2005 Legislative Session: First Session, 38th Parliament

HANSARD

The following electronic version is for informational purposes

only.

The printed version remains the official version.

Official Report of

DEBATES OF THE LEGISLATIVE ASSEMBLY

(Hansard)

TUESDAY, NOVEMBER 22, 2005

Afternoon Sitting

Volume 5, Number 7

CONTENTS

Routine Proceedings

Page

Introductions by Members

Statements (Standing Order

25 B )

HANDS Together program in Langley

M. Polak

Exposure of children to toxic

substances

Robertson

Cancer care in northern B.C.

Rustad

Saanich centennial trails project

Cubberley

Port Mann Bridge expansion

D. Hayer

Burgess Shale fossil site

Macdonald

Oral Questions

Responsibility for outstanding

child death reviews

C. James

Hon. S.

Hagen

Hon. J.

Les

Handling of child death review of

Brandon James Seymour

C. James

Hon. J.

Les

Austin

Hon. S.

Hagen

Coroner's inquest into death of

Savannah Hall

A. Dix

Hon. J.

Les

Handling of child death reviews

Gentner

Hon. J.

Les

Communication with families in

child death review process

Farnworth

Hon. S.

Hagen

J. Kwan

Cleanliness standards in Victoria health

care facilities

Cubberley

Hon. G.

Abbott

Karagianis

Tabling Documents

Office of the Auditor

General, report, Strategic Direction and

Funding Proposal for the Fiscal Year 2006-07

Motions without Notice

Appointment of Special Committee

on Sustainable Aquaculture

Hon. M.

de Jong

Committee of Supply

Estimates: Ministry of Health

(continued)

Mayencourt

Hon. G.

Abbott

Ralston

C. Wyse

Cubberley

Estimates: Ministry of Labour and

Citizens' Services

Hon. M.

de Jong

Puchmayr

Proceedings

in the Douglas Fir Room

Committee of Supply

Estimates: Ministry of Energy,

Mines and Petroleum Resources

Hon. R.

Neufeld

Simpson

Hon. B.

Bennett

Sather

Robertson

Simpson

G. Coons

Simons

Gentner

[ Page 2095 ]

TUESDAY, NOVEMBER 22, 2005

The House met at 2:04 p.m.

Introductions by Members

Hon. L. Reid: I have the absolute pleasure to introduce family who come to visit us in this place. I'm delighted to welcome my husband's sister Cheryl Ferguson. She's joined by her husband Brett, their son Trevor Ferguson and his wife Jeanette, and the finest little two-year-old named Orlando. I'd ask the House to please make them welcome.

[1405]

H. Bloy: The tourism industry is in Victoria today promoting British Columbia. There are a couple of people from my riding and area that I would like to introduce: Al Ordge, who's the economic development manager for the city of Coquitlam, and Dave Donaldson, who's the dean of the school of hospitality and business and the school of music at Vancouver Community College.

J. Horgan: I know this will come as a surprise to many members, but I was an auction item in a fundraiser, and I've had the good fortune of having some lunch today….

Interjection.

J. Horgan: It was a princely sum, I say to the member from Surrey.

Joining us today in the gallery are the church ladies of Pilgrim United Church, and they are Irene Moore, Marilyn French, Ruth Scott and Pat Ridgers. Would you all please make them welcome.

Hon. O. Ilich: A large contingent of tourism representatives from all across B.C. has been in Victoria today to discuss their vision for tourism, as my colleague just said. We've been sharing some success stories like Rocky Mountaineer Vacations's recent world travel award for the world's leading travel experience by train and Vancouver being recognized by the Economist magazine as the top destination in the world for business travel. By sharing our successes as an industry, we can continue to help ensure that B.C. remains in the spotlight as a world-class tourism destination.

The Council of Tourism Associations has been the lead organizer of today's meetings, and I would like to introduce a number of the COTA executive and staff who are here today. They are Michael Campbell, COTA president; Mary Mahon Jones, COTA CEO; Jim Storie, COTA first vice-president; Petrus Rykes, COTA vice-president; Allan Baydala, another COTA vice-president; and Deane Strongitharm, David Littlejohn, Don Monsour and Will Harding, the policy and planning analyst.

Also taking

part in today's events are two people from my hometown, Tracy Lakeman and Lorenzo Lepore from Tourism Richmond. I would like to thank all of the tourism operators and representatives who travelled here today for sharing their views with us. I hope the House will make them feel welcome. I would like to welcome everybody who has travelled with them to Victoria.

M. Sather: Here in the gallery today is one of my constituents, Janice Elkerton, who is a longtime councillor from the municipality of Pitt Meadows. I'm pleased to report that she was successful again last Saturday evening. Janice is also chair of the Municipal Insurance Association and is here on MIA business. Will all members please make her welcome.

V. Roddick: In the gallery today is the treasurer of the Council of Tourism Associations, also responsible for COTA's air transportation portfolio. Allan Baydala, a longtime constituent of the gateway community of Delta South, was president and owner of West Coast Air Ltd. and an executive of Canadian Airlines and Air B.C. Currently, he is the president of the North Fraser Port Authority. Will the House please give him a warm B.C. tourism welcome.

D. Routley: In the gallery joining us today are Leanne Baird and Glynnis Yves, two constituents from Cowichan-Ladysmith and members of the Vancouver Island loggers safety support group. This is a group made up mainly of family members of loggers and logging truck drivers who are rallying in order to bring attention to the many deaths that have been experienced in B.C. forests in the past year — that unfortunate and tragic total now at 38. They're trying to bring attention to a rally on Thursday, November 24, at 1 p.m. and 2:15 p.m. at Leroy Trucking in Chemainus. I'd like the House to make them welcome, please.

R. Hawes: In the gallery today is Dr. Lenaya Betel. She manages Hatem, which is an internationally known aboriginal tourism destination site in Mission, B.C. Could the House please make Lenaya very welcome.

[1410]

C. Trevena: As we all know, there are many representatives of the tourism industry here, and tourism is vital for the B.C. economy. I would like the House to make welcome two constituents of mine. One is Brian Gunn, president of the Wilderness Tourism Association, who is promoting our wonderful wilderness in B.C. The other is Craig Murray, who owns and runs Nimmo Bay Resort, an internationally renowned resort which attracts many international visitors. I hope the House will make them very welcome.

R. Sultan: In the galleries today is Mr. Rick Baxter, a constituent who also owns and operates West Coast Airlines. Along with his rival, Greg McDougall at Harbour Air, these two gentlemen run the harbour-to-

[ Page 2096 ]

harbour air service that gets many MLAs to work safely and on time — except when it's foggy.

J. McIntyre: I'd like to welcome some guests in the gallery today too, who are with the COTA group on tourism. They're from the Whistler area, and I would like to introduce Derek Gagner, Ian Dunn and Michele Comeau-Thompson from Tourism Whistler along with Christina Moore from Whistler-Blackcomb.

Mr. Speaker, I'd like to share with you that Whistler has just received another two awards recently, naming them as a number-one ski destination. So I'm very proud, and I hope the House will make them feel welcome today.

A. Dix:

Many members of the House had an opportunity today to meet with representatives

of the We Survived Woodlands group, who have brought stories of courage and

perseverance to us. The Minister of Children and Families and I will have an

opportunity to discuss their issues later in the week. I wish to welcome to the

galleries Gregg Schiller, Arlene Schouten, Richard McDonald, Ken Milne, Gary

Hill, Len Zimmer, Bill MacArthur, Debbie Yaschuk, Shelley Starr, Paul Irwin and Roxanne Gregory. I ask everyone in the House to wish them a fond welcome.

V. Roddick: Also in the gallery today is a great collection of grades 11 and 12 students from Tsawwassen Southpointe Academy. They're accompanied by teacher David Scholefield and school counsellor Wendy Diomis. Their tour of the Legislature emphasized government, parliamentary tradition, some history and other applicable topics through our education and outreach branch. Will the House please give these possible future MLAs an enthusiastic welcome.

N. Simons: I would also like to add my welcome to the folks from COTA who hosted us for breakfast this morning. I managed to have some breakfast, which is good. I'm glad they're here, because they remind us about the important work we have to do as MLAs. I thank them for their hospitality and for treating me nicely. And I won't go further, but make them welcome.

L. Mayencourt: Today in the gallery I have a constituent from Vancouver-Burrard. Her name is Laurie Moffat, and she's joined by her son Mitch Miller, who is from northern Ontario.

Yesterday I spoke about the constituency assistants I have that are beyond compare. They're just wonderful people. A former constituency assistant of mine is here with the Council of Tourism Associations — Ashley Haslett. I would invite the House to join me in welcoming them to the Legislature.

Hon. I. Chong: I, too, would like to add my welcome to a member of the COTA board.

Lana Denoni, who I see in the gallery just behind the Hansard booth, is a hard-working individual who used to be a chamber of commerce president here. She is very involved in tourism and works for a very important tourism business in my riding, the Oak Bay Marine Group, which also operates Painter's Lodge and April Point Lodge. She is here in the gallery, and I ask the House to please make her welcome.

[1415]

D. Hayer: Since we have tourism as the theme, I will add my two words. Today we have in the House from go2 — the resource for people in tourism — Arlene Keis, the chief executive officer, and John Leschyson, the director of industry human resource development from the riding of Surrey-Tynehead. Would the House please make them very welcome.

Statements

(Standing Order 25

b) HANDS TOGETHER PROGRAM

IN LANGLEY

M. Polak: On November 18 it was my privilege to attend the official launch of the Langley HANDS Together project. The acronym HANDS stands for health, activities, nutrition, development and safety, with "together" referring to the parent-child relationship. The HANDS Together project will provide parents and caregivers with information about child development, while at the same time providing tools that will aid them in promoting literacy, good health and nutrition habits, and physical activity as their children grow and mature.

The first part of the project uses developmental wheels. The wheels are funded through a grant from the Fraser Health Authority, and they offer practical information about child development from birth to school entry in an easy-to-read format. The wheels, along with other helpful information, are provided to a family when a public health nurse visits their home after the birth of their new baby. Subsequent wheels will be distributed to families as they bring their children in to be immunized at public health clinics in the community.

The second part of the project provides information kits that are funded through the Make Children First initiative. Each kit focuses on a different developmental milestone and contains children's books, a music tape, a felt board story, a puppet and a video, as well as a book for parents and a list of other resources.

This exciting project is the result of a community working together to promote healthy child development. The working group included Aldergrove Neighbourhood Services, Langley Child Development Centre, Langley Family Services, Langley public health, Langley

City Library and Langley child and youth mental health. Together these organizations and the parents of Langley are bringing B.C. ever closer to reaching our goals in education, literacy and healthy living.

[ Page 2097 ]

EXPOSURE OF CHILDREN

TO TOXIC SUBSTANCES

G. Robertson: The people of this province who are most vulnerable to toxins are children. After accidents, childhood cancers are now the leading cause of death in Canadian children. There have been frightening increases in asthma rates, chemical sensitization, learning disorders and early onset of puberty. Our schools and day cares are ground zero for exposure of our kids to toxins. From building materials to industrial cleaners, contaminants are a very significant health concern.

Some outstanding organizations are tackling this head on, though. Kitsilano Area Child Care Society, which operates a day care in the Premier's riding, has researched environmental design and non-toxic materials for a new day care portable which would be a showcase for truly healthy child care. They're also willing to fund half of the additional cost for the healthy building. To date, though, this government has declined to invest matching funds in this worthy pilot project.

