British Columbia Hansard — Thursday, May 15, 2003

H0515pm-14

British Columbia — Debates (Hansard)

4th Session, 37th Parliament OFFICIAL REPORT OF DEBATES OF THE LEGISLATIVE ASSEMBLY (HANSARD) Thursday, May 15, 2003 Afternoon Sitting Volume 15, Number 14 THE HONOURABLE CLAUDE RICHMOND, SPEAKER ISSN 0709-1281

PROVINCE OF BRITISH COLUMBIA (Entered Confederation July 20, 1871) LIEUTENANT-GOVERNOR Honourable Iona Campagnolo 4TH SESSION, 37TH PARLIAMENT SPEAKER OF THE LEGISLATIVE ASSEMBLY Honourable Claude Richmond EXECUTIVE COUNCIL Premier and President of the Executive Council................................................................................. .........................Hon. Gordon Campbell Minister of State for Intergovernmental Relations.............................................................................. ..................... Hon.

Greg Halsey-Brandt Deputy Premier and Minister of Education ....................................................................................... ..................................Hon. Christy Clark Minister of Advanced Education................................................................................................. ...........................................Hon. Shirley Bond Minister of Agriculture, Food and Fisheries.................................................................................... ..............................Hon.

John van Dongen Attorney General and Minister Responsible for Treaty Negotiations.............................................................. .................... Hon. Geoff Plant Minister of Children and Family Development.................................................................................... ..............................Hon. Gordon Hogg Minister of State for Early Childhood Development.............................................................................. .................................Hon.

Linda Reid Minister of Community, Aboriginal and Women's Services......................................................................... .................. Hon. George Abbott Minister of State for Community Charter........................................................................................ .................................. Hon. Ted Nebbeling Minister of State for Women's Equality ......................................................................................... .................................... Hon.

Lynn Stephens Minister of Competition, Science and Enterprise ................................................................................ ..................................Hon. Rick Thorpe Minister of State for Deregulation ............................................................................................. ............................................ Hon. Kevin Falcon Minister of Energy and Mines................................................................................................... ....................................... Hon.

Richard Neufeld Minister of Finance ............................................................................................................ ....................................................... Hon. Gary Collins Minister of Forests ............................................................................................................ .................................................. Hon. Michael de Jong Minister of Health Planning .................................................................................................... ............................................ Hon.

Sindi Hawkins Minister of Health Services.................................................................................................... ................................................ Hon. Colin Hansen Minister of State for Mental Health ............................................................................................ ...................................Hon. Gulzar S. Cheema Minister of State for Intermediate, Long Term and Home Care ............................................................................. Hon.

Katherine Whittred Minister of Human Resources.................................................................................................... ............................................Hon. Murray Coell Minister of Management Services................................................................................................ .........................................Hon. Sandy Santori Minister of Provincial Revenue................................................................................................. ................................................Hon.

Bill Barisoff Minister of Public Safety and Solicitor General ................................................................................ ..................................Hon. Rich Coleman Minister of Skills Development and Labour...................................................................................... .............................Hon. Graham P. Bruce Minister of Sustainable Resource Management.................................................................................... ..................................Hon.

Stan Hagen Minister of Transportation..................................................................................................... .................................................... Hon. Judith Reid Minister of Water, Land and Air Protection..................................................................................... ....................................Hon. Joyce Murray LEGISLATIVE ASSEMBLY Deputy Speaker................................................................................................................. ..............................................................

John Weisbeck Leader of the Opposition ....................................................................................................... ...........................................................Joy MacPhail Deputy Chair, Committee of the Whole ........................................................................................... .............................................. Harold Long Clerk of the Legislative Assembly .............................................................................................. .........................................E.

George MacMinn Clerk Assistant ................................................................................................................ ................................................................... Robert Vaive Clerk Assistant and Law Clerk .................................................................................................. ........................................................ Ian D. Izard Clerk Assistant and Clerk of Committees........................................................................................ ............................................Craig H.

James Clerk Assistant/Committee Clerk................................................................................................ ............................................ Kate Ryan-Lloyd Sergeant-at-Arms ............................................................................................................... .........................................................A.A. Humphreys Director, Hansard Services ..................................................................................................... ........................................

Anthony Dambrauskas Legislative Librarian.......................................................................................................... ............................................................. Joan A. Barton Legislative Comptroller ........................................................................................................ .................................................................Peter Bray Published by British Columbia Hansard Services, and printed under the authority of the Speaker by the Queen's Printer, Victoria.

Rates: single issue, $2.85; per calendar year, mailed daily, $298. GST extra. Agent: Crown Publications Inc., 521 Fort St., Victoria, B.C. V8W 1E7. Telephone: (250) 386-4636. Fax: 386-0221. www.leg.bc.ca/hansard In addition to printed transcripts, Hansard Services publishes transcripts on the Internet and broadcasts Chamber debates on television.

Party Standings: Liberal 75; New Democratic 2; Independent Liberal 2. ALPHABETICAL LIST OF MEMBERS Abbott, Hon. George (L) ....................................................................... Shuswap Anderson, Val J. (L) .............................................................Vancouver-Langara Barisoff, Hon. Bill (L)............................................. Penticton–Okanagan Valley Bell, Pat (L).........................................................................Prince George North Belsey, Bill (L).................................................................................

North Coast Bennett, Bill (L) ........................................................................... East Kootenay Bhullar, Tony (Ind. L) ................................................................. Surrey-Newton Bloy, Harry (L).................................................................................. Burquitlam Bond, Hon. Shirley (L).........................................Prince George–Mount Robson Bray, Jeff (L)......................................................................Victoria–Beacon H ill Brenzinger, Elayne (L) ...............................................................

Surrey-Whalley Brice, Susan (L) ............................................................................Saanich South Bruce, Hon. Graham P. (L)................................................ Cowichan-Ladysmith Campbell, Hon. Gordon (L)............................................. Vancouver–Point Grey Cheema, Hon. Gulzar S. (L) ..........................................Surrey–Panorama Ridge Chong, Ida (L)................................................................ Oak Bay–Gordon Head Christensen, Tom (L) .............................................................

Okanagan-Vernon Chutter, Dave (L) ........................................................................... Yale-L illooet Clark, Hon. Christy (L) ..................................................Port Moody–Westwood Cobb, Walt (L) ............................................................................. Cariboo South Coell, Hon. Murray (L) ........................................ Saanich North and the Islands Coleman, Hon. Rich (L) .............................................. Fort Langley–Aldergrove Collins, Hon.

Gary (L).........................................................Vancouver-Fairview de Jong, Hon. Michael (L)....................................... Abbotsford–Mount Lehman Falcon, Hon. Kevin (L) .......................................................... Surrey-Cloverdale Hagen, Hon. Stan (L) ................................................................... Comox Valley Halsey-Brandt, Hon. Greg (L) ..................................................Richmond Centre Hamilton, Arnie (L)............................................................Esquimalt-Metchosin Hansen, Hon.

Colin (L) .....................................................Vancouver-Quilchena Harris, Roger (L)......................................................................................Skeena Hawes, Randy (L) ............................................................ Maple Ridge–Mission Hawkins, Hon. Sindi (L).......................................................... Kelowna-Mission Hayer, Dave S. (L) ................................................................... Surrey-Tynehead Hogg, Hon. Gordon (L) ........................................................

Surrey–White Rock Hunter, Mike (L) ...................................................................................Nanaimo Jarvis, Daniel (L)...................................................... North Vancouver–Seymour Johnston, Ken (L)............................................................ Vancouver-Fraserview Kerr, Brian J. (L).............................................................. Malahat–Juan de Fuca Krueger, Kevin (L).................................................

Kamloops–North Thompson Kwan, Jenny Wai Ching (NDP) ...............................Vancouver–Mount Pleasant Lee, Richard T. (L).......................................................................Burnaby North Lekstrom, Blair (L)................................................................. Peace River South Les, John (L) .......................................................................... Ch illiwack-Sumas Locke, Brenda (L) ...........................................................

Surrey–Green Timbers Long, Harold (L) ...................................................Powell River–Sunshine Coast MacKay, Dennis (L)....................................................... Bulkley Valley–Stikine McMahon, Wendy (L).............................................Columbia River–Revelstoke MacPhail, Joy (NDP) ..........................................................

Vancouver-Hastings Manhas, Karn (L) .............................................Port Coquitlam–Burke Mountain Masi, Reni (L) ...................................................................................Delta North Mayencourt, Lorne (L) ..........................................................Vancouver-Burrard Murray, Hon. Joyce (L) ........................................................... New Westminster Nebbeling, Hon. Ted (L) .......................................... West Vancouver–Garibaldi Nettleton, Paul (Ind. L)..................................................Prince George–Omineca Neufeld, Hon.

Richard (L)...................................................... Peace River North Nijjar, Rob (L)...................................................................Vancouver-Kingsway Nuraney, John (L) ...............................................................Burnaby-W illingdon Orr, Sheila (L) ...........................................................................Victoria-Hillside Penner, Barry (L)....................................................................... Ch illiwack-Kent Plant, Hon. Geoff (L) ......................................................... Richmond-Steveston Reid, Hon.

Judith (L)............................................................Nanaimo-Parksv ille Reid, Hon. Linda (L) ................................................................... Richmond East Richmond, Hon. Claude (L) ................................................................ Kamloops Roddick, Valerie (L)..........................................................................Delta South Sahota, Patty (L).....................................................................Burnaby-Edmonds Santori, Hon. Sandy (L)..............................................West Kootenay–Boundary Stephens, Hon.

Lynn (L) ........................................................................ Langley Stewart, Ken (L)...................................................... Maple Ridge–Pitt Meadows Stewart, Richard (L) ...................................................... Coquitlam-Maillardville Suffredine, Blair F. (L) ................................................................Nelson-Creston Sultan, Ralph (L)....................................................... West Vancouver–Capilano Thorpe, Hon.

Rick (L) ..........................................................Okanagan-Westside Trumper, Gillian (L)................................................................Alberni-Qualicum van Dongen, Hon. John (L) ................................................Abbotsford-Clayburn Visser, Rod (L).................................................................................North Island Weisbeck, John (L).........................................................Kelowna–Lake Country Whittred, Hon.

Katherine (L) ...................................North Vancouver–Lonsdale Wilson, John (L)........................................................................... Cariboo North Wong, Patrick (L)............................................................Vancouver-Kensington LIST OF MEMBERS BY RIDING Abbotsford-Clayburn....................................................... Hon. John van Dongen Abbotsford–Mount Lehman ..............................................Hon.

Michael de Jong Alberni-Qualicum.......................................................................G illian Trumper Bulkley Valley–Stikine ..............................................................Dennis MacKay Burnaby North..............................................................................Richard T. Lee Burnaby-Edmonds............................................................................Patty Sahota Burnaby-Willingdon......................................................................

John Nuraney Burquitlam ........................................................................................ Harry Bloy Cariboo North ..................................................................................John Wilson Cariboo South .................................................................................... Walt Cobb Chilliwack-Kent ............................................................................. Barry Penner Chilliwack-Sumas .................................................................................

