1998 Legislative Session: 3rd Session, 36th Parliament

HANSARD

The following electronic version is for informational purposes only.

The printed version remains the official version.

Official Report of

DEBATES OF THE LEGISLATIVE ASSEMBLY

(Hansard)

THURSDAY, JULY 23, 1998

Afternoon

Volume 12, Number 5

[ Page 10393 ]

The House met at 2:07 p.m.

T. Stevenson: I have a number of introductions, but before I make them I want to make the House aware of the fact that one of our colleagues is having a birthday today. I didn't actually know how old he was, so I checked with his staff. They told me he was 39 and holding. I said: "Yeah, how old is he?" They said: "No, 39 and holding." I said: "Come on." "No, 39." So today is the thirty-ninth birthday of the Minister of Employment and Investment. I hope the House will wish him a happy birthday.

Interjections.

The Speaker: Members, the member for Vancouver-Burrard has the floor.

T. Stevenson: I do have a number of introductions. It has been my pleasure over the past while to be working with a group on secure care for the Ministry for Children and Families. This group has been working very hard over the past several months to look at secure care for young people in the province. Some of them are in the gallery today, and I want to introduce them because this is their last and final meeting.

I'd like to introduce Tim Agg, who is executive director of the Pacific Legal Education Association; Stan Wilcox, who is a retired RCMP superintendent; Roy Holland, who is a psychiatrist and clinical director with the Maples Adolescent Treatment Centre; Philip Bryden, who is a lawyer and a professor in the faculty of law at UBC; Carole James, who is the chair of the Victoria school board and president of the B.C. School Trustees Association; and Diane Sowden, who is a parent and executive director of the Children of the Street Society. I hope that all members will make them welcome.

Hon. H. Lali: My guest in the gallery today is a bright young individual from Surrey. He is a BCIT student studying international trade and transportation. He is hugely interested in a career in politics. Would you please welcome Justin Ginetz, the future member for Surrey-Cloverdale, sitting right up there.

S. Orcherton: Joining us in the gallery today, hon. Speaker, is Mr. John Glenwright, who is a former Deputy Minister of Health. Accompanying him are some of his guests from Switzerland. They are Margrit and Alex Hochli and their children, Meta and Andres. On behalf of yourself, myself and our constituents respectively, I bid them welcome to this chamber.

J. van Dongen: I'd like to welcome to the Legislature today Paula McAleese. She's a dental hygienist in the city of Abbotsford. I ask the House to please make her welcome.

G. Wilson: It is my pleasure today to introduce some members of the ICBC youth employment initiative for the south Vancouver Island region. With us today are John Main, Robb Tones, Niels Bednarczyk, Jennifer Campbell, Bryce McFadden, Sheilagh Smyth and Christina Wilson. Will the House please make them welcome.

K. Whittred: This morning I was surprised to look up into the gallery and see an old friend and colleague. I did not get an opportunity, however, to introduce his friend at the time. Visiting with Mr. Lepkin, whom I introduced this morning, is David Matzele. He is from Vancouver.

I would like to reintroduce Mr. Lepkin, my colleague with whom I worked for many years. Mr. Lepkin is known to some members of this House as Mr. Burnaby South. I might point out that within this chamber there are, I believe, three graduates of Burnaby South: the member for Surrey-Whalley, the Minister of Fisheries and the member for Port Moody-Burnaby Mountain -- to say nothing of this member, who was a staff member, and also that esteemed member of the press gallery, Mr. Keith Baldrey. It is my pleasure to remind all members of the House of what a great impact a teacher such as Mr. Lepkin can have.

Hon. G. Clark: It is my honour to introduce to the chamber an esteemed member of the Hong Kong media, a very prominent and popular individual, Mr. Albert Cheng. He is visiting us in Victoria today. This gentleman started out in British Columbia as a Canadian Airlines engineer. He has gone on to become a successful businessman and media talk show host, presenting Hong Kong's most popular broadcast, "Teacup in a Storm," five mornings a week. He is considered to be one of the top 25 most influential people in Hong Kong. It would give me great pleasure to have all members of the House welcome him here.

Hon. L. Boone: I have two introductions, but before I make them I too would like to make an announcement. I'd like to ask the House to wish happy birthday to another colleague of mine who is not 39 and holding, but is 54: Paul Ramsey, the Minister of Education.

I would also like the House to welcome two individuals who are employees in my office. Amanda Welch, unfortunately, is leaving to attend law school in Calgary, but the good news is that she is being replaced by a very capable young woman formerly from the North Island, Nicole Normand. Would the House please make them welcome.

[2:15]

Hon. P. Ramsey: Joining us in the gallery today, I just noticed, is a woman who is an old friend to many of us in this chamber and a strong advocate and friend of public education in this province: Carole James, president of the British Columbia School Trustees Association. Would everybody please help me make her welcome.

Hon. A. Petter: It is my very great pleasure today to introduce to the House the winner of the 1998 Queen Elizabeth II British Columbia Centennial Scholarship, Salman Ali Manki. This prestigious scholarship, our government's highest scholastic award, was established in 1971 to commemorate the Queen's visit during our centennial. The scholarship is worth $20,000, and it supports a British Columbia graduate who will be undertaking further studies in a Commonwealth country.

Salman is a truly exceptional history graduate from Simon Fraser University. He ranks in the top 1 percent of the entire student body, and he'll be pursuing his law degree at the University of Oxford in the United Kingdom. He is joined today by his mother Parveen, his father Zaheer, his sister Zeba and his brother Mohamed. I'd like the House to join me in congratulating Salman and making him and his family feel very welcome.

G. Hogg: It is my pleasure to introduce to the House three members of the Swansburg family from Surrey-White

[ Page 10394 ]

Rock. They are Diane, who is a social worker with the Ministry for Children and Families and responsible for finding foster homes; Abby, who is Miss Manners and responsible for ensuring that all are well behaved; and her brother Kenny, who is my political ally. He is responsible for upsetting Abby. Would the House please make them all welcome.

J. Smallwood: I'd like to welcome to the House Mrs. Jayatilaka. My apologies if I'm pronouncing it wrong. She is visiting us from Sri Lanka. Accompanying her is her daughter, who is a community development worker here in the province. I'd ask the House to make them both welcome.

B. Penner: It appears that it may be Penner day in the public gallery. First of all, it is my pleasure to introduce my uncle Sam and aunt Carol Penner, visiting from Vernon. I owe them thanks for buying me lunch today. In addition, my brother Reg Penner is here from Chilliwack, with his wife Edith and their four children. They are Kristen, Camilla, Carissa -- the youngest -- and my nephew William, also known to me as Wild Bill. Would the House please make the Penners welcome.

G. Bowbrick: Joining us in the gallery today is Chuck Puchmayr, who is a friend of mine from New Westminster, as well as a member of the New Westminster city council. I'd ask all members of the House to join me in making him welcome.

Introduction of Bills

AN ACT TO AMEND THE MEDICAL PRACTITIONER'S ACT

G. Wilson presented a bill intituled

An Act to Amend the Medical Practitioner's Act.

G. Wilson: I move that the bill be introduced and read a first time now.

Motion approved.

G. Wilson: Hon. Speaker, this is a bill that will limit liability and provide that a registered practitioner shall not be found guilty of unprofessional conduct or be found to be incapable or unfit to practise medicine or osteopathy solely on the basis that the registered practitioner employs a therapy that is non-traditional or departs from the prevailing medical practice, unless it can be demonstrated that the therapy has a safety risk for the patient unreasonably greater than the prevailing treatment. I move that this bill be placed on the orders of the day for second reading at the next sitting of the House after today.

Bill M211 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

CELGAR PULP MILL BANKRUPTCY

G. Campbell: My question is to the Minister of Forests. This morning we learned that the Celgar pulp mill in Castlegar will be seeking bankruptcy protection. Stone Container has refused to cover operating losses and debt payments for Celgar any longer. As a result, Celgar has now filed for bankruptcy protection. Will the Minister of Forests tell us when he is going to wake up and recognize the damage that his government's forest policies are creating across British Columbia?

Hon. D. Zirnhelt: This minister and this side of the House are awake, alert and concerned about the state of the forest industry.

The announcement today is unfortunate. But it results from a corporate decision to get out of this kind of business, and it's the result of a transfer. The information that we have is that the receiver is interested in starting the mill as soon as they can.

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

G. Campbell: The reason that Stone Container is looking at getting out of the business is because they can't make any money in the business any longer in British Columbia. The fact of the matter is that Celgar is a major employer in Castlegar. There are 450 people whose jobs are at stake. It's been producing pulp in the West Kootenay for 40 years now. When is this minister going to wake up and decide it's time to make real changes in the forest industry so we can put people back to work instead of pushing them out of work?

Hon. D. Zirnhelt: It's my information that that particular company in that particular location has been broke four times. There is nothing in their release that points to a government forest policy that affects this decision.

Interjections.

Hon. D. Zirnhelt: Listen, the pulp price is about 25 cents; the pulpwood price is 25 cents. It's not a stumpage problem. They don't have any tenures, so it's not a Forest Practices Code problem. If they'd like to point to the policy problem, I'd be happy to examine it.

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

G. Campbell: I just wonder if the minister has ever heard from anybody in the forest industry about the problems that the corporate capital tax is creating in terms of costs by this government. I wonder if the minister has heard about the costs that this government is imposing on every single major employer in the province, therefore driving hundreds and hundreds of people out of work. It was 15,500 in the forest industry in the last year, and now we're looking at 450 people in the town of Castlegar losing work.

How many forest companies have to go under before this minister will actually act to improve the quality of forestry in British Columbia and to improve the balance sheets of all companies, so that people can be hired back instead of losing their jobs?

Hon. D. Zirnhelt: Two years ago the price of pulp was around $900. Today it's around $570 or $575. Profitability is somewhere around plus or minus $600. In this case, if you read the press release from the company, they say that the receiver plans to restart the mill and has been instructed by the bank to look for potential buyers who have the capacity to operate the mill. We understand that they have no marketing arm. They can't sell it, because they have no capacity in the company to perform the marketing function. So the world

[ Page 10395 ]

price is a problem, and until the world price of pulp turns around, we won't see the end of curtailments in the pulp industry. Many pulp mills are taking downtime in order to reduce inventory. Hopefully, the price will go up.

G. Abbott: The most amazing thing about this government's response to the financial crisis facing the forest industry is that it's always everybody else's fault, never this government's fault. This government bailed out Skeena Cellulose to the tune of $300 million. Now Skeena is competing against Celgar Pulp and its 450 employees. And Celgar doesn't have the luxury of millions of tax dollars in its coffers to help them along. Can the Minister of Forests tell us if he thinks that bailing out Skeena Cellulose at the expense of Celgar Pulp and its 450 employees is a responsible way to manage B.C.'s forests?

Hon. D. Zirnhelt: One or two mills in the world will not affect the pulp supply and demand situation. The information I have is that over half the pulp mills in the tropics are down -- information provided me by industry. So some of the lower-cost producers are shutting down. It's a question of the market you're in. The particular market that this mill is in doesn't give them an adequate return to pay on their capital.

But the understanding we have is that the receiver feels that they can get this mill up and running if they put a few things in place: get an operating line and find some ability to market, which they don't have. I repeat: we understand that the reason this has happened is because the owners -- Stone -- have decided to get out of the paper business.

The Speaker: First supplementary, the member for Shuswap.

