Official Report of

DEBATES OF THE LEGISLATIVE ASSEMBLY

(Hansard)

THURSDAY, MAY 22, 1997

Afternoon

Volume 5, Number 6

[ Page 3563 ]

The House met at 2:06 p.m.

G. Janssen: We have with us today His Excellency Johannes Fietelaars, Ambassador of the Netherlands to Canada. Joining him is Karel Birkman, consul general for the Netherlands. If the House will permit me a moment . . . . [Dutch spoken.]

I ask the House to make them welcome.

P. Reitsma: Thank you, hon. Speaker. It's my privilege to join with my colleague for Alberni to welcome His Excellency Ambassador Johannes Fietelaars and the consul general at Vancouver, Karel Birkman. I will make reference, if I'm permitted to speak a couple of Dutch words, to the incredible affinity that exists between the Canadians and the Dutch. [Dutch spoken.]

Would the House please make them welcome.

Hon. G. Clark: In addition to our special guests from the Netherlands, we have a special guest from Hungary. His Excellency Karoly Gedai is the Ambassador of Hungary to Canada. He's visiting British Columbia from Ottawa on business matters. The ambassador is accompanied by Andre Molnar, honorary consul general of Hungary at Vancouver. Please give them a very warm welcome.

S. Hawkins: In the gallery today for a very special occasion are three very special guests: Janet Plant, and Graham and Caroline Plant, who are here to celebrate their father's birthday. Would the House please make them welcome.

G. Brewin: It's a pleasure today to make an introduction that's really an announcement that all members will be interested to know about. It's my pleasure to announce the upcoming marriage of the legislative comptroller, Don Phillips, and his bride-to-be, Ms. Jennifer Salgado of Houston, Texas.

Interjection.

G. Brewin: One of the members talks about something we'll talk about later.

They are to be married on Saturday, May 24. Don and Jennifer met on a western Caribbean cruise early last fall. Will the House please join me in offering them enormous congratulations and best wishes.

V. Anderson: We have with us today Keith Frew, who is president of the Marpole Museum and Historical Society and one of my constituents. He's here as a representative of the Insurance Bureau of Canada, and with him is David Lach from Co-operators General Insurance and Carson Thompson from Federation Insurance. They're here to deal with us about the upcoming earthquake.

Hon. M. Farnworth: In the gallery today are the executive of the Association of Vancouver Island Municipalities. They are Mayor Jim Lornie of Campbell River, Mayor Frank Leonard of Saanich, Director George Holme, chairperson of the Nanaimo regional district, Councillor Pearl Myhres of Zeballos and Director Roxanna Mandryk of the Comox-Strathcona regional district. Would the House please make them welcome.

M. Coell: In the House today I have a number of friends who I would like to welcome. Ron and Carol Olson, from Sidney, are the managers of the Anacortes ferry and the Canadian partners in that venture. Would the House please make them welcome. I also would like to add my welcome to the executive of the AVIM. I once sat on that executive, and I wish them well. I'd like to welcome Frank Leonard and Jim Lornie, close personal friends.

B. Barisoff: Today I have 29 grade 7 students from Okanagan Falls Elementary School with their teacher Mr. Suthic. He's the vice-principal of that school also. They brought down seven parents and the bus driver. Would the House please make them welcome.

Hon. S. Hammell: I'd like to introduce Ariana Chaster, a constituent of Victoria-Beacon Hill, who interviewed me this morning for a presentation she'll be giving to her kindergarten class on the equality of women, a topic she chose on her own. She's accompanied by her mother Sally Chaster. Would the House please make them welcome.

R. Neufeld: Hon. Speaker, you'll be aware, again, that it's not very often I get to stand in the House and introduce anyone from the far north. [Laughter.] But it's certainly my pleasure today to introduce to the House 22 students from Dr. Kearney Junior Secondary School, who have raised the money on their own to come down here. They're with their principal Mr. Chisholm and a teacher, Ms. Petryshyn.

E. Gillespie: I'd like to add my greetings to those of the Minister of Municipal Affairs to Comox-Strathcona regional district director Roxanna Mandryk, constituent and friend.

Oral Questions

VICTIM IMPACT STATEMENTS

DESIGNATION ENACTMENT

G. Plant: Mr. Speaker, $1.7 million will be spent this year under the Victims of Crime Act, employing 35 people whose job is to help victims of crime prepare victim impact statements for use in sentencing hearings. Yet in a case decided yesterday in Victoria, 15 victim impact statements were thrown out of court because this government has not enacted the designation necessary to allow these statements to be used in sentencing hearings.

My question is for the Attorney General. How many more victim impact statements will be thrown out of court before he decides to follow the law and enact the appropriate designations?

Hon. U. Dosanjh: I'm not aware of the details of the case. The hon. member is talking about a particular case; I'm not aware of the details of the case. I'll look into it and advise the House tomorrow -- take it on notice.

[2:15]

The Speaker: I'm sorry, minister, you can't really take it on notice if you gave a partial answer.

[ Page 3564 ]

G. Plant: In any event, the Criminal Code is very simple on this point. Victim impact statements are admissible in evidence if the provincial cabinet passes the appropriate designation. The Victims of Crime Act came into force almost a year ago. So my question for the Attorney General is this: why has he allowed almost a year to pass before passing the necessary designation? What will he do for the victims whose statements have not been admitted?

Hon. U. Dosanjh: I'll take the question on notice. I will be speaking to the criminal justice branch and get back the answer tomorrow.

LEASED VEHICLE FOR

CHAIR OF B.C. TRANSIT

D. Symons: Last year on August 12, in estimates debate, I asked the Deputy Premier about Derek Corrigan and his company-supplied car. The minister promised to get back to me, but he never did. Perhaps, if the Deputy Premier had done his job, the current minister wouldn't be in this mess.

Can the minister responsible for Transit tell the House if the Deputy Premier informed her, as the incoming minister responsible for Transit, of the existence of Mr. Corrigan's leased luxury automobile?

Hon. J. MacPhail: Certainly, as cabinet colleagues, the former minister responsible -- who was doing double duty at the time -- and I discussed the matter of the future of B.C. Transit and the future role of the chair.

CAR ALLOWANCES FOR

CROWN CORPORATION EXECUTIVES

D. Symons: I take that answer as a no on that specific item -- they didn't discuss it, I assume, from the answer given. But when the official opposition first raised the issue of outrageous Crown corporation perks, the NDP defended their luxury automobiles. At that time it was revealed that the president of ICBC received an almost $8,000 car allowance. The president of B.C. Ferries received over $7,200 for a car. Eric Denhoff was into B.C. Transit for a $7,800 car allowance. Guy Simonis at the B.C. Lottery Corporation got the use of a Crown Victoria luxury sedan.

Since the issue of luxury cars supplied to senior bureaucrats was raised in the past, why is it that this government only responds to these excesses after it becomes a media event?

Interjections.

The Speaker: Order, members. Please let's hear the answer.

Hon. J. MacPhail: Certainly our government takes the issue of executive compensation very seriously. As a matter of fact, in terms of our public service compensation, we're in a respectable range, perhaps toward the low end of compensation. We still manage to have an excellent public service, delivering excellent services across government.

There is a balance to be achieved in terms of executive compensation that meets the test of what the taxpayer demands, as well. I know the opposition struggles with that compensation matter in terms of their own internal situation, as well. So we do that: we review it regularly, and changes have recently been made.

INTERNATIONAL RESTRUCTURING OF

PROVINCIAL CARPENTERS' UNION

G. Wilson: My question is to Minister of Labour. As I stand in the House today, the United Brotherhood of Carpenters and Joiners of America are forcing a restructuring in the labour situation with respect to the B.C. Provincial Council of Carpenters. This restructuring is going to strip the rights of Canadian workers to vote on the ratification of collective bargaining in this province. It is also going to strip the democratic right of those unions to organize and to distribute that organization within British Columbia, on the basis of what is being determined in Washington, D.C.

Will the Minister of Labour tell us what steps he is prepared to take today to protect unionized workers in British Columbia from an American restructuring that will put American rules in place, governing Canadian workers?

Hon. J. Cashore: I'd like to thank the hon. member for the question. I just became aware of the situation within the last 24 hours. I view it very seriously. I think the hon. member will appreciate that I do need some time to do some basic research. I need to talk to the Provincial Council of Carpenters and to some of their international representatives. I need to do some work in order to be able to outline those steps that we are going to take to recognize that we uphold the democratic rights of all citizens of British Columbia, including unions.

G. Wilson: By way of supplementary, we have in this province a critical situation with respect to unemployment and the need for local hiring, in order to make sure that jobs are protected in the regions of the province as well as in the urban centres. This forced restructuring is going to eliminate the opportunity for agreements to be cut between unions, management and government with respect to the provision of local hire. It is going to directly affect hundreds of workers in this province who will no longer be able to have local hire protected in their agreements.

Will the minister commit today that in whatever review he is doing he will move to protect the opportunity for local hire, so that we can protect local jobs in the communities of British Columbia and not have them dictated by American unions?

Hon. J. Cashore: While to some extent my mandate is to be a keeper of the process with regard to fair administration of labour law, I want the hon. member to know that I will always support the efforts of our government, which are exemplary in terms of standing up for the creation of jobs and its success and in having the best record on job creation in Canada.

B.C. TRANSIT CHAIR COMPENSATION

R. Coleman: My question is for the minister responsible for B.C. Transit. Hundreds of thousands in British Columbia read Derek Corrigan's self-righteous rant in the newspaper. The now deposed chair of B.C. Transit tried to defend his outrageous payment for severance as "constructive dismissal." The order-in-council appointing Mr. Corrigan states that he will be paid $4,000 per year; this was never amended.

Can the minister today get her story straight and tell taxpayers why we should pay anyone $56,000 in severance for a $4,000-a-year job?

Hon. J. MacPhail: I don't mind repeating the answer that I gave earlier this week to exactly the same question. The order-in-council stated that Mr. Corrigan would be paid $4,000 per year plus $500 per day, per diem.

[ Page 3565 ]

In the course of Mr. Corrigan's duties from 1994 to 1997 . . . . The government under the former Premier pursued a very aggressive policy toward expanding public transit and took on initiatives that were brought in after Mr. Corrigan's original appointment. Those include the ten-year plan "Going Places" and the establishment of light rapid transit in conjunction with the greater Vancouver regional district. Only last month we completed the establishment of the table that will negotiate funding and governance issues for transportation matters across the greater Vancouver regional district.

With those tasks complete, I asked Mr. Corrigan to assume the duties of a part-time chair. He had taken a substantial loss in terms of his law practice and decided that he would return to his law practice.

R. Coleman: Mr. Corrigan went on to complain that he worked so hard for B.C. Transit that he didn't have time to take any vacations. Well, according to his travel itinerary he had time to go to Anaheim, California, for a week last October. The only problem is that B.C. Transit forgot to include the cost of this trip to Anaheim in answering the freedom-of-information request that we gave them.

Can the minister tell the House who went and how much this trip to Anaheim cost B.C. taxpayers?

