2000 Legislative Session: 4th Session, 36th Parliament

The following electronic version is for informational purposes only.
The printed version remains the official version.

Official Report of




Afternoon Sitting

Volume 21, Number 2

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The House met at 2:07 p.m.

B. McKinnon: I'm pleased to introduce to the House today my CA, Kevin Collins, who is here to watch question period for the first time. I bid the House make him welcome.

Hon. G. Robertson: With us in the galleries this afternoon we have a number of members from Kwakiutl Laich-Kwil-Tach Nations Treaty Society. We have Chief John Smith of Tlowitsis; Chief Ernie Hardy of the Comox band; Rod Naknakim, senior analyst for treaty society; Dan Smith, chief negotiator of the Kwakiutl Laich-Kwil-Tach Nations Treaty Society; and John Munro and Rodney Arnold of the treaty society. I would ask that the members please make them welcome to the House this afternoon.

Hon. D. Zirnhelt: In the gallery today are two members of my ministry office staff. I would like you to welcome Teresa Sepala and Suzanne Life.

G. Campbell: Today we are joined in the House by 33 constituency assistants for the Liberal MLAs in the House. I know they've come here to enjoy the public debate, and I want to welcome them. I hope you look forward to this encouraging public spectacle that you're going to see today. Thank you for coming.

Hon. C. McGregor: It's my pleasure to reintroduce today my daughter Cara, who's visiting the House, taking a well-earned break from her university studies. She's joined by a friend, Scott Hart, who's also the chair of the UVic NDP club. Would the House please make those two young people welcome.


Hon. M. Farnworth: It's my pleasure to introduce two constituents in the gallery today, Marjory Kingsbury and Ben Swankey. Would the House please make them welcome on their visit to Victoria.

V. Roddick: Gracing the cover of this year's B.C. Holstein Directory, shot. . . .

An Hon. Member: You're not allowed to use props. Just go: "Moo."

V. Roddick: Okay -- moo.

Gracing the cover of this year's B.C. Holstein Directory is national, international and world champion, 15-year-old Rainyridge Tony Beauty. It was Beauty's year in 1999, as accolades and congratulations poured in from around the world after this magnificent old cow was bestowed honour after honour for her success on the show circuit. Winner of Canada's 1999 cow of the year award and all-Canadian aged cow; supreme champion at World Dairy Expo; people's choice to win the world champion over all international champions; western national grand champion; and doing the millennium right, winning the grand champion honours at B.C.'s Spring Show -- she's done it; owned by Stanhope-Wedgwood, Victoria and Cobble Hill, B.C.

Will the House please acknowledge our very own queen of the Holstein world. [Applause.] We really needed something to lighten things up today.

D. Streifel: I was -- as was the rest of the House, all the members -- captivated by that previous introduction. Being, I guess, somewhat soft towards animals myself, I would like to. . . .

Anyway, on with the introduction. I have a serious introduction today, hon. Speaker. We have visitors in the gallery from India today. We have a special guest from India. I hope the members would join me in welcoming Mr. Satpal Gosain, Deputy Speaker of the Punjab State Legislative Assembly. Accompanying Mr. Gosanh from the Punjab government are Beginder Pal Singh and Rajinder Kumar. I would also like to thank lower mainland residents Gurmeet Singh, Harpreet Singh and Talwinder Singh for their hospitality in having the group join us today in the House. Once again, please welcome our guests from the Punjab.

G. Campbell: Often, I know, in elected office there are people in the public who offer positive solutions to the problems that we face. I would like the House to welcome Ivor Cura and Barbara Cura, who are trying to explain to the people of British Columbia how we can make ICBC and automobile insurance work better for all of us. Welcome them to the House, please.

S. Orcherton: Joining us in the gallery today are two very strident advocates for mental health in the community I represent in Victoria. Joining us is Mr. Murray Galbraith; he's the past president of the Schizophrenia Society of Canada and the current president of the Victoria branch of the B.C. Schizophrenia Society. Accompanying him is Ms. Patricia Donaldson, the executive director of the B.C. Schizophrenia Society, Victoria branch. I ask the House to make both of these advocates very welcome to these chambers.


Oral Questions


G. Campbell: For years this government has been ignoring the growing health care crisis that's facing the people of British Columbia. For years Health minister after Health minister after Health minister after Health minister after Health minister after Health minister -- six in all -- has told us that no crisis exists. Yesterday the Premier said: "I didn't know the enormity of the problem." In fact, the Premier has been well aware of the extent of the problem for at least six months. We have yet another NDP secret strategy document that shows the NDP caucus was fully briefed last June on the magnitude of the problem and on what these latest announcements would be.

My question to the Premier is: why did the Premier decide to hold patients hostage for six months before he decided to make announcements he knew about last June?


The Speaker: Order, members.

Hon. U. Dosanjh: Health care is an institution that Canadians and British Columbians cherish. Health care is so important an issue for me that in February, shortly after I became the Premier, I travelled to Ottawa to talk to the Prime Minister

[ Page 17256 ]

directly, to make sure that at the end of the day we have more dollars starting to flow back into British Columbia -- at the cutting of which dollar the opposition leader said the cuts were not deep enough. That opposition leader said in 1996 -- he's been around for seven years -- that $6 billion is not enough. He said that federal cuts were not deep enough.

Now, we poured money into health care. In the budget in September, we put an additional $300 million into health care as soon as the federal dollars started flowing. We realized that more needed to be done. The new Health minister and I went to various hospitals, from Vancouver General to Children's Hospital and Women's Hospital to Royal Columbian to Prince Rupert to Williams Lake to Quesnel to Campbell River to Powell River. We talked to people on the front lines of health care. We did not hold secret meetings behind closed doors with invited guests.

Each and every member, each and every health care provider that we talked to said to me: "We need to do more for health care." The budget today is $8.6 billion. We have $200 million being injected. The hon. member opposite has no plan.


Hon. U. Dosanjh: Let me conclude my remarks.

The Speaker: Thank you, Mr. Premier. I believe there will be a supplemental question.

G. Campbell: This document is actually a document that records a secret NDP meeting that was held in June of this year. Among other things, the document says: "Capital equipment in health care has been underfunded for several years. Health authorities are concerned that they will not be able to provide appropriate levels of service due to aging and dysfunctional equipment." It goes on to say that the ministry indicates that funding of $80 million annually is needed, and the average budget over the last five years has been $27 million under the NDP.

My question to the Premier is simple: why did the Premier make patients wait for six months before finally announcing some of the resources they needed for patient care in the province of British Columbia?


Hon. U. Dosanjh: Hon. Speaker, we are now getting more money from Ottawa. The economy is now turning around. We poured more money into health care in September. This is an additional increment that's now being debated before the House. I want to make sure that we meet the needs of British Columbians and that we do so in a wise, comprehensive fashion. That's why we have a plan that has several prongs to it -- several aspects to it. We announced it with 200 people from all over British Columbia present.

Let me just say this. The hon. Leader of the Opposition said to the media at noon that he is committed to keeping the expenditures on health care at 40 percent. After giving $2.9 billion in tax cuts, that would mean a billion dollars of cuts in health care in British Columbia, and I will not let that happen.

Some Hon. Members: Shame! Shame!

The Speaker: The hon. Leader of the Official Opposition.


The Speaker: Order. Order, members.


G. Campbell: For years now we have known that there is a nursing shortage in British Columbia. One of the solutions for that is to bring foreign-trained, qualified nurses into the province of British Columbia to help provide care for patients. A week ago the Premier tried to pretend that the bureaucracy was thwarting that program, that they in fact were stopping that from taking place. Then we learned that in fact the cabinet had dealt with it three times, and the Premier and his cabinet had rejected those qualified foreign nurses from coming to work in British Columbia.

The Premier claimed he didn't remember. But again, this document makes it clear that not just the Premier but the members of the NDP caucus were told that there was a need for foreign nurses. They discussed it; they had working groups.

My question to the Premier is simply this: why doesn't the Premier admit the truth? The Premier and his cabinet have stopped foreign-qualified nurses from coming and providing care in British Columbia for the last two years.

Hon. U. Dosanjh: When this program was put in place, there was an institutional view that this program is just for capital investors and immigrant business persons to come into British Columbia. When I became the Premier, I instructed my minister to come back with a proposal. That proposal came to Treasury Board in July, asking for over a million dollars to administer a program that shouldn't cost that much. It finally came back in October. It was approved with almost a $750,000 lower bill attached to it. I want to make sure we invest people's money wisely and that we get the nurses we need.

However, the opposition leader is committed to reducing overall expenditures in British Columbia. That's going to mean a billion-dollar tax cut if he keeps the level of expenditure at 40 percent. Shame on him!


M. de Jong: This document is actually full of interesting little NDP policy nuggets. Here's an interesting one. Back a few years ago, I think it was the Minister of Finance who said -- I think I'm getting this correctly -- that he'd "rather be electrocuted than sell B.C. Hydro." That was the quote in the newspaper.

It might actually be time for him to pull out a pair of insulated underwear, because reading from the "Book of Hidden Policy," chapter 2, reveals that a key part of the government's fiscal program is to "sell big-ticket symbolic assets." And that list includes, amongst other things, the liquor distribution branch, B.C. Lottery Corp, ICBC and, yes, even B.C. Hydro.

But my question is for the Premier. Why is he going around the province telling his union friends that there isn't going to be any privatization, when his own secret policy document says that the biggest Crown corporations are on the block?


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Hon. U. Dosanjh: The Leader of the Opposition says in one quote that was raised here this morning in this House that he has no strategic plan for health care. And after, during the break in the House, he goes out and says that he's going to keep the expenditures at 40 percent after providing dramatic tax cuts and after reducing expenditures. Let me tell you: now we know what the secret agenda is on the other side.

Hon. Speaker, it's absolutely wonderful to be in the House, because I want to tell all British Columbians that unlike that side of the House, we're not going to sell B.C. Hydro. We're not going to sell ICBC. We're not going to sell B.C. Rail.

The Speaker: The hon. member for Matsqui has a supplemental question.

M. de Jong: Getting back to the list, Premier. . . .


The Speaker: Order, member.

M. de Jong: It was your document. And it was your meeting.

The Speaker: Order, member. Through the Chair, please.

M. de Jong: It's interesting, Mr. Speaker. You know, there's one asset, perhaps the most symbolic asset of them all, that's not on this list. You remember the one. It's tied to a dock in North Vancouver already gift-wrapped for Christmas.

I think the Premier is a little upset because he's had his hidden agenda revealed. And now I think he should tell British Columbians which big-ticket symbolic assets the NDP is going to sell first. Is it going to be the liquor distribution branch? Is it going to be the B.C. Lottery Corporation? Is it going to be ICBC? Which one is going to be sold first?

Hon. U. Dosanjh: The secret agenda is all on the other side -- all on the other side. And that secret agenda is to keep the expenditures in health care to 40 percent and give dramatic tax cuts to the wealthiest British Columbians; that means a billion dollars in tax cuts. We just learned that at noon today from the opposition leader -- just noon today.

So I want to know: what is the secret plan for health care? He says one minute that he doesn't have a strategic plan, but the other minute he says 40 percent expenditures on health care. With a reduced expenditure amount, 40 percent would mean a huge cut in health care. Dramatic tax cuts would mean a huge cut in health care. If the opposition member opposite me now says he's going to do deficit budgets after we are going to have balanced three budgets in a row, we will not let that happen. We'll defeat that opposition in the polls.


The Speaker: Order, members.


G. Plant: According to this document, on June 1 and June 2 the NDP were talking about some very big changes in our province's universities.


G. Plant: Wait for it, because you've probably forgotten this. But apparently the NDP is looking at "phasing out some facilities and studies to be replaced by future needs." And one of the examples given is to phase out the province's law faculties. Well, I know the NDP have had a heck of a time with lawsuits -- lawyers all over the place, going to court, losing, paying those bills. My question for the Attorney General is: which of the province's two law faculties is he planning to close?


Hon. U. Dosanjh: We have the opposition that said they were going to cut, in 1996, 15 cents out of every dollar in public expenditures -- every dollar. They are still committed to reducing expenditures and then giving health care only 40 percent of that reduced expenditure. In contradistinction to that, we have added 40,000 additional post-secondary spaces in British Columbia in the last nine years. We have opened in British Columbia the only three new universities anywhere in Canada in the last nine years. We are the party of education; we are the party of health care. That is the party of dramatic tax cuts.

The Speaker: The bell ends question period.


J. van Dongen: This petition is signed by 8,335 residents of the Fraser Valley who are concerned about air pollution and the health hazards from the proposed Sumas Energy power plant. The petitioners ask the government to take all possible steps to prevent the construction of this plant.

Hon. G. Wilson: I have a petition of 657 names from the residents of the lower Sunshine Coast and Pender Harbour area requesting that the government immediately move to put in place a management policy for Roosevelt elk in order to protect local businesses in that area.

