2016 Legislative Session: Fifth Session, 40th Parliament

HANSARD

The following electronic version is for informational purposes only.

The printed version remains the official version.

official report of

Debates of the Legislative Assembly

(hansard)

Wednesday, May 4, 2016

Afternoon Sitting

Volume 38, Number

ISSN 0709-1281 (Print)

ISSN 1499-2175 (Online)

CONTENTS

Page

Routine Business

Ministerial Statements

Response to fires in Fort M c Murray

Hon. C. Clark

J. Horgan

Introductions by Members

Tributes

Nelson Keitlah

S. Fraser

Introductions by Members

Statements

(Standing Order 25B)

Wildstone Group of Companies

D. Ashton

Gyeonggi delegation from South Korea

B. Ralston

ALS awareness

G. Hogg

Farmers market nutrition and coupon project

C. James

Social enterprises

J. Tegart

Youth volunteer contributions

D. Eby

Oral Questions

Tailings pond breach at Mount Polley mine and mining industry regulation

J. Horgan

Hon. C. Clark

N. Macdonald

Hon. B. Bennett

M. Mungall

G. Heyman

S. Simpson

Motions Without Notice

Referral of Municipal Replotting Act to Parliamentary Reform Committee

Hon. M. de Jong

Referral of issues to Parliamentary Reform Committee

Hon. M. de Jong

Tabling Documents

Statement of 2014-15 borrowings

Orders of the Day

Committee of Supply

Estimates: Ministry of Health (continued)

J. Darcy

Hon. T. Lake

V. Huntington

A. Dix

M. Karagianis

B. Routley

Tabling Documents

Opinion of the Conflict of Interest Commissioner Pursuant to

Section 19 of the Members’ Conflict of Interest Act: In the Matter of Applications by David Eby, MLA (Vancouver–Point Grey) and Duff Conacher with Respect to Alleged Contraventions of the Members’ Conflict of Interest Act by the Honourable Christy Clark, MLA (Westside-Kelowna) and Premier of British Columbia

Proceedings in the Douglas Fir Room

Committee of Supply

Estimates: Ministry of Jobs, Tourism and Skills Training (continued)

S. Chandra Herbert

Hon. S. Bond

S. Simpson

M. Elmore

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WEDNESDAY, MAY 4, 2016

The House met at 1:37 p.m.

[Madame Speaker in the chair.]

Routine Business

Prayers.

Ministerial Statements

RESPONSE TO FIRES IN FORT M c MURRAY

Hon. C. Clark: We are watching in horror today as we see what unfolds in Fort McMurray. An entire city is being forced to evacuate, and it is nothing less than a nightmare come to life — a nightmare that people in Kelowna will remember from 2003.

Alberta is our partner. They are our neighbour. They are our best friend in Canada. For many of us, though, Alberta is also family, with so many connections across the Rockies between our two provinces.

In times of need, families stand together, and so although our own resources are very stretched — 48 fires in British Columbia right now; some of them very close to the border between our two provinces — we have been in contact with the Alberta government. They have asked us, as a priority, to make sure that we control the fires along the border and, if they do move into Alberta, that we take the unusual step of chasing them across the border and doing that work on Alberta’s behalf so that they can continue to focus their resources.

This battle is far from over. We all see that in the news coverage that we see on TV every night. But the fact that no lives have been lost is a testament to first responders: paramedics, firefighters, police — all authorities who are so well coordinated and so brave in fighting this terrible fire that people are facing.

We won’t know the full extent of the damage, obviously, until it’s extinguished, but we do already know that thousands of people have lost their homes. I know that hundreds of British Columbians have already reached out. On behalf of all of us here, I’d like to thank them for bringing their heart to this problem to support our friends and family in Alberta.

They are asking how they can help, and I want to encourage them. I want all British Columbians to donate to the Red Cross in their ongoing efforts to support the people in Alberta, in Fort McMurray, who are dealing with this today.

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By rallying together, we can keep each other safer, and we can stay calm in the face of this terrible disaster that’s unfolding. The people of Fort McMurray have shown incredible tenacity, courage and resilience in the face of this. We all wish them our very best.

To the people of Alberta, British Columbia stands with you as we always have and as we always will.

It’s also extraordinary — the amount of help being offered right across country, whether it be in the Maritimes, in central Canada or here, out west, to stand with our brothers and sisters, the men and women and the good people of Alberta. I know that the people of Fort McMurray are among the most resilient in the country. They will regroup, they will rebuild, and they will recover.

As that happens, I echo the Premier’s call. If anyone is listening and watching and has something that they can give, please do that. Reach out to the Red Cross, reach out to faith organizations, and do what we can in a modest way to assist in this difficult time. The work will go on much beyond the fires. But in this time, when we see what could only be described as Hades on earth, it’s critically important for all of us to band together.

I support the Premier and the government in every way possible to bring our resources to bear to address this serious issue just to the east of us. I know that all British Columbians would support that as well.

Introductions by Members

J. Horgan: I thought Tommy Bahama had walked into the Legislature today. I was looking at…. Who’s the most relaxed person on the floor of the House today? Of course, it’s our dear friend Blair Lekstrom, down from the Peace country. I’ve not seen him so relaxed. I’ve not seen him so at ease. I thought it might have been to do with the motorcycle ride yesterday, but he said he didn’t even come down for that. He just came down for some good old-time fellowship with his colleagues on that side of the House as well as his good friends on this side of the House.

I am delighted to be able to say, on behalf of everyone here, would you please make a guy named Blair Lekstrom, the calmest, coolest guy in the place today, very, very welcome.

Hon. T. Lake: Some of my colleagues joined me this afternoon, at lunchtime at the rotunda, to announce the reopening of the Crossing at Keremeos. The Crossing at Keremeos is a purpose-built, specialized residential treatment program for youth and young adults that are experiencing challenges with substance use. We were very happy to announce the reopening of that facility in Keremeos.

It’s overseen by the Provincial Health Services Authority. I would like to welcome a couple of people

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from PHSA: Lynn Pelletier, who is the vice-president of B.C. Mental Health and Substance Use Services, and Connie Coniglio, the executive director of B.C. Mental Health and Substance Use Services.

With them are two members of Central City Foundation, which has become a leader for its model of investing in sustainable, social purpose real estate properties: Jennifer Johnstone, the CEO of Central City, and Carla Shore, the communications director.

Accompanying them are two very important people, the co-founders of the Association of Families and Friends of Drug Users, just the sweetest people who have done so much good for young people in our province: Robert and Susan Ruttan.

Would the House please make them all very welcome.

C. James: I have two guests who are here in the gallery today. Both of these individuals are incredibly committed, through their work and through the amazing organizations they work for, to improving the lives of seniors, of families and of women and children in our community.

The first individual is Candace Stretch, who is assistant manager of women and family services at the Cridge Centre for the Family. The second is Rebecca Mabee, who is the aboriginal early education and nutrition programs coordinator and manager for the Little Paws Preschool at the Victoria Native Friendship Centre.

Would the House please make both these guests very welcome.

Hon. M. Bernier: Just to follow up on the official opposition leader’s introduction, I also want to acknowledge a good friend mine who is here from Peace River South. Such a good friend, in fact, he stepped aside so I could run to take over his spot as MLA in that area.

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I think it’s really important to stress that for 12 years Blair served in this House, serving not only impeccably for Peace River South but also for the province in his time as Minister of Transportation, Minister of Community and Minister of Energy and Mines. He did an excellent job, I’m told by the opposition, on two out of three of those great ministries.

It’s a real, great opportunity to welcome my good friend Blair Lekstrom to the House. Again, please make him welcome.

Tributes

NELSON KEITLAH

S. Fraser: The province has lost a great man. On Saturday last, May 1, Nelson Keitlah passed on. Nelson was a respected Nuu-chah-nulth elder and statesman from Ahousat on Flores Island near Tofino, and he was a friend.

Nelson played a major role in creating the Nuu-chah-nulth governance structure, the NTC or Nuu-chah-nulth Tribal Council, as it is known today. He was first elected as chief councillor for Ahousat. He was the co-chair of the Nuu-chah-nulth Tribal Council for many, many years. He was tribal council negotiator for many years on the B.C. treaty process.

I first met Nelson in 1997, and I was honoured to sit with him on the Clayoquot Sound central region board, where he presided as the Nuu-chah-nulth co-chair. Nelson was fluent in the central Nuu-chah-nulth language, and he was also fluent in all things Nuu-chah-nulth and history. You could learn so much from just being in the room with him.

He was an eloquent and powerful speaker, and he could hold a room with his very presence. Nelson Keitlah was known as the General, and the General will be deeply and dearly missed.

Introductions by Members

L. Reimer: It’s my pleasure to welcome to the precinct this afternoon the Coastal Sound Music Academy children’s choir, led by many volunteers and Diana Clark, who is my constituent. They are hosting this week a group from Dieppe, in Moncton, New Brunswick, named the Jeunes chanteurs d’Acadie. I had the pleasure of listening to all of them sing on the weekend at Old Orchard Hall in Port Moody, and they are so melodic.

Would the House please make them very welcome.

C. Trevena: In the House today are John Bowman, the president of North Island College, and Randall Heidt, the vice-president of the college. They’ve been meeting with the Minister of Aboriginal Relations as well as the Ministers of Advanced Education and Jobs and Tourism.

They’re talking about the importance, to the college and to the whole of the north Island, of a reconfiguration of the Campbell River campus. They are looking for support, and I hope that the Minister of Advanced Education and the Minister of Jobs will be giving them that support. I will also, hopefully, be having meetings with those ministers to talk about this.

I hope the House will make them both very welcome.

Hon. T. Wat: It is my pleasure to welcome eight esteemed guests to the House today. They all sit on B.C.’s Multicultural Advisory Council. The Multicultural Advisory Council was created in 1990 with a mandate to advise the minister on multiculturalism issues. There are currently eight board members, including the chair, and they all generously donate their time as volunteers to carry out their roles. Today the council is meeting to discuss their annual action plan, and I’m looking forward to seeing the developments that arise as a result.

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We are so lucky to have the full team in the House with us today. I’d like to extend a big thank-you to members Dennis Chan, Garrison Duke, Angela Hollinger, Tenzin Khangsar, Steve Kim, Anar Popatia, Tanveer Siddiqui and David Chuenyan Lai for all your service to British Columbia.

Please join me today in giving them a warm welcome.

G. Holman: A number of Vancouver Island MLAs had the opportunity to meet with the ALS Society of B.C. advocacy committee earlier this morning. The committee is here to request very modest support for a pilot program to provide respite for caregivers of ALS sufferers and to document the benefits of the program.

Would the House please welcome Richard Poliquin, chairperson and director of ALS B.C.; directors Dr. Neil Cashman, Ann McArthur and Jim Williams; Wendy Toyer, who is executive director of the ALS Society of B.C.; and, last but not least, Susan Brice, who is executive member of the Victoria

chapter of the ALS Society of B.C. and, of course, a former MLA and currently chair of the greater Victoria transit commission.

Would the House please make all of these guests feel very welcome.

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R. Sultan: It’s my pleasure to introduce to you, for a second time, some of the same guests from the Amyotrophic Lateral Sclerosis, or ALS, Society, perhaps known to many of us as Lou Gehrig’s disease. As the member has already pointed out, this society is dedicated to providing direct support to ALS patients, their families and caregivers, to ensure the best quality of life possible while living with ALS.

Each year in Canada, in the United States, and in most of the western world, only one or two people out of 100,000 get ALS. Men get it slightly more often than women. It can occur at any age, but it’s more common in the middle-aged and the elderly.