Hon. J. MacPhail: The trip the hon. member refers to is the time when B.C. Transit received an international award for its service. I will take the question of the details of the trip and the cost on notice.

CAR ALLOWANCES FOR

CROWN CORPORATION EXECUTIVES

K. Krueger: When the B.C. Liberal caucus brought up the issue of Jeep Cherokees being leased to B.C. Hydro employees, the Premier rushed to defend that lavish perk. But now, when confronted with 13 senior executives with these luxury cars, the minister said that she thinks it's unacceptable. We'd like to know who the government thinks is right: the Premier, who defended these absurd luxury perks, or the minister, who says that they are unacceptable?

Interjections.

The Speaker: Members, please. If we're going to ask a question, we have to wait for the answer.

Hon. J. MacPhail: There's some confusion in the question. The reference was to B.C. Hydro, and I assume the hon. member means B.C. Transit. So I'll rise to answer that question.

In fact, there is a policy in place across government, which has been established by our Crown corporations secretariat, that makes it very clear what the vehicle lease policy is. Executive vehicles should be available only to chief executive officers and vice-presidents, leases should be 48 months in duration unless a more favourable rate can be negotiated, and executive vehicles must not be vehicles which the general public thinks of as luxury vehicles.

K. Krueger: It's understandable that it's difficult for the cabinet to choose who shall answer, because these luxury car lease deals are popping up all over.

Clearly the NDP have had problems with their patronage appointments and their luxury cars. There was Marc Eliesen and his $8,000 car allowance. There was Connie Munro, who had to have a Volvo 750 so she could fit it in her garage. Then Derek Corrigan drove off into the sunset in his Saab 900.

Can the minister tell the House why the NDP, after all the public outrage at these perks -- and the public is outraged -- continues, for years, to give appointees luxury cars?

Hon. J. MacPhail: Let's look at who actually put this policy in place in 1990. Let's look at who was on the B.C. Transit board when the policy was put in place. This is dated July 18, 1990.

Interjections.

The Speaker: Members, order.

Hon. J. MacPhail: Do you know who was on the board of B.C. Transit at that time? The Leader of the Opposition was on the board that established that policy.

Interjections.

The Speaker: Order, members, please. Members! Members, please. We're not going to have time to get to these questions.

B.C. TRANSIT CHAIR COMPENSATION

I. Chong: Let's put this whole issue back into perspective. When Mr. Corrigan was originally questioned about his $120,000 annual billings, he replied: "I'm doing exactly what I proposed I'd do and getting paid exactly what I said I'd charge." Yet when the Premier appointed Mr. Corrigan, the press release said Corrigan's appointment to the chair "is a part-time position, and he will be paid a standard government per diem for his service."

Can the minister tell the House who is telling the truth: Mr. Corrigan, who claims that he was charging exactly what he said he would charge, or the Premier, who said it would be a part-time position?

Hon. J. MacPhail: Hon. Speaker, I know there's often an orchestration of question period, but this is ridiculous.

That question has been answered. But let me put in context, for the member for Oak Bay-Gordon Head, the work that has been done in the last few years in the area of transit for the constituents of her riding. There have been major improvements to the transit service in the greater Victoria area that have been shepherded through since our government took office in 1991. There is a transportation system in place now that is award-winning and that is viewed as a model to be considered across Canada. That has benefited her constituents, and that's the work that was being done at B.C. Transit over the course of the last three years.

Interjections.

The Speaker: Members, could I just remind members that . . . . This has nothing whatsoever to do with question period; this, rather, has to do with standing order 9. Standing order 9 makes reference to strange configurations like the decorum and dignity of the House.

I suggest to members that you place me in an awkward position, given my obligation to impose and uphold the rules

[ Page 3566 ]

of the chamber. Sometimes, when I can't hear questions or answers, we're clearly offending the rules of dignity and decorum. Can I ask members to please take that under advisement for future conduct.

[2:30]

Orders of the Day

Hon. J. MacPhail: In Committee A, I call Committee of Supply. For the information of the members, we'll be debating the estimates of the Ministry of Municipal Affairs and Housing. In this chamber, I call Committee of Supply. For the information of the members, we'll be debating the estimates of the Ministry of Health.

The House in Committee of Supply B; G. Brewin in the chair.

ESTIMATES: MINISTRY OF HEALTH AND

MINISTRY RESPONSIBLE FOR SENIORS

(continued)

On vote 40: minister's office, $462,000 (continued).

K. Whittred: First thing this afternoon I would like to revisit the area of caregivers, and respite in particular, largely because I inadvertently left the main source on what I wanted to speak about this morning in my office. I am referring specifically to a report called "For I and Mine: Respite Services in British Columbia," dated June 1995. This report was commissioned by the provincial respite advisory committee, created by the Ministry of Health in September 1993, which reported eventually to the then Minister of Health and the then Minister of Social Services, who is the current Minister of Health. So that is the background of the report I am using.

Now, it is certainly not my intent to go through all of the various aspects of this report. I think we have touched in general on the main issues. What I want to do is to refer to just a few of the recommendations and to see if these are in fact being followed up on. The first recommendation of the report is as follows:

"A respite coordinating committee be created to coordinate provincial level policy development and to monitor funding and service development decisions. The committee should include representatives of those who use or who are affected by respite services, their advocates, organizations that provide services and all ministries involved in funding or providing respite."

My question to the minister is: has this provincial coordinating committee been established?

Hon. J. MacPhail: Certainly the ministries are working on implementing this report. I actually met with the authors of the report, along with . . . . I don't know whether the Minister of Health of the day was there; I'm sorry, my memory fails me on that matter. And we are working toward making sure that we're moving forward in a coordinated way on the recommendations.

K. Whittred: I will take that answer as a no: there has been no specific committee set up, but you feel that you are addressing the issues in another manner.

A second provision -- and this is an issue that I really haven't addressed in my canvass of issues in this area -- is to give first nations the option of taking authority and responsibility for provincially funded respite services to first nations people. I have not specifically canvassed the area of first nations people, but I'm aware that a very recent report has been issued regarding caregivers for first nations. Could I ask the minister exactly what is being done in that area?

Hon. J. MacPhail: I believe the report the hon. member is probably referring to is a report on the health issues of first nations elders. That report will be received and made public at the June meeting of the Seniors Advisory Council. I expect that is what the hon. member is referring to.

In the area of home care services for first nations, there are some pilot projects going on right now at the regional level that are very successful -- one right here within the capital health region. They provide home care on reserve for elders but also for the first nations population that need home care, and they're very successful.

As always, issues of health care for first nations people are made complex by the division of responsibility -- really, one could argue that there isn't a division of responsibility, that first nations health care is the responsibility of the federal government. In this province we have made sure that we do as much as possible as a provincial government to ensure that first nations people on reserve don't fall through the cracks, in spite of the fact that it is the responsibility of the federal government.

K. Whittred: While we're on this topic, it reminds me of a question, if I may be permitted a little side trip. Sticking with the issue of first nations, I'm somewhat familiar with that, because there was an issue that came up in my own community regarding home care services to the Squamish nation. I gather that they look after that themselves, that it is their own responsibility. However, I also gather that residential care is contracted with the regional board. I wonder if the minister could tell me if that is a unique situation or if that is in fact fairly common practice throughout the province.

Hon. J. MacPhail: It is by contract and differs from region to region in the province, based on the request from the first nation. For instance, Westbank has a similar contractual arrangement to what exists in the member's community.

[2:45]

K. Whittred: Moving back from our little side trip to the report on respite services, another recommendation which I think has broad application throughout the province is one that states that each community or region throughout the province should designate a respite care coordinator to help individual families access the respite resources available in their community. I'm wondering again whether this has been done. Or has that particular recommendation been passed on as a guideline to regional boards?

Hon. J. MacPhail: Respite care and the responsibility of staffing to offer respite care is part of the integrated services that continuing-care assessors hold responsibility for. There is no designated position.

K. Whittred: I will attempt to limit my queries to those recommendations which I think would perhaps have universal provincial application.

Another one which I think might fall into this category is a recommendation that each community establish responsibility for providing 24-hour access to respite information and services, on an emergency basis. I will perhaps modify that a

[ Page 3567 ]

little bit by asking the minister whether or not all regions of the province have access to some sort of 24-hour emergency crisis intervention for caregivers and/or clients.

Hon. J. MacPhail: There are always emergency services available through our health care system, but there's no designated line such as the report recommends.

K. Whittred: This particular recommendation is one which I feel is probably a provincial responsibility and could easily be done through some sort of protocol -- that is, that the needs of caregivers for respite services be identified and referrals made as part of hospital discharge planning. I wonder if any sort of protocol has been put in place.

Hon. J. MacPhail: Respite care is part of the resourcing that's reviewed and determined and assessed at the time of discharge planning. It is part of discharge planning.

K. Whittred: I'm very happy to hear that.

Another one that falls in the same line is a recommendation that all service delivery systems contain measures or guidelines for prevention of the conditions which would lead to neglect or abuse. The same question: are those protocols in place provincially?

Hon. J. MacPhail: The office for seniors has an education and training program for prevention of elder abuse. We have a protocol for assessing and determining elder abuse when a client may present herself or himself with symptoms, and the adult guardian legislation provides for a legislative prohibition against elder abuse.

K. Whittred: Just pursuing that one a little bit further . . . . I am familiar myself, through my own previous occupation and what not, with protocols that deal with the abuse of children. With the aged, do these protocols . . . ? Can the minister describe to what degree these protocols go beyond assessing obvious physical abuse that might be apparent to a health care worker? I'm looking now at situations that may arise in other areas that might deal with emotional or financial abuse and with other caregivers in the community network.

Hon. J. MacPhail: I'll make available the full package of all of the information we have on elder abuse. The protocol -- the educational programs and the outreach -- that we do in that area is very extensive, and I'd be more than happy to make all of that information available.

K. Whittred: I appreciate the minister's gesture. But I think I already have all that information, so I don't think I require it at this moment.

The final recommendation from this particular package that I want to inquire about is recommendation No. 40: "The Ministries of Health and Social Services, in collaboration with service users and their representatives, review issues of user fees, income testing and additional care costs." I am generally familiar with the user fee system. It is also my understanding that there have just been increases. I wonder if the minister could elaborate on that.

Hon. J. MacPhail: There are two initiatives that have occurred. One is the regular quarterly adjustment, based on the change in the OAS rates. The contribution on behalf of the client is based on a percentage of the OAS rate. That took place recently. There's also an income verification project going on right now, where we are verifying clients' income based on Revenue Canada records, and there will be adjustments in individual payments based on that.

K. Whittred: While we have mentioned the issue of adult abuse and elderly abuse, I would be remiss if I didn't at least ask, for the record, the status of the four acts. I must confess that I know the answer, and as you are probably aware, members on this side of the House have been participating on a committee with members opposite. We view this as a completely non-partisan issue. I'm just wondering, for the record, if the minister could report on the status of that committee at this time.

Hon. J. MacPhail: Are the four acts that the member refers to the adult guardianship legislation?

Yes, a very extensive process has been going on since the adult guardianship legislation was passed, which was three years ago. Certainly from our perspective, the office for seniors continues to be an active participant in the joint community-government committees to guide the implementation of the adult guardianship legislation.

