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British Columbia — Debates (Hansard)

Fourth Session, 38th Parliament OFFICIAL REPORT OF DEBATES OF THE LEGISLATIVE ASSEMBLY (HANSARD) Tuesday, April 29, 2008 Morning Sitting Volume 31, Number 6 THE HONOURABLE BILL BARISOFF, SPEAKER ISSN 0709-1281

PROVINCE OF BRITISH COLUMBIA (Entered Confederation July 20, 1871) LIEUTENANT-GOVERNOR His Honour the Honourable Steven L. Point, OBC FOURTH SESSION, 38TH PARLIAMENT SPEAKER OF THE LEGISLATIVE ASSEMBLY Honourable Bill Barisoff EXECUTIVE COUNCIL Premier and President of the Executive Council ............................................................................................................Hon. Gordon Campbell Deputy Premier and Minister of Education and Minister Responsible for Early Learning and Literacy...................... Hon.

Shirley Bond Minister of Aboriginal Relations and Reconciliation ........................................................................................................ Hon. Michael de Jong Minister of Advanced Education and Minister Responsible for Research and Technology ........................................... Hon. Murray Coell Minister of Agriculture and Lands.......................................................................................................................................................Hon.

Pat Bell Attorney General and Minister Responsible for Multiculturalism............................................................................... Hon. Wally Oppal, QC Minister of Children and Family Development ................................................................................................................Hon. Tom Christensen Minister of State for Childcare ........................................................................................................................................................Hon.

Linda Reid Minister of Community Services and Minister Responsible for Seniors’ and Women’s Issues........................................... Hon. Ida Chong Minister of Economic Development and Minister Responsible for the Asia-Pacific Initiative and the Olympics.................Hon. Colin Hansen Minister of Employment and Income Assistance ...........................................................................................................Hon.

Claude Richmond Minister of Energy, Mines and Petroleum Resources .......................................................................................................Hon. Richard Neufeld Minister of State for Mining......................................................................................................................................................Hon. Kevin Krueger Minister of Environment and Minister Responsible for Water Stewardship and Sustainable Communities ...............Hon.

Barry Penner Minister of Finance.......................................................................................................................................................................Hon. Carole Taylor Minister of Forests and Range and Minister Responsible for Housing ............................................................................. Hon. Rich Coleman Minister of Health ......................................................................................................................................................................Hon.

George Abbott Minister of Labour and Citizens’ Services ......................................................................................................................................Hon. Olga Ilich Minister of Public Safety and Solicitor General and Minister of State for Intergovernmental Relations............... Hon. John van Dongen Minister of Small Business and Revenue and Minister Responsible for Regulatory Reform............................................ Hon.

Rick Thorpe Minister of Tourism, Sport and the Arts ......................................................................................................................................Hon. Stan Hagen Minister of State for ActNow B.C. ............................................................................................................................................ Hon. Gordon Hogg Minister of Transportation...........................................................................................................................................................Hon.

Kevin Falcon LEGISLATIVE ASSEMBLY Leader of the Official Opposition .........................................................................................................................................................Carole James Deputy Speaker ....................................................................................................................................................................................Sindi Hawkins Deputy Speaker ...........................................................................................................................................................................

Katherine Whittred Assistant Deputy Speaker.....................................................................................................................................................................Sue Hammell Deputy Chair, Committee of the Whole................................................................................................................................................. Harry Bloy Clerk of the Legislative Assembly .........................................................................................................................E.

George MacMinn, OBC, QC Clerk Assistant.........................................................................................................................................................................................Robert Vaive Clerk Assistant and Law Clerk .......................................................................................................................................................Ian D. Izard, QC Clerk Assistant and Clerk of Committees ....................................................................................................................................... Craig H.

James Clerk Assistant and Committee Clerk ..........................................................................................................................................Kate Ryan-Lloyd Sergeant-at-Arms............................................................................................................................................................................. A.A.

Humphreys Director, Hansard Services ...................................................................................................................................................................Jo-Anne Kern Legislative Librarian ..................................................................................................................................................................................Jane Taylor Legislative Comptroller...............................................................................................................................................................................Dan Arbic

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

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

Gordon (L) .........................................Vancouver–Point Grey Cantelon, Ron (L)..............................................................Nanaimo-Parksville Chong, Hon. Ida (L) .................................................... Oak Bay–Gordon Head Chouhan, Raj (NDP) ...........................................................Burnaby-Edmonds Christensen, Hon. Tom (L) ................................................. Okanagan-Vernon Chudnovsky, David (NDP) ......................................... Vancouver-Kensington Coell, Hon.

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

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

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

Colin (L) ..................................................Vancouver-Quilchena Hawes, Randy (L).......................................................... Maple Ridge–Mission Hawkins, Sindi (L) ............................................................... Kelowna-Mission Hayer, Dave S. (L) ................................................................ Surrey-Tynehead Hogg, Hon.

Gordon (L).....................................................Surrey–White Rock Horgan, John (NDP)......................................................Malahat–Juan de Fuca Horning, Al (L)........................................................... Kelowna–Lake Country Ilich, Hon. Olga (L)...............................................................Richmond Centre James, Carole (NDP).......................................................Victoria–Beacon Hill Jarvis, Daniel (L)..................................................

North Vancouver–Seymour Karagianis, Maurine (NDP) ........................................... Esquimalt-Metchosin Krog, Leonard (NDP)......................................................................... Nanaimo Krueger, Hon. Kevin (L) .....................................Kamloops–North Thompson Kwan, Jenny Wai Ching (NDP)........................... Vancouver–Mount Pleasant Lali, Harry (NDP)........................................................................

Yale-Lillooet Lee, Richard T. (L)....................................................................Burnaby North Lekstrom, Blair (L).............................................................. Peace River South Les, John (L)........................................................................ Chilliwack-Sumas Macdonald, Norm (NDP).................................... Columbia River–Revelstoke MacKay, Dennis (L)....................................................

Bulkley Valley–Stikine Mayencourt, Lorne (L).......................................................Vancouver-Burrard McIntyre, Joan (L).................................................West Vancouver–Garibaldi Neufeld, Hon. Richard (L) .................................................. Peace River North Nuraney, John (L).............................................................Burnaby-Willingdon Oppal, Hon. Wally, QC (L).......................................... Vancouver-Fraserview Penner, Hon. Barry (L)...........................................................

Chilliwack-Kent Polak, Mary (L) ....................................................................................Langley Puchmayr, Chuck (NDP)...................................................... New Westminster Ralston, Bruce (NDP) ............................................................. Surrey-Whalley Reid, Hon. Linda (L) ................................................................ Richmond East Richmond, Hon. Claude (L).............................................................

Kamloops Robertson, Gregor (NDP) ................................................Vancouver-Fairview Roddick, Valerie (L).......................................................................Delta South Routley, Doug (NDP)..................................................... Cowichan-Ladysmith Rustad, John (L) ........................................................

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

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

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

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

Bob Simpson Cariboo South..............................................................................Charlie Wyse Chilliwack-Kent ..................................................................Hon. Barry Penner Chilliwack-Sumas............................................................................... John Les Columbia River–Revelstoke................................................. Norm Macdonald Comox Valley........................................................................ Hon.

Stan Hagen Coquitlam-Maillardville..............................................................Diane Thorne Cowichan-Ladysmith ................................................................. Doug Routley Delta North ...................................................................................Guy Gentner Delta South ............................................................................. Valerie Roddick East Kootenay................................................................................

Bill Bennett Esquimalt-Metchosin.........................................................Maurine Karagianis Fort Langley–Aldergrove ..................................................Hon. Rich Coleman Kamloops.....................................................................Hon. Claude Richmond Kamloops–North Thompson ............................................Hon. Kevin Krueger Kelowna–Lake Country.................................................................. Al Horning Kelowna-Mission ......................................................................

Sindi Hawkins Langley ...........................................................................................Mary Polak Malahat–Juan de Fuca .................................................................. John Horgan Maple Ridge–Mission ................................................................ Randy Hawes Maple Ridge–Pitt Meadows ..................................................... Michael Sather Nanaimo......................................................................................

Leonard Krog Nanaimo-Parksville .....................................................................Ron Cantelon Nelson-Creston .............................................................................Corky Evans New Westminster .................................................................. Chuck Puchmayr North Coast....................................................................................

Gary Coons North Island ...............................................................................Claire Trevena North Vancouver–Lonsdale................................................Katherine Whittred North Vancouver–Seymour..........................................................Daniel Jarvis Oak Bay–Gordon Head ........................................................... Hon. Ida Chong Okanagan-Vernon......................................................... Hon. Tom Christensen Okanagan-Westside..............................................................Hon.

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

Nicholas Simons Prince George North.................................................................... Hon. Pat Bell Prince George–Mount Robson ............................................Hon. Shirley Bond Prince George–Omineca................................................................ John Rustad Richmond Centre......................................................................Hon. Olga Ilich Richmond East........................................................................Hon.

Linda Reid Richmond-Steveston...........................................................................John Yap Saanich North and the Islands ............................................ Hon. Murray Coell Saanich South ........................................................................ David Cubberley Shuswap............................................................................Hon. George Abbott Skeena.......................................................................................... Robin Austin Surrey-Cloverdale............................................................... Hon.

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

Gordon Hogg Vancouver-Burrard..............................................................Lorne Mayencourt Vancouver-Fairview.............................................................Gregor Robertson Vancouver-Fraserview .................................................Hon.

Wally Oppal, QC Vancouver-Hastings .................................................................Shane Simpson Vancouver-Kensington.......................................................David Chudnovsky Vancouver-Kingsway ......................................................................Adrian Dix Vancouver-Langara ........................................................... Hon. Carole Taylor Vancouver–Mount Pleasant........................................ Jenny Wai Ching Kwan Vancouver–Point Grey ................................................Hon.

Gordon Campbell Vancouver-Quilchena.........................................................Hon. Colin Hansen Victoria–Beacon Hill...................................................................

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

CONTENTS Tuesday, April 29, 2008 Morning Sitting Routine Proceedings Page Introductions by Members ....................................................................................................... ............................................ 11673 Introduction and First Reading of Bills........................................................................................ ....................................... 11673 Protected Areas of British Columbia (Conservancies and Parks) Amendment Act, 2008 (Bill 38) Hon. B.

Penner Second Reading of Bills........................................................................................................ ................................................. 11674 Medicare Protection Amendment Act, 2008 (Bill 21) (continued) A. Dix M. Polak N.

