Official Report of

DEBATES OF THE LEGISLATIVE ASSEMBLY

(Hansard)

WEDNESDAY, MAY 14, 1997

Afternoon

Volume 4, Number 25

[ Page 3379 ]

The House met at 2:06 p.m.

Prayers.

G. Brewin: On behalf of the hon. member for Esquimalt-Metchosin and the hon. member for Victoria-Hillside, I would like to introduce in the gallery Mayor Bob Cross from the city of Victoria and councillor Bea Holland, who are here for a special announcement. Would the House please make them welcome.

D. Jarvis: A gentleman who belongs to my riding in North Vancouver and who is a former member of this House is here in his Pecksniffian splendour, Dr. David Schreck.

Hon. J. MacPhail: I would like to join with the member opposite to welcome Dr. Schreck to the Legislature, and also to welcome with David Schreck, Cindy Stewart, the president of the Health Sciences Association and a first-rate community activist. Would the House please make her welcome.

Hon. P. Ramsey: Joining us in the gallery today is Nancy Sly. Nancy is the executive director of the College Contract Training and Marketing Society and a longtime educator here in British Columbia. Accompanying Nancy is Brandy Weber, a grade 12 student from Maple Ridge Secondary School, who is with Ms. Sly as part of her work experience placement. Would the House please make them welcome.

Hon. J. Pullinger: I would like to ask the House to help me welcome my executive assistant, who is down for the afternoon. Joining us in the gallery is Doug Creba.

Hon. U. Dosanjh: I understand that Alec Macdonald, the former Attorney General of British Columbia, may be in the precincts. Would the House please make him welcome.

Hon. J. MacPhail: I am pleased to welcome 35 students from Sir Matthew Begbie Elementary School in my riding. They are here on a school trip, accompanied by their teacher, Ms. Siller. I understand it is their first time here, and I hope that we will make them welcome when we see them in the Legislature.

Introduction of Bills

MISCELLANEOUS STATUTES

AMENDMENT ACT, 1997

Hon. U. Dosanjh presented a message from His Honour the Administrator: a bill intituled Miscellaneous Statutes Amendment Act, 1997.

Hon. U. Dosanjh: I move that the bill be introduced and read a first time now.

This bill amends a number of statutes. They are the Court Order Enforcement Act . . . . That particular amendment updates provisions in the Court Order Enforcement Act which relate to the amount of debtors' personal and family property that is exempt from seizure and sale. The others are the Employee Investment Act, the Hospital Act, the Labour Relations Code, the Municipalities Enabling and Validating Act (No. 2), the Pension Benefits Standards Act, the Property Transfer Tax Act, the Real Estate Act and the Small Claims Act.

I will, of course, elaborate on the nature of these amendments during second reading of this bill. I move that the bill be placed on orders of the day for second reading at the next sitting of the House after today.

Bill 22 introduced, read a first time and ordered to be placed on orders of the day for second reading at the next sitting of the House after today.

Oral Questions

GOVERNMENT POLICY ON

NO-FAULT INSURANCE

G. Campbell: The opposition has just received from the Coalition Against No-Fault a copy of an internal ICBC document which shows that this government has already made a decision with regard to no-fault insurance. In fact, the document makes it clear that not only has the NDP made up its mind, over the last while they've been developing a massive propaganda campaign aimed at deceiving the people of this province. Included in this program is a communications surveillance team aimed at countering legitimate concerns of many citizens across B.C.

My question to the minister responsible is: when does the minister intend to tell the public that he's made up his mind and that he is going to impose his version of no-fault insurance on the people of this province?

Hon. A. Petter: The only deception here is in the way the question was framed by the Leader of the Opposition. The memo concerned, which the member refers to specifically, indicates that presentations are being made to groups in order to assist government in deciding on alternatives being considered with respect to insurance reform. Yes, these alternatives are being considered, and in fact there are presentations being made.

Those presentations are based upon the report of an advisory committee that was set up by ICBC, and my understanding is that such a presentation is being made this very afternoon to representatives of various lawyers' groups from around the province. That's what's happening as we continue to work through the process in order to arrive at a decision.

G. Campbell: The internal document makes it very clear that the government has indeed made up its mind. The minister will know that there have already been resignations from the advisory committee, because they feel the government has made up its mind. The memo points out that an advertising campaign is planned for May 19, and I think it's important to note that people in British Columbia deserve to know the truth.

I have in my hand a letter from the MLA for New Westminster, who points out that the government will be debating this issue over some time: "I also want to assure you that the government has not yet made a decision on this matter and that the entire caucus will be deliberating on this issue in the coming months." While the NDP caucus is supposedly deliberating, ICBC is training 12 disciples of no-fault to spread the word, is planning a television campaign and is planning to flood the province with newspaper ads.

[ Page 3380 ]

My question to the minister responsible for no-fault is: is the member for New Westminster not sharing the facts with his constituents, or is the minister not sharing the facts with his caucus?

Hon. A. Petter: Let me read from the memo concerned, because apparently the Leader of the Opposition is not capable of reading for himself. "In addition, our experts are also raising presentations to various groups identified as members of the Coalition Against No-Fault in an effort to provide some facts about the insurance alternatives being considered by the government."

Yes, there is work going on in respect of communications and advertising groups, directed at trying to correct the misinformation that is being provided by some groups, groups who are trying to suggest to the people in this province that if changes aren't made, rates will stay down, which is not true; groups who are trying to misrepresent this government's commitments and who are trying to suggest that this government is trying to deny access to the courts, which we are not doing; groups who are trying to suggest that this government is trying to reduce income replacement when we're trying to do the very opposite; and groups who are trying to suggest that good drivers and bad drivers will be treated alike.

That kind of misinformation needs to be corrected, and work is going on to ensure that we do correct it.

My question to the minister is: when is he going to come clean with the people of British Columbia and stand up and tell them exactly what he's trying to do, instead of playing these propaganda games day in and day out?

[2:15]

Hon. A. Petter: Hon. Speaker, you can always tell when the arguments start to run out, because that's when the Leader of the Opposition and his colleagues start to engage in ad hominem attacks. You can always tell when the arguments run out.

This government is committed to keeping insurance rates reasonable for British Columbians -- something the members over there appear not to care about. This government is committed to ensuring that there is fair and adequate compensation for British Columbians -- something that the members over there would prefer to ignore in favour of partisan, ad hominem attacks.

Yes, we will continue to consult. Yes, we will continue to work, because we're determined to maintain premiums at a reasonable level for British Columbians and to make the changes necessary to do so.

CONSEQUENCES OF

B.C. FERRIES WILDCAT STRIKE

D. Symons: Yesterday more than 1,000 people were stranded by a wildcat strike of B.C. Ferry workers. This has happened before. Just as before, when the Premier, then the minister responsible, pretended to be outraged . . . . The government pledged to take action. Evidently the 1992 lawbreakers suffered no consequences for their illegal actions.

Can the Minister of Labour tell the families, the small businesses and the truckers of B.C., who suffered personal costs yesterday from the illegal act by the ferry workers, what disciplinary action will be taken and what consequences will be faced by the ferry workers who broke the law?

Hon. D. Miller: As the minister responsible for the B.C. Ferry Corporation, I want to say that I share the member's concern and all British Columbians' concerns that this kind of illegal activity has inconvenienced travelling British Columbians.

The Ferry Corporation sought immediate redress through the Labour Relations Board. We're satisfied that with that order, approved by the courts, there will be no repeat of this, and we're attempting to quantify the costs. As well, the Ferry Corporation has invited people who were inconvenienced to contact them with specific claims that they may have.

D. Symons: That answer sounds exactly like what they were saying in 1992, and nothing happened. When there are no consequences for illegal acts, then they're bound to happen again. People are asking what the government is going to do today to send a clear message to the ferry workers that like the rest of us, the law binds them also.

My question to the Minister of Labour is: how does the government intend to send the message that breaking the law and holding families, small businesses and truckers hostage will not be tolerated in B.C.?

Hon. D. Miller: I hope the member would appreciate that you cannot legislate against people doing ill-conceived things -- in fact, rather dumb things, which I consider this little illegal work stoppage to be. But, hon. Speaker, with all due respect, there is no legislature in the world that can legislate against that kind of behaviour. What you can do is take immediate action when it does occur, which we have done. We are satisfied now that the travelling public will not be inconvenienced. And I think, as I said, we've invited those who feel that they were inconvenienced, on a cost basis, to contact B.C. Ferries to have that issue pursued.

D. Symons: One final question -- very simple. What penalties will there be, and who will pay the costs?

Hon. D. Miller: Hon. Speaker, we have a system of dealing with labour relations issues that I think is recognized and in fact is similar to the kinds of systems that exist worldwide in democratic countries. We have a Labour Relations Board. There are avenues for aggrieved parties to pursue redress; it is through a recognized system. I'm sure the member is not arguing that we should get rid of that kind of system in favour of something that I think would not work.

HOUSTON EMERGENCY AND

RCMP PRESENCE

G. Plant: Mr. Speaker, at 11:40 this morning a natural gas line in the Houston and District Credit Union building in downtown Houston ruptured. At last report, district administrative officials and staff had evacuated a four-block area around the building, and the gas had finally been turned off.

According to the town administrator, there were no RCMP officers in Houston when the gas line ruptured. And

[ Page 3381 ]

the reason there were no RCMP officers on hand to respond to this emergency is because of cuts to the Houston RCMP detachment.

My question is to the Attorney General, a minister who promises more police officers but actually delivers cutbacks: what is his plan for dealing with the emergency taking place in Houston as we speak?

Hon. U. Dosanjh: Hon. Speaker, let me first remind the hon. member that there is a global contract in place for RCMP services in British Columbia, and there have been no cutbacks to that global contract. In fact, what we have done with police officer positions that have come free is allow them to remain funded, and this government continues to allow those positions to remain funded.

With respect to the emergency, I will be seeking more information. I will advise the House as soon as I have it.

G. Plant: Hon. Speaker, this Attorney General and his government made an election promise to increase community police officers in British Columbia.

G. Farrell-Collins: By 100.

G. Plant: By 100.

Interjections.

The Speaker: Order, members -- both sides, please.

G. Plant: Mr. Speaker, Buck Creek is flooding, and the town of Houston will soon be under water unless an emergency dike is constructed immediately. And now there's a gas leak. The townspeople of Houston are desperately hoping that what happened in Quesnel will not happen to them; yet when they look around for government resources, the nearest RCMP officer is in Topley, a half-hour drive away.

Will the Attorney General now finally admit that the cost of his broken promise to add 100 new community police officers is that the people of rural British Columbia lack the police service they need at the very time when they need it the most?

Hon. U. Dosanjh: I said this during estimates, and I'll say this again -- I understand the hon. member has some difficulty understanding arithmetic -- there are 41 more police officers in British Columbia than there were last year; we're going to add at least 50 more by the end of this year. If there is an emergency in Houston, I will seek advice from the provincial emergency preparedness program as to what steps they're taking. They are the ones that coordinate emergency services. The police detachments are governed by the RCMP.

