2002 Legislative Session: 3rd Session, 37th Parliament

HANSARD

The following electronic version is for informational purposes

only.

The printed version remains the official version.

Official Report of

DEBATES OF THE LEGISLATIVE ASSEMBLY

(Hansard)

THURSDAY, APRIL 4, 2002

Afternoon Sitting

Volume 5, Number 8

CONTENTS

Routine

Proceedings

Page

Introductions by Members

Introduction and First Reading of Bills

Registry Statutes Amendment Act, 2002 (Bill 20)

Hon. G. Collins

Criminal Injury Compensation Amendment Act, 2002 (Bill 24)

Hon. R. Coleman

Statements (Standing Order 25 B )

Review of Workers Compensation Board

R. Hawes

Charitable work of Open Door organization

S. Orr

Support services for disabled children

J. Bray

Oral Questions

Education funding

J. Kwan

Hon. C. Clark

J. MacPhail

Referendum on treaty negotiations

M. Hunter

Hon. G. Plant

Health authority accountability

J. Bray

Hon. S. Hawkins

Hon. C. Hansen

Referendum on treaty negotiations

J. MacPhail

Hon. G. Plant

West Coast Express contract

R. Hawes

Hon. J. Reid

Reports from Committees

Special Committee of Selection

Petitions

J. Kwan

Committee of Supply

Estimates: Ministry of Health Services (continued)

J. MacPhail

Hon. K. Whittred

Hon. G. Cheema

Introductions by Members

Committee of Supply

Estimates: Ministry of Health Services

(continued)

I. Chong

P. Wong

S. Brice

M. Hunter

P. Bell

Committee of the Whole House

Freedom of Information and Protection of Privacy Amendment Act, 2002

(Bill 7)

Hon. S. Santori

Report and Third Reading of Bills

Freedom of Information and Protection of Privacy Amendment Act, 2002

(Bill 7)

Hon S. Santori

Proceedings in the Douglas Fir Room

Committee of Supply

Estimates: Ministry of Advanced Education (continued)

Hon. S. Bond

R. Stewart

R. Lee

J. Kwan

B. Belsey

Estimates: Ministry of Water, Land and Air Protection (continued)

Hon. J. Murray

J. Kwan

R. Masi

B. Penner

W. McMahon

M. Hunter

B. Belsey

J. Bray

[ Page 2501 ]

THURSDAY, APRIL 4, 2002

The House

met at 2:04 p.m.

Introductions by Members

J. Les:

It's my pleasure this afternoon to introduce a good friend from Chilliwack,

Grant Ullyot. Grant, for many years, was the news director for CHWK radio, and,

more recently, he is the editor of West Coast Farmer magazine. I would

like the House to make him welcome.

Hayer: I'm pleased to rise in the House today to introduce two guests: Mr.

Mohan Kang, president of the B.C. Taxi Association; and Manpreet Brar, a grade

11 student from Terry Fox Secondary School who is the daughter of a good friend

of mine. Would the House please make them both welcome.

[1405]

R. Lee:

I am pleased to introduce Faizel Gulamhusseih. Faizel is a young student who

attends Moscrop Secondary School, which is located in Burnaby. Would the House

please make him welcome.

MacPhail: Some of us who were in the chamber from '96 to 2001 will remember

the "Scood" missile incident. The "Scood" missile incident

was brought to us by Jim Doyle, the former MLA for Columbia River–Revelstoke,

who is joining us once again with his son Adam. I hope the House will make him

welcome.

J. Bray:

I have the pleasure of introducing some people who are joining us in the

gallery today. We are often amazed by their accuracy and sometimes scorn their

accuracy. Interestingly enough, they ask that their individual names not be

mentioned. However, it's my pleasure to welcome a team of Hansard editors who

have taken the time to come upstairs and see the proceedings live. I'd like the

House to make them very welcome.

Krueger: With us in the House today is Mr. Barry Cross, who's an active

businessman in Kamloops–North Thompson and throughout British Columbia taking

part in the new-era economy as British Columbia roars to life. Would the House

please make him welcome.

Hon. G.

Collins: It gives me great pleasure, on behalf of the Premier, to introduce

a group of very special visitors to the House. In the members' gallery this

afternoon are representatives from the United States Chamber of Commerce:

Clinton Wheeler III, the vice-president of corporate programs, and his wife,

Emily; and Bill Swede, the technical manager. They're in Victoria today to make

arrangements for the U.S. chamber of commerce association committee's 100th

annual general meeting, which will be held in Victoria at the end of June. Also

seated in the gallery is Ian Powell, general manager of the Fairmont Empress

here in Victoria, of course; and Beth Bouvier, director of sales, international

sales office for the Fairmont Hotels in Washington, D.C. Would the House please

make them most welcome.

S. Orr: It

is my pleasure today to introduce two very special people. I would like to

introduce two very special people from our community. I'd like to introduce Mr.

Robin Krause, who is the chair of the board of the Open Door. I would also like

to introduce the Rev. Allen Tysick, who is the minister at the Open Door. Would

this House please make them welcome.

Mr.

Speaker: Hon. members, visiting us today is Elaine Thomson, a member of the

Scottish parliament, representing Aberdeen. She is accompanied by Brian Greer,

our own chief legislative counsel. Would you please welcome them.

Introduction and

First Reading of Bills

REGISTRY STATUTES

AMENDMENT ACT, 2002

Hon. G.

Collins presented a message from Her Honour the Lieutenant-Governor: a bill

intituled Registry Statutes Amendment Act, 2002.

Hon. G.

Collins: I move that Bill 20 be read a first time now.

Motion

approved.

Hon. G.

Collins: I'm pleased to introduce the Registry Statutes Amendment Act, 2002.

This act will amend four registry statutes and enable corporate, manufactured

home and personal property security registries to move towards greater

electronic service delivery.

British

Columbians from all parts of the province are using the Internet to access

information and conduct business from their homes and offices. These amendments

demonstrate the government's commitment to provide an easier, faster and more

convenient way to do business with the government of British Columbia. The

amendments make it possible for the government to provide more information and

services on line 24 hours a day, seven days a week. They're also intended to

reduce the registry's reliance on inefficient paper-based registration systems.

The

amendments will provide the registries with the authority they need to implement

cost-effective and efficient systems for electronic filing and storing of

information. Most importantly, these amendments will assist the registries in

fulfilling the government's vision that all information can be submitted or re-

[ Page 2502 ]

trieved electronically by users from any location at any time.

[1410]

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 20

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.

CRIMINAL INJURY COMPENSATION

AMENDMENT ACT, 2002

Hon. R.

Coleman presented a message from Her Honour the Lieutenant-Governor: a bill

intituled Criminal Injury Compensation Amendment Act, 2002.

Hon. R.

Coleman: I move that the bill be introduced and read for the first time now.

Motion

approved.

Hon. R.

Coleman: I am pleased to introduce the Criminal Injury Compensation

Amendment Act, 2002, which amends sections of the Criminal Injury Compensation

Act.

Last August

this House passed a Crime Victim Assistance Act. Once the act is brought into

effect, the compensation program for victims of crime will be moved from the

Workers Compensation Board to the Ministry of Public Safety and Solicitor

General. The new program will enhance services to victims of crime and eliminate

awards for pain and suffering.

It was

anticipated that this act would come into effect on April 1. However, due to

transitional delays in transferring the program to my ministry, this act did not

come into effect at that time. This amendment is an interim measure that makes

pain-and-suffering awards consistent between the old and the new programs. It

also brings us into line with the rest of the country, which — aside from

Ontario and Prince Edward Island — eliminated pain-and-suffering awards ten

years ago.

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 24

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) REVIEW OF

WORKERS COMPENSATION BOARD

Hawes: In May 2000 my constituent Jodi R. broke a small bone in her hand in

a workplace accident. In June she was referred by the Workers Compensation Board

to a specialist who misdiagnosed the injury and conducted three unnecessary

operations on her hand. One month later she was referred to a second specialist

who correctly diagnosed the fracture and tried unsuccessfully to correct the

damage caused by the first specialist.

Jodi's hand

is now completely disabled and heavily covered with scar tissue. She's in

constant pain and unable to work. Her workers compensation benefits were

terminated in November of last year, and she's now appealing, through her union,

for a disability award.

In 1994 the

previous government amended the Workers Compensation Act to protect WCB doctors

from liability in cases such as Jodi's. On behalf of the Jodis all across this

province, I urge the Minister of Skills Development and Labour to expedite the

review of the WCB soon to come forward. The WCB has failed workers for far too

long in British Columbia, and I urge the minister to ensure that this untenable

situation ends quickly.

CHARITABLE WORK OF

OPEN DOOR ORGANIZATION

S. Orr: I

rise today to tell you about a very special organization in my community called

the Open Door. The Open Door is a non-profit organization. It is 15 years old.

In its earlier days the Open Door would see daily perhaps 40 people. Walking

through their doors today and over the past ten years, they now see up to 400

people a day.

The Open

Door is the living room for the very poor in the inner city of Victoria. It is

for people who are not only financially poor but also emotionally, mentally and

spiritually. It is a place for people to gather and socialize and receive help

and advice. It has a small library, a clothing store and a food cupboard, and it

is somewhere safe for people to go.

The Open

Door also runs an outreach program where one of the staff walks around the inner

city talking and relating to people living on the street. One of the people you

will often — very often — see on the streets is a gentleman called the Rev.

Allen Tysick. The Rev. Tysick is a remarkable human being. His commitment to the

most vulnerable is unconditional. His approach is sometimes unconventional. His

success is well known, and he is respected not only by the people he has helped

but by many businesses and business people in this community.

[1415]

The most

recent and exciting project the Open Door is now moving ahead with is the new

partnership with another excellent organization called the Upper Room. Once

together, they will add to all they have now. They will offer lunch and supper,

as well as 22 sleeping accommodations on a temporary basis. Hopefully, that will

grow.

To finish,

I want this House to know that the Open Door has run this organization for 15

years — and it is very successful — without any funding from government at

all. They are a model of success. Rev. Allen

[ Page 2503 ]

Tysick is a model of success, as is the board chair, Mr. Robin Krause. They

take care of the most vulnerable. We can learn a lot from them.

SUPPORT SERVICES

FOR DISABLED CHILDREN

J. Bray:

Last week I had the privilege of attending a meeting held in the Victoria area

with my South Island colleagues and the Minister of Children and Family

Development. This meeting was organized by the Victoria Association for

Community Living, and I would estimate that there were over 200 families in

attendance. These are parents that have children ranging in age from infants to

middle age who have developmental disabilities. It was a very constructive and

very emotional meeting. I was overwhelmed by the passion and commitment

expressed by these parents. We heard stories of the struggles these families

face on a daily basis in providing love, nurturing and support to these very

special children.

One of

their concerns was the fear that their children would be going back to

institutions that would simply be renamed as congregate care. They and I were

very pleased to hear the Minister of Children and Family Development declare

that this was not happening — period. However, we heard of other concerns

around the existing supports that are in place and concerns about families

falling through the cracks as the Ministry of Children and Family Development

moves services from a centralized model to a community-based model. They support

the direction the ministry is going in, but their anxiety is very real.