S. Orcherton: I rise to present a petition signed by over 16,000 British Columbians supporting private member's Bill M212. They're supporting an act to amend the Medical Practitioners Act, which will allow physicians to practise complementary medicine and refer patients to complementary medical treatments and therapies without fear of harassment and without fear of intimidation from their governing body, the College of Physicians and Surgeons. This is the largest petition on health care presented to this House.

G. Campbell: I rise to present a petition. This is a petition of 2,700 citizens who are asking for an end to ICBC's monopoly and for a return of competition to the automobile insurance industry in British Columbia. I submit it for the House's consideration.

Orders of the Day

Hon. G. Janssen: I call Committee of Supply to debate the estimates of the Ministry of Health.

The House in Committee of Supply B; D. Streifel in the chair.

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The committee met at 2:31 p.m.


On vote 36(S2): ministry operations, $212,000,000 (continued).

C. Hansen: Before the lunch break we were talking about the amount of money that's going to be flowing to British Columbia as a result of the increases to the CHST transfers. The minister advised that there was $331 million in additional dollars that would flow as a result of the first ministers' meeting that was held in September. Given that this health action plan that he announced earlier this week is going to add $146 million to the budget, could the minister tell us whether or not the additional dollars that will flow from Ottawa are in fact going to be allocated to health care or to other government priorities?

Hon. C. Evans: I would repeat the answer I gave this morning, which is that the question, while interesting, is more correctly. . .the Ministry of Finance. I suggest that the hon. member raise it with the Minister of Finance in his budget estimates in the spring.

The Chair: I think we'll just take this question from Quilchena. I think I was in the middle of a thought; I missed the motion behind me. And then we'll move to another member.

C. Hansen: This morning the minister advised us that the increase in the supplementary estimates from $180 million to $212 million that are before us. . . . So $31.6 million of that was not for the implementation of the health action plan. I'm wondering if the minister could explain to us how that $31.6 million will be allocated.

Hon. C. Evans: The answer to the hon. member's question is that the health authorities' administrative reductions are being reinstated to the total of $25 million. There is a built-in estimate of the increased cost of mediated settlements with rural physicians at $1.3 million. There is a funding of shortfall and amortization expenses for capital assets of $2.7 million and a systems shortfall being funded at $2.6 million. The total is $31.6 million, which I believe is the total of the hon. member's question.

Hon. J. Smallwood: Hon. Chair, I am a firm believer in casting light on debates, and I heard something today at lunchtime that I find to be so astounding that I think we need to not only. . . .

An Hon. Member: Well, tell us about it.

Hon. J. Smallwood: And I will. You know, we heard today from the Leader of the Official Opposition that he was committed to maintaining 40 percent of the budget for health care. That was part of his plan. But at the same time -- and I think it's important that the people that. . . .


Hon. J. Smallwood: Now settle down; settle down. Settle down. Take a deep breath. Everything's okay. All right.

An Hon. Member: A deep breath makes me angrier at you.

Hon. J. Smallwood: A deep breath makes you angrier at me.

I think we all know that the opposition has been pretty docile over the last number of months. We can all envision that we've had some strategists in the caucus room saying: "Now, none of you say anything, because if any of you open your mouth in the public. . . . Oh my God, they might find out what we're really about."


I know that must be really chomping at the bit for you. The opportunity to come in the House and actually blow off some steam must feel really good. But you know. . . .


Hon. J. Smallwood: The member across the way wants us to talk about health care. So let's examine where this opposition is coming from. The Leader of the Opposition says that he's going to maintain 40 percent of the budget, but he is committed to cutting the overall budget of government by almost $3 billion. Now, the opposition brags that within the first 90 days of them forming government, they will drive to the lowest personal income tax anywhere in Canada. The outcome of that particular initiative means that we will see serious cuts in government services, serious cuts in health care. As a matter of fact, if you do the math, we're talking about probably a billion dollars in health care cuts alone within the first year.

When you shine a little bit of light on what these people stand for and what they're really talking about, I can understand their strategists saying to the back bench and to these fellows over here that they ought to watch what they're saying. They'd better not say anything publicly, because -- oh my goodness -- if the people of this province really understand what they stand for, who they're serving in this province, they won't get elected.

So I want to just take a look at what the opposition leader has said when he has toured the province talking to his friends. The orchestrated meetings that happened in communities all around this province, orchestrated by old Socreds, orchestrated by old Reformers -- yeah, you guys too -- orchestrated by some of the most extreme right-wing activists we've got in this province. . . . What has this Leader of the Opposition said? Well, let's see.

In Prince George, in the Citizen he says, when he's talking about health care, that it requires a strategic long-term plan for the province and that we don't have one yet. Okay. What is it? We don't have a plan, or we're going to maintain 40 percent of the budget, but it will be a severely cut budget -- a $1 billion cut? No plan, or a $1 billion cut?

Now, it could have been a slip of the lip in Prince George. Maybe he really didn't mean it. Maybe, if we take a look at where he was during some of the other forums, we'll better understand what the Liberals have to say about health care and what their plan is. So I took a look at the Vernon Morning

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Star. Now then, the Leader of the Opposition told the participants that the Liberal government would talk to front-line health care workers and attempt to correct the system. "You won't hear that I have a magic pill and that it will be all okay. But there are some things that need to be done."

He says in Prince Rupert -- and I'm going to quote from the Prince Rupert Daily News: "Clearly speaking, in preparation for an election. . . ."

I read that and thought: hey, maybe this is it; maybe we're going to hear. Maybe we'll understand what those folks have been learning when they've been touring the province. Maybe we'll understand what their position is after nine years in opposition. Maybe we'll understand, in spite of the gag order, what it is these folks stand for.


What it says in the Prince Rupert Daily News is that while he is clearly speaking in preparation for an election, the Leader of the Official Opposition would solve the provincial health care woes by developing a strategic long-term plan. But he refused to give a timetable for how soon after the election his party would roll out such a plan, if they won it. And I thought to myself: huh? What's that about?

We've got these guys over here bragging to everybody in the province that within 90 days. . . . The first thing they're going to do is put money in the pockets of their friends. The first thing they're going to do is give money to their buddies at the top end of the income scale. They're going to cut services, and they're going to work on the health care crisis.


The Chair: Order, hon. member.


The Chair: Minister, hon. member, you're making it very difficult for the Chair. It's awkward. The individual that sat in this chair a number of years ago was actually my MLA, Austin Pelton. He understood, as we understand, that the Chair is in the hands of the House. It's your rules. The rules of debate in committee are relatively rigid around relevancy. I would ask the members, as they're up on their feet in debate. . . . I recognize that all members want to participate in this debate. The standing orders provide for that. The Chair will be in a position where. . . . I'm going to ask the members to keep it within order and come to a question and formulate your question to the minister involved.

Hon. J. Smallwood: Not only are my comments relevant, but they are perhaps the crucial question in this debate around health care funding. I want to go a little bit further. I want to talk about the Liberal leader suggesting that the cuts made by the federal government that put us in this position were "only a myth." That is a quote from the Nanaimo Daily News in October. I want to quote the Leader of the Official Opposition, who says that a $6 billion annual budget is plenty of funding to run a public health care system -- again, in the Nanaimo Daily News.

Now, if the opposition is not prepared to come clean about what it is they stand for, where their priorities are and what their commitment to this health care system is -- if there aren't enough clues on the public record already -- I have a question for the Minister of Health. My question to the Minister of Health is: what, Mr. Minister, would the effects be of this plan that we seem to be seeing unfolding, by these quotes that we've heard from the opposite side? What is it going to mean to a health care system that is cut by a billion dollars in the first year of a Liberal government? The only thing that gives me any comfort in the kind of answer that I'm going to hear is that I don't believe for a moment that the people of this province are going to stand by and elect a government that won't come clean with them.


The Chair: Hon. minister, recognizing standing order 61.

Hon. C. Evans: Hon. Chair, it would begin to appear that we're debating two health care plans here today: the one that is open, which I presented in Richmond two days ago -- and it has been published in the newspaper -- and the one that's evolving by the hour. I would ask some forgiveness for getting the numbers together, because the concept. . . .


Hon. C. Evans: Hon. Chair, this is a fairly. . . .


The Chair: Order, hon. members. Order, hon. member.


The Chair: Order, hon. members.

Hon. C. Evans: Hon. Chair, as you know, government likes to have options before we make decisions. And so the answer to the hon. member's question -- what would the impact be of the Liberal plan to cut a billion dollars from the health care budget. . .? -- would require one of several options.

Option 1. I address this first because it's where the hon. member lives. We could eliminate the entire health care budget for the South Fraser and Simon Fraser. . . .



Hon. C. Evans: You could think this is funny. I'll say it again, hon. member: the entire budget for the Simon Fraser and South Fraser districts.


Hon. C. Evans: Hon. member, it might seem like a joke to you.


The Chair: Order, hon. members. Minister. . . .

Hon. C. Evans: But there's a whole bunch of people living in Surrey who in option 1. . . .

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The Chair: Minister -- order, please.

It's becoming increasingly difficult to hear the debate here, so I would bring the members to order.

Hon. C. Evans: Option 2 would be to eliminate health care entirely on Vancouver Island -- just saw it off from the mainland and let it go.

Now, option 3 is somewhat more complex. Hon. member, option 3. . . . Perhaps we would not wish to have an impact in the large urban centres of Victoria, Vancouver, Surrey. Option 3: you could eliminate health care entirely, according to the plan we heard at lunch, in Creston, where I live; Elk Valley; Fort Nelson; Golden; Trail; Kimberley; Kitimat; Mount Waddington; Nelson; Nisga'a; Arrow Lakes, and that's Nakusp, for those of you who don't know; the Bella Coola Valley; Boundary, and that's the Boundary area; Bulkley Valley; Campbell River; Castlegar; Central Cariboo; Central Coast; Columbia Valley, Comox Valley; Cranbrook; North Coast; North Peace; Powell River -- wiped right out; Queen Charlottes, hon. member -- gone; Quesnel; Sea to Sky; Snow Country; South Cariboo; South Peace; Stikine; Sunshine Coast; Terrace; and the Upper Skeena.

Of course no one in the real world would ever choose one of these options, which is why the idea that we have now heard of the Liberal plan to cut a billion dollars from health care wouldn't work, hon. member.

C. Hansen: I'm not sure much was accomplished by that intervention by the member for Surrey-Whalley, but we will try to get this back on track.

Hon. Chair, the minister earlier, before that intervention from the member for Surrey-Whalley, was telling us of the dollars that were flowing from the federal government. He gave us a breakdown of the extra $31.6 million that is in this supplementary estimates -- which is not there -- to fund this so-called health action plan.

I'm wondering if the minister could tell us: what are the projected deficits of the 52 health authorities in British Columbia? What is the cumulative number today, given that we had this infusion of $180 million in September which in theory was to cover the deficits that were projected at that time? He knows and I know that it did not cover those deficits, that many of those health authorities are still looking at some pretty significant red ink for this current fiscal year. So I'm wondering if the minister could tell us what that red ink amounts to.

Hon. C. Evans: Hon. member, our best estimate at this time would be zero.

C. Hansen: Well, I'm certainly aware of several health authorities that are projecting deficits at this time and that the allocation that came as a result of the September supplementary estimates did not meet those needs. I'm wondering if the minister could tell me if he's aware of any health authorities that are projecting deficits.

Hon. C. Evans: As of December 5 we had received from the 52 health authorities 45 budget statements; we are still awaiting seven. And of the 45 we have received, there are deficits of zero.

C. Hansen: Could the minister tell us, then: in order to bring those deficits under control, to make sure that there are not deficits in any one of those health regions, have any of them had to implement cuts in order to meet the zero deficit projection that the minister is now claiming exists?


Hon. C. Evans: Hon. Chair, all authorities have had to manage money carefully, and I don't know of any that have had to implement cuts. But I think I have heard the word "cuts" often applied in such a way that you can interpret it to mean almost anything. They have to manage the money carefully; there is no glut. They have to make decisions, but I don't know of any that have actually had to cut their budgets.

C. Hansen: The minister indicated earlier that part of the $31.6 million was $25 million that would go to health authorities. Could the minister give us a breakdown as to how that money is allocated?

Hon. C. Evans: We had thought, when the budget was created, that we could get $25 million in savings from the health authorities. We did a study, looked at their administration costs compared to every other province and hospital in the country, and found that they were in keeping with the administrative costs all the way across Canada. So what is happening with the $25 million is that we are reinstating the requested reductions that we had made in the spring.

C. Hansen: So, if I can get this correct, then the extra $25 million is going to flow to the health authorities to cover dollars that were cut back initially because of anticipated savings in administrative costs. When the minister talks about the December 5 budget statements that have come in, does that include their allocation of this anticipated $25 million?

Hon. C. Evans: The answer is no. The reason that the answer is no is that we agreed to do the national study prior to implementing the cuts. So we had not implemented the cuts until the study was finished, and the study said not to do it.

