reporting. British Columbians want to know how their tax dollars are being spent and de- serve assurance that those dollars have been used wisely.

That's why the area of financial reporting is so important in terms of government accountability. Brit- ish Columbia is a leader in the timeliness of its finan- cial reports, and we provide the most comprehensive set of public disclosure documents in Canada. The of- fice of the comptroller general reached a milestone this year with our public accounts fulfilling the commit- ment to fully consolidate information from school dis- tricts, universities, college s and health authorities — the SUCH sector.

As a result, for the first ti me in nine years, B.C.'s Auditor General removed his reservation on the prov- ince's financial statements and provided an unqualified opinion. The Auditor says British Columbia now leads the provinces in complying with GAAP and the inclu- siveness of its budget and financial reports. What those reports show is the excellent track record of sound management of the province's finances. That track re- cord has been noticed. This past year B.C. has earned three credit rating upgrades by the major bond-rating

THURSDAY, NOVEMBER 17, 2005 B RITISH COLUMBIA DEBATES 1925 agencies. Standard and Po or's, Moody's, Dominion Bond have all recognized the government's success in meeting and beating its financial targets. The result is lower borrowing costs. Meantime, our debt-to-GDP ratio continues to im- prove. The ratio is a key measure of debt affordability and one which is closely monitored by the credit-rating agencies. It is forecast to continue to decline during the next three years. Along with debt management, the ministry is re- sponsible for a host of banking and cash management functions.

With government cash flows of about $100 billion a year, we're looking for opportunities to reduce cash management costs. We're also achieving savings in the area of government procurement. Government buys more than $2 billion worth of goods and services each year on behalf of British Columbians, so it is im- portant that we promote best practices to ensure value for the taxpayers and fairness to private sector suppli- ers. I'm very pleased that the ministry's procurement and contract management program has just won a na- tional leadership award fo r its training program for government employees.

The program builds on the expertise and the professionalism of staff involved in procurement and promotes best practices to ensure value for taxpayers and fairness to private sector sup- pliers. This award comes from the Canadian Public Procurement Council, and I'm proud that ministry staff are being recognized for their achievement. Designing new ways of doing things is part of our fourth goal of leadership and innovative business and people practices. For example, the one-stop business registry has changed and im proved the way entrepre- neurs get the services they need from government.

It's a one-window electronic service that lets businesses interact with a wide range of public agencies, saving them both time and money. For example, they can ap- ply for a municipal business licence, a provincial PST number or a WorkSafe B.C. account — all on line. They can do it with a single business number identifier. It does mean that entrepreneurs can spend less time deal- ing with government and more time doing their own business. [1020] Very recently three more partners have signed on to our one-stop system.

Economic development or- ganizations in Surrey, Comox, Port Alberni and Sun Country are now using the service to provide even more support to their local entrepreneurs. I began by acknowledging the skill, the profession- alism and the hard work of staff who have made the Ministry of Finance a national leader on so many fronts. I want to again touch on how important they are to the ministry and public service, and I am very pleased that the ministry has set its goal to attract and retain the very best and the brightest. One of our service plan commitments is to be a learning and innovative orga nization.

We want staff to develop the knowledge and the leadership skills to take us forward in an incr easingly challenging envi- ronment. That's why the mi nistry works closely with staff to hear their ideas, identify areas for development and provide opportunities such as internship pro- grams, career-pathing, ment oring and critical skills training. The ministry relies on all kinds of skills — administrative, accounting, auditing, project manage- ment planning, and human resources. We compete with other employers for people with those skill sets.

The staff and Finance Ministry have the opportu- nity to help guide the $34 billion operation that is gov- ernment. They are rising to that challenge. They take pride in being members of the public service, and I am very pleased at the cultur e of achievement that the ministry has developed. I look forward to seeing con- tinued leadership and innovative business and people practices. I know just in the past couple of months I've h a d t h e c h a n c e t o w o r k w i t h a c o u p l e o f o u r y o u n g interns that we're mentoring and helping along, and it's a positive, good program for young people.

As we begin the estimates debate for the Ministry of Finance, I'm pleased to remind everyone of the ac- complishments of not only the ministry but of all Brit- ish Columbians in restoring sound fiscal management to our province. Again, that sound management pro- vides the foundation for government's five great goals. Our annual budget consulta tion process is underway. We have the report that's just been presented. I look forward to hearing suggestions from all parts of our province on everyone's priorities.