John Les Columbia River–Revelstoke....................................................Wendy McMahon Comox Valley .......................................................................... Hon. Stan Hagen Coquitlam-Maillardville .............................................................Richard Stewart Cowichan-Ladysmith .......................................................Hon. Graham P. Bruce Delta North.......................................................................................... Reni Masi Delta South................................................................................

Valerie Roddick East Kootenay .................................................................................. Bill Bennett Esquimalt-Metchosin...................................................................Arnie Hamilton Fort Langley–Aldergrove ..................................................... Hon. Rich Coleman Kamloops ....................................................................... Hon. Claude Richmond Kamloops–North Thompson ........................................................Kevin Krueger Kelowna–Lake Country...............................................................

John Weisbeck Kelowna-Mission ................................................................ Hon. Sindi Hawkins Langley ............................................................................... Hon. Lynn Stephens Malahat–Juan de Fuca .....................................................................Brian J. Kerr Maple Ridge–Mission ................................................................... Randy Hawes Maple Ridge–Pitt Meadows .............................................................Ken Stewart Nanaimo..........................................................................................

Mike Hunter Nanaimo-Parksville ...................................................................Hon. Judith Reid Nelson-Creston.......................................................................Blair F. Suffredine New Westminster ..................................................................Hon. Joyce Murray North Coast ........................................................................................Bill Belsey North Island........................................................................................Rod Visser North Vancouver–Lonsdale.......................................... Hon.

Katherine Wh ittred North Vancouver–Seymour .............................................................Daniel Jarvis Oak Bay–Gordon Head .......................................................................Ida Chong Okanagan-Vernon .................................................................... Tom Christensen Okanagan-Westside.................................................................Hon. Rick Thorpe Peace River North .............................................................Hon. Richard Neufeld Peace River South .......................................................................

Blair Lekstrom Penticton–Okanagan Valley ....................................................Hon. Bill Barisoff Port Coquitlam–Burke Mountain.................................................... Karn Manhas Port Moody–Westwood......................................................... Hon. Christy Clark Powell River–Sunshine Coast.......................................................... Harold Long Prince George North................................................................................Pat Bell Prince George–Mount Robson................................................Hon.

Shirley Bond Prince George–Omineca................................................................Paul Nettleton Richmond Centre......................................................... Hon. Greg Halsey-Brandt Richmond East .......................................................................... Hon. Linda Reid Richmond-Steveston ................................................................ Hon. Geoff Plant Saanich North and the Islands ............................................... Hon. Murray Coell Saanich South...................................................................................

Susan Brice Shuswap .............................................................................. Hon. George Abbott Skeena.............................................................................................Roger Harris Surrey-Cloverdale ................................................................. Hon. Kevin Falcon Surrey–Green Timbers .................................................................. Brenda Locke Surrey-Newton ............................................................................... Tony Bhullar Surrey–Panorama Ridge................................................. Hon.

Gulzar S. Cheema Surrey-Tynehead .......................................................................... Dave S. Hayer Surrey-Whalley ...................................................................... Elayne Brenzinger Surrey–White Rock ...............................................................Hon. Gordon Hogg Vancouver-Burrard................................................................. Lorne Mayencourt Vancouver-Fairview............................................................... Hon.

Gary Co llins Vancouver-Fraserview ...................................................................Ken Johnston Vancouver-Hastings .......................................................................Joy MacPhail Vancouver-Kensington...................................................................Patrick Wong Vancouver-Kingsway..........................................................................Rob Nijjar Vancouver-Langara....................................................................Val J.

Anderson Vancouver–Mount Pleasant............................................Jenny Wai Ching Kwan Vancouver–Point Grey ................................................... Hon. Gordon Campbell Vancouver-Quilchena............................................................ Hon. Colin Hansen Victoria–Beacon Hill.............................................................................Jeff Bray Victoria-Hillside.................................................................................. Sheila Orr West Kootenay–Boundary.................................................... Hon.

Sandy Santori West Vancouver–Capilano ..............................................................Ralph Sultan West Vancouver–Garibaldi ................................................. Hon. Ted Nebbeling Yale-Lillooet .................................................................................. Dave Chutter

CONTENTS Thursday, May 15, 2003 Afternoon Sitting Routine Proceedings Page Introductions by Members....................................................................................................... ............................................... 6843 Introduction and First Reading of Bills ........................................................................................ ......................................... 6844 Coquihalla Highway Administration Clarity Act, 2003 (Bill M202) J.

MacPhail Statements (Standing Order 25B).............................................................................................................................. .............. 6844 Asian Heritage Month and World Partnership Walk P. Sahota Vancouver school board alternative budget J. Kwan Tabling Documents .............................................................................................................. .................................................... 6845 Vancouver school board alternative budget J.

Kwan Statements (Standing Order 25B).............................................................................................................................. .............. 6845 Langford Lavender Festival A. Hamilton Oral Questions................................................................................................................. ......................................................... 6845 B.C. Rail line between North Vancouver and Squamish J. MacPhail Hon. J. Reid Environmental protection J. Kwan Hon. J. Murray Transportation infrastructure improvements in Cariboo area J. Wilson Hon. J.

Reid Auto theft prevention B. Locke Hon. R. Coleman Film industry in B.C. K. Krueger Hon. R. Thorpe Dental services at Children's Hospital J. Kwan Hon. C. Hansen Committee of Supply ............................................................................................................ ................................................... 6848 Estimates: Ministry of Health Services (continued) J. Kwan Hon. C. Hansen J. MacPhail Hon. G. Cheema

6843 THURSDAY, MAY 15, 2003 The House met at 2:05 p.m. [J. Weisbeck in the chair.] Introductions by Members Hon. S. Bond: I am delighted today to introduce two very special guests in the visitors' gallery. Today, with my colleagues from Prince George North, Vancouver- Burrard, Penticton–Okanagan Valley and Kelowna– Lake Country, it was a pleasure to have lunch with His Excellency Vladimir Kotzy, the ambassador of the Czech Republic, and his wife Michaela. Interjections. Hon. S. Bond: Yes, we are enthusiastic.

I want to tell you that it was a wonderful opportunity to visit with His Excellency and his wife, and I want you to know that their five years in Canada are coming to an end and that they'll soon be returning to their home in Prague. But I want you to know something. They are grandparents who have brought their grandchildren to Canada to play hockey. His Excellency's wife takes figure skating lessons, and she's proud to say that her coach is Donald Jackson. They are a remarkable couple. It was a true pleasure to welcome them to the Legisla- ture.

I know you will want to help me in making them feel very welcome in the gallery today. Hon. G. Campbell: I just wanted to take a moment to say to Ambassador Kotzy how pleased we are that you understand Canada, how pleased we are that you're here in British Columbia and how pleased we are that on July 2 we'll be in Prague and that you'll be able to join us as we are awarded the 2010 Olympic and Paralympic Games in the Czech Republic. Most impor- tantly, we're really looking forward to your wife com- ing back as a member of the Czech Olympic team.

I'm sure she'll look great standing in No. 2, because Can- ada is going to win the gold medal in that event too. J. Les: It's my very great pleasure this afternoon to introduce to the House about 80 people who are in the gallery this afternoon. These are the constituency assis- tants to the various government members. They've been in Victoria for the last two days learning more about gov- ernment programs and all of the things that are available to them as we collectively serve our constituents in the future. I would ask the House to give all of our wonder- ful constituency assistants a very warm welcome. S.

Brice: I am pleased today to recognize the efforts of an ambitious Vancouver Island resident from Lady- smith. Over the past nine days Mike Pellatt has been travelling via wheelchair from Campbell River to Vic- toria to raise both awareness of and funds for amyo- trophic lateral sclerosis, ALS. The efforts of such dedi- cated people as Mike Pellatt help to raise funds for much-needed research into this debilitating disease. Well done, Mike. I ask all members to join in welcom- ing him to this Legislature and thanking him for his remarkable effort. J.

Kwan: I have the pleasure to introduce nine long- time advocates for children in our education system. They are Adrienne Montani, the chairperson of the Van- couver school board; Jane Bouey, school trustee of the Vancouver school board; Pat Gudlaugson, Vancouver Elementary School Teachers Association; Jim Gill, Van- couver Secondary Teachers Association; Jean Dandrea, CUPE Local 15; Mike Potts, CUPE Local 407; Burt Johansen from the trades; Patti Lefkos, Vancouver Ele- mentary Principals and Vice-Principals Association; and finally, Annie Ehman, district parent advisory council.

Would the House please give them a warm welcome. Hon. J. Murray: It's my privilege to introduce today Mr. John Sager, who has had a very distinguished 30- year career in business and government — most re- cently as my ministry's manager for toxics, special waste and pesticides. There's a title. John also was re- cently a member of the contaminated-site review panel that came out with an excellent set of recommendations for modernizing and improving our management of contaminated sites. Would the House please make Mr. Sager — John — very welcome. [1410] Hon. G.

Plant: In addition to my constituency office staff, who have already been introduced by my colleague opposite, today represents the annual visit inside this room of my ministry office staff. I hope the House will make Gail Dawson, Jo-Ann Clar and Cheryl Ryder; my executive assistant, Stephanie Lysyk; and my ministerial assistant, Joan Dick, all very welcome to the chamber. D. Hayer: I would like to introduce to the House two of my strongest supporters and greatest volunteers. My right hand, my wife Isabelle Hayer, is here, and my son Alexander Singh Martinez Hayer is here.

His doctors told him to take a few days' break from his regular hospital treatment and to get ready for his bone marrow transplant session in June. I know that Alex would like to thank all the members of this House and staff and press who have gone out of their way to express their sympathy and their support. I would like the House to welcome both Isabelle and Alex during their stay in Victoria. R. Lee: In the gallery today is Mr. Bill Yuen, former Vancouver school trustee and returning officer for Elections Canada. He is in Victoria today to attend a Canada Post conference.

Would the House please make him welcome. J. Bray: Joining us in the members' gallery today is no stranger to the precincts now. This gentleman has become a very vocal peer advocate for those living with mental illness. He has met with several ministers, and he is really moving the issue of people living with

6844 B RITISH COLUMBIA DEBATES T HURSDAY, MAY 15, 2003 mental illness to the forefront in the media and bring- ing dignity and respect to people living with mental illness. I would ask the House to please welcome again Terry Colburn to the precincts. P.

Bell: The Premier often talks about welcoming young people back to the province of British Columbia, and I can tell you that I am very, very excited today to be able to reintroduce to the House my daughter, who has been gone from British Columbia for four years but who is back, eager to look for work and excited about all the new opportunities provided to young British Columbians. So I would ask that the House please make both Donna Bell and her boyfriend, John Muir- head, very, very welcome. Welcome back. L. Mayencourt: In the gallery we have a visitor from the Red Cross.

This young lady works in a pro- gram called RespectED. I and the member for Surrey– Green Timbers and the member for Columbia River– Revelstoke had the pleasure of meeting Desiree Sattler on our safe schools task force tour. So would the House please make this young lady welcome. Deputy Speaker: I would like to welcome all the rest of the members in the House. Introduction and First Reading of Bills COQUIHALLA HIGHWAY ADMINISTRATION CLARITY ACT, 2003 J. MacPhail presented a bill intituled Coquihalla Highway Administration Clarity Act, 2003. J.