C. Hansen: In other words, spending authority was not granted for that $25 million in the initial supply bill that we passed in this House. And yet that $25 million was included in the budget letters that went to the health authorities; unfortunately, that didn't happen until after six months into the fiscal year. But the health authorities' budgets were operating on the assumption that that $25 million was there. So, in fact, this money has been spent, it has been in the budget, and what the ministry is doing now -- if I get the minister correctly -- is coming to the Legislature, nine months after the start of the fiscal year, to ask for legislative authority for that $25 million, which has in fact already been spent. It's already been in the health authorities' budgets throughout this current fiscal year. Is my interpretation correct?

Hon. C. Evans: No, that's not correct. We held the $25 million reduction centrally inside the ministry while we did the study. The budget letters to the health authorities in the spring did not instruct them to make the cuts.

C. Hansen: There are some aspects of the explanation that just don't connect. On one hand, he has told me that there are no deficits being projected. On the other hand, he has said

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that the health authorities were cut back by a total of $25 million because of anticipated savings in administration costs. Then he said that the money that was there was held back by the ministry. Now he's saying that in these supplementary estimates, we're being asked to approve it. Those don't connect. Somewhere in there, there have been dollars that have not been approved by this Legislature, and that's why he's asking for it today.


If we can simplify this, why is it that the health authorities did not realize that they had to adjust their budgets for this $25 million reduction? Why have they not been operating on that assumption up till now? On the other hand, if they have been operating on the assumption that the $25 million was not going to be available, then why is it that their budget statements are not showing deficits?

Hon. C. Evans: I'm going to try and explain this as carefully as I can for the hon. member. The budget in the spring was assumed on the capacity of health authorities to reduce administrative function by $25 million around the province. However, prior to implementing those cuts, we agreed to do a study of their administrative costs and their comparisons with other jurisdictions to see whether or not that was a justifiable cut. The outcome of the study was that it is not. Happily, everybody can share in the information that the health authorities are operating as lean an administrative cost as is found elsewhere in Canada.

The $25 million that did not come to the ministry in the spring, therefore, needs to come and flow to the authority. We are asking for that appropriation. You can, if you want, interpret it as that we did not ask for enough money in the spring or that the ministry was incorrect in assuming that you could make those cuts. You can interpret it however you want. The fact of the matter is that the money was intended for the authority if the study said that they were offering efficient operations, and that is what happened. And we are here today appropriating that money.

C. Hansen: I still am not sure that that explains it, but I also realize that we're not getting any further along on it.

I want to shift to the issue of mental health. In this supplementary estimate that has been presented to us today, there is a grand total increase for adult mental health programs of $2 million out of a $212 million increase. There was a commitment made by this government, three years ago now, for a seven-year, $125 million mental health plan. We are now almost at the end of the third year since that announcement was made.

The Minister of Health -- not the previous one, but the Minister of Health who was actually in that position as of January of this year -- indicated that that was a mental health plan which, while it was announced, was never budgeted for. Perhaps when the minister talks about this government making announcements that they never had any intentions of implementing. . . . Perhaps the mental health plan was the subject area that was top of his mind at the time.

I'm wondering if the minister can tell us where the mental health plan is. Is the government still committed to implementing it, and why do we not see any evidence of it?

[J. Sawicki in the chair.]

Hon. C. Evans: The hon. member suggests that there should be increased funding for mental health. While I would agree, I just want to set the record straight. The first budget of this government, in 1991, had funding of $194.8 million for mental health. The 1999 budget was $348.7 million for the mental health. So while it's not quite double, it is pushing double over nine years.


The health action plan provided for a total of $8 million new investment in mental health over the course of the next two years: $2 million that will be spent this fiscal year and a further $6 million budgeted for 2001-02.

Hon. Chair, the plan will provide for the creation of 275 supported residential care spaces so that people can live on their own and still obtain the support they need in the mental health community. It provides for seven community support workers who are intended to provide care for up to 77 people. It will provide for a demonstration research project to evaluate home-based treatment for adults with acute psychosis. It will also test emergency stabilization in two regions: one rural and one urban.

Now, I don't want to suggest that the health action plan replaces or detracts from the mental health plan. They are intended to complement one another, and I believe that we maintain the commitment to achieve the goal of completion of the mental health plan.

C. Hansen: The minister's comments just now don't give me any comfort that he even understands the mental health plan, that he even knows what's in it. And it doesn't give me any comfort that he understands what has transpired in the last three years in terms of funding for the mental health plan. In this budget that we approved earlier this year in the main estimates, there was only a grand total of $5 million to go towards the mental health plan this year, and I am told that only about $3 million of that has actually been allocated. So now, in this supplementary estimate, we're being told: "Never mind the mental health plan; the entire adult mental health services are only being increased by $2 million this year." And as the minister indicated, only $6 million next year is projected for adult mental health services.

[D. Streifel in the chair.]

If the mental health plan was being implemented according to what this government had committed to three years ago, we would have been allocating, on average, $15 million a year. So basically by the end of next year we should have been four years into that. We should have been at a $60 million mark if we were to be on target for rolling out that plan over seven years and $125 million. Instead what we see is that only $13 million has been disbursed in three years. Supposedly there's another $2 million in the existing budget, and now we're asking for $2 million more. That's $17 million. If we then add $6 million next year, we're still only up to $23 million. So at that point we would be halfway through the implementation of the mental health plan, and all that would have been allocated is slightly more than what should have been anticipated for year 1 alone.

I have heard through the grapevine that the Ministry of Health has abandoned the mental health plan. Will the minister confirm whether or not that is true?

Hon. C. Evans: That is not true. I'm not going to argue with the hon. member's assertions about money. However, I

[ Page 17262 ]

would like to point out that a whole lot of the mental health plan isn't just dollars; it's changes requested in how we deliver care. And the mental health division and their advisory group state that we have. . . . There were 81 recommendations in the mental health plan, and we have made measurable progress on 79. So I would like to accept that the funding levels that the hon. member is referring to have not been met. However, I think we have to point out that we've made a considerable amount of progress. I'll keep my answer short, but if the hon. member would like to ask me about progress on what fronts, I'd be happy to run through the list with him.


Hon. G. Wilson: I want to come back to an answer that the ministry gave in this debate earlier on, because I think we have today. . . . Certainly I -- and I can't speak for all of my colleagues -- have seen a fairly shocking revelation from the announcements that the Leader of the Official Opposition made at noon today. We know that this debate is about whether or not we should pass additional spending in Health that results from a surplus that we now find ourselves in, in British Columbia. We know that the members opposite are going to vote against this, because if they didn't vote against it, it would be inherently dishonest by virtue of the fact that the private member's bill that was tabled by the Leader of the Official Opposition states within that bill that that opposition believes that all surplus money should be committed to debt retirement. That's what that private member's bill says. So they're all going to vote against it, because that clearly is what the Leader of the Official Opposition has tabled in this Legislative Assembly as their policy.

So given that they're going to oppose this, given that the Leader of the Official Opposition declared today that their policy is to stick at 40 percent of budget, having already told us that he intends to reduce, by $2.9 billion of tax cuts, the overall budget -- $19.4 billion. . . . The minister, in response to a question from the members opposite, has told us that that impact of $1 billion cuts would affect the entire budgets of Powell River and Sunshine Coast health districts. And he said that with people observing this. I need to come back and have that clarified, because that is going to be news to those people in Powell River and Sunshine Coast, who now see what the clear option is, if that party opposite ever forms government in this province.

I ask this because I know that the Leader of the Official Opposition went up to Powell River, met with people in Powell River -- had a couple of dozen in a private, invitation-only meeting -- and at that point he told us that he didn't have a plan. It was clearly reported that he was there only to listen, that there was no plan, and that was widely reported among the health care professionals. The Premier of this province has gone up to Powell River, has met with health care professionals, has identified what the needs are. And in the moneys that we're debating today, the moneys that will be released into that health district will largely go to solve the problems that the Premier and I, as their MLA, have heard about today.

But what I want to ask the minister to clarify. . . . I want him to clarify that in fact the plan we have heard today from the Liberal opposition to cut $1 billion out of health care funding in the province of British Columbia, fully recognizing that to be honest to their commitment and the private member's bill that was tabled in this House, they will vote against these additional expenditures for health. . . . I want the minister to clarify what he meant when he said that a billion dollars lost could mean potentially the entire budgets for Powell River and Sunshine Coast.

Hon. C. Evans: What I was trying to estimate was what would be the ramifications of the plan that we heard earlier to cut a billion dollars from the Ministry of Health budget. Of course, you can estimate that however you want. You could saw off whole divisions of the ministry, like continuing care. Or you could decide to expend money geographically. One of the options would be to eliminate the funding of the health authorities in almost all of rural British Columbia. And absolutely, that would have an impact on Powell River and all of the rest of your constituency and all adjoining constituencies. But of course that's not the only option.

The Chair: Through the Chair, please, hon. minister.

Hon. C. Evans: We could, on the other hand, wipe out the funding for health care in the Fraser Valley or the Fraser Valley and Surrey. One thing I don't wish -- through the Chair to the hon. member -- is for your constituents to become overly concerned, because as long as I have this job and we govern, nothing like that is ever going to happen.

C. Hansen: I would like to get back to the subject of mental health. I would like to point out that it has always been a tradition in this House that there has always been continuity to questions to allow us members to actually follow through on subject areas. I just wanted to say how regrettable I thought it was that people trying to follow this debate suddenly realize that we're talking about mental health, and then the Chair chooses to recognize another member who goes off on another tangent which is totally political. And now we come back to some serious business about discussing mental programs in British Columbia. So perhaps anyone that's trying to follow this debate will have to bear with us, because obviously there are some long-held traditions in this House that are eroding today.


I do want to come back to mental health. In the spring of this year, in May, when we were in the middle of Health estimates, we repeatedly asked: "Where is the implementation plan for the mental health plan?" The mental health plan itself was a document that set out some principles. It was well supported by those in the province who are mental health advocates and those in health care delivery around the province, but there was never an implementation strategy that was attached to it.

Well, we repeatedly asked the Minister of Health when we would see that implementation strategy. In the middle of May the minister promised us that we would see it in a month. So that would have taken us up to the middle of June. On May 16 we asked again, and the minister said -- this was in response to a question from one of my colleagues: "If she's looking at it in terms of the mental health plan, there is the framework implementation which will probably be released within, I think, a month. . . ." It comes up several times. I won't refer to all of them. Oh, actually, here's one, on May 17, where the minister starts to change a little bit. He said: "I've said that we are having a plan of implementation around the

[ Page 17263 ]

framework that is coming up; it will be ready in about a month to six weeks." So there was a little fudging there, and that was only two days later. It was no longer a month, but adding perhaps another two weeks to that. Well, the minister, on June 14, when we asked about it again. . . . His comments were: "Stay tuned. It will be released very soon."

Well, hon. Chair, we never did see the mental health plan implementation plan. I'm wondering what happened to the promise that was made by this government for the release of an implementation plan.

Hon. C. Evans: I completely agree with the hon. member that mental health is of the highest priority. I wish it was in Canada. Currently the ministry spends $0.6 billion on mental health. That goes: $87 million in fee-for-service -- essentially psychiatric diagnosis; $33 million for sessional psychiatry; $133 million for acute hospitals; $2.5 million for home support; $20 million for forensic psychiatric services; $274 million for adult mental health; and $65 million to Pharmacare.

I have an implementation status report about the sections of the funding I just listed that apply to the mental health plan, but it runs to eight pages. It's broken down into such titles as -- I'm sure the hon. member is aware -- access project, early intervention, information technology and the like. I would be pleased to read the status report on each section, if the hon. member would like, or to share the papers with him, if he would like.

C. Hansen: Thank you. I already have that document. I've already read it. It has nothing to do with the mental health plan. You're talking about the adult mental health services that have been existing in the province for some time.

In the mental health plan there were specific commitments made for $125 million towards those programs that were advocated in the mental health plan. We were promised, in May of this year, that there would be an implementation plan released as to how and when aspects of the mental health plan would be rolled out. That promise was never fulfilled. And I'm wondering if the minister can tell us: is he breaking that promise and telling us that it's never going to be released? Or is he going to make a commitment for a new deadline -- we've already missed that one from last June -- for releasing a mental health plan implementation plan or implementation strategy or whatever words you want to put on the cover of the document?


Hon. C. Evans: I am holding in my hands. . . . I think we're both operating from the same paper, but at the bottom of mine it says: "The Mental Health Plan Implementation Status Report on Key Initiatives." For example, we can go to hospital-based emergency mental health care, and in the status report we find all of the changes thus far -- and there are 40 or 50 of these.

The hon. member asks: is there a mental health implementation plan? He says he's got the same document I have, and that's what it's titled, right on that piece of paper. So maybe it would best work if I share my paper with the hon. member, and then we'd talk about the contents of the paper.