The Labour Environmental Alliance Society recently launched an initiative on the students' environmental bill of rights to affirm the right of students and their parents to know what toxic substances they could be exposed to in the school environment. It would also give them the right to avoid exposure if a substance could cause harm.

The key focus here is making our schools healthy places. Many hazardous ingredients are found in the cleaning products used. Non-toxic products are readily available and should be mandatory. The provincial building code for day cares and schools fails to address known toxins and changes needed to improve the standards for air quality in particular.

The work these two organizations are doing advances the goals of this government for both world-class education and environmental standards, and they should be commended and supported by this House.

[1420]

CANCER CARE IN NORTHERN B.C.

J. Rustad: Dealing with cancer is a frightening and exhausting process for anyone. It can be doubly difficult if you live in a northern community like those in my riding, and your treatment requires you to travel hundreds of kilometres.

Make no mistake, Mr. Speaker. A wide range of cancer treatments are available in northern communities like Prince George, Prince Rupert, Fort St. John, Terrace, Smithers and Quesnel. But some cases still require hours of travel and days or weeks at a facility in the lower mainland away from family and friends, particularly for radiation therapy. That's why I, like my fellow Prince George MLAs, am committed to being an advocate for my constituents as we work to build on the existing level of cancer care in northern B.C.

I'm pleased to state today that there is progress on this important northern issue. Cooperation between this government, the Northern Health Authority, northern doctors, the University of Northern B.C. and the B.C. Cancer Agency is producing results. A provincially funded public consultation process is underway to examine cancer care throughout the north, and a recent Northern Health Authority report lays out the stepping stones to achieve a northern radiation clinic.

There are challenges to address at the community level, such as recruitment of cancer specialists and changing physician referral patterns, but we are making progress. I truly believe there will be a full-service cancer program in northern B.C. that includes radiation treatment. It's just a matter of time and continued support from government and our health care professionals. My constituents can be certain that I will continue to advocate for whatever provincial support is needed to make the dream of a full-service cancer care facility in the north a reality.

SAANICH CENTENNIAL TRAILS PROJECT

D. Cubberley: It's my pleasure today to share an initiative in my home community of Saanich in celebration of its 100th anniversary in 2006. I'm referring to the Centennial Trails project, whose goal is to extend access to multi-use trails to every corner of the municipality. The idea is to enable more residents to make the healthy choice to get around without their cars by linking city to country and people to nature using trail networks.

This idea builds on past experience. Since the mid-'90s Saanich has inspired regional interest in trail-building with notable successes like the Galloping Goose and Lochside regional trails. Many thousands of people use these trails daily, prompting a sense of ownership and public appetite for more that is clearly reflected in the Centennial Trails project. Some Centennial Trails will preserve historic rail corridors like the Interurban Rail Trail, which is built on remnants of an old electric railway, the Interurban, which served the Saanich Peninsula. This spring the member for Saanich North and the Islands and I had the pleasure of attending the official opening of part of the trail.

Others like the Blenkinsop Connector, which provides access across the Blenkinsop Valley, link communities like Gordon Head that are isolated by busy roads from the main trail network. Bringing trails closer to where people live and connecting them directly to major destinations creates new opportunities for active living.

In Saanich multi-use trails have become a way of linking parks, open space and destinations into linear networks accessible to all. Opening many new trails and connectors during 2006 will serve as a rolling celebration of 100 years of growth, prosperity and community. The outcome, a city integrated by trails supporting physical exercise and pleasant surroundings, will serve as a model for the changes needed to spark participation across B.C. as we strive to become the healthiest, most physically active province in Canada.

[ Page 2098 ]

PORT MANN BRIDGE EXPANSION

D. Hayer: We have just gone through a civic election, and while I commend those who sought office, some Vancouver-area politicians angered me with a lack of understanding regarding transportation. They just don't understand transportation issues outside their own narrow communities. An example last week was a Vancouver NDP MLA presenting to this House a petition against the twinning of the Port Mann Bridge.

B.C. is one of North America's most significant gateways to trade, and Vancouver is the keeper of that gate. Yet many just don't seem to grasp the notion that people and products must be able to move through it. Vancouver has a great port, tens of thousands of offices, many corporations' headquarters, industry and vibrant construction. But most people working there live too far from their jobs to walk, cycle or ride on transit. Many live in Surrey or points east. Every day they commute, and they do their part to make British Columbia's economy strong and vibrant.

[1425]

But they pay a huge price in lost time stuck in gridlock and adding to the smog pollution at the Port Mann Bridge. The loss to the economy is estimated at $1.5 billion a year, and the loss of quality family time wasted in traffic is even greater than that.

I have spoken many, many times in this House about the need to twin the Port Mann Bridge and widen Highway 1 — this is almost unanimously supported by my Surrey-Tynehead constituents — and to see this bridge designed to carry some sort of future ALRT or SkyTrain system. That is a long-term vision, and that is necessary. The sooner local politicians in the Vancouver area realize that, the better it is for everyone.

BURGESS SHALE FOSSIL SITE

N. Macdonald: Mr. Speaker, the Council of Tourism Associations has members here in the House, and what I'm going to talk about today will, I think, interest not only the members but also you.

What I'm talking about is the potential of melding educational and tourist activities together around the world-famous Burgess Shale. As you know, Mr. Speaker, and I'm sure others in the House know, the Burgess Shale is a fossil site first discovered in 1909. It is a UNESCO heritage site. It sits above Field, in the eastern part of my riding. This is perhaps the world's most significant fossil discovery, and it is here in B.C.

There are three things that make it exceptional. The first is its age. It is over half a billion years old. It came during an explosion of new life forms that appeared during the Cambrian period. This is at a time when all life existed only in the sea. It's significant for that reason. Second, the information it provides related to the study of evolution is important. Stephen J. Gould talked about it. Third is the detail of the fossils. The fact is that these are soft-tissue fossils, and they're really rare. There are gills, stomachs and sometimes even stomach contents visible. This is one of the pre-eminent fossil sites in the world.

Interjection.

N. Macdonald: Here's where we come….

I'm sure the Premier is interested in knowing more about it. The offer I have is, of course, that when you're there — excuse me, through the Speaker — in the spring to open the B.C. tourist site, there's a wonderful opportunity to show you exactly where that facility is going to go. Thank you very much for the opportunity.

Oral Questions

RESPONSIBILITY FOR OUTSTANDING

CHILD DEATH REVIEWS

C. James: Since 2001 the child mortality rate for the general population has remained the same year over year. However, the child death rate among children known to the ministry and those in care has increased every year since 2001. It's an alarming statistic, and it's something the government needs to understand.

My question is to the Premier. "When a child dies, pay attention." Those were his words. Can he explain to this House why the child mortality rate for children in care and those known to the ministry has risen so sharply since his government took power?

Hon. S. Hagen: Every child is important, especially the children in care, to the ministry. We pay very close attention to that. We have an excellent foster care system. We have 5,000 children in care in 3,000 foster homes. The other thing that foster parents provide is one-third of all adoptions. One-third of the 350 adoptions last year came out of foster homes.

We do care about children. We want to make sure that they're safe. That's why we have the Hon. Ted Hughes looking at the system on how we protect children in care. We will pay close attention to what he comes back to us with and will certainly consider all of his recommendations.

[1430]

Mr. Speaker: The Leader of the Opposition has a supplemental.

C. James: We certainly see this government looking at a number of indicators when it comes to issues. One of the indicators, Mr. Speaker, that you would think a government would pay attention to would be a child mortality rate for children known to the ministry and children in care.

The simple fact is that the government doesn't know the answer to the question, and the reason is simple: the government took away its ability to learn from child deaths. The government shut down the Children's Commission and abandoned 713 cases. In addition, since 2003 the government has neglected another 546 cases.

[ Page 2099 ]

So a simple question to the Solicitor General, one that we haven't had an answer to yet: how many secondary child death reviews has the coroner's office completed since 2003, and when will those be released to the public?

Hon. J. Les: I want to say yet again, one more time, that no children in British Columbia are abandoned by this government — not one. When there is the unfortunate event of a child death in British Columbia, that is always thoroughly reviewed. That is reviewed by medical personnel where that is appropriate. That can be reviewed by the coroner either at a full public inquest or an inquiry where a judgment of inquiry results, which is released publicly. It is reviewed by the Ministry of Children and Family Development. It is reviewed by the child and youth officer.

It can be reviewed in the context of a police investigation and, ultimately, then by Crown counsel as well. So there are a variety of people that review child deaths in British Columbia.

Mr. Speaker: The Leader of the Opposition has a further supplemental.

HANDLING OF CHILD DEATH REVIEW

OF BRANDON JAMES SEYMOUR

C. James: To the Solicitor General: we've heard about the reviews — the initial review that is done. The key here is that those reviews have not been made public. In fact, they have not been made public to many of the families of these children, who not only want to know but deserve to know what occurred in the death of their child.

I want to talk just for a moment about one of those children, Brandon Seymour. He died only three weeks after the Ministry of Children and Families placed him in foster care. He was left unattended in a wheelchair that was too big for him. When his caregivers found him, the wheelchair straps were across his neck. The only review to date has been a coroner's report that offered no recommendations.

The Solicitor General has had 24 hours to get some information. So my question is to the Solicitor General: can he confirm if a child death review was completed or if one has even been started?

Hon. J. Les: The member opposite is absolutely right. A review was undertaken of the death of Brandon Seymour. Of course, as in all of these cases, our hearts go out to the family involved, and we want to work very diligently to ensure that these kinds of events don't happen again.

There was a coroner's review that was done of the death, and the coroner's results were that there could be no recommendation based on the fact that the cause of death was undetermined. That is a professional determination. That is not something that we are going to politically second-guess.

The secondary review in terms of that fatality will occur, and that will occur at the discretion of the chief coroner of the province in the context of the child death review unit. We look forward to that reporting out at the appropriate time.

R. Austin: I'm glad to hear that there's going to be a second review. Brandon's mother Dayna Humphrey will be happy to hear that. Once she heard about the 546 neglected cases, she knew that her son was among them. She needed help with her son and felt she couldn't properly manage his special needs. She wants to know why her son died only three weeks after the ministry placed him in a foster home. She hasn't been given a single answer. She tried to follow up with the ministry but got the runaround. The ministry's investigations unit told her that when they finished their review of Brandon's death, they would contact her. Dayna Humphrey never heard back from the ministry.

[1435]

Dayna Humphrey spoke with our office today, and she wants to hear from the Minister of Children and Family Development. Can he explain why her son only survived for three weeks in a foster home when she was told that it would be a safer place for him?

Hon. S. Hagen: I can report to the House and to the member that a deputy director review is in progress.

Mr. Speaker: The member has a supplemental.

R. Austin: Dayna Humphrey had nowhere to turn. The ministry would not help her. There was no independent Children's Commission or advocate to turn to. No one was willing to help her find out what happened to her son, and today the government still cannot explain why Brandon's case, like so many others, was abandoned or neglected. Can the Minister of Children and Family Development explain why his ministry told her they would get back to her but then never returned her call?

Hon. S. Hagen: The member is incorrect. There is no abandonment here. As I have told the House, there is a deputy director review in progress.