The RCMP deploy resources as they see fit, and Houston is part of the global contract for services with the RCMP. I have given the opportunity for the hon. member to come and get a briefing from my ministry so that he understands how this system functions. Obviously he hasn't taken up that opportunity.

WOMEN AND GAMBLING

K. Krueger: This government's own surveys have disclosed that almost 4 percent of British Columbians are already afflicted by problem gambling and pathological gambling. The tragedy of the Jiany family brings home the consequences that British Columbians are facing as the NDP launch their massive gambling expansion. A gambling addict stands accused of attempting to murder his wife and daughter by setting them on fire.

My question is to the Minister of Women's Equality: does the horror of this event persuade the minister that gambling expansion is an issue that affects women? And if so, what will she do to protect women in British Columbia?

Hon. S. Hammell: Everyone in this House was horrified by the description of violence that we read in the paper this morning. My heart -- and I'm sure everyone's heart in this House -- goes out to Mrs. Jiany and her daughter. The type of behaviour described -- whatever its cause -- has no place in our society. Attempted murder and arson are serious crimes and are treated as such. However, let me remind the members opposite that I cannot comment on the specifics of this case.

K. Krueger: What the minister can comment on is what she will do to prevent that from happening to a whole lot more women in British Columbia.

Last summer, this government promised help for gambling addicts in British Columbia, and all we've had since is talk. This spring, the NDP announced a massive expansion of gambling, an 1,800 percent increase in projected revenues to this government from gambling. We know that the more venues that are available, the more victims will result.

The Speaker: Question, please.

K. Krueger: So my question for the same minister is: will you stand up for women? Will you urge the Premier to cancel his gambling expansion?

Interjections.

The Speaker: Order, members, please.

Hon. S. Hammell: Violence often accompanies pathological behaviour, and family violence often happens in the home. That's why it is, as the member has said, so important that we support and treat those who suffer from psychological disorders. That's why we are increasing funding, and new programs are being developed to help people deal with addictive and abusive behaviour.

The Speaker: The bell terminates question period.

Petitions

R. Neufeld: I have a petition to the Minister of Employment and Investment urging:

"That you, as minister responsible for the exploration and delivery of oil and natural gas, intervene immediately to stop the proposal by Kaiser Energy Ltd. to extract same from the location described as Kaiser, Fort St. John, 7-35-83-19 (W6M)" -- that's west of the 6th meridian. "Said location is some 400 metres from the southwest boundary of the city of Fort St. John, in the area known as Grandhaven.

"That you subsequently act to develop legislation to prevent similar applications to explore for natural gas and oil in areas which conflict with existing residential developments; that an acceptable minimum distance and location with respect to prevailing winds be incorporated into that legislation, with special consideration for sour gas drilling proposals."

The Speaker: Thank you, member. May I remind members at this moment that it is not necessary to read verbatim the entire petition. A simple description will suffice.

[ Page 3382 ]

Orders of the Day

Hon. J. MacPhail: In Committee A, I call Committee of Supply. For the information of the members, we'll be debating the estimates of the Ministry of Aboriginal Affairs. In this House, I call Committee of Supply. For the information of members, we will be debating the estimates of the Ministry of Health.

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

ESTIMATES: MINISTRY OF HEALTH AND

MINISTRY RESPONSIBLE FOR SENIORS

(continued)

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

[2:30]

R. Neufeld: The minister may have addressed this issue already. But as I understand it, we're on the issue of CHCs and RHBs, and an issue in my constituency which I've been asked to present to the minister is from the North Peace

chapter of registered nurses.

They, I think, have a good position: why do they not have a place on the CHC? They are so much the front-line workers that really work with the patient all the time and work with the services that the hospital has. They would really appreciate the ability to have a place on the board, much the same as is presently given physicians and the union -- so they can have a voting position, I guess I should put it.

Right now they can sit as an advisory, which is fine but still doesn't give them the same ability that they would like to have, and that's to sit on the board, with voting privileges, to bring forward issues particular to the registered nurses.

Hon. J. MacPhail: I did address this issue over the course of the last two days, but knowing the extra duties that the member has, I'll be happy to repeat my answer. I met with the Registered Nurses Association of British Columbia. They suggested that there was a need for adequate representation from their profession on the boards and councils. Certainly the boards have never been intended to be a group of special interests, and in no way do I say that in a derogatory term -- that the Registered Nurses Association of B.C. is a special interest. What is important is that the nursing profession be adequately represented on the boards and councils.

Yesterday the hon. member for Okanagan-Vernon suggested that maybe there was an overrepresentation of nurses. Over the course of the next few weeks, I have committed to give a listing of the professions, both retired and current, of the board members across the province. But I would say -- and yours may be the exception -- that we have on almost every single board and council either a practising nurse or a nurse who is not currently practising -- retired or out of the workforce.

So that's a long way of saying that I understand the nurses' concerns. I think they are adequately represented, though, but this is one of the issues we will be monitoring over the next two years as we move toward establishing a process for renominations of appointments.

[J. Doyle in the chair.]

R. Neufeld: I apologize again for not being in the House earlier when the question was asked, but it is difficult to be here to follow all the discussions and, sometimes, to be able to get recognized to ask some questions at a particular time.

I would like to say to the minister, and put on the record, that in both the Fort St. John and Fort Nelson CHCs, I am pleased -- and I think the communities are, too -- with the appointments made by the minister to those boards, generally speaking. I'm not trying to say to the minister that I disagree with what took place there, because I think most people are very happy with what happened in the north, although there was some disruption in going from an RHB to a CHC. It's understandable; they accept it, and they'll go on with it.

So in no way am I trying to say that people up there are really unhappy with it. I think what the minister has relayed to me is that she has had enough representation made to her that the nurses have a good point. I agree with you. I'm not trying to talk about special interest groups but more from the fact that the nurses . . . . Being married to a nurse, I know how closely they work with . . . . You know, they're with the patients constantly -- all the time. The doctors aren't there as much as the nurses are, yet they have a place on the board.

So I'm pleased, and I'll relay that message from the minister to the nurses association in Fort St. John, that you're going to review that and keep in mind that those things may change in the next while, in the next year or two -- if I could just get the minister to confirm that. Would I be correct in saying that?

Hon. J. MacPhail: I am committed to putting in place a community process for nominations for the appointments to the councils and health boards. It is important that our boards have a community reflection and also a broad representation of expertise -- business expertise, health care expertise, community expertise -- and that there be a proper gender balance, multicultural balance and first nations balance, if there is a first nations community.

So what you can tell your constituents is that how we nominate for the next round of appointments, which will be effective April 1, 1999, will be decided over the course of the coming months. I am asking communities to come forward with a nominating process that I can consider, one that would work for their community.

L. Stephens: I have a few questions today about regionalization, and I'm going to confine my comments and questions to the South Fraser Valley regional health board.

There are a number of other issues that I'd like to canvass in the Ministry of Health around some women's issues and some other areas that we will do at another time, when we get to those areas. So today I'm just going to confine myself to the issues around regionalization, and two issues primarily: governance and funding.

As the minister knows, the South Fraser Valley board is made up of the four hospitals in our area: Langley, Delta, Surrey and White Rock. Langley was the last to amalgamate -- and not voluntarily, as the minister knows, largely because the community and the society felt that this forced amalgamation was undemocratic. However, the amalgamation has taken place. There are representatives on the regional health board that represent all of the acute care hospitals in the region with the exception of Langley. This is an issue that is very pressing for us.

I wonder if the minister would confirm that there is an intention to appoint a representative from the Langley hospital board to the regional health board. When might that be forthcoming?

[ Page 3383 ]

Hon. J. MacPhail: I understand the member's concern. We have had good discussions about the composition of boards: the need to properly reflect community interests and then to make sure that communities are represented. Let me just offer to the member that I will take her comments into consideration and continue to work away at making the board properly representative of the community.

L. Stephens: I know the minister is aware that we have two representatives from the Langley community on the board. Neither of them is a representative from the hospital board that represents the acute care facility of the hospital. I would suggest that if there are no spaces presently available on the board, one of those two positions be rescinded -- whichever position the minister chooses -- and one of our hospital board members be appointed -- again, whichever hospital board member the minister chooses -- to represent our acute care facility.

You know, we're talking about the only hospital in the region not represented at the regional board level. If we're going to be talking about fairness and equity and inclusiveness, I think this is an issue that needs to be addressed, and it really does need to be addressed soon. The community is very upset about this -- not just the hospital administration and the board but the community, as well -- because they see it as being grossly unfair. So I just want to reiterate to the minister that this is an issue that is pressing and encourage her to move with all speed.

There are a couple of other issues around amalgamation and the fact that the society is no longer in place. One of those issues is the hospital foundation, which raises a significant amount of money for the hospital to purchase assets and capital equipment. Our particular foundation has raised over $2 million since '91.

I would like the minister to confirm that hospital foundations will remain intact, that the assets that have been accrued through the foundations will remain there for the use of the hospital, and that any future contributions to the foundation will also stay at the local hospital to be used for the purchase of capital equipment and whatever assets the hospital may deem appropriate.

Hon. J. MacPhail: Yes, I confirm that.

L. Stephens: Thank you very much, minister. That is good news.

There's another issue around revenue, as well -- protection of revenue. Our particular hospital has room differentials, which raises a little bit of money, and also parking income. Again, the extra moneys that are raised from these operations at the hospital -- user-pay, in these two cases -- are going to, in our case, the implementation of quite an advanced information system. I wonder if the minister could also confirm that revenue raised in this way by the hospitals will also remain at the hospital to be used for upgrading facilities or providing service or equipment or whatever it is that the hospital deems to be appropriate.

[2:45]

Hon. J. MacPhail: Those matters will be decided by the regional health board.

L. Stephens: Could I inquire as to whether or not this would be part of the advisory committee's responsibilities, or will these kinds of decisions be made by the CEO and the executive of the regional health boards?

Hon. J. MacPhail: The policy of the charges to be levied and where the revenue as a result of those charges will be expended will be determined by the boards. It will be a policy decision of the regional health board. I would expect that the advice they receive in reaching their decision would be from a range of expertise in the community.

L. Stephens: The other issue at the hospital -- and again, I'm sure this applies to most of the hospitals in the region -- is the transition period, from the facilities going their own way to merging into the region. Our particular hospital has some strategic plans in place, as I'm sure they all do. So in that period between now and being completely amalgamated, what kinds of transitional plans are in place to assist the acute care facilities to move from their individual strategic plans into the regionalized whole?

Hon. J. MacPhail: The regional health board is fully functioning now. There isn't a transition period. This is exactly the kind of issue that the regional health board will grapple with. It's their business to do this, and they're to do it in the best interests of patient care. I actually look forward to four hospitals in a particular region working together on making sure that individual strategic initiatives are met, but in the context of working together with the other acute care hospitals. This is exactly what the regional health board, both on the administrative side and the board policy-making side, is working on as we speak.