These

parents are the experts in providing community care for children and adults with

developmental disabilities. I urge the government to ensure that we listen and

trust the expertise these courageous advocates are willing to provide. These

parents want to ensure that the services that support an autistic child entering

the school system are there, that respite care for seniors who are still

providing care for their adult child is there, that the successful day programs

that improve the quality of life for these children are there and that the

ministry addresses the realities of service provisions that occur when these

special children turn 19.

I was moved

by the commitment, dedication and love these parents show to their children, and

I applaud their advocacy. I urge all of us to remember that these families are

simply asking for support as they courageously fulfil their desire to be the

best parents they can be. They have earned our support, and their children

deserve nothing less.

Mr.

Speaker: That concludes members' statements.

Oral Questions

EDUCATION FUNDING

J. Kwan:

Yesterday the Minister of Education said that everybody in the education system

has to be accountable, from the minister on down. This is the same minister

who's running for cover after throwing a budget grenade into the laps of school

boards. Will the Minister of Education take her own advice and take

responsibility for the devastating cuts her government is inflicting on

education in Vancouver and in other communities throughout British Columbia?

Hon. C.

Clark: I don't know if I've mentioned this to the member before, but in fact

in the largest restructuring we have ever undertaken in British Columbia, this

government has protected the education budget, and we are the only jurisdiction

undertaking a restructuring of this size that has done that. Not only have we

protected it, but this year we saw in the Finance minister's budget that the

budget was increased by $20 million.

I know

school districts will face challenges because they have some new costs. I know

that. But we have also given school districts the tools to be able to manage

those challenges. I'm confident that Vancouver and all the other districts

across this province will make the best decisions in the best interests of the

children in their districts.

Mr.

Speaker: The member for Vancouver–Mount Pleasant has a supplementary

question.

[1420]

J. Kwan:

The minister is fond of saying that education is protected. Parents are

wondering how this could be when they see education standards going down and

programs being cut.

Maybe the

minister would like to stand up and explain her math to parents and students in

British Columbia. How do larger class sizes, fewer teachers, less services and

cuts to ESL programs add up to anything less than a cut to education?

Hon. C.

Clark: I don't think I have to apologize to anybody in this House for not

taking lessons from that member in mathematics. I can quote some of her

supporters in Vancouver about their budgets that they delivered in education.

COPE said: "If you doubt that this provincial government has the funds

necessary, just look at the money they spent on fast ferries and the SkyTrain.

Look at this disgraceful decision to increase funding to private schools."

Well, well. This government not only has protected education funding. We have

also, for the very first time in the history of this province, protected class

size in legislation. We have a record to be proud of in education. We are making

education our number one priority. We are putting students first.

MacPhail: I yield my time to the opposition Education critic.

J. Kwan:

The New Era document said the government would increase education

funding. It said it would expand training. It said there would be a new

[ Page 2504 ]

era for students in British Columbia. It turned out that what the Liberals

meant was a new era of overcrowded classrooms, school closures, stressed-out

teachers and fewer opportunities.

Interjection.

Mr.

Speaker: Order, please.

J. Kwan:

Young people are counting on this minister to stop breaking her promises. Will

she start acting like a role model instead of a bad influence and keep her

promise and restore funding to B.C.'s schools?

Hon. C.

Clark: Well, I won't make a recommendation for the member opposite to go

into teaching math or anything like that when she's done with this job in

politics. That's for sure. We haven't cut funding to education. The Ministry of

Education's budget is protected this year. In fact, it's increased by $20

million over the amount we provided last year. Not only have we done that, but

we've protected class size in legislation for the very first time. We brought in

new protections for special needs children in legislation, which have never

existed in British Columbia.

We are

fundamentally changing the way we do education in British Columbia. We are

making sure that we protect the funding. We are respecting school boards'

abilities to be able to make decisions in the best interest of children in their

districts. We are including parents, for the first time in a long time, in many

of those decisions right at the school level. That's stuff that we can be proud

of.

Interjection.

Mr.

Speaker: Order, please. Order, please.

The member

for Vancouver–Mount Pleasant has a supplementary question.

J. Kwan:

We know from this minister that when she says she's protecting education, it

means the largest deficit in history for Vancouver school boards. We know that

this government has been forced to admit its mistakes for some of its most

extreme and mean-spirited cuts. It was not until the Law Society threatened the

Attorney General with a non-confidence vote that he found a few extra dollars

for legal aid services.

How much

more heat from angry parents, school boards and students does the Minister of

Education need, to feel that she has to restore education funding? Will every

parent advisory committee in the province have to start taking non-confidence

motions and votes for this minister?

Hon. C.

Clark: I'm going to take one more shot at this. I suspect the member may get

up and ask the question again. I'm happy to continue to answer it.

When she

stands up and says, "Will the minister restore education funding?" I

guess she's trying to say that this budget is somehow less this year than it was

last year. It's not. If she looks at the budget documents, she'll see that not

only is education funding protected in this budget, but it's gone up by $20

million.

[1425]

We said

during the election that we would protect the Education ministry budget. We have

done that. We've increased it by $20 million. We are putting students first. We

have a record to be proud of.

REFERENDUM ON TREATY NEGOTIATIONS

Hunter: As members of this House know, many hundreds of thousands of

non-aboriginal people enjoy recreational activities on Crown lands that have

been identified as possible treaty settlement lands. Can the Minister

Responsible for Treaty Negotiations explain how the referendum on treaty

negotiations deals with this issue?

Hon. G.

Plant: The third principle deals with the issue the member raises. The

treaty process will include a discussion, a negotiation and a reconciliation of

aboriginal hunting and fishing rights, which are protected under the

Constitution but need to be given shape and force in a treaty.

We believe

it's important for the province to also be at the table insisting that hunting,

fishing and recreational opportunities be ensured on Crown lands for all British

Columbians as we move through the treaty process.

Mr.

Speaker: The member for Nanaimo with a supplementary question.

Hunter: Currently, Indian reserves are not subject to provincial or

municipal zoning regulations. Can the Minister Responsible for Treaty

Negotiations tell us how the referendum question that refers to mechanisms for

harmonizing land use planning will help the government deal with this issue?

Hon. G.

Plant: In many parts of British Columbia, first nations have local

governments as their neighbours. Indian bands currently enjoy the ability to

make land use decisions on their lands, as do municipal governments. As we move

through treaty-making into a new era of reconciliation, we need to make sure

that first nations and local governments have the tools in place to organize

their land use decision-making for the benefit of both communities.

People who

believe that treaties should include mechanisms for harmonizing land use

planning between aboriginal governments and neighbouring local governments

should vote yes to the seventh question in the referendum and give the

government of British Columbia and its negotiators a mandate to advance that

principle in treaty negotiations.

HEALTH AUTHORITY ACCOUNTABILITY

J. Bray:

My question is to the Minister of Health Planning. Yesterday the auditor general

released a re-

[ Page 2505 ]

port on the allocation of resources within the health care system. He

concluded in this very thorough report that in the past, health dollars were

being allocated to health regions without any accountability measures attached

to meet specific outcomes.

Unlike the

previous government, can the Minister of Health Planning tell us what steps the

government is taking to hold health regions accountable?

Hon. S.

Hawkins: We clearly agree with the auditor general that the former

government did allocate funding to the health authorities without establishing

any clear goals, expectations or targets for the nearly $6 billion that they

spent.

We are

doing things better. We are demanding accountability every step of the way. We

have set three-year service plans for our health ministries that set clear

goals, expectations and targets. We have performance contracts that we're

signing with our health authorities which clearly outline what our expectations

are for health services delivery.

For the

first time ever, the health authorities got their budgets on time, and we are

starting to allocate funding not based on historical spending but based on

population needs.

Mr.

Speaker: The member for Victoria–Beacon Hill has a supplementary question.

J. Bray:

My question is again to the Minister of Health Planning. The auditor general

made several recommendations as to how accountability can be improved in the

health care system. In my riding, with a major tertiary centre, my office has

already received calls from people concerned as to whether or not government

will follow through on some of these recommendations.

Can the

Minister of Health Planning tell us how regions will be monitored to ensure that

health dollars are being directed towards patient care?

Hon. C.

Hansen: The accountability framework has certainly been developed by the

Ministry of Health Planning. The implementation of that, and the rollout of it,

is in the Ministry of Health Services.

[1430]

The points

that are made in the auditor general's report are really an indictment of the

way things were handled in health in years past. That has been changed, and we

are now putting in place the framework that will allow for the implementation of

the recommendations of the auditor general. In fact, we've been well underway,

because those were started when we took over as government. As part of the

performance contracts that will be signed with each health authority, we'll be

holding them accountable for the proper stewardship of money and the proper

planning process at the health authority level to ensure that patients

throughout British Columbia get the care they need when they need it.

REFERENDUM ON TREATY NEGOTIATIONS

MacPhail: I, too, have a question about the referendum. The ballots are now

arriving. The trouble is that confusion and not clarity reigns. I want to ask

the Attorney General something. Some want to say: "Yes, private property

should not be expropriated." Others want to say: "No, private property

should not be expropriated."

To the

Attorney General: who's the grammatical expert over there? Just how will you

interpret that answer?

Hon. G.

Plant: The ballots that the people of British Columbia are receiving ask

this question: "Do you agree that the provincial government should adopt

the following principles to guide its participation in treaty

negotiations?" The first principle reads as follows: "Private property

should not be expropriated for treaty settlements."

If the

voters of British Columbia agree that the provincial government should adopt

that principle to guide its participation in treaty negotiations, exactly as the

question is worded, then they should vote yes. If the voters of British Columbia

do not agree that the provincial government should adopt that principle, they

should vote no.

Interjections.

Mr.

Speaker: Order, please. Order, please. Order. The member for Maple

Ridge–Mission has the floor.

WEST COAST EXPRESS CONTRACT

Hawes: Mr. Speaker, my question is to the Minister of Transportation. The

West Coast Express opened five years ago. It's used by a lot of my constituents

on a regular basis. However, a badly negotiated contract by the former

government — and after hearing that last question, I understand why it would

be badly negotiated — with CP Rail has proven so onerous and costly that

much-needed expansion to the West Coast Express can't even be considered. Could

the Minister of Transportation update my constituents on the current status of

this contract?

Hon. J.

Reid: Yes, the contract was negotiated by the former government in 1995. It

was a 20-year contract. West Coast Express has come to me to talk about their

concerns with their contract. They would like to see it renegotiated. The

contract does fall under federal legislation, so there's been a reference to the

federal act to allow it to be renegotiated. I have spoken with the federal

minister about their concerns. As well, I have spoken with CPR with regard to

the concerns and asked them to consider a direct discussion with the West Coast

Express.

[End of question period.]

[ Page 2506 ]

Reports from Committees

Hon. G.

Collins: I have the honour to present the first report of the Special

Committee of Selection for the third session of the thirty-seventh parliament.

Mr.

Speaker: Please proceed.

Hon. G.

Collins: I move that the report be taken as read and received.

Motion

approved.

Hon. G.

Collins: Mr. Speaker, I ask leave of the House to suspend the rules to

permit the moving of a motion to adopt the report.

Leave

granted.

Hon. G.

Collins: I move that the report be adopted.

Motion

approved.

[1435]

Petitions

J. Kwan:

I rise to present a petition signed by 2,735 British Columbians, which

requests that this House proceed without further delay in bringing in a B.C.

video game rating system that will have all video games screened and rated and

the distribution regulated, based upon that rating system. Much of the work that

has been done for this petition has been done by a fellow by the name of Cran

Campbell.