C. Hansen: I have read the documents the minister is referring to, because they were available for public distribution at the conference in Richmond. But what was promised was not a mental health plan status report. What was promised was an implementation report. Actually, in a couple of places here, his predecessor refers to this as a framework of implementation, and that we have never seen.

I would like to ask the minister not for a document that is a status report on what has been done, which we know is woefully not enough, because we're only $13 million into a $125 million implementation. What we are looking for is what his predecessor promised us, and that was a framework for implementation of the remaining portions of the mental health plan, which have not been addressed and which have not been funded by this government.

Hon. C. Evans: I want to repeat my earlier comment. I make no argument with the hon. member's quite correct assertion that if you measure the mental health plan in dollar form only, the government has yet to meet its commitment. I want, though, to put this in a little bit of context.

Our expenditures are greater than -- and in some cases, much greater than -- other provinces in Canada on mental health. It is usual in an estimates process for members of the opposition to question government about whether they're spending money well. The assertion is that of the 71 recommendations in the mental health plan, there has been progress on 69 of them. I would encourage the hon. member to question me: why don't we get on with the other two?

The government needs to increase funding for mental health in the future. I don't think anybody here would disagree with that. I'd be happy to answer any questions about whether or not we're getting good value for the money we're spending. Perhaps I'm obtuse. I do not understand why the hon. member doesn't find the implementation status report on key initiatives to be a satisfactory document for answering his question of where we are in terms of implementation of the mental health plan.

C. Hansen: I think, to answer the minister's point, the difference is that the status report talks about what has been done, which is woefully inadequate. What was promised to us was a framework for the future implementation of the mental health plan. I would like to ask the minister: if he says that the mental health plan is not dead, then where do we see any evidence that this government, in its forward planning in terms of the next three, four years of this health action plan. . . ? There is no commitment in there to fully fund the mental health plan as they had promised.

It is one of the worst examples of a broken promise and a broken commitment by this government -- to actually make a promise of $125 million over seven years for those in our society who probably need that reassurance more than anyone. They need reason to trust government, and what this government has given is reason not to trust government, reason to show that they have been betrayed by this government and this party.

I'm wondering if the minister can tell us at what stage he is going to unveil to mental health advocates in British Columbia how the remaining $102 million of that mental health plan commitment is going to be forthcoming.


Hon. C. Evans: I'd like to repeat: we all agree on the need to increase funding for mental health. Of course, that will

[ Page 17264 ]

require increasing the funding for the health budget generally, and of course, that will require that we get on with this debate and vote for the appropriation.

I will go back to my original comments. The health action plan includes $2 million funding for mental health and a series of initiatives that I just laid out. We have agreed on the need to increase funding for mental health generally.


Hon. C. Evans: Maybe what the hon. member is looking for is this document called "Foundations for Reform: the Mental Health Policy Framework for the Ministry of Health and Health Authorities 2000-05." The hon. member shakes his head. There are advocates for the mental health community on the adult mental health services advisory board that made up this document. If this isn't it, I'm not sure what it is.

I will reiterate. We agree -- government, opposition -- on the need for increased funding. We are here today trying to obtain increased funding for the Ministry of Health. We agree on the need to implement structurally and also fiscally the mental health plan. We have made measurable progress on 69 out of 71 recommendations, and I think we need to keep going. I absolutely agree with the hon. member that we need to progress in implementation of the mental health plan, both structurally and fiscally.

C. Clark: Over the course of the debate this morning and this afternoon, we've watched this spectacle of cabinet ministers getting up in estimates and throwing softballs at the Minister of Health, in an effort to try to reframe this debate so that it's about anything but the government's record on health care, so that it's about anything but what this government really plans to do, so that it's about anything but the government's secret plan that they cooked up six months ago and have been sitting on, so that it's about anything but what they really plan to present to British Columbians in the next election. You know what that is? That is a total lack of a plan.

We have sat here for a decade with the NDP in government and watched our health care system fall apart. These cabinet ministers get up and ask questions, when you would think that they would have the opportunity to ask those very questions in cabinet. How about that? Maybe they'd have the opportunity to ask those questions in caucus. Maybe they'd have the opportunity to ask those question at their retreats. Maybe they'd have the opportunity to do it when they go out for their regular meals with one another. Who knows?

The fact is that members of cabinet have ample opportunity to request answers from this minister, and the fact is that the one single opportunity that the opposition gets to ask those questions -- the one single opportunity that we get to stand up in this House and present questions on behalf of the citizens -- is during the estimates debate.

When we are denied the opportunity to do that -- because we have an emergency session that's for a short period of time, and we have cabinet ministers who demand opportunity on that agenda to speak -- it's an abuse. It's an admission of the total incompetence of every member of this cabinet who's gotten up to speak today, because they have a duty. They have a duty to share this information in advance of coming to the House.

If this indeed is a plan that the government has worked on for months, if indeed it's a plan that they've discussed, and they've gone out and consulted on, and they've talked to everybody else about, then why all the questions? Because this is the one opportunity that people like the mental health advocates, who are here today, have to put their questions forward. I don't see the members of the government doing that.

I don't see the members of the government that have gotten up to speak asking the minister where the money is for mental health -- asking the minister why he hasn't fulfilled his promises, why this government hasn't fulfilled its promises to people who are mentally ill in British Columbia. I don't see a single member of cabinet getting up and asking those questions. I don't see a single member of cabinet getting up and asking what the minister is going to do about the disgraceful waiting lists at Royal Columbian Hospital.


I don't see the members of cabinet standing up. I didn't see the member for New Westminster stand up and ask this minister why he doesn't do something about opening up the perfectly good intensive care unit that sits closed and idle and collecting dust at Eagle Ridge Hospital, so that it can relieve the wait-lists and the backup at Royal Columbian Hospital, which is, after all, in his community. No, instead these cabinet ministers want to stand up and reframe this debate so that it's about anything but this government's hopeless, shameful, irresponsible incompetence with our health care system in British Columbia. That's what this has been.

For this government to come here and call a special session today, because they forgot that they might need. . . . Because the Premier was never aware of the acuity of the problem. He didn't know the enormity of the problem until yesterday. What did he think? What did he think that the rural health care providers were leaving their hospitals for? What did he think over these last months that all those rural communities that have come down here protesting the lack of services in their community were talking about? What did he think was going on with Sharon Singh when she couldn't get her transplant?


The Chair: Hon. member, order.

C. Clark: It was only yesterday that he recognized the enormity of the problem.


The Chair: Hon. member, order, please.


The Chair: Order. Would the Minister of Employment and Investment come to order, please.

C. Clark: One of the cabinet ministers got up today. . . . The member from Surrey did say something that I connected with. She said: "Maybe it feels good for members of the opposition to get this opportunity and stand up and let off a little steam about what's been going on with the government."

You know what? That's true, because every time anyone, any single member of this opposition, stands up, we are

[ Page 17265 ]

acutely aware that we are doing it on behalf of the three million British Columbians who stand in opposition to this government, who are begging for an election -- all the British Columbians who've been denied care in our health care system, all the British Columbians that would desperately love to be able to stand up for one minute and tell their story to this government, be able to ask the Minister of Health how he can stand to be part of a government that is so hopelessly incompetent that our health care system has been driven into the ground.

We spend a lot of money on health care in British Columbia, and we've got to ask ourselves why the NDP still haven't even come close to starting to make it better. Every year we spend more money, and they seem to make it worse. This debate is about the hopeless, total incompetence of this government. And we have a duty on this side of the House to make sure that this money is spent correctly, because it's not the size of the budget that counts; it's how you spend it. That's what counts.

You know, this government can sit there and throw money at the problem. But what we in the opposition want, what British Columbians are desperate for, is a plan to fix the problem. We need a plan that will look at the problem holistically. Why doesn't the government say, for example, that they would like to provide long-term funding to health regions so that they can operate in a stable environment. Instead, the health care system reels from crisis to crisis, minister to minister.

We've had six Ministers of Health in four and a half years, since the member for Vancouver-Kingsway was elected Premier. That's disgraceful. How can the government -- how can the Premier -- pretend that he's providing any stability for the health care system when he won't keep with a minister long enough to let them even get to know the names of the folks that work in his office? How can we have stability in our system?

The biggest problem facing our system today is the chaos that people are expected to work within, and I'm going to tell one story about that, because it's, I'm sure. . . . Maybe the Premier doesn't get this kind of correspondence, because he wasn't aware of the enormity of the problem until -- guess what -- just yesterday. But maybe I'll share this with the minister. This is a story from a daughter whose father-in-law was 86 years old. They waited a week for a bed -- a week for a bed -- in Royal Columbian Hospital, until finally her father got sick enough that they had to send him to emergency.


An Hon. Member: You always find one.

C. Clark: No, hon. member, this isn't just one.

Hon. Chair, the minister, in his heckling, says that we always find one. Well, the fact is that these stories are legion. And if he would check with his constituency assistant, he'd find that it happens in Vancouver-Burrard too. These problems are not specific to Port Moody-Burnaby Mountain. It's true in every constituency from every side of the House as well.

Let me give you the story. He waited a week for his bed, until he became so acute that he had to go into emergency. He sat in a wheelchair in emergency at Royal Columbian for three hours. After that, the family finally found him a couch to lie on in the waiting room. Then she phoned the administration to try to get some help, and she got an answering machine. Then she finally phoned her MLA's office, who didn't happen to be me; it was an NDP MLA. She still got no help. She phoned my office. Then, after we phoned the hospital, he got a bed -- after six hours.

Now, it may not have been the phone call from my office that got him a bed. But the fact is that the man had to wait six hours until he got a bed. And do you know the response from the nurses, the desperate nurses in that hospital who are totally run off their feet? They said he wasn't sick enough to get a bed. In the context of all the other people in that waiting room who were so acute, this man wasn't sick enough to get a bed. He finally got a bed, after six hours of waiting, and then he died. Now, I don't know if he would have died anyway. But I do know that that man spent the last six hours of his life without the dignity that he deserved before he died. I know that his family went through a great deal of pain not just in those six hours but in the week before that they had to wait for a bed.

The minister knows that these stories are common, and the minister, I'm sure, sympathizes with the family. But the fact is that these problems are legion in British Columbia, and they have been for a long time -- not just when the Premier discovered the problem yesterday, not just when the new minister was appointed a month ago, not just when the government came out with its last health plan in the fall or its plan before that in the previous budget. These problems have been multiplying and getting worse for a decade, because the government has been entirely neglectful of our health care system. The government has been so incompetent in its allocations of our public money that the system is falling apart.

There is one thing that this minister can do to try to relieve the problems for people like this family and to make sure that Royal Columbian works a little better. One of those is to devote some money to getting the intensive care unit at Eagle Ridge Hospital -- which is a feeder hospital for Royal Columbian -- back working again. It was built years ago, and it's never been used. It's fully prepared and ready to function.

The health region is out there now trying to scrape together enough dollars within their existing budget to get the thing going, because they know that if they can get the ICU at Eagle Ridge up and running, they won't have the problems that they currently have at Royal Columbian. They won't have patients on stretchers, practically out the door, waiting for beds. That's what they need to do to relieve the pressure. So where in this budget, in these supplementary estimates, has the minister accounted for money for the Simon Fraser health region, for the ICU at Eagle Ridge Hospital, so we can relieve the acute pressures at the hospital that's in the Attorney General's riding?


Hon. C. Evans: Staff are unaware of whether the Simon Fraser district has put in a submission for funding for that particular unit, and we are going to attempt to find out.

I do want to respond in one respect, and that is to say this: the entire system, including members from the hon. member's community, has said that we need a provincial bed-management system in order that the entire system, especially in the lower mainland, can relate to one another without having to do so individually by telephone. That is in the

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health action plan. If I get an answer to the specific question that the hon. member asked about the specific hospital during debate, I will supply it to her.

M. Sihota: Finally, after listening to the member for Port Moody-Burnaby Mountain, we're starting to have the kind of debate that we ought to be having in this chamber. If I may say so, hon. Chair -- and it's not often that I say this -- the member opposite is right on one point: this debate in the House today is all about plans. It's all about the kind of vision about health care that we on this side hold versus the kind of vision that they hold on the side opposite.

Let's be clear about those visions, about what we stand for versus what they stand for. On this side of the House, we've made it very clear. In this health action plan, which the Premier and the Minister of Health tabled before British Columbians a few days ago, we've made a fundamental commitment for more beds, for more doctors, for more nurses, for more community care and for more equipment in hospitals throughout this province, whether it's the urban regions of the province or the rural regions of the province.

And you know what? In doing so, we have increased our expenditures. Let me say, parenthetically, that we don't make those expenditures simply to make them; we make them to try to get best value for dollar. But we've increased them by almost a billion dollars -- by $800 million over the course of this fiscal year.

