2007 Legislative Session: Third Session, 38th 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)

TUESDAY, MAY 8, 2007

Morning Sitting

Volume 20, Number 3

CONTENTS

Routine Proceedings

Page

Second Reading of Bills

Health Statutes Amendment Act, 2007

(Bill 26)

Hon. G. Abbott

A. Dix

Committee of Supply

Estimates: Ministry of Health

(continued)

R. Chouhan

Hon. G. Abbott

Reports from Committees

Select Standing Committee on Parliamentary Reform, Ethical Conduct,

Standing Orders and Private Bills

A. Horning

Proceedings in the Douglas Fir Room

Committee of Supply

Estimates: Ministry of Community

Services and Minister Responsible for Seniors' and Women's Issues

(continued)

C. Wyse

Hon. I. Chong

[ Page 7657 ]

TUESDAY, MAY 8, 2007

The House met at 10:02 a.m.

[Mr. Speaker in the chair.]

Prayers.

Orders of the Day

Hon. G. Abbott: In Committee A, I call continuing estimates

debates on the Ministry of Community Services, and in this chamber, second

reading of Bill 26, intituled Health Statutes Amendment Act, 2007, followed by

continued estimates debate on the Ministry of Health.

Mr. Speaker, I would request that consent be granted for the

Private Bills Committee to sit while the House is sitting. I understand the

Opposition House Leader has supported this consent.

Leave granted.

Second Reading of Bills

HEALTH STATUTES AMENDMENT ACT, 2007

Hon. G. Abbott: I have the honour to move second reading of

Bill 26.

The Health Statutes Amendment Act will amend three separate acts.

The Health Statutes Amendment Act will amend the Health Care (Consent) and Care

Facility Act in a number of ways. It will apply the definition of a care

facility to a broader range of facilities, including those outside the Community

Care and Assisted Living Act. This will include unlicensed family care homes

that provide care for only one or two persons.

The act will also provide for informed consent on the admission

and release to these care facilities, with a clear framework for an adult or a

person acting on the adult's behalf to apply for admission into or release from

a residential care facility.

This act will strengthen the rights and protections of adults in

care facilities by extending the provisions of the adult care regulations to

these facilities.

[1005]

This legislation is timely and necessary. There has been no

provincial standard guiding the consent to admissions or release of individuals

in residential care facilities. Now, with this bill, there's a clear and safe

framework to support care facilities, health authorities and individuals to make

better choices. There was, as we did our consultations, very considerable

response from stakeholders and strong support for the amendments to move

forward.

These amendments support the work we've been doing in redesigning

our home and community care system. Since June 2001 we've built 8,102 new and

replacement beds and units across British Columbia, adding over 3,000 net new

units to the province. By the end of 2008 British Columbians will not only have

5,000 net new beds, they will have thousands of upgraded beds and units in

modern facilities with the latest equipment. We're renewing the infrastructure

to ensure the legislation also meets modern standards.

The Health Emergency Act will also be amended to do the following:

transfer the B.C. HealthGuide program, B.C. NurseLine, B.C. HealthGuide on line,

B.C. HealthGuide Handbook , Dial-a-Dietician and B.C. Bedline to the

Emergency and Health Services Commission to expand and strengthen the scope of

its health information services.

The B.C. HealthGuide program provides 24-hour seven-day reliable

health information and advice to British Columbians through the HealthGuide

Handbook , HealthGuide on line, B.C. HealthFiles and B.C. NurseLine. The

self-care program helps individuals manage and make better decisions about their

health.

The Emergency and Health Services Commission offers emergency

health services and ambulance services throughout the province. These

non-emergency, amalgamated services will now be called HealthLines Services B.C.

and, as part of the commission, will play an integral role in the expanded

portfolio to include strategic self-care and health system navigation strategies

in the province. By transferring these important services to the Emergency and

Health Services Commission, we can better enhance and expand pre-hospital care,

self-care and health system navigation service in the future.

The B.C. Ambulance Service already works with B.C. Bedline and

B.C. NurseLine to ensure safe, appropriate and timely care for patients. Under a

single commission, these linkages will continue in areas such as patient

transfers and referrals of non-emergency 911 calls. All current staff, of which

there are approximately 250, will be offered employment with HealthLines

Services B.C.

Additionally, this move is representative of the Ministry of

Health's goals to build on accomplishments and extend innovation across the

continuum of health care services. The Ministry of Health will work closely with

the staff of each affected service to ensure a smooth transition to the

commission.

The Health Statutes Amendment Act will also amend the Pharmacists,

Pharmacy Operations and Drug Scheduling Act to allow electronic prescriptions to

be recorded in the province's PharmaNet system and strengthen patient

confidentiality by providing a new level of accountability to patients with the

future provision of authorized on-line patient access to their own medication

profile and access log.

PharmaNet records information on all prescriptions dispensed in

community pharmacies throughout British Columbia and processes approximately 41

million prescriptions each year. The network provides on-line 24-7 availability

of patient medication information. Health professionals access the electronic

network for prescriptions and patient health information every day throughout

the province.

This amendment will strengthen the confidentiality provisions of

the act and clarify the types of information that must be recorded within

PharmaNet and add new types of information that may be recorded within

PharmaNet, such as over-the-counter medication. It will also mandate how

information can be used and

[ Page 7658 ]

will facilitate electronic prescribing on PharmaNet, direct patient access to

PharmaNet and sharing of the information within PharmaNet with health

information banks under the Health Act.

This will also assist in the development of the foundation of

e-prescribing and e-drug, two areas of the province's e-health initiative set to

be operational in coming years. E-prescribing will be implemented in alignment

with the electronic medical record project, a commitment to the health system

made in February's throne speech.

[1010]

The province's e-health initiative places the utmost importance on

the protection of personal health information and complies with provincial

government requirements, B.C.'s Freedom of Information and Protection of Privacy

Act and international standards that protect privacy and assure system security.

E-health will improve health care quality, safety and outcomes; increase

services, service efficiency, productivity and cost-effectiveness; and enhance

service availability. It will also increase satisfaction for citizens, patients

and health professionals in the management of these sensitive and important

health records. The province's vision for e-health supports accessible health

information when and where it's needed, health care decision-making and

patient-focused, sustainable public health.

B.C.'s Information and Privacy Commissioner has reviewed these

changes to the legislation, and the College of Pharmacists of B.C. has expressed

support for it as well. British Columbians want access to the best health

services available. This amendment allows health care providers to continue to

provide safe, quality health care through leading-edge technology to patients

throughout the province.

In closing, the Health Statutes Amendment Act, 2007, supports the

Ministry of Health's goal of continued excellence in service, innovation and

quality health care in a public health system for all British Columbians. I look

forward to hearing the comments of other members and to debating the bill at

committee stage.

A. Dix: It's good to rise on Bill 26, the Health Statutes

Amendment Act, 2007, and bring forward a few comments. As the minister notes,

this is essentially a miscellaneous health bill, so I think the majority of the

debate that will take place will take place at committee stage as a result. I'll

just make a few comments in an introductory way.

It's a tribute to the minister's panache that he continues

to try and depict the government's broken promise of 5,000 long-term care beds

as some sort of success. But I will leave that issue aside because we can debate

that in estimates — that a promise one would have expected to have been

completed years ago is still years away from being completed. I guess in the

context of the minister's record, perhaps he views that as a success.

Let me just say on the specifics of the bill…. Some of the issues

that members of the opposition will raise at committee stage…. I'll just

underline them. First of all, on the issue of PharmaNet and use of personal

health information, I think many of the changes in the bill authorize the

exchange, recording and, in some cases, the disclosure of personal health

information. I think the parameters around disclosure need to be clearly

delineated.

I know that the Minister of Health has today, for example, tabled

amendments around

section 36 of the act,

section 23 of the bill, and we look

forward to pursuing that within the committee stage. The Information and Privacy

Commissioner has made some quite reasonable comments. I understand the Minister

of Health has listened to those, and we'll canvas the issues raised by the

Information and Privacy Commissioner at committee stage.

Equally, with respect to the transfer of responsibilities to the

commission, there are issues around that that we would like to discuss. The

minister has said that no employees will lose their positions. Clearly, there'll

be interest in discussing the consultation that's taken place with those

employees at committee stage. Equally, I'm sure that during estimates, if not

during discussion of this bill, we will discuss the future of the commission and

the future of the ambulance services commission, which the minister referred to

briefly in his statement.

The final set of things or the changes with respect to residential

care…. The minister will know that our critic for seniors health will have some

questions to ask about this at committee stage. Clearly, there is ongoing

concern about the level of protection available for people living in small

unlicensed residences, and these are issues we'll raise at committee stage.

So with that, those are the main…. I think discussion of this bill

isn't about the debate in principle, since there are many statutes being

amended. But at committee stage we'll have that debate, I understand, for those

watching at home, on Thursday. I look forward to having an exchange on the

details of the bill with the minister at that time.

Mr. Speaker: Seeing no further speakers, the Minister of

Health closes debate.

[1015]

Hon. G. Abbott: I thank the opposition Health critic for

his comments, and I do look forward to pursuing those issues at committee stage

as well. I now move that the bill be read a second time.

Motion approved.

Hon. G. Abbott: I move that the bill be referred to a

Committee of the Whole House to be considered at the next sitting of the House

after today.

Bill 26, Health Statutes Amendment Act, 2007, read a second time

and referred to a Committee of the Whole House for consideration at the next

sitting of the House after today.

Hon. G. Abbott: I call continuing estimates for the

Ministry of Health.

[ Page 7659 ]

Committee of Supply

ESTIMATES: MINISTRY OF HEALTH

(continued)

The House in Committee of Supply (Section B); S. Hammell in the

chair.

The committee met at 10:17 a.m.

On Vote 36: ministry operations, $12,819,670,000 (continued).

R. Chouhan: This morning, as we mentioned yesterday, we'll

be dealing with the mental health portion of the Ministry of Health budget.

When Senator Kirby investigated the issue of mental health in his

report, he said that approximately 800,000 people are affected by mental illness

and that a large number of those people suffer from mild to serious illness.

Since July 2006 when I was appointed as critic for mental health,

I have traveled all over B.C. and met with stakeholders and service providers.

They have consistently told me of the number of difficulties that they have been

experiencing since then.

Senator Kirby said in his report that he was shocked by how

fragmented our system of mental health care is and saddened by the effect of

that fragmentation on persons living with mental illness. That was repeatedly

confirmed by many of those stakeholders and service providers. I was in Prince

George, Kamloops and Kelowna and on Vancouver Island and the lower mainland.

Each and every one of those people who I met with were talking about those

inconsistencies in the system.

I know that the minister would say how much more money has been

spent and invested in this area, but if that's the case, then that money is not

well spent. We have to make sure that the resources for these services, for

those people who need these services, are there when they need it.

[1020]

We have also found out that since the provincial advocate was

eliminated in 2001, there is nobody to monitor what's happening about the

problems experienced by these people. The cuts in the Attorney General's

department have led to the elimination of the mental health Crown positions, of

mental health screening on admission to B.C. jails and of the Vancouver

Pretrial.

We have also seen that because of these cuts, many of the police

officers who get into this kind of situation when they have to face somebody

who's suffering from mental illness are not trained and are not equipped with

how to handle that individual. A few months ago we had an incident in Vancouver

where a person suffering from mental illness was…. His house was surrounded by

police for almost 24 hours.

