2008 Legislative Session: Fourth Session, 38th Parliament

HANSARD

The following electronic version is for informational purposes

only.

The printed version remains the official version.

Official Report of

DEBATES OF THE LEGISLATIVE ASSEMBLY

(Hansard)

TUESDAY, APRIL 29, 2008

Morning Sitting

Volume 31, Number 6

CONTENTS

Routine Proceedings

Page

Introductions by Members

Introduction and First Reading of Bills

Protected Areas of British Columbia (Conservancies and Parks) Amendment Act, 2008 (Bill 38)

Hon. B. Penner

Second Reading of Bills

Medicare Protection Amendment Act, 2008 (Bill 21) (continued)

A. Dix

M. Polak

N. Macdonald

Proceedings in the Douglas Fir Room

Committee of Supply

Estimates: Ministry of Economic Development and Minister Responsible for the Asia-Pacific Initiative and the Olympics (continued)

Hon. C. Hansen

D. Routley

R. Fleming

[ Page 11673 ]

TUESDAY, APRIL 29, 2008

The House met at 10:02 a.m.

[Mr. Speaker in the chair.]

Prayers.

Introductions by Members

C. Trevena: In the gallery this morning are 25 grade 6

students from Georgia Park Elementary, and they're going to be joined by their

teacher Mary Begg and parents. They're at the start of a month-long study of

government systems, and they evolve through coming to see what we do down in the

House and learning all about different sorts of governments. I hope the House

will make these students from Campbell River very welcome.

Introduction and

First Reading of Bills

PROTECTED AREAS OF BRITISH COLUMBIA

(CONSERVANCIES AND PARKS)

AMENDMENT ACT, 2008

Hon. B. Penner presented a message from His Honour the

Lieutenant-Governor: a bill intituled Protected Areas of British Columbia

(Conservancies and Parks) Amendment Act, 2008.

Hon. B. Penner: Mr. Speaker, I move that the bill be

introduced and read a first time now.

Motion approved.

Hon. B. Penner: It's with great pleasure that I introduce

the Protected Areas of British Columbia (Conservancies and Parks) Amendment Act,

2008. This bill contains amendments to the Protected Areas of British Columbia

Act to continue this government's expansion of British Columbia's parks and

protected areas system, including the creation of conservancies on the central

coast, north coast and Haida Gwaii as well as the Morice and Sea to Sky areas.

This bill continues the work of implementing land use decisions by

protecting in legislation some of the most significant, spectacular and

ecologically diverse landscapes and coastal areas in the entire world. The

creation of these parks and conservancies is taking place in the broader context

of land use agreements and plans that will also provide certainty for land use

to support economic opportunities for communities.

This balancing of environmental stewardship with economic

development is based on a historic collaboration that has taken place between

first nations, industry, conservation organizations, local governments and many

other stakeholders to arrive at the central coast and north coast land use

decisions that were announced by the Premier two years ago.

[1005]

In 2006, 24 new conservancies were established pursuant to those

decisions, followed by 41 additional conservancies last year. The amendments in

this bill will complete the implementation of the protected areas component of

the north coast and central coast land use decisions.

Fifty new conservancies will be established by these amendments,

and two existing areas under the Environment and Land Use Act will be converted

to conservancies. Additions will also be made to two existing conservancies. The

addition of these conservancies, along with others being established in other

parts of the province that I will note in a moment, will bring the total number

of conservancies in British Columbia to 135.

There are also amendments to the act that will make changes to the

protected areas system in other parts of the province as well. Seven new

conservancies in six new class A provincial parks will be established in the

northwest part of the province pursuant to the Morice land and resource

management plan.

Nine new conservancies and additions to two existing class A parks

are being made in accordance with the Sea to Sky land and resource management

plan for the area in and around Squamish to Pemberton — in that corridor. For

example, Duffey Lake Provincial Park will increase in size by 93 percent to

4,048 hectares.

Two new conservancies will be established on Haida Gwaii,

otherwise known as the Queen Charlotte Islands, to begin the implementation of

the Haida Gwaii land use agreement. These two conservancies will cover 147,759

hectares in total. Four new class A parks are being established pursuant to the…

Mr. Speaker: Could the minister put the question.

Hon. B. Penner: …Okanagan-Shuswap — one last sentence —

resource management plan, along with the conversion of the Kalamalka Lake

protected area to class A park status in addition to the existing Kalamalka Lake

Park. The addition to the existing class A park plus the area of the four new

parks in the Okanagan-Shuswap region totals 3,600 hectares.

Mr. Speaker: Question, Minister.

Hon. B. Penner: I move this bill be placed on the orders of

the day for second reading at the next sitting of the House after today.

Bill 38, Protected Areas of British Columbia (Conservancies and

Parks) Amendment Act, 2008, introduced, read a first time and ordered to be

placed on orders of the day for second reading at the next sitting of the House

after today.

Orders of the Day

Hon. B. Penner: I call continued second reading debate on

Bill 21, Medicare Protection Amendment Act, 2008.

Mr. Speaker: And in Committee A?

[ Page 11674 ]

Hon. B. Penner: For the information of members, continued

debate of the Ministry of Economic Development budget estimates.

Second Reading of Bills

MEDICARE PROTECTION AMENDMENT ACT, 2008

(continued)

A. Dix: As we were leaving the debate yesterday, you will

recall that the minister gave one of, I think, the most irrelevant second

reading speeches we've ever heard in this Legislature. He chose not to defend

his legislation, explain his legislation or explain the purpose or the need for

the legislation at all.

[K. Whittred in the chair.]

Presumably, that invites a lengthy committee stage debate that

will come, for him to explain the reasoning of the legislation. But you'll

recall that this legislation really comes out of an idea from the Premier — an

idea of the Premier's that he believes. He wanted to mitigate some of the

principles of the Canada Health Act, principles that are supported by every

political party in Canada, including the federal Conservative Party — except,

apparently, the B.C. Liberal Party.

His intent in bringing forward this idea in 2006, in campaigning

on the idea and spending $6 million in public funds to promote the idea, in

asking people in the Conversation on Health to endorse the idea…. They declined.

His idea was to put this forward to limit and to mitigate principles that are

fundamental to our public health care system such as universality,

That's the purpose of the legislation. In a sense, what he's doing

is changing the obligation. Instead of saying to government that we have a

public health care system and it needs to be universal and comprehensive, he's

giving government an argument in the debate that it should not be. That's the

effect of the legislation. It could not be any other effect. The effect is, in

fact, to defend the financial interests of the government against the sick.

That's the purpose of this.

[1010]

The five principles of medicare work together to define a health

care system that is public, that is comprehensive, that is universal, and that

is portable and accessible for all. This government has decided that its issue

in health care is to attack those principles, to say those principles should be

mitigated, that the problem with public health care is that it's universal.

The problem with public health care is that it's intended, at

least until this government came to office, to be comprehensive. That's the

problem. That's the mischief, if you will, that they want to resolve by this

legislation. In fact, as you can see — and certainly as you can see from the

health care record of the government — that's the direction we're going to.

Hon. Speaker, you'll recall that this is a slight change in their

position — what they used to say. They used to talk about health care where and

when you need it. That was a campaign pledge by the Premier in 2001. The

minister talked about other pledges they made in 2001, which they broke with

respect to long-term care, home care, acute care. Promises broken, promises

broken, promises broken.

The minister bragged that we've dropped in per-capita funding from

second place to seventh place in Canada. He bragged about that. He thinks that's

a good thing — that he carves money out of the health care system and shifts

costs from the health care system to the sick. They think that's a good thing.

That's their approach, and that is the purpose of this legislation.

Now, it is surprising, as we noted yesterday, that the government

really has no explanation and no defence for this legislation. Clearly, what

happened is that this was the Premier's idea, and everyone else rejected it. You

know, George Bush in the United States calls himself the Decider. The Premier in

British Columbia is the Decider.

You'll recall, hon. Speaker…. My friend from Saanich South will

recall this, because he asked questions about it in this Legislature. In 2003

another Minister of Health brought forward a medicare protection amendment act

that would have strengthened public health care, which would have given the

government the capacity to find out what was going on in the system. The Premier

intervened in that debate and said he wasn't involved in the debate.

It apparently got through cabinet and the Legislature without the

Premier knowing, but the Premier got some phone calls from his allies in

for-profit health care. All the groups supported it. Everyone supported it.

Everyone thought it was a good idea. It was intended to ensure that the Canada

Health Act was respected in British Columbia.

The Decider — our George Bush, if you will — the Premier, said no,

even though the effect of that politically, I might add, was to humiliate a

senior cabinet minister, the former Minister of Health and current Minister of

Economic Development.

That didn't matter to the Premier, because there were other

interests at bay. He was against strengthening the Medicare Protection Act at

the time to protect the principles of the Canada Health Act, and here he goes

again. No one else supports this. The government can't explain what its purpose

is, what the intent is, what the role of adding this principle in medicare is,

what its effect will be in the debate. I'm sure we'll ask the minister at

committee stage what legal opinions he has to support this, and I'm sure he'll

say: "Oh, those legal opinions are confidential. We can't talk about that."

But he's also failed in this debate to provide any rationale for

the impact this will have during his hour-long diatribe on the 1990s — any

rationale for why this is needed now except that apparently the Premier wants

it.

He's spoken about some of these issues before, but let's talk

about what other people say. You remember that yesterday, hon. Speaker, during

the debate the

[ Page 11675 ]

Minister of Health went on at length. He suggested that this information came

from the Canadian Centre for Policy Alternatives. It talks about provincial

health spending as a share of GDP. It's gone — 2002 to 2007 — from 7.4 percent

to 6.9 percent.

The minister said…. What did he say about that? He said that was

entirely without basis. It is utter nonsense. You'll recall that the source of

that information, of course, was the government itself. So his conclusion may

not have been that surprising, but who he was talking about when he said….

I'm quoting from him here, because one wouldn't want to misquote

the Minister of Health. He called it specious. He said: "It's entirely without

basis. It is utter nonsense."

Well, the source was, of course, the B.C. Financial and

Economic Review , page 95. And who produces that document? Who's responsible

for that document — what the Minister of Health calls utter nonsense, entirely

specious and entirely without basis? Well, it happens to be the Ministry of

Finance.

[1015]

I want to say "the Ministry of Finance" here — and of course,

responsible in the House, the Minister of Finance. That's who he was referring

to.

Of course, the same information is available from the Canadian

Institute for Health Information in every budget they ever produce, because it's

an easy calculation to make. Once you add the GDP numbers and add the health

spending numbers, you make the calculation. It's gone from 7.4 percent to 6.9

percent.

Apparently, the government is ignorant of the basic facts about

health care in this province. That's what they're saying. I don't know if they

are. I think that may have just been…. It's possible that it may have been an

excuse for the Minister of Health to attack someone who disagrees with him. It

may have been just an excuse.

But the fact of the matter is that the Minister of Health was

wrong in this House. He discussed it at length in this House. He was wrong. The

source of the information was his own government.

What it says, and what that information said was…. What it says,

if you take it back 20 years, is that health care spending as a percentage of

GDP in the province has gone roughly from 6.1 percent to 6.9 percent today.

That's over 20 years.

