Health -- Issue No. 27 -- Wednesday, January 28, 2004 a.m.

2003 Legislative Session: 4th Session, 37th Parliament
SELECT STANDING COMMITTEE ON HEALTH
MINUTES AND HANSARD

REPORT OF PROCEEDINGS
(Hansard)

SELECT STANDING COMMITTEE ON
HEALTH

Chair:	Hon. Susan Brice (Saanich South L)
Deputy Chair:	* Blair Suffredine (Nelson-Creston L)
Members:	* Val Anderson (Vancouver-Langara L) * Jeff Bray (Victoria–Beacon Hill L) * Elayne Brenzinger (Surrey-Whalley L) Walt Cobb (Cariboo South L) Hon. Roger Harris (Skeena L) * Randy Hawes (Maple Ridge–Mission L) * Blair Lekstrom (Peace River South L) * Harold Long (Powell River–Sunshine Coast L) * John Nuraney (Burnaby-Willingdon L) * Val Roddick (Delta South L) * Joy MacPhail (Vancouver-Hastings NDP) * denotes member present

B. Suffredine (Deputy Chair): Welcome, everybody. It's nice to see the member from Victoria arrive just in the nick of time. You've all got the agenda in front of you.

B. Suffredine (Deputy Chair): Firstly, to review the committee's terms of reference. Those should also be distributed.

B. Suffredine (Deputy Chair): I think the first order is to review the terms of reference. Does anyone have any comments on whether these terms of reference are acceptable? Because the terms of reference are, of course, set by the House, we're not in a position to directly alter them. I would ask the committee to consider whether the March 31 date is workable at this point and whether we should be asking for any alteration of it.

R. Hawes: I'm assuming, though, we can ask for clarification. It says, "conduct consultations," and I'm not sure…. Is it contemplated that this committee is going to travel again? Is that the type of consultation, or do we know?

B. Suffredine (Deputy Chair): To the best of my knowledge, all the consultations will take place either in Victoria or in Vancouver. We won't be travelling.

B. Suffredine (Deputy Chair): That's up to the committee to seek input from as broad and as many sources as we feel we can within the scope of what's available to us.

B. Suffredine (Deputy Chair): Again, just for the record, the reason I point the committee to the March 31 time line is that the appointment of Susan Brice to cabinet may cause some complications with our work. It may be appropriate for the committee to request an extension of that time.

H. Long: Just a question on bullet 2 here. It says to investigate other successful health promotion campaigns in other jurisdictions, analyze their potential and that type of thing. Who is monitoring the different campaigns and jurisdictions and how they're doing things? How do we get that information to this committee — exactly what is out there, what we should be looking at, if they're successful? How are we getting that information to us so we can go and investigate it? This is a good plan, but if it stops here, it stops here.

B. Suffredine (Deputy Chair): Well, it's really up to the committee to design requests for public input — to invite as broad a community input as in any other committee.

H. Long: According to this, it's successful health promotion campaigns in other jurisdictions. I guess my questions are: how do we know what they are, where they are and how we would investigate them?

B. Suffredine (Deputy Chair): I would expect it's part of the work of the consultant to make recommendations to us on how we make those inquiries and get the appropriate information.

H. Long: So the recommendation would be that when we do have someone that's a consultant, they come forward with recommendations on other jurisdictions that we can look at to make our health care system better.

V. Anderson: It would be my understanding — and I'm not sure if I'm correct or not — that this is the final meeting of the last committee and that a new committee will be formed. That's why it reports on March 31 the activities of this committee during the past year. Now, if I'm right, then is there a draft report available of what happened during the year, and do we review it before it goes public?

B. Suffredine (Deputy Chair): I'm sorry. I'm not quite sure if I understood what you're saying. We're actually scheduled for a meeting next week, as well, and we're just commencing. To the best of my knowledge, we're not reporting on the last year of activities.

V. Anderson: I'm going on: "…shall report to the House no later than March 31, 2004." That's coming up very quickly. It would seem to me that's a report of what has happened in the past year, not the beginning of a new year.