At the end of the day, even when the family intervened and told

the police about his mental state, the police didn't take those steps, and he

was arrested. He suffered physical abuse, and I personally still don't know what

happened after that, though the family really was very concerned about that

individual.

So my question to the Minister of Health is: what is the

government's mental health plan, and how is this plan funded?

Hon. G. Abbott: The member raises quite a number of issues

in his opening comments, so I'll try to address at least some of them and would

invite him to set out some supplementary questions on those points that I may

have missed.

Let's begin where the mental health critic began, which is with

Senator Kirby and the Senate report with respect to mental health, which as I

recall was entitled Out of the Shadows , which is a very appropriate title

for the work. It's very good work that Senator Kirby and his Senate committee

did in respect of mental health, and I think it's appropriately titled because

one of the prevailing themes that we saw in Out of the Shadows was moving

beyond the stigmatization that is so often associated with mental illness.

Again, I don't want to overly simplify what is a complex problem

and a complex work in response to it, but I believe that one of the themes that

struck me in respect of Out of the Shadows was that we should begin to

try to address the challenges and the needs of mental illness in much the same

way that we do with physical illness. In short, move beyond the stigmatization

that is so often characteristic of both our understanding and our treatment of

mental health issues.

I think the Kirby report was a very important report in terms of

our understanding of mental illness and how to move forward with a new framework

for mental illness. I very much thank Senator Kirby and other senators for the

very important work that they did in Out of the Shadows. I know it is, in

many respects, a framework that British Columbia not only endorses, but it will

be helpful in moving us forward on our work in terms of meeting the needs of

people with mental illness in this province.

[1025]

We in this province expend over $1 billion every year towards

mental health and addictions issues. When we say "mental health and addictions

issues," we don't try to undertake a severing of that because so often there can

be a correlation between those two very compelling issues in people's lives. I

suspect among mental health professionals there might be some difference of

opinion on this point, but I think we would generally see correlations between

50 percent and 70 percent, between additions issues and mental health issues.

Often they are intertwined in individuals. It makes treatment more difficult and

the issues they are facing often even more compelling, so we need to look at it

in that sense.

Also, I should note — again, in response to the mental health

critic's introductory comments — that I've had the exceptional opportunity to

meet with Senator Kirby on a few occasions. He is remarkably well-informed on a

range of issues. I guess if there was ever a model senator, Senator Kirby is it.

[ Page 7660 ]

I should note to the member that in fact Senator Kirby found

British Columbia to be a model of how we should proceed in the future. Yes, the

Senate committee points out the challenges of a sometimes-fragmented approach to

mental health and addictions issues, but he wasn't using British Columbia in

that reference. In fact, in my discussions with Senator Kirby he has been very

complimentary of the work that has been done in British Columbia in respect to

mental health issues.

In particular, Senator Kirby — and I presume the Senate committee

would share this view — is supportive of the continuum of services that we have

built and are building in this province. I would not for a moment suggest that

we have reached something approaching perfection in relation to the delivery of

mental health programs. This is an ongoing challenge, and we know that there is

work to do.

Are we doing most of the right things? Yes, absolutely we are. I

think if you ask Senator Kirby, he would agree with that. We are doing most of

the right things. We are always receptive to suggestions on how to do things

better. We always welcome that.

He likes, in particular, the continuum of care that we have built.

We have come a long way in terms of moving away from what was, some years ago,

an overly centralized system. Everyone who had at least mental health issues

that required institutionalization…. People with those challenges were obliged

to leave their home communities, leave their home regions and go to Riverview to

access service and treatment.

We have made a huge investment in regionalization. It is exactly

the right thing that needed to be done. We have seen great success stories in

British Columbia that involved the repatriation of mental health patients to

their home communities or home regions, and it's been a tremendous step forward.

As a great example, I was part of the opening — not as minister

but as the regional MLA — of South Hills in Kamloops, a beautiful facility that

I think is leading-edge in terms of a community mental health facility. That was

one example of moving it out, but we've got lots of them: Seven Sisters in

Terrace, Seven Oaks in Saanich, Iris House in Prince George, Sandringham in

Victoria. There are some more recent ones: Cottonwood and Connolly Lodge, both

on the original Riverview sites but in a new, home-like setting, which I think

is highly appropriate and highly effective for dealing with the needs of the

mentally ill.

[1030]

I am tremendously proud of the work that the Provincial Health

Services Authority has done as the lead in respect of mental health issues,

tremendously proud of what the officials in my ministry, the Ministry of Health,

have done in respect of mental health issues.

We have come a long way. Is it possible that we can continue to

build and improve on this system? Absolutely, and there's work that will be done

in the years ahead. I certainly look forward to the opposition Health critic's

advice about what we ought to be doing incrementally in this area.

Exciting things have been done, and there's more to do. But let me

assure the member that what we will be doing will be consistent with the overall

direction of Senator Kirby and the Senate committee, consistent with the overall

direction of Out of the Shadows . I think we're doing so many of the right

things in British Columbia. I wouldn't want us to get off on the note of

suggesting that Senator Kirby was somehow being critical of British Columbia in

his report. If anything, he would probably put forward British Columbia as a

model for other jurisdictions to follow.

R. Chouhan: It's great to hear that the minister is very

much in favour of accepting the Kirby report. Could the minister tell us how the

Kirby recommendations are being implemented?

Hon. G. Abbott: We will be meeting with Senator Kirby on

May 16 in Vancouver. This will be the first forum on the delivery of mental

health services since the release of the report, so that will provide some

follow-up in respect of it.

Another thing that I think I should point out here is the

misinterpretation that the Leader of the Opposition placed on the Kirby report,

because it is entirely inconsistent with what the Kirby report actually says.

The Leader of the Opposition claimed that the report was critical of British

Columbia.

In fact, what does the report actually say? I want to put this on

the record because I think this is very important. This is a direct quote from

the standing committee, and it reads as follows: "Ideally, a broad set of

coordinated services and supports would be available to address substance use

problems, such as the continuum of services described in the recent B.C.

government framework Every Door is the Right Door: a British Columbia

Framework to Address Problematic Substance Use and Addiction ." That is a

direct quote from Out of the Shadows .

R. Chouhan: My question was very simple. I understand the

minister is meeting with Mr. Kirby fairly soon, but his recommendations have

been on record for a long time. What steps are being taken to implement his

recommendations, if any?

Hon. G. Abbott: The beauty of this is that we don't have to

undertake any kind of shift to meet the recommendations of the Kirby report.

We're doing it. British Columbia is in many respects the model for the nation in

terms of the provision of mental health services, as is reflected in the direct

quote from the document itself.

[1035]

However, just so the member understands the range of things that

we would be doing — mental health promotion, prevention and harm reduction…. I'm

just going to give him the headlines here, and he can dig deeper on these points

if he wishes.

Promotion, prevention, harm reduction are a big piece of our

strategy. Out-patient mental health and addictions services are another piece.

Short-term acute community mental health home care. Withdrawal

[ Page 7661 ]

management services. Residential addictions treatment and support recovery

services. Mental health community residential and family home care homes and

supported housing programs. Psychiatric emergency services. Community-based

crisis response and stabilization services. Psychosocial rehabilitation. Primary

care. Pharmacare plan G. Acute in-patient psychiatric services. Tertiary acute

and rehab psychiatric services. Provincial specialized programs and mental

health and addiction services for special populations. That, in headline form,

describes the continuum of the B.C. mental health program and services.

That continuum is what Senator Kirby was, I think appropriately,

praising in his report. We do not have to undertake a shift here in order to

accommodate that. We have come a long way since 1998, when a former NDP Health

Minister had to acknowledge that the $125 million mental health plan they had

constructed had never secured budget approval. We have not only walked the walk;

we've walked the talk as well. I think these are the right things to be doing,

and they are consistent with the Kirby report.

R. Chouhan: We are dealing with people suffering from

mental illness in British Columbia, and we need to have a very consistent plan

here to adjust those issues. On the one hand, the minister is saying that he

likes what Senator Kirby has said in his report, but then again, he's saying

that they don't have to implement those. I don't know why.

Now, my question to the minister is: who plays an oversight role

in the province over these issues?

Hon. G. Abbott: Just so the member doesn't misconstrue my

words, I said that it would not be any kind of shift to implement the direction

and framework of the Kirby report, because in pretty much all respects we have

in place and are building the continuum which in fact the Kirby commission finds

appropriate. I know this is a political debate, but I want to make very clear

what I was saying in respect of that.

In terms of who has the oversight role, the Provincial Health

Services Authority is the lead in respect of mental health services, and of

course, the health authorities are critical partners in that. The Ministry of

Health also has a strategic and policy role in respect of mental health.

R. Chouhan: Is there anyone from the Ministry of Health

with the responsibility for mental health inside the Ministry of Health, outside

of PHSA?

Hon. G. Abbott: Yes.

R. Chouhan: Who is that person, please?

Hon. G. Abbott: Wendy Hill is the assistant deputy minister

responsible for that area of public policy, and Ann Marr is the lead beneath

Wendy in the ministry.

R. Chouhan: Is the assistant deputy minister not solely

responsible for mental health within the Ministry of Health?

Hon. G. Abbott: No.

R. Chouhan: So we don't have one individual assigned the

responsibilities to deal with the serious problem of mental health in British

Columbia. We used to have a minister of state dealing with that. Is there

anybody taking it seriously, or are there any plans to deal with this at that

level?

Hon. G. Abbott: Yes, the Minister of Health.

[1040]

R. Chouhan: I'm pleased to hear a short answer from the

Minister of Health for a change.

In this year's budget the minister announced $100 million for a

health innovation fund. The priorities for that fund include primary care, ER

decongestion and performance. Why is none of that $100 million innovation fund

allocated for mental health?

Hon. G. Abbott: The issue is not that simple. If the health

innovation fund is dealing with, for example, emergency room issues, often

emergency room issues are mental health issues as well. There is a portion of

the patient base that presents at an emergency room with a compelling mental

health issue — perhaps a psychotic episode, an addiction withdrawal issue, those

sorts of things. Emergency rooms do struggle with those issues. They are not

particularly well suited and well equipped for those issues.

One of the things that we have been working studiously on, in

terms of trying to improve the flow-through of emergency rooms, is trying to

find ways to ensure that those who need mental health or addiction supports in

ERs are given those supports. So when we talk about effective emergency rooms,

one of the elements in an effective emergency room is the management of those

mental health issues.

Similarly, on primary care, which I hope is going to be one of the

features of our health innovation fund…. Primary care is not just for chronic

physical illness; it is also for chronic mental health issues. Again, how we

manage those issues outside the acute care stream can be remarkably important in

terms of how well that acute care stream operates.

Primary care is something where I think we need to build our

continuum and resources in the years ahead. I say that not just because of the

aging demographic — that's certainly a part of it — but also the growing

incidence of some physical chronic diseases like diabetes. The chronic mental

health illnesses are also part of the challenge we have for primary care.

R. Chouhan: Could the minister give me a breakdown for

mental health spending, please?

Hon. G. Abbott: I thank the member for the question. I'll

try to give him the overall, and then he can pursue these more extensively or

intensively, should he wish to do that.

