Hansard -- Volume 19, Number 15 -- Thursday, May 11, 2000

2000 Legislative Session: 4th Session, 36th Parliament

HANSARD

The following electronic version is for informational purposes

only.

The printed version remains the official version.

Official Report of

DEBATES OF THE LEGISLATIVE ASSEMBLY

(Hansard)

THURSDAY, MAY 11, 2000

Afternoon Sitting

Volume 19, Number 15

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The House met at 2:07 p.m.

Hon. G. Wilson: In the members' gallery today we have some very special guests visiting us from Germany. His Excellency Jürgen Pöhlmann is the newly appointed Ambassador of Germany to Canada, and he's making an official visit to British Columbia. The ambassador is accompanied by his wife Ulrike; and Klaus Kröger, who's consul general of Germany in Vancouver, and his wife Christel. Would the House please make our friends welcome not only to this House but to our province.

Hon. G. Mann Brewin: I have an introduction, and a little bit of an introduction to the introduction that follows, on part of the reason why the German Ambassador and the counsel general are here.

On Sunday, May 28 in Ottawa, the remains of an unidentified Canadian soldier killed at the Battle of Vimy Ridge in 1917 will be reinterred in a tomb at the National War Memorial. This will mark the end of a four-year Canada-wide effort spearheaded by the Royal Canadian Legion to establish a Canadian equivalent of the national tombs of unknown soldiers in London, Paris and Arlington, Virginia.

This morning, in a moving ceremony at the cenotaph in front of the parliament buildings, His Honour the Lieutenant-Governor presented a symbolic portion of British Columbia soil to Michael Cook, president, Pacific command, the Royal Canadian Legion. Mr. Cook will carry this soil to Ottawa, where it will be mixed with soil from the other Canadian provinces, the three territories and France, to be placed in Canada's Tomb of the Unknown Soldier.

With us today in the gallery is Michael Cook, his wife Judy and senior officers of the legion in British Columbia. Would you please join me in giving them a very warm welcome to this House.

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G. Campbell: I'd like to join with the government in welcoming Mr. Cook and congratulating the legion on their undertaking. This is a major millennial project for the legion, and I think British Columbia is playing a very important role. As I'm sure members may know, not just is our soil going to be mixed with the soil of other provinces and territories and also with the soil of France, but part of the monument that will be made was actually created by a B.C. artist from Mission and is being forged in a B.C. company in Roberts Creek. It is, I think, a worthy tribute to all of those in British Columbia who served our nation so well.

For all of us, the ultimate sacrifice that was made in the search and the quest for freedom and democracy is something that we can never forget; we must always remember. I want to thank the legion for taking the leadership in making sure that we bring this project to a successful conclusion on May 28.

Hon. J. MacPhail: I'm delighted today to welcome to the gallery 25 grades 11 and 12 students from the Spectrum Senior Secondary Alternate Program in my riding. They're joined today by their teachers, Ms. Laurie Finch and Mr. Gene Derreth. I would ask everyone to make them welcome.

E. Conroy: In the gallery today is Erica Watters. Erica used to work for BKR radio in the community that I come from in the Kootenays. She is presently working for CKNW radio -- I hope, Erica, I got the radio station you're working for correct. Would the House please make her welcome.

M. de Jong: It is my great pleasure to welcome to the gallery today my parents Ann and Jack de Jong. I hope members will not only make them feel welcome but talk to them and let them tell you what a wonderful guy I really am.

Hon. M. Farnworth: In the House today are Chris Allnutt, the secretary-business manager of the Hospital Employees Union, and George Heyman, the president of the British Columbia Government and Service Employees Union. Would the House please join me in making them welcome.

G. Hogg: We have joining us in the gallery today nine grade 10 students from Heritage Christian School in South Surrey, who are here to learn about how we work and what we do. Would the House please make them welcome.

Hon. G. Wilson: Also in the gallery today we have two guests visiting us all the way from Sydney, Australia. Would the House please make Brian and Julia Woolmer welcome.

Hon. D. Lovick: I suspect that everybody in this chamber has had the experience of speaking to an empty House. We notice, thereby and therefore, those individuals who come here and take a particular, passionate interest in our deliberations. I noticed last week a woman sitting in the gallery who was here for about four days and took a very significant interest in what we do here, and I thought it appropriate then to acknowledge her presence. I ran into her in the hallway; she kindly gave me her name and said: "Please don't embarrass me." So I shan't, but I do want you all to please join me in welcoming Ms. Sabrina Hunter, a real student of parliament -- Sabrina, wherever you are.

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T. Stevenson: I have two introductions and one announcement. The United Church of Canada is holding its annual conference here in Victoria this weekend. It's the seventy-fourth annual general meeting, and there are several hundred delegates from around British Columbia who will be meeting for the weekend. I want to introduce two in the House. One is Rev. Ed Searcy from University Hill United Church, and the other is my own spouse, Rev. Gary Paterson from Ryerson United Church in Vancouver.

The United Church of Canada, when it meets every year, amongst other things ordains people into ministry, and it also acknowledges those people who have served the church for many years as they retire. One of the ministers retiring this year is the member for Coquitlam-Maillardville. After 40 years of service, he is retiring from the United Church ministry. He started 40 years ago up in Fort Simpson and served all over British Columbia before going into politics earlier in this decade. I'd like to make those people welcome and also congratulate the member for Coquitlam-Maillardville.

Hon. G. Mann Brewin: In the gallery today with my ministerial assistant, Heather McLeod, is her mother Mrs. Marjorie McLeod of Victoria and a good friend of hers, Ms. Emma Nering of Vancouver. Along with them is Mr. Bill Schmidt of Victoria. Would the House please make them welcome.

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Introduction of Bills

PETS IN RENTAL HOUSING ACT, 2000

G. Clark presented a bill intituled Pets in Rental Housing Act, 2000.

G. Clark: This bill allows tenants to have pets in residential premises within reasonable limits. It ends discrimination against pet owners by landlords, 95 percent of whom in British Columbia write no-pet policies into rental agreements. It's an issue of fairness. If a pet or owner is not responsible, they can still be evicted. The bill allows landlords to remove pets for end-tenancy agreements if the animal is noisy, aggressive, destructive or flea-ridden. Landlords also do not have to admit dangerous dogs such as pit bulls, bull terriers or Rottweilers.

However, it also means that responsible pet owners are not judged guilty and denied housing before they have an opportunity to prove otherwise.

Studies have shown that people live healthier and happier lives with pets; senior citizens live longer, fuller lives with pets. In fact, one Australian study indicated that over $1 billion could be saved in the health care system if seniors were encouraged to have a pet.

Recently B.C. courts have ruled that blanket no-pet policies are unenforceable. The problem is that even a trivial breach of the no-pets clause, such as keeping a goldfish without permission in British Columbia, could result in immediate termination of the tenancy. The court did not see this as reasonable, and clearly it is not. It is time, my friends, to change the law and bring it in line with court decisions in other jurisdictions like Ontario, Saskatchewan and New York.

Finally, I'd like to thank the SPCA and the group Pets of B.C. Residents for their support. I'd also like to thank Sean Edwards, an intern in the Legislature, for his research and help in drafting this bill. I commend this bill to all members of the House for their consideration.

Bill M203 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.

Oral Questions

CHILDREN AND FAMILIES MINISTRY

AND CHILD PROTECTION

G. Campbell: One of the most serious decisions a government can make is to take a child from its home. Before that critical action is taken, it seems to me that the only question -- and the most important question -- to be asked is: what's in the best interests of the child?

We have a Minister for Children and Families document that suggests that something quite different takes place. It states: "If there is more bad press on performance of child protection workers -- more children may be taken into care." My question to the Minister for Children and Families is simply this: can she explain how bad press has anything at all to do with what's in the best interests of children in British Columbia?

Hon. G. Mann Brewin: The best interests of the child are always what are considered by the ministry in any of those unfortunate situations when that has to happen. It has nothing to do with what's in the media or not.

The Speaker: The Leader of the Official Opposition with a supplemental question.

G. Campbell: This document is the minister's document; it is the minister's briefing book. It is the minister's staff who have said -- and let me say again -- that bad press may require more children to be taken into care.

[1420]

The question for the minister is simply this . . . . These decisions should have nothing whatsoever to do with how comfortable the minister is or how comfortable child protection workers are. It should have everything to do with what is in the best interests of the child. We now know that the ministry acts on bad press. My question to the minister is: will the minister tell the House how many times her ministry has responded to bad press by accelerating the apprehension of children?

Hon. G. Mann Brewin: I reiterate my first response, which was that the ministry always acts in the best interests of the child and the situation that they find when they are called to respond. That's always the case; that always will be the case.

C. Clark: How many years . . . ? How many ministers have we heard stand up in this House -- responsible for the Ministry for Children and Families -- and tell us one thing, while their staff is doing the exact opposite? How many ministers do we have to listen to stand up and say that the world is one way, when it's really another?

This is from the minister's own briefing book. It says: "If there is more bad press on performance of child protection workers -- then more children may be taken into care." Can the minister explain how she somehow squares her ministry's mission, when her staff are more interested in looking after her political interests than they are in looking after the interests of the children that she is duty-bound to protect?

Hon. G. Mann Brewin: I want to say and reiterate that the ministry's job . . . . The people who are involved with protection in the province of British Columbia have a very tough job to do. They need all the support they can get from all of us to do the task they do. That means that in the ministry we must give them the resources they need. In the community we must also give them the support they require to do the important, difficult and tough work that they have to do. It is always to be focused on the best interests of the child.

The Speaker: The member for Port Moody-Burnaby Mountain has a supplemental question.

C. Clark: Again, that's what she says, but that's not what her briefing book says. That's what she says, but that's not what the documents prove. That's what she says, but that's not what her staff think. For goodness' sake, her briefing book, her staff and the documents show an entirely different story. It says that when the ministry has bad media, when it's having a bad day, instead of going out and fixing the problems, instead of going out and closing the gaps, instead of going out and adding more resources, the response is to go out and

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apprehend more children. That is absolutely astonishing. Since when was media coverage relevant to the protection of children in British Columbia? And when did bad press become the basis for apprehending kids in this province?

Hon. G. Mann Brewin: Let me put it another way. It is not government policy. It is not the mandate of the ministry, and it is not the direction of the minister to do other than look after the interests of the child.

MANAGEMENT OF

B.C. FERRY CORPORATION

G. Farrell-Collins: Perhaps the ministers and particularly the Minister of Energy, Mines and Northern Development will be mindful of why members of the public and members of the opposition are a little skeptical about what we hear from ministers. At the time . . .

Hon. D. Miller: Stop being so sanctimonious.

The Speaker: Order, member.

G. Farrell-Collins: . . . when he was minister responsible for B.C. Ferries, he stood up in this House on May 25, 1998, at a time when everyone was worried about the ballooning debt at B.C. Ferries, and said: "I'm not personally, and never have been, worried about the broader debt issues."