The member for Vancouver-Burrard is doing a review to make sure that an appropriate

schedule is in place for proclaiming the legislation, and to recommend ways in which the implementation can be done as cost effectively as possible. We have also retained the expert services of John Hogarth, who is a lawyer with expertise in this area. In the meantime, our ministry is preparing for the legislation to be implemented in the very near future.

I must say that these are pieces of legislation that have provoked a great deal of interest within the community, and there are strongly held views on all four acts. I look forward to the day when all matters are resolved to the vast majority's satisfaction and we actually proclaim the legislation.

K. Whittred: I would like to state for the record that I share the minister's desire that this legislation is, at some point -- hopefully, in the very near future -- brought to some reasonable conclusion, because it certainly is very necessary legislation.

I would like to move now and canvass for a few moments the issue of volunteers, not only within the continuing-care system but also generally within the area of seniors. The value of volunteers is certainly a point made in the book about respite need. I think that the value of volunteers within this area is not in the least questioned. Many, many groups who are greatly concerned that their funding is going to be lost have canvassed me, as critic in this area. In many cases their seed money has been provided for by government grants.

I will start with a letter I have from the B.C. Association of Community Care. Without reading the whole thing, I would simply point out that they express a concern. Perhaps I could read one paragraph which more or less summarizes this:

"The financial contributions made by independent societies to the health care delivery system are quite substantial. Service clubs, community-based charitable organizations and/or denominationally affiliated organizations play a central role in fundraising. Such societies have partially or fully funded the purchase of land, construction of buildings and even operating costs of the original facility. Fundraising is a growing activity of volunteers which adds value to capital programs and services. With government deficits, the need for the community to assist with financial support is greater than ever, and organizations depend more and more on generous donors."

[ Page 3568 ]

The letter goes on to make a point about the role that board members play in organization and leadership; in development, review, monitoring and implementation; in governance and so on. It concludes by saying:

"We are concerned that replacing the board of directors with a centralized administrative structure would tend to shift community care from a holistic approach, which recognizes the importance of social, emotional and spiritual components of care, to a medically based model. A decentralized health care structure is better able to foster diversity and innovation. Many continuing care facilities and agencies originated under community societies in response to local needs and opportunities. Society boards also serve as a mechanism to inform and involve a wide range of community citizens in the health care system."

I am well aware that some of the concerns expressed in this particular letter would not be shared by the minister. It is, however, not an uncommon viewpoint in the community. It has been expressed to me from a variety of organizations who feel that somehow they are going to be shut out of the community initiative with regionalization, even though that would appear to be contrary to the intent. I bring this to the attention of the minister and wonder how she would respond to this concern.

[3:00]

Hon. J. MacPhail: We had a good discussion about this last week under regionalization of health care. Certainly the intent of Better Teamwork, Better Care is exactly the opposite of the concerns outlined in the letter. I'm well aware of the letter to which the hon. member refers, and I have a good working relationship with the association. I have been able to alleviate their fears, in that their foundations will remain unaffected, the volunteer structure will be unaffected, and institutions or contributions that have been designated to health care will remain thus and be unaffected by the regionalization of health care.

But it also seems to me -- it may be just a matter of emphasis -- that what is really needed in the area of community care is further integration with the acute care system, so that our health care system is not dominated by an acute care model and so that the focus is shifted much more to a continuum of care and the appropriate care for people in the appropriate environment. This includes a much greater emphasis on continuing and -- in the context of continuing -- community care.

So I expect this organization to have an even bigger part to play as we regionalize health care.

D. Symons: I ask leave to make an introduction.

Leave granted.

D. Symons: In the gallery and about the precincts are 75 grade 7 students from James Thompson Elementary School in Richmond. They are accompanied by their teacher, Ms. Hallett, and several adults. I would ask the House to please make them welcome. Indeed, since there are a lot of people doing other duties, we'll have to work harder at making that welcome really meaningful to them.

K. Whittred: Continuing with the volunteers, I would like to make reference now to the concerns of the Seniors Health Promotion Network. I am probably correct in assuming that the minister has heard from this organization. To start with, I wonder if the minister could state for the record the kinds of projects that were funded by the Seniors Health Promotion Network.

Hon. J. MacPhail: Sustaining the network will now be part of the regional health boards' responsibilities.

K. Whittred: Yes, I understand that. Can the minister tell me what their funding was previously, under the centralized system?

Hon. J. MacPhail: In last year's funding it was $325,000.

K. Whittred: Can the minister tell me: is that money still being given to the regions in the same proportion as it was before?

Hon. J. MacPhail: Yes.

K. Whittred: I have a couple of other questions to bring up in this category from representations that I have received. One is from the Caregivers Association. The Caregivers Association, I believe, is one of the organizations that received funding under the umbrella of the Seniors Health Promotion Network. They point out that they provide respite and caregiver support for about $6 an hour and that the ministry could not possibly provide the service for that same amount of money. They are concerned that with the change in governance, they too are going to lose their funding. I wonder if the minister could comment on behalf of the Caregivers Association.

Hon. J. MacPhail: The Caregivers Association of B.C. has not received any money since 1996, and there will not be any further government funding.

K. Whittred: How would the minister respond to the caregivers' claims that they were providing this service to a large number of people for a very, very reasonable rate? I have met with these people recently -- in fact, people from various groups -- and their question to me was: why are we being fired? We're doing this for nothing; we're not being paid, so why are we being fired? I think that's a very good question.

Hon. J. MacPhail: Yes, it's a question we struggle with daily across government services in the context of our current fiscal situation, and tough decisions are made about the best use for limited resources. This was a decision made by asking: what is the best possible way to spend our health care dollars? That's on front-line services. But I do know that regional health boards will continue to fund caregiver organizations and will do so on a local basis.

K. Whittred: I'm interested in the minister's response that they will continue to fund front-line organizations, apparently implying that caregivers are not part of the front-line process.

One other program that I would like to mention, because it struck me as sort of ridiculous, was a small program run by a community organization in Penticton. This was a really neat little program. It was a meal preparation program, and it was run through the Penticton and district seniors wellness association, which is another one of these groups that I believe are losing their funding. What they did was get seniors together in a church hall, I believe once or twice a week, and prepare their lunch. They not only had their lunch, which provided nutrition and socializing, but they also prepared extra meals which they froze to take home so they would have a nutritious lunch for the next day.

[ Page 3569 ]

Now, all they were asking for was $300 to buy some pots and pans, and they apparently had great difficulty getting this sort of money. This kind of program -- it costs almost nothing; it addresses all the needs of seniors' well-being, like nutrition, social interaction and mobility -- is the very thing I think we're talking about when we're talking about community health. I wonder why it feels like that kind of program is not valued in the community. That is a concern, and I wonder if I could hear the minister's response.

Hon. J. MacPhail: Well, unlike the federal government, we truly do value the contributions that seniors organizations make. We're left once again in a situation where the federal government is opting out of all seniors program funding -- New Horizons. They've sunsetted their organization's funding, and we're being faced on a daily basis with organizations coming to us, saying: "The federal government is abandoning us. Can you help us?" We are working right now on a strategy to determine what, if anything, B.C. taxpayers can do with the abandonment of seniors by the federal government.

Let me just tell you what we do with our own tax dollars. Let's use the example of meals for seniors. We spent a million dollars -- $1,043,603 -- on seniors meal programs. That was last budget, and we've increased that in this budget. The cost is very effective, there's no question about it; the cost per meal is $1.16. We continue to fund those programs, and they are valued -- but, again, in the context of who best makes those decisions for funding community programs. Should it be us in Victoria, or should it be the regional health board and the community health council? I would suggest it should be the regional health board and the community health council.

Overlying all of this discussion is: how do we best cope with a federal government that has abandoned seniors in this province?

K. Whittred: I do not disagree with the minister's statement that these decisions are best made locally. However, I do have concerns, after talking with many of the organizations, that very important and crucial programs that are often small and often overlooked may in fact become lost in the shuffle as regions make their decisions.

I would like to ask a question now about the peer counselling program. This is a program that I believe was under the jurisdiction of the Ministry of Social Services. One of the things I discovered in my meetings was that it was recommended that this be moved to the office for seniors, and I believe that this has been done. I wonder if this could be confirmed.

Hon. J. MacPhail: I am well aware of this very valuable program, because I had an opportunity to meet with the senior citizens counsellors under my former portfolio. We are discussing the best location for this program. The criteria are based on the fact that we have to take an integrated and coordinated approach to addressing the priority needs of seniors. The whole goal of the senior citizens counsellors program is to make sure that seniors get assistance in accessing the services and benefits provided across government.

Ministries love this program, and there's pride of ownership in the program. But I expect that the discussions will conclude in an amicable way.

K. Whittred: I share the minister's enthusiasm for this program, because I too have heard nothing but good things about it. Perhaps it would be useful, in the interests of sharing and being helpful where I can, to share with the minister the particular reasons that the people I met with felt that it would be better served by being under the auspices of the office for seniors. It was a general feeling on the part of the seniors counsellors that by being in the Social Services ministry, they were somewhat out of the loop. They felt a bit isolated from other organizational and community structures that serve seniors' organizations. So I share that with you, for whatever it is worth.

Continuing with the peer counselling program, I wonder if the minister would state for the record exactly what the purpose of the peer counselling program is.

Hon. J. MacPhail: It's a counsellor program where seniors, on a volunteer basis in their community, work to make sure that the seniors in that community know what government programs are available and how best to access those programs for seniors across government.

K. Whittred: I would like at this time to again share just a little bit more information or input, if you like, that I had related to this. In discussion, some of the people involved in this program felt that there was a need for the mandate of this program to perhaps go a little bit further than it has -- into the area of being available when seniors had crisis situations and being available to help them access family, and perhaps more into an area that we would normally think of as a social service rather than an information service. I'm wondering what the minister's reaction to that is.

[3:15]

Hon. J. MacPhail: No, that's not the intent of the program. We do have crisis services for seniors in need of help. But these are volunteers that perform as I've stated.

K. Whittred: I think I have just about exhausted those areas that I wished to canvass. One last area that I will just mention to the minister and ask for comments on are those areas of federal jurisdiction that fall within the category of seniors and are of particular concern to seniors. These, of course, involve Bill C-91. I am very familiar with the minister's approach to Bill C-91, and, of course, all of those things and issues that surround the Canada Pension Plan, RSPs and other areas of economic security for seniors.

So my question to the minister in this area is: does the minister see it within her mandate to bring these matters to the attention of the government in Ottawa?

Hon. J. MacPhail: I'm sure your colleagues won't assume that was a lob to me -- a soft lob. And thank you for raising the issue.

Yes, I see it as my responsibility on behalf of not just seniors but all British Columbia taxpayers to bring to the attention of the federal government how damaging their law -- Bill C-91 -- is to British Columbians.