Spending out of control? Sustainability out of control? I don't

think so. I don't think by most measures, most evidence-based measures, that's

spending out of control. Since this government came to office and started

closing acute care beds and breaking its promise on long-term care and so on,

we've gone from 7.4 percent to 6.9 percent.

Now, what do independent observers say about this debate? Here's

another group that the minister when he wraps up may be able to cast aspersions

on: the Canadian Health Services Foundation. They've produced a document that

addresses the core of the government's argument in this bill.

What does this document say? It says: "Canada's system of health

care financing is unsustainable." But you know what the document is? It's called

Myth Busters . "Myth: Canada's system of health care financing is

unsustainable." It refers to the fact, which is self-evident because this is the

government's definition of sustainability, that fiscal sustainability — and we

know this; this is a political issue — depends on taxation.

Many of those governments that talk about the sustainability of

our health care system are the same governments that give away, for example, tax

cuts to banks — like this government. You make a big tax cut to the bank that no

one asked for and no one agrees with, and then you say: "Oh, the health care

system is unsustainable because we cut tax to the banks." That's the intention,

and that's the discussion of this legislation.

So what do they say? What we have is the Canadian Health Services

Research Foundation…. They say it's a myth. They're not saying that the issue of

health care costs, which every government since we brought in medicare and even

before that…. Every government concerns itself with health care costs.

They're saying the idea of it, putting it in as a principle of

medicare, mitigating the idea of universality, is wrong — that governments can

reasonably be expected to provide, even though this government is failing to do

it, universal, accessible health care in the public system. That's what they're

saying. They're saying that the government's arguments, to use the turn of

phrase of the Minister of Health, are specious.

The Minister of Health referred to Roy Romanow yesterday. He

thought that maybe we thought that Mr. Romanow wasn't a distinguished Premier.

Of course he's a distinguished Premier. He also produced a very highly

considered, well-thought-out report on our health care system. What does he say?

He says that the sustainability worry is a myth. This is someone who was brought

to the table by the minister in defence of his position.

"The sustainability worry is a myth. We are spending less today

than we did a decade ago. Our spending is in line with that of other wealthy

countries, and there is a need for immediate targeted investment in priority

areas." That is one of the people that minister brought to the table yesterday.

He disagrees with this.

So what does the minister say? What is his defence? What is his

explanation for all this, for changing the fundamental principles of medicare?

It's a change, by the way, as my colleague from Saanich South knows, that the

Minister of Health in Ottawa, Tony Clement, called a non-starter; a change that

had no support from any other Premier; a change that had no support from any

other Minister of Health — completely rejected, seen as completely unnecessary.

[1020]

What does the Minister of Health say now? Well, he wrote a letter

to Burnaby Now , and really what he's saying is that changing the law is

just kind of an advisory thing. You know, we're just sending ourselves a note.

We're saying to ourselves that we need to remind ourselves that the public

health system should continue to exist for future generations. That's why we're

changing the law.

He doesn't provide any evidence about the effect of it, which is

real. He doesn't provide any evidence of the

[ Page 11676 ]

effect of it, and he says platitudes like that. He says that it's about

putting sustainability against universality and accessible and comprehensive in

the Canada Health Act and the Medicare Protection Act. He says that it's about

helping people with chronic disease. He says that it's about helping people to

stop smoking.

To use the minister's phrase — what does the minister call this

sort of thing? — it's entirely without basis. To use his phrase, it's utter

nonsense. There is no evidence that adding sustainability to this bill has any

impact on any of those issues.

What this is about — and the minister came close somewhere else….

Maybe he doesn't like to say the same kinds of things to the Burnaby Now

that he says to the Globe and Mail. I don't know. He did note in the

Globe and Mail that in enshrining this principle of sustainability into law,

we acknowledge our responsibilities to manage the growing costs that threaten

the future of our public health care system. He says that the

definitions and

this addition, presumably of sustainability, take on critical importance in

issues that may be defined in courts of law.

So they are doing something. He acknowledges that they're doing

something. He doesn't say what. But what he's really saying, what the Premier

said…. You'll recall with the Premier, because I remember it. We and many

members of the House were at SFU downtown. The member from Esquimalt was there.

The Premier stood at the front of the room and said: "Our health care system is

not sustainable."

What his belief is, is that universal, accessible health care —

health care, if you will, where and when you need it; what the Premier promised

— is not possible. He's a pessimist. We can't do it. They do it all over the

world, but we can't do it in British Columbia. We need a mulligan in British

Columbia. We need a way out of universal health care.

So that's what he said. Then he offered up in his opening remarks

this canard, which they've since buried in the back yard — go figure. They've

taken the canard and dug a hole in the back yard of the government, and they've

put the canard in the hole. It's still there, but for this debate, we want to

resurrect that a little bit.

So 71 percent, they said, of the health care budget. They don't

say that anymore. It was nonsense then. The Premier — there he was up on the

stage with Brian Day, his first speaker, the guy who's going to deliver the

message, the sermon. At his first meeting on the Conversation on Health, there

was the Premier. We were way at the back. I was at the back of the room. I was

happy to be there to watch this presentation from the Premier.

As he said, 71 percent — an idea that has disappeared from the

government's rhetoric and has disappeared from the debate…. It was an idea that

was used to scare people, and people didn't buy it then. They don't say that

anymore. They said 71 percent by 2017.

It's manifestly not true. And by the way, they're off only by

maybe $5 billion or $6 billion, depending on how you count. Once you talk about

those billions of dollars, you're starting to talk real money. That's how far

off they were on this question.

There he was at the front of the room saying: "We need the

sustainability change because universal, accessible, comprehensive health care —

what I promised — is no longer possible in our province of British Columbia.

It's no longer possible. We need this way out."

What did he do? The member from Esquimalt will know this. He

invited onto the stage Brian Day, the first speaker to define this image. You'll

recall this. I think the Minister of Health will recall. He put up on the screen

a slide. It showed a picture. On one side was an image of George Orwell's

1984 , and on the other side was the Canada Health Act.

The Canada Health Act, which apparently for the Premier…. The

principles of universality, principles that need mitigation according to the

Premier and according to Dr. Day…. That's their view. We can't deliver it here

in British Columbia. We are not capable of that in British Columbia. It requires

mitigation.

[1025]

So they put up this slide. The Premier is there, and his first

speaker…. He invites him up. He puts up this slide — the Canada Health Act on

one side and George Orwell's 1984 on the other side — equating the

principles of medicare, which I think most Canadians believe in profoundly and

think are the right approach to public health care….

We're talking about public administration of our health care

system. We're talking about universality of our health care system, its

talking about its comprehensiveness. That idea of a public health care system —

where getting care doesn't have anything to do with the amount of money you have

in your pocket, and with the American example shining at us across the border —

somehow equated to George Orwell's 1984 .

You know, they said it. They didn't criticize him. I didn't see

the Minister of Health get up and say: "I don't think that's right." I didn't

hear the Premier get up and say: "I don't think that's right." That's what they

did.

What we're doing in this legislation is putting a principle in

place that clearly is intended to mitigate or change the value of the existing

principles of medicare, because the government doesn't think they can do that

anymore.

Sustainability. We said this yesterday, and it's important to note

that it has a different quality than the other principles, which speak to who

will benefit from medicare, what they will receive, their access to health care,

their ability to receive care in their home province and other provinces, and

who will ultimately run and be accountable for the system. Those principles of

medicare are not contradictory.

The idea that they're introducing is their definition of the

sustainability of the health care system, which is not supported in any

international assessment. When international people do evidence-based reviews of

the cost of health care, they don't use their method. But that's okay. The

minister has dismissed all those as they dismiss everyone else who disagrees

with them, whether it's Mr. Romanow, the Canadian Health Services Research

[ Page 11677 ]

Foundation, the OECD or whoever it is. If they disagree with the Premier's

decision…. Of course, presumably all those people are some form of socialist or

something. I don't know.

Nonetheless, all those people who disagree with that position are

dismissed as their views not having any validity. But the fact is that the

introduction of this principle will have that effect, because it's giving

direction. As the minister said, it gives direction to the courts.

What is the mischief that the government is intending to deal

with? What are they trying to resolve? We talked about the case law yesterday,

which says that if you're going to make this kind of change….

I'll just refer to one of the cases that I referred to yesterday.

It's pretty basic stuff. It says that in construction of legislation, the court

must consider the mischief the legislation has intended to remedy, the

provisions of the legislation as a whole and the particular language of the

section in question.

The intent of this provision is to mitigate the values of those

principles of medicare. That's its intent, and the government refuses to

explain, presumably because they're embarrassed, presumably because no serious

policy person in the Ministry of Health would have come up with this idea if the

Premier hadn't. No other Minister of Health in Canada, the federal Minister of

Health, all the evidence-based research…. All of this stuff is sort of set

aside, and we go ahead of that. But that's the purpose of the legislation.

It's for that reason that we oppose it, because we are not

pessimists like the government. We believe that the principles in the Canada

Health Act reflected in the Medicare Protection Act are principles that not only

should be upheld and must be upheld but can be upheld. This pessimistic view put

forward on the other side — that we can't have here in British Columbia what

other people in the world have, that we can't sustain it — is wrong, and it's

not supported by the evidence.

Does that mean there are not challenges in the public health care

system, that there have not always been cost challenges and that there are not

other mitigating factors out there — balanced budget legislation and so on? Of

course there are. Of course those things exist.

[1030]

That's not the question. The question isn't whether there aren't

cost issues in health care. That's how the government tries to frame the issue,

but that's not what they're doing here. They are changing the principles of

medicare. When you go before the Medical Services Commission or the Minister of

Health or the health authorities in deciding how to enact the legislation, the

issue of universality is mitigated, is undermined, in the legislation. It has to

be put up against this principle that the government defines in its own terms as

sustainability.

That's the purpose of it. The government refuses to defend it, but

that is what they're doing, and that is why we think it's not a good idea. Look,

as I said, sustainability is conceptually an obvious modifier of the other

principles. That's what it is. While it's conceivable that if you wanted to, you

could engage in a process — and this is, a little bit, what the government is

doing — of a universal, portable and publicly administered plan that rations

services, it never intersects with the taxpayers' ability to pay. The principles

sustainability.

What you have is an idea of a set of principles for public health

care, and you say to government: "Deliver health care policies based on this

principle." This is a government that doesn't believe in those principles and

thinks that it needs help. It thinks that it needs, in fact, to mitigate those

principles — that they can't do it here. They can't do here what people do and

must do and should do all around the world, which is deliver public health care

to citizens in an effective way.

Hon. Speaker, this is, I know, a somewhat arcane debate. We have

the government refusing to explain its position. It's putting forward a

discredited idea by the Premier which has received no support since he launched

it and which he seems to have lost interest in, although I'm looking forward to

his speech in this debate.

I'm looking forward to his explanation of what he's doing in this

debate. It'll be something to anticipate. I'll want to be here for that. I want

to be here when he stands up and says what he was thinking when Brian Day put

the Canada Health Act up against 1984 . I'll be interested to hear what he

was thinking when that happened — when he put that up as his first speaker.

I'll be interested to see what he was thinking when he went around

and spent $6 million on this 71 percent number that was fallacious and which

they've now buried in the government's backyard. I'll be interested to hear what

he was thinking, what his approach is, because it will be important for people

to understand, as we go forward in this debate about public health care, where

the government stands and what they should expect and what's at stake.