Our Ministry of Health has supported ALS research by financially supporting agencies such as the Michael Smith Foundation for Health Research. In addition to the names of the guests in the gallery today that have already been mentioned, I would like to single out my constituent Rick Poliquin, who is chair and director of ALSBC.

I would like to acknowledge for the second time, my old buddy, Susan Brice, MLA for what was, in those days, known as Saanich South. We had the pleasure of sitting directly behind Jenny and Joy, the only two NDP members in the House. Some of the barbs aimed in their direction glanced off them, and we had to duck from time to time.

The good news is that Wendy Toyer, the executive director of ALSBC, has told us that if you’re going to get this affliction, British Columbia is the place to get it, because the Ministry of Health’s, G.F. Strong ALS facility is “the best in the world.” That’s from Wendy, and I believe her.

Would the House again make the ALS Society welcome.

J. Shin: Last year I visited South Korea twice, in the spring and in the fall, and had the pleasure of visiting the federal government to meet with the MPs; the capital city, Seoul; as well as Burnaby’s sister city, Hwaseong, to connect with the council; and, of course our sister province, Gyeonggi, where my colleagues, members for Surrey-Whalley and Surrey–Green Timbers, and I were received so warmly.

We extended our invitation to them to reciprocate and to continue our dialogue on trade, educational and cultural relationships between South Korea and British Columbia. I’m thrilled that our sister province of Gyeonggi has accepted.

They are here, all 13 MLAs, led by the Minister of Urban Development and Environment, with their parliamentary secretaries and senior staff in the entourage of 26 guests today. Would the House please make our special guests from across the Pacific, the MLAs Oh Se Young-nim, Yom Jong Hyun-nim, Kim Kyu Chang-nim, Park Dong Hyeon-nim, Yang Keun Suh-nim, Im Chae Ho-nim, Jung Yoon Kyung-nim, Cho Kwang Myung-nim, Kim Chul In-nim, Lee Jung Hoon-nim, Jung Jin Sun-nim, Cho Jae Wook-nim, Chun Dong Hyun-nim, Cho Min Ho-nim and Shin Shung Hai-nim, feel very, very welcome.

J. Martin: We have a delegation joining us this afternoon from the B.C. and Yukon Catholic Women’s League.

Please welcome legislation chairperson Gisela Montague, from Chilliwack; president-elect Evelyn Rigby, from Powell River; education and health chairperson Agnes Geiger, from Nanaimo; and resolutions chairperson Dianne Barker, from Kamloops. Please make them welcome.

L. Reimer: I would like to welcome, as well, my friend Steve Kim, who is here today. Steve has been a very active member of the C3 Canada-Korea society and is with Boilingpoint communications. I’ve had the great pleasure to run with him, back in 2013.

Would the House please make him welcome.

S. Chandra Herbert: Well, members of this House will know I’ve spoken of the Dragons before and my love for King George high school in the West End.

I’m very excited today to have about 42 students from King George, in grade 11 and grade 10, in the House today. They’re incredible people.

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If you see them around the hall, tell them so. They will give you a few opinions, I think, about education and their crowded school, but they’re great students. I hope you’ll listen to them. I’d also like to welcome them.

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Along with them are Sherry Preston, Patrick Wilband, Malini Rajkumar, Cliff Butt, Lee Rachar, Steve Scrimshaw and, of course, the Dragons. So please give it up for the King George Dragons. Welcome to the people’s House.

Statements

(Standing Order 25B)

WILDSTONE GROUP OF COMPANIES

D. Ashton: I’d like to take a moment to speak about one of the terrific family-run businesses based in Penticton. As general contractors, builders, engineers and construction managers, the Wildstone Group of Companies provides services throughout western and northern Canada, including some of the most remote and unforgiving places on this continent.

The goal of the company and its 100-plus employees is to provide a better building experience than any other company in the building industry. In addition to encouraging each other to be better at their jobs, their core values also include the commitment to be strong contributors to the community and a demand for a healthy family-worklife balance. Wildstone Group of Companies was founded in Penticton in 1995 by professional engineer Jim Morrison and now has branches in Whitehorse and in Yellowknife.

Some of the major projects the company has undertaken include a $42 million gas pipeline in Canada’s far north and a nearly $20 million northern Arctic RCMP detachment built on thermal piles. This is the first installation of its kind in Canada.

As a testament to Wildstone’s overall excellence, it was recently named one of Canada’s 50 best-managed companies by Deloitte. As we know, this is one of Canada’s most prestigious business awards. This is the second year in a row that Wildstone has been selected as B.C.’s finalist in the Deloitte Canada’s best-managed program.

Wildstone and its employees are also rightfully proud of their safety record, which now stretches five years without a lost-time incident — a record that is approaching one million hours on the job, much of it in the high Arctic. I’d ask each and every one: let’s knock on wood for that company. As a longtime and lifetime resident of Penticton and area, I’m extremely proud of this home-grown company’s achievements, and I’m very proud to be able to share their success with this House.

GYEONGGI DELEGATION

FROM SOUTH KOREA

B. Ralston: Today in the House we welcome an important delegation of elected legislators and their supporting staff from the Gyeonggi Provincial Assembly of the Republic of Korea.

The word gyeonggi means “the area surrounding the capital,” and indeed, the province wraps around the national capital of Seoul. The provincial capital of Gyeonggi is Suwon. Seoul, Korea’s largest city and national capital, is located at the heart of the province but is administered separately as a provincial special city. Gyeonggi is Korea’s most populous province, with 12 million people, and is home to globally recognized companies such as Samsung, Hyundai, Kia and LG.

British Columbia and Gyeonggi established a sister province relationship in May 2008. The member for Surrey–Green Timbers, the member for Burnaby-Lougheed and myself visited as guests of the provincial assembly in November 2015, and we are pleased that such a large delegation has chosen to visit us here in our provincial capital of Victoria. We look forward to pursuing talks on a wide variety of topics and strengthening the bonds of friendship between the Gyeonggi Provincial Assembly and the British Columbia Legislative Assembly.

The implementation of the Canada-Korea Trade Agreement, supported by both sides of the House, has opened new opportunities for exports to Korea, particularly from British Columbia. Korea has a dynamic cultural and business environment. There are opportunities for Canadian business in such areas as clean tech services, education and high-tech specialties such as gaming. We will strengthen the bonds of friendship between the Gyeonggi Provincial Assembly and the British Columbia Legislative Assembly.

To our many guests from Korea, on behalf of all members here, welcome.

ALS AWARENESS

G. Hogg: There’s an old adage that, I think, is attributed to that profession that we love to hate — lawyers. It says that you should tell people what you’re going to say; you should then say it and then repeat it so that people will know what you’ve said. With the help of two of my colleagues, we’ve already praised the ALS Society of B.C. So let me tell you what they told you, in different words.

Each day an average of 2.5 Canadians die of ALS. It affects one in 350 people, about one-third as many as are affected by diabetes.

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ALS is a progressive, neurodegenerative disease that relatively quickly causes muscle weakness, paralysis and, ultimately, respiratory failure. It can affect anyone at any time, and it is not yet treatable. The amazing freezing success of the ice bucket challenge raised a frigid awareness of the disease and reinforced our resolve to persevere and to find a cure.

The ALS Society of B.C. was founded 35 years ago, and it is dedicated to providing the best possible quality of life support to ALS patients, their families and caregivers. With over 445 trained volunteers, they support over 400 British Columbians with ALS.

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We are blessed in British Columbia to have the world’s best ALS specialists caring for our patients at the ALS Centre at the G.F. Strong Rehabilitation hospital. B.C.’s continued partnership with the centre is a crucial component in ensuring that we can provide the best possible quality of care and service to our ALS patients.

June is ALS Awareness Month in B.C. Your support of the many events occurring in communities across this province is both needed and appreciated.

Thank you to the B.C. ALS Society.

FARMERS MARKET NUTRITION

AND COUPON PROJECT

C. James: The B.C. farmers market nutrition and coupon program has been a great success in my community. The program, built with community partners, makes local fresh food available to low-income expectant moms, families and seniors.

Funding is provided through HealthyFamilies B.C., in partnership with the B.C. Association of Farmers Markets. It’s available in 48 communities across B.C. Last year more than 3,000 households and over 9,000 British Columbians used this service.

In Victoria, the Moss Street Market and the Oaklands Sunset Market both participated, in partnership with the Victoria Native Friendship Centre and the Cridge Centre for the Family. This year the James Bay Market and the James Bay Community Project have been added to the program.

Program participants receive $15 in coupons per week for 16 weeks, redeemable from June to October, to purchase fruit, vegetables, meat, fish, cheese, nuts and fresh herbs at local farmers markets.

The community partners often participate by offering skill-building activities such as cooking, meal planning and gardening classes. The participants have the opportunity to connect and be a part of their community at the farmers markets. This program also supports local farmers and keeps money in the local economy.

This year the program is at capacity and was not able to fund all of the participants requested. There are 137 families funded this year in greater Victoria, but 82 requests had to be turned down.

The B.C. farmers market nutrition and coupon program has been well received, and other community partners and other markets want to offer it as well. So I add my voice in the hope that funding for expansion will occur.

Thanks to those who’ve worked so hard to get this program up and running and make it such a success. It’s improving nutrition for families in my community and improving lives.

SOCIAL ENTERPRISES

J. Tegart: I rise in the House today to recognize May as Social Enterprise Month.

Social enterprises across B.C. are making a difference in people’s lives, in our communities and in our neighbourhoods. They use business strategies to serve the common good, finding innovative ways to help societies most pressing social, cultural and environmental problems.

They range from thrift stores and farmers markets to businesses that provide work experience, affordable housing and job opportunities for people with disabilities or other barriers to employment.

In 2012, a survey from the Canadian social enterprise sector survey project stated that B.C.’s social enterprises provided services to nearly 700,000 people and paid $37 million in wages. They are an important part of B.C.’s economy, and the sector continues to grow.

This is the third Social Enterprise Month in British Columbia. Ten years ago a social enterprise was a relatively new concept, but now a business focused on achieving social or environmental goals is mainstream.

Our government is committed to strengthening B.C.’s social innovation sector. In 2011, we started a conversation about social innovation. Since then, we’ve formed partnerships, supported the sector and enacted legislation. We’ve worked to create an environment where social entrepreneurs are welcome and can thrive.

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We know that no single organization, government or business can solve society’s most difficult challenges on its own. This month I encourage everyone to celebrate and to raise the profile of this important sector and the work they do to strengthen our communities. I encourage you to visit and support social enterprises in your community and go to hubcapbc.ca to learn more about B.C.’s social enterprise system.

YOUTH VOLUNTEER CONTRIBUTIONS

D. Eby: One of our community newspapers, the Campus Resident , recently featured five outstanding young people for their exceptional volunteer work in our community. I’d like to share their stories with the House today.

High school student Eric Lin spent his time as a volunteer coach of the Math Challengers club at a local elementary school, Norma Rose Point. Andrew maintains the club’s blog. He coaches 40 grade 5 to 8 students once a week. This year he gave an extra hour and a half of time for the 20 competitors for SFU’s provincial math contest. Their team came in first place in the province. Congratulations to Eric and the hard-working team at Norma Rose Point.

Alice Hong is a core member of — I don’t think I’m wrong to say — the famous CRAZI Youth Club Dance

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Crew, which she helped found in 2012. The Crazy Crew have been the stars of several community events. Alice and her friends always keep the crowd entertained with their amazing choreography. Alice also volunteers with the social fitness program, and she hasn’t missed a single session.