It costs $40 million per year in excessive drug prices in Pharmacare alone -- a direct result of the law of Bill C-91. I went to Ottawa, and I didn't say: "Get rid of Bill C-91, and get rid of the 20-year patent." We know that that's just simply impossible. That's setting ourselves up for failure. I went there and said: "Yes, keep your 20-year patent, but make it work in a way that's fair to taxpayers. Don't allow the 20-year patent to become a 25- or 26-year drug patent" -- which is what's happening now. We also gave some good advice, I think --

[ Page 3570 ]

and were actually carefully listened to by the standing committee reviewing Bill C-91 -- on how they could control excessive marketing practices which lead to overuse of drugs -- particularly by seniors. Unfortunately -- and I'm sure it wasn't my presentation that provoked it -- they called the election within days after that. We will await the conclusion of the federal election and once again start our advocacy on the issue of Bill C-91 on behalf of British Columbians.

In the area of pensions, yes, that is a very important item. It is on the agenda for the next meeting of federal-provincial-territorial ministers responsible for seniors -- which includes me. We also have a committee in British Columbia organized by the office for seniors that monitors all the changes and impacts to pension and retirement income legislation. And, of course, we work very closely with the ministry responsible for pensions in our government, which is the Ministry of Finance.

K. Whittred: I sort of walked into that one, didn't I? I didn't intend to provide the minister with a soapbox, but I am glad to hear that she is representing these issues with the federal government on behalf of seniors.

Just a couple of little things to conclude with. Of things I have noted that drive seniors crazy, one of them has to do with technology. A frequent complaint that I get often has to do with things like parking ticket dispensers, automated phone systems -- you know, the kind of phone number where you phone and have choice A, choice B, choice C and so on. And I simply pass along to the Minister Responsible for Seniors that this is an area that is very difficult for seniors. Many of them become extremely confused and therefore give up on the process.

Another one that I will pass on to the minister is the federal 1-800 number. There is apparently only one number to access for many, many seniors issues that relate to their old age pensions and benefits which, as you know, are largely federal. So perhaps I will leave you with that little bit of warm advice and leave that in the good hands of the office for seniors.

I have to leave in just a moment to catch a helijet for an event in North Vancouver. So thank you.

I. Chong: I just have a few questions for the minister. Although they have been asked by the member for North Vancouver-Lonsdale, I would just like more precise clarification.

On the issue of the adult guardianship legislation, which I understand was passed in July of 1993, and which I understand is going through a process for proclamation at this time . . . . I understand there are some seniors groups that are concerned about the representation agreement. If those concerns cannot be addressed, will that particular act be removed, rediscussed and dealt with in isolation from the proclamation of all four acts? Or how will you be proceeding with that?

The Chair: Hon. member, that is a matter of legislation, and it's not a subject for debate during estimates. You have to wait for second reading or find another opportunity to ask that question. But it's not a proper topic, as is demonstrated on page 138 of the rules.

I. Chong: Hon. Chair, thank you for the clarification. It's just that it had been brought up earlier. We had just discussed the matter of proclamation, it was clarified to us, and I just wanted further clarification. So if I'm not able to approach that subject, that's fine. I'll wait until I speak to the seniors groups and get more direction from them.

The other area I wanted to touch on, as well -- which the member had asked about and addressed prior to my speaking -- was the Seniors Health Promotion Network. I am clear on the fact that it was a volunteer group and that the budget of $325,000 was provided by the Ministry of Health. And, in fact, I was told that that funding had expired at March 31. The Minister of Health has just advised that the funding will continue and be passed on to the capital regional health board.

Can I confirm that that entire funding would be passed on? How will it be dealt with?

Hon. J. MacPhail: The $325,000 was the provincial funding. The responsibility for the program is being turned over to the regional health boards, and the allocation of funds across the province is to be determined.

I. Chong: Again, for clarification, I recognize that the $325,000 was the provincial funding, and that it will continue at this point. And the allocation of that $325,000 is all that we're talking about. Is that correct?

Hon. J. MacPhail: Well, I'm not even holding to the $325,000. There may be changes in that; there could be increases, for all we know. We are now figuring out where the money should go on a region-by-region basis or a community health council basis. Those discussions are ongoing.

I. Chong: I guess my concern is that, given the change -- and I know there has been a discussion at length on regionalization . . . . This is of primary concern to a number of seniors -- especially those that reside in my riding -- because a number of very small grants have been allocated. They were very prudent in what was being allocated to a number of groups which exist throughout the capital region area, in particular.

The concerns I received were, first of all, to ask and canvass the minister as to whether the $325,000 would be in place -- if it's greater, fine -- and if the allocation that will be passed on to become the responsibility of the regional health boards or the community councils . . . . If a particular group is not satisfied, is there any recourse, redress or appeal process that groups would be able to seek through the ministry? If the seniors' group felt that they were shut out . . . . As I have it, there are about a dozen groups that receive grants from the $325,000.

They're very concerned that they'll be lost in the shuffle and that regionalization efforts will leave them without representation.

Their concern to me, which I'd like the minister to give me some direction on, is: is there any kind of approach they could take, or are the capital health board and the community councils the only places they have?

Hon. J. MacPhail: They will be able to talk to the health board directly. That is the approach they should take if indeed their fears have substance. I would ask them to be patient, but they can appeal directly to the capital health board.

I. Chong: I thank the minister for that. I will pass that message on, because I know fears are perhaps premature sometimes. Again, they are seniors, and that's what they do concern themselves with.

The other area I want to ask the minister on, hon. Chair, is . . . . She mentioned that federal funding for seniors projects was being abandoned, yet my recollection from last summer is that there was a press release from Health Canada -- "New Horizons: Partners in Aging" -- that said funding of some

[ Page 3571 ]

$44,000 had been provided for a project. I'm wondering whether or not that is a project that the ministry also participates in and whether there was shared funding in place for the New Horizons program.

Hon. J. MacPhail: It was solely federal money.

I. Chong: The answer I'm hearing from the minister is that this was a program that was totally federally funded, and in fact it was a seniors program that was provided. So federal funding has not been totally abandoned by the government. Is that correct?

Hon. J. MacPhail: Well, if the member is trying to defend the federal government's record on seniors with this one, minute example, good. But they have basically sunsetted the entire New Horizons program.

I. Chong: I'm not trying to defend anyone; I just want clarification. The earlier comment was that programs had been totally abandoned, and I found this one particular one. I wondered whether there were more and whether or not the provincial government was also providing some matching dollars.

Another question I have is another concern that seniors have at this point. I am wondering whether the minister has . . . . I know I may be approaching the wrong ministry. Again, it deals with the issue of no-fault insurance and seniors. Has the Minister Responsible for Seniors looked at this issue in respect of how this may affect seniors?

Hon. J. MacPhail: That's future policy.

I. Chong: I thought that might be the answer, but I just wondered if there had already been any projects or discussions in place.

The other issue I'd like to quickly canvass -- and again I will see what the minister has to advise us on this -- is property taxation, which seniors are currently finding . . . . I realize that this has to do with Municipal Affairs; however, we're wondering if seniors have been able to speak to the minister. Is there any group or any branch of the ministry that they're able to approach? Seniors who are on fixed incomes and who are dealing with heavy property taxes due to increases in their values . . . . Has there in fact been any attempt for them to have consultation with the ministry to deal with that?

[3:30]

A lot of seniors do live in my riding, as they do in parts of the lower mainland, and they're not sure what ministry they should be dealing with. I recognize that property taxation is in the Municipal Affairs ministry, but again, because it deals with seniors, is there a particular branch of her ministry that has an opportunity to look into this area?

Hon. J. MacPhail: Well, this is a matter that my Seniors Advisory Council has addressed. They say that we need to make sure that all of our seniors are well aware of it and that there's public education about what is available to seniors in terms of the property tax deferment program run by our Ministry of Finance. In fact, that is not only a program where you can actually defer your taxes but there's also consultation available to seniors about whether it meets their financial needs and how to do it.

It's a matter of making the information available to seniors in order to make the proper decision and alleviate their own concerns. We do our best to advertise the program, and we'll continue to do so.

I. Chong: Those were the very few, brief questions I had on this particular subject area, and I thank the minister for her answers.

K. Krueger: One of the issues touching on the lives of seniors that repeatedly comes up in my constituency is the long lineups to get into the extended-care and medium care facilities as people reach that age. It's tremendously stressful on the seniors who need to get into those facilities and on their loved ones who try to support them. They sometimes find themselves dealing with their mothers and fathers, grandmothers and grandfathers through the last stages of their lives, when they're very ill-equipped to do so. People die in their family's home still waiting on those waiting lists.

That is the situation in the Kamloops-North Thompson and Kamloops constituencies. I'm not certain if it's a situation in most constituencies around the province. I wonder if the minister could please give me a status report on that situation and tell me about plans to remedy it.

Hon. J. MacPhail: I don't know whether the Blues are out from this morning, but we did have a good discussion on this matter of provincial wait-lists this morning. I ask the member to take the opportunity to read that, and then if there are further questions, I'd certainly be more than happy to answer them.

Very briefly, there's a provincial wait-list strategy. Seniors get to choose to be wait-listed for two care institutions anywhere in the province. The wait-list is established chronologically but also takes into account the special needs of a particular senior or person needing continuing care. That could be a change in health circumstances that requires the person to move up on the wait-list.

There are stats available by region, and I can make those available to the member.

K. Krueger: I spent some time travelling around my constituency with public health nurses who are involved in continuing care and, with the families' and patients' permission, sitting in on some of the interviews that are done to assess people as to whether or not they ought to be moving on into that kind of care. I've received distressed communications from these nurses concerning a recent Labour Relations Board decision that continuing-care nurses need not necessarily be registered nurses. I would appreciate an update on the status of that matter and what the government's intention is.

Hon. J. MacPhail: We certainly would never interfere with a Labour Relations Board decision. However, I believe the concerns raised by nurses to me directly around this matter have been addressed in the legislation that I tabled yesterday, and we can appropriately discuss that during that debate.

K. Krueger: That's good to hear, and that's what we'll do.

I have a concern with regard to the fact that the members of the regional health boards have been appointed. While many of them seem to me to be really good people, I don't know if their level of expertise is such that they are going to be able to deal with problems like the one I was just discussing in the same way as people who have spent a lot more time in

[ Page 3572 ]

their life preparing for that type of decision-making. I'd like to know about any concrete plans that the government has to actually build facilities or deal with improving the number of beds available to people in my constituency and elsewhere around the province for medium and extended care.

Hon. J. MacPhail: I will be making announcements very shortly on our capital investments for 1997-98. Capital planning for continuing care remains the responsibility of the provincial ministry, but we'll work in consultation with regional health boards and community councils.

K. Krueger: Eight months before the May 1996 provincial election, the minister of the day and the MLA for Kamloops-North Thompson, who was an NDP MLA, made a promise in Clearwater that a multilevel health care facility would be built that included the provision of beds so people could live out their lives in the community where they spent them with their loved ones. Of course, it's a bitter disappointment to people there that the facility isn't in place. In fact, it's far from it. I would appreciate an update on the status of that particular project.

Hon. J. MacPhail: In the meantime, we had an election where the issue of debt and debt accumulation was a primary focus raised by what is now the official opposition. At that time, there was a great deal made about the fact that our government had invested hundreds of millions of dollars in schools, hospitals, nursing homes, universities and colleges, and somehow that was considered a negative by the official opposition.

