2002 Legislative Session: 3rd Session, 37th 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)

MONDAY, MARCH 11, 2002

Afternoon Sitting

Volume 4, Number 2

CONTENTS

Routine

Proceedings

Page

Introductions by Members

Tributes

Hon. L. Reid

R. Hawes

Hon. R. Thorpe

Statements (Standing Order 25 B )

Dairy industry in B.C.

J. Les

Lifesaving society

R. Lee

Volunteers in community services

R. Hawes

Oral Questions

Funding for Delta Hospital

J. Kwan

Hon. C. Hansen

J. MacPhail

Review of funding for affordable housing projects

T. Christensen

Hon. G. Abbott

Compensation for physicians

R. Hawes

Hon. C. Hansen

Government policy on nuclear presence in Nanoose Bay

J. Kwan

Hon. G. Campbell

Affordable child care

E. Brenzinger

Hon. L. Stephens

Speaker's Statement

Commonwealth Day

Motions without Notice

Message to Queen Elizabeth II

Hon. G. Campbell

Committee of Supply

Estimates: Ministry of Health Planning

(continued)

J. MacPhail

Hon. S. Hawkins

J. Kwan

Proceedings in the Douglas Fir Room

Committee of Supply

Estimates: Ministry of Education

Hon. C. Clark

J. Kwan

R. Masi

S. Brice

D. Jarvis

R. Lee

S. Orr

P. Wong

K. Manhas

[ Page 1697 ]

MONDAY, MARCH 11, 2002

The House

met at 2:03 p.m.

Introductions by Members

Hon. G.

Plant: I'm informed that visiting us in the gallery today is Mr. David

Tilson, one of Her Majesty's counsel, learned in the law, and his son Greg. I'm

told that Mr. Tilson is a member of the Ontario Legislative Assembly, and for

both of those reasons I would ask members to please make both of them very

welcome.

Hon. G.

Campbell: I'm pleased to recognize in the House today seven legislative

interns who started, on March 4 of this year, working full-time for the

government caucus. They will remain working with the government caucus until the

end of June. I'm sure you know, Mr. Speaker, that the legislative intern program

in British Columbia is well regarded across the country. I'm very pleased to

have such quality individuals serving with our government caucus: Jacqueline

Eaton, who is at the University of Northern British Columbia; Terri Giesbrecht,

University of Northern British Columbia; Tara Marsden, University of Northern

British Columbia; Scott Morishita, University of British Columbia; Milan Pavlic,

Simon Fraser University; Eldon Sala from Simon Fraser University; and Shawna

Towriss as well. I hope we'll make them welcome.

[1405]

MacPhail: We'd like to match our interns with their interns, if I may, and

welcome our interns, as well, to the legislative chamber. I must say that we are

being extremely well served by this group of incredibly intelligent young

people. Both those factors make me very annoyed. [Laughter.]

Audrey

Ackah from the University of British Columbia, Richard Overgaard from the

University of British Columbia, Daphne Powell from the University of Victoria,

thank you very much for all of your assistance.

S. Orr:

I'm very pleased to introduce today to the House 40 extremely bright grade 11

students from St. Michaels University School, which is in my riding, and with

them their teacher, Mr. Jack Shergold, and his wife, Mrs. Shergold. Would the

House please make them welcome.

Hon. R.

Thorpe: It's a pleasure for me to introduce seven members of a management

team of Shaw Communications, a very prominent Canadian firm, visiting Victoria

today and talking about the future of opportunities here in British Columbia.

Here today are Peter Bissonnette, Ken Stein, Terry Med, Colin Paterson, Peter

Nielson, Alex Park and Chris Ewuznik. Would the House please make them welcome.

Tributes

MARIE ASH

Hon. L.

Reid: I would ask the House to please join with me in a moment of

remembrance. Born November 13, 1913, Marie Ash passed away March 7, 2002. This

was a woman of incredible warmth and great, great spirit. When she and I first

met many years ago, she said she hoped to live long enough to see a Liberal

elected. That was prior to the 1991 election. Her husband served this House for

many years as an MLA more than 50 years ago.

Following

our election in 1991 she said, "I just want to live long enough to see a

Liberal government" — so success on both counts. Marie, you will be

missed. I would ask the Speaker to please send a letter of condolence to her

family.

Mr.

Speaker: So ordered. Thank you.

WOMEN'S BASKETBALL

Hawes: This last weekend Mission's Heritage Park Highlanders won the

provincial girls AAA basketball championship. That's the third year in a row,

this year under coach Frank Chan. At the same time this weekend the SFU Clan won

the Canadian college championship for our province. The thing that connects the

two is that Bruce Langford, the coach of the Clan this year, was for the

previous two years the coach of Mission's Heritage Park Highlanders. Mr.

Langford is an outstanding coach and educator in this province, and I'd like to

ask all members to salute both of these teams of women athletes and in

particular Coach Langford for his outstanding service.

Hon. R.

Thorpe: Last week the House was advised on March 6 that it was the birthday

of the member for Comox Valley. Unfortunately, it wasn't his birthday last week.

In fact, it's his birthday today. It's his sixty-second birthday, and apparently

he's taking it very hard, because he's home ill today. I wish the House would

extend their best wishes to the member for Comox Valley that he's feeling

better.

Statements

(Standing Order 25

b) DAIRY INDUSTRY IN B.C.

J. Les:

I would like to briefly discuss the dairy farming industry this afternoon. Dairy

farming has been an economic mainstay in British Columbia and particularly in my

riding of Chilliwack-Sumas for many years. Often our area has been referred to

as the milk bucket of British Columbia. Our province is home to some of the most

advanced and modern dairy farms in the world. Leading-edge technology and

nutrition, together with modern genetics, have combined to pro-

[ Page 1698 ]

duce some of the highest-production herds and some of the most efficient

management practices in the world. Dairy farming in British Columbia is a

world-class industry and a real credit to the dairy farmers of this province.

They supply a first-class product to the consumers of British Columbia.

[1410]

Until

recently the majority of B.C. milk was processed and marketed by a cooperative

known as Dairyworld. Previously known as the Fraser Valley Milk Producers

Cooperative Association, this cooperative had its origins in my riding in the

early twentieth century. In early 2001 the co-op was purchased by Saputo Group

Inc., based in Montreal. Saputo was the largest dairy processor in Canada and

one of the leading cheese producers in North America.

A dynamic,

world-class company, Saputo today employs over 7,100 people. The company's

shares are listed on the Toronto Stock Exchange. Recently the Saputo executive

team, including chairman and CEO Mr. Lino Saputo, toured the lower mainland and

met with dairy producers as well as government officials. They were extremely

impressed not only to see the first-class dairy operations that I referred to

earlier but also with the much-improved business environment now apparent in

British Columbia.

I'd like to

thank the various cabinet members who met with the Saputo team — in particular

the Minister of Agriculture, who spent some considerable time with them. I am

optimistic that as a result of these meetings and with the calibre of B.C.'s

dairy farmers, the future of B.C.'s dairy industry has never been brighter and

that more investment in both production and processing will follow. That's no

bull.

LIFESAVING SOCIETY

R. Lee:

The day before yesterday I had the honour to participate in the ninetieth annual

Commonwealth honour and rescue awards ceremony of the Lifesaving Society of

Canada, B.C. and Yukon Branch. The Lifesaving Society was formed in England in

1891 to reduce the number of drownings prevalent in the United Kingdom.

In 1911 the

British Columbia branch was formed, and in 1971 it became the B.C. and Yukon

Branch. The Lifesaving Society is a non-profit voluntary organization dedicated

to preventing accidents and saving lives in an aquatic environment. It has been

teaching swimmers to be life-savers, lifeguards and instructors since 1896, when

the first life-saving class was taught in Canada.

The awards

ceremony was a very special day for many of the volunteers who have spent their

time promoting aquatic safety for the benefit of the entire community. It's also

a special day to honour those who, through their individual acts of bravery,

have saved the lives of so many.

Many

heart-touching stories were told at the ceremony. We heard the story of a

ten-year-old boy, Justin Zutter of Surrey, who pulled a woman out of Hathaway

Lake near 100 Mile House. We heard about the heroic rescue performed by Kevin

Brown of Nanaimo, who desperately tried again and again to open the door of a

car floating in the Fraser River to get the driver out. We heard the story of

Charlene Comeau, Per Humle, Jessica Kerr, Gerry Langdon and Jill Witowich, who

had prior skills and knowledge gained through the society programs to aid

victims of aquatic emergencies.

To the many

brave men, women, boys and girls who go out to meet the challenges in an

emergency, I salute you.

VOLUNTEERS IN COMMUNITY SERVICES

Hawes: March 22 marks Volunteer Appreciation Night in the district of

Mission. This is an annual event that takes place in Mission and is put on by

the city council and by the chamber of commerce in Mission. Each year the award

recipients include the sports volunteer of the year, the service volunteer of

the year, business of the year, citizen of the year and a lifetime achievement

award.

Today I

just want to take a moment to remind all of us that volunteers actually are the

backbone of every community. They touch every facet of community life from minor

sports, disease control, youth development, public safety…. Our hospitals

don't run without volunteers. I want to particularly salute today the volunteers

that work in our CPAC offices and community policing and in our volunteer fire

departments across the province.

[1415]

On behalf

of all of us, I want to salute the volunteers not just in the district of

Mission but right across the province. They deserve our thanks, and I urge all

of us to give them that.

Mr.

Speaker: Thank you. That concludes members' statements.

Oral Questions

FUNDING FOR DELTA HOSPITAL

J. Kwan:

Will the Minister of Health Planning provide an assurance to the residents of

Delta that a formal consultation process will proceed before the Fraser health

authority cuts funding to the Delta Hospital?

Hon. C.

Hansen: Each of the health authorities in the province has been undergoing a

review of the most effective way to deliver patient care in their respective

areas. Those plans are going to be coming to government sometime in the near

future, and we'll be reviewing them when we receive them.

J. Kwan:

The residents of Delta had an assurance that there would be consultation on the

cuts to the Delta Hospital, but the opposition has learned that the consultation

process which was promised has been

[ Page 1699 ]

axed. The minister said last week in estimates that she would hold regions

accountable for consultation.

Again, to

the Minister of Health Planning: the Fraser health region is not consulting.

What are you going to do about that?

Hon. C.

Hansen: Each of the health authorities has had ongoing discussions. There

have been discussions with medical staff and community leaders. They've been

looking at the best way of actually meeting the needs of patients in these

communities, not focusing first of all on the bricks and mortar but on the needs

of individual residents in accessing the care they need in the most effective

manner. Every region is doing that; every region is at different stages in the

development of their plans. Nothing will be finalized until such time as those

plans are reviewed by government.

MacPhail: Well, isn't that interesting? Perhaps the Minister of Health

Services should actually let the Minister of Health Planning answer the

questions for which she's responsible.

In a letter

to staff that we obtained, the chief operating officer of the Fraser health

authority says that plans are moving forward to implement the cuts, including

those to Delta Hospital. Needless to say, the Delta Hospital Foundation is very

upset. The Minister of Health Services probably doesn't know what's going on. I

don't blame him; not very many people tell him what's going on.

To the

Minister of Health Planning. If the minister won't answer my colleague's

question, perhaps she will answer the same question that was put in writing to

the health authority's CEO by the Delta Health Foundation. Why is the health

authority being allowed to proceed with the cost-cutting recommendations without

consultation with the community and the Delta Hospital Foundation, as was

promised?

Hon. C.

