British Columbia Hansard — Tuesday, April 2, 2002

H0402pm-05

British Columbia — Debates (Hansard)

3rd Session, 37th Parliament OFFICIAL REPORT OF DEBATES OF THE LEGISLATIVE ASSEMBLY (HANSARD) Tuesday, April 2, 2002 Afternoon Sitting Volume 5, Number 5 THE HONOURABLE CLAUDE RICHMOND, SPEAKER ISSN 0709-1281

PROVINCE OF BRITISH COLUMBIA (Entered Confederation July 20, 1871) LIEUTENANT-GOVERNOR Honourable Iona Campagnolo 3RD SESSION, 37TH PARLIAMENT SPEAKER OF THE LEGISLATIVE ASSEMBLY Honourable Claude Richmond EXECUTIVE COUNCIL Premier and President of the Executive Council................................................................................. .........................Hon. Gordon Campbell Minister of State for Intergovernmental Relations.............................................................................. ..................... Hon.

Greg Halsey-Brandt Deputy Premier and Minister of Education ....................................................................................... ..................................Hon. Christy Clark Minister of Advanced Education................................................................................................. ...........................................Hon. Shirley Bond Minister of Agriculture, Food and Fisheries.................................................................................... ..............................Hon.

John van Dongen Attorney General and Minister Responsible for Treaty Negotiations.............................................................. .................... Hon. Geoff Plant Minister of Children and Family Development.................................................................................... ..............................Hon. Gordon Hogg Minister of State for Early Childhood Development.............................................................................. .................................Hon.

Linda Reid Minister of Community, Aboriginal and Women's Services......................................................................... .................. Hon. George Abbott Minister of State for Community Charter........................................................................................ .................................. Hon. Ted Nebbeling Minister of State for Women's Equality ......................................................................................... .................................... Hon.

Lynn Stephens Minister of Competition, Science and Enterprise ................................................................................ ..................................Hon. Rick Thorpe Minister of State for Deregulation ............................................................................................. ............................................ Hon. Kevin Falcon Minister of Energy and Mines................................................................................................... ....................................... Hon.

Richard Neufeld Minister of Finance ............................................................................................................ ....................................................... Hon. Gary Collins Minister of Forests ............................................................................................................ .................................................. Hon. Michael de Jong Minister of Health Planning .................................................................................................... ............................................ Hon.

Sindi Hawkins Minister of Health Services.................................................................................................... ................................................ Hon. Colin Hansen Minister of State for Mental Health ............................................................................................ ...................................Hon. Gulzar S. Cheema Minister of State for Intermediate, Long Term and Home Care ............................................................................. Hon.

Katherine Whittred Minister of Human Resources.................................................................................................... ............................................Hon. Murray Coell Minister of Management Services................................................................................................ .........................................Hon. Sandy Santori Minister of Provincial Revenue................................................................................................. ................................................Hon.

Bill Barisoff Minister of Public Safety and Solicitor General ................................................................................ ..................................Hon. Rich Coleman Minister of Skills Development and Labour...................................................................................... .............................Hon. Graham P. Bruce Minister of Sustainable Resource Management.................................................................................... ..................................Hon.

Stan Hagen Minister of Transportation..................................................................................................... .................................................... Hon. Judith Reid Minister of Water, Land and Air Protection..................................................................................... ....................................Hon. Joyce Murray LEGISLATIVE ASSEMBLY Deputy Speaker................................................................................................................. ..............................................................

John Weisbeck Leader of the Opposition ....................................................................................................... ...........................................................Joy MacPhail Deputy Chair, Committee of the Whole ........................................................................................... .............................................. Harold Long Clerk of the Legislative Assembly .............................................................................................. .........................................E.

George MacMinn Clerk Assistant ................................................................................................................ ................................................................... Robert Vaive Clerk Assistant and Law Clerk .................................................................................................. ........................................................ Ian D. Izard Clerk Assistant and Clerk of Committees........................................................................................ ............................................Craig H.

James Clerk Assistant/Committee Clerk................................................................................................ ............................................ Kate Ryan-Lloyd Sergeant-at-Arms ............................................................................................................... .........................................................A.A. Humphreys Director, Hansard Services ..................................................................................................... ........................................

Anthony Dambrauskas Legislative Librarian.......................................................................................................... ............................................................. Joan A. Barton Legislative Comptroller ........................................................................................................ .................................................................Peter Bray Published by British Columbia Hansard Services, and printed under the authority of the Speaker by the Queen's Printer, Victoria.

Rates: single issue, $2.85; per calendar year, mailed daily, $298. GST extra. Agent: Crown Publications Inc., 521 Fort St., Victoria, B.C. V8W 1E7. Telephone: (250) 386-4636. Fax: 386-0221. Internet: www.legis.gov.bc.ca/hansard

Party Standings: Liberal 76; New Democratic 2; Independent Liberal 1. ALPHABETICAL LIST OF MEMBERS Abbott, Hon. George (L) ....................................................................... Shuswap Anderson, Val J. (L) .............................................................Vancouver-Langara Barisoff, Hon. Bill (L)............................................. Penticton–Okanagan Valley Bell, Pat (L).........................................................................Prince George North Belsey, Bill (L).................................................................................

North Coast Bennett, Bill (L) ........................................................................... East Kootenay Bhullar, Tony (Ind L) .................................................................. Surrey-Newton Bloy, Harry (L).................................................................................. Burquitlam Bond, Hon. Shirley (L).........................................Prince George–Mount Robson Bray, Jeff (L)......................................................................Victoria–Beacon H ill Brenzinger, Elayne (L) ...............................................................

Surrey-Whalley Brice, Susan (L) ............................................................................Saanich South Bruce, Hon. Graham P. (L)................................................ Cowichan-Ladysmith Campbell, Hon. Gordon (L)............................................. Vancouver–Point Grey Cheema, Hon. Gulzar S. (L) ..........................................Surrey–Panorama Ridge Chong, Ida (L)................................................................ Oak Bay–Gordon Head Christensen, Tom (L) .............................................................

Okanagan-Vernon Chutter, Dave (L) ........................................................................... Yale-L illooet Clark, Hon. Christy (L) ..................................................Port Moody–Westwood Cobb, Walt (L) ............................................................................. Cariboo South Coell, Hon. Murray (L) ........................................ Saanich North and the Islands Coleman, Hon. Rich (L) .............................................. Fort Langley–Aldergrove Collins, Hon.

Gary (L).........................................................Vancouver-Fairview de Jong, Hon. Michael (L)....................................... Abbotsford–Mount Lehman Falcon, Hon. Kevin (L) .......................................................... Surrey-Cloverdale Hagen, Hon. Stan (L) ................................................................... Comox Valley Halsey-Brandt, Hon. Greg (L) ..................................................Richmond Centre Hamilton, Arnie (L)............................................................Esquimalt-Metchosin Hansen, Hon.

Colin (L) .....................................................Vancouver-Quilchena Harris, Roger (L)......................................................................................Skeena Hawes, Randy (L) ............................................................ Maple Ridge–Mission Hawkins, Hon. Sindi (L).......................................................... Kelowna-Mission Hayer, Dave S. (L) ................................................................... Surrey-Tynehead Hogg, Hon. Gordon (L) ........................................................

Surrey–White Rock Hunter, Mike (L) ...................................................................................Nanaimo Jarvis, Daniel (L)...................................................... North Vancouver–Seymour Johnston, Ken (L)............................................................ Vancouver-Fraserview Kerr, Brian J. (L).............................................................. Malahat–Juan de Fuca Krueger, Kevin (L).................................................

Kamloops–North Thompson Kwan, Jenny Wai Ching (NDP) ...............................Vancouver–Mount Pleasant Lee, Richard T. (L).......................................................................Burnaby North Lekstrom, Blair (L)................................................................. Peace River South Les, John (L) .......................................................................... Ch illiwack-Sumas Locke, Brenda (L) ...........................................................

Surrey–Green Timbers Long, Harold (L) ...................................................Powell River–Sunshine Coast MacKay, Dennis (L)....................................................... Bulkley Valley–Stikine McMahon, Wendy (L).............................................Columbia River–Revelstoke MacPhail, Joy (NDP) ..........................................................

Vancouver-Hastings Manhas, Karn (L) .............................................Port Coquitlam–Burke Mountain Masi, Reni (L) ...................................................................................Delta North Mayencourt, Lorne (L) ..........................................................Vancouver-Burrard Murray, Hon. Joyce (L) ........................................................... New Westminster Nebbeling, Hon. Ted (L) ..........................................

West Vancouver–Garibaldi Nettleton, Paul (L).........................................................Prince George–Omineca Neufeld, Hon. Richard (L)...................................................... Peace River North Nijjar, Rob (L)...................................................................Vancouver-Kingsway Nuraney, John (L) ...............................................................Burnaby-W illingdon Orr, Sheila (L) ...........................................................................Victoria-Hillside Penner, Barry (L).......................................................................

Ch illiwack-Kent Plant, Hon. Geoff (L) ......................................................... Richmond-Steveston Reid, Hon. Judith (L)............................................................Nanaimo-Parksv ille Reid, Hon. Linda (L) ................................................................... Richmond East Richmond, Hon. Claude (L) ................................................................

Kamloops Roddick, Valerie (L)..........................................................................Delta South Sahota, Patty (L).....................................................................Burnaby-Edmonds Santori, Hon. Sandy (L)..............................................West Kootenay–Boundary Stephens, Hon. Lynn (L) ........................................................................ Langley Stewart, Ken (L)...................................................... Maple Ridge–Pitt Meadows Stewart, Richard (L) ......................................................

Coquitlam-Maillardville Suffredine, Blair F. (L) ................................................................Nelson-Creston Sultan, Ralph (L)....................................................... West Vancouver–Capilano Thorpe, Hon. Rick (L) ..........................................................Okanagan-Westside Trumper, Gillian (L)................................................................Alberni-Qualicum van Dongen, Hon.

John (L) ................................................Abbotsford-Clayburn Visser, Rod (L).................................................................................North Island Weisbeck, John (L).........................................................Kelowna–Lake Country Whittred, Hon. Katherine (L) ...................................North Vancouver–Lonsdale Wilson, John (L)...........................................................................

Cariboo North Wong, Patrick (L)............................................................Vancouver-Kensington LIST OF MEMBERS BY RIDING Abbotsford-Clayburn....................................................... Hon. John van Dongen Abbotsford–Mount Lehman ..............................................Hon.

Michael de Jong Alberni-Qualicum.......................................................................G illian Trumper Bulkley Valley–Stikine ..............................................................Dennis MacKay Burnaby North..............................................................................Richard T. Lee Burnaby-Edmonds............................................................................Patty Sahota Burnaby-Willingdon......................................................................

John Nuraney Burquitlam ........................................................................................ Harry Bloy Cariboo North ..................................................................................John Wilson Cariboo South .................................................................................... Walt Cobb Chilliwack-Kent ............................................................................. Barry Penner Chilliwack-Sumas .................................................................................