[ Page 7662 ]

The overall projected '06-07 budget for mental health and

addictions services is $1,086,800,000. That compares to $1.058 billion in

'05-06, $997.7 million in '04-05, $996.5 million in '03-04, $982.1 million in

'02-03 and $905.3 million in '01-02. So we've seen across those years a

substantial increase in mental health and addictions funding.

The range of service, and I talked about the continuum in an

earlier answer…. The funding goes into these general areas: acute care services;

the continuum of community-based mental health and addictions services; the

specialized services managed by the Provincial Health Services Authority; such

things as Riverview Hospital and Forensic Psychiatric Hospital and community

clinics; Pharmacare; physicians' services, including general practitioners and

psychiatrists — both salaried and sessional.

[1045]

It also includes work being undertaken with the Centre for Applied

Research in Mental Health and Addictions to develop evidence-based information

to support health authorities in the ongoing implementation of mental health and

addiction reform. It goes to the development of an information plan to provide

accurate and timely information to people with mental disorders and substance

abuse disorders, to their families and to sectors of the public, including

service providers.

R. Chouhan: The minister has also agreed that the mental

health system in British Columbia is nowhere near perfection. In 2001 the

provincial Mental Health Advocate position was axed. What steps is the minister

planning to bring it closer to perfection when we don't even have somebody to

monitor provincewide the issues dealing with mental health? Are there any plans

in the works?

Hon. G. Abbott: We believe that mental health issues are

far too important to delegate all of that responsibility to one person, so we

have a very large team that deals with mental health issues in this province. I

have the honour of leading that team as the Minister of Health, but it also

includes my Deputy Minister, Gordon Macatee. It includes Wendy Hill, whom I

mentioned earlier, who's the assistant deputy minister responsible for mental

health issues.

Bob Nakagawa is our ADM of Pharmacare, and they deal with

Pharmacare plan G for mental health consumers. Paula Bond is the nurse executive

in our ministry and an assistant deputy minister, and her responsibility

includes registered psychiatric nurses.

Stephen Brown has responsibility for primary care, including

mental health. Ron Danderfer is assistant deputy minister responsible for

information technology. He looks at the health tools that we are building to

support our mental health clients.

I think the mental health consumers of the province are better

served by having a team which, I must say, works relentlessly to try to improve

the conditions and services for mental health consumers in this province. The

notion that somehow one can create an advocate's position and that those issues

get resolved without having the team in place is a specious notion. It is not

one that I subscribe to.

I think what we're doing is building the continuum. We're building

it in an effective way. We're building it because we have a team that's

committed to the effective provision of mental health services in this province.

R. Chouhan: There's no independent voice who can speak on

behalf of the people who are suffering from mental illness. We used to have that

until 2001, and now you may have some individuals in the big, huge Ministry of

Health who may be responsible for dealing with some of the issues. But

independently there's no one in the province who is able to speak on behalf of

the hundreds of thousands of people who are suffering mental illness.

Where's the accountability for funding in mental health programs?

Is there any program, any person, any individual or any group of people who are

dealing with the accountability portion of the spending on mental health?

Hon. G. Abbott: I've gone through now a couple of times a

listing of the people who have responsibilities around mental health

programming. As I noted, the Provincial Health Services Authority is the lead

among the health authorities for mental health and addictions issues, but these

are very much a partnership.

[1050]

The accountabilities are set out in the government letters of

expectation, and those accountabilities are followed up on relentlessly. In

fact, we are moving forward with a sound, effective plan on mental health. We're

not going to do what the member suggests, which is to create a mental health

advocate and then think that all these challenges suddenly disappear, because

they don't.

We need to have a team that can build on these things. I have the

honour to lead that team. There are a whole lot of people in the health

authorities, in the ministry and in communities who are a part of that team, and

we'll continue to build on that.

R. Chouhan: We may have the team, but there is still no

provincial mental health plan. The question I asked earlier and I repeat is: is

there any provincial mental health plan?

Hon. G. Abbott: Yes, there is. I'm not sure if the critic

will be aware of this report. I think this probably precedes his election to the

Legislature. But I'll just quote from the second annual report of the Mental

Health Advocate for British Columbia. This is her annual report for the period

January 1 to December 31, 2000.

In that report — on page 9, for the member's reference — it says:

"The current recommendation, issued in March 2001 by the Associate Deputy

Minister of Health,

[ Page 7663 ]

is that the positions move inside the Ministry of Health Services and become

part of government." So the member may wish to reference that report. It's from

the Mental Health Advocate of B.C., and it's for the period January 1 to

December 31, 2000. It makes that interesting observation about the Mental Health

Advocate.

The member will have to remind me what the latter portion of his

question is.

R. Chouhan: My question was: do we have a provincial mental

health plan?

Hon. G. Abbott: Yes, we do.

R. Chouhan: Could you please advise where we can find it?

Also, the reference that the minister has made to the provincial advocate's

report on page 9…. Did the ministry adopt that recommendation? Was it

implemented?

Hon. G. Abbott: In response to the latter portion of the

member's question — was the recommendation by the Associate Deputy Minister of

Health in 2001 acted on by the NDP government? — I've consulted staff with

respect to that matter. They're not aware that it was acted upon.

But of course, the time frame between the recommendation in March

2001 and the departure of the former NDP government from office in June of 2001

was relatively short. He may wish to canvass his colleagues from the day to see

if that occurred, but I would be surprised if there was sufficient time in there

for that to occur.

[1055]

In terms of the plan, I referenced earlier Every Door is the

Right Door: a B.C. Planning Framework to Address Problematic Substance Use and

Addiction . I should also note that the plan includes these elements:

providing a full continuum of high-quality mental health and addiction services

within each health authority to better integrate primary, secondary, community

and tertiary care within larger care networks.

The plan also includes working with the Ministry of Forests and

Range, now responsible — as the member knows — for B.C. Housing, working with

health authorities and other partners to better address the housing and service

needs of those with mental illness and addictions. I'm sure the member would

agree that stable housing is often a very important part of stabilizing those

who have challenges with mental health and addictions issues.

The plan includes the enhancement of services for people with

dementias, including Alzheimer's disease. Targeted improvements include earlier

assessment, clinical guidelines to improve treatment and better integration of

services.

I don't believe I need to persuade the opposition Health critic on

this point that as we have an overall aging demographic in our society, as we

see that percentage of the population age 65-plus move from about 12 percent to

13 percent of the population currently to, in about 20 years — including me,

sadly — over 25 percent approximately…. As we see that change, we are going to

see this particular provision around dementias and Alzheimer's take on

additional importance in terms of the continuum that we are building in the

mental health plan.

Other elements in the plan: expanding drug and alcohol treatment

for at-risk and addicted people who seek help and specifically addressing the

need to provide integrated programs for youth addictions, including both

detoxification and outreach programs. Particular focus will be placed on

contributing to government's integrated approach to addressing crystal meth use

in B.C.

Finally, in terms of the plan, working with other B.C. government

ministries to ensure initiatives, programs and services are integrated to

achieve maximum benefit for those in need, including people suffering from

mental illness and/or substance misuse, children with special needs, children

and seniors at risk, and persons with disabilities.

Those are several key elements in the plan. Of course, as always,

I'm happy to try to fill in any further information that the member would wish.

R. Chouhan: Let's for a moment deal with the issue of

housing. As Senator Kirby has said very clearly in his report, governments at

all levels must build affordable housing for people with mental illness.

What's the plan of this government to deal with the housing

situation faced by people suffering from mental illness? Are there any mental

health housing initiatives in the works in B.C.?

Hon. G. Abbott: We believe profoundly that stable housing

is an integral part of bringing overall stability into the lives of those who

are afflicted with a mental illness or are potentially afflicted with a

substance abuse problem or addiction, and sometimes those who may be afflicted

with both those things.

[1100]

There are a couple of areas that I think need to be noted. There

is a range of initiatives which are underway with the leadership of the Premier

and the Minister of Forests and Range and Minister Responsible for Housing in

partnership with the Ministry of Health and others. They are moving ahead with

some very ambitious programs in relation to that, and the member may wish to

canvass the Minister Responsible for Housing on those points in his estimates.

There is, though, a purpose-built housing program that is led by

the Ministry of Health, which involves mental health community beds in health

authorities, and I will just note that we are making very good progress in

respect of those mental health community beds. If one compares, in 2001 there

were 4,940 mental health community beds in this province, and today — and the

number is maybe even a little bit higher than this — in 2006, 6,391 community

mental health beds in British Columbia.

[ Page 7664 ]

We have made a substantial investment in this area. We've seen

substantial increases since 2001 in respect of community mental health beds, so

we're proud of that. Again, we recognize that the demand is something that

shifts and grows in response to societal and other issues, but the number is

certainly there.

I'm glad to provide for the member a breakdown of where those

incremental community health beds are by health authority between 2001 and 2006,

should he wish it. I won't take his time unless he wishes those things, but I'm

glad to provide that on request now.

L. Krog: Hon. Chair, I'd ask leave to make an introduction.

Leave granted.

Introductions by Members

L. Krog: With us in the premises today — including a number

of them already behind me in the gallery, I believe — is a group of grades 4 and

5 students from Coal Tyee Elementary School in Nanaimo, a very inquisitive group

who gave me quite a grilling on the steps earlier. I'd ask the House to please

make them welcome.

Debate Continued

R. Chouhan: Could the minister just briefly tell me where

those beds are that he's talked about and what supports are available? When he's

talking about beds, are they solely meant for mentally ill people, or are they

used for other purposes as well?

Hon. G. Abbott: The answer is yes. These are community

mental health beds, and they are for those in need of mental health supports.

Where they are located: 874 of the 6,391 are in the Interior Health Authority,

and that 874 compares rather favourably to the 548 that were in Interior Health

in 2001; 1,879 of the total beds are in the Fraser Health Authority, and again,

that number represents approximately a 400-bed improvement over the 1,498 that

were there in 2001.

For the Vancouver Coastal Health Authority the total number of

community mental health beds in 2006 is 2,175, and that compares favourably to

1,769 back in 2001; 1,195 of the mental health community beds are in the

Vancouver Island Health Authority, compared to 930 in 2001; and for the Northern

Health Authority, 268 community mental health beds, compared to 195 in 2001.

Again, all of those total 6,391 compared to 4,940 five years ago.

[1105]

R. Chouhan: Recently, there were a number of purchases made

by the Ministry of Forests and Range — Housing. Some buildings were bought.

There are two buildings that were bought in Burnaby, in particular, and we were

told that some of those units will be housing people who are mentally ill. Could

you please confirm if those units will be available for people suffering from

mental illness?

Hon. G. Abbott: The question would be more appropriately

directed to the Minister of Forests and Range and Minister Responsible for

Housing.

R. Chouhan: What is this government doing in terms of early

intervention for mental health issues?

Hon. G. Abbott: Early intervention and outreach are very

important parts of what we do in respect of youth, particularly, but of all

those who may have mental health issues or in some cases substance abuse issues.

So those outreach and early intervention programs…. These are the two general

categories, and again I'd invite the member to pursue it more intensively should

he wish.

One area is outreach services. Each health authority has developed

outreach and early intervention services, which include street youth peer-based

programs and always include street nurses and outreach workers. These are the

brave folks who are out on the streets in actual front-line, face-to-face

dealings with those who need their help. So those are the outreach services, and

they're in every health authority.