David He is the winner of the 2016 citizenship award at UHill Secondary, in part for his role in leading the fundraising for the Downtown Eastside Women’s Centre. With 140 hours of volunteering to date, David’s efforts have improved the Community Connection Night, the Let’s Cook Club, the UNA Annual Barn Raising, our lunar new year celebrations and the Westbrook outdoor movie.

Now, I met volunteer Jessie Ou at the Green Depot, where she volunteers regularly to educate community members about diverting e-waste out of the garbage. Despite wind, rain and cold at our annual Wesbrook Festival, Jessie and her colleagues bravely staffed the weigh station, making sure that we had a minimal environmental impact.

Eric Luo is a new arrival to Canada, but that hasn’t slowed him down from volunteering for 46 hours for every major University Neighbourhoods Association community event since he arrived. This spring he’ll be helping run the floor hockey program at our beautiful new community centre.

I ask all members of this House to recognize the amazing and outstanding volunteer work of these young people in my community.

Oral Questions

TAILINGS POND BREACH AT

MOUNT POLLEY MINE AND

MINING INDUSTRY REGULATION

J. Horgan: Yesterday the Auditor General tabled what could only be described as a scathing report on the enforcement and compliance capacity of the provincial government. I want to read several excerpts over the next number of minutes, and I’ll start with this one with respect to regulation and oversight.

The Auditor General said the following: “We have found over a decade of neglect in compliance and enforcement program activities within the Ministry of Energy and Mines and significant deficiencies within the Ministry of Environment.” So “a decade of neglect” is how it was characterized by the independent Auditor General.

In that report, we didn’t just hear about environmental degradation. We heard about taxpayer liability and lost jobs as a result of that neglect. My question to the Premier is: why did it take a catastrophic disaster at Mount Polley for her government to wake up to their responsibilities to adequately and appropriately regulate the mining sector in British Columbia?

Hon. C. Clark: The mining industry in British Columbia is vitally important to many, many communities and thousands of people whose families depend on it for an income. We’ve worked hard to make sure that we support the industry and those workers in continuing to be able to generate the wealth that our province depends on but, also, the income that they need to be able to make sure that their lives are good ones and that they’re raising their children in the kinds of homes that they’d like to raise them in.

British Columbia has enjoyed, over the last many years, a reputation around the world as one of the best places — the most environmentally sound, the most safe — in the world in which to do mining.

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When the Mount Polley incident happened, we were all shocked. It was a real wake-up call for everyone. An incident that’s almost unique over the last 75 years. A reminder, for a mine that had been permitted long ago, that we do need to make sure that we always, continually, improve. We are acknowledged to be amongst the best in the world, but we can certainly do better.

The reports from the independent panel of engineers and geologists and from the auditors are both extremely helpful in helping us make sure that we make the changes that we need to. Many of those changes are underway because we intend to make sure that we stay not just amongst the best in the world but that we will be acknowledged as the best in the world for mining.

Madame Speaker: Recognizing the Leader of the Official Opposition on a supplemental.

J. Horgan: It always astounds me when government members stand up and say: “I’m shocked. I had no idea.” The government has been in power for 15 years. “A decade of neglect” was entirely and totally on their watch.

The Auditor General went on to say, with respect to the reputation that the Premier just referenced: “We found that almost every one of our expectations for a robust compliance and enforcement program” within the Ministry of Energy and Mines and the Ministry of Environment was not met. Every one not met.

She went further to say the Ministry of Energy and Mines “has the ability to compel a mining company to take corrective action when necessary.” However, at Mount Polley, the ministry “did not use any of these enforcement mechanisms to compel the mine operator to build or operate the dam as designed or intended.”

What the conclusion was is that the government was asleep at the switch. Professional reliance was what they depended on, not people on the ground protecting the public interest, people on the ground protecting the jobs of people in the mining sector.

My question to the Premier is: what possible reason does the Premier have for not using the tools at the dis-

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posal of the ministry to protect the environment, to protect workers and to protect the resources that belong to all British Columbians?

Hon. C. Clark: One of the most important things that we have to do at this juncture, in our province, in order to protect mining jobs and mines in British Columbia is ensure that we protect the reputation that British Columbia has established as one of the best, safest, most environmentally sound mining industries in the world.

That does mean that we need to respond to the recommendations both of the independent panel and of the auditors, and we are working to do that. Amongst some of those things is setting up a new compliance and enforcement board, working to boost penalties for non-compliance, new guidelines for engineers and geoscientists.

This was a mine that was permitted long ago. The independent panel said that the cause of this terrible mess at Mount Polley was the fact that not enough holes had been drilled to determine the nature of the subsurface on which the tailings pond stood. They met the standards of the time, in the 1990s. But as the Auditor General reports today, they don’t meet the standards of today.

We need to make sure that we continue to change the way the….

Interjections.

Madame Speaker: Please continue.

Hon. C. Clark: Thank you, Madame Speaker.

We need to make sure that we continue to change the way that we set those standards and meet those standards. The Ministry of Mines is doing that now in response to the reports that we’ve seen. That work will continue. We are amongst the best at mining anywhere in the world. We want to protect that reputation. We want to enhance it. Making sure that we maintain that public trust and that public confidence is absolutely crucial to making sure that we protect those jobs for those families that depend on it.

Madame Speaker: The Leader of the Official Opposition on a supplemental.

J. Horgan: If I’m not mistaken, I was at Mount Polley two summers ago. The Premier joined me there. The minister joined me there. I think the reputation of the mining industry kind of left the barn on that day. When you have 25 million metric tonnes of junk coming down from a tailings pond and going into a pristine water body, that’s a problem. It’s not an unfortunate circumstance. It’s a catastrophic event.

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The Auditor General reviewed that event, reviewed our preparedness for this very activity. The Premier talks about when the permit was issued. It was amended 12 times, not by people on this side of the House but by people on that side of the House. The permit to operate was amended a dozen times over a decade, and the Premier wants to think that it was someone else’s problem a long, long time ago.

Unfortunately, the people of British Columbia got more going on than that. They know that people sitting in government are the ones that are supposed to be accountable, not the opposition.

The Auditor General went on to say, with respect to taxpayers and the consequences for all of us inside the mining industry and outside of the mining industry: The Ministry of Energy and Mines “is not holding an adequate amount of security to cover the estimated environmental liabilities at major mines.” Not enough liability. In other words, the Yellow Giant mine — we made reference to it earlier in the week — a problem for all taxpayers. Mount Polley — potentially a problem for all taxpayers.

The Premier talked about trust. This is a big challenge for her, and I hope she’s got a good answer. How can the people of British Columbia trust our enforcement and compliance process when the owners of Mount Polley contributed $800,000 to the governing party over the past ten years? During that decade of neglect, the government’s party received $800,000 from the mining company that sent 25 million metric tonnes from their tailings pond into pristine water. How should we have trust in that?

Hon. C. Clark: The mining industry also created jobs for 30,000 citizens directly in British Columbia. The average salary for those jobs was $120,000. Five new mines creating over 1,300 jobs since 2011. We are continuing to work to make sure that our mining industry not only grows but that it grows in a way that enhances our reputation as amongst the best in the world at mining and mine safety.

That’s why we’re responding to both reports fully, accepting all of the recommendations from the Auditor General’s report, save one, where we are accepting it, trying to make sure we understand it better and seeing whether or not it can be fully implemented.

We want to make sure that we remain number one in the world, that we protect our reputation as a great place to do mining. We know that that’s vitally important, because on this side of the House we know that mining jobs matter to a lot of people. They matter to a lot of families. They matter to a lot of communities…

Interjections.

Madame Speaker: Members.

Hon. C. Clark: …that they keep alive. One of the many things that we need to do to preserve those jobs, to preserve those communities, is make sure that we

[ Page 12692 ]

preserve, protect and enhance our reputation for mine safety and environmental sustainability across the province. In accepting these recommendations, we will continue to do that.

N. Macdonald: The Auditor General says, with respect to the Mount Polley disaster: “We focused on why the dam failed.” Then she went on that they found the ministry did not ensure that the tailings dam was built properly or operated according to the approved design. “Nor did it ensure that the mining company rectified design and operational deficiencies.”

In short, the Auditor General says that the Mount Polley tailings storage facility failed because the minister failed to do his job. The Auditor General says that repeatedly throughout the report.

The minister promised to resign if he or his ministry were found at fault. That has happened. When is he going to resign?

Interjections.

Madame Speaker: Members.

[1420]

Hon. B. Bennett: Apparently, I have bad news for the opposition. I have no intention of resigning. But I would like to tell the House and the public what I plan to do.

Interjections.

Madame Speaker: Members. The Chair would like to hear the answer.

Hon. B. Bennett: They’re going to have to contain their disappointment, hon. Speaker.

What I want to do on behalf of this government is I want to take the seven recommendations that were made by the independent expert engineering panel. That report came out in January 30 of 2015. I want to take the 19 recommendations that came from the chief inspector of mine’s report. That report took 18 months to do. It was done by several engineers within the ministry. There are 19 recommendations from that report and 17 recommendations, in total, from the performance audit that was done and released yesterday by the Auditor General. As the Premier just mentioned a second ago, that totals 43 recommendations.

Now, government is going to implement — and in fact is already in the process of implementing — all of those recommendations, even the 43rd recommendation. We have accepted every single recommendation of the two engineering investigations as to what caused the accident and, also, the recommendations that come from the Auditor General’s performance audit that came out yesterday, with that one exception, which I would imagine I will get an opportunity to explain, perhaps in a follow-up question, if the opposition decides they want to ask more questions.

Madame Speaker: Columbia River–Revelstoke on a supplemental.

N. Macdonald: Well, the question I asked, the minister ignored completely. He made a promise that if the findings such as we had with this report came forward, he would resign. That is what he promised.

I don’t mind…. I’m not surprised that he actually avoided the defence he used yesterday, because it’s ridiculous, what he said yesterday. He said that he only promised to resign if the panel that he handpicked and appointed said he was responsible for Mount Polley. Well, the Auditor General, the expert this Legislature appointed, says Mount Polley is his fault. The Auditor General’s report is an indictment of this minister’s tenure.

The question I have for the minister is: after reading the Auditor General’s report, how can the minister do anything other than resign? Where’s the integrity?

Hon. B. Bennett: The member for Columbia River–Revelstoke would love to see me resign, I know. I’m sorry on a personal level that he feels that way, but I’m not going to resign.

He calls into question the independent expert panel of engineers that was appointed within two weeks following the Mount Polley disaster. We appointed that panel. He referred to them as “handpicked.” Let’s just take a moment and consider who these three people were.

Steven Vick is from the United States of America. He is the gentleman who is responsible for investigating the failure of the levees in New Orleans after the hurricane. The second person who was on the panel is a PhD geotechnical engineer who teaches at UBC and who currently is in Mexico City, as I speak, giving a lecture. What on? On tailings dams. The third person, who chaired the panel, teaches or used to teach at the University of Alberta. He also is a PhD geotechnical engineer.

[1425]

Those three geotechnical experts came to the conclusion that the accident at Mount Polley was caused by something called a glaciolacustrine layer. That’s what they said.

They also said that the men and women who work in the Ministry of Energy and Mines are actually really good at their job. That’s what these three engineering experts said. They said, in fact, that the people who work within the Ministry of Energy and Mines are actually some of the best people they’ve ever encountered anywhere in their travels.

M. Mungall: Well, the minister knows, or at least he ought to know, that the panel looked at what happened with Mount Polley, but the Auditor General was looking

[ Page 12693 ]

at why it happened. According to her, the ministry did not conduct geotechnical inspections for several years, even though the ministry policy requires annual inspections. According to the Auditor General, these inspections would have identified that the operator was not building or operating the tailings dam according to the permitted design.