CORONER'S INQUEST INTO DEATH

OF SAVANNAH HALL

A. Dix: Just to say to the Solicitor General that in fact we were told…. He gave a press conference last week and said that 546 child death reviews have been completed. This one hasn't even been started. I think, when you talk about an original coroner's review that has no recommendations and is indeterminate about the cause of death, that is completely unacceptable. Brandon Seymour was one of 546 cases that the government has neglected since 2003.

Savannah Hall was one of 713 cases the government has forgotten. From e-mails released to the official opposition, it is clear that the Ministry of Children

[ Page 2100 ]

and Family Development knew about the harness that Savannah Hall's foster family was using to restrain her and that the ministry had given its approval for the use of this restraint. After Savannah died, the ministry told the coroner they did not know about the harness and that they would not have approved its use.

Will the Solicitor General admit that a coroner can't be expected to do his or her work when other ministries do not provide accurate information? And will he order an inquest today so that we can all find out what happened to Savannah Hall?

Hon. J. Les: I guess the member opposite didn't hear the first time, so I will repeat. Every child's death in British Columbia is reviewed — every one, without question and without exception. I wish that the members opposite would quit propagating the myth that somehow that does not occur.

With respect to the 713 files we've talked about, each of those cases has been reviewed, as I outlined earlier, by a variety of professional people who work for us every day on our behalf in British Columbia. Those 713 files all require a secondary review, and that is going to happen. I have made that commitment publicly, and that will happen. The 546 files have had a secondary review, and they will be reported out appropriately. As the member knows, there is….

Mr. Speaker: The member has a supplemental.

A. Dix: Well, it's extraordinary that the Solicitor General has not taken the time to inform himself of the views of the Premier, who said very clearly again and again and again in the 1990s that an original coroner's review focused on the cause of death was not enough. In the case of Savannah Hall, the parents want a review. The foster parents want a review. All of the investigators of the coroner's service who were involved in the case want a coroner's inquest announced by the minister.

What is the minister waiting for? When will he get on with it and order a coroner's inquest into this case?

Hon. J. Les: As I started to say in my previous answer, I want to remind the member opposite that the reporting process with respect to the 546 files that have been completed has already produced a report from the child death review unit. The member might want to have a look at it. It focuses on the deaths of children between birth and a year old — focuses on 47 deaths. I think the member might find it somewhat enlightening, and frankly, I would recommend it to him.

With respect to the case he cites, there are ongoing processes that make it inappropriate for me to request any further ministerial intervention at this time.

[1440]

HANDLING OF CHILD DEATH REVIEWS

G. Gentner: We've heard about two tragic cases today: one from the hundreds this government forgot and one from the hundreds this government has neglected since 2003. Savannah Hall's family and Brandon Seymour's family are still waiting for answers. They are not alone. Harvey Charlie and his family are still waiting to hear what really happened to his granddaughter. All of these deaths have one thing in common. They involve children in care or children known to the ministry — the same groups of children that have experienced alarming increases in mortality rates.

The Solicitor General has said that the system has been working fine. If that's the case, can he explain why child death reviews and recommendations have stopped, and why the number of child deaths among children in care and those in the ministry has increased?

Hon. J. Les: First of all, let me underline that the child death review process has not stopped. It is in fact working well. I have informed the House previously — I think as recently as two or three minutes ago — that since 2003, 546 of those files have been looked into and completed on a secondary review basis. That work continues. I am wondering, frankly, what part of that the members opposite don't get.

Mr. Speaker: The member has a supplemental.

G. Gentner: The families that have come forward to date all have one thing in common. They want answers, and they would have them if this government did not shut down the Children's Commission. There would have been recommendations to help prevent future deaths, but this government doesn't have them. Will the Premier help the families of these children move on, and reinstate a Children's Commission so the deaths can be properly reviewed and the government can learn from these tragedies and prevent future deaths?

Hon. J. Les: I am sure I speak for all members of this House when I say that we all want all of the possible answers we can possibly find that relate to these tragedies. Every one of us wants all of the possible answers we can develop and all of the possible lessons we can learn from those examples.

However, I need to point out that some of these files actually go back as far as 1997. For a variety of reasons, sometimes it takes a long time before we can conclude one of these files. It's not because of a lack of desire by government or by the officials who we're privileged to have working for government. We want to conclude these files, learn from them what we can and protect children in British Columbia.

As a result of that, working together, I think we can really achieve a lot on behalf of the children of British Columbia so that they can be protected to the maximum extent possible. I'm committed to doing that. All members of this House are. I would encourage members opposite to work with government to help make that happen.

[ Page 2101 ]

COMMUNICATION WITH FAMILIES

IN CHILD DEATH REVIEW PROCESS

M. Farnworth: The minister says he's committed. Well, I'd like to again ask the Minister of Children and Families the question that the member for Skeena asked. Dayna Humphrey was told she would be contacted by the ministry. She was never contacted. Can the minister tell us why?

Hon. S. Hagen: I will follow that up with my staff and find out why.

I also want to read into the record numbers that pertain to a question asked by the Leader of the Opposition, and that is the fatalities of children and youth in care in British Columbia. The total numbers starting in 1996 are 19; for 1997, 21; for 1998, 14; for 1999, 15; for 2000, ten; for 2001, nine; for 2002, nine; for 2003, 12; and for 2004, 14.

[1445]

So if the Leader of the Opposition is trying to make a case that a rise from '02 to '04 of nine deaths — 12 deaths, 14 deaths — is an issue, I would say that it isn't. Every child's death is important to us, but to try and stand up in the House as she did and say that there is a trend…. There's actually a trend downward from 1996.

Mr. Speaker: The member has a supplemental.

M. Farnworth: There's a trend, and that is of a government that is saying it is committed to doing things. Yet when they give a commitment to individuals who have names, they're not following through. The minister has said that the Dayna Humphrey family will be contacted. Can he tell us how many of the other 712 families have not been contacted?

Hon. S. Hagen: I can tell the member opposite this. I am confident that my staff, who deal with these sorts of issues and very difficult issues every hour of every day, are sensitive to the plight of families and are sensitive to getting back on telephone messages. If some mistake has been made and someone didn't get back, we'll follow that up. But for this member to raise that sort of issue places the entire ministry and the staff of the ministry — every social worker — at question. I don't appreciate that, and I don't think the social workers of the ministry appreciate that either.

J. Kwan: The lack of confidence that the opposition has is about this government and how they have handled these files. The fact is that this government only just found 713 files in a warehouse that they had forgotten in the last three years. The families have been waiting for more than three years for answers from this government about what happened to the children. This government has not responded to date. They say now there are all sorts of reviews going on, and it is only because of the opposition raising the issues in this House and putting pressure on the government. So let us be clear about that.

I'll give this minister another opportunity to explain to the families how it is possible that this government neglected to follow up on what they said they would do — that is, to phone the families whose children have died, which the government knows about — and how it is that to date so far this minister has not actually picked up the phone and phoned those families and apologized.

Hon. S. Hagen: I find it to be totally unacceptable for that member opposite to malign the workers of the Ministry of Children and Family Development. It is unconscionable. I have met many of those workers who give their hearts to their clients. When I ask them, "Why do you do the job that you do?" they say: "Because we love to help people."

Here we get the NDP maligning individual social workers for what they do or what they don't do. I'm very proud of the work that the social workers in my ministry and other ministries do. I think they do their job extremely well. As I've said before, they probably have the most difficult challenges to deal with of any ministry in government.

Mr. Speaker: The member has a supplemental.

J. Kwan: My question is to the Premier. The government consciously made the cuts in the Ministry of Children and Family Development. The government consciously closed the children's commissioner's office. We now have a situation where parents want to know answers, and they have not been getting them for the last three years. Will the Premier rise in this House and apologize to those families?

Hon. S. Hagen: Our hearts and our sympathies certainly go out to the families that are affected. Having said that, I go back to supporting the social workers in my ministry. I think they do an exceptional job with very, very complex issues. For the members opposite to malign what they do, I find very disturbing.

[1450]

CLEANLINESS STANDARDS IN

VICTORIA HEALTH CARE FACILITIES

D. Cubberley: A rodent problem at Vic General Hospital has grown to the point of public concern. Saanich Peninsula Hospital has also registered a growing rodent problem at their facilities. You can't deny that growing infestations of rodents raise concerns about cleanliness.

To the Minister of Health. Cleaning services at many Island facilities have been contracted out to a private company, yet no audits have been undertaken to ensure that the private contractor is meeting high standards of service. Can the minister explain why his ministry is not monitoring cleaning standards since Compass Group has taken over?

[ Page 2102 ]

Hon. G. Abbott: The members may ask: how do cleaning standards compare to, say, ten years ago when the former government was in office? It would be impossible to answer that question because there were no audits done — ever — under that former government around housekeeping. They never audited housekeeping, which we have now done on a sustainable and consistent basis across health authorities and across the province.

We're going to demand the absolute highest standards, whether those housekeeping services are delivered in-house by the Hospital Employees Union or whether they are driven by contracts. In either case, we are going to drive the very best, very highest standards, both of housekeeping standards and of food standards, across hospitals in British Columbia.

In terms of the rat problem which the member raises — and I do acknowledge….

Mr. Speaker: Thank you, minister.

Hon. G. Abbott: I do acknowledge his expertise here, and I'll perhaps conclude on the supplemental portion of that.

Mr. Speaker: The member has a supplemental.

D. Cubberley: You know, the minister may make light of a rodent infestation, but I don't think British Columbians are going to. The public has raised concerns about cleanliness in hospitals, health facilities themselves have raised concerns about cleanliness in hospitals, and recently the capital regional district raised the red flag on the same issue in a letter to the minister.

The opposition has been asking for an independent audit of cleaning standards since May. Now the CRD is also asking for an independent audit of, among other things, cleaning standards under private contracts. Yet the minister continues to make light of it. Why is the minister refusing to take action on an issue that affects the health and safety of patients?

Hon. G. Abbott: I think part of the problem is that the red flag flies all too frequently over the CRD. I hope that's changed modestly with the last local elections, but I think that often we do see an unfortunate tendency on the part of CRD and others to be overly critical of and unfair to the Vancouver Island Health Authority.

The fact of the matter is that in terms of the rodent problem at the hospital, the only one I'm aware of is Vic General, where there has been some acknowledged concern. That is a periodic problem that occurs around large institutions. In the case of that one, VIHA is well aware of it. It is related to a construction project that is underway, and VIHA is taking all the appropriate steps to ensure that that problem is appropriately managed. This is not a major health concern, notwithstanding the opponents of outsourcing who — quite irresponsibly, I think — are trying to make a case that it's related to outsourcing. It simply is not.

M. Karagianis: This government's experiment with privatized cleaning contracts is a disaster, and the complaints continue to mount. The fact that the minister is now basically disregarding the CRD…. I would hope this is not the kind of relationship-building that we can expect to see in the future with the municipal governments here in the region.

Frankly, we have rodents running loose at Victoria General. There have been reports to the health authority of rodent problems from Saanich Peninsula as well. Sunset Lodge in Esquimalt cancelled their contract with Compass Group because it failed to meet acceptable cleaning standards. A superbug is currently ensconced in the top three floors of the Royal Jubilee Hospital, which they cannot get rid of.

[1455]

I actually see a connection between the privatized cleaning contracts and all of these health hazards. I would ask: does the minister see the same connection here?