The other major program is early psychosis intervention, and B.C.

has become a leader in research and development in respect of early psychosis

intervention programs. They're established in every region in conjunction with

the child and youth mental health regional program. This is an area where we are

working closely with the Ministry of Children and Family Development and working

in partnership to try to address the needs of youth.

R. Chouhan: Before I start asking other questions, let me

just get one clarification from the minister. When you were giving the breakdown

of those beds in different locations in B.C., who qualifies for those beds? Are

there any criteria set which would make those people access those beds?

Hon. G. Abbott: The clinical assessments are undertaken by

the appropriate health care professionals before a client would be designated to

a facility.

R. Chouhan: When we talk about mental illness, it's not

confined to one group of people. It knows no boundaries. You know, all cultural

groups and language groups suffer from that. So my question to the minister is:

are there any particular programs designed or available which would make it easy

for people from different ethnic communities to access these programs in B.C.?

[1110]

Hon. G. Abbott: We don't have the answer immediately

available. We can get the member more information in respect of the

multicultural responses within health authorities to these issues.

[ Page 7665 ]

I would say generally that our government is responding to the

quite wonderful cultural and multilingual diversity that we have in the province

by constantly working to extend the range of documents and programs that are

available in more languages. I'd just use as an example the B.C. HealthGuide

— which has now been translated into, I think, Hindi and Mandarin and perhaps

other languages as well.

What we aim to do on every occasion is to try and build that

continuum. It is enormously challenging — as I'm sure you would agree, Madam

Chair — to try to address every linguistic group that exists in the province.

There are probably 100 or more linguistic groups that exist in the province, but

we are trying to meet the cultural and linguistic diversity in a reasonable and

balanced way by providing more materials and programs in more languages than

ever before.

We're certainly doing that, but we'd be glad to try to get more

specifics on what is happening in each health authority for the opposition

mental health critic, as is possible here, later in estimates.

R. Chouhan: We have had these conversations on health in

several communities of B.C. During those conversations on health, were there any

steps taken to make it easy for people suffering from mental illness, especially

from different linguistic groups, to make their participation in those

conversations more comfortable and more easy?

Hon. G. Abbott: In the Conversation on Health, we have made

every effort to have as wide an opportunity for British Columbians to give us

their advice on health care as is possible. Certainly, mental health and

addictions issues are part of that broad reaching-out for the views of British

Columbians in respect of all health matters, including mental health issues.

We have, I think — as the member knows — created quite a

remarkable process in the Conversation on Health. First, it's not an overnight

process. This is a process that's probably about a year in duration. It was

launched last September and will continue through until at least this September

when, hopefully, we'll be in a position to deliver a report to government on

that.

Among the ways that British Columbians can provide their thoughts

and advice on the health care system are the regional forums. There are 16 of

those. We're about two-thirds of the way through those regional forums now.

There have been some 6,400 British Columbians who've registered and reflected

their interest in being a part of those. They've been very well attended.

I've had the opportunity to attend a number of those. As well, the

Parliamentary Secretary for the Conversation on Health has attended those that I

have not been able to attend. We've attended professional forums with doctors

and nurses and front-line health care workers across the province. They've been

tremendously well attended as well. Great ideas were generated by that.

We've had patient forums where we've actually taken the

opportunity to sit down and listen to the experience of patients and what they

thought, from their perspective, could be possible to improve the provision of

services in our province.

[1115]

We have the website, of course, that has had tens of thousands of

visits, and thousands of submissions have been made on the Web to the B.C.

Conversation on Health site. We've seen great takeup in that regard too. Of

course, we've received all the old traditional ones like letters and phone calls

as well. In terms of a process that is inclusive of the people that it aims to

include, this process has been second to none.

If one compares it to the Romanow commission or any of the

processes that preceded it, the public involvement in this has been absolutely

remarkable — probably hundreds or thousands of times more involvement by the

citizens of this jurisdiction than there was involvement overall by citizens of

Canada in, for example, the Romanow report and Romanow commission.

R. Chouhan: Is there any information available as to how

many people with mental health and addictions participated in the Conversation

on Health? Is there any information, any breakdown available? Did they identify

themselves when they participated?

Hon. G. Abbott: We never ask people to identify themselves

in respect of the submissions, and I think that's the right approach.

Just to clarify a point that I made earlier, the health guide has

now been translated into Punjabi and Chinese as well as French — not Hindi, as I

misspoke earlier.

R. Chouhan: What happened to the Ministry of Health's

mental health advisory board which we used to have? Is it still functioning? Do

we still have it?

Hon. G. Abbott: The mental health review board is still

very much a part of the processes of adjudicating mental health issues in the

province.

R. Chouhan: When was the last time it met, and who is on

that board?

Hon. G. Abbott: Just to be clear, the mental health review

board is a very large structure with many members. It forms into panels to deal

with individual cases, and of course they meet whenever those cases appear. So I

wouldn't be surprised if they were meeting today. They meet on a continuous

basis in response to the adjudication of particular appeals by the mental health

client.

R. Chouhan: Why does this government refuse to have

services available for mental health clients during evenings and weekends?

Hon. G. Abbott: That assertion is incorrect. The member

will have to persuade me as to why he would want to make such an assertion.

[ Page 7666 ]

Just to go back to the earlier point in respect of the materials

developed a guide for physicians, families and individuals to provide

evidence-based information on prevention, early intervention, self-management,

treatment, crisis management and relapse prevention of depression, anxiety

disorders, substance abuse disorders and early psychosis.

The guide provides detailed evidence-based information for

physicians consistent with clinical practice guidelines developed by GPAC and

supplemented with information for individuals and family members, translated

into the five most common languages in B.C. Those are Cantonese, Mandarin,

includes information related to workplace mental health.

R. Chouhan: I'm advised that there are no services

available for people with mental illness during the evenings and weekends. If

it's true, could you please confirm where they can access those programs in the

evenings and on the weekends?

[1120]

Hon. G. Abbott: There is a whole range of ways in which a

mental health consumer might be able to access information during the evenings,

during the night. This is a program that is 24-7. There's a variety of different

ways. For example, one could call the B.C. NurseLine and get information from

one of the registered nurses that is available. If there is a compelling issue,

the mental health consumer could visit an emergency department and get a

reference from there. Additionally, we have psychiatric emergency services,

community-based crisis response and stabilization services.

All health authorities have and are building a continuum of crisis

response and emergency psychiatric services, which include crisis response

networks comprising 24-7 crisis lines, mobile units, crisis stabilization beds

in the community and an integrated team of ER and police response.

There are lots of examples of these initiatives, but I'll give a

few examples: the mobile crisis response unit, car 87, an excellent crisis

response unit in Vancouver; the mobile crisis response team in Victoria; a new

emergency crisis stabilization residence for women in Campbell River; a new

six-bed, short-stay crisis stabilization treatment facility in Nelson; the

psychiatric emergency services unit, Archie Courtnall Centre at Royal Jubilee

Hospital in Victoria; and increased psychiatric liaison physicians in emergency

departments in the Fraser region.

R. Chouhan: Are all of these programs that the minister has

now stated available after hours and on the weekend?

Hon. G. Abbott: Yes.

R. Chouhan: What steps has the government taken to promote

mental health in the schools and colleges in light of the recent Virginia Tech

incident that we had? Are there any plans to promote and deal with those kinds

of issues at the school levels and the college levels?

Hon. G. Abbott: When it comes to those issues in schools,

he may wish to canvass — although I believe they're completed — the estimates of

the Minister of Education or alternatively, if we're talking out-of-school

mental health issues for youth, the Minister of Children and Family Development.

R. Chouhan: My question is: is there any coordination

between the Ministry of Health and the Ministry of Education? We are talking

about mental health issues. In a news item today in the Vancouver Sun , it

says: "The stigma of living with a mental health disorder explains why 63

percent of youth feel embarrassed and fearful about seeking help." This is a

quote from Sen. Michael Kirby. He further says that though up to a quarter of

all youth have mental health concerns, only one in six has sought services from

a health professional.

My question to the Minister of Health is: is there any

coordination between the Ministry of Health and the Ministry of Education? Are

there any programs designed by the Ministry of Health for students in schools

and colleges?

[1125]

Hon. G. Abbott: The answer is yes, there is coordination.

The Ministry of Education, the Ministry of Health and the Ministry of Children

and Family Development all work in an integrated and coordinated way to deal

with those issues. In terms of what may happen with a particular program, our

public health nurses may or may not be involved, to a greater or lesser extent.

But yes, there is coordination.

R. Chouhan: Is that coordination plan available? Is the

information available to the public?

Hon. G. Abbott: We work together at a local level on a

constant basis. This is the real-world working-together of those who provide

those front-line services.

I should just add to the record, as well, that in terms of the

Mental Health Review Board, there are currently 67 members on that board. As I

indicated in my earlier answer, they do form into quasi-judicial panels to hold

hearings where applications are presented to them.

R. Chouhan: What's the status of the children and youth

mental health plan?

Hon. G. Abbott: We know the plan is proceeding, and the

Ministry of Children and Family Development is the lead.

R. Chouhan: We have heard from the mayor of Vancouver. His

plan is the cleanup act, which is coinciding with the 2010 Olympics. What is the

long-term support or planning beyond 2010 to deal with people who are

[ Page 7667 ]

suffering from mental illness regarding their housing concerns? I know the

minister has said we should be talking to the Minister for Housing, but I'm

talking particularly about people who are suffering from mental illness.

Are there any plans to deal with their concerns beyond 2010?

Hon. G. Abbott: I can't speak for the mayor of Vancouver.

But the date 2010 — apart from the fact that we're holding the Winter Olympics

and Paralympics in Vancouver and Whistler — from a mental health perspective,

has no particular magic to us. We know that the challenges of mental health will

continue on after 2010, as they are today.

R. Chouhan: We have dealt with this issue before as well.

When a person suffering from mental illness is lucky enough to go to hospital,

is there any consistent discharge plan provincewide when they're released from

the hospital? What plan are they dealing with?

Hon. G. Abbott: I'll provide a shorter version of this

answer to start off here, and then the member may wish to pursue further details

around it.

[1130]

Everyone who is discharged is discharged with a care plan, with

appropriate supports as they return to the community. That may involve facility

support on a day basis. It may involve ongoing care involving a physician. It

may involve the appropriate use of plan G in Pharmacare. There will be a plan

assembled for each person who leaves those facilities.

R. Chouhan: If a person who ends up in hospital is homeless

and after the treatment the person is released, where would that person go? The

person doesn't have anywhere to go to. Are there any steps included in the

discharge plan to deal with those people?

Hon. G. Abbott: The member is setting out a hypothetical

instance. Of course, when we have specific human beings attached to the

situation, the answer may change here. We can't take account of every situation

that may occur.

What hospitals will attempt to do with a patient-client who has

utilized the hospital's facilities and programs and who is ready to be

discharged…. They will try to have a coordinated plan with the community mental

health officials so that there is support. That may also involve B.C. Housing

and the opportunity for the mental health patient to have a support there.

Again, this is a hypothetical situation the member is advancing,

so it's difficult to be definitive, but that is the general scheme of things —

that we work with the community mental health to try to ensure they don't get

lost in any kind of shuffle.

R. Chouhan: We are not talking about hypothetical

situations. I was in Prince George and met with several doctors and care

providers there. They have told me there were at least two incidents where a

couple of these people were homeless and were left on a street in downtown. The

vicious circle started all over again.