And we're very proud on this side of the House, as this debate has demonstrated today, to stand up and talk with some passion about our commitment to health care. After all, we are the political party that gave birth to health care -- the concept of medicare, a publicly funded health care -- in this country. We feel, on this side of the House, a special obligation to make sure that that publicly funded health care system is never threatened in any way whatsoever. That's what this expenditure is all about.

You know, you never hear anybody opposite, including the member for Port Moody-Burnaby Mountain, stand up and speak with pride about their vision, outline in any comprehensive way their plan, articulate what it is that they would do in terms of health care. But it is fascinating that during the course of this debate, a number of plans from the members opposite have emerged.

First of all, it was apparent from the debate this morning that the members themselves, through their leader, were prepared to concede that they have no plan for health care. Imagine that. On the eve of a provincial election, before they are to go to the voters of this province, after nine years in the political wilderness in opposition, they still don't have a plan. If I am to be doubted on that point, let me just read what was stated in the Prince George Citizen after the Leader of the Opposition gave an interview. He says: "This requires a strategic long-term plan for the province of British Columbia, and we don't have one yet." That was on September 21.

Again, a few days prior to that, on September 19 in Prince Rupert, he said he would refuse to give a timetable for how soon after the election his party would roll out a plan on health care, if it won the election. Imagine that -- no plan.

That's where this debate started today. But now the members opposite start saying: "Don't worry. We have a plan. Don't worry. We'll release it after the election." Well, if you have a plan, where is it? Why do you have to keep it in a state of concealment between now and the next election?

An Hon. Member: Call an election.

M. Sihota: We'll get to the election. We'll get to the election in a second.


M. Sihota: Hon. member, you will show the cowardly side of yourself in a few minutes, when I get to the election.

So then they say: "We'll release it come the election." So we think: okay, fine, they do have a plan, but it's part of a hidden agenda. Obviously, with our knowledge of where those members are often at, that hidden agenda, in my view, must contain elements of privatization.


But this afternoon, during the lunch hour, the Leader of the Opposition finally found the way to walk through those doors and face the scrutiny of the press, and he had to concede that his health care plan contained a $1 billion cut. In other words, with the Liberals there would be $7 billion, not $8 billion, spent on health care.

The Minister of Health has pointed out the catastrophic consequences to British Columbians if we were to have a billion-dollar cut in the health care system. And there's every reason to believe that that's what we would see from the opposition. After all, during the course of the last election campaign, the Leader of the Opposition stood up and said that he would make an expenditure of about $6 billion, because he thought that was enough. And now he stands today -- finally -- and discloses his plan of making a billion-dollar cut. Now all of us are informed about the consequences of a billion-dollar cut, because the Minister of Health has informed us of those consequences. That may explain why it is that the member opposite, the member for Port Moody-Burnaby Mountain, is not prepared to speak with some passion to defend the position of her leader. I challenge her -- and this is the cowardly side -- or the Health critic opposite to stand up and defend that billion-dollar plan.

The one thing I would say about them. . . . The Leader of the Opposition, in his comments, went further today. Not only did he say that he'd make a billion-dollar cut to health care, but he committed himself to two consecutive deficit budgets should his party form government. Now, think about that. On this side of the House, we have gone through some turbulent economic times. We've turned the corner. We've balanced our budgets. We have a surplus. We are applying those funds to health care. We're looking after the priorities of today's families. And what would they do? They would cut the system by a billion dollars. They would run two consecutive deficits in a row.

So we now know the difference. On this side of the House we are prepared, through this initiative, to increase funding to health care by $180 million. On the other side of the coin, they are prepared to cut health care by a billion dollars. I say to that member opposite: be courageous; don't be cowardly. I challenge her right now to stand behind the program that's been outlined by her leader -- to stand up and vote against this expenditure. I challenge that member opposite not to speak against what we're doing and then vote in favour of it. I challenge her, just for once, to have the strength of her convictions and all of her colleagues opposite and vote against this $180 million expenditure.

[ Page 17267 ]

I'm sure the minister will now answer my question about what the implications of cutting it by $180 million will be.

Hon. C. Evans: The answer to the hon. member's question is the same as it was before: government would have options. Since the hon. member lives on Vancouver Island, he probably would rather that government didn't choose the option of eliminating all health care on Vancouver Island. But that would only leave a couple of other options. You eliminate health care generally in the entire southwestern Fraser Valley, all the way up to Surrey, or you wipe it out in every rural part of the province. Unless you wanted to eliminate some entire division of the Ministry of Health, I don't see any other way to solve the problem. Consequently, I think it would be bordering on immoral to cut a billion dollars from the Ministry of Health at this time.

C. Clark: It is amazing to hear members of the NDP talk about convictions. I think they're the last people that should be having discussions about that in this House.

Having said that, though, let me add this: the thing that would show real courage, real leadership, on the part of this Premier. . . . The thing that the spin doctors around the NDP are so desperate to veil him in -- this idea that he's a great leader, a man capable of courage and leadership for British Columbia. . . . Well, if he's got so much courage and leadership, call an election. That's the thing that would be gutsy. That's the thing that would show the courage of his convictions. Call an election. Go to the public with your record. Go to the public with your plan, and let them issue their verdict on what you've done for the last ten years in government.


But I do have a question following up on my previous topic -- before I was interrupted by the member for Esquimalt-Metchosin -- and that is about the Simon Fraser health care region and, in particular, Royal Columbian Hospital and its very acute bed shortage. The minister said he didn't have the details about what would be going on with Eagle Ridge Hospital. What else, then, is the ministry specifically intending to do to relieve the bed shortage in the Simon Fraser health region, particularly at Royal Columbian Hospital, and where can we find that in this plan?

Hon. C. Evans: The hon. member's question, I think, is: how are we going to relieve the shortage of acute care beds at Royal Columbian? Just for interest's sake, that is one of the hospitals that the Premier and I visited. I found the physicians and nurses and hospital staff most helpful and very educational. Then we met with the chair of the health authority, who pointed out to us that their greatest need was for continuing-care beds in order to relieve the pressure on the acute care system.

Through the Chair to the hon. member, the exact answer to her. . . . The Simon Fraser health authority will receive funding for 258 continuing-care beds as a result of the health action plan. Just for interest's sake, staff are still looking for the answer to her previous question.

C. Clark: Do those continuing-care beds include the expansion of the Burquitlam Lions intermediate care facility in Coquitlam, which was promised in 1996?

Hon. C. Evans: In the interests of keeping things moving, staff will look for that answer. The information thus far on her previous question is that there is an ICU review at Eagle Ridge presently underway. That review has not reported out, and we do not have requests from the health authority based on it. It's expected that the report will be done early in 2001. And we will look for the answer to her present question.

I. Chong: I appreciate the opportunity to participate in this debate for supplementary estimates of the spending for Health. I think it's no surprise that all of us have constituents in our areas who have been contacting our offices, because health care has become a crisis. Health care is in chaos in our regions. I'm receiving letters on a daily basis and phone calls on a daily basis from people who are telling me this. I'm not putting these words in their mouths; they're expressing these to me.

Today I would like to share three of those incidents with this minister in hopes that he can perhaps provide me with an answer -- an answer that this new plan is supposed to provide for those constituents. And then they'll have some assurances that this government is doing something about health care -- health care that they have so terribly mismanaged.

I'm not going to engage in the kind of rhetoric that government members have done. I know that the purpose of this emergency session is about finding out where the moneys are going to be allocated, for what purposes, so that our constituents are well served by that. I will focus on that, and I will ask the minister if he can provide me with specific answers.

The issue of long term care beds, I know, is a growing one. In the Speech from the Throne in this past spring, I believe that in fact it was indicated that there would be 2,000 new beds that would be promised provincewide. And to date, I understand, there's been no funding for that. I know that in this particular region, 300 beds at least are needed. And as a result of no action on the part of this government, we do have some very severe cases occurring.


One in particular just happened within three weeks ago, where a constituent called -- a Mrs. Rolstone -- and said that her husband has been in an acute bed for eight weeks. She asked that I mention this to you, knowing that we were coming back to the House today. She says she has no idea what's going to happen. She's an elderly person; her husband is a veteran and currently is taking up space in an acute care bed. He has been there for eight weeks.

She would just like to know -- and I'm wondering if the minister can provide any kind of answer -- just how soon we can look to be placing him in a long term care bed. Given that there are new moneys being provided, what kind of action immediately will be effected in this area, so that I can at least tell her? Will he have a long term care bed before Christmas? Will it be after Christmas? How much longer is it going to be? There is tremendous stress on her part. That is one of those questions I'm going to ask or that I would like the minister to provide an answer for, hon. Chair.

I'll lay it out so that the staff can help look for those answers. And I'll give all these three cases at once, to be an effective use of time.

The second is another constituent who contacted me, by the name of Andy Horn. This young man is only 22 years old.

[ Page 17268 ]

Basically his e-mail to me is quite alarming. He writes and says: "I hope to see my twenty-third birthday in December." This gentleman has cystic fibrosis and has been on a wait-list for a double lung transplant. He realizes that transplant of organs is difficult enough, that you have to wait for those things and that it requires a tragedy in another case to save a life. But his concern is -- in light of the recent revelations, as he's indicated -- the shortage of critical care beds that happen at Vancouver General. His question is very simple, and I can't answer it.

So maybe the minister can provide an answer as to, again, what part of the funding that's available in this new capital health plan will deal with this and specifically, perhaps, for this area. He says: "Is there anything that the Minister of Health can do to assure me not only that I will receive my transplant when an organ becomes available but also that the lack of critical care beds will not interfere with the timing of my transplant?" It's a simple question but a very serious one. I know, as I say, that it takes time to put some of these things in place. But maybe the minister can again share with us just how long that will be. And what kind of funding is being allocated for the critical care bed shortages?

Another instance: a Mrs. Barton also contacted me, and it was again in regards to, in this particular case, hip surgery. This has to do once again with wait-lists. We thought that wait-lists had been dealt with when we provided or approved the extra spending in September, but apparently it's still escalating. And there are still problems. Mrs. Barton says she requires hip surgery and has been rescheduled for the third time. Originally it was supposed to be October 27; it was moved then to November 17; now she's been told December 18. Again, this woman is definitely in pain and not able to sleep in the evenings due to her hip problem and certainly has difficulties with mobility and can only handle short distances with a cane, if in fact she is able to get out. And she just wants to know, as well, what we're doing about the wait-lists.

So these are some of the issues that I, as an elected MLA, am experiencing in my area. And I've been asked by these particular constituents, when I return to the House today, to ask the minister these questions, because only he would be able to shed a little light here. Only he will be able to tell us whether or not money has been targeted for these areas, and I certainly hope they have been targeted. Also, how much of that is targeted for this area in particular, the capital health region?

In conclusion, I do want to also mention the area of the medical equipment, because I'm aware that in the last expenditure in September, of the $70 million that had been allocated for that, Victoria in fact did get $7 million. And I am grateful for that, as are all the residents in greater Victoria. I would also ask the minister if he would be able to give me an idea -- a detailed list, if he will -- of the amount that is going to be allocated to Victoria, in addition to the kinds of equipment that are going to be made available.


I'm not going to ask questions on the mental health plan, because I know that my colleague the opposition critic has already done so. But I can tell the minister that when I met with the mental health advocates only two days ago, they had some serious concerns about the genuine integrity of the mental health plan that was introduced, the $125 million commitment that was made some years ago, which is still at this time not being funded. I just put that on the table once again for the minister, for his awareness that in this particular area, in the capital health region, we are watching very closely to see that we do get our fair share of the dollars to be allocated to deal with the health care crisis in our area. I'll ask the minister if he would provide those answers to me.

The Chair: Just before the Chair recognizes the minister, the Chair is going to draw attention to the committee. There's a background ambient noise here, with the multiple conversations. If we could tone them down, whisper softer. . . . I don't know if the Chair's hearing is getting better or not, but that's all the Chair can hear at this stage.

Hon. C. Evans: I'd like to preface my remarks to the hon. member by saying that I'm going to speak about the generalities of the three different issues she raised: the need for continuing care beds, the transplant issue and the hip surgery wait-lists. I want to say on the record that I do not wish the citizens involved to think I am commenting on the particular care of any individual. That's inappropriate for the Minister of Health.

On the first issue of people living for eight weeks in an acute care bed, the story that the hon. member tells is all too frequent around British Columbia. That situation pertains in my constituency and hers and around the province. My anecdotal observation would be that 20 percent of the acute care beds in the province have people occupying those beds who ought more properly to be cared for at home or in some other level of care. Now, in her region the allocation of the continuing care beds ought to fund, over the course of the next four years, 186 continuing care beds for people in the situation like the one she describes here today.

Secondly, I want to repeat that I don't know anything about the individual case. But there are some people in acute care beds who can, through home care nursing and the like, go home. There is an allocation for home care services, including nursing, increasing in the capital region. I don't have it right here. Oh, hang on -- yes I do. The increase in the capital budget for home care is $1.24 million -- the operating budget for delivery of home care.