Orders of the Day

Hon. G.

Collins: In Committee A, I call Committee of Supply. For the information of

members we'll be beginning with the estimates of the Ministry of Advanced

Education, followed by the Ministry of Water, Land and Air Protection. In this

House, I call Committee of Supply. For the information of members we'll be

debating the estimates of the Ministry of Health Services.

Committee of Supply

The House

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

The

committee met at 2:38 p.m.

ESTIMATES: MINISTRY OF

HEALTH SERVICES

(continued)

On vote 31:

ministry operations, $10,053,791,000 (continued) .

MacPhail: We were discussing plans for the 5,000 beds that the New Era

document had promised — 5,000 intermediate and long-term care beds. We

concluded, Mr. Chair, by me saying that, once again, this government is robbing

Peter to pay Paul. The Minister for Intermediate and Long Term Care stands up

and says: "Oh, we're building assisted-living units." Well, B.C.

Housing is building assisted-living units that used to be provided for by the

Ministry of Health, and now there's fewer dollars available for the social

housing needs of people in this province.

[1440]

There

are a couple of comments that the minister has made in the past few months

around the issue of how communities will fund multilevel care. Let me just quote

from the Campbell River Mirror . This would have been Tuesday, November

13, 2001. The minister says…. I'll read the first two paragraphs to put it in

context.

"'Health

authorities are on their own to fund any new multilevel or health care

facilities. Money for such projects has to come from the health regions, not

from the government,' says Katherine Whittred, minister responsible for

Intermediate, Long Term and Home Care, during a recent visit to Campbell

River. 'The health region is going to have to look at their priorities and

perhaps transfer resources from one area to another,' Whittred said, having

just finished a tour of the old Yuculta Lodge. She added: 'There is not

going to be any additional government funding for health regions, but there

also will be no less.'"

What

answers does the minister have now? Where will health regions transfer resources

to cover intermediate and long-term care?

Hon. K.

Whittred: I think I have actually covered off on this line of questioning,

but I'll go through it one more time.

I have said

that it is our goal to build capacity into the health system in communities that

are going to provide service for our population that uses intermediate and

long-term care. The vast majority of that population are in fact seniors —

although, I might add, at this point they are not all seniors. There is a

significant population of younger people who suffer from catastrophic illness or

spinal-cord injury or brain injury — other problems that cause them to be

clients of the long-term care system.

Regardless

of the circumstances, we know that what has been going on over the last number

of years doesn't work. I was looking back at a graph that went back as far as

1991. That would have been the first year that the member opposite, I believe,

was elected to government. In that year the health budget was, I believe, $5.4

billion. Today it is $10.4 billion. It has increased incredibly, and yet we

still have the same pressures on the health system. Therefore, it seems to me

that any reasonable, thinking person has to look at that and say: "Okay, I

think we have to not only do things differently, but maybe we have to start to

think a little bit smarter. Maybe we have to think strategically."

Perhaps I

can use the example that the member quoted, which was Campbell River. I was in

fact in Campbell River, and I visited the new Yuculta Lodge.

[ Page 2507 ]

It is a very, very nice, new multilevel facility. It has some very good

innovations. One of the innovations I would mention is that it uses a piece of

technology called "Vigil." This might be of interest to the member.

Vigil is a technology that can be programmed; it's electronic software. It can

be programmed to anticipate the regular movements of clients. This enables the

staff to know whether a client is perhaps wandering at night. If they are

normally in bed, Vigil will inform staff when clients are behaving in an

unpredictable pattern. That perhaps, Mr. Chair, is an example of what I said

earlier about changes in technology.

To get back

to the first part of the question, and thinking more strategically, when the new

Yuculta Lodge opened, there was in fact an old Yuculta Lodge. It seems to me

that the community now has a decision. What can they do with the old Yuculta

Lodge? Well, I suppose they could sell it. They could convert it to assisted

living. It has a fairly new kitchen and a good dining room. Portions of it are

very much outdated.

[1445]

I think

that's what I meant when I said that communities are going to have to make those

decisions. The other thing that exists in Campbell River is a fairly overcrowded

extended care facility. So you have a community that has many different problems

that are all related to intermediate and long-term care. Within that scope and

within the possibilities, I think that communities and the health authorities

can make those decisions. I don't think decisions have to be made in Victoria. I

believe that if communities think strategically and take advantage of

partnerships, whether it be with community organizations or with the private

sector, there are many possibilities and all sorts of areas for innovation. That

is the kind of thing we're looking for.

MacPhail: Mr. Chair, it's the minister's responsibility to stand up and say

what she is doing, because the cuts are happening now in intermediate and

long-term care. It's all very well and good for the minister to stand up and say

here's what she heard one day and here's what she heard the next day and that

this technology is available. What is her government doing?

Frankly,

it's time for the government to stop saying that nothing is achieved by

investing in health care. By acknowledgment of this government's own Progress

Board, here's what's changed over the last decade in British Columbia. We are

now the healthiest province in Canada, and we achieved that throughout the 1990s

— her own Progress Board report. We have the best health indicators of all of

the provinces — number one.

AIDS

treatment is vastly improved because of the investment in research in this

province. People who have HIV/AIDS now live; they don't die. That's the result

of investment in health care. While cancer rates remain the same, the treatment

and survival of cancer in this province are among the best in North America

because of investment. Infant mortality is down. Low birth weight are down.

Longevity is up. Investment in health care throughout the 1990s has paid off.

The reason

I'm looking to this minister for real concrete solutions is because the problems

are facing us as of April 1. I actually have the greatest respect for health

care deliverers across this province. I have the greatest respect for the public

servants who deliver health care in this province, but the deputy minister in

November of last year told the Pacific health forum: "There are some very

good things that we've been doing that we won't be able to do." That's

exactly what I'm trying to figure out. We know the good things that have been

done won't be done. That's what the increased funding paid for. We need to

figure out what the alternatives are that this minister can provide.

Let's go to

Creston, where the minister was on November 26. I quote from the Creston

Valley Advance : "Health Solutions Must Come From Within." There

was a long-term care forum that the minister attended. The people were grateful

that the minister attended that forum, and that's good. The local MLA said the

meeting was a good first step, but it was only that.

"[The

Minister of State for Intermediate, Long Term and Home Care] added that

expanding home support services would keep seniors in their homes longer,

saying solutions must come from within the community. Asked how that might

be accomplished, she admitted she didn't have an answer. 'I think we have to

rely upon the innovation and skill of the people in the community,' said

Whittred, 'That's why we have the skilled people that we do working in the

various jobs in the Ministry of Health and the various levels of care for

our senior citizens.'

"[The

minister] refused to be pinned down when asked about the time frame for

opening five beds at Swan Valley or how many of the government's announced

5,000 future long term care beds will come to Creston."

[1450]

This is such a dilemma for people in the community. The minister says the

solutions have to come from within the community. The public service admits that

good things that happened in the past aren't going to be done. The community is

saying: "Help us. What are we supposed to do?" As far as I can tell so

far, what this minister is saying is: "Families, it's up to you." Is

the minister telling a family to go out and buy this new technology, the

wonderful tracking technology for people with dementia? Is a family supposed to

go out and buy that? Where are they supposed to get the resources to do that?

What happens if actual long-term care is needed, where the mom, the dad, the

grandmother or the person with the disability actually needs care in a facility?

It's shocking to me that these cuts are coming within four weeks, and the

minister has nothing to offer families.

Hon. K.

Whittred: A good deal of what the member opposite says is accurate, when she

talks about the health status of the people in British Columbia. For that, I am

very pleased.

I, too,

have a great admiration for the people I've met who work in the field. I have,

in my travels, spoken to many people who are home care providers. They are

residential care attendants. They are case

[ Page 2508 ]

managers, managers in facilities, nurses, administrators and home nursing

people, and I have nothing but the highest admiration for them. I also wish to

congratulate them, in many respects, about the kinds of innovation and in fact

flexibility that they've allowed into their workplace.

I think I

spoke earlier about the dementia care, and something I've learned about dementia

care is that homeyness, apparently, is very important when we're talking about

people with dementia. They've introduced things like baking bread. This sounds

so simple, but it actually has a calming effect. I, too, share with the member

that these are very, very valuable people we have that work in the system.

However,

having said that, I think that we — those of us who care about our health care

system, and I know the member opposite cares, and I think she knows that I care

— have to acknowledge that we cannot simply continue to put another billion a

year into the system. The increasing amount of resources that we have put into

the system over the last number of years is not…. While we have been rewarded

certainly with very good outcomes, we can't continue to pour those kinds of

resources into the system indefinitely.

[1455]

The results

in many instances — for example, the cancer outcomes in the patients, the

results in this province — are not about dollars; they are in fact about a

smart, strategic approach to treating the illness. Standardized protocols are in

place that are there for the treatments that are effective for cancer patients.

It's the strategic practices used to treat cancer that are most responsible for

the very, very positive outcomes that we have. It's this that we're trying to

achieve in long-term care.

I make no

apologies, Mr. Chair, to the member opposite that my ministry is a very

strategic one. It is one where we are looking for best practices. We are asking

these very talented people who work in the field to find smarter ways to achieve

the same results. We know, and the research shows us, that for the lower-acuity

clients, they actually fare better in assisted living than they do in

residential care. We know that. The challenge to the health authorities — and,

in fact, the challenge to me and the staff around me — is to make that

transition so that we have those appropriate resources.

Right now

in many areas of this province we do have wonderful care, but in some

communities we don't have the continuum of service that we're hoping to see.

Some communities, of course, are better served than others. I've already

mentioned that the community right here in Victoria is very well serviced. Other

communities aren't. We're hoping that we can encourage other communities to

invest in those kinds of services.

We know,

for example, that nutrition…. Now, nutrition isn't really a health treatment.

Nutrition is something that we all need. We know that it is often an issue in

care of the elderly. Nutrition does not have to be delivered through a costly

program. There are, in fact, many responses to delivering good, nutritious meals

to people. I think the task ahead is to develop these systems and to build on

the success that some of the health regions have had.

One of the

things that's going to be much easier with fewer health authorities is that it's

going to be much easier for the health authorities to exchange information. The

people in charge of home and community care, in fact, meet regularly. With a few

of them, as they are now, it's very easy for them to say, "Well, gee, you

know, we just started this program in Parksville," or wherever, "and

it's working really well," and describe it to the people in the north. They

can say: "Oh well. You know, maybe we can adapt that for our

community."

Through

this exchange, this is an ongoing work in progress. As I said before, we're not

going to accomplish this overnight. It is a five-year program. At the end of

five years I'm confident we're going to see some very positive results.

MacPhail: I'm exhausted by trying to get answers — immediate answers —

because, of course, the cuts are taking place in the next four weeks. Everyone

knows it. The member's own caucus knows it. The minister knows it herself. I

know it. The people who are going to be affected by the cuts know it. It happens

in four weeks.

Let's look

at some potential solutions that this minister is responsible for. Let's look at

the end-of-life care, palliative care. This government was going to develop a

plan for end-of-life care. The draft discussion document went out in October of

2001 — six months ago. Can the minister tell me the status of the end-of-life

care plan?

Hon. K.

Whittred: The interdisciplinary team that was appointed and headed by Dr.