G. Abbott: In fact, it's a question of being competitive. If this government wants to find out why our industry is no longer competitive, they need only look in the mirror, because that's exactly where the fault lies -- right in the mirror.

During the Skeena Cellulose bailout, forestry expert Les Reed wrote that keeping the Prince Rupert pulp mill in operation would simply worsen the viability of struggling mills elsewhere in B.C. What does the Minister of Forests have to say now that this prediction of other bankruptcies is coming true?

Hon. D. Zirnhelt: I repeat that other experts will tell you that one or two pulp mills, in the world supply of pulp, won't make any difference.

COSTS OF BEVERAGE CONTAINER RECYCLING

G. Wilson: My question is to the Minister of Agriculture. This government is introducing a deposit requirement on wine bottles in this province, and the wine industry is being told that because of bottles already in the system, they are going to have to put costs up front to carry the cost of bottles that will be returned. Can the Minister of Agriculture assure us today that the millions of dollars that will be required out of this industry will not be extracted by this government for general revenue, putting small family-farm-owned wineries out of business in British Columbia?

Hon. C. Evans: Sure.

The Speaker: First supplementary, the member for Powell River-Sunshine Coast.

G. Wilson: We'll hold the minister to that.

Now to the Minister of Environment. The Minister of Environment has shown considerable wisdom in pulling Bill 40 today. Will the minister now recognize that it is premature to put in place a deposit requirement on Tetra-Paks, given that this government has done nothing to put in place a process by which Tetra-Paks may be recycled in British Columbia?

Hon. C. McGregor: I'm pleased to have the opportunity to speak to the question of Tetra-Pak recycling. As the member well knows, it is of significant concern here in North America, because we no longer have any facility in Canada through which Tetra-Paks can be recycled. This will be a severe obstacle to our proceeding with Tetra-Pak recycling as part of the beverage container deposit refund expansion, scheduled for October 1. That's why we're currently working very hard with the industry, as well as industry within the province, to see if there is an opportunity for us to bring a Tetra-Pak pulping facility to British Columbia.

CELGAR PULP MILL BANKRUPTCY

R. Neufeld: I'll tell the minister that the 450 people in Castlegar who may lose their jobs are concerned. They're not in the tropics; those are jobs that are needed in that area of the province.

The NDP were warned by forestry experts that propping up the Skeena Cellulose mill would only drive other vulnerable pulp mills out of business. What does the Minister of Forests have to say to those 450 forest workers in Castlegar whose jobs were jeopardized the day this government decided to prop up Skeena Cellulose and bail out the Minister of Northern Development?

Interjections.

The Speaker: Members, order.

Hon. D. Miller: Madam Speaker, I must confess that I find it somewhat paradoxical that the members opposite are working themselves into a froth. We are concerned about the issues in Castlegar, but they are recommending that we shut down the jobs in northwestern B.C. It seems rather foolish to take that kind of inconsistent position.

[2:30]

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

R. Neufeld: Hon. Speaker, if there's anything inconsistent it's this Deputy Premier, let me tell you. During the Skeena Cellulose bailout, forestry analyst Ross Hay-Roe . . . .

Interjections.

The Speaker: Members, order, please.

R. Neufeld: Listen, hon. members.

Interjections.

The Speaker: Order, order.

R. Neufeld: Ross Hay-Roe predicted that B.C. mills were already on the brink, without the NDP propping up Skeena

[ Page 10396 ]

Cellulose -- even after Celgar invested $800 million of their own money modernizing their plant.

I want to ask the Minister of Forests: did the member for Rossland-Trail ever talk to the Minister of Forests about the devastation that could occur in his community if his government went ahead with the bailout of Skeena Cellulose? Did he ever say to the minister: "This could be a problem"?

Hon. D. Zirnhelt: This member asking the question is the very same member who said in Revelstoke that he would not assist Evans Forest Products. He didn't care about the 1,000 jobs in Golden. They don't care about the thousands of jobs in the northwest; I doubt they care about the jobs in Castlegar.

We all care about the jobs in Castlegar. That opposition has not pointed to any forest policy matter that would affect this mill. Pulpwood is 25 cents. They have no licences, so the Forest Practices Code costs can't affect the operation of this mill. They can buy and sell pulp chips; they're cheap. It's a buyers' market on pulp chips, an open market. This is a business decision by a company somewhere offshore to shut down its business in pulp.

CHERRYVILLE TELEVISION TRANSMITTER TAX

A. Sanders: For almost half a century residents of the North Okanagan have had television services provided by community clubs and TV societies. These are all volunteers. Since the mid 1960s, the Cherryville Community Club has given the land, labour, time and money needed to provide repeat broadcasts to Cherryville. Yet the NDP has slapped a $1,200 tax bill on the club's 6-foot-by-8-foot transmitter shack located on a quarter-acre on the top of a mountain accessible only by four-wheel-drive. That 6-foot-by-8-foot shack, whose original cost was $50, has now been assessed at $27,000.

Can the Minister of Finance explain why the government is blowing a non-profit volunteer TV service right off the mountain and off the air by bankrupting them with an NDP tax?

Interjections.

The Speaker: Order, order.

Hon. J. MacPhail: If the facts are as the member says, then it certainly is a matter that I need to look into immediately, and I will.

NURSES WORKING CONDITIONS AT BURNABY CORRECTIONAL CENTRE

S. Hawkins: On June 29 I wrote to the Attorney General and asked him to urgently address the issue of nurses' safety at the Burnaby Correctional Centre for Women, and the minister has not as yet responded. I want him to know that one nurse was suspended without pay while his ministry's internal review is being done. Can the Attorney General tell us why his ministry is dragging its feet while this nurse's life is on hold?

Hon. U. Dosanjh: Hon. Speaker, this is a very serious issue. As soon as I was made aware of the issue, I ordered an investigation by Allan Anderson, who is the independent investigator under the Correction Act, directly accountable to me. Just this morning I was briefed with respect to his report, and we're preparing a response. The matter has been dealt with to a certain extent, and certain other measures will be taken in due course -- very quickly.

The Speaker: First supplementary, the member for Okanagan West.

S. Hawkins: At the same time that I asked the minister to address that issue of nurses' safety, we also asked the minister to look at the safety of the working conditions at the correctional centre -- where it stands now. We as well as the B.C. Nurses Union asked that a guard be posted for the safety of women. We understand that a guard is posted for the doctors, and I'm wondering if the Attorney General has directed the correctional centre to post a guard for the safety of nurses.

Hon. U. Dosanjh: That was the very issue that led me to order an investigation. The report is in my hands. I was briefed this morning on the report. We are dealing with the issue. It's a very serious issue. On the face of it, it seemed that doctors were provided security, while nurses were not. On the face of it, it did not appear to be appropriate, and certain interim measures have been taken. Further steps will be taken, based on this report.

Tabling Documents

Hon. D. Zirnhelt: I have the honour to present the 1997-98 annual report of the Forest Land Commission.

Motions Without Notice

Hon. J. MacPhail: I'll be seeking leave to move the establishment of some committees.

Leave granted.

SELECT STANDING COMMITTEE ON AGRICULTURE AND FISHERIES

Hon. J. MacPhail: By leave, I move:

[That the Select Standing Committee on Agriculture and Fisheries be appointed to examine, inquire into and make recommendations with respect to an "Agri-food policy for the new Millennium and beyond for British Columbia and in particular, without limiting the generality of the foregoing, to consider:

1. deliberations of the Ministry of Agriculture and Food's agri-food policy consultations; and

2. any other matters referred to the Committee by the Minister of Agriculture and Food.

In addition to the powers previously conferred upon the said Committee, the Committee be empowered:

(

a) to appoint of their number, one or more subcommittees and to refer to such subcommittees any of the matters referred to the Committee;

(

b) to sit during a period in which the House is adjourned, during the recess after prorogation until the next following Session and during any sitting of the House;

(

c) to adjourn from place to place as may be convenient and

(

d) to retain personnel as required to assist the Committee,

and shall report to the House as soon as possible, or following any adjournment, or at the next following Session, as the case may be; to deposit the original of its reports with the Clerk of

[ Page 10397 ]

the Legislative Assembly during a period of adjournment and upon resumption of the sittings of the House, the Chair shall present all reports to the Legislative Assembly.]

Motion approved.

SELECT STANDING COMMITTEE ON PUBLIC ACCOUNTS

Hon. J. MacPhail: By leave, I move:

[That, in addition to the powers previously conferred upon the Select Standing Committee on Public Accounts the Committee be empowered:

(

a) to appoint of their number, one or more subcommittees and to refer to such subcommittees any of the matters referred to the Committee;

(

b) to adjourn from place to place as may be convenient;

(

c) to sit during a period in which the House is adjourned and during the recess after prorogation until the next following Session;

(

d) to retain personnel to assist the Committee;

and shall report to the House as soon as possible, or following any adjournment, or at the next following Session, as the case may be; to deposit the original of its reports with the Clerk of the Legislative Assembly during a period of adjournment and upon resumption of the sittings of the House, the Chair shall present all reports to the Legislative Assembly.]

Motion approved.

Orders of the Day

Hon. J. MacPhail: I call second reading of Bill Pr401.

VANCOUVER FOUNDATION AMENDMENT ACT, 1998

(second reading)

T. Stevenson: I move that Bill Pr401 be now read a second time.

This bill will give the Vancouver Foundation greater flexibility in the development of investment and distribution policies. It has passed through the Select Standing Committee on Parliamentary Reform, Ethical Conduct, Standing Orders and Private Bills.

Motion approved.

Bill Pr401, Vancouver Foundation Amendment Act, 1998, read a second time and referred to a Committee of the Whole House for consideration forthwith.

VANCOUVER FOUNDATION AMENDMENT ACT, 1998

The House in committee on Bill Pr401; E. Walsh in the chair.

Section 1 approved.

section 2.

G. Plant: Let me just say this. The members of the opposition were pleased to have an opportunity to scrutinize this bill when it came before the committee. These changes to the powers of the Vancouver Foundation are a useful way of ensuring that the foundation can deal with changes in the marketplace. I think this is one of those occasions when speedy passage of this bill would be in the best interests of the public.

Sections 2 to 10 inclusive approved.

Title approved.

T. Stevenson: I move that the committee rise and report the bill complete without amendment.

Motion approved.

The House resumed; the Speaker in the chair.

Bill Pr401, Vancouver Foundation Amendment Act, 1998, reported complete without amendment, read a third time and passed.

Hon. J. MacPhail: I call second reading of Bill Pr402.

VICTORIA FOUNDATION AMENDMENT ACT, 1998

(second reading)

M. Sihota: I move the bill be read a second time now. This bill improves the efficiency of the administration of the Victoria Foundation.

Motion approved.

Bill Pr402, Victoria Foundation Amendment Act, 1998, read a second time and referred to a Committee of the Whole House for consideration forthwith.

VICTORIA FOUNDATION AMENDMENT ACT, 1998

The House in committee on Bill Pr402; E. Walsh in the chair.

section 1.

[2:45]

G. Plant: Let me say, hon. Chair, that this is an occasion when I am persuaded, and the opposition is persuaded, that these provisions are going to be a useful way of improving the operation of the Victoria Foundation in light of current market realities. I look forward to what will probably be the speedy passage of this bill.