By trying to pretend that this is about flowery platitudes when it

is about nothing of the sort, the government is…. The effect of their actions is

to mislead people, and I hope that the Premier comes here and says what his

intentions were and what his explanation is. We have not had an adequate

explanation so far, and the issues at stake for British Columbians, I think, are

significant.

What can we say about the government's record in health care? The

minister talked about Bill 29 yesterday. Clearly, he spoke with pride about the

havoc the government wrought to public health care with Bill 29. Clearly, he

thinks a model where at Nanaimo Seniors Village, a model created by the

government…. It's the vision that they brought to that bill.

Our position is that that's not the right model. We're against

Bill 29. We were against it then; we're against it now. We're even more against

it after the Supreme Court of Canada, in spite of a big effort by the

government, ruled three important sections of that bill to be illegal and forced

the government to pay compensation.

The Minister of Health is proud of that. That's an example of his

vision of health care. It is a message about his vision of health care — a

vision, in that case, that deterred people from taking up health care as a

profession. It said to care aides and LPNs and others,

[ Page 11678 ]

people in the public health care system: "We don't value your work." That is,

in fact, the approach the government took.

[1035]

Yes, the minister wants specifics. Yeah, we have a disagreement.

We don't think Bill 29 is the way to go. We are against Bill 29. We were against

it then; we're against it now. We're going to change it when we get into

government. You bet we are.

What else? They've gone from second place to seventh place in

health care spending. The minister says: "It's $2 billion we cut out of the

system." That's what his suggestion is.

We know that the number of hospitals — let me use the Canadian

Institute for Health Information's numbers — has gone from 99 in '01-02 to 82 in

'05-06. That is a reflection. That's what happens. Services get cut when you

de-emphasize health care as a priority of government. That's what happens. The

reality is that that is consistent with a government that no longer believes you

can deliver health care where and when you need it and that is more interested

in advancing the interests of private interests in our society than in

maintaining a universal public health care system.

They shut down acute care beds — 1,270 beds between 2001 and 2004.

They closed hospitals. A net 17 hospitals closed, according to the Canadian

Institute for Health Information, between '01-02 and '05-06. They promised

health care where and when you need it, and then they said: "Sorry, we can't

deliver."

Now we introduce legislation that gives us the right to argue

before the courts that we don't have to deliver, that the founding principles of

public health care do not matter. This is the direction the government is taking

health care. It is not, I would suggest to you, hon. Speaker — and we'll get

into this in a moment — an evidence-based direction.

I would say this. I think that this debate we're going to be

entering into over the next little while is an important debate, because it

shows the contrast between a government that is ignoring the evidence in health

care…. It doesn't follow what all the international evidence is but wants to, in

fact, limit the scope of public health care and increase the costs for

everybody.

Its idea of sustainability and efficiency is to transfer costs.

Its only idea — its idée fixe — is to transfer costs from the government

to the sick. We know what that means in jurisdictions where that happens. What

that means is real health consequences and life consequences for real people.

That's what it means when you do that. It's why we are against this legislation.

Another part of the bill that the minister didn't touch on in his

remarks is the changes to the

preamble. He has added new words to the

preamble.

I'll remind you again what the case law says about legislation. I'll read this

again because I think it's important to remember that when you change the law,

presumably the intent of what you're doing is to remedy some problem.

They've decided in the

preamble, which doesn't have as much

weight…. It guides the rest of the legislation. It surely doesn't have anything

like the weight of a basic principle of health care, but it gives us an

understanding of what they mean.

Two notions. You've got this idea that there's some problem.

They've added notions — let's talk about two of them: individual choices of

preamble and personal responsibility — without explanation. I suppose because….

We could have expected the Minister of Health, in a speech about

the bill, to explain what the intent is and what he was attempting to remedy by

changing the law here, but he failed to do so. He absolutely, fundamentally

failed to do anything about these important issues but rant about the 1990s.

He's the one changing the law. He's bringing this Premier's discredited idea

into this Legislature, and he refuses to talk about it. He fails to talk about

it. He provides no evidence to support it. He has no explanation as to what the

actual effect of the law will be.

Instead, what he does — and it's not surprising — is spend a long

speech haranguing us about what he thinks the NDP position is or isn't on some

issue, because he has nothing to say about this bill, which is clearly not the

work of anyone seriously concerned about our public health care system.

[1040]

What's the remedy here? Look, if it's the case that the idea of

personal responsibility is about, for example, eating more vegetables or going

for a run or living a healthier life, that's interesting, and maybe the minister

could state that for the record. That might actually be valuable, to explain

their intent. If the question is…. Of course, we had smoking cessation laws, the

best program in the 1990s. It was turned around by this government 2002, when

they overruled the independent WCB. We all recall this on smoking. If there is

something that needs to be remedied, what's the explanation for that?

Does personal responsibility in the act…? We'll have to, I

suppose, get into this at committee stage. We might have expected the government

to have addressed these issues earlier. If personal responsibility means taking

on the burden of costs for the health care system linked to the sustainability

of the government, then that's one thing. If it's simply, say, eating more

asparagus, that's another thing. But the need for it in this legislation is, I

think, highly questionable.

Equally, hon. Speaker, look at the issue of individual choice.

They've decided to add this principle — this founding principle, this founding

idea that they've put it in there — of individual choice. What does that mean?

Does that, in fact, mean in the way it's been defined by other people, by Dr.

Godley of False Creek Surgical Centre? Does it mean a choice between a public or

a private system? Or does it mean what we've traditionally had, which was lots

of choices within the public system — for example, your choice, if you can find

one these days, of a family doctor? What does that mean? Why was it necessary?

What was it that the government wanted to remedy?

We know in 2003 what they wanted to remedy — significant

violations of the Canada Health Act and the Medicare Protection Act that were

going on in this province. They wanted to give themselves the right to

[ Page 11679 ]

find out what those were and to remedy those, and the Premier said no. It's

"don't ask, don't tell" on for-profit health care. He didn't want to know the

extent of the problem, the extent of the extra billing, and he took specific

action to stop that from happening.

We knew what the purpose of the bill was then. We knew what the

problem was then. They had got instructions, in a sense, from Ottawa that the

Canada Health Act was being violated here in British Columbia. They needed to

take these steps so that they could assess what the nature of the violation was,

and the government decided not to do it. Well, the Premier did. The government,

of course, all voted for it, but the Decider, our George Bush, decided, and it

was bad news for British Columbians. It means more extra billing, more

for-profit medicare, more two-tier health care, and we see in this province the

chilling effect since that on our public health care system.

So what was it? What is it in this

preamble that the government

wants to deal with, hon. Speaker? What is it that they want to deal with? Why is

it that these notions of individual choice, these notions of personal

responsibility are included in the act? Is it, in fact, Dr. Godley's definition

or Dr. Day's definition or Mr. Copeman's definition of choice, or is it an

entirely public definition of choice? Is it, in fact, the intention of the

government to provide a legislative basis for that or not? These are the

questions we ask.

Certainly, it seems to me that we could have done without. There

was no need for these amendments. That's the best position you could have.

That's the best defence the government seems to have. What they say is: "Don't

worry; trust us. We're doing this, but it's entirely irrelevant. Let's talk

about the NDP in the 1990s."

If I may summarize in a short time what the minister said

yesterday, that's it. "What we're doing here is irrelevant. Yes, it was an idea

by the Premier. We gotta do it. God, I gotta do it. It's terrible stuff. I must

do it, but I don't want to do it. The devil didn't make me do it. The Premier

made me do it." That's their approach to these things.

[1045]

So you believe that, and this whole initiative that they spent $6

million in advertising and everything else is just an irrelevancy. That's the

best

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

interpretation. But they refuse to say; they refuse to discuss their intent. One

day they're saying: "Well, really, what it's about is controlling cost. It's too

expensive for us to be universal and accessible and comprehensive. It's too

hard. It's going to be 71 percent of total government spending." That's what

they said. They buried that idea in the backyard. It's no longer relevant. They

acknowledge that it's not the case.

How is this? The scary line, "71 percent by 2017," became "50

percent by 2013" — big difference. The difference between those things is more,

I think, than the cost of the entire school system. That's the difference

between those estimates. It's a pretty significant attempt to distort the

information and to fool people into supporting this measure.

So their best position is that, but what they're clearly intending

to do, what the clear intent of the law as it's written, not as the minister

explained it…. As the minister explained it, you might think it was actually

more about the Canadian Centre for Policy Alternatives than it was about the

founding principles of medicare. But the real purpose of this is to mitigate

those principles of medicare, and we on this side of the House are not

pessimists about that. We believe in public health care. We are the party that

founded public health care in this country, and we are going to continue to

fight for public health care every single day.

There we have the, sort of, provisions of this bill — the

government's position. How has that expressed itself in reality? I think it's

fair to say, and we've talked about this, that the government and its course

over the last number of years have not contributed to the principles of the

Canada Health Act. It's no wonder they want to mitigate them, because they have

not, in any kind of sustained way, followed them.

At a time, as we've said, of economic growth, we've gone from

second to seventh place in Canada in terms of health spending. They've broken

key promises they made. Virtually every single promise they made on health care

in the 2001 election was broken. Oh, you remember it, hon. Speaker — a personal

commitment from the Premier to HEU workers: "We won't tear up your contract." It

took the Supreme Court to call him into line on that canard. Five thousand

long-term care beds — broken. Health care where and when you need it — cuts to

acute care beds, cuts to home care. That's their record on health care.

Now, having done that, having taken those steps about our public

health care system and, in addition to that, having failed to do what they

needed to do in the previous amendment to the Medicare Protection Act — failed

to take the steps to protect British Columbians from facility fees, failed to

take the steps to protect British Columbians from extra user fees, failed to

take the steps to protect British Columbians from two-tier health care….

You remember the case of Barbara Gosling from Williams Lake, who

went to her doctor's office and was told — this was in 2006 — that she could

have an appointment in the public system in 2008 or she could see the same

doctor for $350 in two weeks.

What the government says, because they won't audit the system,

won't do anything about the system, is that it's Barbara Gosling, who is dealing

with serious issues in the health care system, who has to challenge her doctor

and challenge for-profit health care in order to bring this issue forward. She

did, and boy, was she courageous. But they're saying that they won't take any

steps to defend the public health care system. It's up to Barbara Gosling.

You remember what was happening in St. Paul's Hospital. Using the

MRI at St. Paul's Hospital, using that in the public health care system….

Interjection.

A. Dix: The minister has woken up. It's good news.

[ Page 11680 ]

You remember what the minister said? He said: "Oh, that's not

happening." He said, "It couldn't happen. It's not happening," and that I was

wrong. This is a theme of the minister: I was wrong; he was right.

[1050]

You know, I sadly have to reflect on the evidence, which

subsequently showed, after the investigation by the Deputy Minister of Health,

that, in fact…. And this is just the Deputy Minister of Health. I'm reluctant to

even mention it to people who said that I was right, and the minister was wrong.

That's what all….

Interjections.

