1998/99 Legislative Session: 3rd Session, 36th Parliament

HANSARD

The following electronic version is for informational purposes only.

The printed version remains the official version.

Official Report of

DEBATES OF THE LEGISLATIVE ASSEMBLY

(Hansard)

WEDNESDAY, JULY 7, 1999

Afternoon

Volume 16, Number 19

[ Page 14167 ]

The House met at 2:07 p.m.

Prayers.

G. Janssen: Joining us today is June Payne, a nurse and health administrator

from London, Ontario. With her is her daughter Judy Payne, a legal adviser in the Ministry

of Finance in Victoria.

W. Hartley: I'm pleased to introduce two people that I met with this morning

from Delta Cedar Products, which is the largest value-added remanufacturer on the coast of

B.C. As part of their growth in the last seven years, they have doubled their workforce

and created a new mill, Halo Sawmill, in Pitt Meadows. They are Glen Franke, the

comptroller, and Rowland Price. Would members make them welcome.

[1410]

Hon. C. McGregor: I would ask the House to indulge some introductions in

acknowledging some special guests we had in the House with us yesterday. I understand they

visited MLAs on both sides of the House, and they brought with them a special token to

acknowledge the importance of the Vancouver Island marmot and the marmot recovery efforts

that we're engaged in in the province of British Columbia. I hope that everyone is

enjoying their marmot friends and that they will use them as an opportunity to promote the

very worthwhile project that the Marmot Recovery Foundation has been promoting in building

a captive breeding facility.

Hon. Speaker, if I could acknowledge the young people who were here yesterday . .

. .

The Speaker: Yes, proceed.

Hon. C. McGregor: I'd like to acknowledge Alison Ludgate, Becky Haegart, Jasmine

Chiang, Vanessa Nation, Roslyn Howell, Kate Partridge, Gillian Dixon, Matthew Nation,

Michael Lee Gresham, Morgana Gresham, David Ludgate, Robin Tilby, Miranda Calderwood,

Lauralyn Calderwood and Alexandra Skey -- students from Glenlyon-Norfolk School -- and

Carol Ludgate, Laurie Nation, Chris Nation, Mary Tilby, Colleen Calderwood, Debbie Howell

and Charles Peacock -- the parents that accompanied them.

Hon. J. MacPhail: I'd like to actually pay tribute to what are becoming the

thinning ranks of the press gallery -- and I'm not referring to their hairlines in this

case. Today is a special day for a member of the press gallery. It's the forty-fourth

birthday of Scott Sutherland. I would say that even though he is attempting to grow a

beard, we should probably wait until his forty-fifth birthday to judge it. Happy birthday.

J. Weisgerber: In the gallery today are three gentlemen: Merrick Andlinger,

president, and Irshad Ahmed, vice-president, of Pure Energy Corp. in New York, joined by

Bill Vanderland from Nanaimo. They're here promoting clean-burning ethanol and meeting

with government officials. Please welcome them.

J. Sawicki: I would like to introduce three special guests. The first two are

Coro Strandberg and Blaise Salmon. Coro is currently the chair of VanCity and was

nominated Woman of the Year. More importantly, she is one of my constituents and one of my

dearest friends. Blaise Salmon is a financial planner, and he's a volunteer president of

Results, which is an international organization working to end world hunger. But it's the

third guest, their new daughter Mireta, that's the focus of this introduction. She's three

weeks old, and she's already had a picture taken with her MLA and with the Premier. Would

the House please make them all welcome.

P. Calendino: I've just been informed that there are two constituents of mine in

the gallery. They are students who reside in Burnaby but probably go to school here in

Victoria. They are James Blasina and Steven Gibson, and I would ask everybody to make them

welcome.

[1415]

Oral Questions

VANCOUVER TRADE AND

CONVENTION CENTRE PROJECT

G. Campbell: On June 21 the Minister of Employment and Investment informed us

during his estimates that the total cost of the convention centre project was going to be

$810 million. He was then contradicted by the Premier, who now says that it's going to be

$900 million. On Monday the Minister of Employment and Investment told us all that there

was a $300 million cap on the provincial contribution to the convention centre project.

Within 24 hours the minister was contradicted by the Premier, who said that there was

going to be a $530 million cap.

My question to the Minister of Employment and Investment is: when the government can't

get its own story straight, is it any wonder that nobody trusts them and that no one wants

to do business with British Columbia's government?

Hon. M. Farnworth: There are a number of issues. One, we have been in

negotiations to ensure that we can get the best deal on the trade and convention centre

project for the taxpayers of British Columbia. This is a project that is composed of a

public part, around a convention centre, and a private part, around a hotel. Now, the

costs have changed somewhat on the hotel, and the question is whether or not the province

should be picking up some of the costs associated with the hotel.

An Hon. Member: What do you think?

Hon. M. Farnworth: I'll tell you what I think, hon. member, and it's the same

thing this government does: there is no blank cheque. We are not going to be paying for

costs that are legitimately the costs of the hotel or of Greystone. That's what we're

saying.

The Speaker: Minister, conclude your remarks, please.

Hon. M. Farnworth: Our negotiating team is negotiating hard on behalf of the

interests of the taxpayers of British Columbia.

The Speaker: First supplementary, the Leader of the Official Opposition.

G. Campbell: The staggering incompetence of this minister is shown by that

answer. On Monday the minister said that

[ Page 14168 ]

there'd be a $300 million cap; the Premier came in and said: "No, it's $530

million." This Premier undercut our negotiating stance from the word go when he said

that the province would go it alone. He undercut it with the federal government, and he

undercuts that every time he undermines this minister. Every time he contradicts this

minister, the province's position is weakened. How can this minister stay in a cabinet

with this Premier when he is undercut day after day after day?

Hon. M. Farnworth: Well, this is the same leader that's undercutting his

colleagues day after day after day on their side of the House.

The issue around the province's contribution to the . . . .

Interjection.

Hon. M. Farnworth: Well, you've never had a good line, hon. member.

The Speaker: Members, members.

Hon. M. Farnworth: The province's contribution to the convention centre project

is based on a number of issues. One is the agreement that's negotiated at the table.

Second -- and my comments on Monday relate directly to it -- is whether or not the federal

government participates in the project. We have been negotiating with the federal

government. We would like to see them contribute $170 million to the project. The

question, at the end of the day, becomes: if they are not there, then do we cancel the

project because they're not participating, or do we recognize the significant benefits to

the province of British Columbia and make some decisions about whether or not we should

proceed?

The Speaker: Minister, thank you.

Hon. M. Farnworth: The fact of the matter is that we are negotiating an

agreement that is in the best interests of the people of the province of British Columbia.

The Speaker: Second supplementary, the Leader of the Official Opposition.

G. Campbell: This minister clearly doesn't get it: this Premier is destroying

the province. Does this minister have the gumption to stand up to the Premier? Is there

anyone on that side of the House who will tell the Premier that it's time for him to go,

so we can get on with building the province again?

Hon. M. Farnworth: This government is negotiating an agreement on the trade and

convention centre that's in the best interests of the taxpayers of British Columbia. This

government is saying that there is no blank cheque. The question that the Leader of the

Opposition should answer is the one that he failed to answer yesterday, when he was asked

how much he would contribute to the project. How much does he believe the taxpayers of

British Columbia should be contributing to the trade and convention centre project? He had

no answer, just like on most other things.

G. Farrell-Collins: If the government has the guts to call an election, we'll

start a business plan in 28 days, and we'll build the thing.

The fact of the matter is that the government isn't negotiating . . .

Interjections.

The Speaker: Members, order, please. Order in the chamber.

G. Farrell-Collins: . . . with its partners; they're negotiating

with each other, and they're doing it in public.

Interjections.

The Speaker: Order in the chamber.

[1420]

G. Farrell-Collins: On Monday the minister responsible said there is a July 31

construction deadline. The next day, less than 24 hours later, the Premier said there is

no such deadline. Can the Premier or the minister responsible tell us which it is? Is

there or is there not a deadline? How much money is the cap? Is there a cap? Do either of

them know what the other is thinking at any time? Would they like to put their seats

together so that they can discuss it before they get up and answer the question? Is there

or is there not a July 31 deadline for construction?

Hon. M. Farnworth: We have been working towards a July 31 start date, at which

point we would receive the environmental permits which would allow us to start to do the

work required in the water. This would involve environmental mitigation, habitat

replacement and starting to do the work around the pilings. Plus, it would start us in

proceeding further down the road to when the physical construction of the plant actually

takes place. As a result of the actions that took place in the negotiations this morning

between our negotiating team and those of Greystone and Marriott -- when additional

demands were placed on the table which impact on the project -- we have said that we will

not proceed with the project while there is not an agreement in place that's in the best

interests of the taxpayers of British Columbia.

The Speaker: First supplementary, the member for Vancouver-Little Mountain.

G. Farrell-Collins: There has been no agreement all along. There has been no

business plan; there has been no arrangement. There has been a nice theory and idea inside

the Premier's head that occasionally he shares with the minister responsible. Can the

minister responsible tell us: why is it that the people they're dealing with -- the people

of Marriott and the people of Greystone -- came out of a meeting today and said that they

don't know from minute to minute what the story is? They hear one thing from the

minister's staff and his negotiating team and something else from the Premier's Office.

Can the minister tell us how anybody in the world is going to invest and develop projects

in British Columbia when the minister and the Premier can't get their act together?

Hon. M. Farnworth: We've made it clear that this government is committed to the

trade and convention centre project. It has our full support. We have a negotiating team

in place that is negotiating hard for the province of British

[ Page 14169 ]

Columbia. The complaints that I heard this morning from the other parties were:

"Oh, the province is trying to unload costs on us." In other words, we're not

there with a blank cheque giving away the farm. We're negotiating hard, as we should be.

We are not going to apologize for negotiating hard in the interests of the people of

British Columbia.

G. Plant: In the last 48 hours, the Premier and the Minister of Employment and

Investment have outdone themselves in their race to disagree with each other and to raise

the stakes of failure on the convention centre development. First it's $810 million; then

it's $900 million. First it's $300 million; then it's $530 million. It's been nine minutes

since the start of question period. Perhaps the Minister of Employment and Investment has

yet another set of figures for this NDP-made disaster. Let's get a progress report. What's

the total cost now? What's the total cap on provincial expenditure now? Is the province

still saying that it will build the thing all by itself?

Hon. M. Farnworth: The province is committed to this project, and we want to see

it go ahead. The business community wants to see this project go ahead; the people of

British Columbia want to see this project go ahead. But it will not go ahead unless there

is an agreement in place that represents the best interests of the taxpayers of British

Columbia. Our negotiating team has said that the demands placed on the table today have an

impact on the project. We're going to take time to consider what those demands and impacts

are, and then we will respond. But we will not enter into an agreement that is not in the

best interests of the taxpayers of British Columbia.

We want to see the project go ahead. As I said earlier, hon. Speaker, where is the

opposition? How much money do they think the province should be committing to the project?

You know what? When they were asked the question yesterday, they couldn't answer it.

The Speaker: First supplementary, the member for Richmond-Steveston.

G. Plant: Project after project, year after year, this government has sold the

taxpayers of British Columbia down the river, and it hasn't protected them once. No

government has less credibility when it talks about blank cheques than this government.

Only an NDP government would spend $54 million -- and counting -- on a project that

doesn't even have a business plan. Will the Minister of Employment and Investment stand up

and admit that his project is a complete and utter disgrace -- that's all it is, and

that's all it will continue to be?