John Les Columbia River–Revelstoke....................................................Wendy McMahon Comox Valley .......................................................................... Hon. Stan Hagen Coquitlam-Maillardville .............................................................Richard Stewart Cowichan-Ladysmith .......................................................Hon. Graham P. Bruce Delta North.......................................................................................... Reni Masi Delta South................................................................................

Valerie Roddick East Kootenay .................................................................................. Bill Bennett Esquimalt-Metchosin...................................................................Arnie Hamilton Fort Langley–Aldergrove ..................................................... Hon. Rich Coleman Kamloops ....................................................................... Hon. Claude Richmond Kamloops–North Thompson ........................................................Kevin Krueger Kelowna–Lake Country...............................................................

John Weisbeck Kelowna-Mission ................................................................ Hon. Sindi Hawkins Langley ............................................................................... Hon. Lynn Stephens Malahat–Juan de Fuca .....................................................................Brian J. Kerr Maple Ridge–Mission ................................................................... Randy Hawes Maple Ridge–Pitt Meadows .............................................................Ken Stewart Nanaimo..........................................................................................

Mike Hunter Nanaimo-Parksville ...................................................................Hon. Judith Reid Nelson-Creston.......................................................................Blair F. Suffredine New Westminster ..................................................................Hon. Joyce Murray North Coast ........................................................................................Bill Belsey North Island........................................................................................Rod Visser North Vancouver–Lonsdale.......................................... Hon.

Katherine Wh ittred North Vancouver–Seymour .............................................................Daniel Jarvis Oak Bay–Gordon Head .......................................................................Ida Chong Okanagan-Vernon .................................................................... Tom Christensen Okanagan-Westside.................................................................Hon. Rick Thorpe Peace River North .............................................................Hon. Richard Neufeld Peace River South .......................................................................

Blair Lekstrom Penticton–Okanagan Valley ....................................................Hon. Bill Barisoff Port Coquitlam–Burke Mountain.................................................... Karn Manhas Port Moody–Westwood......................................................... Hon. Christy Clark Powell River–Sunshine Coast.......................................................... Harold Long Prince George North................................................................................Pat Bell Prince George–Mount Robson................................................Hon.

Shirley Bond Prince George–Omineca................................................................Paul Nettleton Richmond Centre......................................................... Hon. Greg Halsey-Brandt Richmond East .......................................................................... Hon. Linda Reid Richmond-Steveston ................................................................ Hon. Geoff Plant Saanich North and the Islands ............................................... Hon. Murray Coell Saanich South...................................................................................

Susan Brice Shuswap .............................................................................. Hon. George Abbott Skeena.............................................................................................Roger Harris Surrey-Cloverdale ................................................................. Hon. Kevin Falcon Surrey–Green Timbers .................................................................. Brenda Locke Surrey-Newton ............................................................................... Tony Bhullar Surrey–Panorama Ridge................................................. Hon.

Gulzar S. Cheema Surrey-Tynehead .......................................................................... Dave S. Hayer Surrey-Whalley ...................................................................... Elayne Brenzinger Surrey–White Rock ...............................................................Hon. Gordon Hogg Vancouver-Burrard................................................................. Lorne Mayencourt Vancouver-Fairview............................................................... Hon.

Gary Co llins Vancouver-Fraserview ...................................................................Ken Johnston Vancouver-Hastings .......................................................................Joy MacPhail Vancouver-Kensington...................................................................Patrick Wong Vancouver-Kingsway..........................................................................Rob Nijjar Vancouver-Langara....................................................................Val J.

Anderson Vancouver–Mount Pleasant............................................Jenny Wai Ching Kwan Vancouver–Point Grey ................................................... Hon. Gordon Campbell Vancouver-Quilchena............................................................ Hon. Colin Hansen Victoria–Beacon Hill.............................................................................Jeff Bray Victoria-Hillside.................................................................................. Sheila Orr West Kootenay–Boundary.................................................... Hon.

Sandy Santori West Vancouver–Capilano ..............................................................Ralph Sultan West Vancouver–Garibaldi ................................................. Hon. Ted Nebbeling Yale-Lillooet .................................................................................. Dave Chutter

CONTENTS Tuesday, April 2, 2002 Afternoon Sitting Routine Proceedings Page Introductions by Members....................................................................................................... ............................................... 2349 Tributes....................................................................................................................... ............................................................... 2349 HM Queen Elizabeth the Queen Mother Hon. G.

Campbell Introduction and First Reading of Bills ........................................................................................ ......................................... 2349 Health Services Statutes Amendment Act, 2002 (Bill 18) Hon. C. Hansen Health Planning Statutes Amendment Act, 2002 (Bill 19) Hon. S. Hawkins Statements (Standing Order 25B).............................................................................................................................. .............. 2351 RCMP commendation awards D. Hayer Parkinson's disease awareness G. Trumper Smithers ski resort development D.

MacKay Oral Questions................................................................................................................. ......................................................... 2352 Impact on aboriginal rights of referendum on treaty negotiations J. MacPhail Hon. G. Plant Cost of referendum on treaty negotiations J. Kwan Hon. G. Plant Referendum on treaty negotiations K. Krueger Hon. G. Plant Impact of air travellers security fee on northern and rural residents W. McMahon Hon. J. Reid Hon. R. Thorpe Lobbyists registry J. MacPhail Hon. G.

Plant Point of Privilege (Speaker's Ruling) .......................................................................................... ........................................... 2354 Motion on Privilege............................................................................................................ ...................................................... 2355 Referral to committee: disclosure of Education Committee draft report R. Masi J. MacPhail Hon. G.

Plant Petitions ...................................................................................................................... ............................................................... 2356 Hon. S. Hawkins

Committee of Supply ............................................................................................................ ................................................... 2356 Estimates: Ministry of Health Services (continued) J. MacPhail Hon. C. Hansen K. Krueger D. Jarvis S. Orr I. Chong S. Brice R. Hawes J. Les B.

Lekstrom Proceedings in the Douglas Fir Room Committee of Supply ............................................................................................................ ................................................... 2378 Estimates: Ministry of Agriculture, Food and Fisheries (continued) V. Roddick Hon. J. van Dongen B. Belsey Estimates: Ministry of Human Resources (continued) J. Kwan Hon. M. Coell

2349 TUESDAY, APRIL 2, 2002 The House met at 2:03 p.m. Introductions by Members Hon. M. Coell: In the House today there are 13 members of the Victoria Newcomers Club, the gradu- ate club from Sidney. I ask the House to please make them welcome. J. MacPhail: I think these people are members of a renewed newcomers club. They're the Malahat–Juan de Fuca NDP club: Kevin Logan; Christine Heal, who is Kevin's wife — and they have their six-month-old daughter, Eileen; Herb Strom; Manuel Roussy; Evelyn Roussy; Richard Hughes; Don Cropp; Faye Kemmis; Lorne Tomalty and Peggy Tomalty.

Would the House please make them welcome. Hon. J. van Dongen: I rise today to introduce to this Legislature a large group of farmers and ranchers from all parts of British Columbia. They're here today to tell us a little bit about their industry as part of Agri- culture Day. [1405] Before I do that, I also want to mention the good news that, having been locked in a trade dispute with the United States on our tomato shipments for the last year or more, we're very pleased today to have an an- nouncement by the U.S.

Trade Commission that by a 4- to-1 decision they're issuing a finding of no material injury to the U.S. industry and no threat of material injury. Effective ten days from now, there will be no duty on tomatoes going to the United States. I truly want to congratulate all those in the agrifood industry who worked very hard on that case to ensure that the interests of British Columbians, Canadians and con- sumers in North America were well represented. On that happy note, I want to ask the House to welcome all of the farmers and ranchers here from all over B.C. J.

Bray: Joining us in the members' gallery — and I can't actually see him from my vantage point — is Mr. John Sanderson, who is the president of the Victoria Harbour Authority. Mr. Sanderson is here today to talk about some important issues on Victoria's harbour and making it a better and more environmentally, aestheti- cally and economically viable harbour. I ask the House to please make him very welcome. Tributes HM QUEEN ELIZABETH THE QUEEN MOTHER Hon. G. Campbell: As members of the House know, Queen Elizabeth the Queen Mother died this Easter weekend at the remarkable age of 101 years.

It was with sadness that we learned of her passing, for hers was a remarkable life. She passed away peacefully at the end of a long life that touched us all. Lady Eliza- beth Bowes-Lyon was born on August 4, 1900. Imagine that, Mr. Speaker: before the advent of the airplane, before automobiles were ubiquitous, before many of the challenges that we face became commonplace. She was born a commoner, the ninth of ten chil- dren. She witnessed a century of unparalleled change and unheard-of calamity. But when we needed her, when England needed her, when the Commonwealth needed her, she was there.

The Queen Mother will be remembered with great affection for her unflagging sense of duty, her strong and constant support of her family, her wonderful charm and sense of humour. She was indomitable. In fact, the Queen Mother didn't decide that she was go- i n g t o m a r r y t h e D u k e o f Y o r k u n t i l h e ' d a s k e d h e r three times. She was concerned that perhaps she didn't know enough of the royal protocols that would be re- quired for someone in her position. That's when she was going to marry the Duke of York. After the abdication she became the Queen. Then came the war.

For many it was the Queen Mother's strength, it was her sense of duty, it was her commit- ment to the common people of England that made her, in the eyes of Hitler, "the most dangerous woman in Europe." Dangerous to Hitler. The foundation upon which victory was built. It was her spiritual strength and, as I mentioned ear- lier, her commitment to family that reflected herself in the strength of England as they went through that in- credible period. As we reflect today on her life and times, we know that through the tumult of a century of change her example was a beacon of calm in the turmoil.

The Queen Mother's courageous leadership and support of her husband, George VI, during the dark hours of the Second World War should never be forgotten. Here in C anad a we were very fortu nate becau se t he Queen Mother loved Canada, and Canadians returned her love, as did British Columbians. Queen Elizabeth the Queen Mother was the embodiment of grace. We shall not see her like again. I have conveyed to the Queen and the royal family the deepest sympathy and feeling of loss from the people and government of British Columbia.

Members of the Legislature and the public are invited to join me in signing our book of condolence, which is on the main floor of the parliament buildings today. [1410] Introduction and First Reading of Bills HEALTH SERVICES STATUTES AMENDMENT ACT, 2002 Hon. C. Hansen presented a message from His Honour the Administrator: a bill intituled Health Ser- vices Statutes Amendment Act, 2002. Hon. C. Hansen: I move that Bill 18 be read a first time now.

2350 B RITISH COLUMBIA DEBATES T UESDAY, APRIL 2, 2002 Motion approved. Hon. C. Hansen: This bill makes several minor amendments to two statutes: the Hospital Insurance Act and the Medicare Protection Act. At present the Medicare Protection Act provides flexibility for the Medical Services Commission to grant coverage to in- dividuals who would not otherwise be eligible for medical services — for example, individuals who are close to meeting residency requirements. The Hospital Insurance Act contains different

definitions and does not have that same flexibility. This legislation amends the act to adopt the more flexible

definitions of resi- dency and beneficiary, and thereby ensures consistency between the two statutes. This bill also contains a number of minor changes to the Medicare Protection Act that are related to the powers of the Medical Services Commission. Specifi- cally, it eliminates the commission's power to de-enrol physicians at age 75, a power which may be deemed to be unconstitutional. It also allows the commission to charge interest on inappropriate or fraudulent billings by medical practitioners as determined by a commis- sion review panel.