L. Stephens: Ensuring quality care and services for patients is what the minister is talking about, and I'm sure the boards are moving in that direction, too, as individual institutions have done. Under the regionalization process the boards are an entity, but I would suggest to you that they are far from up and running in a way that is assuming the responsibilities that we're talking about here.

The minister talked yesterday about benchmarks and assessments. In our particular hospital we have a quality management program, and we have a risk assessment program. I wonder if the minister is aware of whether or not the health boards are going to be encouraged . . . . Well, I'm sure they will be encouraging these kinds of programs to take place. Have there been directives from the Ministry of Health around what kind of programs must be in place, what kind of benchmarking will be required to maintain and ensure that quality care and the risk assessment programs for patient care and patient delivery?

Hon. J. MacPhail: We had a very good discussion over the course of the last two days about what those benchmarks are. They're on the record. Perhaps I could refer the member to Hansard , and if she has any subsequent questions we could deal with those.

L. Stephens: I will have a look at the Hansard s and determine whether or not the questions were answered fully. If not, we will come back.

On a per capita basis, the South Fraser region was underfunded. As I'm sure the minister knows, we have a very large seniors population and a very rapidly growing community. Does the '97-98 budget reflect a correction of this inequity in funding in our region?

Hon. J. MacPhail: The budgets that are out this week do reflect a recognition of the previous underfunding of the region, but I expect that we could assume that the region

[ Page 3384 ]

would not think it would solve the problem. I hope to offer the region the comfort that probably later this fall we will be starting discussions with the regions on a method of funding that recognizes the perceived -- and in some cases real -- inequities of funding amongst regions. That will commence in the fall with the regions.

L. Stephens: Could the minister indicate how much of an increase -- either a dollar figure or a percentage amount -- that will be for our region? The second question is: when will the funding for the regional health boards be handed over to them to actually begin to administer the money for programs and services in the region?

Hon. J. MacPhail: The funding was transferred to the regions on April 1. What I was referring to was the hospital budgets that will be released over the course of this week. I can get the information for the member on the hospital operating budgets for the hospitals in her particular region. I'll get that this week for her.

L. Stephens: I have the amount for the Langley hospital. The amount we have been allocated for our hospital operating appears to be sufficient, and we are not unhappy on that score. The region is the one that needs to be looked at as far as the funding is concerned, because we are underfunded. That's the one that I really want to stress. The funding amount that is going to the regional health board needs to be seriously looked at. My understanding is that at this time the board is not in a position to allocate funding. I wonder if the minister would comment on that.

My information is that they feel that there's another year before they are actually ready to allocate dollars to the different programs and institutions.

Hon. J. MacPhail: Never say that I disagree with prudence, but that is the prudence of the regional health board. They now have the authority to allocate, but I also understand that a regional health board may want to proceed cautiously in the first year of operation.

L. Stephens: Could the minister indicate the funding for the administration of the regional health boards? Is there a percentage of funding that goes to the health boards to be used or not to be exceeded -- administration costs?

Hon. J. MacPhail: Is the question on funding for administration for the regional health board structure itself? Oh, okay.

We gave them some infrastructure money, in terms of getting the administration started up. But future funding for regional health board administration is to be found within the region and is not to come from clinical or patient programs. It's to come through cost savings.

L. Stephens: I have been told that the acute care hospitals in the region have been asked to set aside 1.5 percent of their funding to go back to the regional health board to provide for the costs of administration of the regional health board. Is that something the minister agrees with or has knowledge of?

Hon. J. MacPhail: Without knowing specifically whether the figure is accurate, let me just comment generally on how the regional health board will deal with its administrative costs. It makes sense for a regional health board to say: "We are amalgamating financial services and administrative services. We are joining together to have some administrative cost savings, and therefore you, acute care hospital, will need less to invest in your own individual administration.

We need that money to make the amalgamation happen." So that kind of situation is possible, and I support it, with these two caveats: one, that patient programs and client services programs are not to be affected; secondly, that there should not be money flowing from community care to acute care. The flow of money should be transferring from acute care into community care.

L. Stephens: I understand there are going to be a number of efficiencies from the acute care hospitals, if they're not having to . . . . I'm trying to remember all of the different areas -- purchasing, central purchasing, laundry, food services and all those kinds of things -- that will be assumed by the regional health board. The acute care facilities do not have those costs, however, the board and the staff at the board level, plus the advisory committees -- and I understand three advisory committees are proposed -- will have staff support provided to them.

Is there a directive from the ministry about what level of support services can be provided? Is there a dollar amount? Is there a percentage amount of budget to make sure that the administration doesn't balloon out of control? I wonder if the minister has any idea about those kinds of issues.

Hon. J. MacPhail: That's a very good question. Each regional health board has to put in place a management plan that puts in place the proper management for dealing with all of the aspects of health care in its particular region. The management plan has to reduce overall administration and have cost savings in the administrative area. The boards have also been told that when they achieve that, though, that money will be left with them to be put into patient care.

The management plan has to be agreed upon by the Ministry of Health before the final strokes are put in pen to paper. But also, I just want to say that the concept here is to have less administration. The administration may be all in one place now and therefore may seem substantial, or it may not. But it will all be in one place rather than dispersed amongst several institutions. We have a target of cost savings in the area of administration. By the year 1999 it will be, overall, $24 million across the system. That's exactly what the regional health boards and community health councils have been told that they have to achieve -- and can.

[3:00]

L. Stephens: The staff running the health boards -- I wonder what kind of management skills and experiences they have in running facilities, acute care hospitals. A number of the staff have come from government, from the bureaucracy -- from, for instance, mental health or continuing care or whatever -- and have never run a large organization or an acute care facility. So I wonder if the minister could give me some comfort that the people that are in place -- the CEOs of these regional health boards -- have the level of expertise and training they need to do this job.

Hon. J. MacPhail: The regional health board is required to hire, to make sure that there is a team assembled and that the administration team at the regional level carries all the full range of expertise. In your particular region, it would be safe to say that range of competent expertise is distributed across the whole team. The regional health board is mandated to ensure that this competence is in place and to make changes where it isn't.

[ Page 3385 ]

I would actually give recognition to the member's region. The hospitals in that region have a good record of very efficient and competent management. The transfer of people from the acute care sector onto the regional health board to continue that competence is appreciated.

L. Stephens: The hospital administration in our region is, I believe, exemplary. The individuals, the management that I was talking about, are the CEOs and staff members of the regional board. Whether or not . . . . You know, a lot of these people that have come out, they've come out from the ministry, the bureaucracy, and have not managed those large organizations. Those are the individuals that I'm talking about.

I'm not talking about the hospital acute care CEOs and those managers who actually have had experience delivering patient care -- running a large facility in a very large organization, all of the nuances of doing that and delivering that patient care. People who have been there and sort of done that on the front line see it every day when they walk into the hospital.

So I wonder if that's something the ministry is going to be watching very carefully to make sure that this kind of expertise is in fact there and that the individuals involved are in fact abiding by the benchmarking and that focus on patient care and quality service.

[G. Brewin in the chair.]

Hon. J. MacPhail: I reiterate that the full complement of health care and management experience should be reflected on the regional health boards. I appreciate the member's concern about the complexities of acute care hospitals. But there are other complexities in the health care system -- public health, mental health -- as well, that are complex systems and that require management skills. So there is a wealth of experience which we can tap into across the health care system; I say that with the greatest respect to the acute care hospital sector. But there are other ranges of experience, as well. And then, yes, all of the benchmarks and accountability will stem from proper administration.

L. Stephens: Yesterday the member for Okanagan-Vernon talked a little bit about an example from her constituency, about one of her constituents moving from her particular area to Vancouver Island and not being able to receive a medical procedure. I'd like to know if there are in place, because . . . . The minister's response at that time, I think, brought to her attention something that she wasn't aware was happening across the province.

I wonder how we can prevent a sort of fragmentation or balkanization, if you like, of health care services in the different regions, because part of the recommendations of the review panel was to recognize that each of the regions are different and require different kinds of service. I wonder how the ministry is going to try to maintain a level of service in every single region and not allow a fragmentation or balkanization of services that are available in those regions to the people who live there -- and indeed to those people moving in or on holiday, as in the case that the member for Okanagan-Vernon talked about yesterday.

Hon. J. MacPhail: I understand that the doctor from the area brought this to our attention. We had a chance to investigate this particular example. So because it's the only example brought forward, let's use it as a problem -- as how we reached a solution on it. It is a program that we fund on the basis of the patient needs. It's a life-support system, and he or she needs that system. How do we accommodate that life-support system and the family needs and lifestyle issues as well, all of equal importance?

Just to give you an example of how this was resolved, it is true that initially the Sechelt centre only had accommodation for the two patients in that area that required dialysis. In the meantime, we have made arrangements -- and this was done before, of course -- for the patient to be treated in the interim at the St. Paul's in-centre dialysis unit. Then the health council, Sechelt, is moving to expand the hours of operation to accommodate the patient. There is a transition period, very brief, in which dialysis will be provided at St. Paul's. The ordinary operation of the dialysis unit will be extended by three hours while the patient is in the area.

S. Hawkins: Hon. Chair, I ask leave to make an introduction.

Leave granted.

S. Hawkins: In the gallery today -- I think they just arrived -- are students from my constituency of Okanagan West. They're a grade 7 class from the Kelowna Christian School, and they're here with their teacher Mr. MacArthur. I saw a whole bunch of chaperons with them as well. I understand they've been visiting in Victoria since Monday; they're going home on Friday. They've just finished a tour of the Legislature. And just as the Minister of Health asked us to be on our best behaviour when her mother was here, I'm sure she'll do the same and show the kids that we're very civilized here today. I ask the House to please make them welcome.

L. Stephens: I'll just carry on a little bit with the level of service that can be expected in each of the regions. I'm sure the minister knows that currently in the rural areas of the province, there are some services that are available and some that are not. There is some equipment that is available and some that is not.

Under the regionalization, is there a deliberate plan to make sure that each region would be sort of a compact whole, with services available in each of those regions -- the equitable services available in those regions? I'm now thinking primarily of the north, which suffers greatly. The lower mainland has everything within a short distance. I know that in the north some of those services are available, but the issue is time -- whether it's five minutes, ten minutes or two hours or three hours. So I wonder how the regionalization is addressing those two issues: the services and the timeliness of those services in the regions.

Hon. J. MacPhail: Each region will be self-sufficient in primary care and secondary care, but tertiary care is a provincial planning exercise, and we will continue to do that.

Also, just for the member's information, because we discussed this earlier, the funding will be on the basis of where the patient receives the treatment and not where she comes from. So there will be adequate funding for those that provide tertiary care to the other parts of the province, as well.

L. Stephens: I'd like to ask a couple of questions around private care. I know the minister was at the annual general meeting of the Pricare association. I understand that about a third of the intermediate care and extended-care facilities in the province are private. I have a number of them in my constituency -- as every constituency does -- and they're

[ Page 3386 ]

concerned about their futures and with all of the changes with regionalization. Everyone is just trying to feel their way through and wondering what changes will come to private care around the intermediate care and extended-care facilities.

