2008 Legislative Session: Fourth 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)

THURSDAY, MAY 8, 2008

Morning Sitting

Volume 32, Number 8

CONTENTS

Routine Proceedings

Page

Reports from Committees

Select Standing Committee on Parliamentary

Reform, Ethical Conduct, Standing Orders and Private Bills, second report

A. Horning

Tabling Documents

Office of the Auditor General, report No. 4,

2008-2009, Managing Government's Payment Processing

Second Reading of Bills

E-Health (Personal Health Information Access

and Protection of Privacy) Act (Bill 24)

Hon. G. Abbott

A. Dix

Speaker's Statement

Rules for public bills in the hands of private

members

Proceedings in the

Douglas Fir Room

Committee of Supply

Estimates: Ministry of Forests and Range and

Minister Responsible for Housing (continued)

D. Thorne

Hon. R. Coleman

[ Page 12153 ]

THURSDAY, MAY 8, 2008

The House met at 10:03 a.m.

[Mr. Speaker in the chair.]

Prayers.

Reports from Committees

A. Horning: Hon. Speaker, I have the honour to present the

second report of the Select Standing Committee on Parliamentary Reform, Ethical

Conduct, Standing Orders and Private Bills.

I move that the report be read and received.

Motion approved.

Law Clerk:

Mr. Speaker:

Your Select Standing Committee on Parliamentary

Reform, Ethical Conduct, Standing Orders and Private Bills begs leave to

report as follows: that the

preamble to Bill Pr403 intituled The Grassy Plains

Community Hall Association (Corporate Restoration) Act, 2008, has been proved,

and the committee recommends to the House that the bill proceed to second

reading.

All of which is respectfully submitted,

A. Horning, Chairman.

A. Horning: I ask leave of the House to permit the moving

of the motion to adopt the report.

Leave granted.

A. Horning: I move the report be adopted.

Motion approved.

Bill Pr403 ordered to be placed on orders of the day for second

reading at the next sitting of the House after today.

[1005]

Tabling Documents

Mr. Speaker: Hon. Members, I have the honour to present the

Auditor General's report 4, 2008-2009, Managing Government's Payment

Processing .

Orders of the Day

Hon. B. Penner: I call second reading of Bill 24, entitled

E-Health (Personal Health Information Access and Protection of Privacy) Act.

Mr. Speaker: Committee A.

Hon. B. Penner: And for the interest of members, in the

small House, as we like to refer to it, we'll have continued estimates debate on

the Ministry of Forests and Range.

Second Reading of Bills

E-HEALTH (PERSONAL HEALTH

INFORMATION ACCESS AND

PROTECTION OF PRIVACY) ACT

Hon. G. Abbott: I am pleased to move second reading of Bill

The new E-Health (Personal Health Information Access and

Protection of Privacy) Act will govern the collection, use and disclosure of

personal health information contained in health electronic databases that are

designated by the minister in designation orders. The act sets clear rules for

the collection, use and disclosure of the personal health information contained

in ministry and health authority electronic databases. The collection, use and

disclosure of personal health information will be permitted only for specific

health-related purposes.

The E-Health (Personal Health Information Access and Protection of

Privacy) Act will lay the foundation for individuals to have access to their own

electronic health record. The electronic health record will permit individuals

to access their personal health records and look at the electronic footprint or

record of access to their information by others, and will allow individuals to

make disclosure directives to limit access to their personal health information.

The act will create a data stewardship committee to approve

individual requests for personal health information from health information

banks for health research and other secondary purposes. The committee structure

will enable government to make objective and expert decisions on the appropriate

disclosure of personal health information for secondary purposes. The act will

add whistle-blower protection for individuals who report privacy breaches.

[K. Whittred in the chair.]

There will be restrictions on the disclosure of personal health

information from a health electronic database on a bulk or regular basis. Such

disclosures will be limited to a restricted number of public bodies. The act

will prohibit disclosure of information from a health electronic database for

market research. On a case-by-case basis, with the approval of the Privacy

Commissioner, health researchers will also be able to contact individuals to

request their participation in health research studies.

The amendments to the Pharmacists, Pharmacy Operations and Drug

Scheduling Act will harmonize its privacy and security provisions with the new

E-Health (Personal Health Information Access and Protection of Privacy) Act,

providing a legislative foundation for consistent implementation of the

electronic health record.

They will also harmonize penalties for privacy and security

breaches. Penalty provisions for privacy breaches

[ Page 12154 ]

in the Pharmacists, Pharmacy Operations and Drug Scheduling Act and the

personal health information access and protection of privacy act will be changed

to a maximum fine of $200,000.

On a case-by-case basis, with the approval of the Privacy

Commissioner, health researchers will now be able to request information from

PharmaNet so they can contact individuals to request their participation in

health research studies.

This legislation sets a framework for privacy protection for

e-health initiatives. E-health is about using information technology to provide

the best possible patient care. B.C. has seven e-health projects underway that

will provide electronic health records, lab test results, diagnostic scans,

electronic prescriptions and electronic medical record systems by 2012.

Authorized health care professionals will have secure access to

their patients' information so they can make appropriate and timely clinical

decisions. E-health will also give government reliable, de-identified — or

anonymized — statistical information so we can make informed and evidence-based

decisions on the allocation of valuable health care resources and future health

system planning.

[1010]

In e-health systems, access to patient information will be

restricted to only those having legal authority and specific permission to do so

in accordance with provincial e-health privacy protection policies. E-health

systems are designed to provide enhanced patient privacy protection as compared

to paper records.

Every time someone accesses e-health information, that access will

be recorded, leaving an electronic footprint. The province will continue to work

with health authorities, health professions, community groups and other partners

to develop privacy protection measures to ensure that patients' personal

information and confidentiality are protected.

In conclusion, this legislation will create an effective balance

between individual rights and public responsibilities. It will help us pursue

the goal of faster, better, safer health care through electronic health records

while protecting privacy.

I know there are some organizations that have raised concerns on

the balance in this legislation between individual privacy and the need for a

properly functioning e-health system. Since introduction of this bill, our

ministry has been consulting with those organizations that also had been

consulted in the development of this bill, as well as with the Information and

Privacy Commissioner, to see if we can bridge the gaps while ensuring the

balance between privacy and a properly functioning e-health system.

Members of this House will be aware from today's orders of the day

that I have tabled some amendments for committee stage debate that the

government believes will address the concerns raised by the Privacy Commissioner

and stakeholders.

For the members present, I can also advise that the staff from the

Ministry of Health met with the official opposition yesterday to walk them

through the amendments on the orders of the day. I look forward to the comments

from the opposition Health critic shortly regarding this bill and these

amendments, as well as discussing the bill and amendments in greater detail in

committee stage.

With that, I conclude my remarks and look forward to comments from

other members of the House.

A. Dix: Just for the interest of those who may watch these

debates from time to time and who may be wondering what happens in the House,

how they can know when legislation is going to be called and when legislation

isn't going to be called.

In fact, generally speaking, what happens is that the discretion

for when legislation is called is entirely in the hands of the government. They

get to choose. They can start one bill, and then they bring in another bill, and

that's the way it happens. So if you were watching yesterday at the end of the

day….

Hon. K. Falcon: It's called government.

A. Dix: I'm just explaining. I may need to explain it to

the Minister of Transportation as well, who appears confused on these points.

Yesterday at the end of the day we were discussing Bill 26, the

Health Statutes Amendment Act. We were in the middle of that debate, but we

haven't finished that debate. We've moved on to this bill, which is also a very

important piece of legislation. We're on to Bill 24, which deals with this

really important issue of e-health.

It's very important, and I think the Minister of Health would

agree with this. The potential for the health care system to use electronic

health instruments to improve the quality of care is great. I think most of the

reports, if you look into health care, which talk about the potential for

improving primary care…. We're talking about the potential for improving and

making more cost-effective but also improving the quality of care — patient

control over their own care.

Most of those reports in the past have seen and envisioned a great

potential for e-health, and indeed there is. We're going to go through some of

the potential for that today. The potential is great, as one can imagine.

I actually left it in my office this morning, but previously, for

example, it was often entirely dependent on whether or not one wore a MedicAlert

bracelet at a time of great urgency that an emergency room nurse or doctor might

know that a person was suffering from some sort of ongoing or chronic disease.

[1015]

It's hard to deal with in the media sense, but having access to

patient records in an appropriate way might help assist many patients and many

doctors and nurses who might well be in trouble, who might be having difficulty

in terms of providing care. The potential is great in that sense, and we talk

about this.

These are some of the debates that take place in terms of the

privacy of e-health legislation. So what happens? How do you balance those

issues of privacy and those issues of disclosure?

[ Page 12155 ]

I know another member is about to stand up to make an

introduction. If that member will stand up so I can keep my place, I will allow

her to do so.

Introductions by Members

S. Hammell: I'd like the House to welcome Wendy Kaland, a

teacher from Green Timbers Elementary School, and the 65 grade 5 students and

some teachers and parents who are visiting the precinct this morning.

Green Timbers School is in the constituency of Surrey–Green

Timbers, which takes its name from the Green Timbers plantation that was one of

the original nurseries for forest seedlings that went out throughout the

province. However, that aside, would the House please welcome these students

from Green Timbers.

Debate Continued

A. Dix: It's wonderful, in fact, to have guests in the

precinct today to listen to this very important debate.

As I was saying, I think the potential — if one looks at the

reports, as we will this morning — of e-health to improve the quality of care

across the system, a combination of e-health, for example, and telehealth…. We

can think of important projects that have gone on around the province using both

e-health and telehealth to improve the quality of primary care in communities.

One of the issues that I think is really important to many people

when you're dealing, for example, with mental health services — and this becomes

an important issue when you're talking about this debate — is the fact that

often the place where people seek assistance for mental health services is

either their primary care physician or nurse practitioner.

The ability for us to use telehealth, for example, which is not

strictly dealt with in this bill, to improve performance measures, to inform

doctors about the appropriate types and level of care in terms of primary care

and mental health, which is an area often that doctors are not well suited to

deal with…. They're not well trained to deal with it. It's only part of their

training. They help people get well, but often their training in terms of

providing mental health care isn't as good.

We've seen projects in the last few years in British Columbia that

provide access to information for doctors on medical health information, but

through telehealth and through other things that have in fact enhanced the

ability of primary care doctors to deal with primary care and mental health,

which is an important challenge for primary health care doctors — especially

general practitioners and especially in areas which may not have ready access to

mental health services because of their distance or their smaller population

centres….

If you think of e-health and what we're talking about, what it

means is that…. The minister has talked about the government's plans, their

electronic health records scheme, their lab records, their diagnostic scan and

so on — all the projects that we will be talking about shortly.

When we're talking about this, we're talking about enormous

possibilities in the hospital care setting for improved levels of care. We

talked about emergency room care a moment ago. What happens if someone is in

trouble and doesn't have, for example, a MedicAlert bracelet? That's something

we can all understand.