[1425]

Yet at the same time, on December 17, 1998, the treasurer of B.C. Ferries wrote a memo to Treasury Board and other senior people in the government and said: "As you know, B.C. Ferries insolvent financial position has required, for the last two years, that the Minister of Finance provide a letter of commitment to our auditors to avoid a 'going concern' qualification in our financial statements . . . . To that end, we have made three submissions to Treasury Board and cabinet since November 1997 seeking direction on this issue."

Hon. Speaker, my question is for the minister of B.C. Ferries or the former minister of B.C. Ferries. Will one of them tell us exactly how long it's been government policy to stand up in this House and tell British Columbians one thing when their staff is telling them something completely different?

Hon. J. MacPhail: We had a chance to canvass this yesterday under the legislation as well. Let me reiterate what the government's response was on this. Yes, it is true that B.C. Ferry Corporation has been in financial difficulty over the last few years, and indeed, action has been taken by the government to put the corporation in a solvent position.

Interjections.

The Speaker: Order, members.

Hon. D. Miller: I beg your pardon, Mr. Speaker. The member for Peace River North said . . . .

The Speaker: The Deputy Premier has the floor.

Hon. J. MacPhail: There was a close examination that began in the time period that the hon. member reiterates. It resulted in an investigation by a chartered accountant and then a subsequent auditor general's report as well. However, the action has been taken, and we expect the Ferry Corporation to remain in a solvent position.

The Speaker: The Opposition House Leader has a supplemental question.

G. Farrell-Collins: The question was to the minister -- the former, the current, the past, any one of the five who have had the portfolio over the last number of years. The question was: how long has it been government policy to stand up in this House and tell members of this House and the public one thing when the internal documents of government say something completely different?

What I'd like to know and what I'd like to hear from the minister responsible for B.C. Ferries now . . . . She was Minister of Finance at one time. She wrote one of those letters to B.C. Ferries that guaranteed their debt -- a full year or two or three years before we've now assumed, through legislation, the debt of B.C. Ferries. Will she table in this House today the letter she wrote and the letter her predecessor, who's now the Attorney General of this House, wrote to B.C. Ferries guaranteeing their debt three years before they had the nerve to stand up and tell people the true state of the finances?

Hon. J. MacPhail: Hon. Speaker, there have been no secrets kept on this matter at all. In fact, the books are tabled every year. Yes, the books show that the corporation was in a deficit position for years. What the government did over the course of the years was assume responsibility for that deficit position. In fact, that was reported in the

summary accounts through all of these years. Subsequent to that, the government has taken further positions that the

summary accounts are the bottom line, and all of those matters are reported.

The difference, though, is that under the new government we have dedicated revenue for the very first time. Now, with that dedicated revenue source and with the debt recision, B.C. Ferry Corporation is expected and will be held accountable to remain solvent.

M. de Jong: Let's make sure we're getting this straight. Government makes a big production a few weeks ago about assuming B.C. Ferries massive debt, under the guise of some notion of openness. Now it turns out that the government was actually forced to do that very thing three years ago -- three years ago, Mr. Speaker.

The question is: will the minister . . . ? This minister hasn't been able to do it in over two days. Maybe someone else would like to try and take a crack at it. Why did the government cover up for three years the fact that the only thing that was standing between B.C. Ferries and bankruptcy was a pledge by the NDP to use taxpayers' money to bail out the billion-dollar debt they created?

[1430]

Hon. P. Ramsey: We concluded debate this morning on a budget measures bill that does several things for the future of B.C. Ferries. First, it acknowledges clearly that the debt on B.C. Ferries books was not sustainable if it was to become a viable public corporation and takes that debt off their books. Second, we have dedicated a stream of revenue to B.C. Ferries to ensure that as they look at re-establishing and ensuring a high-quality passenger and car service to coastal B.C. and are seen as part of the highways system, they -- like the highways system -- have a dedicated stream of revenue.

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Finally, we have said clearly -- and the documents that we tabled with the opposition during that debate show the facts of it and the details of it -- that we need to move forward. We need to put the debt incurred by the fast ferries project and many others -- many others -- behind us and move forward.

Hon. Speaker, those are the facts of the case. These books are sound. B.C. Ferry Corporation has tabled a performance plan in this House for public debate. Their books are open; anybody can look at them and have a good debate.

The Speaker: The member for Matsqui has a supplemental question.

M. de Jong: On December 17, 1998, as you know, the treasurer of B.C. Ferries wrote to cabinet planning and communications, Crown corporations secretariat, Treasury Board -- every one of those ministers: "As you know, B.C. Ferries' insolvent financial position has required, for the last two years, that the Minister of Finance provide a letter of commitment to our auditors to avoid a going concern . . . . " They didn't want any blemishes on the financial statements, and they covered up the facts.

For three years they covered up the fact that this was spiralling out of control. The simple question is: why should they expect British Columbians to give them the authority to spend one plug nickel on B.C. Ferries after their record of inept, negligent mismanagement?

Hon. J. MacPhail: I'm tempted, actually, hon. Speaker, to offer a technical briefing to the opposition, as we did yesterday. They refused to take it yesterday. Frankly, they probably could have asked some real questions today about important issues, if they had taken the technical briefing. Every single issue that this opposition is raising today is in the public domain and has been canvassed by the ministers responsible under the

summary accounts -- every single issue.

What is different, though, is that this government has said that the

summary accounts will be the bottom line. It hasn't been that it's been hidden or kept from anybody. But now the

summary accounts, in which all of this is included . . . . Whether there be an operating deficit from a Crown corporation or an operating surplus, all of that is included in the

summary accounts.

I would just make note for the opposition that the B.C. Ferry Corporation is a Crown-supported corporation; it is not a commercial Crown.

The Speaker: The bell ends question period.

Ministerial Statement

NISGA'A TREATY

Hon. D. Lovick: Mr. Speaker, I rise to make a brief ministerial statement. It gives me very, very great pleasure today to report that this is the day the Nisga'a treaty comes into effect.

As everybody here will recognize, the treaty is the result of years of tough negotiation, of the Nisga'a nation's endurance and perseverance and, perhaps most importantly, of the nation's struggle for justice and equality. B.C.'s first modern-day treaty will foster self-reliance in the Nisga'a nation and allow the Nisga'a to manage their own affairs and maintain their culture within the framework of the Canadian constitution.

The treaty demonstrates, it seems to me, that we can indeed resolve issues through negotiation. We've proven here that we can reconcile our interests and their interests by sitting down together and working out our differences.

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The Nisga'a treaty is about the Nisga'a people participating as full members of British Columbia society. I am proud that this government could play some role in achieving this historic agreement. I look forward to continuing to work with Canada and the Nisga'a nation on implementing the provisions of the treaty. I therefore offer today, on behalf of our government, my congratulations to the Nisga'a nation on this historic event and in particular to Chief Joseph Gosnell, for his outstanding leadership and his pivotal role in making this agreement happen.

M. de Jong: This is the effective date for the historic Nisga'a treaty. It's no secret that the opposition had, and has, serious concerns about the provisions of that document -- of the treaty. That having been said, on behalf of the opposition, I want to emphasize our respect and regard for the Nisga'a people, their perseverance and their patience.

Interjections.

The Speaker: Order, members. Continue please, hon. member.

M. de Jong: I also want to acknowledge, as the Minister of Aboriginal Affairs did, the leadership of Chief Gosnell for the work he has done along with his council. I also want to emphasize the respect I think we all have in this chamber for the democratic process by which legislators in Victoria and Ottawa have signalled their approval of this treaty.

If I have a regret today, it is the government's apparent lack of regard for the ongoing judicial process which, in my view, has an important task remaining. I understand that the government takes a different view on the constitutionality of this document than we do in the opposition. What I don't understand is why they wouldn't want to wait a few more days, when the Supreme Court of British Columbia will be considering those very questions and providing answers to those very questions.

So with the greatest of respect that we have for the Nisga'a people, we wish them well as they continue this journey. It's a historic day; it could have been more historic.

J. Weisgerber: I request leave to respond to the ministerial statement.

Leave granted.

J. Weisgerber: I'd like to respond briefly, first of all, by extending my congratulations to the Nisga'a. I too will say up front that there are elements of the treaty that I passionately disagree with. But having said that, one can't ignore the importance of the achievement of the Nisga'a. Going back 25 years, when they first signed a framework agreement with the federal government, when the province wouldn't negotiate --

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back to the days when they appeared on the steps of this Legislature and were turned away nearly 100 years ago . . . . It is an important step.

Interestingly, yesterday we passed the McLeod Lake Adhesion Agreement, which was another treaty, and we have indeed dealt also with the Sechelt. But the Nisga'a clearly have led the way for British Columbia into the negotiation process, and I think it is the style of the Nisga'a and their leadership that has made this possible. I think that the confrontational mode that has been characteristic of British Columbia over the last couple of decades on this issue would have probably destroyed the process had it not been for the Nisga'a, who never -- despite the temptations, I'm sure -- allowed themselves to be drawn into that kind of confrontation.

[1440]

While I will continue to disagree, particularly with the self-government model that is part of this treaty, I extend to the Nisga'a my most heartfelt congratulations on the achievement of a treaty on their behalf.

Tabling Documents

Hon. J. Sawicki: Hon. Speaker, I am pleased to table the annual report of the Ministry of Environment, Lands and Parks for the year 1999.

Orders of the Day

Hon. D. Lovick: I call Committee of Supply. In Committee A, we shall be continuing the debate on the estimates of the Attorney General. In this chamber, we are going to be debating the estimates of the Ministry of Health.

The House in Committee of Supply B; T. Stevenson in the chair.

ESTIMATES: MINISTRY OF HEALTH AND

MINISTRY RESPONSIBLE FOR SENIORS

(continued)

On vote 36: ministry operations, $8,125,203,000 (continued).

K. Krueger: In 1991 the NDP won the provincial election and elected two members in Kamloops and Kamloops-North Thompson, partly on the basis of a promise that a cancer treatment facility would be built in Kamloops. Of course, the rest is history; it never happened. It was a bitter disappointment and betrayal to the people of Kamloops. In subsequent years a decision was made to establish a tertiary-care psychiatric facility in Kamloops, but we have yet to see a spade in the ground.

I would appreciate it if the minister would give us, on the record, a status report and confirmation of the government's commitment to proceed with the construction of that facility.

[1445]

Hon. M. Farnworth: We are fully committed to that project, hon. member, and it will be built.

K. Krueger: I appreciate the clarity of that statement from the minister. I wonder if he could tell us when we can expect construction to begin.

Hon. M. Farnworth: The funds for the design of the project have been released, and it is expected that the facility will open in 2002. What has to happen is that they do the design, and then they can go to construction stage. But 2002 is the scheduled opening date.

K. Krueger: We actually had a commitment from last year's Health minister that construction would begin last year. I wonder if the minister could be more clear as to the target date for the completion of design and commencement of construction.

Hon. M. Farnworth: Hon. member, funds have been released for the design. The design work is being done. As soon as that's done, then we go on to the next stage. Accordingly, it is moving to plan; in fact, I'm hearing that it's moving a little bit ahead of plan. It will open in 2002. I would like to see it open as quickly as possible. It will be built, and it is being built in Kamloops.