Romayne Gallagher to come up with an end-of-life care strategy is in fact

working as we would expect. They will be submitting, very soon, a discussion

paper which will be circulated and discussed in the community over the summer

months. The report, I believe, will be finalized in September. I believe that is

the time line.

[1500]

MacPhail: Maybe this is what the minister could do. The Vancouver coastal

health authority is allowing for the North Shore, the minister's own area, to

cut palliative care patient-days by 1,460 annually. This is a solution? I'm a

huge advocate of palliative care. I am so thrilled that my community, working

with me as the MLA and then the Minister of Health, put in place and opened up

Cottage Hospice, which is an extremely effective community palliative care home.

It meets the needs of first nations aboriginals, it meets the needs of HIV/AIDS

patients, and it's a very, very cost-effective health care solution to not

having enough money.

Here the

minister, on the one hand, has been working six months to develop a plan for

end-of-life care. Fair enough. But in the meantime they're not waiting.

[ Page 2509 ]

The Vancouver coastal health authority is cutting palliative care

patient-days by 1,460 annually. Will the minister step in and order the

Vancouver coastal health authority to not make that cut before the end-of-life

care plan is developed?

Hon. K.

Whittred: The document the member is quoting from is a discussion document.

I have stated many times throughout this questioning that the health authorities

have been asked to present plans. This is an ongoing process. The process is

that they will make their plans — they have their budgets — they will

discuss those plans with the boards that have been appointed, and ultimately

their plans will be finalized. The documents that were leaked to the member

opposite have to be treated in that manner. They appear to me to be the kind of

thing that a staff might discuss sitting around a table, throwing ideas out

about what we might do or what we might not do. They are in no way a final

decision. I for one am going to wait until we do see the final plan before I

make any judgments.

MacPhail: This is like the Minister of Education sticking her head in the

sand and saying that there are no cuts to education. That's like this minister

somehow saying that these leaked documents are just discussion documents. The

Vancouver coastal health authority admits that this is where they're going. This

government had a plan. At least have the guts to acknowledge the effects of your

plan. The Minister of Education stands up and says: "We protected education

funding. Oh well, what we forgot to say was that we off-loaded a whole bunch of

increased costs on the school boards that we're not funding. What's anybody

complaining about?" The Minister of Education stands up with a smirk on her

face that's so arrogantly disrespectful and in denial about what the real effect

of their government's agenda is, just the same way this minister does — to

somehow deny the reality of a leaked document.

It's a real

document; these are real cuts. The member for West Vancouver–Garibaldi

understood that, and this Minister of State for Intermediate, Long Term and Home

Care has to understand exactly the same thing. It's a real document; these are

real cuts that are coming. I'm extremely disappointed that the one area where

the minister has responsibility and some negotiating ability, the area of

end-of-life care, palliative care…. The minister is doing a study, doing a

plan, and all she had to do was stand up and say: "I will make sure that

the Vancouver coastal health authority is not proceeding with this massive cut

in palliative care days until my study is complete."

[1505]

Let's look

at home care, then. The cuts in this document for home care are huge. They're

going to reduce home support. This isn't a discussion document. They're going to

reduce home support in the whole area of the Vancouver coastal health authority.

It's unbelievable. It says: "Service reduction and efficiencies utilization

improvement." That's where the document then goes on to say that there will

be real consequences also to (1) not having any intermediate or long-term care

beds for people who need them and (2) then cutting home support.

What are

the plans to cope with the cuts in home support? Assisted living, as I

understand it, is a model saying to families in the year 2002: "Here are

your relatives back, to look after yourself. Oh, by the way, we're cutting the

support that may be available for you in the area of home support." What's

a family to do?

Hon. K.

Whittred: I think that perhaps one of the differences between that member's

government and ours is that we do have some confidence in the people that work

in the health authorities. They have been given the task, with a fairly

significant budget, to supply services in their areas. There's no doubt that

they're going to have challenges. I don't think there's a system anywhere in the

world today that does not have challenges in health.

It's my

belief that the health authorities are going to have to think sensibly and

strategically, or they're not going to achieve the performance goals that have

been set by the ministry.

[L. Mayencourt in the chair.]

It would

not seem possible to me that they would not be able to make decisions based on

their knowledge, their experience in the field in particular, their accumulated

knowledge about best practices, and so on, without taking into account the

risks. I believe that they will take those risks into account. That is why I

think we're going to see very effective and good working documents when the

eventual plans are completed and have passed through the boards. That is where

my confidence is.

In terms of

home care specifically, the member talks about cuts. We have made no change in

home care. We are implementing the policy of the previous government that was

brought in, in November of 1999. I might just remind the member a little bit

about the history and the evolution of that particular policy.

In June of

1994, due to budgetary considerations, the ministry instructed the continuing

care people to discontinue admission of lower-care clients who were needing

assistance only with housekeeping. Later in that same year staff were instructed

to introduce further restrictions.

In 1995 a

further instruction went out not to provide service to new applicants at the

personal care or IC 1 levels if the only support they required was housekeeping.

Clients at the IC 2 level were restricted to four hours if all they required was

housekeeping.

[1510]

In November

of 1999 another statement went out from the ministry, stating that clients who

required personal assistance could receive housekeeping and then only when

appropriate. It was only if that was necessary in the area of providing other

personal care services such as bathing. It would make sense to tidy the bathroom

after you bathe the client.

[ Page 2510 ]

We have

done nothing. We have made no change in the area of home care policy. What the

health authorities are trying to do is rationalize the service across their

regions. In spite of those policies that went out from the previous government,

there were still many, many clients — 2,284 in the system — that were still

receiving care contrary to the ministry's policy. I think that is what is meant

when the member talks about cuts. They are not cuts. They are simply

rationalizing the service across the delivery area. What was found was that this

was particularly true in the area of the interior, that the various community

health councils…. There was a wide divergence of policy when it came to the

delivery of home care services.

This is

simply the enforcement of a policy that has been there since 1999. We have made

no change in that policy. I believe it is being implemented by the new health

authorities.

MacPhail: I find it interesting. I've been trying to think of a way of

capturing the mantra of this government about the past. Here it is: "Oh my

God. Everything in the past was bad."

I said

during the debate for Bills 27, 28, and 29 that the past was the evil empire.

Glen Clark was Satan, and union leaders were the soldiers of Satan. We hear it

day after day. The Liberal backbenchers stand up and lob questions to ministers,

and they go: "Oh my God. That was the bad, bad previous NDP

government."

When this

government is required to give real answers about what they're changing to

deliver on the promises that they've now misled the public about in terms

protecting health care, they say: "We're just doing what the NDP did."

That's what they say.

In this

House today, we saw both. We had several cabinet ministers stand up and say:

"Bad NDP government. Wasn't that evil? We're going to do different."

Now we have the Minister of State for Intermediate, Long Term and Home Care

standing up and saying: "We're just doing what the NDP did."

Well, it

ain't gonna work, because for one thing, what this government has done is taken

away any targeted funding requirements on any program whatsoever for the very

first time and said to health authorities: "We're cutting you one cheque,

and you decide what to do with it." Here's what health authorities are

doing. They're reducing home support; they're reducing community grants; they're

ending outreach workers that help look after seniors in their homes. That's what

they're doing. We'll get into the mental health program cuts that they're

making.

The

minister hasn't changed the policy — true. But what she has changed is to say:

"It's up to you, health authorities. We're giving you no money for the

programs We're giving you zero dollars for the programs, and by the way, you

decide what pressures are the best to fund." Health authorities are making

decisions to cut home care.

[1515]

I'm reading

from the Nelson Daily News of Monday, February 18. A local health

advocate says that the latest announcement by the interior health authority to

cut home care services for seniors and the disabled is shortsighted. Last week

the interior health authority announced that it will attempt to save between $6

million and $7 million by trimming support for people with chronic or

progressive medical conditions. Locally, those cuts will come at Nelson and

District Home Support Services Society. Former Nelson and District Home Support

Services Society administrator Joan Reichardt, who is an incredibly thoughtful

community advocate for home support services, said that any cuts to home support

will end up costing the health system more money in the long term. She said:

"When you cut back or eliminate completely some of the most basic parts of

care that make it possible for people to remain independent, you automatically

create huge pressures on much more expensive types of service. If you can keep

somebody at home out of an acute care bed or long-term placement with a couple

of hours of home support a day, it's money well spent."

These are

cuts under this government to the funding for home support.

Here's what

the Vancouver coastal health authority document says. It's not a what-if, not a

blue-sky document. This is on cuts in support services such as cleaning and

housekeeping.

Oh, I'm

sorry. That's referring actually to cuts in housecleaning the hospital. They're

quite devastating too. Sorry. That was about how that will increase infection in

the hospital.

Here's what

it is on cuts to the community health services, which are in-home services:

"Reduced access to acute home care nursing" — because it isn't just

housekeeping; cuts are being made in home care nursing — "will further

move Vancouver below the B.C. average home nursing care utilization rate. There

will be less continuity of care for home support clients. Caseloads for nursing

case managers will increase by one-third under this government."

I guess it

would be helpful if this government could at least have the guts to admit what

their programs will do. Stop saying either, "The past was bad,"

and/or, "We're just doing what was done in the past," because neither

is true — neither.

I am deeply

disappointed in all the responses I've received today. I know this minister has

a strong personal commitment to the well-being of seniors. She has an incredibly

strong commitment to the well-being of children, which she's practised all of

her life. Her government is letting her down. Her government is giving her zero

tools to work with to make intermediate, long term and home care work properly

in this province. It is an area where the community is just not going to accept

the consequences of the cuts that are being foisted upon them.

The last

thing I say ends my time with the minister.

This

government has said to families: "Time for you to take greater

responsibility, families. You have to do more in the area of child care. We're

not going to help you out nearly as much as we did in child care. In fact, those

of you who are on welfare and have young child-

[ Page 2511 ]

ren have got to go back to work when your child is three. If you've got

ailing parents, it's time for you to look after those ailing parents on your

own."

If a child

is vulnerable and at risk in this province…. The government is cutting funding

to help children in need of protection. Every single move this government is

making is ripping asunder the social safety net for families — ripping it

asunder. It is going to have huge and dire consequences. I know this minister

understands that fully. She has the passion and the compassion to advocate a

different way, and that's what I'm urging her to do.

Hon. K.

Whittred: I thank the member opposite for her kind words toward me. However,

I make no apologies for the route my government is taking. From a purely

financial point of view, we are now at the position in government where health

care is eating up all the revenues from personal income tax, MSP premiums, total

federal transfer payments, tobacco taxes and the latest increase in sales tax.

[1520]

I do value

the system, and I think all the government side of the House values the health

care system. We have, in the last year, put $404 million of extra funding to the

health authorities. We have put $100 million of extra funding to capital

restructuring. That money is there for the health authorities to use for

restructuring long-term care facilities if that is how they choose to spend it.

I would

like to remind the member opposite of a conversation we had when we were, in

fact, on opposite sides of the House. I was questioning that member, and I asked

her about seniors assisted living or supported housing. This is when that member

was the Minister of Health. She said something to the effect: "Oh well,

that wasn't my responsibility. That is the Minister of Housing." I went and

asked the Minister of Housing, when the appropriate time came in estimates, the

same question. He replied: "Oh, that is the responsibility of the Minister

of Health, responsible for seniors."