The mine operators were not following the ministry’s rules. In the case of Mount Polley, we would have known that if the minister hadn’t given a pass on the annual inspections for that mine.

It’s clear that the minister neglected his responsibilities. Why did he do that?

Hon. B. Bennett: It’s great to see another MLA from the Kootenays up on her feet talking about mining. I’ve never heard her, ever, in her time here ever mention mining before. I appreciate the fact that she actually knows that it exists as an industry.

The member is asking about inspections that may or may not have taken place at Mount Polley over the last 15 years. What I can say is that there was a period of time, between — I hope I get my dates right — I think 2009 and 2011, where there were not the number of geotechnical engineering inspectors within the ministry that there ought to have been. That is something that we have acknowledged.

That is something that I will acknowledge right here today. It’s absolutely true, and we can’t let it happen again. Government takes responsibility for not letting that happen again.

Interjections.

Madame Speaker: Members.

Interjections.

Madame Speaker: Members, this House will come to order.

Hon. B. Bennett: Here’s what those three engineers said about inspections. They said that no number of inspections would have found that hidden, unstable layer of clay under the perimeter embankment of the tailings storage facility. That’s what they said. It wouldn’t have mattered if you had 1,000 inspectors wandering all over that tailings storage facility. They would not have found what caused the accident at Mount Polley. That’s what the three experts said. It is clear that the members in the opposition don’t like that, but that’s what they said.

Madame Speaker: The member for Nelson-Creston on a supplemental.

M. Mungall: First, let me invite the minister to any of the annual dinners or holiday parties that the Kootenay Chamber of Mines hosts. I’d be happy to see him there. In fact, maybe he’d actually buy something from one of the auctions.

The Auditor General, who’s an independent officer of this Legislature, said: “It is the Ministry of Energy and Mines’ responsibility for regulating all mining-related activity in B.C., including design, construction, operation, closure and reclamation. The chief inspector is given significant power and discretion during all phases. These powers include ensuring the safety and stability of tailings storage facilities.”

[1430]

It is the minister’s responsibility to ensure the safety of tailings storage facilities. The minister neglected to do that at Mount Polley, and I have to ask a question that I know is on British Columbians’ minds across this province. Is that because the mine’s owners are big-money donors to his political party?

Hon. B. Bennett: I couldn’t help but notice that Teck Resources, one of the biggest mining companies in the world, gave the NDP $59,400. I’m not….

Interjections.

Madame Speaker: Members. Members, we will wait.

Hon. B. Bennett: The ceremonial leader of the NDP could buy a lot of suits with $59,000.

You know, the best thing that we can do…. And I know that question period is all about theatre and politics and partisan politics. I’m not immune to participating in that. Everyone knows that. However, Mount Polley was a terrible disaster. There is no question about it. I think both sides of the House agree that it was a terrible disaster.

I think what the people of the province really expect from us…. I know they expect that from government; they may not expect that from the opposition. I think the opposition and government both have an obligation to learn what we can from what happened at Mount Polley.

It was an unprecedented event. It has not happened before in this province. There are 43 recommendations from the engineering panels that looked into the accident, that did the investigation, and also from the Auditor General’s report. Government is working on all of them.

G. Heyman: The minister may not be inclined to listen to the advice of independent officers of the Legislature, but the Auditor General went on to say: “The Ministry of Energy and Mines was unable to demonstrate how the mine performed against its permit requirements for the last two decades. In particular, the panel concluded that had the downstream slope on the perimeter embankment been flattened in recent years, as proposed in the original design, failure would have been avoided.”

[ Page 12694 ]

“Failure would have been avoided.” Does the minister agree with the Auditor General that had he decided to force Imperial Metals to follow their original design, the failure at Mount Polley would have been avoided?

Hon. B. Bennett: I’d like to go back to one of the engineering experts. His name is Harvey McLeod. He doesn’t work for government. He’s actually chairing our code review tailings storage facility subcommittee. He’s also vice-president of Klohn Crippen Berger engineering. Here’s what he has to say about the concept of “original design.”

He said: “This is the nature of mining. The tailings dam design at Mount Polley, just as at mines around the world, is not static. It evolves throughout the life of operations. That is appropriate engineering practice. Operating mines evolve their tailings dam designs over time to reflect actual operating conditions.”

With the greatest respect to the staff in the Office of the Auditor General, I think that what we got yesterday was a very good performance audit with 17 good recommendations. That’s what I think.

[1435]

I also think that if you want to understand what happened at Mount Polley, you should go to the two reports that were done by engineers. That will tell you. If you really want to know what happened, go and listen to the engineering advice that was provided by those experts.

S. Simpson: What’s clear from the Auditor General’s report is that the minister and the Premier made a choice. They chose to listen to major donors who fund the B.C. Liberal Party instead of workers who raised concerns about bad mining practices. The Auditor General called this a decade of neglect. It wasn’t a mistake; it was a choice. The result is that mineworkers lost their jobs. Mining communities are left with considerable environmental damage. Listening to major donors was the wrong choice for this minister.

Will he make the right choice and resign today?

Hon. B. Bennett: Forty-three recommendations. We’re going to implement all of them, possibly not all of one — not sure yet. That one recommendation deals with separating permitting from compliance and enforcement.

What we have said — I said it yesterday, but to get it on the record here today — is that we will do a jurisdictional scan, not just across Canada but around the world, to find other places where they have separated permitting from compliance and enforcement. Once we find those other models that are out there, according to the Auditor General, we will have a good look at them, and we will make a determination then as to whether we’re going to implement that particular recommendation fully.

The last thing I want to say…. It’s really important today that I say this. The people who work in the Ministry of Energy and Mines and the Ministry of Environment are people who are absolutely committed to doing everything they possibly can to protect the natural environment. We all know that.

S. Simpson: What we know today is that the workers at Mount Polley and the residents at Likely look at the $800,000 the mine owner gave to the B.C. Liberal Party and wonder what impact that money had. They look at the million-dollar dinner the mine owners held for the B.C. Liberal Party in Calgary and wonder: what impact did that money have? They look at the Auditor General’s report, and they see that the Premier and the minister chose not to enforce the law.

It’s time for the minister to demonstrate some integrity. Last chance — resign now, Minister.

Hon. B. Bennett: You know, when you look at the mining industry and you look at what the regulator is responsible for, governments do have a choice. We have a choice between trying to reduce the risk as much as we possibly can to make sure that workers are safe — and certainly B.C. mining workers are safe, the safest heavy industry in the world — and also to make sure that the environment is not jeopardized by the activities of mining….

It is not possible to remove all of the risk out of the mining industry or, frankly, any other activity on the land base, except by doing one thing. That is to simply eliminate the industry, get rid of it, which is what the other side did in the 1990s. That’s what they did. For every mine that opened in the 1990s, two closed.

Hon. Speaker, I look forward to tomorrow.

[End of question period.]

Madame Speaker: Hon. Members, I will take this opportunity to caution all members. It is never appropriate — never appropriate — to impugn the integrity of any hon. member in this House.

[1440]

Motions Without Notice

REFERRAL OF MUNICIPAL

REPLOTTING ACT TO

PARLIAMENTARY REFORM COMMITTEE

Hon. M. de Jong: A couple of things for members, and I think the hon. Opposition House Leader and the independent members have received the first motion that I seek leave to move, relating to the revision of the Municipal Replotting Act and the submission of that to the Select Standing Committee on Parliamentary Reform, Ethical Conduct, Standing Orders and Private Bills. I seek leave to move that motion.

[ Page 12695 ]

[The revision of the Municipal Replotting Act [RSBC 1996]

Chapter 323 be presented to the Select Standing Committee on Parliamentary Reform, Ethical Conduct, Standing Orders and Private Bills for examination and recommendation pursuant to the Statute Revision Act [RSBC 1996]

Chapter 440.

In addition to the powers previously conferred upon the Select Standing Committee on Parliamentary Reform, Ethical Conduct, Standing Orders and Private Bills by the Legislative Assembly, the Committee is empowered:

a) to appoint of their number, one or more subcommittees and to refer to such subcommittees any of the matters referred to the Committee;

b) to sit during a period in which the House is adjourned, during the recess after prorogation until the next following Session and during any sitting of the House;

c) to adjourn from place to place as may be convenient; and

d) to retain such personnel as required to assist the Committee;

and shall report to the House as soon as possible, or following any adjournment, or at the next following Session, as the case may be; to deposit the original of its reports with the Clerk of the Legislative Assembly during a period of adjournment and upon resumption of the sittings of the House, the Chair shall present all reports to the Legislative Assembly.]

Leave granted.

Motion approved.

REFERRAL OF ISSUES TO

PARLIAMENTARY REFORM COMMITTEE

Hon. M. de Jong: Secondly, I seek leave to move a second motion that also involves the Select Standing Committee on Parliamentary Reform, Ethical Conduct, Standing Orders and Private Bills. Again, I think this has been provided — I’m certain this has been provided — to the Opposition House Leader and the independent members. I will read the referral, though, because I think it’s a significant one for members to hear.

[The Select Standing Committee on Parliamentary Reform, Ethical Conduct, Standing Orders and Private Bills be appointed to examine and make recommendations by October 31, 2016 with respect to the practice and procedure relating to:

1. the referral and consideration of Estimates by Committee of Supply; and

2. the establishment of Select Standing Committees for the life of a Parliament.]

In seeking leave, I am obliged to the member for Delta South and the Opposition House Leader for their assistance with respect to the motion itself.

Leave granted.

Motion approved.

Tabling Documents

Hon. M. de Jong: Finally, pursuant to the Financial Administration Act, I would like to present the reports for the fiscal year ended March 31, 2015. The reports cover all amounts borrowed by the government and, secondly, all amounts loaned to government bodies and provide an overview of the province’s borrowing activities for fiscal year 2014-15.

Orders of the Day

Hon. M. de Jong: In Committee A, Committee of Supply, the ongoing estimates of the Ministry of Jobs, Tourism and Skills Training, and in this chamber, the ongoing estimates of the Ministry of Health.

[1445]

Committee of Supply

ESTIMATES: MINISTRY OF HEALTH

(continued)

The House in Committee of Supply (Section B); R. Chouhan in the chair.

The committee met at 2:48 p.m.

On Vote 29: ministry operations, $17,820,706,000 (continued).

J. Darcy: I’d like to begin by canvassing some issues related to health human resources, in particular as they relate to seniors care.

We have, on many occasions and over several years, had discussions with the ministry about health human resource strategies, shortages of various occupations. Certainly, one of the things that has been impressed on the ministry on various occasions is the importance of looking at — very broadly — what shortages we have in health care, not in restricting it to a few specific occupations. Certainly, organizations representing care aides have raised the issue over the years — about shortages of care aides in various areas of the province and the need to address that.

Now, the B.C. Care Providers recently has already spoken out on this issue, very strongly — that the ability to attract qualified care aides to B.C. has increasingly become a challenge, is particularly acute for residential care operators in the Interior and on Vancouver Island. For home support employers, this is a provincewide issue with chronic shortages in the north.

[1450]

They have stated that we are simply not training enough care aides to deal with what we’ve all known for some time, an aging population, and that the lack of care aides in the Interior and Vancouver Island and home support workers in Metro Vancouver is just an early warning signal of what lies ahead. Our workforce is also aging, Daniel Fontaine says, and it’s critical to ensure that we recruit and train enough staff to ensure the adequate levels of seniors care that are needed across the province.