Macdonald Proceedings in the Douglas Fir Room Committee of Supply............................................................................................................ ................................................. 11689 Estimates: Ministry of Economic Development and Mini ster Responsible for the Asia-Pacific Initiative and the Olympics (continued) Hon. C. Hansen D. Routley R. Fleming

11673 TUESDAY, APRIL 29, 2008 The House met at 10:02 a.m. [Mr. Speaker in the chair.] Prayers. Introductions by Members C. Trevena: In the gallery this morning are 25 grade 6 students from Georgia Pa rk Elementary, and they're going to be joined by their teacher Mary Begg and parents. They're at the start of a month-long study of government systems, and they evolve through coming to see what we do down in the House and learning all about different sorts of governments. I hope the House will make these students from Campbell River very welcome.

Introduction and First Reading of Bills PROTECTED AREAS OF BRITISH COLUMBIA (CONSERVANCIES AND PARKS) AMENDMENT ACT, 2008 Hon. B. Penner presented a message from His Hon- our the Lieutenant-Governor: a bill intituled Protected Areas of British Columbia (Conservancies and Parks) Amendment Act, 2008. Hon. B. Penner: Mr. Speaker, I move that the bill be introduced and read a first time now. Motion approved. Hon. B. Penner: It's with great pleasure that I introduce the Protected Areas of British Columbia (Conservancies and Parks) Amendment Act, 2008.

This bill contains amendments to the Protected Areas of British Columbia Act to continue this government's expansion of British Columbia's parks and protected areas system, including the creation of conservancies on the central coast, north coast and Haida Gwaii as well as the Morice and Sea to Sky areas. This bill continues the work of implementing land use decisions by protecting in legislation some of the most significant, spectacular and ecologically diverse landscapes and coastal areas in the entire world.

The creation of these parks and conservancies is taking place in the broader context of land use agreements and plans that will also pr ovide certainty for land use to support economic opportunities for communities.

This balancing of environmental stewardship with economic development is based on a historic collaboration that has taken place between first nations, industry, conservation organizations, local governments and many other stakeholders to arrive at the central coast and north coast land use decisions that were announced by the Premier two years ago. [1005] In 2006, 24 new conservancies were established pursuant to those decisions, followed by 41 additional conservancies last year.

The amendments in this bill will complete the implementation of the protected ar- eas component of the north coast and central coast land use decisions. Fifty new conservancies will be established by these amendments, and two existing areas under the Environ- ment and Land Use Act will be converted to conservancies. Additions will also be made to two existing conservancies. The addition of these conservancies, along with others being established in other parts of the province that I will note in a moment, will bring the total number of conservancies in British Columbia to 135.

There are also amendments to the act that will make changes to the protected areas system in other parts of the province as well. Seve n new conservancies in six new class A provincial parks will be established in the northwest part of the province pursuant to the Morice land and resource management plan. Nine new conservancies and additions to two existing class A parks are being made in accordance with the Sea to Sky land and resource management plan for the area in and around Squamish to Pemberton — in that corridor.

For example, Duffey Lake Provincial Park will increase in size by 93 percent to 4,048 hectares. Two new conservancies will be established on Haida Gwaii, otherwise known as the Queen Charlotte Islands, to begin the implementation of the Haida Gwaii land use agreement. These two conservancies will cover 147,759 hectares in total. Four new class A parks are being established pursuant to the… Mr. Speaker: Could the minister put the question. Hon. B.

Penner: …Okanagan-Shuswap — one last sentence — resource management plan, along with the conversion of the Kalamalka Lake protected area to class A park status in addition to the existing Kalamalka Lake Park. The addition to the existing class A park plus the area of the four new parks in the Okanagan- Shuswap region totals 3,600 hectares. Mr. Speaker: Question, Minister. Hon. B. Penner: I move this bill be placed on the orders of the day for second reading at the next sitting of the House after today.

Bill 38, Protected Areas of British Columbia (Conservancies and Parks) Amendment Act, 2008, introduced, read a first time and ordered to be placed on orders of the day for second reading at the next sitting of the House after today. Orders of the Day Hon. B. Penner: I call continued second reading debate on Bill 21, Medicare Protection Amendment Act, 2008. Mr. Speaker: And in Committee A?

11674 B RITISH COLUMBIA DEBATES T UESDAY, APRIL 29, 2008 Hon. B. Penner: For the information of members, continued debate of the Ministry of Economic Develop- ment budget estimates. Second Reading of Bills MEDICARE PROTECTION AMENDMENT ACT, 2008 (continued) A. Dix: As we were leaving the debate yesterday, you will recall that the minister gave one of, I think, the most irrelevant second reading speeches we've ever heard in this Legislature. He chose not to defend his legislation, explain his legislation or explain the purpose or the need for the legislation at all. [K.

Whittred in the chair.] Presumably, that invites a lengthy committee stage debate that will come, for him to explain the reasoning of the legislation. But you'll recall that this legislation really comes out of an idea from the Premier — an idea of the Premier's that he believes. He wanted to mitigate some of the principles of the Canada Health Act, principles that are supported by every political party in Canada, including the federal Conservative Party — except, apparently, the B.C. Liberal Party.

His intent in bringing forward this idea in 2006, in campaigning on the idea and spending $6 million in public funds to promote the idea, in asking people in the Conversation on Health to endorse the idea…. They declined. His idea was to pu t this forward to limit and to mitigate principles that are fundamental to our public health care system such as universality, accessibility, comprehensiveness and the others. That's the purpose of the legislation. In a sense, what he's doing is changing the obligation.

Instead of saying to government that we have a public health care system and it needs to be universal and comprehensive, he's giving government an argument in the debate that it should not be. That's the effect of the legislation. It could not be any other effect. The effect is, in fact, to defend the financial interests of the government against the sick. That's the purpose of this. [1010] The five principles of medicare work together to define a health care system that is public, that is comprehensive, that is universal, and that is portable and accessible for all.

This government has decided that its issue in health care is to attack those principles, to say those principles should be mitigated, that the problem with public health care is that it's universal. The problem with public health care is that it's intended, at least until this government came to office, to be comprehensive. That's the problem. That's the mischief, if you will, that they want to resolve by this legislation. In fact, as you can see — and certainly as you can see from the health care record of the government — that's the direction we're going to. Hon.

Speaker, you'll recall that this is a slight change in their position — what they used to say. They used to talk about health care where and when you need it. That was a campaign pledge by the Premier in 2001. The minister talked about other pledges they made in 2001, which they broke with respect to long- term care, home care, acute care. Promises broken, promises broken, promises broken. The minister bragged that we've dropped in per- capita funding from second place to seventh place in Canada. He bragged about that.

He thinks that's a good thing — that he carves money out of the health care system and shifts costs from the health care system to the sick. They think that's a good thing. That's their approach, and that is the purpose of this legislation. Now, it is surprising, as we noted yesterday, that the government really has no explanation and no de- fence for this legislation. Clearly, what happened is that this was the Premier's idea, and everyone else re- jected it. You know, George Bush in the United States calls himself the Decider. The Premier in British Columbia is the Decider. You'll recall, hon. Speaker….

My friend from Saanich South will recall this, because he asked questions about it in this Legislature. In 2003 another Minister of Health brought forward a medicare protection amendment act that would have strengthened public health care, which would have given the government the capacity to find out what was going on in the system. The Premier intervened in that debate and said he wasn't involved in the debate. It apparently got through cabinet and the Legislature without the Premier knowing, but the Premier got some phone calls from his allies in for-profit health care. All the groups supported it.

Everyone supported it. Everyone thought it was a good idea. It was intended to ensure that the Canada Health Act was respected in British Columbia. The Decider — our George Bush, if you will — the Premier, said no, even though the effect of that politically, I might add, was to humiliate a senior cabinet minister, the former Minister of Health and current Minister of Economic Development. That didn't matter to the Premier, because there were other interests at bay.

He was against strengthening the Medicare Protection Act at the time to protect the prin- c i p l e s o f t h e C a n a d a H e a l t h A c t , a n d h e r e h e g o e s again. No one else supports this. The government can't explain what its purpose is, what the intent is, what the role of adding this principle in medicare is, what its effect will be in the debate. I'm sure we'll ask the minister at committee stage what legal opinions he has to support this, and I'm sure he'll say: "Oh, those legal opinions are confidential.

We can't talk about that." But he's also failed in this debate to provide any rationale for the impact this will have during his hour-long diatribe on the 1990s — any rationale for why this is needed now except that apparently the Premier wants it. He's spoken about some of these issues before, but let's talk about what other people say. You remember that yesterday, hon. Speaker, during the debate the

TUESDAY, APRIL 29, 2008 B RITISH COLUMBIA DEBATES 11675 M i n i s t e r o f H e a l t h w e n t o n a t l e n g t h . H e s u g g e s t e d that this information came from the Canadian Centre for Policy Alternatives. It talks about provincial health spending as a share of GDP. It's gone — 2002 to 2007 — from 7.4 percent to 6.9 percent. The minister said…. What did he say about that? He said that was entirely without basis. It is utter nonsense. You'll recall that the source of that information, of course, was the government itself.

So his conclusion may not have been that surprising, but who he was talking about when he said…. I'm quoting from him here, because one wouldn't want to misquote the Minister of Health. He called it specious. He said: "It's entirely without basis. It is utter nonsense." Well, the source was, of course, the B.C. Financial and Economic Review , page 95. And who produces that document? Who's responsible for that document — what the Minister of Health calls utter nonsense, entirely specious and entirely without basis?

Well, it happens to be the Ministry of Finance. [1015] I want to say "the Ministry of Finance" here — and of course, responsible in the House, the Minister of Finance. That's who he was referring to. Of course, the same information is available from the Canadian Institute for Health Information in every budget they ever produce, because it's an easy calculation to make. Once you add the GDP numbers and add the health spending numbers, you make the calculation. It's gone from 7.4 percent to 6.9 percent. Apparently, the government is ignorant of the basic facts about health care in this province.

That's what they're saying. I don't know if they are. I think that may have just been…. It's possible that it may have been an excuse for the Minister of Health to attack someone who disagrees with him. It may have been just an excuse. But the fact of the matter is that the Minister of Health was wrong in this House. He discussed it at length in this House. He was wrong. The source of the information was his own government. What it says, and what that information said was….