I. Chong: I concur with the comments made by my colleague the member for Richmond-Steveston. I do have one very quick question regarding

section 1. The definition of returns is: " . . . all dividends, interest and capital gains and losses, both realized and unrealized." I was just curious as to why the term "realized and unrealized" was included in this particular

section -- just as a clarification, if I could.

M. Sihota: I think I heard the question right. I think the purpose here with regards to returns . . . . Previously the foundation could secure returns on investments only of a certain type, and because the realization of income on its returns was

[ Page 10398 ]

not that which it could be, the foundation is now trying to increase their returns by changing the subset of investments that it can make. They're moving from just straight interest-bearing investments to investments in a more diverse portfolio, so as to increase their return.

Sections 1 to 8 inclusive approved.

Title approved.

M. Sihota: Hon. Chair, I move the committee rise and report the bill complete without amendment.

Motion approved.

The House resumed; the Speaker in the chair.

Bill Pr402, Victoria Foundation Amendment Act, 1998, reported complete without amendment, read a third time and passed.

Hon. P. Ramsey: I call Committee of Supply. For the information of members, we'll be considering the estimates of the Ministry of Health.

The House in Committee of Supply; E. Walsh in the chair.

ESTIMATES: MINISTRY OF HEALTH

AND MINISTRY RESPONSIBLE FOR SENIORS

(continued)

On vote 47: minister's office, $469,000 (continued.)

R. Neufeld: I just want to deal with a few issues as they affect the community of Fort St. John in a few areas: capital upgrades to the hospital, ambulances services and long-term care.

The minister knows that in 1992 there was a study done -- paid for, actually, by the Minister of Health at a cost of some $200,000 -- on upgrading the Fort St. John General Hospital to a much better shape than it is today. I want to just read into the record, so the minister knows some of the conditions that the Fort St. John hospital has been facing over the last while . . . .

Before I do that, I should probably say that between Fort St. John and Dawson Creek, the two major hospitals in that area, it was decided that the Dawson Creek hospital needed the upgrade sooner than Fort St. John; that was agreed to. Dawson Creek's upgrade went ahead. When I look at the statistics for capital funding for Dawson Creek, I see that they received some $14 million for upgrades.

I think it was agreed that Fort St. John's planned upgrade would happen after phase 1 of the Dawson Creek upgrade went ahead. It was to run around $9 million or $10 million over a period of years. But the community has made me aware, not just this year but years previous, of a couple . . . . I've been asking for a couple of years now about funding, to actually look seriously at this facility. The ICU is in a state where the plaster is falling off the walls, which I think is absolutely unacceptable anywhere.

"WCB has noted that ventilation is far below appropriate standards. Handicapped access is virtually nonexistent. Only a minimal part of the facility has a sprinkler system. In fact, I've been informed that if it were not a hospital, WCB probably would have shut it down awhile ago because of the state of its air-exchange system and sprinkler systems. The intensive care unit was substandard in comparison to most facilities in the province, as I noted. The maternity unit, which delivers 500 babies a year, is not designed to provide the type of care that is expected and available in other communities.

There is no appropriate space to accommodate persons who are violent and may pose a risk to themselves or others. Confidentiality and privacy in the emergency area are nonexistent, particularly as our daily visits are in excess of 100 persons."

There is a whole host of other things that are wrong with the Fort St. John hospital, which actually need immediate attention. Maybe the minister could relay to me whether or not this is actually in the works this year. Can the Fort St. John hospital and the health council actually expect that some of this work is going to take place this year? I'll leave it at that, and then we'll pursue it a little bit further after her response.

Hon. P. Priddy: I think that the points the member raises are very legitimate ones. I think he has made the case very articulately for people in his community. I'm sure that when we announce the capital projects, the member will find that I have listened carefully to his strong advocacy for his community.

R. Neufeld: Well, that response gives me a glimmer of hope that this year we are actually going to see some expenditure of money in the Fort St. John hospital. Maybe I could just explore it a little bit further. I fully understand what the minister just told me. But will we be looking at the three-year plan as was studied and recommended by both the health council and the regional district that funds their share in our area? As the ministry found out in their $200,000 study, this should be done over a period of time in a sequence of events that should take place.

I don't want to see us having to do this on a yearly basis; I would rather see us go ahead on these plans in a planned way that doesn't require all the expenditure in one year but that will . . . . At the end of the three-year term, as the study had stated, we'll see all those projects that were identified not just by me but by the health council and the people from the regional district. Maybe the minister could just explain that to me.

Hon. P. Priddy: The plan, as it's laid out, and its priorities . . . . I'm not at this stage saying that all of the priorities laid out in the plan are part of the capital planning. But the resources that might go to that community will indeed follow the priorities laid out -- follow the way the plan laid out the recommendations for how to go forward.

R. Neufeld: Well, I think I'll leave that, and maybe we'll carry on with the ambulance. I appreciate the response from the minister. I and many individuals in Fort St. John wait with bated breath for the day that the minister will make her announcement. Just on that portion, while I'm on my feet, I would like to thank the minister for actually looking seriously at this issue in Fort St. John and, hopefully, coming forward with some funding. So I thank you in advance. Guaranteed, if it's not enough, I'll be here next year and maybe not in such a happy state.

Interjection.

R. Neufeld: I will be happy, she says, so that's great.

The second issue I want to deal with briefly is not the Ambulance Service, but the garage. I want to go back to just over a year ago, to a previous Minister of Health who, in question period, after moving the ambulances out of the fire hall into temporary quarters, informed me that last year there

[ Page 10399 ]

would be an expenditure for a garage before the snow fell. Well, we're still in temporary quarters. The snow has fallen, it's melted, and it's almost ready to fall again.

I just want to put on the record what the previous Minister of Health told me, and I quote from a response in question period:

"The community of Fort St. John has also known since 1990 -- under the previous, Social Credit government -- that there was an industrial inquiry commission that ordered all ambulance services be transferred from fire departments to the B.C. Ambulance Service. We've been working with the community since then . . . . We are working to put in place a proper ambulance depot there. It will be leased or whatever is most cost-efficient for taxpayers."

Well, hon. Chair, the minister went on to accuse me of standing in the way of it happening -- the construction of this depot for the ambulance. I never asked another question. I took the previous Minister of Health at her word. I expected that last summer we would see the construction of an ambulance garage. I watched all winter as the spare ambulance sat outside in minus-30-to-minus-50-degree weather. Now we're in a position that where the ambulances were parked will be taken over on August 1 by the hospital to provide some other medical service. That puts the ambulances back out on the street.

As I understand, there is funding allocated -- or supposedly allocated. But I have never really had it said to me that we are actually going to put up bricks and mortar so that we can put these ambulances inside a garage. As I said to the minister, the community has waited for well over a year -- for 13, 14, 15 months -- for a promise that the previous Minister of Health . . . . I know it wasn't the present minister, but it's the same ministry that's responsible.

I want some assurance from the minister that we are actually going to build an ambulance depot this year, as soon as possible, so that we can have the ambulances in Fort St. John under a roof, where they should be. Could the minister give me that assurance, please?

[3:00]

Hon. P. Priddy: I know that the member has, again in a very articulate way, made known the needs around facilities for ambulances in his community. It would seem to me that if there were going to be additional dollars for the hospital to be renovated, that would be a logical time for the kinds of changes the member speaks to around an ambulance station to be made. The member asked earlier about whether people could hope to see progress on the renovations to the hospital, and I indicated that because of his strong advocacy, I was sure that that would be listened to when the capital announcement was made.

It would be logical for any ambulance station to be done in the context of that renovation.

R. Neufeld: Well, you're making me very happy so far. We're committed to upgrading the hospital and to actually putting the ambulances in the north under a roof. I think that's a good move. Like I say, I am pleased. Hopefully, we will see that come to fruition.

This is another issue; this is twice now. We're going to try a little bit more and see how far we can get. It's long term care as it exists in Fort St. John. I think the minister is aware that when she was in Dawson Creek and made the announcement of about $5.6 million in multi-level care and some upgrades in Dawson Creek, the people in Fort St. John, although they don't begrudge that happening in Dawson Creek, had a very good case to put forward to me and, I think, to the ministry about long term care in Fort St. John. Fort St.

John is a community that is growing faster than Dawson Creek; there's no doubt about it. I don't say that in deference to my colleague the member for Peace River South. It is in fact true.

If you look at the comparison between South Peace and North Peace, South Peace has 171 beds -- this is information that was given to me by the health council -- and North Peace has 95 beds. We have well over 100 people waiting on a list to get into long term care. In fact, a fair portion of the hospital is occupied by long term care patients. If I recall correctly, earlier in the debate there was discussion around the cost of that and whether that was really a wise use of scarce health care dollars -- using hospital beds for long term care when other things should be provided.

I'm going to make another plea to the minister, and I'm not sure how she can respond to this. I know that since I was elected in 1991, I've had cases put to me almost yearly in Fort St. John on the basis that people are leaving the community to go to other areas to find beds and that we should look seriously at starting to fund a few more beds in Fort St. John -- to look at the growth in that area and people that actually need some long term care in Fort St. John. Maybe the minister could just respond to that briefly for me, please.

Hon. P. Priddy: I think that we canvassed earlier some of the points the member has made -- in principle, not about his community -- like the fact that there are people in acute-care beds who could more appropriately, be and would probably wish to be, in some kind of alternate level of care support. We have, as the member may have heard earlier, a continuing-care review going on, and the committee will be reporting out to me in, I think, November -- late fall. In that review I expect that people will have looked at those needs throughout the province.

I hear the member's comments about disparity between the North Peace and the South Peace. That will certainly be taken into account during the review.

In the meantime, I realize that there are extended-care facilities in the community that may need upgrades, just around the sort of basic elements of safety. Perhaps the member might expect to see a little bit of that when the capital budget comes out, because of his fine advocacy. The larger picture of additional beds will be taken into account during the review.

R. Neufeld: One other item I'd like to touch on . . . . I know you briefly touched on physician supply in the north and the issues surrounding the Royal College of Physicians and Surgeons. I understand and know and agree with the minister when she states that in British Columbia we have far too many doctors for the number of patients. Unfortunately -- and the minister is quite well aware of this -- that's not the case in the north. We have far too few doctors and have to rely heavily on bringing people from other parts of the world to Fort St. John and Fort Nelson to practise medicine.

It just seems that it doesn't matter if you pay them more; it doesn't matter if you give them 20 percent a year more for their services, or whatever. If they're trained in the southern part of British Columbia and come from the southern part of British Columbia -- or anywhere in the southern part of Canada -- they're not going to come north.

What we do have very good luck with is bringing doctors from, specifically, South Africa or England. Thank goodness for those two regions, or we wouldn't have any doctors. That is in fact true. Fort St. John has been searching for a number of years for an internist -- in fact, more than just a number of years. I think the internist we have now has been wanting to retire for four or five years, and they've been trying to replace

[ Page 10400 ]

that person with a new internist. They've finally been successful in locating an excellent person, again from South Africa, whose wife is a physician. They both want to come to northern British Columbia specifically. The community is having some trouble with the Royal College of Physicians and Surgeons in trying to have that happen.

The other issue we're going to have in another community in the very near future . . . . It's in Fort Nelson. We have a very able surgeon in Fort Nelson -- in fact, one of the best. Again, he's a person from overseas who came to Fort Nelson and has spent most of his life there but will be retiring before long. They are faced with the same situation. In fact, I have a letter from the community health council of Fort Nelson-Liard, having trouble with the Royal College of Physicians and Surgeons in trying to recruit people from oversees to come to northern British Columbia to practise medicine.