My question is very specific: is there any plan that the ministry

has to deal with those people who may not have a home to go back to?

Hon. G. Abbott: I'm glad the member asked that question,

because do I ever have a volume of information for him here in respect of

follow-up on this. First, I want to note that not everyone who accesses hospital

services for either physical or mental illnesses or injury will require

follow-up. But it is very impressive that we do have, obviously, a program of

follow-up that is working very well.

I'll give the member and those who are watching here some

excellent information in respect to just how effective that 30-day follow-up is

from a mental health centre, or from hospital to mental health centre, community

mental health centre or a physician. For the Interior Health Authority in

2006-2007, 79.5 percent of those hospital mental health clients were followed up

by either a mental health centre or a physician — almost 80 percent in Interior

Health. That compares to some 73.2 percent back in 2001-2002.

For the Fraser Health Authority: 76-percent follow-up on hospital

mental health clients by the community mental health or a physician, and that

compares to 75.1 percent in 2001.

[1135]

For Vancouver Coastal Health — where, of course, the downtown east

side is located and which is one of the more challenging areas in terms of both

the numbers that present in hospital and the compelling nature of their

challenges — for '06-07 hospitalized mental health clients had an 82.6-percent

30-day follow-up by mental health centre or physician. That compares to 70.8

percent back in '01-02 — so a full 12-percent increase in the number of people

who were receiving follow-up services from community mental health and the

physicians. That is a stark improvement over five years by Vancouver Coastal

Health.

Vancouver Island Health Authority: 77.3 percent compared to 75.5

in 2001. Northern Health Authority: 78 percent compared to 71.2 percent in

'01-02. Overall in British Columbia: a follow-up rate of 78.3 percent versus

72.9 in fiscal '01-02.

Bear in mind that not all of those appropriately need follow-up. I

think the system is doing remarkably well in trying to ensure that the clients

or patients, as they leave a hospital setting, are not lost or forgotten in

terms of their mental health or substance abuse needs.

R. Chouhan: That was quite a short answer. I shouldn't say

anything like that, I know.

We canvassed this question last year. Let me ask this again

because we don't have an answer for that yet. Do the health authorities know how

many homeless people with mental illness are in their regions?

[ Page 7668 ]

Hon. G. Abbott: The answer to the member's important

question is this. One could only estimate what the portion of homeless that

could be afflicted with mental illness might be. First, when it comes to the

homeless themselves — and depending on the definition one would use in

determining whether one constituted homeless or not — one could only provide an

estimate.

Of course, when it comes to those among that cohort who have

mental health issues, that would be even more difficult to estimate with

precision, given that we have not been able, nor will we be able, to do a

clinical analysis and assessment of all of those who would be deemed homeless.

We would have to do that clinical assessment to say with precision what it might

be.

I understand from staff that there are some estimates of what that

number might be. I presume it would probably be an estimate based on the general

population having about one in five or one in six in terms of mental health or

addictions issues, and then extrapolating from that what the number might be in

a homeless cohort.

That having been said, these are going to be estimates, but the

estimates do exist, and we could provide those. We don't have them with us, but

we can provide our best information that we have to the member, should he wish

it.

R. Chouhan: We know that 50 percent of people in the

prisons suffer from mental illness. What kind of support services are available

for those people who are in the prisons?

[1140]

Hon. G. Abbott: To begin, the member used a figure of 50

percent in relation to that portion of the prison population which he reckoned

would be afflicted with a mental disorder or addictions issue. The estimate that

my ministry has in respect of the number that might be affected in the prison

population is 30 percent.

In terms of that 30 percent, there is a coordinated

interministerial strategy related to mentally disordered offenders. It's a

partnership that's been developed with the Ministry of Health, the Ministry of

Children and Family Development, the Ministry of Public Safety and Solicitor

General and the Ministry of Attorney General. All of this partnership revolves

around improved integration, planning, services and supports for people with

mental health or substance abuse disorders who are involved in the criminal

justice system.

Among the initiatives currently underway we have evaluation of the

Vancouver intensive supervision unit, or VISU; analysis of the service needs of

a cohort of chronic offenders; further integration and evaluation of the urgent

response team; planning a community court pilot project in downtown Vancouver;

implementation of a chronic offender pilot project in Vancouver; enhancement and

analysis of integrated cross-ministry data to improve planning and services; and

implementation of better central and regional structures and processes to

improve planning and service delivery.

R. Chouhan: I have a copy of this press release from the

Canadian Mental Health Association and the Schizophrenia Society of Canada, in

which they're saying that a large number of inmates have a mental illness that

requires treatment. Of these, 7 percent to 9 percent have a serious mental

illness such as schizophrenia, bipolar disorder and major depression. If these

inmates do not receive hospital-standard psychiatric care, their chances of

rehabilitation are extremely low and their risk of reoffending remains high.

Do we have any specific programs to deal with or provide services

to these people in our prisons?

Hon. G. Abbott: The member might better refer his questions

to the Minister of Public Safety and Solicitor General.

R. Chouhan: Let me ask this question of the minister: is

the minister aware of any coordination between his ministry and the other

responsible ministries? Are police officers trained to deal with mental illness

situations? Are prison guards trained to deal with these mental illness

situations in the prisons?

Hon. G. Abbott: Yes, there is coordination. Again, the lead

with respect to these programs and issues is the Ministry of Public Safety and

Solicitor General.

[1145]

R. Chouhan: Let's deal with Riverview Hospital. Can you

give us an update on the Riverview redevelopment program? Where is it now?

Hon. G. Abbott: The question the member asks has a number

of levels of complexity associated with it, as you might expect. I know staff

are digging out a range of materials which may be of assistance in answering

more detailed questions in respect of Riverview.

Let me sort of give an overview of what we attempted and are

attempting to do with the Riverview devolution project. The aim was to take what

are some of the outmoded, outdated and declining facilities at Riverview and see

their replacement with regional facilities. I mentioned a number of those in an

earlier response.

Among those regional facilities which we've seen move out: Seven

Sisters in Terrace; South Hills in Kamloops; Sevenoaks in Saanich; Iris House in

Prince George; Sandringham in Victoria; and of course the Cottonwood Lodge —

Connolly Lodge — facility, which while on the Riverview site, is a new facility

oriented towards being a home-like environment. Again, it is a huge improvement

over the facilities that they left at Riverview.

The other piece, which has been very important because it saw the

closure of a really outdated facility at Riverview, was the 44-bed tertiary

Hillside facility in Kamloops, in conjunction with Royal Inland Hospital. I had

the honour of officially opening that several months ago. It is a beautiful

facility, and I think the province can be very proud that for those cases where

there's a concurrent injury and brain illness or disorder, we at last have a

facility that is really appropriate.

That's sort of the overview. I know the member may have more

specific questions, so I'll invite him to

[ Page 7669 ]

submit those. I think the staff now have more information that we can offer

up in response to his questions.

R. Chouhan: Are the complex care case individuals still

residing at Riverview? Also, when are they going to be transferred to

community-based programs?

[1150]

Hon. G. Abbott: I can add to the level of detail here and

then invite the member to ask further questions.

Of the 600 approximate patient population when the devolution

process began, about 300 have been transferred now to the regional health

facilities, which I outlined in my previous answer. About 300 patients remain at

Riverview Hospital. A portion of that 300, I am advised, are patients who are

ongoing, in much probability there for the balance of their lives.

There is another portion, however, who are new, who are being

treated, and who will in due course be discharged. So there is a division among

that 300 between the sort of chronic, ongoing population and those that, while

they may have chronic issues, will be treated and discharged.

Another example of those with chronic disorders is the new 44-bed

neuropsychiatry facility which has been constructed near Royal Inland Hospital

in Kamloops and now provides excellent premises, where the previous facilities

at Riverview really cried out for closure some time ago.

R. Chouhan: We're going to pursue this line of questioning

later on this afternoon. In the meantime let me ask another question, given that

we don't have much time left. What is the government's approach for specifically

adult mental health care?

Hon. G. Abbott: We just wanted to make sure that we

understand the member's question. What we thought we heard was: "What are we

doing about adult mental health care?" If that is the question, we outlined much

earlier in the estimates today the continuum of care that has been developed and

continues to be developed for the mental health consumers of the province.

But I suspect we may have misunderstood the question. If the

member wouldn't mind clarifying what he's seeking here, I'd be glad to respond

again.

R. Chouhan: Let me give you a little background. In

February of this year the government closed the waiting list for the adult ADHD

clinic at the B.C. Children's Hospital. Let me ask this question; maybe then you

can cover the previous question as well. Will the government reopen this waiting

list?

Hon. G. Abbott: Thank you to the member for his question.

We believe that the issue the member is canvassing here is in respect of a pilot

project undertaken at Children's Hospital, which involved consultation with

adult sufferers of ADHD. I believe what we're talking about here was that pilot

project.

[1155]

The pilot project has proceeded, as we understand it. Staff are

going to pursue this further, so we may see ourselves refining this answer a

little bit later on. But my understanding is that the conclusion that Children's

Hospital came to was that it is not a core function of Children's Hospital to be

providing adult ADHD programming, that ADHD is something they want to focus —

perhaps appropriately for Children's Hospital — on children. That will be their

core program in the future, so for that reason they declined to add any further

clients to the adult pilot project in respect of ADHD.

Again, we may refine that answer as we get more information from

PHSA and Children's on that point.

Noting the hour, I move we rise, report progress and ask leave to

sit again.

Motion approved.

The committee rose at 11:56 a.m.

The House resumed; Mr. Speaker in the chair.

Committee of Supply (Section B), having reported progress, was

granted leave to sit again.

Committee of Supply (Section A), having reported progress, was

granted leave to sit again.

Reports from Committees

A. Horning: Mr. Speaker, I have the honour to present a

report from the Select Standing Committee on Parliamentary Reform, Ethical

Conduct, Standing Orders and Private Bills.

I move that the report be read and received.

Motion approved.

Law Clerk:

May 8, 2007

Mr. Speaker:

Your Select Standing Committee on Parliamentary

Reform, Ethical Conduct, Standing Orders and Private Bills begs leave to report

as follows: (1) that the

preamble to Bill (No. PR401) intituled Pacific Coast

University for Workplace Health Sciences Act has been proved, and the

committee recommends to the House that the bill proceed to second reading; (2) that

the

preamble to Bill (No. PR402) intituled Mission Foundation Amendment Act,

2007 , has been proved, and the committee recommends to the House that the

bill proceed to second reading.

All of which is respectfully submitted,

A. Horning, Chairman

A. Horning: By leave, I move that the report be adopted.

Leave granted.

Motion approved.

[ Page 7670 ]

Bills Pr401 and Pr402 ordered to be placed on orders of the

day for second reading at the next sitting of the House after today.

Hon. G. Abbott: With that very appropriate addition to our

business of today, I move the House do now adjourn.

Hon. G. Abbott moved adjournment of the House.

Motion approved.

Mr. Speaker: This House stands adjourned until 1:30 this

afternoon.

The House adjourned at 11:59 a.m.

PROCEEDINGS IN THE

DOUGLAS FIR ROOM

Committee of Supply

ESTIMATES: MINISTRY OF

COMMUNITY SERVICES AND

MINISTER RESPONSIBLE FOR

SENIORS' AND WOMEN'S ISSUES

(continued)

The House in Committee of Supply (Section A); J. McIntyre in the

chair.