A. Sanders: Before the break for the afternoon, we had been talking about the mental health plan and the historic announcement of $125 million over seven years for funding. That funding never did materialize. It materialized, over three years of a seven-year project, to the total of what we can track as $10 million. That's a $38 million shortfall in projected moneys that may have been there, based on annualization of those funds. How many cheques have actually been cut? Of the announcements that have been made to date, what is the total number of cheques that have already been cut and in the mail for the projects that were promised?

Hon. M. Farnworth: A total of $10,331,706 in cheques has been checked -- expensed.

A. Sanders: In January when the $5.7 million package of programs was announced, my understanding is that a number of the health authorities were told that they had to spend that money before March 31. Is that true?

[1450]

Hon. M. Farnworth: The only portion that had to be expensed before March 31 was $293,706.

A. Sanders: Is this money -- as the minister suggested before lunch -- annualized, and if so, where is it in the budget?

Hon. M. Farnworth: It is annualized and is reallocated from within the ministry.

A. Sanders: Reallocated from where?

Hon. M. Farnworth: All over the ministry, hon. member.

A. Sanders: I think it's not inappropriate to recognize that this is not new money. What we have from the minister's statement is $10.331 million disbursed; that was the $10 million promised in the first year. That means that there was $293,703 spent in '99-2000 on mental health. So I think it's appropriate to look at those numbers in the harsh light of reality, as opposed to talking about buckets of new money that are going towards a program or an area of health that is already stretched and underfunded.

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Many of the opinions that I would like to voice are not only my own. I read: "There are two tragedies in mental health in B.C. One is that lives are lost, families torn apart and people left seriously ill without support or treatment. The other tragedy is that government has long known what to do about the shortfalls in the mental health system but has never sustained any action to rectify them." This is from the report "Promises Made, Promises Broken," a report on the implementation of the '98 mental health plan -- or should I say the lack of implementation? Quite frankly, the plan has not been implemented either in dollars or in spirit.

A number of groups have coalesced under a common umbrella, because they are so unhappy with the mental health plan not being implemented. In fact, I think it's even worse having been promised, because once it was promised, then there was an expectation by many of the lobbying groups that there would be some action. To read in the newspapers statements from the former minister statements that the money had never been budgeted was, I think, something that has really sparked a lot of aggressive behaviour towards the minister from the public over the issue of mental health.

This is the third mental health plan that we've had since 1987. In 1992-93 the first mental health plan wasn't working so well, and a $50 million allocation was put into mental health to try to get the community to absorb some of the tertiary beds. Beds were closed at Riverview, but ancillary services in the communities were never created. By 1995 the resolution to even do something that along that line was completely gone.

In 1997 a system in crisis was identified. At that time the former Minister of Health responded to that crisis in the public with the mental health plan. Many of the interest groups who looked at that mental health plan looked at it with great anticipation and expectation, because it was a good plan. Both sides of the House at that time did agree that this was a plan that, although it was lacking in time lines and accountability structure, did have ideas that would have brought mental health much more sharply into focus as something of importance in our province with respect to health care.

In 1998 we were basically looking at a deterioration in our acute services and not a commensurate increase in our community services. In '87-88 we had 725 in-patient psychiatric beds in the province. By 1997 we had 717, and today we have 680 beds. This is not a system that is expanding; this is a system that is contracting.

[1455]

We see those effects in the communities where the mentally ill live. Anyone who has had the opportunity to go to Stanley Park these days and run on the trails can find a regular population of people living in Stanley Park. There's a regular population of people living on the streets in east Vancouver. And even in communities such as mine, in the summer there's a regular population of mentally ill who live in Polson Park in downtown Vernon.

We were promised a lot of things in the mental health plan, and I'd just like to list, for the record, the specific things that we were promised: 2,600 supported housing units, and to date 132 have been provided. Three clinicians for each of 30 communities for crisis after-hours service were promised, and three clinicians and nine communities were targeted for January 2000; 1,000 subsidized public housing units were promised, and 200 have been allocated; 410 assertive case managers, some of whom may have been allocated in the total 65 full-time employees created since 1998.

The ministry is unable to identify which of these positions are for case managers. It is also interesting to note that in addition to the 410 case manager FTEs, 30 new case manager FTEs were promised in forensic services and have never been allocated.

Spaces for 2,900 people in rehab programs; 50 spaces have been created. Establishment of interministry committee to coordinate mental health policy; no committee has been struck. Development of outcome indicators and measurements at individual, program and regional levels were promised; there's no budget for implementation.

Provincial health advocate appointed by government; an advocate is appointed on contract by the Ministry of Health with no security of tenure. And one can ask whether it is appropriate for a mental health advocate to actually report to the minister. In other words, to criticize your own boss may have dire consequences in the world of politics and the world of government. For someone to truly do their job, one has to question whether there should be something along the line of an ombudsman structure for that position.

So we have a mental health plan that is itself in crisis, and this is year 3. When the minister says that he is committed to implementing the mental health plan, will he submit to us a time line and some dollar figures for how he plans to implement that plan? We have not seen money forthcoming, in any way, necessary to implement the plan as described.

[F. Randall in the chair.]

Hon. M. Farnworth: The member raises a number of issues, and I think it's important to stress a couple of points. First off, the mental health plan is to be phased in over a seven-year period. So when one is discussing specific numbers, you have to realize that it is over a seven-year period. We have to meet those targets. I have said that we're committed to implementing the mental health plan, and we're going to.

I think it's also important to point out that for some of the figures the member talks about, there's more to it than just those specific numbers. When she talks about the beds and the units and the number of beds that have been built to date, those are beds that have been specifically targeted to people with mental illness -- that are available to them. But at the same time that has been taking place, we have been constructing a significant number of social housing units around the province that are accessible by people with mental illness. Granted, they're not specifically built for people with mental illness, but people with mental illness can access them.

We do need to maintain the construction of units that are targeted towards people with mental illness. But it's important to note that, because I think we miss out the fact that there is a lot of social housing being built around the province. Further on that, we are one of two provinces in this country that are actually building social housing and, with that, housing for people with mental illness.

[1500]

The point the member raises around the mental health advocate, for example, is a good one. I myself am currently looking at options in terms of how we deal with the mental health advocate's position. I think there is merit to the idea of looking at making the mental health advocate's position similar to the ombudsman or to the child advocate, as an arm's-length position that reports to the Legislature. I'm looking at

[ Page 15563 ]

how that structure might possibly work. That will allow a mental health advocate to do their job but also raise the profile around mental health in British Columbia.

I take the implementation of the mental health plan seriously enough that shortly after taking over this portfolio a couple of months ago and looking at where expenditures were being made in the budget, I asked the ministry staff to go back and make sure that the money that was allocated back in January is annualized for a full year -- that it's not a one-time expenditure.

I want to repeat for the House and for the member's benefit that I'm committed to making this plan work and implementing it. I've told the mental health advocates that's what I wanted to do. I'm going to sit down with them and look at how we do it and the objectives that we have to meet. It will require more money. I'm committed to ensuring that we get the money to implement the plan over its full seven-year period.

A. Sanders: In this budget, how many units of supported housing are funded?

Hon. M. Farnworth: This year 18 projects will be built, which will house 140 people across the province. I'd also like to point out that over the last decade, the number of supported housing, family care homes, licensed residential and emergency shelters for people with mental illnesses increased by 2,600 spaces, or over 109 percent.

A. Sanders: Where is the line item for the moneys that will be used for the housing identified by the minister?

Hon. M. Farnworth: There isn't a line item, because this is the money that was reallocated from within the ministry to fund these particular projects.

A. Sanders: What will the net increase in funded forensic spaces be?

[1505]

Hon. M. Farnworth: We may need to clarify your question, hon. member, because there isn't a forensic housing budget, and there traditionally hasn't been one.

A. Sanders: I'll rephrase that in a minute. What we have to look at is the decrease in housing that's available for the mentally ill since the beginning of the nineties. You have to look at what the studies show. It requires about 70 days' more hospitalization for support for someone with schizophrenia who has nowhere to go. What we're doing with these individuals is that they are being hospitalized for very long extended periods of time, if they do not have a place to go, when they may have actually gone to supportive housing.

In 1999 we had 60,000 people with serious illness related to either psychosis from schizophrenia or bipolar illness. We had 4,805 housing spaces -- 60,000 people and 4,000 spaces. Since 1970 single affordable housing stock has gone from 13,400 single-room occupancy units in the Vancouver area to 7,500. The waiting list for housing for the mentally ill in the Vancouver-Richmond area is 2,800 souls. We have 718 supported housing units for the mentally ill, plus 92 for severe mentally ill. Those are the spaces we have; that is our wait-list.

The 1998 mental health plan targeted 2,800 housing units, 1,000 subsidized housing spaces and 244 residential care spaces. Since 1998 we have had 318 units of supported housing and 170 added to forensic services.

Based on the minister's commitment to implement the mental health plan, when will we get the rest of the spaces? If we have 318 and 170 for forensic, when are we going to get the rest of the spaces that were promised in the mental health plan? It totals 4,000 new spaces in different kinds of environments.

Hon. J. Sawicki: I rise to ask leave to make an introduction.

Leave granted.

Hon. J. Sawicki: I've just had the pleasure of meeting with a class of Grade 9 students from Burnaby Central Secondary School, in my riding, to talk to them about the job that I do here as their MLA. They are accompanied by two teachers, Mr. Hayward and Ms. Brkich. Would the House please make them very welcome.

Hon. M. Farnworth: The rate at which housing spaces are, can and will be built is dependent on a number of factors. One is the resources available to government to build them. The fact of the matter is that government has been building housing for the mentally ill. The fact of the matter is that the government is also building social housing which is accessible to people with mental illness. As well, there is a considerable amount in terms of our ability to upgrade older facilities, which can improve the level of accommodation. All those things are taking place and continue to need to take place.

As the mental health plan is implemented, clearly we need to ensure that we're building housing as a key component of implementing the plan. Part of that also goes to the fact that we are constructing a facility in Kamloops which will come on in 2002, for example. It also includes the work that's done in other ministries outside of Health, specifically around social housing in general.

[1510]

I think one of the key ways in which we will ensure that housing is there for people, as the plan is implemented, is that there is a commitment by the province to continue building social housing. As I said earlier, we are one of two provinces in this country . . . . British Columbia and Quebec are the only provinces in Canada that build social housing. We are the only provinces in this country that are building social housing that is accessible to the mentally ill. No other provinces are doing that.

Our commitment is clear in that we will continue to provide social housing. As I've said, the mental health plan is going to be implemented, and part and parcel of that means having to ensure that we're building housing units.

A. Sanders: Along with that, it might be important to recognize that we're also the only province that doesn't provide unfettered access to the new anti-psychotics that make the lives of people with schizophrenia so much more tolerable. To me, that is probably the worst of the worst with respect to what this government has done with the mentally ill.

[ Page 15564 ]

Let's look at the report card so far. Funding: $125 million promised; $10 million delivered. Supportive housing: 2,600 promised; 132 beds delivered. Subsidized housing: 1,000 units promised; 200 delivered. Tertiary facilities: we don't have any more; when they're there, then we'll look back. Specialized residential care for 244 people with severe and complex mental illnesses was promised; none was developed. Emergency response beds: 35 more beds needed; none developed since 1998.