It became such an important issue that after the election, during which we listened very carefully, we put a freeze on all capital construction plans and did a complete review of capital construction. We made sure that we put in place all the criteria for justifying our capital expenditures across government, and we put in place some excellent further criteria for cost containment measures. That was a direct result of the last provincial election.

Hence projects such as the one that was announced in Clearwater have been confirmed, so that each and every commitment we made will be implemented over the course of the next four years. But the way we do that will be announced in the coming days by my ministry.

K. Krueger: With respect, the financial situation of British Columbia was known and understood, and it has been clearly documented by Treasury Board officials in documents that we obtained and produced publicly. It was documented well before the election. Nevertheless, a promise is a promise is a promise, and that facility was promised eight months before the election. It wasn't one of the $2 billion worth of promises made in the 60 days before the election. Rather, it was made as a result of careful consideration.

It was apparently a business decision that was taken well in advance of the election, so I would very much appreciate a specific date as to when the shovels will go into the ground in Clearwater to honour that promise.

Hon. J. MacPhail: Let me just take that as advice from the member for us to continue to spend on capital projects. I appreciate his advice to me, and an announcement will be coming shortly.

K. Krueger: My advice is to keep specific promises but not to spend money on fixed-wage policies and unnecessarily expensive ways of building capital projects without open tendering. If that advice could also be accepted, I would very much appreciate it -- and so, I think, would the taxpayers of British Columbia. People expect good value for the dollar. They also expect government to keep its promises.

In the matter of the seniors population, it is astonishing to people that it seems to have taken the government by surprise that there are presently so many seniors in our population. The continuing-care nurses I was referring to say that their cases are much more severe on average than they used to be, and they are expected to deal with a whole lot more people than they used to do. As the population has aged, the resources haven't been put into place to absorb the impact or to provide the same level of attention and care as was provided in the past. I'd appreciate the minister's comments on those points.

Hon. J. MacPhail: I understand the concerns of the registered nurses in terms of the appropriate staffing mix for continuing-care institutions. Our ministry staff are well aware of that and are working within the industry to resolve the issue. But certainly, staffing mix is an issue that needs to be addressed by the institutions themselves among the various professions that are affected by that.

Secondly, I would just advise the member that we continue to provide increased funding to continuing-care institutions where there has been understaffing, and we will continue that policy. We are also working as a ministry with the BCNU on a study regarding levels of staffing and the mix of staffing.

K. Krueger: I know that the minister is a compassionate person who cares about the individuals who are hurt by constrictions in the delivery of service. I hear of these cases, and I'm sure she does too.

One elderly gentleman had lived most of his life in Kamloops and was approaching the end of his life. In the last eight hours of his life, he had to be taken by ambulance to Ashcroft, because that was the only place where there was a bed for him. He died there, apart from his family, and it was extremely traumatic for the family. Really, it seems unfair to him, although I'm sure everybody was doing the best they could under the circumstances. That's why I hope that this particular problem is one that will receive a high level of priority from the regional health boards, and I hope that they have that direction from the ministry.

I had a constituent speak with me this past weekend -- and I've had a number of them over past months -- about the reference-based pricing policies. I understand the rationale for them. This gentleman said that because of the medication change that was attempted with his wife as a result of that policy, she ended up in intensive care for ten days because of a bad reaction to the new medication. I'd ask the minister how common that type of problem has been with the reference-based pricing policy.

[3:45]

Hon. J. MacPhail: There are two ways in which we accumulate the statistics around this. On the special authority form on which a doctor has the authority to just submit a request for the drug, there is an area to say whether there's an adverse reaction to a drug. But more importantly -- and I would hope that the member would bring this advice back to the constituent -- the doctor is also required to report this information to the College of Physicians and Surgeons, who have been charged with monitoring this issue. To date,

they

[ Page 3573 ]

have received no reports such as the hon. member describes. So I am very interested in him, if he could, making sure that the patient's spouse asks the doctor to report this to the College of Physicians and Surgeons, because certainly to date there has been no report.

K. Krueger: I will do as asked. I wish to speak with the minister later in these estimates about other matters, but for the time being my colleague from Langley would like to ask some questions on seniors issues.

L. Stephens: I would not like to go over a lot of the ground that colleagues have gone over. There's been quite a bit of canvassing of different issues. I do want to have on the record a few things around mental health that are in my particular constituency and of concern to me, but they will be primarily for the minister's information. I'd like to start with the issues in the constituency, and then I'd like to go into women's health issues, which are broader and in the more provincial arena.

The one thing that has caused us a great deal of consternation, if you like, is the flesh-eating disease cases that have occurred in Langley. I know that there's been an inquiry into why there are so many cases in one spot and that they haven't been able to find anything at the moment. It's reported that the health officers are considering making it mandatory for all health professionals to report cases of flesh-eating disease and infections associated with it, such as invasive streptococcus A.

I wonder if the minister is giving direction of some kind on that particular initiative and whether or not this is something that should be pursued. For us in Langley -- I would encourage the minister -- this is a serious issue.

Hon. J. MacPhail: The direction that I would follow on this would be to receive the advice or the recommendation from the B.C. Centre for Disease Control or the provincial health officer. Then I would be prepared to immediately act upon their recommendation to me.

I certainly sympathize with the community around this matter and was pleased that our B.C. Centre for Disease Control took such quick action to have a national conference on this issue. Of course, it has been publicly reported that they came to the conclusion that the cluster of disease was unrelated. Nevertheless, they will continue to explore the matter. If they come to the advice that this is a reportable disease, then I will certainly act on that.

L. Stephens: That is comforting. I wanted to bring that to the minister's attention, because we will be monitoring how that particular process is moving along and whether or not the health officers are going to be looking at it seriously.

I want to just briefly talk about mental health. Again, on the record, our particular community is very concerned about the government's decision not to cover olanzapine as a first-line treatment and to withdraw risperidone from its coverage -- again, for all of the reasons that previous members have talked about. It seems to be a consensus that communities and those in mental health that have had a long history of dealing with those disorders believe that these two initiatives deserve a second look.

Again, the Schizophrenia Society in my community is very concerned, particularly about keeping its youth safe. That brings up housing. Something that I'd like to know is if the minister has any initiatives to expand safe and secure housing, particularly for young adults that suffer from schizophrenia and bipolar disorder.

Hon. J. MacPhail: In fact, we had a very good discussion on olanzapine and risperidone. I know the member is well aware of that. We will continue to make our decisions based on the best evidence available; we will continue to review the evidence and will change, if needed, based on the best evidence available.

On the issue of housing for people with mental illness, we are in the process right now of investing $2.2 million this year, which will be spent in a variety of ways. Initially, there will be 200 more independent supported units available for people with mental illness. Beyond that, there will also be money available for support services in the community as they live independently. Lastly, we're also working with the B.C. Housing Management Commission, investing health care dollars to ensure that the new policy of priority placement in BCHMC housing being given to people with mental illness does occur.

L. Stephens: Could the minister just indicate to me where these 200 more independent supported units would be was canvassed? If all of that was taken into consideration and talked about, I will look up those conversations in Hansard . If not, I would like the minister to say where those units will be. Is there going to be an allocation around the province in any sort of equitable way? Will they be run by non-profit societies? All those issues around that . . . .

Hon. J. MacPhail: No, we didn't actually have a discussion about how the beds will be allocated initially, but they are allocated on the basis of need. That means about 120 to 130 are in the lower mainland, and the rest are allocated throughout the province.

There will be a combination of methods by which supported independent living takes place. The model that seems to be working very effectively is market rate -- market housing -- but with support services in place to accompany the person. It's market rate, but with a subsidy to the person and staff support as well.

L. Stephens: Has this particular initiative been announced, or will it be announced soon? Could the minister indicate where I could get more complete information on what this will entail?

Hon. J. MacPhail: Actually, I announced it, not in a news release but to the community -- to public mental health. Certainly the Canadian Mental Health Association, B.C. division, is making sure that I do my job. They have the information, but I could make it available to you in a detailed way, as well.

L. Stephens: Thank you for that information.

The other issue that's important to our area is case management -- the resources for case management to help individuals determine where their best interests lie, as far as treatment and accessing services. Is that going to be a function of the regional health boards? Now, I understand that the union boards of health are being folded into the regional health boards. Would that be an issue that the regional health boards would have to deal with? If so, what would be the process or the mechanism for mental health to bring forward those kinds of issues?

Hon. J. MacPhail: I believe the member is asking about case-managing for people with mental illness. The mental

[ Page 3574 ]

health workers will be the responsibility of regional health boards and community health services societies, and there will be coordinated case management. Also, we had a good discussion yesterday about how that coordination, when we're talking about children, will take place with the Ministry for Children and Families.

And yes, the union boards of health have been transferred to the regional health boards and community health councils. I'm pleased to say there's excellent representation by union board members on the current regional health boards and community health councils. Union boards of health provide an invaluable service, and that contribution will continue through the regional health boards and community health councils.

L. Stephens: I know there was discussion the other day around bulimia and anorexia, which are two illnesses that I think are becoming much more common and that certainly seem to be on the increase. I know a discussion was had by a number of members around that particular issue, but I would like to highlight for the minister that I think it is one that we need to pay particular attention to, particularly with our youth. There needs to be some information and educational initiatives in that direction -- perhaps also educating adults, parents, as to what to look for, what signs to look for with their children.

I know a couple of young girls who have anorexia, and it's really quite devastating for the families and even friends.

The other issue that I'd like to talk a little bit about is the provincial health officer's annual report. This is the '95 one; the '96 isn't out. When he was making some recommendations around mental health, he talked about restoring and maximizing the level of independence and quality of life for women with mental illnesses. His recommendation was to "improve reporting of population mental health status and effectiveness of mental health services." I wonder if the minister could talk about whether or not a baseline has been established for women with mental health and whether there has been an improved delivery service for women with mental health problems.

Hon. J. MacPhail: Yes, we do keep a database on people with mental illness, and that information is available. I'm sorry that I don't have it with me today, but if the member would like me to report later to the Legislature on that, I will. Of course, I am pleased -- this has been an unheralded announcement, too -- with the putting in place of plan G under our Pharmacare program, which covers drugs for people with mental illness, and that's good news as well. But on the statistical, if any, increase, I'll have to report later.

[4:00]

L. Stephens: The other issue he highlighted was that there needs to be an increased access to and responsiveness of clinical care for women with acute and/or persistent mental illness. He talks about there being no current baseline -- that was in '95, so perhaps it has changed -- to measure client satisfaction and to determine whether or not there are appropriate levels of mental health care and particularly emergency mental health care for women in communities.

Hon. J. MacPhail: We've had a great deal of discussion on the performance measures we're putting in place in the acute care hospitals, which include patient satisfaction and health outcomes. And indeed, the same performance measures will apply to our mental health system, as well. So those will be the indicators. As we regionalize, the performance indicators will be based on the recommendations of the provincial health officer.