Now, the second issue that she raises -- again, I don't know about the individual case -- is the question of transplants. She raises the somewhat disturbing question that an individual and perhaps some individuals around the province expressed some concern, as a result of recent events, that they might be at risk. Staff advise me -- and again, this is anecdotal; it's not based on statistics -- that the only person that we at present know of who has missed a transplant due to the inability to assemble the team at the appropriate moment is the case involving Mrs. Singh, which has since been resolved. The people of British Columbia, and especially the hon. member's constituents, should keep in mind that we had never tried before to deliver two liver transplants in one facility on one day. I acknowledge that we ought to be able, if we have that need ever again, to meet that level of need on an ongoing basis.

The B.C. Transplant Society was just awarded a national award as best in Canada for its capacity to manage the needs for transplants here in the province. And I'm quite proud that we have a transplant society managing the process, because it assures everybody that Ministers of Health don't decide who receives care.


[ Page 17269 ]

The third issue that she raises. . . . She asked what we are doing to improve the number of critical care beds around the province. In the short term, immediately there will be an increase of three critical care beds in the lower mainland. In the middle term, there will be an increase of six -- three before the end of this fiscal year and three more next year.

The third issue that she raises is the question of an individual who was scheduled for hip surgery three times. Of course, hon. Chair, I know nothing about this particular case. I will say that one of the cost-effective ways of managing an operating theatre and staff resources is that optional operations are scheduled to use those resources and then, through the process of immediate triage, are sometimes dropped off the list because there's someone in a life-threatening situation on that day. While I don't know the case of the hon. member's constituent, I consider that to be a rational use of resources, because it assures that we have the people at the appropriate place on the day that they're needed by anyone in a life-threatening situation.

The last thing I would like to say -- thanking the member for the concise nature of her questions -- is that staff will follow her question in Hansard, and if she requires further follow-up on those individuals or on those particular questions, she can obtain it at another time.

I. Chong: I thank the minister for answering those questions, but I would just like some clarity, because I might have misunderstood. I will check Hansard again, but before I leave the debate. . . . The 186 continuing-care beds which will be funded -- does that mean that they're funding the beds which perhaps aren't funded now? Or are these new beds that will be opened up? And are the 186 beds in the capital health region? If he could just confirm that very quickly for me.

Then home care -- the $1.24 million that he said has been allocated. Is that also specific to the capital health region? As he can understand, I'm looking for specifics for my area. That's what my job is, to come to this legislative precinct to ask questions of the minister on behalf of my constituents. If the minister can provide those answers, I'd appreciate it. And I do thank him for being cooperative, and I hope other members on the other side of the House will be concise when they ask their questions of the minister as well.

An Hon. Member: Hear, hear.

Hon. C. Evans: The equipment allocation for the hon. member's area -- in the greater sense, the capital region -- is $6.919 million; the home care allocation -- new money -- is $1.24 million; the flex-bed money is $813,000 of new money; the mental health allocation is $140,000 of new money -- for a total of $8,997,740. And the allocation of beds -- and this is not capital costs but operational costs of new beds. . . . I make no comment about whether those beds physically exist at present or not. We are going to fund the operations of beds, and it's up to the capital region health district how they come to exist. That's 186 new beds.

D. Miller: Well, Mr. Chairman, I followed the discussion with interest. I would note and commend the minister on the plan. If the minister has not had an opportunity to read the press in my constituency, in Prince Rupert, I just want the minister to know that the CEO of the health council has described the new spending as "very positive" and goes on to say -- and I think, illustrative for all members: "I think everyone realizes that there has to be action. I can't see anybody disagreeing with this -- whatever the political party." From a very unbiased source, albeit one that is concerned with health care, there seems to be some satisfaction with the action plan that the government has outlined.


Now, rural health care has been a very divisive issue, and I took part in some meetings myself in Terrace and met with doctors in my home community of Prince Rupert in an attempt to try to understand it. I note that there had been a significant amount of controversy vis-à-vis the $40 million offer that was on the table for rural physicians and a great deal of debate. Some doctors themselves were saying, for example, that they thought the Prince George agreement was too rich; it shouldn't be that high.

I followed the debate here, particularly both what the members of the opposition have said in written form outside of this House and what they've been saying inside this House. It's very difficult. I'm trying to look for some clarification, I suppose. On the one hand, when we -- and I've done this in my capacity as chair of caucus -- have said, "Here's what we think the Liberal agenda is," and we've itemized that, and we've taken their statements about massive tax cuts -- which they continue to say, by the way -- they deny it.

[P. Calendino in the chair.]

I'm flabbergasted that the Liberals have spent -- at least in the last couple of weeks -- a fair amount of time actually denying that they ever had an agenda of tax cuts. Yet every time I pick up a newspaper and read the quote from the Liberal House Leader or whatever, they say tax cuts are the key. So you can appreciate that I, like members of the public, am somewhat confused. Somewhat confused, somewhat -- in fact, very -- confused. . . .

They've cited as one of the reasons for their failure, after nine years in opposition, to actually table a plan. . . . They've said: "Well, we're not the government." That's one of the excuses they give. The other excuse they give is: "Wait till the election is called, and we will tell you." That's a bit of an insult to British Columbians, but fair enough; if they want to insult British Columbians, they should do it.

They have stressed repeatedly that they can't make commitments because they don't have the information. Yet I was struck by a release put out by the Leader of the Opposition in which he said, two years ago March, that we should commit $100 million to rural physicians -- $100 million. This is the same gang that says they can't make commitments because they don't have the information and then puts out a release saying $100 million.

I note that the Vancouver Sun on October 19, 2000, made a reasonable observation, and I'll quote that: "One promise has been to put $100 million more into rural health, a number he" -- meaning the Leader of the Opposition -- "now concedes was plucked from the air. . .rather than arrived at through any calculation of needs."

Maybe there was some other motive. Maybe there was another motive. I'm curious about that. After saying repeatedly that they couldn't make commitments because they didn't have the information, or there was an election called, or they weren't the government, they managed to come up with a number that was two and a half times what

[ Page 17270 ]

we've got on the table to try to resolve the important rural doctors issue. Maybe the ulterior motive was a letter they sent out this past November to all the doctors -- and I'm quite curious where they got the list of all the doctors. But the letter went out to all the doctors asking for money.

Here we have an opposition party that claims they don't have the facts to make these kinds of announcements and that made an announcement, a commitment by the Leader of the Opposition for $100 million, even though he admits he doesn't know where it's coming from or indeed if it's an appropriate number. But they do know how to raise money. They do know how to raise money, and they've managed to send a letter to the doctors in effect saying: "Give us money." It's sort of a quid pro quo. "We'll give you money if you give us a little bit back."


In my book, some people might call that a conflict of interest. Some people might call that not being very straight up. I'm just kind of curious where these lists came from, where they got the lists for the doctors. I'm kind of curious how much money they've collected from the doctors. Is it linked in any way to their promise to give them $100 million without even knowing whether or not that is an appropriate amount?

You know, we have lots of. . . . I'll go back to the quote from the CEO of the community health council, who says that this should not be political, this should not be partisan. We have a Liberal opposition who, in my view, as I said earlier, are trying to exploit the very real strains that exist in our health care system, not just in British Columbia but right across this country -- very real strains exacerbated to a large degree by the withdrawal of federal transfer payments.

We now have an opportunity -- with the restoration, at least in part, of some of those transfer payments and the additional money we're putting into health care -- to try to improve the system. Nobody would say that you can have a flawless system where there are never any problems. But it is a bit unseemly to have an opposition party who appear, in my book, to simply be trying to capitalize on these problems for political gain and who make irresponsible statements about spending $100 million when they don't even know where the money comes from or if it is appropriate. Then they follow that up in the most shallow, shameful way with a letter to the doctors saying, "Give us some money," when they've already promised to give the doctors a lot of money.

I think maybe part of the problem we've been having in this province with respect to the debate around health care is that we've got an opposition party that would rather try to capitalize on these problems for political gain than actually try to propose solutions. The proof of that is, I think, that despite our repeated requests -- not just us but others in British Columbia -- they will not table any document that says how much money they will spend on health care, what their priorities are and how they're going to manage that vis-à-vis the kinds of tax cuts they're proposing. Their questions to me ring rather hollow, and I'm wondering what kind of destabilizing effect these Liberal games are having on our ability to try to bring some sense and calmness in terms of our relationship with doctors and other health care providers in the province.

An Hon. Member: What was the question?

Hon. C. Evans: The question -- I'll repeat it for anyone who missed it -- was: what kind of destabilizing effect do political promises have on negotiations with physicians? I'm pretty sure that's what Hansard would say is exactly what the question was.

I would like to make a request of all hon. members that they respect the six negotiating tables that we are at with physicians, the negotiating tables that we are at with nurses, HSA workers and HEU workers. And please do not continue making partisan statements about how those negotiations should come out.

An Hon. Member: You're not serious.

Hon. C. Evans: Hon. Chair, I'm deadly serious, and I mean it for people on all sides. The only way to have peace in the land on health care negotiations is for them to be many steps removed from partisan politics, and that goes for members of the government as well as for members of the opposition.


I would like to commend the rural physicians, who, as everybody knows, have been negotiating in good faith for some time now. And those negotiations, now that they are removed from the front pages, are, I think, going quite well. Tomorrow, I believe, the Hope report -- the rural mediation report -- will be released jointly by the Ministry of Health and by the doctors themselves.

Through the Chair to the hon. member, you may have noticed that I have not commented on the outcome of those negotiations ever since I got this portfolio. Nor have I commented on any of the other tables, because it feels to me like the only way to make the system work is if we -- elected people -- stay away from the process of labour negotiations or physician negotiations.

So congratulations to all the parties. I have nothing but hope that we can resolve this. I would ask members on all sides: as we move through the next few months, please remain aloof from the process of discussing settlements at any table.

P. Nettleton: We've heard it all today. We've heard the minister implore us to refrain from partisan debate after having himself led in what was clearly orchestrated, a string of partisan comments directed to himself. In any event, here we are today, with the latest health care minister delivering this government's latest vision for health care.

As a member who represents the people of Prince George and surrounding communities, I witnessed the local health care system come awfully close -- too close -- to collapsing in the past year, after years of neglect by this government.

The Minister of Health suggested some months ago that the health crisis was simply a concoction of the news media. I wonder if he might tell the people of Prince George and other rural and northern communities if he still believes the health crisis is simply a concoction of the media.

Hon. C. Evans: Hon. Chair, I believe and I've said over the course of the last few days that the story of the status of health care in British Columbia is fairly complex. I'm going to give you an example. On the one hand, we all know that there have been moments in communities or, in particular, hospitals where there have been moments of crisis with our inability to

[ Page 17271 ]

deliver either the equipment or the staff or, literally, the beds at moments of people's need. On the other hand. . . . And of course that gets the public's attention.

But hon. member, I want you to have some pride, especially as a rural MLA, about the progress that we've made in ten years. Ten years ago the infant mortality rate in British Columbia was eight per 1,000. My understanding is that this means that of every 1,000 babies born, at the end of one year's time there had been eight premature deaths. Now, hon. member, all over the world the measurement of the well-being of society is based on that figure of infant mortality. I understand that the reason for that is that this single number constitutes the nutrition or malnutrition factor, the ability of governments to deliver health care in all regions and to all people. It has something to do with substance abuse; it has something to do with income levels; it has something to do with reproductive options for parents. So the United Nations uses infant mortality figures to basically say what is the health of a society.

While we talk about crisis -- and I'd be the first to recognize that there are moments of constriction in the system that need the health action plan to fix them so those constriction points go away -- I would like the hon. member, especially as a rural MLA, to take huge comfort in the fact that over the course of the last ten years, we've gone from an infant mortality figure of eight to 3.7 per 1,000. Hon. member, that means there are now only four nations in the whole world healthier than our population, by that figure. And we started ten years ago from a place somewhat shameful in the position in the world. The great news is that northern citizens, by our ability to deliver health care and nutrition and options to people where they live -- rural citizens -- improved at twice the rate, 200 percent the rate, to bring that number down than did urban citizens.


So I guess my answer to your question would be: it's a complex story. On the one hand, there are points of constriction or failure in the system, which the health management plan is intended to rectify. On the other hand, this group of people should celebrate. Over the course of a decade we improved public health in the province of British Columbia at a rate which I think is somewhat phenomenal, not just in this country or on this continent but in the world.

P. Nettleton: It's a sorry state of affairs when the current Minister of Health has to point to an obscure United Nations report dealing with infant mortality to take some credit for this government's mismanagement of health care in northern rural British Columbia. It's an absolute disgrace. I'm just absolutely shocked.

It appears the only way this government knows how to operate is by crisis management. In Prince George, only after specialists withdrew services did this government finally take action, not because they finally awakened to the health care crisis in Prince George or the fact that patients were suffering but because of political pressure.

