Official Report of

DEBATES OF THE LEGISLATIVE ASSEMBLY

(Hansard)

TUESDAY, JUNE 3, 1997

Afternoon

Volume 5, Number 12

(Part 1)

[ Page 3769 ]

The House met at 2:05 p.m.

Prayers.

Hon. C. McGregor: It is my pleasure to remind members of the House that this week is Environment Week. In that regard, I am pleased to take this opportunity to introduce to the House the winners of the 1997 Minister's Environmental Awards, who are here in the gallery today: first, Mark Angelo, of the Outdoor Recreation Council and the B.C. Heritage Rivers Board; Irving K. Fox, from Smithers; and Dr. Elaine Golds, from Port Moody. A fourth winner is Gerri Young of Fort Nelson. Unfortunately, she isn't able to be with us today, as she is at home convalescing from surgery. I'm certain that the House would support welcoming her and wishing her a speedy recovery.

We also have, as visitors here, recipients in other categories. First are representatives from Beach Grove Elementary School in Delta: their principal Della Henderson; teachers Susan Anderson and Susan Earles; and grade 5 students Andrea Parsons and Kathleen Evans. Also joining us is His Worship Mayor Douglas Drummond, on behalf of the city of Burnaby, and the Okanagan-Similkameen Parks Society, represented by its president, Don Sloan. Trevor Hill and Rob Murray are here, representing Hill, Murray and Associates Inc. of Victoria, as are Dr.

Valentin Schaefer, who heads the Institute of Urban Ecology at Douglas College, and finally, Bob Ferguson of the Delta Optimist newspaper. I believe their achievements deserve our highest commendation, and I would ask the House to join with me in welcoming them now.

F. Gingell: Much as I do not approve of people being introduced twice, I am going to beg the indulgence of the House in allowing me to add my special welcome to Mr. Bob Ferguson of the Delta Optimist , a good friend. I welcome him to the club of previous years' winners of the Minister's Environmental Award.

F. Randall: In the gallery this afternoon we have a crew from Rogers Community TV, which is located in Burnaby, their western Canada head office. We have Harley Steubing, Trevor Broadbent and Norman Wong. This is their sixth annual visit to the Legislature. They come here each year to interview the local MLAs. Would the House please make them welcome.

J. Sawicki: Burnaby-Willingdon is represented in introductions about the same as it is represented in the Minister's Environmental Awards this week, which makes us all very proud. I want to mention that on behalf of my colleagues from Burnaby North and Burnaby-Edmonds.

I really rose to introduce two more guests in the gallery from my constituency. They are Lindsay and Kelly Angelo, who, of course, are the daughters of Kathy and Mark Angelo, who are here. I think Lindsay and Kelly remind us of a central message of Environment Week: they will inherit the planet that we leave behind. Would all members make them welcome.

F. Randall: In the gallery we also have 57 visitors who are grade 5 students, and some adults with them. They are here with their teacher Mrs. Carol Taylor, and are from Armstrong Elementary School in Burnaby-Edmonds. Would the House please make them welcome.

B. Goodacre: I would also like to add my congratulations to Irving Fox for his award, and to have the House recognize that Irving has been a great contributor to my community and my riding over the years. We're all very proud that he has achieved this award, and I ask the House once again to welcome him for that.

C. Clark: On behalf of the opposition, I would also like to extend a hearty welcome to the mayor of Burnaby, Doug Drummond, and, of course, to Elaine Golds, who is a tireless worker on behalf of the environment in my riding of Port Moody. She has done more to promote the protection of fish and the care of fish in our community than just about anyone at that end of Burrard Inlet. So I'd like to add our welcome to them, as well.

P. Calendino: The person I wish to introduce has already been introduced because he has received an environmental award. He's a good friend of mine, a resident of my constituency and a good supporter of mine. I would like the House to welcome Mayor Doug Drummond of Burnaby, for the second time, and his good wife Jean.

The Speaker: I think that concludes "Let's Celebrate Burnaby Day."

Oral Questions

COST OF HEALTH LABOUR ACCORD

G. Campbell: Hon. Speaker, as one travels from community to community around the province today, it's clear that patient care is deteriorating across British Columbia, and we now know why. In December 1994 the NDP Minister of Health said that total savings by the end of the health labour accord "are estimated at $450 million." However, the opposition now has a briefing document that was prepared for the current Minister of Health, which reveals the truth. The document states clearly that the net cost of the accord is now estimated at $188.77 million.

Will the Minister of Health tell this House which version is the truth, the version the former minister was telling the public or the version the minister's staff was secretly telling the minister?

Hon. J. MacPhail: Actually, the health labour accord has been very successful in retaining the services of skilled workers in our health care system, which is the reason why we have the best health care system in all of Canada.

In an industry where services are 80 percent labour-intensive, it's unusual for the opposition to distinguish that somehow these services are delivered not attached to bodies, to human beings that are skilled and dedicated. That's what the health labour accord is all about. This year there is an allocation of funds for the wages attached to the labour component of my budget, and it has been well accounted for in the budget.

G. Campbell: This isn't about the skill of the health care professionals that are working in the system; it's about whether or not the government is telling the people of British Columbia the truth.

The Premier bragged about the accord, saying it would improve health services and save tax dollars. The fact of the matter is that the minister's own staff -- the Health ministry

[ Page 3770 ]

-- has said very clearly that the health labour accord didn't save tax dollars. The net cost -- and it's a cost at the expense of patients across British Columbia -- is over $188 million. Does the Minister of Health stand by the statements of the Premier that health care has improved in British Columbia, that patient care has improved in British Columbia? Or will the minister admit the truth, which the document says? The cost is $188 million, and that is a cost at the direct expense of patients across the province of British Columbia.

[2:15]

Hon. J. MacPhail: Here are the facts about the health labour accord. As of last year, there are 2,100 fewer FTEs working in the health care system. In the absence of the labour accord, the cost to the health care system would have been $246 million. What the health labour accord has meant is, over the course of the accord, $50 million in net savings to the health care industry. At the same time, even though we have 2,100 fewer FTEs working in the health care system, we have retained the experience and the skill of those people. And they are now working throughout the health care system in a way that, once again, is delivering on the best commitment to health care in Canada.

G. Campbell: This is the minister's own document. This is a document that was provided to us, and I assume it has the truth in it when we get it. This is what the minister's officials have said: "As a result, the net cost of the accord is now estimated at $188.77 million."

My question is to the minister. Your staff has said it's $188.77 million, as a net cost. How much does the minister say the net cost is?

Hon. J. MacPhail: The savings . . . .

Interjections.

Hon. J. MacPhail: No, no. There are net savings as a result of the health accord. That's $50 million, and I'd say that's quite an achievement.

S. Hawkins: There's no doubt that the cost of the health care accord is being felt by patients across the province. Another ministry document that we received, written in February 1995, states: "The anticipated savings may not have been achieved, placing hospitals in further financial difficulty in the '95-96 year."

My question is to the Minister of Health. How can she say that the health accord has not hurt patients, when her own ministry says that the accord was bleeding hospitals dry?

Hon. J. MacPhail: It's about the same as what they're doing in estimates, hon. Speaker. They're going back two, three, four or five years in order to figure out some way of attacking the best record ever in health care in Canada. Our government this year didn't cut one cent out of the health care budget. In fact, we added $300 million to my health care budget, to this government's health care budget. Acute care hospitals get $83 million more in funding for health care, of which 80 percent goes into labour costs.

I know that this opposition doesn't care a whit about those on the front line in the health care system. I know that they don't value nursing or health care workers or lab technologists. I know they would support a two-tier health care system. We support it . . . and even in that context, we have saved $50 million because of the health care accord.

Interjections.

The Speaker: Order, members. I would just caution members that saying "Order" and "Time" at . . . . An open-ended question tends to produce that kind of response.

S. Hawkins: This side of the House is the side that's standing up for patients, and this question is about telling the truth -- which this government has failed to do for the last three or four years, and that's why you're getting the questions. Last year the Health minister actually said: "The labour accord has improved our health care system."

I ask the minister: will the minister explain how draining $188 million from patient services -- which she says are only 20 percent of the hospital budget after labour costs -- has improved our health care system?

Hon. J. MacPhail: Eighty-three million dollars into acute care services; half a billion dollars over the course of the last five years into community health care services; millions and millions into the reduction of wait lists for surgery -- all of this done in the context of 2,000 fewer FTEs working in the health care system, more efficiently and with higher skills, in the area that we need them. That's good planning; that's excellent planning. We've done it without strikes, and we've done it in the context of saving $246 million in costs that would have occurred without the health labour accord.

I don't for a moment understand how this opposition party can turn that kind of cooperation into what they say is bad news for the health care system.

FORT ST. JOHN AMBULANCE SERVICE

R. Neufeld: My question is also for the Minister of Health. Up until a month ago, the Fort St. John ambulance service was operated out of the firehall by union workers and did a fine job, and everyone was happy. But largely to appease CUPE, the ambulance service was moved out of the firehall and now sits behind the hospital, waiting for a new garage to be built just two blocks away from where they were housed before.

Could the minister explain why it is necessary to spend in excess of $350,000 for an ambulance garage that nobody wants and nobody needs -- but CUPE? Can she explain why CUPE and the firehall unions aren't compatible enough to share the same building? And is she aware that her move has actually hurt ambulance service and hospital service in Fort St. John? Can she also explain how this move saves money in health care?

Hon. J. MacPhail: Hon. Speaker, over the course of the last five years the provincial ambulance service has moved to take over all ambulance services throughout this province. We have, in most areas, worked very cooperatively with the firefighters and fire departments in this move. We've done it in a very cost-effective way. And we've done it in a way that doesn't add costs to health care services but actually provides a more enhanced, ambulance-oriented service -- and doesn't involve us getting involved in any jurisdictional disputes between firefighters and ambulance drivers.

I would say that if anyone is getting involved in a jurisdictional dispute that doesn't offer any valuable contribution to the health care system, it's the hon. member across the way.

Interjections.

[ Page 3771 ]

The Speaker: Order, members. Members, please.

Interjections.

The Speaker: Members, order!

R. Neufeld: For several years, the Fort St. John General Hospital has been trying to acquire funds to upgrade its facilities. It needs money for patient treatment and care more than it does to build a new ambulance garage. Again, I ask: why in heaven's name would the minister spend in excess of $350,000 on a new ambulance garage two blocks away from where they were housed before, when 3,000 people gave her a petition that they didn't want it to happen in Fort St. John? They were perfectly happy with the way things were being handled at the time, yet she made the move to appease her union buddies in CUPE.

That's the reason, and I would say it's that minister that's bothering health care in Fort St. John, not the member for Peace River North. [Applause.]

The Speaker: Has the member not posed his question yet?

R. Neufeld: Everybody is far too exuberant today, hon. Speaker.

The Speaker: Could we have a less than exuberant question?

R. Neufeld: I want to ask: why would the minister waste all that money on a garage when the plaster is literally falling off the walls in the intensive care unit? I tell you, I have seen the plaster that has fallen off.

The Speaker: Thank you, member.

R. Neufeld: You tell me how that makes sense . . .

The Speaker: Member, your question has been asked.