Outreach: targeted to needs of each health authority; no service commitment. Hospital diversion and after-hour crisis service: plan to expand that in 30 communities in acute-care hospitals, provide three clinicians to each of the 30 communities; January 2000 announcement included development for three communities. Day hospital programs: increase in 30 acute care hospitals for up to 1,800 clients; none developed. Assertive case management services: new staff for up to 8,200 people; 65.5 FTE employees in the first phase and perhaps 30 allocated to forensic care.

Community psychiatry sessions: more planned; two FTEs allocated in the lower mainland; 0.46 in East Kootenay; 0.77 in Simon Fraser. Psychiatric services to remote areas: training for family doctors in psychiatry skills; $164,000 invested in training funding. Rehab training: spaces for 2,900; 50 spaces funded. Second deliverable on rehab training: supported competitive employment; an announcement made -- nothing more. Family respite: no information available; promised to up to 12,000 families.

Riverview Hospital: we'll get to Riverview later. Interministry coordination: no committee formed to do that coordination. Provincial mental health advocate: future uncertain. Treatment advisory committee structure: Mental Health Advisory Council to liaise with Health Association of B.C.; people appointed -- nothing back. Governance of Riverview: we do have a new board. We can talk more about Riverview after.

Governance of forensic psychiatric services: plan to amalgamate Riverview and Forensic Psychiatric Institute shelved. Early identification and intervention -- a program of absolute extreme importance to people who work in the area of mental illness: support development of policies and protocols in the regions for early intervention; $1 million in one-time funding allocated.

[1515]

Management information: we don't have enough information. Accountability framework: I would like to see an accountability framework on the mental health plan. If the minister truly feels that he has the will to implement the plan in the four years remaining, then I'd like to see an accountability framework that would be able to track the resources, which would show that there was an accountability structure in place, that there were going to be deliverables on this plan. I have yet to see that, and I think, quite frankly, it is because it doesn't exist.

That's the sad reality of the mental health plan. Very few of the actualities of it have been delivered, and as a result of that, we have mentally ill people in British Columbia who are poorly served by the Ministry of Health. Is there a plan to develop a time line for implementation, and if so, when will that be available?

Hon. M. Farnworth: Yes, there is, and it will be released within a month.

A. Sanders: And could the minister give us some highlights of what that will look like?

Hon. M. Farnworth: It includes a number of activities and targets, and I'll read them briefly into the record.

Firstly, "Direction" -- the next steps for the mental health plan are clear. They include: (

a) complete consultation and release of the mental health reform framework to health authorities; (

b) articulation of the Ministry of Health processes for supporting the provincial strategic initiatives; and (

c) seek additional funding to implement priority objectives.

Second, "Accountability" -- significant reporting, communication and consulting have occurred, but the next steps are to build upon the current level of reporting, consultation and communication activity and support interregional communication, information and sharing.

Third, "Consistency" -- implement revised mental health financial policies and clarify 2000-2001 funding approach, including targeted versus unspecified funding allocation formula and budget and policy approval processes. Information system development should be a priority.

Health authorities are to complete mental health reform plans with support from Ministry of Health as required. Complete the workforce analysis; plan a high-profile stakeholder conference for the winter of 2000-2001; increase provider support, emphasizing best practices; and work with other ministries to provide effective and comprehensive service.

That's part of it, and you will have much greater detail when it's released within a month.

A. Sanders: Did the minister say in his statement that he will be seeking funding or that he had funding?

Hon. M. Farnworth: This is a mental health plan that's going to require funding. As I've said, one of the things I want to do is ensure that it is funded. So we're starting now to identify how and when we're going to fund it. We're starting to look at year 2, year 3, year 4.

A. Sanders: Is this a new plan, or is this for the remaining four years of the seven-year plan? Or are we starting from square one?

Hon. M. Farnworth: This is the original plan and a continuation of the work that's been done. It's not a revision of the old plan; it's not a new plan. It is the mental health plan that all of us in this House voted on.

A. Sanders: I'd like to turn from the mental health plan to the report of the mental health advocate of British Columbia. This was the office that was launched in 1998, following the recommendation from the ombudsman in her 1994 report entitled "Listening," as part of the announcement of the 1998 mental health plan. One of the responsiblities outlined for the advocate was the annual report. This is the first report from the advocate. Would the minister please give me some feedback on this report? What differences has it made in his understanding of what will be going forward for the mentally ill?

[1520]

Hon. M. Farnworth: The report is thorough and comprehensive. It points out a number of areas where we need to be concerned in terms of how we implement the mental health plan. I see it very much being used in terms of how we move forward with implementing the mental health plan.

[ Page 15565 ]

A. Sanders: Is this the report in its entirety, or is there any part of the report that was not published along with this report?

Hon. M. Farnworth: It is her complete report in its entirety, reviewed by her and dealt with by her. It is her work.

A. Sanders: I'm pleased to hear that.

The mental health advocate has a number of responsibilities. She -- at this time it's a she -- is to advocate for the mentally ill in the province. They are to comment on the standard of care and the acceptability and uniformity of care through the province. They are to advise government on how to improve care for the mentally ill.

The mental health advocate is asked to have some research priorities, to provide a referral and triage service within the office for those who seek her services, to educate the public, to produce an annual report, and to liaise with the public health officer and the advocacy officers of other jurisdictions. It's a very large amount of responsibility for the shoulders of one person. I think that any one of those in British Columbia these days would probably be a full-time job.

I looked with interest at the report and at the utilization of the office. This is a brand-new office. People are not particularly used to going to this office. It doesn't have a regular path to it, as many of our jurisdictions do. But in the report the advocate states that 857 contacts were made during the year of 1999, and 630 of those were individuals; the rest were repeats. Of the contacts, 33 percent related to difficulties getting services.

To the minister: is the minister surprised that 33 percent of our mentally ill in this province have to go to an advocate in order to get services?

Hon. M. Farnworth: I would say that I'm concerned, in a sense, that people should be able to access the system directly, in the same way that you or I would go to see our physician. I would know what the services are that I would need. But I would also say that the statistic you quote is also evidence of the awareness of the mental health advocate's position. In that sense, she is being successful in her role, which is to advocate for people. Part of that is pointing them into the right direction in terms of receiving services.

[1525]

Clearly, though, what is most desirable is a province where people can readily know what services available and, once they know what services they require, can access them directly without having to go through somebody. But until we reach that stage, I take some comfort in the fact that when people contact the mental health advocate, they are able then to access service.

A. Sanders: The sad reality of our system is that 33 percent of people do have difficulty getting services. One of the most sad and difficult cases is Mr. Trott, a murder suspect in our province this week. People with mental illness who do not get services often have very undesirable outcomes.

Has the minister thought in any way of looking at those 33 percent and what resulted from them not getting services? Is there any part of the report that could procure that information for me?

Hon. M. Farnworth: One of the things that comes, when we receive a report like this, in terms of examining and looking at the recommendations, is looking at the problems outlined in the report.

Okay, we've got the data now; we see that. Is that -- and this is what I'm interested in now -- geographically evenly spread around the province? Is there an urban-rural split within the province? Is there an intraurban split, for example? Is it in the downtown east side or in areas outside that? Is it areas in remote parts of the province such as the Peace River, for example? Or is it in the Kootenays, where there is a lack, where the bulk of the services aren't located? Is that why they're accessing the mental health advocate?

These are the questions that now come into my mind when we discuss this figure. This is the work that I would like to see take place -- and see how we address that issue now.

A. Sanders: Does the minister have a plan for addressing these issues, so that the mental health advocate has a direction from the ministry -- a leadership, a vision -- for the work that would go on in the next year?

Hon. M. Farnworth: We are, right now, preparing a detailed response to the mental health plan and all the recommendations outlined within that report. That will then be given to the mental health advocate. I will be sitting down with the mental health advocate and discussing the ministry's response to the recommendations. At that time, these are the types of issues that I would be raising and saying: "Look, we need to do some work in this particular area." So there will be an opportunity to do that, and we can start to deal with some of these questions.

A. Sanders: The report of the advocate is not particularly favourable on how we are serving the mentally ill in British Columbia. In terms of utilization, the figures were interesting: 33 percent of individuals were not able to get services; 20 percent of the calls and visits were related to the B.C. Benefits program or previous private insurance benefit programs; 14 percent of those who accessed the advocate had problems with safe, accessible, affordable housing; and 18 percent of individuals had legal matters -- either criminal code, custody or property issues -- that needed to be ameliorated for them.

[1530]

I think it's important for people to recognize that mental illness is often a permanent state. Some people may be mentally ill for a very short period of time, and other people may be mentally ill with a chronicity that extends their entire life. The problems don't go away. We have to look at how we are going to deal with these a little bit more effectively.

One of the places where we have, in the past, been able to do that has been at Riverview. We have an 800-bed facility at Riverview. Historically it has been much more. But at this point, with the halting of the downsizing of the facility since '96, 800 beds have been maintained. The reality of that is that it really is about 100 acute beds, I believe, because the other 700 beds are individuals who will never be leaving Riverview and will spend most of their time in that facility. What was intended with the downsizing of Riverview was a repatriation of those tertiary services.

My colleague from Kamloops had discussed the facility in Kamloops and when, perhaps, that 88-bed facility would be

[ Page 15566 ]

built. I have one question on the Kamloops issue, and then I'd like to go back to Riverview. With the Kamloops facility, could the minister give me an idea of why on earth it was decided to be built in Kamloops when it is to serve the Kootenays, the Cariboo, the Okanagan and the North Thompson? The centre of that universe would certainly not be Kamloops, if I am thinking from the point of view of a family that has to go and service a member of the family at that facility -- should we ever have it and have it operating. Can the minister tell me why Kamloops was the designated area? Was that a political decision? Was that a decision of convenience? Or was that just the best place to have it?

Hon. M. Farnworth: That decision was taken before I became minister -- in fact before I went into cabinet. I would also add . . . . I don't know if the member for Kamloops-North Thompson would appreciate that line of questioning. The decision was taken some time ago. I know one of the reasons why is that Kamloops does have a fairly extensive system of community support, but in reality this was done long before I became minister and went into cabinet.

A. Sanders: It's something I'm asked quite often. I think people in the Kootenays always feel shortchanged. It's one of the more difficult areas of the province to get in and out of. The Cariboo has its difficulties as well, and Kamloops is certainly not the centre of the universe with respect to the population it would serve.

I'd like to turn to Riverview and have an update on its present status as an institution.

Hon. M. Farnworth: Before I do that, I would be remiss if I didn't introduce the individual to my left here. That is Alex Berland, who is the interim director of mental health and CEO out at Riverview. I'll be able to deal with the questions . . . .

[1535]

As the member pointed out a few minutes ago, the downsizing at Riverview ceased back in '96. It's currently funded for 808 beds. It's the major tertiary psychiatric hospital for British Columbia. Currently the occupancy rate is around 97 percent, and we have about 50 adults waiting for admission to Riverview.