Could the minister perhaps give us a little bit of an overview of her comments to the private care annual general meeting, to tell the House what some of those issues are?

Hon. J. MacPhail: Again, we did talk about this yesterday, but I don't mind discussing it again.

There were two themes. One is that the relationship will continue where it makes sense and, in fact, makes sense from a capital point of view. That commitment is there on the part of our government. I referred the Pricare association to the capital review plan published by the Minister of Finance at the beginning of this year, with cost containment strategies, and there was a great deal of interest expressed in that.

The second message was that private care institutions will not be required to amalgamate with regional health boards or community health councils. But I certainly urged them to begin a cooperative relationship with the boards and councils in their area, because that made good health care sense, and they certainly agreed with that.

L. Stephens: I have one final question, and it is on the private care again. Are there or will there be opportunities for private-public partnerships around this particular sector? It does have a large private component to it. I'm thinking primarily of multilevel-care facilities, which we are going to be looking at in my constituency. I think a lot of the areas around the province are looking at a very substantial increase in the number of seniors in the not too distant future.

Is that one of the areas where these opportunities for partnerships with private individuals will be encouraged or certainly discussed? Is that something that is beginning now? Or when does the minister see those kinds of initiatives taking place? Is it going to be from the ministry, or is it going to be primarily from the regional health boards that this particular direction comes from?

[3:15]

Hon. J. MacPhail: Again, the capital review plan that I referred to that was made public at the beginning of this year indicated that the area of multilevel-care, continuing care, was a prime candidate for private-public partnerships for future capital development. That certainly is not only a demand of the Minister of Finance but will be the direction of the Ministry of Health as well.

B. Penner: I am pleased to get up and take

part in this estimates debate of the Minister of Health's budget. I am going to ask for some indulgence from the minister, because I'll be asking for some background explanation just to help clarify the situation in my mind and, I'm sure, in the minds of many of my constituents as to how the regionalization process is working in the upper Fraser Valley -- or, at least, how it is intended to work.

One of the most consistent questions I get as an MLA in Chilliwack is: what is happening with health care in our community? Specifically, people are interested to know: what stage are we at in the regionalization process? What authority does the regionalization process give to local boards? What does this mean in terms of elected representatives for community health councils and regional health boards? And finally, what will it mean for services available at our local hospital in Chilliwack?

Obviously there's been some controversy at our end of the Fraser Valley in recent months, and I'll just begin by asking a question of the minister about what stage we're at in terms of appointments to the regional health board. I believe its title is the Fraser Valley regional health board. Perhaps the minister could correct me if I'm wrong on that.

There were some appointments made, then I understood that one person was leaving the province to accept a job or a career opportunity outside of British Columbia. That person was appointed from Chilliwack, and I am wondering if that position has been filled and just how many appointments in total are being made to this new regional health board in the Fraser Valley.

Hon. J. MacPhail: Actually, it would be my view that the Fraser Valley health region is functioning very well and is well on its way to being a success story. The appointments are made, except for the aboriginal representative that still needs to be appointed, and we have a consultation process with first nations communities about appointments to regional health boards and community health councils.

Yes, I am aware of a potential vacancy there, of a person who was from the community of Chilliwack, and I am currently working to make a new appointment. Certainly I would be pleased to have the member's input on that.

B. Penner: Just for clarification, then, is it correct that the minister anticipates the Fraser Valley regional health board will have a total of 14 members on the board? Is that the expected total, or is it 15?

Hon. J. MacPhail: It is 15, including the aboriginal appointment.

B. Penner: Again just to confirm matters for me and my constituents, it is my understanding that the Fraser Valley regional health board will have jurisdiction over not only hospitals in Chilliwack but also the MSA hospital in Abbotsford, and, I believe, the Fraser Canyon Hospital in Hope and perhaps a facility in Mission. I am wondering if that understanding is correct and if the minister could indicate whether there are any other hospitals or medical facilities under the jurisdiction of the Fraser Valley regional health board.

Hon. J. MacPhail: I'll just name the hospitals again: Chilliwack General, Fraser Canyon, Matsqui-Sumas-Abbotsford General and Mission Memorial. They have all amalgamated. There is the Menno extended-care hospital; it's a denominational facility, and we'll have an agreement negotiated with the . . . . It doesn't amalgamate, but it will have an agreement negotiated with the regional health board during this fiscal year. Yesterday I informed the House that denominational facilities and service organizations are not required to amalgamate, but they will have service contracts negotiated.

And then there's transfer of the programs -- like public health, community health, mental health and continuing care.

[ Page 3387 ]

B. Penner: I'd like to thank the minister for that response, and I was interested to learn about the Menno long term care facility. In years gone by, members of my extended family spent some time in that facility, so I am somewhat familiar with the services provided there. It will be something that I continue to watch in the future.

Again, I'll ask the minister's indulgence in terms of giving me and perhaps other members of this Legislature some education. I continually get tripped up in my own mind about the interplay between regional health boards and the community health councils: on just what the real connection is going to be to each other and who is responsible for what. For example, will the Chilliwack General Hospital take its instructions directly from the Fraser Valley regional health board? Or will the Fraser Valley regional health board issue directives -- for lack of a better word -- through the community health council and then to the hospital?

Hon. J. MacPhail: Part of the Better Teamwork, Better Care announcement made late last year was that where there is a regional health board, there will no longer be community health councils, and vice versa: where there is a community health council, we will not have regional health boards. We eliminated the duplicated bureaucracy. But we have also encouraged regional health boards to make sure that where a regional health board represents more than one community, there is some substantial community input, perhaps on an advisory basis or whatever. But there's no spending authority, and there's no legal authority other than the authority that rests with the regional health board.

B. Penner: To summarize, then, what I understand the minister to say is that the Fraser Valley regional health board will have direct responsibility for the Chilliwack General Hospital. I see she's nodding her head in agreement, so I'll take that as confirmation.

One of the concerns that was expressed at the time the appointments were made to the Fraser Valley regional health board was about the relatively small number of people from the community of Chilliwack who were appointed to that board. My understanding is that initially, two out of the 15 positions were filled with members from Chilliwack and that subsequent to those appointments, one of the people appointed -- a woman -- has indicated that she may well be leaving British Columbia to pursue career opportunities elsewhere.

This has led to some controversy in the community, particularly from people who have been involved in the past in a voluntary capacity serving on hospital boards, about Chilliwack not getting an adequate voice on the Fraser Valley regional health board.

In fact, you don't necessarily have to take my word for it. I'll just refer the minister to an

article that appeared in the Chilliwack Progress dated March 4, 1997. The headline is: "Diehard New Democrat Blasts Health Board." In that article, Rollie Keith, who represented the NDP provincially in the election of 1996 as well as in the provincial by-election in Abbotsford in 1995, says that he agrees Chilliwack is not getting a fair shake in terms of the appointments to the regional health board.

I'm just wondering what kinds of criteria the minister uses in terms of making appointments to regional boards. I realize that this question was asked in a different sort of way yesterday, and the minister provided some answers at that time. But I do intend to explore in more detail the appointment process and just what types of criteria are used in terms of people's educational backgrounds or work experience backgrounds and also, I guess, their geographic locations.

Hon. J. MacPhail: The member is quite right. We've had a very good discussion on exactly this issue over the past two days. I don't want to cut off debate, but maybe what the member could do is read Hansard and then we could explore beyond that. But I'll summarize it very quickly for you.

There's a balance of interests and experience that needs to be represented on the boards. There has to be multicultural diversity, business experience, health care experience -- but, most of all, community experience and a commitment to delivering all the health care services that are mandated under the Canada Health Act and provided by our governments beyond the Canada Health Act.

It is recognized that in some regional areas, there is more than one distinct community represented. And it's important that we not only have a balance of community-by-community representation but also an understanding that health care services are not delivered in isolation in one community but are shared among a region, and therefore an understanding that the planning and delivery of health care extends beyond one community.

B. Penner: I'll be happy to review Hansard , but I would like to get this on the record and address the minister directly while I have the opportunity. There is a feeling afoot that perhaps one of the things the ministry is not considering sufficiently is the issue of people having relevant experience before being appointed to these regional health boards. As the minister pointed out, in our case they will have jurisdiction over four hospitals in the Fraser Valley.

Again, longtime New Democrat Rollie Keith was quoted in the Chilliwack Progress on March 4 as saying that "out of the blue," the ministry appointed two "neophytes" unfamiliar with health issues to the regional health board. And he said that this left Chilliwack without "proper representation." Again, these are not my words but the words of a longtime supporter of the NDP.

In terms of the overall weighting that takes place -- I know the minister just mentioned a few of the criteria that are considered -- I'm wondering whether in fact greater weight should be placed on people who have some experience in the health care field. Could the minister give us some comfort that more emphasis will be placed on people who have some experience in terms of either administering health care or working in the field?

Hon. J. MacPhail: I hope all members in the House noted that I'm under severe criticism from a New Democrat for the way that I'm proceeding, so they will lay off me in other areas.

On the issue of experience, let's use the board that covers the member's region. Six of the 14 current appointments -- less the aboriginal appointment -- have previous hospital board experience, but there is also a requirement that there be a great deal of other experience represented on the board -- for instance, business experience and perhaps an understanding of other community issues that affect health care.

In terms of health care experience, the review team that went out over the course of last summer came back with the recommendation that New Directions didn't recognize the value of including health care professional experience right on the boards. That's why we changed and said that there should be one seat on each board and council for a physician and one for a front-line health care worker. We took that recommendation. So amongst the 15 appointments, one will always be a physician and one will always be a front-line health care worker, as a minimum. In fact, many of the boards go much beyond that.

[ Page 3388 ]

B. Penner: So in the Fraser Valley regional health board case, the minister is indicating that at least two of the 15 positions would be reserved for people with direct medical experience. I see that she's indicating that that's correct, hon. Chair.

In terms of the administration of these new entities -- in our case, the Fraser Valley regional health board -- I understand that in the past there has been some discussion about a requirement for additional funding being provided to help these entities carry on their functions. I believe George Peary, a person from Abbotsford, has now been appointed to be the chairman of the Fraser Valley regional health board.

He's quoted in the Chilliwack Progress , this time on April 1, 1997, indicating that some time ago there was an indication from the minister that some decision about funding for the new entity would be forthcoming. However, he then said that administrative funding won't be increased until at least the next fiscal year, in April 1998, despite a written promise to double the Fraser Valley board's funding to $864,000.

I wonder if the minister could provide some background and explanation about what this extra funding is for and where we're at in terms of a decision about the appropriate level of funding for this new regional health board.

[3:30]

Hon. J. MacPhail: I'm sorry, I don't know where the commitment came that there would be a doubling of funding. We committed to infrastructure money that could be used in transition for regional health boards to set themselves up from an administrative point of view, and that was the $432,000. It doesn't in any way indicate that that funding will continue. In fact, beyond this year the regional health board will be required to find their administrative funding from within the region -- and certainly not from clinical programs or patient service programs.