What it says, if you take it back 20 years, is that health care spending as a percentage of GDP in the province has gone roughly from 6.1 pe rcent to 6.9 percent today. That's over 20 years. Spending out of control? Sustainability out of control? I don't think so. I don't think by most measures, most evidence-based measures, that's spending out of control. Since this government came to office and started closing acute care beds and breaking its promise on long-term care and so on, we've gone from 7.4 percent to 6.9 percent. Now, what do independent observers say about this debate?

Here's another group that the minister when he wraps up may be able to cast aspersions on: the Canadian Health Services Foundation. They've produced a document that addresses the core of the government's argument in this bill. What does this document say? It says: "Canada's system of health care financing is unsustainable." But you know what the document is? It's called Myth Busters .

"Myth: Canada's system of health care financing is unsustainable." It refers to the fact, which is self-evident because this is the governme nt's definition of sustain- ability, that fiscal sustainability — and we know this; this is a political issue — depends on taxation. Many of those governments that talk about the sustainability of our health care system are the same governments that give away, for example, tax cuts to banks — like this government.

You make a big tax cut to the bank that no one asked for and no one agrees with, and then you say: "Oh, the health care system is unsustainable because we cut tax to the banks." That's the intention, and that's the discussion of this legislation. So what do they say? What we have is the Canadian Health Services Research Foundation…. They say it's a myth. They're not saying that the issue of health care costs, which every government since we brought in medicare and even before that…. Every government concerns itself with health care costs.

They're saying the idea of it, putting it in as a principle of medicare, mitigating the idea of universality, is wrong — that governments can reasonably be expected to provide, even though this government is failing to do it, universal, accessible health care in the public system. That's what they're saying. They're saying that the government's arguments, to use the turn of phrase of the Minister of Health, are specious. The Minister of Health referred to Roy Romanow yesterday. He thought that maybe we thought that Mr. Romanow wasn't a distinguished Premier. Of course he's a distinguished Premier.

He also produced a very highly considered, well-thought-out report on our health care system. What does he say? He says that the sustainability worry is a myth. This is someone who was brought to the table by the minister in defence of his position. "The sustainability worry is a myth. We are spending less today than we did a decade ago. Our spending is in line with that of other wealthy countries, and there is a need for immediate targeted investment in priority areas." That is one of the pe ople that minister brought to the table yesterday. He disagrees with this. So what does the minister say?

What is his defence? What is his explanation for all this, for changing the fundamental principles of medicare? It's a change, by the way, as my colleague from Saanich South knows, that the Minister of Health in Ottawa, Tony Clement, called a non-starter; a change that had no support from any other Premier; a change that had no support from any other Minister of Health — completely rejected, seen as completely unnecessary. [1020] What does the Minister of Health say now? Well, he wrote a letter to Burnaby Now , and really what he's saying is that changing the law is just kind of an advisory thing.

You know, we're just sending ourselves a note. We're saying to ourselves that we need to remind our- selves that the public health system should continue to exist for future generations. That's why we're changing the law. He doesn't provide any evidence about the effect of it, which is real. He doesn't provide any evidence of the

11676 B RITISH COLUMBIA DEBATES T UESDAY, APRIL 29, 2008 effect of it, and he says platitudes like that. He says that it's about putting sustainability against universality and accessible and comprehensive in the Canada Health Act and the Medicare Protection Act. He says that it's about helping people with chronic disease. He says that it's about helping people to stop smoking. To use the minister's phrase — what does the min- ister call this sort of thing? — it's entirely without basis. To use his phrase, it's utter nonsense.

There is no evi- dence that adding sustainability to this bill has any impact on any of those issues. What this is about — and the minister came close somewhere else…. Maybe he doesn't like to say the same kinds of things to the Burnaby Now that he says to the Globe and Mail. I don't know. He did note in the Globe and Mail that in enshrining this principle of sustainability into law, we acknowledge our responsi- bilities to manage the growing costs that threaten the future of our public health care system. He says that the

definitions and this addition, presumably of sustainability, take on critical importance in issues that may be defined in courts of law. So they are doing something. He acknowledges that they're doing something. He doesn't say what. But what he's really saying, what the Premier said…. You'll recall with the Premier, because I remember it. We and many members of the House were at SFU downtown. The member from Esquimal t was there.

The Premier stood at the front of the r oom and said: "Our health care system is not sustainable." What his belief is, is that universal, accessible health care — health care, if you will, where and when you need it; what the Premier promised — is not pos- sible. He's a pessimist. We can't do it. They do it all over the world, but we can't do it in British Columbia. We need a mulligan in British Columbia. We need a way out of universal health care. S o t h a t ' s w h a t h e s a i d . T h e n h e o f f e r e d u p i n h i s opening remarks this canard, which they've since buried in the back yard — go figure.

They've taken the canard and dug a hole in the back yard of the government, and they've put the canard in the hole. It's still there, but for this debate, we want to resurrect that a little bit. So 71 percent, they said, of the health care budget. They don't say that anymore. It was nonsense then. The Premier — there he was up on the stage with Brian Day, his first speaker, the guy who's going to deliver the message, the sermon. At his first meeting on the Conversation on Health, there was the Premier. We were way at the back. I was at the back of the room.

I was happy to be there to watch this presentation from the Premier. As he said, 71 percent — an idea that has disappeared from the government's rhetoric and has disappeared from the debate…. It was an idea that was used to scare people, and people didn't buy it then. They don't say that anymore. They said 71 percent by 2017. It's manifestly not true. And by the way, they're off only by maybe $5 billion or $6 billion, depending on how you count. Once you talk about those billions of dollars, you're starting to ta lk real money. That's how far off they were on this question.

There he was at the fron t of the room saying: "We need the sustainability change because universal, accessible, comprehensive health care — what I promised — is no longer possible in our province of British Columbia. It's no longer possible. We need this way out." What did he do? The memb er from Esquimalt will know this. He invited onto the stage Brian Day, the first speaker to define this image. You'll recall this. I think the Minister of Health will recall. He put up on the screen a slide. It showed a picture. On one side was an image of George Orwell's 1984, and on the other side was the Canada Health Act.

The Canada Health Act, which apparently for the Premier…. The principles of universality, principles that need mitigation according to the Premier and according to Dr. Day…. That's their view. We can't deliver it here in British Columbia. We are not capable of that in British Columbia. It requires mitigation. [1025] So they put up this slide. The Premier is there, and his first speaker…. He invites him up.

He puts up this slide — the Canada Health Act on one side and George Orwell's 1984 on the other side — equating the principles of medicare, which I think most Canadians believe in profoundly and think are the right approach to public health care…. We're talking about public administration of our health care system. We're talking about universality of our health care system, its portability between provinces. We're talking about its accessibility. We're talking about its comprehensiveness.

That idea of a public health care system — where getting care doesn't have anything to do with the amount of money you have in your pocket, and with the American example shining at us across the border — somehow equated to George Orwell's 1984. You know, they said it. They didn't criticize him. I didn't see the Minister of Health get up and say: "I don't think that's right." I didn't hear the Premier get up and say: "I don't think that's right." That's what they did.

What we're doing in this legislation is putting a principle in place that clearly is intended to mitigate or change the value of the existi ng principles of medicare, because the government doesn't think they can do that anymore. Sustainability. We said this yesterday, and it's important to note that it has a different quality than the other principles, which speak to who will benefit from medicare, what they will receive, their access to health care, their ability to receive care in their home province and other provinces, and who will ultimately run and be accountable for the system.

Those principles of medicare are not contradictory. The idea that they're intr oducing is their definition of the sustainability of the health care system, which is not supported in any international assessment. When international people do evidence-based reviews of the cost of health care, they don't use their method. But that's okay. The minister has dismissed all those as they dismiss everyone else who disagrees with them, whether it's Mr. Romanow, the Canadian Health Services Research

TUESDAY, APRIL 29, 2008 B RITISH COLUMBIA DEBATES 11677 Foundation, the OECD or whoever it is. If they disagree with the Premier's decision …. Of course, presumably all those people are some form of socialist or something. I don't know. Nonetheless, all those people who disagree with that position are dismissed as their views not having any validity. But the fact is that the introduction of this principle will have that effect, because it's giving direction. As the minister said, it gives direction to the courts. What is the mischief that the government is intending to deal with? What are they trying to resolve?

We talked about the case law yesterday, which says that if you're going to make this kind of change…. I'll just refer to one of the cases that I referred to yesterday. It's pretty basic stuff. It says that in construction of legislation, the court must consider the mischief the legislation has intended to remedy, the provisions of the legislation as a whole and the particular language of the

section in question. The intent of this provision is to mitigate the values of those principles of medicare. That's its intent, and the government refuses to explain, presumably because they're embarrassed, presumably because no serious policy person in the Ministry of Health would have come up with this idea if the Premier hadn't. No other M i n i s t e r o f H e a l t h i n C a n ada, the federal Minister of Health, all the evidence-based research…. All of this stuff is sort of set aside, and we go ahead of that. But that's the purpose of the legislation.

It's for that reason that we oppose it, because we are not pessimists like the government. We believe that the principles in the Canada Health Act reflected in the Medicare Protection Act are principles that not only should be upheld and must be upheld but can be upheld. This pessimistic view put forward on the other side — that we can't have here in British Columbia what other people in the world have, that we can't sustain it — is wrong, and it's not supported by the evidence.

Does that mean there are not challenges in the public health care system, that there have not always been cost challenges and that th ere are not other mitigating factors out there — balanced budget legislation and so on? Of course there are. Of course those things exist. [1030] That's not the question. The question isn't whether there aren't cost issues in health care. That's how the government tries to frame the issue, but that's not what they're doing here. They are changing the principles of medicare.

When you go befo re the Medical Services Commission or the Minister of Health or the health authorities in deciding how to enact the legislation, the issue of universality is mitigated, is undermined, in the legislation. It has to be put up against this principle that the government defines in its own terms as sustainability. That's the purpose of it. The government refuses to defend it, but that is what they're doing, and that is why we think it's not a good idea. Look, as I said, sustainability is conceptually an obvious modifier of the other principles. That's what it is.

While it's conceivable that if you wanted to, you could engage in a process — and this is, a little bit, what the government is doing — of a universal, portable and publicly administered plan that rations services, it never intersects with the taxpayers' ability to pay. The principles of comprehensiveness and acces- sibility directly engage the idea of sustainability. What you have is an idea of a set of principles for public health care, and you say to government: "Deliver health care policies based on this principle." This is a government that doesn't believe in those principles and thinks that it needs help.