Hansen: Each of the health authorities is putting their proposals together

for the redesign of the health care system to actually make it start working for

patients for a change — unlike the last ten years, where we saw the health

care system deteriorate.

There are

not cuts in health care in British Columbia. An additional billion dollars has

been put into the health care budget by this government, and we want to make

sure that every dollar spent in the health budget is spent in a way that meets

the needs of patients. The health authorities are now trying to come up with

their design for the health care system so that we can actually get on with the

change and get on with meeting the needs of individual British Columbians in

every community throughout this province.

Mr.

Speaker: The Leader of the Opposition has a supplementary question.

MacPhail: Perhaps the minister should try to catch up with what's really

going on out there in the real world.

Six billion

dollars is being handed over to unaccountable — completely unaccountable —

health authorities, and the government, including these two ministers, is just

washing its hands of any responsibilities. Hospital closures are coming in every

region in the province, but last week the Minister of Health Planning said that,

oh, it's not her responsibility and passed the buck to the regions.

The regions

make promises to the public to consult, and then they break them just as easily

as the Minister of Health Planning did. British Columbians are consigned to

watching this bureaucratic game of buck-passing and butt-covering like we've

never seen before, all as the government dismantles health services.

Again, to

the Minister of Health Planning: will the minister order the Fraser health

authority, which she created and appointed the chair, to undertake, as they

promised, a consultation process before any decisions are made to cut vital

health services to Delta as outlined in this correspondence?

[1420]

Hon. C.

Hansen: I'm actually quite surprised this member doesn't realize that the

health authorities fall under the Ministry of Health Services. As a result, I'll

be pleased to try to answer.

This is the

first time in B.C. history that we've actually put in place accountability

measures for the health authorities — the first time — instead of the

approach that was taken by the previous government, where they continued to pump

more and more money into the health care system without results. In fact, we saw

the health care system deteriorate at a time when they were pumping…

Interjections.

Mr.

Speaker: Order, please, members.

Hon. C.

Hansen: …more and more money into it. The health authorities are engaged

in consultations throughout the province. They're sitting down with community

leaders; they're sitting down with health care professionals; they're getting

the advice of doctors on the front line and nurses on the front line. They're

going to be coming forward with their plans to redesign the system. At the end

of the day the accountability for those decisions will rest here with this

government, because we're going to get on with fixing the health care system.

REVIEW OF FUNDING FOR

AFFORDABLE HOUSING PROJECTS

Christensen: Last October the Minister of Community, Aboriginal and Women's

Services announced a freeze on approximately 1,700 proposed housing units while

his ministry was to conduct a review of all the projects and the ability of the

province to pay for them. Those projects are around the province. One of

[ Page 1700 ]

them is in my riding. Can the minister give us an update on the status of

that review?

Hon. G.

Abbott: One of the challenges we inherited from the former government was a

budget expenditure line for B.C. Housing that rose from $126 million in the last

fiscal year to $170 million in '04-05.

Interjections.

Mr.

Speaker: Order, please.

Hon. G.

Abbott: That clearly is not a sustainable budget line, even among

spendthrifts like the former government. That produced the very difficult

decision to put the projects under review. I'm very pleased to say that after a

lot of work at B.C. Housing and within the ministry, we have now reached a

sustainable budget line. We do that through strengthened partnerships with the

federal government, local governments, health authorities, the non-profit

sector. That has allowed us to be in a position where, hopefully, later this

week we will be announcing about 700 units that will proceed. About a thousand,

unfortunately, won't be able to proceed, at least at this time.

Mr.

Speaker: The member for Okanagan-Vernon with a supplementary question.

Christensen: Given the financial constraints the province does face and

that, as the minister has indicated, all the units won't be able to go ahead,

can the minister outline the criteria used in the review and the type of project

that will be proceeding?

Hon. G.

Abbott: Certainly, the key criterion…

Interjections.

Mr.

Speaker: Order, please.

Hon. G.

Abbott: …with respect to our review of the projects was around whether the

projects were in fact targeted to those who are most vulnerable in our society:

the frail elderly, the homeless, the physically and mentally disabled or ill.

Those projects that we'll be announcing are all certainly targeted in that

direction. The other thing about them is that they are all very strongly

partnered. In fact, these 20 projects….

Interjections.

Hon. G.

Abbott: I don't blame the opposition for being consumed by the bad news that

eats them up each and every day. Those 20 projects bring $49 million in

partnership equity to the table. I think that's a remarkable achievement.

We believe

some of the remaining projects will be able to proceed. Certainly, we're going

to challenge them to bring more to the table — whether it's land, the

servicing to the land…

Mr.

Speaker: Thank you, hon. member.

Hon. G.

Abbott: …and other aspects of it. I'm sure, knowing British Columbians —

now that they've recovered from the legacy of the former government — they'll

rise to that challenge.

[1425]

COMPENSATION FOR PHYSICIANS

Hawes: My question is to the Minister of Health Services. This past weekend

the minister met with the BCMA in Vancouver. Health care is uppermost in the

minds of most British Columbians, and there seem to be conflicting messages that

have come out of this meeting. Can the minister please tell us what he hoped to

accomplish at this meeting?

Hon. C.

Hansen: I did meet with the executive of the BCMA for about two hours on

Saturday. We have put $390 million on the table for the coming year and each of

the subsequent years to deal with physician compensation. That's an average

increase of $50,000 per doctor in British Columbia. My goal in meeting with the

BCMA was to follow up on a letter from the president of the BCMA urging us to

get on with sorting out the details, so those cheques can actually flow to

doctors as soon as possible.

We're

anxious to sit down with the B.C. Medical Association as soon as possible to

deal with some of the outstanding issues, so physicians in this province can

start to realize the cheques that flow as a result of that $392 million

increase.

Mr.

Speaker: The member for Maple Ridge–Mission has a supplementary question.

Hawes: I know there's been a number of physicians corresponding and speaking

with each other about this issue over the last few days. Specifically, I know

they've had a number of discussions around their pay increase, etc. There's a

lot of confusion around this. I wonder: could the minister tell us exactly what

settlement the doctors in this province are going to get? Can you clear up the

confusion?

Hon. C.

Hansen: There is a 6.2 percent increase across the board on fee-for-service,

which is retroactive to last April 1. Those cheques should start to flow within

the next few weeks. There is an additional 5.1 percent increase that takes

effect retroactive to November 1, and again we're trying to get those dollars to

flow as soon as possible. Annualized, that means an increase in physician

remuneration of $180 million for fee-for-service.

There's an

additional $80 million increase for on-call payments for physicians throughout

the province.

On top of

that, there is $127 million to deal with issues around increases for salaried

and sessional physicians, increases in the remuneration for rural doctors

[ Page 1701 ]

in the province — increases there to make sure we cover growth in

population and the increased utilization. It is a very generous comprehensive

package there to assist in making sure we can retain and recruit the physicians

we need to meet the needs of British Columbians in the years ahead.

GOVERNMENT POLICY ON

NUCLEAR PRESENCE IN NANOOSE BAY

J. Kwan:

Last week the Federal Court of Canada overturned the federal government's

expropriation of Nanoose Bay. In 1999 the now Premier stated he supported the

no-nukes policy in Nanoose Bay. Last week the Premier backed away from that

commitment, breaking yet another promise. To the Premier, on the course of

agreeing with the former government's decision on Nanoose Bay — that it is the

property of British Columbia: why is the Premier breaking his commitment and

allowing nuclear weapons in British Columbia waters?

Hon. G.

Campbell: Actually, the member opposite does not recollect what our position

was. We said it was wrong for the federal government to expropriate that land.

During the campaign we said we would ask the federal government to repatriate

that land. We continue to pursue that policy. We're going to continue to ask the

down this coast and to live up to the terms of a lease which says that coastal

communities come first.

Mr.

Speaker: The member for Surrey-Whalley.

Interjections.

Mr.

Speaker: Order, please, hon. members. The member for Surrey-Whalley has the

floor.

AFFORDABLE CHILD CARE

Brenzinger: My question is to the Minister of State for Women's Equality.

Child care remains a priority for many British Columbians. A number of my

constituents have been asking me what our government's plans are to provide

affordable child care. Can the Minister of State for Women's Equality tell us

what her plans are to make child care in B.C. more accessible?

[1430]

Hon. L.

Stephens: This is a very important question. It certainly is for all of the

working families in British Columbia and for the single moms around the

province. We are undergoing a new direction for child care.

In the fall

I did a consultation around the province. We touched 12 communities and sent out

20,000 surveys. What we are developing now is a child care plan that is

partnership-driven, community-focused, fiscally sustainable and directed to

target families who need it the most, and to increase and expand the number of

child care spaces in British Columbia.

This new

targeted system will reduce administrative costs for providers and make more

effective use of our limited resources and will provide predictability…

Interjections.

Mr.

Speaker: Order, please.

Hon. L.

Stephens: …and stability to families of British Columbia and to child care

providers.

[End

of question period.]

Speaker's Statement

COMMONWEALTH DAY

Mr.

Speaker: Hon. members, today is Commonwealth Day. In legislatures in

Commonwealth nations throughout the world a common thread is shared by a special

Commonwealth Day message provided by Her Majesty Queen Elizabeth, Queen of

Canada and head of the Commonwealth. As members of the British Columbia branch

of the Commonwealth Parliamentary Association and through you to the people of

British Columbia, it is my honour to convey, on behalf of Her Majesty, the

Queen's Commonwealth Day message celebrating diversity.

"Over

the last 50 years the Commonwealth has undergone a remarkable transformation

from an association defined by its history into the modern, multicultural

organization we know today. Across those years it has been the privilege of

many of us to witness that evolution, to see at firsthand the contribution

made by the Commonwealth leaders, as evident in Australia last week, and to

share in the enthusiasm and warmth of its peoples.

"Today

the Commonwealth is a meeting place for north and south, east and west. It

is built on diversity, which is why this year's theme, 'Celebrating

Diversity,' goes to the heart of the association.

"Politically,

the Commonwealth sees its diversity as a strength. That was certainly true

of its invaluable contribution to the ending of apartheid in South Africa.

The practical assistance it was able to offer in such crucial areas reflects

the kaleidoscope of its membership and its expertise. As a result, the

Commonwealth was able to work with all the different communities of what is

now proudly called 'the rainbow nation.' Bridging social and political

divides has also been a feature of the Commonwealth's continuing work in

seeking to encourage democracy, good governance, the rule of law and respect

for human rights.

"In

all this, we recognize that promoting diversity is not just tolerating

difference. Living together as neighbours needs more than that. The true

celebration of diversity involves reaching out, recognizing and embracing

difference and, in so doing, enriching our lives. It requires respect for

others and a readiness to learn from them, recognizing that we have duties

as well

[ Page 1702 ]

as rights and seeking to leave the world a better place

than the one we inherited.

"As

each of the last 50 years has passed, so, too, has our appreciation of the

contribution made by the Commonwealth, an association of peoples as much as

it is of governments, bound together by ideals as well as interests. If the

Commonwealth is to remain a force for good, we must ensure that those ideals

are carried forward by the millions of young people across the world who are

its future so they, too, can celebrate and build on the diversity of this

unique organization.

"Elizabeth R.

March 11, 2002"

Hon. G.

Campbell: Mr. Speaker, thank you for conveying Her Majesty's Commonwealth

Day message to Members of the Legislative Assembly and the people of British

Columbia.

Motions without Notice

MESSAGE TO QUEEN ELIZABETH II

Hon. G.