MacPhail: I move the bill standing in my name on the order paper entitled Coquihalla Highway Ad- ministration Clarity Act, 2003, be introduced and read a first time now. This bill amends the Ministry of Transportation and Highways Act to ensure that the revenue stream from the tolls on the Coquihalla Highway cannot be leased, contracted out, sold, auctioned off or otherwise granted to an entity other than the provincial government. I was in Kamloops earlier this week, and the grow- ing anger at this decision to sell off the Coquihalla and increase tolls was palpable. Residents say they weren't consulted.

They say it will take money out of their pockets and hurt their economy. And they say the tolls they pay should not pad the bottom line of a private company. That's why today the opposition is moving to table a bill that would ensure all tolls collected by the government remain in public hands. The Coquihalla has already been paid for. It be- longs to the people of British Columbia. As a vital transportation link between the lower mainland and the interior, it is critical to the long-term economic health of our province.

It should not be sold off to pay for this government's record deficits and failing eco- nomic policies. [1415] Motion approved. J. MacPhail: I move that this bill be placed on the order paper for second reading at the next sitting of the House after today. Bill M202 introduced, read a first time and ordered to be placed on orders of the day for second reading at the next sitting of the House after today. Statements (Standing Order 25B) ASIAN HERITAGE MONTH AND WORLD PARTNERSHIP WALK P.

Sahota: As mentioned by my colleagues yesterday, May is Asian Heritage Month, and a number of events and celebrations are taking place around the lower mainland in recognition of the influence of the Asian cul- ture and civilization. A number of my constituents are involved in some of these wonderful and worthy projects. Starting tomorrow is the International Dalit Con- ference in the lower mainland. It is community-based, and its objective is to bring Dalits, which are often re- ferred to as the lower castes, together from around the world to discuss such issues as human rights and social justice.

What better place to have this conference than right here where we embrace all people, regardless of their race, religion or caste. The second event is a World Partnership Walk, which will take place on Sunday, May 25 at Stanley Park. This walk was started 19 years ago by five women from the lower mainland who wanted to make a difference in the world. Today the World Partnership Walk is Canada's largest event helping people in developing countries around the world, and it is held in ten cities across the country.

This year the Premier is an honorary walker and is lending his support to raise awareness of this important issue, and my Burnaby colleagues and I have formed the B.C. Liberal MLA team to help raise awareness for this worthy cause. The funds raised will help people who live on little more than their determination and perseverance to break the cycle of poverty. It supports sound long-term projects in parts of the world where access to clean water can be a distant dream.

The funds raised also contribute to programs in areas like health care and education and pay special attention to the plight of women and children in developing countries. These are complicated and important issues, but I want to pay special tribute to B.C.'s Ismaili community, which has been at the forefront and leading the charge as they work together to find solutions. On May 25, come and participate in a worthy cause and be part of the solution. VANCOUVER SCHOOL BOARD ALTERNATIVE BUDGET J. Kwan: Earlier today members of the Vancouver school board came to the Legislature — and they are

THURSDAY, MAY 15, 2003 B RITISH COLUMBIA DEBATES 6845 here now — to present and discuss their alternative budget, titled the three-Rs budget. The Vancouver school board has put together a comprehensive picture of a system not being properly supported by this gov- ernment. With the support of groups like the district parent advisory council, the Vancouver Teachers Association, the B.C. Principals and Vice-Principals Association as well as many others, the Vancouver school board is calling on the province, the minister and all MLAs in this chamber to reinvest, renew and rebuild public education in B.C.

It is time this government realizes that imposed cost pressures and a two-year funding freeze have greatly reduced the capacity of educators to give chil- dren the opportunities they deserve. They came here today to ask MLAs to help restore educational services, which have been cut by $25.8 million in Vancouver alone since the last election. By supporting the three-Rs budget, all of the MLAs in this House can give back much-needed services to special education, English as a second language, in- structional supplies and classroom services. We need to learn from mistakes in other provinces.

In Ontario, a funding freeze much like the one we have seen in B.C. forced boards to make significant cuts to the edu- cation system. Ontario now faces a bill of over $1 billion just to reverse the damages done by the funding freeze. The message from Ontario and the message from the Vancouver school board today is clear. Immediate attention and action is required to prevent cuts to vital services for our children and our communities. The three-Rs budget is ready to go. The work has been done. It's time to act. Tabling Documents J.

Kwan: With that, I'd like to table the budget now so all MLAs can take the time to review it. Deputy Speaker: Member, you need leave to table that. J. Kwan: I ask leave to table the budget. [1420] Leave granted. Statements (Standing Order 25

B) LANGFORD LAVENDER FESTIVAL A. Hamilton: O n J u l y 1 2 a n d 1 3 t h e c i t y o f L a n g - ford invites one and all to their second annual Lang- ford Lavender Festival. You can catch the free bus pro- vided by B.C. Transit from the western exchange or drive down Veterans Memorial Parkway, which the province of British Columbia partnered with Langford and local business to construct, and participate in fes- tivities. The annual festival is a celebration of community pride and spirit. It takes place in Veterans Memorial Park, the centrepiece of their downtown beautification project.

This festival brings together businesses, volun- teers from the Royal Canadian Legion, Rotary, Kins- men, Lions, Juan de Fuca Rec, the RCMP, Langford volunteer fire rescue, various non-profit groups and the families of Langford to celebrate the pride they feel for their community. Saturday will begin with a pancake breakfast and then a parade through city centre to Veterans Memorial Park.

At this beautiful park location, you can visit an arts and crafts fair with local artisans, kids activities coordinated by Juan de Fuca Rec, wine information from local wine specialists, music in the park, great entertainment and family fun for all. Later that night there will be a Lavender Cup feature race at the West- ern Speedway, and I definitely won't be driving. An adult dance will be in full swing at the Langford Le- gion. On Sunday there are more of the same activities at the park and a giant garage and bake sale scheduled to help the legion.

The proceeds from the Langford festi- val will enable various community organizations and service clubs to raise funds to support their activities and enable the Langford beautification and festival committee to support community projects. Last year proceeds were designated to assist the funding of phase one of a new skateboard park near Belmont school. Langford is proudly celebrating ten years as a mu- nicipality during this second annual festival.

In the past ten years Langford has grown from 14,000 to 20,000 residents and has balanced economic growth and new commercial developments along with residential de- velopment and green space. What other municipality can boast three lakes within walking distance of their city hall, a national award-winning trail system, and a new fire hall, police building and city hall? I urge all to come and celebrate with us the com- munity pride and spirit that make things happen. Oral Questions B.C. RAIL LINE BETWEEN NORTH VANCOUVER AND SQUAMISH J. MacPhail: In the secret proposal from the CN to buy B.C.

Rail, the company proposed abandoning the rail line between North Vancouver and Squamish in order to build a highway to the Olympics. The minister responsible for B.C. Rail hasn't said whether or not she would allow such a move. Can the Minister of Trans- portation tell the House what the consequences will be if the B.C. Rail line between North Vancouver and Squamish is abandoned? Hon. J. Reid: W e h a v e s a i d t h a t w h e n w e g e t t h e Olympic bid, we're going to have to provide a third lane of traffic for the Olympics. We're looking at that third lane of traffic to be that railway line for the dura-

6846 B RITISH COLUMBIA DEBATES T HURSDAY, MAY 15, 2003 tion of the Olympics. For roughly two weeks in time, that will become a road. Other than that, it will operate as a railway. Deputy Speaker: The Leader of the Opposition with a supplemental. J. MacPhail: This isn't a Minister of Transportation; she's the fairy of transportation. She can build a road in two weeks and then have it abandoned in two weeks. Isn't that interesting? This government has been spreading misinformation about B.C. Rail in a desper- ate attempt to weasel its way out of the Premier's elec- tion promise not to sell B.C. Rail.

The opposition has come into possession of a highly confidential B.C. Rail briefing… Interjections. Deputy Speaker: Order, members. Order, please. Proceed. J. MacPhail: …document prepared for the govern- ment, which strongly warns against abandoning the line between North Vancouver and Squamish. Let me quote from the document. Abandoning the North Van- couver to Squamish line "would place the B.C. Rail enterprise at a severe business risk and eventually put B.C.

Rail out of business." Now that I've refreshed the minister's memory, perhaps she can explain to the House — and in particu- lar to her backbench colleagues, the communities and those who represent the communities that depend on B.C. Rail — how she could allow such a vital, profitable service to be put at risk by the Liberal Party campaign backers like CN? [1425] Hon. J.

Reid: Freight rail service in British Columbia is an important part of our infrastructure that needs invest- ment and that needs to be sustainable, and working with communities, working with industry, we're looking for a partnership for operations. The province will retain own- ership of the rail bed, the right-of-way and the tracks. Deputy Speaker: Leader of the Opposition with a further supplemental. J. MacPhail: I was always told that this fairy queen of transportation, who can make a road come and a rail line change in two weeks, read her briefing notes.

It's not subject to freedom of information, but it is a brief- ing document from the rail corporation to this minister. Now, that briefing document goes exactly against what this minister and the Premier have said. Everyone knows that CN is the frontrunner on the fire sale led by this government of B.C. Rail. This document explicitly warns that shutting down B.C. Rail's North Vancouver to Squamish line will lead di- rectly to an enormous competitive advantage to CN. CN gave the Liberals more than $36,000 last year alone.

Will the minister guarantee to this House today that under no circumstances will the new private sector operators of B.C. Rail be permitted to shut this line down no matter how much money they donated to her party's election machine? Hon. J. Reid: Indeed, the rail line and the integrity of the rail line are important to communities — are important to this province — and the mistake that the member is making is confusing a document from CN that is not a proposal to government. Government does not consider it a proposal, has not considered it and is not interested in that.

We are today putting out a call for expressions of interest. We are working with com- munities, and we are working with industry to make sure there is a sustainable… Interjection. Deputy Speaker: Order, please. Hon. J. Reid: …rail system for the future in British Columbia. ENVIRONMENTAL PROTECTION J. Kwan: Leading environmental groups today gave this government and this minister a failing grade on environmental stewardship.

To the Minister of Wa- ter, Land and Air Protection: why should British Co- lumbians have any faith in her when advocates for clean water say that B.C. is the only government in Canada to weaken drinking water regulations since the Walkerton tragedy? Hon. J. Murray: Here's why British Columbians should have faith in me and in this government: we have an environmental record of which we are ex- tremely proud. Interjection. Deputy Speaker: Order, please. Order. Hon. J. Murray: I'm glad the member opposite asked that question: what is our record?

We have im- proved the recycling of polluting substances with our used oil stewardship program. We have accelerated protection of wildlife habitat under the new Forest and Range Practices Act. We have improved the tools that we have for identifying and solving water quality risks, including source-water protection. We have increased the targets for clean energy from 10 percent under that member's government… Interjection. Deputy Speaker: Order, please. Hon. J. Murray: …to 50 percent of new energy…. Interjection.