L. Stephens: One of the other issues that comes out of mental health and women is that many women -- a third of the women -- who require mental health services are women who have experienced violence, and these require some specialized programs. I know that the women's bureau in the ministry has made some progress in this regard and has put together some programs. I wonder if the minister could talk a little bit about whether this is being expanded and if there are going to be some extra services and extra facilities around women who have experienced abuse and violence and who are requiring mental health services.

Hon. J. MacPhail: Yes, we did discuss the Stopping the Violence programs. The Ministry of Women's Equality is coordinating those programs. They work very closely with our women's health bureau and also now the health authorities -- it was just in the individual communities, but is now through the health authorities -- to implement those programs.

The details of the programs that are in place, how they address the concerns . . . . I mean, they're certainly inclusive and integrated programs. But if the member is asking if there are any Stopping the Violence programs targeted specifically at women with mental illness . . . . Oh, okay, she's not asking. Within the context of the Stopping the Violence programs, there is a mental health component to each and every one of them and advice on mental health issues.

R. Kasper: I appreciate the opportunity, actually, to ask a couple of questions during the minister's estimates. It deals with the whole question of the practising of medicine in the province, and the main issue that I've encountered in the past few weeks deals with our Member of Parliament, who actually practises medicine part-time while still collecting a full-time salary as a Member of Parliament. The questions I have relate to the whole issue of the right of a physician to practise medicine in the province and to maintain their billing status.

Since this individual is a Member of Parliament, are there provisions in our billing practices for them to take a leave of absence so that they can still practise medicine upon completion of their duration as a sitting Member of Parliament?

Hon. J. MacPhail: The policy is that a physician can be out of the province for two years and not have their billing number affected, and after that they have to apply for an extension of that right beyond two years. Certainly if there is any question around this, the matter can be referred to the Medical Services Commission for review.

R. Kasper: I'm glad to hear that answer, because that's contrary to what I've been hearing publicly. This particular individual has billed the system in excess of $60,000 over the past two years and claimed that he had to do so in order to maintain his status as a practising physician in the province. But he had previously billed in the other years and had practised medicine on a continuous basis. So I find it odd.

But more importantly, what I find odd is that this individual happens to be the strongest advocate within the Reform Party of Canada, who's out there doing his utmost, to do away with our health care system in Canada -- and in British Columbia, in particular -- advocating a two-tier system. I find it totally hypocritical and ironic that this individual has been double-dipping into our health care dollars while the federal

[ Page 3575 ]

government has been cutting in excess of $300 million to the province of British Columbia over a three-year period -- dipping into our health care dollars in order to feather his nest, to practise medicine. In the event -- and I'm sure he's hoping -- that a two-tiered health care system would occur -- over my dead body -- he'd like to be there front and centre so that he can collect his gravy train and continue to do so.

Another concern I have is that this same individual has a licensing authority to practise medicine in the United States. Not only does he have the opportunity to practise medicine in this province, in this country, he also has the opportunity to practise medicine in the United States, which clearly demonstrates to me that his concern is for a two-tiered health care system. So that he can be in line . . . . He's already been groomed by our neighbours to the south as to how they deal with health care issues and those concerns.

[P. Calendino in the chair.]

I think it's important that we get this on the record so that the minister knows that these kinds of activities are occurring -- that there are advocates within the system who are pounding their desks, not only in the offices where they're practising medicine as doctors, but in Parliament in Ottawa, where they're demanding that we restructure the health care system so that they can have a two-tiered system. Individuals, for him . . . . And his attitude is very blatant.

He says: "Those who can afford to pay should go to the front of the list." I hope that the minister could at least comment on our concerns, the government's concerns, about preserving our national health care system in Canada and, for that matter, British Columbia.

Hon. J. MacPhail: This matter -- the preservation of universality in our health care system -- has been a major topic of discussion throughout these estimates. Frankly, there is a lack of understanding about what universality means and about the fact that the federal government only considers the universality of medicare to cover physicians, who are treated very specially in our health care system, and hospitals. Beyond that, the contribution to the rest of our health care system is strictly from B.C. tax dollars. So it is an important topic of discussion, and it has been laced throughout our discussions in estimates.

I am concerned about those who would advocate a two-tier health care system. Certainly our public has considered that and has discarded the idea completely and without hesitation. There is absolutely no support amongst the public in British Columbia for a two-tier health care system. We have recognized that public point of view by incorporating in provincial legislation, under our Medicare Protection Act, the five principles of the universality of medicare. We are the first and, to date, I think we continue to be the only province that has done that.

I am concerned by those who are within the system and benefit by the system through earning wages from the publicly funded health care system. I am concerned by those who would advocate anything other than a universally accessible health care system that is based on need for health care and not on the size of your wallet. So let me reassure the member that there is continuing and unfettered commitment by the NDP government to a universally accessible, single-tier health care system.

M. Sihota: I just want to make a few comments on that same issue, because Dr. Keith Martin, to whom the hon. member just referred, is also the Member of Parliament for our area, representing the Reform Party. And I have to tell the hon. minister that people in my constituency are absolutely outraged that on one hand he can collect the part-time salary as an MP, and at the same time continue to bill the Medical Services Plan here in British Columbia and engage in his own form of double-dipping -- I think somewhere in the neighbourhood of $60,000 over the last two years. They find it absolutely outrageous.

It's no wonder -- and they find it even more outrageous -- that he takes the following position, which he enunciated on June 13, 1995, in the Medical Post publication and which I want to quote. He says:

" . . . those people who can afford private treatment should be allowed to have that treatment here in Canada and not have to go to other countries, taking Canadian dollars with them . . . . It will be argued that such a two-tiered system would provide superior services to those that can afford it. Of course it will . . . . "

"Of course it will" -- those are his words. So we have someone in the House of Commons today advocating a two-tiered system like the United States, just as Reform here in British Columbia would . . . .

Interjections.

M. Sihota: And I hear them now coming to the defence of their colleague, acknowledging that it's going to cost Canadians more.

I think it's important that all members of this House make it clear that it's absolutely unacceptable to Canadians that there be a two-tiered, USA-style system and that this kind of double-dipping occur. I would hope that the minister would concur that this is a rather shameful attitude on the part of that Reform MP.

B. Penner: I'd just remind the members opposite that the nomination . . . for the federal election.

I seek leave to make an introduction.

Leave granted.

B. Penner: It's my pleasure to introduce today two people who are visiting the Legislature: Dr. Soledad Tossell from Chilliwack and her friend Dr. Lane Scott, who, interestingly enough, is a physician visiting us today from the United States of America. He's listening with interest to this debate on health care issues in our province. Would the House please make them welcome.

M. Sihota: Point of order. I notice that the member for Chilliwack was up in the galleries, and perhaps he may want to acquaint himself with the traditions with regards to strangers in the House.

The Chair: Point well taken.

[4:15]

R. Neufeld: Well, it's interesting to listen to the federal election take place within Ministry of Health estimates in the B.C. Legislature. I've never seen anything . . . . If you want to talk about gross, if you want to talk about being out of line, if you want to talk about doing things that you shouldn't do in the House, which the member for Esquimalt-Metchosin just talked about . . . . He should listen to his own words. My goodness gracious, there's a federal election happening out

[ Page 3576 ]

there, and if the government of the day wants to move itself out of here and go electioneer for all those NDP candidates in British Columbia, then just get at it. Why don't you just recess the House and go out? Both of them from Esquimalt are guilty. To come in here . . .

The Chair: Excuse me, member. There is a point of order.

G. Janssen: We are discussing the estimates of the Ministry of Health, and the member clearly . . . .

The Chair: Member, just a second, please. Give me a chance to recognize you.

The member for Alberni on a point of order.

G. Janssen: I ask the Chair to bring the House to order. We are discussing the Ministry of Health estimates. Clearly, if the member for Peace River North has a question on Health estimates and has some discussion, I ask you to have him direct those to the minister.

[4:15]

R. Neufeld: Well, if the member for Alberni will just listen for a while, he'll get a question on Health, which has not come forward from either the member for Esquimalt-Metchosin or the member for Esquimalt, Malahat . . . . Where is your constituency, anyhow? Where are you?

Interjection.

R. Neufeld: Malahat-Juan de Fuca. There you go.

Hon. Chair, we're talking about a two-tiered health care system. I find it very interesting when two members from Vancouver Island, who happen to be in a constituency where they've got a buddy who's fighting against Dr. Keith Martin in a federal election, stand up and blast the Reform candidate in the federal election over health care. When those two members live in the part of British Columbia that enjoys the best health care that British Columbia can offer . . . . The best health care that British Columbia offers is right here on the point of this island.

You have every service available to you, whether it's in health care, whether it's in social services, anything. You have number one. In the north, we have two-tiered health care. We have two-tiered health care in the north, and we have had for as long as I've lived there -- and it's been awhile. So I want to know how the minister intends to deal with two-tiered health care in the constituency of Peace River North. That's one question.

Secondly, in response to the member for Esquimalt-Metchosin, when he talks about Dr. Keith Martin double-dipping and practising medicine . . . . How about the member who used to sit in this House as a provincial NDPer, Mr. Bernie Simpson, who had a business that made millions out of suing ICBC? He made millions -- Bagman Bernie -- out of suing ICBC, and that was all right. But I can understand that, coming from that gentleman. Has that minister -- or the used-to-be minister . . . ? I guess he created so many problems in the government that he got fired out of every portfolio going. He comes along and starts talking about double-dipping.

But I'd like to know how the minister intends to deal with the two-tiered health care that we experience in the north.

We have taken several initiatives. There's the northern isolation allowance paid to health care providers. There's also our physician supply measures that have recently been implemented -- and are controversial. There's no question that amongst certain groups of physicians, the physician supply measures, which we have recently introduced in legislation to deal with the issues that the member brings forward, will be controversial. But we have taken, really, the bull by the horns and have implemented them in legislation, even though we know that people will protest our physician supply measures.

We also have an education program through the UBC school of medicine now to work with educational institutions in the north to do physician training that's never been done before. And that is so that people can receive their medical training in the community, in the northern areas, and therefore perhaps reside in those communities after their training is complete. That is meeting with a great deal of success, and I'm now working with the UBC school of medicine to discuss how we can further expand that program.

We have in place the travel assistance program for patients in rural and remote areas to assist them with travel. We also fund our health care system on the basis of where the treatment is given and not where the patient or the health care consumer resides so that there is equitable distribution and access to the services, even though the services may not be located in the person's own community. These are not issues that are unique to British Columbia, and I know the member is aware of that. And in fact we have spent a great deal of effort investing in trying to balance the needs with the resources available.

We have recently put in place the teleradiology project, and the member's own community is affected by that. The project is working extremely well. If the members are not aware of the northern teleradiology project, I would be more than happy to go on at length about its success.

We will continue to grapple with these issues, and we will continue to treat them as a priority.

L. Stephens: I would like to congratulate the members for Peace River North and Peace River South for the representations that they make to this House for their communities. As the northern members -- there's the two of them -- I think they've done a fine job in representing their communities.

As the minister very likely knows, a number of the official opposition were on a northern tour and visited the member's community and some of the other communities in the north. There were a lot of health issues that came forward and were discussed by those people in the communities.