B. Suffredine (Deputy Chair): To the best of my knowledge, we're to report by March 31 on the substance of the terms of reference. This has been set for us at the end of the last session, and it's a fairly short window that we have to conduct our investigation and report back.

V. Anderson: I'm still unclear. Normally, if I am right, a legislative committee will report to the Legisla-

ture a summary of its duties during the year it has been authorized. Has that report been done and presented?

B. Suffredine (Deputy Chair): This committee wasn't active until recently struck.

B. Suffredine (Deputy Chair): Yeah, we commenced December 2. You'll see in the terms of reference.

J. Bray: I think these are actually very exciting terms of reference. I've been on this committee since 2001, and some of the focuses of our recommendations were on exploring how we help change and what government's role is in changing people's attitudes toward health and becoming more active in their own health. Both of our first two reports had components of that.

But I would support your concern, Mr. Deputy, that March 31 might be a bit constricted with respect to doing a report that would maximize the committee's opportunity to look at other jurisdictions and compile a report that would be useful to the Legislature. If you were considering asking the House for any amendment to that reporting date, I would be supportive of that to ensure that this committee can make full use of the information we could get and do a report that would be most useful.

B. Suffredine (Deputy Chair): All right. That being said, perhaps the committee could consider it generally and discuss what is an appropriate time frame so that we might make a recommendation to the House Leader for the setting of a time frame that we think is workable.

J. Bray: I would certainly suggest that unless there's an issue with that being done within the same fiscal year, April 30 would at least be a more appropriate date for it to be complete and presented to the House and for any debate that might occur in the House. At least another month would be helpful, knowing the complexity of health issues.

B. Suffredine (Deputy Chair): My advice from the Clerk is that it shouldn't be affected by the fiscal year.

J. MacPhail: I can't understand why the time line was set on this by Gary Collins. We're going into a legislative sitting. I don't know why this committee thinks that it can travel during the legislative sitting. It's going to be extremely difficult.

I'm not sure, Mr. Chair — and I do understand the circumstances you find yourself in, so this is just helpful direction, not criticism — but I can't imagine why we would limit our travel, if we are going to travel, to just Vancouver and Victoria, given the mandate of this committee. The mandate of the committee is about healthy lifestyles. I think the rural populations would be outraged if we determined healthy lifestyles based on an urban visit. Those cappuccino-sucking, yuppie people who live in Kitsilano, for instance, should not be dominating our committee.

I also think this is a very complex assignment we've been given, based on the mandate. One, the review of the last two reports will take a substantial amount of time. Then looking at the promotion of healthy lifestyles, particularly as they relate to children, will require us to consult with the education system, Boys and Girls Clubs, sports associations. It will require us to hear from alternative medical practitioners — or I would propose that we need to — the chiropractors, the dietitians, the people who promote healthy lifestyles.

Why not the end of the sitting? In fact, I can't imagine how we're going to do it by the end of the sitting and do an effective job — and include not just government caucus members but the opposition as well.

B. Suffredine (Deputy Chair): Thank you for that constructive criticism. It's really up to the committee to make whatever recommendation it thinks is appropriate to the House Leader. It's a matter of what the committee feels, having heard the comments.

V. Anderson: In light of discussion, it seems realistic to me that March 31, 2005…. There's no way this committee can make any kind of sensible report in another month or two months if it's not reporting simply on what's been done. If it's going to be reporting on what's going to be done…. We couldn't even agree on the projects by then.

If we're going to hire an adviser-consultant, then we needs terms of reference for that consultant about what we're going to do. I don't know if we're going to hire somebody with a blank cheque and say: "Well, we have a job. We don't know what it is; we don't know what it's going to be. Would you like to undertake it?" It would seem to me that some kind of terms of reference would be given to the consultant before we hire them.

I agree we should get on and hire somebody, but unless we're going to hire them to help us write the terms of reference or what we're going to do with job descriptions….