THURSDAY, MAY 15, 2003 B RITISH COLUMBIA DEBATES 6847 Deputy Speaker: Order, please. The member for Vancouver–Mount Pleasant has a supplemental. J. Kwan: Get the facts on the table. The report card on B.C.'s two-year environmental record: energy and climate change, fail; health and pollution, fail; en- forcement and public participation, fail; wildlife and parks, fail; resource management, fail. The report card from B.C.'s most respected environmental organiza- tions is an indictment of this minister and this govern- ment. Interjections. Deputy Speaker: Order, members. Let's hear the question. Interjection.

Deputy Speaker: Member for Vancouver–Mount Pleasant, you have the floor. [1430] J. Kwan: The report card also highlights this government's decision to roll back standards to pre- vent pulp mill toxins from flowing into B.C. waters. B.C. now has some of the weakest pulp mill effluent standards in the industrialized world. Again, to the Minister of Water, Land and Air Protection: why does the minister continue to ignore her own re- port's recommendation to address the discharge of what's known as toxic black liquor from pulp mills into B.C. waters? Hon. J.

Murray: The member opposite is quoting from a report from an environmental group, and I want to point out that some environmental groups work very constructively with government, and some use very questionable tactics to try and pressure gov- ernment. Interjections. Deputy Speaker: Order, please. Hon. J. Murray: This member is quoting from a report… Interjection. Deputy Speaker: Leader of the Opposition, would you please come to order. Let's hear the answer. Hon. J. Murray: …that is critical of our government actually dealing with the pine bark beetle in forests.

If that member's government had dealt with this issue ten years ago, we wouldn't have the biggest environmental nightmare of this decade. Interjections. Deputy Speaker: Order, please. Order, please. Let's hear the question. Leader of the Opposition, would you please come to order. TRANSPORTATION INFRASTRUCTURE IMPROVEMENTS IN CARIBOO AREA J. Wilson: My question is to the Minister of Trans- portation. For a great many years residents of the Cariboo have depended on the Marguerite ferry to cross the Fraser River.

While very nostalgic residents have voiced concern, this ferry service was plagued with service capacity problems and undeniable financial challenges. Can the Minister of Transportation explain to the residents of the Cariboo region how industry and residents are benefiting from infrastructure im- provements even without the ferry service? Hon. J. Reid: This member has strongly repre- sented the needs of his community — the industry, the agriculture, the forestry and the roads in this area. The West Fraser Road and the Soda Creek Road are going to see an investment of $750,000 this year.

This ferry service ends every winter. It is only a passenger ferry service, and it does not allow for the transport of commercial or industrial vehicles. The investment into these roads will help the communities and will help the residents. As this ferry has not been operating since last October and doesn't operate every winter, the residents of this area are well prepared to use the road. AUTO THEFT PREVENTION B. Locke: My question is to the Solicitor General. ICBC has recently released figures that show that auto theft is increasing. During 2002, stolen vehicles in- creased by 7 percent.

This means that vehicle thefts have risen 25 percent in the past two years alone. The trend must stop. A rise in auto thefts results in higher costs for ICBC and puts pressure on the insurance rate for all consumers. Can the Solicitor General tell us what action is being taken to combat this problem? Hon. R. Coleman: Last month the auto theft task force was renamed and made more permanent. In coop- eration with police and ICBC in the province of British Columbia, it is now called the Integrated Municipal Pro- vincial Auto Crime Team.

This group is integrated with seconded officers from both the RCMP and municipal forces to work across boundaries with regard to statistics in auto theft where we've been able to use this team and the bait car program, which we've also put into place. We do find we can push back and reduce auto theft in communities like Vancouver where we actually have, with the bait car team, been able to reduce it by 30 percent. It is an ongoing problem.

The only way you can approach it is by having good statistical informa- tion to deal with crime community by community and to use an integrated operation so that you can push back on it, and that's exactly what we're doing.

6848 B RITISH COLUMBIA DEBATES T HURSDAY, MAY 15, 2003 [1435] FILM INDUSTRY IN B.C. K. Krueger: Kamloops and region have been de- lighted for the past number of weeks to host Robert Redford and Jennifer Lopez as they film the movie An Unfinished Life . I've been a fan of Mr. Redford since Lassie was a pup, and probably his dinner invitations are piling up in my mailbox while I've had to be here listening to the Leader of the Opposition. Sadly, I haven't seen them yet.

Our economy, locally, has certainly been benefiting as an $18 million expenditure has occurred in our area, and of course we're absolutely delighted with that. Provincewide, the industry comes in at about $1 billion a year for British Columbia. People are concerned about the rising value of the Canadian dollar and wondering how that is going to impact this vital industry in our province. I wonder if the Minister of Competition, Science and Enterprise could tell the people of B.C. what he thinks about that risk. Hon. R.

Thorpe: Our dollar remains very competi- tive with the competitive jurisdictions of the world — namely, Australia and Europe. In fact, our dollar has risen by 10 per cent while other currencies have risen by 17 percent to 24 percent. Under the leadership of our Premier, our govern- ment has made sure we have a competitive tax policy that attracts the film industry to British Columbia. In fact, we increased regional tax credits to assist areas like Kamloops, Trail and other areas of the province where we've had shootings this year.

At the present time we have 31 productions underway i n Britis h Co- lumbia, and all studios in Vancouver are booked. In addition, Canadian programs like Da Vinci's Inquest, Cold Squad and Edgemont have renewed their contracts as we go forward. This is a billion-dollar industry, and later today our government will release the information on the year 2002, which shows that once again it's a $1 billion in- dustry in British Columbia. DENTAL SERVICES AT CHILDREN'S HOSPITAL J. Kwan: Two thousand children a year are treated at Children's Hospital for dental disease.

Many of these children are treated for a condition known as severe dental decay, which primarily affects low-income kids. Untreated, the health and well-being of these children can be severely affected. That's why doctors, health professionals and advo- cates for children are very concerned that Children's Hospital may have to cut in half dental services to kids to deal with budget cuts — a cut that will affect ap- proximately 900 kids a year. The only other option available to these kids is to have private treatment, which can cost up to $600 — way too much for these families.

For the sake of children's health, will the Minister of Health Services take action to ensure that Children's Hospital has the funding to deliver proper dental care to children in B.C.? Hon. C. Hansen: The provincial health services authority has been reviewing surgical procedures, gen- erally, and trying to determine whether we have the appropriate utilization of our hospital-based services. The review of that has determined that there are sig- nificant numbers of children who have been referred for surgical dental care in a hospital operating room when in fact that is not necessary.

Throughout the health care system we're trying to make sure that we get proper utilization of services, and we have determined that about 50 percent of those den- tal surgeries can be properly provided in community- based clinics. [End of question period.] Orders of the Day Hon. G. Collins: I c a l l C o m m i t t e e o f S u p p l y . F o r the information of members we'll be debating the esti- mates of the Ministry of Health Services. [1440] Committee of Supply The House in Committee of Supply B; H. Long in the chair. The committee met at 2:44 p.m.

ESTIMATES: MINISTRY OF HEALTH SERVICES (continued) On vote 29: ministry operations, $10,038,097,000 (continued). J. Kwan: Just prior to the break we were looking into some of the wage differentials, particularly the ones that exist between women and men, that impact the health care sector. Aside from the wage rollback, I was speaking particularly about the fact that many of the health care workers, who are primarily women — and immigrant women, for that matter — will be faced with a reduction in salary.

Also, in the comparisons between provinces, I was speaking to the cost of living and particularly the housing component — earlier, before the break. [1445] In essence, when you account for the cost-of-living differences in Canada for these workers, effectively the wages for the support workers — who are essential to our health care system — are not really as high as the minister and this government like to make it. The minister actually said that there is a pending agreement with health care workers with HEU and

THURSDAY, MAY 15, 2003 B RITISH COLUMBIA DEBATES 6849 that that information would be forthcoming. When does the minister anticipate information from that agreement to be released? Hon. C. Hansen: I don't have any particular inside knowledge with regard to when that ratification vote is going to be released. I did see a media report today that quoted — I guess the title is secretary-treasurer, is it? — Mr. Allnutt of the HEU. I'm not sure of his actual title. It quoted him as saying…. I understand today is the last day for voting on that ratification.

It also indi- cated in the media report that results would be an- nounced tomorrow. That's the only source of informa- tion I have. J. Kwan: I'd like to actually canvass for a few mo- ments on a different track — on the issues that impact my community more significantly. That is, of course, the drug addiction question. Earlier this week we de- bated a bill with the Minister of State for Community Charter. Part of the changes in that would give mu- nicipalities a lot of authority to determine what ser- vices would be provided.

Particularly when it deals with health care services, the ramifications I'm con- cerned about would be to let municipalities or jurisdic- tions put in regulations or bylaws to prevent services from being delivered in their own community. The example I use with the Minister of State for Community Charter is Surrey, where they have put in a bylaw to prevent methadone services from being delivered. Really, they're getting around it by increas- ing the fees — exorbitant amounts of fees — for people to get their business licence.

Therefore, in essence, peo- ple are not able to provide those services in their com- munity. Where issues become a health concern, the legislation does allow a provision for the minister to act, and that is the Minister of Health Services. I'm wondering whether or not this minister would be look- ing into that matter and taking action to ensure that members in the community actually have access to the health services required. [1450] Hon. C. Hansen: My ministry has been very much involved in the development of the Community Char- ter to make sure that the health issues are, in fact, pro- tected.

I'll just quickly read for the member some back- ground as it pertains to the Community Charter. "Local governments will be able to regulate in areas of concurrent authority. In order to do that, there must be a regulation drafted giving them authority in public health matters. A municipality may only adopt a bylaw in one of the concurrent spheres if the bylaw is (1) ap- proved by the minister responsible, (2) in accordance with an agreement with the minister responsible or (3) in accordance with the minister's regulation." So municipal bylaws cannot override provisions of another act.

All specific conditions and restrictions established in other legislation still apply. Local gov- ernment will not be able to approve a bylaw that is less stringent than what provincial legislation currently or in the future sets out. J. Kwan: I'm familiar with the Community Charter and the piece that the minister read out. We debated that extensively — I think it was last Wednesday — in the House until 9 o'clock. But the issue I'm asking the Minister of Health about is this.

When a health risk service is as a result of municipal government's changes either in bylaw or by regulation, and therefore it poses a health risk for their community, then I understand from the Community Charter and through our debate that the Minister of Health Services can actually intervene.

So in the case where it relates to methadone services and other ser- vices — I just use methadone services as one example, but there may well be other examples that we can util- ize at another time — I would like to have the assur- ance from this minister that, in fact, he will intervene and that he would ensure that there's…. Maybe the minister can advise what mechanism he would put in place to make sure that health risks are being moni- tored and therefore, when intervention is required by the minister, he actually has the information to do so. Hon. C.

Hansen: Certainly, we rely on our local health officials to report to us on any actions taken at a local level that may compromise access to health care delivery. That system has certainly worked effectively. We do get that information in a very timely way. When there are issues where a municipality may be taking an action that could be compromising health care delivery, we certainly undertake to meet with the municipality.