Campbell: I'd like to move, seconded by the Leader of the Opposition, that

the following message be forwarded to Her Majesty Queen Elizabeth II, Queen of

Canada and head of the Commonwealth:

[The Queen's

Most Excellent Majesty, Most Gracious Sovereign, on Commonwealth Day, 2002.

We, the Members of the 37th Parliament of the Legislative Assembly of the

Province of British Columbia, beg to offer our sincere congratulations on

the Fiftieth Anniversary of your reign. In this Golden Jubilee year, the

people of British Columbia are proud to join other members of the

Commonwealth in paying tribute to Your Majesty's guidance and devotion to

duty and to reaffirm our continuing loyalty and respect.

The

citizens of British Columbia are looking forward with great pleasure to the

visit of Your Majesty and His Royal Highness The Duke of Edinburgh to our

Pacific province, in the year of your fiftieth reign. We pray that Your

Majesty will continue to reign in peace, health and happiness for many years

to come.]

[1435]

Hon.

Speaker, believe it or not, I can still remember when Her Majesty's coronation

took place. I remember it because it was actually the first television my family

ever had. It was rented, it was huge, and it took up most of the room, but the

family stood around and watched that ceremony — incredible for all of us in

the Commonwealth.

Her Majesty

has led us through incredible times of change. She has always been a symbol of

stability, a symbol of integrity, a symbol of grace and a symbol of the

greatness that we have in the Commonwealth, where we have a constitutional

democracy and democracies that are thriving, that have spread around the world

and, in fact, that have been an example to everyone. I am pleased to stand on

behalf of this Assembly to celebrate Her Majesty's jubilee year.

Motion

approved.

Orders of the Day

Hon. G.

Collins: In Committee A, I call Committee of Supply, and for the information

of members, we'll be debating the estimates of the Ministry of Education. In

this House I call Committee of Supply as well, and for the information of

members, we'll be discussing the estimates of the Ministry of Health Planning.

Committee of Supply

The House

in Committee of Supply B; H. Long in the chair.

The

committee met at 2:39 p.m.

ESTIMATES: MINISTRY OF

HEALTH PLANNING

(continued)

On vote 30:

ministry operations, $16,633,000 (continued) .

[1440]

MacPhail: I note from the general responsibilities under health planning

that the Minister of Health Planning is responsible for seniors', women's and

aboriginal health. I checked that out at the beginning of estimates, and the

Minister of Health Planning acknowledged that. My questions today are going to

be about aboriginal health.

I have

correspondence from the director of aboriginal services. Perhaps the Minister of

Health Planning could review for me aboriginal health services as they stand

today.

Hon. S.

Hawkins: What we've done with aboriginal health is devolve the funding for

the contracts down to the health authorities. What we've kept in the ministry is

the strategic planning aspect. That is how we've delineated it. We've got a

smaller office, but we're going to focus on strategic planning for aboriginal

health.

MacPhail: If the minister has a sore throat, I totally understand it; but if

not, I'm having trouble hearing her. Perhaps just lean closer to the mike. I

understand about having a sore throat, believe you me, and I wish her better

health.

What is the

change, then? If you've devolved aboriginal health, what is the change?

Hon. S.

Hawkins: I'll try to speak into the mike.

We've moved

the funding for the contracts to the health authorities. We are expecting the

health authorities to create health plans for the aboriginal communities. We

want them to develop the relationship with the health communities. We will be

monitoring aboriginal health on a higher level, a more strategic level. That's

the relationship. They will look after funding. We expect them to put plans in

place. I think most of the

[ Page 1703 ]

health authorities are pretty well on the way to having their aboriginal

plans in place. With the provincial health officer, we will be monitoring the

health of that population.

MacPhail: There was a provincial Aboriginal Health Advisory Council in

place. What's happened to that?

Hon. S.

Hawkins: The provincial aboriginal health organization or council is still

in place, and they will be helping us develop a provincial aboriginal health

services strategy.

MacPhail: So the advisory council is still in place. Could I have the

membership of that, please?

[1445]

Hon. S.

Hawkins: The steering committee includes representatives from political

organizations such as the First Nations Summit, the Union of B.C. Indian Chiefs,

the Métis Provincial Council and the Aboriginal Peoples Council. It has

provincial health organizations — Community Health Associates of B.C. is the

rep — and provincial advocacy organizations such as the B.C. Aboriginal

Network on Disability Society, the Council of Aboriginal Women of B.C. and Red

Road HIV-AIDS Network.

MacPhail: When did they last meet, and what has been the meeting

schedule

under this government?

Hon. S.

Hawkins: I'm not sure if they met last month or two months ago, but they are

meeting on Thursday of this week.

MacPhail: Under the provincial health goals, particularly goal No. 5, which

identifies aboriginal health as a priority, the Minister of Health Planning and

I discussed this in her last set of estimates last August. At that time the

minister said she was committed to all of the provincial health goals. What has

she done in the last…? What discussion has occurred between the B.C.

Aboriginal Health Council and this minister, particularly with regard to goal

No. 5?

Hon. S.

Hawkins: I'm trying to remember the groups I met with over the last few

months. I'm trying to get that clear. I met with aboriginal governors from the

different health authorities. That was a couple of months ago. They were working

on the health plans for the health authorities. I also met with the First

Nations Summit, the Union of B.C. Indian Chiefs, the health committee. We will

be meeting with them again this week.

We are very

committed to looking at the health status of the aboriginal population. It's an

area of great concern. We've identified that there are issues we can work on

together. We'll be meeting with the first nations health committee

representatives this week and starting to work on specific issues to address to

get us to the health goals so they match the general population. We know that

the health status of the aboriginal population is well below that of the general

population.

MacPhail: Does the part of the Ministry of Health Planning that's still

responsible for aboriginal health, and that hasn't been devolved to the health

authorities, continue to be called the aboriginal health division? What is it

called? How many staff are there? What is the reporting mechanism?

Hon. S.

Hawkins: The new department is the special adviser, aboriginal health. There

are 2.5 staff in that office. They report directly to the provincial director

general, population health and wellness.

[1450]

MacPhail: There's a special adviser on aboriginal health. Who is that,

please?

Hon. S.

Hawkins: Lisa Allgaier.

MacPhail: She reports to the provincial health officer, as I thought I

heard?

Hon. S.

Hawkins: She reports to the provincial director general, population health

and wellness unit. That's Andy Hazlewood.

MacPhail: We have 2.5 people looking after policy around aboriginal health.

The minister refers to the fact that the aboriginal health plans are moving

forward. I have correspondence received at the beginning of this year from

aboriginal people wondering what was happening with the health plans. How are

aboriginal health plans proceeding at the regional level? Perhaps the minister

could take one regional authority and describe to me how it's happening, because

certainly not every aboriginal group knows this is happening out here. Just take

one.

Hon. S.

Hawkins: The health plans were started when there were 52 health

authorities. We've restructured and now have six health authorities, so we've

got five regional health authorities. Those health authorities are taking the

health plans that were started by the 52. If you went into the interior health

region, they would be taking the health plans that were within their region. We

have extended the deadlines for them to work on those plans; I believe we've

extended them to this fall. They will be responsible for showing us they have

worked with their aboriginal community and come up with some health plan around

what they were working on initially with the 52 governors. We expect them to

have a more comprehensive view of what is required, because they are in a bigger

population base now.

Those

health plans are very valuable. I know, when I met with the governors, that the

52 different regions were at different stages of working on those health

[ Page 1704 ]

plans. In fact, if I'm correct, I think the interior and some of the rural

areas were further ahead in developing their health plans. We have now extended

that to this fall, and we expect the health authorities to come back to us with

a framework for an aboriginal health plan.

MacPhail: Will aboriginal health programs be delivered through the health

authorities as part of the $6 billion, or is there any targeted funding listed?

I couldn't find any targeted funding in the estimates book.

[1455]

Hon. S.

Hawkins: If I could just go back for a minute, I should clarify those health

plans. The health plans must address improved access to service and increased

aboriginal involvement in decision-making and planning for their population, and

they must show the establishment of a meaningful working relationship between

the aboriginal communities and the health service providers, the health

authorities and the province. That's what we're expecting in the health plans.

My understanding is that $9.5 million is in the budget for the Ministry of

Health Services for planning, service delivery and contracts for aboriginal

health.

MacPhail: When one says "meaningful consultation," perhaps…. Is

there going to be sign-off from first nations aboriginal groups on the health

plan?

Hon. S.

Hawkins: No, we haven't asked for sign-off for today. We're going to hold

the health authorities accountable for ensuring that they have had meaningful

discussion with their aboriginal population, that there has been consultation

and that they have engaged them in the planning, in the decision-making.

There are

four policy tables that we are engaged in insofar as helping with health

planning. I listed them before. That was the First Nations Summit, and that's

representing the first nations engaged in the B.C. Treaty Commission

treaty-making process; the Union of B.C. Indian Chiefs; the Métis Provincial

Council of British Columbia; and the Aboriginal Peoples Council. At a ministry

level, we are engaged in those at a policy table. At the health authority level,

we expect them to make sure they have engaged their aboriginal communities.

We'll be holding them accountable for that.

MacPhail: What role, if any, will aboriginal people be playing in the health

authority governance?

Hon. S.

Hawkins: I understand that there has been interest and that people have come

forward and names have been put forward for people of aboriginal descent who

would like to serve. There is no requirement per se. How can I put it? There's

no select spot on a board for a representative, but I understand that there have

been names put forward.

MacPhail: Well, there used to be a designated spot for first nations on

health boards. I gather what the minister is trying to say is that that seat for

governance is no longer there for aboriginal first nations people.

Let me just

ask a very specific question in terms of the health plan. There was a

publication called Healing Ways which talked about aboriginal health in

this province. Is the minister familiar with it, and is it forming any part of

the planning process for aboriginal health plans?

Hon. S.

Hawkins: I'm familiar with a document that…. There are several, actually,

that are titled similarly. Can she give me more information on the one she's

talking about?

[1500]

MacPhail: It was a document that was published by aboriginal communities

throughout the province, called Healing Ways . It was just about how

aboriginal health had to be all-encompassing in terms of the services provided

and the different nature of health services required by aboriginal people. It

concentrated as much on urban aboriginal health requirements as on non-urban

aboriginal health requirements. The document did very much concentrate on the

different needs of aboriginal communities in terms of alternative therapies.

I noted

with interest the relationship between Healing Ways and the government's

recent changing of the legalities of practising alternative health in this

province. Has the minister had any discussion with…? I'm thinking specifically

of naturopaths. The previous government had introduced legislation allowing for

that kind of practice of medicine without penalty for a physician. That was

removed — repealed — by this current government so that it's now an

open-ended question about whether physicians can practise alternative methods

without penalty. Has the minister or the aboriginal health advisory council had

any further discussions about alternative methods of health delivery for

aboriginal communities?

Hon. S.

Hawkins: No, we haven't had any specific discussions, but I just want to

make it clear to the member that we didn't take away any rights. We did not

remove any. There are no impediments to practitioners practising complementary

medicine. They're going to be held to the same standards that every other

physician that is registered with the College of Physicians and Surgeons is

going to be held to.

As far as

physicians out there practising complementary medicine, we did not say there was

going to be a penalty for them practising. We removed some pretty interesting

pieces of legislation — I don't want to get into it here — in estimates. We

brought everyone back to the same standards that the College of Physicians and

Surgeons holds for all of its members.

[ Page 1705 ]

MacPhail: Those are not my words; those are the words of the medical

practitioners who practise complementary medicine about the government's removal

of their right to do so without consequence.