Hon. G. Abbott: What I see is a connection between the desperation of the opposition to try to make a reasonable point around health and what are, I think, completely inappropriate questions. The fact of the matter is that we have a great health care system in British Columbia. We have 120,000 people who work in that health care system. They work tirelessly every day to deliver the best health care they possibly can to the people who, for a time, are patients in our hospitals.

I think the notion that somehow a contracted cleaning service is inherently superior to an in-house cleaning service is wrong. I know that the members opposite, because of their structural links to organized labour, reflexively recoil at any notion that there could potentially be outsourcing in any system. But the fact of the matter is that for the first time ever, our government rigorously monitors and audits housekeeping and food standards across the province — something that that former government never did during their ten years in office.

Mr. Speaker: The member has a supplemental.

M. Karagianis: Well, I would ask the minister: what more does it take to get the minister to pay attention to these health hazards? We have rats running in our hospitals. We have a superbug loose in our hospitals…

Interjections.

Mr. Speaker: Members.

M. Karagianis: …and if poor cleanliness is at the heart of this, then I think it is the minister's responsibility to take a very keen interest in this.

Interjection.

Mr. Speaker: Member, member. Quiet, please, so we can hear.

Continue.

[ Page 2103 ]

M. Karagianis: I think that in fact, it is imperative that the minister take responsibility for these mounting disasters in our health facilities here. High cleaning standards are not negotiable. In fact, the health and safety of our health facilities and the citizens of this province are at the top of the priorities of this side of the House. I would like to see the minister step up and make that a top priority, not disregard…

Mr. Speaker: Does the member have a question?

M. Karagianis: …all of these health problems, saying that it is simply labour or the opposition.

Again I will ask the minister, as I have several times before in the past: will you commit to an independent audit of the health facilities in this region to report out on the standards to the public?

Hon. G. Abbott: If anyone should take responsibility for anything, I think that member opposite ought to take responsibility for absolutely ridiculous and, I think, totally irresponsible comments about rats running in hallways in hospitals. That is absolutely absurd and so totally irresponsible that I can't imagine why anyone would say it.

It's interesting, Mr. Speaker, that when these members call for their independent inquiries on this and that, it somehow is always related to contracted services. Why is that? It is because of the structural links.

Interjections.

Mr. Speaker: Members.

Hon. G. Abbott: I understand they're a bit jumpy on this point because they have a party convention this weekend. I think they're considering at this point in time moving from overt ownership by the B.C. Federation of Labour to covert ownership, so I can understand why they are jumpy on this point.

[End of question period.]

Tabling Documents

Mr. Speaker: Hon. members, I have the honour to present the report of the Auditor General, Strategic Direction and Funding Proposal for the Fiscal Year 2006-07.

Hon. S. Hagen: I seek leave to make an introduction.

Leave granted.

[1500]

Introductions by Members

Hon. S. Hagen: Today I have the pleasure of introducing 24 students and two teachers from the Comox Valley and Powell River. These students have chosen to learn at home with the assistance of their parents and supportive teachers from the program, Partners in Learning. I would ask the members to please make our guests welcome.

Motions without Notice

APPOINTMENT OF SPECIAL COMMITTEE

ON SUSTAINABLE AQUACULTURE

Hon. M. de Jong: This is a bit different than normal motions for committees, but not that different.

By leave, I move

[That a Special Committee on Sustainable Aquaculture be appointed to examine, inquire into and make recommendations with respect to Sustainable Aquaculture in British Columbia and in particular, without limiting the generality of the foregoing to consider:

1. The economic and environmental impacts of the aquaculture industry in B.C.

2. The economic impact of aquaculture on

B.C.'s coastal and isolated communities.

3. Sustainable options for aquaculture in

B.C. that balance economic goals with environmental imperatives, focusing on the interaction between aquaculture, wild fish and the marine environment.

4. B.C.'s regulatory regime as it compares

to other jurisdictions.

5. Solicit and consider written and oral

submissions from any interested person or organization by any means the Committee considers appropriate;

The Special Committee so appointed shall have the powers of a Select Standing Committee and is also empowered:

(

a) to appoint of their number, one or more subcommittees and to refer to such subcommittees any of the matters referred to the Committee;

(

b) to sit during a period in which the

House is adjourned and during any sitting of the House;

(

c) to adjourn from place to place as may

be convenient;

(

d) to retain such personnel as required

to assist the Committee;

and shall report to the House as soon as

possible but no later than May 31, 2007 or following any adjournment, or at the next following Session, as the case may be; to deposit the original of its reports with the Clerk of the Legislative Assembly during a period of adjournment and upon resumption of the sittings of the House, the Chair shall present all reports to the Legislative Assembly.

That the Special Committee be comprised of

Mr. Austin (Convener), Messrs. Cantelon, Coons, Fraser, Hogg, Jarvis, Robertson, S. Simpson, and Yap and Ms. Trevena,]

I do, by leave, move that motion.

Leave granted.

Motion approved.

Orders of the Day

Hon. M. de Jong: I call Committee of Supply — for the information of the members, in this chamber, estimates for the Ministry of Health and in Committee A,

[ Page 2104 ]

the estimates for the Ministry of Energy, Mines and Petroleum Resources.

[1505]

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 3:06 p.m.

On Vote 34: ministry operations, $11,323,248,000 (continued) .

L. Mayencourt: I have a number of questions for the Minister of Health on his estimates, and the first place I'd like to start is with respect to the supervised injection site in downtown Vancouver. I wonder if the minister could articulate why we created the supervised injection site in British Columbia.

Hon. G. Abbott: I thank the member for his very important question. The decision to move ahead was a multipartnered decision, including the federal government through Health Canada, the provincial government through Ministry of Health, the Vancouver Coastal Health Authority and the city of Vancouver. All were supportive of implementing and incorporating — under, I guess, the broad umbrella of the five pillars of harm reduction — what appear to be international best practices around the management of heroin addiction.

The potential benefits that can flow from a supervised injection site, as opposed to what has been the case for a long time — kind of ad hoc injection of the drug out on streets and

in alleys and so on — are reduction in the occurrence of HIV with the careful management of needles; the reduction of the potential for overdose deaths, as medical personnel are closer at hand; and avoidance of occurrence of other health-related issues like hepatitis but certainly not limited to that.

[1510]

L. Mayencourt: Yes, I understand that it was a multipartnership agreement. The Ministry of Health, Vancouver Coastal, the city of Vancouver and, of course, the Canadian government supported this. How much money did we spend in creating the supervised injection site, and how much is its operating budget for this year?

Hon. G. Abbott: When the member asks what our contribution is, I assume he is talking of the Ministry of Health and Vancouver Coastal Health Authority. The initial capital cost to the province was $1.2 million to renovate the site, and the annual cost for operation of that site is about $2 million. That's about the level of the provincial contribution. I believe there are some additional contributions from other partners, but that would be our contribution to it.

L. Mayencourt: Do you have any estimate of what the other contributions are? What's the city of Vancouver putting into it? What's the federal government ministry of health putting into it?

Hon. G. Abbott: I thank the member for his question. In addition to the $2 million, which is the approximate annual operating contribution from Vancouver Coastal Health Authority via the Ministry of Health, there is $1.5 million from the federal government over three years for the purpose of evaluation of the study. We don't have the information about what the city of Vancouver may contribute, if anything, but we will get the member that information. We just don't have it present with us at the moment.

L. Mayencourt: Assuming that the city of Vancouver…. I'm sure the city's contributing something, but I would imagine that probably the bigger contributors would be the province and the federal government. So roughly, we're looking at about a $3.7 million commitment to create and run for one year the supervised injection site.

Earlier I asked the minister about some of the reasons why the supervised injection site was created. He mentioned the reduction of the spread of HIV, a reduction in the number of overdoses and a reduction in the transmission of hepatitis C. There were a couple of other things that were actually part of it, to my recollection. One was to reduce the impact of the open drug scene in downtown Vancouver or, in other words, to try and make it a little less noticeable, I guess. Another one was to improve access to treatment and improve access to detox. Then the final one was to improve health outcomes for residents of that neighbourhood. That's my recollection of it.

I recently read a report from the centre for excellence talking about the spread of HIV/AIDS and hepatitis C in the downtown east side. I wonder if the minister could please tell me: how is it going with the spread of HIV/AIDS and hepatitis C in the downtown east side?

[1515]

Hon. G. Abbott: I want to, first of all, acknowledge that my recollection as a former minister responsible for the Vancouver agreement under the Ministry of Community, Aboriginal and Women's Services…. I think the additional points that he read into the record in terms of why governments were undertaking to do this are correct. There may be additional insights that could be provided by the current minister responsible for the Vancouver agreement that I can't, but I do believe that the member was correct, at least in terms of the broad kind of umbrella of reasons why governments chose to proceed with this.

To clarify: the $1.2 million was to renovate the site. It is not an annualized cost; it is a one-time cost. The

[ Page 2105 ]

ongoing operating cost would, we suggest, be in the $2 million range. I thank the member for this, because it's important that we have rigorous and robust analysis of what the product is, of the safe injection site.

The year-one evaluation released in September 2004 highlighted a number of positive preliminary results — for example, a high intake of the SIS service by people who inject illicit drugs in Vancouver, with an average of close to 600 injections per day; 107 on-site drug overdose interventions with no fatalities; regular referrals of clients to addiction treatment and counselling services — an average of two to four a day at this time in the year-one evaluation; a noticeable reduction in public-injection drug use, publicly discarded syringes and injection-related litter; and no significant increase in the number of drug dealers in the vicinity of Insite, or the SIS site.

The member asked the important question: are we attempting to move people from this facility to where, notwithstanding its beneficial aspects, we want people to move on and try to turn their lives around and defeat their addictions? There are referrals. I'm sure that the folks that work there work hard to try to encourage people — where there is any interest in turning their addictions around — to do that.

In terms of other issues, the member asked about the issue of new HIV-positive tests by health authorities. This is the best information we have in relation to Vancouver Coastal, which is the green bar in this particular graph, and I'd be glad to provide the member with this graph. It's illustrative of this point: in 2002, 249 new HIV-positive tests by the health authority; in 2003, 233; and in 2004, 224 — so an approximate 10-percent reduction in the number of new reported HIV cases.

[1520]

The other day, I think in response to questions from the opposition Health critic, we did talk about some of the challenges around having HIV now be a reportable disease. We think there was a jump, initially at least, in the number of HIV cases because reportability was now required. There was probably some — I won't want to call it artificial — jump in response to that.

These numbers are encouraging in terms of Vancouver Coastal. I'm just trying to take a quick look here at some of the others. In the north we have significantly rising new HIV-positive tests, from 12 in 2002 to 21 in 2003 and 26 in 2004. That's certainly one where we would be concerned that the numbers, although smaller, are going in the wrong direction.

In the case of Fraser it's more mixed, moving from 100 down to 84 and then up to 106, and in the case of Vancouver Island moving from 56 down to 50 then up to 76. These are interesting, but given the volume of the numbers at Vancouver Coastal, I suspect that a lot of those new HIV-positive tests might be associated with intravenous drug use. Again, it's difficult to say that with certainty, but those are the numbers, I think, and the best we have currently around that important issue.

L. Mayencourt: Is it safe to say that hepatitis C is a common factor for those people in the downtown east side that are using the supervised injection site? It seems to me that in my community there's a fairly big discussion about the spread of hepatitis C which, although it is not perhaps as deadly as the AIDS virus, has some very debilitating consequences to anyone that is infected with it.