A. Sanders: Has there been stabilization of the Riverview situation, and if so, could the minister describe that?

Hon. M. Farnworth: The stabilization process that has taken place has allowed a number of things to happen. One has been a modernization of services there. It has managed to see a reduction in the wait-list from around 150 down to 50, and in fact, last year 12 new beds were able to be opened.

A. Sanders: What is the present governance of Riverview?

Hon. M. Farnworth: There's a new board in place. They have had two meetings, and one of their prime activities right now is a search for a permanent CEO.

A. Sanders: Are there any plans this year to change Riverview's governance from a stand-alone institution to coming under any of the other health boards?

Hon. M. Farnworth: Not at this time.

A. Sanders: What is the relationship at this point between Riverview and the Forensic Psychiatric Institute?

Hon. M. Farnworth: They are two separate institutions, but there is a considerable sharing of services between the two facilities for efficiency purposes.

A. Sanders: It was mentioned earlier that in the mental health plan there was a move to have further integration and communication between these two services. What steps have been taken to streamline that process, seeing that the integration has not occurred?

Hon. M. Farnworth: There are a number of initiatives that have taken place. I'll give you some of the key ones. They involve shared information technology, shared information systems, the shared transfer of patients and the shared education of staff.

A. Sanders: Is there a default system, where a patient can go from one facility to another should there be a space available and that patient is suitable?

Hon. M. Farnworth: Not at the front end of the system. The reason for that is that there are legal constraints that don't allow that.

A. Sanders: In the mental health plan, $2.1 million was allocated for 30 forensic liaison workers. At this point, are there any further FTEs in the forensic system than there were in 1998?

Hon. M. Farnworth: All 30 of those positions have been filled, and they are distributed throughout the province.

[1540]

A. Sanders: I was just reading from my colleague's letter here where it says additional psychiatric services -- three FTEs annualized to facilitate enhanced response for assessments.

When the minister says 30 forensic . . . . We were discussing forensic liaison workers. Are we talking about the same thing? Is this a person working in the system, an MSP person or a person on sessional fee? How is that described?

Hon. M. Farnworth: The 30 people that I mentioned, the liaison workers, can be basically broken down into three categories.

Court liaisons -- their role is to determine if options for community treatment exist and to advise the court on these options when it is appropriate. They can assist in diverting people out of the criminal justice system and into the health system.

The second group are correctional facility liaisons. They ensure that mentally disordered offenders will receive the treatment they need while they are in jail. In addition, these workers assist in planning the discharge of these individuals to ensure that their care continues once they are no longer in a correctional facility.

Community case managers -- they work closely with mentally disordered offenders who have been discharged into

[ Page 15567 ]

the community. They work to ensure that these individuals have access to the community resources they need to help improve their chances of avoiding return to prison.

A. Sanders: Of those numbers, how many are on contract and how many are in-house?

Hon. M. Farnworth: It is my understanding that all of them are employees of the forensic commission and are therefore in-house. I will confirm that, but I am 98 percent sure.

A. Sanders: I was referring to a letter from Chief Judge Metzger that was tabled in the House yesterday. In that letter he states: "As you are aware, the lack of facilities at the Forensic Institute has resulted in very significant delays in the assessment of mentally disordered offenders." This is a very serious problem.

What is the mean length of time that we are talking about when we discuss a "significant delay"?

Hon. M. Farnworth: In terms of the priority that is attached to the particular assessment, the delay can range from a few days to a few weeks.

A. Sanders: This is a very important area within mental health. Often jail is this default mental health facility that many of our psychiatrically disabled offenders end up in, as opposed to treatment. The amount of time between charging and assessment is not always timely. The mental health advocate has written in her report that many people are waiting considerable amounts of time without diagnosis but in circumstances of incarceration, which perhaps is not the most suitable place to be.

Can the minister tell me about the pre-trial centre at the Vancouver jail, and how that is functioning?

[1545]

Hon. M. Farnworth: It's functioning well. We have a good relationship with it, and the reports we have had from it are, in fact, satisfactory.

A. Sanders: When offenders are undiagnosed or the forensic system is full, we often end up with them waiting for assessment and having them spend time in jail as a result of that. It's not unusual for people who are mentally ill and incarcerated with nuisance-type charges to lose their homes and all of their possessions during that period of time. It is a very serious problem for those individuals.

To the minister: what actions are being taken by the ministry to monitor the participation rate of the seriously ill in the regional mental health systems, in the forensic system and in the correctional system?

Hon. M. Farnworth: The member is right. That is a key part of the mental health plan. That's one of the reasons why one of the earliest things that was done was the hiring of the 30 liaison workers; that is a significant part of their role.

A. Sanders: Is the ministry gathering statistics on this issue at this time?

Hon. M. Farnworth: That's part of the framework plan, which I mentioned a number of minutes ago, that will be released at the end of the month.

A. Sanders: Does the Forensic Psychiatric Commission have a strategy to treat mentally ill people in jail?

Hon. M. Farnworth: Absolutely, they do. That's again around the 30 that I talked about and the functions that they are performing around court liaison, jail liaison and community case management.

A. Sanders: I want to read a few statistics into the record. I find it alarming sometimes that people assume that the mentally ill are violent. We are talking about the forensic issue here, so I thought it might be appropriate to dispel that myth.

One percent of our population has schizophrenia. About 3 percent of the population are seriously and persistently ill. Of the people at Riverview, 53 percent have pre-existing criminal charges. The mentally ill are no more likely to demonstrate violence than the average population -- unless addiction is a factor. That's important to recognize.

Because of a lack of care and access to drugs, self-medication is very common; 50 percent of schizophrenics will have substance misuse problems. That's a very important key in the forensic system and a very important reason why we not only need a good forensic system, but we need to have good substance abuse programs, and we need to have easy, facilitated access to appropriate medications for people with schizophrenia.

[1550]

When we are looking at the mentally ill, one in five individuals will have a problem with mental illness at some time next year. We are talking about around 800,000 British Columbians. This is a huge number of people who will experience some diagnosis along the spectrum of impulse control, schizophrenia, dementia, substance abuse, anxiety or mood disorder. This is just to put into the record that we are talking about a considerable number of people in this province who we are not treating as well as we should.

In the advocate's report, patients' rights were delineated as an area of importance. To the minister: is there any move within the ministry and the regional health boards to develop standards of care in mental health -- a type of patients' rights proclamation?

Hon. M. Farnworth: The answer is yes. In fact, that will be part of the framework structure that we will be releasing within a month. I want to say that I think that is one of the key elements in terms of implementing the mental health plan and in fact dealing with a number of the issues that the member has raised.

I want to say that you have raised some important points. They relate back to the issue around stigma and public perception. Having grown up near Riverview and the forensic institution, I know from firsthand experience that what you say is accurate. I also know how important it is that the immediate family and support network of people with mental illnesses be involved in the decision-making process and in implementation.

The short answer to your question is: yes, they will be.

A. Sanders: Will the patients' standards for mental health care be done in collaboration with family groups, individuals with mental illness and those who care for the mentally ill, or is this a document coming from the ministry without that input?

[ Page 15568 ]

Hon. M. Farnworth: It will be a collaborative process.

A. Sanders: What is the framework for that process to take place? I am somewhat surprised that it would be here in a month when there haven't even been any rumblings about it. I'm interested in how that has evolved and what it looks like at this point.

Hon. M. Farnworth: We have in place already the one that's been developed for Riverview, the Riverview patients' rights charter. What we are doing in terms of the framework is now saying to the local health authorities that they in turn must develop their own standard, but it must meet local needs. It's not going to be imposed from Victoria, saying that this is how it should be done, how you should treat the mentally ill in Quesnel or in Vernon. Rather, the health authorities in those areas are going to have to develop the plans and involve the patients, the families and the advocates in that process.

[1555]

A. Sanders: I am going to ask one additional question and leave the report of the advocate. Next week I would like to discuss the problem with youth that is identified in her report, as well as a little bit more on the housing circumstance.

I want to ask one question of the minister before I go. The nurses that work with the mentally ill are paid around $3 less per hour, in the area of the severely mentally ill. Specifically, I'm talking about Riverview. That in itself puts a stigma on who might go to work there. I wonder if the minister has any comments on that. Is there any action plan to make sure that at a time when we have few nurses, the mentally ill do not suffer more than their share by finding that people are not being remunerated to look after them in the same way that they are in other institutions and other areas of care?

Hon. M. Farnworth: I'm aware of the issue that the hon. member raises, and we're trying to resolve it. I would also add one point as well, though, and this relates to your first comment about how you wanted to talk about children's mental health. A lot of that will be in the Ministry for Children and Families -- just so we know that.

C. Hansen: Rather than interrupting the flow of questions from my colleague, I made notes of some supplemental questions to follow up on some of the various areas that we've canvassed over this last hour and a half. I want to come back to some of these issues, so if it sounds like I'm revisiting stuff that we've covered earlier this afternoon, I am -- not to duplicate, but rather to get some additional clarification to some of the points that the minister made earlier.

One of the things that is not clear, I think -- to anyone that has followed this discussion this morning and this afternoon, and certainly if they were to try to read through it -- is how much money is in this year's budget for the funding of the mental health plan.

[T. Stevenson in the chair.]

Hon. M. Farnworth: We spend $364 million a year on mental health services in the province of British Columbia. That is, in large measure, what the mental health plan is about -- how we spend those resources and where they're going. The mental health plan is building on that. It is a plan to increase and improve services and to make sure the services are being directed to the people who need them most.

C. Hansen: The commitment that was made by this government when the mental health plan was introduced was that there was going to be $125 million of new money. I would like to ask the minister: in the line item that is titled "Adult Mental Health" in the budget that we have before us, how much of that budget is for the implementation of the mental health plan, how much of those are new dollars and how much of those are simply reallocation of old dollars?

[1600]

Hon. M. Farnworth: Last year's budget was $348.7 million; this year's budget is $364 million. I'd also make the proviso that the mental health plan isn't just about adding money and saying that you will add $15 million, $15 million, $15 million, etc. It is just as much about making changes in how money that's already spent is allocated and about putting in place structural changes that allow us to implement the mental health plan. In some years you may in fact have to spend considerably more money to achieve objectives. That's why it's a seven-year plan.

C. Hansen: If the minister's telling us that there is no new money in this year's budget for the mental health plan, why doesn't he just stand up and say that? He seems to be trying to find every other way to make that statement without actually saying it.

On April 3, when we asked specifically about the mental health plan in question period, the minister said: "Does it require more money? Absolutely. Are we committed to the plan? Absolutely." On May 1 he said: "The plan is being implemented. The money is in place to put those services into the region." Another quote: "This government is committed to implementing the mental health plan and the recommendations in it."

I think what I hear the minister saying is that they've got this document called a mental health plan -- a framework that has been largely endorsed by the mental health community in British Columbia . . . . What he is telling us is that there is no money in this budget specifically for the implementation of it. All we're doing is trying to categorize some of the existing spending under adult mental health in the budget and claim that it is in fact implementing a mental health plan. These are not new dollars.