On the nursing front, it's been suggested that Prince George Regional Hospital is in need of as many as 100 nurses. At the same time, UNBC will graduate seven nurses this year, and only two of those are likely to remain in the north. How, specifically, is this so-called action plan going to address the need for more nurses and other health care professionals from the north? Frankly, we've heard it all before.

Hon. C. Evans: I just would like to correct the record. That obscure report -- the one that didn't make any sense to him and that he doesn't think is relevant -- is written by the provincial health officer. That's the gentleman whose job it is to measure the health of British Columbians, especially northern and rural British Columbians, who the provincial health officer was talking about.


Hon. C. Evans: I was very quiet. Okay -- I'm going to calm down.

It isn't obscure. It means that the people here are getting healthier, especially in rural areas. I wasn't even taking credit for it. All I was suggesting to the hon. member is that we should be glad, as British Columbians, of the improvement we made over ten years. The gentleman who said so is kind of like the ombudsman, the child protection officer, the auditor general. He is an independent appointment to talk to you, hon. member. I've sent a copy of that report to your Health critic. Perhaps he could share it with you, and you could correct your notion about the obscurity of the data.

The question was, as I took it: what particular benefit will this have to rural nursing? There is $2.5 million, hon. member, allocated for recruitment and retention strategies and initiatives for nurses and other health care workers, expressly for rural areas -- bursaries for nursing students from rural areas and bursaries for aboriginal students, especially to rural areas. And there will be increased funding and access for rural health science students. So that the hon. member understands the difference I'm talking about. . . . Well, perhaps the hon. member knows: those technicians like radiation therapy, the X-ray technician and the physios -- all aimed at rural British Columbia.


B. Barisoff: Just a couple of questions to the minister. I was going through the document, and I noticed that there was nothing on long-term care, particularly in South Okanagan. The reason I ask the question is that I had an opportunity earlier in the week to meet some of the people that were involved in long term care in the South Okanagan -- in Penticton, Oliver, Osoyoos. They indicated to me that there was a great possibility that there would be some long term care funding in this announcement, particularly for Penticton, Oliver and Osoyoos.

I'm just wondering whether the minister could elaborate what happened to it or whether it got pulled out at the last minute, because there was a strong indication in one of the documents -- I don't know how many documents there were -- that there was some facilitation for some new long term care beds in the South Okanagan. The minister knows that we are short at least 300 beds, and it's climbing. Could the minister elaborate on what happened to that?

Hon. C. Evans: The allocation of beds isn't up to the Minister of Health -- or even, really, up to the ministry staff. The allocation of beds is a decision made by the health authorities and funded by the ministry, so of course the ministry is somewhat involved, at least in okaying that allocation. But we will not be deciding whether those beds go to Penticton or Summerland or Oliver or what have you.

The allocation to the health authority that the hon. member refers to is 230 continuing-care, long term care beds over

[ Page 17272 ]

the course of the next few years. I can't answer for the hon. member exactly what towns or facilities the local health authority would choose to assign those operational costs to.

Even though it wasn't part of his question, I'll suggest that as well as continuing care, most of the health authorities desire relief on the acute care side by home care. The Okanagan-Similkameen health authority also has an allocation of $757,950 for a home care increase.

[D. Streifel in the chair.]

B. Barisoff: The regional district of Okanagan-Similkameen has approached the ministry on funding for the new multicare facility in Keremeos. I've been led to believe that this funding is supposed to have come on a number of occasions. The facility is almost ready to be opened, and the operating costs and everything seem to be in limbo. I took the opportunity to phone your office, and the response I got was: "Don't worry; it's going to be coming." Then I heard of this big announcement that was coming on Tuesday. And of course, we're coming to sit today, so I assumed that's when the money would be coming. I'm just asking the minister: what happened to the operating funding that was supposed to come to the new multicare facility in Keremeos?

Hon. C. Evans: I would like to preface my remarks by saying the particular question the hon. member is asking is not part of the health action plan, and the resolution of the issue is not part of the health action plan. I'm going to try and answer the question anyway, because it seems perfectly reasonable to do so.

The hon. member's belief that an announcement would be about a particular issue in his constituency was erroneous. I'm very disturbed by any notion that any MLA on either side would phone my office and receive an assurance one way or another on a particular project. A minister's office doesn't usually operate that way, and I would like to hear from the member about who he phoned in my office and who it was that was giving him assurances.


I am advised by staff that the operational funding of the facility the hon. member is asking about is in the ministry budget, and there is an issue related to the ownership of the facility, which the health authority is working its way through.

B. Barisoff: I think what I was asking. . . . It wasn't a matter that the minister or the minister's office has got letters from the regional district of Okanagan-Similkameen. There were some real concerns -- in particular by the chairman, Roger Mayer, and the chairman of the health authority, Joe Cardoso -- that this money, for whatever reason, wasn't there. The startup operating costs for the new facility weren't there. They both contacted me. They have grave concerns that this money wasn't there. It just so happened that I phoned last week because they had asked me if I could contact the minister's office to see what was happening with this money.

Maybe it was coincidental that these big announcements were coming and whatever else was happening. I didn't know the announcement was coming. But after I heard that the announcement was coming, with the comment I had from the minister's office -- as one of my colleagues said, the "cheque is in the mail" kind of attitude -- I assumed that maybe it was tied to this. So my real concern is to make sure that when the chairman of the regional district and the chairman of the hospital board are concerned about what's happening. . . . I guess my concern, along with them, was: what is the delay, and why isn't this money forthcoming?

Hon. C. Evans: I'm advised by staff that there is some issue about the fact that the regional hospital district owns the long term care facility and are reluctant to transfer title to the health authority. I have no idea of the cause or the resolution of this issue. I would like to offer the hon. member a briefing and an opportunity to discuss his suggestions for resolution with the staff.

B. Barisoff: I'll certainly take the minister up on that. I think that the area of the Similkameen has waited through two previous governments. I think it started back in the eighties when they were promised, and they were promised again, and then they were promised again. And lo and behold, it came to my point of seeing what I could do for them. The building was built, and I would just like to make sure that the facility is up and operating.

The other question that I have to the minister -- because over the years we have had a substantial amount of dealings, working with Agriculture -- is the fact that I asked the previous minister in estimates about the long term care problems in the South Okanagan and the fact that there was an assisted-living facility in the Oliver area that had offered 15 or 20 beds or whatever to alleviate the problem with the acute care in the region of the South Okanagan. The minister of the day assured me -- and that was back in June or late May -- that he would look into it and that something would be done and that we could alleviate some of those problems, rather than having some of the long term care patients in acute care beds at whatever it is -- $900 per day.

The assurances I got were that something would happen. Well, nothing has happened, and we've gone through some six months now. I'm asking you, as the new minister, whether I could get more than just assurances to make sure something will happen and that we alleviate some of these problems.


Hon. C. Evans: Well, absolutely. Although I don't want the hon. member to think that I'm. . . . It's just good luck that I happen to have this opportunity. We are able to give you not only some assurance, we're able to give you a commitment for 230 continuing-care beds over the course of the next four years. The intention is precisely that your health authority source those beds, and then the Ministry of Health will pay for their operational costs in order to move people out of the acute care beds, exactly as the hon. member suggests.

Similarly, the $757,000 for home care. . . . That's exactly what we're intending to do. If the previous minister gave you a commitment that there'd be some resolution, I hope you'll find that the operational costs of 230 beds in the Okanagan-Similkameen constitute keeping that commitment.

B. Barisoff: I guess looking on paper and seeing the minister indicate that there would be 230 new beds in the next four years is not really the answer I was looking for, on the basis of the fact that we're short today. The Okanagan, and particularly the South Okanagan, is the draw for a lot of our retired people. By the time we get 230 beds built, we'll be short 500 or 800. As my colleague from Penticton says, we'll

[ Page 17273 ]

be probably short 800 beds by that point in time. My concern is, I guess, that there was great anticipation when this announcement was coming, and the people that I talked to. . . . I think there was more than just anticipation. There was something there. There would be absolutely no reason for them to indicate to me that there was some movement or there was some document by the ministry that said that these were going to start. In fact, the comment that the person made was that they would probably even be started before there was an election. I said that that was highly unlikely because we expect an election probably within the next two or three months. And he said: "Trust me; this is going to happen."

So I guess my concern, again, to the minister is: was there something there? Was there something in one of the documents that said. . . ? You're indicating that there is a proposal for 230 long term care beds. I'm looking to see whether there was something in the document that was supposed to happen immediately, not a year from now or two years from now or whatever else; that there was something that was going to be announced; that we were going to be looking at an immediate building of some long term care beds. I think the indication was that it would be starting with Penticton, and then there were going to be some in the Oliver-Osoyoos area.

So I want to go back to that question and find out whether the minister can find out whether there was actually something there that was going to start immediately, not looking at a year or two years or three years down the way. As the minister knows, because he's probably driven through the Okanagan enough times, it is the retirement area of British Columbia. It's a beautiful area, and people are moving in all the time, so we have to look to see how we're going to alleviate this problem.

Hon. C. Evans: I'm talking with the staff about whether anyone knows of a document related to a particular construction opportunity in the southern Okanagan that might have been what the hon. member's talking about. We don't. It was suggested that perhaps it's a Kelowna initiative, but I doubt it, because the hon. member knows exactly where Kelowna is.


I want to speak more generally. What we're announcing is operational funding for 2,000 beds. The speed with which they get there is largely due to the individual health authorities' ability to deliver the physical plant. Of course, there's some private, some non-profit, some public. Every health authority in the province, I think, has plans on the shelf or that they're engaged in with the ministry or that they have been thinking about, if they had operational funding. The fact that we are guaranteeing operational funding for approximately 230 beds in the hon. member's area ought to liberate the capital to initiate events. This is not the lollipop session of the government. We're not cutting ribbons here; we're not announcing goodies. We're saying: "Here is the operational funding for 2,000 beds, and your health authority can source those beds in the most creative way they can."

The other thing I would like to say is that the hon. member referred to the fact that by the time he got 230 beds built, he might need 800 or 1,000 or something. There are several steps here. I don't disagree; I think the health planners think that when I and the hon. member are in need of continuing-care beds there may be a need for 16,000 more beds or something. And that's where we have to go to; we have to go there. And governments have to go there with some haste in order that people have some faith that there will be care for them.

But the deputy points out that the best care for some folks may not be in a facility. And the fastest kind of care that the health authority can provide to get people out of acute care facilities that are there now is home care funding. That's kind of the short term -- about a million dollars, I think, in the hon. member's area for home care funding -- so that people can go home, and then operational funding for 230 beds in the middle term so that they can get built if that's what's required. Then there is the long-term need for more beds and more options in the hon. member's area, and that will need to evolve.

But take all three steps. Go home and say, "Okay, deliver the home care to relieve the stress on the beds today"; build the continuing care to take advantage of the government's commitment; and then make the plans for the longer term, when we need 1,000 in his area.

B. Barisoff: I guess, in all fairness to the minister -- and I know that he does listen to these kinds of things -- it's that we do have a building, an assisted-living building, that is there and is able to service some of these needs. And because of the bureaucratic nightmare that it travels, it kind of misses in the night somehow. The facility is there; it's built. It's like home care, because that will be their homes. But every time we've gone through the process, Housing says, "Yeah, we can put our support in," but the Ministry of Health says: "No, we can't, because that doesn't fall within the mandate that we should be able to do it." I guess my concern is that the minister look at this.

A couple more items, hon. minister, and one is the paramedics. I notice that in this document there's a number of paramedics announced. I guess, knowing that the minister comes from a very rural area, as I do, that in Okanagan-Boundary in particular we have a lot of well-qualified paramedics. But in all fairness to the rural parts of British Columbia -- and I speak for all the rural parts and particularly Okanagan-Boundary, where, like in Osoyoos, you're maybe 20 kilometres from a hospital or whatever -- we should look at more highly trained -- or they should be the most highly trained -- paramedics to go into these areas first. I notice that we only have maybe ten or 12 positions that we've offered in this. I'm just wondering whether the minister has looked at a lot more of the rural areas to put paramedics in.

Hon. C. Evans: I want to deal with the long term care facility that the hon. member is talking about first. Hon. member, I'm advised that you are allowed to use home care money to make the assisted-living opportunity work. So if you have a facility -- okay? -- my advice would be to go see if you could make that work, since there's a million dollars in home care.

Secondly, I completely agree with the hon. member on the subject of rural ambulance service. It's such an important job that you can graduate straight from there to the Legislature of the province of British Columbia. There are 17 full-time paramedic positions being created over two years, and they will be in Qualicum Beach, Courtenay, Enderby, Salmon Arm, Vernon, Westbank, Winfield, Golden, Terrace, Fort St. John and Central Saanich.


[ Page 17274 ]

B. Barisoff: One last item. I know the minister read off the areas, and I guess my concern is that there has got to be more. In particular I'm just using Osoyoos as an example of an area where there should be more.