My question is: what about hep C? How does that fit into this particular scenario?

Hon. G. Abbott: I thank the member for his important question on hepatitis C. I'm advised that hepatitis C is a blood-borne disease that in some instances is transported by injection drug use just as HIV might be. Generally speaking, what limits the spread of HIV in terms of best practices or safe practices will also limit the spread of hepatitis C.

We understand that approximately 55,255 British Columbians have been confirmed as infected with hepatitis C. That is the most recent figure we have. About 25 percent of those infected with hepatitis C are known to spontaneously clear their infection. Therefore, at the present time about 41,000 of the 55,255 of antibody-positive individuals are likely to have a chronic infection with hep C.

Due to shared risk factors an estimated 1,050 to 2,625 British Columbians are infected with both HIV and hepatitis C. There is a range there based on the best estimates from the B.C. Centre for Disease Control. The BCCDC is working with the B.C. Centre for Excellence in HIV/AIDS to verify the actual number of people who are co-infected with the two diseases.

[1525]

L. Mayencourt: I thank the minister for that answer. The next question I have…. The minister had articulated a few of the successes of the supervised injection site. Just a question or so ago he mentioned detox, public injections — injections on the street, I guess — injection materials lying around the street and a number of people who were coming through every day. Could he repeat that for me, please?

Hon. G. Abbott: I won't repeat it in full, because I know there are probably more questions than we have time for me to answer comprehensively here, but it was the overdose interventions with no fatalities; regular referral of clients to addiction and treatment counselling services; noticeable reductions in public injection drug use, publicly discarded syringes and injection-related litter; and no significant increase in the number of drug dealers in the vicinity of Insite.

When we talk of the successes here, I think we're talking in relative terms, because if the member were to argue — and I'm not suggesting he's going to — that all of those issues still exist in some measure on the downtown east side, I wouldn't disagree with him. My most recent car journey through that area would suggest that there are still problems there. I think it has improved, though, in fairness.

[ Page 2106 ]

Is there lots of improvement yet to be had? No question about it. I think there are still some very compelling social, economic and medical problems to be addressed on that particularly troubled area of the downtown east side. So this is not a cure-all. Is it a step in the right direction? I think our evaluation to date would suggest that it is.

L. Mayencourt: I would agree most certainly with the Minister of Health on the prevalence of the open drug scene. It is pretty evident to anybody that drives through the downtown east side that there's an awful lot of drug activity that occurs on Hastings and Main, through the lanes and what have you. As the minister knows, I've taken a lot of walks through that neighbourhood, and I see a lot of people shooting up in the alleys and smoking crack in the alleys and those sorts of things. So I certainly understand that it's going to be hard for us to change the way that the street looks.

I was interested, really, in the spread of HIV with respect to the new harm reduction models — which were implemented, I think, in about 1996 — and to see how the trend is going. In other words, if I was to go back to 2001 or the year 2000 or the year 1999 when the harm reduction model was in place, what kind of numbers were there at that point?

I thank the minister for letting me know. I guess from his numbers that there's somewhere maybe around 2,000 people that are co-infected, and that's an important thing for me to consider. But I guess what I'd like to know is: if you look at HIV/AIDS and the spread of it within British Columbia — I'd only wanted to do it in the downtown east side, but the minister has pointed out that the north is rising, Fraser is sort of up and down and that VIHA seems to be on the rise, actually — how did it look before we started with all the harm reduction stuff?

[1530]

Hon. G. Abbott: In answer to the member, these are provincial numbers but the most recent ones we have, and it's a table again. I'm happy to share this with the member. Generally, we're making progress in terms of the rate and number of people testing HIV-positive. In 1996 the rate was approximately 20 per 100,000. In absolute numbers, close to 800 people tested positive for HIV in 1996. It has fallen. It continuously fell until 2001. It has pretty much plateaued through the period at a rate of about 12 per 100,000 in terms of a rate and number of people testing HIV-positive.

Again, there may be some influence on reportability around this. I'm not sure. Reportability occurred in 2004. So again, I think we'd say we're not happy with the numbers. On the other hand, I think it's an indication that some of the strategies that have been undertaken — not just the safe injection site but broader than that — have borne some positive results.

L. Mayencourt: The next question I have for the minister…. He mentioned referrals to detox and to treatment, and I wonder if the minister could say again how many people are referred, I think, on a weekly basis. I'd also ask: where are they being referred to?

Hon. G. Abbott: The answer was that two to four clients per day are referred. They're not referred out. They can actually get counselling right on site with respect to addiction treatment opportunities. So they get the counselling service on site, and some two to four a day are accessing or utilizing that opportunity for counselling and referral to treatment addiction facilities. Vancouver Coastal is, I think it's fair to say, the leader in this province in terms of addictions management, addictions treatment, and they have developed a very sophisticated continuum of facilities and programs that are aimed at meeting the needs of the clients that they serve.

L. Mayencourt: So it's not two to four referrals to a detox program or a daytox program from there but rather that they're getting some counselling services while they're inside the Insite building?

Hon. G. Abbott: It is two to four a day that are being referred to addiction treatment and to counselling service, so they're getting both.

L. Mayencourt: So that's two to four a day, and we've got about 600 people going through there. So two to four a day get some sort of counselling on site and perhaps some referral to a detox facility. Is that right?

Hon. G. Abbott: It's 600 injections per day. It may, in fact, depending on how frequently the client is injecting, be significantly less than 600, but I don't have that information. And yes, when they are there, they have an opportunity to access the counselling that's immediately there. They have an opportunity, should they decide that now is an opportune time for them to try to shed their addiction. Vancouver Coastal certainly has the opportunity to move them off to addiction treatment centres to help them overcome their addictions.

[1535]

L. Mayencourt: I guess what I'd like to know is: how many individuals who are clients of the supervised injection site have been referred to a detox program?

Hon. G. Abbott: We don't have that information with us, but we will commit to getting that material from those who know and giving it to the member.

L. Mayencourt: Thank you. I'll look forward to receiving that information. The reason that I ask is that it is, of course, one of the reasons why we opened the supervised injection site — to have people access detox. It's very difficult to measure its success without having that piece of information.

The other reason I ask it…. I'll just put it to the floor right now. The supervised injection site is in, I think,

[ Page 2107 ]

the 100 block of East Hastings, and one block north of that is the Salvation Army's Harbour Light. Harbour Light is a detox facility. Recently I spoke with individuals that are in the business of managing the detox facility there, and they indicated to me that they don't think they've ever received a referral from the supervised injection site to their detox program.

I did a similar inquiry with Vancouver Detox. Vancouver Detox was a little bit more generous. They said they'd probably had three or four. But that was three or four in the course of however many years. I'm not even sure how many years the supervised injection site has been there. I believe it's three years at $3 million per, so $9 million, and nobody seems to know how many people have been referred to the detox. Does that concern the minister?

Hon. G. Abbott: The member should note my words carefully. We don't have that information here. That's not to say someone doesn't know how many there are. I actually committed to get the member that information, but it's not a piece of information that we have with us. Should it come to us during the course of this debate, I'm glad to provide it to the member. I don't want to let his suggestion go that nobody knows the answer, because I'm sure they do.

In terms of the cost annually, our operating cost is about $2 million a year. I appreciate the member's point that one of the reasons why the federal government has engaged here to do an evaluation around the effectiveness of this program is that we need to find out what the effectiveness of this program is. I think this is an area where every day we are learning more about how to manage people with addictions. This is a terribly serious problem, as the member knows. He has been a leader in respect of a lot of these issues, and I know he feels very passionately about them. I don't think for a moment that we believe we have all the answers here.

The injection site, I'm advised, has been in place now for two years. This does need to have rigorous evaluation so that we can learn what's working and what's not. Based on that, that will guide the future development or future evolution of how these programs are managed.

L. Mayencourt: I would encourage that rigour. Like the minister has said, it's really important that we know what we're getting for our dollars. If we can get some sort of indication of whether people have been referred to Vancouver Detox, Sally Ann's Harbour Light, the daytox program, what have you, that would be helpful to me.

I recently had a meeting with individuals from the RCMP, and we talked a little bit about the supervised injection site. Actually, there was one from the Vancouver police department. I wonder if the minister can tell me how many overdose deaths occurred in the city of Vancouver in the year 2001 and in the year 2004.

[1540]

Hon. G. Abbott: I'll read the member these numbers, and we can provide them in greater detail, should he wish them. Illicit-drug-overdose deaths in Vancouver, 1997 to 2004. It ranges from 140 in 1997. It rose to the highest level in 1998, at 191. It fell to 108 in 1999; 87 in 2000; 90 in 2001; 49 in 2002; 50 in 2003; and 64 in 2004. There is a little bit of a bounce up in 2004, but generally speaking, the number of overdose deaths has been falling as a general pattern.

L. Mayencourt: It is indeed encouraging to see that the number of overdoses has decreased, even if there is a slight increase in 2004. Obviously, we're trying to make sure that nobody overdoses, but we can't control all the factors. That's worth taking a look at — and what have you.

The next question that I have is also on the drug issue, and that's with respect to crystal meth. I know the minister has a crystal meth strategy. I wonder if you could define what that strategy is and how it's working thus far.

Hon. G. Abbott: In terms of the province and the leadership of the province around this very important and compelling area of public policy and public concern — crystal meth use — in August 2004 the Ministry of Health released a strategy entitled Crystal Meth and Other Amphetamines: An Integrated B.C. Strategy . It involved numerous ministries of government, and it aimed at five priority action areas: informing the public, building safer communities, identifying high-risk populations, increasing skills of service providers and reducing harm to individuals.

All of that is available, obviously in much more detail, at www.healthservices.gov.bc.ca/mhd. Actually, that strategy has been adopted as best practice by numerous other Canadian jurisdictions since its publication.

Further, as the member may recall, on September 29 at the UBCM annual conference the Premier announced the creation of a crystal meth secretariat, with the Ministry of Public Safety and Solicitor General in the lead, $7 million in additional funding to support community-based anti-meth programs, additional treatment resources and an extensive public awareness and education campaign. That included $2 million to provide $10,000 in seed funding to support community initiatives, $3 million for a major public awareness campaign and $2 million for targeted treatment programs. All of that continues to unfold since the Premier's announcement.

[1545]

L. Mayencourt: The members on the opposite side have a number of questions, so after this question I'm going to step aside but will come back to ask some questions of the minister later on today, I hope.

I'd just like to finish off the crystal meth questions, if I could. I'm going to try and cram them all together. The first question I have is: how many treatment beds are set aside for crystal meth addicts? How does the minister feel about the province limiting access to precursors, including ephedrine and pseudoephedrine? And how does the minister feel about mandatory treatment of crystal meth addicts?

[ Page 2108 ]

Hon. G. Abbott: The member's question in respect of crystal meth and particularly, I guess, the issue of crystal meth use by youth. There is a continuum of youth addiction services that crystal meth is a part of. What we are finding is that frequently those youth who are using crystal meth are also using, sometimes, a multiplicity of other drugs. It is uncommon to see youth using crystal meth only. Frequently there are other drug uses involved.

The continuum ranges from prevention through to outreach and early intervention, often through school programs or community-based programs; withdrawal management through either out-patient home detox or in-patient detox; and then treatment, either through out-patient programs, day programs and through a range of residential programs as well.