In the budget that is before us for adult mental health today, there is an increase over last year. The minister actually used some numbers that are slightly different from what I have before me, but the restated estimates for the last fiscal year were that adult mental health was going to be $348.449 million. This year's budget is $363.974 million. That is an increase of $15.525 million.

Will the minister tell us if any of that $15.5 million is for program spending? Or is it, in fact, that that $15.5 million is purely to fund collective agreements, wage-parity issues and the other wage issues that were documented recently by the Minister of Finance?

Hon. M. Farnworth: Of the $15.3 million that the member has raised, $5.5 million is new money to mental health. It's

[ Page 15569 ]

not reallocated from within mental health; that is new money to mental health that has been reallocated from within the Ministry of Health. That is new to mental health, and it is for program expenditures.

[1605]

C. Hansen: Earlier in the discussion we were talking about the announcement that was made on January 19, titled "Mental Health Funding Announced." It talked about a $5.7 million package of programs. Then the minister, earlier, explained to us that only $293,000 of that $5.7 million in last year's budget was actually disbursed. That basically still leaves roughly $5.5 million, out of the January announcement. My question to the minister is: is the $5.5 million that he just referred to what is required to simply implement the announcement that was made on January 19 of this year by the previous minister?

Hon. M. Farnworth: That is correct.

C. Hansen: So in terms of the dollars that are in this budget, in terms of new money that could be tallied towards the $125 million commitment that was made by this government of new money for the mental health plan, all that is in this year's budget, if I hear the minister right, is $5.5 million. Could the minister confirm that? And that $5.5 million was already announced by the previous minister back in January.

Hon. M. Farnworth: The $5.5 million is money that is new to mental health this year. It was reallocated from within the Ministry of Health budget and is new to mental health.

C. Hansen: Could the minister tell us where it is reallocated from within the budget?

Hon. M. Farnworth: It's allocated from the entire ministry outside of mental health. So it's some here, some there, some there.

C. Hansen: I want to come back to the press release that was put out on January 19 by the previous minister. Of this $5.7 million announcement that was made, it was indicated that there was a total of $2.98 million that was going to be used to expand community mental health services like supportive employment, substance abuse prevention and early intervention. It says: "The remaining $2.73 million will provide intensive community support for up to 50 hard-to-house people with mental illness." I'm sure anybody who is involved in the mental health community will applaud those as noble objectives and clearly part of the objectives that were trying to be achieved by the mental health plan.

[1610]

Could the minister explain to us, first of all, what portion of that was in fact the $293,000 that was allocated from last year and how much of those two categories gets carried over to this year? Secondly, could the minister explain how these projects are annualized?

Hon. M. Farnworth: The $293,000 was from last year, and it went to the following: supportive employment, early identification and intervention, northern clinical, provincial neuropsychiatry and expansion of GP training. The others are all annualized.

C. Hansen: One of the things contained in the report from the B.C. Mental Health Monitoring Coalition is a reference to this money that was announced in January. I'll read the

section from the report on page 5: "Much of this was one-time funding allocated for 'demonstration' projects. The announcements came in the ninth month of the fiscal year, and regions were asked to write proposals for it" -- making it difficult for regions to access the money, which we've explained earlier. I would like to ask the minister: are these in fact demonstration projects, or are they in fact annualized projects?

Hon. M. Farnworth: It's all ongoing funding. It's all continuing funding; it's not one-time funding. But the projects that are being funded are not necessarily all ongoing projects. Most of them are, but some of them are pilot projects. Let's say, for example, one of the projects only lasted a year. It means that at the end of the year, if that project wound down and it was decided not to pursue it further, that money would still be available to fund something else. All the funding is ongoing funding, but not all the projects receiving the funding are ongoing projects.

[1615]

C. Hansen: On page 15 of the same report they talk about a survey that the coalition undertook with representative staff in regions around the province. I don't think they pretend that this was some kind of a scientific survey; rather it's a sampling of opinion and feedback on their experience with the implementation of the mental health plan -- or the lack of it, as we've come to realize.

One of the things they talk about is the sense in the regions that the timing of these announcements make it very difficult for the regions to respond to it and a sense by those representative staff that these projects are deliberately set up for failure because of the way they are funded.

Another area that I think is quite important is that regions have no way of knowing what to expect for future funding, and they have little confidence to plan. In other words, they're not given the sense that this is in fact ongoing funding. This is very much project funding; it has a termination to it. They can't make the long-term commitments for these projects, because nobody knows from month to month -- or from year to year, at least -- when their project is going to run out. They have no sense of certainty in terms of delivering a service that consumers will be able to count on for more than just a few months at a time.

Hon. M. Farnworth: The member raises some good points. One of the key things we want to do is ensure . . . . I don't want to approve any project to be set up for failure, because I think that if a project is approved, it's approved for a specific purpose. The idea in the case of a pilot project is that it's funded for a particular length of time that allows for it to be properly evaluated. We can make a determination at the end of the project that either the goals of the project were met or the outcomes were the desired outcomes. We can then make a decision on whether we take a pilot project and run it provincewide or whether the pilot project didn't particularly work.

Around ongoing projects, when a project is approved and is viewed as ongoing, then it has to be communicated that this project is expected to be ongoing. You should have reasonable

[ Page 15570 ]

assurance that in fact, yes, the funding is there. Again, it needs to be properly evaluated along the way. Certainly nothing is set up for failure.

If that is a perception in some areas -- and I take the member's comments about it being a small sample and some opinions -- clearly that is something we can address in terms of when funding is approved and what the expectations are and how we see projects, with ongoing or pilot projects being implemented.

C. Hansen: I think one of the critical issues here is the issue of certainty. In terms of those individuals in the province who are responsible for trying to coordinate and deliver these kinds of services, will they be able to get a sense of some stability and certainty to these programs when they see the implementation report sometime within the next month?

Hon. M. Farnworth: That is very much the intention.

C. Hansen: I'd like to move on to the issue of governance and how it affects mental health programs. Certainly in these documents that we have received, there are several references to some real problems, I think, in terms of direction. Specifically, I want to refer to the ministry's performance plan under the area of mental health. The very first key program objective under mental health on page 9 in that performance plan is: "Support health authorities' capacity to strengthen mental health services, including those serving rural and remote communities." That is obviously a noble objective.

[1620]

Performance measures. They talk about a clear policy direction, and they talk about the development of best practice resources and tools. In that context, I just wanted to highlight a couple of comments in these two reports. The first was a reference out of the report of the mental health advocate, where she says: "Currently competent emergency mental health services are not uniformly available around the province." I'm going to skip to various sections, because I think it's a theme that comes up in several different contexts throughout these reports.

On page 13 she talks about difficulty in moving from one region to another: "Portability is a basic condition of medicare, but in the regionalized system, individuals with mental illness often found it difficult to take their benefits from one region to another . . . . "

I had a phone call about three months ago from a constituent in Vancouver who had just very recently moved from Kelowna. She is a mental health consumer, and she described to me the very different services that were available to her between Kelowna and Vancouver. It was almost as if she had moved from one country to another in terms of a very different approach to how mental health services were delivered, particularly the continuum of care and the ability to access services in one office -- being shuffled from one office to another in Vancouver as opposed to the very centralized service that she had experienced when she was in Kelowna.

Further in the report she says: "One rural regional director noted to the advocate that currently there are 22 different employers in his health region responsible for mental health service delivery." Another quote: "When learning about the elements of the mental health system, it quickly became clear that in fact there were at least 18 different mental health systems being played out in the regions" -- the 11 regional health boards that we have around the province and the seven community CHHSs.

What I see happening -- which, actually, I think we see happening in areas other than just mental health across the spectrum of delivery of health services, but is particularly true in the area of mental health -- is this patchwork that we have developing in the province when it comes to the standards of care and what a consumer or patient can expect in terms of care.

In terms of the coalition's report itself, they make a couple of references to this same theme. They talk about the scope of each mental health director in the region. That responsibility varies widely from region to region. They also note that the alignment with the 1998 mental health plan varies widely from region to region. They also note: "In most jurisdictions where mental health funding has not been protected, mental health funds have been diverted to other priorities." This is an area that I want to touch on not just in the context of provincial standards but in terms of accountability as well.

The last reference I want to make in terms of this regional patchwork that we're seeing is again in the area of accountability, where the coalition's report under the title "Regional Governance and Public Accountability" says: "The regions have been given letters of understanding about their obligations to preserve funds for specific mental health programs. This is only as effective as the goodwill and compliance of the regional authorities; no accountability is enforced."

I'm wondering if the minister could comment on this patchwork that we have, the need for provincial standards when it comes to how mental health services should be delivered in the province and what kind of accountability mechanisms he sees coming into place so that we can ensure that these dollars are in fact being spent on patient care, to the benefit of mental health consumers around the province.

[1625]

Hon. M. Farnworth: That's what the framework of implementation that is to be released in about a month is intended to address -- the issues around standards -- so that there is a standard out there, across the province, that all health authorities can look to and see what they are supposed to be doing. Also, in terms of resources, it's so we can see who's spending what and where they're spending it.

This is very much in line with the comments the member raised around the patchwork of services that are available out there. There are a number of reasons why that patchwork has developed the way it has. Part of them are historical; part of them are geographical. It is no secret that for the longest time in this province, mental health services were primarily focused -- institutionalized, certainly -- within the lower mainland. There has been a much greater specialization in terms of services here in the lower mainland,

whereas geography has in some cases dictated a much closer-knit ability to deliver services outside the lower mainland. But these issues are certainly one of the key things that are intended to be addressed by the framework for the mental health plan implementation.

C. Hansen: This leads us into the second key program objective that was set out in the performance plan. That is the development of mechanisms for accountability in mental health services. In terms of performance measures, it talks about a performance-monitoring framework and baseline

[ Page 15571 ]

report. It also talks about a resource utilization management report. I'm assuming from the minister's comments that in fact we will see these in the implementation report.

For my benefit, could the minister explain to us what we can expect in terms of a resource utilization management report? What is it we're talking about? What is it we should expect to see in that particular aspect of the report?

Hon. M. Farnworth: Both performance monitoring and resource utilization are part of the framework plan and objectives, which will be in this month. So the issues that you're raising . . . . It's a baseline, based on expenditures as they were taking place in '97-98, which will be repeated later this year, so we can see where the dollars are going and how they're being expended. That will help, I think, give a much clearer picture.

C. Hansen: I gather from the minister's comments that when we talk about a baseline report, we're talking about the allocation of dollars as opposed to program delivery or objectives on the outcomes of programs. Is it a baseline in terms of dollars?

The other thing is the reference to resource utilization management. If the minister could explain what is meant by that term . . . .

Hon. M. Farnworth: In answer to your first question, it is in fact both. It's not only dollars but also program delivery.

In terms of resource utilization, it will show by region, for example, doctors' services, hospital use, community services -- those types of things. It will be fairly comprehensive.

C. Hansen: The third program objective that was set out is to support initiatives that strengthen the inclusion and contributions of mental health consumers and their families in service planning and evaluation.