V. Roddick: I would suggest — because I was unaware of this March 31, 2004, date — that we use February 4 to resolve all the issues that are up in the air right now — the fact that the Chair is part of cabinet

and we need to discuss another Chair and how we would take that into consideration. Then we can discuss and do some investigative work re the dates. I agree that March 31, 2004, appears not to be particularly helpful. If we could look at this and find out the parameters of the consultant, the time, whether there's any travel involved…. You were saying earlier, Deputy Chair, that there wasn't supposed to be a lot of travel, so we need to look at that and bring forward a plan on February 4. How does that sound to the rest of the committee?

V. Roddick: Okay. Yeah. Sure. I didn't actually make a motion, but I can. I wanted to put it out for discussion, but we can make a motion and put it up for discussion.

B. Suffredine (Deputy Chair): Do you want to just state your motion, so it's clear what people are voting on?

V. Roddick: "That we designate February 4 as the meeting that we resolve the position of Chair and we put forth a plan for the consultant to the committee and a time line that would allow us to undertake the investigation and discussions to promote healthy lifestyles, and then we can arrive at a date that we report to the House."

B. Lekstrom: I, too, have some concerns about the deadline of March 31, 2004, under our terms of reference. I think, as I had some brief discussion earlier with my colleague on the right, that we could possibly come up with a report outlining what the plans of this committee are to the Legislative Assembly by March 31, 2004; outlining the strategies we plan to incorporate into our investigations; notifying that the full report of this committee will not be until March 2005. I think that would be acceptable when I read into these terms of reference. Now, whether the House would have to adopt that change for the final report…. I believe they would.

If we're to do the job as outlined in these terms of reference, I think it would be a mockery for this committee to think we could do that by March 31, 2004. We wouldn't be doing justice for the people of British Columbia.

J. Bray: I actually think the motion makes a lot of sense, but I'm wondering, rather than coming back on February 4 and basically starting from where we are now and having the same discussion, whether or not this — the concept of a time line, exploring whether or not we can amend the date…. We've been charged by the House with specific things to report out under, and if we just walk back in on March 31 and report out that we're not reporting, it probably wouldn't be sufficient. Clearly, the date is an issue. I'm wondering whether or not this is the work of a subcommittee — to work on the time line, exploring whether or not we can get an amendment to the time line and exploring how this might look in terms of consultations and the witnesses we might expect to have, and then report back to the full group on February 4. That might actually be the work of a subcommittee as opposed to just delaying the discussion till February 4 — to actually come back with a concrete proposal that we can vote on.

R. Hawes: The Legislature would decide whether or not they want to accept a proposal that we would put to them, and I don't think you're going to find that out when the Legislature is not sitting. This committee, I think, can do almost anything it likes, and if we make a recommendation that says, "Here's the time line, and we'd like the House to endorse that time line," then that's up to the will of the House. I'm sure it'll be accepted. I don't see what a subcommittee is going to do. I don't quite understand that.

To look at time lines and stuff…. I think that's up to us. I prefer what my colleague to the left had to say — or perhaps to the Left. That would be that we should be meeting to talk about how we're going to accomplish this task and just report that on March 31 to the House. "This is what our plan is, and this is when we intend to report out." We will have finalized and will report out to the Legislature on this date. Then the Legislature is going to make a decision — aren't they?

Who would you suggest that we go to, to get permission? This is a legislative committee. We exist at the pleasure of the Legislature, which is not now sitting. I suggest that we just carry on, on February 4, begin our discussion about laying out what our plan of action will be, and have that complete and ready to report out by March 31. I wouldn't want to set a date like, "February 4 is when we will complete this task," because maybe we won't complete it on February 4. It may take several meetings to come up with a comprehensive plan of action. This is a very important topic.

B. Suffredine (Deputy Chair): Thank you. Just for the record, I can't pass on noting that you've indicated that both sides of you are left.

E. Brenzinger: I just wanted to concur with Joy. I understood this committee was to travel, to go to different places and promote healthy living styles, bring back information on how we can help save some money in the health care system and report back what's on here. That was my understanding. I thought we would be travelling during the session. I understand the Finance Committee did, and other committees have. I've done it with the Standing Committee on Education. We all know lifestyles are very different in the city than they are up in Dawson Creek. They smoke; we drink lattes.