The bill amends the Medicare Protection Act to allow for broader and more equitable coverage of sup- plementary services for people on premium assistance who have access to private insurance. Currently, pri- vate insurers cannot provide any coverage for supple- mentary services to individuals on premium assistance, because they are covered by the Medical Services Plan for up to ten visits per year. This prevents those pa- tients on premium assistance with private insurance from being reimbursed when a practitioner charges more than what MSP will pay.

The amendment will allow private insurers to cover additional amounts that may be charged by supplementary providers. The bill also improves the efficiency of the Medical and Health Care Services Appeal Board by allowing panels of one to sit in the case of very minor issues and the dismissal of cases in which a complainant has not further pursued the appeal. Mr. Speaker, I move that this bill be placed on or- ders of the day for second reading at the next sitting of the House after today.

Bill 18 introduced, read a first time and ordered to be placed on orders of the day for second reading at the next sitting of the House after today. HEALTH PLANNING STATUTES AMENDMENT ACT, 2002 Hon. S. Hawkins presented a message from His Honour the Administrator: a bill intituled Health Plan- ning Statutes Amendment Act, 2002. Hon. S. Hawkins: I move that Bill 19 be read a first time now. Motion approved. Hon. S. Hawkins: I'm pleased to introduce these amendments.

This bill demonstrates our commitment to ensure that health- and safety-related acts are effi- cient, up to date, and genuinely meet the needs of Brit- ish Columbians. I'm introducing seven amendments today. They will strengthen public safety, improve the governance of health professions, modernize or eliminate outdated regulations and use resources more efficiently. All the savings that will be realized from these changes will be directed back to patient care. The first amendment is regarding the Health Pro- fessions Council. It was appointed in 1991 to advise on self-regulation of health professions.

It submitted its findings and recommendations last March, and the changes to the Health Professions Act will transfer the remaining functions of the council to the minister effec- tive December 31, 2002. We are also making amendments to the Health Emergency Act, which will establish a new college for the regulation of emergency medical assistants, giving emergency medical assistants the authority to effec- tively regulate their own profession. The Hearing Aid Act will be repealed, and a new arm's-length governance structure will be established for hearing-aid dealers and consultants.

This new self- regulating structure will replace the existing licensing board, making them consistent as well with other health professions. [1415] The Seniors Advisory Council was established long before the creation of the Minister of State for Interme- diate, Long Term and Home Care, who now acts as a voice at the cabinet table on issues that affect seniors.

To reflect this change in cabinet priorities, the Seniors Advisory Council Act is repealed, and the council is replaced with a special adviser for seniors in the Minis- try of Health Planning, who will work with all four health ministers and the seniors groups across the province. The bill also amends the Name Act to require adults applying for legal name change to provide documentation of a criminal record check. Upon ap- proval of a name change, the Vital Statistics Agency will forward the information to the RCMP, who will check it against the national database of criminal re- cords.

I want to thank the Solicitor General for helping to close this loophole in the legislation so that people with criminal records can't change their names and hide their criminal pasts. As well, there are amendments to the Survivorship and Presumption of Death Act and the Vital Statistics Act to make it easer for families and executors to con- clude the personal and business affairs of a person who is presumed dead but whose body can't be found. We're also making changes to the Vital Statistics Act.

It will be further amended to include the particu- lars of a father on a child's birth certificate, where there is a court order declaring the child's paternity, unless the court orders that the father's particulars are not to be included.

TUESDAY, APRIL 2, 2002 B RITISH COLUMBIA DEBATES 2351 Lastly, the bill will repeal a redundant requirement for the director of vital statistics to provide a list of re- cent deaths to the district registrar of voters and local government officers. The chief electoral officer already performs this duty. I move that the bill be placed on orders of the day for second reading at the next sitting of the House after today. Bill 19 introduced, read a first time and ordered to be placed on orders of the day for second reading at the next sitting of the House after today. Statements (Standing Order 25

B) RCMP COMMENDATION AWARDS D. Hayer: I rise today to speak of courage, of duty and of selfless acts that have made our province and our communities a better place to live. I want to speak today about individuals who have risen above fear, who have done the right thing and who in some in- stances, by putting their own lives at risk, have saved others. I speak of those individuals who on March 27 re- ceived certificates of appreciation and commendations from Jamie Graham, the chief superintendent of the Royal Canadian Mounted Police at the Surrey detach- ment.

I attended the ceremonies along with Mayor Doug McCallum of my city of Surrey, my MLA col- leagues from Surrey–Green Timbers and Surrey- Whalley, and many others to honour these brave peo- ple and to recognize their heroic deeds. Many of these people put their lives at risk to save the lives of others. One young lady is accredited with saving the life of a stabbing victim. Another woman put her discomfort aside at a vehicle accident and ren- dered CPR in the pouring rain until the ambulance crew arrived. It was not just the general public who were hon- oured.

There were RCMP and municipal police officers and Canadian customs officers. These officers acted in a manner that was above and beyond the call of duty. In effect, one officer, Constable Scott Marleau, received three separate citations for commendable action. The people recognized in my riding of Surrey- Tynehead last week are just a few of the unsung heroes who walk our streets every day. To them I would like t o s a y , o n b e h a l f o f a l l m e m b e r s o f t h i s c h a m b e r , a grateful and very appreciative thank you. PARKINSON'S DISEASE AWARENESS G.

Trumper: The month of April is dedicated to Parkinson's awareness. Parkinson's disease is a neuro- logical disorder which causes involuntary movement of muscles, gradually affecting one's ability to walk, speak and swallow. It is not contagious, and its cause appears to be a combination of genetic disposition and environmental triggers. It is progressive, degenerative and presently incurable. This cruelly debilitating disease appears to be af- fecting more people every year. Although it is mainly an illness of middle age, it also affects younger people. Parkinson's can develop slowly, or it can move quickly.

For 10 percent of Parkinson's patients, there are some very difficult complications such as personality changes and dementia. [1420] Although Leonardo da Vinci first described the symptoms of Parkinson's, this disease was identified by a Dr. James Parkinson in 1817. Today, almost 200 years later, there have been giant steps in treatment for Parkinson's, but we are still a long way from a cure. Well-known individuals who have suffered from Park- inson's include renowned artist Bill Reid, the Pope, Muhammad Ali, Katharine Hepburn and Michael J. Fox.

For those living with Parkinson's, keeping active is important to well-being. I want to read an excerpt from a paper which was written by my late husband, a phy- sician who suffered from Parkinson's: "Learn a new truth at least once a day. Smile inside and out. Never give in or give up or give out. Life is still worth living." As you read and write, particularly this month, about Parkinson's disease, remember those individuals and their families who need understanding and assistance. U n t i l a c u r e i s f o u n d , w e n e e d t o b e g e n e r o u s i n o u r support of further medical research.

SMITHERS SKI RESORT DEVELOPMENT D. MacKay: Today I am pleased to announce what I feel is one more good-news story for the province. This good news is a result of our government's com- mitment to attract private sector investment back to the province with tax concessions, a reduction in regula- tions, faster access to Crown lands and, most of all for the people in the northwest, new employment, new job opportunities.

Today I am pleased to announce that Canadian Rocky Holdings, a wholly owned subsidiary of Cliffs Communities Inc., has entered into an agreement with Hudson Bay Mountain Adventures, also known as Ski Smithers, for the future development of the ski area in Smithers. The first phase of the agreement provided that Ecosign Mountain Resort Planners of Whistler, B.C., complete a ski operation study and assessment. Developers expect the master plan to be completed within the next six months for presentation to the pro- vincial government.

Approval will allow the compa- nies to proceed with upgrades such as new ski runs, new ski lifts, additional on-site lodging and new amenities. This speaks highly of the course we have now set for the province: long-term sustainability, long-term jobs, new opportunities, new private sector investment. That's what we committed to. I'm pleased to report that this project has the makings of a new world-class ski resort in the province. I am proud to support the pro-

2352 B RITISH COLUMBIA DEBATES T UESDAY, APRIL 2, 2002 ject and excited for all those who live in the Bulkley Valley and, more specifically, the residents of Smithers. Mr. Speaker: That concludes members' statements. Oral Questions IMPACT ON ABORIGINAL RIGHTS OF REFERENDUM ON TREATY NEGOTIATIONS J. MacPhail: To the Attorney General: does he agree with B.C. Treaty Commission representative Jack Weisgerber that the land claims referendum is increas- ing tension and may handcuff the treaty process? Hon. G. Plant: It's a great day for democracy in British Columbia.

For the first time in over a decade of treaty-making, the government is bringing all British Columbians directly into the discussion about what their vision is for treaties in British Columbia. I think it's a great opportunity for people to see and experiment in how we can expand our conception of democracy to engage people in a discussion about is- sues.

In the treaty context, it's vitally important that we engage people in a discussion about the issues that are on the table so that for the first time the province's ne- gotiators will be at the table informed by a public mandate that will allow us to move forward and put an end to uncertainty in British Columbia. Mr. Speaker: The Leader of the Opposition with a supplementary question. J. MacPhail: That's interesting, because B.C.'s Su- preme Court ruled against the now Attorney General and the current Premier in their suit against the Nisga'a treaty.

The case established that the Nisga'a have a constitutional right to self-government under

section 35 that extends beyond municipal government. Will the Attorney General confirm that in seeking a man- date to negotiate municipal-style self-government, he's really attempting to take away rights from aboriginal people that they won when the B.C. Supreme Court ruled against his own court case? [1425] Hon. G. Plant: Mr. Speaker, treaty-making is a po- litical process.

It's entirely appropriate that we involve the people of British Columbia directly for the first time and ask them the question: when the province's negotiators sit at the table, what is the model, the prin- ciples of self-government, that they should be advocat- ing for to ensure that aboriginal communities can con- trol their lives and have authority over the decisions that affect them but also that there are in place systems of democratic accountability and that there are appro- priate delegations of authority? These are important issues.

There are choices in- volved for the people of British Columbia, and there are choices involved at the treaty table. I think the ref- erendum engages the people of British Columbia in the discussion about those choices, and I look forward to the next six weeks as we hear from the people of British Columbia on their vision for negotiating treaties in the twenty-first century. Mr. Speaker: The Leader of the Opposition with a further supplementary. J. MacPhail: Mr. Speaker, the Attorney General said that he would protect and respect aboriginal peo- ple's constitutional rights. That's not political.

The At- torney General abandoned his appeal of the Nisga'a decision. What possible rationale, then, does he have for seeking to diminish aboriginal constitutional rights that were established by the failure of his own court case? Hon. G. Plant: As the member knows and as all British Columbians need to know, nothing in this ref- erendum will undermine constitutionally protected aboriginal rights and titles. In fact, as the member knows, there was an argument made to the contrary last week in the Supreme Court of British Columbia, and the argument was completely rejected.