A. Dix: The Minister of Health is inspired, hon. Speaker.

He's inspired. He's back. I have awoken him. The memory of that moment when he

said: "You're wrong. It couldn't happen. It's not happening here." And it was

happening here.

That memory has awoken him. It's awoken him, and there he is. But

that's the reality of what they've done. They believe that unless people come

forward with a specific complaint — publicly come forward against maybe their

own doctor or maybe health services — the government won't do anything. It's:

"Don't ask, don't tell."

The Minister of Health was in the House. He was in the Legislature

of British Columbia. He stood up, I believe, and voted for that bill, which they

didn't proclaim — that the Premier put under the table and wouldn't proclaim.

There he was in the House, and there he is…. "Don't ask, don't

tell" — that's his approach to public health care.

Hon. Speaker, you'll recall the Minister of Health, when he

privatized, when he sent out in VIHA…. They asked him. The favouring of that

system. They asked him, when he contracted out surgeries in VIHA: "Well, how

much does it cost?"

Hon. G. Abbott: Big hypocrite.

A. Dix: Oh, he's inspired now.

You see what happens, hon. Speaker? You see what happens? You

bring the evidence here, and the Minister of Health starts name-calling. That's

all he has. For an hour and 15 minutes yesterday, all he had was name-calling.

Interjections.

Deputy Speaker: Members. Members.

Continue, Member.

A. Dix: That's all he has left now. He has a bill that he's

clearly embarrassed about — he should be embarrassed about — that he refuses to

defend, and all we have from him is an hour of name-calling and some more

name-calling now. That's all he has to defend this shameful legislation. All he

has to defend this shameful legislation is his longstanding contempt for the

public in this province.

Anyone who stands up to that government's position, whether it's

the Hospital Employees Union or women workers who were laid off and who took

them to the Supreme Court, are cause for the minister's contempt.

Patients who challenge the minister, challenge his contempt. There

are think tanks who challenge his view. They're cause for his contempt.

Yesterday for an hour he refused to defend this bill that he brought into the

House. We didn't bring this bill into the House. He refused to defend it. He

refused to say what it meant. He refused to say anything about it.

He spent an hour name-calling. I guess he needs practice, you

know? It's training for some future campaign, but the reality of it is that we

have legislation. We are bringing forward a serious analysis of the bill, and

the minister has nothing. He has nothing but contempt for the serious issues,

the issues that we're debating in this Legislature, issues of the founding

principles of our health care system that he wants to change and mitigate. Now

all he has is name-calling. That's all he has left.

You'll recall, hon. Speaker….

Interjections.

Deputy Speaker: Order, Members.

Interjections.

Deputy Speaker: Order, Members.

I remind members about the use of parliamentary language, and I

would like decorum in the House.

Continue, Member.

A. Dix: Well, it'll be something new for the Minister of

Health. But there you go, hon. Speaker.

What they did…. And let's remind people of their approach and what

I think the right approach is. Their approach, for example, when they contracted

out surgeries. They asked the Minister of Health: "What's the relative cost? Are

there cost savings?"

[1055]

He said: "Oh, I don't know." What did he say? I quote him. I never

want to misquote the Minister of Health. What did he say? "I am not sure. I am

not sure we have an authoritative version of that."

Interjection.

A. Dix: He said: "I am not sure we have an authoritative

version of that."

Do you know, hon. Speaker…? I understand why he's yelling now:

because it's embarrassing. We're talking about millions of dollars in public

funds, and he had no idea what he was doing. He couldn't defend what he was

doing then.

This is an ideological approach which people do not support in

British Columbia, and there he is. You know when he starts yelling that you're

hitting close to home. That, in fact, is what's been going on.

You know, it's fascinating. It doesn't take long, does it? All

they have left is personal invective. That's all they have left. It's shameful.

It's shameful for a Minister

[ Page 11681 ]

of Health, vitiating the founding principles of health care with legislation.

He comes to this House and won't defend it. It's shameful.

Now all we get from him…. We got it yesterday, and now we get more

of it today. This is what we can expect: yell and call people names. People who

support public health care in this province — yell and call them names. That's

what we have. That's what his speech was about yesterday. I'm sure there'll be

more people added to that list.

We have a different view than the government, and that part of it

is fair enough. What I'm calling on the government to do is to be

straightforward about what their position is. It may be fair enough if they say,

"We don't believe in the principles of universality anymore," if that's their

view.

That appears to be their view, from their policies over the last

few years. It appears to be their view, from the Premier's specific comments. It

appears to be their view on the specific question of for-profit health care.

That appears to be their view. Then they can state that view. We can have a

debate about it, but they don't want to do that.

You know why they don't want to do that? Because the people of

British Columbia don't agree with that view. They don't agree with that view.

What we get from the Minister of Health instead is this kind of cutesy nonsense,

where they bring forward a bill that they will not and cannot defend. They

vitiate those founding principles of health care. They won't say what it means.

The minister clearly has been made to do this in some fashion by the Premier,

and so that's their position. That's what they want to do.

They want to change our health care system in the dark, and we

want to shine a light on it. That is our role — to shine a light on it — in this

debate. We intend to do that. From now, throughout this debate, members on the

opposition side will be laying out how the main threat to the sustainability of

health and to our public health care system in British Columbia is the members

over there.

We will show it with the evidence. We are going to show that the

main threat to public health care is a government that won't defend it, won't

enforce the law and now, after the fact, wants a mulligan, where they change the

law. That's what they want. They want to do it, and they want to make these

changes under the cover of invectives. That is their plan.

I think the people of British Columbia are going to reject this

approach. They are going to reject this approach. The people of British Columbia

want us instead to have an approach to health care that focuses on improving

services for people. They believe we can do that. They don't believe that the

only innovative idea that a government can come up with is to off-load costs

from the government to the sick. They don't believe that. They believe we can do

better in public health care.

[1100]

In Ontario, for example, with the results…. It's not an NDP

government in Ontario. It started under an NDP government but has been carried

out by governments of different stripes. The Ontario case costing initiative or

the Saskatchewan Health Quality Council…. Proposals like that — unlike the

government's proposals, unlike the government's efforts to get at issues such as

chronic disease — involve people who are not in a conflict of interest but focus

on the highest possible quality in a public health care system.

Let me just give you one example of what I mean. What does the

Saskatchewan Health Quality Council do? It provides independent, evidence-based

assessments of the effectiveness of the province's health care services,

including patient outcomes.

Let me give you one example that has come out of that — the

chronic disease management collaborative. It's an initiative to improve the

health of people living with coronary artery disease and diabetes by focusing on

the quality of care they receive. It also includes efforts to improve access to

physician practices.

It uses, contrary to the government and its approach, a

collaborative model that importantly does not include — and this is an important

fact, and we're talking about sustainability here — the pharmaceutical industry

or interests that may profit from the initiative. They say it's very important,

and this is something that is not happening in British Columbia to the extent

that it should be happening in British Columbia.

[S. Hammell in the chair.]

They say that the working definition of "collaborative" that they

use is "an improvement method that relies on the spread and adaption of existing

knowledge to multiple settings to accomplish a common aim." How different from

the approach of this government, with its proposal for service-based funding to

take away the collaboration between institutions, its market-based approach, its

favouring of for-profit interests. What a different approach.

That's the kind of approach — an approach based on collaboration,

on ensuring that British Columbians have the resources they need and that the

doctors and nurses and health care workers have the resources they need to do

the task…. That is the difference between their position and our position.

to a comprehensive range of services. Without that, quality of care declines.

When you mitigate those services, as this government has done systematically, it

has an effect on the quality of care.

That is what we have seen in British Columbia. We have brought the

cases forward. We have brought the debate forward. There have been real

consequences to this government's litany of broken promises on health care. This

attempt to rewrite the law as a mulligan, to say that that's okay, that it's

comprehensiveness of our health care system…. That's okay, and here's a

principle to put up against those items. That's okay.

That's their approach, but it is not our approach. That's why I am

hopeful. I am enthusiastic at the idea that the coming election will be fought

on some of

[ Page 11682 ]

these very health care issues. Because I think, and this was reflected in the

Conversation on Health, it was reflected every time you asked British Columbians

what they want…. They believe in the founding principles of public health care.

They disagree with the government when it attempts to say that

it's not possible. They disagree with the Premier when he puts forward

misleading data to try and convince them that it's impossible. They disagree

with that.

They understand. The people of British Columbia understand what

we've always known, which is that you have to provide service in the most

cost-efficient way possible. You don't need to change the founding principles of

medicare to know that. It has always been true.

But what we're seeing…. The minister talked about the 1990s. One

of the elements that he conveniently left out was cuts made by the federal

government of the 1990s, a Liberal government of the time.

One of the reasons, in fact, why we're second in Canada is that

here in British Columbia we had a real commitment in a Medicare Protection Act

that had substance and that the government believed in. We believed in universal

services, in accessible services, in comprehensive services.

That's why we were second in Canada at a time when it was

difficult to do that because the federal government was withdrawing from the

field and cutting funding. In a different context since then, when there have

been some — nothing like what they cut out — addition of federal supports into

the argument, this government has gone in another direction.

I believe, and I think British Columbians believe, that the

founding principles of medicare are possible, can be done and require a

government prepared to fight for them, not a government that's prepared to

mitigate and throw away those founding principles.

[1105]

We, in this debate, are going to take on this government. Right

through the next election we're going to take on this government. We are going

to present our positions on health care.

You can't undo the damage they've done in one year, but you have

to start to undo it. You cannot undo the damage they've done to health care in

one year or even two years, but you have to start to do it, and you have to have

a plan to do it. That is what we will be bringing forward, and it is a plan that

will be based on the founding principles of the Canada Health Act, the founding

principles that stand in the Medicare Protection Act. That's what our plan will

be based on.

We won't be looking for a mulligan. We won't be promising what

they promised — health care where and when you need it — and then not deliver.

We won't be promising more acute care beds, and cutting acute care beds. We

won't be promising 5,000 long-term care beds and breaking that promise. We will

deliver, because health care is fundamental to what the opposition believes is

important in British Columbia. That is the difference between us and them.

That's the reason why this, at best, unnecessary…. It's unusual

for a minister to stand up and say: "I'm introducing this bill, but it's

unnecessary. It doesn't mean anything." That's unusual. It's a new tactic, even

from this government, but that's what they did.

But changes to the law have meaning. All of the evidence tells us

they have meaning, shows us they have meaning, and this change has meaning too.

We believe in the founding principles of medicare. We will fight

for them in this Legislature, and we will fight for them in the next election.

That will be a difference between us and them, and I believe that British

Columbians from every part of this province will be with us in that debate.

M. Polak: I apologize ahead of time to those listening to

me. With great irony, I happen to be sick today when I'm talking about health

care. Perhaps that will help us all to draw our minds to what we're really

talking about today, and that is who in this House are the real defenders of

public health care that will serve patients in British Columbia for today, for

tomorrow, for coming generations. I am here to tell you that it is not the

opposition side.

That's not something that I've come to as a conclusion quickly. It

took some time to read through some of the comments that have been made by the

opposition critic, by other members of the opposition, in the media and in this

House. In reviewing those, I have to admit that I did have a certain amount of

anticipation that I would begin to see a plan. I would begin to see an

alternative laid out for British Columbians that said: "You know, if you don't

like what government's doing, we've got a different plan for you." But I haven't

seen it.