This is certainly an area that I have heard a lot about, as I'm sure the minister has, from consumers and family members who really feel that in the last couple of years there has been a significant decrease in their opportunity to be involved in the planning process. Some of the various organizations that were self-help and were being organized and managed by mental health consumers have seen their funding dry up. The inclusion of mental health consumers on certain boards has been reduced.

[1630]

There is a specific reference in the coalition's report to the B.C. Mental Health Society board -- that a decision was made by the ministry . . . . Excuse me, I'm getting the wrong quote here. There was a spot on the forensic commission for a consumer, and apparently that spot has never been filled. I'm just wondering if the minister could comment on how we are going to see more involvement by mental health consumers on the boards, in terms of planning both the program development and policy directions for the future.

Hon. M. Farnworth: First, there will be no reduction in dollars in this area. Second, if there is a position vacant, I'm more than happy to fill it. Never let it be said that I would pass up an opportunity to fill a position. If there are individuals in the consumers' families, I'm quite happy to see that filled and do that at the earliest possible opportunity.

C. Hansen: But as a matter of policy, is the minister prepared to ensure that mental health consumers have a place at the table in all of the boards and planning bodies that are involved in the development of mental health policy and programs in the province?

Hon. M. Farnworth: Yes, I am.

C. Hansen: I want to move on to a couple of areas involving Riverview. My colleague from Okanagan-Vernon, I know, touched on this area very ably, and I just want to pick up a couple of issues. Two were contained in the report of the mental health advocate, where there is a reference to individuals who could be discharged after long hospitalization with no benefits and no bus pass. Actually, if I give the full quote, maybe it'll put it in better context: "The Riverview advocate was also concerned that someone could be discharged after long hospitalization with no benefits and no bus pass."

I'm just wondering what the policy of the facility would be in terms of how they discharge individuals and how this particular concern of the advocate is going to be addressed.

Hon. M. Farnworth: Those were in fact isolated incidences. In fact, the one concerning the bus pass was a single individual, and that was an internal problem. Steps have been taken to address that particular concern.

C. Hansen: I think the second reference, again, is in terms of how some of these policies affect individuals' lives. I don't believe this is pertaining directly to Riverview, but I'll read the reference and ask for the minister's comments: "The advocate's office was contacted by two people who lost their housing because their shelter allowance was not continued when they were in hospital for four months." Given a length of stay of that duration, it was an admission to Riverview, I would assume. "These people lost their homes, their furniture and also all of their personal possessions, because the ministry considers it cheaper to pay for new household items than to pay for storage."

I'm just wondering if that is in fact a ministry policy, whether or not it's being reviewed and what individual mental health consumers might be able to expect in the future.

Hon. M. Farnworth: My understanding is that it's not ministry policy, but I will look into it for the member and for my own edification.

C. Hansen: There is reference made to the B.C. health information management project. I'm wondering if the minister could give us an update on where we're at with that project, whether or not the funding is in fact stable and what kind of a time line, specifically, we might expect for that project.

[1635]

Hon. M. Farnworth: This report is an industry group -- a report made up . . . people right across the province. We have completed phase 1 of the work, which is currently being reviewed by the ministry for response. Once that is done, we will go and see what further action is required. It's a little bit premature at this particular point to say, "Okay, here's the next set of time lines," but we have received and are actually reviewing it.

C. Hansen: I know that my colleague touched on some of the forensic issues earlier as well. I want to ask the minister to

[ Page 15572 ]

define for us where the role of the Ministry of Health divides from the role of the Attorney General responsibilities when it comes to forensic programs.

Hon. M. Farnworth: I guess that in a strict definition sense, the line is in terms of budgetary items, such as: "We're responsible for program A, and the Attorney General is responsible for program B." But in a practical sense, I think what's important is that my ministry and the Attorney General's ministry recognize that in a number of areas, there is an overlap of interests. We have to work to ensure that our two interests are working together and that there's communication between my ministry and the Attorney General ministry -- particularly when it comes to, for example, Corrections and jails.

That's one of the reasons why these 30 liaison officers were hired. Part of their role is to keep that liaison in place so that there is communication and that the clients we're serving have someone there who can work with institutions and services which are in the Attorney General ministry as well as those which are in my ministry.

C. Hansen: My interest is in where the dividing line is for programs. If there is a program initiative that is seen as desirable, is it sort of a case of who can scrounge the budget or who's got the most impact with Treasury Board? Or is there in fact a dividing line as to which program would fall into the Ministry of Health, as opposed to being the Attorney General's responsibility?

Hon. M. Farnworth: Part of the answer to your question is in terms of how the court system determines . . . . If you're looking at an individual on whether the program . . . which ministry they are coming towards in terms of receiving services, part will be determined by what a judge does in terms of passing sentence. So if a judge's sentence is prison, then clearly that's in the Attorney General's sphere. If the judge's sentence is a forensic sentence, that comes into our sphere.

Now, having said that . . . . On your question around programs, what we need to look at is twofold: what's the nature of the program, and what is the purpose of the program? If the purpose of the program is of a judicial nature or a correctional nature, then that would be more Attorney General-driven.

Whereas, if the nature of the program is health-driven or has a health outcome, it will be Health-driven.

But what is crucial, and what we've got to realize, is that we have to look at the program and what its objective is. Sometimes there's a blending of the two. That's where you will find that Health and Attorney General will fund something jointly.

So it's not a question of saying: "Okay, I can get it out of Health budget, so we'll do it," or " . . . out of Attorney General's budget, so they'll do it." It's a question of: what is the nature of the program, and what is its specific purpose? Quite often there's a combination of the two, and it will require joint funding from both ministries.

[1640]

C. Hansen: The reason for my concern is that we often see individuals who go into the corrections system and who are suffering from mental illness do not have programs available. I'm not reassured by the minister's comments, because in that response, there's still too much opportunity for people to fall between the cracks in terms of being able to access programs.

In the report of the mental health advocate, she uses the number of 32 percent of inmates in our correctional facilities with signs of mental disorders. She also goes on to say: "When people are undiagnosed or the forensic system is full, people waiting for assessments end up in local correctional facilities. People who are charged, in jail and mentally ill tend to receive minimal or no treatment."

I wonder if the minister could outline for the House: if this problem is going to be addressed, who do we hold accountable for addressing it? Do we hold the Minister of Health or do we hold the Attorney General accountable for ensuring that there are programs in place for individuals who are in B.C.'s correctional facilities?

Hon. M. Farnworth: I think it's a question of holding both of us accountable. I don't think it's possible for one or the other to pass the buck and say, "No, it's Health's responsibility" or "It's Attorney General's responsibility," because a lot of these are joint-funded -- or there's a joint interest there. That's one of the reasons why the 30 liaison officers were hired. I illustrated before the three areas in which they're broken down. That's a key part of their role -- to ensure that there is that liaising taking place between the individual and trying to identify the services they need and ensuring that they get them, particularly at that court level.

C. Hansen: I was surprised at the minister's earlier answer on this, when he said that he was 98 percent sure that all of these various workers were in fact in-house, with government. My understanding is that some of these court liaison workers are in fact on contracts through some of the advocacy groups. I'm thinking particularly of the Mental Patients Association in Vancouver, which I believe has some court workers. My understanding is that it was in fact a model in the province -- that a lot of these services were handled by various support groups on contract to the ministry.

[1645]

Hon. M. Farnworth: I have now had that 2 percent clarified. Those 30 liaison officers are employees of the province; they are not contract employees. The contract employees are in fact . . . . Those 30 employees are over and above contract employees that we may have hired for particular services.

C. Hansen: My understanding is that these court liaison positions have been in place for some time now. They certainly are not very recent, in terms of months. I'm not sure whether they've been there a year or two years, or whatever it may be. And yet what we see is that the problems that have been identified are in fact current and real.

I wonder if the minister has any thought of expanding that program, in terms of what additional resources are being contemplated to put into that forensics system -- or the corrections system generally -- in order to ensure that those suffering from mental illness have the opportunity to get into programs and get assistance in that context before they are put back on the street without those kinds of services and programs available.

Hon. M. Farnworth: A number have been in place for some time -- certainly within the last year. But a number have

[ Page 15573 ]

also been much more recent; they weren't all hired at once. Particularly in the more remote areas of the province, getting people is not always the easiest thing. But all the spaces are now filled, and they're in place.

One of the key elements taking place is an evaluation of the program and of the performance and progress of the new officers. I'm expecting that evaluation will be completed shortly, and we'll be able to review what's happened to date. I'm particularly interested in this, because I think that if it does prove successful and we do start to see the desired outcomes, then clearly if there is a way that we can have an impact, my sense of it would be to look at expanding a program such as this if it's ensuring that people are getting the treatment or it is working to reduce some of the problems.

C. Hansen: I know my colleague wants to come back to some of the issues surrounding children's mental health, and I appreciate the fact that this is under Children and Families. One of the questions I want to put to the minister today, before we go down that road on another day, is to get a clear understanding as to where -- just as the line is drawn between the Ministry of Health and the Attorney General -- the line is drawn between the Ministry of Health and the Ministry for Children and Families when it comes to the delivery of programs.

My understanding is that it's not simply a question of how old someone is, because there are some programs that in fact cross over that age definition. Could the minister outline that for us?

[1650]

Hon. M. Farnworth: Again, in a strict definition, in general 19 is the line, but there are some key exceptions to that. One of them is around . . . . We get children that show up at institutions, for example, who are under 19 or 16, and they receive treatment. So that happens. As well, the other major area is around adults with developmental disabilities, where physically or by calendar years they're over 19, but on a developmental basis they are nowhere near that age. There are important and compelling reasons why you should be treating them or housing them with people at the same stage of development. So that is one difference.

The second point I'd like to make is that, similar to the relationship with the Attorney General, there is a close relationship with the Ministry for Children and Families. It involves interministerial committees that look at those areas where there is overlap, where there's a commonality of interest. There's a recognition that while 19 is there, at the same time there are lots of areas where there is that overlap taking place.

I recognize that that is a challenge, but it's one that we are working on and actively recognize and are dealing with.

C. Hansen: For those mental health consumers under the age of 19, does the Ministry of Health deliver any programs on behalf of the Ministry for Children and Families? I'm aware, in the area of drug and alcohol programs, that the Vancouver-Richmond health board has been contracted by the Ministry for Children and Families to deliver those programs. Are there similar kinds of contractual arrangements between the Ministry for Children and Families and the Ministry of Health in the area of adolescent mental health programs?

Hon. M. Farnworth: In terms of ongoing projects, hon. member, there are very few. There may be one or two. But primarily, anything with children is with Children and Families and anything with adults is with Health.

In terms of the question around alcohol and drugs and MCF, the contract is with the Vancouver-Richmond health board.

C. Hansen: I was quite aware of that. I was just using that as an example of a similar contractual arrangement in another area. One of the issues that I hear come up too often is the concern that individuals fall between the cracks when they turn 19 and the lack of consistency in programs from Children and Families for an 18-year-old to the Ministry of Health for a 19-year-old. I'm wondering what kind of casework is done. Not the interministerial policy kind of committees that the minister referenced earlier, but what kind of programs are in place to ensure a continuum of care for an 18-year-old to a 19-year-old as they transfer between these two ministries?