I intend, as Attorney General and on behalf of a government that intends it, to protect aboriginal rights and title as we are required to do by law and as we ought to do as a matter of common morality. But treaty-making is about negotiating among the choices to ensure that treaties give effect to constitutionally protected aboriginal rights and title in a way that's workable, affordable and promotes certainty, finality and equality for the benefit of all British Columbians. COST OF REFERENDUM ON TREATY NEGOTIATIONS J.

Kwan: It's costing British Columbians roughly $9 million to destroy the treaty process through this stu- pid referendum — money that could be spent fixing health care, improving child protection or maintaining legal aid. Can the Attorney General tell the vast majority of British Columbians who don't want this referendum how much money taxpayers will save on every ballot that is not returned? Hon. G.

Plant: Earlier today I heard the chief elec- toral officer say that as a result of the work he's done with his budget, the original number that he put for- ward for his responsibilities of $9 million may in fact be reduced by a million and a half dollars. I think it's a great day when all people who are part of the govern- ment of British Columbia recognize that we can deliver on the important services and spend less money than we have to. Mr. Speaker, this referendum is a new way of doing democracy, and democracy does have a price.

This referendum will cost significantly less than a general election, but what's far more important is this: if we spend $10 million on this referendum, as against the

TUESDAY, APRIL 2, 2002 B RITISH COLUMBIA DEBATES 2353 billion dollars we have spent on treaty-making in Brit- ish Columbia with only one successful treaty to date, I think it's a very small price to pay to ensure that we have a process that works, that is affordable and that produces good agreements for all British Columbians in the years to come. Mr. Speaker: The member for Vancouver–Mount Pleasant has a supplementary question. [1430] J.

Kwan: Again to the Attorney General: will he commit to British Columbians — who think that the referendum is a dumb idea, that it's a huge waste of money and that it sets back the treaty-making process when treaties have never been more important to our economic future — that every penny British Columbi- ans will save the province by throwing their ballots in the recycling bin be spent on more pressing priorities like health care for aboriginal children? Hon. G. Plant: I h a v e s o m u c h m o r e f a i t h i n t h e people of British Columbia than the member opposite.

The people of British Columbia want this opportunity to be included directly in a conversation about the fu- ture of treaty-making. We have embarked upon that conversation at a relatively modest cost. You know what I think is going to happen?

I think that across this province people are going to get their ballots; they're going to sit at their kitchen tables; they're going to have a conversation with their family members about their vision for reconciliation and re- spect with the province's aboriginal people; they are going to fill out that ballot with pride that they live in a democracy that gives them that voice in their future. I think the citizens of British Columbia will partici- pate with enthusiasm. They'll participate out of duty.

They'll participate because they know this referendum will help reinvigorate a treaty process that's urgently needed in the province of British Columbia. REFERENDUM ON TREATY NEGOTIATIONS K. Krueger: Again, to the Minister Responsible for Treaty Negotiations. The

preamble to the referendum on treaty negotiations launched by the minister states that the government is committed to providing — as the minister said moments ago — certainty, finality and equality. At the same time, however, the govern- ment admits that it cannot guarantee specific outcomes at the treaty table based on the outcome of this refer- endum. Can the Minister Responsible for Treaty Negotia- tions tell us how he reconciles those two statements? Hon. G.

Plant: I think all parties in the treaty proc- ess are committed to negotiating agreements that will produce certainty, that will give and create finality, and that will lead to equality. Of course, all parties to the process bring to the table their own set of visions, their own set of outcomes that they want to work towards and their own set of principles.

It's time for the people of British Columbia to be brought into the debate around what those principles should be, recognizing that the province's negotiators will go to the table and do the best they can on behalf of the people of British Columbia to achieve agreement at a table that has two other parties that will also be working hard to represent the interests that they're there to represent. With three parties at the table work- ing from a principle framework, we hugely increase our chance of creating workable, affordable and just settlements. Mr.

Speaker: The member for Kamloops–North Thompson has a supplementary question. K. Krueger: Many of my constituents welcome the opportunity through this referendum for greater clarity on matters respecting aboriginal self-government. However, can the Minister Responsible for Treaty Ne- gotiations tell us why the government has chosen to define self-governance as having the characteristics of local government when some people argue that the Nisga'a model of self-governance seems to provide a better understanding of the definition of aboriginal self-government? Hon. G.

Plant: W e c a m p a i g n e d i n t h e l a s t c a m - paign on a platform commitment to negotiate self- government according to a vision, a model, that saw that aboriginal self-government would have the charac- teristics of local government with powers delegated from Canada and British Columbia. We think that is the most workable model for aboriginal self- government. There are other visions of what aboriginal self- government as a political exercise should involve. They include the Nisga'a model.

People who think that the government of British Columbia should be at the table with a broad sense — a virtually unlimited sense — of the potential models for aboriginal self-government may want to vote no,

whereas people who think that aboriginal self- government will be more practical and more account- able if it has the characteristics of local government with delegated powers and local accountability will vote yes. That's a real choice, and once made, it will guide the province effectively as we move forward with treaty negotiations. [1435] IMPACT OF AIR TRAVELLERS SECURITY FEE ON NORTHERN AND RURAL RESIDENTS W. McMahon: My question is to the Minister of Transportation. Many people have expressed concern over the implementation of the federal government's air travellers security charge which came into effect yesterday. This added tax not only hurts the travelling

2354 B RITISH COLUMBIA DEBATES T UESDAY, APRIL 2, 2002 public but also is a serious detriment to British Colum- bians who live in isolated and rural communities where air travel is not a luxury but a necessity. Can the Minister of Transportation tell me what the government is doing to convey these concerns to the federal government? Hon. J. Reid: While I agree that security is an impor- tant issue, I am concerned about the flat fee that has been imposed. I have written to the federal minister request- ing that this be re-examined.

It is a detriment to not only the smaller airports but also the short-haul carriers. Mr. Speaker: The member for Columbia River– Revelstoke has a supplementary question. W. McMahon: My supplementary is to the Minister of Competition, Science and Enterprise. The flow of tourism dollars into my region is dependent on com- petitive prices for air travel, and this flat fee has serious implications for smaller airlines and short-haul opera- tors. Can the Minister of Competition, Science and En- terprise tell me if he thinks this fee is fair? Hon. R.

Thorpe: First of all, security is a top prior- ity for everyone in our government. We are working together with British Columbia's tourism industry. On March 15 I sent a letter to the Minister of Finance, Mr. Martin, pointing out some pitfalls that we thought were there. On March 25, together with nine other min- isters of tourism across Canada, we wrote Minister Martin and Minister Collenette pointing out some is- sues of concern. We are very concerned about the impact on small communities, small airports and small carriers. We are working hard.

We have put forward solutions for the federal government to consider, and we're going to continue to work on behalf of the tourism industry, small communities, small airports and small carriers across British Columbia. LOBBYISTS REGISTRY J. MacPhail: Last year the Attorney General said that he expected the Lobbyists Registration Act to be proclaimed and operational by March 31. Last month the Attorney General said he was working on it. In the meantime, the Premier and ministers are moving ahead with the privatization of health services and the priva- tization of ICBC and B.C. Hydro.

We're seeing the ex- pansion of private liquor sales. We've seen the gov- ernment back down on the smoking ban. That's just to the benefit of special interests. What we can't see is just who the government's meeting with, whether in their offices or in the Premier's living room. To the Attorney General: how's it going? Interjections. Mr. Speaker: Order, please. J. MacPhail: Did you meet your deadline, or are you still stalling until after the government… Interjections. Mr. Speaker: Order, please. J. MacPhail: …has sold everything off to its politi- cal supporters? Interjections. Mr. Speaker: Order, please. Hon.

G. Plant: We are, as I said the last time I was asked this question, working on it. We have identified one issue that we believe will require a minor change in the legislation to ensure that the legislation works to achieve its purposes. We're moving forward on that. We are also, I think, very close to the end of our discus- sions with the information and privacy commissioner about making sure that he has… Interjections. Mr. Speaker: Order, please. Hon. G.

Plant: …in place in his offices the protocols and the processes that will be required to ensure that when we bring this bill into force, it will be a leader across Canada as this government continues to keep its commitment to be the most open and accountable gov- ernment in all of Canada. Interjections. Mr. Speaker: Order, please. Order, please. Order, please. [End of question period.] Point of Privilege (Speaker's Ruling) Mr.

Speaker: Hon. members, on Monday, March 25, the member for Delta North rose and reserved his right to raise a matter of privilege relating to a purported leak of a draft report from the Education Committee. On Wednes- day, March 27, the same member rose and presented a matter of privilege for consideration by the Chair. I note that the member has meticulously followed the practice of this House in presenting his matter of privilege in that he briefly stated the matter, tabled the newspaper

article which disclosed the possible breach of privilege and tendered the motion he proposes to move should it be found that a prima facie case of breach of privilege has been established. [1440] On Wednesday, March 27, the member for Vancou- ver–Mount Pleasant stood in her place and advised the House that she had shared the draft report with a group

TUESDAY, APRIL 2, 2002 B RITISH COLUMBIA DEBATES 2355 of people, prior to the report being tabled in the House, on what she understood to be a confidential basis. To her credit, the member went on to express her regret and apologized to the House for her

part in the matter. Before turning to the merit of the presentation of the member for Delta North, let me briefly observe that the Chair considers matters of privilege and contempt and alleged breaches in the most serious vein. It is a tradition as old as parliament itself that members are entitled to conduct their deliberations without inap- propriate harassment or intimidation being brought to bear on their work.

Let me further observe that the release of a draft report from a parliamentary committee prior to that report being tabled in the House has been held to be a breach of privilege many times, particularly where the release of the report interferes directly or indirectly with the committee's deliberations. See Parliamentary Practice in British Columbia, third edition, page 51. I have examined with care the material laid before me in this matter, and it would appear that the leaked report was used in such a way as to attempt to intimi- date members of the Education Committee.

Among the materials filed was an extract from the Vancouver Sun of March 18, 2002. If the allegations contained in that

article are substantiated after an examination of this matter by a committee of the House, the Chair would consider that a serious offence has been committed. The precedents are clear. It is not within the Speaker's authority to make a final determination, but rather I must satisfy myself that the materials and ar- guments presented are sufficient to constitute a prima facie breach of privilege or contempt of this assembly. The Chair finds that the materials submitted, com- bined with the admission of the member for Vancou- ver–Mount Pleasant, establish a prima facie case.

Ac- cordingly, I invite the hon. member for Delta North to move his motion. Motion on Privilege REFERRAL TO COMMITTEE: DISCLOSURE OF EDUCATION COMMITTEE DRAFT REPORT R. Masi: I n v i e w o f y o u r d e c i s i o n , M r . S p e a k e r , I propose the following motion. I move that the matter pertaining to the premature disclosure of the Select Standing Committee on Educa- tion report be referred to the Select Standing Commit- tee on Parliamentary Reform, Ethical Conduct, Stand- ing Orders and Private Bills. Mr. Speaker: You've heard the motion. Debate on the motion, the Leader of the Opposition. J.