It th inks that it needs, in fact, to mitigate those principles — that they can't do it here. They can't do here what people do and must do and should do all around the world, which is deliver public health care to citizens in an effective way. Hon. Speaker, this is, I know, a somewhat arcane debate. We have the government refusing to explain its position. It's putting forwar d a discredited idea by the Premier which has received no support since he launched it and which he seems to have lost interest in, although I'm looking forward to his speech in this debate.

I'm looking forward to his explanation of what he's doing in this debate. It'll be something to anticipate. I'll want to be here for that. I want to be here when he stands up and says what he was thinking when Brian Day put the Canada Health Act up against 1984. I'll be interested to hear what he was thinking when that happened — when he put that up as his first speaker. I'll be interested to see what he was thinking when he went around and spent $6 million on this 71 percent number that was fallacious and which they've now buried in the government's backyard.

I'll be interested to hear what he was thinking, what his approach is, because it will be important for people to understand, as we go forward in this debate about public health care, where the government stands and what they should expect and what's at stake. By trying to pretend that this is about flowery platitudes when it is about nothing of the sort, the government is…. The effect of their actions is to mislead people, and I hope that the Premier comes here and says what his intentions were and what his explanation is.

We have not had an adequate explanation so far, and the issues at stake for British Columbians, I think, are significant. What can we say about the government's record in health care? The minister talked about Bill 29 yesterday. Clearly, he spoke with pride about the havoc the gov- ernment wrought to public health care with Bill 29. Clearly, he thinks a model where at Nanaimo Seniors Village, a model created by the government…. It's the vision that they brought to that bill. Our position is that that's not the right model. We're against Bill 29. We were against it then; we're against it now.

We're even more against it after the Supreme Court of Canada, in spite of a big effort by the government, ruled three important sections of that bill to be illegal and forced the government to pay compensation. The Minister of Health is proud of that. That's an example of his vision of health care. It is a message about his vision of health care — a vision, in that case, that deterred people from taking up health care as a profession. It said to care aides and LPNs and others,

11678 B RITISH COLUMBIA DEBATES T UESDAY, APRIL 29, 2008 people in the public health care system: "We don't value your work." That is, in fact, the approach the government took. [1035] Yes, the minister wants specifics. Yeah, we have a disagreement. We don't think Bill 29 is the way to go. We are against Bill 29. We were against it then; we're against it now. We're going to change it when we get into government. You bet we are. What else? They've gone from second place to seventh place in health care spending. The minister says: "It's $2 billion we cut out of the system." That's what his suggestion is.

We know that the number of hospitals — let me use the Canadian Institute for Health Information's numbers — has gone from 99 in '01-02 to 82 in '05-06. That is a reflection. That's what happens. Services get cut when you de-emphasize health care as a priority of government. That's what happens. The reality is that that is consistent with a government that no longer believes you can deliver health care where and when you need it and that is more interested in advancing the interests of private interests in our society than in maintaining a universal public health care system.

They shut down acute care beds — 1,270 beds between 2001 and 2004. They closed hospitals. A net 17 hospitals closed, according to the Canadian Institute for Health Information, between '01-02 and '05-06. They promised health care where and when you need it, and then they said: "Sorry, we can't deliver." Now we introduce legislation that gives us the right to argue before the courts that we don't have to deliver, that the founding principles of public health care do not matter. This is the directio n the government is taking health care. It is not, I would suggest to you, hon.

Speaker — and we'll get into this in a moment — an evidence- based direction. I would say this. I think that this debate we're going to be entering into over the next little while is an important debate, because it shows the contrast between a government that is ignoring the evidence in health care…. It doesn't follow what all the international evidence is but wants to, in fact, limit the scope of public health care and increase the costs for everybody. Its idea of sustainability an d efficiency is to transfer costs. Its only idea — its idée fixe — is to transfer costs from the government to the sick.

We know what that means in jurisdictions where that happens. What that means is real health consequences and life consequences for real people. That's what it means when you do that. It's why we are against this legislation. Another part of the bill that the minister didn't touch on in his remarks is the changes to the

preamble. He has added new words to the

preamble. I'll remind you again what the case law sa ys about legislation. I'll read this again because I think it's important to remember that when you change the la w, presumably the intent of what you're doing is to remedy some problem. They've decided in the

preamble, which doesn't have as much weight…. It guides the rest of the legislation. It surely doesn't have anything like the weight of a basic principle of health care, but it gives us an under- standing of what they mean. Two notions. You've got this idea that there's some problem. They've added notions — let's talk about two of them: individual choices of

preamble and personal responsibility — without explanation. I suppose because…. We could have expected the Minister of Health, in a speech about the bill, to explain what the intent is and what he was attempting to remedy by changing the law here, but he failed to do so. He absolutely, fundamentally failed to do anything about these important issues but rant about the 1990s. He's the one changing the law. He's bringing this Premier's discredited idea into this Legislature, and he refuses to talk about it. He fails to talk about it. He provides no evidence to support it.

He has no explanation as to what the actual effect of the law will be. Instead, what he does — and it's not surprising — is spend a long speech haranguing us about what he thinks the NDP position is or isn't on some issue, be- cause he has nothing to say about this bill, which is clearly not the work of anyone seriously concerned about our public health care system. [1040] What's the remedy here?

Look, if it's the case that the idea of personal responsibility is about, for example, eating more vegetables or going for a run or living a healthier life, that's interesting, and maybe the minister could state that for the record. That might actually be valuable, to explain their inte nt. If the question is…. Of course, we had smoking cessation laws, the best program in the 1990s. It was turned ar ound by this government 2002, when they overruled the independent WCB. We all recall this on smoking. If there is something that needs to be remedied, what's the explanation for that?

Does personal responsibility in the act…? We'll have to, I suppose, get into this at committee stage. We might have expected the government to have addressed these issues earlier. If personal responsibility means taking on the burden of costs for the health care system linked to the sustainability of the government, then that's one thing. If it's simply, say, eating more asparagus, that's another thing. But the need for it in this legislation is, I think, highly questionable. Equally, hon. Speaker, look at the issue of individual choice.

They've decided to add this principle — this founding principle, this foun ding idea that they've put it in there — of individual choice. What does that mean? Does that, in fact, mean in the way it's been defined by other people, by Dr. Godley of False Creek Surgical C e n t r e ? D o e s i t m e a n a c h o i c e b e t w e e n a p u b l i c o r a private system? Or does it mean what we've traditionally had, which was lots of choices within the public system — for example, your choice, if you can find one these days, of a family doctor? What does that mean? Why was it necessary?

What was it that the government wanted to remedy? We know in 2003 what they wanted to remedy — significant violations of the Canada Health Act and the Medicare Protection Act that were going on in this province. They wanted to give themselves the right to

TUESDAY, APRIL 29, 2008 B RITISH COLUMBIA DEBATES 11679 find out what those were an d to remedy those, and the Premier said no. It's "don't ask, don't tell" on for-profit health care. He didn't want to know the extent of the problem, the extent of the extra billing, and he took specific action to stop that from happening. We knew what the purpose of the bill was then. We knew what the problem was then. They had got instructions, in a sense, from Ottawa that the Canada Health Act was being violated here in British Columbia.

They needed to take these steps so that they could assess what the nature of the violation was, and the government decided not to do it. Well, the Premier did. The government, of course, all voted for it, but the Decider, our George Bush, decided, and it was bad news for British Columbians. It means more extra billing, more for-profit medicare, more two-tier health care, and we see in this province the chill ing effect since that on our public health care system. So what was it? What is it in this

preamble that the government wants to deal with, hon. Speaker? What is it that they want to deal with? Why is it that these notions of individual choice , these notions of personal responsibility are included in the act? Is it, in fact, Dr. Godley's definition or Dr. Day's definition or Mr. Copeman's definition of choice, or is it an entirely public definition of choice? Is it, in fact, the intention of the government to provide a legislative basis for that or not? These are the questions we ask. Certainly, it seems to me that we could have done without. There was no n eed for these amendments.

That's the best position you could have. That's the best defence the government seems to have. What they say is: "Don't worry; trust us. We're doing this, but it's entirely irrelevant. Let's talk about the NDP in the 1990s." If I may summarize in a short time what the minister said yesterday, that's it. "What we're doing here is irrelevant. Yes, it was an idea by the Premier. We gotta do it. God, I gotta do it. It's terrible stuff. I must do it, but I don't want to do it. The devil didn't make me do it.

The Premier made me do it." That's their approach to these things. [1045] So you believe that, and this whole initiative that they spent $6 million in advertising and everything else is just an irrelevancy. That's the best

interpretation the government can put on this fatuous bill. That's the best

interpretation. But they refuse to say; they refuse to discuss their intent. One day they're saying: "Well, really, what it's about is controlling cost. It's too expensive for us to be universal and accessible and comprehensive. It's too hard. It's going to be 71 percent of total government spending." That's what they said. They buried that idea in the backyard. It's no longer relevant. They acknowledge that it's not the case. How is this? The scary line, "71 percent by 2017," became "50 percent by 2013" — big difference.

The dif- ference between those things is more, I think, than the cost of the entire school system. That's the difference between those estimates. It's a pretty significant attempt to distort the information and to fool people into support- ing this measure. So their best position is that, but what they're clearly intending to do, what the clear intent of the law as it's written, not as the mi nister explained it…. As the minister explained it, you might think it was actually more about the Canadian Centre for Policy Alternatives than it was about the founding principles of medicare.

But the real purpose of this is to mitigate those princi- ples of medicare, and we on this side of the House are not pessimists about that. We believe in public health care. We are the party that founded public health care in this country, and we are going to continue to fight for public health care every single day. There we have the, sort of, provisions of this bill — the government's position. How has that expressed itself in reality?

I think it's fair to say, and we've talked about this, that the governme nt and its course over the last number of years have not contributed to the principles of the Canada Health Act. It's no wonder they want to mitigate them, because they have not, in any kind of sustained way, followed them. At a time, as we've said, of economic growth, we've gone from second to sevent h place in Canada in terms of health spending. They've broken key promises they made. Virtually every single promise they made on health care in the 2001 elec tion was broken. Oh, you remember it, hon.