[1425]

Hon. M. Farnworth: I suggest the member should in fact talk to Greystone and

Marriott, because they are saying that they want to make the project work. The government

is saying that we want to make the project work. But we are going to negotiate hard for

the taxpayers of British Columbia, and we are going to ensure that we get the best deal

possible and that the project will not go ahead until there's an agreement in place that

represents that. The member likes to talk about the business plan. Well, there is a

business plan in place, and we've been negotiating hard.

Some Hon. Members: Where is it?

Hon. M. Farnworth: What we've said is that when the agreement is complete, we

will release the documents. We are in negotiations right now. We have been in negotiations

to achieve a deal. But as I keep repeating, there were demands placed on the table today

that have a significant impact on the project. We are not going to proceed with the

project if those demands impact on the taxpayers of British Columbia in a negative way. We

have a competent, tough negotiating team, and they're doing their best on behalf of the

taxpayers of British Columbia.

SEX OFFENDER REGISTRY AND GUN REGISTRY

J. Weisgerber: My question is for the Attorney General. On Monday a judge released

a known sexual predator who had breached every condition of his bail. Yesterday a judge

released a Washington man who smuggled a gun into Canada, put it to his wife's chest and

pulled the trigger. They let him off with a slap on the wrist. What plans does the

Attorney General have to introduce some common sense into our judicial system?

Hon. U. Dosanjh: With respect to the first case that the hon. member is speaking

about, I haven't the particulars. I'll try and get those and respond to the hon. member.

With respect to the second case that the hon. member raises, the Crown will be

reviewing the particulars of that case and seeing if there is a possible appeal with

respect to sentence.

The Speaker: First supplementary, the member for Peace River South.

J. Weisgerber: You know, it's ironic. This government is the only government

west of Quebec that still supports Ottawa's idiotic gun registry, which wouldn't have done

a damn thing to prevent this guy from smuggling a gun into Canada and threatening his wife

with it.

The Speaker: Member, I'm sure . . . . That word was not appropriate,

as you know.

J. Weisgerber: I'm sorry, Madam Speaker. "Darn" would, I guess, be

more appropriate.

But while this government supports a gun registry, it's still dragging its feet on a

sexual predators registry that would at least ensure that people threatened by these kinds

of sexual predators are notified about their whereabouts in the community. Will the

Attorney General commit today to at least review his position on both these issues? I

think he's dead wrong on both of them.

Hon. U. Dosanjh: I will be signing a letter today, which has been prepared for

me, to ask the federal Minister of Justice to make some changes to the process in the gun

registry. On the issue of the registry for sexual offenders, B.C. is the first province to

introduce the most comprehensive notification policy in place in this country. We did that

a couple of weeks ago, with the B.C. Association of Chiefs of Police supporting us. I have

said that we would monitor that process and that once that process has been monitored,

perhaps by the next sitting of this Legislature, we may have some legislation to be

[ Page 14170 ]

brought forward to actually establish a wide and comprehensive sexual offender

registry, which is something that I support. I actually want the federal government to do

it, because it's a national problem; criminals know no boundaries. They should be doing

it. If they don't do it, we are prepared to go alone.

[1430]

Tabling Documents

Hon. D. Miller: I have the pleasure to table the first annual report -- from

October 23 last year, when it was formed, to the end of the last fiscal year -- of the

British Columbia Oil and Gas Commission.

Reports from Committees

R. Thorpe: I have the honour to present the fourth report of the Select Standing

Committee on Public Accounts for the third session of the thirty-sixth parliament,

entitled "Earthquake Preparedness in British Columbia." Hon. Speaker, I move

that the report be taken as read and received.

Motion approved.

R. Thorpe: I ask leave of the House to suspend the rules to permit the moving of

the motion to adopt the report.

Leave granted.

R. Thorpe: I move that the report be adopted. In so moving, I would like to

commend all of the members of the committee, who have worked so diligently over the past

14 months in preparing this report. I would like to thank all of the British Columbians --

the parents, the individuals, the experts -- that provided insight into this report.

I would also like to thank very much our former Chair of the committee, my friend Fred

from Delta South. This report is tabled in his memory. All of the committee and all

British Columbians share and appreciate his guidance, his thoughtfulness and his

appreciation and caring in trying to protect British Columbians into the future.

The Speaker: Thank you, member. You've moved a question of the adoption of the

report. Oh, I'm sorry -- I recognize the member for Comox Valley, as Deputy Chair.

E. Gillespie: I would like to speak to this motion and also to commend the work

of our Chair, Mr. Fred Gingell, the member for Delta South, who led us through the

preparation of the "Earthquake Preparedness in British Columbia" Public Accounts

report and who ensured that the voices of British Columbians were heard and represented in

this report.

Motion approved.

Tabling Documents

Hon. J. MacPhail: I have the honour to present a few reports, if I may. First is

the report of the business done in pursuance of the Pension (College) Act during the

fiscal year ended August 31, 1998. I also have the honour to present the '98-99 annual

report of the office of the auditor general of British Columbia. And I respectfully

present the unclaimed money deposits report for the fiscal year ended March 31, 1999.

Hon. J. Kwan: I have the honour to present the 1998-1999 annual report of the

homeowner protection office.

Petitions

I. Chong: I rise to present a petition on behalf of 500 residents in the Gordon

Head neighbourhood concerned about the potential closure of Torquay Elementary School.

E. Walsh: I rise today to table copies of a petition signed by more than 4,000

residents of the Kootenays. These citizens oppose the hunting of Rocky Mountain elk in the

mating season and want the provincial government to end this practice and to help restore

elk and other herds for the benefit of Kootenay hunters.

I am also tabling examples of more than 4,000 additional letters that I received which

make the same request of the provincial government.

Orders of the Day

Hon. J. MacPhail: I call Committee of Supply. For the information of the members,

we will be debating the estimates of the Ministry of Health.

The House in Committee of Supply B; W. Hartley in the chair.

[1435]

ESTIMATES: MINISTRY OF HEALTH AND

MINISTRY RESPONSIBLE FOR SENIORS

(continued)

On vote 36: ministry operations, $7,569,524,000 (continued).

C. Hansen: I want to start out by turning it over to my colleague from

Kamloops-North Thompson, but just before I do that . . . . Before we adjourned

yesterday morning, I gave an indication of the sequencing of issues as I saw them coming

forward. Given that the House didn't sit for the balance of the day yesterday, there have

been some changes to that. So I thought, just to put it on the record and for those who

are perhaps trying to follow this through video Hansard, that I'd give sort of a revised

sequencing so that people know in what order we're going to be dealing with things.

We're going to start out dealing with capital projects. Many of these were dealt with

by my colleagues in terms of their constituency-by-constituency issues, but there are some

loose ends that we'll clean up there. We'll be talking about the allocation of federal

dollars. We'll talk a bit about public health issues, health research, communications and

issues management, and legislation and professional regulations. We'll then go on to

information management, the Medical Services Plan and mental health. With that bit of an

overview as to where we're going with these discussions, I'll turn the floor over to my

colleague.

[ Page 14171 ]

K. Krueger: Last week, at the beginning of Health estimates, the minister and I

covered some questions with regard to the new psychiatric unit to be constructed at Royal

Inland Hospital in Kamloops. That's the first of the capital projects that we'd like to

talk about.

The reason that I bring it back to the minister's attention is that statements have

been made by local health authorities since our discussion -- our discussion was well

publicized -- wherein the minister said, with regard to the commencement of construction

of the psychiatric facility in Kamloops: "My intention would be -- this is sort of

one of those 'God willing and the creek don't rise' things -- that sod would be turned

this summer." And a little while later in the debate that day, she said: "Yes, I

intend that it go ahead."

[1440]

I know that she meant it, and it's certainly long overdue. The government has announced

and reannounced this project over the last four years. There was a press release on March

8, 1996, entitled "Petter Reaffirms Psychiatric Facility to be Built in

Kamloops." That was two Health ministers ago, all with this government. The second

paragraph of that press release -- March 8, '96, mind you; almost three and a half years

ago -- says this: " 'The decision is final,' Petter said. 'There will be no

revisiting this issue now or in the future. We now have to get on with the job of building

the facility, and that's exactly what I am going to ensure happens." Well, he was

unable to ensure that that happened.

On April 26, 1996, shortly before the last general election in British Columbia,

Kamloops-North Thompson MLA Fred Jackson and Kamloops MLA Art Charbonneau made another

announcement, which it says is on behalf of Health minister Andrew Petter. It goes on to

talk about how the city is donating land for the facility to be built. Again, that was

over three years ago.

There hasn't been a spade in the ground. I think the minister is perhaps as chagrined

as I am about that. As I say, she is the third Health minister since that discussion,

counting the one we were talking about at that time.

Well, this week, in question period and in the news, everyone's thrashing around this

question of the Vancouver Trade and Convention Centre, which apparently is about to see

construction begin and in fact has had some $54 million spent on it without a business

plan, without a budget as far as we can tell and without funding being in place. Then we

have this situation up in Kamloops, where there's been long and careful planning,

announcement after announcement, the budget carefully prepared, I believe, and the

business plan in place. It's been studied to death.

In the meantime, of course, we have an appointed health board in that area. That health

board has made some grievous mistakes in the past, including what I think may have been

the inadvertent firing of the administrator of Royal Inland Hospital, who by all accounts

was a tremendously competent administrator and probably should have been the CEO of the

Thompson regional health board. But another individual, Mr. Garry Olsen -- whose comments

I quoted in the chamber last week -- was appointed by this health board instead, thereby

accomplishing the constructive dismissal of Mr. Chapin, which ended up in a

half-million-dollar severance judgment against the Thompson regional health board.

Now this Mr. Olsen appears to be riding roughshod over the opinion of the people of

Kamloops, who are almost universally opposed to some of his plans. He's had a good offer

from St. Ann's Academy, which belongs to the diocese of the Catholic Church next door to

Royal Inland Hospital, which wanted to provide land if that was necessary for a parkade or

to even build the parkade and lease it to the health board. Mr. Olsen rejected that

publicly out of hand and made insulting remarks about the church attempting to make money

off the staff and patients of Royal Inland Hospital. This whole situation has degenerated

into quite a nasty fight in Kamloops. Subsequent to the minister's commitment last week,

Mr. Olsen's been in the media saying: "No, that's wrong. The construction won't

proceed until spring of the year 2000." This just seems totally objectionable to me

and to the people of Kamloops. We are opposed to him ramrodding his parkade through in the

location that he's demanding it should be. There have been strong intimations to the

community that if we resist that decision on the parkade, we'll lose the project.

The minister made it clear last week that as far as she is concerned and, I believe, as

far as the MLA for Kamloops is concerned -- and certainly myself -- the parkade question

can be resolved subsequently. The psychiatric unit should go ahead. There are grievous

needs with regard to psychiatric care throughout this province, certainly in our region

and certainly in Kamloops. The superintendent of police told me a couple of years ago that

he had nowhere to take people with psychiatric treatment needs and sometimes found himself

having to keep them in jail because there was nowhere for the police to take them, even

though their activities were clearly caused by mental illness rather than necessarily any

criminal intent.

Interjection.

K. Krueger: I ask you, hon. Chair, if you might silence the Minister of Energy,

Mines and Northern Development, who's not in his place and is heckling me.