R. Neufeld: . . . to spend $350,000 on a garage.

Hon. J. MacPhail: This has absolutely nothing to do with appeasing anybody in any union whatsoever. We have a professional provincial ambulance service that is highly trained. The taxpayers invest hundreds of thousands of dollars each year in training for professional ambulance and emergency medical attendant services. The people of Fort St. John are absolutely benefiting from that. The hon. member knows full well that his acute care hospital received a substantial increase in its funding this year. There have been absolutely no complaints whatsoever out of Fort. St. John on this matter of hospital funding.

And I will tell you, hon. Speaker, that if somehow this hon. member is undermining the value of our provincial ambulance service . . . he should do so now because he knows it's one of the best in the country.

PHOTO RADAR CONSULTATION

B. Barisoff: The Minister of Municipal Affairs repeatedly stated in this House that he is committed to the protocol agreement to consult local governments on any policy change. Yet last week the NDP government imposed photo radar on all local governments without consulting them. Could the Minister of Municipal Affairs explain why he has broken yet another promise to consult with local governments and instead foisted photo radar upon them?

Interjections.

The Speaker: Order, please, members.

Interjections.

Hon. M. Farnworth: We can spend the rest of question period listening to the howls of the opposition, or we can hear the answer.

The protocol is working extremely well. In fact, I discussed the issue of photo radar and the implementation of it throughout the province with the president of the UBCM. The fact of the matter is that we are currently addressing the issue of photo radar at the joint council table, in particular around the areas of revenue-sharing. The bottom line, when it comes right down to it, is that photo radar is a safety issue, it is a law enforcement issue, and that is a decision up to the Attorney General.

Interjections.

The Speaker: Order, members. Order! Excuse me, minister, just for a moment. Members, there is something terribly wrong in the chamber when one has to shout to either ask a question or to be heard answering. It shouldn't happen.

Hon. M. Farnworth: At the end of the day, safety in this province is an issue that should be addressed on a provincewide basis, not by a patchwork quilt, which the opposition seems to favour.

The Speaker: The bell terminates question period.

Ministerial Statement

ENVIRONMENT WEEK

Hon. C. McGregor: This week, June 1 to 7, is Environment Week in British Columbia. People across the province have been invited to take stock of their lifestyles and consider what they can do all year round to become better stewards of this planet and the land, air and water of this beautiful province.

This year we have special Environment Week activities taking place in communities across the province, ranging from a special Eco Education school program day to special Clean Air Day events taking place here in front of the Legislature tomorrow. This is also Bike to Work Week in a number of communities. Members may have noticed earlier today that we had a B.C. Transit bus outside, and it's just been fitted with a bike rack -- one more incentive for people to get on board with cleaner and healthier transportation alternatives. I encourage members to support and, where possible, participate in the Environment Week events being held in their constituencies.

Earlier I introduced the winners of this year's environmental awards. One of the reasons British Columbia is leading the way in environmental protection is because of the community leadership and hard work of people like these. The other essential ingredient is leadership and commitment from government. That's why this government is moving forward on fisheries renewal and conservation, and with further measures to preserve B.C.'s natural heritage and to ensure clean air and clean water. That's why Premier Glen Clark has taken a strong stand with the federal and U.S. governments to ensure that we get a salmon treaty that prevents . . . .

Interjections.

[ Page 3772 ]

The Speaker: Minister, you know the error that you have committed, I hope. Please, just proceed.

[2:30]

Hon. C. McGregor: I'm sorry. My apologies to the members.

That's why the Premier has taken a strong stand with the federal and U.S. governments to ensure that we get a salmon treaty which prevents American overharvests and which respects the principles of conservation and equity. That's why we've also introduced the Fish Protection Act, to ensure that our salmon stocks have the water and high-quality habitat they need to survive, in addition to quadrupling the dollars invested in fish habitat protection and restoration over the past year. That's why we're taking further measures to reduce waste by expanding the depot and refund system for beverage containers.

That's why, during this session, we'll continue to move forward to protect this province's natural heritage by introducing legislation to create, expand or upgrade more than 20 provincial parks and confirm the boundaries of 70 others previously announced.

Hon. Speaker, citizens across the province, like the winners of the environmental awards here today, are making a 100 percent effort. They deserve nothing less than a government that's equally dedicated and acts on its commitments. That's what we're doing and will continue to do throughout this mandate.

C. Clark: On behalf of the opposition, I too would like join in celebrating Environment Week and congratulating the winners of the Environment Week awards, particularly since some of them come from my local community and have really made such an enormous contribution to protecting the environment. I'd also like to encourage every member of this House, when we go home on the weekend, to celebrate Environment Week with the people in our communities who have made a difference.

As legislators it is important that each of us remembers that it is individuals who make change; it is individuals deciding that they are able to go out and make a difference that makes our society move forward. That's where progress begins.

I'd like to ask the government, as well, in this Environment Week, to think about making some new commitments -- some real, new commitments they can make to protect our environment. Perhaps go to B.C. Hydro and say: "We want you to do something about protecting fish habitat rather than destroying fish." B.C. Hydro is a Crown corporation, and this is the week of the year when the government can really go out and do something about protecting fish habitat, not through a long negotiation process -- which certainly needs to happen with the Americans -- but tomorrow they can go to B.C. Hydro and ask them to protect fish.

I'd like to ask the government this week to think about the commitments they've made to cleaning up our air in British Columbia. We know that air quality in British Columbia is consistently getting worse. The government is consistently failing to meet its target to clean up our air quality. I would ask the government to think about making some real commitments to making sure that our air is cleaner. And perhaps with the big bus outside, the government might want the next time around, to think about leasing a bike rather than a car for the chair of B.C. Transit.

British Columbians do deserve a government that's serious about cleaning up the environment. British Columbians deserve a government that sees taking care of our environment as something that's useful for its own sake, not just for public relations purposes.

So I'd ask everyone in this House to consider carefully the commitment that we make to the environment, and I'd ask everyone to participate and to thank and congratulate those citizens who have made such an effort on behalf of the environment to make sure that this province is a beautiful and clean place to live, not just for us but for our children and our children's children as well.

R. Neufeld: I rise to respond to the ministerial statement.

Leave granted.

R. Neufeld: Hon. Speaker, you'll recall that in the introduction time, I very seldom get to introduce in the House anyone from the north. I couldn't resist the opportunity today to speak a little bit about a lady from a community that I lived in for many years and know quite well -- about her work in the community of Fort Nelson, a community that I represent here in the Legislature.

I think that all of us, regardless of what party we come from, have become a lot more cognizant of our environment and how we have to try to maintain it in its state or help it get better -- and I guess that is with riding bikes or buses, or all kinds of things. Maybe building fewer highways in the lower mainland, where cars congregate, and building some in the north might help, so we can continue to operate this province.

It is a week when I congratulate all the winners and all the participants. It's great to see people from all across the province, but especially Gerri Young from Fort Nelson, who actively supported environmental protection through her work on key local issues and her successful effort to encourage wider involvement by helping others. By helping develop effective environmental programs in local schools, she has helped encourage better environmental awareness and active participation among young people in her community, and that's basically where Gerri has worked. The community thanks Gerri very much.

On behalf of the constituency of Peace River North, I thank Gerri Young very much for her work and congratulate her.

Tabling Documents

Hon. L. Boone: I have the honour to present the annual report for the B.C. Transportation Financing Authority, 1995-96.

Orders of the Day

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

G. Janssen: I ask leave to make an introduction.

Leave granted.

G. Janssen: Visiting us today from the real salmon capital of British Columbia, Port Alberni, are 15 students from

[ Page 3773 ]

Alberni District Secondary School, my old alma mater. With them is their teacher Mr. Frank Holm. I ask the House to please make them welcome.

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

ESTIMATES: MINISTRY OF HEALTH AND

MINISTRY RESPONSIBLE FOR SENIORS

(continued)

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

S. Hawkins: I have in my hand a document, and I'll pass it over if the minister wants it. Okay, she probably is aware of it. It is the document that was . . . .

Interjection.

S. Hawkins: The document in my hand, if I may continue, is the document that I was referring to in question period today, and it is entitled "1995-96 Ministry of Health Estimates Debate." I'm not tabling it; I'm just passing it over for information purposes. In this document, as the minister can see once she gets it, there are parts of it severed.

But this is where we get the information that, as a result, the net cost of the accord is $188.77 million. I heard the minister say that there were savings around this, and I'm wondering if she can go into a little more detail as to where those savings were achieved, when this document from her own ministry says that the cost of the accord as of the end of '95-96 was $188.77 million.

Hon. J. MacPhail: You know, this is a document that was prepared and that the opposition has used in quite a nefarious way, actually, to piecemeal on what has been a very successful accord. What this document talks about is the implications of what would happen if indeed the health care accord did not succeed in the end. This document was prepared very early on in the health care accord, and in fact it says that what it's talking about is what could happen if we didn't achieve what we said we were going to achieve in the health labour accord. That's good briefing material for a minister in preparing himself or herself for issues as they unfold.

However, we are now in June of 1997, and here are the facts: as of March 30, 1996, which was the conclusion of the health labour accord, there has been a reduction of 2,100 FTEs in the system. If indeed we had not achieved those reductions, if indeed the health care unions had not agreed to forgo their bargained and agreed-upon wage increases, if indeed there had not been a change in the hours of service delivered by health care workers, the costs . . . . If the health care accord had not been in place, the cost to the system under the old collective agreement, carrying on as the status quo, would have been $246 million.

We have projected that as a result of that, the final savings, after the cost of the health care accord and in terms of the retraining estimates, is a total of $49.1 million, and 2,153 fewer FTEs have led to . . . . Now, let me just make it clear, because I know that on the other side of the House, you have virtually no experience in collective bargaining and no experience in what it means to reach an agreement between an employer and a union.

The collective agreement was in place, was negotiated, and the cost of that collective agreement, if it had proceeded unfettered with no health labour accord, would have cost $246 million. What happened was that we sat down with the health care workers and the government and brought about a health labour accord. That health labour accord, including all the retraining costs, which for the first time puts trained health care workers in the system where they're needed, saved -- on the basis of $246 million cost to the status quo -- $50 million.

[2:45]

S. Hawkins: That was about as clear as mud. On the next page, the document goes on to say: "In the '95-96 year, the anticipated savings may not have been achieved, placing hospitals in further financial difficulty in the '95-96 year." We know for a fact that the BCHA, which is the B.C. Health Association, advised the ministry last year in a document that the health labour accord had cost acute care $125 million, and they advised the ministry of this.

Now, attached to this document is also . . . . You know, it's interesting how the government's numbers keep changing. We're just looking for the truth, because the numbers keep changing. They keep playing with them. They keep saying that they're going to have this much in savings, and now they say they have this much. In a press release dated December 31, 1994, the minister of the day said: "Total savings by the end of the accord in March 1996 are estimated at $450 million." It is now spring or summer of '97, and the minister says . . . .

An Hon. Member: Ask your question.

The Chair: Hon. minister.

Hon. J. MacPhail: We are in estimates for 1997. I certainly don't mind debating the savings to hospitals on labour adjustment for 1997, but we are now into the fourth week of our estimates, and the hon. member is back in 1994. There have been public accounts in '95-96 that dealt with this issue, as well as in '94-95. Hon. Chair, this member is totally out of order. If she has questions about '97-98 estimates, let her ask them.

The Chair: The point is well taken, and I offer to the opposition the point that we are in the estimates of 1997, so stick with those.

S. Hawkins: Hon. Chair, this totally relates to '97 estimates because the health labour accord . . . .

Interjection.

The Chair: Hon. member, then tie it . . . .