Speaker — a personal commitment from the Premier to HEU workers: "We won't tear up your contract." It took the Supreme Court to call him into line on that canard. Five thousand long-term care beds — broken. Health care wh ere and when you need it — cuts to acute care beds, cuts to home care. That's their record on health care.

Now, having done that, having taken those steps about our public health care system and, in addition to that, having failed to do what they needed to do in the previous amendment to the Medicare Protection Act — failed to take the steps to protect British Columbians from facility fees, failed to take the steps to protect British Columbians from extra user fees, failed to take the steps to protect British Columbians from two-tier health care….

You remember the case of Barbara Gosling from Williams Lake, who went to her doctor's office and was told — this was in 2006 — that she could have an appointment in the public system in 2008 or she could see the same doctor for $350 in two weeks. What the government says, because they won't audit the system, won't do anything about the system, is that it's Barbara Gosling, who is dealing with serious issues in the health care system, who has to challenge her doctor and challenge for-profit health care in order to bring this issue forward. She did, and boy, was she courageous.

But they're saying that they won't take any steps to defend the public health care system. It's up to Barbara Gosling. You remember what was happening in St. Paul's Hospital. Using the MRI at St. Paul's Hospital, using that in the public health care system…. Interjection. A. Dix: The minister has woken up. It's good news.

11680 B RITISH COLUMBIA DEBATES T UESDAY, APRIL 29, 2008 You remember what the minister said? He said: "Oh, that's not happening." He said, "It couldn't happen. It's not happening," and that I was wrong. This is a theme of the minister: I was wrong; he was right. [1050] You know, I sadly have to reflect on the evidence, which subsequently showed, after the investigation by the Deputy Minister of Health , that, in fact…. And this is just the Deputy Minister of Health. I'm reluctant to even mention it to people who said that I was right, and the minister was wrong. That's what all…. Interjections. A.

Dix: The Minister of Health is inspired, hon. Speaker. He's inspired. He's back. I have awoken him. The memory of that moment when he said: "You're wrong. It couldn't happen. It's not happening here." And it was happening here. That memory has awoken hi m. It's awoken him, and there he is. But that's the reality of what they've done. They believe that unless people come forward with a specific complaint — publicly come forward against maybe their own doctor or maybe health services — the government won't do anything. It's: "Don't ask, don't tell." The Minister of Health was in the House.

He was in the Legislature of British Columbia. He stood up, I believe, and voted for that bill, which they didn't proclaim — that the Premier put under the table and wouldn't proclaim. There he was in the House, and there he is…. "Don't ask, don't tell" — that's his approach to public health care. Hon. Speaker, you'll recall the Minister of Health, when he privatized, when he sent out in VIHA…. They asked him. The favouring of that system. They asked him, when he contracted out surgeries in VIHA: "Well, how much does it cost?" Hon. G. Abbott: Big hypocrite. A. Dix: Oh, he's inspired now.

You see what happens, hon. Speaker? You see what happens? You bring the evidence here, and the Minister of Health starts name-calling. That's all he has. For an hour and 15 minutes yesterday, all he had was name-calling. Interjections. Deputy Speaker: Members. Members. Continue, Member. A. Dix: That's all he has left now. He has a bill that he's clearly embarrassed about — he should be embarrassed about — that he refuses to defend, and all we have from him is an hour of name-calling and some more name- calling now. That's all he has to defend this shameful legislation.

All he has to defend this shameful legislation is his longstanding contempt for the public in this province. Anyone who stands up to that government's position, whether it's the Hospital Employees Union or women workers who were laid off and who took them to the Supreme Court, are cause for the minister's contempt. Patients who challenge th e minister, challenge his contempt. There are think tanks who challenge his view. They're cause for his contempt. Yesterday for an hour he refused to defend th is bill that he brought into the House. We didn't bring this bill into the House. He refused to defend it.

He refused to say what it meant. He refused to say anything about it. He spent an hour name-calling. I guess he needs practice, you know? It's training for some future cam- paign, but the reality of it is that we have legislation. We are bringing forward a se rious analysis of the bill, and the minister has nothing. He has nothing but contempt for the serious issu es, the issues that we're d e b a t i n g i n t h i s L e g i s l a t u r e , i s s u e s o f t h e f o u n d i n g principles of our health care system that he wants to change and mitigate. Now all he has is name-calling. That's all he has left.

You'll recall, hon. Speaker…. Interjections. Deputy Speaker: Order, Members. Interjections. Deputy Speaker: Order, Members. I remind members about the use of parliamentary language, and I would like decorum in the House. Continue, Member. A. Dix: Well, it'll be something new for the Minister of Health. But there you go, hon. Speaker. What they did…. And let's remind people of their approach and what I think th e right approach is. Their approach, for example, when they contracted out surgeries. They asked the Minister of Health: "What's the relative cost?

Are there cost savings?" [1055] He said: "Oh, I don't know." What did he say? I quote him. I never want to misquote the Minister of Health. What did he say? "I am not sure. I am not sure we have an authoritative version of that." Interjection. A. Dix: He said: "I am not sure we have an authori- tative version of that." Do you know, hon. Speaker…? I understand why he's yelling now: because it's embarrassing. We're talking about millions of dollars in public funds, and he had no i d e a w h a t h e w a s d o i n g . H e c o u l d n ' t d e f e n d w h a t h e was doing then.

This is an ideological approach which people do not support in British Columbia, and there he is. You know when he starts yelling that you're hitting close to home. That, in fact, is what's been going on. You know, it's fascinating. It doesn't take long, does it? All they have left is personal invective. That's all they have left. It's shameful. It's shameful for a Minister

TUESDAY, APRIL 29, 2008 B RITISH COLUMBIA DEBATES 11681 of Health, vitiating the foun ding principles of health care with legislation. He comes to this House and won't defend it. It's shameful. Now all we get from him…. We got it yesterday, and now we get more of it today. This is what we can expect: yell and call people names. People who support public health care in this province — yell and call them names. That's what we have. That's what his speech was about yesterday. I'm sure there'll be more people added to that list. We have a different view than the government, and that part of it is fair en ough.

What I'm calling on the government to do is to be straightforward about what their position is. It may be fair enough if they say, "We don't believe in the principles of universality anymore," if that's their view. That appears to be their view, from their policies over the last few years. It appears to be their view, from the Premier's specific comments. It appears to be their view on the specific question of for-profit health care. That appears to be their view. Then they can state that view. We can have a debate about it, but they don't want to do that. You know why they don't want to do that?

Because the people of British Columbia don't agree with that view. They don't agree with that view. What we get f r o m t h e M i n i s t e r o f H e a l t h i n s t e a d i s t h i s k i n d o f cutesy nonsense, where they bring forward a bill that they will not and cannot defend. They vitiate those founding principles of he alth care. They won't say what it means. The minister clearly has been made to do this in some fashion by the Premier, and so that's their position. That's what they want to do. They want to change our health care system in the dark, and we want to shine a light on it.

That is our role — to shine a light on it — in this debate. We intend to do that. From now, throughout this debate, members on the opposition side will be laying out how the main threat to the sustainability of health and to our public health care system in British Columbia is the members over there. We will show it with the evidence. We are going to s h o w t h a t t h e m a i n t h r e a t t o p u b l i c h e a l t h c a r e i s a government that won't defend it, won't enforce the law and now, after the fact, wants a mulligan, where they change the law. That's what they want.

They want to do it, and they want to make these changes under the cover of invectives. That is their plan. I think the people of British Columbia are going to r e j e c t t h i s a p p r o a c h . T h e y are going to reject this approach. The people of British Columbia want us instead to have an approach to health care that focuses on improving services for people. They believe we can do that. They don't believe that the only innovative idea that a government can come up with is to off-load costs from the government to the sick. They don't believe that.

They believe we can do better in public health care. [1100] In Ontario, for example, with the results…. It's not an NDP government in Ontario. It started under an NDP government but has been carried out by governments of different stripes. The Ontario case costing initiative or the Saskatchewan Health Quality Council…. Proposals like that — unlike the government's proposals, unlike the government's efforts to get at issues such as chronic disease — involve people who are not in a conflict of interest but focus on the highest possible quality in a public health care system.

Let me just give you one example of what I mean. What does the Saskatchewan Health Quality Council do? It provides independent, evidence-based assessments of the effectiveness of the province's health care services, including patient outcomes. Let me give you one example that has come out of that — the chronic disease management collaborative. It's an initiative to improve the health of people living with coronary artery diseas e and diabetes by focusing on the quality of care they receive. It also includes efforts to improve access to physician practices.

It uses, contrary to the government and its approach, a collaborative model that importantly does not include — and this is an important fact, and we're talking about sustainability here — the pharmaceutical industry or interests that may profit fr om the initiative. They say it's very important, and this is something that is not happening in British Columbia to the extent that it should be happening in British Columbia. [S.

Hammell in the chair.] They say that the working definition of "collaborative" that they use is "an improv ement method that relies on the spread and adaption of existing knowledge to multiple settings to accomplish a co mmon aim." How different from the approach of this government, with its proposal for service-based funding to take away the collaboration between institutions, its market-based approach, its favouring of for-profit interests. What a different approach.

That's the kind of approach — an approach based on collaboration, on ensuring that British Columbians have the resources they need and that the doctors and nurses and health care workers have the resources they need to do the task…. That is the difference between their position and our position. The central focus of quality, surely, is universal accessibility to a comprehensive range of services. Without that, quality of care declines. When you mitigate those services, as this government has done systematically, it has an effect on the quality of care. That is what we have seen in British Columbia.

We have brought the cases forward. We have brought the debate forward. There have been real consequences to this government's litany of broken promises on health care. This attempt to rewrite the law as a mulligan, to say that that's okay, that it 's okay that we've affected the universality and accessibility and comprehensiveness of our health care system…. That's okay, and here's a principle to put up against those items. That's okay. That's their approach, but it is not our approach. That's why I am hopeful.

I am enthusiastic at the idea t h a t t h e c o m i n g e l e c t i o n w i l l b e f o u g h t o n s o m e o f

11682 B RITISH COLUMBIA DEBATES T UESDAY, APRIL 29, 2008 these very health care issues . Because I think, and this was reflected in the Conversation on Health, it was reflected every time you asked British Columbians what they want…. They believe in the founding principles of public health care. They disagree with the government when it attempts to say that it's not possible. They disagree with the Premier when he puts forward misleading data to try and convince them that it's impossible. They disagree with that. They understand.