B. Penner: If I understand the minister correctly, what she is saying is that there will be $432,000 made available on a one-time basis to assist the Fraser Valley regional health board in creating its own, I suppose, internal structure and management structure so that it can get on with the job. I just wonder if that is correct -- if it's a one-time payment only of $432,000 to help them create their own structure.

[J. Doyle in the chair.]

Hon. J. MacPhail: The funding was for '96-97 and '97-98. But these administrative costs have been rolled into the base funding now, and if there is any need to change the funding for administration of the regional health board, the regional health board will have to do that themselves.

B. Penner: I am just seeking some clarification. Was there a separate sum of $432,000 that was committed? Was that in '96-97 and an additional $432,000 for '97-98, for a total of $864,000? Or was it a total of $432,000 over two years?

Hon. J. MacPhail: In 1996-97 they received $432,000. In 1997-98 they will receive $432,000, for a total of $864,000 over two years.

B. Penner: I presume, then, that in future years -- as the minister indicated -- that the Fraser Valley regional health board will have to find its administrative funding from its existing funding base for the whole region in terms of all operations.

I'm wondering if the ministry or the minister has set out any guidelines for the various regional heath boards in terms of what an appropriate amount of spending would be in terms of administrative costs. I wonder if there is any kind of a guideline that the ministry has put out or a rule of thumb that can be applied. Do the regional health boards have completely free rein in terms of how much administrative costs they build up, or is there some rule set out by the government in Victoria?

Hon. J. MacPhail: Yes. I appreciate that the member might have been busy earlier today when this question was asked, so I'll repeat it. We are going to save $24 million in each fiscal year to 1999, and it will come from administrative savings. The regional health boards will be able to keep every dollar they save, when they put it back into patient services. There are a couple of caveats in terms of expenditure of administration after these savings. One is that savings cannot affect patient programs or clinical support programs.

You can't take administration expenditures out of clinical support programs or patient service programs. In any case, there should not be any money flowing from community care into acute care. It would be fine to move money from acute care into community care, but not the reverse.

B. Penner: One topic I want to touch on just briefly is an issue that flared up around the same time that a number of hospital boards were dismissed. It was an apparent . . . . It was reported in some of the news media -- and I'm quoting here again, this time from the Chilliwack Progress on April 1 -- that the minister had apparently vowed that "pro-lifers would not be allowed on the regional health boards to 'stack' them against abortion" as had happened at some community hospital boards in previous years. I'll give the minister an opportunity to correct whatever comments may have been reported in the newspapers.

Hon. J. MacPhail: As I stated earlier when the member asked for the criteria for appointment, people must be committed to delivering all of the legal health services required under the Canada Health Act and be committed to delivering them in an accessible way to their members who live in their community. That's the criteria for appointment.

B. Penner: I'd like to move, now, to another issue. After the Chilliwack hospital board was fired by the minister -- I believe in early March of this year -- she appointed a gentleman by the name of Donald Juzwishin as the administrator on an interim basis to look after matters at the Chilliwack General Hospital. One of the duties that he was apparently assigned by this government was to prepare a report back to the minister. Initially, we were told in Chilliwack -- and I think this was on March 25 -- that the report would be complete within a week, would be sent to the minister and subsequent to that would be made public. Several weeks later an

article appeared, again in the local newspapers in Chilliwack, indicating that the report would be completed by the end of April and would be made public in very short order. We're still waiting, in Chilliwack, to find out whatever happened to Mr. Juzwishin's report, and I'm wondering if the minister could provide us with a progress report on that report.

Hon. J. MacPhail: Mr. Juzwishin, who is the public administrator appointed by me, was asked to report on actions that the previous board of the Chilliwack hospital had taken with regard to the dismissal of Etta Richmond, the CEO of Chilliwack General Hospital. He did that, and let's just say

[ Page 3389 ]

that it certainly gave us renewed vigour to pursue legislation which I tabled two weeks ago around the issue of severance.

B. Penner: Is it correct, then, that I hear the minister to say that the report from Mr. Juzwishin has been completed and is now in her hands?

Hon. J. MacPhail: Yes, I have received the advice from Mr. Juzwishin. It's ministerial advice.

B. Penner: We were told some time ago that a report would be prepared on all of the circumstances involving Ms. Etta Richmond, the former hospital administrator in Chilliwack, a person who had spent 30 years in the health care sector. We were also told that that report would be prepared in some detail, would be sent to the minister and would then be made public. I wonder if the minister could tell us if, in fact, that report will be made public.

Hon. J. MacPhail: It's ministerial advice, but certainly if the member opposite wishes to engage in a discussion around severance, I'd be more than happy to do that.

B. Penner: Obviously this is a controversial issue in Chilliwack, so there has been a lot of talk amongst people waiting for the release of this report, not the least of whom are the people who feel that they've come in for some rather harsh criticism -- unacceptably harsh -- from the minister. They've been waiting to see what this report has to say. Those people include the former chairman of the Chilliwack hospital board, a person who served in a voluntary capacity for 14 years without ever receiving any remuneration, and a person who is very busy in his own private life with a large family and a busy accounting practice.

Many people have been told that this report would be released and made available to the public so that we could have an open discussion about it. It comes as a bit of a surprise to me now, hon. Chair, to hear that this report is not going to be released. We've been told repeatedly by Mr. Juzwishin and by spokespeople from the Ministry of Health that the report would be made public after the minister had had some time to digest the contents of the report.

I just wonder if the minister can explain why it is that this report will not be released to the public.

Hon. J. MacPhail: I am certainly more than willing to engage in a discussion around the advisability of severance for Ms. Etta Richmond, the advice the board received prior to severing her, the lack of necessity for that severance and the cost to the taxpayer. There is absolutely no unwillingness on my part, after receiving the advice from the administrator, to discuss those issues.

The commitment to make the report public didn't come from me. The whole issue is, for me, a matter of public record, because we're dealing with tax dollars here -- tax dollars that should be going into patient care. So let's have at it.

B. Penner: For the record, hon. Chair, I'll take that as the minister's statement that she is not prepared to release the report from Mr. Juzwishin.

There were a number of media accounts at the time the Chilliwack hospital board was fired by the minister. One of the things she stated in a variety of interviews, including one with the Vancouver Sun , was that the severance package to Ms. Etta Richmond, who had been in the health care field for some 30 years, was excessive. The Health minister gave a figure for the severance package as $250,000. In fact, the amount of the severance, we now know, was $173,000.

I'm just wondering if the minister is prepared to correct her remarks, in terms of the amount of the severance package, which she overestimated by almost 50 percent.

Hon. J. MacPhail: Again, the member misses the point here. We can talk about $173,000 of health care funding, we can talk about $250,000, or we can talk about $500,000: the money was improperly spent. It did not need to be spent, because there was no severance necessary. The Chilliwack hospital board had been advised not to make any staff changes, that personnel would be accommodated, and that there was no intent, in any way, to change the employment circumstances of the CEO of the hospital.

So it is like dancing on the head of a pin to ask what the exact value of the severance was. One dollar would have been too much, because it would have been one dollar coming out of patient care and going into severance costs that were unnecessary, unwarranted, and that the board had been advised against doing.

B. Penner: Around the time this whole issue erupted in Chilliwack -- it was in early March of this year . . . . One of the reasons it was received with so much concern in our community was that the current government had just announced plans to close the Chilliwack courthouse after promising the people of Chilliwack a new courthouse prior to the last election.

In an interview on March 11, 1997, the minister was asked by the editor of the Chilliwack Times why she was taking so much exception to this particular severance package when in years gone by the NDP government had seen a whole variety, a whole parade, of large severance payments to many of their longtime supporters who had been appointed to lucrative positions in this government. She was specifically asked about the severance package given to Marc Eliesen, a person who had worked at B.C. Hydro for, I think, less than two years.

At that time the minister told the Chilliwack Times that there was absolutely no severance package and no money going to Mr. Marc Eliesen. We now know that in fact he is receiving something in the amount of $25,000 per month from this government.

I think that highlights a lot of the problems we have at our end of the valley. There seems to be a double standard: one for people that are longtime supporters of the NDP government, and a completely different standard for other people who have given, in this case, 30 years of commitment and expertise to the health care system. That's where we, at our end of the Fraser Valley, are coming from. We see a double standard by this government.

I would like to ask the minister, however, if she's prepared to release any letters or documentation that support her claim that the Chilliwack hospital board had been told not to dismiss Ms. Richmond as part of the regionalization effort.

[3:45]

Hon. J. MacPhail: The public record also documents the advice received from the regional health board chair, George Peary, himself. George Peary is on record saying that he advised the board not to take this action. The hon. member knows full well that that's part of the public record. Those discussions had occurred directly with the Chilliwack

hospi-

[ Page 3390 ]

tal. Certainly, we had been continuously giving that advice through our regional health board chairs. In the face of that, the Chilliwack hospital decided to ignore that advice.

B. Penner: I've asked people in Chilliwack if they've ever received any letters with this written advice from the minister, and I've been told no. From the minister's answer here today it sounds like there was in fact no such written advice ever given.

While she's on the topic of George Peary, the new chair of the Fraser Valley regional health board, she may be interested to know that on March 18 George Peary said, in the Chilliwack Progress , that the ministry must get over its command-and-control attitude towards regional health boards, or else the latest version of the health care policy is "destined to fail." I don't think she has the world's strongest supporter in George Peary either, so she's treading on some thin ice when referring to him for support.

We all understood that the regionalization process was supposed to lead us to an era where there would be less costs of administration. It seemed sensible, I suppose, to the Chilliwack hospital board -- although I can't speak for them, because I wasn't there and I was never a member of the hospital board . . . . It seems, from an outsider's perspective, that if you're going to try and reduce administrative costs, one thing you might try to do is reduce the number of administrators. And I see the minister is shaking her head to the contrary.

If we're not going to find administrative cost savings by reducing the number of administrators, how do we find administrative costs savings?

Hon. J. MacPhail: Hon. Chair, of course that's the direction that we will be achieving in the regionalization of health care.

And I would appreciate that the hon. member not read excerpts from news clippings out of context.

Let me say this to the member across: there will be savings achieved from administration. Those issues will be decided by the regional health board. I have the fullest confidence in George Peary to carry that out. That was the advice that he gave to the Chilliwack General Hospital. They will be finding administrative savings in areas that I've already introduced in this House, such as finance, human resources, laundry, payroll, purchasing, material management, information services and health records, to name a few examples.

The question I have for the hon. member is this: when you are guaranteed that your job is there, that there should be no layoff, that there should be no severance, does this hon. member then support $173,000 of tax money that should be going into health services now going into the pocket of a person who had a job?

B. Penner: I wonder if the minister could tell us if the ministry contemplates that there will be any administrative positions eliminated through the course of regionalization around the province. Are there any administrators anywhere that this minister sees as becoming redundant as a result of regionalization in British Columbia?

Hon. J. MacPhail: Yes, there are.

B. Penner: I wonder why that approach does not apply to the Fraser Valley regional health board if it applies to other parts of the province.

Hon. J. MacPhail: I guess this hon. member will do anything to avoid answering a direct question.