The committee met at 10:08 a.m.

On Vote 22: ministry operations, $255,333,000 (continued).

C. Wyse: Good morning to everyone. Yesterday we finished up

our discussions around contracts and grants that extend to UBCM from the

ministry. I would like to provide an opportunity for the minister to clarify the

accountability process that the ministry has with UBCM with regards to the goals

and objectives that have been set up between her ministry and UBCM for

contracts, grants, and so on.

Hon. I. Chong: The UBCM has been able to provide a number

of programs on behalf of various ministries, not just the Ministry of Community

Services. For example, we will have Ministry of Education who may ask UBCM to

deliver some programs in terms of their school community connections program. We

could even have the Ministry of Health asking UBCM to undertake some initiatives

where local governments can be involved. We know through the Ministry of Public

Safety and Solicitor General, the emergency preparedness program, for example,

would be an area that they would be taking a look at.

[1010]

A number of initiatives that we believe local governments can be

involved in and oftentimes would request grants of various ministries can make

it problematic. What we have undertaken to do from time to time is set aside

dollars in whichever ministry is appropriate and provide it to UBCM so that they

can link with their local government in a much more direct way.

What each ministry is then able to do is deal directly with UBCM,

and it's generally the executive director, Mr. Richard Taylor, who I know the

member knows, who would then be able to provide us with a reporting — it can be

as frequent as quarterly but most often at least once a year, annually — as to

how the grants have been distributed and for what particular projects.

Again, because we believe local governments at that level who are

accessing those dollars know best what they're wanting, we also rely on UBCM to

make the determination whether it fits within that program. One example, I

guess, perhaps the easiest, is the $25 million we've provided for the community

tourism program. I understand that half of those dollars have been expended. The

second half has just been reviewed, and UBCM has reported out to myself as well

as to the Minister of Tourism which municipalities applied for those dollars and

how they have used those dollars in their communities to promote tourism.

There is an accountability mechanism insofar as they do have to

report back and see how those dollars are expended, and from time to time they

will seek our direction as to why there hasn't been perhaps a large pickup on

that and other times to just let us know how quickly people are accessing. You

can imagine the emergency preparedness as one example. Many local communities

look to receive those grants fairly quickly.

As I say, these programs are administrated through UBCM. They, I

believe, have it on their website as well. I'm aware, just as an example, that

the community tourism program put a sheet on the website, and they'll perhaps

even cite examples of how the dollars have been used. The West Nile virus risk

reduction initiative is another example. Strategic wildfire prevention

initiative, school community connections program, the seniors housing and

support initiatives, which we spoke about briefly yesterday — these are all….

There is a number of them, and I know UBCM has them on their website. On a very

regular basis at the annual conference UBCM provides workshops for local

governments, as well, to share with them what's been happening in those

particular areas.

I'm hoping that that's satisfactory for the member.

C. Wyse: It seems to me, if I understood the answer

correctly, that there is no direct accountability for the ministry to determine,

in actual fact, whether the objectives that either her ministry or other

ministries have are actually being achieved. I don't wish to put words in the

minister's mouth, so I would like the minister to either agree or disagree with

that statement that I have made.

Hon. I. Chong: I would disagree insofar as we do believe

there is a mechanism to monitor these programs and provide for accountability.

Now if the member is suggesting that we are going to suggest to local

governments that they cannot expend the dollars in the way they

[ Page 7671 ]

feel is most appropriate and he feels that we should be placing conditions on

those grants, then I guess I would ask him to make that clear.

In many cases we do provide these grants in an unconditional

sense, other than to provide them with the purpose and intent of which they are

to be used. Just as an example, and this is not about dollars being transferred

to UBCM, I know the member is aware that the traffic fine revenue sharing, a

grant that we provide to the local governments through our ministry.

[1015]

Those are unconditional, except that when we said we would provide

those dollars, they would be for things such as policing, crime prevention,

community safety. If the member expects that I would have to go to each

municipality and ask them to be accountable, and it doesn't fit with what we're

asking…. If they believe that they've accomplished the policing initiative or

crime prevention initiatives, then I will accept that.

What we are able to do is ask local governments to report back to

us. In the case of the traffic fine revenue sharing, what we have now asked is

for a reporting out every year of how they have spent those dollars, not just

for my benefit but for the benefit of all British Columbians and all taxpayers

to see. When large sums of dollars are going to local governments which are

saying that it's to provide additional services, I would expect their taxpayers

would want to see how those dollars are spent. So absolutely there is a

mechanism.

In some of these programs, such as the emergency planning, the

local governments will be able to say how those dollars are spent. They would

tell their citizens, as well, how additional dollars are able to be accessed

through the UBCM program, share with their constituents or taxpayers as to how

that was spent in their community. UBCM would then be able to list that as one

of the outcomes or achievements that community has and list them for everyone

else to see.

It is an ongoing process, and UBCM is constantly updating it. But

if the member is suggesting that the accountability requires that we direct how

money is to be spent, then I would say that is not how the programs actually

occur. We don't direct.

The crystal meth program is another one that UBCM administers. We

say: "Here are the dollars." Community after community has said this is a

scourge on their local areas, and they needed a way to access dollars. They have

in mind what it is. One community may decide to put on workshops to tell parents

and raise awareness of what crystal meth is all about and how to watch for these

in their communities. Another community may decide to post a webpage for parents

to have support systems.

We're not going to say, "This one is the right one," or "That is

the wrong one," or "This is the one you should follow." But we will say: "Here

are dollars that are available, because you say these are the needs that you

have in your community. We're prepared to provide those dollars through UBCM,

allowing you to access those dollars, and you decide how you feel it best meets

the needs of the citizens in your area. We want to hear back from you."

They do provide us with a report. That is a method that can show

taxpayers where dollars have been spent.

C. Wyse: I think I followed the response from the minister.

At no time was I suggesting that an evaluation would be made upon the projects

that were chosen by local governments to achieve the objectives of the province.

I was simply attempting to determine whether the province had any agreement with

UBCM for some type of an evaluation to ensure that the funds that were being

provided to meet the provincial objectives were basically being expended in that

very broad area of those objectives. From what I have understood, it's fluid.

At that moment I'm going to move on to another topic, which is the

trade, investment and labour mobility agreement. TILMA was signed by the B.C.

and Alberta governments on October 6 as a bilateral offshoot agreement from the

agreement on internal trade.

The deal has basically been done behind closed doors of joint

B.C.-Alberta cabinet meetings. A number of protocols and memorandums of

understanding on specific issues have been signed in the lead-up to this

agreement.

The first the public heard about the apparently final deal being

signed was a news release issued after the pact was signed April 28, 2006. There

has been no legislation concerning this deal introduced in the Legislature to

date, and there is no provision in the agreement for public consultation or

legislative debate. The Premier of Saskatchewan, however, has committed to a

public consultation process prior to signing on to TILMA.

[1020]

Under TILMA municipalities are prohibited from implementing any

measures that may impact trade, investment or labour mobility between B.C. and

Alberta. Municipalities are very worried about the impacts of TILMA on municipal

autonomy. For instance, Burnaby Mayor Derek Corrigan, who is also the GVRD's

representative on the international trade agreement, suggests that "it isn't

necessarily in the best interests of our communities to have international

corporations using our regulations to make money, the greatest amount of money

possible," and that "TILMA is a situation in which there is an omnibus attempt

to take away the powers of municipalities."

Now, there is a legitimate objectives exemption that I would also

like to bring to the attention of our discussion here. The B.C. Economic

Development Minister wrote in an e-mail to a constituent on November 28, 2006:

"B.C. and Alberta have reserved the right to supersede the agreement when they

are pursuing a legitimate objective."

However,

article 6 of TILMA, "Legitimate objectives," allows

government to justify their measures only if they can demonstrate to the

satisfaction of a dispute panel that…. There are three conditions, and all three

conditions must be met. They are: (1) they are pursuing one of the few

objectives TILMA defines as legitimate, (2) their measure is not more

restrictive than necessary to achieve that measure, and (3) they are not engaged

in a disguised restriction on trade investment or labour mobility.

It is not enough, therefore, to claim the pursuit of a legitimate

objective, as the Minister of Economic

[ Page 7672 ]

Development suggests. What B.C. and Alberta have created in TILMA's

article 6

is a next-to-useless defence against challenges rather than a right to supersede

agreement.

As the Council of Canadians notes, the track record of governments

trying to convince trade panels that their measures are necessary has been

resoundingly negative. In the six cases brought to similar panels under the

existing agreement on internal trade, when governments have tried to prove that

what they were doing was necessary, those governments lost every time. Dispute

panels have argued the government must prove that there is nothing else they

could do to meet their objectives, an almost impossible task. Clearly, these

restrictions on legitimate objectives leave municipalities extremely susceptible

to losing any authority they might have to overrule any action or inaction as a

result of TILMA.

TILMA is extremely broad in that it assumes that everything is

covered by it except those areas designated as specifically excluded. The

legitimate objectives specified are — and there are a number of them: public

security and safety; public order; protection of human, animal or plant life or

health; protection of the environment; conservation and prevention of waste of

non-renewable or exhaustible resources; consumer protection; protection of the

health, safety and well-being of workers; provision of social services and

health services within the territory of the party; affirmative action programs

for disadvantaged groups; and prevention or relief of critical shortages of

goods essential to the party.

However, I emphasize that there are potentially numerous policy

areas not included in this list, including land use planning, preservation of

heritage sites and the agricultural land reserve. The three categories of

exemption — the general exemption,

part 5; legitimate objectives,

article 6; and

also the transitional measures,

part 6 — are relied on heavily to reduce fears

about the impact of TILMA.

It is thus important to note, and I repeat, that the list of

exceptions is very narrow and that TILMA is so broad that anything is not

explicitly articulated in the current wording of the agreement is not protected.

Even with general exemptions it is stated in TILMA that there is the intent to

shrink this list over time through annual review, with a view to reducing their

scope.

Legitimate objectives are subject to TILMA's necessity test and

least-restrictive test, which means that a government does not only need to

prove that its policy, any measure, is a legitimate objective, but even if a

measure falls under this exemption, a government would still have to prove that

the measure is the least restrictive it could be on trade, investment and labour

mobility to accomplish the objective and that there is no other available

option, in the wording of TILMA,

article 6, that has minimal adverse effects in

trade, investment and labour mobility.

[1025]

All exceptions are still subject to dispute procedures whereby

investors can always argue to the three-person panel that there is a less

restrictive way to accomplish a goal. While local governments have been told

that TILMA does not apply to them until April 1, 2009, in fact there are some

aspects of TILMA that apply to local governments starting this April 1, 2007.

What is more, TILMA also contains a provision that states that no new measures

can be introduced after April 1, 2007, that would be inconsistent with this

agreement, and after April 1, 2007, government cannot "amend or renew a measure

in a manner that would decrease its consistency" with TILMA.

TILMA comes into effect April 1, 2007, with a two-year transition

period. The agreement covers the provincial government and its entities,

including Crown corporations, government-owned commercial enterprises, local

government, regional districts, school boards, health and social services, and

non-governmental bodies that exercise authority delegated by law — for example,

the Workers Compensation Board.