[ Page 12696 ]

My question is: what is the minister doing to address the shortage of care aides — both those who work in residential care as well as those who work in home support?

Hon. T. Lake: The training of health care aides is carried out both in the public system and through other providers as well. Currently there are 41 education providers that offer the health care assistant program; 16 of these are public colleges. There are two school district programs and 23 private colleges. Quite a number of programs around the province.

Where we do see a shortage, we try to bump up the number of seats in that area. Since 2008, we’ve been providing one-time funding for short-term health education programs to address the immediate needs where we see the need in a community.

For instance, in 2013-14, part of that funding was awarded to Camosun College, here on the Island. In 2014-15, there was $356,000 awarded to the great university in Kamloops, Thompson Rivers University — to their health care aide program. I was there for that announcement and saw the great work they’re doing. In 2015-16, $153,000 was awarded to the College of New Caledonia for 18 additional health care aides in the Quesnel campus.

What we do is we have a base of 41 providers. Where we see there is a shortage in any particular part of the province, we inject money to boost the programming in that area to meet that demand.

J. Darcy: I’d like to turn to the issue that relates to staffing, human resources, and to continuity of care for seniors. This is an issue that we have also discussed extensively, both in estimates as well as in question period.

I want to go back to the Ombudsperson’s report on seniors care of several years ago, when she spoke of the significant mass replacements of staff.

[1455]

“Mass replacement of staff can occur when facility operators switch from contracting with one private service provider to another. Such turnovers can disrupt the lives of seniors in residential care, especially those…whose care needs are complex. Over time, long-term staff acquire specialized knowledge of these needs, so the simultaneous replacement of many employees can make it difficult for the seniors because continuity of care is disrupted. This is particularly the case for residents with dementia.”

She also goes on to talk about how incredibly stressful this is for families.

This phenomenon, which is…. We’re not revisiting legislation now, but we know it is a direct result of Bill 29, going back 13 years. We have more instances. There are instances of this that occur every year — mass displacements of staff, most recently Wexford Creek in Nanaimo where workers will lose their jobs and where care for seniors will be disrupted. The staff who care for their most intimate care needs will be torn away from them.

Last year in this place we discussed Inglewood, where the contract has been flipped five times, and Laurel Place. We could go back every year with numerous instances.

My first question on this is whether the Ministry of Health or health authorities are tracing the number of times that services have been contracted out or flipped in residential care.

Hon. T. Lake: The member and I share a concern. I know other members of her team have expressed a concern, and I know that members on our side have expressed concern.

When caregivers are subjected to a change in a contract or for a long-term residential care facility…. People do get very attached, obviously, to the people who care for them every day. It’s important to their well-being that there is continuity of care, that there is familiarity, that there is trust. When we do see a change, it can be impactful on residents and their family.

[R. Lee in the chair.]

I want to, again, just acknowledge what the member said — that through 2010, 2012 and 2014 collective bargaining agreements and the Bill 29 settlements, both health employers and unions agreed through negotiations to allow contracting out to continue. I want to stress that this was part of a discussion with the unions, and it was agreed that the ability to contract out would be preserved.

The member said that it’s happening more and more every year. I’m not sure that’s the case. We are in discussion with the seniors advocate, asking her to take a look at this particular issue.

What we have done, in the meantime, is we have developed a policy, which is policy 6.K, “Large-scale staff replacements.” This is policy that is in the Home and Community Care Policy Manual that health authorities have to follow. “Health authorities must ensure service providers plan and manage the change process for clients when a service provider is planning a large-scale staff replacement.”

The requirements are that they ensure that maintenance of the quality and safety of the client’s care is the priority through the process and that the client and their families are provided with information about the upcoming change; clients and families should have an opportunity to meet with the service provider, the new staff members, to identify key concerns; and ensure that the staff replacement does not happen until all clients are informed and have had an opportunity to have their concerns heard.

We acknowledge the impact this can have on residents and on families. We are working with the seniors advocate to look at making sure that we are tracking how often this is occurring and for what reasons it’s occur-

[ Page 12697 ]

ring and, in the meanwhile, ensuring that the impacts on families and residents is absolutely minimized by health authorities.

[1500]

J. Darcy: To suggest that anyone agrees with contracting out because they have been unsuccessful in achieving protections or guarantees against it is a bit of a stretch.

The reality is…. We discussed this very issue last year in this place, as we have in question period. The minister said exactly the same thing last year. “We have this policy. This is where you find it.” Referring to what the minister just said, he said…. It talks about meeting with family members, providing them with information. It doesn’t say anything about changing the practice.

Now, it is true that it is legal to contract out. It is legal to flip contracts. But the minister has levers. The minister has the ability to say…. Because the ministry provides funding to residential care operators through health authorities, the minister certainly has the ability to set policy that says that even in the event of contracting out or contract flipping, there is continuity of staffing and, therefore, continuity of care.

Besides the policy that the minister referred to, which involves meeting with and sharing information, what is the minister prepared to do to actually ensure continuity of care?

Hon. T. Lake: The member refuses to acknowledge that…. Bill 29, and the contract negotiations that occurred, was an agreement. Union members agreed that contracting out would still be allowed to occur. The reason for contracting out is in order to save money. There’s another way to save money, and that’s to not ask for so much on the other side of the bargain that is created.

This is a two-sided bargain. To suggest afterwards, after unionized members agreed to a certain raise, an increase to allow for savings on the other side, and then after the fact say: “Well, we didn’t really mean it. We didn’t want that….” Well, okay, give up the other side of the bargain as well. It’s just disingenuous to suggest that the government or the contractors should give something up when it was bargained for in good faith by both sides.

What we have said is that we are going to monitor this situation. We have instructed the health authorities to minimize the impact on families in the ways that I just outlined. That’s what we are doing. We want to minimize impacts on families while still ensuring that we have a sustainable system of caring for our seniors in residential care. Again, the answer from the member opposite is always: “Just put more money into something.” There has to be a way of ensuring that the system is sustainable. That is why the bargain was made — the grand bargain to allow contracting out to continue.

J. Darcy: Well, we’re not going to pursue that line of discussion further. I’m actually extremely familiar with what the minister is talking about, and he has it wrong. But that’s a discussion for another time.

Let’s move on to….

Interjection.

J. Darcy: The minister is laughing, but the impact of contract flipping on seniors care, on their morbidity and their mortality, is well documented.

Let’s discuss the issue of staffing level and staffing mix in residential care. One of the issues that has been discussed in question period over a number of days this session is the issue of….

Interjections.

J. Darcy: I’m sorry, hon. Chair. I’m….

The Chair: Minister.

Member.

J. Darcy: Thank you, hon. Chair.

We have spent some considerable time talking in this House during this session about the 3.36 hours of care that is the guideline for care per resident in residential care.

[1505]

My question to the minister has to do with whether or not his ministry has provided any advice, guidance or direction to health authorities beyond the 3.36 hours of discussion starter, which seems to have been in place for some time.

It would appear that health authorities have, in some cases, developed their own staffing mix guidelines. For instance, in Island Health, there’s a requirement, I understand, that contracted long-term-care providers meet that direct care hour accountability for which they are funded. But there is flexibility in those accountabilities, with the minimum of professional hours being 15 percent. Professions, as defined in the Health Professions Act, can include dieticians, occupational therapists and social workers. It would appear that the hours of care per resident can vary depending on the professional percentage.

In Vancouver Coastal Health, I understand, they have recently reviewed staffing levels, and they’re attempting to standardize it with a new model of a mix of 10 percent RNs, 22 percent LPNs and 68 percent care aides, with the maximum number of RNs proportionate to facility size, which I understand was rolled out just last month.

My question is whether or not the ministry is planning to apply some consistency across health authorities, across the province — some consistency between funded residential care facilities. Just further to that, I know that

[ Page 12698 ]

an increase in residential care fees back in 2010-2011 was supposed to standardize staffing across the sector. That clearly has not worked. What are the ministry’s plans or intentions to standardize care?

Hon. T. Lake: When the changes occurred to client rates in 2010, we committed to ensuring that all additional revenue would be invested to improve residential care services. In fact, that is what happened. Over $250 million of incremental revenue between 2010 and 2013 went into increasing staffing levels, increasing staff education and acquiring equipment.

Seniors in residential care obviously do not all have the same care needs. So 3.36 direct care hours are included as a guideline to help planning when health authorities are looking at moving forward and at the needs to help them with budgeting. But it is not a requirement at this time.

The mix of the seniors that are being cared for in the residential care facility will dictate the number of hours. In many of the health-authority-owned-and-operated residential care homes, the needs of the clients are higher. It is not unusual to see a higher number of direct care hours in those HA-owned-and-operated facilities.

In other health care residential care facilities, the needs are at a lower level. The staffing number of direct care hours can be lower, reflecting the lower needs of that population base. It is not a requirement. It’s a guideline.

I know that the seniors advocate has been thinking about this. I remember this discussion when she first came on board. She was not at that time a proponent of mandating hours for every resident of residential care services based on a particular number. I know that she has been doing some thinking about that, and her opinions have evolved.

[1510]

I have asked my Parliamentary Secretary for Seniors, the MLA for Abbotsford South, to work with the seniors advocate, to work with the community of care providers and with the ministry to look at the number of hours for client care in residential care. I look forward to seeing the results of that work later this year.

J. Darcy: I’d like to move on to staffing shortages in the area of health science professionals. We have, in several areas amongst health science professionals, some significant shortages, according to the occupations most in need in both the ministry’s documents and documents that flow from the Ministry of Advanced Education. Some of the most acute shortages, I understand, are in the area of diagnostic medical sonographers — that is, the folks who do ultrasound — psychologists, physiotherapists and also occupational therapists and respiratory therapists.

When we’re talking about shortages, we’re talking about budgeted vacancies that employers are trying to fill but can’t find people to hire in order to fill those. Even though there are not huge numbers of health science professionals in some of those categories — the percentage in terms of people employed in public health care in those categories — it has a very huge impact. There is a growing reliance, in the case of sonographer and psychologist positions and several others, on privately contracted health science professionals, who actually cost the health care system more.

My question for the Health Minister is: what steps is the ministry taking to address the shortages of health science professionals in areas like sonographers, psychologists, physiotherapists, occupational therapists and respiratory therapists? I understand one of the issues is that we have far more people applying for these positions than we have training spaces. What is the ministry planning to do, together with the Ministry of Advanced Education, to ensure that we have the training spaces in order to fill those needs?

[1515]

Hon. T. Lake: The member asked about a number of professions. Each of them has their different challenges.

Ultrasonography. We have increased the number of seats at BCIT from 24 to 30, and there is still some challenge in filling all the vacancies. Part of that challenge has been some of the wage disparities between what health professionals in this category would earn here versus Alberta. Alberta stands out as quite a bit higher from all other provinces.

I recall a discussion I had with a former Minister of Health from Alberta who admitted that they had been solving labour issues by writing very large cheques for a long time. He did not think that was sustainable.

When we look at the gap, Alberta, for instance…. The hourly wage for a six-year ultrasonographer is about $9 more in Alberta than it would be in British Columbia and about $15 more than it is in the province of Quebec. You can see that our proximity to Alberta and the ease of mobilization certainly is a challenge when we’re trying to keep ultrasonographers here in the province of British Columbia.

Health Employers Association of B.C., working with the Ministry of Health…. We do a forecast of health human resources. Each of the professions that the member asked about is included in our forecast.

Now, forecasting is exactly that. It’s your best estimate of the needs over time. With ultrasonographers, it’s estimated that as we move into 2016-2017, the supply will be somewhat nearer to the demand than it is today. But again, that’s a forecast. That will be with our population coming, increased numbers coming out of BCIT, and I think we will see a migration of health care professionals back from Alberta over the next number of years. Again, it is a forecast.