I've seen some interesting phrases. One of my favourites is

"evidence-based decision-making." If you're going to move to evidence-based

decision-making, I suppose that begs the question: what on earth did you make

decisions with before? By its very nature, decision-making is based on evidence.

I would ask British Columbians and others to consider the evidence that we've

had presented in this House about who really believes in public health care.

Maybe we should start with who really believes in the Canada

Health Act. I'm a Canadian. I've grown up in British Columbia for all of my 40

years. I've been raised to believe that the Canada Health Act is one of the

differentials…. It's one of the things that makes us as a nation stronger and

better than other countries around the world. We care for people. We look after

them. We make sure they have the basics of medical care.

The Canada Health Act is, of course, something that New Democratic

parties around this country have held not only in high regard but also held as a

flag before them to say: "This is what we stand for. This is what we're behind.

We did this, and it's an important thing." So I find it quite shocking that we

are today presented with an opposition who don't even realize that their leader

has come out expressing concern about the very words in the Canada Health Act.

It's shocking.

[1110]

[ Page 11683 ]

We began this road to change and improving health care in an

important throne speech — important because governments around this nation,

around North America, probably around the world, are very frightened to talk

about health care. They've been told that if you talk about health care, you're

going to get voted out of office. Nobody wants to talk about it.

This government took it on and said that there are important

questions to ask. We committed to a conversation that didn't just involve

committees internal to government, didn't just involve cabinet, didn't just

involve MLAs, but involved people around this province, engaged them for the

first time.

We had elders in aboriginal communities who thanked us for

travelling to their community to ask them for their input about health care. One

of the elders even said at one of the meetings that they had been praying that

government would come to talk to them, and that they felt this was an answer to

their prayer.

This is meaningful to people around British Columbia. So

meaningful that we had thousands upon thousands of submissions from British

Columbia about how we can improve and strengthen our medical services, our

health care services in British Columbia and, in fact, the health of all British

Columbians.

What we see in the legislation today is a response to that. In

fact, our throne speech laid it out very clearly. This is where the concern

comes in, because in the throne speech…. I'll quote a piece from it. In

part it

says about this act:

"Amendments will define and enshrine those five

principles of the Canada Health Act under the Medicare Protection Act. A sixth

principle of sustainability will be added to ensure our health care system

will be there for our children, our grandchildren and their families.

"Our goal is an efficient, effective, integrated

health system that promotes the health of all citizens and provides

high-quality patient care that is medically appropriate and ensures reasonable

access to medically necessary services consistent with the Canada Health Act."

What a laudable goal. You would think the opposition would be

lining up to support that kind of a goal, to support a government that actually

thinks it's important enough to put that in a throne speech, to put that in

legislation. But oh no — that's not what we heard.

Surprisingly, we heard the Leader of the Opposition get up in this

House and question the phrase "reasonable access." She said it concerned her.

Here's what she said: "Now that promise has changed to a health system that

provides 'reasonable access to medically necessary services.'" She says:

"Reasonable access. What does that message say to patients? It says: 'get in

line.'"

That's what she believes reasonable access means. In other words,

one can only think from this quote that she believes the phrase "reasonable

access" is wrong, that somehow we shouldn't be supporting reasonable access.

Well, that's where the concern really should lie for British

Columbians about who really supports the Canada Health Act. I now want to share

with you where that wording came from. Guess what? That wording comes from the

Canada Health Act. Oh yes. The real defenders of the Canada Health Act are not

on the opposition side of the House. They're on the government side. It's in the

throne speech. It's in the commitment.

I'll read to you from the Canada Health Act. This is from

section

3 on Canada health care policy, and here's what it says. "It is hereby declared

that the primary objective of Canadian health care policy is to protect, promote

and restore the physical and mental well-being of residents of Canada and" —

listen up — "to facilitate reasonable access to health services…."

How is it possible that we could have a leader of an NDP

opposition questioning the Canada Health Act? Yet that's what we see here. In

fact, we've heard for a couple of hours the opposition Health critic questioning

the very nature of sustainability of public health care.

How on earth could you promote reasonable access, which is what

our throne speech calls for and what the Canada Health Act calls for, without

making sure it's sustainable? The fact of the matter is, for all the opposition

wants to say that they believe in the principles of the Canada Health Act, their

very leader has come out opposed to the Canada Health Act and to the principles

that underlie it.

[1115]

This is a government that committed to enshrine the principles of

the Canada Health Act in legislation, and that's what this legislation does. It

recognizes the value of the input of British Columbians who took part by the

thousands in the Conversation on Health. It talks about their values. What were

they? Values of choice — that's in the

preamble. The

preamble says values of

"individual choice, personal responsibility, innovation, transparency and

accountability." Those are things that people around British Columbia talked to

us about. They want to have choices.

British Columbians wanted to know why on earth our current health

care system restricts them to receiving prescriptions only from their general

practitioner when they're on medication that they've been on for years and a

pharmacist could do the job just as well. We're going to change that. We

listened to them.

British Columbians wanted to know why it is that they're

restricted, when they're in an emergency room, to having a doctor come and refer

them for medical diagnostic testing. We listened, and we're going to change

that.

On and on we can list off, through the 11 pounds of input that we

got in the Conversation on Health, example after example — not only in the

throne speech, in legislation being tabled by the Health Minister — of listening

to British Columbia and acting.

The opposition Health critic wants to claim that the main threat

to public health care is this government. I beg to differ. If that's what he

wants to say, then he would be supporting this bill because he would be tying

government to the Canada Health Act. But he won't do it. Why? Because he doesn't

support the Canada Health Act. His leader doesn't support the Canada Health Act.

She said so in this House.

The fact of the matter is that reasonable access is what we are

going to ensure by ensuring sustainability. Reasonable access is something that

we count on as

[ Page 11684 ]

British Columbians, as Canadians. It has to be weighed in the balance against

all the services, the range of services that health care encompasses. We have to

ensure that that access is there, not only for us now but for those who are

coming after us.

Anyone who supports the Canada Health Act would be supporting this

bill, because what's this bill made of? This bill is made of the principles of

the Canada Health Act — things that we should as Canadians hold close to our

hearts.

Public administration. This bill enshrines the definition of

public administration in legislation. It ties government to that. If you support

the Canada Health Act, if you think governments of any type would be a threat to

it, you'd support this legislation.

Comprehensiveness. We have a huge range of services now available

through our health care system that were never even dreamed of when the Canada

Health Act first came into being, were never dreamed of when public health care

first began in Canada. They're there. They're ever-expanding. They're ever

putting pressure on a system that is bearing it relatively well, considering the

changes and challenges that we're facing.

Universality. I don't know how you have universality without

having sustainability. I don't know how you have it, really, without reasonable

access. Universality here is defined as 100 percent of beneficiaries on uniform

reasonable access, but the opposition leader…. She's concerned about that. She's

concerned about reasonable access. She thinks it means: "Get in line."

You would think that the great defenders, so-called, of the Canada

Health Act would actually take the time to read it. Well, we've taken more than

the time to read it. We've taken the time to put our commitment behind it and to

follow through on what we promised British Columbians and what they asked us for

in the Conversation on Health.

Portability — the idea that you can go anywhere and you take your

services with you. They're there. They don't say: "Well, you're from Langley, so

you should go back there."

sustainability? How do you have it without reasonable access? Shouldn't it be

reasonable? The Canada Health Act thinks it should; the opposition leader

doesn't.

Then we come to sustainability. We've heard all sorts of talk

about what sustainability might be. It would probably help if the opposition

critic read the act. But then I guess he can be somewhat blinded by the fact

that, clearly, on that side of the House there is a belief that governments

should have unfettered access to the taxpayer's pocket. There is a belief

somehow that government has some of its own money.

[1120]

When we go around the province throughout the Conversation on

Health and we talk about the ability of taxpayers to pay, yes, they recognize

that there's a need to be paying taxes to support a public health care system.

They realize that. They recognize that, but they also recognize that their

taxpayers' money, their hard-earned money, is a resource that we ought to value.

They recognize something else. They recognize that sustainability

goes beyond finances. Sustainability goes to the very resources we use in terms

of technology and in terms of human resources. All those different facets of the

system are a part of sustainability.

We've taken some action on that. We've looked at health prevention

and promotion. That's another area in the Conversation on Health that the public

asked us to take hold of and take a leadership role on, and we've been doing

that. You can see the ActNow trailers outside on the front. That's an

award-winning program to promote a sustainable health care system through

prevention and promotion of good health. That's sustainability.

Sustainability is also about innovation. You have to have growth,

change and research. You have to have innovation in a health care system, and

you have to encourage it. We've done that. The UBC Centre for Surgical

Innovation is something that even won praise from the opposition. Why? Because

it's a good program. We have many, many more across this province.

When it comes to health professionals, I've mentioned already the

changes that we're making with respect to what nurses are allowed to recommend

for medical diagnostic testing. How many times have people been waiting in an

emergency room, all because of a restriction that says that a nurse can't take

them for their diagnostic testing? Imagine the change that that will make for

everyday people — everyday lives being lived in an emergency room, waiting.

That's called action. It's a plan. It's tangible. It's not

something that has empty words. It's something that has real change behind it.

What about the pharmacists? We know from the research that when

you have pharmacists involved in prescribing medications for patients with

chronic diseases, when they're involved in chronic disease care, those patients

with chronic diseases do better. They're healthier.

That's another part of sustainability. It's looking at what

British Columbians have told us, listening to what we've learned from other

places around the world and taking action. Sustainability is all about that.

As a principle, I don't know how you don't support sustainability.

I don't know how that's even possible. The opposite view, of course, is to say:

"Well, I don't think we should make it sustainable. We should have a health care

system that just keeps on going, sees the light at the end of the tunnel and

doesn't realize it's a train. We shouldn't get off the track. We should just

wait till it hits us."

I don't know that it's really worthwhile even to get into a debate

about how fast the health care system is going to gobble up the rest of the

money in the government coffers. The fact of the matter is that whether it's ten

years from now, 20 years from now, 30 years from now, 50 years from now….

I'll tell you what British Columbians did acknowledge. I'll tell

you what they acknowledged en masse in the

[ Page 11685 ]

Conversation on Health: eventually it will happen. Eventually, if we don't

change, it'll happen.

What will that mean? Sadly, that will mean that not only will

health care services be compromised, but other services that are important to

British Columbians will be compromised — services for children, for the

homeless, for seniors. These are all things that are valuable. None of them can

be sustained if health care is not sustainable.

We have to be thinking all the time about the future. If there is

a threat to public health care in British Columbia, that threat is from those

who would put their heads down, pay no attention to the challenges that are

facing health care in British Columbia and say: "Everything's fine. It should

stay the same."

Of course, that brings us back to the most common theme that we

hear from the opposition. We hear it in transportation; we've heard it now in

health. It really is a broken record. It is that while they decry the state of

anything that's going on in British Columbia today, especially health care, they

want it to stay the same. The biggest thing they rail against is change. "Don't

change it."

[1125]

They maintain two conflicting positions. They do that on the Port

Mann Bridge. They do that on health care, and we hear it again today. "The

system is broken. It's in crisis. There are all these terrible things going on.