I look forward to input from members of this House and especially the members opposite, and I lo ok forward to answering your questions today. J. Kwan: I thank the minister for her opening com- ments and, as well, for the complement of staff that she has with her. I look forward to canvassing questions to the minister around the ministry. There is no doubt that many of the staff the minister has with her, many w h o m I h a v e w o r k e d w i t h i n t h e p a s t i n d i f f e r e n t c a - pacities, certainly do have a very professional approach to the work, and they are certainly very skilled.

There is no doubt about that. With that, congratulations, Tamara, on the Top 40 Under 40 award. That's actually wonderful to be rec- ognized, especially for a woman in the sector. My con- gratulations to her. Let me just put on record, Mr. Chair, the order of things, if you will, in term s of the questions that I would be asking the minist er around her ministry. I would begin with the overview of the ministry and the review of the services plan. Within that, there are some specific questions, not necessarily in the extensive de- tail one might expect but just some broad questions I might cast in that area there.

Then we are going to move on to the public affairs bureau, the government procurement policy, Partners hips B.C., taxation policy and, finally, economic and financial analysis. So I would expect that's how we would proceed. I will also from time to time have colleagues who would have questions they would like to put to the minister, and of course, I would welcome that, and I

1926 B RITISH COLUMBIA DEBATES T HURSDAY, NOVEMBER 17, 2005 would at that time yield the floor to my respective col- leagues. Let me first, then, begin with the overview of the ministry and the review of the services plan. In the document it reads that the ministry is responsible for a variety of functions and activities, some of which the minister identified in her opening remarks. I'm particu- larly interested in this piece around the capital project oversight. Could the minist er please outline for me: what sort of steps does the ministry go through with respect to capital project oversight? [1025] Hon. C.

Taylor: It is true to say that probably in the first four years most of the concentration of govern- ment was on balancing the budget. This particular four years coming up, we intend to spend a lot of time look- ing at the balance sheet. That means, of course, capital managed debt management. With the new regulations that make us GAAP compliant, it means that we have taken on to our books all of the SUCH sector: schools, universities, colleges and hospitals.

That has been a little bit of a shock to everybody's system because it means that all of the capital projects from those sectors, whether or not there is one penny of provincial money going towards them, come onto our books as debt. So, therefore, if we are to maintain control over the debt levels in the years going forward, we have to know what's coming. We have to know what's around the corner.

For the first time in the summer I sent a letter around to all of the ministries but also all of the sectors, asking for their ten-year capital plan so that we could start to at least see what was out there — see what the options were, what the expectations were. We received all of the capital plans by the end of Au- gust. We are now, within staff, charting the flows of when they expect to build what they've got on their list. We're also trying to determine what's a necessity and what's a wish list, because the numbers, as you can imagine, are large. We are now going through that process.

It's coming to Treasury Board, even as we're working through the analysis, so that Treasury Board is constantly aware of what those patterns look like. We hope, by the February budget, to have a clearer notion of exactly what the num- bers are, what sectors in particular will require capital funding, but the whole…. The big idea for this is to know what's out there, know what's coming and then to try and manage it properly. J. Kwan: Could the minister please advise what criteria she is using to dete rmine what projects fall un- der the wish list category and what projects fall under the necessity category? Hon.

C. Taylor: Mr. Chair, as a start, we are just asking the agencies. J. Kwan: Is the minister expecting to develop some sort of criteria that she would apply in evaluating these projects as they come in? Hon. C. Taylor: Because this is a work in progress, I would say to you that our first step was to get the in- formation. Our second step — we've now asked the question: "What are the real absolute needs and com- mitments?" Some of the projects, of course, have al- ready started, and once we see those numbers, then we'll know what the next question will be. J.

Kwan: I fully appreciate that — in terms of need- ing to know what is out there. However, one would expect, though, that the minister has some sort of idea what would fall under the category of a wish list. Would that be…? Well, I'm just going to leave it at that. I'm not even going to give examples of what one might call a wish list project versus a necessity project. But I think that when the minister says that, though, I detect, fairly definitively, that these are the kind of categories by which the minister will be evaluating these various capital projects.