Those are my comments. I just wanted to say that was my understanding. That's what I got from this committee.

V. Roddick: Perhaps, when you see the diverse understandings here, it might be a good thing to follow up on Jeff Bray's comments. Perhaps a group, a small subcommittee, could get together with some points and come back and report. Then we can discuss. It doesn't mean they're going to make a decision as to what this committee is going to do. It's going to correlate a few things and come back, and it'll be the foundation for discussion on February 4 as to how this will go ahead. It does seem to be a bit nebulous out there. Could I suggest that maybe Jeff Bray's comments aren't so bad after all?

We could have a subcommittee to give a basic foundation for discussion on February 4 — a discussion of the workplan.

B. Suffredine (Deputy Chair): I have Harold Long, Val Anderson and Elayne Brenzinger — the last two being in a tie — so I'll randomly pick which one.

H. Long: I want to go back to the members, Randy and Blair, on their suggestions — more so Randy's in this case — to go right back to basically laying it out for the Legislature exactly what we intend on doing as far as a timetable. I think it's going to be up to the whole committee to make sure that we have in our agenda what each one of us feels is important. I don't want to leave that just to a subcommittee to lay out the terms of reference — what we're going to investigate or not investigate — because I have some ideas of my own in the future.

I'd suggest that we go along with the member's statement that we possibly just take this to the Legislature and tell them what our time frame is. If we have to report out by March 2005, that's the way it is, because I believe there are some huge issues in health that we have to deal with. Just going over our terms of reference here opens up a huge workload for us.

I would like to concur with what Randy said. I want to be part of not only a subcommittee but the whole committee so that they have their input into what we want to investigate, where we're going to get that information and how we're going to do this in the future. It's not just a matter of turning in a report that's a report; it's a matter of turning in a meaningful report that really makes a difference to this province.

V. Anderson: Two things I'd like to ask about. One is that it says: "In addition to the powers previously conferred upon the Select Standing Committee on Health…." I would be interested in knowing what powers were previously conferred on the committee that we're adding to. That would be one question. Then I would express the comment that regardless of the name of the committee, it's the Standing Committee on Health and Social Services, not the Standing Committee on Health. Those are two big areas of concern, and I wouldn't want us to be considering just health without social services. That's partly what Joy referred to, and I think we need to highlight the social services as being equally as much involved in this committee as health.

B. Suffredine (Deputy Chair): All right. Just for the edification of the committee, all committees are charged by a standard motion at the beginning of the session. They have things like the power to call witnesses — standard powers. It's in addition to the standard powers of all committees.

E. Brenzinger: I just wanted to make a comment that I think this is an exciting committee to be on. I think people need to learn in this province to take responsibility for their own health. We need to look for areas where we can do that, because so many people just don't know what they need to do or how to change their habits — or whatever we find out there. I know for a fact that I'm really proud to be on this committee so that I can help reduce the costs in the health care system and we can get people to be more responsible for their own health.

J. Nuraney: I think the general consensus here is that we don't have enough time to do justice to our terms of reference. As you can see, it is fairly extensive work that the committee is to undertake, particularly when they talk about these health promotional campaigns and programs in other jurisdictions and their outcomes as to whether they were successful or not. This in itself just as one item on the terms of reference would need a lot of work, particularly because it now goes beyond our boundaries.

I like the idea that Randy suggested — that we move along as we see fit and report out on March 31. It need not be a conclusive report. It can tell the Legislature that the work is still in progress. If it is a pleasure of the Legislature to extend the mandate, so be it.

B. Suffredine (Deputy Chair): Harold, you were next on the list, but do you want Jeff to go first?

H. Long: My only question was that if in fact the paper in front of me states Select Standing Committee on Health and in the mandate it's social services, too, why isn't it in the heading of the committee?