I think our record -- in the North Peace, anyhow, that I'm aware of -- is fairly good with doctors coming and actually staying in the communities. That's always a reason to say: "No, we shouldn't do it, because all they want to do is come to Canada. They'll come to the north and stay for a little while, and then they just move down south." I'm not going to say that doesn't happen, but I think that in the North Peace, anyhow, it doesn't happen all that often. I just wonder if there is something that the ministry can do to help us.

In fact, I just wrote a letter recently, in the last two weeks, in support of these two people coming from South Africa. I wonder if the minister could briefly let me know her feelings on it and the ministry's feelings on how we can try to have this come to fruition.

Hon. P. Priddy: Several things the member has said . . . . By the way, the North Peace has had very good success. If you look at communities throughout the north, there are some . . . .

Interjection.

Hon. P. Priddy: The articulate one? That's what I thought.

Interjections.

Hon. P. Priddy: The mailer will be good, eh?

There are some communities throughout the north where physician turnover or physician stability has not been a problem. The member is quite right. Physicians come from other countries, and they stay. They base their families in that community and so on, yet there are some communities in the north where it is almost impossible to have some stability, and there's just a really large turnover of physicians. Undoubtedly because of the efforts of their MLA, of course, that stability has been seen more in the North Peace than perhaps in some other places.

Several things. We do meet with the Royal College of Physicians and Surgeons and the Department of Citizenship and Immigration to address these issues on an ongoing basis. Perhaps my staff could contact you about the particular circumstance you're currently dealing with, and I'll ask them to do that. Secondly, we've looked at a number of pieces -- and of course Dobbin recommended that we do that, as did the other report -- about how, if you were not just relying on people from overseas, you would actually recruit and retain them in those communities.

One of the things I think we know, although it has had mixed success in other places, is that if a medical student or any person goes away to university from a particular community, they may be more likely to return to that kind of community or lifestyle. There's always the option of looking at funding expenses for medical students -- the tuition and so on -- from northern communities and having them sign a five-year contract or whatever in an attempt to ensure that they go back to a northern community -- maybe not any particular one.

I actually think that's a very good idea, but it has had very mixed success in other places. When people walk from their contract, there's often no way to enforce it. It is an issue I've asked the ministry to look at, because I think there may be some chance of success if we do that.

I'll only do a couple more, hon. Chair, just in terms of the time. The medical school at UBC is providing more opportunities for rural practicums and rural opportunities for medical students who may not come from rural areas, but who perhaps, if they have experience in one, might choose that lifestyle. I mean, there is life outside Vancouver and Victoria, and lots of people acknowledge that and embrace it. But maybe if you haven't seen it, you're not as likely to choose it. So -- more opportunities to support students to have an opportunity in a rural area.

In point of fact, one of the students I heard about recently has decided to actually practice in the north as a result of that experience. None of those are short-term solutions, except perhaps the one with Immigration, but they are things that I think will make it more stable over the medium term.

R. Neufeld: I appreciate the minister's response. I know that it didn't matter which Minister of Health I talked to. We always have this problem, and everyone was more than willing to try to work to some resolution.

Getting the students to come back after going up there to do their initial work is fine to the degree that you need the experienced people there as well. That's part of the problem we have, not just in the supply of physician but in all other professions, whether it's teachers or whatever. It's fine, and I don't have any problem with the young people having an opportunity and a chance to get going. That's great and I appreciate that, but we do need those people who have had some years of experience in this work to be there to backstop many of the things that go on.

The last item I'd like to talk to the minister a bit about is Mission Air and its operations in British Columbia. I chide the government about bringing in legislation late, but I believe I have a piece of legislation that's almost ready to come to the House in regard to health care travel.

Last year the Minister of Health was kind enough to extend some funding for one of our researchers to work with Canadian Airlines and Air B.C. on a program that would see travel points gathered from all people whose flights are funded by the public purse, regardless of where they come from, whether they're MLAs or people who work for government or whether they work for different school districts or municipalities -- all those kinds of things.

[3:15]

I had written a letter to every municipality, regional district and school district in the province of British Columbia. Interestingly enough, I received fairly positive replies from all those out of the lower mainland area: "Yes, I think that's a good idea, and we'll go along with it." It was quite interesting to see some of the letters I received from hospitals or school districts and all that within Vancouver. I don't have them in front of me, but some of them said: "That's a benefit we have for our people, and we don't have any intention of giving up that benefit." I think that's a bit shortsighted.

[ Page 10401 ]

I think it's a good program, one I've been trying to work on ever since I've been elected. Since about the second year, I think, I've also been introducing legislation with other Ministers of Health, but I will, hopefully, have it ready next week to present to the House. It is a lot more studied, and I think it's probably something that we can start working to.

Mission Air, just so the minister knows -- and I have some stats here from October 1995 to October 1996 -- flew 296 individuals in British Columbia for health care purposes, and we should really be thankful to Mission Air for doing that. This is an organization that operates out of Ontario. It is based in Ontario and run by volunteers in Ontario, yet they still fly people in any part of Canada or arrange for flights for them. As I said, in British Columbia in that year -- '95 to '96 -- it was 300 people. In '96-97 it was about 200 people in the province.

I would hope that British Columbians would have that big a heart if it were the other way around. I want to say publicly to Mission Air: thank you very much for your hard work and your dedication to people from all across Canada, and especially to the people I mentioned who you have flown.

Again, these are people who can't afford to fly but who have to. I think the minister is aware that in the air ambulance service we have, which is an excellent one, people are flown from Fort St. John or Fort Nelson to Vancouver or to Calgary or Edmonton. It's mostly Calgary and Edmonton. But regardless of where they go, they're flown there, and if it's a youngster, they have to have a parent or guardian with them. Then they're on their own. They don't have a flight back.

They don't know when they're going to be released from the hospital, and in the meantime, it's usually mom or dad or an aunt or uncle or a friend who is staying at the local hotel down the street for whatever -- one day, two days, three days, five days. Ronald McDonald House is available, when they can get into that. It is a very expensive proposition. Often, people who don't have the resources or friends who may be able to help them can find themselves in dire straits when they're left in the city and aren't able to get home, especially if they need to be flown back.

I'll just give the minister one other quick example. I had a gentleman come to me. He had had a serious eye injury just recently, and the doctor immediately . . . . They didn't take the air ambulance, but they sent them on a commercial flight. It was leaving within less than an hour. That gentleman's wife had to go with him, because he couldn't see. Their flights were just over $2,000, which they had to pay unexpectedly out of their pocket, just like that, to get to Vancouver, plus the cost of being in Vancouver. Many people down here don't realize how costly some of those things are and how precious our health care system is.

Prior to 1994 the Ministry of Health donated money to Mission Air, and there are corporate donors to Mission Air. But since 1994 the ministry has elected not to give that donation, and I think that's wrong. In 1989 they gave $5,000; in 1990, $5,000; in '92, $6,000; in '94, $6,000; and since then, according to my records, they have given nothing. Yet companies like Lignum and Placer Dome and Cominco are funding this operation to a certain degree. I just think that it would be . . . .

Although it's not a lot of money, it is a token of our appreciation from British Columbia to the folks at Mission Air: yes, we care, and thank you very much for flying the hundreds of people that you do in the province, even though you have absolutely no obligation to do it. I wonder if the minister could find that within her budget somewhere, so we could start refunding -- or at least give back to Mission Air that kind of money. I think it's very inexpensive for the ministry for such a good service. Maybe the minister . . . . I've been so lucky so far. This is one more envelope.

I promise the minister that this is the last one that I'll push this afternoon; in fact, that's the last question I have for the minister.

Hon. P. Priddy: For the rest of the estimates, I assume, that's the promise -- right? Okay.

Two things. One of them is about the piece of work that you've been doing along with your colleague from Peace River South and along with the researcher. I think the researcher's name is Sarah Bonner, and everybody I meet tells me what superb work she has done. I forget; I think she's done her master's on this now. Yes. Anyway, everyone tells me that she has just done a superb piece of work, so I needed to acknowledge that out loud.

We have two proposals around the air travel points. I'll probably be in trouble with all kinds of colleagues. I actually think that if they're paid for by the public purse, then people don't get to have them as a benefit. It doesn't work like that, in my opinion. We have proposals in -- certainly Sarah has been the one who's done those -- to both Air Canada and Canadian Airlines. It says here that those are both outstanding. I actually thought that perhaps we'd heard recently from Air Canada that they weren't interested, but I'd have to check on that.

But Canadian Airlines has yet to respond and actually looked at it a bit more favourably, I think, when the proposal went in. So we will be actively pursuing that, because it is important. In point of fact, you and your colleague and Sarah Bonner have done a large part of the work on this.

The second point around Mission Air that you've raised, of which I was unaware . . . . I'll certainly commit to looking at that and reviewing it, hon. member.

He's batting fine; leave him alone. He's done well today.

K. Krueger: Before the rural doctor issue erupted in northern B.C. the way it did, a bad thing happened to the community of Barrière, which is in my constituency, 60 kilometres north of Kamloops. It lost two of its three doctors at the end of 1997. When I got word in the fall of 1997 that this was happening, I jumped into my car and drove out to speak with them. They expressed many of the problems that have come to the fore in the northern doctors dispute. They were flat burned-out from the work they'd been doing, from constantly being on call. They weren't looking for more money.

They were simply so tired -- from being awakened in the middle of the night, from continually having those responsibilities, from never being able to take a vacation -- that they had decided to quit. They were husband and wife, two doctors who had been educated in the Maritimes and had come out and chosen rural B.C. in which to practise. No amount of pleading could change their minds. They had had it. In fact, they said: "We're not even sure we want to be doctors anymore.

We've done this for seven years, and it's just too much for us." They expressed their difficulty ever getting any professional upgrading, ever having a vacation, ever having a good night's sleep. And then all the other kind of side issues such as sometimes being called in, in the middle of the night and only having one patient, sometimes having half a dozen from a motor vehicle accident, never knowing exactly what they were up against.

There was one money issue in that they had been abruptly cut back on their northern living allowance. They thought they were the only doctors this had happened to in British Columbia, but they said the border had been extended slightly to exclude them, so instead of a 13 percent allowance, they got an 8 percent allowance. They said there was no way

[ Page 10402 ]

to appeal that, that it was totally arbitrary, and that in a way it had been the straw that broke the camel's back. Although I want to make it clear that I believe they were going to go anyway, they were burnt out. My first question is: is it totally arbitrary when a change like that is made to that allowance? Is there an avenue of appeal?

Hon. P. Priddy: Yes, they can certainly appeal it to the Medical Services Commission, which is tripartite -- physicians, government and public.

K. Krueger: I thought there probably was a method, but it was clear there was no changing these people's minds. One of the really major issues to them was that they couldn't see any relief in the future. I've talked to a lot of people about this problem since and thought about it as we experienced the whole issue of the northern doctors withdrawal of services. A couple of ideas have been expressed to me, and I don't frankly know the pros and cons of these.

One is that students graduating from medical school in British Columbia could be given a forgiveness option for student loans if they practised where most needed, perhaps for five years or some contracted period. I wonder what the minister's point of view on that is.