Whether or not you'd care to intervene and do that, as I think you should, I'd like the

minister to speak to this issue of the Thompson regional health board and its appointed

CEO making statements that are contradictory to what she has assured me and the people of

Kamloops and this House, and assure us that direction will be given, that construction

will begin this summer as she indicated it would and that the parkade question should be

resolved as and when it can be, without impeding progress on that facility.

[1445]

Hon. P. Priddy: My position is unchanged. The facility will go ahead. I have not

seen the recent comments. Although I understand they were in the paper, I haven't had the

opportunity to see those. My only concern is that people deal with this parkade. They have

approval to go ahead with it, and they'll have to deal with the parking. The facility must

go forward. Now, it's still in design. The faster that design is done, the closer it

brings us to a construction date. But the design by the people managing the project up

there isn't finished yet.

C. Hansen: I want to take us back to last year's budget, particularly the

capital plan that was put in place last year. Specifically, if we look at the amount of

dollars that were allocated for capital projects in health last year -- actually, the

revised numbers for last year's budget . . . . Sorry, let me start

[ Page 14172 ]

that over again. The 1998-99 budget estimate for capital spending on health in the

province was $222 million. When the revised numbers came in, when the budget was tabled at

the end of March of this year, we found that the amount of money actually allocated for

health-related capital expenditures in the last fiscal year was only $150 million. So we

actually saw a decrease.

We often talk about whether there's enough money in the province to build the kind of

facilities that we need. What we had last year was $222 million was set aside in the

budget initially, money that the Ministry of Finance said was available for health

construction in this province. So it's not a case of a wish list or of saying: "If

only there was enough money." These are actual dollars that were put aside in the

budget last year -- $222 million. What we find at the end of the year is that they

actually underspent that capital budget by $72 million.

On one hand, you might say: "Well, in a time when our books are not in very good

shape in this province, perhaps underspending a budget is a good thing." But let's

come down two lines in the report that came with the budget this year, and let's look at

the B.C. Ferry Corporation last year. The B.C. Ferry Corporation was given a budget of $85

million at the start of the fiscal year last year. When the numbers came in at the end of

March of this year, we found that the revised forecast for the last fiscal year was $160

million. So B.C. Ferries overspent their capital budget by $75 million. At the same time,

this government allowed spending for health facilities in this province to be underspent

by $72 million.

That begs the question of where the priorities are in this province. I would like to

ask the minister: in starting out on this section, where was she at the cabinet table when

$70-plus million got diverted from health facilities in this province to B.C. Ferries?

Hon. P. Priddy: There are two points to this. My position was to advocate for

capital funding for the Ministry of Health, which I did. There are two reasons, generally,

that the Ministry of Health does not -- although I think we've cleaned up part of it --

always expend what is forecast. One of them is -- as the member knows, I'm sure -- that in

most projects, it's a 60 percent-40 percent split with municipalities and regional health

districts. We have had some difficulty over the last couple of years with regional health

districts not having their 40 percent ready when the 60 percent from the province is ready

-- which, of course, ends up with those dollars not being able to be expended because the

region doesn't have them there.

The other thing I would note . . . . I don't know how this was canvassed

under the Ministry of Finance, hon. member. Our responsibility in the Ministry of Health

-- my responsibility and my staff's responsibility -- is to plan capital funding for the

Ministry of Health. Once that plan is approved, that responsibility moves out of this

ministry -- as it does in Education -- and it is the responsibility of the Ministry of

Finance both to implement and to manage those projects.

[1450]

C. Hansen: I don't think the minister has really given us an explanation as to why

capital moneys got diverted in other directions. If they weren't ready to be allocated

last year -- and I want to go through a series of those, where promises were certainly

made and nothing happened . . . . She hasn't explained to us why $75 million

or $72 million would in fact not materialize.

I'll put this in the form of a very specific question to the minister. There is an

organization within the Ministry of Finance -- or at least it reports to the Minister of

Finance -- the Provincial Advisory Committee on the Procurement of Design and Construction

Services. I assume that this is what the minister is referring to. I gather that this is a

board that hasn't even met for some time, that its main interest is in setting the capital

budget in the first place and that the actual decisions to move ahead with specific

capital projects within the Ministry of Health are driven by the Ministry of Health.

I can see the minister shaking her head, so perhaps she can enlighten us as to what

happens to this capital budget and why she doesn't have a say on how it's allocated to

some of these needed projects around the province.

Hon. P. Priddy: The answer to your question is that within the Ministry of

Health, we do do the planning, based on the capital needs submitted by the regions. We

take it, and we do the evaluation, with the prioritizing. We take it through the approval

process at Treasury Board. Then that responsibility is picked up by the Ministry of

Finance, in terms of getting that money out the door, managing the projects and doing the

viability studies. The Ministry of Finance does any additional work that needs to be done.

I'd like to spend every cent that we have, and I object if we're not able to do that. But

once it's approved by Treasury Board, those dollars are expended by the Ministry of

Finance.

C. Hansen: Yet I believe it is the public in British Columbia who expect that

the Minster of Health is going to be advocating for the kind of health facilities that we

need in this province.

Let's go back and talk about some of the hospitals and health facilities in this

province that have not been built as a result of the underfunding -- underspending -- of

that capital budget last year. Where have we heard that before, when we start talking

about which hospital will not be built? Well, these are hospitals that have not been

built; these are hospitals that have not been built in spite of commitments that were made

many years ago. What I'm going to do off the top is run through a list of these, in the

interests of time. Perhaps the minister can respond to them. We can certainly deal with

them one at a time, if she wishes to.

I want to go back to January 4, 1996, when there was a commitment made to Creston

Valley Hospital to receive money to renovate the treatment and emergency room. The project

has still not started. Let's fast-forward to April 20, 1996, which is an interesting date,

being in the middle of the last election campaign. Keremeos was to receive a new health

facility. There has been no construction started on that facility yet. In the same week --

it was a busy week in the last two weeks of the campaign -- Clearwater, on April 25, was

to receive funds for the construction of a new health centre. On the same day, April 25 --

this, I'd just like to remind you, was three days before provincial election day -- the

Burquitlam Lions were promised an intermediate care facility that would have a major

renovation and expansion. Nothing has happened to date. April 27: St. Bartholomew's

Hospital was to be replaced by the new health and healing centre in Lytton. No

construction has yet begun. April 29: G.R. Baker Memorial

[ Page 14173 ]

Hospital was to receive $850,000 in funding to plan for the expansion and renovation of

that facility, and nothing has happened yet.

[1455]

Those were all in the days immediately leading up to the call of that election

campaign. So when we start talking about health facilities in this province that have not

been built and yet they were promised and moneys were allocated last year . . . .

And even with that allocation of funds which, in theory, was available for the last fiscal

year, we could have dealt with those that were promised before the last election -- never

mind commitments that were promised two years ago or one year ago.

Just to run through some of the other ones that happened subsequent to the election. We

can come through to July 28. Fraser Canyon Hospital was to proceed with emergency

department renovations, to be completed in early 1998. Well, here we are in the middle of

1999, and nothing has happened. On October 20, 1997, a new health centre was to be

constructed in Alert Bay by the end of 1999. We're getting close. No construction has yet

begun. On November 7, 1997, Port Hardy Hospital was to receive two new multilevel beds by

the fall of 1997, and no construction has yet begun.

I would like to know, in terms of these commitments that have been made . . . .

I'm sure the minister is going to stand up and say: "Well, this one is in the

planning stage, and on this one they're about to break ground." And on this one,

they're probably about to put out the sixth press release announcing that it's about to

begin. The point is that somebody has to be lobbying for whatever available capital

dollars there are from the beleaguered taxpayer in this province to make sure that these

projects go ahead once they are promised and committed. What we see is that time and time

again promises are made and nothing is delivered, other than more promises and more press

conferences and more press releases. I would like to ask the minister why she wasn't

standing up to the Finance minister last year to make sure that those capital dollars got

spent on these kinds of health facilities rather than being spent on the Premier's fast

ferry program.

Hon. P. Priddy: I'm not going to respond -- the member indicated that -- to all

the things on the list. I think there are actually a couple of those that are open, but

nevertheless, we'll look at the list at another time and get back to the member.

This year in the budget we had a $378 million increase in our capital budget. That

increase is there because I lobbied for the capital needs of people in British Columbia.

Now, I want every dollar of that expended. If a regional hospital district says to us,

"I'm sorry, we don't have our 40 percent now," then it's very hard for that

project to go ahead. And never have I had the Finance minister come to me and say:

"We want to take health capital money and spend it somewhere else." But if it is

underspent -- and it is; you're correct -- I cannot ensure that regional health districts

have the dollars to put towards ours. As the member well knows, construction is no longer

handled by the Ministry of Health; it is handled by the Ministry of Finance. But a $378

million increase says to me that I have lobbied and advocated on the part of British

Columbians -- or you wouldn't see the largest increase in the province's history during my

tenure as the Minister of Health.

C. Hansen: Actually, for the information of the minister, the total capital

budget for this current fiscal year is $358.9 million. That's not an increase; that's the

total amount that's been allocated. Then from that you've got to take away $100 million

that this minister has allocated for Y2K projects, which are a one-time thing. They're

obviously essential. So when you start talking about health facilities in this province

that were promised years ago, that doesn't start the process of addressing that need.

But the issue is not whether or not there are basketfuls of taxpayers' dollars to be

poured into health facilities. The question is the priority in the allocation of whatever

capital dollars are available and who, in terms of government, is making sure that they're

spent on health facilities where they are desperately needed. Certainly if you look at the

actual increase in the capital budget from last year, it's actually -- let me see if I can

do my math in my head here -- about $130,000-some-odd. If you take the $72 million that

was underspent last year, and you take out the $100 million that was allocated to Y2K,

what we see in terms of capital dollars available for health facilities is in fact going

down in terms of the ability for any new initiatives in this province.

If the minister wants to respond to that before I move on to another subject, I'll give

her that opportunity; otherwise, I'll move on.

[1500]

Hon. P. Priddy: I will just do so briefly. The amounts, even in the Y2K funding, by

the way . . . . As we talked about the other night, a significant part of that

is actually for new equipment. That's capital funding. That's what comes under a capital

funding budget. It's not all about the new building; it's about the major new equipment

that goes into the building.

Your colleague talked about a project today which he's talked about previously. One of

the things that sometimes happens is exactly what he described. Somehow, something happens

locally -- in this case, a parkade -- where the local people who need the facility can't

get agreement on how to move forward. I can't make that happen faster when it's the

decision of a city council.

Can we work harder at getting money out the door? I'm absolutely sure that we can. But

my job is to get as much money allocated as I can. That's what I have done. We do

everything we can, including working very hard with Treasury Board, to get that money

through as fast as we can. Quite frankly, we've been able to do that fairly successfully

with some of the projects that you just named.

C. Hansen: I want to move to the allocation of federal dollars. In the budget

brought down by the federal Finance minister earlier this year -- it was called a health

budget -- moneys were allocated to the provinces for increased health spending. But if you

look at the budget documents tabled by the Minister of Finance at the end of March of this

year, what they show is that the total amount of dollars being transferred from the

federal government for health-related matters totals $488 million -- the increase in the

CHST funding that came through for health.