I cannot comment on the specific issue that the member is talking about with regard to busi- ness licence fees, because that is before the courts right now. [1455] But I can comment on the other issue which I think she may get to, and that's the bylaws around disclosure of patient information around the dispensing of methadone. We have met with the municipality. My deputy minister went out to Surrey to meet with the municipality around that. Certainly, there was very strong opposition expressed by the College of Physi- cians and Surgeons and also by the College of Pharma- cists in that regard.

Rather than taking a confronta- tional approach, we have tried to work through this, and we think we're going to make the progress neces- sary to ensure that those health care services continue to be delivered. J. Kwan: I wonder if the minister could commit in this House that he would have either himself or his staff advise the opposition in terms of the progress that's being made in this regard. This is particularly important for myself in Vancouver–Mount Pleasant, as the minister can anticipate. We have a huge problem and challenge in our community.

In the downtown east side community we continuously get attacked by oth- ers to say there are too many services in the downtown

6850 B RITISH COLUMBIA DEBATES T HURSDAY, MAY 15, 2003 east side, but at the same time other communities are not stepping up to the plate to provide the services that are needed. Therefore, we actually have a situation where it creates a loop. It's a circular loop where we can't really tackle the problem unless the other com- munity steps up to the plate. We really need this minis- ter and this government to hold the other municipali- ties accountable. I'm concerned about it, because the Community Charter allows for broad powers.

I'm not necessarily opposed to municipalities having broad powers, but I do oppose it when they actually limit access to health care services that would be critical because they have a NIMBY — not in my back yard — approach to it, and that's simply not acceptable. I would appreciate for the minister to intervene when access to health care ser- vices is being limited by municipalities and for the minister to advise us accordingly of all the actions ei- ther his ministry or he himself is taking to prevent that. Hon. C.

Hansen: I agree with the member's re- marks entirely, and I will certainly undertake to have somebody from my ministry contact you to make sure y o u ' r e f u l l y u p t o d a t e o n w h a t ' s h a p p e n i n g o n t h a t front. J. Kwan: I would like to thank the minister for that commitment.

On this issue, while I've got the opportunity, I would like to ask the minister if he could please advise this House what the status is with respect to the devel- opment on harm reduction initiatives to address the drug issue, particularly in Vancouver, on things like heroin maintenance, safe injection sites and other ini- tiatives like that. Hon. C. Hansen: I know we did canvass the super- vised injection sites fairly comprehensively this morn- ing, so I won't repeat that.

I don't know if there's addi- tional information you're seeking in that regard, but I would certainly endeavour to answer any additional questions you may have. With regard to harm reduction generally, the Van- couver coastal health authority is trying to maintain and indeed enhance strategies in the downtown east side. There is the contact centre that has been estab- lished. The needle exchange program is ongoing.

They are currently undergoing a review of the various con- tracts that are for groups working in the downtown east side to try to see if there are areas of lower priority where funds could be diverted to the areas of higher priority and higher need. I know there has been a lot of talk about…. There are so many…. I was going to say dozens; there are actually hundreds of great organizations that are trying to make a positive contribution to the downtown east side, but there has also been a concern about possible overlap and duplication.

We're trying to look at if there is duplication or if there is funding that's going into areas that may no longer be as high a priority, whether or not we can reallocate some of those dollars to some of the other strategies in the downtown east side that are of higher priority. That is work that is ongoing by the Vancouver coastal health authority. [1500] J. Kwan: To clarify then, there are no additional moneys for new initiatives on the harm reduction front for the downtown east side community; rather, it's real- location of existing funds. Is that what the minister is advising? Hon. C.

Hansen: All of the health authorities in the province received an increase in their budget last year. They all received an increase in their budget again this year. They will have the challenge of trying to identify their areas of priority in terms of how those dollars get spent within that area. If they determine that there are priority areas for new and additional moneys on some of these programs, they certainly have the authority to do that.

In addition to that, one of the things we have done is transferred — this is the area of addictions funding, which is obviously a component of this — contracts that used to be administered directly by the ministries of Health. They have now been transferred to the health authorities. That transfer resulted in about 35 FTEs being transferred. The total cost of contracts and addiction services that were transferred over to the health authority was $19.6 million.

They will be look- ing at how those particular contracts integrate with o t h e r w o r k t h e y h a v e b e e n d o i n g i n t h e p a s t o r o t h e r contracts they have. Generally speaking, they've got two options. They can either allocate a portion of their increased funding towards these programs, or they can find those resources by reallocating existing funding within their budget. J. Kwan: Could the minister please advise what the status is with respect to the NAOMI project? The min- ister, I think, knows what that is, so I don't need to ex- plain it. Hon. C.

Hansen: That particular proposal is sitting with the federal government. We have not seen any progress on that particular file for many months now, and basically the ball is with the federal government to move that forward. We're waiting for feedback from Ottawa in that regard. J. Kwan: Does the NAOMI project have the support of this minister and this government? Hon. C. Hansen: The NAOMI project is a trial that is being proposed by the federal government. If they determine that it is a legal and desirable health care service, then the province will do its part to facilitate implementation of it. J.

Kwan: When the minister says that the province will do its part to facilitate its implementation, does that include funding?

THURSDAY, MAY 15, 2003 B RITISH COLUMBIA DEBATES 6851 [1505] Hon. C. Hansen: This proposal is a research pro- posal that the federal government is obviously looking at. If the federal government makes a determination that this research project should go forward, it's our hope they will also provide the necessary operating funds for that. I guess in the hypothetical situation that they don't, it becomes one of the additional challenges that we have in terms of determining if available funds can be identified from within budgets and moved around from other projects.

It's our hope and our ex- pectation at this point that if the federal government is going to proceed with this research, they would also fund it. J. Kwan: Will the minister undertake to have these discussions with the federal government to move it forward? Maybe he's already done that; I don't know. If he has, could he advise: when did that take place? If he hasn't, will he undertake to engage in discussions with the federal government to move these kinds of projects forward? Hon. C. Hansen: Our provincial health officer, Dr.

Perry Kendall, is on the Advisory Committee on Popu- lation Health, and one of items on their issues of con- cern is the NAOMI trials. That has been discussed, I gather, by the advisory committee, so we have an on- going dialogue with Health Canada in that regard. J. Kwan: Yes, I understand the various committees are still having their discussions. That was the case when we were in government as well. Perry Kendall has done an exemplary job in trying to advocate for changes at the provincial level, the municipal level and the federal level.

What I'm wondering at the political level, though, is whether or not the Minister of Health Services will engage in a discussion with his federal counterpart, because we actually, at the end of the day, need a po- litical decision on that. I wonder whether or not the Minister of Health Services will advance the NAOMI project and commit to having a discussion with his federal counterpart. Hopefully, we can see results soon. This is what I'm driving at. Hon. C. Hansen: I don't know when I would next be meeting with the federal Health minister, but I'll certainly find an opportunity to raise this subject. J.

Kwan: A quick way of doing it, also, is the tele- phone. I thank the minister for that commitment to engage in those discussions. When the minister does, would he also undertake to advise the opposition? My interest is not political in nature. My interest here is really just to see these projects move forward, because they do make a difference in our community. They save lives. They've been evidence-based in other jurisdictions as well, so it's not political that I'm trying to raise these matters. One more issue, though. These issues are close and dear to my heart.

They impact many of my constituents in my own community. The last question I'd like to ask the minister around this is, of course, the notion of stimulant maintenance. The other addiction challenge we face in our community is addiction to cocaine, and I know there's been research done around that stimulant and the maintenance of that. Could the minister please provide his perspective on that and whether or not he supports stimulant maintenance in that regard? Hon. C. Hansen: I must confess that is a new subject to me.

I would certainly appreciate any background information the member may have, and I'll undertake to review it if she has material she can send to me. J. Kwan: Yes. Actually, I do have a study with re- spect to stimulant maintenance. I'd be happy to pass it on to the minister and his officials for them to review and respond to it accordingly. Okay. [1510] J. MacPhail: I have a document here that I received last year. It's called

Summary of Reported Health Author- ity Activities: Fiscal Year Ending March 31, 2002 . It's a

summary document all on…. I'm sorry, Mr. Chair. I'm moving to the individual health authorities now and issues around that. It's a

summary document, though. On the top line are all the six health authorities, and then down the left-hand side are breakouts of reve- nues, expenditures, financial status, acute care, mental health, home and community care. It's got the changes from the previous year. Is such a document ready yet for the fiscal year ending March 31, 2003? Hon. C. Hansen: I think what she's referring to is sort of broadly what we've pulled in, and it's before it becomes data that is really solid. It is used internally within some of the health authorities to give them rough indicators.

It's also the first stages in the data that eventually flows to CIHI and is then reviewed to make sure that it is, in fact, sound data and that it is comparable with other jurisdictions, for example, be- fore CIHI produces its numbers. I think what she's referring to is data that is gener- ated on an ongoing basis, that is extremely raw and that is not really the basis upon which we can draw long-term conclusions. But it does provide the health authorities with some indicators on different time schedules. The short answer is that it's very, very raw data, I gather. J. MacPhail: Well, actually, it isn't.

This document is dated August 9, and it's a complete

summary of the fiscal year-end. I'm not trying to use it to embarrass anybody. It's just a good document to work from; that's all. Given the fact that the regional health authorities are not here to answer questions directly, it's a sum- mary document with which I can work and the opposi- tion can work in discussing these matters.

6852 B RITISH COLUMBIA DEBATES T HURSDAY, MAY 15, 2003 Will this not exist for the fiscal year ending March 31, 2003? Hon. C. Hansen: I gather that these reports are cranked out on an ongoing basis and are used within the ministry and within the health authorities. J. MacPhail: Okay. I'm going to continue to FOI them, because I think they're very useful. I want to start with the Vancouver Island health authority, please. There are reports that the Vancouver Island health authority will have a surplus ending March 31, 2003. If so, what is the surplus? Hon. S. Hawkins: I ask leave to make an introduc- tion.

Leave granted. Introductions by Members Hon. S. Hawkins: Today one of the classes from my constituency was here. It was Dr. Knox Middle School. [1515] Unfortunately, due to unforeseen circumstances, they couldn't come to see me. I do want to acknowledge that I hope they have a great time here in Victoria and they take back good memories. Unfortunately, they couldn't see how the Legislature was run, but they were in my thoughts. I just want everyone to welcome them and make sure that maybe next time they come, we will let them into the buildings. Debate Continued Hon. C.

Hansen: The year-end surplus for the Van- couver Island health authority is $700,000 on a base budget of $988 million. J. MacPhail: I've got the performance agreement between the Ministry of Health Services and the Van- couver Island health authority. I'm wondering if I could go through the targets, starting at page 5 on their year ending '03, "Expected performance." The first target is: "Increased use of needs-based and evidence-based best practices to achieve." There was no expectation in the year '02-03. The expecta- tions begin this year.