S. Hawkins: I will, hon. Chair.

Interjections.

The Chair: Order, hon. members. It is very important that we tie the questions and comments that are made to the estimates, as opposed to some generalization. To the estimates, please, hon. member.

S. Hawkins: Hon. Chair, we know for a fact that hospitals this year and in the last few years have been saying that their funding has been reduced. It has been reduced, and it's effectively . . . . The government is putting more money into health care, so they say, but it's not coming into patient services. It's going somewhere else, and this document . . . .

[ Page 3774 ]

The Chair: To the budget, hon. member. Speak to the budget.

S. Hawkins: This document talks about budgeting for the next few years . . . .

The Chair: Hon. member, to the budget.

S. Hawkins: Well, to the budget, then. In this year's budget, how much is the health labour accord going to cost patient care?

Hon. J. MacPhail: Oh, hon. Chair, this is so outrageous. This Health critic is so ill-informed about the health care system, it is stunning. The health labour accord ended March 31, 1996. That proves how little this hon. member understands about the health care system. The collective agreement was renegotiated last year. The health labour accord concluded in 1996.

But let's talk about the funding for acute care hospitals. Let's talk about the funding for nurses, for health care aides and for lab technologists. Let's talk about what those hospitals got: $83 million more this year into the acute care hospital sector. What did the B.C. Health Association do when we announced our funding this year? They issued a news release congratulating our government on the increased funding.

And you know what? Maybe this hon. opposition would like a lesson in health care labour relations. Maybe they would like a lesson in collective bargaining or a lesson in how many individual workers make up our health care system. You know what? It's not just doctors. It's not just specialists. It's not just big, rich lab clinics that make up the health care system. There are tens of thousands of health care workers working in this system, contributing in a valuable, unbelievably skilled way.

Our government invested in their training. Our government made sure that the right people were working in the right places in the health care system. Does that cost money? Yes, it does. Does our government fund the hospitals for what it costs in that way? Yes, we do. Did the hospitals say thank you? Yes, they did.

S. Hawkins: It couldn't have been a very good weekend for the minister.

On the $83 million that the minister says her ministry has invested in health care and that the B.C. Health Association thanked her for, she probably should have read the press release a little further, because they said that it wasn't very much when it's spread across . . . . How many hospitals across the province? When they say . . . .

Hon. J. MacPhail: Show me where they said that.

S. Hawkins: Well, it was in their briefing document.

Hon. J. MacPhail: Read it aloud. No, no. Read it aloud.

S. Hawkins: Oh well, I will.

Hon. J. MacPhail: Put your money where your mouth is.

S. Hawkins: You know, as the minister always promises documents to me, I'll make sure she gets that one, too, in the same timely manner -- maybe next year -- that I get documents from the ministry.

Anyway, the minister has said that 80 percent of a hospital budget goes into wages and benefits, and some of that is sucked into inflation. When they say they're putting in $83 million, we know that a large portion of that is going to go into wages and benefits. That gets back to the labour accord and the deals that they negotiate with the health care unions, because that money in the deal that was made is still being paid for today. The deal that was made reduced hospital operating days by ten days. They were called EDOs -- extra days off. Can the minister explain how these extra days off, which continue today, are contributing to patient care and saving money?

Hon. J. MacPhail: Hon. Chair, really. It is time for us to focus on the 1997-98 estimates. I don't mind giving this hon. member another briefing by every single person she would wish to have a briefing from, in terms of what estimates mean and in terms of what it means for the health care budget for 1997-98.

Acute care hospitals had their wage increases fully funded out of this budget -- fully funded, hon. Chair. How many more ways can I say that? Did the hospitals come to us and tell us what they needed to make sure patient care services were continued? Yes. Did we fund those requests? Yes. Did they say that that's good? Yes, they did. The information around how individual hospitals coped with that and how individual hospitals decided to cut their health care administration costs two or three years ago are good discussions for Public Accounts.

S. Hawkins: The minister knows very well that the funding that has gone into hospitals has translated into a very low percentage. When she says she gives hospitals what they are asking for, she knows that's wrong. I brought up in estimates last year, and today it continues at my hospital . . . . We had to close 20 beds. Last year she said that was a normal summer closure, and it wasn't. They never got the funding they needed to keep those 20 beds open. It continues today.

The percentage they got from the ministry . . . . This minister brags about $83 million. They say they're protecting health care for patients, but why do waiting lists keep continuing? Why do hospitals keep closing beds? They say they're protecting health care, and they know darn well they aren't.

That's why I say, when she talks about funding for hospitals . . . . I toured hospitals across the province. I took six weeks and toured hospitals. I saw old equipment and overcrowded emergency rooms, and everywhere I saw beds closed on wards. In fact, I saw a very cute cartoon at Shuswap General Hospital, which read: "Come and see Shuswap General Hospital. It's a historical site; same number of beds we had 40 years ago." The community has grown by 10, 20, 30, 40 percent or more, and they've never kept up to the need. That has happened everywhere.

They can say what they want about protecting health care in this province, but they know they're not doing it. They can throw around big numbers: $83 million, $6.5 million for cardiac wait-lists, or whatever. They know that that's hardly going to get them anywhere. The $83 million announced . . . . She knows darn well that $27 million or $28 million is going to Vancouver Hospital for their . . . . I understand it's going for capital equipment to one major hospital. So it's interesting for her to throw all these big numbers around, but they're not protecting health care. We know that places around the province are a mess.

This again brings to mind Nanaimo Regional General Hospital. I know there's a review going on there right now,

[ Page 3775 ]

because that hospital has apparently not been able to function on the amount of money it has been getting. I understand the wait-list at that hospital is around 2,800 or 3,000 people. When the minister visited that hospital, there were patients strewn around in the cast room and sleeping overnight in the emergency wards, and she says she's giving enough money to hospitals to operate. That is outrageous! We see patients sleeping in hallways, we see them sleeping in cast rooms and we get letters about patients on waiting lists. They haven't been protecting health care; they haven't been doing it at all.

Frankly, it's unbelievable to say that the agreements they've made are protecting patient care, when she admitted herself that 80 percent of a hospital budget goes toward wages, so it leaves very little. When you only get a 2 percent increase in your hospital budget and it barely covers wages and benefits, and you've got inflation to add on top of that, how does that protect health care at the acute care level? No wonder hospitals are cutting back.

I want to ask the minister to break down the $83 million that she's bragging about giving to hospitals this year and tell us exactly where it's going. Tell us exactly how much of an increase each hospital is getting. Tell us what they're getting, if that is so much money.

The Chair: Member, to the budget.

S. Hawkins: Perhaps the minister would like to break down the $83 million that she says is going to acute care this year and tell us how much each hospital is getting.

Hon. J. MacPhail: The good news is that it's not $83 million; it's $92.4 million. Even better good news! And yes, we can break it down for you. The costs for wage increases are: HEU pay equity was $8.24 million for last year; for this year it's another $8.5 million across the system. Equipment is $27 million.

I know that the hon. member got confused between capital budget and operating budget, but I'm sure that will get straightened out soon and that she will learn the difference. For equipment, $27 million -- that's not wages; it's equipment. This isn't wages: new bed programs, $10 million. Tertiary care programs: $11 million; that's not wages. Funding for extended care: $2 million. Funding for special programs: $7.4 million. Funding allocation on models PG 1 to 7 and 10 is $11 million. Remoteness factor is $700,000. Inflation funding for tertiary care is $2.34 million. And across the system there is another $4.27 million for acute care contingencies.

[3:00]

S. Hawkins: It's very nice to put it in global numbers, but how much of a percentage increase did each hospital get? There are about 116 hospitals in the province. How much did they get? We have one hospital . . . . They're in the paper all the time. One hospital that I read about this morning said they got 0.68 percent. That's not even going to cover their wage inflation and benefits. In fact, when you get a percentage increase like that . . . . Perhaps the minister makes magic out of numbers, because I know that just last year we had two balanced budgets and a surplus. Somehow that vanished this year, and somehow hospital funding keeps vanishing this way too.

When this hospital gets 0.68 percent, or 2 percent, that doesn't amount to very much. That doesn't protect patient care. The minister says that the hospitals can do what they want with the money. But they've kind of got their hands tied, don't they? When 80 percent of a hospital budget is salaries, wages and benefits and what have you on the labour side, that doesn't leave very much for patient care, does it? So you know what? That doesn't leave much for patient services. Then we see beds closed. We see patients sleeping in hallways, we see surgeries cancelled and we see capital equipment not being paid for because they don't have any kind of surplus.

In fact, this ministry promised money. I don't even know if they paid it back. This ministry promised money for a roof project at Cottonwoods in Kelowna, in my riding of Okanagan West. Because they are good managers -- not like the Ministry of Health -- the hospital had a surplus. They spent $300,000 out of their surplus to fix the roof on Cottonwoods, which was leaking on elderly patients -- it's a seniors home. And as far as I know, there is no money coming from the Ministry of Health to put it back. The ministry hasn't paid them back.

That money came because they managed their budget well, and they put the surplus into their account for a rainy day. And I guess this was a rainy day, because the ministry certainly didn't come up with the money for them. Apparently the Ministry of Health has a commitment to put this $300,000 or $280,000 back into the budget in Kelowna General Hospital, but who knows? They don't keep their promises. We haven't seen promises kept here. So we'll just wait and see if they get that money.

There were beds closed in the hospital in my riding last year, and there were beds closed in hospitals around the province. There are beds closed everywhere. Now, how is that protecting patient services? Lineups and waiting lists are getting longer because of the EDOs in the contracts the government has imposed on health employers. The health employers themselves say they don't know where this money is going to come from. It certainly doesn't come from the Ministry of Health. So they have to cut back patient services. What are patient services?

Well, rehab services, ICU services, cardiac services, cancer services -- all kinds of patient care services. There is no money. We saw surgery cancelled in Prince George because there were no sutures, for goodness' sake -- $7 sutures. That is absolutely ridiculous!

But this minister doesn't get the message. She can stand up and rant and rave all she wants about how we don't understand -- we don't understand collective agreements, and we don't understand this or that or whatever -- but she doesn't understand, because she has never worked on the front line and seen patients who are ill, patients who are dying. And do you know what? Look at a patient's face. Look at them when they're in the hallway getting bathed or getting fed, when they should be in a room being treated with some kind of dignity.

Maternity. This minister says she stands up for women, and in Quesnel we see maternities, women who have just delivered babies, being cared for in the hallway. Anyone can walk by, and they're breastfeeding their babies and everything in the hallways. Well, that is absolutely outrageous! People have to put up with that.

They say they're protecting health care. They say: "Oh, we're giving you money." But do you know what? They're not. They're not giving the money. They're putting it somewhere. Who knows where they're putting it? They certainly don't know, because none of their numbers add up. They never have. In fact, they say they're going to save $450 million here; now they say they're only saving $50 million here. We don't even know if those numbers are true. It just doesn't make sense.

[ Page 3776 ]

When I ask the minister how much of a percentage increase of the $80 million or $92 million -- now it's $92 million -- that each hospital got, she won't answer.

Hon. J. MacPhail: Did you ask?

S. Hawkins: I asked. This is the third time I'm asking: how much of a percentage increase did each hospital get?

Hon. J. MacPhail: What the hon. member asked, "What did that breakup go toward?" is exactly what I gave her. But let's just use some examples. And I'll tell you something, hon. Chair: if there's any waste going on here, it's the fact that this hon. member is raising one single incident of sutures not being available as an example of the health care system collapsing. She raised that one week ago. She raised it two weeks ago. She raised it three weeks ago. And she brings up . . . .