MacPhail: The debate will be on the advisability of referral, as I understand it. Before proceeding to vote on the merits of this motion to refer this matter to committee, I believe it's important to consider some of the observa- tions about the practice of drafting reports in committees and the jurisprudence that has evolved over the years. Mr. Speaker, you referred to some of that jurispru- dence, but there is much more to it. Firstly, I do want to recognize the gravity of the matter as reported to this House by the member for Delta North.

Certainly, the committee members — and indeed all members of this House — must continue to have confidence that the contents of draft reports remain the property of mem- bers until published by the committee.

While various investigations into so-called leaks in parliaments throughout the Commonwealth continue to uphold the notion that publication of draft reports prior to presentation in the respective House is a viola- tion of privilege, it is also not uncommon for members of committees to at times, on a confidential basis, seek a d v i c e f r o m e x p e r t s o n m a t t e r s i n c l u d e d i n d r a f t r e - ports. There are many cases in parliamentary law dealing exactly with that point.

Indeed, the Committee of Privi- leges in the United Kingdom, in its second report of the 1984-85 session, found that members "naturally discuss the work of their committees with other members, with their own staff or with others who may have relevant advice or experience without intending publication." That's parliamentary law as it exists today. Of course, the report also found that some of those experts who may be consulted, after being consulted, may not have had the appropriate respect for the in- f o r m a t i o n t h e y ' d b e e n m a d e p r i v y t o i n s u c h a n e x - change.

We don't deny that. [1445] Mr. Speaker, we have already had the benefit of receiving a full and, I say, an unprecedented apology from the member for Vancouver–Mount Pleasant re- garding any part she may have played in this incident. Although the Government House Leader may not have had the grace to recognize the significance of that event in his response here on the floor, I know that many of the members of the public that I spoke with over the long weekend certainly did. Unless, Mr.

Speaker, the members opposite believe that there may indeed be other sources who could have potentially become a source of the remarks made by Mr. Chudnovsky, which then found their way into the Vancouver Sun , then it does seem rather odd to now refer the matter to a committee. There is nothing to be achieved unless there is other information that any member in this House has about someone other than Mr. Chudnovsky receiving information through what the member for Vancouver–Mount Pleasant has al- ready admitted and apologized for.

Therefore, it's my view that the matter has been sufficiently canvassed both in this House and in the hallways and in the media, and the motion should be defeated as being now irrelevant. Mr. Speaker: Thank you, hon. member. Further debate, the Attorney General. Hon. G. Plant: Well, I will urge the members to support the motion.

2356 B RITISH COLUMBIA DEBATES T UESDAY, APRIL 2, 2002 The issues raised by the member in her presenta- tion of a moment ago are as much issues for the com- mittee that would be charged as a result of the passing of this motion as they are issues for debate now. In- deed, the purpose of convening the committee is to undertake an investigation into both the specific issues and the context for those issues. It is rare in this House — certainly unique in my short experience — for an issue of privilege to be raised and for a Speaker to determine that a prima facie case of breach has been established.

These are circumstances in which, to protect the privileges of this Legislature, my view is that the appropriate next step — not per- haps the final step, but the next step — is for this House to adopt the motion and move to a process that will ensure that the very questions and issues raised by the opposition leader are given the airing, the investi- gation and the analysis they deserve. For those reasons, Mr. Speaker, I urge members to support Delta North's motion. Motion approved on division. Petitions Hon. S.

Hawkins: I seek leave to table a petition from concerned constituents who oppose the use of animal leghold and body-hold traps. Orders of the Day Hon. R. Coleman: In Committee B, I call Commit- tee of Supply. For the information of members, we will be debating the estimates of the Ministry of Health Services. In Committee A, I call Committee of Supply.

For the information of the members, we will be debat- ing the estimates of the Ministry of Agriculture, Food and Fisheries, followed by the Ministry of Human Re- sources and, if time, the Ministry of Attorney General. [1450] Committee of Supply The House in Committee of Supply B; H. Long in the chair. The committee met at 2:58 p.m. ESTIMATES: MINISTRY OF HEALTH SERVICES (continued) On vote 31: ministry operations, $10,053,791,000 (continued). The Chair: The committee will stand recessed for another two minutes so the opposition can enter the House.

We have been in recess and have delayed this for a previous five minutes. The committee recessed from 2:59 p.m. to 3:03 p.m. [H. Long in the chair.] The Chair: The committee will come to order. I'd like to remind the member that when they ask for a recess of two minutes, we expect it to be two minutes, not a 15-minute delay. The committee will carry on. J. MacPhail: Chair, I greatly respect your advice. I didn't ask for a recess, though. I said I'd be back in two minutes.

I assumed, given that this is the third hour of estimates with a ministry budget that's $10 billion, that other members of the chamber would have questions. I'm not challenging your ruling, Mr. Chair, but that's specifically why I didn't ask for a recess. I said I'd be back in two minutes. I wasn't — that's true — but it is unbelievable that with 75 members in this chamber… Interjection. The Chair: Order, member. Order, member. J. MacPhail: …there's no questions. The Chair: On vote 31. [1505] J. MacPhail: You know, I have to tell you some- thing.

I had decided to conduct these estimates in a way that would just get information out, but I find it absolutely shocking that unless I'm here in this cham- ber, there is no examination of a $10 billion budget. It's not as if people aren't sitting here doing something. It is unbelievable. Once again, even though there are two of us and this government is trying to do everything to make us one — why would that be? — there is no ex- amination of any of these issues. If I just sat down, it would be very interesting to know what would happen here. What would happen in this chamber? Interjections. J.

MacPhail: I was absent. I was absent from the chamber. That member was sitting there, and he said nothing — absolutely nothing. Whatever this government tries to do to silence opposition, to silence any questioning of their agenda, it is left up to only my colleague from Vancouver– Mount Pleasant and me to ask the questions. And yes, it does put me in an extremely cranky mood — ex- tremely — and quite unnecessary, if you ask me. Quite unnecessary. On the issue of health authorities, in terms of budget-making, is the minister satisfied with the range of questions we've already had on that? If he is, I'll move on.

Hon. C. Hansen: I certainly want to apologize to the member if there was a misunderstanding around the delay in the start. Clearly, there are many other members in the chamber that do want to participate.

TUESDAY, APRIL 2, 2002 B RITISH COLUMBIA DEBATES 2357 The tradition we've had in this chamber, certainly in the six years that I have been a member, is that the op- position — and the Leader of the Opposition, in par- ticular, or the appropriate critic, as the case was in years gone by — gets the opportunity to lead question- ing. I was certainly trying to defer to that tradition rather than encouraging other members to participate.

We recognize that the task she has in providing over- sight for a budget for the entire government, and par- ticularly a $10.2 billion budget for the Ministry of Health Services, is an enormous challenge. We're trying to accommodate that in whatever ways we can. If the member would like us to go to other private members and some of their issues, I'd certainly be pre- pared to do that. It was only out of respect for her posi- tion as Leader of the Opposition that we wanted to give her the first opportunity in leading questioning around these estimates. That's the intention. J.

MacPhail: In the last six years there was a critic for every single portfolio. The fact is that there are now two opposition members and 76 Liberal MLAs. To somehow say that we carry on with the same practice is ridiculous — absolutely ridiculous. My colleague and I stand every day in this House and do our duty — every day, beyond the call of duty. Government members here say nothing — rise up and say nothing. Well, I'll tell you what. I find this ex- ercise completely unhelpful. I've asked my questions on the budget for the health authorities, so I'll be mov- ing on.

If any other private members have any ques- tions, or any other members, feel free. K. Krueger: I've been listening to the debate, of course, and if the member would like government pri- vate members to do some of our questioning at this point, I'm sure we can do that. We all assumed she would like to cover her questions first, and as the min- ister said, normally we have waited to allow formal critics to ask questions of government before members of government — indeed, her government — asked their questions.

If the member would like me to, I have a number of Kamloops issues and issues from up the North Thomp- son Valley that I would like to canvass. If she'd give me a nod, I'll proceed with those if she would prefer, or she can continue with her line of questioning. J. MacPhail: Mr. Chair, we agreed on an order. I'm fine to deviate from the order, but we agreed on the order. The first order that I outlined this morning — this is for information, for the member for Kamloops– North Thompson — w a s t h a t w e a g r e e d o n a n o r d e r .

We would discuss health authorities, and in that con- text we would discuss health authority budgeting and then health authority appointments. What I'm saying is that I'm finished my portion of the agreed order on budgeting for health authorities, based on this process that is ridiculous. So if you want to change the agenda and the mem- ber wants to go in and ask about local issues, fine. [1510] K. Krueger: Well, certainly there are some issues around health authority budgeting for our interior health authority that I and probably other members would like to raise.

We don't want to interfere with the flow of the member's agenda. I could do that now. I think it would probably be less of an interruption to her preparations and order of delivery if we allowed her to carry on. However, we are perfectly willing to have our private members step in and do their ques- tioning whenever the opposition member needs some time to reorganize or attend to other duties. J. MacPhail: Go ahead. K. Krueger: She's indicating that I should go ahead.

One of the questions that has come up repeatedly in our area — it's quite understandable, with the change of organization and the beginnings of the major project of the tertiary psychiatric facility in Kamloops — is the question as to which budget pays for the tertiary psy- chiatric facility and which budget pays for the opera- tions of the tertiary psychiatric facility after it's estab- lished. I've seen the minister answer those questions publicly, and I think I know the answers, but I would like to have them on the record. Hon. C. Hansen: It is a very good question from the member for Kamloops–North Thompson.

The new TOKO psych facility, as it's being referred to, is made up of two components. There's the acute care, which is 44 acute-care beds that will be located on the property of Royal Inland Hospital. The actual operational costs of that facility will be borne out of the budget for the provincial health services authority. The operating dol- lars for the residential component, which is the two 20- bed units that would be located elsewhere, is also go- ing to be funded out of the provincial health services authority.

In addition to that, there is money that is part of the targeted moneys vis-à-vis the mental health plan. Some of that targeted money will be spent through those facilities. There is money that will be flowing to the interior health authority as a direct result of these tar- geted dollars. If you look at the mental health dollars in total, the ongoing budget for adult mental health as well as the mental health plan dollars that are specified, those will flow to the health authority for their ongoing programs as well as the new mental health plan programs.

The operating dollars for the two facilities that we're talk- ing about in the specific question the member asked will come out of the provincial health services author- ity. K. Krueger: I understand, then, that on an indefi- nite basis, the funding for service of the patients who make use of the tertiary psychiatric facility to be lo-

2358 B RITISH COLUMBIA DEBATES T UESDAY, APRIL 2, 2002 cated in Kamloops will come from the provincial health authority. It sounds like not any of it is from the interior health authority itself. Hon. C. Hansen: That's correct. K. Krueger: That's very clear. We have a brand-new hospital almost finished con- struction in Clearwater. The people of Clearwater are tremendously grateful for this. It was longed for, for a long time. It was probably one of the last hospitals in British Columbia where the bathrooms actually weren't heated.