This is one of the debates we're going to have and talk about when

we talk about privacy with respect to the bill. Often the debate is: how can you

give consent if, for example, you're unconscious? So we have this debate.

[1020]

The doctors may in fact be able to access information about you

that would be critical to saving your life, but your privacy and consent is also

very important in terms of saving your life. Ordinarily, you would say that

something as private and essential as a medical health record could not be

disclosed. But surely most people might reasonably say under those circumstances

that they would want their medical health record disclosed.

Most people would, but maybe not all. These are the debates and

the challenges you face when you're dealing with e-health issues — the privacy

issues.

The advantages are so clearly before us, on the one hand, to

improve the quality of care for patients, to improve the quality of care

provided by doctors and nurse practitioners and health sciences workers and

everyone else. The potential is so clearly there, but the dangers are very

clearly there as well.

As we know, the context of this debate is a little bit set by the

events of recent times not just in British Columbia but across the world. This

of course is not, in fairness, really about e-health at all, but it shows the

potential concern that people may have about the dissemination of health

records.

It's an interesting context to this debate so that we understand

the issues, both the privacy issues that are so much a part of this debate and,

again, the potential advantages if we can resolve those privacy issues of

dealing with e-health. But as you know, hon. Speaker, because you may well have

been watching this yesterday, the freedom-of-information commissioner and the

Ombudsman of New Brunswick issued concurrent reports yesterday about the failure

of governments to protect personal health information.

So just to understand what happened…. What happened was that in

October 2007, there was a shipment from New Brunswick to British Columbia of

computer tapes. They contained the personal health information of a lot of

citizens. They were in no way protected. The system, I think it's fair to say —

the minister would probably agree with this — was sloppy in this regard not just

here in British Columbia but in New Brunswick as well.

The New Brunswick Ombudsman said in this report: "New Brunswick's

health department failed to ensure that personal health information was

protected through encryption, and that's not good enough." As a result of this

episode, changes were made, fortunately. He went on to say that he's satisfied

that the department had taken proper steps to ensure that this does not happen

again.

What happened here is that the governments combined…. These tapes

were sent from New Brunswick to British Columbia by courier. They weren't

protected in

[ Page 12156 ]

any way. So if someone obtained access, they would gain access to the

information about, in this case, the 124 patients involved. Pretty serious

stuff. I think none of us would want that to happen to our own personal health

information.

This is an interesting context for what we're dealing with today.

So 124 patients' data is out there somewhere, and what we hope is that it's kind

of lost and thrown away and no one will get access to it. That's what we would

hope, because obviously nobody wanted it to happen — not the government of

British Columbia, not the government opposite, not the opposition, not the

government of New Brunswick.

So this happened. The data involving 124 patients was lost. But

the implications of that for those people might well be serious. That's why

B.C.'s freedom-of-information and privacy commissioner Mr. David Loukidelis, who

the minister is aware of and has in fact consulted in depth on this bill — or at

least his staff has….

He agreed with his counterpart in New Brunswick. He said: "B.C.'s

Health Ministry should not have been couriering around unprotected tapes of

personal health information like this. It doesn't matter that the tapes can only

be read using technology that's not commonly available. Proper encryption is the

basic standard for portable data storage like this."

[1025]

What he went on to say is — and I think this is important: "We

agree that this highlights the need for all governments in New Brunswick and

British Columbia to ensure that they properly protect personal information in

transit. Citizens expect better, and they deserve it. It's also the law."

What we have here is quite a significant incident that puts all of

this in context. In fact, what the Information and Privacy Commissioner said

quite explicitly was that the measures put in place by the Ministry of Health,

in this case, did not meet the measures required under

section 30 of the Freedom

of Information and Privacy Act.

The other issue — and this comes to a fundamental issue that is

dealt with on issues of e-health records and what's required in this system for

us to realize the considerable benefits…. To just briefly talk about what those

benefits might be…. We know this. There are e-health projects like this. The

forward by the government of British Columbia have been, in part, funded by the

We know that to realize the many benefits we can find from an

e-health network in terms of patient care — potentially patient control over

their own care; patient information about their own care; access to their own

records as well as access by doctors and others so that they can properly

diagnose and treat patients…. There are enormous benefits here, and as the

designated speaker for the NDP, I recognize those benefits.

in fact "an essential element of health care renewal. Its application to

Canada's health care system will result in benefits to Canadians through

since the 1997 federal budget, including federal commitments towards first

ministers agreements. Those include, of course, the agreements signed in

September 2000 by the previous NDP government and in 2003 by the current

government.

For example, they talk about the benefits, in their view, of

electronic prescribing. So they have addressed some of those issues at the

federal level, and I think it's important to know that.

What they talk about when they talk about the benefits of health

is improved hospital care — so improved capacity to have telemedicine,

teleconsults, telepathology, teledermatology. That's to name just a few of the

areas they talk about in terms of the hospital setting that can benefit from the

expansion of electronic health.

I know that in British Columbia, at least according to last week's

report by the B.C. Medical Association, there are serious issues overall with

home care in British Columbia that they've identified. You think about the

advantages in terms of monitoring systems used for diabetic medicines, for

asthma, for other chronic disease that you can find, people who require dialysis

— all the systems that can assist people in providing a more efficient level of

care in the home and home care efficiency. I know that the members opposite are

particularly interested in that.

We talked about that a little bit earlier and the potential

advantages in the primary care setting for the use of information by general

practitioners and by pharmacists for medical records, potentially for electronic

prescribing, and other advantages in the system — the ability to make the system

more efficient but also to raise the level of care.

What is essential in doing that, it seems to me — in enhancing the

level of care and the advantages that we can realize from the expansion of

e-health — is public confidence in the system. If people do not have confidence

that their privacy will be protected…. Further, if doctors don't have confidence

that the privacy of patient records, in the appropriate way, need to be

protected….

[1030]

In other words, if you can imagine an e-health system, because

it's kind of what we have in British Columbia, you know, as a system in the

middle that's designed…. I think Sun Microsystems got this contract, and we'll

talk about our friends at Sun Microsystems in a second. There's the centre, and

then there are various spokes coming out from the centre. One would be

electronic health records; another would be PharmaNet and other things.

What you want is for people to have access — and this is the

challenge — to the parts of that system that they should appropriately have

access to without having access to all of it. So you're setting up a system

where maybe a pharmacist out here can have access to some of the records, the

appropriate records, of a particular patient but surely, we would hope, wouldn't

have access to specific electronic medical records from that primary care

physician.

[ Page 12157 ]

You have to be able to develop and build confidence in a system

where people have access to records that they need but don't have access to

records that are beyond their professional interest. That's a major challenge,

and that's why we will be setting up, with the various contracts that the

government has let…. I'll be going into those issues later in this speech.

There is an absolute key here in terms of building confidence of

the public in the system. If the public has confidence in the system, then they

will not, in fact, have any desire to withhold information because of — oh, I

don't know — concerns that people in government, that employers — if their

employer were to be the government — might somehow be able to access that

information. So this issue of privacy seems important, but it's also essential

to the efficacy of the system.

If people don't want to play, then the benefits can't be realized.

So if there are significant concerns — for example, of people who suffer from

AIDS — about the system and they don't want to be involved in this system…. And

this was a major debate before in terms of the sharing of health information.

A former Minister of Health in Saskatchewan, for example, who is

on the board of Fraser Health, took the position, in Saskatchewan, that was

against confidentiality. In my view, he would have discouraged people from

getting tested for AIDS at all. That was his position back in the 1980s. That

position may well have changed. But that issue….

If as a patient you have concerns about that…. We would want

people who might have risk to be tested, for example, for AIDS, for HIV — to get

HIV-tested. But if people are concerned that those tests, in fact, may become

more broadly available than they would like or that they wouldn't have control

of that information, they might not get tested.

I think it's really critical that there be public confidence in

the system, because without that, all of those benefits that we've talked about

and that we'll be talking about here with respect to this bill will be lost.

Getting back to what happened yesterday, which frames our debate

on this legislation, here's what the Information and Privacy Commissioner said

about what happened in British Columbia. He said: "Large organizations have to

invest in paying attention to the small stuff. I think it's a question of

oversight."

But he expressed very strong concern with the fact that the

ministry seemed to know that the information was lost, yet it took them 41 days

to notify the people affected, by letter. To quote the Information and Privacy

Commissioner on this point: "You notify affected individuals where there's a

prospect of identity theft as soon as you practicably can. That wasn't done

here."

Why is this important? Well, let's put it in a broader context.

Why this issue of public confidence in the system? It goes beyond just the

provisions of this bill. We're dealing with the bill now. The minister tabled

some amendments to me which seem, at first blush…. We'll be looking at them at

committee stage. They may, in fact, improve those parts of the bill and address

at least some of the concerns of the Information and Privacy Commissioner.

Although, I don't think all of the concerns of groups that have expressed

privacy concerns with respect to this legislation….

[1035]

Why is it that people could appropriately be concerned? Well, let

me give you an example, a high-profile example that's not in our jurisdiction.

We had this case, of course, this week where the Health Ministry

was strongly criticized for losing medical records. And, like I say, our great

hope in that case is that the 121 B.C. residents affected will not actually

suffer a loss of privacy, because the tapes are lost and they won't turn up

anywhere. They're hopefully somewhere, perhaps in some landfill.

Just to put in context how serious these issues can be and how

important public confidence is to the success of legislation like Bill 24, we

can talk about an international example which happened just last October. The

breach happened in October, and people were informed of it in November.

What happened in the United Kingdom? Well, in that case, something

quite similar, in a sense, to what happened in British Columbia occurred in the

United Kingdom. What happened was that data related in that case to child

benefits went missing. The two disks that went missing contained the personal

details of all the families in the United Kingdom claiming the child benefit, of

which the take-up, if you can believe it, is nearly 100 percent — so an enormous

number of people.

It concerned in that case, not as it did in British Columbia…. If

we take the case here in British Columbia yesterday, it concerned the medical

health records of 124 patients, which is pretty serious, especially if you're

one of the 124, but it's pretty serious for public confidence in the system. In

the United Kingdom the lost data concerned approximately 25 million people. The

personal data on the missing disks was reported to include names, addresses and

dates of birth of children, together with the national insurance number and bank

details of their parents. Further, there were issues raised, very significant

concerns raised about the protection of the information.

So the entire data system in the United Kingdom, a lot of which

had been contracted out in a very similar way to what's happened here in British

Columbia…. A lot of that data, which involved approximately 25 million people in

the United Kingdom, was lost.

Now the breakdown of the loss…. Let me just give you a sense of

the breakdown of that loss. So 7.25 million claimants were involved; 15.5

million children were involved; 2.25 million alternative payees were involved;

and so on.

Now, what happened in this case? There was lots of discussion of

what happened in the case. But the system failed, as can be obvious to everyone,

and the confidence in the entire government record system that included the

records for health was affected by that. So in the wake of that serious breach

of the U.K.'s Data Protection Act, there was a series of resignations that

followed and police investigations.