I know that the minister and the Premier made comments prior to the start of this

legislative session that this year's Health budget would be increased to reflect the

increase in transfers from the federal government -- and much more. But in fact, what we

see in the budget that's been brought down this year is that Health spending in this

province has gone up

[ Page 14174 ]

$478 million over what was budgeted for last year. It was actually only an increase of

about $350 million over what was actually spent last year. But the actual increase in the

Health budget from . . . . What was budgeted last year was $478 million, and

yet the increased transfers from Ottawa were $488 million.

I'm wondering what happened to the commitment made by the minister and the Premier that

the provincial health budget would increase by considerably more than the transfers from

Ottawa.

Hon. P. Priddy: I believe that the figure the member is referring to is indeed

the CHST, but that includes health, advanced education and income security. It's not only

for health. The commitment was that that amount of money -- and more -- would be spent on

health, and that is correct.

C. Hansen: By far, the overwhelming part of that CHST increase is dedicated to

health. Certainly I am going to go into the CHST supplement and where that has gone.

One of the provisions that was set out in the federal budget was an allocation of $3.5

billion to the provinces for the CHST supplement. That was funding to be allocated to the

provinces over a period of three years. It was allocated on a strictly per-capita basis.

British Columbia got its share of that $3.5 billion based on our percentage of the

Canadian population. So in British Columbia our share of that $3.5 billion was $471

million, to be spread over a three-year period.

One of the things that the federal government did was leave it to the discretion of the

provinces as to how they drew down their particular allocation over that three-year

period. In British Columbia this government has chosen to draw down $350 million of that

in this first year alone. So all that's left in that three-year allocation of funding,

under the CHST supplement, is $121 million to spread over the remaining two years. I would

like to ask the minister why it was seen to be fiscally prudent in this province to draw

down that fund to the tune of $350 million in year 1, thereby leaving only $121 million

for the following two years. Does that not jeopardize the future of health care in this

province, once we get through this particular fiscal year?

[1505]

Hon. P. Priddy: I'm sure the member also canvasses the Minister of Finance. But

let's be clear that the money that's drawn down is one-time money. This year, while there

was one-time money and provinces could draw it down any way they wanted over the next

three years -- you're quite correct -- there was absolutely no base increase to the

incremental funding at all. What will happen next year is that . . . . There's

still money to draw down, but there is also a change in the incremental funding that

begins next year and ramps up over the following two years after that. Over a three-year

period you have the base ramped up. But this year there was no increase, which is the

reason for drawing down more out of the one-time funding: to try and make up for those

years of having been clawed back.

C. Hansen: In fact, I can enlighten the minister even further in terms of how

this ramping up is going to work. What happened in the federal budget is that they

announced that the CHST funding was going to be increased over a five-year period by a

total of $11.5 billion, and $3.5 billion of that was on the CHST supplement. The balance

was $8 billion, which as the minister says, starts to ramp up -- which is a strange word

to use -- as of next year. The $3.5 billion was meant to be a bridge to allow consistency

in funding over a period of five years. If the provincial government was to draw down only

the share that would have allowed for consistency over this five-year period, they would

not have drawn down more than $268 million in this fiscal year. As it ramps up . . .

. Next year, of the remaining $8 billion in this increase in the regular CHST, $0.5

billion is allocated to all provinces. The year after, there's $1 billion allocated to all

provinces. Then it goes up to a level of $2 billion and, in the years after that, $2.5

billion, to make up our $8 billion.

What this government has done this year, by drawing down $358 million, is that they

have in fact shortchanged the following two years, even considering the ramping up that

will take place. I would like to ask the minister whether we're going to see a decrease in

funding for health care next year in this province or whether we're going to have to find

brand-new sources for funding, internal to the British Columbia budget, that allow us to

maintain the level of funding for health care that we have this year.

Hon. P. Priddy: No, we are not going to see a decrease in health care funding

next year for the Health ministry in British Columbia. Actually, it's the first time I've

heard about the five years. And I've checked with my staff, and they haven't heard about a

five-year commitment, either.

Interjection.

Hon. P. Priddy: There is a four-year commitment, not five.

But aside from that, the choice to draw down was based on what we saw as the current

needs in the province. There's no criteria around this that says it's intended to make

sure it's consistent. I suppose we could have drawn down less. We could have less cardiac

surgery, less orthopedic surgery, fewer long-term beds, etc. We've been able to keep up

but not get ahead, and that need is so great in British Columbia, after four or five years

of significant federal clawbacks in transfer payments, that that's what we felt we needed

to do this year. No, there will certainly not be a decrease next year in funding for this

ministry.

[1510]

C. Hansen: Actually, I find it very surprising that the minister wasn't aware of

the basis upon which the CHST dollars will be allocated in the years to come, because

those are dollars that are specifically allocated for health care in British Columbia. One

of the things that I take great exception to is the way in which this government

approaches the funding of health care over the long term. You're not going to protect

health care in British Columbia unless you anticipate how we are going to fund health care

five years or ten years or 15 years from now. Certainly I think it's a disservice to

British Columbians when we only look at it from the point of view of one year and don't

give regard to where those dollars are going to come from in the years to come.

What I'd like to ask the minister is: given that there is now going to be . . . .

Because they've basically raided the cookie jar in year 1 of this three-year program,

where does she anticipate finding the dollars to maintain health spending next year and

the year after?

[ Page 14175 ]

Hon. P. Priddy: I think it is important to note that in the four years preceding

this budget year, the federal government cut back payments to this province -- from 15.4

percent to 10.8 percent of our health expenditures. We, in turn, did not cut back the

health care system. We did not say: "Okay, we can't pick this up; we'll just have to

cut back the health care system entirely by 5 percent." We chose not to do that; we

chose to pick up the costs. But clearly that did mean that there were pressing needs and

other things that have not happened in the province or the system as a result of that.

When the one-time money came in, I don't think we raided the cookie jar at all. We

said: "There has been a 5 percent cut from the federal government over four years. We

clearly have some pressing needs, and we will need to use more this year." But I do

not think that anybody was "raiding the cookie jar," given that . . . .

Well, I don't want to go on with that analogy.

We do look at where money will come from, not only for this year but for next year. We

know how much the federal contribution will be in terms of increases, and there will not

be a cut to the health care budget.

S. Hawkins: I would like to discuss public health issues with the minister. What

I've been hearing -- and certainly what members on this side of the House have been

hearing -- is that public health services have suffered in the last few years. Certainly

when I meet with public health nurses, I understand that because of the way the services

are now funded -- through the Ministry for Children and Families and partly through Health

-- the reporting system and the services, as well, are not as ideal as they could be if

they were all under the Ministry of Health.

Public health doesn't get the profile that acute care does; it's not a high-profile

issue. But we all know that the services provided under public health are essential to our

constituents, to our patients, to our communities. I understand that population growth has

had quite a dramatic effect on public health services. Certainly immunization, speech,

nutrition, audiology and dental programs . . . . I believe that 80 percent of

those programs are picked up by the Ministry for Children and Families, but I know that

the health regions have talked to the minister about funding issues with respect to public

health, specifically in the area of environmental health. I understand, again, that with

the impact of population growth, the health regions are feeling that they don't have the

funding to help with the increase in demands placed on them by things like environmental

health reviews, inspections, permits, WCB smoking regulations and certainly other things

that businesses need because of the increased volume of services in the communities --

businesses that require environmental health reviews.

First of all, I want to know from the minister exactly what her ministry funds, as far

as public health, to the regional health boards and how she liaises with the Ministry for

Children and Families to make sure that public health services are delivered for the need

that's out there.

[1515]

Hon. P. Priddy: Can I clarify part of the question? I certainly have the amounts,

and I can answer the question about liaison. Did you ask what we fund under public health?

Interjection.

Hon. P. Priddy: I thought you did. I'll just be a second.

If somebody wants to provide me with more as I move along, I will . . . .

Two things. One of them is that we do have a standing committee with the Ministry for

Children and Families around the public health issues. I would suggest that the structure

has added some complexities to doing that work. In terms of the kinds of programs that are

covered, there's environmental health; community care licensing; public health nursing --

but only 20 percent of public health nursing, as it relates to adults; what people call

the SAND program -- speech, audiology, nutrition and dental, which is, again, adults only;

immunization, but only the cost of the drug, with the actual costs of the nurse doing it

being carried by Children and Families; medical health officers; the B.C. Centre for

Disease Control; and radiation protection. I think that's about the total of that.

I would say that over the last two years there has been a total of about an 8.52

percent increase in funding for the regions under public health, if you include Children

and Families.

S. Hawkins: Can the minister tell me if the letters of funding for public health

have gone out? I understand from some of the regions that they haven't received them yet.

If she can give us a commitment to tell us how much each region received for public

health, we would appreciate that.

Hon. P. Priddy: To the best of my knowledge, the letters have gone. And I'll get

staff back in who can actually tell you the amounts.

S. Hawkins: I understand that about five years ago, perhaps six years ago -- in

1993 or 1994 or somewhere in there -- there was a considerable amount of work done around

provincial standards for public health. I know there's a concern in this area, as well,

about equitable funding. I know that, but I'm wondering if the minister can tell me if

there are provincial standards established for public health services and what the

minister is looking at for equitable funding.

I know the funding differs from region to region, just like it does for acute care and

for other places. You know, it ranges quite widely per capita between regions. It can go

from $30 in one area to $35 or $36 in another. I wonder if the minister can give us an

idea if the ministry is looking at this, if there are provincial standards for public

health and how the ministry is looking to establish equitable funding for this area.

[1520]

Hon. P. Priddy: Yes, there are standards. Some of those go back to '97, and some of

them are recent. But there are provincial standards on environmental health, on community

care licensing. We have both standards and targets on immunization -- which is, as I say,

partly Children and Families. But it's a particular interest of mine, as people know.

We're currently working with Children and Families on outcomes around public health nurses

and, again, the SAND -- speech, audiology, nutrition and dental -- program and with MHOs

-- medical health officers. The B.C. Centre for Disease Control has its own standards as

well.

You asked about dollars. We are currently working with the new assistant deputy

minister -- as of today, to my left here . . . . Andy Hazelwood is working

with another part of

[ Page 14176 ]

our ministry to actually see about taking these dollars and rolling them into the

regional budgets. So at that time we'll be looking at whether there's a way to do more

equity.

S. Hawkins: I would be interested if the minister could give a copy of the

standards that they've developed and commitments for any further ones that could go to the

critic, so that we can have a look at them.

I'm also interested if the minister knows about morale in this sector, because since

the reorganization of public health out of the Ministry of Health and into the Ministry

for Children and Families, I have been meeting with more and more public health nurses who

are concerned about standards and funding and reporting -- who they report to and whether

the people that they report to actually understand what they do. I'm wondering if the

minister has heard these concerns and if she's heard these concerns from the regional

health board or from public health nurses. I'd like her to comment on the morale in that

sector right now, because I think it is very low.

I am concerned. I know they're overworked. Again, it's that old home care stuff,

because they do provide services in the home, as far as baby wellness visits and stuff

like that. There's this really overwhelming feeling of doing more and more with less and

less. Again, with the people that they're reporting to not necessarily being public health

superiors, they feel that sometimes their message of what they need to get their job done

is being lost. So I wonder if the minister has heard that.

Hon. P. Priddy: Yes, I have, both in this portfolio and in my previous one. So

that's not an unheard statement to me.

I think that a couple of things have happened. Currently, of course -- with the changes

-- public health nurses are working for the regions, which is a change -- aside from the

change about who is responsible to Children and Families and who reports to the Ministry

of Health, if you will. So both of those changes have been very difficult for a lot of

people.