Ah, but it really is okay. You don't need to change it. There really aren't any

problems." I'm not exactly sure how that kind of cognitive dissonance is

maintained.

But I suppose the opposition has learned very well to live with

ambiguity, or they wouldn't be able to listen to the speeches from their

opposition Health critic. Then again, this is also an opposition who claims to

believe in the Canada Health Act yet listens to their leader decry some of the

very principles undergirding it. So living with ambiguity seems to be a common

practice on the side of the opposition.

One of the realities that you face in health care in British

Columbia, and our Health Minister knows it well, is that there is a constant

change taking place. For a minister of Health and for someone who may wish to be

a future minister of Health — without a plan, albeit — the reality is that one

daren't take their finger off the pulse of what is happening. Yet we have in the

opposition a group who are willing to castigate government for any kind of move

to change without putting forward a plan of their own.

I really, really waited to hear more of a plan during the speech

from the opposition critic. I really was hopeful that it would come. I waited

and waited. It didn't happen. But maybe what did happen is that we saw the

reality of the choice that British Columbians will be facing.

The choice that British Columbians will be facing — and it's true;

they will — is a choice between a government that says that we recognize that

health care is important to all of you, that public health care is important to

all of you…. We recognize that you want the principles of the Canada Health Act,

including reasonable access, to be a part of what we're committed to. That's the

choice that we're laying out for them. Or you can vote for a group who don't

have a plan. You can vote for a group who want to talk about everything being

awful but who offer no solutions for changing it.

It's interesting to me that in spite of the fact that the

opposition are fond of calling for inquiries and reviews and commissions and

all-party committees on just about everything, when it came to the Conversation

on Health, they opposed it. They opposed it. We went around to talk to British

Columbians all around this province. They engaged. There were something like

close to five million hits on the website, thousands of submissions. What did we

hear from the opposition? "Don't go talk to British Columbians. You should have

health professionals making those decisions."

Really? Is that a plan? It sounds to me like what they want to do

is hold away in an all-party committee somewhere and decide that everything's

still okay, because that's the only message we hear. On this side we've

recognized that British Columbians want change, and we've taken some dramatic

action.

You know, talk about what's happening in emergency rooms. The best

thing you can do is ask patients. What happened when we asked them? Some 85

percent of emergency room patients rate their care as good to excellent. I can

tell you that I grew up in Surrey, and it wasn't like that many years ago. There

are big changes afoot, big changes taking place, like $12 million that was

invested in an emergency room strategy that was launched in '03. We have a

Health minister and a government who are responsive, who watch, who see what's

going on, respond and change. That's what this bill is about.

When it comes to surgery wait times — that's one of the things the

opposition are fond of bringing up — let's look at what has happened. There was

no wait time for almost half of the record 459,388 surgeries performed in '05

and '06. In '06 and '07, 52 percent of hip replacements were completed within 26

weeks, and 49 percent of knee replacements were completed in 26 weeks. Wouldn't

you want to improve that? Wouldn't you want to work harder on that? Isn't that

part of sustainability?

Since 2001 the number of surgeries performed in B.C. has increased

by record amounts. You're looking at a 7 percent increase in coronary bypasses,

33 percent in cataract surgeries, 47 percent in hip replacements, 62 percent in

angioplasties and 84 percent in knee replacements. Evidence, if the opposition

wants it, of a system that is improving, that's changing, that's innovating.

We're here to support that. They're not.

They don't support the innovation. They don't support the changes.

They vote against it. And I believe, sadly, that they're going to vote against

this bill.

[1130]

I'm not sure how you square that circle. I'm not sure how you say

that you're voting against this bill and say you believe in the principles of

the Canada Health Act. Perhaps one of them wishes to get up and explain that.

Perhaps they will. I don't know if I'll understand it after their explanation

any better. But I don't see how you square that circle.

[ Page 11686 ]

We've seen improved access to diagnostic testing — 11 new CT

scanners, 19 new MRI scanners and B.C.'s first PET scanner. Since 2001 we've

seen more nurses. In fact, we've put $174 million into nurse education and

recruitment, and we've added 3,300 nursing education spaces. There's a really

good reason why nurses weren't being trained in the past. There wasn't any place

to do it. There weren't any spaces. We've added those. We're training them.

Some $1.4 million to launch the first three-year accelerated

nursing degree. There's another one. We'll see if the NDP wants to support that.

BCNU does. We're bringing people on side that would have never been

traditionally aligned with government in initiatives and innovation in health

care, and they're there.

Perhaps that's what rankles the opposition. Everybody else

realizes that health care needs to change. Everybody else realizes that that

change needs to happen by incorporating the principles of the Canada Health Act

in everything we do, and yet I think they're going to vote against it.

In the last five years we've graduated more than 7,500 new nurses.

That breaks down across a pretty broad spectrum, actually. You've got 4,909

registered nurses; 2,286 licensed practical nurses; and 344 registered

psychiatric nurses. In the last two years we've increased the number of

internationally educated nurses in B.C. — 521 nurses from the U.K. and $500,000

per year to fast-track registration of internationally educated nurses.

For the first time B.C. is training nurse practitioners. In 2005

B.C. graduated its first class of nurse practitioners, and there are now more

than 51 nurse practitioners working in B.C. We graduate 45 nurse practitioners a

year.

Are they going to support that kind of change? Sustainability is

about that. Sustainability is about making sure we have the health professionals

with a broad range in what they're allowed to do in order to make sure that

they're there.

We talk about a system. We say a health care system, and it sounds

really vague and machine-like. But it's not a system. It's people. How do you

support them? How do you make sure you have enough of them?

How do you make sure you have enough doctors? We've wrestled with

that problem too. We've increased the funding for postgraduate medical education

by 73 percent since 2003. It's now $75.1 million. Residency spaces for Canadian

medical graduates are up by 75 percent since '03. Residency spaces for

foreign-trained doctors have tripled. We actually have more doctors per capita

than almost every other province, and for the first time, doctors are trained

outside of the Vancouver area.

That's sustainability. Making sure you have enough doctors is

certainly important. It wouldn't be sustainable without it. But then they're

opposed to sustainability. Clearly, by voting against this bill, they're opposed

to the Canada Health Act. This bill, and the test that voting on it will put

before us, really is about the fight to maintain a public health care system for

all British Columbians.

It might, in fact, be the beachhead. Successive governments,

nationally and provincially, have avoided dealing with the complex issue of how

you make sure that our health care system remains available for people, that

reasonable access is maintained for people across this country. We're the first

ones to take it on, to ask British Columbians what they want us to do, and to

respond with aggressive legislation, to respond with thoughtful legislation and,

significantly, to respond by renewing our commitment to the principles of the

Canada Health Act and renewing our commitment to British Columbians by

enshrining sustainability as one of those principles.

Sustainability is all about reasonable access. Sustainability is

about making sure that the interests of all of us in receiving medical care, in

receiving other services from government, are balanced against the needs of the

taxpayer to be able to pay.

There's nothing sinful or evil about that. It's a principle that

has been held out and held before us in times past by those who would never be —

I don't think, anyway — someone who would frighten the opposition Health critic.

But he does seem frightened by it.

[1135]

It might be a comfort to the opposition Health critic and perhaps

to the leader, who needs to go and re-read the Canada Health Act, to know that

even a former well-known member of this Legislature, Minister Paul Ramsey, was

supportive of the principle of sustainability.

In fact, they introduced a bill. What was it called?

An Act to

Protect Medicare. It has an interesting passage in it. It says: "WHEREAS the

people and government of British Columbia recognize a responsibility for the

judicious use of medical services…." So now we're even beyond reasonable access.

They only want judicious use. To me, that sounds much more limiting: "…judicious

use of medical services in order to maintain a fiscally sustainable health care

system for future generations…." That was the NDP Health Minister.

I hope that gives some comfort to them, because certainly in

debate he tried very hard to ensure that people understood that sustainability

was not something to be frightened of — sustainability was integral to the

future of our health care system. Here's what he had to say in committee stage

debate. He said:

"Finally, I want to comment on the concern about

fiscally sustainable health care. British Columbians and those of us charged

with overseeing the health system have the responsibility of making sure that

we have a fiscally sustainable system. That means allocating adequate funding

for delivery of services but also, and perhaps even more importantly, taking

measure to make sure we are delivering services as efficiently as possible and

involving the public in discussion about the judicious use of medical

services."

Well, I'm pleased that even back in the days when Paul Ramsey was

the Health Minister they saw the need to incorporate fiscal sustainability in

health care. I'm pleased with that. I do hope it's a comfort to the opposition

Health critic.

As I close my part of the debate, I would put up that our language

of reasonable access is much more closely aligned to the Canada Health Act than

anything that was in a previous NDP act.

[ Page 11687 ]

N. Macdonald: I rise to speak against Bill 21.

Bill 21 is the Medicare Protection Amendment Act. What the bill

puts forward is six principles that will guide the deliberations of the Medical

Services Commission. The five principles are familiar to us. They're the

existing and familiar provisions that have been in place for Canadians for a

long, long time and have served Canadians very well.

Those principles are, as I say, familiar to most. The ideas that

we would have public administration, the ideas of universality, portability,

this bill intends to do is to add a sixth principle, which is sustainability.

Now, "sustainability" is a term that is, at worst, innocuous. It

is a term that most would see as a reasonable term, but it depends very much on

how the term is going to be defined by the government and the true impact that

it will have on medical services in British Columbia.

What we would expect is that the minister, bringing the

legislation forward, would come into this House and provide an explanation for

British Columbians about what sustainability meant, because if you are bringing

in legislation and you intend to make it the law of the land, it must have some

meaning, and it must have some impact. Naturally, what you would expect is the

government would come in and explain exactly the impact and exactly what it

means.

[1140]

Instead, we had an hour and a half with no explanation about what

the bill means. Yet we can assume that the direction this will take us in is the

direction that the Premier has consistently wanted to go — a direction that he

would go if he was not so aware of the fact that Canadians, British Columbians,

would be totally against the privatization that he wants to take the province.

So he brings in the bill, and the minister brings in the bill, adding the term

"sustainability," adding a term that is going to be interpreted and will have

meaning and will work to take away from the five existing principles, and tries

to undersell it and tries to tell the public that they shouldn't be concerned

about something that is of fundamental importance.

We have government saying: "This is no big deal. It means

nothing." But what British Columbians know with this government is that every

single thing that is put forward needs to be looked at very carefully, because

so often it is couched or packaged with particular words that try to draw people

away from the true impact of what is being proposed. With this, we have an

attempt to undermine those five important principles of medicare, principles

that have served Canadians very, very well.

I mean, the fact is, certainly from my area, that this government

and this Premier do not have credibility on health care. British Columbians do

not feel that they are committed to looking after each and every person in this

province and, quite rightly, feel that with this policy and with, frankly, every

other policy of this government there is a narrow corporate interest that the

government and this Premier would choose to serve rather than the public

interest.

So we have bland assurances, and we have enough experience over

these seven years to know that we should hear these bland assurances and be

concerned. The sustainability principle was put forward by the Premier before

the Conversation on Health. In the Conversation on Health the people did come

forward, and they talked about a lot of things. But what they didn't talk about

or didn't accept were many of the premises that the Premier put out at the

beginning of the Conversation on Health, despite an incredible amount of the

government's resources being put towards trying to convince people of a point of

view.