The issue of downsizing, of achieving administrative cost savings, is the responsibility of the regional health board. I have said over and over again here that it needs to be done in a planned way. A management plan has to be put in place. And it has to be done with the priority being given to patient care and patient satisfaction -- the highest priority. It makes sense, when we're moving to a system where there will be administrative cost savings due to integration of services, that it be done in a planned and orderly way, and that we also do that by using the valued experience that exists in the region.

Many regions . . . . Sorry, I won't exaggerate. Regions have already done that. They have their management plan in place. There are administrative positions being eliminated. But there are also requirements that it be done in a way that doesn't involve the wasteful expenditure of severance costs.

B. Penner: It's certainly true that this side of the House is opposed to outlandish severance packages that we've seen all too often from this government over the last five and six years; it's completely irresponsible.

However, the longtime New Democrat supporter whom I referred to earlier, Rollie Keith, is quoted on March 11, 1997, in the Chilliwack Times as saying that the Chilliwack hospital board was merely looking out for the best representation of the community and "was not irresponsible" in reacting to the Minister of Health, the member opposite. So there are many people in our community, including longtime New Democrats, who really feel that this ministry and this minister had a completely different agenda when she set forth to fire the Chilliwack hospital board, and that the whole issue of severance in Chilliwack was a smokescreen for pursuing the particular agenda that her government is pursuing.

Hon. J. MacPhail: What would be that agenda?

B. Penner: Well, we've . . . . The minister, hon. Chair . . . .

Hon. J. MacPhail: Where on that list . . . ?

The Chair: I ask members to please address their questions through the Chair. Otherwise we should adjourn to the bar or somewhere, where we could do what you're doing right now.

B. Penner: I'm sure the minister will take that caution from you, hon. Chair.

There are people in our community who felt there was some other agenda at stake. One of those agendas that was feared was that there was a move afoot to withdraw medical services from the Upper Fraser Valley and centralize those in other parts of the Fraser Valley. That was the concern expressed not just by Rollie Keith, the former New Democrat member of the Chilliwack hospital board, but by -- I don't want to exaggerate -- probably close to a hundred people who contacted my constituency office at the time of the Chilliwack hospital board firing.

They were all concerned that this was merely a precursor to the withdrawal of medical services from Chilliwack and the downgrading of the Chilliwack General Hospital. That is where the fear is coming from. The minister asked me what our fear was in the Upper Fraser Valley, and that's what it is.

We see that the government, contrary to its earlier promise, was planning to close the Chilliwack courthouse. Then the

[ Page 3391 ]

government also fired the Chilliwack hospital board and, in making appointments to the new regional health board, appointed only two out of 15 people from our community. So although maybe the concerns are not necessarily always accurate, I think there is a realistic foundation for people to have those concerns and to voice those concerns, certainly as Mr. Rollie Keith has done on numerous occasions in our community. I wonder if the minister can address some of those remarks.

Hon. J. MacPhail: There were many unfounded fears as we went through the process of change across the province, moving toward regionalization. We dealt with the unfounded fears and worked, in problem solving, with the fears that had a basis of reality to them.

In particular, the Chilliwack hospital was told that there was absolutely no intent in any way to change the service delivery level or the way those services are delivered from that hospital. They had that reassurance before they fired -- unnecessarily -- the CEO. They had that reassurance in isolation from anything else that was going on in the community of Chilliwack hospital. They had that reassurance from the ministry. They had that reassurance from the regional health board chair.

But I guess it does please me that there is an alliance between the hon. member and a good, solid New Democrat as well, in being upset about the whole process. It truly is non-partisan, then.

B. Penner: The hon. minister is correct that there is a coalition in Chilliwack. That coalition is there to stick up for our community when we're being attacked by the NDP government in Victoria.

I'll just end with one final question. I'm just wondering if the minister has in any way extended her thanks or appreciation to the members of the Chilliwack hospital board, some of whom, as I've indicated earlier, served as long as 14 years without ever receiving any compensation for their countless hours of work and dedication. Rather than criticizing the hospital board as she's done through the media, I think it would be more constructive if she were to thank the members of the hospital board for their many years of selfless dedication to the cause of health care in the Upper Fraser Valley.

Hon. J. MacPhail: Yes, I have sent a letter thanking them for their services, recognizing the value of their contribution to the community and looking forward to continuing to work with them.

L. Stephens: I request leave to make an introduction.

Leave granted.

L. Stephens: It's a pleasure for me today to welcome in the gallery, from the Langley Fundamental Elementary School, 62 students in grade 7 and their teacher Mr. Wiebe. Would the House please make them welcome.

T. Nebbeling: I would like to ask a couple of questions of the minister as well. But before I do that, I would like to give some historical perspective of what has happened in my riding as far as the providing of health care is concerned. My riding is West Vancouver-Garibaldi. While West Vancouver, Bowen Island and Lions Bay traditionally have been serviced by Lions Gate Hospital in North Vancouver, the communities of Squamish, Whistler and Pemberton have always been kind of a playball in the field of where they belong.

For a long time, it was the Coast-Garibaldi health unit that was responsible for health care provisions in the Sea to Sky corridor, as I recall this particular part of my riding. That meant that health care provision was, in part, not necessarily controlled but working together with the rest of the Sunshine Coast, which is Sechelt and Gibsons.

One of the problems, of course, of being part of a health board that includes Sechelt, the Sunshine Coast and Gibsons is that in order for . . . . Members of the board who live in Squamish, Whistler or Pemberton actually have to drive about 100 kilometres up the road to catch a ferry and then, being on the Sunshine Coast, continue to travel to wherever the meeting is going to be held. This has caused a lot of trouble. Members who attended meetings couldn't get ferries back home, so they had to stay overnight on the Sunshine Coast, where the meetings were held in general. The pressure on the volunteers . . . .

We also have to remember, then, that many of the people that volunteered to be on hospital boards were volunteers. They were often hindered and hampered in doing or playing that role.

Ever since I've been involved in the Sea to Sky corridor, there's always been a strong push to do what common sense would have dictated in the first place when it came to providing health care. That is to see the Sea to Sky corridor actually being married or connected with the North Shore -- West Vancouver and North Vancouver -- and have the Lions Gate Hospital, actually, as the really focused trauma and acute care provider for that particular area.

While we were members of the Coast-Garibaldi health unit, that dialogue took place for three or four years to see a transfer, to get these three communities together with the North Shore. In 1991-92, it began to look like indeed the commonsense argument of going together began to hold, get some foundation. The process of transition from the Sunshine Coast -- to be members with the Sunshine Coast to the North Shore -- started to develop.

Then, of course, we got a little wrench thrown into it all, and they approached a new direction. With New Directions, the whole dialogue of the Sea to Sky corridor -- Squamish, Whistler, Pemberton joining West Vancouver and North Vancouver as one health unit -- was put on the back burner. Actually, it was eliminated as an option, because through the ministry it became clear that these three communities were still going to be part of Sunshine Coast-Sechelt, with the addition of Powell River.

To just give you the logistics of being part of a board that has that kind of representation, a board member from Pemberton would have to drive to Horseshoe Bay, which is 127 kilometres, take a ferry to Langdale, which is 45 minutes, then drive the Sunshine Coast, take another ferry and get to Powell River. That is about a five-hour trip.

Again, these members are volunteers. Of course, that was one of the reasons we had much concern in the Sea to Sky area about New Directions. The other reason that we had a lot of concern at the time was the fact that because of all the debate and the discussions that were going on as to where the Sea to Sky corridor did belong and who they would in the long term be married off to, upgrades to the Sea to Sky corridor, as far as hospital service was concerned, really fell behind.

[4:00]

Often the argument was made, when, for example, the Squamish hospital needed some upgrade and some extra funding: "Well, we have to make sure that we know exactly,

[ Page 3392 ]

that we know the service will be provided in your region, and once that is all established then we can exactly identify where to put the money.

So New Directions, of course -- after the dismal success that it has delivered after three years at a cost of $40 million to the taxpayers of this province -- was abolished, and regionalization became the new fashion word, so to speak.

Again, the Sea to Sky corridor communities became part of this new drive, this new creation, and some very obvious questions were raised during that period as to how a community like Pemberton or Squamish could truly become partners with a community like Powell River, which is five hours down the road and for which you have to cross two waters. How can you make, as a region, the savings that were to be derived from the regionalization approach? This has been going on for a while.

Then, of course, in April of this year the decision was made to make Powell River its own region, I believe, with Nanaimo, Sechelt-Sunshine Coast will be a region of its own, and now we see the Sea to Sky corridor being its own region as well, as far as hospital service is concerned.

My first question to the minister is: obviously now that the Sea to Sky corridor has been identified as a region on its own and considering that over the past -- and we can go a little bit further in that -- funding for upgrades or funding for essential services that the hospital should have been providing and didn't provide because it was not available . . . . And I know the minister is smiling because she's thinking . . . .

You see, here she is again constantly looking for cuts, cuts, cuts, and the first thing she's going to say is: "Where is the money?" But the minister wouldn't do that because she understands the seriousness of the point I'm making -- that is, here is a hospital that lacks a tremendous amount of services to the point that the people living in the Sea to Sky corridor still cannot use that hospital for the services they need.

Knowing that the minister is very much aware of what's happening there, can the minister give me a bit of an overview of what she sees happening now with the Squamish hospital and how that hospital will indeed be brought into this century as far as equipment is concerned, as far as services are concerned? Then I have some other questions.

[T. Stevenson in the chair.]

Hon. J. MacPhail: It's interesting to hear the recounting of the history. I find it very useful as well.

The issue of hospital funding, of course, will be part of the community health council's responsibility in the future. I'll just tell the member what I have said earlier in that we will, starting this fall, be working with the regions and the health councils to talk about how or whether we have a different funding method now that community health councils and regional health boards are in place.

So there will be an opportune time for . . . now that the community health council is in place. And my understanding is that in the hon. member's area it is functioning very well. There are no significant problems at all. But that will be the time for the community health council to work with the ministry in a review about suggestions for funding methodologies that may better meet the needs of the community.

T. Nebbeling: I understand that we are in the future going to have a dialogue. However, looking at the budgets, it's clear that nobody in his right mind today can anticipate fairly substantial increases to bring a hospital up to speed. When I say "up to speed," I mean bring a hospital up to a level that it can indeed serve the corridor or the area it's supposed to.

The reason I bring it to the attention of the minister, in particular, is the fact that up to now, because of the lack of proper facilities in Squamish, many of the patients that come from beyond Squamish -- like Whistler, Pemberton to a certain extent, but particularly Whistler -- are actually transferred immediately to Lions Gate. And the reason is that Squamish has just not been able to accommodate these patients. So here is a very unique . . . .

No, it's not a unique situation; it's an unusual situation, where there is a hospital in an area that does not have the equipment, the staffing or the facilities to deal with the needs of that area. As a consequence of that, the patients are actually delivered to the next region, which is the North Shore Lions Gate Hospital, and Lions Gate Hospital has traditionally been receiving the money for providing the services to these patients, as expected.