I talk about public health and preventive health a lot, and I talk about how hard it is

to get people to focus on that as opposed to acute care. I think that people don't

recognize the important work that public health nurses do. I guess that once you get into

a multidisciplinary group there's a benefit: it means that more people learn to understand

what your work is. But it takes some time for that to happen. Yes, I have heard it. Every

time I'm out talking to people, I work to be sure that they understand how much the

minister appreciates their work.

[1525]

S. Hawkins: Can the minister tell me how she's asked the regional health boards to

address this morale issue? I know that the nurses I met with have raised this, and I don't

know if they feel that their issues are being heard. This seems to be across the board in

just about all the health care personnel right now. Is the minister so concerned that

she's . . . ? Are there committees out there working to hear these people so

that their concerns are addressed? How are we dealing with this morale issue in the health

care sector?

Hon. P. Priddy: There are two things. One of them is that one of the strategic

objectives in the strategic document is about improving workplace environments. That would

certainly fall under that. We do meet regularly, though, with the Public Health Nursing

Administrators Council -- the provincial one. Through that council, we do provide feedback

to health authorities about information provided to us. But having had you raise it, I

will put it on my next agenda with the health authority chairs and CEOs, because I meet

regularly with them now. They're fairly informal, so we have some good back-and-forth

conversations. I will commit to do that.

S. Hawkins: I thank the minister for taking that initiative on. I raised it last

year, but I don't see it getting any better this year. So perhaps if she raises it at her

level, it might get some attention at the local level.

I have a question, as well, in the public health area -- and this is another issue I

raise every year -- with respect to the AIDS strategy. Every year we have asked for an

AIDS strategy. We see the downtown east side as a model of what goes wrong when we don't

have a strategy to deal with HIV and AIDS. I know that interministerial initiatives need

to take place to deal with something like the downtown east side. I want to know where we

are with that and if we do indeed have a provincial AIDS strategy. There was a panel --

which was appointed last year, I believe -- working on that.

If the minister can just give me an overview of where we are there. Then, can she

commit to tell us -- or today if she has the numbers -- what the different organizations

and regions received for AIDS funding? In my own area, I understand the funding has been

cut by 44 percent. So if she could just answer those two questions.

Hon. P. Priddy: One point is that the AIDS strategy is actually out there.

That's the document that the AIDS advisory committee is working with -- to advise us on

how to make sure that that strategy does move forward. The HIV/AIDS advisory committee,

which was struck -- I can't remember now -- about three months ago, has met on at least

two or three occasions to move that strategy forward. There is reasonably diverse

representation on that committee. The AIDS dollars are currently not regionalized,

although the regions have got planning money to plan for AIDS support in their

communities.

[1530]

What we've asked each region to do is say: "Here are some planning dollars. Tell

us how you would use dollars and what you need in your community before they're

regionalized." That was a fairly major concern on the part of the AIDS community:

that if the AIDS dollars went out, they would not be diverted somewhere else. That's why

we gave planning dollars: to actually develop a strategy for that. Although this is really

only about . . . . That

part is provincial.

The other point that I would make is that I think the urban development agreement that

the Minister of Municipal Affairs has been working on has a good opportunity in the

downtown east side to be able to at least bring together -- I mean with federal partners

and municipal partners and so on -- all of the organizations providing those kinds of

services. There are a myriad of them. I know the member knows that there are a variety of

views out there as well. I think that's one of the best opportunities we've had so far to

do some of the cross-ministry coordination of that.

The actual health authority dollars for consultation and planning was $120,000 to

health authorities -- not to each one,

[ Page 14177 ]

obviously. Each health board had $5,000, and each community health services society

received $7,000. An additional $16,000 was allocated to five lower mainland regional

health boards to facilitate a lower mainland interregional HIV/AIDS plan -- because you

can't, in the lower mainland, only look at the downtown east side. While it certainly is

focused on the downtown east side, if you go to Surrey or anywhere else . . . .

That is a problem that we're seeing everywhere in the lower mainland -- and, by the way,

everywhere around the province. It makes more sense to work together as five lower

mainland committees.

I could provide for you -- I'm not sure there's a point to my reading it into the

record -- the list of agencies, where they are and how much money they've received in the

'99-2000 budget. I can read it into the record, but I'm not sure it's useful.

S. Hawkins: I would appreciate having the list. That's fine; the minister

doesn't have to read it into the record.

I wonder how much contact the ministry has with the AIDS centre of excellence -- with

Dr. O'Shaughnessy's group at St. Paul's. I understand that he did a lot of work with the

medical health officer's report that came out about a year ago; I believe it was titled

"Somewhere to Sleep, Something to Eat and Someone Who Gives a Damn." In that

report it was very clear that the Minister of Health can't deal with the AIDS problem in

the province in isolation. It has to be the Attorney General; it has to be Housing; it has

to be Children and Families -- there's a whole myriad of people that should be involved.

It has to be the city of Vancouver; it has to be the health authorities across the

province. We know, certainly from touring in the area and from walking the streets with

the street nurses and aboriginal health nurses and with the police and fire and ambulance .

. . . People from across the province come down to that area. It's rife with drugs

and everything else that makes for a good brewing place for the kinds of problems we're

seeing down there.

What is the minister doing as far as liaising with these groups that are helping to

treat patients down there? I wonder how much of a budget the AIDS advisory committee

really has. I believe -- and I could be wrong -- that there was a budget for the AIDS

strategy last year. I want to say that it's around $50 million, but I think two-thirds or

more of it was for drugs. So I want to know, as far as funding the AIDS strategy, whether

the minister could break down how much we're paying and where the money is being spent.

Hon. P. Priddy: As it relates to the Centre for Excellence in HIV/AIDS, not only

does the ministry staff work regularly with them but also they are represented on the

HIV/AIDS advisory committee. So we know that there's no thought whatsoever that the

Ministry of Health could, would or should do it alone; there are far too many people who

need to be involved with us. I have spent a fair bit of time working with the mayor of

Vancouver, as well, around some of these issues.

[1535]

If you take out the thing that you've mentioned -- the actual cost of drugs -- then

there's close to $8,600,000 spent on other parts of the strategy, such as funding

organizations that have a piece of the strategy, and $2,400,000 on needle exchange

programs.

S. Hawkins: Can the minister tell me what the public policy is behind the needle

exchange programs? Is this an increase over what was funded last year? What basis is the

ministry using to fund the needle exchange? It seems to me that there have been a lot of

concerns, certainly, from community groups down in the lower mainland questioning whether

the needle exchange is the way to go, or if there are other models we should be using. So

what is the ministry's philosophy? Is it still harm reduction? Where are they going with

the needle exchange and the IV drug users?

Hon. P. Priddy: Currently there's $2.5 million in funding for 14 needle exchange

programs in communities throughout the province. As you know, there were additional

dollars for the downtown east side to do some expansion. We will see from the regions,

when the AIDS plans come in, what they have identified -- whether there's a further

identified need for needle exchange programs. As you know, you have to locate one

somewhere where you've got some connection to primary care and so on. You can't just sort

of set it down where people don't have those other kinds of supports around them. But I

heard the debate last year at the AIDS conference about whether needle exchanges work or

not, and that would not be for me to say. Certainly the people I've talked with here who

are the experts in the field believe they do. Is the ministry's position still harm

reduction? Yes, it is.

S. Hawkins: I've heard the debate, and it concerns me. I do understand that our

HIV rates have stabilized, more or less. It's not because, I understand, we've done

anything better; it's basically because we've burnt out that level of people who could get

HIV. Everybody who possibly could -- I'm talking about the downtown east side now --

basically has got there. That concerns me because I understand that we still have an

epidemic raging in the downtown east side and in the province.

Places like Montreal and Seattle have done a better job at controlling this public

health concern. Do we get advice from these places? Montreal had a huge problem about, I

would say, six, seven or maybe even ten years ago. They seem to have got theirs under

control. I understand that ours is perhaps a little bit different because we do have more

access to cocaine and heroin out on the Pacific Rim here than perhaps they do. But

Seattle's on the Pacific Rim too. Why don't they have the same raging problem that we do?

I think part of it is that they have zero tolerance. I think they have stronger drug

enforcement. They put more attention to that.

I've heard the debate on zero tolerance and harm reduction. Harm reduction, to me, says

that we will always tolerate a certain level of addiction in our society and that we

understand it's going to be there, so let's just decrease the harm. I have a problem

sometimes getting over that. I'm wondering if that is the right way to go. There was a

debate last year, which is still raging, whether we will allow areas where addicts can

come in and shoot up -- like safe places. Certainly there's a debate raging with health

care personnel, public health, the IV drug users groups, the police and municipal

politicians. I think there are more against than for, if we're keeping score.

[1540]

What are the minister's ideas on this? Are we getting advice from other jurisdictions

that have been through this, who have reduced their rates? For some reason, I don't know

why . . . . Part of it, I think, is that we haven't really put a plan into

place. The last few years, I know, the ministry's been working on it. Hopefully, we're

getting something in place

[ Page 14178 ]

now to deal with this. But certainly, I think, the AG has to be involved, because a lot

of this is drug-related. I just want to know what the minister's thoughts are on this --

with harm reduction versus zero tolerance.

Hon. P. Priddy: I think there were three or four questions in there. So let me

start at . . . . I'm not sure it was the first one, but let me try. There is,

I think, a difference. I mean, zero tolerance in terms of selling, zero tolerance in terms

of illegal activity, is absolutely correct. That is a matter that I'm sure the member

canvassed under other ministries. But I don't think there's any question about that.

But if zero tolerance for people means that we won't treat anybody unless they're

already clean and sober, then we're not going to treat very many people. So for some

people, what harm reduction means is that you try and find a way to reduce the harm and

have the person move . . . . This isn't actually my portfolio, so I'm not

going to speak long about this.

The only two harm reduction programs we really have are methadone and the needle

exchange program. But even if you look at the needle exchange program, that is a harm

reduction; surely nobody would suggest that it shouldn't be there. So yes, absolutely zero

tolerance as it relates to illegal activities -- to selling, to all of those things which

as a country we can be much tougher on, and should be. I think that harm reduction as it

relates to my perspective as the minister, in needle exchange programs and methadone

programs, is necessary. We do know that with needle exchange and with methadone, it has

made a difference in the rate of deaths of people who are certainly at least using heroin.

You asked about linking across the country. Our centre for excellence is actually

considered to be the national centre for excellence. But certainly we work with centres

across the country; there's no question about that. They very often actually will come to

us. Maybe the difference has been the difference between in what cities heroin is used and

in what cities cocaine is used. You know, when you get into talking about cocaine, you're

talking about people who are injecting 20 times a day. So there are some different

dynamics between cities and the kinds of drugs being used.

I mean, there are needle exchanges in the downtown east side. We could talk about the

downtown east side, as well, as we both have. But this is also a problem in Prince George

and in Kamloops and in Surrey and probably in Langley and . . . . You know,

name another community. There are needle exchanges in those communities as well. So the

more we can put money out to the regions or regionalize the money, the more support people

can find in the regions for people with HIV/AIDS -- it won't remove it -- and the less

likely people are to migrate to the downtown east side, which is historically what's

happened.