[ Page 3577 ]

One of the areas that we're going to be talking about a little later on that I would like to talk about is the B.C. reproductive care program, which relates very much to what is happening in the interior and in the northern part of the province.

But for now, there's one final comment I want to make on the mental health services, and that is that I understand there is an interministry committee which does look at the issues around the Stopping the Violence program, and that includes mental health, social services, Women's Equality and the Attorney General ministry. The Attorney General was not aware that there was an interministry committee, so I would like to ask the Minister of Health if that in fact is the case and whether or not her ministry is represented on that committee.

Hon. J. MacPhail: Well, if this is a test, I don't have the answer immediately. I don't know whether we sit on a committee or not, but we sure work . . . . We are integrally involved with the delivery of these programs.

L. Stephens: What we will be doing is making sure that we monitor very closely this government's involvement and those areas in the communities to make sure that mental health services are in fact delivered, as this government talks about.

One of the other areas that we need to talk about is community services. Again, I want to just flag these issues for the minister. The continuing care in the communities really isn't there. The hospitals are really concerned about discharging people into communities, because the supports for the families and the patients aren't there. This is why many people end up back in the emergency ward or back in the hospital again.

What the hospitals are telling me, what my hospital is telling me, is that they are becoming very concerned. When they discharge a patient into the community, they are not comfortable that that particular individual is in a safe environment, that the people who are looking after that individual know what they're doing and that the community support is there. They're concerned that the individual will end up back in the hospital again, sicker or in more distress than when they were discharged -- or certainly more than when they were admitted the first time. So those are issues I want to highlight for the minister.

Also, lack of availability of acute care beds is becoming a serious problem. There doesn't seem to be recognition that we have a significant population that still requires acute care beds. And we're not past the point where individuals coming into the health care system are in on the preventative side and are more healthy. We still have a significant number of people coming into the health care system that are acute and need acute care beds. The congestion in a number of emergency departments around the province, I think, will attest to that. I'm sure if the minister has spoken with emergency staff, they will probably tell her the same thing.

So those are the issues I want to convey to the minister that I'm sure she's hearing from a number of people.

Home support is another area. Again, this primarily affects women. Women are the primary caregivers when they are faced with looking after family members who need medical care or need support. Also, 99.9 percent of home support workers are women. This is an area which has a huge impact on women and women's lives. And when funding is cut -- as it has been -- and when the initiative is taken to move people out of the hospital much more quickly to go into their homes again, this has a huge impact on women.

What I would like the minister to address is: what kind of a structure is in place, or what kind of initiatives is the ministry bringing forward around funding and the structure of home support?

Hon. J. MacPhail: We increased funding by 5 percent this year, and that was after an increase last year. The overall community continuing care budget has increased by $569 million since 1992.

If I could, I'd like to commend the member for putting this in the context of a women's issue. I agree -- I totally agree -- that it's a women's issue, and fair wage is certainly part of that issue for community health care workers, particularly home support workers. It is a matter of controversy right now, in that the industry and the unions representing workers are taking strike votes. I am certainly aware of the issue of fair wage for home support workers.

But I also want to note that giving proper recognition to the value of the work done requires substantial tax resources. We've had discussion about this before in this House. I do say this with the greatest respect to the member for Langley: we can't say at one point that the way our government could resolve every single health care issue is by refusing to pay a decent wage to the health care workers -- and by attacking us giving proper wages to the health care workers. They are integrally involved; they're the same thing.

When you deliver proper health care services in an industry that's 80 percent labour-intensive, by the nature of that you have to talk about wages -- and an adequate wage. I believe that the member opposite recognizes that. But it does cause me some trouble when every single solution by some members opposite is offered by saying: "Cut the wages of the workers providing the health care services, and then you'd have enough money to deal with wait-lists."

[4:30]

L. Stephens: I believe that this whole issue of wage parity is an enormous problem for the Minister of Health, for a variety of reasons. One is that the acute care facilities, as the minister knows, received a wage increase, and then the community care sector was left with no money. There is, from all accounts, a huge cash flow problem with the government, particularly with the health industry. So the minister has serious problems on this front. It'll be interesting to see how it's all resolved.

There's no question that my focus and interest are on women, both the caregivers . . . . And by that, I mean women who are left in the home to look after their sick husband or their sick daughter or their disabled son, or whoever it may be, without adequate and proper community supports there for them to rely on. Moving care facilities from the acute care setting into homes, where there isn't any support for individuals, is a very serious problem. That's the issue I really want to address: how are New Directions or Better Teamwork, Better Care making that transition from the acute care hospital into the community in a way that is meaningful and appropriate for people in their homes?

In this particular instance, I really want to focus on the women who are left in the homes to look after their family members, and how they are going to cope with these changes that seem not to have found any kind of resolution around moving from acute care into the communities. I'd like the minister to address that problem.

[ Page 3578 ]

Hon. J. MacPhail: Yes, and we've really had good discussion, led by the member for North Vancouver-Lonsdale, on this matter. So again, I'll refer the member to Hansard . But let me summarize our discussions quickly, if I could.

There is substantially increased funding for continuing care -- which includes community care, home support services, respite care and Meals on Wheels. All of those programs have received substantial increases in funding. We've also more carefully directed our dollars in a way that actually meets the needs of the patient that the member describes.

In previous years much of our community care or home support dollars went toward providing housekeeping services that were not health care-related. We changed the criteria, and now we have a few fewer clients -- even though there are tens of thousands served every month. But there are many more hours of service being delivered to the clients now for their health care needs, to alleviate the family situation -- just as the member described.

We have also said to regional health boards: "You must integrate these services now. You must not say, just because a patient leaves an acute care institution, that somehow it's somebody else's responsibility and we have to start from Ground Zero in dealing with this patient." The health authorities will be required to integrate services. I personally know that there are regional health boards that are coming up with some very substantively creative ways of integrating those services, up to and including the community support service agencies right on the site of the hospital.

Also, there are other methods by which we will integrate services so that the continuum of care is provided not only for the patient but also for the family.

L. Stephens: As the regional health boards progress and work through their management plans and as those kinds of programs reach out into the community, we will be watching to see that, in fact, those programs are integrated. Because I agree with the minister that that's what has to happen, and hopefully, it will happen.

I'd like to leave the local community for now -- other than, when we get to facilities, there are some things I'd like to talk about with the capital program, which I understand we'll talk about a little bit later.

I'd like to look at some of the leading causes of death for women, and I only have the stats for 1994. Cardiovascular disease is the leading cause of death -- heart attacks and strokes -- for women now, and lung cancer. All of these particular diseases can probably be traced back to smoking. I know the government has taken a strong stand on developing programs for smoking and is trying to provide information and education around those kinds of things. I wonder if the minister could perhaps update us on what is happening around the smoking issue.

Also, perhaps first of all, I'd like her to talk about cardiovascular diseases and lung cancer -- those two specifically. Aside from the smoking campaign, I'd like her to talk about what she's doing around prevention, screening and diagnosis, treatment information and support, and research around cardiovascular diseases and lung cancer for women.

Hon. J. MacPhail: I am pleased to be able to cite examples from the health care system. I take only minimal credit for it as a government, because really, the successes are out there in the community -- our world-renowned researchers in this area and our health care professionals providing these services.

I'm just going to do this off the top of my head, but I will provide even more detail if the member requires it. In the area of cardiovascular disease, we have recently funded a $500,000 study that will be done by the Heart and Stroke Foundation -- to do a public survey of all the issues around the causes and effects of heart disease, a really in-depth, personal study on what the health care issues and the lifestyle issues are that lead to heart disease in individuals. It will be related to tobacco use as well, and will survey very carefully the effects of tobacco advertising on young women, in particular.

We also have just opened up the heart centre in St. Paul's Hospital, which already has a world-class reputation as not only illness-focused but prevention- and wellness-focused as well. I would be pleased if the hon. member would like to visit the program, because it is truly wonderful. When I was there, I visited the wellness section. There was a range of adults from young to quite old in the wellness program, which incorporates exercise and dietary advice as well -- and many lifestyle issues that of course contribute to this number one cause of death, particularly among women.

In the area of lung cancer -- again, I'm not a health care professional -- I feel that I've received some of the best advice possible from our B.C. Cancer Agency and the B.C. Cancer Society as well. The contributing cause for lung cancer is indeed smoking. In the very next few weeks, the members of the House can expect a very comprehensive announcement by our government around a tobacco reduction strategy.

I also was pleased to be informed by the head of the B.C. Cancer Agency just last week about leading-edge research and treatment of precancerous lung tumours. I'll just take the opportunity to announce their good news. They have developed breakthrough research in laser treatment of precancerous lung growths, I believe. They can examine high-risk patients for these precancerous growths, thereby treating them and then giving some very serious lifestyle-change advice for the patients affected.

That's just the general thrust, but if the member would like, I could also spend a great deal of time on the issue of tobacco use.

L. Stephens: The program that the government has initiated around the anti-smoking campaign was going to focus on teenage girls particularly. That's an area that showed a significant increase; teenage girls had a significant increase in smoking. Has that been effective, or has there been any ability to do any measurements at this time? Could the minister talk a little bit about how she is focusing that particular program? Is it in the schools? I know there has been some advertising on television, but I'd like to know whether there has been any measurement of any success rates or whatever.

Hon. J. MacPhail: Indeed, the member raises a very important issue. Success has been reversed in the area of tobacco use; indeed, where the rate of tobacco use was falling, it is once again rising among certain sectors of our population. The member is exactly right: the greatest increased use is amongst young women -- teenage and young women. It is very disturbing. We have targeted our program, really, so that the main thrust of our tobacco reduction program is aimed at young women, although we do have other programs for the general population as well.

A successful program is the Knowledge Network's "KidZone" series, which is targeted very specifically at tobacco use by youth, and actually deals with strategies on how to get youth, in their own environment-friendly way, to

[ Page 3579 ]

stop smoking. We also have an overall tobacco reduction strategy that is targeted very specifically at smoking prevention programs for children, youth and young women, and that is delivered through our education system.

We invest in conferences. Just very recently, we invested $6,000 towards a conference that's targeted at 12-to-14-year-old students. Its very specific focus is problem-solving, healthy lifestyles and the prevention of substance misuse. The students will be trained how to initiate tobacco reduction activities and education within their specific schools.

Let me just bring one other program to the member's attention. There are numerous programs in place, but the Canadian Cancer Society, through the B.C. division, is expanding its demonstration projects for women, which are used to develop, implement, monitor and evaluate tobacco prevention and cessation programs for prenatal and postnatal women, low-income women and women in the workforce. Actually, we've recently given more money to the Cancer Society because those programs have proved to be very effective. Again, I would just offer that that's what our record is to date.

But the members of the Legislature can expect an announcement of expansion of a whole tobacco reduction strategy in the upcoming days.

[4:45]

[G. Brewin in the chair.]

L. Stephens: Could the minister break down the budget for this year that the ministry will be setting aside for this teen smoking initiative in the education system, or wherever the money is going to be coming from? Is it coming from the minister's budget, or is it coming from the Education budget? Does the minister know how much it is?