But surely the minister has some sense, though, even as the projects are coming in, what the numbers may look like — what those guidelines might be. Or is someone anywhere within the ministry developing that for the minister? Hon. C. Taylor: H o n . C h a i r , y e s . I n f a c t , t h a t ' s e x - actly what we're doing. When I say wish list, what I'm talking about is if I say to you: "If you had all the money in the world, what would you build?" Whether you're in the Health ministry or Education or whether you are in Transpor- tation, you get one answer.

When you say, "What can we reasonably pay and afford as taxpayers?" you get an answer that is tighter in terms of criteria from each ministry and from each organization. We have publicly stated that what is guiding us on this is our debt-to-GDP ratio. It's what the credit rating agencies have said that's what they're watching for because what that ratio is, is really a measure of how affordable our debt is. It's saying we're not going to let the debt grow faster than the economy. That's all that ratio means. [1030] That's our commitment. We know what those numbers are.

We've been successful in bringing it down each year. It is our intent — as we look forward, first of all, to the three ye ars and then to the ten-year plan that we're asking for — to make sure that the debt remains affordable for British Columbians, because unfortunately, all debt is, is a bill for our kids, so we've got to be very careful. J. Kwan: I fully appreciate the issue around debt and debt to our GDP and so on and the issues related to it.

But my question, of cour se, is that I'm trying to get an understanding from the minister: what kind of guidelines will she use to determine what a project is that, for it to go ahead, would actually be a higher pri- ority than that of others? If the concept is that th e wish list is something where the minister will ask an agency to provide the

THURSDAY, NOVEMBER 17, 2005 B RITISH COLUMBIA DEBATES 1927 minister with a list of everything that the agency wants to do, that would be deemed to be a wish list. Then the necessities within that wish list are: what are the top one or two things that you must have in order for the organization to function? That's one way of getting an understanding of the wish list versus that of a necessity project. That's from the organization's side.

From the minister's and from the government's side, once the government receives this information, what guidelines will the minister be using to evaluate, for the government and for th e minister herself, what would be deemed to be priority projects? Is it a hospi- tal? Is it a hospital that will deal with wait-lists? Is it schools — although it's not happening very much — in terms of capital initiatives that are required to address aging buildings that are no longer safe or viable for the community?

Or is it, let's say, development of a park in a new area where we need to provide for some new infrastructure for a community? I don't know what the government will be using to determine priorities in that se nse. I'm just trying to get a sense of it, to see if the minister could shed some light on that. [A. Horning in the chair.] Hon. C. Taylor: Yes, and in fact, you have identi- fied a few of the issues that are before us.

The minis- tries know their needs better than we do at the Minis- try of Finance, so it's important for us, first of all, to ask them what they see as th eir short-term, medium-term and longer-term needs. When you ask the question that way, you'll often find that they themselves, within their ministries, have a notion of what state of readiness various projects are at. Ther e are some projects that they want to do right away. There are other projects they certainly want to do, but they're not ready for them yet, so they would say that might come in the second half of the ten-year plan.

Also, these projects have to link into the policy statements of this government. This government has run on the idea of five great goals, so those are our guiding principles in terms of the projects that will go forward. There are a number of issues that will deter- mine this, but the very first step, which is exactly where we are now, is seeing what the expectations are in the community. Then we track it to see, also, if there are bulges, because one of the things that the government can do is pace various projects.

There are some that we might bring up earlier if, in fact, we feel that we've got room within our spending to do it earlier rather than later. It's mostly, at this point, in analysis, looking at the state of readiness, the state of priority and how they match with government's goals. J.

Kwan: What I heard from the minister: some of the things that would be a pplied in determining prior- ity centre around the state of readiness for a particular project, the policy statemen ts of the government under the five great goals, and "r oom within our spending to do it earlier." That's a direct quote from the minister. [1035] I'd like the minister to pl ease expand on that. When she says, "room within our spending to do it earlier," does the minister mean contingency dollars, leftover dollars? What exactly does she mean? Hon. C. Taylor: We're talking just about capital now.