B. Suffredine (Deputy Chair): The "Social Services" is not part of the committee's name.

J. Bray: I'm just wondering if we can call the question on the motion of the subcommittee, because if that's not on, then….

B. Suffredine (Deputy Chair): I'm actually waiting till the discussion stops, so we can vote on the motion that is on the floor.

B. Suffredine (Deputy Chair): Yeah. I was going to read it. I was just waiting until everyone had their turn.

J. Bray: I was wondering whether or not Val Roddick was suggesting a friendly amendment to her motion rather than just coming back….

B. Suffredine (Deputy Chair): Do you want me to read back what we've got, and then we'll find out from there?

"That the committee designate the February 4 meeting date to resolve the question of position of Chair, a consultant workplan and revised report time lines."

R. Hawes: I have a little problem when we say — if you don't mind, Mr. Chair — that we're going to resolve it that day, because it's a pretty big issue. I don't know what the time lines are going to be, because you've got to determine what the workload is going to be first. That might take more than February 4; that may take a couple of meetings. That's all I was trying to say. So I can see us moving to begin that work on February 4, and it'll be finished when it's finished.

J. MacPhail: The consultant workplan — you mean to hire the consultation or what work we would assign to a consultant, who we could then send out to bid to see who can fulfil it?

J. MacPhail: Okay. That's good. I certainly agree with that interpretation, but I also think that we're kind of not focusing on the breadth of the topic. Mr. Hawes just has. This topic is not only broad, but point No. 2 says that we have to determine any potential financial savings to the health care system as a result of improved fitness of the general population and children and youth in particular.

That's huge — determining the savings — and it's also extremely controversial. When Alberta went down this path about savings to the health care system, it blew up like crazy. Of course, one of the ways that you can determine savings is to say that people pay a differential into the public coffers dependent on their health status. That was extremely controversial in Alberta when that happened. I don't want us to miss that point — that we've been directed to do that. I mean, we're going to have to get health economists, if you ask me. Otherwise, you can't…. How else are we going to do it, to determine any potential savings?

V. Anderson: It seems the context of this is to review the last two reports of 2001 and 2002. In the light of our review of those reports, then to go on to whatever else we needed to do…. So we have a context of two sets of recommendations. Are they valid? Are they not valid? The ones we think are valid, then, are the ones we would go on to do the other implications. So the first task, it seems to me, is to review those two reports.

V. Anderson: Might I ask, Mr. Chair, that copies of those two reports be made available to us so that we can review them as soon as possible?

Well, that was a brief agenda item. In light of that, it would seem inappropriate to recommend we proceed with item 2 until next week. Does the committee agree? It would seem to me that we should move to other business if we're not in a position to make a decision on a consultant this morning until we have a workplan.

V. Anderson: With regard to the consultant, the question was raised — and it would have to be looked at next week — of whether we're going to have a workplan. We'll put it out to bids, a variety of people that might be interested. Or how do we go…? The process of selecting a consultant would also be important.

B. Suffredine (Deputy Chair): I'm not certain I know the answer to that this morning. I wonder if we'll not have to come forward with the recommendation next week.

B. Suffredine (Deputy Chair): I'm not sure you missed much, because the question was one I couldn't answer either. It seems to me we won't be in a position to decide on the hiring of a consultant until we're here next week with some recommendation on how we go about that.

J. MacPhail: I agree with Val Anderson that the first item of business is to see the progress made on the '01 and '02 reports, but the second part of our mandate is an area that we haven't yet as a committee explored in any detail — the financial aspect of it in terms of the

economics of it and the giving of advice. I mean, I think we're being asked to recommend advice about lifestyle, so it may require a range of help — smaller portions of a range of help.

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CONTENTS

		Page

Review of Committee's Terms of Reference		901

Other Business		905

Committee Staff:	Robert Parker (Committee Researcher)

REPORT OF PROCEEDINGS (Hansard)

SELECT STANDING COMMITTEE ON HEALTH

REPORT OF PROCEEDINGS
(Hansard)

SELECT STANDING COMMITTEE ON
HEALTH