Of course, the winters in Clearwater are such that that could cause freezing of plumbing. Doors had to be left open so that the plumbing in the bathrooms wouldn't freeze. Cellophane had to be put over the windows. This was a good hospital from the point of view of the service provided by doctors and nurses and other health care workers there. It's just the physical facility itself that was something of an embarrassment and, worse, potentially a risk.

People there are thrilled to have this facility nearing completion. [1515] Again, there have been some rumours in the com- munity that the budget concerns of the government are such that the hospital may never open. I'm confident that that isn't true at all, but I'd like to give the minister a chance to answer that question on the record. Hon. C.

Hansen: My understanding is that this is a facility where the construction and the capital cost are absorbed under the old model, which means that the provincial government centrally will carry the debt- servicing costs because this is a project that is already, as the member pointed out, close to completion. Those projects that are either underway or are contractually obligated to are going to be funded out of the old model, which means that the debt-servicing costs will be paid for by the provincial government.

The operating dollars will be covered by the health authority itself, which is consistent with other projects of this nature throughout the province in years gone by. K. Krueger: Since the new facility is replacing an old facility which had an operating budget, my infor- mation from the new chair and the CEO of the interior health authority, Mr. Dolman and Mr. Ramsden, is that operating funds will now be applied to operation of the new facility, and there is no threat whatsoever that it won't open as has been rumoured. Hon. C. Hansen: Yes, that's the case. K.

Krueger: Under the new scheme of things where funding follows the patients, insofar as that's possible, there's a question in my constituency and probably in many where constituencies include a lot of highway. People from all over British Columbia travel those highways and frequently, unfortunately, come to grief on them and end up in local health facilities.

The ques- tion is whether some of the funding that accrues to those British Columbians in their home constituencies will then be transferred to the local health authority — in our case, the interior health authority — for the time that they spend in facilities within that health author- ity's domain. We have very willing and able volunteers right through to the best health care professionals to deal with these people. We have wonderful people from the community who show up at motor vehicle crashes on a volunteer basis and extract the victims with the Jaws of Life.

They willingly give of themselves, their time, their resources and their community resources to equip the emergency vehicles that are used. Frequently, they themselves are injured in their efforts to deal with the victims of motor vehicle crashes. All of this, of course, people are more than willing to do. I was called to Clearwater on one occasion where a doctor was meet- ing with a number of the emergency volunteers who had been cut up while extricating people from a motor vehicle crash and then had learned that several of the occupants of the car had hepatitis C.

They were very concerned that they may have been exposed them- selves. That's just one example of the things that local people do in providing this service to victims of high- way crashes. I wonder if we could have some enlightenment on whether funding that follows those particular patients will be transferred to the health authorities which dealt with the care of the victims. Hon. C. Hansen: It is certainly our intention to move towards a system of dollars following patients in a more direct way.

As an interim step, what we have in place as part of the funding formula that we were talking about this morning is a system that reflects the volume of demand that has been put on our health care system from the previous year. If we see, for example, referral patterns that may cross a health authority boundary change in one particular year, then that would be reflected in the funding that would flow the following year. [1520] I certainly feel that a more direct system of dollars following patients will actually produce better results and better accountability within our health care sys- tem.

It's not something that we can simply snap our fingers and make happen tomorrow. There is a fair amount of work. One of the biggest challenges is around how to cost cases. We do not do a good job of determining, for exam- ple, how much an appendectomy costs or how much a multiple fracture would cost to set.

When you talk about the dollars following patients and the dollars being trans- ferred from the health authority where the individual is resident to the health authority where the service is pro- v i d e d , w e h a v e t o b e a b l e t o d e t e r m i n e w h a t i s t h e a p - propriate dollar value for services. It's something we do not do a good job of, and a lot of work is being done now to try to determine how to put a proper value on particu-

TUESDAY, APRIL 2, 2002 B RITISH COLUMBIA DEBATES 2359 lar medical procedures. We're working towards it. That change is not imminent, but it's my hope that we will get there over the next number of years. K. Krueger: There's tremendous angst in Kamloops about a long history of services, jobs, organizations and people that have migrated down the valley to Kelowna instead of staying in Kamloops — which, we're con- vinced, is a much better place for people to live and enjoy life. There has been some real anger in the past about decisions that have been taken.

At one time it was decided that Kelowna was to be the location of a cardiac excellence facility. That pre- dated my time in Kamloops, but I'm told by many medical people that there was a deal, actually, between the two groups of medical people. Since Kelowna would receive that facility, the cancer treatment facility, when it came to the interior, would go to Kamloops. Indeed, there was an announcement by the two Social Credit cabinet ministers of the day in the late eighties that the cancer clinic would be built in Kamloops, and a sign was erected on the lawn.

Then the Social Credit government fell to an NDP government, and during the election campaign the people with the NDP, as they campaigned, promised Kamloops that they would go ahead with those plans and that the cancer treatment facility would be built in Kamloops. In fact, it wasn't. It was also built in Kelowna. There was a real outcry about that — and justified in my submission.

Now, with the decisions as to who would be the chief executive officer and the chairman and the chief financial officer, for that matter, for the new interior health authority and with all of them being resident in Kelowna, a lot of fears have been expressed that we're going down that road again. Royal Inland Hospital is the third-largest trauma referral centre in the province, and that's because it is force-fed that work by the calamities that happen to people on the highways and in heavy industry.

We're confident in the level of expertise that we have and the service that's being provided, and — with the fact that the work comes to us by nature of our location and the location of the people when they receive those unfor- tunate traumas — that we will continue to have the status of regional referral centre. Yet, there has been so much concern in the community that again I would like to put it on the record to the minister that Royal Inland Hospital is a centre of excellence for trauma care in British Columbia.

We believe that by virtue of all those things I dis- cussed, it should be the second major hub of the interior health authority with regard to referral of patients. We have a critical mass of medical expertise — a body of very well qualified health care professionals. We're anx- ious that we not lose any of that and that we continue to attract medical expertise to Royal Inland Hospital. I'd like to have the minister's views on this ongoing concern about the status of Royal Inland Hospital. Hon. C.

Hansen: A s t h e m e m b e r k n o w s , w e h a v e asked all of the health authorities to review all facilities in the province. Every hospital should be challenged in terms of where it fits into the delivery of health services for British Columbians. As I mentioned this morning, that is really what is driving this agenda.

It's not how to best utilize the facilities we have but rather how to deliver the programs that are expected of us and ser- vices that are expected of our health care system. [1525] I do not know yet what specific recommendations will come from the health authority with regard to Royal Inland Hospital, other than an acknowledgment that Royal Inland has always been a major hospital in this province. It's an important part of the network of health care facilities in this province. I have every ex- pectation that it will continue to be so as a result of the service redesign that's currently underway. K.

Krueger: I appreciate the minister's answer and the fact these decisions have been delegated to the health authorities themselves. Being that this is a time of transition, I hope he'll continue to indulge us with his patience in dealing with some of these issues that really concern local people. One is the fact that the radiology and emergency room areas of the hospital are significantly outdated. They were built for a much smaller population a long time ago, with different equipment.

I'm advised that the interior health authority has told our doctors and many people in the interior health authority region, including our health service delivery area, that the re- construction of those facilities is the number one capital project for the interior health authority. Yet, they're unable to commit as to what that means insofar as the dates that construction for those renovations is likely to commence. I wonder if the minister would update the House on how he sees questions like that being re- solved and how he sees such matters unfolding. Hon. C.

Hansen: A s w e w e n t a t s o m e l e n g t h t h i s morning talking about the change in how capital dol- lars will be allocated, this is a transition time for us in terms of a new way of approaching capital projects. I think the good news for people in Kamloops is that finally they're going to have the ability to make those decisions regionally to meet their priority areas. In the past, hospitals and health authorities generally had to come begging Victoria to put their projects on a prior- ity list.

Now, under this new model, the health authori- ties themselves will be able to determine their priorities and allocate their capital dollars as they see fit, which gives the ability to get on with the projects in a much more timely way compared to the last number of years. K.

Krueger: Prior to the reorganization of health care, I was receiving lobbying letters from medical people, including doctors in the Revelstoke and Salmon Arm areas, essentially saying they expected we were going to reorganize health care and that when we did, they did not want to be obliged to refer their pa- tients down to the Okanagan Valley. They would like to continue what they consider to be the natural and

2360 B RITISH COLUMBIA DEBATES T UESDAY, APRIL 2, 2002 historical method of referral to Kamloops along the Trans-Canada Highway, which we all service. Since the health care reorganization, the doctors in those communities are understandably keeping their cards a little close to their chests because they don't know where they're going to end up. My understand- ing is that they still wish to do their referrals in the direction of Royal Inland Hospital.

This is deemed to be an important question in our health service delivery area because we understand the 200,000 population number in the catchment area to be significant in the question of regional hospital referral status. I wonder if the minister can give his views on the matter of which direction patients will be referred by their doctors. Hon. C. Hansen: We are not going to be telling doctors where they have to refer their patients. Clearly, in the past doctors have used their discretion and their knowledge about where they think their patients can best get access to the care they need.

In some cases you would have doctors who would refer patients to Van- couver. In some cases it might be Calgary, Edmonton, Kamloops or Kelowna. There may even be cases out of Revelstoke where a doctor would think it appropriate to refer a patient to Prince George if that's where that patient's family network is, for example, and support. [1530] In all of the redesign we're doing, we're not going to change that prerogative of the doctor. What we are going to do is look at how we can ensure there is stable provision of core specialty services.

Too often through- out British Columbia now, you will have a group of maybe fewer than five specialists in an area. They can't provide consistent coverage. If you only have three specialists in an area, they may try to provide the one- in-three on call, which is pretty draining on a specialist. In some cases where you've got only three specialists, they've said they'll only do one in five, which means there will be two nights out of five where there will be no coverage at all.

When you get a physician from an- other community wanting to refer patients into that specialty group, the big problem we then get is the uncertainty as to whether that specialty group is avail- able in a stable, 24-hour-a-day, seven-day-a-week manner. P a r t o f t h e r e d e s i g n i s t o s a y : h o w d o w e e n s u r e that these core specialties are going to be provided in a consistent way 24 hours a day, seven days a week?

Part of when they're looking at where these specialty ser- vices should be located is to ensure that there is a criti- cal mass of specialists to ensure that we don't get the physician burn-out we've seen in the past, but we also give a certainty to the GPs who are referring their pa- tients that in fact there is the competency there 24 hours a day, seven days a week. This, in many cases today, is inconsistent. That's part of the redesign that's going to be coming forward. K. Krueger: Just one more question, and then I'll defer to some of my colleagues across the way who wish to ask some questions.