You did not have ordinary British Columbians coming forward and

talking about the need for a sixth principle in medicare. That did not happen.

People did not come forward and say that. They did not come forward and accept

the Premier's disaster scenario around the cost of health care. That did not

happen.

When you read through the Conversation on Health, you have people

talking about ideas around solutions. You do have people talking again and again

about the importance of health care to their lives and the importance of doing

health care properly. I think that there is a recognition, and there is a

recognition from this government, that that attempt to scare people about the

costs of health care just didn't work.

It was put forward. You had all the resources of government. You

had the — what is it? — 200, 300 people in the public affairs bureau. You have

all of those people. You have all of the advertising that went along with the

kickoff for the Conversation on Health, and people did not buy that 71 percent

of all government spending by 2017 being an accurate figure. It's part of the

reason why it's no longer repeated here, because it was a preposterous figure.

It was inaccurate. It was misleading — intentionally so.

You had many, many people pointing that out very, very quickly.

I'll just go to one

article out of many. It's by a journalist that I read and

respect, and I enjoy his articles — Paul Willcocks. What he said in one

article

really clearly was that there's no crisis in health care. I think everybody

recognizes that there are and always will be cost pressures and that we need to

be aware of those. But with health care spending at $13 billion, that is a cost

that Canadians and British Columbians are willing to accept.

[1145]

He points out, as others have, that British Columbians spend $10

billion on slot machines and lottery tickets. Slot machines and lottery tickets

could not be the first priority for most families — not compared to health care

— yet we quite willingly will spend $10 billion on gambling in this province.

Just as a sidebar, gambling was something this Premier came in promising to

reduce or not expand, but that's another issue. But it does point to the fact

that $13 billion, while a tremendous sum, needs to be looked at in that context,

that British Columbians still have $10 billion in excess to spend on something

that would list very far down their list of priorities.

Paul Willcocks goes on to say that this legislation, this Bill 21

that's in front of us "fuels fears the government

[ Page 11688 ]

will use scare tactics to justify cutting care or offering patients the

chance to pay extra for private treatment — a shift that would actually increase

health care costs overall. User fees mean the total cost for a specific

procedure rise. Health care will cost each British Columbian about $3.50 a week

more this year than it did last year."

Well, that's hardly a crisis. That's a conclusion any reasonable

person would reach. So why are we being fed this? What's the agenda? Why are we

doing this? I think, before we move on to that, we need to talk about values,

and we need to talk about what's important for people.

What is the core thing that is important? What I would say is that

public health care and public education will be at the top of almost every

person's list. At certain moments in our lives, and we all have been there,

we've all experienced them, there is no question that more than anything else

health care and a health care system that works are the most important things in

the world.

While we disagree on many, many issues on both sides of the House,

one thing that we do agree on is that, compared to pretty well anywhere else in

the world, British Columbians are fortunate. We're fortunate with the

professionals that we have in the field working for us. We are fortunate with

the system that we have put in place.

On this side — the NDP — we feel passionately that we not only

have to retain it; we have to strengthen it and make sure it is not only here

now, but that it is here in the future. That is a question of political will.

What this bill does is undermine a system that works well.

I'll give you an example just from the recent past. We had a baby

born in Golden. It was a wonderful thing. A friend of mine was going to be a

grandfather for the first time. Doctors were worried about that child and felt

that the child needed to be taken immediately to a Lower Mainland hospital where

a better service could be provided, just to be careful.

There is something fundamentally wonderful about a system where

you have health professionals concentrating on the needs of the individual.

There was no question about ability to pay. That did not come into it at all. A

citizen, a new citizen of this province, needed care, and the collective

resources of the people of British Columbia made sure that a jet flew out, took

the child, brought them back to the Lower Mainland, that that child got care,

and then that child was flown back.

[Mr. Speaker in the chair.]

Now, it didn't all work perfectly, but isn't it something

wonderful that we, as a province, would make sure that every person that we

could help, we would try? And that the individual cost or who was going to pay —

none of that was part of the consideration. It was only the interests of that

child.

For many of us and for many people in the province, we have been

raised in a system with public health, where we take it for granted. But we also

have many people that have gone to other parts of the world and have other

experiences.

[1150]

I can tell you that my experience in Africa was that within the

region that I lived in, in northern Tanzania, we had access to Nairobi, and

there were two good hospitals there. There were hospitals there that were up to

a standard that Canadians would be comfortable with, but you had a vast majority

of the population that would have no access to that care.

What it leaves with you is that understanding that it is a

fundamentally different life that people have when there is that insecurity.

There is the possibility that at any moment, through misfortune, you or somebody

you love can be put in a place where they need medical attention. There is a

medical solution that could easily be found, but for lack of money, it will not

be found.

The experience that I had there was that somebody I worked closely

with, his brother died of tetanus. His brother died because he couldn't pay to

go and get a shot for tetanus. He knew about tetanus. He just didn't have the

money to go and get the service, and the service was a dollar. So for lack of a

dollar, you have people grieving and all of the emotion that goes with that and

all the hardship because the person couldn't afford to get help.

It wasn't just for individuals. The thing about health care that

people understood a long time ago is that if you are not dealing with people's

health care concerns as a community and as a society, if you're instead leaving

health care to those that can afford it, there are impacts even for the people

who can afford health care.

Where we were, we would get malaria. We would get malaria often,

regardless of how you tried to prevent it from happening. But until you deal

with it as a whole population, you cannot get rid of malaria. You can't deal

with it effectively, because, of course, it pools in people who do not get the

treatment. Therefore, even if you have access to it, you share the health

problems of the wider population. So there is a moral reason that we come

together to look after health care as a collective, but there are also practical

reasons why we do it.

Now, is Canada the best in the world? I suggest that, depending on

political decisions, you can do better. The example I would use for that is the

experience that I had in the United Kingdom. Now, the United Kingdom's system is

not perfect, but it does point to what a society can do if they want to.

When my grandmother was aging in the United Kingdom — she was in a

rural area of Scotland, up in the islands — she had a doctor come to her house

once a week. She had a nurse that came to her house in the morning and came to

her house in the evening and helped with meals. She was in her house until she

was 98. She stayed at home until she was 98. Now, that is purely a political

consideration. There are tax implications, but if you want to do it, you can.

Secondly, when my daughter was with us and we were visiting

Scotland, she became sick. We went to the doctor, and we were told that because

she's a child, she will not pay for the visit with the doctor. Is that something

that in Canada we can do? Yes. Will it cost more? Yes. But it's a political

decision. Do we have the capacity to do it? Yeah.

[ Page 11689 ]

Now, all of those things you can do. She was not a British

subject. She was a visitor to a country. She got her treatment for free. When

she needed medication, we went to the pharmacist with the prescription. The

pharmacist told us, as we went to pay for it: "There's no cost. She's a child."

Any child that comes to Britain gets their medicine for free, because that's

what the people in the United Kingdom believe. That is their collective decision

about the decent way to treat people in the system. All of that is a political

decision.

Now, this idea about we can't afford it…. At the same time, we're

spending $13 billion, and at the same time, we spend $10 billion on lottery

tickets. We put it into different gambling establishments that we have here in

B.C. I cannot believe that that is a reasonable argument that somebody would put

forward.

[1155]

In the United States we went to a hospital. Again, my child was

sick. It was $300 to have her looked after there. Now, for us we had the

capacity to do it, so we were able to. That's no problem. But there are people

who would not treat an ear infection, because of that barrier. There's no

question it would be a barrier to some. I would be interested to hear how anyone

could rationalize that as a reasonable way to approach public policy.

One of the best things about this province, one of the best things

about Canada, is the fact that we collectively look after each other. That is

the most decent, most civilized part of this country.

What I would put to people in British Columbia is that this bill

is the beginning of undermining that…. It's not the beginning. We've seen it

consistently, actually, with this government, as they try to undermine the

quality of care that we have in this province and undermine the principles of

equity — the principles that people in rural areas, the principles that people

with less money have the same standard of care.

That is the most fundamental, civilized part of this province.

It's part of the reason why the government cannot stand up and say that they

want to move away from those ideas, away from those principles, because it's

indefensible. The public will reject it.

Now I see the time — that we need to take a break. I would like to

reserve my opportunity to come back and finish the time that's allotted to me. I

move adjournment of debate, and I look forward to the opportunity to continue my

comments.

N. Macdonald moved adjournment of debate.

Motion approved.

Committee of Supply (Section A), having reported progress, was

granted leave to sit again.

Hon. B. Penner moved adjournment of the House.

Motion approved.

Mr. Speaker: This House stands adjourned until 1:30 this

afternoon.

The House adjourned at 11:57 a.m.

PROCEEDINGS IN THE

DOUGLAS FIR ROOM

Committee of Supply

ESTIMATES: MINISTRY OF ECONOMIC

DEVELOPMENT AND MINISTER

RESPONSIBLE FOR THE ASIA-PACIFIC

INITIATIVE AND THE OLYMPICS

(continued)

The House in Committee of Supply (Section A); H. Bloy in the

chair.

The committee met at 10:09 a.m.

On Vote 24: ministry operations, $225,218,000 (continued).

Hon. C. Hansen: Actually, I wasn't planning to make any

lengthy introductory comments, because I know our time is quite limited. I

thought I would just go straight into the questions that the member may have.

[1010]

D. Routley: Thank you to the minister and to staff who have

come a long way to attend these estimates. I appreciate their involvement and

appearance here.

The ITA is said to be industry-driven. It's clear that industry

has its stakeholder interests in all these outcomes, but one of those interests

that the industry grapples with is the need to build things as quickly and

cheaply as possible. So it might be argued that their interest is somewhat

narrow, and the lack of involvement of other stakeholders in the governance

structure of the ITA and ITOs might be viewed as a mistake given that there are

varying interests at play here. It's clear that labour unions have had a very

successful history in training and apprenticeship guidance and structuring

programs.

So my question would be: does the minister think there's an

opportunity in the coming year for greater involvement of other stakeholders in

the governance framework of the ITA and the ITOs?

Hon. C. Hansen: I was remiss in not introducing Kevin Evans

right off the top as the CEO of the Industry Training Authority. We're pleased

that he's able to be over here today to assist in this process.

First of all, I would take issue with the premise that the member

used to stage his question or to introduce his question. When he talks about the

industry's primary interest being to build as cheaply and quickly as possible, I

must say I have never met anybody in industry who doesn't put quality of product

and quality of workmanship and safety of workers at the top of their priority

list.

[ Page 11690 ]

So I think the member doesn't give industry enough credit for ensuring that

there is a quality product and safe workplaces as well.

But in terms of the role of the industry training authorities,

this was really in response to feedback we got from employers around the

province who felt that the apprenticeship training program wasn't always meeting

their needs. When they had workers that came to work for them who had come

through a training program, in many cases they found that the training being

offered wasn't meeting the needs of the workplace. In many cases the employers

would then have to retrain the individuals to ensure that they actually had the

skills and the training necessary for the workplace.