Here's what a commentator said about that. "Let us be clear about

the scale of this catastrophic mistake. The

[ Page 12158 ]

names, the addresses and the dates of birth of every child in the country are

sitting on two computer disks that are apparently lost in the post, and the bank

account details and national insurance numbers of ten million parents and

guardians have gone missing."

This was, according to critics, the final blow for the ambitions

of this government to create a national ID database. There were also criticisms

in that process of the use of disks, just as there has been in the process we've

seen here this week in British Columbia.

[1040]

These incidents have, of course, a profound and chilling effect on

the entire system, and in particular, on electronic health. Why? Well, as you

know, hon. Speaker, you can imagine why the effect would be particularly

chilling in health, because some of our most intimate, personal details are

shared with health professionals who assist us. Some of them include, for

example, details, perhaps, about chronic diseases we may have which might affect

our employment or events that happened, including events related to mental

health and so on.

One can imagine that in one's own life, one would want to have

control over the process by which such information was shared and divulged.

Well, that control has never been absolute. Once information is shared, it

always seems possible that it might be shared again.

This information, in terms of a mass loss of data…. In fact, the

potential for that seems greater and the risks become greater, strangely enough,

when one's ability, when our mechanisms to share data, also become greater.

That's why the issues raised in this legislation are so important.

They're so important to people with an interest in the area. The

Freedom of Information and Privacy Association would find it very important. The

civil liberties association would find it important. Obviously, health care

groups like the BCMA and the HSA and the BCNU would find it important. But I

think this debate about medical health records and electronic health records is

particularly important and will be seen as particularly important by ordinary

people.

I think some of these issues were raised with people in the most

recent consultation, the Conversation on Health. I do think one of the problems

with consultation processes is that, in a sense, the people with specific

interests and irregular interests have been consulted, but regular people — all

of whom, I am sure, will have a real interest in this question — haven't been

consulted. I don't think they have a sense of what's going on with this

legislation.

What did this mean in Britain in terms of health records? Well, it

meant that the planned database there of 50 million patient records, which is

obviously bigger than our database…. The opposition in Britain, just to remind

people who they are, are the Tories and the Liberal Democrats. It's an odd

situation, but we're now, I think, in…. Is it the third or the fourth

consecutive term of Labour government in Britain? I don't know what it is. I

think something similar, no doubt, will be coming to British Columbia soon.

What the opposition and a lot of patient groups expressed in the

wake of the fiasco that occurred with the child benefit records were concerns

about the loss of health records. In the NHS…. The very health record system

that we're talking about in this legislation has its own parallels in Britain,

and here's what we know about what has happened in Britain.

Eight health trusts. They've developed a different model of health

care than we have on the organizational side. I won't get into that, although

I'm sure the minister would be extremely interested in that. Perhaps we can do

that in another debate at another time. Eight health trusts are reported to have

lost "168,000 patient details in total." That's what happened.

How did they find this out? Why did this find this out? I know the

member for Delta North is particularly interested in this. They found this out

only when they did checks after they lost 25 million child benefit records. Once

they learned about that situation, they recognized that they needed to do their

own checks, and they discovered in their audit that they'd lost 168,000 patient

details. Now, that's a pretty serious situation.

They were forced — the trusts in question, the health trusts in

the National Health Service in Britain — because the systems didn't work

properly in terms of the protection of information, to bring in a whole bunch of

new measures to ensure patient safety. Again, the consequences of that….

[1045]

Just to give you an example of what we mean, because the 168,000

figure seems a bit out there in the sky. We don't know what that means when big

numbers like that are thrown out. What we're talking about, for example, are the

clinical details of 160,000 children by the City and Hackney Primary Care Trust.

We're talking again, in that case, about child health. This is an important fact

there as it is here in our case in British Columbia, which we learned about

yesterday in the report by the Information and Privacy Commissioner.

People found out about it in November. It actually occurred in

October, I should say, the New Brunswick case, at the same time as this British

problem happened. People were informed 41 days later. The same kind of thing

took place, and what it has led to is a profound concern in all of Britain about

the potential security involved in protecting patient records.

I'll just give you another example. Another trust was also

reported over the weekend to have lost patient data. Another trust lost patient

records eight times in the last five years. It's not that they haven't gone to

tender and gone to deal with electronic health records, as this government has.

But what it shows, it seems to me — and this is a critical point — is that

what's needed in addition to a framework for the debate is a great deal of

public confidence.

That public confidence in the case of something as important as

electronic health records can be quite easily shaken. The events of this week in

British Columbia and in New Brunswick and the events in Great Britain last fall

would tend to raise those issues of concern. What they say is that we as

legislators have to be particularly vigilant, and the public has to become

[ Page 12159 ]

involved and know about the critical issues involved in this legislation.

The minister noted in his speech this morning that the government

has tabled a number of amendments that deal with something called patient

disclosure directives — patients having the right to give directives about the

information about them that's disclosed. For example, it might conceivably be

possible for me if I didn't want people to know about type 1 diabetes. If

another patient who was HIV-positive didn't want them to know, they could do

this disclosure directive around that.

It would probably be the opposite in my case. I'd want that to be

disclosed. That would be the first thing I might want to be disclosed to other

health professionals. The question and the key point is that that would be my

choice. I have some mechanism to say to the government: "You can't just throw

around my information if I don't want you to throw it around."

This was a critical question raised by the B.C. Civil Liberties

Association, the B.C. Freedom of Information and Privacy Association and others.

What the government did this morning was table some amendments to try and deal

with some of those concerns that were raised. This issue of disclosure

directives….

The bill that we're debating now — these amendments, of course,

are not part of the bill we're debating now at second reading; they'll be dealt

with at committee stage — said that the minister may include disclosure

directives in an order designating a health information bank. The current

legislation essentially gave the minister the discretion to determine whether or

not they should exist. This obviously was a matter of great concern to

organizations concerned with privacy.

What the amendments do — and we will certainly be supportive of

this particular amendment…. This is an issue that I've been raising in

discussing the bill as well, so I'm pleased to see this change. What they say is

that the minister must now — not may, but must — include disclosure directives

and orders.

[1050]

One of the issues here, one of the challenges, is that we

obviously have old record systems and new record systems coming into place. The

reason, in fairness to the minister, why he may have originally preferred the

"may" — I think this was his explanation — was that some of the old systems may

not have the capacity to integrate this idea of a disclosure directive. The

result was that the minister or the government wanted to have the discretion.

This issue of public confidence, which I'll be returning to in a

little while…. I know particularly the member for Malahat–Juan de Fuca is

interested in this question. There's so much at stake in that that I think this

idea that the minister might have discretion on the question of disclosure

directives was of great concern to groups.

Now, what these amendments appear to do — and that's very

important, it seems to me — is to ensure that people will have that right.

Hopefully, what that does is put the onus away from people. The idea of privacy

protection, which I think is fundamental to the success of this — not just to

the protection of privacy, as if that's an impediment to the success of an

e-health system…. I think it's essential to ensure that there's the confidence

by doctors and nurses and health care workers and, of course, most importantly,

patients.

In that system, this idea that patients should be allowed to give

directions and that it will be up to the government to make sure that the

systems change to meet the privacy needs of the patient and not the patient

having to sacrifice their privacy needs because the government isn't ready yet

or might not be ready yet….

That's one of the amendments that have been tabled today, and I

think it's an important question, because it goes to this issue of confidence.

This issue of patient disclosure directives, which are vital and which will be

vital, I think, to the future success of the electronic health system…. In that

regard, we're pleased with that change.

Now, as you know, the government has been contracting out a number

of things with respect to health information for some time. Sometimes that

contracting out takes place to companies that are in Canada. Sometimes that

contracting out takes place to companies in the United States. This is another

issue of great concern which we'll be dealing with, of course, at committee

stage. It's a great concern to stakeholder groups.

Here's the concern they've expressed. It's that this legislation

allows an exemption for IT maintenance to be done remotely from outside of

Canada — okay? This concern has been ongoing with respect to several government

databases. One can remember the concerns raised very eloquently by my colleague

from Saanich South about the Maximus contract.

This concern has been ongoing with respect to several government

databases that are contracted out to multinational companies with operations

outside of Canada. Why is this so important? Well, as you know — and we know on

this issue of e-health it's a central question — other jurisdictions do not have

the same approach to these issues, I think, that we in Canada have. Indeed, the

far-reaching implications of the Patriot Act in the United States cause concern

to any Canadian who might think or might see that their health records are to

leave Canada for any reason for the United States and potentially be subject to

that act.

I think probably everyone in this House knows that for a bunch of

reasons citizens from our country often have trouble at the border or have often

in the past, in particular — sometimes for their political views, sometimes for

other things — had problems getting access to the United States, or having their

health records shared or having personal information about them developed by the

United States. The Patriot Act has had, in fact, a profound effect and a

profoundly chilling effect in the United States, because there are broad and

sweeping powers in that act that override civil liberties.

If our health information crosses the border to the United States,

as it does in terms of billing information now, there have been concerns raised,

not just by the opposition — although the member for Saanich South raised these

issues, I think, in a particularly eloquent way — but by the Information and

Privacy Commissioner,

[ Page 12160 ]

by civil liberties groups and, most importantly, by our constituents who have

repeatedly come to us and said: "We are concerned about this. I do not want my

medical records, my billing records, to go to the United States and be subject

to the Patriot Act."

[1055]

So those concerns of cross-border IT maintenance and system

security as it relates to the security of the data we have here in Canada being

secure from other governments…. Some people might think it's reasonable that the

government we elect in British Columbia can be trusted to have control of our

health records under a set of prescribed circumstances as are somewhat described

here in Bill 24. But I think it's fair to say that we in Canada don't elect the

government of the United States and that most Canadians think that the powers of

the Patriot Act, which take a very different view of health information, are

powers they wouldn't like to see applied to their personal information.

That's why there was so much concern in British Columbia beyond

the contracting out concerns, beyond the cost of the contract concerns, beyond

the fact that one couldn't seem to phone up and get an answer with contracts

like the Maximus contract, which my colleague from Saanich South eloquently

described as "Maximus minimus." That's why there was so much concern with that,

it seems to me.

That concern grows when we think of all of those records now that,

because of decisions by our government and the decision by our government to

allow those records, potentially, to be accessed by the Patriot Act…. All those

concerns of our citizens in British Columbia…. And they're not frivolous

concerns. We've seen, with the loss of health records and with the experience in

the United States with the use of the Patriot Act, that all of those conventions

that we as Canadians, in terms of the protection of privacy, see as central

concerns for us are frequently overridden in the United States.

Now, we love the United States. They're our dear friends and

neighbours, but they have, particularly since the coming into force of the

Patriot Act, a different view of these issues. Certainly, the government of the

United States doesn't respect and wouldn't respect even the provisions, I

suggest, of this legislation or other legislation with respect to privacy.