I was left

in a quandary, Mr. Chair, about exactly who in that government was in fact

responsible. Well, my government — this government — has appointed a

minister of state with that responsibility. I share with the opposite member

that it is an integrated job. It is a job that spans more than one ministry, and

she is in fact right.

We are

partnering with B.C. Housing in the building of assisted-living units. I believe

that was canvassed during the estimates of that minister. I make no apologies

for that. I believe that the previous government did the same thing. I look

forward to proceeding with this task that I have over the next four years, and I

look forward to its conclusion.

The

Chair: The committee will recess for two minutes.

The

committee recessed from 3:22 p.m. to 3:24 p.m.

[L. Mayencourt in the chair.]

MacPhail: I welcome the Minister of State for Mental Health. I understand

that this minister of state has to leave at 5:30. I will do my best to get all

of my questions in, but I have many questions.

[1525]

I conducted

an exercise with the Minister of State for Intermediate and Long Term Care.

Referring to page 144 of the estimates book, could the minister of state look at

vote 31, note F, and tell me what areas of regional health sector funding he is

responsible for?

Hon. G.

Cheema: I would like to answer all the questions, and I will do my best. I

think this is a good place for exchange of ideas and also answering the

questions. I will encourage the member to just continue with her questioning, to

be very specific, so that we can have a productive dialogue.

I just want

to also express my sincere thanks for her concerns about mental health. As I

have worked for the last ten months, I have been aware of her noble intentions

to improve the status of mental health in this province.

To be

specific on her question, my role here is that I'm responsible for mental health

services to adults both on an out-patient basis and in tertiary psych

facilities, adult forensic psych facilities, public and prevention services for

mental health. That's my role, to be specific on what she has been asking me.

MacPhail: I was curious to know whether this was the place to ask questions

about adult forensic psychiatric services, so I am pleased to do that. I want to

do something here. One of the areas — in fact, the biggest area — I'm

concerned about with the new way of funding that this government has for

regional health boards is the area of mental health. I want to walk the minister

through some points I have on funding, because I know, in my questions from

other ministers, it's: "Don't worry. Performance contracts will take care

of these matters." But we'll get into that in a moment.

In 1998, if

one goes to the Estimates book, one sees that adult mental health was a

targeted funding classification, by subvote, of $333.151 million. One will also

see from that book that $296.089 million had been spent in 1997-98. In 1997-98

the budget for adult mental health, by targeted funding, was $296.089 million.

In '98-99 it increased to $333.151 million. I have all of that information here,

Mr. Chair, if the minister cares…. But I'm sure; I'm reading out of Estimates .

Then we go

to '99-2000. Vote 36 shows that in '98-99 we did spend $340.840 million, and we

budgeted an increase in '99-2000 to $348.666 million for adult mental health.

Targeted funding — that's what people had to spend it on. The first figure is

$296 million. Let's remember that. Then for the estimates for the year 2000-01

we saw that, yes, indeed we did spend $348.449 million, and we budgeted an

increase to $363.974 million, targeted money for adult mental health. My point

will become clear very shortly, Mr. Chair.

[ Page 2512 ]

[1530]

For the

estimates for '01-02, the last time we saw targeted funding, the subvote

for mental health showed that in 2000-01 we had spent $368.57 million, and adult

mental health funding was increased for '01-02 to $404.13 million. That's not

including capital expenditures, by the way; that's operating expenditures. So we

started with $296 million, and we were up to $404 million over the course of

four years. That means that there was an increase in funding for adult mental

health of $108 million over four years. That excludes capital expenditure for

residential care for mental health.

I just want

the minister to understand that if he stands up and says, "The mental

health plan was not funded," he is dead wrong. There's the proof of the

pudding. I've held my tongue every single time he says it — every single time.

And here's why. Yes, one of my former colleagues did say: "Oh, the plan

didn't go to Treasury Board." I confess. I announced the mental health plan

before it had gone to Treasury Board. But I also knew that within weeks I was

going to be the Minister of Finance. It was my highest priority to fund the

mental health plan, and I did, as the Minister of Finance. The proof is in the

pudding. Until this minister took over, mental health funding from '97 through

to '01 — four years — increased by $108 million, on track with the funding.

So stop. Do not for one second stand up and say: "That minister didn't fund

mental health."

Here's what

did happen. I confess to this with great disappointment. The community,

rightfully so, started advocating that the services weren't on the ground. They

moved in the way that the community should do, that mental health advocates

should do, to say: "When are you going to deliver?" They said:

"The money's there. We know the money's there. Why aren't you getting the

services on the ground?" And I shared that frustration. I shared it over

and over again. However, we did make progress; we did. But for this minister to

set the bar that the money wasn't there…. The bar has been yanked away from

his belly. The money was there. In fact, it was funded ahead of schedule.

[1535]

I will

engage this minister in a discussion. Given the fact that the money was there,

and it was still difficult to deliver the services on the ground, what are we

going to do about that? Let me ask the minister this: as recently as three weeks

ago the minister made an announcement, which was incredibly self-congratulatory,

that $263 million would be dedicated to mental health. That actually includes

capital funding, which was never part of the $404 million for adult mental

health. Where has the rest of the money gone? Where's the $404 million that was

there for adult mental health?

Hon. G.

Cheema: A number of issues have been raised by the member. Let me just first

deal with the number one issue. According to her, there's $108 million from 1997

to 2002. This money was there, but my question will be to her: was this money

actually spent on community services or not? Our answer is no, it was not. It

went to compensation packages. It went for other services, but it was not spent

on a mental health plan. When I stand up in this House, I talk specifically

about the mental health plan.

In 1998 and

1999 there was only $10 million spent on the mental health plan. In 2001 and

2002, $15.5 million was spent on the mental health plan. The total, $25 million,

was spent during that time. When the member is giving us the figures, she is not

being very careful with those numbers, because those numbers don't….

Interjection.

The

Chair: Order.

Hon. G.

Cheema: Mr. Chairperson, I think I gave her the opportunity to ask

questions, and it's my opportunity to answer the questions. With all due

respect, I will answer the question. The money was spent — only $25.5 million.

We have funded the rest of the package. Over the period of six years this will

be $125 million.

To answer a

second question, this year for the first time we have given the global funding

for the health authorities, and we have given them clear guidelines. Those

guidelines must be met. What that means for patients is that the money for

mental health services is protected indirectly because they have to meet those

guidelines. We are not going to micromanage the system. We have given specific

guidelines, and those guidelines will be met. We are very confident that once

those guidelines are met, we will improve the mental health in this province.

[H. Long in the chair.]

MacPhail: The minister is not answering the questions. I know it's a nice

little mantra, just the same way as the evil empire mantra works — that this

minister thinks he can get away with standing up to say that the money wasn't

there for mental health. There was $296 million in '97; $404 million dedicated

in 2001 — an increase of $108 million in adult mental health, not including

bricks and mortar. This minister has dedicated a total of $263 million including

bricks and mortar, so stop it.

[1540]

The

minister has to stop misleading the public right now. He can't have it both ways

— on the one hand to say the money wasn't there and then on the other hand to

say: "Oh, there was $404 million, and I'm now giving a total of $263

million." In fact, it's only $125 million for operating. In fact, it's only

$125 million that this minister is committing to adult mental health,

whereas

there was $404 million for adult mental health when he took over. Where did the

rest of the money go?

Hon. G.

Cheema: This year we are funding an additional $36.9 million over and above

last year's $404 million. That's a 9.1 percent increase in the budget. We have

given full authority to the health authorities. We

[ Page 2513 ]

have given them clear guidelines and clear goals, and those goals must be

met. It's so important for mental health to have clear goals. What this member

is worried…. She's not fearful about patients; she's fearful that we'll be

successful because we have given clear guidelines.

And I'll

answer the other question she was raising. Their funding was only $25.5 million

as a part of the mental health plan. We have gone over and above our commitment.

There's $138 million more on the facilities, which are part and parcel of the

mental health plan. We are also funding that over a period of six years. You

cannot have a mental health plan without community placement. You cannot have a

mental health plan without community beds. You cannot continue to mislead the

patients. We made that commitment, and we are fulfilling that promise. The only

party who misled this province and the patients with mental illness was their

government, not ours.

MacPhail: How ridiculous. You know, it's embarrassing what this minister of

state is saying. Let him put his money where his mouth is. Show me any document

where the minister can show that the $404 million that was turned over to their

government for adult mental health is there, and they're adding more. Show me.

Just show us the money. Prove it.

Hon. G.

Cheema: I repeat my answer again. We have given clear guidelines and

performance measures to the health authorities. They have been given global

funding. That funding must be spent on the basis of performance measures, so

indirectly we are protecting money for mental health. We are doing three things.

We are being responsible, we are being innovative, and the health authorities

will ultimately be accountable for how the money is being spent on mental

health.

[1545]

MacPhail: Pretty direct question that went unanswered — completely

unanswered because the money isn't there. This minister claims to be putting

money into the mental health budget. He's putting it in the front door, and

because there's no targeted funding, the health authorities are shovelling it

out the back door in cuts. That's what they're doing.

Let's just

go through it. The Minister of State for Mental Health says: "Don't worry,

even though there's no $404 million there. It's now $125 million for

operating." He'll go to the performance targets. Well, let's go. Let's go

to the performance measures and targets. I'm looking at page 11 of the Health

Services budget. I assume this is what we're working with. Is this what we're

working with?

Mr. Chair,

they didn't hear my question. I'm fine to repeat it. I understand.

The

minister says: "Don't worry. The performance measures and the performance

targets are what will be…." The money's not there. The minister can't

prove that there's any money there. That's what will make sure that the money is

actually going to mental health. Let's look at the performance measures and

targets on page 11 of the Ministry of Health Services service plan. Is that what

the minister is referring to in terms of targets and measures?

Hon. G.

Cheema: Again, this is the first time we have given them performance

measures, and we expect them to meet those goals and those standards. What that

will do for patients is improve the quality of life for patients — for

example, if the patient is discharged from a hospital, how that patient will be

getting the service in the community. This is one example. The rest of the

examples…. The member has the book. I think what needs to be done…. We have

given them the full authority. We have given them the guidelines and clear

goals, and those goals must be met. We will be measuring those goals, and we'll

be reporting on those goals.

MacPhail: Could the minister answer my question, please?

Hon. G.

Cheema: This year we'll be giving $5.9 billion to the health authorities.

Out of that, $404 million plus $15 million additional money for the mental

health plan is there. It's in the papers.

[1550]

MacPhail: The minister is making that up. There's nowhere…. He's just

making it up. Could he actually stop misleading the House or provide the details

that show where the $404 million is dedicated to mental health and that there's

more money on top of that? Stop making it up. It's not there. The question I

asked the minister…. He said he can't show where that money is. It's gone.

What we do know is that there's $125 million over six years and that he's going

to rely on performance measures and targets. I asked the minister whether the

performance measures and targets he's relying on are those outlined on page 11

of the Ministry of Health Services service plan. Just yes or no.

Hon. G.

Cheema: Yes.

MacPhail: Well, then let's go through them.

Mental

health indicators. This is the only thing we have to rely on that the health

regions are going to do what they're supposed to do. This is how we're going to

find the missing $404 million.