S. Hawkins: I appreciate those comments. It's a difficult one to wrap one's mind

around. But part of the problem that we had with the HIV epidemic -- a huge problem, I

think . . . . I mean, the world was horrified. We were horrified in B.C. to

know that we were the worst in the world as far as an HIV epidemic. But I think part of

the problem is that we didn't provide the detox and drug addiction programs. Hopefully,

the Minister for Children and Families -- and I know the critic wants to address this too

-- is going to be announcing some programs. But we shut down some very important detox and

drug addiction services in this province and specifically in the lower mainland, so I

think that contributed quite a bit.

[1545]

The policing and the immigrant issues that we're dealing with in the lower mainland --

I think those have a lot to contribute to that as well. I really hope that we're coming

together with a strategy, a plan, that crosses different ministries, and that it's being

given the priority that I think people out there -- people working in those areas and

across the province -- want it to be given. Even though we've seen the HIV level

stabilize, that doesn't mean that it's actually gone down. It means that we've gotten to a

rate where people have basically burnt out. Every addict that could -- and anyone that

could -- now has it. That is going to have a huge impact, as the minister knows, on our

health care services, on drugs and on treatment -- certainly on the needle exchange

program, for which I think the budget has been going up every year.

I just leave the minister with those comments. I know that next year we're going to

stand up and ask the same questions again. Hopefully, we'll have some positive outcomes,

and the minister can announce next year that things have actually gotten a little better

and that there is an AIDS strategic plan -- it's in place, and it's working.

C. Hansen: This is under the heading of public health. I appreciate that we've

broadened the latitude of that discussion a bit. The issue I want to raise is one that I

appreciate doesn't fall under public health per se, but it certainly flows from the

discussion that we've just had. That's the issue of alcohol and drug programs in the

province. One of the things that I hear time and time again, both in large cities and in

small communities around British Columbia, is that nobody really sees the rationale as to

why the alcohol and drug programs are administered by the Ministry for Children and

Families and not the Ministry of Health.

My understanding is that there have been some discussions with regard to who is in the

best position to administer alcohol and drug programs. I'm wondering if the minister could

report on any progress that's been made in that regard.

Hon. P. Priddy: The only specific discussions I'm aware of are the discussions

going on with the Vancouver-Richmond health board. I know that the member would not expect

me to enter into a debate about whether programs in another minister's portfolio should be

in a different place.

C. Hansen: One of the things that I know my colleague touched on a few minutes

ago was the liaison between the Ministry of Health and the Ministry for Children and

Families. Certainly there are a variety of areas in terms of the funding from the Ministry

for Children and Families for public health programs, which are in fact administered by

the Ministry of Health or by the regional health authorities. We have examples such as the

possibility of the Vancouver-Richmond health board taking over responsibility for alcohol

and drug programs in that region on a contract basis with the Ministry for Children and

Families.

I'm wondering if the minister could reassure us with regard to the liaison that takes

place between the Ministry of Health and the Ministry for Children and Families and how

active that liaison is. Too often we see complementary services by different ministries

where there isn't really an active liaison taking place. I'm just wondering if the

minister could explain to us how that liaison happens in the current environment.

[ Page 14179 ]

Hon. P. Priddy: There are two points. One of them is that there is an ADM policy

committee with the Ministry for Children and Families and the Ministry of Health. I'm not

sure if there are other ministries . . . . I do know that for some of the

senior staff in my ministry, a significant amount of their time is spent not just at a

policy committee but doing that day-to-day work with the Ministry for Children and

Families.

C. Hansen: I want to move on to the issue of health research in British

Columbia. In the federal budget that came down earlier this year, there was a very

significant increase in the allocation of dollars to health research. Perhaps the best way

to embark on this is to ask the minister if she feels that we are well positioned to

maximize the advantage of this new federal funding to researchers in British Columbia.

[1550]

Hon. P. Priddy: I think we are in a position to use those research dollars. We can

all always be in a better position around researchers. People in the province talk to me

frequently about the need for more researchers in a particular area and how we can recruit

more nephrologists or how we can recruit more researchers who therefore bring with them,

obviously, the research dollars or the research projects.

But in terms of the federal money that was announced, I think we are. You have to be in

shape not only with cost-matching dollars but sometimes with a facility and the people to

do it. I guess one of the examples is the prostate research at Vancouver General Hospital.

The best people in the country work there. They will have a first-class physical facility

in which to work when the tower is completed. Those are the kinds of things, I think, that

help make you prepared to utilize research dollars.

C. Hansen: One of the things that I think we often hear is the government of

British Columbia jumping up and down and complaining that we don't get our fair share of

the allocation of federal dollars. In the case of health research, my understanding is

that federal dollars are allocated through a very empirical -- if that's the right word --

peer review that is motivated by where in Canada they have the best ability to deliver on

the health research that is sought. It's certainly not something that's allocated on a

political basis or a per-capita basis. If we want to get our share of federal dollars,

jumping up and down and complaining about it isn't going to do us any good. I certainly

would never accuse this minister of jumping up and down and complaining, but I would

accuse some of her colleagues of doing that.

Hon. P. Priddy: We'll pass it on.

C. Hansen: I appreciate the minister's offer to pass that comment along.

But in this case, what we've seen in British Columbia is funding for health research

decrease significantly in the last couple of years. As a direct result of that decrease in

funding, I believe we have also seen a significant decrease in the amount of health

research that is attracted to British Columbia.

If you look at the funding for the B.C. Health Research Foundation, we were at $10

million a year, and decreased to about $4 million last year. My understanding as of a few

weeks ago was that they still didn't know what their 1999 fiscal year allocation would be

for the Health Research Foundation. I'm wondering if the minister could tell us if that

commitment has now been made.

Hon. P. Priddy: The answer to his last question is no, it has not yet been set.

C. Hansen: I want to put into context why this particular issue is so important

to British Columbia. The Medical Research Council of Canada allocated about 8.5 percent of

its operating grants to British Columbia in the '96-97 fiscal year and 8.2 percent in the

'97-98 fiscal year. Again, as I mentioned, these allocations are not based on any

political decisions, as I understand it, but are based on the peer review of grant

applications that are submitted.

[1555]

One of the real concerns that I've had expressed to me is that British Columbia is

diminishing the infrastructure that we have in this province in order to enable us to

secure those national grants or those national research programs. If B.C. were to receive

13 percent of the MRC funding, which would be our per-capita share, there would have been

an additional $12 million coming into British Columbia from MRC alone. Several people have

looked at how that money would be levered in terms of British Columbia. There are all

kinds of different formulas that are used, but if you apply the average of these -- which

would be about a 5-to-1 leverage of the $12 million -- you would see a benefit to the B.C.

economy of about $60 million coming into this province.

The other piece of information that's been given to me -- and this comes from MRC data

-- is that they estimate that for every $1 million invested in research, we see 62 direct

and indirect jobs created. So if B.C. were to receive its per-capita share of the research

dollars nationally, there would be an additional 720 new jobs created in this province as

a direct result.

The concern I have is that what we are doing in this province, by eroding the funding

base for the Health Research Foundation, is eroding the infrastructure that we have with

which to apply for these national grants. I'm wondering if the minister can tell us when

the Health Research Foundation can expect to be allocated their budget for the fiscal

year, which started over three months ago, and whether or not they can anticipate that

there'll be an increase in funding for this coming fiscal year.

Hon. P. Priddy: As to when the BCHRF will have their figure, it will be fairly

shortly, but I don't have a date for you. I would say, though, that there are a couple of

other factors. I agree with the member that every X amount of dollars does create jobs --

and we could talk about how many jobs. I think we've had a couple of challenges here in

British Columbia; they're not easy ones. But given a $1.2 billion cutback from the federal

government over four years, people have to make hard choices about whether you put it into

patients or into increasing research dollars. People can say: "Oh well, that's not an

issue at all." Well, it is an issue if you're faced with needing to increase cardiac

surgeries or orthopedic surgeries. I'm sorry, but I think that is indeed the case.

The other thing is that we do support other kinds of research projects here in British

Columbia. You talked about the $12 million from the Medical Research Council, but we did

[ Page 14180 ]

just get -- or VGH just got it, not us -- an additional $10 million for VGH alone, in

terms of research dollars. I think the infrastructure is not as sound as it was a couple

of years ago. I would not disagree with the member on that. I think there's also some

discussion going on with medical faculties about the size and capacity of medical

faculties to attract world-class researchers. That, I understand, is also one of the

challenges here.

C. Hansen: Certainly all provinces faced cuts in terms of federal government

transfers for health care over the course of the last five years. Yet other provinces are

doing significantly better than we are in terms of health research. If you compare B.C. to

Alberta, just as an example, the share of MRC dollars to B.C. went from 12 percent in 1991

down to its current level of 8.2 percent, as I mentioned earlier -- at least as of a year

ago.

By contrast, Alberta's share went from just under 10 percent to just under 13 percent,

which is obviously significantly higher than their per-capita share. I think that if you

start digging and looking at the reasons why, you suddenly realize that in Alberta they're

putting funding into health research in the neighbourhood of about $13 per capita,

compared to British Columbia, which is less than $2 per capita. So I think in there is

some indication of why it is. It's not simply the cutback in federal dollars, but rather

that there is that kind of encouragement and support from the provincial government.

[1600]

I'd like to ask the minister specifically why it is that the Health Research

Foundation, three months into the fiscal year, does not know what its budget allocation

is.

Hon. P. Priddy: There are two things. One of them is that we fund a number of

research organizations, not just BCHRF, and we are still trying to decide the allocations

amongst those organizations. In terms of the member's comment about Alberta versus British

Columbia, I think that's true. Alberta did what British Columbia should have done 20 years

ago, which is identify health research not only as an important thing to do from a public

policy perspective but also as a growth-driver. They are significantly further ahead than

we are in this area, and we need to make strides to catch up. I would not disagree with

the member on that.

C. Hansen: I want to move on to communications. One of the issues I raised right

at the very start of the Health estimates, a week ago last Monday, was the issue of annual

reports. On a couple of occasions since, I've underscored that particular issue because of

the fact that the annual report is to be used as an accountability tool in the future if

things like the strategic vision document are in fact finalized, incorporated and

proceeded with. Right now the most recent annual report that has been made public is for

the fiscal year starting April 1, 1996. That was basically the fiscal year that started

prior to the last election date, yet no other annual report has been forthcoming from the

ministry since then. I would ask the minister: why is it that the ministry is running

three years behind in terms of the development or the presentation of its annual reports?

Hon. P. Priddy: I think the outstanding report -- there is only one, which is

'97-98 -- will be tabled in the next few days.

C. Hansen: So '97-98 -- '98-99 is also finished. But what I would like to ask

for is a commitment from the minister as to when we might expect the '98-99 annual report,

not the '97-98 annual report. One of the purposes of an estimates debate in this chamber

is to hold the government accountable for how it is spending public moneys. The annual

reports are one of the very important tools that the public has to rely on in order to

hold the government accountable. I find it unfortunate that that annual report was not

made available to us well in advance of the estimates process.

One of the things that I would like to get a commitment from the minister on is not

only that we will have the '97-98 annual report tabled in a few weeks, as she says, but

also that we will have the following annual report tabled in a very timely manner. I'm

wondering when we might be able to expect that. I know the minister has been very careful

not to make commitments on specific dates, but this is one issue that I want a specific

commitment on.

Hon. P. Priddy: Just in terms of timing for next year's report . . . .