But now we have the situation where Squamish is far behind. It doesn't get the extra funding that I believe it's going to need to bring itself up to the level where it can indeed do the services -- except trauma, I suppose -- that the North Shore Lions Gate Hospital is providing for the Sea to Sky corridor. I would like to see how the minister can deal with that catch-22 that we are in in the Sea to Sky corridor today and have been for the last five, six years.

Hon. J. MacPhail: Those are interesting points for me to consider. If I could just seek some input, because I know this member has a great deal of municipal experience as well. Perhaps I could ask the member for his opinion -- and I appreciate your comments around the Squamish hospital -- on whether there is a fluctuation in the use of services. Would that be his estimate because of it being a resource-based community or a tourist community? Or is it his view now that basically there's year-round evenness of demand for services in the Sea to Sky area?

T. Nebbeling: Well, the population of the Sea to Sky corridor has grown dramatically. No doubt, many of the serious accidents that do happen in the Sea to Sky corridor are recreation-related, so in the winter months you certainly face more broken bones and serious fractures that often need trauma treatment before the patient can be shipped out -- or flown out, I should say, in this particular case. They go straight away to Lions Gate, once they've been brought under control.

But at the same time, considering that we have industries in the Sea to Sky corridor during the summer months that also have a high level of accidents, such as the forest industry, mining industry . . . . And there's a lot of recreational activities in the summer as well -- mountain climbing, kayaking -- very often with accidents that need treatment that should not necessarily be done at Lions Gate Hospital but should be done in the Squamish area. Lack of facilities hinders that.

Hon. J. MacPhail: That's very useful, and I can give the hon. member my assurance that all these matters will be considered as we review the funding.

T. Nebbeling: Just one more point, and that is that speaking to the Squamish hospital, they have been asked to start, July 1, providing dental services for children. They've been asked by Children's Hospital to do this, based on the fact that there is a 12-month waiting time, according to the information I've been given. So I have nothing on paper to substantiate it. The Squamish hospital just doesn't have the facilities to do

[ Page 3393 ]

this. So they asked me -- that's how I got to know about this particular issue -- if I could be part of a group to start fundraising to fund the facilities that are needed to accommodate this children's dental centre in the Squamish area. That to me is very symbolic of what is happening here. Certain services are now being requested to happen in the corridor, because it is a unit on its own. The facility is not able to provide it because the equipment is not there.

Rather than receiving the funding that should be coming with requests such as that, they turn around and say: "Well, talk to your community leaders, and maybe they can find the funding." So I had to ask that question because it really concerns me, looking at what else is needed in that particular hospital. The fundraising element may do a little, but certainly not enough, to bring it up to the status that indeed is a corridor hospital. That's what I'm looking for.

Hon. J. MacPhail: Thank you for bringing this item to my attention. Actually, I'll investigate it, because certainly if Children's Hospital is delegating to communities, then it should be done in a fashion where funding follows. So we need to . . . . I'll look into that matter.

R. Coleman: I want to ask the minister some questions this afternoon about some of the impacts of amalgamation and transference of assets. I'd like to start out first of all dealing with the transference of land assets from either non-profit organizations or hospital societies that have paid for them with charitable dollars they've raised in the communities. Is there any compensation going back to these societies or communities that have actually raised the money and paid for these assets themselves at the local level?

Hon. J. MacPhail: Yes. I know the member may be aware that we discussed this previously, but I'll quickly answer the question. The assets are transferred to the regional health board or the community health council, but if there is a caveat on the use of the land that has been put in place by the donation, that caveat remains and is transferred along with the land. So if a particular fundraising effort was done to accumulate lands specifically for the purpose of an acute care hospital, that . . . . Is it a covenant? Maybe I'm not using the right language, but that attachment stays.

I just note for the member that this is the way for all fundraising mechanisms in hospitals, colleges, universities and school boards, as well -- donations are transferred with the structure.

R. Coleman: I understand the transference on the one side and the covenant side. I'm thinking more in terms of . . . . I'll give you an example. Let's say it's a care facility that was run by a Lions organization for the last 25 years and is now being absorbed by the regional health board. The Lions have gone into the community. The society has had the mortgage in its name, has paid down the mortgage, has built up equity in the facility in the name of the society. I'm wondering under what provisions we're transferring that asset over to regional health board when somebody else has paid for it. Or is this just an expropriation of an asset?

Hon. J. MacPhail: Again, we had an excellent discussion about this yesterday. I noted for the record that service organizations are not part of the amalgamation. Their assets are not transferred unless they voluntarily wish to do so.

R. Coleman: One of the concerns I have about the regionalization with regard to assets is, if you look historically . . . . Before I move into that, I want to express to the minister my deep disappointment in the fact that in my jurisdiction the hospital board and the hospital society from Langley, which was a four-year accredited facility -- one of the best-run in Canada -- have nobody appointed to the regional health board. I'd also like to bring to her attention

section 1.1 of her own Human Rights Amendment Act regarding discrimination against people with regard to their appointment and their use and involvement in a British Columbia society. However, my concern is with regard to the fact that I'm wondering how the minister chooses to address this in the future. When I look at amalgamation and at some of the uses of amalgamation, I know that some of the hospitals in the lower mainland were already sharing some things like accounting services and things like that.

I don't understand the reason for the regional health board when the only thing you're really eliminating here are volunteer health boards that weren't costing you any money. If you could just amalgamate the services and leave those boards in place, you might be able to get the community involvement to remain.

[4:15]

I'd like first of all to address how the regional health board system, without that community involvement, without that community commitment, which you're going to lose -- which you've already lost in many communities -- and the fact that most of these hospital trustees and boards in the local area have done things a bit differently . . . . How are you going to address what hospitals have done in the past -- like Peace Arch District Hospital in Langley, where they've acquired years ahead of time land reserves through volunteer and community donations to address future needs?

Who's going to be doing that, now that there are no trustees in place to take those initiatives and to raise money locally in order to make those things happen in the future?

Hon. J. MacPhail: There is no plan to eliminate foundations.

R. Coleman: That wasn't my question. My question was on the elimination of trustees -- in other words, the elimination of volunteer health boards. In my community the volunteer health board drives a tremendous amount of that particular fundraising along with a separate foundation. Now you've basically taken one piece of the heart out; you've taken a second piece of the heart out as well.

The other one is that these hospitals in my particular area have operated on a long series of balanced budgets with the exception of the Surrey Memorial Hospital, where most of the people that have been appointed to the regional health board come from. I'd like to know on what basis and what qualifications the people . . . ? I know you recently appointed one from Peace Arch, which was done after the fact, after sort of a second thought, and I'm wondering what provisions you're putting in place to make sure there's regional representation from every community on these health boards.

Hon. J. MacPhail: Well, we've certainly had a good discussion over the previous three days on this very matter. I would refer the member to Hansard -- that was the discussion around the balance between community representation and also recognition that health care planning is done on a basis beyond individual communities -- and then if he has any subsequent questions, I would be more than happy to answer them.

On the representation on the particular south Fraser Valley regional health board of which this member's

commu-

[ Page 3394 ]

nities are a part, I can provide the hon. member with the biographies of the regional health board members. But looking at this, clearly there's a great diversity of community experience, professional experience, business experience, health care experience, city council experience.

R. Coleman: We might also note the experience of donating to provincial NDP campaigns and being members of slates or whatever that ran under NDP flags in our particular area. If the minister would like me to give her that list, I can provide that for her.

The other concern I have with regionalization in this particular regard is that I came across some files recently through one of the acute care facilities, where there has been what we refer to as a gift letter. A gift letter is when a society or a non-profit group or a corporation or an individual philanthropist makes a specific donation to a facility, that being an asset. Although we can pick a number of things, let's say, for instance, it's a package of items including some big-screen TVs, VCRs and some carts of stuff for the children's ward of a particular hospital.

The letter states very clearly that these assets, these donated items, are to be used in that specific facility. On the transfer of assets, how are you dealing with those particular types of gift letters?

Hon. J. MacPhail: Their use will continue as they were designated.

R. Coleman: Is there any guarantee to these communities in any of these agreements, then, that they will not be moved to another community?

Hon. J. MacPhail: I do take the question seriously. The regional health board is not going to be a moving company, snatching assets in the middle of the night from one community to move them to the other. Regional health boards have been asked, and have agreed, to commit to sustaining the assets that a community has developed in that community. Common sense will prevail. I don't think there's any record of any regionalization process in any part of the industrialized world that would give rise to an example such as the member anticipates. Certainly I don't anticipate there being any different application of regionalization of health care in British Columbia.

R. Coleman: I was reviewing some of the agreements that are in place between various organizations with regard to regional health care, and, of course, I noticed that we have a memorandum of understanding between the Crown and the B.C. Buildings Corporation with regard to the physical buildings -- the leases and what have you -- that are being transferred down.

Can the minister tell me how many facilities are being re-leased to BCBC from one area of a ministry to another, as far as some sort of guarantee into their leasing arrangement?

Hon. J. MacPhail: What I will commit to provide to the member is the information on the . . . . This is for clarification, if this is what he's asking for. Where the Ministry of Health leased a building that provided community health services -- mental health services, public health services . . . . I think the member is asking what's happening with those. I will commit to get that information for him.

R. Coleman: I'll take that commitment from the minister.

I want to basically deal with a couple of concerns in that regard. First of all, the various facilities are basically transferred by either a lease or an operating agreement in principle between the Crown and B.C. Buildings Corporation. The normal practice within government is that the lease can be cancelled with six months' notice to BCBC, which then absorbs the balance of the term of the lease -- its lease-up costs and the balance of operation. I'm just wondering if we're doing that with these particular facilities as well.

Hon. J. MacPhail: That will be part of the information that we'll provide to the member. I'm sorry, I'm not aware of the answer to that, so I will make a commitment to provide the answer.

R. Coleman: The information I would really like, then, would be the square footage of the building and the lease as it sits today -- its expiry date. If the unit is continuing to be leased by the ministry back to BCBC, it's really not an issue -- it's information on the ones we're closing down and what the download costs are to the B.C. Buildings Corporation, so that we can determine what those costs are.

Also, in some of your information, it says that the ministry is continuing its discussions with Canada Mortgage and Housing Corporation to ensure blanket approval for amalgamations and to confirm regional health board and community health council eligibility for mortgage subsidies.

I'm just wondering what your status is with your negotiations with CMHC -- whether they are going to ensure your loans on these particular transfers when you transfer the mortgages over. I notice that you've applied for an exemption from a property transfer tax, so I assume there's obviously some asset removal under land titles taking place here. I'm just wondering what your status is with CMHC at this point in time.

Hon. J. MacPhail: I see that as part of the information I would provide. If the member wishes to put on record all of the questions he wants answered, I'll certainly make a commitment to get those answers.

R. Coleman: With all due respect to the minister, I sent her ministry a letter with a series of questions about a month ago and got quite a bland letter back. For all intents and purposes, I will now have to canvass something like 30 different societies as we move into estimates, just for information because the answers weren't provided.