I'll move on to the next one, which is: "Improved continuity of care measured by the proportion of persons hospitalized for a mental health diagnosis who receive community or physician follow-up within 30 days of discharge." The target for '02-03 is 3 percent. I couldn't get the base targets last year in estimates. The minister and I had quite a discussion around base targets so that I would know — or the public would know — what the increase is, how to meet the increase. I guess that must have been figured out in order to say how that performance target is met.

Perhaps the minis- ter could give me the base and then whether this target was met. Hon. C. Hansen: I am advised that all of the health authorities are on target with regard to meeting that commitment. What I don't have right here is the base- lines for each of the health authorities. I can provide for her the rollup for the province. That is, in 2000-01, a baseline of 70.9 percent. By 2001-02 we were at 72.6 percent.

For 2002-03 it is partial data only, so it is at 73.1 percent, but they are projecting a 3.1 percent in- crease from the baseline. [1520] Just to put this in context, in most of the perform- ance indicators, wherever we could possibly do this, we tried to find an outside independent source for data. We were trying wherever possible not to use our own internal data for these measurements so that we could rely on objective, independent sources. I think one of the good sides of that is it does give the public more confidence in the data and the per- formance evaluation. The downside is the timeliness of that.

So in the case of getting those numbers from CIHI, we're looking actually towards the end of the calendar year before we'll probably get some definitive num- bers. But so far our projections show that we are on target to achieve those goals. J. MacPhail: I'm sorry. At the beginning, did the minister say those were provincial stats? He's nodding yes. Will the individual authorities be expected to meet their own targets? Hon. C. Hansen: As I understand it, there wasn't a different baseline for each health authority in the prov- ince.

The health authorities were actually given the provincial baseline, and they were all expected to make their target improvements from that baseline. So when we do get final data from our various independent sources — which, as I say, will probably be towards the end of the calendar year — that will be put into an ac- countability report to determine with certainty that the health authorities are meeting their targets or to iden- tify areas where they are not meeting targets.

It is our expectation that that information will become public as part of their accountability not only to us, as govern- ment, but to the public generally. J. MacPhail: Let me just ask another point of clar- ity, then. I am going to go through all of these targets for the Vancouver Island health authority. But would the minister then be giving me information…? I mean, we're still going to do it. But will the information he'll be giving me be provincial information, and therefore am I to conclude that these targets are the same for every health authority? Hon. C.

Hansen: Most of the expectation targets are common across all of the performance agreements. There are some specific ones where they vary from

THURSDAY, MAY 15, 2003 B RITISH COLUMBIA DEBATES 6853 health authority to health authority. Just one example is actually the next one that we would have come to, which is the Riverview replacement units. Certainly, in cases like that, each health authority has its own targets. [1525] J. MacPhail: Thank you. That helps a lot. So the next one is — I'll just read it into the record — for the Vancouver Island health authority: "Devel- opment of Riverview replacement units and selected locations to be achieved over the three-year period." The target for '02-03 was 33 units. Hon. C.

Hansen: The Seven Oaks facility was opened. That has 24 units, so they are falling short of their target for that year, and they're going to have to make it up. J. MacPhail: I understand that these are three-year plans, but this is the first year that we've had to see the success of the targets. Sorry, I missed my page here. The next perform- ance is in the area of home and community care. There are other targets, but these ones are just specific to numbers. Or does the minister want me to ask this one of the minister for…? Okay.

"Increase the proportion of home and community care clients with high care needs, requiring care at the IC 2 level or higher, living in their own home rather than in a facility. This is indi- cated by the number of high-care-needs clients at home as a percentage of high-care-needs clients in total." The target for '02-03 was a 2 percent increase. Hon. C. Hansen: Based on the interim data, they are ahead of that objective. J. MacPhail: On Vancouver Island. Thank you. "Public Population Health" — no, that's fine. Then the sixth one. "Support and Administrative Service.

Expected performance: reduce the annual expenditure for support and administrative services, excluding information sys- tems." Oh, that's a target for '04-05 by at least 7 percent. Does the minister have an update for Vancouver Island on that? I do accept it's a target for '04-05. Hon. C. Hansen: Yes, they are on track. All of the health authorities are actually on target to meet that 7 percent expenditure reduction in administrative and administrative support services. J. MacPhail: Next I'll turn to my health authority, the Vancouver coastal health authority.

What surplus or deficit is the Vancouver coastal health authority running at the end of '02-03, please? Hon. C. Hansen: At this stage, they are projecting a $4.4 million surplus on a base budget of $1.6 billion. [1530] J. MacPhail: I just want to bring to the attention of the minister something I received from my own health authority. I do raise it with the greatest of respect. It's from the communications department of the Vancou- ver coastal health authority, and it is to me as an MLA. It's the Vancouver coastal health one-year anniversary spotlight on Vancouver, April 2003.

I read the letter, and it is targeted specifically to members of the Legis- lature. It says: "It is very likely that the April one-year anniversary of the announcement of health care redesign will prompt a review of progress to date in building equitable access to a high-quality patient-centred system of care that is sustainable. In that regard, I am writing today to share with you what I hope will be helpful information on our progress. "Members of the Legislative Assembly play a critical role in advancing recognition of health accomplishments and improving public confidence in their health care system.

Accordingly, I want to provide you with at-a- glance information on Vancouver coastal health authority achievements for patients and their care at a broad level, as the case may be, within your community and the constituency you represent." I t ' s v e r y m u c h t a r g e t e d t o w a r d m e a s a n M L A . However, it's completely irrelevant to the performance agreement of the Vancouver coastal health authority. The first thing I did was get out the performance agreement in my own health authority and compare it, and it was impossible to compare. This may be useful. I'm not sure.

Regardless, it's an interesting document, but there's not one overlap between this, which is their record of achievement as professed by them…. I can't figure out anything about what it has to do with their achievements in terms of the performance agreement. So I was interested in that, because it is specifically t a r g e t e d t o m e a s a n M L A . I o n l y m a k e n o t e o f t h a t . The only advantage to the minister to have that infor- mation is that it could have shortened estimates if there was an overlap, so there could be something in it for him if he gets that corrected.

Anyway, we have to go through this for my own health authority as well. Let's talk about this. I actually had some more in- terest…. I'm approaching this from a local MLA's point of view too, so I have some extra questions on per- formance targets in this. One is emergency health ser- vices. I'm looking at page 4 of the Vancouver coastal health authority performance agreement. It says: "Expected performance.

Within the process directed and supported by the provincial health services authority, collaborate with the Ministries of Health and other health authorities in developing guidelines to better manage demands on the emergency health services in the acute hospital system. The process will include a review of literature and research as well as practices and performances in other jurisdictions. "The product during (a) 2002-2003 will be a set of guidelines for best practices in the management of emergency health care, including reporting requirements, measures and assessments of service coordination.

These guidelines will be adopted by the health authorities." [1535] [K. Stewart in the chair.] Hon. C. Hansen: There has been a tremendous amount of work done on this by not only the Vancou-

6854 B RITISH COLUMBIA DEBATES T HURSDAY, MAY 15, 2003 ver coastal health authority but indeed all of the health authorities under the direction and leadership of the provincial health services authority. They have done guidelines, and as they rolled through this process, they realized that would become an ongoing process to enhance those guidelines.

Specific to Vancouver coastal health authority, they have completed phase 1 of their emergency services planning project that was completed in November, which made recommendations on the required emer- gency department capacity — how this capacity should be sited, and the required systems to ensure accessible, high-quality, appropriate, coordinated and cost- effective emergency room services. Phase 2, involving the implementation of the phase 1 recommendations, is currently underway and is expected to be completed in March of 2004. J. MacPhail: Will that be made public? Hon. C. Hansen: The answer is yes.

The provincial health services authority will be posting this informa- tion as soon as they get loose ends pulled together on it. I should also point out that it is going to be an evolv- ing process. It's not going to be sort of static guidelines that then sit in perpetuity. This is an ongoing process to make sure that it's current and that we can learn and enhance these guidelines as we go forward. J. MacPhail: In noting the time left for us to debate matters until the conclusion of this session, I will be spending less time than I would have liked on the issue of ambulance services.

We will be concentrating on that in the next set of estimates, but I do want to ask this. Part of the emergency health services performance tar- gets says: "Measures may include an implemented flu season response plan, regular sample surveys of the movement of selected marker conditions throughout the emergency system and a reduction in the wait times and periods on diversion in the emergency de- partments. The work will include representation from B.C. Ambulance Service." Is there any update on those?

Those indicators aren't necessarily assigned to any particular year, but I'm won- dering whether the minister has any update on any of those targets. We have been through a flu season, and I'm just wondering whether there's any analysis done. Hon. C. Hansen: Just to touch on a couple of the points. For flu season we actually expanded the immu- nization program to include other individuals that are qualified for free flu vaccine in this last year. We were certainly fortunate that the flu season wasn't as bad. It did happen.

It was actually a little later this year than it has been in previous years, so it did impact in a signifi- cant way on some of our emergency rooms. We're cer- tainly learning, and the response plans that are being developed as part of this process are taking that data into consideration. The other thing is in terms of the time it takes for someone to be treated and their throughput in the emergency room system. We set targets.

Specifically, in Vancouver coastal they set targets for themselves in terms of what appropriate wait times are in their emer- gency rooms, and they're making progress in that re- gard. [1540] Also, with regard to B.C. Ambulance Service, they are very much integrated with this process of emer- gency rooms. They are obviously a key element in making sure that both ambulance wait times and wait times for patients generally are down at our emergency rooms.

Much of that becomes part of that bigger puz- zle, which is getting access to admit patients into acute care beds on wards, and that then gets blocked or frus- trated by patients who can't be discharged because of lack of community care beds. We are working on all elements of that, but it al- most has to happen in a parallel process, where all of these stages within the health care system have their challenges addressed so that ultimately it comes back to the emergency rooms. I recall when the St. Paul's emergency room shut down for a 14-hour period, I think it was, in November of 2001 or thereabouts.

One thing I learned from my discussions with those front- line workers the following day was that while they see the pressures, the real problem is elsewhere in the sys- tem and being able to get patients through the emer- gency room in a timely fashion. So we're certainly mak- ing good progress in that regard as a result of this whole program review. J. Kwan: What about in the area of surgical proce- dures? Let's start with that as well. With the service plan, there are targets that the government has out- lined. How are we doing with respect to trying to meet those targets? Hon. C.

Hansen: Again, we did spend a fair amount of time this morning on this around the pro- vincial surgical and procedural services project. I was able to report that the Vancouver coastal and the inte- rior health authorities are making good progress around the development of this surgical review. I think it's well on track, and I expect that under the leadership of the PHSA we'll be able to put a comprehensive pro- vincial approach in place that will allow us to deal with wait-lists more effectively and to integrate the findings and the results of the Western Canada Waiting List Project.