We're not talking about the budget side of things. In the capital, when you start to overlay what the pos- sible expenditures are going out over ten years, we haven't got the final numbers yet, but it is possible that there will be bulges. The papers have been talking quite a bit lately about whether there will be a bulge in construction spending related to the Olympics. We want to look at our plan and look at where everyone is expecting to build and the timing. If there is a bulge, for instance, around 2009…. I'm saying quite clearly that I don't know yet because we haven't got all of our information in.

But if there were, it migh t be possible that we could start some of those projects earlier so that the bulge doesn't happen all at one time. We want to be able to manage this in a way that really effectively uses tax- payer dollars and also manages the debt so that it's something we can afford. J. Kwan: When does the minister expect all the in- formation would come in around these infrastructure projects, capital projects? Hon. C. Taylor: Because this is the first time it's being done, I can't give you specific time lines except that I'll tell you what I'm trying to do.

We got the first numbers from all of these mi nistries and agencies by the end of August. Staff ar e now looking at them and have gone back to all of the agencies asking once again what their strong priorities are and what the sequence of these capital expenditures would ideally be for them. That information is now coming in. We have been keeping a ll of Treasury Board in- formed along the way of what we're seeing and as it's changing. We will continue to do that. It's not just the Minister of Finance who is sitting and looking at this. All of Treasury Board is aware of this.

This is how I'm expecting to approach this. I expect that we will see more certainty in what is expected to be built in the next three years than certainty at the ten- year period. I think that's just logical. We can be sure right now about what projects are necessary and what their costs are more than we can be sure about ten years out.

I would think that by the February budget — that's my deadline — I would like to be able to at least pre- sent to British Columbians a pretty clear picture of what that ten-year pattern looks like in general for the debt, but more specifically what the three-year pattern will involve. I think you'll s ee more detail on the three- year than you'll see going out to the ten-year, but you'll

1928 B RITISH COLUMBIA DEBATES T HURSDAY, NOVEMBER 17, 2005 see what we're looking at in terms of total dollars and our hope to manage that appropriately. J. Kwan: Presumably, Mr. Chair, the minister is also, in her process, as she engages in discussions with the various organizations about their capital project initiatives…. In the budgeting side of things, the antici- pation and the stresses of potential cost overruns would be highlighted for each of these agencies and, therefore, would be accounted for when the minister receives its final documents as she evaluates priorities. Am I assuming that correctly?

Hon. C. Taylor: You're exactly right. What we are trying to do is to have good numbers. But I think we all know, if we're talking about the cost of a project ten years from now, that it is more difficult to say exactly what those numbers will be compared to a project that's happening this year. We are trying to encourage all of those who are doing their budgeting to be aware of the situation that you've just described and to make sure that they have contingencies in place as well.

Budgeting is a difficult science at the best of times, and I think we all recognize that we're in a period of some pressure on cost prices for sure. We saw that with the convention centre, for instance, on some of their construction prices. So there's a recognition that that is an issue. J. Kwan: Could the minister identify for me, please, what the cost pressures are that she has highlighted for these agencies to pay attention to? [1040] Hon. C. Taylor: Specifically, what we are seeing at this point…. We're not seeing it across the board, which is also interesting.

We're not seeing it in every project, but what we have seen in a couple of projects is the cost of construction materials, particularly concrete, steel and even copper wire. We know copper commod- ity prices are at a high righ t now, so we're seeing it with copper wire, as well, in buildings. It's construction materials in particular that we're seeing those pressures on right now. J. Kwan: Are those the only factors? Hon. C. Taylor: I would never make the statement t h a t w e k n o w f o r s u r e w h a t all the factors are, but it seems to be primarily in co nstruction materials.

There may be some stress on labour as well. There is some discussion about how, when you get to very low un- employment, there is some pressure on the skills to make sure that you've got the labour there. So we may see it there as well, but right now it is mostly in con- struction materials. J. Kwan: I was talking to a developer just last week, and he advised me that it had come to his attention that virtually every major construction project in Brit- ish Columbia is faced with tremendous cost pressures and cost overruns — related to materials, absolutely, but also a skilled-labour shortage.

Has that issue been highlighted to the minister? The minister has said that it's a secondary issue after construction materials, although she has also said it has not been a major issue as of yet. Maybe I'm as- suming, then, that in the publ ic projects it's not a major issue. Maybe it's just in the private sector where they're running into problems. Could the minister clarify that for me, please? Hon. C. Taylor: As I said before, it's not consistent across the board. We have the Sea to Sky Highway and the Abbotsford hospital that are coming in on budget, on time — no issues.