Hon. P. Priddy: Two points. One of them is that we're prepared to look at anything that will encourage people to do that. There are two points -- actually the same ones -- about paying medical students and about offering relief from student loans. One of them is, if money isn't the issue, then I'm not sure that offering . . . . As people stated earlier, it's really the issue of relief, not the issue of financial resources. I don't know how long that would actually make a difference for people. By the way, I'm not at all unprepared to look at that, because that's all part of what we will be doing with Dobbin.

I think the experience in other provinces where this has been done -- and it has -- is the same as the experience with paying medical students. When you do that and forgive the student loan, it's got very mixed reviews about whether it's successful or not, because if somebody walks away from it a year into their practice with X amount that's been forgiven, there really is no way to enforce that contract. You can't make the person stay there. So I want to try and see if there are some ways that make that a little firmer in terms of being able to make sure the contract is met. But I'm prepared to look at that.

K. Krueger: At the B.C. Liberal convention this spring, the Young Liberals, many of whom are students and certainly represent students in all the universities in B.C., brought forward a resolution recommending that as a doctor, a recent graduate, progressed through the term of such a contract, the government could do a matching forgiveness of student loans so that anything that the doctor repaid, the government would match. Perhaps that would help address that concern.

Hon. P. Priddy: I think it's a good idea that you've put forward. We are prepared to look at any option that enhances the chance that someone will go there and stay there, so I appreciate the member's comment on that.

I think the other thing we have to look at in the context of this is the role of nurses, because in the communities where we have some pilot projects, like in Ashcroft -- and I don't know if it is close, but it's not that far from the member's riding -- it has made a tremendous difference. I think we have to look not only at the physician part but also at the role of nurses and how they can make a difference in terms of people not burning out.

[3:30]

K. Krueger: A second and somewhat more draconian recommendation I had heard was that people take the view that our medical schools are so heavily subsidized that a graduate is essentially being given a winning lottery ticket, and that graduates who don't pay the full freight for their tuition ought perhaps to have to accept assignment, at the direction of the government, to some point of need in British Columbia for the first few years of their career. I'm not endorsing that; I want to have it on the record as something that some British Columbians think is a feasible solution.

I want to ask the minister about the RN First Call program, and I thank her for introducing this subject. Is there a rollout plan, along the lines of the Ashcroft model, for other communities such as Barrière?

Hon. P. Priddy: I'm not sure that I can suggest at this stage that there is a plan to roll it out in Barrière; there may be. We are absolutely committed to expanding the Ashcroft project in as many places as we're able to move into.

K. Krueger: A last issue on this problem of doctor supply in small communities that I want to canvass is the issue of procuring locums. These doctors who left had had tremendous difficulty getting locums. That was compounded by the fact that since they were married, the two of them wanted to go together. They had had some plans fall through; locums with whom they thought everything was arranged cancelled. There again, it comes to mind that people who have recently graduated from medical school perhaps haven't put roots down to the same extent as people who have been in practice for some time.

I wonder if there is anything fresh on the horizon from the government with regard to the supply of locums.

Hon. P. Priddy: Yes, there are some, but I don't think this is ever going to be particularly easy, particularly around the issue of locums. I would suggest that there are some things we can do through the central recruitment assistance program. We want to be more vigorous in having that organization recruit locums. We have asked them to be quite aggressive in doing that. Over the last year or so, recruitment assistance has placed 43 permanent physicians and 24 locums in communities throughout the north and rural parts of the province.

But we've asked people to do a more aggressive job around the recruitment of locums, and part of it is that we need to also look -- which we have done through Dobbin -- at the compensation locums receive. I think that's part of what was addressed in Dobbin.

K. Krueger: Moving on to another, yet related, topic, the community of Clearwater has worked for years on acquiring approval for what's termed a multilevel-care facility there, incorporating intermediate and extended health care with acute care. Some eight months before the last provincial election, that community was promised -- in good faith, I believe; I absolutely believe that -- by the current Minister of Education, who was then the Minister of Health, that that building would be getting underway. Money was spent on planning and preparation, and people have been earnestly hoping to see the shovel in the ground ever since. It's a really pressing problem.

One time when I checked, there were over 30 people from Clearwater farmed out and in other intermediate and extended care facilities throughout the province. It's a long

[ Page 10403 ]

way away. Kamloops alone is an hour and a half from Clearwater, and some of these people are placed in facilities in the Fraser Canyon. It's an awfully long way to go, particularly in the winter. Of course, the residents don't do as well when they're separated from their families by great distances. All things considered, it's seen as tremendously unfair that nothing has happened with that facility. Despite the fact that it wasn't an election promise, it was a promise; it was a business decision.

I've spoken about this at least twice in previous estimates with previous Ministers of Health. I believe the intent is there, but nothing is happening. I know the minister has received a very significant volume of mail on this issue, because I've been copied on the mail, and there are hundreds of letters. The health council in Barrière recently sent a letter to the minister, which she may not have seen yet, with her volume of mail. They unanimously and wholeheartedly support the construction of the facility up in Clearwater. They're not asking for one for themselves. I would really appreciate the minister's commitment to see that proceed soon.

Hon. P. Priddy: Again, another MLA who advocates well for his community.

Yes, we have received letters about this, hon. member. Certainly the ministry is well aware of what the need is there. While we have not as yet made announcements around a number of capital projects, I certainly hear the good advocacy that this member's making on behalf of this project.

K. Krueger: Somehow that doesn't seem quite as affirmative as the responses that the member for Peace River North was getting, so tell me, "What's He Got That I Ain't Got" -- as Kenny Rogers says.

Hon. P. Priddy: As my kids would say: "Don't go there, Mom." I thought I was every bit as positive with this member as I was with the last one.

K. Krueger: There's some heart balm in that.

Something that happens to people throughout these rural communities which generally service stretches of highway is that they are called out in the middle of the night to motor vehicle crashes and emergencies of all kinds. They frequently put their lives on the line, extricating injured people from motor vehicles that are twisted by crashes and so on. Sometimes a fire is involved.

I was at a meeting in Clearwater where a number of the people who had responded to a particularly bad accident were being counselled by a doctor, because the victims turned out to be hepatitis C sufferers, and people were really frightened. They had been cut themselves, as they were working; there was a lot of blood involved.

One of the travesties, from their point of view, is that when they need some training or equipment, they frequently have to raise the money themselves. I know it's an interministerial concern, and I know there's goodwill from the various ministers involved, but I don't really think that it's the government of British Columbia's intent that people like this should have to reach into their own pockets to pay for the Jaws of Life and other equipment they need or to pay for their training as provincial emergency program volunteers.

I know I'm crossing into a different ministry when I talk about this, but -- without meaning to make any pun or play on words about the minister's name -- it's kind of a penny-wise, pound-foolish situation when people who are already giving so much of themselves, so much of their time and taking risks and so on, are then restricted from delivering the service. Sometimes they lose heart, because it also costs them money, personally, and costs their communities money.

I'm not necessarily expecting any firm answer right now, but I'd just like the minister to speak with the Attorney General about that, with regard to the provincial emergency program, and try to make sure that it isn't so difficult for people to have the equipment they need to perform these lifesaving services, which they do voluntarily.

Hon. P. Priddy: Yes, I will do that, and I will tell the member that when I have met with ambulance service providers across the province . . . . A number of people have raised with me -- as have a number of communities, local mayors and so on -- the importance of training for volunteers. They're correct. Although volunteers would not necessarily be trained to the highest rescue and resuscitation levels, nevertheless, they do have the right to have access to training. Otherwise, we're risking people's safety.

So yes, it has been raised with me, and I will talk with the Attorney General, as well, although certainly a significant part of that responsibility does fall with the B.C. Ambulance Service. But you're right. If it's around the PEP program, it is with the Attorney General. So we'll do that.

T. Nebbeling: I would like to speak briefly on the issue of fair and equal treatment, regardless of whether you live in an urban area or in a rural area. I've always believed that the government is committed to the principle that each and every citizen of British Columbia has the right to treatment, regardless of where they live.

I'm dealing in my riding with a rather serious situation, where a patient who suffers from a debilitating illness, Crohn's disease, was treated for a long time by UBC hospital as an out-patient. He received at that time a care package which he needed to be able to be at home -- syringes, tubing and stuff of that nature. This patient's bill is approximately $700 to $1,000 a month. The gentleman comes from Pemberton and is back with his family. To the horror of the family, which is a low-income family, he is not being given that same privilege in Pemberton.

This family now has to lay out $700 to $1,000 on a monthly basis in order to get him the needed medication and tools to deal with his disease. Can the minister tell me if this indeed is a situation that has unfortunately crept into the system but is not correct? Should this patient be given the same treatment he was receiving in Vancouver at UBC hospital? Or is there a difference, so that when you're in a rural area, you do not qualify for that same type of treatment and the same type of tools?

Hon. P. Priddy: Certainly the principle of equal access is one that we all believe in. We all do understand that it is harder in rural and remote areas. But I'm just being a bit hesitant here. If the member would give my staff the information about this particular circumstance, then my staff will look into it and get back to the member before the estimates are finished.

T. Nebbeling: I have brought this issue to staff's attention in writing. I brought the same issue to estimates last year. This is a case that has been going on for a lengthy period of time. I know that the family is still paying for the needed tools to deal with the illness. I will once again provide the name of the patient and where he is. But I am not encouraged by just having the minister promise me that we will be given an answer very soon, because I've been looking for that answer

[ Page 10404 ]

for a long time. However -- through the Chair -- you are a new minister, and I give you the benefit of the doubt that indeed we can deal with this issue. It has created tremendous hardship. Not only does this gentleman's wife work to have additional income to provide him with this, but his whole family is really in disarray.

I have a second issue along the same lines, in a sense. The minister is aware that most hospitals stock TPA for cardiac arrest. In smaller communities, again, often this medication is not available, because of the cost of the medication. As it is a stock item, with the low budgets that rural clinics and hospitals have, often they can't afford to have the TPA in stock just in case there is a heart attack.

What I would like to ask the minister is: while this situation is being looked at, what happens in the Pemberton clinic? Can the minister indeed have a look at how that kind of situation can be addressed as well? I don't think it is fair that if a person has a heart attack in Vancouver, the chance of dealing with that heart attack positively is much higher than when a person has a heart attack in a community like Pemberton. Again, from the equal access perspective, I think that medication should be available.

[3:45]

Hon. P. Priddy: I do actually have staff coming about this particular question. I appreciate the member raising it. There are two issues here, as I understand it, and I'm not sure that cost is the predominant one, although staff may come and tell me it is. It's also having a skilled clinician who is able to utilize the drug. There's not much point in having it in a facility if people don't have the training to use it.

I've just had someone come, and if you could just give me a minute, we'll get a more advanced answer.

T. Nebbeling: While the minister is being instructed, I have a little bit of a simpler question about ambulance services that the minister can maybe deal with. Again, the Sea to Sky corridor has a very unique problem. There are 27 ambulance drivers under contract for the Sea to Sky corridor, which includes the communities of Squamish, Whistler and Pemberton. Because of the way the collective agreement has been written, these drivers can actually live in areas other than where they are professionally active. In the Sea to Sky corridor, including the community of Pemberton, there are 27 drivers, and only one actually lives in the Sea to Sky corridor; 26 of them live in Vancouver.