Mental

health indicator No. 1 is: improved continuity of care measured by the

proportion of persons hospitalized for a mental health diagnosis who receive

community or physician follow-up within 30 days of discharge. Then it says

'02-03 — 3 percent increase. What's the base number we're dealing with here?

Hon. G.

Cheema: At this time we don't have baseline data. I will be happy to provide

it to the member later on.

We are

working with the mental health evaluation community consultation group. They'll

be collecting

[ Page 2514 ]

data. We'll be basing our performance measures on their data.

MacPhail: Well, that's completely unacceptable. The minister completely

misleads the House that there's $404 million in the base for mental health —

completely misleads the House. Then he says: "Don't worry. It's there,

because the performance measures and targets will make sure that that money is

there and spent."

I want to

know the basis on which he's saying that. Here it is. The indicator is improved

continuity of care measured by the proportion of persons hospitalized for a

mental health diagnosis who receive community or physician follow-up within 30

days of discharge. Then it says that the target is a 3 percent increase — a 3

percent increase of what? That's what I'm asking.

Hon. G.

Cheema: I just want to correct the member's statement. This year we have

given part of our health care budget funding to the health authorities, and the

$404 million is there.

As for the

second part of her question, in terms of the baseline data, as soon as I have

the data, I'll be able to give it to her.

We are

going to be improving services in many ways. One way to improve the service is

to give specific indicators and performance measures and see how the system will

function.

[1555]

This is a

work in progress. This is important for mental health. We are, in fact,

protecting the funding for mental health by having special targets and specific

performance measures. Those will be based on the academic work and the data

which is going to be available to us. We are going to use that data, and we will

work with the health authorities.

This is a

very complex thing. Ultimately, we are accountable. We have to improve the

quality of life for patients. This will be done only if we can give a global

budget to the health authorities, give them guidelines and performance measures,

and those must be met. This time we are not giving them a special line for each

area of health care.

MacPhail: This is ridiculous. I'm looking for real numbers here. The

minister can't stand up and say things he can't support. Show me the $404

million. If the minister can't show it to me, stop saying it's there.

Here's what

it was in '01-02, the last budget before this government took over. It was still

there in the July 30 budget that the Finance minister really just retabled with

some accounting changes. Vote 33 showed a $405 million subvote for adult mental

health. The budget note with respect to that $405 million said: "Adult

mental health provides for the management and delivery of mental health services

to adults on both an outpatient basis and in tertiary psychiatric care, as well

as adult forensic psychiatric services. Government transfers are provided and

services delivered to or on behalf of individuals, corporations, community

groups and other organizations, including health authorities, the British

Columbia Mental Health Society and the Forensic Psychiatric Services

Commission."

Where's

that now?

Hon. G.

Cheema: If the member would read vote 31,

section (

f) clearly outlines some

of the things the health authorities will be doing. The adult mental health and

the mental health services are an integral part of those lines.

We will be

funding the health authorities with $5.976 billion, and mental health is a part

of that funding. I don't know how many times we need to do that. We have given,

for the first time, global funding for the health authorities. We don't think

it's right for us to micromanage the system. We are giving them guidelines and

performance measures, and those standards will be met. That will help the

patients.

MacPhail: The $404 million is nowhere to be found. The minister finally

admits it — finally. It's not there; it's gone. What it's replaced with is a

commitment for $125 million of expenditure on mental health and nothing else. In

fact, that expenditure of $125 million guarantees $18 million of expenditure

this year. That's the guarantee.

Then the

minister says: "Don't worry; the health authorities know they have to spend

that money, and it's the performance targets which we're going for."

I'm at the

first performance target, and the minister can't answer the question about what

the performance target means. He can't even answer the first one. Well, let's

get it all on record. Let's get it all on record about what the performance

targets really mean.

The next

one for mental health. The minister can't answer the first one. You see, the

reason why this is important is because there's no money to be found. The $404

million for mental health is gone — gone. How we're going to know whether the

health authorities are spending the money properly is to see whether they've

matched these targets. A target has to be based on a base, and on the first one

we don't have the base. In other words, it's a meaningless target. We don't know

where the money is, and we don't know what the target is.

[1600]

Let's look

at the next one, then. This is for mental health indicators — improved

availability of community services, measured by (1) percentage of days spent by

mental health patients in hospitals after the need for hospital care ended,

'02-03. Well, the minister's off the hook — no change this year. Isn't that

interesting? Then the next year: 2 percent reduction over the prior year. What's

the base?

Hon. G.

Cheema: We are looking for performance where there is improvement for mental

health care in this province. The second indicator is going to be in terms of

the availability of community services, by percentage of days spent by mental

health patients in hospital after the need for hospital care has ended. Each

[ Page 2515 ]

and every health authority will have those baselines and will look for the

improvement for next year. This year's baseline is going to be different for

each and every health authority.

[L. Mayencourt in the chair.]

Right now,

because we have put all the health authorities in the…. It's a new structure.

I don't have the baseline at this time. We are looking for a baseline from them

so that next year we can show improvement that will improve the quality of

mental health in this province.

MacPhail: We have evidence of what the health authorities are doing about

mental health. They're cutting it. They're cutting the programs. As we speak,

they're cutting mental health programs across the province. They can do that,

because no longer is there any targeted funding — $404 million gone, replaced

with an absolute pittance. The minister doesn't even have…. What did he think?

Did he think people would look at these performance measures and targets and not

ask these questions?

Let's look

at the next one. So far it's zero. So far I'm batting zero, absolute zero, for

getting any real — actually, any information; let's just be clear —

information from this minister. This self-righteous arrogance better come to a

stop on mental health, because so far the minister hasn't given one real

commitment to mental health.

Let's look

at this one: percentage of mental health clients receiving services in their own

region. Increase — that's the target. What's the base? What's the number that

we're dealing with, so we can understand whether there's been an increase?

Hon. G.

Cheema: As I said as part of my first answer on the performance outcomes, we

are working with the Mental Health Evaluation and Community Consultation Unit

through UBC. These new health authorities will have the baseline data. Once we

have the baseline data, which I will share with the member once we have it, we

are looking at the positive outcomes from that baseline. We have to have those

baselines, and we are working on those baselines.

I think the

member is missing a point here. We have given a global budget to the health

authorities. Part of the global budget is the mental health funding. Part of

that mental health funding is the performance indicators. Once we have the

baseline, we will be able to measure all of them.

[1605]

We are

looking for improvements. For this member to say that we are cutting mental

health…. That's absolutely not true. What's happening is that each health

authority has been given clear guidelines, and they will meet those standards.

Once those standards are met, there will be improvement.

There will

be reorganization. We're not saying there won't be reorganization; there will

be. If the system was functioning, why would we change it? Why was mental health

ignored in the past? We are not only funding over and above last year, which was

$404 million, we are also funding additional money as a part of the mental

health plan. What I want the public to understand is that the mental health plan

is a separate section. That's money we are funding for part of the commitment we

made during the campaign.

I think

there will be improvement. We shall simply wait for the numbers, and then I will

share them with the member.

MacPhail: Why does the minister keep repeating falsehoods? There is no

evidence to support his claim — zero. I've asked him over and over again for

the evidence to support his claim that his funding is over and above the $404

million.

The

Chair: Order. The Chair has granted the member great latitude in this, but I

would remind the member that she is coming very close to unparliamentary

language.

MacPhail: Thank you, Mr. Chair. I'll guide myself accordingly.

Why does

the minister keep making statements that he cannot prove, even after repeated

requests? Not only is there no proof that this minister is increasing funding

for mental health, there is no evidence — except for an announcement that this

year they're spending $18 million on mental health — that he's doing anything

in terms of spending money on mental health.

I'm trying

to get information from the performance indicators. It's got no information

there, so where do we have to turn? We have to turn to the health authorities,

so let's do that. Let's turn to the health authorities. What are they doing in

the area of mental health? Well, on the North Shore…. I saw the member for

West Vancouver–Garibaldi. He's gone now. Oh, there's the member for North

Vancouver–Seymour; he'll be interested in this. Maybe he'd like to stand up

and lob a nice, soft question to ask the Minister of State for Mental Health:

"Tell me, minister, is the money going to be there for my community?"

I'll just

give him the information on that: almost $2 million of mental health cuts for

the North Shore — that's not the whole region, just the North Shore. Here's

what their own document says: "Changes to the mental health services"

— i.e., the cuts — "noted above may result in an increase in the number

of admissions to the emergency department and acute psychiatry."

That's why

I'm very curious about these performance indicators. Here's what's going to

happen. Cuts to mental health are going to occur. This minister hasn't got any

baseline indicators in place yet, so the baseline indicator will be put in place

after the cuts to mental health have been made. Then he'll claim victory when

the cuts become restored a tiny bit, if at all. That's exactly what's going to

happen, because here it is: the very indicator that he's supposed to be

monitoring is

[ Page 2516 ]

already predicted to increase. The baseline will increase because of cuts to

mental health.

"At

present, the North Shore has the lowest recidivism rate in the province because

of the treatment and support provided in the community." Oh. "Every

psychotic episode requiring an admission for a schizophrenic permanently reduces

their cognitive capacity. Aside from the permanent damage to the individual,

this increases the cost of care in the community and future hospital

admissions."

Is that me

saying that? No, it's the health authority themselves analyzing what their

mental health cuts will do.

[1610]

I seek

leave to make an introduction while we're waiting for the answer.

Leave

granted.

Introductions by Members

MacPhail: We're joined today in the gallery by a young woman who is close to

a person I work with. I am delighted that she's here. Claire Theaker-Brown is up

in the gallery watching the proceedings. Would the House please make her very

welcome.

Debate Continued

Hon. G.

Cheema: We will have the data. The baseline information is going to be

there. It's being prepared by the Mental Health Evaluation and Community

Consultation Unit. It's an academic group. They work out at UBC. It's well

renowned. I think they do a great job. Once I have those numbers, I will share

them with the member. I wanted to correct that information.

Secondly,

about the issue she has raised about the leaked documents. Some of them are

working documents. They are in discussion with their own groups. They are

looking at all the options. We have given them clear goals and clear guidelines.

Once they make their decision, they'll come back to us, and then we'll be able

to see how we will be serving the patients.

I just want

to emphasize again, here, that we are not going to micromanage the system. We

are there to help our patients. We are going to ensure that we have community

placements there. We want to ensure that we have respite care. We want to ensure

that we have emergency care beds available.

What the

member is saying…. Those are real concerns. I share those concerns. Everybody

else shares those concerns, but those are not real things happening at this

time. These are working documents. Once the information comes, I am sure the

member will get a leaked document again, and she will be able to share with us.

We'll be able to share with our….

MacPhail: Again, how ridiculous. These documents, while leaked because the

government doesn't have the guts to admit its agenda, are not denied by the

Vancouver coastal health authority. They're not denied, so stop it. Stop it.

These are real documents. These are real cuts that are coming.

Let me ask

this. The next target is the percentage of mental health clients receiving

services in their own region. The target this year is to increase. Increase from

what base?

Hon. G.

Cheema: As I have told this member repeatedly, I will have the information,

and then I will share with her. We are working on the basic information. These

are new health authorities. There are five of them. We have to work with the

provincial health authorities to have the numbers and collect the data and be

careful with our baseline numbers. Once we have those numbers, I will share with

her.