[1655]

Hon. M. Farnworth: I understand the issue that the member raises, and the question of falling between the cracks when you turn from 18 to 19 is one that has been around for a long time, even before the splitting of the resources into the Ministry for Children and Families and Health. I think one of the things is that there is a real effort to minimize that between the ministries and to ensure that there is ongoing work between the two ministries.

In respect to the specific part of your question, one of the things that happens in the province is that within the local health authorities, there are specific committees that deal with trying to ensure that there is a proper liasing between the different agencies and ministries -- whether it's MCF or social services. In some areas it even includes Attorney General. So there is an effort, there is a recognition and there is work being done to make sure that the problems that can occur in fact don't.

C. Hansen: Certainly it's an area that I think needs to be flagged as an area that is of great concern. It only takes three or four examples to be brought forward, certainly, to make me realize that it's a very real problem. There are young men, I guess in particular, who have committed suicide at about that stage. I certainly don't want to draw an inference that this was what led to the suicide, but I know that there are certainly concerns about the lack of -- I am trying to choose my words carefully here -- consistency of care as they make that transition.

The change of caseworkers and the change of programs add undue stress to an individual who already has a great deal of difficulty dealing with other stresses, and that rather than the programs helping, the programs in fact . . . . There's certainly speculation that that change is part of the problem rather than part of the solution. I'm glad to hear the minister say that it's an area they're working on, because I think there are certainly those in the field who feel it is a major issue that needs to be dealt with better than what we have been able to do up to now.

I do want to shift gears now -- unless the minister wants to make any other comments on the area of mental health. I think we will probably come back to mental health before the estimates are over, but I'll certainly try to give the minister's office an indication of the specific areas that we have not canvassed at this point.

[ Page 15574 ]

I'd like to move on to some of the capital management issues, particularly the report by Deloitte Consulting that came out recently regarding the capital management review process. When we raised this issue during the supply debate that took place on March 29, the Minister of Health was unavoidably absent from the Legislature at the time. I believe he was at a Health ministers meeting in Ontario. The Minister of Finance stood in for him on those discussions, and we didn't pursue them at great length, partly because of the hour of the day and partly because of the minister's absence.

[1700]

I raised some concerns about the problem we have seen for the last couple of years in terms of a capital budget being set out for health-related capital projects and the inability of government to deliver those projects. If we go back to the fiscal year that ended a year ago, the '98-99 fiscal year, the capital budget at that time was underspent by $72 million. In the fiscal year that just ended, the capital budget was underspent by $129 million. I would have loved to go back prior to two years ago, but the reporting system wasn't such that you could really track those numbers in a consistent way.

Certainly in the last two years, we have seen budget allocations that have said that the budget is there for capital projects. We certainly know that the need is there around the province, yet we have not seen those projects being moved forward or ground broken or the ability to live up to the announcements that have been made by this government.

I've been through the report of the capital management review process that was tabled. I guess that was about a month ago now. I have read through the sections that particularly pertain to the Ministry of Health. I must say that what was contained in this report raised a lot of concerns, but it really didn't answer a lot of questions in terms of what the crux of the problem was.

What I see is that we've got many players involved in this process. We've got the Ministry of Health involved in the process; we have the regional districts, other than the GVRD; we have the regional health authorities involved in the process. To be honest, I'm actually not sure where the regional hospital districts fit into this process, but perhaps the minister can enlighten me. We also have the Ministry of Finance that has been in charge of this process -- that's my understanding -- for about the last two years.

I'm wondering if the Minister of Health can explain to me why it is that the Ministry of Health has not been able to get health capital projects underway when it seems to me that while there have been problems in other ministries, as outlined in this document, there are none that have been quite as difficult as the problems we have seen in getting Ministry of Health projects underway. I'm wondering if the minister could enlighten us in that regard.

Hon. M. Farnworth: The member raises some valid points. When I read the report, I had many of the same questions. I think we're both on the same wavelength on this, but a number of issues need to be recognized.

First is the issue of cash flow and capital planning, in the sense that there needs to be recognition of the time horizon -- for example, over three years, as opposed to what is happening or what has been happening. Also, recognition that there are different competing interests . . . . The member listed them off: the province, the health authority, the hospital district -- with the exception of the regional district. Because of the TransLink agreement, that's now picked up by Victoria. In terms of the hospital district, for example, they institute a levy which goes on your tax bill to pay for capital. Their priorities are not necessarily the same as the health authority's priorities.

Then there is the interaction between the province and the health authority. I would suggest that that is a significant part or one of the problems that needs to be addressed. As well, in terms of implementing inventory and assessment, there was a lack around the requirements for there. I think there was also a lack of targeting, in terms of what's ready to go and what isn't.

[1705]

C. Hansen: I was interested in the minister's use of the words "competing interests" among these various bodies. My understanding is that when the management of these projects was transferred to the Ministry of Finance, that was done to reduce, to eliminate, this whole competing interest issue. In fact, what I see time and time again . . . . If you look at some of the various outstanding projects -- ones that have been outstanding both in terms of the time and of what they'll do for the communities as well -- the regional districts have their funding in place.

They don't really have an option in terms of being able to roll with their funding when the project is ready to roll. I see that all of the players, outside of the Ministry of Health and the Ministry of Finance, seem to have their ducks in order -- and yet these projects can't proceed.

We see projects that get delayed for years and years. We've got the example of the Royal Jubilee Hospital -- which I don't want to get into right now, because I know the member for Oak Bay-Gordon Head will certainly be pursuing that at the start of next week. But we see examples of projects where even the basic planning work that is done up front becomes obsolete, because costs change or other circumstances change before they can even get a shovel in the ground to get the project underway. Yet what I see is that those other bodies are ready to go. The only thing that's holding up those projects is the green light from either the Ministry of Health or the Ministry of Finance.

I'm just wondering if the minister could explain to us why we have seen so many of these projects in the past couple of years stymied because of -- what at least appears to be -- a lack of priority, a lack of ability to get things moving, at the level of the provincial government.

Hon. M. Farnworth: The member has outlined a number of the key concerns. Certainly one of them is around the complexity of health buildings themselves and the number of people who are involved in signing off on the design and the detail. The movement of capital out of the different ministries to Finance was an effort and a recognition of the problems. In terms of getting things out the door, I think that was the first sort of sign that the government itself recognized there had to be changes made. Then we've had the report which outlines what the state of construction capital is within the different ministries.

The fact of the matter is that the problems are there in Health, and I think they are there for a number of reasons, not the least of which is the number of players who are involved. Even when you deal with the health districts -- they're in a row; they're ready to go . . . . Even when you deal with the

[ Page 15575 ]

health authorities and they're ready to go, you're still dealing with a considerable number of players, for example, in dealing with the particular physical plant itself.

I think that's why we have taken seriously the recommendations in Deloitte and have started . . . . I think about six months ago, you started to see a number of significant changes being put in place to address this. It's why I have instructed my staff, in terms of the rest of the recommendations in the report, that we have to deal with this problem and get it resolved.

[1710]

C. Hansen: One of the contradictions that I find in the report -- and it's probably just because I'm not reading it as carefully as I should or maybe not understanding the report . . . . I see two contradictions in here. On the one hand, what the report is saying is that there has to be more centralization of management within the Ministry of Finance for projects and project management. On the other hand, there are specific recommendations regarding the Ministry of Health.

They talk about current actions, which I think the minister may be alluding to in his previous comments: "The Ministry of Health has established a capital planning advisory committee composed of officials from local agencies, the Ministry of Health and the Ministry of Finance and Corporate Relations to address process issues." It talks about planned actions: " . . . the Ministry of Health to review the structural problems identified in the report and to revise Ministry of Health's planning document, per recommendations."

Does the minister see the solution to the problem as being one of bringing back control of these projects into the Ministry of Health, or of allowing the Ministry of Finance to take an even greater role in project management, as seems to be indicated elsewhere in parts of the report?

Hon. M. Farnworth: I actually think it's a question of the ministry getting its act together in terms of the planning and delivery -- dealing with those issues and making sure that everything's being done each step of the way as it should be. The role for Finance is at the beginning and then, in terms of evaluation, at the end. So I don't think it's necessarily an issue of Finance having greater control or greater authority.

I think it's more a point of recognizing: okay, this is Finance's responsibility; this is Health's responsibility; and this is what each of us has to be doing along the way -- then making sure that those steps . . . . And at the end of the process, there's the ability there to review it and make sure that that is in actuality what took place.

[J. Cashore in the chair.]

C. Hansen: I had the opportunity to sit down recently with an individual in one of the regions who is involved with a capital project that did actually get underway. He described to me some of the micromanagement that they were going through. He indicated that even issues such as the selection of the architect for the project were not being dictated by the Ministry of Finance but were being directed in a way that they felt they had no other choices. That's not the process that the minister just described in terms of . . . .

He described a process that was very hands-on by the Ministry of Finance, and one of his concerns is that he didn't feel that the officials in the Ministry of Finance necessarily had a sensitivity to construction design of a health care facility.

Is the minister saying that the Ministry of Health is going to take back some of those responsibilities and roles that have been assumed by the Ministry of Finance in recent times?

[1715]

Hon. M. Farnworth: It's fair to say that in recognition that there has been a change taking place and a concern about the inability to get projects moving, there was initially a tightening of the role by Finance. But it is clear that what we want to see happen is the health authorities playing a much greater role in planning and implementation of that part which Health is responsible for -- the planning and development -- than has been the case in the recent past. I would say that you would probably see a lessening of control in that area by Finance. That would be something I would want to see happen.

Clearly, in terms of the planning and development of a facility, it's crucial that the health authority is actively involved in that. We have to recognize that health facilities . . . . In fact, it doesn't matter whether it's an educational facility or a health facility; there are specific requirements to that. The people that it's going to serve, the people working in there, the people responsible for it, have to be participants in that. I don't think it's the intent to see Finance having a stranglehold on the planning and development process.

C. Hansen: I gather that is a fairly deliberate shift we are going to see. My understanding is that two years ago there was a very deliberate shift to give the Ministry of Finance more responsibility for the management of these projects.

Am I hearing the minister say that what we're seeing now is a very deliberate shift of those responsibilities back to the Ministry of Health? That's my question.

Hon. M. Farnworth: No, not back to Health, but back to the local agencies which are actually building the particular facility.

C. Hansen: In other words, what we're going to see is less micromanagement of a project from Victoria, whether it be by the Ministry of Finance or the Ministry of Health, and more responsibility for construction and design decisions being left locally to those who are actually going to have to use the facility and make it work at the local level.

Hon. M. Farnworth: In essence what you have is a good plan in place at the beginning, which is Health. At the end you have the evaluation, which is Finance. The implementation and development of that plan is up to the authorities, so you've got considerable input at that local level.

C. Hansen: Some of those I've talked to in the construction industry tell me that Health capital projects have the most change orders of any projects they work on. In other words, they bid on a project, and it's common knowledge within the construction industry that it really doesn't matter if they bid low to get the project, because that's not where they make the money. Where they make their profit on a construction project is in the change orders that are brought down after the contract is awarded for construct