Well, for

the minister's information — and perhaps she can discuss this when she meets

with her aboriginal health advisory council — there has been much work done by

off-reserve aboriginal people, particularly the need for urban aboriginal health

services. It is my understanding that the majority of those services are at

threat now due to the lack of targeted funding, and no longer will the

government be providing targeted funding for aboriginal health services. They

will be competing along with heart surgery and knee surgery within the various

health authorities.

I actually

don't think that lives up to provincial health goal No. 5. My constituency and

the member for Vancouver–Mount Pleasant's constituency together form the

largest off-reserve aboriginal population in all of Canada. In meeting with our

aboriginal constituents, our first nations constituents, their two highest

concerns about achieving economic equality are lack of proper health care and

lack of proper education.

It's true.

For the last ten years we tried very hard to change those numbers, and we were

changing them. But we did it through targeted funding, both targeted funding in

the education system and targeted funding in the health system. I think all of

that is at risk now. I know very well how difficult it is to compete for

valuable health dollars when you have a small alternative type of health care

delivery that a specific part of society uses. Frankly, aboriginal peoples in

this province need more love and care and health attention than the vast

majority of the rest of us.

[1505]

One of the

reasons why I brought Healing Ways to the attention of the minister is

because all of these questions are addressed in that document and were leading

to some solutions. One of the solutions that was put forward was a healing

centre that would serve the off-reserve, urban aboriginal population.

The last

correspondence I had on that issue…. There was silence from the government.

Can the minister, in terms of health planning for aboriginal health, give me

the status of where the aboriginal healing centre for the lower mainland stands?

Hon. S.

Hawkins: Let me say, first of all, that we are developing a closer

relationship with the aboriginal communities. We met for the first time — all

of cabinet — with the first nations. I myself and the Minister of Health

Services have met with the first nations health committee.

I've met

with different representatives from health authorities around the province, the

past governors that were working on the health plans. I believe the provincial

health officer is releasing a report this spring on the health status of our

aboriginal population in B.C. There's quite a bit of work being done around

this.

I want to

make sure the member realizes there's not a cut to that funding. It's $9.5

million. It's going to continue. It is targeted for three years. That's my

understanding from the deputy minister. It will continue to be targeted for

three years. In those three years we're asking the regions to consult with the

health authorities, particularly with respect to general access issues around

the continuum of care and specifically around mental health and addictions.

Those are the two areas we're asking the health authorities to work on with the

aboriginal communities.

I can tell

you that I share the member's frustration with the disparity between urban

aboriginal health and, shall we say, reserve aboriginal health. We know there's

a funding disparity. We've certainly discussed that with the First Nations

Summit and other groups. I've also spoken to the federal minister about it. It's

something we're all going to work on together, because we recognize that the

federal government gives so much funding for aboriginals on reserves but forgets

that they do travel around. As the member rightly points out, there is a huge

population in the urban areas. We need to start addressing their concerns and

making sure there's funding in place that addresses their health needs as well.

[1510]

MacPhail: One of the reasons why, in the last set of estimates, I asked

specifically about the provincial health goals is because so many of the health

goals deal with indicators of health that I don't think this government has done

a very good job of paying any attention to whatsoever. Those are the

socioeconomic factors that affect health outcomes in this province. I have

become increasingly worried about what this means for my own constituents.

Perhaps but for a couple of members from the city of Surrey, my colleague and I,

the two opposition members, share the lowest-income neighbourhoods in all of

British Columbia.

I am very

concerned about the lack of targeted funding specifically toward off-reserve,

urban aboriginals. I'm very concerned about the lack of targeted funding that

affects programs for lower socioeconomic British Columbians. I think there are

health programs that overlap with education programs.

I will be

watching this extremely carefully, because the Premier in his estimates said

there isn't a day goes by in a Premiers' conference that the issue of aboriginal

health is not mentioned. It's always mentioned at the Premiers' level in the

context of dollars from Ottawa. I know that because I've been there, and I heard

exactly what happened at the last two Premiers' conferences, as well, from the

inside. It's not about health outcomes. It's not about equality for first

nations or aboriginal people. It's about more dollars from Ottawa to pay for

their responsibilities — i.e., the federal aboriginal health. That was the

discussion I had with the Premier, as well, in his estimates.

I will be

watching extremely carefully the aboriginal health plans that come out of the

health authorities. I'll be watching extremely carefully what it means by virtue

of the fact that, from the minister's own briefing notes, the mandated

representatives for physicians,

[ Page 1706 ]

aboriginals and union are gone and what the consequences of that are. I'll be

watching very carefully what it means to no longer have targeted funding for

aboriginal health programs. We had a long discussion last week, before we left

off, about the fact that all of this would be outlined in a contract between the

health authorities and the government, that there would be an outline of what

money was to be spent on what.

I have to

tell the minister, through the Chair, that I can predict as accurately as anyone

possibly can that the minute this government gets caught in a health-funding

downward spiral, where there's not enough dollars, this government will ignore

the contracts with health authorities to solve that crisis. If the crisis is in

heart surgery wait-lists or cataract surgeries, that contract will be set aside,

and the money will flow to those services at the expense of others. I also fear

that, with the fact that there's so little cooperation amongst the health

partners today, there will be jockeying for health dollars for various programs

like we've never seen before.

I can't

figure out where the accountability is. I'd love to be able to see these

aboriginal health plans. I have no idea how to get my hands on them; I have no

idea. That's why I wanted to go through one — to tell me exactly how it's

going to come about. We used to be able to get them through the health

authorities. They would be public documents — rolling documents, works in

progress — through the regional health boards and the community health

councils. That no longer exists.

It is not

in a threatening way. It is in a way of unbelievable concern that I have for

aboriginal health outcomes in this province. I worry. I worry about the kids who

go to schools in my riding, the kids who…. They're first nations kids. We

don't beat around the bush about it. It's not politically incorrect to say that

in our inner-city schools, in my and my colleague's ridings, the majority of the

kids who are ill-affected at the socioeconomic level are aboriginal kids. We

admit to that.

[1515]

These kids

no longer have their guaranteed meal programs. These kids no longer have the

guaranteed funding through their aboriginal health programs anymore, and I

worry. I worry about these children like you can't even possibly imagine.

As I leave

this topic, at every estimate — and if not at estimates, at every opportunity

I have — I will stand up here and ask this minister what she's doing for

aboriginal health services in this province.

Hon. S.

Hawkins: Let me just say that the aboriginal health plans are being

developed. They were never finished, so I don't know what the member's referring

to as far as having access to them before. My understanding is that they were

never completed.

We are now

working with the health authorities, and we're asking them to complete the

plans. They will be public documents. We've met with different aboriginal groups

and asked them to help us prepare accountability measures and standards with

respect to aboriginal health that we can hold our health authorities accountable

for.

Let me just

say this. She mentions the broad indicators of health, and she's concerned about

the socioeconomic factors that affect them. Let me remind her that B.C. is now a

have-not province. One of the best indicators for health is a good, thriving

economy. We were elected to make sure that we got our province's fiscal health

back. In good financial health we could then provide funding for the kind of

social programs that she's concerned about.

You know

what? This government has protected funding for health and education. In fact,

we have increased funding for health. You know what? Unless we get the

province's economic picture back to a good state of health, we're not going to

be able to afford all the kinds of programs that she's concerned about. We are

doing the best we can with the funding that we've got. We've protected health

and education, and we're going to continue to do that. We're going to make sure

that our health authorities are not going to function like the past ten years,

the status quo, where we kept dumping money into health care and didn't measure

outcomes.

She talks

about looking after the crisis of the day. We're hoping to move away from that.

We want to make sure that the funding we actually give to the health authorities

will be used to make sure patients actually benefit from the programs set up.

That's what we've asked our health authorities to do. That's how we're

functioning.

Whether she

believes it or not, the $9.5 million for aboriginal health is still there. It's

there, and it's targeted for next three years. What we're asking them to do in

the next three years is to consult with the communities to make sure they

recognize the priorities, work with the health authorities and put the funding

where it needs to go to make sure we have the positive outcomes for our

aboriginal population as well as our general population.

MacPhail: My point is exactly the same as the minister makes, but from the

flip side. The delegation of accountability has been put down to the health

authority. It is not here with this government. They have abdicated their

responsibilities to the health authorities.

If I need

to find out whether the health authority money is being spent on aboriginal

health services, I guess I have to go to the individual regional health

authorities. That was never, ever the intent of any previous government

whatsoever, and it's not right. It isn't right that an unelected one-man band in

a region gets to make decisions about health care.

You can bet

your boots the health crisis will come up on funding, because it happens all the

time. That minister knows that, because she used to stand up here and rail

against lack of services — renal dialysis services and heart surgery services.

She used to do it herself. There would be funding that would go. We would

[ Page 1707 ]

examine it carefully. We would not take away from Peter to pay Paul, but we

would add funding to deal with those crises.

[1520]

What this

government has done is say: "No more money. You health authorities figure

it out yourselves. By the way, we're actually not going to tell you in any way

what the ballpark figures are for you to be spending. We're going to write up a

contract with you, and we hope you live with it. By the way, we don't honour

contracts anyway." This government somehow suggesting that a contract is a

document of trust is absolutely laughable.

In terms of

the well-being of the province in indicators of quality of life, this province

is first. That minister knows it, because she sat in front of the progress board

chair who reported that. In quality of life and health outcomes, this province

was first. It will not in any way assist this minister — about which she knows

nothing in terms of have versus have-not province discussions — to use that

argument again, because it will come right back to haunt her. But she's welcome

to enter the Minister of Finance estimates when we have that one.

I leave it

as I did before. There seems to be an inability for the minister to understand

this issue. The well-being of this province, from the point of view of

socioeconomic equality, is measured in how well first nations and aboriginal

people do. Progress was made in the last ten years, and I will be watching to

see what happens to that with these changes made by this government.

The next

area that I'd like to go to, which is the second item of general

responsibilities, is capital planning for the Minister of Health Planning. In

the documents we received last week — not the one just specifically for the

minister herself but for the Minister for Health Services — there's much talk

about capital planning. In this document it's broken down into A, B, C and D

lists of capital funding. Can the minister please tell me, in her planning

exercise, how the lists were determined?

Hon. S.

Hawkins: I just want to go back again for a minute on accountability. She's

again railing — I'll use her word — on accountability. I can tell you that

the last ten years were an example of failure of accountability of the health

system that just sucked in money and didn't necessarily put out good health

outcomes. We know that. We've seen a health care budget that has more than

doubled in ten years. Again, when you go around the province, you don't hear

people saying, "Gee, the quality of the health care is twice as good,"

or "We've reduced the waiting lists by half." What I was angry about

when I was in discussions with the minister on her crisis funding was that there

was no planning for these kinds of things. Frankly, when we travelled around the

province, what we heard from people was: "Get the politicians out of it.

Put good people in there, and let them listen to the communities. Let them do

the planning, and let them make the decisions that make the best sense for

patient care and meeting patients' needs in their communities." That's what

we're doing, and that is what we're going to hold the health authorities

accountable for.

With

respect to the projects on the list that she's talking about, again, that is

Health Services. Those are decisions made with respect to the budget in Health

Services. What my ministry is responsible for is a high-level plan for the next

ten years. We're going to look at the needs of the province. With respect to the

authorities, over the next three, five to ten years we'll be doing that in

consultation with the health authorities.

MacPhail: Well, maybe the minister could define what high-level planning

means.

Hon. S.