MacPhail: Why doesn't the minister say to the health authorities: "Stop

making mental health program cuts until we have the numbers in place upon which

we can judge them"? Why doesn't he do that right now? Why doesn't the

minister say to the health authorities that we're not ready to have them take

over the funding for mental health services because we don't have our

performance targets in place? In the meantime, don't make any cuts to mental

health programs. Why doesn't the minister, if he's truly the advocate for mental

health, do that?

[H. Long in the chair.]

Hon. G.

Cheema: I will repeat my answer again. We have the data, but I don't have

the information with me at this time. As soon as I have the information

available, I'll be able to share it with her. The same information is going to

be shared with the health authorities. We are working on a very complex set of

goals, and they are not that simple. We are trying to improve on mental health,

and we want to be very careful.

[1615]

This is a

work in progress. It's not something where I can stand up and say today that we

have worked out everything at this time. We are working very hard to ensure we

have the data, the correct information. Whenever I give her information, she

should have some comfort that we will be monitoring from that baseline data so

that we can see improvement as a part of our performance measures.

MacPhail: I'll repeat my question. Why doesn't the Minister of State for

Mental Health say to the health authorities: "We the government don't have

our performance indicators ready yet; we're not ready to allow the health

authorities to make cuts to mental health programs, so don't do it until we have

our mental health performance indicators in place"? He's the advocate for

mental health. That's what he was assigned to do. Why doesn't he stand up and

say no to any mental health cuts?

Hon. G.

Cheema: As I told the member already, we do have the information, but at

this time I personally

[ Page 2517 ]

don't have it available right now. The health authorities would have that

information, and they are going to make the best use of the taxpayer dollars to

meet the needs of the patients. They will be guided by these performance

outcomes.

MacPhail: I'm sorry. The minister is saying the health authorities do have

this information. Is that what he said?

Hon. G.

Cheema: Mr. Chairperson, I am told by staff that the health authorities do

have the baseline data.

MacPhail: Well, I'm at a loss here. The minister is, to date — because we

don't have any of this information — making things up, as far as I can tell. I

can't find the $404 million; it's disappeared from mental health. Every single

year under the previous government one could document the increase, from '97 to

2001 — the increase in adult mental health by $108 million. The only basis I

have to judge the accuracy of this minister's statement is to refer to these

performance measures and targets. How can anyone make an informed decision in

this House on whether to pass this vote? How can we possibly proceed?

Secondly,

let me just add this. I have to say, Mr. Chair, that it's ridiculous to even

continue these estimates. It's ridiculous without this information. The minister

has no information on anything. In the meantime, if the health authorities do

have the information on these targets, they're going ahead and making cuts to

mental health programs.

[1620]

They must

be in complete violation of the performance targets, because here's some other

cuts that the Vancouver coastal health authority is…. These cuts are real. I

met with mental health advocates on the weekend, and these cuts in the Vancouver

coastal health authority are real. The Vancouver coastal health authority is

closing 67 residential mental health care beds. How are we going to know? Is

that the base from which we'll operate to judge whether people are receiving

services in their own region? It's real; it's happening.

Maybe the

member for North Vancouver–Seymour would be interested in this. On the North

Shore they're discontinuing any mental health community supports and contracts

that don't provide housing. If you have a person with a mental illness in his or

her own home, it's gone — no support. "Discontinue the contract for

clubhouse programs." Oh, gee, I guess they weren't very useful.

"Discontinue contracts for outreach workers." How will we possibly

know, then…? What target will we be basing on the proportion of mental health

clients accessing community services? Will that target be after these cuts are

put in place?

Mr. Chair,

I have to tell you, because this minister has taken such an extremely arrogant

approach — that he's the mental health advocate, that he's going to do things

better…. Every single question asked and not answered puts the lie to that.

There is no ability for me to have any grounds to vote in favour of this vote.

The answers are not there, and, frankly, it makes any further statement from

this minister that he's the defender of mental health ridiculous — absolutely

ridiculous. The community knows that; people who have mental illnesses in this

province know that. It's time for the minister to either do his job and give the

answers or admit that this government has no commitment to mental health.

Hon. G.

Cheema: As I said from the beginning, we made a commitment during the

campaign, and we have fulfilled our commitment. We said there would be funding

in the mental health plan, and we have done that. Not only are we funding the

mental health plan, but we are also funding the capital funding for the

facilities across this province. We are also spending the money on mental health

as a part of our global budget. We have given the health authorities clear

guidelines. Those guidelines are very clear. The baseline data will be shared

with the member once it's available.

I must tell

this member that we are doing a lot more than the mental health plan itself.

While she has outlined some of her fears and some of the information from the

leaked documents, these are working documents. We are dealing with a new way of

delivery of mental health in this province. We are dealing with the delivery,

and where the institutional model has not worked in the past, we will be dealing

with a new model — a model of a continuum of services from acute care to the

community level. Some patients will always need acute care, and acute care is

going to be provided. Some patients will always need chronic care, and that will

be provided. Some patients will require community-based funding, and that will

be provided. That's part of our one plan.

The other

thing we will be doing is having a depression strategy in this province. We'll

be dealing with anxiety disorders in the province. We'll also be dealing with a

youth and child mental health plan in this province. Once all these things are

functioning, the mental health system will improve. We are starting from a

baseline. We don't want to practise the way it has been practised in the past.

We have to move away from the institutional model. A number of initiatives are

being done in this province.

[1625]

I'm working

with the other three ministers and various other ministers in this government to

ensure that the mental health issues are addressed across various ministries. We

have done a number of things. As the Minister of State for Mental Health, I have

met with the Minister of Human Resources. I have addressed with him the issues

of disability for patients suffering from mental illness. I have met with the

Minister of Education to discuss some of the issues which are important for

patients with a mental illness. I have met with other ministers to deal with

some of the important issues.

[ Page 2518 ]

To say to

us as a government that we are not committed is far, far from the truth. This

member does have a strange relationship with the truth.

The

Chair: Minister, that's unparliamentary. Will you withdraw it.

Hon. G.

Cheema: I will withdraw that.

The

Chair: Thank you.

Hon. G.

Cheema: Our numbers are very clear. As part of the global budget, we have

given….

Interjection.

Hon. G.

Cheema: The numbers are clear. The budget is there. The performance

indicators are there. The baseline data is going to be there. Service will be

improved.

If this

member thinks we should be doing the same thing they were doing in the last ten

years, we are not going to do the same thing. We have to move towards a model

which is compassionate and caring. We have to move patients away from

institutions. Part of our mental health plan is the redevelopment of Riverview

Hospital as well. Unlike the previous administration, we are not going to

release any patient without a community placement. As of June 5 last year, not a

single patient has been released without a community placement. That's our

commitment. That's the way we are delivering mental health in this province.

We are not

going to judge the health authorities. The health authorities have been given a

very difficult task: to manage health care in this province. Mental health is an

important part of health care. It's part of the $10.4 billion — $1.3 billion

more than last year. That's not a cut in health services; that's an increase in

health services. Mental health is an important part of our whole health care

agenda. Our government is committed.

If this

member wants to know their record on mental health, she should simply call the

B.C. Mental Health Monitoring Coalition, which includes the Canadian Mental

Health Association. The Anxiety Disorders Association is part of that. Last year

and the year before that, before we came into power, they gave a failing grade

to that administration. They had one slogan: "Promises made; promises

broken." That was the NDP. We made the promise; we are fulfilling that

promise. Our promise is to make sure that patients will get the care and respect

they deserve.

I was in

the Kootenays for the last two days. If you ask the front-line workers, social

workers and health care managers, they will tell you we are moving in a

reasonable way. We are not raising expectations to a great extent. Mental health

is not something which is going to improve over a period of a day or two or a

month. This will take some time. We want to make sure that when we move along,

we have improvement in mental health in this province.

Every part

of the health sector is working with us. In my opening statement I asked this

member to work with us, to help us, so that we can improve the mental health in

this province. It's not only people in this community who are looking towards

us. In other parts they are also watching us. We are working with professionals,

community groups, family associations and health care associations in this

province. Most of the organizations in this province are supporting our plan.

That is the good news. For the last ten months I have met with almost every

possible organization. Our policy is that we'll meet with anybody who wants to

improve the mental health in this province.

Our staff

have worked very hard. For the first time there are performance measures and

indicators and special guidelines. This three-year plan is a work in progress.

We will improve on this plan. We'll see next year how this is going to be

functioning.

[1630]

There are

three ways of ensuring that this will function. First, the health authorities

will be reporting on performance measures. Each year, each June, I'll also be

reporting on some of the indicators to the public to ensure that they

understand.

Mental

health is not that simple. It's not so simple that you can come and that

overnight you can improve. We are taking smaller steps; we are taking firm

steps. Those steps are important.

Nobody has

a monopoly on mental health. I said in my remarks that this member had…. They

had good intentions, but they were never able to implement those intentions. If

I want to read their record into Hansard , it will take a long, long time,

but I didn't come here…. I didn't want to get into this mode, but I cannot

listen to that member and not put things on the record and correct some of the

mistakes of the past. This is the way they have done that.

Interjection.

The

Chair: Order. Order.

Hon. G.

Cheema: Mr. Chairman, I gave her all the opportunities to ask questions. I

gave her the opportunity to say whatever she has to say. It's my turn. It's our

turn.

We have not

given anybody wrong indication. We have told them clearly how we are moving

towards a community-based health care system in this province.

This is the

way to deliver mental health. We tell everybody this. Mental health is not a

personal failure, it's not a failure of the family, and it's not a failure of

the community. But ultimately, it's a failure of the government if we don't

deliver.

We made a

promise. We are fulfilling that promise. Look at what we have done over the

period of the last ten months. Not a single member from our caucus has not been

involved. They're all actively involved. We have participated with most of them.

We read the

news. We read a lot of stuff, but our responsibility is to have the clear

indicators and per-

[ Page 2519 ]

formance outcomes and to ensure that those outcomes are met so that we can

achieve the quality of life for patients in this province.

It's too

bad. They had the opportunity. They didn't do it. I wish they had done it so

that we could have learned from their mistakes.

We are

starting from a very base level. A base level is to have effective community

care. Mr. Chairman, you understand from your community that sometimes patients

were left without a community placement. For the first time there will be

outcomes and performance indicators, and those must be met. That's what we are

moving towards, those goals.

I want to

assure this member that she will have a lot of opportunity to ask questions.

Measure us on performance. We are starting from a baseline. Next year she'll be

able to ask more questions on how we have done during this year. I would simply

request her to cooperate and work with us. If there are mistakes, we'll be able

fix those mistakes.

MacPhail: This is one of the most ineffective members of this overblown

executive council I've ever seen. He….

Interjection.

MacPhail: Oh, sorry. There's another one.

[1635]

This

minister doesn't have a clue what his mental health plan is. He can't answer

where the money is. He can't answer what the performance targets are. He has no

plan. He stands up and rants in a rambling way so that nobody has any idea what

he's talking about. He can't give any answers. It's unbelievable.

However,

it's not that dissimilar to the rest of the health care system and the health

promises that this government has made. They say one thing when they're in

opposition, and they do another thing or do nothing — do nothing — when

they're in government. It's consistent across the board with this government.

The fact that this minister responsible for mental health can't even answer some

basic questions about where the money is and what the performance indicators are

proves that they have not a clue and have no money for mental health — none.