The net result is to ensure that people get timely and effective access to care. J. Kwan: Is it still anticipated, in terms of time lines, that '03-04 will see the introduction of these measures and standards, and that then in '04-05 you can see demonstrated improvements in terms of the perform- ance of these surgical services? [1545] Hon. C. Hansen: The target in '02-03 was the de- velopment of measures. There's been a lot of work done in the development of those measures, so we are

THURSDAY, MAY 15, 2003 B RITISH COLUMBIA DEBATES 6855 well into that process. If you'll note, the '03-04 target is continuation and completion of those deliverables, and that is underway. Finally, in '04-05 the demonstrated improvement — we anticipate that will be met. J. Kwan: The minister is saying they're actually on target with respect to this plan, and then we can expect to see the demonstrated improvement of performance in this area in '04-05.

While we're talking about performance measures, could the minister please advise why mortality rates for children were deleted as part of a health perform- ance measure? Hon. C. Hansen: Infant mortality was never dropped from the performance measures. When we developed the performance measures for the health authorities, what we tried to do was identify areas where we had particular challenges in the health care system. We wanted to make sure the health authorities paid specific attention to those specific challenges so we could see measurable improvement in those areas.

Infant mortality is one that is measured by the pro- vincial health officer as part of his regular report. We obviously want to make sure that infant mortality is as low as it can possibly be in this province. What we did in the performance contracts was put in place a specific measure for aboriginal infant mortal- ity. That was an area where there was a population that had a different outcome than the general population, so we wanted to make sure the health authorities focus particular attention on infant mortality.

Certainly, as a reportable measure it continues to be reported in the same way as it has for the last number of years. I'm not sure how far it goes back in the annual report of the provincial health officer. J. Kwan: My understanding was that infant mortal- ity was deleted. If I'm mistaken in that, I stand cor- rected. Maybe the minister can advise, then, what the measurements are now in terms of performance in health services for British Columbia. What are the per- formance measurements right now? Hon. C. Hansen: Maybe I should get some clarifica- tion. I'm not sure what she means.

Maybe she could rephrase the question or restate the question. J. Kwan: My understanding was that infant mortal- ity was deleted as a performance measure for health service and its delivery. If I'm mistaken in that, I stand corrected. The minister advises that the measurements have stayed constant for the last number of years. If that's the case, maybe the minister can refresh me in terms of what those measurements are and list them for me. [1550] Hon. C. Hansen: The infant mortality was never a performance measure for the health authorities. What was in there was aboriginal infant mortality.

I did not say that it was constant. What I said was that we tried to identify areas that were of a particular challenge, where we wanted health authorities to focus on them. Aboriginal infant mortality is one that is not consistent with infant mortality for the general population. It's an area where we felt the health authorities should pay some particular attention. That's why we put that in as a particular performance measure for them so that they would focus on that particular challenge within the health care sector. J. Kwan: Could the minister please advise, then, what measures are being used right now? Hon.

C. Hansen: If the member is referring to the performance agreements of the health authorities,

schedule A, which sets out those performance indica- tors, consumes seven pages. I can certainly send a copy t o t he m e m b e r i f s he wo u l d l i k e m e t o p as s i t o v e r t o her. There's a whole range of different indicators that I would be pleased to provide her with. J. Kwan: Sure, I'll take a look at that. Then maybe I'll come back to it. I'll find the document I just came across saying that the performance measures have ac- tually changed and that infant mortality has been de- leted as one of the measurements. Anyway, I'll take a look at that and perhaps come back to it if need be.

Let me ask the minister. In the performance agree- ment the next sections, of course, deal with mental health and home and community care. Now, I just want to be clear and seek advice from the minister. Should I be asking the minister the questions here around these areas, or should I wait to ask the two ministers of state in these areas the questions? Hon. C. Hansen: It's really up to the member. I have responsibility for the relationship with the health authorities.

The Minister of State for Mental Health has responsibility for that sector and the development of policy and, therefore, was very much an integral part of developing the performance measures we have set out. It's up to her. I can try to answer them. Perhaps if there are areas that the minister of state is better able t o , w e c a n d e f e r , a n d h e c a n p i c k t h e m u p w h e n y o u ask him questions. J. Kwan: Then in the area of mental health services first, could the minister please advise how much money is being allocated from his budget for mental health services? Hon. C.

Hansen: I can refer the member to page 14 of the service plan for the ministry. In there what we have done is set out all of the mental health service funding. If you look at the chart on the bottom of that page, in the coming year, '03-04, there is $1.067 million for mental health services. J. Kwan: How much of that is being allocated to the Vancouver coastal health authority?

6856 B RITISH COLUMBIA DEBATES T HURSDAY, MAY 15, 2003 [1555] Hon. C. Hansen: We do not allocate from the min- istry a line item that says there has to be a specific allo- cation of their financial resources to mental health funding. What we have done in this chart on page 14 is with the information provided to us by the health au- thorities in terms of how they have allocated their budget and what the funding levels for the mental health services would be for the province.

The only item that we've actually allocated in a specific sense in the last year is the area of addictions, which was ad- ministered centrally by the ministry. It has since been transferred to the health authorities. In that regard, that one item alone was $19.6 million that was transferred to the Vancouver coastal health authority vis-à-vis ad- diction services. J. Kwan: If the budget for mental health services for the Vancouver coastal health authority is about $1.6 billion, how could the minister…? Sorry. Actually, that's not the money for the coastal health authority.

The minister doesn't know how much of that $1.6 bil- lion is being directed towards mental health services in each of the regions. How can the minister be sure that mental health services are actually being protected within his budget and that services are being delivered? Hon. C. Hansen: We have specific targets and out- come measures in the performance agreements. They're indicators in terms of appropriate delivery of mental health services, so we are holding the health authorities accountable for delivering services.

I guess part of the big shift that we are doing as a government is no longer focusing on how much money we spend on programs as a definition of a good program, but rather we're looking at the outcomes of that. [J. Weisbeck in the chair.] With our population needs–based funding allocations, we have made sure that each of the health authorities gets a fair allocation of the Ministry of Health Services budget. Then we give them the flexibility to determine how they can best meet the needs in their region within that budget.

We hold them accountable by measuring outcomes that are set out in the performance agreements. J. Kwan: In the performance measures outlined in this service plan, or performance agreement as you call it, I already see shortcomings in terms of how you make sure that people in the area of mental health ser- vices are actually getting the services they need. The measurements don't necessarily give you the ability to capture the reality of what's going on. Let me first ask a broad question of the minister.

Does the minister not see some of the shortcomings in terms of the performance measures that are outlined in this service plan? Hon. C. Hansen: Probably if I read this short para- graph, it might answer the member's question: "The proportion of patients that have community or physician follow-up within a four-week time frame is intended to be a measure of improved continuity of care, as it measures the health system's responsiveness and continuity of care for people with a mental health diagnosis.

A high rate of community or physician follow- up indicates the hospital and community or physician services are well coordinated and that community or physician services are available and accessible.

By ensuring a high rate of follow-up after hospitalization for clients hospitalized with a serious mental health diagnosis, health authorities can expect to impact positively on quality health outcomes and reduce the need for hospital readmissions." In addition to the indicators that we've got in our performance agreements, there is also a considerable amount of work done by MHECCU, based at UBC, to evaluate outcomes in the area of mental health. Cer- tainly, we rely on basically the whole range of reports that we get back, which are actually indicators that we are seeing improvements to the system. [1600] J.

Kwan: I'll use one example here in terms of prob- l e m s t h a t I h a v e w i t h s o m e o f t h e p e r f o r m a n c e m e a s - ures outlined in this performance agreement. Under the mental health services component, expected per- formance is measured by increased use of needs-based and evidence-based best practices to achieve…. Then it goes on to list sub (i), sub (ii) and sub (iii). Sub (

i) states: "Increase in early intervention capacity as evi- denced by the decrease in average patient age at first contact with a physician or health service provider for serious mental illness." Let me just stop here and ask the question: how does one define a serious mental illness so that you can actually determine whether or not early intervention took place? Hon. C. Hansen: The definition of serious mental ill- ness is actually a protocol that is fairly well established.

There are diagnostic codes for various mental illnesses so that the physicians that are doing diagnosis will assess their patient and determine their particular illness. It is based on the reporting of those diagnostic codes that we have measurables. We then compare it against the age. One of the objectives for good mental health services is to make sure that people get diag- nosed as early as possible, because the earlier they can get into treatment the better we are able to manage their long-term illness. J.

Kwan: Then under sub (ii) it says: "Decrease by 4 percent over three years in the alternate level of care days spent by mental health and alcohol and drug cli- ents in hospitals once the primary need for in-patient care has completed, specifically: target '02-03, zero; target '03-04, 2 percent; and then target '04-05, 2 per- cent." This is a measurement of how many days are being spent in the hospital. The minister earlier also referenced a performance measure in terms of how often a person is readmitted,

THURSDAY, MAY 15, 2003 B RITISH COLUMBIA DEBATES 6857 yet in this performance agreement it doesn't actually state that. What I'm worried about is that there are other ways — there need to be other ways — t o d o a measurement, to do a true assessment, of what is really going on and whether or not the needs of the commu- nity are being met. Yet it's not stipulated in this per- formance agreement specifically. How does the minis- ter get the assurance or the reassurance that the per- formance is actually satisfactory? Hon. C.

Hansen: Again, what I'll do is read you w h a t i s r e f e r r e d t o i n t h i s d o c u m e n t a s t h e i n d i c a t o r rationale as to why that particular indicator is seen as appropriate. "ALC measures are commonly used as an indicator of inefficiency in hospital care and provide a measure of more cost-effective use of hospital and community resources. Current mental health reform efforts are intended to provide more community resources for people with serious mental illness.

Over the long run, improved access to these services in the community should reduce the unnecessary use of hospital beds by mental health patients." [1605] What's important about the indicator is that it's measuring system change. When we talk about health status…. The provincial health officer's report, as the member will know, is very comprehensive. It actually measures health status, but what we're looking for are indicators of how the health authorities are effectively managing change in the system that will lead to en- hanced health status in the future. J. Kwan: Well, let me use an example, then.

In my community, actually, there are a lot of people who are multi-diagnosed. They may have a mental illness. They may have an alcohol and drug problem or childhood traumas amongst a variety of things. The list is endless. In many cases, because these individuals are so complex in terms of their health needs and because they're so marginalized, they often actually don't get the service they need until they're in a crisis situation where they end up in an emergency situation. Some- times they may not even end up in the hospital, be- cause they live in such situations that they can't get the assistance they need.

So in those cases, where's the measurement in terms of a performance measure to ensure that those individuals are getting the kind of care they need? Oftentimes they are the people who fall through the cracks. Because they are multi-diagnosed and each of their challenges is so severe, people may actually cast aside their mental illness, as an example, and really just look at them as alcohol and drug problems. So I'd like the minister to clarify how we ensure that population base gets the care they need and how that is measured. Hon. C.

Hansen: I know we had the discussion earlier about what may be appropriate for the Minister of State for Mental Health, and there is a lot of policy development work around dual diagnosis that is in progress now. We have set a goal of 2004 to have com- pleted a best practices for concurrent disorders, includ- ing substance misuse and mental illness. That is a pro- ject that's being worked on, and my colleague the Min- ister of State for Mental Health will certainly be more familiar with that than I am at this point.