Municipalities are exempt from the provisions of TILMA during the

transition period to April 1, 2009, except being bound to — there are three of

them — involvement in further consultations and negotiations to identify any

special provisions, exclusions and other transitional provisions; working on

reconciling differences in standards and regulations, investment, business

subsidies, labour mobility and procurement of professional services of

architects and engineers; not establishing new or amending or renewing existing

standards or regulations that operate to restrict or impair trade, investment or

labour mobility.

TILMA has structured trade panels to interpret the agreements.

It's important to understand some things that the trade panels themselves may

and could do. TILMA could be used to challenge local government zoning as an

obstacle to investment. B.C. local government bylaws could be challenged even if

they do not discriminate in any way against Alberta investors. TILMA does not

exempt government measures simply because they serve the public interest.

Private investors can pursue complaints under TILMA and be awarded compensation

without having the support of the government where they are based. TILMA panel

rulings effectively cannot be appealed.

There are a number of areas of concern in this agreement, and I

list them: the effect of harmonizing B.C. standards and regulations with those

in Alberta, the effect of the provincial government possibly leaving itself and

municipalities open to lawsuits on actions construed under the agreement as

restricting investment, concern around restrictions on procurement policies that

would discourage such practices as local hiring, and ethical purchasing

policies.

TILMA is an agreement that has occurred with no public

consultation or input and will have devastating effects on numerous sectors of

the province. Members on this side recently called on the government to bring

TILMA into the House for a full debate. The government voted against this and

therefore proved that they are not willing to have any public discussion or

consultation on TILMA. Consequently, we are here pursuing questions in this

particular process.

My first question to the minister on this particularly important

topic is: why has the government refused to bring in legislation to implement

TILMA?

[ Page 7673 ]

Hon. I. Chong: My apologies. I had forgotten to introduce

staff who are with me here today. Very quickly here, to my right I have my

deputy minister, Sheila Wynn. To my left, Gary Paget, executive director,

governance and structure and deputy inspector of municipalities. Behind me I

have Assistant Deputy Minister Shauna Brouwer, management services. Beside her,

Marijke Edmondson, manager, local government liaison. I was remiss in not

introducing them, and I want to ensure that the members know who is here today

with me.

In regards to TILMA first of all let me say that this is an area

that the Minister of Economic Development has the lead on, and he will be

primarily responsible for it. What I can say is that it is an agreement that

British Columbia and Alberta entered into to eliminate barriers to trade and to

enhance competitiveness and stability of both provinces. I should note that we

have had in the past an agreement, the existing agreement on internal trade —

the AIT, I believe it was called — that came into effect in 1995. It's not that

there has never been internal trade with provinces, but there have been some

problems with that.

[1030]

With TILMA we're expecting to eliminate some barriers to trade and

to enhance, as I say, the competitiveness and stability of both provinces. It's

not an agreement that is designed to negatively impact on municipalities.

Rather, it is an agreement that is expected to produce many economic benefits

for both British Columbia and Alberta.

It should be noted that TILMA will not profoundly change the way

in which local governments operate because, just like the province, local

governments have long been expected to operate in a trade-competitive manner. So

I think some of the issues that have been raised, that there are going to be

some drastic changes in the way local governments operate, are incorrect and in

fact unfounded. I know that TILMA is going to have a direct impact on local

governments in three areas specifically, which is in terms of business

registration, business subsidies and procurement.

Again, TILMA is not designed to constrain the ability of local

governments to develop bona fide non-discriminatory bylaws or make land use

decisions. There has been talk that there would be land use decisions affected

by TILMA, but that is not the case.

What I can provide the member with…. I know he may have a series

of questions, but let me put this to him. The fact of the matter is both

provinces will come into compliance with TILMA by April 1, 2009.

It came into effect April 1, 2007 insofar as to advise or make

aware that both provinces must not, in these two years of transition leading up

to the full compliance requirements of April 1, begin to enter into any such

arrangements as would therefore have to be adjusted or reversed by April 1,

2009. Knowing something will be required to be in full compliance two years out,

we would expect that both provinces would not be jeopardizing the spirit and

intent of the TILMA during the transition period.

In terms of consultation and involvement, I know that the Minister

of Economic Development met with the UBCM executive — I believe on the 18th of

April, when the executive were here in Victoria — and then subsequently wrote a

letter to the president of the UBCM, Ms. Brenda Binnie. I'll just read to you

two paragraphs in that letter:

"In response to your first

request" — and this is where the UBCM requested some involvement — "I would like

to emphasize that UBCM'S participation in the TILMA negotiations would be

welcomed. Your expertise and knowledge of local issues will certainly benefit

the discussions required to ensure maximum benefits to your members as the

TILMA's coverage is extended to the broader public sector.

"With respect to the consultation agreement, I have

directed staff to work with your Executive Director Richard Taylor to complete

work this area."

Those two paragraphs are in the letter dated April 20 that was sent

to the president of the UBCM, Ms. Brenda Binnie. So my understanding is that the

Minister of Economic Development has agreed, pursuant to

section 277 of the

Community Charter, to consult with UBCM as to the negotiations that can take

place over the next two years. I know that they are looking forward to engaging

and providing information and input from their members, so I believe we have to

allow that process to take place.

Any other specific articles and sections that the member or any

other members — his colleagues — may have in regards to the agreement in itself,

I would ask they direct to the Minister of Economic Development.

C. Wyse: I would take under advisement the suggestion from

the minister upon where questions may or may not be directed. This is Community

Services. Local government, to my understanding, falls very much underneath this

particular ministry, and there are questions that come into play around TILMA.

The minister is quite correct when she refers to the Community

Charter in consulting local government, with all due respect, upon items that

will affect them. But the consultation is taking place after the agreement was

signed. The horse is out of the barn when the consultation is now beginning with

local government. There are concerns that local government has around this issue

that have been conveyed to me.

[1035]

I will return to the question with which I started off the

discussion around TILMA. So once more, back to you shortly, the minister made

reference to trade. Trade is a federally regulated item, and anytime that an

issue around trade or any trade barriers has come up at a provincial level, the

federal government has stepped in and stopped immediately any practices that

were considered to set up trade barriers between the provinces. I do wish to

have that upon the record.

Now my question, once more, back to the minister. I would wonder

what her rationale or reasoning is. Why did the government refuse to bring in

legislation to implement TILMA to the House?

The Chair: Member, if I could have your attention for a

moment. I want to caution you that your questioning about the need for

legislation or not is not

[ Page 7674 ]

strictly contained in this. We're here to debate the estimates for this

ministry.

Certainly, certain questions, as you indicate, are probably

relevant, but questions about the need or not for legislation, which is the

second time you've asked this question, are really not within the bounds of

this. I'm encouraging you, essentially, to stay on topic.

C. Wyse: Thank you, Chair. On topic or off topic, I'm

always appreciative of obtaining information from my colleagues opposite on

their points of view.

Well then, let's return to this question. Does the minister

recognize the devastating effects this agreement will have on the municipal

economy?

Hon. I. Chong: I've already indicated in my first response

to the member that the purpose of TILMA for British Columbia and Alberta local

governments is to allow for competitiveness and to create stability. In that

sense, I would think that local governments would appreciate that.

I can also say that it's not the first time that UBCM were made

aware. I understand that a letter on January 31, 2007, was written by the

Minister of Economic Development as well as the Alberta Minister of

International, Intergovernmental and Aboriginal Relations — the minister

responsible for TILMA in that province — to Mr. Taylor at the UBCM as well, so

they have certainly been apprised of ongoing work in this area.

In terms of the effects and impacts on local governments, I've

already stated to the member the three areas where TILMA will have direct

impact. Those are business registration, which is to require local governments

to reconcile their business registration and reporting requirements with those

of Alberta; business subsidies, to prohibit local governments from providing

business subsidies that provide an advantage to an enterprise that would entice

a relocation of an enterprise or that otherwise distort investment decisions;

and thirdly, procurement, which would require local governments to provide open

and non-discriminatory access of their procurement activities. Those are the

three areas where TILMA will impact on local government.

As I've indicated, the Minister of Economic Development, who is

leading the implementation of TILMA, has welcomed the input and participation of

the UBCM executive. They will provide, whoever that person will be, information

that local government member municipalities may wish to have addressed at that

consultation process.

C. Wyse: From this I understand…. I will back up just a

little bit. My recollection was that the letter that was referred to, in

January, was advising — that is, the Alberta and B.C. counterparts — that in

actual fact TILMA was well along the way and that input and consultation would

be provided at a different period of time.

I think we are very much on the same page, that the consultation

is taking place after the agreement has been signed. I think we can just move on

to deal with the issues of the concerns that do exist now with local governments

around the restrictions on their particular area.

Now, it might be interesting to look at the difference between the

two levels of government and what their various functions are, and then view

that in the context of the description that I gave of TILMA. Provinces are in

the business of regulating trade investment and labour mobility. They set

regulations for the registration of vehicles and businesses. They set the

criteria for professions and trades. They set minimum standards in areas of

health and safety. They regulate transportation, agriculture, energy, minerals,

forests, fish and wildlife, the environment and financial institutions.

[1040]

A good description, in my mind, of some of the functions that a

senior level of government, the province, does. Let's compare that to the

description of a local level of government. The role of a local government,

however, is to establish unique rules in specific areas to achieve the specific

goals of their community. This aspect of local government is described in

several different ways.

As you can see, that contrast between the two levels of government

is very dramatically different, yet TILMA applies equally to both sets of

circumstances. Through you, Chair, to the minister responsible for local

government: what steps is the ministry taking to help municipalities learn about

TILMA and prepare them for the effects that this agreement will have on

municipal autonomy?

Hon. I. Chong: I would say to the member that we are not

removing municipal or local government autonomy. They still have autonomy in the

areas that they're most and primarily concerned with. What we are saying is that

this agreement is intended to eliminate barriers to trade and to enhance the

competitiveness and stability of both provinces.

Now, if the member and his colleagues are suggesting that we do

not want our local governments to be competitive, then I guess we'll beg to

differ on that. We do believe that this province continues to lead in economic

growth, in economic opportunities, because we have shown to be and have been a

leader across Canada as a competitive province. We believe that local

governments want to join us in that so that their communities can also thrive

and do well and create jobs and have the potential that they believe they can

have.

Again, I will say that TILMA has a direct impact on local

governments in three specific areas. I've listed those areas. The Minister of

Economic Development has engaged the president and the executive director at

this time of UBCM to be involved in the negotiations and in the consultation

process. I would expect that we would ask the president of UBCM as well as the

executive director and the entire executive how they wish to include their

member municipalities in how that engagement should take place.

It may be in the form of a workshop at UBCM, or it may be in terms

of the area associations. I'm not going to dictate or direct that's how it

should be. I'm going to ask the UBCM president and the executive director what

they would like in terms of assistance to facilitate, to share that information,

if that's what the member is asking.

How will member municipalities be able to learn about TILMA? Well,

there are a variety of ways. If they

[ Page 7675 ]

feel it's helpful to have it in some form of workshop, again, we will have to

decide how that can best be accomplished. Sometimes it's a lot more difficult at

UBCM, because you have a thousand delegates. Everybody is trying to partake in

every particular workshop or forum that takes place, and it's just not possible.

Perhaps the area associations would be the best place.

Again, I'm going to await and receive input from the UBCM

president and executive as to how they want to proceed. But I do know that the

Minister of Economic Development opened that door and said to UBCM: "You're very

welcome to speak with us on how we can engage your member municipalities on

understanding the implementation of TILMA."