But that's just a minor flip-flop.

conclusion, Mr. Chair, let me just give you one example of how this government

doesn't have a clue about what it's doing about health. Let's just talk about

how they're going to deliver health care services. Here's what was said on

November 28, 2000, about the issue of private clinics: "Our job is to make

private clinics redundant. I want to get the public system back, firing on all

cylinders, so that they become redundant." Another quote: "We want to

make private clinics redundant. We want to make the public sector system work

for patients." November 28, 2000. Who said that? The now Premier of the

province. April 3, 2002: "What's the government doing about private

clinics? The Health minister said he's trying to come up with a public policy

framework to guide the operation of private clinics." That was then; this

is now.

It's

exactly the same with the mental health plan. That was then; this is now.

Money's gone. No indicators are in place — absolutely no proof anywhere that

this minister can come up with what, if any, money he's spending on mental

health. And I have no ability to debate — none whatsoever. Without being able

to understand the numbers behind the performance targets, the performance

targets are absolutely meaningless. I don't know how anybody in this House can

make an informed vote on the Ministry of Health Services, Mr. Chair.

The

Chair: Shall vote 31 pass?

Member for

Oak Bay–Gordon Head.

Chong: I just have a couple of questions I'd like to ask the Minister of

State for Mental Health.

I've been

listening to the dialogue, the exchange between the Leader of the Opposition and

the Minister of State for Mental Health. It's regrettable because it appears she

hasn't been able to get the answers that she wants. Part of the problem is that

she hasn't been able to take a look at the government restructuring that's been

taking place, especially in the way that this government is trying to save

health care from the unsustainable path that it was on.

I do

understand that in my area, particularly in the Vancouver Island health

authority region, there has to be some work done with a new board to work with

our ministry as well to continue to develop performance measures and outcomes

that are expected so that we can evaluate and measure them this time next year.

I realize

the complexity of the issue of mental health, and I appreciate the fact that we

do have a Minister of State for Mental Health to get us to that level of

understanding and to make the system work better.

I don't

have a specific facility in my riding, Mr. Chair, but there is a facility that

borders my riding. I was able to attend this particular facility when I was a

member of the opposition. I recall that at the time, they were very excited

about having this new facility start up. I believe that they're still developing

it. The fact that it is taking some time to be developed shows that mental

health is a very complex issue.

The

facility I speak of is the Seven Oaks facility in the Blenkinsop Valley. Part of

that riding is adjacent to my riding. I know that the member from Saanich South

is familiar with it as well. I'm wondering if the minister can advise how this

kind of facility is being advanced or promoted within the new changes that he's

intending for the area of mental health.

[1640]

Hon. G.

Cheema: Part of our mental health plan is the redevelopment of the Riverview

Hospital. When some of the beds will be transferred to the various parts of this

province, Seven Oaks in Victoria is one of the facilities. This facility will be

fully operational in

[ Page 2520 ]

August 2002. There were 12 clients temporarily displaced, and they've been

moved back in.

These are

very special facilities. These are prototypes for respect and for compassionate

care. The idea behind this facility is to bring patients back to their

communities so that they can stay close to their families. As the member would

know, there are some patients who may never be able to fully function

independently, so we are trying to make sure they get care close to their

community.

This is one

good example, and I think this is the way the questions and answers are

important: to get some information so that we can improve the quality of life.

I'm glad the member is asking a specific question which is going to have an

impact in her community.

Chong: I appreciate the minister's response to that. As I say, I visited the

facility on the evening they were talking about the hopeful opening of Seven

Oaks. I met with some parents at that time who had an adult child — I

shouldn't call an adult a child; that's an oxymoron — in their family who had

been over in the Riverview institution. They were concerned that as they were

fast approaching the age where their travel was being complicated by their

physical impairments, they couldn't visit their child as often. Knowing that the

child would be closer to home was much more satisfying to them.

I do

want to talk about the mental health plan, the so-called $125 million initiative

that I know the Leader of the Opposition seemed to think their government had

funded. I know that very shortly after its announcement, we were able to see,

when we were in opposition, that it had not been set aside. The initiative was

certainly laudable. The goals were certainly ones that we would have shared.

However, like so many things when funding isn't in place, you begin to wonder

whether there is going to be any movement in that area.

Our

government, as I understand it, has gotten approval through the budgetary

process, through Treasury Board, that $125 million would be funded for the

mental health plan. I'm wondering if the minister of state is able to share with

us how that funding will be rolled out over the course of the next six years.

Maybe more specifically, for my area of the Vancouver Island health authority

— I realize it includes the entire Island — I wonder if he can share with me

how we might participate in that kind of funding allocation.

Hon. G.

Cheema: As we have announced already, we will be funding the $125 million

mental health plan. This plan will only deal with chronic and persistent mental

illness. This plan was announced in 1998, and it was only funded for $10

million. This year it will be funding a total of $17.8 million more as part of

the mental health plan.

The

Vancouver Island authority will be getting close to $6.474 million this year as

a part of the mental health plan funding. That will give opportunities for

patients to have day hospitals, evening hospitals, community-based care, respite

care and also some beds in the community for crisis intervention. This funding

will also provide some money for the physicians who will be providing mental

health services in the community.

Chong: There's no question that the $125 million has to be allocated and

rolled out or completed over the next number of years because a plan has to be

in place to ensure that we adapt to the changes of those with mental challenges

and mental illnesses. I'm not trying to commit future governments, but my

concern is: what happens after the mental health plan initiative — the $125

million? I think that also has to be considered.

[1645]

As we move

along, we talk about sustainability of programs or services to be delivered.

With people with mental illnesses and mental health concerns, it's not something

that is fixed and then tomorrow you're healed, and you go on, carrying on in a

different manner.

Mental

illness can last a lifetime and may need supports over a lifetime. I think it's

important to know what plans, even beyond three or four years, the minister of

state may be working on to have in place something that future governments would

be able to carry on — a sustainable mental health plan that will last well

into the future. Can the minister share with us whether he's working on a plan

of that nature?

Hon. G.

Cheema: Part of the mental health plan is also to have facilities across

this province. We'll be spending an additional $138 million on that.

This member

has a real concern about what will happen after this money is all spent and what

will happen to those patients. That's why we are looking at best practices.

We're looking at how we can continue to provide the best possible care. We're

moving away from the institutional model. That model is very effective. You have

to have acute care, you have to have chronic care, and you need the

rehabilitation care.

Our main

focus is with the patients and the families. As we go along, we'll be able to

continue to monitor what we are doing and continue to learn from our own ideas

so we can improve. The basic concern there is whether we'll have the funding in

the long run. The answer is yes.

I think

it's important to continue to give assurance in real dollars and in real terms.

That's what I was trying to explain to the member from the NDP. We are funding

mental health as a part of the global funding and also as part of the mental

health plan.

Money is

spent through various resources. We have given indicators, and those performance

indicators are important. As we go along, those will become a part of the mental

health culture. I think we are looking towards a cultural shift and better

understanding. Once you improve the understanding and you have structures put in

place, patients' needs are met. The public will demand those things, and they'll

be there. I think

[ Page 2521 ]

that's up to us, during these four years, to ensure that we are doing what we

said so that we can give confidence to the patients and to the families.

I think the

member is right. What's going to happen after four years' time? I think we have

to see as we move along. There is one assurance we can give: this government is

serious, and we are spending money. We are also looking at various options.

I just want

to explain to this member that mental health is not about acute care beds only.

Mental health is not only about a physician and a patient. Mental health is more

than that. There are so many health care providers who can provide the mental

health care, starting from mental health workers to the nurses, social workers,

physicians and psychiatrists. I think those things are important.

Families

are also an important part of the mental health care system. Part of our mental

health plan is to provide respite care for the families. We have those families

who have loved ones with mental health problems. They can be taken care of in

the community. We are looking at those things at this time.

There are a

number of other initiatives we'll be launching soon. One of them is a provincial

initiative for depression and anxiety. Another issue that is very important, and

about which the member has expressed her concern to me a number of times, is

about the public information and education campaign. We have to ensure that the

public has the understanding about mental health issues. Right now there is a

lack of understanding, and because of that the issues for mental health have not

been addressed in the past.

The

statistics are very clear. One in four British Columbians will have mental

illness during their lifetime. No family is immune from mental illness. Mental

illness affects people of every culture, race, gender and socioeconomic status.

[1650]

We'll be

looking at a meaningful public information campaign that will deal with the real

issue of stigma and discrimination. Once we've worked on all these projects, I

think that will help the patients.

The other

issue which is of concern to us as a government is the role of advocacy. We

value a lot of work which is being done by various organizations. We fund up to

$2.1 million for various organizations in this province. They are having

individual advocacy for the patients and their interests.

My role is

for broad changes and to work across various ministries to ensure that what the

member has said, and the other members have told me privately and publicly….

We must ensure that in the long run the mental health funding is there, so we

can continue to provide the best possible care.

Recently,

last October, there was a report released from the world mental health

organization. If you look at that report, there are ten basic things they want

the world to do, and we are already doing most of them. I think we are moving

along with the rest of the world. We have to take small steps but firm steps.

Mental

health is so complex. It's not that simple that you can come for 45 minutes and

scream and shout and move away from the House. It's not going to solve anything.

We are working with the patients. We are working with the families. I'm working

with my caucus colleagues. We are working through various organizations to

ensure that there are services.

The only

way to ensure that services are there is if you have performance indicators and

you can be responsible. By these indicators, you'll be responsible, you'll be

accountable, and you'll be innovative. We are asking health authorities to be

innovative. We are giving them a set of funding. They're under a lot of

pressure, because they have to meet so many goals. This is a tough job for them,

but it's our responsibility to ensure that they deliver those services.

Chong: There's just one final area on mental health that I'd like to leave

with the minister. I had written to him last December. I realize it's something

that his ministry is probably still looking at.

had written to provide information on a mental health program offered at that

time by the CHR, the capital health region — now reclassed as the Vancouver

Island health authority — which provided quality preventative services that

were more than welcomed by the clients and were provided at a relatively low

cost. Home support workers were involved. The program was such that the CHR

would contract to an agency who would then hire home support workers to provide

on-site services to mental health clients living in single-room-occupancy —

SRO — buildings.

When

I was in opposition, I recall attending at one of these buildings in the

Victoria area. There were many people there who had mental challenges and mental

illnesses. I saw that these home support workers offered a very caring approach

and were there to help in the monitoring of their medications, monitoring of

their behavioral changes and generally to provide support to a whole range of

mental health clients.

In some

cases, because of the interventions of the home support workers and because of

their communication with the authorities they had to report to, those clients

were provided with certain supports and assistance they otherwise would not have

had. In this way it helped them to stay out of hospital, which reduced costs. In

some cases, it helped them stay out of jail. As we all know, sometimes people

misinterpret those who are mentally challenged, and they end up in the wrong

place, whether it be in hospital or in jail.

I just

wanted to remind the minister of the letter that I had written him, and I hope

that his staff will have an opportunity to review it. I bring it up in the

context of…. In looking at mental health, there are options and different ways

of delivering services that I hope this new minister of state will consider,

just as the Minister of State for Intermediate and Long Term Care is looking at

different ways of providing long-term and intermediate care to people — not

all being in institutions or facilities and providing different mechanisms,

[ Page 2522 ]

different facilities or just different placements for people.

[1655]

So, too,

with