As we go through this, I would also like the minister to . . . . Obviously I know what CMHC is: an insurance company. It's not a mortgage company; it's an insurance company. CMHC charges fees on transfer. They charge placement fees, and they charge insurance fees on insuring mortgages. In my experience dealing with them, there's always been a fee attached to whatever they do when they're doing business with you. So I wonder if the minister could also tell me if she could give me the cost and the listings of mortgages that are being transferred and what CMHC is going to charge you in fees.

Hon. J. MacPhail: Hon. member, I will take these questions on notice. If he wishes to just read them into the record, I'll be more than happy to provide the answers.

R. Coleman: Having dealt with the mortgaging issue, that also means that we have some sort of a transfer-in-title issue. I know there's a movement of assets, but normally when you transfer an asset, when you transfer the mortgage

[ Page 3395 ]

especially, and you do it with CMHC -- which is a movement, and you're re-issuing the title . . . . I'm wondering if there is some form of contract for purchase and sale or agreement of transfer that's a standard format utilized for these transfers and how you're applying it within the Real Estate Act.

Hon. J. MacPhail: I'm sorry, I missed the last part of the question.

R. Coleman: The question was basically . . . . A movement of an asset is taking place, and you are dealing with a movement of a mortgage from one organization to another. Somebody is assuming the mortgage. Because there's a property transfer tax exemption involved, that means we're also having a transfer of title. I believe that when those two take place, under the Real Estate Act there should be some form of agreement -- either purchase and sale, or some form of formal agreement of transfer -- being utilized. I'd like to know what we're doing, with regard to how if affects the Real Estate Act, to meet those provisions of the transfer.

Hon. J. MacPhail: This will be part of the information that will be provided to the hon. member. We are aware of the letter that was sent. We did provide you with some information and referred the member to the public record where this information is available. These are very detailed questions. We committed to provide the member with the answers. It will take up a great deal of administrative time, but I'm sure the member sees that as a good investment of health care dollars.

R. Coleman: I think that any time somebody does a finite examination of the use of taxpayers' dollars and how they're benefiting the community -- whether there are business plans in place or whether there is a method of measuring performance when we spend dollars -- I don't find that to be a waste of taxpayers' money. I will certainly be pleased to canvass the questions, outside of the ones that are being dealt with with the corporate searches right now, during estimates as they come up.

Obviously when we deal with transferences of mortgages and transfers of titles and what have you, there has to be some agreement on the other side with regard to these. As we do these, if there is an organization like a hospital foundation or hospital society involved, are these voluntary decisions made by these organizations to transfer title, or is there a provision that is being used in legislation to basically force the transfer of title?

Hon. J. MacPhail: They are statutorily mandated.

R. Coleman: My next question is with regards to . . . . I just want to use an example. I have a great deal of concern about the loss of certain types of funding -- and not funding from taxpayers, because we know that the idea behind regional health boards and regionalization is to save us money. I'm just wondering if there has been a cost-benefit analysis done on regionalization from the standpoint of looking at what the losses might be on a local level in another case. I'd like to give you an example of that, so you can answer it with regard to this type of cost-benefit analysis.

The Peace Arch Hospital Foundation put in over $3.2 million in capital expenditures in 1996-97, and only $310,000 came from government. I know that in the communities that I've dealt with regarding regionalization, people are basically walking away from involvement with hospitals and looking for another place to put their charity dollar. They're concerned that the assets will not stay in the community. They're concerned that their money isn't going to be wisely spent.

They're concerned that they don't have control anymore because there's no longer a board of directors at the hospital they're donating these funds to -- either through the foundation or individually -- that has some sort of local control or input.

I'm wondering if the ministry has done a cost-benefit analysis on the other side of regionalization as to the downside loss from community involvement in the funding of hospitals and capital expenditures.

[4:30]

Hon. J. MacPhail: I certainly appreciate the member's expression of fears. Those are fears that we're trying to deal with community by community.

Really, there is no evidence of a decrease in fundraising amongst foundations, but I do appreciate the member's concern that somehow certain groups feel that there's a loss of autonomy or that there will be a loss of value attached to their fundraising efforts. Foundations are staying in place; fundraising arms are staying in place. Even as we speak, the fundraising is going on at a wonderful level. I hope that people who are responsible opinion leaders will allay those fears and understand that indeed nothing whatsoever changes in that area.

R. Coleman: The only thing that changes in that area whatsoever is the belief of the community in the fact that they can now be involved in making their hospital better without the last of those assets leaving the community. What happens there is that you begin to have a loss of faith. As we're going through this process, it's fine to say that foundations are not seeing their fundraising drop off. But revisit this in two years and find out where they actually sit, and I think you may be very surprised.

I sincerely hope that is not going to be the case. I do know that one service organization, which I am involved with, recently held back on a donation, waiting for a decision on whether their local care facility was going to be dealt a blow by regionalization as far as the involvement of the board, which had been there for a long period of time, was concerned. That concern was actually expressed by one of their own board members coming to the club and saying: "Maybe you should hold off until we know something about this." So that is out there. That concern is out there, that impact is out there, and we should be very aware of it.

I'd like to go back to something that I dealt with here a minute ago, and that's the asset situation. I'm just wondering whether all the assets that are now being dealt with are strictly being dealt with as assets -- their land base -- that are held by acute care facilities and not by any other organization or independent body.

Hon. J. MacPhail: Sorry, we're not clear on the question. The assets that are transferred are assets that are acute care and continuing care. As I said earlier, assets held by denominational groups or service organizations are unaffected; there will be no change for them. There will be no transfers unless they voluntarily request to do so, which has occurred in some parts of the province.

R. Coleman: Is there any intention to expand the mandate of the regional health boards? Once we've dealt with the acute care and continuing care facilities, do we then go to the ones that are funded through the ministry that have been run

[ Page 3396 ]

by volunteer boards -- either mixed or service clubs and community groups and what have you -- to begin to claw back those assets and control under the regional health boards?

Hon. J. MacPhail: No.

R. Coleman: I'd like to deal with a specific facility just for a minute, because I think it's probably the closest-to-home example of a facility that I have. Maybe the minister can tell me where this facility fits within the regional health board, the asset base and its community usage. The facility is located in Aldergrove. It's referred to as the Jackman Manor facility. It's basically an intermediate care facility that also has an Alzheimer's wing. I'm wondering where that fits in within the regional health board jurisdiction and how its asset base is affected at this point in time.

Hon. J. MacPhail: We can certainly get that information for you, but perhaps the member could provide me . . . . Is it run by a service club? Is it a private care facility? If perhaps he could help me with those, I could maybe provide him with the generic answer right now.

R. Coleman: The board of directors of this society is largely made up of members of the Lions Club in Aldergrove. It is a facility funded by the Ministry of Health. Both the Alzheimers wing and the care facility are funded through the ministry, as I understand it. It is not a private facility. I don't know what else you'd need to know in order to give me your generic answer.

Hon. J. MacPhail: I assume it's a Lions Club service organization running the facility with ministry funding. On the basis of that, I will offer you this. It will continue as is; it will receive its funding from the regional health board. The relationship will probably be established by a service contract. I have also encouraged the service organizations to establish a working relationship with the regional health boards.

R. Coleman: With regard to these type of facilities, is the regional health board going to have representation on the boards of these particular facilities or have some influence on their board for decision-making, other than the operating agreement?

Hon. J. MacPhail: It's a contractual relation, not a board representation. But I don't want to preclude that if there's some government employee volunteering on the board, would change in any way. There would be no change in the relationship other than a service contract being signed with the regional health board now.

R. Coleman: So I'd be correct in the supposition, then, that this would be covered under a funding or transfer agreement with the ministry and that that funding or transfer agreement would be for a set period of time. Most of the ones that I've looked at to this point are on an annualized basis for annual renewal. Is that basically the standard format of operation?

Hon. J. MacPhail: Yes.

R. Coleman: Knowing the regionalization situation, when you have an annual contract -- I know the minister has said there's no intention to do anything -- is there any way of establishing or dealing with some of the concerns of these non-profit groups with regard to what their real security of tenure is in the operation of the board of their particular facilities?

Hon. J. MacPhail: It's interesting. I raised that same question just right now with the previous Minister of Health, the member for Prince George North, and I said: "Why is it that I had to give all these reassurances? Why didn't you do it?" And he said: "Well, actually I did."

But I understand that people need reassurance by action. The previous minister met to give this reassurance and to outline the relationship. I have met with service organizations. I've met with private care organizations as well and given these reassurances. These reassurances have also come from the ministry.

That's not to say that we have to continue reassuring. Let me just put very clearly that the relationship with organizations such as the ones that you give as example is unchanged by regionalization. I would offer this to the member, because I know his background in the organization. I will continue to meet with service organizations to make sure they're well served by regionalization, because the fact of the matter is that we rely greatly on service organizations to provide care facilities, and they do a wonderful job of that.

R. Coleman: I should make it clear to the minister that I've never been a Lion. So even though the Lions are in . . . .

Interjection.

R. Coleman: I think, from my standpoint and from the hon. minister, just my taking a copy of Hansard and sending a letter to the organizations involved in health care and giving that reassurance to them, so that they can have it in their files and on record, will probably be as big a step as one can take with regard to reassuring them as to their tenure and their involvement.

I think it's really important that we do that, because I do know that the particular facility in Aldergrove I referred to would not be in existence if it wasn't for the involvement of the Lions, to begin with -- and the board of directors is composed of Lions -- and also the Kinsmen, the Rotary, the Legion and the fraternal organizations of that community that continue to funnel money into this facility to provide additional benefits to the residents of the facility.

I think it's absolutely key that we secure the tenure of these particular groups, because having that base lost in a community is something we should never want to have happen.

I want to canvass the leasing situation with BCBC once I receive some of the information. I will be reviewing the base lease this evening. I may have some more questions tomorrow, so I will pass to another member now.

Hon. J. MacPhail: Hon. Chair, I would just like to offer to the members generally that it makes sense for me to ask the regional health boards themselves to meet with service organizations to offer reassurances. That has occurred in some areas of the province and not in others. So I will undertake to ask the regional health boards to do that, as well.

M. Coell: I have a number of questions regarding regionalization and the capital regional district here in greater Victoria. I intend to keep to this area with my comments. I hope that staff are also here with the minister to respond to that.

My riding has a number of Gulf Islands in it, Saltspring being the largest. Saltspring has 15,000 people living on it in

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the winter and 45,000 living on it in the summer. It has a hospital, the Lady Minto Hospital. That hospital has been there for many decades and was served by a board of directors and a local society. There is an intermediate-care and extended-care seniors housing facility on the island, as well, served by a board of directors and a group of volunteers and auxiliary.

With regionalization, that facility -- the Lady Minto -- has been taken over by the capital health board. From the perspective of having representation from the community on that board, I wonder if the minister could tell me if there is anyone from Saltspring Island -- anyone who has been involved with the Lady Minto Hospital, a previous board member, or anything like that -- on the new capital health board.

Hon. J. MacPhail: There is one representative from the Gulf Islands, and I will undertake to see whether that member is from Saltspring. Sorry, we don't have the hometown.