The people of British Columbia understand what we've alwa ys known, which is that you have to provide service in the most cost-efficient way possible. You don't need to change the founding principles of medicare to know that. It has always been true. But what we're seeing…. The minister talked about the 1990s. One of the elements that he conveniently left out was cuts made by the federal government of the 1990s, a Liberal government of the time.

One of the reasons, in fact, why we're second in Canada is that here in British Columbia we had a real commitment in a Medicare Protection Act that had substance and that the government believed in. We believed in universal services, in accessible services, in comprehensive services. T h a t ' s w h y w e w e r e s e c o n d i n C a n a d a a t a t i m e w h e n i t w a s d i f f i c u l t t o d o t h a t b e c a u s e t h e f e d e r a l government was withdrawing from the field and cutting funding.

In a different context since then, when there have been some — nothing like what they cut out — addition of federal support s into the argument, this government has gone in another direction. I believe, and I think British Columbians believe, that the founding principles of medicare are possible, can be done and require a government prepared to fight for them, not a government that's prepared to mitigate and throw away those founding principles. [1105] We, in this debate, are going to take on this govern- ment. Right through the next election we're going to take on this government.

We are going to present our positions on health care. You can't undo the damage they've done in one year, but you have to start to undo it. You cannot undo the damage they've done to health care in one year or even two years, but you have to start to do it, and you h a v e t o h a v e a p l a n t o d o i t . T h a t i s w h a t w e w i l l b e bringing forward, and it is a plan that will be based on the founding principles of the Canada Health Act, the founding principles that stand in the Medicare Protection Act. That's what our plan will be based on. We won't be looking for a mulligan.

We won't be promising what they promised — health care where and when you need it — and then not deliver. We won't be promising more acute care beds, and cutting acute care beds. We won't be promising 5,000 long-term care beds and breaking that promise. We will deliver, because health care is fundamental to what the opposition believes is important in British Columbia. That is the difference between us and them. That's the reason why this, at best, unnecessary…. It's unusual for a minister to stand up and say: "I'm introducing this bill, but it's unnecessary. It doesn't mean anything." That's unusua l.

It's a new tactic, even from this government, but that's what they did. But changes to the law ha ve meaning. All of the evidence tells us they have meaning, shows us they have meaning, and this change has meaning too. We believe in the founding principles of medicare. We will fight for them in this Legislature, and we will fight for them in the next election. That will be a difference between us and them, and I believe that British Columbians from every part of this province will be with us in that debate. M. Polak: I apologize ahead of time to those listening to me.

With great irony, I happen to be sick today when I'm talking about health care. Perhaps that will help us all to draw our minds to what we're really talking about today, and that is who in this House are the real defenders of public health care that will serve patients in British Columbia for today, for tomorrow, for coming generations. I am here to tell you that it is not the opposition side. That's not something that I've come to as a conclusion quickly.

It took some time to read through some of the comments that have been made by the opposition critic, by other members of the opposition, in the media and in this House. In reviewing those, I have to admit that I did have a certain amount of anticipation that I would begin to see a plan. I would begin to see an alternative laid out for British Columbians that said: "You know, if you don't like what government's doing, we've got a different plan for you." But I haven't seen it. I've seen some interesting phrases.

One of my favourites is "evidence-based decision-making." If you're going to move to evidence-based decision-making, I suppose that begs the question: what on earth did you make decisions with before? By its very nature, decision-making is based on evidence. I would ask British Columbians and others to consider the evidence that we've had presented in this House about who really believes in public health care. Maybe we should start with who really believes in the Canada Health Act. I'm a Canadian. I've grown up in British Columbia for all of my 40 years.

I've been raised to believe that the Canada Health Act is one of the differentials…. It's one of the things that makes us as a nation stronger and better th an other countries around the world. We care for people. We look after them. We make sure they have the basics of medical care. The Canada Health Act is, of course, something that New Democratic parties around this country have held not only in high regard but also held as a flag before t h e m t o s a y : " T h i s i s w h a t w e s t a n d f o r . T h i s i s w h a t we're behind.

We did this, an d it's an important thing." So I find it quite shocking that we are today presented with an opposition who don't even realize that their leader has come out expressing concern about the very words in the Canada Health Act. It's shocking. [1110]

TUESDAY, APRIL 29, 2008 B RITISH COLUMBIA DEBATES 11683 We began this road to change and improving health care in an important throne speech — important because governments around this nation, around North America, probably around the world, ar e very frightened to talk about health care. They've been told that if you talk about health care, you're going to get voted out of office. Nobody wants to talk about it. This government took it on and said that there are important questions to ask.

We committed to a conver- sation that didn't just in volve committees internal to government, didn't just involve cabinet, didn't just involve MLAs, but involved people around this province, engaged them for the first time. We had elders in aboriginal communities who thanked us for travelling to their community to ask them for their input about health care . One of the elders even said at one of the meetings that they had been praying that government would come to talk to them, and that they felt this was an answer to their prayer. This is meaningful to people around British Columbia.

So meaningful that we had thousands upon thousands of submissions from British Columbia about how we can improve and strengthen our medical services, our health care services in British Columbia and, in fact, the health of all British Columbians. What we see in the legislation today is a response to that. In fact, our throne speec h laid it out very clearly. This is where the concern comes in, because in the throne speech…. I'll quote a piece from it. In

part it says about this act: "Amendments will define and enshrine those five principles of the Canada Health Act under the Medicare Protection Act. A sixth principle of sustainability will be added to ensure our health care system will be there for our children, our grandchildren and their families. "Our goal is an efficient, effective, integrated health system that promotes the health of all citizens and provides high-quality patient care that is medically appropriate and ensures reasonable acce ss to medically necessary services consistent with the Canada Health Act." What a laudable goal.

You would think the opposition w o u l d b e l i n i n g u p t o s u p p o r t t h a t k i n d o f a g o a l , t o support a government that actually thinks it's important enough to put that in a throne speech, to put that in legislation. But oh no — that's not what we heard. Surprisingly, we heard the Leader of the Opposition get up in this House and question the phrase "reasonable access." She said it concerned her. Here's what she said: "Now that promise has changed to a health system that provides 'reasonable acce ss to medically necessary services.'" She says: "Reasonable access.

What does that message say to patients? It says: 'get in line.'" That's what she believes reasonable access means. In other words, one can only think from this quote that she believes the phrase "rea sonable access" is wrong, that somehow we shouldn't be supporting reasonable access. Well, that's where the concern really should lie for British Columbians about who really supports the Canada Health Act. I now want to share with you where that wording came from. Guess what? That wording comes from the Canada Health Act. Oh yes. The real defenders of the Canada Health Act are not on the opposition side of the House.

They're on the government side. It's in the throne speech. It's in the commitment. I'll read to you from the Canada Health Act. This is from

section 3 on Canada health care policy, and here's w h a t i t s a y s . " I t i s h e r e b y declared that the primary objective of Canadian health care policy is to protect, promote and restore the physical and mental well-being of residents of Canada and" — listen up — "to facilitate reasonable access to health services…." How is it possible that we could have a leader of an NDP opposition questioning the Canada Health Act? Yet that's what we see here. In fact, we've heard for a couple of hours the opposition Heal th critic questioning the very nature of sustainability of public health care.

How on earth could you promote reasonable access, which is what our throne speech calls for and what the Canada Health Act calls for, without making sure it's sustainable? The fact of the matter is, for all the opposition wants to say that they believe in the principles of the Canada Health Act, their very leader has come out opposed to the Canada Health Act and to the principles that underlie it. [1115] This is a government that committed to enshrine the principles of the Canada Health Act in legislation, and that's what this legislation does.

It recognizes the value of the input of British Columbians who took part by the thousands in the Conversation on Health. It talks about their values. What were they? Values of choice — that's in the

preamble. The

preamble says values of "individual choice, personal responsibility, innovation, transparency and accountability." Those are things that people around British Columbia talked to us about. They want to have choices. British Columbians wanted to know why on earth our current health care system restricts them to receiving prescriptions only from their general practitioner when they're on medication that they've been on for years and a pharmacist could do the job just as well. We're going to change that. We listened to them.

British Columbians wanted to know why it is that they're restricted, when they're in an emergency room, to having a doctor come and refer them for medical diagnostic testing. We listened, and we're going to change that. On and on we can list off, through the 11 pounds of input that we got in the Co nversation on Health, ex- ample after example — not only in the throne speech, in legislation being tabled by the Health Minister — of listening to British Columbia and acting. The opposition Health critic wants to claim that the main threat to public health care is this government. I beg to differ.

If that's what he wants to say, then he would be supporting this bill because he would be tying government to the Canada Health Act. But he won't do it. Why? Because he doesn't support the Canada Health Act. His leader doesn't support the Canada Health Act. She said so in this House. The fact of the matter is that reasonable access is what we are going to ensure by ensuring sustainability. Reasonable access is someth ing that we count on as

11684 B RITISH COLUMBIA DEBATES T UESDAY, APRIL 29, 2008 British Columbians, as Canadians. It has to be weighed in the balance against all the services, the range of services that health care encompasses. We have to ensure that that access is there, not only for us now but for those who are coming after us. Anyone who supports the Canada Health Act would be supporting this bill, because what's this bill made o f ? T h i s b i l l i s m a d e o f t h e p r i n c i p l e s o f t h e C a n a d a Health Act — things that we should as Canadians hold close to our hearts. Public administration.

This bill enshrines the definition of public administration in legislation. It ties government to that. If you support the Canada Health Act, if you think governments of any type would be a threat to it, you'd support this legislation. Comprehensiveness. We have a huge range of services now available through our health care system that were never even dreamed of when the Canada Health Act first came into being, were never dreamed of when public health care first began in Canada. They're there. They're ever-expanding.

They 're ever putting pressure on a system that is bearing it relatively well, considering the changes and challenges that we're facing. Universality. I don't know how you have universality without having sustainability. I don't know how you have it, really, without reasonable access. Universality here is defined as 100 percent of beneficiaries on uniform terms and conditions. It means everyone across British Columbia will have that reasonable access, but the opposition leader…. She's concerned about that. She's concerned about reasonable access.

She thinks it means: "Get in line." You would think that the great defenders, so-called, of the Canada Health Act would actually take the time to read it. Well, we've taken more than the time to read it. We've taken the time to put our commitment behind it and to follow through on what we promised British Columbians and what they asked us for in the Conver- sation on Health. Portability — the idea that you can go anywhere and you take your services with you. They're there. They don't say: "Well, you're from Langley, so you should go back there." Accessibility. How do you have accessibility without sustainability?