We work with Advanced Education. We have, through our agreement with the Health Sciences Association, a

[ Page 12699 ]

recruitment and retention committee to look at each of the areas that the member has mentioned, look at the number of seats available and make a plan, going forward, to meet that demand.

Rather than go through each of these professions in turn, I would commit to the member that we will provide a written response for all of those professions that she has outlined.

J. Darcy: That would be greatly appreciated.

Just on the issue of physiotherapists, my understanding is that we have far more people applying to get in, in an area of significant shortage. As well, we have far more students applying to get into the program every year. The last number I have is 310 applying in September of 2013. There are only about 80 of those accepted, some of them in the northern, rural and remote cohort, each year.

Are there plans to increase the number of training spaces? Perhaps that’s part of what the ministry can provide — what plans there are to increase training spaces in the area of sonography, physiotherapists and the other health care professionals that I referred to.

[R. Chouhan in the chair.]

Are there any plans to expand those training spaces so that they are provided outside of the Lower Mainland, because we know that health professionals are far more likely to stay in the communities or the regions that they come from and where they receive their training?

[1520]

Hon. T. Lake: When I went to UNBC, I actually participated and met with the physiotherapists there that were established as a northern and rural cohort in September 2012. This is part of the UBC training, but it gives students training and experience at UNBC. That is to the member’s point that we need to ensure that physiotherapists are looking at all areas of the province to practise.

We have identified a gap in physiotherapists, which by 2018 will mean we’ll be falling short by 169 physios. That’s our estimate. As I said, that’s a forecast. Difficult to know exactly because people move in and out of the province. We’re seeing a net migration of people from Alberta at the moment.

However, the ministry is currently engaged with the Ministry of Advanced Education and other health system partners to analyze both public and private post-secondary education and training programs, including clinical placement capacity. That analysis will be used in concert with workforce planning models to identify opportunities to realign programs with the population health needs.

It is very competitive to be placed in the master’s program, which is what the physical therapy program is. I know this because a former ministerial assistant of mine, who was very, very keen, was very interested in entering the program. We’re doing work with the Ministry of Advanced Education at the moment, and part of that will look at training physiotherapists in more parts of the province than currently occurs.

J. Darcy: The minister will also be aware that in addition to training, the clinical practicum spaces are absolutely critical. What is the Ministry of Health doing to ensure that we have an increased number of clinical practicum spaces for sonography students as well as physiotherapy students?

[1525]

Hon. T. Lake: Yes, in my last answer I said that we were looking at the training programs, including clinical placement capacities. That’s a joint committee that we have with the Ministry of Advanced Education.

The member is quite right. It’s one thing to have the classroom time, but you need to have those clinical placements available at the same time, so we are looking at that as well.

J. Darcy: The minister referred to working with the Ministry of Advanced Education. I know that if we look at the B.C. labour market outlook, health occupations as a category are predicted to have the sixth-highest number of vacancies over the next ten years. That’s out of ten broad occupational groups, including some that we discussed yesterday — RNs, as well as specialty nurses, nurse practitioners. Previously we talked about health care assistants, care aides and licensed practical nurses.

The occupations that we’re discussing now — health science professionals — certainly are on that list: physiotherapists, OTs, respiratory therapists, stenographers, medical laboratory technologists and profusionists.

I understand there is a cross-ministry committee that is dealing with shortages in priority occupations going forward. Is the Ministry of Health represented on that committee? If so, who is it in the ministry that sits on that committee?

Hon. T. Lake: The Ministry of Advanced Education and the Ministry of Health have formed a partnership committee on health and education. It stays in close contact with the cross-ministerial committee looking at labour market needs.

The member is quite right. We talk a lot about trades and technologists. When you look at the health professions, it is right up there in terms of the demand that will be there for professions, and so we are paying a lot of attention to that.

We have, as I mentioned, the partnership committee on health and education, which acts as a forum to facilitate strategic planning and dialogue, to make recommen-

[ Page 12700 ]

dations on an integrated provincial approach to practice education, simulation and other issues where health and education intersect.

We have a wide membership here. We have members — executive directors, for instance — from the Ministry of Health. From the Ministry of Advanced Education, we have a director of the provincial practice education, Health Sciences Placement Network from the Provincial Health Services Authority. We have chief nursing officers from the Chief Nursing Officer Council. We have the First Nations Health Authority. We have VPs of human resources representing the health authorities, the VPs of medicine from the health authorities.

[1530]

UBC is represented there — the associate provost of health; research university, health and human services dean; teaching university’s school of health sciences dean; and a regional post-secondary institution dean from science, technology and health from Okanagan College. So it’s a combination of health authorities, ministries involving Advanced Education and Health, and academic institutions that all work together to plan and look for the gaps that we will be looking at so that we can meet the demand in these various health professions.

J. Darcy: I’d like to move on now to what we refer to as general health categories — so it’s not about health human resources — and the issue of insulin pumps, diabetes care.

The minister is, I know, very well aware of the numbers of people living with diabetes in the province of British Columbia — according to the Canadian Diabetes Association, approximately 460,000 diabetics in B.C. Those numbers are predicted to steadily increase. Of those people living with diabetes, approximately 20,000 have type 1 diabetes. The minister will be very well aware, of course, of the impact of diabetes on the health care budget and that diabetes cost British Columbia $1.6 billion last year.

The member for Vancouver-Kingsway, in a previous role, was really very active in leading the efforts in this province to get coverage for insulin pumps for type 1 diabetics for whom they were clinically necessary. The government did, a few years ago, agree that insulin pumps would be covered up to age 25 under the PharmaCare program. But as the minister also knows, there are many type 1 diabetics over the age of 25 for whom an insulin pump is not just valuable but considered medically necessary, clinically required by their physicians and by their endocrinologists. They’re not covered past the age of 25.

At the cost of $7,000 per pump, that puts insulin pumps out of reach for thousands of British Columbians.

We know that the diabetes pumps can significantly reduce the risk of serious complications like blindness, kidney failures, heart attacks, strokes and amputations. The case is being made powerfully by the Canadian Diabetes Association and by a very active group called Young and T1.

[1535]

Will the minster change the government’s policy and decide to start funding insulin pumps that are clinically required beyond the age of 25? There are indeed cost savings that have been clearly demonstrated by the business case made by the Canadian Diabetes Association. Will the government change its policy in this regard?

Hon. T. Lake: Of course, we’re always analyzing proposals that come either up through the ministry or through patient advocates. That’s what we did when we met with the Canadian Diabetes Association and advocates — some very powerful advocates, I might add. I have to give a shout-out to Nel Peach, who was very persuasive when we looked at covering insulin pumps up to the age of 25.

You know, it’s often where you’re going from late teens into early adulthood, a lot of people are going to university or just starting a job, and so often don’t have extended health care coverage, which would cover the use of an insulin pump. I think that what we did — I believe it was about 2½ years ago — to increase the coverage to cover everyone that wanted an insulin pump up to age 25 made a big difference in the lives of those people.

Now, there’s no question that for some people an insulin pump is the best way to control their diabetes. I’ve talked with some type 1 diabetics who prefer to use injections, even though they have coverage which would provide them with an insulin pump. It is not necessarily the best control mechanism for every type 1 diabetic, but we do understand that for many a pump is preferable. It costs, I believe, around $2 million each and every year when we made the change to cover the insulin pumps for those up to age 25.

After meeting with the Canadian Diabetes Association and Nel and some of the other advocates just recently, here in Victoria, I’ve asked my staff to go back and look at this issue to see what it would cost to extend the coverage of insulin pumps. Of course, when we are dealing with the allocation of scarce resources, these are decisions that have to be thoughtful. For every decision you make to increase coverage in one area, you have to look at how you’re going to manage your entire budget.

For 2016-17, our PharmaCare budget is $1,174,714,000. You would think that a few million dollars here or there doesn’t make a lot of difference, but the reality is that every time one of these decisions is made, it means that something else can’t be covered. When we’re looking at the addition of the newer hepatitis C drugs, which come at a cost of $50,000 to $70,000 per treatment, it leaves little room for flexibility on some other areas that you would like to increase coverage.

I have not ruled out a future decision to increase the coverage of insulin pumps, but we are faced with the challenge of finding out where we can find savings that

[ Page 12701 ]

would allow us to do that. I must say that our staff work very hard to look for those opportunities to have savings so that we can use those savings to increase coverage in areas where we know it would make a difference.

J. Darcy: I’m certainly glad to hear that the ministry is taking a hard look at this. The Canadian Diabetes Association estimates that of the 20,000 type 1 diabetics in British Columbia, approximately 13,000 of them are over the age of 25. They also estimate based on that that only about 40 percent of those would probably decide that they wanted to use an insulin pump. It is, absolutely, very much a matter of not just personal choice but also very much what medical advice people receive about the situations in which this is clinically required.

Alberta and Ontario have both introduced coverage beyond the age of 25. What was introduced in those provinces states very clearly that we’re talking about clinically required, medically necessary, and it spells out what that is.

[1540]

Certainly, the people who have come to this place to advocate on this issue have been very, very clear about what kinds of complications and what kinds of costs to the health care system have already been avoided because they were on an insulin pump up to the age of 25.

Some of these young people — and it’s not just about young people — sure as heck don’t have access to extended health coverage that pays for this. Some of them have now been on insulin pumps for a number of years and can’t afford to stay on one. Companies are calling back the pumps that they have as loaners.

Can the minister say within which time frame he hopes to make a decision about extending insulin pump coverage beyond the age of 25? There are an awful lot of people waiting on his answer.

Hon. T. Lake: I apologize for not introducing my staff from the PharmaCare division. Barb Walman is assistant deputy minister, and Mitch Moneo is executive director. I want to thank them publicly because they’ve done some phenomenal work on a number of very difficult files, and I always appreciate the advice they give me.

I can’t commit to a timeline at this point. It is, as I mentioned, a delicate balance looking at the potential savings in other areas. We are working on a number of different plans to try to save money in our PharmaCare budget. When we are further down the road of realizing those savings, we’ll be in a better position to be where we can make a decision to cover insulin pumps for everyone, or, unfortunately, it may be that we won’t be able to make that decision because we can’t find the savings. It is something that we are committed to working on, but I cannot make promises at this point.

I do want to make this point: even if we do not cover an insulin pump for someone 25 or older that is using one, we do pay for all of their insulin pump supplies. That’s an important factor. In 2014-15, our expenditure for insulin pumps was $2.19 million, and for insulin pump supplies, it was $3.9 million — so a significant public coverage of insulin pump supplies, which does, obviously, help those that are using a pump, even if the pump itself is not covered.

J. Darcy: I’m well aware that the supplies are covered, but $7,000 is a cost that very, very few people can afford to pay. It essentially means that we’re talking about unequal access to health care. If you can afford to pay for your own pump beyond the age of 25, or if you’re lucky enough to have a Cadillac extended health plan that covers it — because most plans don’t — then you have access to it. If you don’t have enough money in your bank account or you have a lousy or nonexistent extended health plan, then you don’t have access to it.

I’d like to move on to HPV vaccine.

[1545]

About a year and a half ago, I wrote to the minister about two boys in my constituency who had just learned that they were not eligible to receive the HPV vaccine that girls in their classrooms were receiving. I raised that issue with the minister. At that point, boys were not covered at all.