The Speaker of the House and I have received a very concerted lobby by a number of employees of Royal Inland Hospital who have been employed in the finance area. They have presented a very well reasoned proposal establishing their argument of why centralized billing and accounts receivable functions for the interior health authority should remain and be located in Kamloops. Essentially, the argument is: "We are your resources. We're fully trained. We do this job already. It's largely done electronically. It can be done anywhere within the interior health authority. We have the equipment; we have the offices.

Everything's in place. It costs nothing to allow us to continue to do the work here." They have been alarmed by some statements by the financial officer, Mr. Mazurkewich, and there have been some suggestions that people who wish to retain that type of work will have to be relocated to Kelowna. There has been discussion of leasing a building in Kelowna to put all these people in one place, and so on. Of course, that has played right into the fears I dis- cussed earlier as to Kamloops losing jobs, economic activity and indeed expertise to Kelowna. I know that Mr. Dolman and Mr.

Ramsden are work- ing through that, and I'm confident they'll make the best possible use of all resources and be very respectful of families' needs, and so on, and not do unnecessary moves. If it does work out that there is some need for an arbitration — using the term in a very generic sense — of disputes like that between Kelowna and Kamloops, is there any provision for that as far as appealing to the ministry if, within health authorities, there is significant dissension over decisions that are taken? Hon. C.

Hansen: Part of the challenge we've given to the health authorities is to find the most cost- effective way of providing the services necessary, first of all, in terms of patient care but then, secondly, in terms of the support services the health authority needs to make sure it operates efficiently and effec- tively. Those are the kinds of decisions that are clearly not political decisions. These are administrative deci- sions around cost-effectiveness.

I know the management team in the interior health region is aware of the issues that have been put for- ward by staff in Kamloops, and at the end of the day they're going to have to make their determinations on how to run the health authority most cost-effectively. If they can do that with the existing configurations, then they have the authority and the flexibility to do that. Also, if they feel that in order to deliver good patient care, it is necessary to consolidate services, then they also have the power and the responsibility to do that.

We're not going to dictate those kinds of decisions from the ministry, but we're going to basically ensure that they make good decisions based on the best use of every health dollar available so that we get the most cost-effective provision of services possible. [1535] D. Jarvis: I want to ask the minister a few brief questions in regards to structuring in our hospital sys-

TUESDAY, APRIL 2, 2002 B RITISH COLUMBIA DEBATES 2361 tem. As you know, I am from the North Shore. We are now included in the large health authority of Vancou- ver coastal — North Shore, Coast-Garibaldi, along that vein. Also, just recently there was a supposed docu- ment leaked with regards to certain particulars as to how the North Shore region was being handled. I ap- preciate the fact that this document, which was sup- posedly released, was really just a working paper on the part of the health region, but my following ques- tions are necessary so that I can get some clarification on the situation.

As you know, the North Shore health region was rated by Maclean's magazine as the number one health region in Canada for the past two or three years. So, I guess, a lot of people in my riding are real concerned at the fact that it's now being taken away and included into a big behemoth running from Delta almost up to Prince Rupert or up into the Bella Coola area. One of the questions is: what is going to happen to our area? Then, all of a sudden, we find we have a pseudo- leaked document coming in which states that they are going to refocus the direction of care in my riding spe- cifically, all the North Shore.

They're going to reduce the intermediate care beds by 200 and some odd. I was told by one of the directors of the region that this was being done so that they could give more quality home care. Then you go further down on the "leaked memo," and you find that home care is being reduced as well. It doesn't jibe. It doesn't fit. First of all, I wanted to know: the funding for the area that you have absorbed — the North Shore, now absorbed into the Vancouver coastal, North Shore, Garibaldi, etc., etc….

I don't know what the exact name is really, because on one of the papers I have here it says Vancouver coastal health authority, and then an- other one says the Vancouver, North Shore, Coast- Garibaldi, Vancouver and Richmond authority. It does get confusing for a layman. I'd like to know how the funding is going. Are we going to be short of funding now that we're part of a large group or several differ- ent health regions that have been combined? Or are we looking at equivalent funding to what we had before, with an additional amount? That's my first question, if you wouldn't mind. [T.

Christensen in the chair.] Hon. C. Hansen: Every health authority in this province has seen an increase in their budget from what was there last year. Actually, the correct term is the Vancouver coastal health authority. Just to give the member the restated base budget, last year for the Van- couver coastal health authority it was $1.536 billion. In this fiscal year, which is just starting, that increases to $1.647 billion, so we see an increase of about $110 mil- lion over what was there last year. [1540] That's not to say that's the panacea to all of their problems.

They still do have cost pressures that they are going to have to manage. There's not enough money to continue with the status quo the way we were doing things. What we have asked of all authori- ties is not to…. You can't look at the health care system as being a collection of isolated and disjointed pro- grams and facilities. There has to be an integration and a determination to make sure the facilities and the pro- grams meet the needs of those living in the region. That's the challenge we give them. I am aware from the news reports of the leaked document that the member's referring to.

I have no idea yet whether that is or is not — or whether part or parts of it have been — accepted by the health authori- ties in their recommendations to come forward, be- cause I haven't seen what their recommendations are yet. The bottom line is that throughout all of these changes that we will see, we will be holding the health authorities accountable for the delivery of better health outcomes. There may be changes in home care, changes in terms of home support, but what changes in one area may be enhanced in another area.

The Minister of State for Intermediate, Long Term and Home Care is looking at some of those innovations, as to how we can better provide for those needs. But at the end of the day we are holding the health authorities accountable — it's in our service plan; it is a measurable item — to ensure that we actually get bet- ter home care for more people in all of the health re- gions throughout the province. At the end of the day that's what they're going to be held accountable for. It's not just about balancing a budget. It's about ensuring that we actually get better health outcomes at the end of this change process.

There is change, and I have no doubt that the resi- dents of the North Shore will continue to have the best h e a l t h o u t c o m e s i n C a n a d a . W h a t i t s p e a k s t o , w h i c h comes out of the World Health Organization, is that the biggest determinants of health outcomes are not so much the provision of acute care facilities or things that you would actually consider health services, but the biggest determinants in terms of health outcomes are around economic status and education levels. Those are the things that really are drivers of better health outcomes.

I think that in the North Shore you see longer life expectancy and better health outcomes partly because we do have a good health care service, which we're not going to compromise, but we also have those other socioeconomic factors that drive bet- ter health outcomes throughout the world. D. Jarvis: If you have increased the funding for Van- couver coastal health authority, are they the ones that designate now whether the North Shore coastal area has funds reduced there that they have to make up by mak- ing adjustments? When you say they have to be ac- countable, on whose authority?

The minister says that t h e y h a v e t o b e h e l d a c c o u n t a b l e . Y o u ' v e g i v e n t h e m directions as to how they're going to operate, but what if they don't operate their system the way that you feel is accountable or that the citizens in the North Shore feel is accountable — whether they still have the same level of service? Do we come back to the Vancouver coastal

2362 B RITISH COLUMBIA DEBATES T UESDAY, APRIL 2, 2002 health authority, or do we come to the North Shore coast region, or do we come back to the Minister of Health? Hon. C. Hansen: What we are putting in place, which is the first time in Canada that any government has done this, is measurable outcomes when it comes to the difference that health care services make in indi- viduals' lives. In the past the only measurement was whether or not a budget was balanced, whether there was a deficit or no deficit. This is the first time that we've gone beyond that to say there are measurable outcomes.

For example, we will be measuring the number of seniors with high medical needs who are being prop- erly supported in their homes, and the reduced reliance of long-term care residents on the acute care system, to ensure that they have stability in their healthy lives. Those are measurables that we have built into the ser- vice plans. The service plan for the ministry as a whole is there on the website.

We are currently working on the performance contracts with each of the health au- thorities to make sure they assume their share of that responsibility in meeting those health outcomes. [1545] It is a fundamental shift. We're not simply going to measure the success of health care in British Columbia by how much money you put into the system, how many programs you have or how many employees there are in the system. For the first time we're actually going to start measuring and reporting to the public the out- comes of those in terms of how it actually results in healthier lives for British Columbians.

Those are meas- urables, and those are items that the senior executives of the health authorities will be held accountable for. As you may know, there is a salary holdback for the CEOs of the health regions. If they don't achieve their targets, then they're going to face the consequences when it comes to their own pocketbooks as well as the ability of the ministry to give them the latitude with which to manage their affairs.

If they show that they're delivering on their outcomes, that they're living up to their expectations, then first of all they're going to be given the latitude to manage with less oversight and less interference from the ministry on a day-to-day basis, because they will have demonstrated that they're meeting the needs of the population. We're going to give them the latitude to continue to do that. D. Jarvis: I just have one quick, short question, and that'll finish my questions for the moment. Maybe it's a softball question to you, but it is loaded.

There's a rea- son for it being loaded in the sense that I can now go back to my constituency and tell them that although we may have had a lot of services before, some of them were superfluous. We're going to move them aside because we can't afford them anymore, but the overall service to the patients in North Vancouver, whether they be emergency or long-term or acute patients, will be better than it was before. Hon. C. Hansen: I would be reluctant to call any health service superfluous. Although there may be examples, I think they're probably few and far be- tween.

I don't think you'll find any doctors or other health care providers in this province who are provid- ing services that are superfluous, but I think it is a question of priorities. We have to make sure that the health dollars we have available are going to priority a r e a s .

W e h a v e t o m a k e s u r e t h a t w e d e l i v e r o n t h e needs of residents of all communities throughout the province, whether it's the North Shore or northern B.C. — that we deliver on those services in a way that en- sures they get access to the urgent and emergency care they need and that elective surgery is organized in a way that ensures that people get timely access. What is not realistic is to say we're going to be pro- viding that service on every street corner in every community.

We have to ensure that we provide those services in a way that is sustainable; that can be counted on 24 hours a day, seven days a week, if that's what's needed; and that no resident in British Colum- bia, regardless of where they live, is going to go with- out necessary medical care. That's what I think we see happening too often in British Columbia today. That's what we will change.

I believe that you're on firm ground in giving your constituents that kind of assur- ance that the health care system will be there for them as and when they need it where they live and that we're going to build on the successes of the past. S. Orr: I first of all want to say that I just want to make a comment on the member for Vancouver- Hastings's comments. I actually, as a rookie member, was being polite. I was waiting to ask my questions, but I'm very happy to ask questions on a budget of $10.4 billion. It is a very large budget, and it is of great interest and concern to all of us. Where I want to ask….

A lot of the questions have already been asked previously, but where I'm coming from is…. Now that we've consolidated and restruc- tured the regional health authorities, what I would like to ask you is: could you clearly define to me what the ministry's relationship is going to be with the health authorities in their performances and their contracts? I'd like to see that picture, if you could explain that to me. Hon. C.

Hansen: What we will be putting in place — and a lot of this work is now already done, but we're sort of putting the finishing touches on it — are the provincial standards of care that we expect to be deliv- ered anywhere in British Columbia so that regardless of whether you're in Dawson Creek or in Saanich, you will be able to expect a minimum standard of care that will be consistent throughout the province. Those standards of care have been delivered to the health authorities.