And, by the way, I don't disagree with the member. It should have been done earlier. We

need to pay more attention in this ministry to annual reports, which are used as

accountability documents. If the annual report is going to have the kind of accountability

that I described in the earlier canvassing we did, then it needs to be treated in a much

more serious and timely way. You are correct.

[1605]

In terms of timing for the next one, the information from CIHI comes to us at the end

of September, so we won't have any data to work with until September. The hope would be

that the report is . . . . I'm hoping that maybe the Clerk will help me here.

The information I'm given is that it should be ready by December. I need to ask, though,

hon. Chair . . . . I don't know how I need to ask this question. It's about

whether or not it needs to be tabled in the House before it can be released publicly.

C. Hansen: I will intervene and answer the question for the minister. Certainly

we see annual reports made public throughout the year, and it is the obligation of the

minister to then table that annual report on the first sitting day following its release

publicly.

The other thing that I would like to point out to the minister -- and I have certainly

raised this issue in other ministries for which I have had the pleasure of being the

opposition critic -- is that we often get too hung up on how pretty our annual reports

look. What is important is what's in the annual reports, not what they look like -- or

even, in fact, whether they're printed. I think it is a far more useful vehicle for annual

reports to be put onto the web site for the ministry, which, I must say, is generally very

useful. I would bet that most individuals who make use of the annual report in 1999 would

much sooner access it on the web site than they would in their filing cabinet. So rather

than even waiting for the printing of an annual report, I would encourage the minister to

make sure that it's made publicly available through the web site at the earliest

opportunity.

Certainly among the various accountability documents that we've talked about during the

course of these estimates -- and I know the minister has talked about many, many different

documents that all form accountability -- I see the annual report as being the one that

has to knit a lot of this stuff

[ Page 14181 ]

together and at least reference where some of these other accountability documents are

lodged. I think it's only with that kind of accountability that the public can be assured

that $8 billion worth of taxpayers' money is in fact being spent wisely and with a view to

achieving better health care in the province, rather than simply being spent for

spending's sake.

When we were dealing with their strategic vision document -- I think it was -- on an

earlier occasion, I asked the minister about polling that was done by the ministry. There

was reference to regular polling that has been done in the past and, I gather from the

strategic vision document, will continue to be done to evaluate the satisfaction of

British Columbians with health care delivery in this province. I'm wondering if the

minister could outline for us how frequently this kind of polling has been done and what

kind of feedback we're getting from the public with regard to their changing satisfaction

with regard to the delivery of health care.

Hon. P. Priddy: There have been two polls done in the last year, as it relates

to public satisfaction -- which I think is what you asked. Yes or no?

C. Hansen: Generally.

Hon. P. Priddy: Okay. Generally, the last poll we did showed 52 percent of

people believing or feeling that we were doing an excellent or good job on health care. Of

course, as you know, Angus Reid certainly does its own, and sometimes there are health

care questions in that. Sorry; I don't know if there's more to that question.

Interjection.

C. Hansen: It's nice to have an audience in the gallery that appreciates what

we're doing here.

The minister mentioned that there were two polls specifically done on public

satisfaction. Could the minister tell us how many . . . ?

Interjection.

C. Hansen: Sorry; I may have misinterpreted that. Could the minister tell us how

many polls have been commissioned by the ministry over the course of the last . . . ?

Okay. I got the signal that those were the two that had been commissioned.

[1610]

There was a poll that I was familiar with, which I believe was done in May of 1998, so

I gather that these two polls have been done subsequent to that. Would the minister

undertake to make those polls public -- the two polls that have been done by the ministry?

Hon. P. Priddy: Absolutely. Actually, they're in the archives -- B.C. Archives.

C. Hansen: When you say the archives, is it the archives of the ministry, the

archives of the provincial government or the provincial library? Perhaps you could clarify

that, because it's certainly something that I would be interested in taking a look at.

Hon. P. Priddy: They are publicly available. I don't know if it's actually B.C.

Archives -- which it says here -- or the library, but I'll check. But they're public, yes.

C. Hansen: If the minister could advise me with regard to where I could take a

look at them, I'd appreciate it.

I want to ask the minister about the number of press conferences that the ministry has

held since the start of the calendar year. If you start looking at the number of press

releases that have been issued over the course of the last three years, there has been a

very significant increase in the number of press releases that have been issued this year.

Certainly, when you start looking at what's in them, it's not like there's been any

significant increase in the number of announcements that need to be made. Rather, it

points to a deliberate strategy on the part of the minister to increase profile and

basically to generate more press conferences and press releases. I'm wondering if the

minister could explain why we see this dramatic increase in the number of press

conferences that are paid for by the ministry.

Hon. P. Priddy: The notes I have don't actually show a dramatic increase in

press conferences. There were 20 last year, for a full year. We've had about ten this

year; we're in the seventh month of the year.

There is an increase in the number of press releases. I would suggest that the Health

ministry certainly gets enough profile, so nobody needs to gain more. But there's a

significant increase in a number of activities in the ministry this year, including

tobacco, including the increase in the Health budget and including a number of the

announcements that I know the member has either seen or been at. So there have been press

releases about those -- occasionally in response to something, but generally about

something that's going on in the ministry. But in terms of press conferences, there's not

a significant difference.

C. Hansen: Certainly it's something we've been tracking, and I would gladly

share some of the graphs and stats that I have, which do show a fairly significant

increase. Maybe it's a question of definition as to what constitutes

"significant."

The other thing that has been pointed out to me is that the nature of the ministry's

press conferences has been changed. Rather than using the press theatre here in Victoria,

which is a permanent facility, what we typically see is press conferences being staged at

a particular facility where elaborate staging, draping and audio equipment are brought in.

I'm wondering, at a time when Health dollars can certainly never go far enough, why the

ministry sees it as a priority to stage elaborate press conferences rather than use those

Health dollars where they could benefit patients in the province.

Hon. P. Priddy: Well, I must admit that I will now start paying attention -- and

I think somebody else has -- to whether there are drapes or not at a press conference. But

let me talk about location as opposed to whether there's a stage or there are drapes

behind it already owned by the government. It's not that somebody does additional

purchases for that. But you're quite right; there would be staff resources through the

organization that we contract with.

[1615]

The reason for doing it in a facility -- as opposed to the press theatre here -- is

that when you do a press conference around something that's related to people, you want to

actually put some faces on those people. So when we've been at places like the Children's

Hospital, there have been people there . . . . We've had children who talked

about what their

[ Page 14182 ]

experiences were, parents who talked about their experiences, physicians who talked

about the difference it made or didn't make or whatever that was -- to the particular

announcement. So I actually think that that's just a better way than a couple of

politicians standing in a press theatre making an announcement -- if the press can

actually talk to the people for whom the announcement will make a difference.

But I'm not sure that lots and lots of talking-heads press conferences are always the

best way to go. The most recent one we did was actually very limited. There were only two

media there. We did it so the media would have the greatest opportunity to talk to the

patients and the physicians, which is what they did -- which is what an announcement

should be about.

C. Hansen: Could the minister give us an idea of the number of outside

contractors that are used, typically, for these types of announcements and what a press

conference . . . ? The most recent one that I attended, which the minister

undertook, was at St. Paul's Hospital. But there were others at Vancouver Hospital that I

also attended, where there was the elaborate draping and everything else that went on.

Could the minister give us some indication as to what the costs to the taxpayers are for

those types of press conferences?

Hon. P. Priddy: We don't use independent contractors for those, except for the

setup of the facility. We don't use independent contractors to put them on, to organize

them, etc. The cost of doing one is about $1,000.

C. Hansen: I want to move on to professional regulation issues. In terms of

communications, that's all we have to deal with at this point, although I'm sure it's an

issue that's going to get revisited in the weeks and months to come.

Interjection.

C. Hansen: But I gather that the minister wants to add something to that.

Hon. P. Priddy: No, actually.

C. Hansen: The first thing I want to ask the minister is with regard to the

initiatives from the RNABC to change the structure, I guess, of the nurses' profession and

specifically to bring the nurses under the Health Professions Act. I'm wondering if she

could update me as to where we're at with that process.

Hon. P. Priddy: I just wanted to check if there was a different status for

RNABC. As I'm sure the member knows, this is being done under the Health Professions

Council, looking at whether to bring all professional organizations, if you will, under

one umbrella. The indication I've had from the RNABC is that they would be prepared to

move forward to do that, as long as all other health professions were.

C. Hansen: I gather from the minister's comments she just made that the Health

Professions Council has not actually proceeded yet on this process.

I can see that the minister wants to respond to that. My understanding is that it was

underway. But I also want to get an understanding from the minister in terms of the

parameters of what they were considering, in particular in the area of scope of practice,

when we might see that process move ahead and when it might become perhaps a more public

debate than we've seen up till now.

[1620]

Hon. P. Priddy: I'm sorry; I should have given you a bit more detail in the

beginning. This review has been going on for some considerable period of time, actually.

The legislative review part of it is due to report out at the end of the summer. The scope

of practice part of it is probably not due out until well into next year. There have been

preliminary reports, though, on scope of practice in a variety of other professions. I

don't think there is a preliminary report on scope of practice for nurses yet.

C. Hansen: I actually did want to go to those other professions. I wonder if the

minister could tell us where we're at in terms of the changing scope of practice for other

professions designated under the Health Professions Act or those other professions that

still have their own stand-alone legislation.

Hon. P. Priddy: I can give you a copy, if you like, but I can briefly tell you .

. . . For naturopaths, there is a draft preliminary report that I think was

circulated for comment at the end of December. For dentistry, a draft preliminary report

was sent out some time ago now, and there is a hearing set for September. For medicine,

there is a draft preliminary report that was completed some time ago, and the hearing has

taken place. I just don't know the result of it. For psychology, there is not a

preliminary report. For optometry, there is a preliminary report, and the hearing is in

September. For LPNs, there is a draft preliminary report. For RNs, there is a draft

preliminary report, this says, with discussions ongoing. There's a new submission that was

received for RPNs. There is a preliminary report for RPNs, and the hearing is set for

January.

For chiropractic, there is a report. The hearing actually should have taken place by

now, according to this date. For podiatry, the draft preliminary report was circulated

some time ago, and the hearing is set. For physical therapy, there is a draft report, and

their hearing was -- according to this -- last month. Massage therapy has a draft

preliminary report, and they've had their hearing. Pharmacy has a draft preliminary report

that's being prepared. I think it has not been released yet, so their hearing is a ways

off. For dental technology, there was a preliminary report, and their hearing is set.

That's it.

C. Hansen: Could the minister outline for us any initiatives that may be

underway with regard to the changing scope of practice for opticians or optometrists in

British Columbia?

[1625]

Hon. P. Priddy: With regard to opticians, I don't know -- because their scope of

practice was actually set quite recently -- whether there would be any change to that,

because it's quite new.

In terms of optometrists, I actually can't do it for any of those, because they're only

preliminary reports. There hasn't been a hearing with the council, so it's difficult to .

. . . Other than the information you may have had about what people have suggested,

I think it's difficult, until those hearings have taken place, to really comment.

[ Page 14183 ]

C. Hansen: With regard to the preliminary reports that are being circulated at this

time, could the minister give us a general time line? I'm not looking for a specific time

line for each and every profession that she outlined. But generally speaking, what kind of

time line is anticipated before these particular reports are finalized?

Hon. P. Priddy: I don't think there will be anything in terms of a consolidated

report much before next summer. They're not being done as one-offs; they're being done all

together. So what I'll get is a final report from all of those. It won't be: "Here's

the recommendation for optometrists, and next month we'll do nurses, etc." I won't

expect to see much before summer.