It's why those issues have been raised so eloquently by groups

such as the B.C. Persons with AIDS Society, the B.C. Civil Liberties Association

and the B.C. Freedom of Information and Privacy Association. There are also

issues, in the past, that have been raised by the Information and Privacy

Commissioner.

So think of this. You've just put it in context, hon. Speaker,

because we were talking about patient disclosure directives. That's what

section

8 of the act says. It says that the minister may, in an order, create a health

information bank — authorize individuals to make disclosure directives regarding

their own health. This is why this change from "may" to "must" is important in

B.C., because even here in B.C. we wouldn't want…. If a person wanted to give a

directive not to release certain information regarding their own health, we

wouldn't want even the government of B.C. to do that.

This is particularly important when you consider the possibility,

and it's something we have to guard against, that such records might eventually

be the subject of the U.S. Patriot Act. I think most people in British Columbia

would be concerned about that and are concerned with that.

That's why there was so much concern expressed in this Legislature

but also across British Columbia by regular citizens — not by the groups, not by

what you'd call the usual participants in the public debate, but by citizens —

about the government's decision to contract out certain health records. Some of

them seemed to be able to go outside the country. There are some issues here

about the power to enable such records to go outside of British Columbia.

Those are issues, clearly, that my constituents and, I know, the

constituents of the member for Malahat–Juan de Fuca will want to be discussed in

detail at committee stage.

Getting back to the issue of disclosure directives for a moment.

What they allow patients to do — and this is in

section 8 of the legislation —

is block access to their medical information. One of the reasons provided for

this being left to the discretion of the minister was the inadequacy of existing

technologies. We've talked about this.

[1100]

So the fact is that some of the information systems that currently

house that information, which would be affected by this act, aren't in a

position to accommodate, from a technological point of view, the idea of

disclosure directives.

[S. Hammell in the chair.]

What the Information and Privacy Commissioner said…. This is why

it's so important that this bill, which currently says "may" but we hope after

committee stage will say "must…." He urged the minister to ensure that the

systems accommodate disclosure directives. He made that case, I think, very

strongly to the minister.

I'm glad to see that those concerns and, just as importantly, the

concerns put forward in detail by the B.C. Freedom of Information and Privacy

Association, amongst others, have been taken up at least in

part in this

legislation. I think that issue of being able to trust the system and being able

to say to your government that this information shouldn't be shared, for

whatever reason…. People don't have to, it seems to me, give reasons about

access to their personal health information. Their reasons are their reasons.

They're not really for us to judge.

It's absolutely critical to the confidence that people have in the

electronic medical records system and in the e-health system that they be

allowed to do that — that a constituent in Malahat–Juan de Fuca living in Sooke

has the right to be able to say: "No. I don't care how fancy your system is and

how much you've promised not to release it to other parts of government or what

a great commitment you've made. I don't care about that, because I don't want

this information shared — period. This issue is between me and my doctor or

between me

[ Page 12161 ]

and another health professional. I do not want the issue shared, and I want

the right to give a disclosure directive."

What this implies, of course, is that subsequent to the passage of

this legislation and the creation of these directives…. What it implies, it

seems to me, is that there will need to be a very significant public campaign.

If you think about it, people will only be able to use such a disclosure

directive if they know one exists. As much as we know that the riveting debates

held in this Legislature are widely heard throughout British Columbia, the fact

of the matter is that most people, once this bill is passed, will not know that

such a disclosure directive exists. So we need to inform them.

What I'm not suggesting is that participation in the system

requires consent. It seems to me that that would be an enormous public

undertaking, and it would be very unlikely that the system would be taken up to

the degree you'd need to take it up in order to be effective, to realize the

gains. What we're saying is that patients in British Columbia deserve at least

the same rights as cable companies wanted to impose on subscribers back when

there was negative-option billing — that you have the right to know that you

could give a disclosure directive to your government with respect to your health

information.

What will be required after this, it seems to me — because this is

an individual right — is a significant effort by the government to let people

know that such a disclosure directive exists, that the right to have a

disclosure directive exists. I think that is a very significant situation.

Are people right to be concerned? Are groups such as the B.C.

Persons with AIDS Society right to be concerned about the issue of cross-border

IT maintenance?

[1105]

Well, there will be a debate about that. The minister across, I'm

sure, will say: "No. We've taken the proper safeguards." But just remember what

the U.S. Patriot Act permits. Here's what it permits, and it's pretty serious

for people who have concerns about this. It doesn't mean to say….

Interjection.

A. Dix: Oh, the minister thinks that the legitimate

concerns people have about the application of the U.S. Patriot Act in Canada are

not to be taken seriously, but of course they are.

We don't have

an act like the Patriot Act in Canada because we

have different views on this issue. Thank goodness we have different views on

this issue. I know that the Minister of Health has different views on these

issues. He wouldn't want to see the Patriot Act applied in Canada the way it is

in the United States.

If you don't want the Patriot Act applied in Canada, then I think

you've got to take special care, certainly more care than this government has

taken in the past, to ensure that the personal health information of British

Columbians is not accessible to the U.S. government. If that information goes

across the border, we know that all of the protections we can provide in Bill

C-24, in other legislation and in the Freedom of Information and Privacy Act go

out the window. Of course, they would treat our Bill 24 a little like this

government treats the Canada Health Act at times — like a scrap of paper. They

would not take the protections that we provide very seriously, and I think

that's a pretty important question to deal with.

What does the U.S. Patriot Act permit? It permits greater access

to business records, increased use of Secret Service searches, increased ability

to do surveillance and wiretapping. The FBI can obtain an order to search any

type of record and does not have to go through any judicial assessment. The FBI

can investigate an individual with no obligation to show probable cause, no

procedure to challenge an order for disclosure. Failure to comply with an order

constitutes contempt. Anyone served with an order for disclosure is forbidden

from telling anyone else that the order exists. Individuals will not even know

that their personal information has been handed over to authorities.

When you think of the outsourcing that we've already seen…. These

aren't electronic medical records. They're often billing records and other

things. The implications of these changes for the outsourcing we've already seen

and the concerns about the loss of medical records, which we've seen in British

Columbia this very week, not in some distant time in the past…. There was a

report yesterday on the loss of records. This is an area of legitimate concern.

Just to give a sense of what Maximus has access to, they have

access to much of this information, much of the information that we think…. They

probably know, I would suggest, from their files about my chronic disease and

other people's issues and health care issues here in this Legislature. So they

have that information.

Whether or not it matters to me whether that information is shared

with the United States government, I would not want it to be shared with the

United States government in this context. In fact, what we have seen is that

there aren't very many mitigation strategies that can be used to protect patient

records or protect personal information if it leaves Canada and goes to the

United States, because the Patriot Act, within the borders of the United States,

overrides those concerns.

I think that far from being a boogeyman, as the Minister of Health

would want to suggest, it's just a serious issue, one we need to discuss in

detail to ensure and to provide the assurance to British Columbians that the

access to their patient records and their personal health information is not

going to in some fashion be subject to the U.S. Patriot Act. We're going to

discuss that at some length at committee stage, and hopefully, the minister's

answers to those questions will provide confidence to people.

We want people to want to participate in an e-health system. We

want people to participate in the e-health system that works and improves the

broader health care of everybody in British Columbia. But what's required to do

that, what's required to make that work, are clear protections for that data and

that information. The reason such protection is important isn't just because of

the individual rights of the citizen, although those are very

[ Page 12162 ]

important, but it's important because it will build system confidence.

[1110]

Now, this brings me around to the really vital issue of system

confidence. As you know — just to give a sense of what this bill does — the bill

provides the framework. But the contracts that the minister talked about in his

second reading speech, which was somewhat parsimonious in detail but nonetheless

touched on these points…. The issues raised in this create the framework for the

system.

But what we're doing is we're creating that legislative framework

sort of after the contractual horse has left the barn. They've let the

contracts. But the minister referred to those contracts in his second reading

speech and those things, so I'm going to try in some detail to let people know

some of the issues involved in those contracts and how they relate to this

information.

What does this bill do? Let's remind people what the bill does. It

allows patients, medical professionals and health research and planning

organizations to access personal health information contained in what are called

health information banks, as defined by the legislation. It creates rules around

access to those data banks, including particular rules for the access to those

data banks for health research but also for health services planning, for

maintenance, for improvement, for billing, for the assessment of public health

needs and for assessing and addressing public health threats.

Those information banks give us the possibility, give us the

capacity, to learn a whole bunch of things about our entire health care system,

especially people in the Ministry of Health who have to do some of the planning

for that. It gives them access to that information, hopefully to improve things.

It creates, really, in addition to that thought, what we call the

privacy framework for those health information banks that have been created and

for the ministry databases that are created. That's important. We've been

discussing the implications of that.

It creates, as the minister said, a data stewardship committee

that will evaluate requests for the disclosure of data for health research. So

you have a committee that will deal with requests.

If a researcher goes to them, they will assess both the value of

it and the right of that project to have access to this information. That

committee will be responsible for approving that access. Obviously, the

membership on that committee, who is on that committee, becomes very important

in that regard.

I think what the bill will therefore do is allow medical

researchers with the specific, and only with the specific, approval of the

Information and Privacy Commissioner…. For the information of people listening

on TV, the Information and Privacy Commissioner is appointed by unanimous vote

of a committee of this Legislature, meaning by the government and the

opposition.

He's an independent officer of the Legislature. He doesn't report

to the government. This is an important fact. He does not report to the

government, but he has to provide medical researchers with specific approval.

I think what the government is trying to do, because they're

trying to address this fundamental issue of confidence in the system that's

required for the system to work…. What one would hope from that is that, in

fact, it will build public confidence in the system and ensure that the Privacy

Commissioner, whose first obligation is to protect the privacy of individuals,

will consider those considerations even before he considers the possible

research advantages of a particular project.

As well, individuals — and this is an important part of it — will

be able to access their own medical records, and they will be able to know who

has accessed their information, which is very important to the confidence of the

system. Most importantly, as we've said, there is this whole issue of patient

disclosure directives, which we'll be dealing with when we have the opportunity

to deal with the minister's amendments at committee stage. So those are some of

the issues that are raised.

Now, I just want to return briefly, because…. So that's the

framework. It creates the frame from which these health information banks

operate. But the government, of course, has set up a series of contracts

already. It's a bit of a hub-and-spoke model, like we talked about earlier.

[1115]

Sun Microsystems, I think, got the contract for the hub of the

system, which has to be designed to sort of manage the traffic on the system and

the access on the system so that somebody who has access to pharmaceutical

records may not be able to get access to the rest of the records. That's the

idea of this hub-and-spoke model.

Of course, one of the key spokes, if you will, is the government's

contracts…. Others were involved. A committee involving representatives of the

BCMA were involved. It's a contract that will involve both public funds and the

funds of doctors to promote an electronic health record system through doctors'

offices across British Columbia.

The government scheme, in that regard, is worth approximately $108

million. What the idea is, is that essentially that's a subsidy to doctors to

adopt electronic medical record programs and systems for their own offices. So

what you have is a subsidy. Then what you would hope is that the doctors would

buy into it.