Last year, the Minister of Health expanded the HPV vaccination program to include boys and young men that it deemed as “vulnerable,” such as those who are gay, bisexual or questioning, along with those who are street-involved or HIV-positive. But the reality is — and this won’t be the first time the minister has heard this — that this policy move is discriminatory in that it forces boys and young men to come out as gay, bisexual or questioning to their parents and classmates in order to receive the vaccine.

Will the Minister of Health do the right thing and expand vaccination to all boys and young men, not just those who are prepared to out themselves, with all of the stigma that is still attached to that?

Hon. T. Lake: Again, when we are looking at allocation of resources, we need to make sure that we are using them optimally. The vaccination of girls in a school-based program does provide a level of herd immunity for the population. But it has been identified that there are some males that are at risk, so we have allowed that vulnerable males would be eligible for the vaccine — but not in a school-based program. It is not a requirement that any male would identify or put themselves in a position that they have to make a public announcement about anything. They can simply go to the public health service and say that they are vulnerable, and they will be provided with the vaccine.

[1550]

[ Page 12702 ]

J. Darcy: I think the minister is missing the point. We are still putting these boys or young men in a position of having to self-identify about their sexual or gender identity or self-identify as being at risk. That, itself, is a barrier to ensuring that, in fact, the protections are in place for some of the young men who are most in need of the vaccine.

By doing this, we are also effectively…. We’ve now said that certain males, if they self-identify and risk the stigma that goes with that, can have access to the vaccine. We are effectively saying that responsibility for vaccination, in order to protect against diseases that have to do with sexual activity, if they are between girls and boys, males and females, are girls’ responsibility, are females’ responsibility.

It seems to me that this is discriminatory on both counts. Surely, we want to have boys and girls — in this case, ensuring that boys, all boys — take responsibility for sexual activity and what might flow from that.

One of the best ways to ensure that we have the greatest possible protection, including what is referred to in the public health field as “herd immunity,” which we only achieve when a certain percentage of that population of young people actually receives the vaccine…. Surely, we want to increase the numbers significantly in order to have that kind of herd immunity, for the sake of preventing cancers amongst this population and because of the costs that would be incurred by the health care system down the road when they do.

Can the minister speak to both issues, both what self-identifying means for young boys and also the fact that we are effectively putting the onus for male-female sexual relationships on girls by not protecting all boys?

[1555]

Hon. T. Lake: I want to go over a couple of points if I didn’t make it clear. If you’ve got a young male that is concerned about human papillomavirus and being exposed to the virus, they simply have to attend with a public health nurse in a confidential manner. It does not need to involve anybody else. They don’t have to make a public statement. They don’t have to reveal to anybody else what their concerns are and why they feel they’re vulnerable. The vaccine would be provided free.

The vaccine, for the member’s edification, is $250 for the series of vaccines, so it is not an inexpensive vaccine. Again, we are dealing with finite resources and how we use those finite resources to get the best possible coverage of immunity for these particular diseases that we are forced to confront.

We’ve gone from a situation where no boys were being vaccinated — which is a position taken by most jurisdictions, by the way. The member has quoted two jurisdictions, but two out of 13 jurisdictions across the country is certainly not a majority. Now we’ve gone to where we have provided the opportunity for the highest-risk males who will not benefit from the herd immunity that is created by vaccinating females. We’ve provided that opportunity for them to be covered.

If the member is criticizing a decision that has provided coverage for vulnerable males, well, I’m sorry, but these are the decisions that have to be made when you have a finite number of resources. It is a decision that’s made on the advice of professionals like Dr. Bonnie Henry, who is our deputy public health officer; Dr. Perry Kendall, our provincial health officer; and Warren O’Briain, who is my executive director. These are the recommendations that come from committees.

If, in fact, we can bring the price of that vaccine down, reconsideration can be given. But these are the decisions that have to be made in order to utilize the resources we have available.

J. Darcy: The minister refers to other jurisdictions, and he also refers to costs. There was a study done by Princess Margaret Cancer Centre in Ontario that found that if all Canadian boys aged 12 years of age were vaccinated in 2012 there would be a savings of $8 million to $28 million for this cohort over their lifetime.

Speaking of other jurisdictions, in April of this year Ontario extended HPV vaccination to all youth, joining with Prince Edward Island, Alberta and Nova Scotia. So British Columbia would be the fifth in line if it were to join those.

Speaking of expert advice, the Canadian Cancer Society of British Columbia is calling for a gender-neutral HPV immunization program. So are the National Advisory Committee on Immunization, the Federation of Medical Women of Canada, the Society of Obstetricians and Gynaecologists of Canada, the B.C. Pediatric Society and the Canadian Medical Association.

They have all called for a gender-neutral HPV immunization program based both on cost analyses such as the Princess Margaret study and on the growing numbers of cancers that are developing amongst girls and boys as a result of the HPV. Has the minister studied those other provinces’ decisions as well as the cost-benefit analysis that has been done in other jurisdictions?

Hon. T. Lake: Yes, we look at all of these studies. I believe that the Princess Margaret study was before a universal female program was instituted. One of the reasons we went to a targeted program for males was a result of a study that indicated a targeted program for males would be highly cost-effective.

[1600]

That’s the decision that we made based on studies that showed that it would be highly cost-effective to cover vulnerable males in a way that, I believe, protects the confidentiality and privacy of the patients that are being vaccinated. And I’m assured that since the HPV vaccine has been available, we are seeing the number of infections drop. The herd immunity is developing with the univer-

[ Page 12703 ]

sal female program. Adding the targeted male program will add to that — the gap in herd immunity for vulnerable males in a manner that has been studied and shown to be highly cost-effective.

J. Darcy: I’d like to move back to PharmaCare issues, if we could. I’d like to ask a number of questions related to pharmaceuticals, beginning with the issue of the Trans-Pacific Partnership and its potential impact on drug costs.

The Trans-Pacific Partnership, for which this government seems to have given its unequivocal support…. There are numerous research reports that indicate that the TPP is likely to increase drug costs for British Columbians. I’d like to ask the minister whether he has done any research into the cost of the Trans-Pacific Partnership on drug costs for individual British Columbians and for the provincial PharmaCare program.

[1605]

Hon. T. Lake: Two agreements could have an impact on pharmaceuticals. That’s the Comprehensive Economic and Trade Agreement, or CETA, between Canada and the European Union, and the Trans-Pacific Partnership, which is a free trade agreement that includes 12 countries around the Pacific area.

The federal government, obviously, is leading those negotiations. In terms of CETA, the federal government has said that they are prepared to address any incremental cost impacts to provinces. In the Trans-Pacific Partnership, we have expressed our desire to work with the federal government to look at compensation related to any potential increased drug costs — of, first of all, CETA.

Alberta is leading a CETA working group, with Manitoba and Ontario, to look at the impacts of CETA to provincial and territorial governments. They are working to represent the provinces and the territories on CETA and the potential impact it would have on pharmaceuticals. We would, at the provincial-territorial table, work in that same process so that any potential impacts to costs of pharmaceuticals to provinces would be compensated by the federal government.

J. Darcy: Well, I’m glad the minister referred to CETA, because it is estimated that this could lead to increased drug costs of between $850 million and $1.6 billion annually, primarily because of extended patent protections for drug manufacturers. The TPP could extend those patent protections for as much as five years.

We already know that drug prices in Canada, compared to many other countries — U.K., France, Italy and others — are significantly higher, including outpacing countries like the United States, and that we’ve seen approximately 184 percent growth in total drug costs.

I guess my question to the minister…. The minister is suggesting that the federal government is going to reimburse provinces for the, potentially, hundreds of millions of dollars of additional costs that could be incurred by the health care system in British Columbia. Does this government have a firm commitment of that from the federal government?

Hon. T. Lake: I just mentioned that Alberta is co-chairing a provincial-territorial committee to have those discussions with the federal government. Of course, with the change of federal government recently, those discussions will probably be refreshed, and they will be very active.

This new federal government has come to the table with the provinces and territories in joining the Pan-Canadian Pharmaceutical Alliance, which allows us to purchase, I believe, 18 drugs now, commonly drugs used drugs across the country, at 18 percent of brand name. Adding the federal government to that table — because they cover a lot of people that either work for the federal government or through extended health care plans that they currently cover, to First Nations in particular — will give us increased bargaining power.

[1610]

They have indicated a willingness, the new federal government, to working with the provinces and the territories. I’m optimistic that they, in their quest to create these trade partnerships internationally, will look at the impacts on the health care system for provinces and agree to mitigate those.

We don’t have a solid commitment at this point, as the member well knows. The discussion about the federal participation in health care funding is a very lively one at the moment, and we continue to push them in what we feel is the right direction.

J. Darcy: The issue of a national PharmaCare program has been the subject of considerable discussion in recent years, including during the recent federal election and in the Federal, Provincial and Territorial Health Ministers meeting, which the minister took

part in earlier this year. I have been struggling to understand what the B.C. government’s position is on a national PharmaCare program.

I know that there were provinces and Health ministers that advocated very strongly for a national PharmaCare plan. One day the Premier was quoted in the media saying: “Yes, we’re supportive of a national PharmaCare plan.” A couple of days later the minister, when interviewed after the Health ministers conference, expressed serious concerns. “Ambivalence,” I think, was the term he used.

In the discussion about a national PharmaCare program, certainly on this side of the House what we support and what the CMA, nursing organizations and many organizations across the country and across B.C. support is a national PharmaCare program — yes, bulk-buying, absolutely — in order to increase economies of scale between provincial and territorial governments and the fed-

[ Page 12704 ]

eral government. That’s absolutely an important part of it. A national PharmaCare plan is also far more than that.

The minister referred yesterday to…. When we were talking about doctors and fee-for-service, he talked about the original conception of medicare, which was, yes, initially about hospitals and the payment of doctors.

Certainly, the vision of the founders of medicare and the approach that many health care advocates take today is that if we’re going to take public health care, medicare, to the next step, it needs to include a national PharmaCare plan that is not just about bulk-buying but that is, in fact, about taking serious steps towards a universal PharmaCare program. That would enable Canadians who cannot afford to take prescription drugs that are vital to their health also to be able to have that kind of health care coverage, in addition to reducing costs significantly for governments and for our public providers who cover PharmaCare and drugs for a certain percentage of the population.

What is this government’s position on the need for a national PharmaCare program — not just bulk-buying but a national PharmaCare program?

Hon. T. Lake: Well, we had a very interesting discussion at the federal, provincial and territorial meeting. I wouldn’t say it was a very extensive discussion. We had a deeper discussion when I went to Toronto and the Ontario minister hosted a round table on this topic. I think Dr. Steve Morgan was there from UBC. He’s a big advocate of a national PharmaCare program. But I would say that there were differing opinions around that table. I’m sure the member has read the different opinions that are out there.

Currently, extended health care programs do cover a lot of the costs of pharmaceuticals for many Canadians. When the member talks about the impact on the public health system of making certain decisions, she would know that there are studies that show that a national PharmaCare program would transfer between $5 billion and $8 billion worth of pharmaceutical costs from the private sector to the public sector.

Now, that is a significant amount of money that needs to be found, unless there are levers built in to the system to reduce the costs of those drugs. Through bulk-buying, we are able to get the costs down, but there’s certainly no guarantee that instituting a national PharmaCare program would reduce the cost to the public system. It may reduce costs to individuals that don’t have extended health care plans. I will say that. But it comes at a big cost to the taxpayer.

[1615]

The Fair PharmaCare that we institute in British Columbia looks at individuals and their financial resources when making judgments on coverage. For instance, low-income British Columbians — I believe it’s plan C — will have essentially all of their drugs, extended health care, covered by the government plan. As your income goes up, then the burden transfers over to the individual. In many cases, individuals will have extended health care plans that will cover that.