Hon. J. MacPhail: There's a $2 million tobacco reduction strategy that's funded by my ministry, some of which is used to fund programs in schools. But I will certainly make the Minister of Education, Skills and Training aware that he may be asked a question of whether they have programs on their own.

Let me just give you some examples. There's the $500,000 that went to the Heart and Stroke Foundation, which I've just talked about, and $250,000 is allocated to a public education program on environmental tobacco smoke. Over and above the $500,000 to the Heart and Stroke Foundation there's another $120,000 that goes to them for the tobacco reduction strategies they have in each region. There's $24,000 to the North Shore health department for a research project on the impact of a comprehensive program on smoking uptake and cessation in the school-age population.

I referred to the Canadian Cancer Society conference funding. Those are the major examples of the current funding for the tobacco reduction program.

L. Stephens: Part of the anti-smoking campaign involved a prohibition on selling cigarettes to people under 19, and there are penalties involved if retailers are caught doing that. Could the minister provide a number that has been received by the government by way of penalties? How much money has the province received by way of penalties, and how many retailers have actually been charged with selling tobacco to individuals under 19?

Hon. J. MacPhail: The member is right; our Tobacco Sales Act prohibits the sale of tobacco products to persons under 19 years of age in British Columbia. I'll just give you the details of the program. To date, 14,500 routine visits have been carried out to more than 7,000 tobacco retailers throughout the province to ensure the enforcement of this legislation. More than 300 stores have received ticket fines, and under the Tobacco Tax Act, 15 retailers have had their authority to sell tobacco suspended. That was at the end of the last fiscal year. We continue to make this a priority in the enforcement of this very important legislation.

L. Stephens: Of those retailers who were charged, convicted and fined, could the minister give me a number on what those fines amounted to? How much money was paid to the ministry or the provincial government or the treasury or whoever for those infractions?

Hon. J. MacPhail: I did make a public announcement on those. The Ministry of Finance collects the fines and will have that information, so I could prepare the Minister of Finance for that question. But over and above tickets, retailers actually had their licences withdrawn, as well, and suffered a substantial revenue loss because of that.

L. Stephens: The other question that I have is: what is the cost of this enforcement program? Is it borne by the Ministry of Health? What would that cost be for the last year? What does the minister anticipate the cost of that enforcement to be for '97-98?

Hon. J. MacPhail: For the last three years this program has been jointly funded between our province and the federal government, and has cost $1.2 million over the three years. The program will now be part of the health authorities, and they have been directed by the Ministry of Health to continue to make this an enforcement priority. I will just say that a few months ago I was very concerned that the federal government may not continue its joint funding of this program. I certainly have encouraged the Minister of Health that this should be a priority.

We have had unofficial word that they agree and will continue the funding. But I'm anxiously awaiting the conclusion of the federal election so we can have that formally confirmed.

L. Stephens: Is the joint federal-provincial funding part of the overall social transfer tax initiative, or is this dedicated funding? Is this a dedicated federal-provincial program, and as such does it have a dollar amount attached to it? If so, what is the provincial share of the money they are actually spending on this enforcement program?

Hon. J. MacPhail: The enforcement activities are through staff. I can get the information about the number of FTEs that go into enforcement provincewide.

L. Stephens: So when the minister says that this is a joint federal-provincial initiative, what she means is that the moneys used come from the provincial transfer payments. Is that correct?

Hon. J. MacPhail: There is a separate agreement, a joint agreement. Under this agreement the federal government has contributed $1.2 million over the last three years. The joint agreement is for us to enforce both the federal legislation and the provincial legislation. So, in effect, the federal government is paying us to enforce its legislation as we enforce ours. We match their dollars in kind, through the staffing resources, to enforce both pieces of legislation.

[ Page 3580 ]

L. Stephens: That clarifies things considerably. I'll make a brief comment about the smoking issue, because it does have serious consequences not just for women but for men, as well, and for children. The more we can do to develop appropriate and effective anti-smoking campaigns, the better off we all are.

I'm going to move now to another initiative, and that's breast cancer. As the minister knows, British Columbia has the highest incidence of breast cancer in Canada. I'm probably going to give the minister another opportunity to say all of those great things that her government and ministry are doing on behalf of women and breast cancer. There have been some good initiatives come forward: the expansion of the mammography services is one, and the grants program to assist breast cancer support groups. But there needs to be a lot more done in this area.

I wonder if the minister could talk about what her ministry has planned for the coming year around breast cancer. I understand there is a pilot program to streamline the diagnosis of women who have questionable results. Presently they have to wait sometimes up to two months before they get notification of whether or not they need further treatment. So I'd like the minister to talk about that particular pilot program and then perhaps whatever other initiative is included in her '97-98 budget around the breast cancer issue for women.

Hon. J. MacPhail: The program to which the member refers is the provincial breast assessment and diagnostic partnership program. It began operating last November, and it's funded by the ministry. The objective of the pilot project is to shorten the time a woman with an abnormal mammogram must wait for a definitive diagnosis, from what was an average of nine weeks to about 72 hours.

It's located at B.C. Women's Hospital and Health Centre, and the hospital works in partnership with the B.C. Cancer Agency and the screening mammography program of B.C. It does provide interdisciplinary care as well as counselling and education about breast health. Clinical and diagnostic assessment takes place three mornings per week with a nurse, clinician, mammography technologist, radiologist and/or surgeon present.

I have heard back directly and very gratifyingly from people who personally have been affected -- and their families who have been affected -- by this very successful pilot project. Certainly I know that I'll cause some gasps around here, but it would make sense for us to expand as the pilot project reaches its conclusion and meets and -- what I will hope -- continues to meet with its success. It makes sense, then, that we expand it.

In the area of breast cancer, we have funded $2.7 million into cancer wait-lists. It's a general discussion around cancer wait-lists that we perhaps could have at a later date. But certainly we continue to fully fund our mammography screening program, which covers all the women in the province.

[5:00]

L. Stephens: Could the minister talk a bit about what is available in the northern parts of the province? This is one of those areas where the northern parts of the province are at a bit of a disadvantage when it comes to medical services. What kind of waiting is required in the north? Have there been studies done? Does the ministry know where those trouble spots are and whether there have been initiatives undertaken to provide equity to services for women in the north and the interior?

Hon. J. MacPhail: Yes, and I too believe . . . . What I've heard from women, particularly in the northern coastal area, is that more needs to be done. I have asked our staff in charge of the screening program to look into that and to make recommendations on how we can even improve the service to women in the northern coastal areas. Right now, there are 20 screening centres and three mobile screening units, and they have provided about 170,000 screens.

There are fixed centres located in Prince George -- I'm just dealing the ones that are in the north, but, of course, Prince George would probably say they're not northern -- Dawson Creek, Fort St. John, Kitimat, Prince Rupert and Terrace. There are other fixed centres, as well, and then the mobile unit. Let me see: where does the mobile unit cover? It covers Hudson's Hope, Chetwynd, Mackenzie, Vanderhoof, Fort St. James, Houston, Burns Lake, Quesnel and Fort Nelson. Those are the areas covered in the north.

L. Stephens: Are there programs being developed around the research component of breast cancer, whether or not there is some additional research capability or programs in place in British Columbia, perhaps at B.C. Women's, to address breast cancer research?

Hon. J. MacPhail: I would say that the B.C. Cancer Agency, in association with the B.C. Breast Cancer Foundation -- which, of course, is not funded by government -- is on the cutting edge of breast cancer. The B.C. Cancer Agency, of course, is funded but not the B.C. Breast Cancer Foundation. It's a wonderful organization founded by women in B.C. to make their contribution to breast cancer research. Yes, there is much activity taking place in this area, particularly around genetic research into breast cancer as well.

L. Stephens: There was a notice not too long ago that the mastectomy rate in British Columbia was higher than in some of the other provinces. I wonder if there has been any highlighting or flagging of that particular fact to the Minister of Health and whether there have been any investigations as to why that may be the case.

Hon. J. MacPhail: The provincial health officer does monitor cancer rates, and we can certainly make that information available to the member. This particular issue has not been brought to my attention personally by the Cancer Agency.

L. Stephens: Well, I'll just sort of highlight and flag that for the minister -- to perhaps take a look at the numbers and the stats around mastectomies and lumpectomies and whether or not our province appears to be doing more mastectomies than perhaps are needed. That's what the initial numbers I have indicate, and that lumpectomies are not as prominently done in British Columbia as they are in other provinces. So I'll just ask the minister to perhaps inquire about that and get back to me at another time.

The funding for the breast cancer program was $6.8 million in '96-97, I believe. Could the minister indicate what her budget is for '97-98 for the breast cancer mammography program?

Hon. S. Hammell: I request leave to make an introduction.

Leave granted.

Hon. S. Hammell: In the gallery there are a number of grade 11 and 12 students from Queen Elizabeth high school in

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Surrey. They are accompanied by their teacher Ms. Barlas and a number of adults. They are over here for the day to watch this place in action and to take in the sights of Victoria. So I'd like the House to make them all welcome.

Hon. J. MacPhail: I'm going to beg the member to repeat the question, please, if I may.

L. Stephens: I'd be happy to. I'm looking for the total amount of money budgeted for this coming '97-98 year for the breast cancer mammography screening program.

Hon. J. MacPhail: There is excellent news here. The budget is now $7.7 million, and that's an increase of $1 million over last year's budget. So that's excellent news.

L. Stephens: That is good news, and I wonder if the minister . . . . We talked a bit about some of the programs, but could the minister tell me where, specifically, that extra $1 million is going to go?

Hon. J. MacPhail: That will be spread evenly throughout the system for increased screening, just to generally cover the demand across the system.

L. Stephens: I'd like to move to a variety of services now. I'd like to start with HIV -- women and HIV, and children. What was the budget for the HIV program last year, and what is the budget anticipated to be for this year?

Hon. J. MacPhail: I can actually provide the member with the fact sheet on this. AIDS prevention and education community group funding is $7.4 million; needle exchange funding is $1.67 million; bulk purchases of needles and supplies provided to exchanges is $590,000; and then the Ministry of Health funding through Pharmacare for AIDS drugs for people is $28 million. The centre for excellence is located at St. Paul's Hospital, and it provides education to clinicians, conducts studies, develops innovative laboratory analysis and carries out clinical trials, and operates a central drug program for HIV/AIDS patients.

It's fully supported by our Ministry of Health, with $3.9 million in an operating grant and then another $10.36 million in Pharmacare funding. We also announced Dr. Peters Centre for AIDS, which has $1 million in funding from the province to create a hospice and drop-in facility for persons living with HIV/AIDS.

L. Stephens: Those are huge numbers for a disease that is 100 percent preventable. We're really spending a lot of money in that area, but it is necessary for the prevention programs and certainly for providing treatment to those individuals.

I'd like the minister to talk a bit about the prevention programs and what her ministry is contemplating in this coming year. Are there any new programs around prevention? And I'd like her to perhaps just focus on mothers -- women and their babies who have HIV -- street people and people who are marginalized. That could be the multicultural group as well. That's another area that we tend to not be conc