The government went through an elaborate process, a steering

committee process out of the physician information technology office for British

Columbia that was set up as part of the 2006 collective agreement with the BCMA.

It set up a process and a bidding process for these contracts.

I think the issues involved are really serious. I think most

people would say what you would want, first of all, is the best possible

contractors, the most experienced possible contractors, contractors who have

done similar projects in other jurisdictions to win the contract. Unfortunately,

in British Columbia that didn't happen. We've raised and others have raised

serious concerns about this.

Now, I think this is central to — the minister mentioned this

process in his speech — our understanding of Bill 24, the E-Health (Personal

Health Information

[ Page 12163 ]

Access and Protection of Privacy) Act. Public confidence is essential, it

seems to me.

There have been significant incidents with respect to contracting

out of electronic health records that need to be addressed — and I don't believe

they have been addressed — to ensure that that particular spoke in the

electronic health system has public confidence, and public confidence, in

particular, in the integrity of that initiative. I'm talking about this $108

million contract or subsidy contract for electronic health records.

Now, there's an issue involving a senior civil servant who was

very much involved in this process, but we're not going to get into that,

because that issue is still the subject of a police investigation. We're going

to set that aside and not deal with that for the moment. Some of those issues

are probably most appropriately dealt with in an estimates debate in any event.

But let's just give a sense of some of the concerns about how that

contract was let, because that contract is central to our understanding of Bill

24. So what don't we know? We don't know, for example, what steps the Minister

of Health and other senior officials took to ensure that potential conflict of

interests were avoided with respect to this contract.

Remember, many experts have expressed concerns about the outcome

of this contract, not with respect to the bids or the low bidding, but with

respect to the quality of the bids themselves and whether they met the standards

required, particularly the standards to ensure that both the system worked

appropriately and that we wouldn't have to rebuild it after having tried to

encourage people to be part of it, on the one hand, and on the other hand, the

very privacy of the concerns.

So what we had was a process, and the people in charge of that

process were very highly paid. There's a senior medical consultant in the

Ministry of Health responsible for e-health who billed for, really, a salary

contract — $368,000. He wasn't a minor official in this matter.

[1120]

His name is Dr. Jonathan Burns, and he was involved in that. He

was also, in his free time, when he wasn't earning the $368,000, a very

significant contractor in e-health. All of which is interesting, and presumably,

it's his very interest in e-health that led the government to hire him. There's

nothing nefarious about that in particular, but what it did say was that to

ensure public confidence in the system, surely, very strict rules with respect

to dealing with potential conflict of interest should have been in place.

Now, we asked about these questions in question period, and the

Minister of Health at the time refused to answer. We did not know…. It's another

question that has not been answered: what steps were taken to ensure that no

PITO members had conflict of interest? We don't know the answer to that. The

government hasn't said.

Dr. Jonathan Burns attended all of the PITO steering committee

meetings. On his business website, Dr. Burns describes Wolf Medical, one of the

winners, as a partner. Was this relationship disclosed prior to the development

of the PITO EMR RFP? We don't know that.

Again, it's central. These are questions that surely could simply

be answered by the government. They're not complicated questions, and the

government has chosen instead to leave them unanswered. The government was

reluctant in this case. Again, it relates to this issue of public confidence,

which is central, it seems to me, to how this bill will come into force, how it

will be received, what impact it will have on our public health care system.

The very purpose of the bill is placed into question when people

lose confidence in the government's contracting model that they've set up around

this legislation. They didn't answer that question. They were reluctant to

discuss who was involved in the development, shortlisting, testing and

evaluation of the RFP. We asked; other people asked. It's not just us. Other

people asked, and the government refused to say.

Many of the bidders have wide business and personal relationships

in the e-health fields. How did the government assure itself that none of these

relationships, directly or indirectly, involved those in the design of the RFP,

the selection, the original shortlist and the final decision? The RFP was

scheduled to be launched in October 2006. It was delayed, and the requirements

were significantly changed and softened to allow more bidders.

That's not what you want to hear when it's a matter of your health

records. You don't want to hear that the requirements were softened. But they

were. Eventually the RFP was set out in February 2007. There were 37 bidders who

were released to a shortlist of ten and then to six successful vendors. They're

the vendors who will be allowed to sell their products, and the people who buy

those products will have access to this $108 million in public funds which is a

central piece of the whole architecture of what's being set in place by this

legislation, I would suggest.

We don't know why the RFP requirements were changed. We'd like to

know. We don't know why they were changed. We don't know what pre-RFP meetings

took place between bidders and government officials to lobby for looser

requirements. The requirements very plainly were loosened. This is central to

this issue, again, of public confidence, it seems to me. Without that public

confidence in the system, which we want to see succeed and improve the running

of our health care system, it will not succeed, I submit.

We want to know why the key requirements of ASP capability and

clinical standards were downgraded at that time. We would like to know the

answer to that question. I think that's a legitimate and reasonable question to

know about, especially in the context of this legislation. How many of the

successful bidders, those that will be in charge of elements of the system, were

allowed to bid as a result of the softening of the requirements? This would be

very interesting. It would be very compelling.

We don't know who lobbied for softening the requirements. The

government hasn't explained why they softened the requirements, and we don't

know who

[ Page 12164 ]

was successful and who wasn't successful in the bidding process as a result

of the softening of the requirements. When you're talking about legislation here

that deals with the most personal of health information, these are vital

questions for us to know. They're vital questions of system confidence for us to

know.

They're not small issues. They're large issues, and ones that we

surely should want and have a desire to learn about. Further — and it's

important to go through this, I think, in detail — we'd like to know if any of

the physicians involved in that process resigned during the course of testing

and, if they did, why.

[1125]

Given the stated requirements of that RFP, which as the minister

stated is central to the notion of Bill 24, why did several of the successful

bidders have little or no experience in B.C.? We want to know. Given the stated

requirements of the RFP, why did several of the successful bidders have little

or no experience dealing with the security and privacy considerations of

managing patient data?

This is an important question when you consider the stakes here

and consider what happened in Britain, what's happened with the loss of

information in the United States, what's happened in other jurisdictions. That

seems to me to be a reasonable question to ask. Why did so many inexperienced

bidders win?

Now, there may be answers to those questions — answers that those

bidders can provide, answers that the government can provide. But it seemed to

me that what the government was doing — and ended up doing, in this case — was

valuing a low bid over experience with security, and it was completely

unnecessary.

Remember what these contracts do. It's still up to the doctors to

buy the systems. What the government was managing was the number of companies

who had access. So the companies would still have had to bid and compete on

price with the doctors, to have access for the doctors to be able to use the

$108 million to buy their systems.

Why was the bidding process seen as more important by the

government than these questions of experience? That's the question. Given the

state of the requirements of the RFP — which, as the minister said, is central

to this legislation — why did several of the successful bidders have little or

no experience in delivering electronic medical record applications in Canada?

These are, I think, fairly serious questions.

Five of the six successful bidders had no production experience as

an ASP. Why did the government take a chance on unproven vendors, especially

with something as vital as patient records at stake? There may be an answer to

that question. Hopefully, the answer, given the nature of the process….

This wasn't a low-bid process per se, although that was part of

it, but the competitive process is happening after the fact. This is access, in

a sense, to a subsidy by only six businesses. Again, it's very central to this

whole discussion of Bill 24. The question is: why were the requirements

loosened?

Those are the questions that we need an answer for. They become

central to this debate for the very reasons that we've discussed. This is a very

fundamental question of patient confidence, because if there is a lack of

patient confidence in a system, then the architecture one puts in place won't

matter. One has to build confidence in that architecture and an understanding of

that architecture.

What will be required here is in addition to a vigorous government

campaign to explain to people their rights under

section 8 of this legislation —

I would suggest, a vigorous government campaign to explain to people that they

have the right, in fact, to provide disclosure directives regarding their own

health. What will be required, as well, is public confidence and physician

confidence in that system.

A lot of physicians I've talked to…. A doctor named Dr. Tom

Elliott, who is a very innovative endocrinologist, was involved in this bidding

process. He has grave concerns with how the process was conducted, and this is

not a central part of his business. He's an endocrinologist, but he knows a lot

about electronic medical records. He has devised systems through his own

practice that worked for his own practice. He is amongst the many people who

have expressed very grave concerns about this process.

Again, one can build a legislative architecture — and this is what

we're doing today — that can, hopefully, meet the tests that people have. But if

as a practical matter, the contracts — the records themselves — do not have

adequate protection or have not met the test of adequate protection, if the

systems that the government has put forward do not meet that test and if the

contractors do not have adequate experience in that area, then all of our good

wishes in a bill such as Bill 24 can in fact be compromised. I think that's not

a small issue.

[1130]

You'll just remember, hon. Speaker, in addition to that…. The

Auditor General — we talked about the freedom-of-information and privacy

commissioner — has had things to say recently about some of these issues as

well. His recent report about alternative service delivery, called ASD, found

that some aspects of the e-health plan, such as the inclusion of provincial

laboratory information services, did not have a sufficient business plan.

Again, this is central to what the government says it intends to

do. The PLIS contract was awarded to Sun Microsystems for $140 million in public

funds. The one we were just talking about, which we raised very significant

questions about in this House, was a $108 million contract. This contract is a

$149 million contract. Add those together, and just for those two contracts it's

$257 million.

These are not small investments that are being made. They're being

made by federal money in part and by provincial money in part, but the process

has been organized principally here by this provincial government. The minister

talked about those processes briefly in his second reading speech related to

Bill 24. The contract was awarded to Sun Microsystems for $149 million.

Let's quote from the Auditor General:

[ Page 12165 ]

"The PLIS" — which is the Provincial Laboratory Information

Solution — "was part of the Ministry of Health's e-health strategic framework.

As such, it had already been approved in principle as part of a broader health

strategy. However, no separate business case or other detailed analysis of

costs, risks and benefits was done for the PLIS. This means that the ASD route

has been taken for the project without government really knowing whether it is

the optimal solution. And even if the ASD route is considered simply to be a

policy decision, we still think it should be taken only with all the facts

available."

"All the facts available." I think that's what our concern

is with this circumstance. It's not that we can't, especially with the

amendments that have been put forward by the minister last night, which appeared

on this morning's order paper a few minutes before this debate was scheduled to

begin….

The fact of the matter is that when one is talking about one's

personal health information and about health records in the system, one doesn't

want to hear about decisions taken without all facts available. One doesn't want

to hear about decisions taken without a sufficient business plan. One doesn't

want to hear about a government loosening standards in the RFP process without

explanation.

These are things we don't want to hear about, and they're not

minor matters. They're central, I would argue, to the potential efficacy of the

entire process. When we're talking about this issue of system confidence, we're

talking about the issues that have been raised about cross-border IT

maintenance. We're talking about the issues and concerns that have been raised

about patient directives.