Hawkins: It's probably something she's not at all aware of. It's long-term

planning.

MacPhail: Could she flesh that out a bit, please? What exact actions are

being taken now?

[1525]

Hon. S.

Hawkins: We'll be working with the health authorities to look at the needs

of their communities, their changing populations and their different burdens of

disease. We'll be looking at the needs for facility planning over the next three

to five to ten years in consultation with them.

MacPhail: Well, it's already been done, so I'm not sure what the minister is

saying about long-term planning. It's already here. Let me just read a list.

I'll work backwards between attachments A, B, C and D in terms of the

consolidated capital plan.

List D,

program-related projects in planning. I assume this refers to what the Minister

of Health Planning, a full-fledged minister responsible for health planning, is

talking about. It says that health authorities must fund all debt service,

amortization and operating costs, so that means there's no new money for any of

this given to the health authorities. The planning has been done here. It says,

for instance, in the Fraser — it's the top of the list — the Maple Cottage

Detoxification Centre replacement facility…. If it's going to be carried

forward, the health authorities must fund all debt service, amortization and

operating costs. Is the minister somehow saying that this isn't the case?

Hon. S.

Hawkins: That is the case.

MacPhail: What other planning would the minister be involved in? For

instance, there's the interior. Earlier today I heard the member for

Kamloops–North Thompson get up and say how wonderful things were going to be

in his community with the election of a new government. Here it says that a $14

million project for the second-floor redevelopment of the hospital is going to

be the sole responsibility of the health authority. The Nelson health campus as

well, a replacement facility that was fully funded by the previous govern-

[ Page 1708 ]

ment, now has to be paid for by the health authority completely: debt

service, amortization and operating costs. Given these decisions, what is the

minister working on for long-term planning?

Hon. S.

Hawkins: Hon. Chair, she knows full well that many of these were not fully

funded. I would ask her to think about what kinds of decisions their government

made for facility planning. Many of them were political. People across the

province have asked for politicians to get out of that kind of decision-making

and make sure that the money targeted for health care is actually used to meet

patients' needs in the best way for patients across the province. That is what

we're doing. We're working with our health authorities.

Many of the

projects on this list are under review. What we're trying to do, in the long

term, is look at our population needs. We know we've got a huge growing seniors

population, and we know there are different ways of looking after them. We have

a Minister of State for Intermediate, Long Term and Home Care who is looking at

the needs in the long term for that population, from extended care and those

kinds of facilities to perhaps assisted care and more in-home care. Those are

the kinds of things we're looking at. Building monuments isn't something we're

going to do in a political way.

What we've

asked the health authorities to do here in the short term is identify the needs

of their communities and their populations. The Minister of Health Services, I'm

sure, would be happy to discuss with you how this list was drawn. In the long

term we're going to be working with our health authorities to flesh out the

kinds of needs their populations are going to be facing, the different diseases

they expect to be facing in the next few years. The member knows full well that

we're working on primary care renewal. We're looking at more integrated teams of

care to look after chronic disease care populations.

[1530]

Those are

the kinds of plans we're putting into place as we go forward in planning for

facilities and equipment. We know there are going to be equipment changes in the

next ten years. We're not going to do what the previous government did, which

was bulk purchasing. I might have a facility in which a certain piece of

equipment is No. 1 on my list. In another facility, it's No. 30 on their list.

But guess what. The province thinks they got a great deal, so they end up

purchasing a whole bunch. Whether it's No. 1 on my list or No. 30, we get it. We

can't afford to do that with health care dollars. We've got to be smarter. We're

going to work with the health authorities, and we're going to plan for future

facilities and equipment planning.

MacPhail: Does the minister plan on bringing the health authority CEOs and

chairs in here for estimates?

Hon. S.

Hawkins: No.

MacPhail: Then answer my questions. If the health authority chairs are not

going to be in this chamber, the minister has to answer these questions or get

them in here. It's $6 billion, and this minister stands up and says we're going

to have the health authorities do it. Either she has them in here and lets the

taxpayers see what accountability they have of the chairs, or she answers the

questions.

She is in

charge of health planning, and all she does…. It is actually unusual that it's

3:30 and she hasn't brought up fast ferries. What we're looking for are answers

from this minister on what she does on a regular basis. What's her job? What

does she do at 8 a.m.? What does she do at noon, and what does she do on a

Thursday afternoon? That's what I'm trying to find out from this minister.

Do we have

to have leaked documents to find out what her briefing notes tell her to say?

She's in charge of capital planning. Answer the questions. I want the specifics,

not that she's going to say to the health authorities to plan for capital

planning. Tell me what the interior health authority is doing about capital

planning for Nelson.

Hon. S.

Hawkins: I know this member is having trouble understanding this. This is

long-term planning. It isn't crisis planning. It's not day-to-day planning. It's

not back-of-the-napkin planning like how her ministry used to function when she

was in charge of it. This is long-term planning. I didn't say the health

authorities would be responsible. I said we would be consulting and working with

the health authorities to develop that ten-year plan.

Right now

they're going through an assessment of what the needs of their population are.

We're also asking them to project, long term, on the basis of their population

needs and what kinds of facilities, perhaps, or equipment or other things they

might need in the long term. That is what we're going to be working with them

on.

I'm having

trouble understanding why this member isn't getting this through her head. If

she wants to go through the list item by item, she can certainly do that with

the Health Services minister. That's in the budget of his ministry. In my

ministry we will be looking at what the health authorities are doing and how

they're making their decisions around long-term planning. We'll work with them

to make sure we are planning the kinds of facilities and equipment they need in

their authorities to move ahead into a ten-year plan.

MacPhail: What is the long-term planning for the community of Nelson?

Hon. S.

Hawkins: We'll be working with the health authority on that. They are in the

process of developing their plans, and I'm sure they'll be consulting the

community and consulting the different communities around there. In the next few

months I'm sure we'll come up with plans that this member can be entitled to.

Next estimates, perhaps, we'll have a long-term plan for that community.

MacPhail: There were 700 very concerned people out to meet with the regional

health authority in Nel-

[ Page 1709 ]

son. The town of Nelson knows what they want, so the chair has had that

meeting with the town of Nelson. What is the minister's discussion with the

chair of the health authority about the long-term plans for Nelson?

[T. Christensen in the chair.]

Hon. S.

Hawkins: You know, it's really regrettable that politicians interfered in

such a horrible way in that community. That member's government promised

something that wasn't funded. They knew they couldn't deliver and did it in a

very political way before an election. That is the kind of stuff we're trying to

get away from. When we travelled around the province, people told us:

"Don't do this. Get the politicians out of it."

[1535]

I can't

tell you how many administrators, health care providers, doctors, community

people and patients said: "You make sure you get the best people to make

the decisions for what's needed in our communities." That's what we're

doing. We're not going to be politically interfering. We're going to let the

decision-makers, the people that know about health care, the administrators, the

communities as well…. We're hearing from the communities. We're going to make

sure it makes sense for all the population around that area. That's what we have

committed to do, and that's what we're going to do.

MacPhail: The meetings have taken place in Nelson with the health authority,

the CEO and the chair. The community has spoken. What is the minister doing

about that?

Hon. S.

Hawkins: She's absolutely right. The chair has been there, and he's been

there several times. He's listened to the community. He's taken their comments,

and they're looking at what is required for the needs of the population around

that area. You know what? This is so frustrating. It's not: "What are we

going to do for this little community, this little community, this little

community?" Maybe the NDP way of doing things is to be very political and

say, "We'll give you this, but we won't give you this," or "We'll

put that there." That is not what we're asking our health authorities to

do.

We're

asking our health authorities to think about what they've got for funding and

think about making sure they put patients first — that patient care is a

priority — and to organize health care within those health service delivery

areas, within their health authorities, to make sure they're getting the best

value for the dollars that they're being funded for and make sure the patients

are being well served.

I'm sorry I

don't have an answer for that member on what, politically, we might think of

doing in that area. I don't know. We're waiting for the health authorities, who

are making their plans, to come back to us and tell us what makes sense for

patient care so we make sure the patients all over that region, all over that

health service delivery area, get good care.

MacPhail: Am I to assume that this list on attachment D that says that

health authorities must fund all debt service, amortizations and operating costs

is wrong, then? Is that what I'm to assume — that you haven't made a decision

on this list?

Hon. S.

Hawkins: I understand that attachment A, the A list, is going ahead. The

others are under review.

MacPhail: Well, it says here very firmly that a decision has been made, and

actually, letters have gone out to the health authorities with those

attachments. Has the minister recalled those letters outlining attachments A, B,

C and D? Has she recalled those?

Hon. S.

Hawkins: She's got the letters in front of her. None of them are being

recalled. Everything's clearly laid out in the letters. The letters stand the

way they are.

MacPhail: It doesn't say they're under review. It says — it's very

specific — that these are the four categories. I am trying to find out what

the long-term plan is. The Minister of Health Planning stands up. During

estimates last year, this was how she described how Health Planning was taking

place: "Well, we meet in the hallway, and we have some great conversations.

The Minister of Community, Aboriginal and Women's Services and I have some good

conversations with the Minister of Children and Family Development. We just meet

in the hallways. We don't have any formal meeting."

I was

asking specifically about cabinet committee meetings. I reviewed these estimates

from last year, believe you me. It was: "Oh no, we're just bonding like

crazy, and we have some great conversations in the hallway."

I thought

maybe Health Planning had moved on a little bit from last August. Maybe you

weren't just sort of meeting in the hallways, and there was actually some sort

of formal planning process going on. That's what I'm trying to figure out —

what it is the minister's doing. Has she moved the discussions into some sort of

formal aspect where the public actually knows what's going on, where her

colleagues may know what's going on and that can be actually examined, as is

required by law, in this Legislature?

[1540]

All we have

is a document that but for a leak would never have come to the public eye. And

we have a list of four categories. The category that I'm referring to with the

minister was attached to a letter sent to the interior health authority CEO

saying: "You've got to pay for these yourself."

What kind

of input would they get from the community of Nelson that would change their

mind on, let's say, the Nelson health campus — that they might actually want

to put some money into it? What is the list of questions being asked that the

minister keeps to referring to, which would allow for the public to

[ Page 1710 ]

change the government's mind — let's just say about the Nelson health

campus?

Hon. S.

Hawkins: She has the letter. If she looks at the letter, on page 4 it does

say: "The next step is that the health authorities should review all

capital projects for consistency with possible service delivery changes, overall

priority among other local needs, alternative procurement opportunities and

affordability." They've been asked to look at all of their projects and

review them within the context of those criteria.

She keeps

going back to the Nelson health campus — again, a political decision that was

unfunded. They didn't intend to fund it. It's a pretty sad statement for a

government that was on its dying breath to try and do that.

We are not

going to politically interfere with the planning. We've asked professionals to

go out there and tell us what is required to make sure that patients get good

care within their health service delivery areas within the health authorities.

That is what we've asked them to do, and that is what we're going to continue

asking them to do.

They're in

the process of planning. She's absolutely right. The different administrators

and the chair have been out. He's met with communities. He has travelled quite a

bit. I know that there have been other community meetings. Our MLAs have been

out listening to community groups as well. We will take all of that into account

as the health authorities develop their plans.

With

respect to long-term planning, again, that's exactly what it is. I am not going

to make short-term decisions. That is up to the Minister of Health Services and

the health authorities. We are looking at the needs of the population over a

long term. We know that there's going to be a huge impact on the health care

budget if we don't get our chronic disease numbers under our belts here, if we

don't get them under control. We know that we have to develop strategies for

diabetes, for asthma, for heart disease, and we're working on groups to do that.