The convention centre did show, in signing a couple of their contracts, that there were unexpected higher prices on construction materials. It's different with each project, but it is enough of a warn- ing for us that we are keeping an eye on it. We're aware that it's a risk in terms of our cost projections. J. Kwan: Does the minister have a list of all the capital projects now underway where it shows cost overruns — or, actually, where th ey're on time and on budget — and where the problems are? Could the min- ister make that available?

I fully understand that the minister may not have the full, long list here today, but could the minister make that available to the opposi- tion at a later time? Hon. C. Taylor: We track projects that are over $50 million. We will certainly give that information to you with the detail that you're asking for about their budgets. J. Kwan: I would appreciate that. That would also give me some idea as to where the cost pressures are out there for what regions, for what specific projects.

Maybe it's just construction that's related, I guess — for lack of a better word — to buildings, such as the Trade and Convention Centre and to the construction indus- try in housing, because of the housing boom. Maybe it's not related to highways. I don't know. I have also met with the mining association people. They tell me that they're very worried about the skills shortage in that sector, as well, so that will have ramifi- cations for the economy over all too. I certainly would appreciate a list detailing the con- struction projects that are now underway and where they are at with respect to the budgets.

Are they on time, on budget? Or are they facing challenges in that respect? I would appreciate it. I'd like to now actually move to another area under the core business areas. That is around the public sector bargaining mandate. [1045] We've heard the minister in her opening statement where she talked about the value of staff and abso- lutely needing to remain competitive and so on. I'm particularly interested, though, in understanding, with the public sector side of th ings and with the many bar- gaining units that will be up for negotiations next

THURSDAY, NOVEMBER 17, 2005 B RITISH COLUMBIA DEBATES 1929 spring: where exactly are we in terms of that ranking of competitiveness for these various sectors? Are they second across the province? Are they third across the province? Are they first? I just simply don't know. I would appreciate if the minister could provide me with that information. Again, I fully understand, because there are many different sectors that are out there, that the minister may not have that information at her fingertips today.

But I would appreciate it if the minister could get that information to the opposition — where she outlines each sector that is to be negotiated by the government and how it ranks in terms of the wage scale and bene- fits scale in the other jurisdictions across the country. Hon. C. Taylor: As you've identified, it is a compli- cated and changing issue, but we think that we're tracking around third. That is our best assessment at this point. J.

Kwan: Yes, that's perhaps an average, an overall of the public sector services, but I'm interested in a little bit more detail than that in te rms of each of the sectors, respectively, and where it ra nks. For example, teachers — relative to other jurisdic tions, are they third? Are they second? For example, nurses — are they first? Are they second? Are they third, and so on? If the minister could commit to providing the opposition that infor- mation for all the sectors, I would appreciate that very much. Hon. C.

Taylor: We are in the process, as you can imagine, of starting to think about this wage mandate going forward. I have committed, at least in broad terms, to put out the wage mandate before Christmas, because I know that some of these organizations would like to start talking early rather than late. As part of that, we are pulling together research and information, and as we pull that together, we will have a clearer idea of the specifics that you're asking for. J. Kwan: When does the minister expect to have that information available? Hon. C. Taylor: We're hoping that we'll have it early in the new year. J.

Kwan: I would assume that the minister would for sure have the information by the time negotiations begin and certainly by the time the minister sets her mandate in terms of what that would look like. With- out it, it simply wouldn't be prudent to try and move forward with that informatio n. Am I hearing, just to reaffirm, a commitment from the minister that she w o u l d p r o v i d e t h a t i n f o r m a t i o n t o u s a s s o o n a s i t i s available to her? Hon. C. Taylor: I'm not the negotiator — right? What I'm trying to do in terms of wage mandate is to look at the affordability for t

Document details

Collection	British Columbia — Debates (Hansard)
Citation	H1117am-02
Type	hansard
Volume / chapter	H1117am 02
Language	en
Format	pdf
Source	PROVINCIAL
Identifier	10acb4cc4106fb8dff5de24b9b0f867a396a5d69

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