As they go through their redesign process, they will have to meet those minimum standards of care. [1550] There are many parts of British Columbia where that will mean they will have to provide an enhance- ment to the existing levels of care. In many small com-

TUESDAY, APRIL 2, 2002 B RITISH COLUMBIA DEBATES 2363 munities, they may have health services provided but not for a consistent 24 hours a day, seven days a week. As everybody in this chamber knows, health emergen- cies happen at all hours of the day and all days of the week. It's not something that fits into the convenience of Monday to Friday, 8 o'clock to 5 o'clock. The other dimension of what goes to the health authorities is performance contracts. There are certain requirements and certain guidelines that are being set out for them there.

When I talked earlier about our own service plan for the ministry and the goals we have set of how we want to achieve better patient out- comes for the next three years, that will be constantly extended by a year, so we're always working on a three-year horizon. Those objectives, those measurable outcomes, will be built into the performance contracts for the health authorities. They will have to deliver on their share of those obligations so that we can meet the provincial targets. What is changing is that we will no longer be micromanaging every single decision the health au- thorities make.

They are going to be given an envelope of money, and they now know what those budgets are going to be. They're going to be given flexibility to meet their regional priorities within those budgets. If that meant reallocating dollars in the past, they would have had to come to Victoria and ask permission, and there was a delay there. By the time it all got sorted out, the problem got worse in many cases. The health authorities will have flexibility without us hanging over their shoulder.

At the same time, they're going to be held accountable at the end of the day for the health outcomes everybody wants to see, which is an enhancement of better health outcomes for individual British Columbians. S. Orr: On the consolidation of the health authori- ties, could you tell me what the savings were? Do you have that figure? Hon. C. Hansen: At the time we made the an- nouncements of the restructuring in December, some of the preliminary work that was done by the ministry indicated we would get administrative savings in the neighbourhood of about $20 million over a three-year period.

That took into consideration severance pay- ments we felt would have to be paid for administration staff and senior executive staff. This obviously has been in the news, but if we're going to restructure and save money, sometimes it costs money to save money. What the number doesn't include is the ability to consolidate services. There has been a lot of work around shared services.

We have also given the health authorities the ability to consolidate services, particu- larly around support areas, and the ability to contract out, if they think that's the way they can get the cost savings, so there's another whole level of cost savings that will flow from the restructuring announcements. That will be considerably more than the $20 million o f d i r e c t s a v i n g s . C l e a r l y , I t h i n k , i t d e p e n d s o n h o w many years you want to go out.

Initially, there are up- front costs around severance payments that will be quite expensive, but by going through that restructur- ing, it will allow us to save considerably more money in the long term in ways that will allow those dollars to be refocused on direct patient care. We're not talking about reductions in patient pro- cedures. What we're talking about is changes in how support services are provided, how administrative services are provided, so we can get the most cost- effective support systems for the delivery of direct pa- tient care. S.

Orr: I have just one more question, and I would be remiss if I didn't ask a question that was directly related to my area. I happen to be privileged to live in an area where we're well facilitated by hospitals, spe- cialists and doctors. This is the Vancouver Island health authority. I don't hear a lot of complaints about the health care system in Victoria, because we have facili- ties, but I want to take this a bit further. I want to take this up-Island. [1555] We have a patient now who is up in Tofino or Ucluelet.

If that patient requires a specialist or requires medical attention, can you give me a picture as to how that will change from how it is now to how it will be now that we've restructured? Somebody in Tofino has had a serious injury. Where do we go with that patient? Before, they would have probably gone to a local hos- pital. I'm not quite sure how many hospitals there are up there, but with the restructuring, what will happen now to that patient? How will it be more beneficial to him or to her? Hon. C.

Hansen: Well, first of all, I just want to say to the member that I'm very reluctant to talk about any particular community. I have yet to receive the recom- mendations from the Island health authority with re- gard to their restructuring and their plans for any facil- ity on the Island. I f w e c a n t a k e t h a t s o r t o f o n e s t e p b a c k a n d t a l k about a hypothetical remote community, our commit- ment is that when somebody's involved in an accident, we want to make sure they can get access to emergency care as close to where the accident occurred as possible. They need to be stabilized.

We often hear about the golden hour that people have if they're in any kind of a trauma situation, whether it's an accident or something like a severe heart attack. They need to get access to emergency care. What is the case today in many small er communi- ties in British Columbia is that they don't have consis- tent 24-hour-a-day, seven-day-a-week coverage. We are asking the health authorities to ensure that 24-hour- a-day, seven-day-a-week coverage is there. That is, it has to be a priority for them.

Then they have to have the ability to stabilize the patient, to do the assess- ments, to do whatever diagnosis is within their capac- ity. My hope is that withi n a few sho rt years, we 'll be able to expand the amount of telehealth that's available so that diagnosis around trauma can be rolled out into

2364 B RITISH COLUMBIA DEBATES T UESDAY, APRIL 2, 2002 more smaller communities. Currently, it's being piloted in Cranbrook and Terrace, but clearly there's an oppor- tunity to put that technology into many smaller com- munities around the province as well. The next stage is to ensure that the physicians who are attending that accident victim or that heart attack patient know exactly, on a consistent and dependable basis, where they can refer that patient to get the next level of care that's required.

That has to be within a radius of only a few hours in terms of what's appropri- ate for them to get into an appropriate level of care for more serious injuries. As the health authorities are doing this redesign, they have to make sure they can provide emergency care, they can stabilize, they can begin diagnosis, and they can then refer the patient to an appropriate facility they know is staffed with the appropriate specialists 24 hours a day, seven days a week with consistency. In fact, they would have access today to what's called B.C.

Bedline, which is an innovation brought in by this gov- ernment last September I believe it was, where physi- cians throughout the province can actually determine which hospitals have beds available that can provide the specialized care that may be required for that par- ticular individual. W h a t w e ' r e t r y i n g t o m o v e a w a y f r o m i s a v e r y disjointed level of care we've had in the past where doctors would spend hours on the phone trying to find a hospital that can receive their patient.

Many times they can find a hospital that has a bed, but they don't have the specialists on call who are required for that particular need. [1600] W h a t w e w a n t t o d o i s e n s u r e t h a t t h e n e w , r e - designe d health care system is in fact one that is inte- grated and is truly a system, a network of dependable, predictable, reliable, 24-hour-a-day, seven-day-a-week services so that the accident victim you refer to is going to get the care they need within the time they need it. I think people will see it as a significant improvement over the unpredictable, disjointed system that we have today.

I. Chong: I want to begin by thanking the Leader of the Opposition, the member for Vancouver-Hastings, for yielding the floor to many of us private members who do have questions to ask. Having been in opposition for the past five years, it was always a time where opposition members were able to ask questions. Other members timed them so that we could engage in the categories that would flow and make it relevant with the minister's staff to be here at the time so that we didn't have too many staff people here.

Having heard that she yielded the floor to those of us who would like to ask questions, I do want to thank her for this opportunity. I want to also follow along the lines of asking about the regional health authorities. As the member who spoke just before me represents the same area that I do — Vancouver Island health authority — I first of all want to say that I do appreciate the fact that the new structure, the new model of governance, is going to provide a better health care system for our constitu- ents.

I represent a riding that is heavily populated with seniors, so in particular I am concerned because their needs are much more demanding on the health care system, in addition to the fact that they will be the ones most interested in knowing where we are headed in terms of the long-term community care beds. Before I move on to that, I also want to say that for those constituents of mine who may be paying atten- tion to today's deliberations, they can feel assured that the structure is now in place where ministers have been very receptive to members bringing issues to their of- fices.

The accessibility to ministers — all ministers — that the Premier has instilled in all of us has been very fortunate indeed. Many of the cases that come to my office, and indeed to many of the members here, we are able to raise with the minister's office as opposed to dealing with constituent after constituent in estimates debate, which used to be the case in the past. However, I will have a couple of issues with constituents' con- cerns that I will raise. [H. Long in the chair.] First of all, I'll talk about the Health Services minis- try and the service plan.

I was curious to see that a number of programs and services are being discontin- ued — in particular, ministerial advisory committees. I have received some concerns about these, and I'm wondering if the minister can advise how these are going to be transferred where there will be a more di- rect responsibility. [1605] As noted in the service plan, the advisory commit- tees on HIV/AIDS, the seniors advisory committee and the women's health and injury prevention advisory committee are being transferred so that regions will be directly responsible.

I am getting questions on just how that direct responsibility will affect the constituents in my area. In the context of those advisory committees, could the minister advise how that responsibility will flow through to our local areas? Hon. C. Hansen: Just to back up a little bit, I think it's important to define the framework in which a lot of this work is being done. The Ministry of Health Ser- vices itself is getting out of the business of direct provi- sion of health services. It is the health authorities that have to take responsibility for that.

Over the last number of years there has been a sig- nificant transfer of responsibility from the ministry to the health authorities. With our restructuring of the health authorities, there's even a greater capacity now with the six health authorities to assume full responsi- bility for the administration of the delivery of health services. That provides for a much better integration of health services at the regional level instead of the stovepipes that we had before. We have found that a lot of the issues these various advisory groups in the past had been focusing on were

TUESDAY, APRIL 2, 2002 B RITISH COLUMBIA DEBATES 2365 operational issues in terms of the delivery of services. That is now rightly in the purview of the health au- thorities. We are asking the health authorities to estab- lish the appropriate advisory committees that they think are needed in their regions. Some health authori- ties are further along in that process than others. That's really where a lot of these groups would want to make representation and have influence around how services are actually delivered.

When it comes to the provincial perspective around women's issues, which the member mentioned specifi- cally, there is an excellent policy capacity around the Children and Women's Health Centre of B.C. in Van- couver, which falls under the provincial health service authority. They have that capacity there. Also, if you start looking at the policy issues, the policy framework and the accountability mechanisms that are needed in the longer term, we now have at the cabinet table a minister responsible for intermediate, long-term and home care who is actively ensuring that voice is heard around mental health issues.

Obviously, the minister of state there is actively ensuring that those voices are heard when it comes to the policy de- velopment. There is a separation between the advice we would be taking on the policy front, which is being champi- oned by ministers at the cabinet table, and the opera- tional health service delivery issues, for which we are looking to the health authorities to ensure they're get- ting those inputs. I.

Chong: I thank the minister for that because I think there were concerns in our constituencies and certainly in mine, when there was the announcement that a number of these advisory committees were being discontinued. The fact they can still exist more focused i n w h a t e v e r r e g i o n i s m u c h m o r e i m p o r t a n t b e c a u s e , like so many things, not all regions are the same. The entire province is not identical in their cost pressures and their health demands.

In those areas and in my area where seniors are very important, I'll expect that they will go and see their health authority and health regions to request they have input in that area. That's very, very helpful. I think it was important to put that on the re

Document details

Collection	British Columbia — Debates (Hansard)
Citation	H0402pm-05
Type	hansard
Volume / chapter	H0402pm 05
Language	en
Format	pdf
Source	PROVINCIAL
Identifier	c582de866fede8e914fe1eddd6eddc8ff85f9fab

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