If she went

through the service plan for Health Planning and looked at some of our

strategies, our goals, our targets that we hope to reach, she would see that

there is a lot of good work being done now in the Ministry of Health Planning.

But she wants to focus on health services and the short term and some of the

things that the health authorities have been assigned to do in view of the

decisions that they have to make in planning over the next one to three years.

That's fine; we can continue this. But if she wants to focus on health planning,

maybe she wants to look at the service plan there.

We can tell

her about all the good work that we have accomplished to date, like the nursing

strategy. We've done a ton of work around the nursing strategy. We've actually

been able to reduce nursing vacancies in this province by 20 percent. We went on

a recruiting mission. We were actually able to recruit 46 specialty nurses. We

were actually able to get a return-to-nursing-in-B.C. program established —

and guess what. There are over 250 applicants from nurses who weren't practising

in B.C., who are now coming back because of the grants we laid out that will

help them to get their refresher program and licensure again.

There is a

lot of good work being done. If she wants to keep being Chicken Little —

fearmongering, scaring patients and doing that kind of stuff — we can continue

that kind of dialogue here.

[1545]

MacPhail: I'm not quite sure what the Minister of Health Planning is talking

about — fearmongering. I'm reading from her own document, so I'm not quite

sure. It's a document, of course, that had to be leaked. It's a violation of the

Budget Transparency and Accountability Act that this wasn't part of the budget.

It's outrageous that the Minister of Finance withheld this information from the

public in violation of the Budget Transparency and Accountability Act. I'm not

quite sure why the minister is somehow saying that I'm fearmongering. I'm

reading from her own documents. They're documents that were kept secret from the

public, in violation of their own legislation. All I'm doing is discussing it

now. I'm not quite sure why the executive-council benches are so up in arms.

I just want

to carry on with the discussion, because this minister set up the health

authorities. The great plan she brought to cabinet set up the health

authorities. She must have known what she was doing. I know that it took her a

couple of tries to get the health plan through her cabinet, but she must have

known what she was doing. She must have had some idea of what the long-term

planning was going to be for each health authority.

What I'm

trying to do is just discuss, to take one example. I've been trying throughout

the whole thing to just walk through a case study. I asked for it on aboriginal

health. We couldn't do it there, which is part of her responsibilities. I'm not

making this up. It says capital planning right here. I went through this at the

very beginning with the minister. Capital planning — that's all I'm trying to

do.

The Nelson

health campus was fully funded by the previous government. There's evidence

completely to that effect. The government's trying to say it wasn't fully

funded.

Interjections.

The

Chair: Members, could we have a bit of order and allow the member to proceed

with her questions?

MacPhail: I think, Mr. Chair, the Minister of Finance needs to actually read

his acts and figure out what his job requirements are. To hold himself

accountable to the public, he would have released this document with his budget

if he'd been following the law. He broke the law, and now he's upset by the fact

that he broke the law.

[ Page 1711 ]

The Chair: Member,

if we could restrict our comments…. We're dealing with the Minister of Health

Planning's estimates. Could we proceed with those, please?

MacPhail: Yes. That's actually what I'm trying to do. I'm reading from the

government's documents. I'm not quite sure why the Minister of Health Planning

is so upset by that.

Let's try

to take another case study, then. I'm just trying to figure out one that maybe

the minister…. Let's talk the provincial health services authority, then. That

was set up with great pride by the Minister of Health Planning.

She stood

up in her estimates and said that for the very first time ever, we were going to

set up a provincial health authority. So here we have under attachment D, the

provincial health services authority…. Riverview Hospital is all going to have

to be funded by the provincial health services authority: the debt servicing,

the amortization and the operating costs. What was the thinking behind having

Riverview Hospital entirely of its own — having to take money from Peter to

pay Paul…?

Hon. S.

Hawkins: She was on capital planning. I'm just wondering where she's moved

on to now. She's now talking about Riverview.

If she

looks there, from what I can tell, 100 percent of the capital funding is coming

from the ministry. Some of it is under construction. Some of them are

substantially complete. The operating will come from the provincial health

services authority.

[1550]

MacPhail: Sorry, no. I'm reading from attachment D, program-related projects

in planning. Health authorities must fund all debt service, amortization and

operating costs. Then you move down to the provincial health services authority,

Riverview Hospital. I'm just using that as a case in point. When you set up your

provincial health services, separating it out — Riverview used to be a

separate board unto its own — what was the thinking of the Minister of Health

Planning as she set up the provincial health services authority?

I refer to

the documents that were actually made public by the government as opposed to

this one, which wasn't. July 30, 2001 — I think that was the first economic

update of this government. Their own documents say "Capital expenditure

projects. Replacement of the Kootenay Lake regional hospital and Mount St.

Francis Hospital with the Nelson health campus in Nelson" — fully funded.

Hon. S.

Hawkins: I'm pretty proud of the fact that this government accepted, for the

first time ever, a health services authority that looks after provincial

programs, because I know, again, over the last ten years or so we saw patients

around the province who were not very happy that they weren't getting access to

equitable care. We wanted to make sure we pulled out the programs, put them into

one health authority and made sure there's representation from around the

province on that health authority to make sure people across the province would

get equitable care.

The reason

that Riverview went into that provincial health services authority is that it is

a provincial resource, a provincial hospital. That's where we felt the needs of

patients would be best met.

MacPhail: What I'm trying to find here is, in terms of health planning….

Let's just take mental health, then, for health planning. Riverview Hospital is

now the major facility for people with mental illness that need long-term care.

That's Riverview Hospital. There was a plan to change that. I'm looking through

lists A, B and C to find out what the plan is for Riverview Hospital or regional

health facilities as well — for instance, the one in Kamloops. Among the lists

A, B, C and D, I'm trying to figure out what the minister's long-term planning

is for people with mental illness who need chronic care attention.

Hon. S.

Hawkins: We're looking at Riverview to see how it can meet the tertiary

needs of patients across the province. We're also looking at different models to

see how community needs can be met for patients that require mental health

services.

As far as

detailed planning for the mental health plan, she's certainly welcome to talk to

the Minister of State for Mental Health, who is going to be delivering the $125

million mental health strategy that her government failed to deliver. In the

short term, he will be doing that. He will be rolling that out. I believe he's

been working very hard at that. We've been working with this minister on the

long term, as I said, on how Riverview can meet the tertiary needs of mental

health patients, as well as working with him to see how we can meet the needs of

patients in communities.

MacPhail: Maybe the minister can understand my difficulty in finding out

some information. If you go to the blue book, there's not one single line for

mental health — not one. There's no money designated specifically for mental

health — none — just as there's no money designated for aboriginal health.

It's a big lump-sum payment and then about a hundred responsibilities under

that, which are being delegated to the health authorities.

It's not

like people who are advocating for a family member with mental illness can open

up the blue book and figure out how much is there. The minister keeps saying

$125 million. I can't find out where the $400 million went that was in the last

budget. I can't find out where that went, for mental health. Right now there's

zero.

[1555]

This is the

minister responsible for long-term planning. Mental health is a huge issue in

this province. I go to the capital plan, and I'm trying to find out, in terms of

long-term planning, what the idea is for resi-

[ Page 1712 ]

dential, acute care or chronic care for people with mental illness. All I can

find is a listing for Riverview Hospital saying: "Hey, provincial health

services, we're giving you nothing to do anything about Riverview Hospital. If

you want to do anything, it all comes out of your own pocket."

Perhaps the

minister could walk through with me the long-term capital planning for mental

health facilities.

Hon. S.

Hawkins: There is $138 million in capital funding for mental health. This

includes the facility in Kamloops, which her government failed to fund and never

built. It includes the facility in Prince George, and it also includes modular

facilities for moving patients out of Riverview and into communities as their

needs need to be met. Again, she can talk to the Minister of State for Mental

Health, who's working very hard at this.

understand, as well, that the money for mental health has gone to the health

authorities. She's certainly welcome to canvass the Minister of Health Services

on how that money is going to be spent and how some of it is being targeted and

some of it is being looked at as they make their plans to meet the needs of the

populations within their health authorities.

MacPhail: I will be asking the Minister of Health Services the information

that's in his area as well. This minister is responsible for capital planning.

That's why I'm putting the questions here. She also admitted that the regional

health authority chairs would not be available for questioning. That's why I'm

asking her the questions.

In this

consolidated capital plan budget I can't find a figure where it says $138

million for mental health facility capital planning. What I can find is a figure

of $11.8 million for new-era commitments for capital planning for the year

'02-03 and then another $23.6 million for '03-04 and another $23.6 million for

'04-05. Does the minister have some paper that…? She came up with the figure

of $138 million. I can't find that anywhere — leaked or public.

Hon. S.

Hawkins: Again, that is the money that's been delegated for capital planning

for mental health. Again, if she wants to question the Minister of Health

Services and the Minister of State for Mental Health around that, she's welcome

to do that. You know what? I can understand why she doesn't get it. She focuses

on the immediate. She just doesn't seem to understand long-term planning.

If she goes

into the service plans for health planning, she'll see that for the first time

ever…. We've probably put out more information than we ever got from them in

the last five years. I can't ever recall having the detail of information that

we put out in our service plans. We actually set goals. Under those goals we

actually set some objectives. Under those objectives we actually set some

strategies. Then, in order to measure how well we were going to do, we actually

set some targets.

[1600]

As far as

capital and equipment, I am responsible for the long term. We've asked our

health authorities to tell us now and into the next year or two how they can

best utilize the capital and equipment they've got and to identify their needs.

Within the context of those kinds of discussions we will be developing a

long-term capital and facilities plan for the province. In fact, our target for

long-term plans for the health sector — our complete four-year capital plan;

complete acute care and intermediate and long-term care facilities plan; an

update on our health human resource plan; and a complete design and consultation

on medical machinery, equipment and technology — is '03-04. You'll find that

on page 7 of your leaked document. Actually, it was not leaked; it's public

information.

MacPhail: No, it wasn't public information until someone other than the

government made it public. Please don't in any way try to take credit for

telling the public the truth.

Perhaps the

minister could show me where in that document the $138 million for long-term

mental health facility planning is listed. I can't find it anywhere. I read the

health plan, I read the health planning service plan, and I can't find it

anywhere. Just point me to it.

Hon. S.

Hawkins: I am absolutely amazed that she has the gall to ask these

questions. Her government, for the last four or five years, said they were going

to fund a $125 million mental health strategy and didn't put one cent into it.

They were forced — forced — to put money into it when they were called on

it. Frankly, the Minister of State for Mental Health has been working extremely

hard to implement the strategy that they started. We will have a long-term plan

for mental health. It's being developed. We're working with our provincial

health services authority and our regional health authorities.

Again, I

can see why she's having trouble focusing on long-term planning, because she's

more inclined to think of the immediate. We're inclined to think of the long

term. We're asking for our health authorities to get the best information

possible to identify needs, to look at planning for the next two or three years.

Then we'll sit down with them to look at the needs of the population over the

next five to ten years.

MacPhail: Can the minister tell me where I can find the figure of $138

million for mental health facilities, please?

Hon. S.

Hawkins: That figure was given to me by the deputy, who also serves the

Minister of Health Services. I told her — through you, Chair — that she is

welcome to canvass those questions when the Ministry of Health Services has its

estimates.

MacPhail: No, I'm asking for the piece of paper so that the public would be

able to know about it.