[1045]

C. Wyse: It's an interesting situation that I find here. A

group has been taken to the dance and told they are going to dance. They were

not asked whether they wanted to dance. Once that has been established, then

we're going to discuss, possibly, how local government is going to learn about

the effect of the agreement.

Sometimes my analogies are not particularly good. So I'm going to

swing back over to the minister and try to rephrase this question. What direct

plans does her ministry have for working with local government on dealing with

TILMA and its effect — and if, furthermore, local government has the option of

actually even being involved in TILMA?

Hon. I. Chong: I've indicated to the member that the

implementation of TILMA will be led by the Minister of Economic Development.

However, because there are three areas that will have a direct impact on local

governments, our ministry and staff will be working with the Ministry of

Economic Development and with UBCM in these negotiations.

Again, my understanding is — I've just checked with staff — that

UBCM has already indicated that they would like to consider having a workshop at

this year's conference. But because I don't set the agenda, I can't say

absolutely that will occur. But there is every indication that they're hoping to

put on a workshop at UBCM in September of 2007.

C. Wyse: Let me try it this way, then. What funds have been

allocated in your budget to the process of adapting to TILMA?

Hon. I. Chong: As with many initiatives that sometimes go

across government, you don't actually have to set up a particular fund to deal

with a particular initiative. What you do is you dedicate staff and reallocate

resources, in a way, within your ministry. We do have at least one of our staff

members, and perhaps it will be more, dedicated to or who will be working with

the Ministry of Economic Development to ensure that the concerns we hear can be

addressed. Again, I would say that it's not expected that TILMA will profoundly

change the way in which local governments operate.

Respectfully, if local governments have those concerns and if they

raise them with the critic or they raise them with me, we have an avenue with

which to pursue those. We have the UBCM, the UBCM executive. We have the annual

conference. We have the area association meetings.

More than that, what I can say is that local governments meet with

me regularly throughout the year. They call me regularly. I'm in their

communities on a regular basis, and if an issue is raised, then I'm able to

bring that back and share that when the consultation process takes place with

the Minister of Economic Development. But in terms of bringing as many people

together as possible, I guess UBCM has chosen that they would like to consider

that at this year's conference.

C. Wyse: Let me try it this way, then. What is the Ministry

of Community Services' actual role in this process of TILMA and its effect upon

local governments?

Hon. I. Chong: The Ministry of Community Services will play

an active role in ensuring that these three areas which have a direct impact on

local government will be addressed if any of these concerns are raised. If local

governments are concerned about how the business registration should take place,

then I'm confident they will let me know. I will certainly have my dedicated

staff person in those discussions and will raise that with the Minister of

Economic Development, and we will see whether we can facilitate any changes to

ensure that everyone understands how that business registration should take

place.

In terms of business subsidies, another area that will impact on

local governments, if there are concerns about how that is understood,

interpreted, we will bring those issues — if it's unclear — to the Minister of

Economic Development, get that clarity and ensure local governments are aware.

[1050]

In the area of procurement, once again, this is about ensuring

that local governments can disclose their procurement information and look at

where the value of goods is greater than $10,000, the value of service is

greater than $75,000 and the value of construction is greater than $100,000.

Those are what are in the agreement.

In the event that local governments raise concerns or issues on

it, as their representative at the executive council level, I will then present

these to the Minister of Economic Development and say: are these legitimate

concerns? Do we share them across the province? Are they only in one province

versus another? How can we ensure that there is understanding as a whole?

For these three areas in particular that directly impact local

governments, my ministry staff will be involved to ensure that there is clarity

and understanding, that local governments are able to implement them and come in

compliance by April 1, 2009.

C. Wyse: I appreciate the honesty of the minister in

acknowledging that there are at least three areas where there is agreed-upon

concern.

[ Page 7676 ]

However, when you have an agreement that is subject to

interpretation by panels, and when there are no rulings to date — no past

practices to establish, in actual fact, where other areas of concern may be — to

simply state that there are only three is presupposing the rulings of these

panels I referred to, which will ultimately be making the final say.

Establishing the overall effect of TILMA is still to be decided. That statement

hasn't been made.

I now have become a little bit confused. At this moment in time

I'm not certain whether local government is to be consulting the Minister of

Economic Development or the Minister of Community Services with issues around

TILMA, so I would ask to have that clarified. Who does local government get in

contact with when they have concerns here?

Hon. I. Chong: I'm sorry if I created confusion in the mind

of the member for Cariboo South. I'll try to be clearer this time.

Because the Minister of Economic Development is leading the

implementation of TILMA and because there are three areas that directly impact

local governments — and I say that these three areas directly impact local

governments — he has allowed and permitted the UBCM executive to be involved in

the consultation process, as required under

section 277 of the Community

Charter.

For that reason primarily, I would expect that many of the

concerns that we hear should be coming through the UBCM process. Therefore, the

UBCM representatives in this consultation process will be able to directly speak

to the Minister of Economic Development and have those issues of concern dealt

with.

As the Minister of Community Services, I too, on a daily, weekly,

monthly and an annual basis hear from local governments — as I'm sure the critic

will — and meet with them on a variety of issues. If the issues concerning TILMA

are raised with me directly, then I'm just suggesting that I won't be dismissing

those. I will take those and share them with the Minister of Economic

Development.

He may not be meeting with all the local governments that I meet

with on a frequent basis, but if the Minister of Economic Development chooses

to, and if local governments choose to meet with him, they can do that. If a

local government chooses to meet with me instead, to raise an issue of concern

with me — whether it's on TILMA, on water or sewer, or on local government

grants — they can do that. They know they can.

My door has always been open to local governments. If they raise

an issue with regard to TILMA with me and have not had an opportunity to bring

it to the attention of the UBCM executive or the Minister of Economic

Development, then I would be more than pleased to make sure that those areas of

concern or those issues will be brought to their attention. If I have

information to provide back to the local government, then I will do so. I will

facilitate that exchange of information.

I do that not just for TILMA, but on a whole host of requests that

I receive from local governments. I'm hoping that's clearer for the member.

C. Wyse: I think it's clear for me now that local

governments have got two ministers that they're dealing with on an item where

we're in agreement that there are at least three areas of concern that are going

to have profound effects upon local government.

[1055]

It seems to me that we're also in agreement that the minister with

assigned responsibility for this area has somewhat of a significantly different

role than advocating for the needs, wants and desires of local government. I

will have to leave that up — to have a system as has unfolded here in this

discussion — for local governments to sort out to whom they are going to now be

pitching their interests and concerns upon this very, very important item.

That leads for me into another area, then. As I've already noted,

under TILMA "…municipalities are prohibited from implementing any measures that

may impact trade, investment or labour mobility between B.C. and Alberta." My

question now is specifically to the minister here: what measures is her ministry

taking to ensure that matters of municipal concern be protected, even though

they may conflict with the interests of trade, investment or labour mobility

between B.C. and Alberta?

Hon. I. Chong: I want to ensure that I've got the member's

question correct. Is he suggesting, if local governments are not interested in

having a competitive environment and aren't interested in having TILMA

implemented, that his expectation would be that we would advance those issues?

I find that rather odd, because TILMA is an agreement that our

government has signed. I'm part of our government; I support the TILMA

agreement. I also support the process that the Minister of Economic Development

has put forward, the welcoming of the UBCM executive and president to be

involved in the transitional period.

Perhaps I'm just not as pessimistic as the member opposite. I do

believe that in those two intervening years we are going to be able to work with

local governments to have any of the areas that they feel are of concern

addressed appropriately.

[R. Cantelon in the chair.]

At the end of the day if there are matters still required to be

resolved, then I would expect that we will continue to work towards that. My

role as the Minister of Community Services is in fact to ensure that our local

governments can be vibrant, sustainable communities. We've done it in a variety

of ways. Here's just another tool that will allow our local governments to do

that.

It is about allowing them to be competitive. It is about allowing

them to ensure that we continue to lead the country in growth and that their

communities continue to realize the potential that they can.

I'm not sure of what the member is asking — whether I'm to reject

TILMA because he feels that some local governments may be expecting that at this

time. That's not what I'm hearing. What I'm hearing from

[ Page 7677 ]

local governments currently is that they don't know how it will directly

impact. They would like information. That's why the offer has been made to UBCM

to have them be involved, and I would expect that UBCM will provide that

information to local government.

For the member to say that local governments have now two

ministers to come to…. Local governments go to every minister on every possible

issue that can impact their particular community. I have seen local governments

meet with the Minister of Transportation, the Minister of Small Business, the

Minister of Health, the Minister of Education and with me.

[1100]

We see this at the UBCM. They don't report to me. I can tell the

member that. Local governments have dialogue with every ministry that they feel

is relevant or pertinent to the decisions that they're making for their

citizens.

What we have here is an agreement that the Minister of Economic

Development will be leading the implementation on. We have the UBCM, which will

be involved in the next two years to ensure that local government issues and

concerns, if raised, will be addressed. We have UBCM committing to a workshop.

As I understand it, that will take place this year and perhaps even at the local

area association.

I think we have listened to local governments, and we're going to

be working with them over the course of the next two years. I'm looking forward

to that process unfolding.

C. Wyse: The point that needs to be reiterated here is that

when we have health issues that affect the local government, we fully expect

that they're going to go and talk to the Health Minister. When they have

transportation issues, it's fully understood that they're going to go and talk

to the Minister of Transportation.

However, the distinctively different point we have here underneath

TILMA is that TILMA clearly, in agreement, has effect upon how local governments

will govern. No question about it.

We're in agreement that there are at least three areas where there

are concerns. Why local government would not be coming to the minister

responsible for local government on this item is where the ambiguity comes into

play. They are now, in my judgment, dealing with a different minister about how

local governments will in actual fact conduct their business.

I read into the record two very distinctively different

descriptions of the two levels of government and what their functions are about,

and we have an agreement that applies to these two levels of government equally.

Therefore, the effect upon local government is now agreed, by the hon. member

opposite, to have at least three areas of concern. Those are three areas that

were not agreed to a while earlier.

One more time, Chair, if I may. What avenue is there for

municipalities concerned about their autonomy under TILMA — local government

that has those concerns? What avenue can the minister offer to those

municipalities with those concerns?

Hon. I. Chong: Let me make it clear for the record. I did

not suggest that there were three areas of concern. I said that there were three

areas that directly impact local governments, or that TILMA will have impact on

local government in these three specific areas.

Whether local governments are concerned about those three areas,

we'll find out over the course of the next number of months and next two years.

What I did say was that these were the three areas that TILMA has direct impact

on. Again, I want to be clear on that. Local governments may have concern in

other areas, but these are the three areas of direct impact.

In the letter written to Mr. Taylor of the UBCM on January 31,

2007, there was some clarification that I think the ministers of the two

provinces attempted to provide. I'll just read that into the record. This goes

to local government autonomy. This goes to local government areas of

responsibilities, in response to what the member has to offer.

This is what this paragraph says:

"As an example,

the TILMA is not intended to constrain a local government's ability to establish

or maintain bona fide, nondiscriminatory measures such as zoning bylaws, height

restrictions or rules applying to signage. Nor are we expecting changes to land

use decisions applying to areas like agricultural land reserves or parks. Should

these types of measures be specifically challenged under the TILMA, the

governments of the two provinces maintain the right to jointly declare t