How do you have it without reasonable access? Shouldn't it be reasonable? The Canada Health Act thinks it should; the opposition leader doesn't. Then we come to sustainability. We've heard all sorts of talk about what sustainability might be. It would probably help if the opposition critic read the act. But then I guess he can be somewhat blinded by the fact that, clearly, on that side of the House there is a belief that governments should have unfettered access to the taxpayer's pocket.

There is a belief somehow that government has some of its own money. [1120] When we go around the province throughout the Conversation on Health an d we talk about the ability of taxpayers to pay, yes, they recognize that there's a need to be paying taxes to support a public health care system. They realize that. They recognize that, but they also recognize that their taxpayers' money, their hard- earned money, is a resource that we ought to value. They recognize something else. They recognize that sustainability goes beyond finances.

Sustainability goes to the very resources we use in terms of technology and in terms of human resources. All those different facets of the system are a part of sustainability. We've taken some action on that. We've looked at health prevention and promotion. That's another area in the Conversation on Health that the public asked us to take hold of and take a leadership role on, and we've been doing that. You can see the ActNow trailers outside on the front. That's an award-winning program to promote a sustainable health care system through prevention and promotion of good health. That's sustainability.

Sustainability is also about innovation. You have to have growth, change and research. You have to have innovation in a health care system, and you have to encourage it. We've done that. The UBC Centre for Surgical Innovation is some thing that even won praise from the opposition. Why? Because it's a good program. We have many, many more across this province. When it comes to health professionals, I've mentioned already the changes that we're making with respect to what nurses are allowed to recommend for medical diagnostic testing.

How many times have people been waiting in an emergency room, all because of a restriction that says that a nurse can't take them for their diagnostic testing? Imagine the change that that will make for everyday people — everyday lives being lived in an emergency room, waiting. That's called action. It's a plan. It's tangible. It's not something that has empty words. It's something that has real change behind it. What about the pharmacists?

We know from the research that when you have pharmacists involved in prescribing medications for patients with chronic diseases, when they're involved in chronic disease care, those patients with chronic diseases do better. They're healthier. That's another part of sustainability. It's looking at what British Columbians have told us, listening to what we've learned from other pl aces around the world and taking action. Sustainability is all about that. As a principle, I don't know how you don't support sustainability. I don't know how that's even possible.

The opposite view, of course, is to say: "Well, I don't think we should make it sustainable. We should have a health care system that just keeps on going, sees the light at the end of the tunnel and doesn't realize it's a train. We shouldn't get off the track. We should just wait till it hits us." I don't know that it's really worthwhile even to get into a debate about how fast the health care system is going to gobble up the rest of the money in the government coffers. The fact of the matter is that whether it's ten years from now, 20 years from now, 30 years from now, 50 years from now….

I'll tell you what British Columbians did acknowledge. I'll tell you what they ackn owledged en masse in the

TUESDAY, APRIL 29, 2008 B RITISH COLUMBIA DEBATES 11685 Conversation on Health: eventually it will happen. Eventually, if we don't change, it'll happen. What will that mean? Sadly, that will mean that not only will health care services be compromised, but other services that are important to British Columbians will be compromised — services for children, for the homeless, for seniors. These are all things that are valuable. None of them can be sustained if health care is not sustainable. We have to be thinking all the time about the future.

If there is a threat to publ ic health care in British Columbia, that threat is from those who would put their heads down, pay no attention to the challenges that are facing health care in British Columbia and say: "Everything's fine. It should stay the same." Of course, that brings us back to the most common theme that we hear from the opposition. We hear it in transportation; we've heard it now in health. It really is a broken record. It is that while they decry the state of anything that's going on in British Columbia today, especially health care, they want it to stay the same.

The biggest thing they rail against is change. "Don't change it." [1125] They maintain two conflicting positions. They do that on the Port Mann Bridge. They do that on health care, and we hear it again today. "The system is broken. It's in crisis. There are all these terrible things going on. Ah, but it really is okay. You don't need to change it. There really aren't any problems." I'm not exactly sure how that kind of cognitive dissonance is maintained.

But I suppose the opposition has learned very well to live with ambiguity, or they wouldn't be able to listen to the speeches from their opposition Health critic. Then again, this is also an opposition who claims to believe in the Canada Health Act yet listens to their leader decry some of the very principles undergirding it. So living with ambiguity seems to be a common practice on the side of the opposition. One of the realities that you face in health care in British Columbia, and our Health Minister knows it well, is that there is a consta nt change taking place.

For a minister of Health and for someone who may wish to be a future minister of Health — without a plan, albeit — the reality is that one daren't take their finger off the pulse of what is happening. Yet we have in the opposition a group who are willing to castigate government for any kind of move to change without putting forward a plan of their own. I really, really waited to hear more of a plan during the speech from the opposition critic. I really was hopeful that it would come. I waited and waited. It didn't happen.

But maybe what did happen is that we saw the reality of the choice that British Columbians will be facing. The choice that British Columbians will be facing — and it's true; they will — is a choice between a gov- ernment that says that we recognize that health care is important to all of you, that public health care is important to all of you…. We recognize that you want the principles of the Canada Health Act, including reasonable access, to be a part of what we're committed to. That's the choice that we're laying out for them. Or you can vote for a group who don't have a plan.

You can vote for a group who want to talk about everything being awful but who offer no solutions for changing it. It's interesting to me that in spite of the fact that the opposition are fond of calling for inquiries and reviews and commissions and all-party committees on just about everything, when it came to the Conversation on Health, they opposed it. They opposed it. We went around to talk to British Columbians all around this province. They engaged. There were something like close to five million hits on the website, thousands of submissions. What did we hear from the opposition?

"Don't go talk to British Columbians. You should have health professionals making those decisions." Really? Is that a plan? It sounds to me like what they want to do is hold away in an all-party committee somewhere and decide that everything's still okay, because that's the only messa g e we hear. On this side we've recognized that British Columbians want change, and we've taken some dramatic action. You know, talk about what's happening in emer- gency rooms. The best thing you can do is ask patients. What happened when we asked them?

Some 85 percent of emergency room patients rate their care as good to excellent. I can tell you that I grew up in Surrey, and it wasn't like that many years ago. There are big changes afoot, big changes taking place, like $12 million that was invested in an emergency room strategy that was launched in '03. We have a Health minister and a government who are responsive, who watch, who see what's going on, respond and change. That's what this bill is about. When it comes to surgery wait times — that's one of the things the opposition are fond of bringing up — let's look at what has happened.

There was no wait time for almost half of the record 459,388 surgeries performed in '05 and '06. In '06 and '07, 52 percent of hip replacements were completed within 26 weeks, and 49 percent of knee replacements were completed in 26 weeks. Wouldn't you want to improve that? Wouldn't you want to work harder on that? Isn't that part of sustainability? Since 2001 the number of surgeries performed in B.C. has increased by record amounts.

You're looking at a 7 percent increase in coronary bypasses, 33 percent in cataract surgeries, 47 pe rcent in hip replacements, 62 percent in angioplasties and 84 percent in knee replacements. Evidence, if th e opposition wants it, of a system that is improving, that's changing, that's innovating. We're here to support that. They're not. They don't support the inno vation. They don't support the changes. They vote against it. And I believe, sadly, that they're going to vote against this bill. [1130] I'm not sure how you square that circle.

I'm not sure how you say that you're voting against this bill and say you believe in the principles of the Canada Health Act. Perhaps one of them wishes to get up and explain that. Perhaps they will. I don't know if I'll understand it after their explanation any better. But I don't see how you square that circle.

11686 B RITISH COLUMBIA DEBATES T UESDAY, APRIL 29, 2008 We've seen improved access to diagnostic testing — 11 new CT scanners, 19 new MRI scanners and B.C.'s first PET scanner. Since 2001 we've seen more nurses. In fact, we've put $174 million into nurse education and recruitment, and we've added 3,300 nursing education spaces. There's a really good reason why nurses weren't being trained in the past. There wasn't any place to do it. There weren't any spaces. We've added those. We're training them. Some $1.4 million to launch the first three-year accelerated nursing degree. There's another one.

We'll see if the NDP wants to support that. BCNU does. We're bringing people on side that would have never been traditionally aligned with government in initiatives and innovation in health care, and they're there. Perhaps that's what rankle s the opposition. Everybody else realizes that health care needs to change. Everybody else realizes that that change needs to happen by incorporating the principles of the Canada Health Act in everything we do, and yet I think they're going to vote against it. In the last five years we've graduated more than 7,500 new nurses.

That breaks down across a pretty broad spectrum, actually. Yo u've got 4,909 registered nurses; 2,286 licensed practical nurses; and 344 registered psychiatric nurses. In the last two years we've increased the number of internationally educated nurses in B.C. — 521 nurses from the U.K. and $500,000 per year to fast-track registration of internationally educated nurses. For the first time B.C. is training nurse practitioners. In 2005 B.C. graduated its first class of nurse practitioners, and there are now more than 51 nurse practitioners working in B.C. We graduate 45 nurse practitioners a year.

Are they going to support that kind of change? Sus- tainability is about that. Sustainability is about making sure we have the health professionals with a broad range in what they're allowed to do in order to make sure that they're there. We talk about a system. We say a health care system, and it sounds really vague and machine-like. But it's not a system. It's people. How do you support them? How do you make sure you have enough of them? How do you make sure you have enough doctors? We've wrestled with that problem too. We've increased the funding for postgraduate medical education by 73 percent since 2003.

It's no w $75.1 million. Residency spaces for Canadian medical graduates are up by 75 percent since '03. Residency spaces for foreign-trained doctors have tripled. We actually have more doctors per capita than almost every other province, and for the first time, doctors are trained outside of the Vancouver area. That's sustainability. Making sure you have enough doctors is certainly important. It wouldn't be sustainable without it. But then they're opposed to sustainability. Clearly, by voting against th is bill, they're opposed to the Canada Health Act.

This bill, and the test that voting on it will put before us, really is about the fight to maintain a public health care system for all British Columbians. It might, in fact, be the beachhead. Successive gov- ernments, nationally and provincially, have avoided dealing with the complex issue of how you make sure that our health care system remains available for people, that reasonable access is ma intained for people across this country.