I think all of these tell me one thing — that the people of B.C.

have important interests involved in this debate and in this bill. Questions

that we are dealing with today in this bill have a central interest to people. I

believe that in many ways, people have been excluded from that debate.

For example, I think one of the reasons that consultation

processes are important is that they give people the sense, even if they're not

directly involved…. If you have a consultation process that includes, for

example, the Civil Liberties Association and the B.C. Freedom of Information and

Privacy Association, that consultation process will in fact lead…. Even if you

don't directly get involved to protect your interests, there are other people

out there providing what you would describe as checks and balances in the system

to ensure that those interests are protected.

[1135]

What can we say about this? That's particularly important in this

case because, remember, this is not a small matter — the issues raised in this

debate. The privacy of personal health information is a constitutional right in

Canada, and even without it being a constitutional right, it's a common-law

right in Canada. The essence of it is simply this. You should have the right to

withhold consent.

Further, you should have the right to believe that the government

that is holding that information on your behalf is taking every step necessary

to protect that information and to ensure that in fact the only people who might

have access to that information are individuals who should have access to it,

and that that information doesn't get out to people who certainly don't need it,

who don't have to have a look at it, who don't want to look at it for curiosity,

who don't want to look at it for nefarious reasons. Their motives really don't

matter.

I understand one of my colleagues is going to stand up and seek

leave to make an introduction, so I'll sit down for a moment and hold my place.

J. Horgan: I seek leave to make an introduction.

Leave granted.

Introductions by Members

J. Horgan: Hon. Speaker, on behalf of yourself, the member

for Surrey–Green Timbers, I would like to welcome, again, Wendy Kaland and her

grade 5 students from Surrey's Green Timbers Elementary School. This is the

second group to visit the chamber this morning. They're enjoying a very pleasant

tour, and I know they're very pleased to see their member of the Legislature

sitting in the Speaker's chair presiding over the proceedings here today.

Debate Continued

A. Dix: As the member for Malahat–Juan de Fuca said,

everybody who is here in the House is involved in some way in this bill.

Sometimes, as the member for Malahat–Juan de Fuca knows, we deal with bills that

have very narrow interests. Sometimes government decisions, like the decision to

give preferential treatment in a place, in a community — oh, let me just pick

one out of the hat: Jordan River — involve very narrow interests.

But in the case of this legislation, in the case of Bill 24, every

single person who's with us today is affected by it. Everybody watching today is

affected by it. Everyone not watching today — maybe most importantly, everyone

not watching today — is affected by the issues raised in this legislation.

That's why I think it's really our obligation as members of the opposition and

as all members of the Legislature — government members, as well, government MLAs

not in cabinet — to give this legislation a great deal of scrutiny.

There's an argument that this kind of legislation, with all of the

issues involved, with the system that's being put in place now — this

architecture for the system with people's health records in question — would

have been an ideal topic to be addressed by the Select Standing Committee on

Health. The outstanding Chairman of that committee, from West Vancouver, and

myself…. I think I might well be…. The committee hasn't been constituted since

I've been the Health critic, much to our disappointment.

[ Page 12166 ]

This issue, though, of personal privacy, of how to balance the

advantages of the expansion of e-health against the potential risks of the

development of e-health…. That subject area, the concerns that have been raised

about the contracts that have been let, would be an ideal subject for a referral

of the whole thing to a legislative committee to review, maybe over the summer.

You can even make the argument, I dare say — and it's something

that members of the House might consider — that this legislation should be put

off for that period, not to oppose it but to ensure that there's more public

understanding about the legislation and that we ourselves have gone over the

details of it to justify the important issues involved in the bill. There's an

argument for that. I'm not going to make that argument right now, of course,

because there's also an opportunity to raise some of those issues at committee

stage, I would guess, although there is not an ability at committee stage to do

what we really need to do, to do that well.

[1140]

Wouldn't it be important, wouldn't it be useful, for example, to

be able to call doctors who had concerns about the EMR system, to call doctors

who have left health authorities because of their concerns about the sharing of

information, to call ordinary citizens who have concerns about the potential and

what it would mean for them for their health information to leave the country?

They listen to the government to have them make the case and, hopefully, to

address those concerns, to have witnesses come before the committee and address

those concerns. If the government, in fact, proceeds as one would expect….

[Mr. Speaker in the chair.]

Certainly, in principle we support the bill, particularly with the

government's intention to make amendments made explicit now on the order paper.

This isn't a debate where we're fighting legislation and they're putting forward

legislation. This is a case of where we would hope the legislative process would

make improvements to this legislation.

I think the minister would have to agree with that, given that

he's tabled amendments today that we will be dealing with and that he referred

to in his speech here at second reading. Given that he's tabled legislation and

amendments today, he would agree that the process since first reading has

already led to improvements in the legislation.

What do some of the groups say? There are four groups that were

involved in this process and that tabled concerns, and here is sort of the crux

of their concerns. Who are they? The B.C. Civil Liberties Association, a highly

respected group in this province; the B.C. Coalition of People with

Disabilities, a very highly respected group in this province — they're all very

highly respected groups; the B.C. Freedom of Information and Privacy

Association; and the Persons with Aids Society.

What do they say? Well, they note — and this is good news for the

government — that patient and privacy groups were consulted on this legislation.

They were concerned, they had to say, when the bill was tabled at first reading.

They had an expectation — what they said they expected to see — around privacy

rights enshrined in an e-health bill consistent with the constitutional and

common-law right of Canadians to privacy of their personal health information —

that that right would be fully enshrined in the legislation.

One of the key issues. The minister has dealt with this issue a

little bit, we hope, and we hope we'll deal with this issue at committee stage.

They suggested — we talked about this earlier — that a pure consent model would

not work. I think that if they had their druthers they would probably prefer

that consent model, which would say that you kind of have to opt into the system

— as a patient, I mean. The only way your e-health information would become part

of the system would be for you to opt in. But I think most of us would argue

that that's unrealistic.

Why? Because, you know, we have things that we advertise for, like

elections, where people can opt in, and not all of them opt in. In fact, a

significant percentage of people — in the hundreds of millions of people in that

case — in spite of all of our efforts of all MLAs and the media and everything

else, choose to opt out. They opt out for their own reasons. In some cases,

opting out is a statement. In that case, not voting is a statement.

But in this case, in the case of Bill 24, it was generally thought

that that consent model wouldn't work because it would be too hard to launch a

campaign to get enough people integrated into the system for it to work. So the

model that was selected instead — that that fundamental right to privacy that we

talked about, that right enshrined in the B.C. Freedom of Information and

Privacy Act but also in the Charter of Rights and Freedoms and in the common

law, could be adequately protected by disclosure directives….

That's why I think that question — that central question that,

hopefully, we'll deal with at committee stage of this bill with the amendment

proposed by the government — is so central, and we have to discuss that, and we

have to involve it. So that's the first set of issues they have.

I want to just quote from their brief, because they believe…. They

have concerns about the number of people — even with that — who will now have

access to your health information, including…. I think they just don't know the

Minister of Health as I know him, but they say in this brief: "…including the

Minister of Health and other officials such as planners, managers and

researchers."

They say that the bill creates a huge conflict between, on the one

hand, the desire and legal right of individuals to keep their health information

private and to control who has access to their health information and, on the

other hand, the desire of government planners and managers for access to

personal health information for a wide range of secondary purposes.

[1145]

What does that mean in connection to this piece of legislation? It

means that this core debate, which needs

[ Page 12167 ]

to be resolved, I think, in the public mind…. And not just the public's mind,

if you will — the public that's directly involved in medical records, meaning

doctors, nurses and officials in the Ministry of Health and others. So there's

that public. They have to have confidence in the system and a belief in the

mechanisms that we are putting forward in Bill 24. That's really essential, and

I think we know that on the one hand. They need to have confidence in that

system.

On the other hand, the patient needs to have confidence in that

system. That's everybody. There's nobody excluded from that. When we pass this

legislation, every single person, hon. Speaker — you, me, our staff here in the

Legislature, all the MLAs, all the staff who work for government and all the

other people in British Columbia — will have the right to make disclosure

directives. In fact, this right may be exercised more than we would like.

So if, and this will be a crucial question, they aren't informed

about that right — their need to have that right that's contained here in

section 8 of this legislation — that, I submit, will be a serious issue. I think

that is a subject that should be publicized — that the government should make

every effort. That's good — how they spent $6 million promoting the idea of

sustainability. I think they might need to spend a little bit of money in that

case to let people know what their rights are once Bill 24 is passed and then

brought into force by regulation. They may have a period in between those two

events where they can do that.

It seems to me that is a necessity, in this case, that people not

just have the right but be informed of what's going on — beyond, of course, the

large television audience for these proceedings — but that all members of the

public have that right and have that information — the opportunity that's

contained in

section 8.

As we say, hon. Speaker, as the bill clearly says,

section 8

previously had disclosure directives that were inadequate. We've corrected that

problem.

Section 24 allows parts of the e-health system to be launched before

disclosure directives are fully implemented. They've dealt in part with that

problem, but not without comment from people. Let me just read the concerns, for

example, of Ross Harvey of the B.C. Persons with AIDS group. He says that

e-health is proceeding this year with the provincial laboratory information

system data system, the PLIS system, and perhaps PharmaNet too, bereft of all

but the most primitive, clumsy and unacceptable disclosure directives. That's

what he said.

So if you're going ahead with such a system, the public needs to

know. They need to be informed of their rights. It's not enough for us in this

Legislature to vote those rights. We have to do more than that. We have to

believe more than that. We have to, in fact, ensure that in this legislative

process they are informed fully. That argues for…. And we're not arguing for

this, but it argues, potentially, for committee hearings. That's what it would

argue for.

In some jurisdictions we go that route, where we invite witnesses

to come and say, "This is what we would like to see changed, and that's what we

would like to see changed," and the government to come and be cross-examined

about why that is. We do that process here at committee stage in the House —

that latter part of the process — but we don't have the former part of the

process when we deal with legislation.

Instead what often happens, and this is a problem, is that the

government introduces dozens of bills right at the end of the session and then

wants them passed right away without debate.

This is not, of course, what's happening here. We're having a very

significant and important debate on Bill 24. I think that's a good thing, but it

argues for that potentially, because the issues in this legislation are so

central.

Now, what else do these groups say about the legislation? They

say…. They deal with issues about the range of purposes that the minister can

use this information for, in

section 4 of the bill, that are neither what you'd

call planning or research. Many are management purposes for which access to

personally identified information is not necessary at all. That's what these

groups say.

[1150]

Which groups are they? They're not small groups. They're the B.C.

Civil Liberties Association, the B.C. Coalition of People with Disabilities —

all members of this House have met with representatives of both groups — and the

B.C. Freedom of Information and Privacy Association.

Let me say what an extraordinary job that group and its executive

director, Darrell Evans, do of bringing issues to our attention and the public's

attention, of fighting for the very rights of access to information from

government and, at the same time, for protection of the individual right of

privacy that all British Columbians need. Many groups and many of us are busy

with other issues.