Under normal circumstances that may be okay, but the area of the Sea to Sky corridor past Squamish, because of its mountainous area and its heavy snowfall in the winter, is not always accessible for traffic coming from the lower mainland. There is traffic opportunity within that area, but it is often impossible to get through certain passes. How will the minister be able to address that problem? Again, I have written on this issue, and up until now there have been no changes made in dealing with that kind of problem. I would like to hear from the minister if she contemplates any action to rectify this impossible problem.

Hon. P. Priddy: This is an issue that has been raised with me, particularly around the Sea to Sky corridor, by some other people from that area -- some elected people and some people who practise medicine. The situation, as I currently understand it, is that it has been acknowledged as an issue. I do understand that if you're living in Vancouver and there's a lot of snow on the road, the chances of your getting there can be reduced. Currently there are ongoing discussions with the ambulance services and CUPE around this particular issue of local hire.

I'm sorry I can't give you an outcome of that, because those discussions are ongoing. It has been identified as a specific issue, and a committee was struck to look at that specifically.

S. Hawkins: First of all, I want to say that I appreciate all the time and effort that some of the members in the House have put toward developing the travel assistance program. I know that the members for Peace River North and Peace River South and some of the other northern members have done a very good job. I had a file on that too, but I think I will just say that patients who are transferred -- and I think the minister recognizes this -- are transferred by necessity and not choice.

I have pulled a few letters of patients who have written. Certainly the costs are in the hundreds and in some cases a couple or three thousand. There are some very sad stories. I don't know if the minister has heard them in her tenure as Health minister. One that comes to mind is that in March of this year, an 87-year-old lady was taken from her home to hospital. She was then transferred to Prince George Regional Hospital and then to Vancouver and left there, with just a housecoat and $20. She phoned her son in Vancouver to pick her up. I think 87 years old is kind of old to be left on your own in a city.

Frankly, my understanding is that a lot of patients don't expect to be left there; they expect to be transferred back the same way they got there. So plans like those that the members for Peace River North and Peace River South have been speaking about would certainly assist those kinds of patients. I hope we do get some movement on those very good ideas.

I want to go back and clarify. I asked the minister a couple of days ago about the Dobbin report and whether the contract with the doctors had indeed been signed and settled. The minister said that there was an issue about payment for extra hours. The call hours weren't established; the doctors were disputing whether the call hours were six to eight in the morning or five to nine in the morning. My understanding -- and I spoke to a representative of the northern doctors' group -- is that they had abandoned that. That was something that indeed had been put to the minister because that was their

interpretation, but they said that wasn't the issue. The real issue is the CME funding. I never heard the minister tell us that.

With respect to the Dobbin report, I understand that there is extra funding for CME -- which is continuing medical education. I understand that it is proposed that the ministry will give the money to the region, and the region says it's a pool of money that will be used for whatever kind of education they want to put on -- workshops or whatever. Frankly, the way that I understand the physicians are interpreting the Dobbin contract is that it's a top-up for the CME they already get. Correct me if I'm wrong, but I think the BCMA administers CME currently.

I understand that they are very prepared to continue to administer CME for the physicians that need the extra training, because they are isolated and they don't get as much current education on certain medical procedures and diseases and the latest advances that they could.

Perhaps the minister can tell me exactly what her understanding of the dispute is, and whether indeed it is true that the minister and the ministry are interpreting it as a pool of money that should go to the region that everybody has access to, or whether it's a pool of money that really is for continuing

[ Page 10405 ]

medical education and for the physicians to submit to for reimbursement of their expenses when they travel -- the way that it exists now.

Hon. P. Priddy: By the way, I did know about the issue of continuing medical education, but at the time, my understanding was that the hours were a higher-priority issue. So yes, I am aware of the continuing education. I think it's important to note that while part of this is a pool, physicians continue to receive $1,600 for their continuing education, which is directly for them. The rest, depending on the number of physicians and how long they have been practising, is part of a pool that is to be used in the region for continuing medical education.

My expectation is that the regional health authority, whoever they are, would work with the physicians in that area to determine jointly what the continuing education needs would be. It often does make sense to actually bring in a specialist who can work with four physicians, as opposed to every one of those four having to go out somewhere. The $1,600, which was an increase from $1,100, still goes directly to the physician; the rest is to a joint pool for their use.

S. Hawkins: The minister can correct me. Is that $1,600 sum just for northern physicians, or does every physician in the province get $1,600? I'm unclear on that. Or is that $1,600 just a new top-up for rural physicians?

Hon. P. Priddy: It's for all NIA communities.

S. Hawkins: Yeah, that's what I understood. The other thing I heard the minister say was that there were bills being sent and that money was being paid out already, even if the contract wasn't signed. My understanding is that no money has been disbursed -- as of Monday, anyway. Bills have been sent from Mackenzie and Fort St. James, but they haven't been paid. Can the minister confirm that?

Hon. P. Priddy: The health authorities were all told to go ahead and pay the bills that were submitted. I will check on the two areas that the member has raised for me, because health authorities all had instructions to pay the bills submitted.

S. Hawkins: During the five-month northern rural crisis, I believe there were a lot of additional costs attributed to boosting up the hospital and the Ambulance Service and to transporting patients to and fro. I wonder if the minister has the cost -- the additional cost or the total cost -- of the Ambulance Service during that five months.

Hon. P. Priddy: We're still collecting the ambulance information around billings, because it has to be calculated. If people had to be transported further because of this, then they wouldn't be billed the additional amount, so we're still collecting that.

I do have the information on the hospital, if the member would like that. I may as well just say it, rather than sit down and have the member get up, and then I'd get up again. I think it's about $325,000.

S. Hawkins: I would appreciate a commitment from the minister to get us the cost of the Ambulance Service for all the communities that were affected. Also, I'm wondering if the cost of what she said about the hospital . . . . Is that just the cost of Prince George Regional Hospital? What was the cost, then, of all the other hospitals operating at full staff with no patients in them? Has the ministry calculated that as a total?

Hon. P. Priddy: I'm just trying to think a little bit about the focus of this. I'm not sure that those were necessarily seen as costs or savings. We told people in the north that even though their physicians were not there, this was not about closing hospitals. I suppose what we could have done was simply to have closed them during that time, but I think that that kind of fear -- when people in the north already worry about losing a health care facility -- is totally unfair. So we chose to keep those hospitals open during that time, hoping that physicians would continue or would start to use them. I'm not sure that it's fair to put those in the perspective of either savings or cost.

S. Hawkins: The minister will know that the doctors were using the hospital in that time period. I understand that they weren't closed. In fact, in many of those communities, long-term patients or palliative-care patients were being looked at in those hospitals. If there was a decision to close them entirely, it would have put a lot of the long-term and palliative-care patients at risk as well, so I don't think there was an option, really, to close them.

I was also informed, by residents and certainly by community leaders -- councillors in the different areas -- that residents were told that the cost of the Ambulance Service would be reimbursed, if they submitted their bills. Are these the bills, then, that the ministry is collecting from individuals who would have been treated in their own hospitals but, because of the dispute, had to take an ambulance to Prince George? I'm wondering if the minister can confirm, first, if that is indeed true -- that the ministry is picking up the cost of those kinds of claims.

[4:00]

Hon. P. Priddy: We may find out that some bills went out that shouldn't have, and we will address that. What we said we would do during that time and what we have done is that if somebody required an ambulance to their closest hospital, whichever that may have been, then they would be billed for the ambulance from, for instance, home to their nearest hospital. If they could not receive service there and needed, as a result of the withdrawal of services, to be sent to a hospital in Prince George, then they would not be billed for the difference in that. They would only be billed for the amount for where the ambulance would have taken them under normal circumstances.

S. Hawkins: If the minister will commit to getting us the number of requests that were submitted to her ministry -- because I know I get copies of them -- and how many will be fulfilled because of the northern rural crisis, I would appreciate that.

I also want to speak about another recommendation in the Dobbin report, and this is with respect to medical education students. It's interesting. I got a letter from one of the associate professors at the UBC department of family practice. He is -- I believe that the department is -- making a submission to the ministry about the rural residency program. In the letter it's interesting that he points out, in fact, that Lucy Dobbin points out in her report that the rural residency program survives because the practitioners support it monetarily.

I understand that the rural preceptors, who are the rural doctors, currently pay $300 a week for the privilege of teaching. I don't know if the minister is aware of that. This doctor says that this is not sustainable. Elsewhere in the country, rural teachers receive compensation for their efforts.

When we talk about the physicians only wanting money, I think we have to be cognizant of the fact that they do a lot of

[ Page 10406 ]

community service. They do a lot of teaching service, as well as make sure that they get medical students in and train them, so that hopefully they'll come back and work there. Right now the physicians there are paying for the so-called privilege of teaching, which is also extra hours of work that they do besides running their own practice.

I understand that Dr. Joanna Bates, who is the UBC residency program director, is the one who's preparing the response to that recommendation for the Ministry of Health. I look forward to reading her recommendations. I just want to point it out to the minister, because from that side of the House, unfortunately, we've heard a lot of slamming. That's kind of unfortunate, because when we look around at some of the service that the physicians have been providing up there . . . . I was unaware that they were actually doing this, so I was quite impressed that it was happening.

I also want to talk about some of the initiatives around the remote and rural health services. I happened to dig back in my files and found some information about a whole bunch of announcements. I know the ministry is really good about making announcements, but then keeping commitments seems to be a bit of a problem. Way back when, just before the election in '96 -- on April 23, actually -- I find an announcement for a $50 million Prince George Regional Hospital renovation. That now, I understand, is $40 million, so that's gone down a bit.

There was a $400,000 TeleCare program announcement; there was a $1 million physician outreach program -- travelling specialists; there was a $1.65 million announcement for 15 regional ambulance training centres, to be up and running by January '97; there was a $750,000 teleradiology program, which I understand is now running in part and actually started a few months late; there was a $175,000 travelling mammography program announced back then too, and I understand it got off the ground in fewer than half the original communities it was listed in.

So when I tallied up those announcements -- what had been promised and what had actually been delivered -- of the total promises not carried out so far it was $51.4 million. Another $1.65 million was slow to come, and that was the regional ambulance training centres -- if indeed they have been set up. The only ones that were really set up were the travelling mammography, in part, and the teleradiology.

I think it's understandable that northerners and rural people do get frustrated when they get all these promises and don't necessarily see the commitments in any short order. I know that they are still waiting for a lot of these, and I have been up to the Prince George Regional Hospital about three or four times in the last year and a half. I understand that just before, or during, the recall campaign for the Minister of Education, the Prince George Regional Hospital announcement was announced again.

I wonder if the minister can comment on these announcements in the millions, and the commitments coming, unfortunately, with a shortfall of money. I'll give the minister a chance to respond to that.

Hon. P. Priddy: I'm not sure we wrote all of the things down on the list quickly enough as the member was speaking. I'm trying to . . . . I think the commitments that the member listed -- that I can remember -- have been followed through with. I don't recall the time; I wasn't the Health minister. I could certainly check back on what the promises were -- whether they were attached to time frames or . . . . I just don't know that.

But the teleradiology has been up and running for some time now. I think there are currently some challenges from insurance companies, but teleradiology, which is a good project, has been up and running for some time.

The TeleCare project. I don't know whether or not it was promised "for the north" in the announcement, but we have done a pilot project on TeleCare, which is absolutely wonderful. We are now looking at expanding that to other places in the province, and the north would . . . . Well, I would expect to see at least a couple of those in various parts of the north or in remote areas.