I guess the hon. member is actually so busy worrying about that one, single incident that she didn't have a chance to read the newspaper today. She didn't have a chance to read about the wonderful work that the B.C. Cancer Agency has done to eliminate wait-lists.

Do you know what? Somehow this member thinks, I guess, that these hospitals are funded out of . . . . I don't know. Maybe these aren't B.C. tax dollars that are going into the health care system, and somehow these hospitals . . . . Do they go to the Ford Agency? Did you have the Ford Agency, hon. member, coming to you and saying: "We'll fund a hospital"? Did Chev fund the hospitals? Did Nabisco fund the hospitals? Did RJR-MacDonald fund the hospitals? Or did the B.C. NDP government fund the hospitals? Yes, they did. Yes, they did. That's who funded the hospital increase.

How well did Kelowna General do? How well did Kelowna General do that this hon. member said . . . ? My goodness, they got funded so well, they had a $1.5 million surplus. Oh, my goodness. Kelowna General Hospital . . . .

Interjection.

Hon. J. MacPhail: Oh, and the hon. member says: "They budgeted for it." Oh, I guess hospitals aren't supposed to be responsible. Hospitals aren't supposed to use their tax dollars in a responsible way.

Why are they closing beds? Because they've done utilization improvements. This hon. member thinks that the way we do surgery now is the same way we did it ten years ago. This hon. member thinks the way that we do surgery is the same as we did it 40 years ago. And do you know what? Everyone but this hon. member has moved on. Everyone else in the health care industry knows how to utilize beds properly. In fact, Kelowna General is at the cutting edge. But somehow these things happen magically.

Do you know what? I'll actually wait for this opposition to tell us where the tax dollars come from for the improvements they want in the health care system. I'll actually wait for this hon. member to show us that somehow these hospitals get funded magically, separate and apart from the provincial government. I'll wait for this hon. member to stand up and show how it is that hospitals that have a $1.5 million surplus somehow do that in isolation from the rest of the system.

The Chair: Hon. members, the Chair has an introduction to make. May leave be granted?

Leave granted.

The Chair: In the gallery today -- and coming in in half an hour is another group -- are two groups of grade 6 students, and some adults, from Wellington Elementary School in Woodinville, Washington, accompanied by their teacher, Mr. Sander. Would the House please make them welcome to our wonderful debate.

S. Hawkins: It's like pulling teeth to get an answer. This is the fourth time I'm asking. Before I ask the question . . . . Just wait for it; just take it in. On the $1.5 million surplus, let me remind the minister again that $280,000 went for a roof for Cottonwoods, and almost $1 million went to help build support services for the cancer clinic. And we don't have that money back in the accounting . . . . They brag. Honestly, they brag about building cancer centres and doing this and "We're doing . . . . " She ribbon-cuts everywhere and puts up backdrops and ignores everything else that's going on around her.

What's going on around the minister is that hospitals have budgeted wisely for rainy days, because they know that this ministry is not going to pay for projects. The money comes in. Yes, they are very good; they are models at utilization. Perhaps the ministry should take a lesson from them. They put away almost $1.5 million. Almost $300,000 went for a roof for Cottonwoods, which was promised by this ministry as a capital project. The money never got back there. And $900,000 was to build a parkade or a parking lot -- this is what Kelowna General was saving for -- but it went to provide and build support services for the cancer clinic.

Do you know what? If they hadn't done that, if they didn't have that surplus and didn't put that $900,000 there, we wouldn't have a cancer clinic opening next spring. We wouldn't, because this ministry didn't come up with the money for them last spring. They didn't. So the hospital board -- which she fired -- did the right thing and put that money towards building support systems for the cancer clinic.

First of all, the cancer clinic was delayed a year, because they couldn't decide. "Geez, we have an NDP MLA in Kamloops and we don't in Kelowna, so how can we get it to Kamloops?" When they finally did the studies, it did come to Kelowna -- a year delayed. Our cancer services in the southern interior are a year delayed because of this government.

Interjection.

S. Hawkins: We'll get to that.

They brag about funding hospitals and everything. Hospitals that are responsible and build up a surplus . . . . Thank God they did. Thank God they were responsible. Thank goodness, in spite of the NDP, this hospital saved $1.5 million and was able to put that roof on Cottonwoods. They're expecting the money back, but I say: "Don't hold your breath, because it ain't coming from over there." And with $900,000 they built support services for the cancer clinic. The cancer clinic would not be built today if we had to wait for these guys to fund that. It just wouldn't be built.

Here's the question for the fourth time, and perhaps we'll hear an answer today. For the fourth time, what percentage increase did each hospital get? The minister now brags about $92 million going into the pool for all hospitals, but she doesn't say how much . . . . I submit to you that if you break it down, it's not going to be very much for each hospital. So how much did each hospital get?

Hon. J. MacPhail: It's right here, hon. Chair. Every single hospital is listed. There are 122 facilities. If the hon. member

[ Page 3777 ]

would rather, she could have the list herself, or I could read it into the record. I'd be more than happy to do it. The average increase is 1.28 percent. The range is from 0.28 to 4.97 percent across the system: a $92 million increase.

You know, I find it very unusual that our budget, which is $7 billion . . . . This opposition was going to spend -- I think it was $6 billion, wasn't it? -- $6 billion. How would they achieve that? Let's see. How would they achieve $6 billion across a system that now gets $7 billion? I guess they would say to the hospitals: "You have to manage even more, and I guess what you'll do is cut wages -- nurses' wages." Maybe we'd even have to cut doctors' wages. Oh, no. "Maybe we'd have to pay less to doctors," is what the opposition would say, because they'd have to find a billion dollars in the system, not a million.

They would have to find $1 billion in savings in the system. So let's see. The Kelowna General Hospital got an increase of about -- let me just see where that is here -- 1.08 percent. I guess they would have to take a cut of 1.08 percent under the opposition's budget of $6 billion for health care.

I don't know, hon. members, how the $7 billion our government spends on health care somehow turns into bad news for 122 hospitals, for community health clinics, for public health, for the Pharmacare program, for doctors' wages, for nurses' wages, when this opposition here was going to spend $6 billion.

[3:15]

S. Hawkins: Obviously the minister doesn't know how to read, as well. If she read the document that we put out during the election, she would have seen that we were going to increase funding for health care. I don't know where she gets her information -- probably the same place where they got their budget estimates from.

I do have a document in front of me. I understand from my assistant that it is the Ministry of Health regional programs hospital budgets allocation. I do read 1.08 percent on here. Now, I want the minister to think about this, put a little attention to this. Calm down; just think about this for a minute. When you have inflation and when you have wages and benefit increases every year . . . . Hospital staff, acute care people do tend to be quite loyal and stick to their jobs. They are good jobs. I nursed for years and I know it's a good job.

It's a very rewarding job when you are able to provide the kind of quality care that you're trained to provide, which I understand is a problem these days.

Anyway, when you have wage inflation, benefits increases and seniority increases, does the minister think 1.08 percent is enough to carry it? Eighty percent of a hospital's budget is wages and inflation. For the life of me, I don't know how . . . . Most of the hospitals are telling me that that's not going to be enough. Perhaps they're telling the minister differently, because I know they don't like to hear . . . . They don't consult with people anyway; they don't like to hear what people say. But with inflation, wages, benefits, seniority . . . is that going to cover it?

For the hospital that got 0.28 percent, is that going to cover it? Could the minister comment on that? Is that a reasonable amount?

Hon. J. MacPhail: Actually, yes, it is. It's not the ministry that makes this up. We have a funding methodology committee. In fact, the vice-president of finance for the hon. member's own hospital sits on the funding methodology committee. We don't sit in our little rooms and say, "Hey, what do you think makes sense here"; we actually investigate. You know what the funding methodology committee said? They said 0.86 percent covers off all of the inflationary pressures on the health care system: 0.86 percent, funding methodology committee.

Really, it is about time that this hon. member learns about the health care system, learns who's actually involved, learns who's making the decision. And 0.86 percent is what the funding methodology committee determined was the inflationary pressure.

S. Hawkins: Perhaps the minister wants to explain the funding formula, then.

Hon. J. MacPhail: Actually, we did this last year at length, but I certainly don't mind going over it again.

"This methodology is used to allocate new funds voted for acute services by the Legislature, after prior commitments, such as new programs, protection of smaller facilities and extended care units, etc., have been met."

So we take into care the special needs.

"The model focuses on the expected weighted cases workload for each hospital . . . . By using provincial utilization rates and . . . a provincial average cost per weighted case, it provides incentives to hospitals to improve utilization management."

I think the hon. member would disagree with that: hospitals aren't supposed to have to participate in utilization management and increased efficiency. I would expect the opposition doesn't approve of them having to increase efficiency, either.

"Hospitals in areas where the utilization rate is below the provincial average will benefit to a greater extent than those in areas where the utilization rate is relatively high."

So if you actually get your utilization management under control, you benefit. There's an incentive for it built into the formula.

"Similarly, hospitals with lower costs per weighted case will benefit more than those whose costs per weighted case are high. Hospitals with extensive teaching activities have higher costs than similar non-teaching hospitals. The funding model recognizes this by increasing the estimated 1997-98 workload for these hospitals.

"The funding allocation model is based on the non-tertiary weighted cases workload. Beginning with [this] fiscal year, tertiary workload is funded separately through performance contracts between the ministry and the regions providing designated tertiary programs."

Then it goes on to talk about . . . .

Interjection.

Hon. J. MacPhail: Oh, I'm sorry. It goes through all of the steps: step one, calculation of population; step two, conversion to workload; step three, distribution of workloads to hospitals; step four, adjustment for teaching; step five, allocation.

Now, who sits on this funding methodology committee? Industry experts.

G. Janssen: I wonder if the minister could inform us how much these Health ministry estimates are costing us in lost time for the staff who have sat here hour after hour after hour, when they could be out delivering services to the Ministry of Health. Some four-odd weeks we've been here, listening to question after question from the opposition. Many of those questions could be answered by a simple letter. They could be answered by executive or ministerial assistants with a very simple phone call. Dollars could be going into health care, into shortening surgery lists and providing health care in hospitals to people that are wanting to access services.

Instead we've been in this House for going on four weeks, now, with questions that are asked time and time again by different members of the opposition. They are repetitive.

[ Page 3778 ]

They deal with things that happened back in 1994, '96, on issues that, as we've just heard . . . on health care accords that expired over a year ago.

Could the minister inform us: how much health care budget money is the opposition wasting that could be going into patient services?

Hon. J. MacPhail: Hon. Chair, I understand the member's frustration, but the estimates process is a very useful process. It's part of the democratic process, and I support it fully. What I do find important, though, is that we not be repetitive.

It is true that it requires a great deal of expertise to run a very complicated system. I happen to think that the staff in the Ministry of Health -- unlike the opposition, who deride them and berate them each and every day -- are some of the best in the country in terms of the public service, and I value them greatly. They are here to assist in making sure that the opposition gets each and every point of information that they have asked for. The only thing I would ask of this Legislature is that when an answer is given, they actually absorb it.