A national PharmaCare plan sounds very good from a high-level, idealistic point of view, but it comes with very real fiscal impacts that cannot be ignored. What I have said — and, I think, an idea that is getting some traction among Health ministers, including the federal Health Minister — is to look at a common formula across the country of commonly used pharmaceuticals.

[R. Lee in the chair.]

Rather than say that we will have a national PharmaCare program that covers all drugs, maybe look at the top, let’s say, 40 or 50 drugs initially in a national formulary that we all agree on. That, I think, would achieve some savings without having the enormous transfer of costs from the private to the public. There’s some work going on to look at that potential idea.

Here’s another reason why I’m not necessarily, at this point, anyway, a fan of a national PharmaCare program. As provincial Health Minister, it is my responsibility to be the steward of the taxpayer dollars that go into health. At the moment, the Health Ministry spends $2 million every single hour — $18 billion a year. So when we look at our PharmaCare plan, which is about $1.2 billion, we need to look at ways and means of saving money.

We have things like the low-cost alternative program, where we say to pharmaceutical companies: “Here’s a particular molecule that has a certain physiological effect, and we want to get the lowest possible price we can.” We open it up for the drug companies to make an offer in terms of giving us that particular molecule.

We also have reference drug-pricing programs, where we look at the common outcomes of a particular pharmaceutical — it doesn’t necessarily have to be the same molecule but a similar molecule that has the same impact, the same clinical benefit — and say that we are going to cover the lower cost of that category of medication that has a clinical impact.

If you give up those decisions to someone else, you lose the ability to save money in your PharmaCare budget. I’m not prepared to do that, because I take that responsibility very seriously, unless there’s a system developed that assures me that there’s not going to be a transfer of costs from the private sector to the public sector that doesn’t come with some of these other levers that allow us to reduce the cost of these particular medications.

J. Darcy: Just on the issue of cost. The minister may be familiar — I have no doubt he is — with a new report by Dr. Marc-André Gagnon, who has found that there are, in fact, tremendous savings to British Columbia if it were to participate in a new national PharmaCare program.

We’re both talking about overcoming the inequities

[ Page 12705 ]

that have health consequences that are costly for those thousands of British Columbians who don’t have health care coverage. They’re not low-income enough to be covered by Fair Pharmacare, and they don’t have coverage themselves. That means that they cannot afford prescription medicine. The minister must hear from these people. I hear from them every week in my constituency. I know that my colleagues across the province do. This compromises their health, with financial consequences for the health care system.

[1620]

Dr. Gagnon’s report also highlights a savings of at least $105 million to British Columbia with a universal PharmaCare program and even higher savings, of as much as $1 billion, if the provinces were to, together with the federal government, decide to repeal certain cost industrial policies that, in fact, have the impact of pushing up prices for drugs considerably.

My question to the minister is whether his ministry has examined that report and whether he has any response to a report that says that in fact a national PharmaCare program can reduce costs for British Columbia and other provinces.

Hon. T. Lake: I will repeat that I can see your one report and raise you two other reports. The science is not settled on national PharmaCare and whether or not it would result in savings to the public health care system. The member can quote studies all day.

This group that works in the Ministry of Health examined all of these. We do talk with experts in the field. We look at what the impacts will be on the province of British Columbia and the taxpayers of British Columbia and the patients of British Columbia, and we make decisions based on that. If someone can unequivocally guarantee that the cost to the British Columbia taxpayer and the cost to the patients and the benefits were to be accrued in a national PharmaCare program, then I would be the first in line. But I have not been convinced by the evidence that I have seen to date.

J. Darcy: I have several other questions related to pharmaceuticals. I know that the member for Delta North has some questions that we’ve been trying to figure out a time for — to work in some questions. If we could shift to some questions for the member, I believe a couple of them she feels she can put on the record and get a written response, but there’s also one she’d like to ask directly.

V. Huntington: I’ll just say that I’m the member for Delta South.

Interjection.

V. Huntington: Quite all right. Just so that my constituents, when reading Hansard , will know.

I’ll just follow up with the issue of PharmaCare for a moment, if the minister wouldn’t mind answering.

I’ve had a constituent approach us mentioning that he is able to buy products, which are provided by PharmaCare providers in the community, on line far more cheaply than he can get them through the community provider, and he is wondering why he’s not permitted to purchase these products — one of which, for instance, is the ostomy skin barrier. He can buy it $5 cheaper on line than he can through PharmaCare. He’s wondering why he is not permitted to do so and whether the ministry is looking at that option as a fairly significant way of saving money across the system.

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Hon. T. Lake: The short answer is: protection of the public, and I’ll just explain what I mean. The role of the College of Pharmacists is to protect the public by licensing pharmacists and, with the new changes we’ve made to the pharmaceutical operations and drug dispensing act, also the pharmacies themselves — the actual sites. That is because when you are talking about a particular product or a pharmaceutical, it’s the pharmacist’s role to protect the patient by ensuring the integrity of the product or the pharmaceutical. We are able to do that by auditing pharmacies to ensure that the product or the pharmaceutical is exactly what it is claimed to be.

The role of the college, of course, comes in regulating the pharmacies and the pharmacists, and they don’t have reach on line, so essentially, you are allowing unregulated suppliers to provide products into British Columbia. And if there is a problem with that product, we don’t have the capacity through the college or through the ministry to take action to protect the public.

V. Huntington: I understand that particularly in the case of products that would be ingested, internalized or are incredibly important for medical purposes. But perhaps on products that aren’t so necessary to regulate carefully through the PharmaCare, like an ostomy skin barrier…. Maybe if I read the question in, we could get a written answer back on the rationale.

Why are British Columbians unable to be reimbursed for purchasing identical medical supplies that would be covered by PharmaCare if sold by a registered PharmaCare provider? I can leave that for the minister to perhaps get back to me with an explanation of the less important, perhaps, regulated items.

The other is that a constituent approached my office asking for assistance in having increased funding for the cochlear implant program at St. Paul’s Hospital. I wondered…. There’s a two-year wait list at the moment. For those needing cochlear implants, this is a very serious hearing issue and definitely a problem for the people needing them.

Can the minister tell us — this, again, I don’t mind receiving a written reply — how many cochlear im-

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plants are funded by the government at St. Paul’s each year and if there is a plan to reduce wait times for British Columbians? Again, I don’t mind if I receive a response at a later date.

My last question is about patient medical records. South Delta is in the throes of the…. I won’t say failure, because I recognize how difficult it is to follow through the GP for Me program, but we are having a very significant time and problem in the community with retiring physicians.

The ancillary to that is while patients are being left adrift and they are attempting to obtain their medical records, they are being forced to buy these medical records back from the company where they are being stored. To have these records transferred back, which people think of as their own medical records, it’s costing more than $100 and sometimes up to $200 for families to get these records back so that they can be given to a new doctor, should one become available.

My office has contacted DOCUdavit and discovered that they offer substantial discounts for individuals who are on social or disability assistance but, in fact, don’t advertise that problem. So we’re having to tell people who come in: “Have they looked at that possibility of reduced record transfer costs?”

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My question is: what is the rationale for insisting that patients who do not have a doctor because their doctor is retired and cannot have another doctor because there are substantial waiting lists for doctors in a community…? Why hasn’t the government looked at dealing with this cost of obtaining personal medical records?

Is there not some program that the government could offer assistance or full payment for the medical transfers? Could they not set up their own payment for in-province storage of the medical records so that people can avoid having to pay for their own medical information in order to find another doctor?

Hon. T. Lake: I want to answer the member’s question on non-pharmaceutical products on the Internet. It will save a response from the staff.

When you’re looking at ostomy barriers, for instance, you can imagine that if a subpar product was utilized from a provider that is not approved here in the province of British Columbia, you could have some serious problems with infections, for instance. The fact that you’re not taking it internally doesn’t mean there’s not a risk in terms of the quality of the product. That, I think, is the reason there.

The member is asking about medical records. I share her frustration on this topic. It seems intuitive that the medical information about a particular person belongs to that person, but in fact the information is gathered and kept and owned by the physician. They keep it, and they, essentially, can transfer it to the patient if they want to. If the practice closes, it’s kept in storage, and there’s a cost to providing that. So I understand the frustration.

If we were to pay all of those fees, it would come at a substantial cost to government. We haven’t looked at that particular approach. What we are doing is looking at empowering patients more than we currently are empowered as patients.

I’ll give you an example of a system that has been piloted in Nova Scotia for two years that provides a patient portal, a secure website, not unlike a banking website where you have your own identification and password to get into. You can create a virtual community with your physician, with your pharmacist, with the laboratory that provides tests, with the health authority to provide imaging, for instance, that occurs. That has been a very successful pilot in Nova Scotia.

What it does is it empowers the patient. The patient can decide who gets to be part of that virtual health portal. The patient owns that information and can download it and do with it what they want.

I sat down with the Privacy Commissioner to talk about this. She assured me that, in fact, that was perfectly fine because the patient then owns the information. You don’t have to worry about the sharing of it. It’s up to the patient to share it.

I think that’s the way we’re going. It empowers patients. In fact, in Northern Health, there are some physicians that are setting up these types of virtual patient portals. There are some hospitals that are working on this and are very close to doing it, at least in terms of the health authority information.

I know the member is probably familiar with the Excelleris program. When you go to a diagnostic laboratory through LifeLabs, you can access that information on your computer. You can see the results of that blood test at the same time your physician sees it. I think this is very empowering.

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This is the way that we need to move with primary care. Empower the patient to have access to the information and to use that information as they want to and move away from the provider-centred kind of service that we had in the 1960s to a more patient-centred system that we need to have today.

V. Huntington: That ends my questions, but I would just like to suggest to the minister and his officials that, really, this is quite an onerous situation for people who are already extremely concerned that they have not got a practitioner.

If there was some other arrangement that the ministry could look at for the storage of or the assistance of obtaining these records back…. Yes, I understand that the physician owns them. People have been told that. They’re frustrated by it. They don’t see that.

The additional costs of sending it back to Ontario to be stored, be sent back and having the patient — who’s no longer a patient — actually pay for that is troubling to my constituents, and I’m sure to most people in the province

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who are running into this problem. If their community doesn’t have a shortage of doctors, it’s not going to be a problem; but when you do, it’s suddenly a very expensive one when you start to add it up.

I thank the minister for his answer, but I would encourage him and his officials to try and find an answer. Coming on line and empowering the patient is wonderful, but it’s going to take a lot of time to get there. I just hope that there is some other assistance that can be provided in this case.

I thank the critic for allowing me the time.

Hon. T. Lake: Thank you to the member. We will provide the answer to the cochlear implant question that she had.

I wonder, hon. Chair, if we could take a recess for health purposes.

The Chair: The committee will recess for ten minutes.

The committee recessed from 4:36 p.m. to 4:50 p.m.

[R. Lee in the chair.]

J. Darcy: I have a couple of questions. Then we’re going to go back to pharmaceuticals. We’re just juggling a lot of issues and a lot of people who very much want a piece of the minister’s time to ask questions. I apologize to the staff for jumping around.

We spoke earlier about the HPV vaccine. We have also spoken in estimates in the past and in correspondence about the issue of shingles, an issue that I’m sure the minister hears about — especially from organizations representing seniors in British Columbia. We have thousands of seniors in B.C. who suffer from shingles every year. This can be a really debilitating and very, very painful disease. Studies have shown that if a person had chicken pox earlier in life, they are at a 95 percent risk of developing shingles.

We know also that the present cost of the vaccine…. It may be higher than this, but whe