But the B.C. Freedom of Information and Privacy Association, which

has presented a very significant brief, was involved in this process, was very

concerned about some of the decisions in this process and continues to be

concerned about some of the decisions in this process. They've put forward these

ideas. That's what they've said.

What else have they said? They've said that the different purposes

of the legislation should be separated out and clarified. Purpose should be

categorized for them — that's what they said — in five categories, as follows:

(1) health services planning, development, maintenance and improvement,

(2) health insurance and health services billing and administration, (3) management,

monitoring and evaluation necessary for the direct delivery of health care

services, (4) public health surveillance and management, (5) health research.

Now, they said that personal health information should not be

available for category 1, which is, to repeat, health services planning,

development, maintenance and improvement. That's what they said. They said that

they didn't think that was appropriate. And remember who these groups are. These

groups are interested. These were the groups that brought the public interest

test to this discussion. There are lots of broader tests.

[ Page 12168 ]

J. Horgan: I seek leave to make an introduction.

Mr. Speaker: Does the member for Vancouver-Kingsway

relinquish the floor?

A. Dix: I'm holding my place.

Mr. Speaker: Okay. Proceed, Member.

Introductions by Members

J. Horgan: I'm very reluctant to interrupt the member for

Vancouver-Kingsway when he's doing such important work, but I do want to take

the opportunity to advise this House that today we've had the pleasure of a

visit from two classes: Ms. Anderson and Ms. de la Salle from Discovery

Elementary School at Shawnigan Lake in my constituency of Malahat–Juan de Fuca.

The kids had a tremendous tour. I even took one of the classes into the basement

and showed them the dungeon. What grade 4 kid could resist that?

Debate Continued

Mr. Speaker: Member for Vancouver-Kingsway, noting the

hour.

A. Dix: Would you like me to note the hour, hon. Speaker?

Well, then, I will happily move adjournment of the debate.

A. Dix moved adjournment of debate.

Motion approved.

Speaker's Statement

RULES FOR PUBLIC BILLS

IN THE HANDS OF PRIVATE MEMBERS

Mr. Speaker: Hon. Members, I had the opportunity to review

Bill M206, Manufactured Home Park Tenancy Amendment Act, 2008, which was

introduced on April 30 by the member for Surrey-Newton. I note that sections 2

and 3 create an impost, and the bill is, therefore, out of order in the hands of

the private member and will not proceed to second reading.

Also, Members, I've had the opportunity to review Bill M205,

Residential Tenancy Act Amendment Act, 2008, which was introduced on April 29 by

the member for Coquitlam-Maillardville. I note that sections 1 and 6 create an

impost in the bill, and it is, therefore, out of order in the hands of a private

member and will not proceed to second reading.

Committee of Supply (Section A), having reported resolution, was

granted leave to sit again.

Hon. B. Penner moved adjournment of the House.

Motion approved.

Mr. Speaker: This House stands adjourned until 1:30 this

afternoon.

The House adjourned at 11:54 a.m.

PROCEEDINGS IN THE

DOUGLAS FIR ROOM

Committee of Supply

ESTIMATES: MINISTRY OF FORESTS

AND RANGE AND MINISTER

RESPONSIBLE FOR HOUSING

(continued)

The House in Committee of Supply (Section A); H. Bloy in the

chair.

The committee met at 10:10 a.m.

On Vote 36: housing and construction standards, $394,318,000

(continued) .

D. Thorne: I want to thank the minister and the staff for

coming out today to answer some questions. Right off the top, I'll say that two

hours will just be hardly enough time to even get started with the type of

questions that I have. I'm hoping, actually, with some of you that are here, the

staff and the minister, to continue this dialogue over the next year. I have had

many, many stakeholders who have been getting in touch with me and asking

questions that I have not been able to answer to my own satisfaction. So I'm

hoping to continue the dialogue after today, which I have actually started with

some of you.

I think what I'm going to do is just go through my pile, my issue

areas, and ask probably one question on each of them. Then, hopefully, I might

get back to a second round in the area, because I'm thinking I won't get through

all the questions, and I don't want to leave some areas out.

I just have some general questions around the service plans and

some statistics and a few questions in those areas. Then I was going to look at

a couple of HPO questions, manufactured homes, floating homes, residential

tenancy issues, stratas, and seniors housing. So I've narrowed down my original

list, which I think my LA sent off to Karen, of all the different areas that

fall under my critic area. Those are the areas I've concentrated on because I

think, perhaps, they're in the most crisis or the most important for this year.

I know that last year I did Ken's questions for HPO first because

he wanted to go home, and I'm happy to do that again.

Interjection.

D. Thorne: Okay, no problem. All right.

So, then, starting with the goals….

[ Page 12169 ]

Interjection.

D. Thorne: No, you can't go home. I'd like to go home too.

It's Thursday. We're not allowed to go home. But, you know, I'm always happy to

send Ken on his way if he wants to go — right? Yeah, sometimes you probably all

feel that way. Okay, we're not going to go down that road, not when I only have

till noon — right?

Looking at the general goals at the beginning of the service plan,

the first statement under goal 3 is affordable rental housing, and the private

market is becoming increasingly scarce. Then it goes into the vacancy rates,

which are even lower now — at 0.7 in Vancouver and 0.5 in Victoria — than when

this was written.

Then, of course, it talks about how in October the rental

assistance program was introduced. Now, I have always found that, as the

minister and the staff know, a bit of an oxymoron. The rent supp program, as

good as it is for some people…. It does change the lives of people who have good

rental accommodation and who are paying high, high percentages of their income

for rent. It makes a tremendous difference for those people.

But the government is admitting that there are virtually no

apartments to rent. So for the vast majority of people who might be eligible for

a rental supplement, it hardly qualifies as a housing program, because there

just are no apartments available. The supply is not there, and what is there is

dwindling daily.

I think that it's incumbent upon the provincial government to

start working with the federal government to try and bring in some tax

incentives and other programs to encourage the private market to start building

more rental housing.

[1015]

I know that I'm talking to people who know that it's been years

and years since we've had any significant new supply of rental housing. It's a

terrible, terrible problem, because the majority of people in the province are

still renters. With land prices the way they are, none of us see that changing

in the near future.

Market housing, market rental housing and all of those issues fall

under my critic area. I'm going to talk a little bit more about that in a

minute. I'm not going to spend too much time on it, though, because I just want

to get this into the record more than anything else. I know we're all aware of

these problems.

I guess my first question, then…. I know that over the last few

years since the rent supp program was introduced, we have made the entry level

easier and easier. I think now it's at $38,000 for income. I know that

originally in '06 when the minister announced the program, he said he was hoping

it was going to immediately benefit up to 15,000 families. I'm wondering if I

can have a figure — you know, the last figure at the end of last month or

whatever it would be — for how many people are actively involved right now in

getting rent supps in B.C.

Hon. R. Coleman: I'm going to clarify a couple of points

the member made. First of all, the majority of people in British Columbia do not

rent. About 70 percent of our population own their own homes, so I think that

that figure should be clear. On the rent supplement, the rental assistance

program threshold for income is $35,000, not $38,000. That was changed in this

year's budget. The number of people on the program today is over 4,800 families.

I do take exception when the member opposite says that…. Actually,

I forget what the comment was, but I can tell you…. I'll just give you one

quote. A lady by the name of Savannah, a single mother with a young man who is

12 years old, wrote me. She wrote me a letter personally, handwritten, and said:

"Thank you for changing our lives. You have made all the difference in the world

to both my son and myself. He can now participate in organized sports. We have

better health, we have better nutrition, and our fear of affordability in our

home is gone."

You know, when $338 is the average amount that a person gets on

rent assistance, it makes a big difference to those people. The actual fact of

the matter is that 4,800-plus families plus, I think, 16,000 seniors all receive

some form of rental assistance in British Columbia today, just so they can stay

affordably in their homes where they are. I can tell you that in the 18 months

of the program…. The member is correct: our goal is 15,000. We didn't say we'd

get 15,000 the first month. We've adjusted the program. We started out at a

$21,000 income. We took it to $28,000 in income. We've now taken it to $35,000

in income.

I have reams of notes and letters from people who tell me what a

big difference this has made in their lives for the risk of homelessness because

they're now affordable. I have had reams of letters from people who actually

think it's one of the greatest things that's ever happened for them because it's

changed their lives.

I know that if in an 18-month period anybody thought they could go

out and build 5,000 units for people…. If you had the land, could go on the

ground and then go through the zoning…. The member used to be a member of local

government and knows the time frame just to do that. Then you've got to build

it. It would take you three years, maybe, to get a piece of property done.

Now, if you add 5,000 units onto that figure, if it's 50 units per

unit, it doesn't take long to figure out how many rezonings in properties and

stuff you have to find in order to find that affordable housing stock when you

can help those people immediately. If you can have them helped immediately, you

change their lives immediately. When you change their lives immediately, a whole

bunch of things happen. Somebody doesn't sit on a waiting list for three or four

years while their teenaged child isn't getting the proper nutrition, because all

of a sudden the money is there immediately. Somebody's life changes because of

those types of things.

[1020]

Now, the member did make a very valid point with regards to

affordable rental housing in British Columbia. For the member's information, we

have been trying to work with the federal government. All the Housing ministers

across the country have been basically trying

[ Page 12170 ]

to get the federal government to recognize that if they could move back to

some form of tax incentives, recapture on capital gain, we could get some more

rental housing built in our communities.

There are other ways to do it, as well, though. Communities, when

they're doing their plans and when they want to add density, can make some of

that density contingent on some rental housing being included into projects by

adding more density into it and trading it off with the development community.

The affordability factors can be addressed with how you deal with your

development cost charges on rental housing, how much parking you require — those

sorts of things.

Certainly on the federal side, the federal Ministers for Housing

have been meeting…. I was the chair for a year and a half. Since I've been

minister, I think I've had three federal ministers responsible for the Housing

portfolio. The present minister, I think, is live to the issue in and around

taxation, and I know that discussion is taking place. But certainly it would be

helpful if we could have some incentives to create some more rental housing

stock in our communities.

But it's not just the federal government. It's also the

densification, stuff that needs to be done at the local government level in

cooperation with all levels of government, quite frankly. That's why we have a

piece of legislation that we recently brought to make sure that we can do

supportive housing in communities, that this gets included in community plans so

that these big public hearings, which the member is probably familiar with, take

place every time somebody wants to build some housing for someone less

fortunate. All of those things are pieces of the puzzle.

That's where it is right now. We're actually very pleased to see

that we're getting much more increase in interest as we've raised the income,

because more people are eligible.

D. Thorne: Thank you for all that information, which really

didn't have much to do with my question. I'm talking about the lack of supply of

rental housing. I do stand corrected on saying there are more renters than

homeowners. I know that. I don't know where that came from, actually. I just

think there are more and more renters coming on the market all the time because

of the high cost of home-ownership. I think in time we'll find that unless we

are more creative around new kinds of home-ownership for entry-level people,

that ratio is going to change. We will see that in years to come.