So what we said to industry was: "We're going to give you a role

in helping to design the training programs so that they're actually producing

the trained workers that the industry is going to require." We have said to the

industry that they can establish the ITOs. They can drive it, and they can

design the ITO in a way that they feel best meets the needs of that particular

industry.

We are certainly open to the idea of trade union representation on

the ITOs — or other stakeholders, as the member put it — but we are leaving it

up to the industry to determine what is the best mix of players in the ITOs that

would be at the table. We fully expect there will be trade union representation

in some of the ITOs, at least, as we go forward.

[1015]

D. Routley: In fact, I would like to correct the minister.

I did not indicate that building cheaply and quickly was the main priority or

the only priority of contractors or employers, but it certainly is one of them.

My stepfather was a carpenter and a contractor. My experience is different from

the minister's. I've met many, many builders who will take a shortcut to make a

dollar.

I think the incentive in the marketplace is to make the greatest

profit possible. The role of government would be, in my mind, to regulate that

playing field to ensure that public standards are met and public safety is

protected and those kinds of issues. It would not be, I think, very prudent of

any society to place that responsibility on the shoulders of the marketplace

without adequate regulation.

That was my point. In fact, it is a factor in the consideration of

what employers do — costs. Driving down costs is definitely the number one

preoccupation of business people — not, perhaps, building things cheaply and

quickly. Maybe that was an unfair characterization. Certainly, driving down

costs is at least second behind building profit. The most important component of

building profit is driving down costs.

Whenever new costs are added to the landscape that employers

operate in, be it to protect public safety in the broader sense, environmental

protections or worker protections, there has been a resistance from industry

against the implementation of regulations that would add cost, in the interests

of protecting those other interests.

That was my point. In fact, they're driven to the table with a

restriction on their ability to openly and freely protect those interests

themselves. I think that labour unions have done a great job in providing that

to our society in the past.

Given their excellent completion rates in their labour schools

where they are still guiding apprenticeships — those are reported to be 90

percent and over, and they are very effectively managed with minimal resources —

it seems to me that guidance and that viewpoint would be critical to the success

of addressing the labour shortage in British Columbia, which we know is so much

demographically driven. We have a lot of skills, but a lot of them are retired

with people.

I think it is imperative that we bring all viewpoints to the

table. I would ask the minister to make a commitment today to ensure that labour

is a stakeholder at all of the ITO tables, in the interest of the success of

those organizations.

Hon. C. Hansen: I certainly agree with the member that some

of the training programs — the apprenticeship training programs that are driven

by some of the unions in the province — are first class, and they do a great job

of providing that service.

We support that through the Industry Training Authority with

funding. In fact, all of those union-driven programs this year received

increases in funding. We want to encourage and support them in their continued

efforts. We certainly recognize that the unions are a very important stakeholder

in the apprenticeship programs and the training programs generally in the

province. The ITA works closely with them, and we will continue to do that.

When it comes to the actual structure of the ITOs themselves, it

is not something that we as a government or I as a minister are going to

interfere with — how they are structured.

We have said to the industry that they need to structure the ITO

with the players that they think are important to have at the table, and we will

leave that decision to them. I think that if you started to try to structure the

ITOs with all the various stakeholders that would be interested, you would have

a very large and unwieldy group.

As I said earlier, I fully expect that some of the ITOs will want

to have union representation at the table. Other ITOs may choose not to go that

route, but we are leaving that decision up to them.

D. Routley: In my way of thinking and viewing this issue

from this side of the House in a critical role of government, I have the

impression that our province is flying somewhat blind in that we do not have

clear numbers to assess where the shortages are and how they're being addressed.

[1020]

If the government just pulls back and lets industry drive by its

immediate need and does not take a role in identifying strategic objectives,

that might create great problems.

One example I would use is the fact that there are no programs or

training available for moulders who

[ Page 11691 ]

work in foundries. This is a very strategic link in the industrial chain, in

that it offers us incredible flexibility in our industries — our forest

industry, our marine construction industry, our civic infrastructure. We can,

through these foundries, make customized castings which address many, many needs

and allow us to adapt to new processes and products.

But that industry is under great pressure. In the recent past

there were, I think, 15 foundries in the Lower Mainland. Now there are five.

It's a very strategic link in the industrial chain, but without some sort of

strategic objective, it's one that could be missed.

It could be missed in terms of cap-and-trade, because it could be

one of those businesses that is most pressured in down cycles of the economy.

Opportunities in cap-and-trade might pose the threat of the same sort of loss of

those strategic links in the chain. I think that if the government doesn't take

some role in having a strategic objective around the priorities of labour market

force adjustments, then we will encounter those kinds of critical losses.

Will the minister agree that there should be something, beyond the

immediate marketplace-driven training model, that anticipates, plans for,

accommodates and implements strategies to address those strategic links that

might be lost?

Hon. C. Hansen: I think the member made reference to the

employers looking at their short-term interests. Again, the employers that I

talk to very much have a long-term view, and they recognize that the issue of

labour shortages is here to stay in British Columbia, and I think that

increasingly, companies are looking longer term to make sure that their labour

force needs are being met.

I would argue that the industry representatives that sit on the

ITOs actually have the best window on where labour shortages would be

materializing. We tap into all of the tools that are available to us when it

comes to forecasting labour force needs of the future.

The member may be familiar with the COPS system, which is the

Canadian Occupational Projection System. I think I've got that right. That is

national. In fact, I attended the conference in 1981, when the COPS system was

first established, and I think it has served Canada well since then.

That system relies on input from employers. It also relies on

input — and we rely on input — from tools like our major projects inventory in

the province, where we know from our latest listing that there is just shy of

$150 billion worth of major construction projects in the province that are

either in development today or are being planned. So that's a valuable tool for

us in looking not only at what kind of occupations are going to be required but

where in the province those occupations are going to be required in the years to

come.

We do rely on all of those tools to ensure that we target the

occupations that are going to be most in demand in the future, and one of our

most valuable sources of that information is, in fact, the employers.

[1025]

D. Routley: It used to be that after six months folks who

didn't continue their training were delisted from registration numbers.

Currently the ITA lists, I believe, around 38,000 registrants, but those

circumstances or prerequisites to being recognized as registered have changed.

Now a person stays on the books for 18 months. There are also issues of multiple

registrations in different programs because of the wait-lists.

I wonder if the minister can give me updated information on how

many registrants there are, what level of duplication, triplication and so on

that he anticipates is present and whether or not there's a good argument for

reducing the length of time that someone is kept on in the registration.

Hon. C. Hansen: First of all, with regard to the number of

registrants, our latest numbers show that we have 39,797 registered apprentices

and youth participants in our programs today. With regard to wait-lists and

double-counting of people on the wait-lists, it is estimated that about 3 to 4

percent of the apprentices on wait-lists are in fact either double- or

triple-registered — in other words, would have been registered at more than one

institution and waiting to get into a program. So it's a fairly small number.

Generally speaking, we estimate that fewer than 5 percent of our registered

apprentices are on a wait-list for courses.

[J. Nuraney in the chair.]

D. Routley: So 39,797 registered apprentices and youth

participants. Can the minister break that number down and tell me how many of

them are youth participants and how deep that goes into the K-to-12 system? Are

you including only the participants in ACE-IT and other high school programs, or

are you going deeper into the programming?

Hon. C. Hansen: The number of youth participants in our

registered apprenticeship program is 5,481. That's since the ITA was first

established in April of 2004. That's an increase from what was then 861

participants, so it's actually a 536 percent increase over that period of time.

All of them — these 5,481 individuals — are participating in our

ACE-IT program or our secondary school apprenticeship program, so they are fully

registered apprentices in the province. They are recognized as apprentices. In

most cases, these students, when they complete their grade 12, will also have

completed at least the first year of their apprenticeship as a result of the

high school programs.

[1030]

D. Routley: Is there updated information as to the

continuation rates of those students in completing their apprenticeships? Now

we're into four years from the beginning of those programs, so I assume we'll be

getting numbers on those completions.

In Alberta the system does not count first-year participants in

any way as registrants in apprenticeships

[ Page 11692 ]

in their training program numbers. Given the low rate of completion overall,

39 percent, does the minister think it's really accurate to include those

first-year participants given that the completion rates are so low and that

continuation rates may be low?

Hon. C. Hansen: I want to differentiate between the

continuation rate and the completion rate. When we talk about the continuation

rate of our secondary school programs, that measures the number of individuals

who continue with their apprenticeship after they have finished high school. In

the case of the ACE-IT program in the high schools, we have a 97 percent

continuation rate, which I think speaks to the great success of that program.

In the secondary school apprenticeship program we're seeing

continuation rates of about 57 percent, which we consider to be far too low.

Just last month the Industry Training Authority provided a grant of $1.1 million

to the Career Education Society to help us look at the reasons why that

continuation rate is not higher and what we need to do to increase it.

When we come to the completion rates, that is a measurement of

what percentage of registered apprentices have completed their apprenticeship

training six years after they first started it or first became registered.

Completion rates across Canada have been an issue. It's difficult to compare

province to province because there are different methodologies. It's very much a

case of comparing apples and oranges when you try to compare rates across

Canada.

But I think the one thing that is consistent is that every

province is finding that completion rate is a challenge. We expect that has a

large part to do with, really, the dynamism in the economy today. Certainly

anecdotally, we know there are many apprentices who are putting off their formal

training component because of the fact that there is such a demand for their

hours in the workplace. We also find that employers are reluctant to allow their

workers to take the time necessary for that training.

We've been trying to address that. That's part of what the tax

credit program was aimed at. It was to give an incentive both to the apprentices

and to the employers to complete the formal part of their training and get on

with it.

[1035]

I think that when you compare the completion rate between B.C. and

Alberta, the fact that we do include all of the first-year apprentices in our

statistics actually creates a much more robust measurement for British Columbia.

So when Alberta doesn't include their first year….

They don't start counting their registered apprentices or

calculating completion rates until after the completion of first year. That will

tend to drive up the statistic for completion rates in Alberta compared to

British Columbia. But we think including all registered apprentices, including

first year, gives us a far more valuable measurement because it really does

speak to the success of the system right from the time that the registered

apprentice first registers.

D. Routley: I would suggest that there was a political

imperative in advertising huge increases in registrations, which is misleading

because, of course, the first year does distort the figures. In fact, it brings

down our B.C. completion rate rather than bringing up the Alberta completion

rate, if you want to look at it from the other point of view.

I would suggest that the more effective goal would be to measure

the outcomes, and that would obviously be completion rates of Red Seal trades.

What we've seen was a drastic decrease in that number since the loss of ITAC and

the founding of ITA. I acknowledge the very difficult circumstances that the ITA

developed under. Still, that was a loss.

Now what employers and the economy read, measure and feel is a

shortage of completed, qualified, skilled workers, not a shortage of

registrations. So it's not as though industry says: "There just aren't enough

registered high school students in apprenticeship programs." I'm not trying to

demean the value of those programs but trying to bring the focus to the

completion side.

So what will the minister do to ensure that that completion rate,

however it's measured, whether we include the first year and end up with a 39

percent figure or not…? What steps are being taken to improve that?

Hon. C. Hansen: The Industry Training Authority is helping

to fund three national research projects to look at this specific question of

completion rates. British Columbia was actually the first province to publish

our completion rates, and other provinces have followed suit, but a