C. Hansen: Could the minister tell us what opportunities exist for public input

into the discussion? Certainly the drafts are being circulated, I understand, to the

various professional groups -- colleges, etc. I just wonder if there is a formalized

process or a deliberate process whereby the public could have an opportunity for input.

Hon. P. Priddy: There are at least two opportunities, if not three. A much

smaller one is, of course, that there are public representatives on each of their college

boards, if you will. Secondly, those hearing dates that I mentioned to you are all public

hearings, and anybody might be there. As well, it's on their web sites.

C. Hansen: As the last area that I want to canvass under this particular

section

before we subsequently go on to information management, I want to raise the issue of

baccalaureate degrees for nurses, which we raised briefly the other day under the context

of training spaces in colleges. At that time, the minister indicated that that wasn't the

best time to raise the issue of whether the requirement for baccalaureate degrees, as a

requirement, was desirable. The Nursing Education Council of British Columbia has agreed

unanimously that all new nursing graduates should have baccalaureate degrees. I'm

wondering if the minister has taken a position with regard to that issue.

Hon. P. Priddy: No, I have not taken a position.

C. Hansen: I gather, then, from the minister's response that it is something

that is being considered by the ministry, that it's not something that has been rejected.

I'm just wondering if the minister could tell us when we might expect the minister to be

making her views known as to whether or not this is desirable or otherwise.

Hon. P. Priddy: I think part of that will depend on the report about our future

needs from the recruitment and retention committee, from the BCNU. Currently what we have

is a mix. I think what we're going to need for some period of time is a mix of diploma

programs, bridging programs for LPNs, BNSC programs, etc. So part of that will depend on

the work of the recruitment and retention committee, but at this stage I don't envision

taking a position. I think that at this stage and for some time to come, we are going to

need both diploma and degree programs.

[1630]

C. Hansen: I want to quote from a Georgia Straight

article that I referenced

before, when we had an earlier discussion on a related topic. It's from the June 3 issue

of Georgia Straight . There's actually a reference in here to the RNABC. Actually,

I'm not sure that this is an accurate portrayal of the RNABC's position, but I'll read the

quote anyway, because I'd like the minister to respond to it. The Registered Nurses

Association of B.C., which is the profession's regulatory body, has stated that the most

important issue is "competencies as opposed to credentials." I'm just wondering

if the minister could comment on that in terms of how we might evaluate competencies. I

guess the issue that particularly comes up is the new licensure examination in Canada,

which is to be offered as of June in the year 2000. I'm wondering where the ministry is in

terms of incorporating that particular licence next year.

Hon. P. Priddy: I'll comment very briefly, but this is really an issue for the

RNABC and not for the Health ministry. I think that across government or across the public

we see all kinds of examples -- which, by the way, I do support -- of what people call

PBL, or prior-based learning. There's a whole variety of terms that are used to do that.

In point of fact, when people move from a diploma program and have served hospital duty

and move into a degree program, there is competency-based training. People are given

credit for that kind of work and experience. So I think that part already happens.

We certainly have no difficulty with the RNABC doing competency assessments. I think

everybody would want to make sure that the bar is at a reasonable level for people. I do

know -- it would not be for us to administer -- that the RNABC is participating across the

country with people in developing a national exam as opposed to provincial exams, I guess.

I think that many other professions have moved to Canadian board exams as opposed to

provincial exams. I know that the RNABC is working with other provinces on developing

that.

C. Hansen: I want to move on to information technologies, or information

management. Specifically, there are several issues that I want to canvass in this area. I

want to start by going back to last July 16 in Health estimates, when my colleague from

Okanagan West was asking about computerization. Specifically, my colleague asked:

"What is the plan, then, for computerization throughout the regions and then

connecting them to the ministry, so the ministry has the information it needs?" The

minister's response at that time was: "The computerization will be done through

HealthNet. Through HealthNet, the regions will be able to link up . . . . "

It's now a year later, and I'm wondering if the minister can give us an update on where

we're at with HealthNet.

[1635]

Hon. P. Priddy: All of the health authorities are on HealthNet and therefore have

regular communication with the ministry. If you like, I could just give you a couple of

points on those key functions that would fall within the larger information management,

which are either complete or in progress -- most of which are completed.

Telecommunications infrastructure is installed in all pharmacies, hospitals and

regions. Secure electronic mail service is available to all health providers that require

it. Improved monthly reporting capabilities for acute-care facilities to report to the

ministry are partially installed. Actually, I think that work is almost done. There's a

completed pilot project to

[ Page 14184 ]

allow hospital emergency departments access to PharmaNet's patients medication profile

information . . . . As you may have read or heard, we've actually had superb

feedback from physicians about that, as well as from the FOI commissioner -- because

that's always one of the concerns around this -- who was very supportive when he visited

the project.

We have working groups set up to allow input from health authorities, medical

practitioners and health industry software support organizations on how we're proceeding.

There's a pilot project underway to integrate the B.C. Cancer Agency's systems with

PharmaNet, which would provide improved patient services and improved cost control for

oncology medications. Then there are a number of others that are in the planning stages.

C. Hansen: I gather from the minister's comments that she sees PharmaNet as an

integral part of HealthNet in the province. I guess I had, perhaps mistakenly, seen them

as two independent initiatives which obviously have to be linked together. Certainly I

share the minister's comments with regard to PharmaNet, and I've heard good things about

it. I do have some specific questions about PharmaNet, but I want to deal with the broader

HealthNet question first of all. Where does the minister see the HealthNet system going

from here? How far along are we in terms of getting it up and running to the extent that

was originally envisioned? What kinds of changes and dynamics do we see to that in the

years to come?

Hon. P. Priddy: In terms of sort of future directions, if you will, PharmaNet is

a stand-alone piece in one way, but we do see it as part of that HealthNet -- that

information management. We don't see those as two totally distinct entities, but certainly

they provide a very different function.

But in terms of where we would see it going, eventually we would see this being

available to health practitioners, not just to hospitals. In point of fact, we do have a

pilot project around PharmaNet, where we're going to pilot PharmaNet in individual

physicians' offices. As it relates to PharmaNet or to HealthNet, we see this as being

available, where it's appropriate, to providers in the system.

C. Hansen: I want to share with the minister some comments that have been made

to me and ask her to respond to them. Generally, the point has been made that in terms of

information technologies, as opposed to our technologies surrounding equipment in the

province, health care in Canada -- not just in British Columbia, but Canada -- is really

far behind other industries when it comes to using information sciences as tools for

effective and efficient communication, feedback, data collection, and the whole subject

that's so important to us these days in health care: health outcomes.

We are significantly behind other industries when it comes to incorporating those

technologies. At the same time, there is a concern that in terms of the initiatives that

are coming from the Ministry of Health, we may not be moving fast enough in terms of the

changing technologies that are available today. We may in fact be going down a path in

terms of information technologies which we have already eclipsed in terms of what's

available to us through Internet technologies as opposed to others that may have been

available several years ago. I'm just wondering if the minister could comment on that and

give us some sense of how flexible and how state-of-the-art the work is that is being done

by the ministry today.

[1640]

Hon. P. Priddy: My staff tell me that in terms of what we're doing in HealthNet, it

is state of the art as it relates to health care in Canada. But the member would also be

correct in suggesting that the health care profession -- some people use industry; I'm

always looking for a better word than that -- is significantly behind other industries. I

don't know, if you looked at that across the spectrum, whether that would apply to all

human services or not, which have been getting into technology much later than perhaps

others.

Yes, that is correct across the country. But I'm told that our HealthNet, as it relates

to health systems in the country, is state of the art.

C. Hansen: I indicated a moment ago that I had a specific question regarding

PharmaNet. I accept the minister's comments that there is some excellent work being done

around PharmaNet. Also, I think that a lot of credit is due to our outgoing

freedom-of-information commissioner, David Flaherty, in terms of the work he's done in

establishing privacy protocols to ensure that patient records are properly protected when

we start building these kinds of databases.

Given that those kinds of protocols are in place, that patient records are protected

and that confidentiality issues have been addressed, could the minister advise us as to

whether or not there may be greater use of PharmaNet made in the future with regard to

those that are doing research in terms of health outcomes in British Columbia? My

understanding is that PharmaNet is seen as an incredible tool that could greatly assist us

in designing cost-effective and meaningful change in terms of health care in the future,

ensuring that we do have the positive outcomes that we're seeking. Yet as it currently

stands, even though the protocols are in place for privacy, there still is very limited

access to that data by those who are doing research in this field.

Hon. P. Priddy: I know that there are actually discussions going on with the

research people and with the ADM who is in charge of Pharmacare, but who is not currently

here. So there are discussions going on with both researchers and others from other

research backgrounds, to look at that. Those discussions are current. We would do, I

think, what you would expect. We would not go beyond, obviously, the boundaries of the

comfort level of the current FOI commissioner.

[T. Stevenson in the chair.]

C. Hansen: Generally speaking, with regard to the computer work that's done by

the Ministry of Health, could the minister give us some overview as to how much of the

work gets done in-house and how much of the work gets contracted out to individuals who

are not actually in the employ of the ministry?

[1645]

Hon. P. Priddy: If you take out capital projects -- which I think the member would

want me to sort of subtract, if you will, from that -- out of $60 million, $2.2 million is

spent on contractors.

[ Page 14185 ]

C. Hansen: So the $60 million is the budget, basically, for computer work that is

done by the ministry, not including capital expenditures. Have I got that right? I just

want to get some clarification.

Hon. P. Priddy: I think the answer is yes, you understood it correctly. The

total operating budget for information management is $67.4 million, but if you take off

the capital projects, it's just under $60 million. So out of that, the rest is all

operating dollars for information management. The staff salaries are at about $10.5

million, and, as I say, $2.2 million on top of that is for contractors.

C. Hansen: Y2K is something I want to touch on in a minute. But does this

include work that's being done under Y2K?

Hon. P. Priddy: Yes, some of this is. Some of the total is Y2K. It's $7.4

million, and some of those dollars would be contracted out as well. The $2.2 million on

contractors I referred to is a fairly ongoing kind of amount. The Y2K, which is obviously

a specific initiative, is $7.4 million.

C. Hansen: Is any of the contract work being done outside of Canada?

Hon. P. Priddy: I understand there was a small amount that was spent offshore,

but our contract was with a Canadian company. They subcontracted offshore. I think it was

about $200,000.

C. Hansen: I want to move to the HSCIS system -- the health sector compensation

information system -- which I understand was set up several years ago to track

compensation rates with various health providers around British Columbia that receive

funding from the provincial government. My understanding is that while it started out as a

great idea, it has really not become a very reliable tool today, because the reporting

that is done by health facilities around the province has fallen off in the last couple of

years. I'm wondering if that's an issue that the ministry is addressing and what actions

are being taken to ensure that this is a reliable and useful tool for providing

information on compensation rates around the province.

[1650]

Hon. P. Priddy: I think others have acknowledged the same points that the member

has raised. There is a steering committee with HEABC and the ministry. They've

commissioned an external review. I think it's an external review of the system to try and

look at where . . . . You know, are there strengths in the system? And where

does it need to be improved? Others have raised the same point. That report is currently

being reviewed.

C. Hansen: Is there a commitment on the part of the minister to make sure that

this system is functioning as it was intended to function? When can we