It's not an inexpensive program, but it's an incredibly successful one -- to have someone on call at the other end of the phone when you're a mother with a three-year-old who woke up with an earache at 3 a.m., and you don't know what to do. The logical thing is that you go to emergency, and that's probably not what you need to do.

The success of the TeleCare project has been tremendous. It will be expanded to other parts of the province, but the commitment was made to have a TeleCare project up and running, which we did, and we will now be expanding it into remote and rural areas.

The understanding I have from my staff is that the Prince George project is still valued at $50 million. TeleCare, teleradiology . . . . Was there another? Sorry, I didn't catch the rest. Those projects are going forward. Actually, many of those are unique projects, like TeleCare and teleradiology.

To actually be able to be in a remote area and look at a patient and then have a specialist who may not be in your community -- who may be somewhere else -- help you look at an X-ray and help make at least a provisional diagnosis, if not a sophisticated one, which leads that practitioner in a small community to know the next steps that she or he needs to take on behalf of their patient, is really quite extraordinary. I'm very proud of that project.

I want to go back for a moment, if I could, to some of the ambulance information, because there's some that I actually do have here. The ministry staff reviewed all the bills that may have been affected by the dispute to date -- so we don't have the complete total on that -- which was a total of 216 bills. It was determined that 213 of those bills should not have to be paid and have been completely forgiven. Three of the bills have been partially remitted, and the total value of the 216 bills that have been remitted, either in whole or in part, is approximately $24,000; 191 bills were intercepted by B.C.

Ambulance and were actually never sent to the patient; 25 bills were inadvertently sent to patients, and they've been contacted by the ministry to have the bills remitted.

S. Hawkins: Thank you for that information. I think I did say I understood that the teleradiology program was up and going. I think the minister spent a lot of time on that. There was a TeleCare program. I'm reading from a press release dated -- gosh, it was just before the election in 1996 -- April 23. It was supposed to establish a toll-free number for residents of remote and rural regions so that patients could call when it was unclear whether they needed to visit a doctor or an emergency department.

It says: "The service will operate initially as a pilot project, at a cost of $150,000 for equipment and $250,000 for annual operating expenses." That was at a cost of $400,000. I believe it was set up as a nurse-first-call system. In January of this year -- unless the minister is giving me new information and things have changed -- the regional health board . . . . I've got a story. It says:

"Nurse Phone System Proves Too Expensive. The Northern Interior regional health board doesn't have money for a telephone nurse-first-call system the NDP government promised

[ Page 10407 ]

almost two years ago. The regional board investigated a sophisticated computer-assisted model in New Brunswick but have turned it down as too expensive at this time . . . . [The CEO] said he was unaware the provincial government had promised in April, 1996, $400,000 to set up pilot projects in the north using the New Brunswick model."

In the last paragraph of this story, it says:

"The NDP funding for the telephone system was part of a package of health care promises for the north Health minister . . . " -- I can't say his name -- "made just prior to the 1996 election."

Again, I think that is part of the reason northerners and health care providers up there get very frustrated. We know that services in those areas are bare-bones anyway. Then when you bribe people, or throw these empty promises at them and never deliver . . . . It's been two years. Unless the minister is telling me that there is money for this, and this system is now set up, and I'm wrong . . . . I think it's atrocious that promises like this are made and never kept. This is something that I understand was going to be a pilot project. It's successfully operating in New Brunswick.

To say two years ago, "We've got $400,000 for you so that you can run this pilot project," and two years later we've got the regional health board looking at something like this and then saying: "Just a minute, it's too expensive; we can't afford it . . . . " Then they're reminded that two years ago, just before the election, the NDP promised this, and the board is not aware of that. I think that's outrageous, and I wonder if the minister can comment on that.

[4:15]

Hon. P. Priddy: The TeleCare project has been piloted over the last, I think, year and a half. It was not piloted in the north; it was piloted locally. I think it was in Saanich as a pilot project, which has been incredibly successful.

What we are now planning for is a provincial . . . . I would not pretend to know how people saw that rolling out when that announcement was made. But it is true that it would be too expensive for one region or one health authority to operate on their own, which is why we have piloted it in a smaller area -- to have a look at that feasibility. Our intention is to make it not just a regional program but a provincial one; it's the only way. It is like the New Brunswick one. That's the one we piloted, etc., and that has been written about quite a bit, actually, by the media.

Making it into a provincial one is the only way you have any opportunity to make it even remotely financially viable. But it's an important project. We did go ahead and pilot it. We are looking at extending it throughout the province.

S. Hawkins: It's cold comfort to the patients up north that don't have it and thought they were promised it a couple of years ago.

The last issue with respect to perhaps this general area is that we know there's on-call pay provided in hospitals around the province. I think one of the most public ones was the Surrey Memorial Hospital. It pays doctors to be on call. I wonder if the minister can get us a list, if she knows how many other facilities around the province budget to pay on-call pay to physicians who provide that service to the facility.

Hon. P. Priddy: I'm not sure I can give the member a number. I'm aware of three hospitals that do that. Obviously, in larger hospitals they pay staff out of their base budget, not with any additional on-call dollars. Some of these hospitals have been doing it for quite some time. They pay a physician to be an in-house physician, to be there in the hospital for hospital patients who are already admitted to hospital -- I can't remember the hours, but sort of during the evening and night. They pay that out of their base budget because they have chosen to do so.

S. Hawkins: Yes, I understand that. I think, in all fairness, that hospitals that get more money can afford to do that. Certainly when I look at Surrey Memorial Hospital, I don't know if that hospital has a lot of money, because it's been running at about a $5 million deficit, and the ministry has helped that hospital out a couple of times.

Where does the money come from at the end of the day? The money comes from the Ministry of Health. So if the hospital runs a deficit and the ministry covers it, the money's still coming from the same pot; it's coming from the Health budget. So whether it's a decision made at the local level . . . . At the time when Surrey Memorial Hospital first started it, the budgets were approved by -- guess what -- the ministry. So when I read that the ministry says, "Well, that's a hospital issue, and whether they can afford to do it, that's their call," that's fine.

But if those decisions were approved by the Ministry of Health . . . . The Ministry of Health knew that it was being done. And a hospital like Surrey Memorial -- which, as I mentioned, faces a deficit situation -- funds programs like that. Then the ministry covers that deficit, at the end of the day. So it's interesting.

I think, again, that rural patients look at that and see an inequity, because that hospital does get the money to do it. Other hospitals do have the money and maybe the flexibility to do it, and places like rural and northern places feel they don't. So if the minister wants to comment on that, she can.

Frankly, the reason why they do it is for quality of life. Perhaps there are 20 or 25 doctors who admit to those family medicine wards. The doctor who's providing that on-call service is only providing it for that in-patient population. That doctor, he or she, is not providing it for emergency patients. There are full-time emergency physicians in the emergency room at Surrey Memorial Hospital; that's what I understand. So the doctors who provide that service do it on a rotating basis, I understand. They get a stipend, plus fee-for-service billings.

Frankly, I understand that they get about, on average, 12 or 13 calls in that period of time, the 13 or 16 hours they cover. The hospital has been running that program.

I'll sit down, and the minister can comment further if she wants. But again, I would like a list from the ministry of the hospitals that do that and the stipends they pay.

Hon. P. Priddy: We'll provide that.

M. de Jong: I was listening earlier to the debate between the minister and my colleague from Peace River North, and I thought that maybe the smartest thing I could do would be to retain his services. I think the record will show that he enjoyed some success.

The minister said at one point that she would provide some answers, and they were answers that my colleague the member for Peace River North found to be reasonably acceptable. The problem in the past, when I have participated in these debates . . . . Some issues affecting the part of the province I call home, Abbotsford, haven't been what the ministers of the day have responded to. Generally the responses have been quite favourable, but it has been the follow-up thereafter . . . . If I had a hospital for every hospital that has been promised, I'd have a dozen of them in and around my

[ Page 10408 ]

constituency. But the sad reality is that the one that's required, which has been promised and which has, as I'm advised year in and year out, met every possible approval required within the ministry still languishes somewhere. Maybe the minister will help me today -- and my constituents, for whom this remains priority number one -- ascertain where it is languishing within the bureaucracy of the ministry and the government.

I don't want to take too much time from others who are wishing to participate in the debate, but I want to ask the minister about some comments and concerns that have been expressed by the Fraser Valley health region by the CEO, Mr. Tokarchuk, and the chair, Mr. Peary. They have spent a great deal of time trying to bring to the minister's attention an issue related to the application of the funding formula within the ministry. I must confess that to the extent that I have any familiarity with these methods of accounting and distributing the proceeds within government . . . .

I am more familiar with the educational fiscal framework, as it's called, than I am with what takes place within the health region. But I think it has been demonstrated -- at least, a case has been made to me that seems very defensible . . . . If the funding formula within the ministry is applied in a way that is equitable, the case can be made that the Fraser Valley health region has in fact been losing $8 million to $9 million a year over the past number of years because of a misapplication and formerly, with the old formula, because of a built-in inequity.

So that's a statement I'll make. I'll let the minister consult with her staff, and perhaps she can respond.

Hon. P. Priddy: The issue of the funding formula . . . . I don't know about the specific numbers that the member has spoken to, but I expect that the member is correct that the Fraser Valley health board -- the same as the South Fraser health board and others -- can make an argument that another kind of funding which better recognizes growth and demographics would more equitably respond to areas of growth throughout the province; at least, everybody believes it would. We have a committee made up of CEOs and health chairs and so on from across the province looking at the funding formula.

I have asked for that work to continue, because in the end I think we actually do need a different formula that more accurately reflects both growth and changing demographics, other than the numbers in the demographics.

But there are some challenges in that. It's a bit like when the funding formula was changed in education. Lots of us thought that for sure we would be significantly changed as a result of that -- and I'll tell you that as a Surrey school trustee, I've made the argument a lot -- because we were so convinced that . . . . That did not turn out to be the case. I think we went from 75 to 74. That was not our anticipation or wish. So I'm not sure that . . . . Every board I've talked with says that if we change the funding formula with the existing amount of money, they'd all have more money. That won't actually happen.

The challenge in this is to find a funding formula that works and to not take dollars away from other existing health authorities; at least, I would think the areas of the province would say that. If you can write this whole new cheque that levels everybody up, then you could probably do that. But if you reassign, based on a different formula with the existing dollars, there are some parts of the province that would have money withdrawn from them. While I, in a growth district, can say, "Well, yes, but I need it," I don't think it's quite as easy to be able to actually go ahead and do that.

I do think the formula has to change and be based on different calculations, and I've asked the ministry to continue. Although some people may not wish to do this, I've asked the ministry to continue, because I think it does need to be changed.

M. de Jong: It seems to me that the minister has identified two possible approaches to attack this problem. One involves addressing the overall funding envelope for the ministry, and I don't want to get into that today. I'm happy to, but I don't think we accomplish anything doing that at this point.

But the minister acknowledges, I think, that there is a need to address the funding formula. She says that on the one hand, and then on the other hand, I think I heard her express a real reluctance to do that in a way that might result in an actual redistribution of money, of resources. It seems to me that if the minister is approaching it from that point of view -- that any adjustments to the funding formula that might have as a consequence the reduction of the amount of money that goes to one part of the province and a resulting increase in the amount of money going to another part of the province . . . .