G. Farrell-Collins: I've been sitting and listening, too. I seem to recall a question being asked five times -- four times, anyways, before I left the chamber; I don't know if it was asked subsequent to that -- on some specific numbers on hospitals, and I understand that it was finally given. Had that information been given the first time it was asked, I think the process would have moved a lot more quickly.

It is important that these issues be raised. The member for Alberni raises an issue of the past. Well, I would advise the hon. member that the health care accord and the impact of the health care accord persists to this day. We just determined today, in fact, that there is a substantial net cost to the health accord, as opposed to the savings that the minister and the Premier promised everyone before the last election.

I think the truth is always in order when we're dealing with estimates, even if that member doesn't think it is.

S. Hawkins: If the member opposite doesn't have any more questions, maybe we could move along with estimates, here, and get out of here like he would like to.

I think this is a very important process. This is where we hold the government to account for what they do. We're trying to get answers, and when we don't get answers, we have to ask the question over and over again till we're satisfied we get an answer.

Now, the minister went through quite a complicated formula for hospital funding. She went through quite a few factors that they use to determine how much each hospital will get. And that was one of the issues that was raised by administrators at hospitals when I did my provincial tour. One thing that came at the top of all their minds was how fair this formula was. They felt there was room for manipulation in this formula; they felt that there was room for adjustments in this formula; and they felt that the special needs of their communities weren't always taken into consideration.

So I ask, with the greatest amount of respect: how much input do the acute care facilities get as far as funding for their own facilities?

Hon. J. MacPhail: Again, we went through this in last year's estimates, but I certainly don't mind repeating it. Peer groups are from the hospitals themselves and are represented on the funding methodology committee.

I also just want to remind this hon. member that we would like the truth from the opposition, as well, when she brings forward a fact like somehow the Kelowna General Hospital had to fund a roof because our government wouldn't fund it. Let me give her the facts. This item, which was referred to by the opposition member, was funded out of an accumulated previous year's surplus. The $1.5 million that I referred to is just this year's surplus after all expenditures. The hospital asked permission to spend their previous surplus on the roof while the Treasury Board review was underway. We've committed it to a refund. So it is very important that we all speak the truth in this House.

S. Hawkins: I'm glad the minister put it on record that they are going to pay the hospital back. That is good news. I appreciate that. I was asked to bring it up to make sure we did get a commitment. I hope the minister can stand up and also . . . .

Interjection.

S. Hawkins: Well, I'll ask the minister. Will she commit to paying back the $900,000 that they used to build support services for the cancer clinic?

Hon. J. MacPhail: You know, I am stunned at this opposition's view of the health care system: that they're little feudal institutions that don't have to work together; that somehow the money comes out of -- I don't know -- thin air; and that there shouldn't be any integrated approach to the health care system.

Let me answer the opposition member's question on this point. Our ministry, responsible for the overall health care purse, was well aware of the huge surpluses that the Kelowna General Hospital was running up. Now, this is a hospital that, I guess, the hon. member represents. "But it's a part of the health care system that is grossly underfunded," says she. This hospital has been running up huge surpluses. We're already in discussions with them about how they have committed money to the B.C. Cancer . . . the support services. We're already in discussions with them about paying that back, as we are in discussions with them about where the surplus has come from and what to do with the surplus.

S. Hawkins: I hope that means they will pay that money back. I didn't hear that from the minister, but I hope the negotiations lead to something, because in the past -- and I always judge future performance by past behaviour -- this government wasn't one to keep commitments. So I hope somewhere in there was an answer that yes, we will pay that back.

Anyway, last year we covered the funding formula, and I asked this before. I understand there's still a problem out there with different rules being applied to some teaching hospitals than to non-teaching hospitals. Has that changed? Why do teaching hospitals continue to get more money than non-teaching hospitals? Again, it is a concern that was raised as I travelled around the province.

Hon. J. MacPhail: I just answered that question five minutes ago.

S. Hawkins: Well, there are not very many answers coming. The minister seems to think that estimates are over and she doesn't need to answer any questions. She might be tired of sitting there and doesn't want to answer any more

[ Page 3779 ]

questions or wants to get out of the House. But do you know what? This is the only chance we get to ask this government questions from people around the province and from our constituents.

[3:30]

Hon. J. MacPhail: I just answered the exact question you asked.

S. Hawkins: She can say, "We just answered," but she didn't answer. Last year I brought up the same thing. Teaching hospitals seem to have a different standard formula than non-teaching hospitals. They get more money. When we talk about responsible hospitals, Kelowna General is a very responsible hospital. Like I said, maybe this ministry should take some lessons from it on how they end up with surpluses.

[E. Walsh in the chair.]

Hospitals that don't end up with surpluses -- and some of the teaching hospitals don't end up with surpluses but get into deficit situations -- the ministry bails out. There seems to be a double standard. That seems to be a concern of hospitals, which say: "We're very good managers, we try to live within our limits and we budget for patient care.

Obviously, we have to cut back in some places, but there may be a day when the ministry doesn't fund us." And obviously there was a day, because the roof at Cottonwoods and certainly the support services for the cancer clinic were that rainy day, and they used that money. But other hospitals that don't, seem to get funded, regardless of how good or bad they are as managers. And we're not really getting any answers from the other side.

I'll talk about the

article that the minister held up on the cancer patients not going to Bellingham anymore. I understand the money that was used to send patients to Bellingham has now been used to extend hours at the three cancer centres. Is that correct?

Hon. J. MacPhail: Yes, some of it will be used in that way.

I'd just like to read into the record the recommendation from the B.C. Health Association for funding to protect health care. "Recommendation No. 1: That the government provide an adequate funding lift to protect health services for fiscal year 1997-98, which for acute and extended care would be a minimum of $72 million for operating . . . . " We did $92 million.

S. Hawkins: How much money was there in the Bellingham project that is now going to extended hours for cancer services?

Hon. J. MacPhail: We can get the actual figure for the member. We have been working with the B.C. Cancer Agency on an overall plan for funding the agency and for funding increased services, and that is being demonstrated by what is coming to fruition now.

S. Hawkins: Yes, I would like to know how much money went towards funding patients who were going to Bellingham and how much of that money is now being used to extend hours at clinics. I would also like to know from the minister how much money is still being channelled to Bellingham. I understand that even though patients are not being sent there as of now, there are patients that fall into the category of still needing to go down there because there are cancer line-ups, apparently, that are still not being alleviated. So how much is being budgeted for that?

Hon. J. MacPhail: None. We are able to deliver all of the services here in British Columbia. We were spending about $750,000 on patients going to Bellingham, and that money is now in British Columbia.

S. Hawkins: Well, I do understand -- and this is as of last week, when I was talking to a spokesperson at the B.C. Cancer Agency -- that there will be patients who will still need to go to Bellingham. So perhaps the minister wants to check on that. There will be radiotherapy patients who will still be required to go, and there's one physician at the B.C. Cancer Agency who okays that.

G. Janssen: Name names.

S. Hawkins: Dr. Tom Keane is the doctor who apparently will okay patients to go down to Bellingham if they need to go.

I understand that the cancer clinic on Vancouver Island is apparently going to be built now. It is on extended hours. What are the extended hours of each clinic?

Hon. J. MacPhail: Ten hours per day.

S. Hawkins: I did have the opportunity to tour these clinics, and I understand that for the extended hours the machines are running longer, obviously. There's a higher maintenance factor for those machines, as well. I understand that the machines at the cancer clinic here are old. They're 13, 14 years old. I wonder if the ministry has a backup plan for the machines if they fail, because they are on their last legs. A clinic here was promised I don't know how many times. I believe that the announcement for a Vancouver Island clinic was made at least four times.

We'll believe it when we finally see a building going up, I suppose, and patients going through the door. Is there a backup plan for patients if the machines here fail?

Hon. J. MacPhail: Yes, the B.C. Cancer Agency has a plan. One of the people that I met with around the plan was Dr. Tom Keane, of the B.C. Cancer Agency. The hon. member mentioned his name in kind of a negative way, so I just want to make it clear that I certainly think he's doing a valuable service in bringing forward a plan for a made-in-B.C. solution. But yes, the B.C. Cancer Agency not only has a contingency plan but also estimates that the life span of the machines has been well taken into account.

S. Hawkins: For the record, I want to say that I never use health care providers in a negative way. I've worked on the front line. Cancer nursing is my background. Why would I put down a physician who says that if patients need to go to Bellingham, he will approve them? I would never do that. So the minister reads whatever she wants into it, but it was not in any way a negative connotation when I mentioned his name -- not at all. In fact, there are some people who care for patients -- unlike the government member sitting opposite, unfortunately.

Radiotherapy machines last year . . . . There was an

article in the paper saying that the radiotherapy machines here -- and I mentioned it before -- were on their last legs. It isn't like

[ Page 3780 ]

you just order a stove or a toaster or something. These machines take a while. To go out, get the right one, buy it, set it up, build the vault and all that kind of stuff at a cost of . . . . I understand it was estimated at around $1.5 million. Now, these are on their last legs. The minister says there's a contingency plan. Can she share the contingency plan with us?

Hon. J. MacPhail: The machines are not on their last legs. The machines are all maintained and are absolutely viable.

S. Hawkins: I hope the minister doesn't live to regret her words. I was just in conversation with representatives of the clinic a week or two ago, and I understand that about three weeks to a month ago one of the machines went down, and patients had to be cancelled. The person I spoke to says that it's a very scary situation. That's what he said: "It's a very scary situation." It appears that this government, as always, has no plan. If they had a plan, they'd share it with us here, but they have no plan.

Last year the minister's own ministry official talked in the paper about the machines being old and said that they would replace them if they failed. The cancer agency spokesperson said in that same

article that these are not like toasters or stoves. If one fails and it goes, it takes about 18 months to replace.

All we expect is that you're planning ahead. We know that cancer services are being stressed in this province. For the last few years people had to go to Bellingham. We know that's still an option if people need to go. We know that the ministry has taken that money and extended hours at clinics so that patients can be treated closer to home.

Now, I'm not saying that they're going to get better service doing that, because the patients who go to the cancer clinic during normal working hours will get the benefits of people who work those normal working days. They'll get the benefits of the social worker, the psychologist and the dietician -- all those kinds of workers. The ones that will be treated after hours will get the benefit of those workers if they're called in and if they can arrange to meet those patients.

I worked in a radiation therapy department as a radiation therapy nurse, and I know that the best time to see those patients is when they're actually being treated and you can look at their skin, you can check them for hydration, you can check them for burns, you can check them for diet. The patients that are being treated in extended hours might not get the benefit of that. But they are being treated closer to home.

All I'm asking is . . . . About a month ago there was a very scary situation. A machine went down at the cancer centre, and patients know it, because they had to be cancelled. If a machine breaks down here, we know that's 100 patient treatments a week, or maybe more. Where are they going to be absorbed? They can't be absorbed by the other machine here. We have already extended the hours in Vancouver and in the Fraser Valley clinic. What is the backup plan? What is the contingency plan? Perhaps the minister will stand up and say that they're buying a new machine and they're going to install it here. That would be wonderful news for cancer patients in the province. What is the backup plan?

Hon. J. MacPhail: We've been through this several times. The B.C. Cancer Agency has a plan for expansion of services. I think that they've done an admirable job in terms of reducing wait-lists and having a made-in-B.C. solution. In fact, part of their plan deals with the replacement of machines from now until the year 2000.