[ Page 1713 ]

Where is that piece of paper that shows the three-year planning for mental

health?

The

minister is saying there's a figure of $138 million. I've been through the

leaked documents and the public documents, and I can't find that anywhere. Just

tell me. It's just a figure. It must be a public figure, so just give it to me,

please.

Hon. S.

Hawkins: If she can't get it from the Minister of Health Services, I'll get

it for her.

MacPhail: Is the minister saying that somehow the figure that she just read

out to me is not available to the public?

Let me just

make it clear that if the government would actually provide information about

this stuff, we could have a decent dialogue. I have a figure. Here's the figure

I have of what they've got planned for mental health: capital planning — $11.8

million this year, $23.6 million next year and $23.6 million the year after

that. That'll be the end of the first term.

I don't

know where else I could get information. All of a sudden, popping out of

nowhere, comes the figure of $138 million. The Minister of Health Planning is

responsible. She gave the figure. Just send it across to me; that's all. What's

the document it's in?

All right.

Let me ask this, then. Here's what I'll ask. Boy, the Minister of Health

Planning is so reluctant to discuss things based on facts. Here's what I had for

the total capital expenditures for the consolidated capital plan until the end

of this government: $324 million for last year, $328 million for '02-03, $200.9

million for '03-04 and $176.7 million for '04-05.

Could the

minister break down what she has as $138 million over that same period of time

and where it fits into the total capital expenditure breakdown, then?

[1605]

Hon. S.

Hawkins: I was trying to be helpful. She asked for a number. The deputy gave

me a number. I told her I will commit to breaking it down for her. In fact, as

soon as staff do it, I will get it for her. But guess what. She asked for the

number. It's probably more information than I ever got when we were questioning

them. They've got all our service plans, which are totally public. She's got

leaked documents which have a ton of information, probably more than we ever got

anywhere. I am trying to be helpful. I don't know why she can't get it through

her head. The deputy said $138 million. I will break it down for her. I'll

commit to doing that.

MacPhail: Good. Thank you very much. I hope the minister isn't surprised….

Interjection.

MacPhail: I'm not sure that the Minister of Health Planning should be trying

to refer her job away to everybody else. Somebody may take her seriously that

she has nothing to do. That's why I'm asking about these particular situations.

I hope the minister isn't offended by the fact that, given all of the

information we've managed to glean, there's no $138 million, and therefore I'm

actually asking for further detail. I hope the minister isn't upset by that.

Let's go

back to the context of that in the overall capital plan, because that seems to

me…. Let me see. If I add that up, that would be probably more than 15 percent

of the total funding for the entire capital plan for health. Is that correct?

Hon. S.

Hawkins: I just got the figures for her. It's $118 million in capital

funding over the next five years for mental health plan capital projects, plus

$20 million for the facility in Kamloops.

MacPhail: Okay, so we've got $130 million over five years. Could the

minister…?

Interjection.

MacPhail: Okay, sorry — $138 million over five years. Could the minister

break that down on what's being spent this year, please — or all five years,

then? The service plan is for three years, the minister may acknowledge.

Actually, where is this information available publicly — like the $20 million

for the Kamloops facility? Where is that in the budget documents?

Hon. S.

Hawkins: Again, I fear that the member doesn't understand that the funding

for this is actually in Health Services. The planning for this is in Health

Planning. The Minister of State for Mental Health is working very hard at

implementing the mental health strategy that the previous government did not

fund or plan for. Frankly, my ministry officials are working with the Minister

of State for Mental Health, but if she wants the breakdowns, she should rightly

discuss it with the Minister of Health Services, who is funding it.

We will be

working with the health authorities. Again, I'm trying to get through to her

that we are long-term planning. Some of these projects are already funded.

They're in the planning. They are going to be built. She can certainly discuss

that with the Minister of Health Services and the Minister of State for Mental

Health.

What we are

going to do is work with the health authorities, work with the Minister of State

for Mental Health and look at what the population needs are over the next five

to ten years, look at what kinds of capital, facilities or projects — or as

the literature and the studies come down and tell us this is the way we need to

be moving for future treatment or community needs. That's what we're going to be

looking at. We're going to meet with our experts, we're going to meet with the

health authorities, and we're going to try and provide for mental health needs

into the future. I hope that helps the member.

[1610]

MacPhail: Well, I've gone through all the documents, and I can't find

anywhere where it says $138

[ Page 1714 ]

million for long-term capital planning, so I expect that the minister's fine

with giving these answers in an open and transparent way. This would be first

and only forum where this information is being given. That's $138 million out of

a total capital plan, over that period of time, of about $900 million. Does the

minister have some sort of sense, in terms of her long-term planning, whether

there will be more capital funding needed?

Hon. S.

Hawkins: We're going to work with our health authorities. We're going to

look at what they consider are the needs of their population. We certainly have

funding from the federal primary health care transition fund. We're certainly

going to be looking at new ways of delivering patient care and health services.

You know what? As the economy grows, we're going to look at what we need to meet

patients' needs. If that means facilities in the future, we'll look at that as

the economy grows and we have the funds to do it.

MacPhail: So there is opportunity for health authorities to lobby for future

funding out of the provincial budget.

Hon. S.

Hawkins: I wouldn't use the word "lobby," hon. Chair. They might

be familiar with using the word "lobby," but I would say that we're

going to plan, we're going to coordinate, and we're going to work with them to

make sure patients' needs are met in the best way possible in the communities

served by the health authorities.

MacPhail: I was just trying to get at what the minister meant that as the

economy grows, there will be more opportunity. There are lots of discussions

going on in communities right now about their future needs for health care —

Nelson being one, the mental health community being another — and about what

the plans are. That's what I see this ministers job is, so if she has some

knowledge that as the economy grows, there will be more resources available,

that's what the public needs to know. They need to understand that's available

and of course that the funding won't be frozen for health care.

Also, this

minister is well into a planning cycle — a major planning cycle. I'm trying to

get a sense of when there will be some certainty for the communities about what

dollars are available for them. That's the kind of discussion we're having.

That's why I asked the minister whether she thought $138 million was, in her

view — given that it's over five years — enough for mental health. That's a

figure she gave. It's not one she might or might not do. That's what is

available for mental health facilities capital expenditure.

In terms of

her planning, what kind of contingency planning is done if pressures grow beyond

that? Let me just maybe say that it's not a trick question. It's not a trick

question at all. I see in the letter from the deputy minister that next steps to

the health authorities would be targeted specifically at mental health

facilities. Here's why. I'll try to explain this in a succinct way.

There is

virtually no committed funding right now that I can tell, out of any document,

for capital expenditures except the minister's word that she just gave me, but

there are needs. Every regional health authority has pressure for mental health

facility capital expenditure. However, as part of the next steps — the

minister herself read this out — the health authorities should review all

capital projects for consistency with possible service delivery changes, overall

priority amongst other local needs, alternative procurement opportunities and

affordability. In the minister's long-term planning, what are the pressures that

may be resolved in the area of mental health amongst those options?

[1615]

Hon. S.

Hawkins: Let me say this first. For the first time ever the health

authorities got their budgets on time. For the first time ever they got

three-year budgets. They were told what their budgets were for three years. And

you know what? It's absolutely incredible that that member can stand up and say

that there's no planning done, when there's probably been more done in the last

nine months than there was ever done in the ten years that they were in power.

It's just amazing that she can stand there and make those comments with a

straight face.

Part of the

reason — maybe most of the reason — that we have a Ministry of Health

Planning is to try and fix the problems that their government created. We're not

going to worry about little short-term fixes, because we know that we have to

work on the long term. We know we have to work on a continuum. Part of the

reason we're in the mess that we are is because there was no long-term planning

done and there was no strategic planning done. Frankly, what that government

chose to do was look at funding crisis after crisis and not really look at why

those crises were created in the first place.

When we

look at pressures, we step back and say: "How come there is a

pressure?" We know that there are a lot of chronic diseases out there. They

are a huge burden on our system. So part of what we're doing as far as

strategies is looking at how we're going to manage those chronic diseases. We're

looking at perhaps putting steps in place so that we deal with those chronic

diseases early, so we don't get to a stage where they've built up into a crisis

and then we're dealing with them in the most expensive way possible.

Maybe they

can be dealt with in a primary clinic. Maybe they can be dealt with by an

integrated team of providers rather than proceeding along with gaps in their

care and not really having any kind of a managed way of looking after, perhaps,

a diabetic. They get to the point where they're in crisis, where we're looking

after heart disease, we're looking after their kidney failure, and we're looking

their gangrene and possible amputation. So that is the kind of planning that

we're doing. We're looking at it in the long term. We're looking at strategies

that we can employ over the long term, and we're certainly working with health

authorities to do that.

[ Page 1715 ]

MacPhail: I never said there wasn't any planning going on, Mr. Chair. That's

what we've been discussing for the last three days. I'm just trying to get from

the Minister of Health Planning what it is she's planning.

Whenever I

talk about mental health, she's on to diabetes management, which is all very

important, and she's on to the nursing strategy, which is all very important,

but we're actually talking about mental health planning here.

I'm not

quite sure what the minister's suggesting in saying that I'm suggesting there's

not any health planning. I'm just trying to find out how it's moved on from last

year, when they were meeting in hallways having good conversations, to what

health planning is actually taking place right now.

I have

documents here that don't have any…. What the minister is telling me isn't

corroborated by anything in writing either from the Minister of Finance or from

the Minister of Health Services. Maybe she has some health planning documents

that haven't been revealed publicly yet herself. That's all.

It's good

that we're having this discussion. The public now knows that somehow there's

$138 million out there over the next five years. I'm sure they'll look forward

to seeing how that's being allocated.

I was using

the example of the provincial mental health because it's part of the provincial

health services authority, Riverview Hospital. It seemed to me that this would

have been at least one area — the minister has taken great pride in setting up

this provincial health services authority — that she would actually know what

plans are in the making.

In terms of

the lists A, B, C and D from this document, the lists of C and D are ones that

very clearly said that the provincial government will be providing no money for

— whether for debt servicing, amortization or operating costs, for instance.

So let's just look at what the minister may be considering when she wrote,

through her deputy, that there could be alternative procurement opportunities.

Could the minister describe those for me, please?

[1620]

Hon. S.

Hawkins: We have said that we're committed to making sure that patients have

access to the system. We're certainly working with our health authorities, and

we've encouraged them to look at ways they can meet the demands for greater

access for patients. There's a variety of options out there. One of them is

public-private partnerships, and the health authorities are exploring that.

MacPhail: I heard the minister briefly on this on the news. Was the minister

making a detailed presentation on that matter, which she could share?

Hon. S.

Hawkins: What I said was that my ministry is working on a policy framework

for P3s, and we expect that framework to be completed in the next couple of

months. I think that was what we had hoped for. As soon as we have that

completed, I'll commit to getting a copy for the member.

MacPhail: I'm sorry — did the minister say in the next three months?

Hon. S.

Hawkins: We're hoping to have that completed in the next couple of months.

MacPhail: There must be more detail to it, then, in terms of public-private

partnerships. The last time we were in estimates, I shared with the minister

some studies that examined privatization of health care. I'm wondering, now that

she's well within weeks of rolling out a plan for public-private partnership,

what studies the minister has now available to show the viability of this

option.

Hon. S.

Hawkins: We are working on a framework. When we're ready to roll it out,

we'll certainly make sure it's public, and the member will have a copy.

MacPhail: I had a study for the minister here. I've got it here somewhere.

I'll keep going through my papers.