As I said to the opposition critic a day or two ago, over all, we spend well in excess of $1 billion a year now on mental health and addictions issues. It is literally impossible to take those pieces apart and say precisely what amount is spent on each of them, because there is at least a 30-percent correlation between mental health issues and addictions issues.

We have added some incremental dollars that I should note: $6 million — I believe it was in the spring budget — for youth addictions. Certainly, crystal meth is a big part of that. That is translated into additional treatment beds but also to more right across the range of the continuum of services. More recently we have added $2 million as part of the crystal meth strategy, which will be aimed at building on some of the residential treatment options around crystal meth.

On the detox question. Let me get back to the member on that.

[1550]

On precursors. I should note that my colleague the Solicitor General is the lead for the government in terms of speaking on the issue of precursors. I understand his position to be that at this point in time there is no evidence that those who are manufacturing crystal meth obtain their precursors through bubble packs purchased from the local pharmacy, and that there's a great deal of evidence that they are getting it in much more bulk form from other sources. So there isn't the volume of evidence, at least at this point, around making a change that would limit the public's access to the precursor ephedrine, etc., in bubble-pack form.

On mandatory treatment. It is not government's policy, at this juncture at least, to have mandatory treatment, but we would, I guess, be always open to debate with respect to that. I know there's a range of thoughts across the spectrum on this, and I'm glad to hear anybody's view with respect to that.

B. Ralston: My question is to the Minister of Health, and it concerns a facility in Surrey called Zion Park Manor, which is a long-term care facility. Mrs. Beddis, whose husband is a resident there, has asked me to pose this question.

Apparently, the residents there and their families have been informed that the Fraser Health Authority has seen fit to reduce the funding to this particular facility by some $300,000 annually, resulting in the layoff of a number of staff. She values the care of the staff for her husband and the other residents there, and she's expressed a concern to me as to why this might be taking place, given the quality of care that's delivered by these staff to her husband and others at this facility in Surrey.

Hon. G. Abbott: Though I'm advised that this is a complex issue, it's a new issue to me. But this is a complex one, which I gather has been the object of considerable attention from the Fraser Health Authority and, to a lesser extent, the ministry for the last couple of years. The issue, as I understand it, relates to the per diem which applied to the Zion Park Manor at the time the authorities were moved from the 52 dispersed authorities across the province and consolidated into the five regional authorities in 2002.

[1555]

There has been a continuing issue between Zion Park Manor and Fraser Health around the per diem that would attach to that residential care facility. I understand that Zion was on the higher end of the per-diem range and that this has been a continuing issue between Fraser Health and Zion. But I also understand that the issue has been, as we understand it, resolved or at least reasonably well resolved with the restoration of funding to Zion to the September 2004 level.

Now, the member may have more recent information, and he can ask us those questions, but I think that is about the extent of my ability to answer that question.

C. Wyse: I am appreciative of the additional time that has been found to be back here to follow up with some questions. Again, to assist I will try and give you an idea of the general area where my questions are coming from, and because of time restraints beyond everybody's control, I've tried to cluster the questions together.

My first question is: who is responsible for guidelines and approvals of the health authority plans?

Hon. G. Abbott: We're not sure that we have faithfully captured the member's question, but we understand that he's probably asking about the three-year plans that are encompassed in the performance agreements that exist between the Ministry of Health and the six health authorities.

Those are initiated by a letter of instruction from the ministry to each of the authorities. The authorities then prepare them. They must win the approval of their boards before they are submitted to the ministry for the ministry's consideration. The final step in that is the Minister of Health's approval of those plans. A similar process and similar kinds of outcomes relate, also, to the redesigned plans.

C. Wyse: I thank the minister for that information. To assist the minister here, on the message from you in

[ Page 2109 ]

the book, I will refer…. I know I don't need to refresh you. But it mentions: "When citizens do need health care, we will provide timely access to needed services, treat illnesses according to evidence-based best practice, and integrate services and providers to help make the health system less complicated and stressful for patients."

[1600]

I have two questions around that information, but more specifically around mental illness — so that you have somewhat of an idea of where I'm coming from. My first question to the minister: what baseline exists for a health authority for provision of timely access to needed services for individuals with a mental illness?

Hon. G. Abbott: We'll start at a fairly high level here. The member can drill down for more detail, which I gather we have — some mind-boggling detail over here.

The question is a very important one. We are trying to build the continuum of mental health services across the province and ensure that each of the health authorities has, in their own right, a comprehensive and well-defensible program for dealing with mental health challenges. The member asked some very good questions the other day around this area — in particular, the challenges of stigma and trying to ensure that local governments are partners with us in terms of ensuring that we can develop facilities where we need them and not be constantly hung up on things like rezonings and so on.

Where this proceeds from is the mental health plan. As the member, I think, knows, there are four distinct parts to the mental health plan. Best practices — again, I can provide some detail around the guidelines that are associated with those best practices. Community-based services are a big part of this — ensuring that whether people are subject to depression or a complex mental disorder, they are able to access the continuum of services. The third area is ensuring that we have the tertiary treatment that we have at Riverview and, in some instances, elsewhere.

And education of the public around how to identify and how to support and manage mental health challenges where they appear. So it's prevention, early intervention, care, crisis response, treatment, non-residential and residential supports and specialized care where it's needed.

C. Wyse: I appreciate the description of the four pillars that are there. I guess, possibly in my naïvety, I don't know whether we've dealt with the issue of the baselines — of where timely access and other items of that nature would be judged from.

[1605]

I will move on to another question, if I may. To the minister: what evidence-based best practice for treatment of mental illness is used by health authorities?

Hon. G. Abbott: I thank the member for his important question. The issue of developing best practices around mental health challenges is certainly something that health authorities are a part of. But the experts tend to be at least provincial in scope and national in scope as opposed to regional in scope. When we are developing best practices…. I'll mention a couple of those best-practice projects for the member's consideration.

In 2004-2005 a family physician guide for depression, anxiety disorders, early psychosis and substance-use disorders was developed, along with a guide to the Mental Health Act and a report to support care of mentally disordered offenders. In 2005-2006 the best practices library expanded with Postpartum Depression Strategy, Best-Practice Guide for Clinicians Working with Suicidal Adults, Planning Guidelines for Health Authorities to Support People with Developmental Disabilities and Mental Illness and finally, Cognitive Behaviour Therapy Core Information .

These tend to be developed on a pan-provincial basis, and certainly health authorities are a part of that. But the research capacity in some considerable measure rests with, for example, the UBC Institute of Mental Health, with its three research chairs, and the mental health evaluation and community consultation unit at UBC. At UVic we have the Centre for Addictions Research of B.C., and UNBC now has a youth research specialization. These tend to be partnerships. Of course, the provincial health officer is a remarkable resource around these issues as well.

So they tend to be multipartnered, and then the health authorities enjoy the benefit of all of that melding of expertise that we can bring together in those best practices guides.

C. Wyse: Once more I thank the minister for his considered response here. I will apologize if I did miss some wisdom and information that was being shared with me here. I may have missed where the actual Ministry of Health fits in, then, to provide direction for the coordination across this wide range of items you put in front of me, for which I'm very appreciative.

[1610]

Hon. G. Abbott: I think there are probably a couple of ways — and I probably won't do justice to either, but I'll do my best — that one might express the role the ministry has in relation to the health authorities and all of the other partners that might be engaged in building best practices. I think stewardship is probably one of the best ways of expressing it. We have a continuing responsibility to ensure that we set standards, that we prescribe outcomes and that we provide necessary and predictable supports to achieve the outcomes that are desired. So stewardship is important.

The other expression that I used the other day, which I think is important as well, is that the ministry has really moved from a rowing function to a steering function. I'm not saying that one's better than the other. It's just that the ministry has restructured itself in that direction. Through performance agreements, through policy, through legislation and regulation — we use all of those and more to try to ensure that we're getting the outcomes we need.

[ Page 2110 ]

The member may also wish to have a look at the 2005-2006, 2007-2008 service plan update September 2005, which goes into some detail around the ministry overview and core business areas and which sort of clarifies services delivered by partners versus services delivered by the ministry. It also goes into some of the stewardship and corporate management that is provided by the ministry.

The member also asks: how do we ensure those outcomes, or how do we try, through performance agreements, to develop measures and achieve outcomes but evaluate those measures? One of the important measures is the proportion of persons aged 15 to 64 hospitalized for mental health or addictions diagnosis who receive community or physician follow-up within 30 days of discharge. That's the measure. It's an important one, because it tells us when someone is identified with a mental health or addictions diagnosis how quickly they are able to get the professional support they need.

The target for 2005-2006 is 76 percent; '06-07, 78 percent; '07-08, 80 percent. We are pushing that up on an annualized basis to try to ensure that people don't have a big lag time between the time they understand the mental health or addictions challenge they have to when they receive professional support.

The second measure which I'll note — I think, again, it's important — is readmission rates for patients admitted to acute care with a mental health or addictions diagnosis. The benchmark we want to achieve is 10 percent. The '05-06 target is 12 percent; '06-07 target, 11 percent; '07-08 target, 10 percent.

The object here, and I think we've had some very constructive discussion between the opposition and our ministry around this point, is that we don't want to see a situation where people who have a mental health or addictions challenge are inappropriately occupying for some period of time an acute care bed, because that's not where they're going to get the care they need. Just as someone who will ultimately need a residential care bed, to have them waiting for a long period of time in an acute care bed, again, is not often the best of scenarios.

We're working hard with the health authorities to ensure that people are getting the services they need, and they are getting them in the venue that is going to work best for them.

C. Wyse: Again, thank you for the information. Time permitting, we may come back and look at the three performance measures, too, which follow up to this particular item. But at this moment in time, there's another area that I would like to go to.

[1615]

I'm going to switch to the general area now, moving away from health authorities and moving over into a broader area involving youth with mental illness. I recognize possible overlap with other ministries here, but given that it's health and that we're talking about the Ministry of Health, I will try and narrow into that area. With that bit of advice, I have a number of questions in this area. I'm very willing to get answers in writing, if they're not readily available.

Children's Hospital youth mental health unit. What is the wait time for a child under 12 years of age referred for psychiatric or psychologist treatment?

Hon. G. Abbott: We don't have the answer to that at our fingertips, but we believe it will come in the course of our discussion here. If you want to move on to your next question, then we'll get the answer to that one when it's available.

C. Wyse: Sorry, I don't have the procedure down quite right. Sometimes I'm up when I should be down.

I would add a follow-up question to go along with the same area. What is the wait time for a child of 12 to 18 years of age — actually this would now be a youth — referred for a psychiatric or psychologist treatment? So the same idea, only now with the youth category.

Hon. G. Abbott: Again, that fabulous instrument that we so affectionately refer to as the BlackBerry is actively in use here. The numbers, I'm sure, will flow in as they are prepared. Again, we'll get the member the answer, but if we could move on to the next question.

C. Wyse: Thank you to the minister. What protocols exist covering the transition from hospital to community between the health authority and the Ministry of Children and Families regarding youth?

[1620]

Hon. G. Abbott: This is a question with some inherent complexity, as many of the member's questions do involve, and that's entirely appropriate because this is a fairly complex area of public policy.

The efforts of the Ministry of Health and the Ministry of Children and Family Development are directed in large measure by the child and youth mental health plan. There one finds a lot of these higher-level aims, strategies and so on associated with the child and youth mental health plan. When mental health issues are being delivered in a facility, i.e., a hospital setting, they are the responsibility of Health, typically delivered through the health authorities. Not always, though; it may be through a regional health authority, or it may be through the Provincial Health Services Authority.