I would just suggest that it is inappropriate to use these estimates as an opportunity to fearmonger amongst those who are most vulnerable. It really is shameful, if you ask me, to somehow suggest that there is not the regular maintenance and repair of machines as needed. Even brand-new machines require some sort of maintenance and go out of operation for a while.

S. Hawkins: I think it's shameful for the minister to suggest that we're fearmongering when she darned well knows that this is the only time we can raise issues for patients. We get cancer patients phoning us, calling us and writing us all the time. They have the gall to say it's fearmongering. It's asking for a plan. We know that this government has no plan. They go from crisis to crisis. We're going to wait until a machine goes down and until we have a hundred or more patient treatments a week that are going to have to be cancelled -- to find them scrambling and looking for a plan.

So I suggest to you that you do get a plan, because what we've seen in the last year is that there is no plan. The plan is just crisis to crisis to crisis -- knee-jerk reactions.

What we're putting to you is -- and this government has heard it from the Vancouver Island Cancer Centre -- that they're in dire straits. They're cramped for space, they've got long waiting lists -- up until extended hours -- and they're extending hours, I would remind the minister, on machines that are old. They went to the media -- very, very unusual. I'll tell you, it's very, very unusual for health care providers to go to the media and talk to them about the state of patient care, because no one likes to scare patients.

[3:45]

But you know what? It's gotten to the point where we see health care providers, all the time in the media, talking about how they're having to do more and more with less and less, how patient lists and waiting lists are growing, how patients are suffering, how they're been treated without dignity in care and how their safety in care is being compromised. And they sit there and accuse us of fearmongering -- absolutely unreal.

What we're doing is raising the issue and bringing it to government's attention, because obviously they're not listening to anybody else. Hopefully, they're listening here. We have patients saying to us: "Please raise this issue because they're not listening. My doctor is telling me this; my nurse is telling me this; my chiropractor is telling me this." They're not listening, because you know what? They don't listen, and they have no plan.

This is about the third or fourth time I've asked, and the minister goes back to: "Well, the cancer agency has a plan." I bet their plan is to ask you what your plan is, and you guys don't have a plan. Why doesn't the minister just stand up and say, "These patients will be able to go to X" -- Bellingham again, or whatever -- just so we know that patients are comforted in case the machine does break down here? They are old machines; they're on their last legs. That's what we were told. We were told that last year, but this minister doesn't want to listen.

This minister should go and talk to the representatives of the Vancouver . . . . Obviously she doesn't listen to them, because this was old news last year. It was very, very well publicized last year that those machines were old, that they needed to be replaced, that that clinic needed to be built, that it was lacking space and that it was very cramped.

Those patients were having to be moved around out of country, and now she's asking for evidence. Perhaps she should take the little tour. I don't even know if she's been there. Perhaps she had a photo op; I don't know. I'm not saying whether she did or not; perhaps she did. Perhaps she should go without photographers. Perhaps she

[ Page 3781 ]

should just walk in patient areas and take a tour with people who will actually talk to her. Perhaps she'll listen, for a change.

We're extending hours on old machines. That's what I've been told. I understand that the situation is very scary. That's the way it was described to me, and I'm passing that on to the minister. She sits there and laughs and makes fun of it. It is not funny. That is an absolutely ridiculous reaction from a Health minister; that is absolutely ridiculous.

We have a situation in this province where we have three cancer clinics -- one that's being built -- and we have evidence from the B.C. Cancer Agency that the problem with sick patients and cancer patients is not going to go away. In fact, growth in this province is increasing. The aging population is increasing. In-migration is increasing. This is not a problem that's going away, and that's why we asked the ministry to plan for it.

When I toured the Fraser Valley clinic, they have a vault there which they're hoping will house a new machine -- a new radiotherapy machine. They're hoping that the Vancouver Island clinic, if it ever gets built, will also have a third machine, because the population here is increasing. They hope -- this is what B.C. Cancer Agency people tell me -- that the new southern interior cancer centre that's being built will also have a third machine.

But what I understand is that there are only two budgeted for Vancouver Island, and the problem is not going to go away. There's not another one being budgeted for the Surrey-Fraser Valley Cancer Centre in Surrey -- and certainly not in Kelowna. I'm wondering if the minister can tell us what she knows about the numbers increasing and if she's been briefed by the Cancer Agency on their request for more equipment to handle the need. Perhaps they wouldn't have to go into extended hours if they had the proper equipment to handle the cancer patients' needs.

Hon. J. MacPhail: Well, the hon. member has the facts wrong again. In the Victoria area the existing three will be expanded to six brand-new machines, so I don't know where her facts are coming from.

I would also like to say that when the hon. member stands up and says there is no plan, it is the B.C. Cancer Agency that she's attacking directly. We have met with them, and they have put in place, through the wonderful leadership of Dr. Don Carlow and his staff, a plan that excels in all of Canada. The details of the plan have been outlined not only in the story today but in the estimates of last year and are committed to us by the funding that we've put in place this year.

For instance, it was at the suggestion of the staff of the B.C. Cancer Agency that the machine hours be extended, and it was their advice that the maintenance and repair of the machines could more than well withstand this. The replacement program for the machines has been budgeted for up to the year 2000 and funded completely, and it is on that basis that the machines will be replaced. By the year 2000 there will be six brand-new machines in Victoria and others in Kelowna, and there are new machines in Surrey. The B.C. Cancer Agency got an annual increase of $3.7 million directly this year alone for their budget.

The Chair: I would just like to say, before I recognize the hon. members in the House, that this issue has been raised repeatedly, and the minister has in fact responded. The exchange, I find, has been very repetitious throughout the discussion. The exchange of the issues has been noted, and I'd like the member to go on to another issue.

M. Sihota: Hon. Chair, I'm just going to spend a few minutes speaking about a number of things. You know, hon. Chair, I've had the privilege of being in this House and sitting through, I think, my eleventh or twelfth estimates of the Ministry of Health. I've never seen such an ineffective and futile effort on the part of the opposition. There has been much discussion during the course of the last few hours . . . .

Interjections.

M. Sihota: Let's talk about plans. The opposition, during the course of the last election campaign, put forward a plan in front of British Columbians. They said that they would plan to spend $6 billion on health care -- an inadequate amount. British Columbians rejected that plan of the opposition, because they put their faith in this side of the House to protect health care.

Interjections.

The Chair: I'd like to call the member to order, and I'd also like to remind all members in the chamber to please pay attention to what the hon. member is in fact saying.

M. Sihota: Then the opposition . . . .

The Chair: Excuse me, member. I would also like to remind the member to please be relevant.

M. Sihota: I will be, hon. Chair.

Then the opposition conceived of a new plan, and their plan was to come into this House and try to spend as much time as they possibly could to try to get a political hit during the course of estimates in Health. We've been here for four going on five weeks in this House, and the opposition have not only failed to get their political hit, but in so doing have demonstrated how ineffective and futile they really are.

I know it's easy to pick a fight, and it's always difficult to get out of one. Let me offer the opposition a plan. The opposition needs to develop a plan to get out of these estimates, and because the hon. member who is leading this debate for the opposition is new, let me take a few minutes to advise the House and all hon. members of what other steps the hon. member could take to . . . .

The Chair: Hon. member, I'd like to call you to order. If you're rising to speak, we're on the discussion of the estimates.

M. Sihota: I will, hon. Chair. I have a question to the minister. I would like to ask the minister if she would agree if the following devices are also available to the hon. critic to ask questions with regard to health care.

The hon. member can put issues on the order paper. I'd like to ask the Minister of Health if she would be prepared to answer questions through the order paper so as to expedite this process, because that process exists. I would like to ask the minister if she's prepared to make her deputy available from time to time, so as to better educate the critic opposite on matters of health, so that we could have a more informed

[ Page 3782 ]

debate. I'd like to ask the minister if she would be agreeable to having her ministerial assistant -- a fine chap, at that -- meet quarterly with the critic of the Liberal Party with regard to health care matters, so that the member could become educated and informed with regard to health care matters.

The Chair: Hon. member . . . .

M. Sihota: Hon. Chair, my point -- and I'm ending on this point -- is that there are many venues available, not just this venue, to ask questions with regard to health care. I am sure that the Minister of Health would agree with me, would she not?

The Chair: Hon. member, could I have you take your seat for a moment, please. The comments being made are out of order. I would ask that the comments and the questions that are being put be made to the estimates of the Ministry of Health. If there is a different line of questions that is going to be coming out of this to the Minister of Health, I would encourage you to please put them forward.

Hon. J. MacPhail: I would just say once again that I very much value the process of estimates. I think they are useful. I think it is the time for the opposition to ask their questions. I think it's a process that is based in democracy, and it's very useful. It complements other matters that we've brought forward, like freedom of information. As a government, we have actually brought public accounts into the twenty-first century, as well. I very much find our estimates process useful, and for questions that have already been answered, the reading of Hansard is useful as well.

G. Plant: Dare I seek leave to make an introduction?

Leave granted.

G. Plant: In the precincts this afternoon is a class from Charles E. London Secondary School in my constituency of Richmond-Steveston. With them is their teacher Mr. Sandy Bucifal and two assistants, Jeff Mah and Rebeca Rubio. I ask that the House please make them welcome.

Hon. L. Boone: I've been listening to this questioning for some time, and it's interesting. I've been listening to the member mention time and time again that there's not enough money to purchase various types of machinery, that hospitals don't have enough money, that there hasn't been enough money put into the system. I've heard her say that the increases in spending have only been 2 percent -- that only 2 percent has gone into an actual increase in a budget. As somebody that . . . . We've seen a 19 percent decrease in my budget in order to sustain a 2 percent increase in this budget.

Interjections.

Hon. L. Boone: Hon. Chair, they don't seem to want to listen, but I would like . . . . A 19 percent decrease in this budget so that we could in fact put money into health care, so that we could protect those services there . . . .

[4:00]

I know that at various times the member has mentioned coming through the Prince George Regional Hospital and has mentioned the various horrors that she saw there. But I also know that that member did not contact the local chair of the hospital board before going through the hospital. In fact, she went through the hospital with one physician, but did not have the support . . . . In fact, the chair of that board was very, very upset about the fact that the member had failed to contact her, and that in fact . . . .

Interjections.

Hon. L. Boone: Well, isn't this interesting, hon. Chair?

Interjections.

The Chair: Order, members. Order!

Hon. L. Boone: They were extremely upset with the negative comments she made in the paper about the hospital. And yes, you can point at any different time to any area -- as we've seen in the ten years that I've been in this Legislature -- and there will be some times when you have people in hallways. That's the nature of the health care system. It has happened that way for ten years.

Interjections.

The Chair: Member, please take your seat for a moment. Members, could we have order, please, in the chamber. The hon. member is trying to speak.

Hon. L. Boone: What the member didn't point out was that she didn't go to see our wonderful new hospice. She didn't see the travelling mammography unit that provides services to women throughout northern British Columbia. She didn't talk about the mobile clinics that are coming through and the transplant clinics that are there. She didn't talk about any of the wonderful things that are in fact going on in the Prince George region with regard to health care, and it really disturbs me.

Time and time again I listen to the members opposite demand more and more services, at the same time demanding that we cut everywhere. I'm sure this same group of people will come into my estimates and demand that we spend more money on highways when, in fact, they are expecting us to cut. So I find it very frustrating to listen to this type of stuff going on.