We're the first ones to take it on, to ask British Columbians what they want us to do, and to respond with aggressive legislation, to respond with thoughtful legislation and, significantly, to respond by renewing our commitment to the principles of the Canada Health Act and renewing our commitment to British Columbians by enshrining sustainability as one of those principles. Sustainability is all about reasonable access.

Sustain- ability is about making sure that the interests of all of us in receiving medical care, in receiving other services from government, are balanced against the needs of the taxpayer to be able to pay. There's nothing sinful or evil about that. It's a principle that has been held out and held before us in times past by those who would never be — I don't think, anyway — someone who would frighten the opposition Health critic.

But he does seem frightened by it. [1135] It might be a comfort to th e opposition Health critic and perhaps to the leader, who needs to go and re-read the C a n a d a H e a l t h A c t , t o k n o w t h a t e v e n a f o r m e r w e l l - known member of this Legislature, Minister Paul Ramsey, was supportive of the principle of sustainability. In fact, they introduced a bill. What was it called?

An Act to Protect Medicare. It has an interesting passage in it. It says: "WHEREAS the people and government of British Columbia recognize a responsibility for the judicious use of medical services…." So now we're even beyond reasonable access. They only want judicious use. To me, that sounds much more limiting: "…judicious use of medical services in order to maintain a fiscally sustain- able health care system for future generations…." That was the NDP Health Minister.

I hope that gives some comfort to them, because certainly in debate he tried very hard to ensure that people understood that sustainability was not something to be frightened of — sustainability was integral to the future of our health care system. Here's what he had to say in committee stage debate. He said: "Finally, I want to comment on the concern about fiscally sustainable health care. British Columbians and those of us charged with overseeing the health system have the responsibility of making sure that we have a fiscally sustainable system.

That means allocating adequate funding for delivery of services but also, and perhaps even more importantly, taking measure to make sure we are delivering services as efficiently as possible and involving the public in discussion about the judicious use of medical services." Well, I'm pleased that even back in the days when Paul Ramsey was the Health Minister they saw the need to incorporate fiscal sustainability in health care. I'm pleased with that. I do hope it's a comfort to the opposition Health critic.

As I close my part of the debate, I would put up that our language of reasonable access is much more closely aligned to the Canada Health Act than anything that was in a previous NDP act.

TUESDAY, APRIL 29, 2008 B RITISH COLUMBIA DEBATES 11687 N. Macdonald: I rise to speak against Bill 21. Bill 21 is the Medicare Protection Amendment Act. What the bill puts forward is six principles that will guide the deliberations of the Medical Services Commission. The five principles are familiar to us. They're the existing and familiar provisions that have been in place for Canadians for a long, long time and have served Canadians very well. Those principles are, as I say, familiar to most.

The ideas that we would have public administration, the ideas of universality, portability, accessibility — ideas like that that have served Canadians very, very well. What this bill intends to do is to add a sixth principle, which is sustainability. Now, "sustainability" is a term that is, at worst, innocuous. It is a term that most would see as a reasonable term, but it depe nds very much on how the term is going to be defined by the government and the true impact that it will have on medical services in British Columbia.

What we would expect is that the minister, bringing the legislation forward, would come into this House and provide an explanation for British Columbians about what sustainability meant, because if you are bringing in legislation and you intend to make it the law of the land, it must have some meaning, and it must have some impact. Naturally, what you would expect is the government would come in and explain exactly the impact and exactly what it means. [1140] Instead, we had an hour and a half with no explanation about what the bill means.

Yet we can assume that the direction this will take us in is the direction that the Premier has consistently wanted to go — a direction that he would go if he was not so aware of the fact that Canadians, British Columbians, would be totally against the privatization that he wants to take the province.

So he brings in the bill, and the minister brings in the bill, adding the term "sustainability ," adding a term that is going to be interpreted and will have meaning and will work to take away from th e five existing principles, and tries to undersell it and tries to tell the public that they shouldn't be concerned about something that is of fundamental importance. We have government saying: "This is no big deal.

It means nothing." But what British Columbians know with this government is that every single thing that is put forward needs to be looked at very carefully, because so often it is couched or packaged with particular words that try to draw people away from the true impact of what is being proposed. With this, we have an attempt to undermine those five important principles of medicare, principles that have served Canadians very, very well. I mean, the fact is, certainly from my area, that this government and this Premier do not have credibility on health care.

British Columbians do not feel that they are committed to looking after each and every person in this province and, quite rightly, feel that with this policy and with, frankly, every other policy of this government there is a narrow corporate interest that the government and this Premier would choose to serve rather than the public interest. So we have bland assurances, and we have enough experience over these seven years to know that we should hear these bland assu rances and be concerned. The sustainability principle was put forward by the Premier before the Conversation on Health.

In the Conversation on Health the people did come forward, and they talked about a lot of things. But what they didn't talk about or didn't accept were many of the premises that the Premier pu t out at the beginning of the Conversation on Health , despite an incredible amount of the government's resources being put towards trying to convince people of a point of view. You did not have ordinary British Columbians coming forward and talking about the need for a sixth principle in medicare. That did not happen. People did not come forward and say that.

They did not come forward and accept the Premier's disaster scenario around the cost of health care. That did not happen. When you read through the Conversation on Health, you have people talking about ideas around solutions. You do have peop le talking again and again about the importance of health care to their lives and the importance of doing health care properly. I think that there is a recognition, and there is a recognition from this government, that that attempt to scare people about the costs of health care just didn't work. It was put forward. You had all the resources of government.

You had the — what is it? — 200, 300 people in the public affairs bureau. You have all of those people. You have all of the advertising that went along with the kickoff for the Conversation on Health, and people did not buy that 71 percent of all government spending by 2017 being an accurate figure. It's part of the reason why it's no longer repeated here, because it was a preposterous figure. It was inaccurate. It was misleading — intentionally so. You had many, many people pointing that out very, very quickly. I'll just go to one

article out of many. It's by a journalist that I read and respect, and I enjoy his articles — Paul Willcocks. What he said in one

article really clearly was that there's no crisis in health care. I think everybody recognizes that there are and always will be cost pressures and that we need to be aware of those. But with health care spending at $13 billion, that is a cost that Canadians and British Columbians are willing to accept. [1145] He points out, as others have, that British Columbians spend $10 billion on slot mach ines and lottery tickets. Slot machines and lottery tickets could not be the first priority for most families — not compared to health care — yet we quite willingly will spend $10 billion on gambling in this province.

Just as a sidebar, gambling was something this Premier came in promising to reduce or not expand, but that's another issue. But it does point to the fact that $13 billion, while a tremendous sum, needs to be looked at in that context, that British Columbians still have $10 billion in excess to spend on something that would list very far down their list of priorities. Paul Willcocks goes on to say that this legislation, this Bill 21 that's in front of us "fuels fears the government

11688 B RITISH COLUMBIA DEBATES T UESDAY, APRIL 29, 2008 will use scare tactics to justify cutting care or offering patients the chance to pay extra for private treatment — a shift that would actually increase health care costs overall. User fees mean the total cost for a specific procedure rise. Health care will cost each British Columbian about $3.50 a week more this year than it did last year." Well, that's hardly a cris is. That's a conclusion any reasonable person would re ach. So why are we being fed this? What's the agenda ? Why are we doing this?

I think, before we move on to that, we need to talk about values, and we need to talk about what's important for people. What is the core thing that is important? What I would say is that public health care and public education will be at the top of almost every person's list. At certain moments in our lives, and we all have been there, we've all experienced them, there is no question that more than anything else health care and a health care system that works are the most important things in the world.

While we disagree on many, many issues on both sides of the House, one thing that we do agree on is that, compared to pretty well anywhere else in the world, Brit- ish Columbians are fortunate. We're fortunate with the professionals that we have in the field working for us. We are fortunate with the system that we have put in place. On this side — the NDP — we feel passionately that we not only have to retain it; we have to strengthen it and make sure it is not only here now, but that it is here in the future. That is a question of political will. What this bill does is undermine a system that works well.

I'll give you an example just from the recent past. We had a baby born in Golden. It was a wonderful thing. A friend of mine was going to be a grandfather for the first time. Doctors were worried about that child and felt that the child needed to be taken immediately to a Lower Mainland hospital where a better service could be provided, just to be careful. There is something fundamentally wonderful about a system where you have health professionals concen- trating on the needs of th e individual. There was no question about ability to pay. That did not come into it at all.

A citizen, a new citizen of this province, needed care, and the collective resources of the people of British Columbia made sure that a jet flew out, took the child, brought them back to the Lower Mainland, that that child got care, and then that child was flown back. [Mr. Speaker in the chair.] Now, it didn't all work perfectly, but isn't it something wonderful that we, as a province, would make sure that every person that we could help, we would try? And that the individual cost or who was going to pay — none of that was part of the consideration. It was only the interests of that child.

For many of us and for many people in the province, we have been raised in a system with public health, w h e r e w e t a k e i t f o r g r a n t e d . B u t w e a l s o h a v e m a n y people that have gone to other parts of the world and have other experiences. [1150] I can tell you that my experience in Africa was that within the region that I lived in, in northern Tanzania, we had access to Nairobi, and there were two good hospitals there.

There were hospitals there that were up to a standard that Canadians would be comfortable with, but you had a vast majority of the population that would have no access to that care. What it leaves with you is that understanding that it is a fundamentally different life that people have when there is that insecurity. Ther e is the possibility that at any moment, through misfortune, you or somebody you love can be put in a place where they need medical attention. There is a medical solution that could easily be found, but for lack of money, it will not be found.

The experience that I ha d there was that somebody I worked closely with, his br other died of tetanus. His brother died because he couldn't pay to go and get a shot for tetanus. He knew about tetanus. He just didn't have the money to go and get the service, and the service was a dollar. So for lack of a dollar, you have people grieving and all of the emotion that goes with that and all the hardship because the person couldn't afford to get help. It wasn't just for individuals. The thing about health care that people unde rstood a long time ago is that if you are not dealing with people's health care conce

Document details

Collection	British Columbia — Debates (Hansard)
Citation	H0429am 06
Type	hansard
Volume / chapter	H0429am 06
Language	en
Format	pdf
Source	PROVINCIAL
Identifier	60c74e0aa9a170aefe211abaca3d0bcb1fb24053

Source file is stored in the law ingest library (pdf).