When you're talking about community-based mental health services, then, generally speaking, those are delivered by the Ministry of Children and Family Development. When a child is moving between an institutional setting and a community setting, there are protocols around that, which we can find for the member. In some instances, as well — just to make this even more interesting — the health authorities actually deliver services by contract on behalf of the Ministry of Child and Family Development.

There is a particular concern with kids at the transition between hospital or institutional-supported venues and community venues, and there are also protocols, I understand, associated with children as they get older, reach the age of majority and move from respon-

[ Page 2111 ]

sibility by the Ministry of Children and Family Development to responsibility, generally speaking, back to the Ministry of Health — back to us. That is a kind of general configuration of how it works, but the member may have additional questions around that.

C. Wyse: Once more, thank you for the information. Follow-up questions that I would have at this time around that transfer and responsibility of the MCFD and youth at that point, I think, would be more appropriate for me to pursue with a different minister. I'm going to try and keep my questions more directed here rather than where the integration of services becomes the question.

With that explanation, once more to the minister: what protocols exist covering transition of youths with mental illness to a court situation?

[1625]

Hon. G. Abbott: The issue of youth, and they may be mentally disordered youth, or they may be just youth who are having an intervention with the justice system….. The overall responsibility around that does rest with the Ministry of Children and Family Development, but it is an area where government has worked very hard to overcome what's often referred to as the stovepiping across government of responsibilities.

So we have seen a lot of work undertaken in recent years by the Ministry of Health, the Ministry of the Attorney General, the Solicitor General, the Ministry of Children and Family Development and others to try to pull together a kind of more holistic way of trying to better manage the challenge of youth with mental illnesses, particularly those who may find themselves as regular or routine offenders within our justice system.

There was a street crime working group of the Justice Review Task Force that recently released a report with recommendations on street crime and disorderly behaviour in downtown Vancouver. So I think some of what they are suggesting are things that will be considered and, hopefully, developed in the years ahead. I won't go into the detail on that, given where we are. But there are also some excellent pilots and other program development underway in different corners of the province.

One I'll make note of: Vancouver Coastal has a health pilot involving a centralized youth intake and youth daytox pilot. That's one pilot that we think has potentially great merit in dealing with some of these issues. We think the urgent response unit in Vancouver, which is under development, is, again, an example of how this might be better managed.

[B. Lekstrom in the chair.]

I know the Attorney General has talked at times about community courts and how they might be structured in a way that really…. I don't want to be unfair to him. Fortunately, he's talking to the Solicitor General right now, so I don't need to worry about saying something that would be incorrect, because he's not listening.

It is important that we find ways to ensure that youth with mental health challenges in fact get the appropriate attention to those challenges, as opposed to trying to deal with them through, I guess, what I would term traditional, sort of punitive measures associated with the court system. That doesn't often work for young people with mental health challenges.

So there are lots of things to think about in this area. Again, I know the member opposite feels very passionate about these issues, and I'm being entirely sincere when I suggest that any time he wishes to provide me with some thoughts or guidance or observations around these kinds of challenges, I'd be more than pleased to meet with him and consider those.

C. Wyse: I do wish to acknowledge to the minister that it would be my intention to work with the Minister of Health around making improvements in here. I've been up in front of the House, pointing out that when we're dealing with issues around vulnerability and mental illness, it should be bipartisan, and we should be looking at making improvements. I would just refresh that I have made that commitment from this side on this issue, and the questions that I've been proposing have been probing in order for me to obtain an understanding of the existing system so that I would be in a better position to do such.

But now I'm being wordy, so I would like to advise the minister that I wish to change here.

[1630]

My topic now is going to be in the area of diabetes and mental health. The Ministry of Health guidelines and protocols for management of diabetes indicate that coexisting depression and other psychiatric conditions are common in patients with diabetes and that treatment of these conditions may improve diabetes outcomes. They also indicate that schizophrenia is a major risk for type 2 diabetes. However, no screening or treatment guidelines are offered, so I have three questions related to this particular piece of information. Why have annual screening for depression in people with diabetes and recommended treatment not been included in the guidelines and protocols for diabetes?

Hon. G. Abbott: I thank the member for his question. The member's question is: given the correlation, on occasion — and it's actually fairly high, as the member suggests — between some chronic diseases — and he mentioned diabetes — and some mental health challenges, would an annual screening be the best approach? I think, in the considered view of the Ministry of Health, that while annual screening can be a very positive and constructive thing to do, we're not convinced at this point that it is the best use of resources in terms of meeting the challenge.

The dispute is not around the challenge. We would agree with the member in respect of that. We have in British Columbia a situation where about 5 percent of those typically afflicted with a chronic disease man-

[ Page 2112 ]

agement issue like diabetes or congestive heart failure or asthma…. That 5 percent of the users of the health care system consume about 30 percent of the resources of the system.

[1635]

We would also agree, as the member rightly notes, that there is a relatively high incidence of mental illness, often depression or other issues, associated with those chronic diseases. We believe and hope that the best approach in terms of trying to get better management of the chronic disease challenge, along with the often-associated mental health challenges, is through the collaborative model of primary care, which we've discussed on occasion during Health estimates.

That is, we build teams of physicians, nurses, counsellors and others — depending on what, exactly, the challenge is — using a collaborative approach through a primary care model, where people can be counselled on lifestyle issues, disease self-management, the range of pharmaceutical or other supports that might be appropriate to their condition and how weight management might have an influence on their health outcomes and their health self-management. All of these, I think, are the benefits that can be derived from a collaborative model of primary care. All of these things are interconnected in the most delightful ways.

We need to have as part of our discussion with the BCMA in the months ahead: how do we build a model for physician support in the province that is going to reflect this goal of building a stronger primary care model so that rather than having the sort of typical rapid rollover of fee-for-service kinds of arrangements, people who have chronic disease challenges can get broader guidance about how to appropriately manage their chronic disease?

C. Wyse: I appreciate the discussion around chronic illnesses, but schizophrenia in itself would be a chronic illness. I'm raising questions about somebody who already has a chronic illness and then has a secondary one also to be managed, as in diabetes. Having listened very closely once more to what you said, and given that other bit of information in addition, my second question is: why have costs for screening of people with schizophrenia and diabetes not been provided for on a periodic basis, let's say, every two or three years — rather than annually, as in the first question I asked?

[1640]

Hon. G. Abbott: I appreciate the member raising the important question. The issue is: how do we produce the best outcome for the patient who is beset by a chronic disease challenge, perhaps exacerbated by a mental health challenge that may have been produced by that? We're not convinced that even intermittent screening is the answer. Rather, we believe the key is for primary care physicians and family physicians, through additional training, to be very sensitive to changes in the patient's condition — to be able to identify and to evaluate and to assist where a patient is seeing his doctor.

When a person is beset by a chronic disease challenge like diabetes, chances are that they are going to see their physician at least a few times and probably at least several times during the year. This is something we are now doing on a more rigorous basis: trying to ensure that when the chronic disease patient meets with their physician, the physician is very aware of complications that may be ensuing from the original chronic disorder.

For example, from diabetes there may be heart disease challenges. There may be eye disease challenges produced by it. And as the member rightly notes, there may be mental health challenges associated with that condition. Every time the patient visits the physician, there's an opportunity to see what may be complicating factors in the disease addressed in that collaborative way we talked about earlier.

Diabetes, I should note, is addressed in the clinical practice guidelines on depression released by the Ministry of Health in 2004. That's one of the examples we talked about earlier.

We are not trying to disparage screening, because screening is important. But if, for example, we were to have a situation where we built in a screening regime on some kind of prescribed basis, it might have the reverse effect of keeping people from getting the kind of counselling they need on an ongoing basis while they wait for an expensive, or otherwise, screening process to occur. Again, we're not disparaging that. Screening has its place and its purpose, but we do think that the best answer here lies in that more robust, more rigorous primary care model that we are developing in this province.

C. Wyse: Again to the minister: I thank him for his information and his considered response. I'm asking questions, in my mind, with an emphasis upon the mental illness aspect of it, not the reverse, in the question. I think that given that, I'm going to advise the minister. Three questions, I told him. I'm going to omit that third question, and I'm going to move on to this case in the area of housing.

The federal government has allocated $1.6 billion for housing. People with mental illness are more likely to be homeless than any other group and represent roughly a third of all homeless individuals. The Premier's own Task Force on Homelessness has identified that across British Columbia thousands of people with mental illness need access to decent housing. My question to the minister: where is the action plan to address this situation where thousands of British Columbians with serious mental illness have no home?

[1645]

Hon. G. Abbott: I'll begin by acknowledging that there certainly is a relationship between homelessness and mental illness. As a former Minister of Housing for this province, I know that one of the focal points for the development of our housing policies in the early 2000s was the challenge of mental illness and homelessness. We worked with the federal government extensively

[ Page 2113 ]

on some of the…. It was called the SCPI program at the time. I can't remember what the initials stand for now. It was an attempt to try to address the shelter and housing needs of the homeless, and in particular, mentally ill homeless people.

This is a big challenge. We know that since we became government, when patients from Riverview, for example, have been discharged to community, they have always gone with appropriate levels of support when they went there. If one goes back further in history, governments have not always been so salutary around ensuring that when deinstitutionalization occurred, appropriate supports went with that deinstitutionalization.

As a consequence, we do have some challenges, particularly in the downtown east side, but by no means confined to the downtown east side, where those kinds of problems are seen with considerable force. Often, too, mentally ill people on some occasions, at least, are very suspicious of shelters and that sort of thing, so they present a special challenge.

The Premier's Task Force on Homelessness, Mental Illness and Addictions is, I think, taking very much the right course in terms of trying to resolve this. The resolution of homelessness issues doesn't involve simply the provision of a home, although that's part of it — ensuring that there is immediate shelter and then second-stage housing and, hopefully, further housing along the way. In every case, the challenge of homelessness, mental illness…. Often there are physical illnesses that need to be addressed. There are certainly education issues that often need to be addressed. There may be employment issues that need to be addressed.

I think the Premier's task force is trying, in partnership with a number of mayors and other local government leaders, to find a more holistic, embracing solution to this. It's not a one-off problem that is quickly and simply going to be resolved.

Just so the member knows, I won't give him the whole breakdown, because I know we're running into a bit of a time issue here, of mental health residential care service beds across the province. In British Columbia today there are approximately 1,530 mental health residential care beds, 3,800 supported-housing beds and 700 B.C. Housing mental health–supported beds, for a total of approximately 6,000 mental health support beds across the province.

[1650]

The Premier's Task Force on Homelessness has also taken some steps, I think very appropriately, in the right direction to break the cycle of homelessness and mental health challenges to becoming more self-reliant and independent. Under the first phase, initial funding: 168 emergency shelter beds, for a total of 879 emergency shelter beds now available; and an additional 208 cold-wet weather beds, for a total of 391 cold-wet weather beds. There have been very substantial additions in the number of shelter and cold-wet weather beds.

Under the second phase, the provincial government and the federal government are allocating together about $42 million each for a total of $84 million dollars for developments that will provide a continuum of affordable housing and support services for those who are homeless or at risk of homelessness — people with mental illnesses, etc.