I guess my question to the minister is: can she tell me what . . . ? I know that last time we did a running count, and we found at the end of the Transportation and Highways estimates that they had asked for $2.6 billion worth of proposals, at the same time telling us that we needed to cut and get budgets in line. Does the Minister of Health have any idea of the cost that would come as a result of the various things that have been requested from the members opposite in terms of additional services and additional moneys going into provincial health care or into our hospital system?

Hon. J. MacPhail: No, I haven't done that. The opposition members are one area that I receive advice from, and I receive it from a wide range of other sources as well.

[G. Brewin in the chair.]

[ Page 3783 ]

G. Farrell-Collins: I find it amazing that at the same time the Minister of Health is complaining about the length of time her estimates are taking, we're getting this exuberant input . . . .

Interjection.

G. Farrell-Collins: Well, the House, a few moments ago.

Interjection.

G. Farrell-Collins: We have these exuberant interjections by the Minister of Transportation and the exuberant interjections from the government Whip.

Interjections.

The Chair: Order, order, hon. members!

Interjections.

The Chair: Hon. members, the Chair has called for order, and order shall happen.

Hon. member, continue.

G. Farrell-Collins: Thank you, hon. Chair. I appreciate your intervention.

The incredible interjection of the member opposite, the member from Costco, who has the gall to talk about people trying to get media hits -- Mr. Media himself . . . . It's interesting to hear the comments from the Minister of Transportation and Highways. She talks about the requests from the opposition members about expenditure of funds on various issues. In particular, she refers to her own ministry.

I'd remind that minister, and indeed the Minister of Health, that it was the members on that side of the House -- in particular, the Premier -- who went around this province for 90 days in the lead-up to the election. I believe they called it "90 Days of Decision"; it was more like "90 Days of Deception," because the government went around to every single community, set up their little photo op and announced whatever it was that the community wanted, told them they were going to get it and told them that all they had to do was vote NDP and they'd get that cancer clinic -- a cancer clinic for every community.

All they had to do was to stand up and vote for the NDP, and they'd get that highway expansion that the Minister of Highways talked about. All they had to do was stand up and vote for the NDP, and they'd get a hospice, they'd get extended care and they'd get whatever it is that they asked for -- anything they wanted.

All they had to do was vote for the NDP. I remember the press conferences. Every single day, for three months, the Premier went around this province and promised people absolutely everything. Then, the day after the election, he had the gall, the nerve, to hold a press conference and say: "I'm going to need a little bit of wriggle room here." Well, he had no intention of keeping those promises. So when the Health critic stands up . . . .

The Chair: Hon. member . . . .

G. Farrell-Collins: Hon. Chair, I didn't notice one interjection from the Chair during the intervention by the Minister of Transportation and Highways, and I expect to be accorded the same respect and the same time to finish my comments.

The Chair: I nonetheless remind hon. members that this is on vote 40, which is the Minister of Health's estimates. I would encourage all members to focus on vote 40, the Ministry of Health estimates.

G. Farrell-Collins: Thank you, hon. Chair. I'll be thrilled to see the first time that that interjection comes when it's the members opposite who are making their comments on vote 40. I'll wait for it.

The Premier went around this province and promised everything to everybody in every community, when he had no intention of keeping even one of those promises. He had no intention because he knew he couldn't and because he knew his budget wasn't balanced. He knew he was half a billion dollars out.

So when the minister gets upset because members opposite stand up to hold this government to account for the way they misled the people of this province during the election campaign, I think it's the minister and the members opposite who should start telling the people of British Columbia the truth about the budget expenditures in this province, not just during the estimates process but every day of the year and even including -- I know it sounds terrible -- the 90 days leading up to the election campaign.

The Chair: Hon. member . . . . Again I remind everyone -- everyone -- that this is about vote 40. It is not about past elections; it's not about current ones. It's about vote 40.

Interjections.

The Chair: Hon. members, it is not about past elections; it is about vote 40. I encourage all members to talk about vote 40.

G. Farrell-Collins: Thank you, hon. Chair. I know that as a member, you've been here as long as I have and that you understand there is a period of about 15 minutes accorded to members to make their point, and then they can ask their question. Hon. Chair, it's hard for you, I know, to understand where my question is leading to, but I promise you that I'll get there and that it will be on vote 40.

When I hear the members opposite stand up and complain that the members of the opposition would ask the government to account for their promises, for the things that they said they were going to do for British Columbians during the election campaign, I know it's shocking. I know it's uncomfortable for all members of the New Democratic Party -- all members sitting over there and at the table . . . .

I know how difficult it is for them to have to face the truth, to have to realize that the people of British Columbia are calling for some accountability and that they were promised something in the last election, they were promised something last year in the budget, and they were promised something again this year.

You have to understand, and you have to sympathize with the voters of British Columbia when they're a little bit suspicious about what it is that's being offered to them by this government, when they're being told that they're going to get planning money for their schools or for the expansion of their hospitals, or being told: "Don't worry about it. We're actually getting rid of the wait-lists. Don't worry, we will. It's coming."

I can't remember the number of times I've had to sit here in question period and listen to a minister of the Crown -- particularly the Minister of Health, and the one before her and the one before him -- stand up in this House and tell us that

[ Page 3784 ]

waiting lists were gone in British Columbia. "That's it, they're done; there are no more waiting lists. We're dealing with it." I've probably heard it five or six times, yet it comes back every year. Every year it comes back, and we've got another horror story, another case, another 20 cases, another 30 cases -- whether it's dialysis, whether it's cardiac wait-lists, whether it's hip replacements, whether it's orthopedic surgeons, whatever it is.

You know, if it was tough to deal with the dollars, if it was tough decisions the government was making about where the health dollars were having to go, that's one thing. The people would probably be willing to help the government with those decisions and to get involved and help at the community level with those decisions and those allocations of dollars -- only to find out shortly thereafter that they were fired by the government because they didn't agree with what they said.

But you could understand that the people of British Columbia, the taxpayers, would be glad to participate in that process if they felt they were being told the truth, and if they felt that the dollars were there and the government's commitments to them were the truth.

But the fact of the matter is that these members all stood up in their ridings in the last election, and again at budget time, and told everybody how wonderful everything was. They told everybody how incredible things were in health care, and what a great government they were for health care. The fact of the matter is that the vast majority of the added dollars going into health care are going to pay off the health accord. They're not going into patient care directly; they're not going into added infrastructures; they're not going into added services.

Interjection.

G. Farrell-Collins: Well, hon. Chair, the minister says . . . . Maybe the minister can tell us how many new nurses this government has hired, how many new lab techs this government has hired and how many new dollars they have put into front-line services to health care.

The fact is that they've cut front-line services to health care, and they've put those dollars into the pockets of the people that are running the unions for this province. That's how they win an election. They go out and buy the votes from interest groups in the province and forget about the patients, who are the ones we're supposed to be providing the system for.

We just had the member for Peace River North ask a question -- a very long question, I might say, but a very good one -- in question period today about the services in his riding and about the added dollars that have gone into his riding, spending -- what is it? -- $300,000 to build a garage to put an ambulance in, when it was at the fire hall two blocks away before.

So that's the problem: this government figures that all you do is throw money at the special groups, the friends of the government, and forget about measuring health care. Has this government started yet to measure the outcomes, to actually measure the impact they're having on patient care in this province? Are British Columbians getting healthier or are they getting sicker? Are they getting better service or are they getting worse service?

The reality is that virtually every added dollar this government has put into health care has gone into pay. It has gone into increased pay for the health care workers, because they were terrified during the last election that there was going to be a strike. So they bought them off in the second week, I think it was, of the election campaign.

Interjection.

G. Farrell-Collins: The minister can't wait to get up in estimates. She's had three weeks to answer all this stuff. I'm just talking about this issue, and she can't wait to get up and answer questions. I suspect that with the enthusiasm of the Minister of Health, we could go at this for days and days. So when we hear the minister and the members opposite talk about the opposition, saying that the opposition is somehow asking the government to spend money on health care and on patient care, they're right; we are.

We're asking them to spend the money they've got wisely, and to make sure that the money they invest is going into patient care and not into special deals to help the government get through an election campaign, only to find out after the campaign that all the promises and commitments that they made have fallen by the wayside because the Premier needs some more wriggle room.

The people of British Columbia are tired of having this government, this minister and, more importantly, that Premier tell them stories, only to find out after the fact that those stories they were being told weren't of the reality kind; they were of the fiction kind. People are tired of hearing that. They want to know. When they're asked by the critic where the dollars are going, where these supposed added dollars in health care are going . . . . Are they going to patient care, or are they going to buy off unions in time for an election campaign? I think we know the answer, but I can't wait to hear it from the minister.

[4:15]

Hon. J. MacPhail: I actually respect this member greatly for his understanding of the process. However, I did answer that question earlier today, and I don't mind going through it again. Of the $92 million, about $16 million is going to increased wages for front-line workers. I gave that answer earlier. I also outlined where all of the dollars are going in the lift merely to operating. I then outlined where increased funding is going to cancer services. That was the question.

But let's talk about what we mean by health care services. I still can't understand, in an industry where it is 80 percent labour-intensive, that somehow it's a building that delivers the service; or that it's this radiotherapy machine that somehow operates on its own; or that an operating room, as a building, gets operated on its own; or that someone who has to be served food each and every day or have the laundry done -- that somehow that isn't a valuable service, that somehow it doesn't contribute to the well-being of patients. But you know what?

I personally value each and every one of those services offered by a laundry worker, by a dietary aide, by a health care worker, by a lab technologist or by a nurse. I value every single one of them.

Let's talk about how many people we have in the acute care health care system. Somehow, earlier on today, the health labour accord was being held up as this waste of money, this horrible waste to the system. And somehow, even though they got their facts entirely wrong about it -- because they had to go back to 1995, an estimates document, where the health labour accord had just been introduced -- they're now saying that because we use our services and we've moved our health care workers into the community as opposed to the acute care sector, that's paying off our labour friends and that that's bad.

Yes, there are 2,000 fewer FTEs in the acute care system. But you know what? Somehow that's used as a bad item by this opposition, and somehow that's a waste of money. But the health care system is changing. There are better health outcomes

[ Page 3785 ]

in the system, and we've talked about those over the last three weeks. I feel badly that the hon. member hasn't had the time to pay attention to that, but those services are now in the community. What the health labour accord did was move it out of the acute care system and into the community services sector. Over the last five years, funding into the community services sector has increased by half a billion dollars. That's "b" for billion; that's $546 million. That's where our health care workers are working, and that's where they're improving the health outcomes of our population.

We have also put performance measures in place. It's the first time ever in North America, actually, where there will be performance measures for health outcomes. We've gone over those, as well, for the last three weeks -- in detail.

But what I can't understand -- and, actually, I would appreciate an explanation -- is how, when we actually pay a decent wage to health care workers, when we actually train health care workers for the emerging issues in the health care system, and when we actually utilize our health care workers in a way that makes sense to the public, where they get their services in the community and not necessarily just in the acute care sector . . . . How is that somehow paying off union friends?

Is it that the opposition members object that health care workers have a collective bargaining process? Is it somehow that they object that there's a way we can make sure workers are treated fairly, that not only employers but workers also are held accountable for standards of performance, responsibilities and wages and benefits?

I'm serious about this. I do not understand the opposition's denigration of front-line health care workers. I do not understand how paying people a decent wage and at the same time making efficiency initiatives in the acute care sector is somehow paying off friends and insiders. I do hope that over the course of these estimates, which actually . . . . Never once have I ever said they're anything but valuable -- ever. Not once. I would actually appreciate the opposition's explanation of why they don't value front-line health care workers.