If that is deemed to be undesirable, then I don't know why you would deal with the funding formula itself. Why else would you review the funding formula except to address the manner in which moneys are allocated? If we accept that there's not going to be a huge influx of new money, part of looking at the possibility of finding more money for one area, based on an adjusted funding framework, is the result that there may be less for elsewhere. Conceptually, if the minister is looking at this exercise from the point of view that anything that results in certain areas losing money . . . .

I don't know why she's undertaking the review. Maybe I've misinterpreted her remarks.

[4:30]

Hon. P. Priddy: We're undertaking the review for two reasons. One of them is that the increments that happen . . . . If you go back over the last five years and look at the increments, they have been based -- not the base but the increments -- on a different kind of funding formula. I'm not even sure that this still addresses the issues of either population growth or changing population -- you know, your whole community is suddenly a community of seniors, because a number of us will soon be there.

I think it is a positive use of time, because even with the additional dollars, those are the dollars that we can indeed distribute differently. It may be that in additional dollars, some regions, based on the population and demographics, might not get any additional lift that year,

whereas a high-growth area with changing demographics may get a lift that's more significant. Some regions might not get any. So I think that it is worth doing even for that 15 or . . . . I can't remember how much the lift has been over the last five years. Sorry, we had it the other day; I just can't pull it off the top. But I think it's hundreds of millions of dollars that have gone out in the lift over the last five years, which have been distributed differently from the way that the base was established . . . . The deputy's just added to that.

I thought we did say several hundred million dollars, which has been based on a different formula. I think that formula can be even better. So it is useful work, even though it means you don't take it away in some regions, but they may not get additional lifts.

Am I reluctant? Sure, because I think that whenever you talk about taking money away, it's hard. Is it impossible? No. Might we need to do that in certain circumstances? Maybe we would. Unfortunately, I think that the areas that would be hurt by that are northern and remote areas. So we continue to use it for the several hundreds of millions that have gone out over

[ Page 10409 ]

the last five years in the lift. I think we can do that lift with a better formula. While you're right, that health dollars are tight, I'm always preparing for the future. It may be that at some stage we are able to begin that levelling up, which means that we don't take away a health service that exists in a health authority, but we are able to better enhance the ones that need it.

M. de Jong: The minister or at least her staff will know that the Fraser Valley health board are sufficiently concerned about what they perceive to be difficulties that are impacting very seriously on the people they service that they have gone out and commissioned a macro-level review of the programs and services in their region, which was performed by the HMRG, a health and public sector consulting group. I believe that that report has been provided to the minister. I don't expect her to necessarily be in a position today to respond to the recommendations, the findings, that are contained in the report.

I will quickly try to highlight for her some of what is in the report and then ask her for some undertakings with respect to responses to those recommendations.

To place this in some sort of context, as the report points out, we are dealing with a quarter of a million people in the health region. That population has increased 15 percent in the past five years, and it's projected to increase demographically a further 12 percent in the next five years. So by the time we get to the year 2004, we're going to be talking about 275,000 people. For the benefit of the ministry, I think the health board is correctly trying to identify for the benefit of the ministry some of the challenges they will face if adjustments and steps aren't taken now to correct what I think can justifiably be called serious funding inequities.

As part of the report there is an assessment done on acute care hospital bed needs, which will increase by 100 to 153 by the year 2004; for home support hours, they'll need an additional 156,000 to 173,000. The report chronicles in a very detailed way what the needs of the people charged with administering health care in the eastern end of the Fraser Valley are going to be.

So maybe I can just ask the minister whether she can confirm that her staff are aware of the existence of the report, and whether she will undertake to provide a response, most particularly to the chairman and to the members of the health region board, and address specifically the recommendations that are set out in the report with respect to the needs.

Let me say this candidly to the minister: a response to a document of this sort that is contained on a page that says, "I recognize the valuable work undertaken by the review, and you can rest assured we will be taking it into consideration at budget time," really isn't worth a lot. These people need to know if the ministry takes exception to some of the projections, some of the needs, based on the data that's available. If the ministry takes exception or finds error with that, then tell them.

Tell them so that they are in a position to make their case perhaps more effectively, or maybe to realize that in this minister's eyes, at least, there isn't a case to be made. That is the undertaking that I would ask from her now.

Hon. P. Priddy: Yes, we are aware of the report. We received it Tuesday, and yes, we will provide a response to the board. We will be as specific as we are able to be, both in terms of . . . . I mean, I hope you would not want to get into a "he said, she said" about the report, but if there are things that clearly don't make sense, then we'll ask about those, or we'll certainly be able to say that. We would certainly be able to point that out if we were in some kind of disagreement, but I would hope it would be looking toward solutions.

I will make the commitment that my staff will do that kind of response to the report. That is not the same as being able to say, even if there is a proven need, that we can address all of that right away, because I don't think we are necessarily in a position to be able to do that. One of the areas the report mentioned, quite legitimately, is the area of home support. We know that that is an increasing need. That's why, since 1995, there has been an 81 percent increase in the home support budget in the member's health authority area. That's an 81 percent increase in three years.

We do recognize and are trying to address some of those needs. But yes, I will make the commitment that we will do as specific a response as possible.

M. de Jong: I don't purport to be an expert on some of the indicators and terminology used, but I note that the report talks about age-standardized utilization rates as one of the means for comparing service utilization in B.C. It includes a table on resource comparison standings. Just for the record and for the minister's benefit, it's the one time of year that I have an opportunity to emphasize to her the challenges facing my local health board.

In the findings from this group on things like public health, it says it's the lowest per capita of all semi-urban and rural areas in the province in 1997. Continuing care, home nursing care and adult care were utilized at a much lower rate. Acute care -- and again, they're referring to the age-standardized utilization rate -- was lower than the provincial average and lower than comparative regions. I think that the point the authors of the report are trying to make is that this is not a part of the province that can be accused of wastefulness, as it were. I'm sure that the minister hears that everywhere.

I'm hopeful that when her staff review in detail the document that the health board has prepared for her, she and her staff will acknowledge and thereafter take some steps.

Quite frankly, I think the most frustrating thing for anyone dealing with government -- the provincial government or any government -- is to get some pat answer, as I referred to earlier: "Yes, thank you for the report." If the resources aren't there, at least do these people the service of acknowledging the need. That, I'm sad to say, has not been the history of the regional board's relationship with the ministry to this point.

I wonder if before I take my seat I could ask the minister -- and this has become a bit of an annual event for me -- to explain to me how the approval of capital projects, which I understand formerly fell exclusively within the jurisdiction of a branch within her ministry but now has been assigned in part to the Finance ministry . . . . Could she explain to me what has happened and the significance of that in terms of capital project approvals?

Hon. P. Priddy: Yes, I can. This is the first year for this, as the member knows. I didn't know this was an annual event, though, or I would have checked back to see what annual answers you've got, so I could match to sample.

What happens as of this year, and will continue to happen, is that the ministry puts together a capital budget -- you know, based on submissions from the regions, the way that's happened in the past. The health authorities submit their capital needs; we put together our budget; we list the priorities. So we submit it in priority order, and it gets approval by Treasury Board -- or Treasury Board says "only this much," as in any Treasury Board submission. So the priorities that we submit are the ones that Treasury Board deals with in approval. After that, it is then managed by the Ministry of

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Finance, simply in terms of better coordinating capital construction throughout the province -- because you have so many ministries with really large capital projects. But the submissions from the health authorities still come to us; we put our own budget together, and we put our priorities on it as the Ministry of Health, and it goes to Treasury Board. So that

part is still the same, but Finance then carries it after that.

[B. Goodacre in the chair.]

M. de Jong: Who and what department within the ministry -- besides the minister, who I suppose would have final say -- are responsible for assigning that priority as the document is shipped off to the Finance ministry for that coordinating function?

Hon. P. Priddy: The responsibility falls under acute care. The sort of capital planning branch falls under the acute care part of the ministry. The acute care part of the ministry does consult with other parts of the ministry, but that is primarily where the responsibility lies. Some of those staff have gone over to the Ministry of Finance, but we still have a branch within the ministry that does that work. It goes to the ADM of acute and continuing care, who's this excellent person, Leah Hollins, here to my left. It then goes to the deputy minister, the excellent person to my right. It comes to me and then goes, with those priorities, to Treasury Board.

M. de Jong: When it is handed off to the Finance ministry, who within that branch of government has responsibility for its safe conduct to Treasury Board?

[4:45]

Hon. P. Priddy: I just want to be clear that it doesn't go to Finance -- well, mind you, Treasury Board is part of Finance. But it goes directly from us to Treasury Board. Treasury Board then makes a decision, and then it's handed off to another branch in the Ministry of Finance that is called, I think, the capital division. There is an individual there who is the counterpart to my assistant deputy minister, and we have a whole liaison committee with them about how they then ensure safe conduct of the project the rest of the way.

M. de Jong: Let me ask what used to be the $120 million question and then became the $125 million, $130 million, $135 million question -- and every year that I ask the question, the price tag goes up more, of course. Tell me where the MSA hospital replacement project -- which has received approval at every stage of the ministerial review process except the one that counts most, and that is the department that signs the cheque . . . . Tell me, please, what stage that project is at.

Hon. P. Priddy: I think it's actually the $128 million question. I have watched and checked; others have, of course, raised this issue as well.

The project that the member speaks of is a project that we continue to see as a top priority. I very much want to see that project move ahead as quickly as possible.

M. de Jong: The member for Abbotsford, who is, I can assure the minister, every bit as interested in this matter as I am . . . . I attend this facility, this community hospital that was built in the fifties for a population of around 30,000 people, a population that has now ballooned to in excess of 100,000 people. As the minister probably understands, we are asked to respond when patients are turned away because the existing facility doesn't have the isolation facilities required to properly treat illness. It doesn't have the emergency room facilities necessary to properly intake patients.

All of the frustrations that arise in a community with a significant aged population are brought to our attention literally on a daily basis. If there is a recurring theme in the community newspapers in the places in B.C. that I call home, it is the frustrations associated with people not being able to access their acute-care facilities.

The question I am obliged to ask yet again this year . . . . I should preface my request, as I do every year, with a recognition of the fact that it was a Social Credit minister sitting in the minister's chair that first held out the prospect of responding to the needs of the community of Abbotsford, and there has been a series of ministers from this minister's party since then. But the question is: in spite of her assurances, what is the ranking? Where is this in terms of the projects that this ministry is recommending to Treasury Board to proceed, recognizing that the ministry is dealing with finite economic resources?

Hon. P. Priddy: We are still having discussions with Treasury Board about a number of capital projects, so I feel a bit uncomfortable commenting at all about this at this stage. One of the challenges here . . . . I more than understand, before I make the statement, that it makes no difference to the citizens of your community, but a $128 million project is harder to do than a $14 million upgrade. Finding the entire $128 million does make it a touch more difficult. For this ministry, it still remains a very high priority. I'm not sure I'm going to be able to give you an answer that you will go away content with.

I guess you will have to watch and see where we are at some period of time from now. But we do consider it a high priority. We have said that to Treasury Board, and that's all I can say at the moment.

M. de Jong: I'm not sure it will make an impression on the minister if I remind her that the people in this community have taken . . . . The portion of that $128 million that the local people are directly responsible for has already begun to be deposited. They're saving the money and accumulating the interest.

I'm going to try again, because in listening to the minister's response, I'm forced to conclude that somehow the minister thinks the people can't take it, that somehow the news will be devastating if they learn that the government ranks this project below several others. Why shouldn't they know that?