Finally, the health authorities have been involved in community consultations within their respective regions to identify the projects and the associated health services that are going to help here. There's, again, a long list of those. It goes back to the partnerships with the non-profits like the Union Gospel Mission and the Salvation Army and so on, who do just a tremendous job, a selfless job, in trying to build these supports for the most troubled people in our communities. We're very proud to be able to partner with them whenever we can.

C. Wyse: Once more, I thank the minister for his information. My question would be: how many beds have been determined to be needed across the province for each one of those categories of housing that he has outlined for me?

Hon. G. Abbott: We suspect that by "benchmarks" the member probably means, for example, how many beds would best practices suggest per 100,000 population, that sort of thing. Those benchmarks do not exist currently in British Columbia, nor to our knowledge do they exist nationally or…. Well, we don't know internationally, but not nationally. We are in the process, though, of developing those benchmarks, because I think that will be an appropriate and useful thing to work towards in the future. Those are being developed within the context of the Premier's Task Force on Homelessness, Mental Illness and Addictions. Hopefully, that will be something that will bear fruit in the future.

C. Wyse: I want to extend my appreciation to you for your frankness and the amount of information you've been willing to share with me. Unfortunately, my time is coming to an end. I do wish we had more. I have one more question for you, Mr. Minister.

In my words, the mental health service system in Vancouver is in crisis. In the past three years there has been a major increase in psychiatric emergency admissions in Vancouver-area hospitals. At St. Paul's, which serves the downtown area, a majority of emergency department admissions are now for psychiatric reasons. The crisis has been caused, at least in part, by the inadequate funding of and cuts to the community mental health services. This is back to the question you asked me about resiliency and disability that we didn't have time for the other day.

In addition, my understanding is that there are no plans to develop and implement evidence-based best practices such as assertive community treatment teams. These practices have demonstrated effectiveness in supporting the seriously mentally ill in the community and significantly reducing hospitalization.

[ Page 2114 ]

[1655]

My question to the minister: when will Vancouver Coastal and the other health authorities adequately fund the community mental health and addiction services required by persons with serious and persistent mental illnesses? And when will evidence-based mental health and addiction services be planned and provided to support the seriously mentally ill in the community and significantly reduce psychiatric emergency hospitalization?

Hon. G. Abbott: I think the question relates to advocates, obviously, in the area of mental health and addictions who want to see more and who believe things can be done better and so on. I'm sure they're right. They can be.

I want to not only say that we're sympathetic to the challenges people face in their lives when they're beset by mental illness. I think that often when they are facing their challenges in the world, it seems like the supports should be way more extensive than what they're receiving. Again, we want to respond sympathetically to people's ideas about how we can take either existing resources or additional resources and shape them in a way that is going to work most effectively for those beset by mental illness or addiction issues.

That having been said, it's not that there haven't been additional resources added in this area. We talked about this very early in the estimates debate. Today, this year, the support for mental health and addiction issues is well in excess of $1 billion. With that $1 billion, we're not just talking about the quantum of money. We're looking at how those dollars are expended and very much trying to focus on building a continuum of care so that people across a range of challenges and geographic areas have the opportunity to access the services they need in a timely way.

It is a challenge. Sometimes, when the system's not working as well as it should or if there is a spike in certain activities, we will also see a spike in the intersection of emergency rooms and mental health and addiction issues. That does happen, but I want to, also, pay tribute to the health authorities and to my staff in the ministry, who are working very hard on a broad range of issues that are aimed at building that continuum and, in fact, making the programs more effective.

[1700]

We talked earlier about the supervised injection site in Vancouver, but there's lots of other stuff happening. The community transitional care team provides support and medical care, including IV therapy, to active and recovering injection drug users in a transitional house setting. The Brain Research Centre is a major project area of the VCHA research institute in partnership with UBC created to develop new approaches to treating diseases of the human brain and to understanding brain function. The geriatric shared care project is working with three community care clinics, providing elderly patients who require psychiatric care with the help they need.

Providing better treatment for depression and bipolar disorder through the mood disorder centre of excellence at UBC; expanding the Vancouver community arts studio program to help people with mental illness explore their talents and abilities; the Dr. Peter Centre; Vista house; the Grandview Woodlands Mental Health Centre — all of these are building different aspects of that continuum-of-care model. I think they are improving every day on the range and types of supports that we can offer to people who, unfortunately and sadly, are beset by mental health or addictions issues.

We appreciate that there's always room for improvement. You know, that's why I'm here as a politician: to hear the hon. member's ideas, all of the hon. members' ideas, about how we might better utilize the talents of people across society to produce better outcomes. I'm very pleased to do that and to work with the hon. member to develop more best-practices and better use of programmatic funds.

D. Cubberley: I see a smile on the minister's face. We are, in fact, at that point now. I just want to take a moment to thank the minister and his staff for being responsive in the estimates process and the minister in particular for the tone and the quality of his responses to questions. There has been a wide array of them. I appreciate it's no easy matter.

We did share a little bit of humour along the way about the minister's tendency to go long. I know he himself is able to laugh a little bit about that, but we've also had some very good discussions on some difficult issues, and we are better informed as a result of those discussions. Probably not always as informed as we or the minister, perhaps, might like — and that's probably on different issues — but certainly, we're better informed than we were before.

Going through this for a first time, I learned that the time itself, which seemed long at the outset for Health estimates, rolls by rather quickly. It probably doesn't feel quite as quick over on that side. For a topic as complex as health care, the time was actually inadequate to do full justice to the many issues and subjects.

I'm contenting myself with the thought that we will be back at this in what will also probably seem a rather short time when it happens and that we'll, hopefully, have a bit longer to work through the Health estimates. I hope we'll benefit from the knowledge of having done it once. I hope that that eagerness to get back at the Health estimates won't, in fact, cause your staff to have a less enjoyable Christmas than they otherwise might. I'm sure it won't.

Let me say once again that the opposition critics have benefited from the briefings provided by ministry staff and that we look forward to more of the same in the future. It's a pleasure to get a good briefing from highly professional staff, and I want to thank you and them, through you, for that.

There are, obviously, some issues where our perspectives are going to differ, and sometimes quite sharply. It would be hard to imagine otherwise, especially as we represent parties and constituencies with

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different perspectives. There are some issues like care beds where we'll be pursuing our dialogue well into the future, I'm sure.

Having said that, I think we do share a similar sense of conviction that a well-functioning public health care system is the primary purpose of the Ministry of Health, and we would likely agree that a constructive debate about ends and means is a healthy ingredient in decision-making. I hope I'm not being presumptuous in saying that, minister.

[1705]

In closing, I also want to thank my colleagues for their indulgence in what was at times a somewhat scrambly process. I was impressed with what they were able to do in the short spaces they got — those who actually got a short space. I want to assure those who didn't have time to ask their questions that we will try and fix that in the next go-round. That is all I have to say in this venue for the moment.

Hon. G. Abbott: Again, given the unenviable reputation I've built for rather too lengthy answers during this estimates process, I know that some members over there are saying: "No, no. Please. More, more."

Let me conclude with these comments. I said at the outset that I have this perverse affection for estimates, and that still remains. In fact, it's reinforced by the very thoughtful and constructive questions that the members on both sides of the House have asked during these debates. I am much appreciative of that and appreciative also, as the critic noted, of the tone of the debate that we have had.

I think it's been a very good one, and I want to thank the Health critic personally for not only the way these have been conducted, but I also appreciate that he and his colleagues bring me issues that affect them at the constituency level. We've been able to resolve some of those in the quiet atmosphere of my office, and so I appreciate the way that's been conducted as well.

I do want to thank the very, very capable staff who are with me here in the chamber, the staff who are outside in the Cedar Room, the staff who are back at our Blanshard Street headquarters, and the staff that are in the health authorities all across the province who have been tuned into this debate and assisting us with the best answers possible over the past days. I am appreciative of all of them. I am every day astounded by the remarkable talents, energy and commitment that everyone in the Ministry of Health and in the health authorities, from the deputy minister on down, brings to this province.

We are infinitely richer as a ministry, government and province as a consequence of that energy, thoughtfulness and commitment which our staff bring. So I do want to thank all of those who have been part of supporting these estimates.

I think we have a great health system in British Columbia. Every great system is great not because we say it is, but because of the people who work in it, and 120,000 people are a part of the health care system in British Columbia. They include some 8,000 doctors, 30-some thousand nurses and many more orderlies, but also health care administrators and researchers, front-line workers across the system who every day not only come into work but come into their place of work with the objective of providing the very best care they can to the patients they serve.

I want to thank all of those 120,000 people for their daily contribution to making British Columbia's health care system the best it can be.

While it's a great system, there is always room for improvement. We have dedicated ourselves in this ministry to continuous improvement. Every day, somewhere in the system, there will be a mistake made. We'll learn from that mistake. We'll build on it, and we'll build a stronger, better, more sustainable, more durable, more focused health care system from that. So again, I do want to thank the hon. members.

I move, Mr. Chair, that the committee rise and report resolution…. No, you don't want to do that yet. Just sit down and go away?

The Chair: Not go away, minister, but we will call the vote prior to doing that.

Vote 34: ministry operations, $11,323,248,000 — approved.

The Chair: We will take a brief recess and reconvene in a couple of minutes.

The committee recessed from 5:10 p.m. to 5:12 p.m.

[B. Lekstrom in the chair.]

ESTIMATES: MINISTRY OF

LABOUR AND CITIZENS' SERVICES

On Vote 35: ministry operations, $192,838,000 .

Hon. M. de Jong: I am acutely aware that we are rapidly coming to the conclusion of the scheduled estimates process. It is important, in my view, that members of the House, and in particular members of the opposition critics, have some opportunity to pose the questions they have been preparing.

First, I will say this. To my left is Ms. Annette Wall. To my right, Mr. Rick Connolly. Behind me, Cheryl Wenezenki-Yolland and Terry

Bogyo. Where is Terry? Hold the presses. He will be along eventually. In any event, I appreciate the fact that staff are here.

The ministry, of course, now comprises the traditional Ministry of Labour. The change that took place after the election was the inclusion of the Citizens' Services Ministry, which I know we will be canvassing in more detail tomorrow. I look forward to the questions that the hon. member and members of the House may have.

C. Puchmayr: Thank you to the staff, and thank you to the minister. I appreciate the briefing the staff gave. It seems like many months ago now. It certainly was

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informative to some degree. I guess I'm here to try, in a short period of time, to get more information to a greater degree.

First of all, I'm appreciative that the minister did receive my message. I gave him the courtesy of explaining the order that I will be proceeding on this, starting with the ministry offices, with the budgets, and then going on to labour employment standards. Then I will be going into workers' compensation. If there's time, even tomorrow, I would like to go into the Labour Relations Board.

[1715]

I was pleased when I walked across to speak to the minister that I saw he wasn't wearing CCM Tacks. I think the previous estimates minister went to get his sharpened, so hopefully we'll be able to move a little bit quicker as we proceed along here.

I want to make some comments with respect to some of the issues that are happening. I'm aware that the current Labour Minister was not the minister in charge of this portfolio previously. I do sense from some of the conversations that I've had with the minister on the crises in the forests that there seems to be a flicker, maybe a spark, of hope right now. I'm reading some things with respect to the Workers Compensation Board, and I have met with the executive of the Workers Compensation Board. I think we're all aware that there is an incredible crisis in our forest industry at this time that needs some extra-special address and some