S. Hawkins: The minister continues with this putting of words into the opposition's mouth, when she knows that we do value front-line workers. The minister herself said earlier this afternoon that they had cut 2,700 FTEs. The member who was just up before me asked: "How many did you hire?" When hospitals are cutting back and cutting back beds, and you say that you're putting more into community care, but we know you're not because people are on waiting lists . . . . There are waiting lists in the community for extended care, for home care, and they keep saying that they're hiring all these people, and that they're out in the community and they're working. Where are they?

The minister gets the same letters I do. I know, because they come to her and they c.c. them to me. She gets the same stuff I do.

The minister says that she is putting money into health care, that this health labour accord, which we talked about before, actually saved money, when we know that their documents say the opposite. We don't know whether to believe . . . . Do you believe what the Premier says? Do you believe what the minister says? Do you believe what the official . . . ? Or do you believe none of them? They've never, never been able to give a straight answer.

A while ago she said that they were protecting health care, that they've got enough workers in the hospital and that they value health care workers. Then, a little while later, she says that they've reduced 2,700 FTEs. Well, which is it? Are you protecting the health care system and putting up front-line workers, or are you getting rid of them?

What we're saying is that you're getting rid of them. We had always said that we would add front-line workers, and she knows it. If she actually took the time to read, she would see that we were going to hire more nurses, because we do value front-line workers. We don't go out there trying to make special deals just to stay in power, which is what this government has a track record of doing. They know it. That's what the health labour accord and all the imposed agreements on health employers were about, and they know it. The truth hurts, doesn't it? The truth hurts because . . . .

Interjection.

S. Hawkins: The minister has to resort to that. That's just a case in point.

We were talking earlier about cancer clinics, and I want to get into wait-lists for cancer, because the minister is bragging about how much money they're putting into the cancer program.

I do want to say for the record, as well, that the minister said I was attacking front-line care workers and people at the B.C. Cancer Agency. I want to say very clearly that I've never done that. I communicate with those people, I get advice from those people, and I bring their concerns to the House -- unlike the minister. She doesn't even listen to what they're saying.

When the minister says they have a plan and the cancer agency has a plan, I have to remind her that they can only plan within the resources that they're given. Guess who provides them with resources. It's the Ministry of Health. So if the Ministry of Health doesn't give them enough resources, then they come up with the best available plan that they have. And we still haven't heard what the plan is in case cancer services at one clinic or the other are shut down for whatever reason.

In no way, shape or form am I attacking any of the caregivers or people that plan for cancer services at the cancer agency. Not at all. If this minister wants to say that, she can say that, but it's not the truth. We know they never speak the truth, so no one is going to believe that, anyway.

I was a cancer nurse for ten years, and I know that we plan with the resources we're given and with the best possible plan that we can, given those resources. When this minister says that they have a plan, I'll tell you it's within what this ministry is able to provide to them, which at this time -- I'm bringing their issues to the House; that's what I'm doing -- is not a heck of a lot. I don't know what plan they've come up with, but it's within what this ministry will provide to them, and what they're telling me is: it's not very good.

What I was told about the Vancouver Island Cancer Centre here is: "It's a scary situation." Those were the actual words. It's very scary. The waiting lists are long. Patients are now coming during extended hours. Those machines are overworked. I know we talked about that before. That's what's happening out there.

We talked about the funding. We talked about equipment and the lack of equipment, which the minister again says that they're going to address, as they've budgeted for it. Again, we'll see it if it happens.

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What I want to know about is the wait-lists. Hopefully, the numbers are up to date. I want to know the wait-lists for cancer by disease group and for each clinic. The minister says they're reducing the wait-lists and they're getting better. I want to know how many patients, in what disease groups, are waiting for their different types of treatment -- for prostate cancer, for breast cancer, for brain cancer. What are the numbers? Can we get some up-to-date numbers?

Hon. J. MacPhail: The B.C. Cancer Agency keeps it by disease category. I'll ask the B.C. Cancer Agency to provide it to the hon. member. Victoria has a wait-list of about 135 people, Surrey has a wait-list of about 35 people, and Vancouver has a wait-list of about 200 people in total.

S. Hawkins: The wait-lists still seem to be rather long, considering that hours are extended. How long, on average -- and again, it will have to be by disease group; hopefully, I can get that information -- are these people waiting for treatment?

Hon. J. MacPhail: There are two waiting times that are kept track of: breast cancer and prostate cancer. The waiting times for breast cancer patients and . . . . I fully understand that any waiting time is tough on the family -- fully understand. But in terms of medical outcome, we are working toward a two-week waiting period. In the meantime, the B.C. Cancer Agency has managed to reduce the waiting time for breast cancer treatment to four weeks in Vancouver and eight weeks in Victoria. For prostate cancer waiting time is about eight weeks in Vancouver and about four months in Victoria.

S. Hawkins: Can the minister explain why they're waiting different times in different clinics?

Hon. J. MacPhail: The extra pressures were in Victoria because of the aging population. Part of the B.C. Cancer Agency plan that is in place is to shift the treatment for patients away from Victoria. Northern Vancouver Island patients are going to Vancouver, for instance, to take the pressure off the population- and age-driven pressures in the Victoria area. This is a part of the B.C. Cancer Agency's plan, which is working astonishingly effectively in reducing the wait times.

I must say that I fully understand, as a human being, that waiting any time is hard on a family. But I also know that in the context of waiting times, the B.C. Cancer Agency's plan . . . . I have heard this hon. member say over and over again that there is no plan. There is a very concerted plan, all of which has been documented publicly.

[4:30]

In terms of the balance of proper, effective and timely treatment, we are much closer, and every day get closer, to meeting the treatment times for cancer patients with the resources available. Of course, those that are deemed emergencies get treated immediately. Where there's palliative care required, they also get treated immediately.

S. Hawkins: I certainly understand the suffering of those patients who have to wait. I understand that the minister's reason for patients having to wait longer than the ideal waiting period is lack of resources. There's an aging population; the clinic here cannot handle that load.

I want to know if the B.C. Cancer Agency came to the ministry and asked for resources and what specifically they asked for that would help alleviate these waiting times.

Hon. J. MacPhail: Yes, they came. I'll ask the hon. member to listen to this. The B.C. Cancer Agency did come forward and ask for resources, and we gave them every single thing they requested.

S. Hawkins: I'll ask the minister again: did they ask for new machines for the Vancouver Island Cancer Centre as soon as possible, because these machines are aging?

Hon. J. MacPhail: I'll repeat it. Every single thing that the B.C. Cancer Agency asked for, we delivered, including their request for new equipment and the timing of the request for that equipment.

S. Hawkins: I understand that the B.C. Cancer Agency is quite concerned about the wait-list, about population growth and about the increase in cancers because we do have an aging population. That's not going to change. People will continue to get sick; people will continue to need treatment. I understand that there have been negotiations around equipment at this clinic and that the Cancer Agency has asked for this clinic to be looked at for equipment. I'll ask the minister: when will this clinic be up and functional with the new equipment that she says her ministry is promising?

Hon. J. MacPhail: I've answered this question before in estimates, and I'll answer it again. The clinic is a total replacement of the current operation. This current operation continues to function until the new, complete top-to-bottom replacement clinic is open by the year 2000.

S. Hawkins: The new clinic with new equipment is going to open in the year 2000. In the meantime the treatment machines continue to age. I'm told that the treatment machines are 13 or 14 years old. One, as I mentioned, broke down just a few weeks ago, and that was very scary for patients. Can the minister reassure patients on Vancouver Island that they will continue to get treatment here and that there is a backup plan on the Island for patients to get their treatment close to home if the machines break down?

Hon. J. MacPhail: There is a provincial radiation therapy committee of the B.C. Cancer Agency. They have developed a contingency plan to deal with a sudden, unexpected breakdown of equipment. They have a plan in place. The B.C. Cancer Agency also stated today that the physics staff at the Vancouver Island cancer clinic has been taking great care of radiotherapy machines and that a complete breakdown of these machines before the opening of the new clinic is not expected. They've estimated it as a very low risk. And you know what? These aren't the bureaucrats for which this opposition has so little respect.

This is the B.C. Cancer Agency making this statement and reassuring the population of British Columbia.

S. Hawkins: Well, it's nice to hear that the minister is able to read something like that. That's what we were asking: is there a backup plan? Obviously, there is some kind of a plan, but the machines are going to continue to age. They can be looked after; they can be cared for; there can be maintenance and all that kind of thing. One day they're just going to conk out. That happens. They just go. It appears to me that there is no budget for new machines until the new clinic opens in the year 2000.

What I understand from the planning around this clinic is that a lot of money went into planning and that the clinic was

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actually going to be expanded on the site where it is right now. But due to the growth in the population, the aging and the treatment requirements needed for patients at this clinic, they're now looking at a new site and a brand-new building. So that's more planning dollars.

This government . . . . I don't know how many times this clinic was announced -- a new photo op every time. I don't know how many ministers announced it -- perhaps a new photo op for this minister, too. Maybe it's three or four times that this clinic has been announced. I mean, lots and lots of money goes into planning. At a time when health care dollars are so scarce, we have a minister sitting here telling us that now we're going to plan for a new clinic on a new site. This is not a new government. This is a government that has been in power for six years.

And six years later, we still don't have a plan for a new clinic on Vancouver Island. We know that the waiting lists are growing, that there are patients suffering and that they're asking questions -- they write to us. The Cancer Agency has discussions with us, as well, and I know for a fact that they're worried. I just spoke to a spokesperson last week. The minister can read all she wants off a piece of paper that comes from the agency, but perhaps the government should realize that sometimes they only get what they like to hear, too.

Again, the contingency plan is only as good as the resources that this government is willing to put into it. I put it to you that you're not willing to put in a lot. They may have got everything they asked for, but probably within the means that you extended to them. So I want to ask the minister: how much in planning dollars is this clinic on the new site going to cost, over and above what's been done already for planning this clinic on Vancouver Island?

Hon. J. MacPhail: Hon. Chair, again we're shifting to capital. Because there's no order to these estimates, they'll have to wait for the answer. I'll get that for them.

C. Hansen: Several months ago I wrote to the minister regarding a constituent of mine who was on a two-month wait-list to have breast biopsy surgery performed. Needless to say, she was extremely distraught. Her physician felt that she was high risk and that the surgery was important. I want to quote from the minister's reply to this constituent, which she signed:

"In British Columbia the priority of treatment is determined by the physician providing care and the options available to them to refer to other specialists with shorter waiting lists and waiting times. The priority is based on their assessment of the mammogram results and the medical needs of the patient. If you require further clarification as to the urgency of your case, I suggest you contact [your doctor. Your doctor] could also refer you to another surgeon who has a shorter waiting list."

I would like to ask the minister: before she sent this letter to my constituent, did she check to make sure that there were any other physicians that had shorter wait-lists? Or was she raising the hope of my constituent and trying to pass the blame onto the doctor rather than onto the ministry and the wait-list and the OR time that was available?

Hon. J. MacPhail: Hon. Chair, certainly I have no idea of the letter to which this hon. member refers, and I know that he doesn't want to raise the name of the patient in the House, as well. So I would be more than happy to answer his question outside the House, after I've had a chance to see the correspondence that