No, my

question is not the study as it's done and completed. I would assume, given the

fact that this government campaigned on being open and accountable…. There are

no health authorities appointed yet. Let's just say, blue-skying it, that there

are health authorities appointed by the end of this month. That leaves a few

weeks before the minister plans to have her plan out on public-private

partnerships. Does that mean the minister won't do anything without public

consultation on this matter?

What I was

looking for was something that's driving the minister in this direction — like

that somehow it's good for health care, that it makes sense from a fiscal point

of view. I'm trying to get what the planning process is of why we're heading in

this direction at all — some substance.

Hon. S.

Hawkins: There is a great need for access out there. Our health authorities

have told us that, and they've asked for a framework within which to explore

these options. We committed to doing that. We are working on a policy framework

that will identify how the public interests will be protected when care is

provided under contract. Certainly, we're going to make sure that we ensure the

highest standard of care and that this is under full compliance with the Canada

Health Act. When that framework is completed, I would be very willing to share

it with the member.

There are

studies that the ministry is looking at. If the member has other studies she

wants to share, we'll look at what she's got as well.

MacPhail: Well, I did give the minister several studies during the last set

of estimates, last August, and I have another one here now. I have actually been

waiting for the minister to tell the public why this is the

[ Page 1716 ]

right direction to go in. This will be a major change in the way health care

is delivered here. Surely, given the fact that the deputy minister is asking the

health authorities to consider alternative procurement opportunities and

possible service delivery changes, there must be some basis for these being the

chosen words, on the basis of it being better health care. I take it the

minister can't provide me with any studies on that basis.

[1625]

Hon. S.

Hawkins: I was trying to refresh my memory. If I recall, it was her

government that actually put something on their government website about

public-private partnerships. Perhaps she can give me the studies that referenced

that this was a good idea, because I understand it was the Fraser health

authority that they were asking to go out and look for opportunities for

public-private partnerships.

Let me say

this: once we get the policy framework in place, we're going to ask the health

authorities to make sure that it makes sense for patient care, that it makes

sense for their business plans and that they're in full compliance with the

Canada Health Act. All those kinds of factors will be addressed. Frankly, it's

exciting. There's been some national work done on this. There's been some

national interest in looking at public-private partnerships. We are exploring

those options as well.

MacPhail: It's always wonderful to hear that this minister's defence is:

"Well, you did it that way too." I notice great help from the Minister

of Finance saying that. Guess what. This government, led by that Minister of

Finance, promised a new era. Every time they rise here, the defence is:

"Well, you did it that way too." I can just see him there. It's

unbelievable. And you know what? If they had run the election on that, it

probably would have been a much more interesting election. But I debated these

ministers — at least a couple of them — and they said: "Oh no. That was

bad." They said: "Oh no, we're going to do it an entirely different

way." And now every time they stand up, it's: "Well, you did it that

way."

In fact,

they're not telling the truth in that area either. The fact that there was

something on the website…. Public-private partnership was being considered,

and none of the solutions were viable. In fact, we deliberately excluded the

operation from public-private partnership. We did a school in Abbotsford. It

turns out to be a modest success. There's no question about that. It was in full

compliance under all of the acts. The workers on the site were involved in it.

The operation is now strictly under the education authority — all of that.

Here we

have this government standing up and saying: "Well, you did it too."

It's just so cute how they're unable to take any responsibility for their

actions, their draconian misleading of the public in what they promised they

were going to do and what they're now actually doing. Here's what they're

actually doing: "Possible service delivery changes." What could that

mean? Could that mean privatization, like the Minister of Health Services was

forced to admit about an emergency ward? Is that what that could mean?

Overall

priority amongst other local needs. Here's one: "Figure out ways…overall

priority amongst other local needs." Does that mean robbing Peter to pay

Paul? Is that perhaps what that euphemism means? Alternative procurement

opportunities — does that mean privatized, for-profit facilities? And the last

one — this is a good one — is affordability. Does that mean: "Well, we

ain't gonna give you any money. Can you figure out some other way to pay for

it?"

The mayor

of Delta is now trying to figure out whether she can raise property taxes. The

mayor of Delta met with the Premier and maybe the Minister of Health Services,

and said: "What we'll do is raise property taxes if you keep our hospital

going, and then we'll give the money from the local citizens to the health

authority." Yeah. That took place last week. That was a nice meeting.

That'll be good news to Delta: "Hey, the good news is that you got your

hospital; the bad news is that your property taxes are skyrocketing." Gosh,

I can hardly wait for that to come out. That's the plan. Is that perhaps what

the deputy minister — through the minister — means by: "There would be

possible service delivery changes"? The hospital keeps going, but the city

pays for it.

[1630]

Hon. S.

Hawkins: We don't have our heads stuck in the last century, perhaps, the way

the last government did. We're looking for innovation. We're looking for

creativity. We're looking at options, and we've asked our health authorities to

explore those options. We're certainly setting up a framework that is going to

help define what the limitations of those options are. As I said, we want to be

in full compliance with the Canada Health Act. We want to make sure that if

they're moving this way, it's to improve access to necessary care. We want to

make sure that patient choice is enhanced, and I think I heard the previous

government saying that was something to be valued.

Frankly,

I'm not saying we're going to do everything the way the past government did. In

fact, I'm hoping to do things much differently from the last government. When

she talks about robbing Peter to pay Paul, there was a ton of that done in the

last decade. Unfortunately, we robbed a lot of the next generation to pay for

the mistakes that the last ten years of the NDP government made.

We want to

make sure we maintain a sustainable public health care system. We want to make

sure we are giving patients access, because that is a huge issue. The health

authorities tell us that. We're asking the health authorities to explore whether

it makes sense to engage in a P3. We are going to develop the policy framework.

We're hoping that in the next couple of months we get that rolled out to give

them a framework within which to work, but as I say, it's going to be done for

patients. Our government believes in putting patients first, and if this is one

option that will help patients get greater access to services, then we're for

it.

[ Page 1717 ]

MacPhail: The mayor of Delta met with the Premier last week and offered to

ask council to raise property taxes to pay for the emergency ward. Is that

something the minister is considering?

Hon. S.

Hawkins: I'm surprised she didn't ask the Premier that question.

MacPhail: The meeting took place after that, so perhaps the minister could

just ask. It's a question for the minister responsible for planning. Her own

next steps here are alternative procurement opportunities and affordability. The

mayor of Delta offered to raise property taxes in order to pay for the hospital.

That would be called off-loading. Is that something the minister is considering

in terms of next steps in terms of paying for health costs?

Hon. S.

Hawkins: That is not something I'm able to answer. If she wants to ask the

Premier about that, I'm sure she'll have ample opportunity to do it.

MacPhail: Sorry, no. I was asking whether, in the minister's long-term

planning under these next steps, that's under consideration. It was a question

for the Minister of Health Planning in her role.

Hon. S.

Hawkins: No, it's not in my next steps.

MacPhail: What are some of the possible service delivery changes that are

being considered? Perhaps the minister could walk me through an example.

Hon. S.

Hawkins: We haven't engaged the health authorities in that discussion.

MacPhail: I'm sorry. It's part of the letter sent to the health authorities

dated February 4.

Hon. S.

Hawkins: We haven't heard back from the health authorities on that yet.

MacPhail: Are there documents that the minister is sharing with health

authorities in terms of these planning documents? How would we know from health

authority to health authority what the planning documents and the requirements

are? For instance, I would assume this is the planning document that the deputy

minister sent out in terms of — I don't think these words fall from the sky

— possible service delivery changes.

What does

the minister mean, she hasn't heard back from the health authorities yet? Let's

say Kelowna decided to privatize the emergency ward. Would that be acceptable?

[1635]

Hon. S.

Hawkins: We've asked the health authorities to look at the needs of their

populations, of the patients they serve in their areas, to make sure they put

patients first, to come up with a plan that addresses patients' needs and makes

sure that patients are provided the range of services that's required in their

health service delivery areas across their region. Those plans have not been

finalized. They have not come back. They're working on them, and that's all I

can say about that right now.

MacPhail: I would appreciate any planning documents the minister has on

sharing with the health authorities, and let me ask about a time line on this.

Will the health authorities' appointments be made before any final decisions are

made? Secondly, what's the community consultation plan, authority by authority,

before any changes are made? That was the question I was asking in question

period today and got no answer for.

Hon. S.

Hawkins: The Premier did commit to having the health authority boards in

place before those decisions were made.

The

Chair: Members, the committee has been sitting for two hours now. Is the

committee agreeable to a five-minute recess? So ordered.

The

committee recessed from 4:36 p.m. to 4:44 p.m.

[T. Christensen in the chair.]

MacPhail: I'm very concerned when I read this stuff about alternative

service delivery methods, prioritizing and alternative procurement methods. Then

the debate that we had around Bill 29 where the Minister of Health Services

admitted that if you just step one foot away from the acute care bed, those

services were eligible for privatization. I'm very concerned. I see later in a

discussion that paramedical staff have had with ministry staff, even bedside

care could be privatized.

[1645]

I do have a

study here. I'll quote it. It's my only copy, but I'd be happy to give the

minister this. It's a radical journal, I must admit. My apologies. It's the New

England Journal of Medicine. They come to the conclusion that both the rates

of per-capita Medicare spending and the increases in spending rates were greater

in areas served by for-profit hospitals than in areas served by not-for-profit

hospitals.

This study

was done two years ago. I thought this would be useful, given the fact I was

looking for studies for the Minister of Health Planning in her long-term

planning where the issue of affordability is clearly one of the factors. I

listened to the Premier at the provincial congress talk about how the health

care system was not sustainable. I assumed that was why the government was

looking at privatizing services. This study is very current, and the conclusions

are dramatic.

I would

appreciate the minister providing me — I asked for this last year, and I'll

ask for it again — the studies that she has available. I think I've now tabled

about four or five studies in the course of the last eight or nine months on

this issue of for-profit health care

[ Page 1718 ]

and the fiscal effects of it. The minister has given me nothing and the

public nothing, even as we head in this direction. I would ask the minister to

do that as quickly as possible because I assume the health authorities

themselves will need that information to determine what direction they're going

in.

Can the

minister make those studies available?

Hon. S.

Hawkins: I thank the member for that study. I'm told the ministry has that

one. You know, again, we're asking health authorities to explore options; we're

not forcing them to do one thing or another. We're asking them to look at all

kinds of innovative, creative new ways of doing things. They have to make sense

for patient care; they have to make business sense. It's not something we're

just embarking on, on a lark. The fearmongering the other side seems to carry on

with is just counterproductive to what is really happening. What is really

happening is that we are developing a policy framework, because we want to make

sure there are parameters within which we explore these options.

The basic

principle is putting patients first. We want to make sure we get the best value

out of the public health care dollar that is spent. We want to make sure health

care is sustainable. We know that at the rate we're going now and if we continue

as in the past decade, it's not. Again, it's not something we're just going to

march blindly into. We are exploring all different options and studies. I thank

the member. If she has more, she can keep passing them this way.

MacPhail: I don't know what the minister means by not marching blindly into

it. They're laying off 14,000 workers over the course of the next year

specifically on the basis of privatization. It's not fearmongering; it's the

minister's own document that says that. It says exactly on the basis of

privatization that 14,000 FTEs will be laid off — fired. Correct me if I'm

wrong, but I don't think that's fearmongering. I think the minister has already

made a decision as well, or else there's been a lot of work done for no reason

— a lot of work.

[1650]

If the

minister has this study, let me read it into the record, then — the abstract,

the background and methods:

"The rate

of con