I'm talking about supply. I said right off the top that I thought

rent supps are terrific for people who are paying a high percentage of their

income for rent, if they have good accommodation. However, the rental market is

fraught with problems. The Residential Tenancy Act is full of loopholes. That's

my word. I'm using that word because right away everybody on the other side

knows what I'm talking about. I don't have to use a lot of language. It's full

of loopholes that can be used — are not always used, and I want that made clear,

but can be used — against tenants.

Tenants are in a very vulnerable position where landlords are

concerned. I know that we have staff here from the residential tenancy branch.

We have discussed this ourselves privately. There are a lot of problems in the

rental market. Rent supps are one part of a problem — the financial end of the

problem. However, when we only have 4,000 people….

I remember. I was at the announcement in '06 — if it wasn't at the

UBCM, it was right around the UBCM time — and the minister did say that he

immediately thought there would be — and I don't want to get into a tangle of

words on that — 15,000 people who would be helped.

I think the program has probably been a big disappointment in

terms of numbers, in terms of the uptake for the Ministry for Housing because

4,000 people, give or take, is not a huge number of people. So one of the things

that I have asked before, and I know other people have asked, is: why, for

instance, are we not sending out information on rent supps through a program

like MSP, where it will reach everybody in British Columbia?

[1025]

There are still people renting out there that I talk to that

didn't know there was a rent supp program. They don't read newspapers or

whatever, for whatever reason. So there are some things we can do. We can

increase the supply, number one, to help renters. If you increase it, you can

get the word out better on rent supplements, make an effort that's more

coordinated rather than ads scattered throughout newspapers. Get the word out

about rent supps.

Let's get those numbers up. Let's get them up to 15,000. If the

minister thinks that the opposition doesn't want to get those numbers up, the

minister would be wrong. I would like to see 15,000 or more people in British

Columbia who can find apartments and get rent supps to help their lives get more

on track.

I know that story the minister just told about the woman. He's

told it before. I've heard it before. I could tell stories about people that I

know and that I've met for whom rent supps have helped. That's not the issue.

The issue is supply. The issue is that getting rent supplements does not help

you find an apartment if there are no apartments. It doesn't help you if you're

in the grip of an unscrupulous landlord — somebody, for instance, who will take

advantage of what I was calling the loopholes, like

section 49 in the

Residential Tenancy Act, where people can be evicted for renovations.

You know, there's so little qualification for doing that. I mean,

we have tenants in the west end who are now comparing the renovations in

buildings from where they were evicted a couple of years ago and from where

people are just being evicted now — the same sort of: "Oh yeah, the white

bathtub." I mean, everybody is talking about that. The level of renovations

seems to be getting lower to qualify for evicting a whole building and putting

people out, possibly on the street, when there is no stock for them to go into.

We're worried about homelessness and all those other issues, yet

we are not doing anything with the Residential Tenancy Act, where it is too easy

for a landlord. A

[ Page 12171 ]

landlord can go in, evict people and not even have the permits yet from the

city. It's happened in New Westminster; it's happened in Vancouver. They should

have to have those permits in hand before people are evicted, and there should

be somebody at the residential tenancy branch who makes sure that these are

genuine renovations. Too many renovations are being done while people still live

in the building — minor to medium renovations.

When I brought in my private member's bill…. The ministry probably

hasn't even looked at it. It's modelled on the Ontario bill, which was an

amendment bill two years ago, around the rights of first refusal. In Ontario

it's working very, very well. They were having exactly the same kinds of

problems that we're having here with evictions. Rents then sometimes were being

up to doubled after minor renovations are done, and there goes more affordable

housing stock.

How can we, on the one hand, have rent supplements and, on the

other hand, watch without doing anything while landlords…? It's like the old

scales of justice. It's just another model of it.

I'm not criticizing rent supps. I'm glad there are 4,000 people

getting them. I hope they don't get evicted next week, all of those people, from

their apartments, because their rent supps won't help them then.

So we have a huge problem in the rental area in British Columbia.

Ontario did too. They saw the light, and two years ago they brought in some

changes to the act, and things are starting to even out a little bit now in

Ontario.

I have hundreds of e-mails here and in my office from people who

are having problems with the residential tenancy branch, and landlords as well.

I mean, I gave one of your staff, I think the director, a copy of an e-mail that

I had recently from a landlord who was finding the same problems with the

residential tenancy branch as many of the tenants are.

I'm very happy. The minister told me yesterday, when I asked him a

question in question period, that in fact that very day — which is, amazingly,

such a coincidence that I can hardly imagine it happening…. Yesterday, the very

day I asked the question, he had just hired a number of new staff for the

branches. That is very good news for the renters in British Columbia and the

landlords as well.

[1030]

A reporter called me from The Vancouver Sun the

other day. She was waiting on the line to get through to the branch for 50

minutes — a reporter. She phoned me right afterwards. She said: "How is this

who are seniors or who are disabled — who maybe don't even have a telephone

because they can't afford one…? How do they sit on a line for 50 minutes to get

through that first call to the residential tenancy branch?" This is a reporter

from a newspaper.

I hope, in any case, that the minister is not going to stand up

and spend 15 minutes telling me how the residential tenancy branch is going to

be perfect now that they've hired these extra people. There are other problems

besides the wait times. There's the dispute resolution process itself. I really

want the minister to tell me how he is going to fix that process, because I

heard him say: "If this doesn't work, I will fix it." That's a pretty big

promise to make to the residents of British Columbia and all of the renters.

I want to know how he is going to fix the telephone dispute

resolution process. I know that it works for the majority of people — people who

everything works out just fine. But there are too many people — the most

vulnerable people — who the system is not working for.

I think we have to have a system where we can somehow

differentiate between people who are vulnerable and need a little extra

assistance and possibly need their dispute resolution to be done in person

rather than on the telephone…. We have to have a way, and we also have to look

at the review process. When somebody has failed or been turned down in their

process, we have to do something different in the review process rather than

just have another lone arbitrator making another decision based on the same

facts. That part of the system may be the weak link.

I just want the minister to tell me that he's going to review this

process and make sure that it is working up to speed. If he does review the

process and is assured and can assure me and the renters of British Columbia

that it is working for 99 percent of the people — of course, we will never get

it absolutely perfect — then next year when I stand up here, I'll have a

different kind of question.

The Chair: All members, direct it through the Chair.

D. Thorne: Through you, Mr. Chair. I know I sounded like I

had a lot of questions there, but they were really just me making a bunch of

points.

My question is: will you tell me and the renters of British

Columbia that you will have your staff review the act, review the dispute

resolution process and fix the kinks, the loopholes — whatever we want to call

them — that are in it? Can you assure me and the renters that you will do this?

Hon. R. Coleman: The member started out questioning whether

we're going to do something with the federal government with regards to trying

to do something on rental housing. I had answered that question when you were

talking to the member for Cowichan-Ladysmith — that we had been in conversation

with the federal government, that all Housing ministers across the country have

identified that issue as an issue, that we would like to see them do something

with taxation.

I went on to explain that through density and some management at

the municipal level, they could also help with regards to…. You know, our

communities have to start to recognize density as an opportunity. If you're

going to give somebody a few higher floors, maybe you could ask for some rental

to be put into the building, which would then be able to be tied into a

[ Page 12172 ]

rent supplement program even for the owners with regards to that.

You can see how some people change how they do business in B.C. We

have one community in British Columbia right now that, if you want to put a

legal suite in a home — which, frankly, is a very good form of affordable

housing for many people…. There are many very good basement suites or secondary

suites in homes. We have one community in B.C. that actually charges a second

$25,000 development cost charge if you want to do that. Yet they come to us and

ask us to solve a problem with rentals in their community, when they do that to

the people that might be able to deliver it.

[1035]

The member also spoke about the rental assistance program. You

know, when we announced this program, we had about 15,000 people, according to

the statistics on the one line of the Revenue Canada lines, who we felt would

probably come forward. As it turns out, that's why we moved the income level up,

to change it. As it turns out, oftentimes people are reporting incomes

separately, but there could be dual-income households. So we actually moved it

up, as we've learned from the experience of doing this. We think 4,800-plus

people is actually a pretty good start. I'm actually quite proud of that

program, and we'll continue to build on it.

I want to sort of caution the member, just only on one way of

thinking. That is this: there are over 500,000 renters in British Columbia

today, and not all of them have problems with their landlords. As a matter of

fact, there are a lot of people who honour that business relationship between

the two parties, tenants and landlords alike.

In everything that's that large you're going to have some players

that aren't particularly good, both landlord and tenant. That's what the entire

Residential Tenancy Act is supposed to deal with.

When the act was changed, there was an automatic tenancy agreement

put in place so that if nobody signed a tenancy agreement, there was one deemed

to be in place, which is an addendum to the act. It states pretty clearly what

that relationship is between people.

As I said, we actually canvassed this yesterday with members from

your caucus with regards to residential tenancies. I'll give some of the same

answers that I gave to them yesterday afternoon, because some of your members

came in and wanted to talk about residential tenancy. So it's a bit of

duplication for Hansard . I apologize.

Basically, a year or so ago in 2006-2007, our average waiting time

was 90 minutes. That wasn't acceptable. I said that yesterday. In 2007-2008 it

was at 55 minutes — still not acceptable. The current phone waits are 40

minutes, based on demand. Frankly, even though it's down again, it's still not

acceptable to us. But we are getting it there.

What we have done is basically changed a number of things over the

last few years. There used to be an arbitration system where arbitrators were on

contract. They would work as much or as little as they liked and on however many

arbitrations they wanted in a period of time.

We moved to dispute resolution officers, who are now employees,

who can do more capacity and do more work and who now can be measured with

regards to their decisions so we can actually see that there's some

understanding for people as to what constitutes a breach on either side,

landlord or tenant.

The residential tenancy branch now works two afternoons per week

in the downtown east side of Vancouver. It's working with the city of Vancouver

to expand this to five afternoons per week. If that's successful, we're going to

consider a further increase.

The Kelowna office is expanding to provide better service to the

Okanagan and the rest of the province through the call centre. We're actually

putting a call centre in Kelowna. We provide service through Service B.C. to 59

locations around the province.

For dispute resolution hearings, orders of the possession,

emergency and the tenancy matters are currently being scheduled within three

weeks. RTB is improving instructions to conference call hearings so participants

won't be confused and miss hearings.

The budget has been increased by over $2 million for the branch,

and the reason for that is to be able to bring more capacity to it. Basically,

there are a number of other things that we're doing as well that the member

talked about. We'll go on to more specific questions.

D. Thorne: Well, I'm certainly very happy to hear that

you're going on to the conference call system, because that will eliminate a lot

of the problems that I know are out there with people waiting and not getting

through to their calls. So that's very good.

I'm not sure what a call centre means in Kelowna. I was hoping

that the office would be back to a full-time office, but the minister….

Interjection.

D. Thorne: It is. Okay. I'm just not familiar with the

terminology. It's the residential ten