When we're talking specifically about the perform- ance measures, hospitalization and hospital use is one of the performance measures. If we have effective community programs in place for those with mental illness or dual diagnosis, then we will see a reduction in the utilization of hospital care. The whole purpose behind the programs in the mental health plan is to ensure that people get care and support in the commu- nities so they are not hospitalized.

So that's why part of the purpose of measuring hospital use and readmission is directly relevant as an indicator to ensuring we are in fact managing these better at the community level rather than at the acute care level. J. Kwan: Yes, it's one measure that is being used and can be used. The point, though, that I'm making is that where those individuals, who may not end up in a hospital bed…. It doesn't mean that adequate care is being given to those who need services.

It does not mean that at all, just because you don't end up in an acute situation. [1610] The other point I want to make, in terms of the per- formance measure, is where a person has multiple di- agnosis, they may actually have a severe mental health issue. But because of the way our society is, quite frankly, and sometimes the way governments tend to be, I think there's an order — a hierarchy, if you will — of what society deems to be deserving and undeserv- ing individuals.

If you're a person with multiple chal- lenges such as addiction challenges as well as mental health challenges, sometimes the addiction problem can overshadow the mental health problem. When that happens, that person is not identified as an individual with a mental health challenge, just as someone who is a drug- or alcohol-addicted person. In our society and particularly in our community, many people look at this group of people as castaways. Somehow they're unimportant and really are non-human beings, if you will.

Nowhere in this instance, then, are we measuring and evaluating whether or not this group of people is getting the services that it needs. I think these are the people that, because they're so marginalized, actually fall into the gaps, and problems actually surface in our system and therefore cost the system more money down the road. I don't see an opportunity within this performance agreement that will target that population base. Am I missing it? Is it in here somewhere, and I'm missing it?

If it's not in here, can the minister advise me, and give me assurance, of how that population base will get the adequate services that it needs? Hon. C. Hansen: I think the points that the member makes are very valid. This is exactly why we have

6858 B RITISH COLUMBIA DEBATES T HURSDAY, MAY 15, 2003 transferred addiction services to the health authorities — to make sure that we do have an integration of those programs at the community level. We actually had addiction services that were being managed out of Children and Families, and mental health was being managed out of the provincial Ministry of Health, so we shifted those programs over to the health authori- ties.

Mental health services were located with the health authorities, but the addiction service was trans- ferred, first of all, to the Ministry of Health Services and then subsequently to the health authorities them- selves so that those programs could be better inte- grated. I think it also speaks to the challenge around meas- uring the inputs that we wind up with programs where you try to measure inputs. Are you measuring inputs on a program that's aimed at addiction or aimed at mental health, when in reality you have programs aimed at both and that really achieve the same objec- tive, and that's integrated care?

But there are other performance measures that cer- tainly are public, which impact on this. One of them is around suicide rates. Our objective, obviously, is to make sure that through proper programs and proper support at the community level, we will see suicide rates come down. If you look at patients in the criminal justice system — which is something that's tracked by the Solicitor General — again, a reduction in the num- ber of individuals with mental illness or dual diagnosis or addictions in the criminal justice system….

If we see those rates come down, it will be evidence that our community-based programs are working better. There are also issues around transmissible diseases, which are reported annually by the provincial health officer. I think that by ensuring we can manage those pro- grams in an integrated fashion at the community level, we are going to have better success in ensuring that those individuals get the supports they need. The net result should be that some of these various indicators are going to show positive changes. [1615] J.

Kwan: Yes, that's the theory, and I suppose that's the goal of what we're trying to achieve here — both the minister and the health authorities. My concern, though, is that in the community, and particularly — again I use my own community as a base because that's the one I know best — when I look around my own community, the challenges are enormous. There are many people who are multi-diagnosed, and I actually foresee further problems coming down the road.

I don't see in this performance agreement that the measure- ments that need to be in place will actually give me the level of comfort that this population base will be taken care of. The other challenge that's coming and is not too far a w a y i s t h e c h a n g e s i n t h e M i n i s t r y o f H u m a n R e - sources when the two-out-of-five-year provision comes in. Next year individuals who are on income assistance for more than two years within the five-year period will no longer be qualified for income assistance, and often these are the people who are faced with multiple challenges.

Some of them are individuals with mental health issues; some of them are people with alcohol and drug addiction problems — the whole range of problems that people are sometimes faced with through no fault of their own, really. It's just the chal- lenges they're faced with. Those individuals already in the system — and I know of some of them through the human resources applications side — are not deemed to be persons with permanent disabilities, because their drug and alcohol addiction problems overshadow their other problems.

The Minister of Human Resources has already said and sent them letters to say that people with alcohol and drug addictions are not deemed to be people with dis- abilities, nor are they even deemed to be the people who are unable to work — not on a permanent basis but on a temporary basis. Really, they will actually be cut off of the income assistance programs after they've been on income assistance for two years with the new changes, and then they're going to be on the streets. That com- bined with the problems they have…. Again, many of these individuals also have mental health issues.

I wonder: how will this population base get the service they need, and how can we be sure they will? Does the minister not see that the problems for these individuals will actually even be worse? When they get cut off of income assistance, the complexity of their problems would be even further exacerbated. How do we deal with that? Hon. C. Hansen: The performance indicators were r e a l l y d e s i g n e d t o b e i n d i c a t o r s o f s y s t e m c h a n g e . I t would be absolutely impossible to put a performance agreement in place that measures every single outcome.

Obviously, we want better outcomes across the health care system, and I appreciate the comments the member has made about the plight and the challenges that indi- viduals with dual diagnoses are facing. I believe our health care system is responding to that. We obviously don't have instant answers or quick fixes, but I think we're making some very good progress in that regard. I would certainly refer the member to page 14 of the service plan, where we set out, as part of that sec- tion, the steps that are being taken by the health au- thorities to address some of these issues.

So I think there is progress being made. It continues and will continue to be a big challenge for the health authorities, but we believe that the performance indica- tors that we put in place capture the broad context of t h e s y s t e m c h a n g e t h a t i s d e s i r e d . W e d o h a v e , a s I indicated, other outcome measures, whether it's from MHECCU or whether it's the provincial health officer's annual report or whether it's other reports that we can refer to from time to time to give us the confidence that in fact these individuals are getting better care than they did the year before. J.

Kwan: I appreciate the fact that these perform- ance measures are targeted towards changes in the

THURSDAY, MAY 15, 2003 B RITISH COLUMBIA DEBATES 6859 institution, but the reality is that whatever change is happening institutionally, the bigger issue for me is: how is that impacting the community on the ground? That's really, at the end of the day, where we need to look at whether or not changes are effective.

Govern- ment can stand in the House or anywhere else and wave these numbers and say how great it is that we have reduced the number of days that people require in the hospital, but when I go out into my community and see a boatload of people on the streets without the assistance they need, I get no comfort, quite frankly, from those numbers.

They don't mean anything to me, nor does it mean anything to our community, broadly speaking. [1620] While I appreciate what the government and this minister are trying to do to change institutionally and to get better numbers accordingly, that doesn't extend necessarily to what is happening on the ground. Those are the concerns that I'm bringing forward.

In the service plan on page 14, which the minister references — in writing — the goal here is to try and integrate and to combine their services by providing a continuum of services between community-based care and hospital care, and to coordinate all of those things. How do you know that this is actually being done is the question I'm asking. Yes, one measure is to say: "Well, let's look at the hospital admissions." How many people have gone to the hospital?

As I say, there are a bunch of people who may not use the hospital system and al- ready, as it exists now, are not using the hospital system, but it does not mean that they are getting the care. I guess my point is that I have no reassurance from this plan and from the words of the minister that somehow that population base will get the services they need. Maybe I can canvass these questions with the Minister of State for Mental Health.

I know that earlier in the small House I started to ask the Minister of State for Mental Health some questions around these issues, but then I was advised by the Government House Leader to hold off my questions until the fol- lowing Monday when we are back. I'm prepared to do that. Maybe I can canvass with the minister of state further on the performance issues related to this popu- lation base not only in my community but in other communities as well. I want to then move to the question around River- view repl acement units.

In thi s document here it tal ks about the development of Riverview replacement units in selected locations to be achieved over the three-year period. Riverview is, as we know, being shut down. The beds are being shut down. Could the minister please advise about the patients who have left those beds as they are re-entering into the community?. What kind of tracking system is in place to follow these pa- tients to see what their needs are and to ensure that the services are available to them to meet their needs? Hon. G.

Cheema: I was just watching the channel, and I was very astonished to see this member asking questions about performance measures about mental health. They had ten years to quote even a single measure, and they had no measurement. We have done a lot of stuff for mental health, and I will just answer the question now. I don't want to go into a path where I just have to repeat all their message, but let me just give her the information about the Riverview Hospital. The River- view Hospital redevelopment project is a part of our commitment, and we are spending $138 million on that project.

By the end of five to seven years, we'll end up h a v i n g 1 1 6 m o r e b e d s i n t h i s p r o v i n c e . W h e n t h e s e patients are being moved into the community, into the smaller facilities — for example, in Kamloops or in Prince George, in Iris House or in Connolly Lodge — these patients are receiving the care they need. We are basing our care on best evidence practices. That means these patients will not only get more mod- ern facilities, but their care will be even better than before. This year we have funded about $3 million as transitional funding for these patients. Members should know that.

It was their plan, and if she had read that plan, it would make very clear that we are meeting all those eight goals in that plan. We have met each goal in that plan. [1625] So far we are tracking those patients, and those patients are receiving care in a very meaningful way. I'll give you two examples. In Kamloops two weeks ago, we transferred about 23 patients. One of them said it's the first time in that patient's life that he was able to see his family in 23 years. That's the kind of care we are providing.

One patient said that in 40 years of his life, this is the first time he thinks he's being respected as a person. That's the kind of care we are providing. Our Riverview redevelopment plan is on track, and we are monitoring the plan. We have a team in place at the Riverview Hospital. That team is being organized by Leslie Arnold. There is a committee where the pa- tients and the families as well as the caregivers and the receiving end of the community are participating, and no patient will be transferred without the approval of that process. J.

Kwan: I'm delighted that the Minister of State for Mental Health is prepared to take questions on this issue, notwithstanding that the Government House Leader advised the opposition caucus to not ask ques- tions in the small House of the Minister of State for Mental Health. Now that we're into mental health services, let me actually get into the meat of it, because the Minister of S t a t e f o r M e n t a l H e a l t h j u s t r o s e i n t h i s H o u s e t o s a y that he was astonished that the opposition have ques- tions for him around mental health issues and per- formance measures.

I have a boatload of questions for this minister around performance measures and the impacts of what's happening in our community with all the cuts in services that are taking place right now across British Columbia. Let me go to the minister of state, then. I'm happy to do this debate accordingly, as such, around

Document details

Collection	British Columbia — Debates (Hansard)
Citation	H0515pm-14
Type	hansard
Volume / chapter	H0515pm 14
Language	en
Format	pdf
Source	PROVINCIAL
Identifier	f69a937de340e9b6a3477118790c9886ced2c230

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