The last thing I want to bring forward, hon. minister, is one that really troubles me. I won't use her name, because I haven't asked her whether I could use her name, but I will pass on the name later. An elderly lady came into my office with a severe growth on her neck. She has been getting progressively worse for the last couple of weeks. She's been sent to a specialist in Vancouver, and we're going around and around in a circle. This poor lady sits at home in Osoyoos and patiently waits for somebody to make a decision for a hospital bed, for her to be operated on.

I guess what I'm doing in closing is basically pleading this case. I'm sure the ministry knows who it would be. I probably don't have to give them that, because we made phone calls, and we've done what we had to do. What I'm saying to the minister is that this is an instance in my riding where there happens to be a severe case of something not being done.

I want to bring it to his attention, to make sure he understands what's happening and my concerns about what's happening with some of the health care dollars, is that nothing is happening for this lady. When she sits in your office and tears are rolling out of her eyes, and somebody is saying to her, "Well, you've got to wait for another week or two weeks or three weeks or whatever," and this has been going on for three or four weeks now, I guess my concern is that somehow, Mr. Minister, we have to look at these things. We have to do a better job for the people of British Columbia, because what has happened in her case is certainly unsatisfactory.

Hon. C. Evans: I'm not going, of course, to refer to this specific case. The provincial bed management system is intended to address precisely that issue. We are trying to increase resources in the lower mainland for precisely that referral benefit. The hon. member points, really, to why there's only one health care system. There isn't a rural and an urban system. We need the specialist capabilities in the lower mainland to be there and the beds to be there for constituents such as his.

Hon. E. Gillespie: We're at a pretty interesting place in British Columbia right now, a place where we actually have an opportunity to make some choices with a budget surplus. For many years in this province we have struggled with trying to contain and to meet budget targets, and we still work very strongly within that envelope of trying to contain but also trying very hard to meet the need. I heard very clearly, and I believe all of us in this House heard very clearly over the latest federal election, that what the public is interested in is good health, good health care and the time to enjoy it.

I would say that women have a huge stake in the public health care system as health care providers and as informal caregivers and as consumers of health care services, and I have some questions for the minister around this subject. Seventy-two percent of informal health caregivers are women -- women who carry family responsibilities and work responsibilities in addition to caring for relatives and friends who need their support. What does the health action plan say to them?

I want to know and women want to know: what does the plan have to say to women who seek health care for themselves and their children, children who don't necessarily get sick between nine and five, Monday to Friday?

We all know that the average age of a nurse in British Columbia is 47, and in Vancouver that average age is 49. We also know that health care providers have the highest rate of injury of any profession in this province. What does the health action plan have to say to health care providers? I ask these questions of the health care minister.


Hon. C. Evans: Chair, really good questions. First, on the subject of health care providers at home, it's really the whole direction of the preventive measures intended in the health action plan. There will be, I think, the largest printing in British Columbia's history of the health guide.

This is an initiative which was brought forward by the people of Victoria. In the capital regional district they created this health guide with 190 different answers to 190 different health questions and then vetted it through all of the colleges, professional groups, educators, nurses and the like, and they developed this booklet.

People in the capital region -- parents, actually -- say to me that it's the best resource in their house. So we have decided -- largely through the advice of the innovation forum, which happened under the previous minister's watch and to his credit -- to print 1.8 million copies of the guide and distribute them to every family in British Columbia. I think the cost of doing that will be $8 a book. Is that right? A bunch of blank faces. The cost will be $8 per guide.

If the guide saves one visit to a doctor's office, it might save $12 or $20 per family over time. If it saves one visit to an emergency room, the saving would be much greater than that.

We're going to add to that, because a parent reading a book isn't really in contact with a human being in the health care system. So when the book is published, we are going to augment it by the employ of 40 full-time nurses, RNs, operating a call centre so that people around the province can call and say: "I have read the book, and here is the issue that I'm dealing with." The nurses can assist that person to decide to take a couple of aspirin or visit a doctor tomorrow or go to a community clinic or call 911, or go directly to an emergency entrance at a hospital. This is like taking health care from the hospital to the home and maybe represents the first real recognition in a long time that the primary health care workers are parents and people looking after their parents where they live.

I hope that answers the minister's questions. I know there was actually another one, but I forgot what it was.

Hon. E. Gillespie: Then I'll ask the question again. There were actually three parts to that question, so I'll ask the other two questions, and I'll ask them one at a time.

I want to ask: what is there in the health action plan that speaks to the occupational injury rate of health care providers?

Hon. C. Evans: As the Premier and I were travelling around, it was made very clear to us by health care workers that the repetitive stress injuries and the back injuries that they

[ Page 17275 ]

are suffering are exacerbating the inability to deliver skilled workers to the health care system, because when the worker is injured, somebody else has to work overtime. Then that person builds up, and that person has to take stress leave, and the whole thing winds up with huge compensation costs and overtime costs to the system.

We have directed that the equipment funding in this announcement in the health care plan be referred for consideration by health authorities to the occupational health and safety committees in every region for comment, so that we can be assured that we're not spending the money just on expensive diagnostic equipment, but also on ordinary tools that health care workers require.


They said to us that they all recognize that we need CT scanners and the like, but that they wanted a percentage of the expenditures put into safety measures, and we have responded.

Hon. E. Gillespie: My final question is about informal health care providers. Seventy-two percent of informal health care providers are women who carry family and work responsibilities in addition to caring for relatives or friends who need their support. I'm asking the minister: what does the health action plan say for them?

Hon. C. Evans: I think that my best answer to your question. . . . In the health care plan are the primary care centres, which are intended to change everything about how we deliver care and how the caregiver relates to family members. A primary care centre is the best example I can give you, because it is the only one I've visited thus far. There are eight. The only one I have visited, twice, is the James Bay clinic. They offer the whole array of physical and social services at one site, from dental to prenatal to young parents with their children, social. . .and then, extending to the elderly, home visits, companionship and nurse practitioners, so that we can relieve the pressure on the caregiver at home and at the same time create a medical system that will go to your home when that's more appropriate than going to an acute care facility.

It doesn't necessarily assist the caregiver at home, generally. I consider this to be sort of the vision part of the document, in that it is aimed at changing the fee-for-service model to a population model of payment, where we pay caregivers to look after people regardless of whether or not those people get sick. So the caregiver's workload decreases if the people are more well. I consider that to be exactly what people in British Columbia have been asking for, for a really long time. What the health action plan says is: we had one two years ago, we have eight today, we will have 13 by this day next year, and we will continue to add five more per year after that for the next four years.

S. Hawkins: I'm quite keen to get in this debate today. I've actually been fascinated this afternoon and this morning listening to members from that side of the House and ministers stand up and question the Minister of Health, the sixth Minister of Health. You know, it's interesting because some of those members never got up, when there were actually crises happening in their own ridings, to question the then ministers of the day. So when I listen to the new Minister of Women's Equality and I think back to when Glacier View Lodge was under assault by this government, and the non-profit charity. . . .

An Hon. Member: It still is.

S. Hawkins: It still is, as the member from Penticton points out. Where was she, asking the questions and sticking up for that lodge? Where was she? Here today, as the Minister of Women's Equality, she's asking the minister questions about women's role in health care and how they're going to be protected. Well, shouldn't her ministry be providing the Health minister with some of that advice and some of those answers? It's very fascinating watching the interaction there.


Anyway, the other thing I find interesting is that after nine years, the party that decimated health care in this province, the party that subjected our health care system to numerous reorganizations, to numerous examples of waste in the system, to making it one of the lowest priorities in the last nine years -- low priority because in the last four and a half years alone, we've seen a revolving door of Deputy Ministers and Ministers of Health. . . . We've got a demoralized workforce. We've got health care professionals, patients, families -- you name it -- in the system who don't trust this government to actually do what they say, because anything that they've announced, they haven't followed through on anyway. Now we have just months. . . . Isn't it amazing what an election call will do -- isn't it amazing? Several months before an election, they now have a plan. Wow, they now have a plan.

We were just here back in September. It's interesting, because all of a sudden the Premier, once he was elected to his seat, decided that we can't alienate Ottawa anymore; maybe we kind of need them. He brags about flying to Ottawa and getting that extra money, and he brags about now putting a plan together -- a plan, apparently, that they had debated in their own caucus back in June but didn't want to release until just months before an election call. Patients had to wait for this. You know what? When I look through this plan, I realize that patients and health care personnel and professionals across the province are going to have to wait some more, because a lot of the announcements in this plan are going to be reannounced or implemented over the next two or three years.

It's interesting; I wonder how the minister comes up with some of these numbers. But I guess the most fascinating thing for me is that after nine years we have a Premier that has the audacity. . . . He sat around that cabinet table and made decisions on -- or maybe he didn't. . .made indecisions, I don't know -- Treasury Board. They set the priorities for the last nine years, and he has the audacity to say that he didn't know the enormity of the problem. I mean, does he not watch TV? Does he not listen to debates in the House? Does he not listen to his constituents? Does he not drive past hospitals and see the ambulance bays backed up? Does he not read the letters that come to his constituency? Does he not talk to his Health minister?

They have members from the north. We had the rural health crisis two and a half or three years ago. For five months we had health care denied to patients in the north. We had patients that came down here and begged for assistance from the government. We had a mayor from Burns Lake -- I'm sure members recall -- camped out on the front lawn of the Legislature to try and make a point.

The Premier just recognized yesterday that the problem was more enormous than he thought. That just blows the

[ Page 17276 ]

mind. The new Health minister does a little road show through hospitals and realizes for the first time: "Hey, maybe it is advantageous, instead of doing a royal tour with an entourage, to actually go talk to people on the front line. You know what? Maybe they could provide us with some answers." He sees up front for the first time how bad things really are. Well, why didn't he think of that before? Why didn't they think of that before?

It boggles the mind to think that. . . . Is this the first minister, in the last four and a half years out of six, that's actually gone and talked to a real health care worker or a real patient or a real doctor and toured a real hospital? Why weren't they in there before? Why is it just three or four months before an election that all of a sudden they think it's important and that they put health care at the top of their priority list?

I'll tell you, the first question on people's mind isn't when are we going to have a health action plan; it's: when are we going to have an election to get rid of these guys? That's the first question on people's minds.

I think it's also telling. . . . I went on a tour with the Leader of the Opposition in the last couple of months. We toured through some northern communities. I did a tour about two and a half or three years ago, and I recall that when I did the tour, when I talked to health care professionals, what they told me two and a half years ago was that they were having difficulty providing quality care -- a standard of care that they would consider providing quality care. When I went back two and a half years later with the Leader of the Opposition, I was absolutely struck by how much the tone had changed, how demoralized the professionals really were. What they were telling us now wasn't that they wanted to provide quality care; what they were telling us now was that they wanted to provide safe care. That scares me.


As someone who is a former health professional, that frightens me because it tells me that they can't aspire to this level, and they're trying to toe the line on just actually trying to provide a safe level of care -- trying to cover shifts for nurses, trying to provide care for patients. They're had their ICUs closed. They've had maternity beds closed. They've had mental health beds closed.

I guess it strikes me as odd that this minister and this Premier, after sitting around the cabinet table and after years and years of saying that health care was a priority for them, just realized yesterday or in the last couple of weeks that things were really bad. For years they were saying that it was a manufactured crisis; it was something that the newspapers and the media were making up. Well, I'm glad they finally woke up and smelled the coffee, because it is bad out there. It's really, really bad out there.

I was listening to the minister this morning saying that when he did the tour, he saw that the people that are supposed to be looking after patients shouldn't be spending a lot of time on the phone. There should be an easier way for these people to find a bed. They shouldn't be spending six hours on the phone when they should be looking after patients. Well, I can't tell you how many of us have stood up in this House and told the Health minister that for the last four and a half years. We have problems like that in regions across the province, in our major hospitals down in the lower mainland, hospital to hospital, where they're spending hours on the phone trying to find a trauma bed, trying to find an ICU bed.

Actually, two years or so ago we put it to, I believe, the Deputy Premier -- who was then the Health minister -- to look at the program that they have in Ontario, at their critical care network. Rather than reinventing the wheel, look there and see the successes that they've had with their program and try to implement it here.

Two and a half years later, still nothing's happening. I mean, there's an announcement. But you know what? They're not going to be able to carry it out, because they're going to be sitting on this side of the House before any of these things ever get done. So they're not really going to have a chance to do it.

Anyway, I have questions for the minister. I have questions on the nursing parts of the announcement, because that's one thing that I know we have been questioning Health minister after Health minister on. As a former nurse, I know that the nursing profession and our professional associations have been warning governments for the last 15 years that there was going to be a nursing shortage. There was a very concerted effort on the part of federal and provincial governments to actually take a different turn about ten or 12 years ago and scale back positions in nursing schools. It's amazing how the chickens have come home to roost. By and large, we do have a critical nursing shortage now.

I see that there is, as the minister points out, an ambitious plan to provide for nursing positions and new nurses and new nursing seats. I would direct the minister to his announcement on education seats for nurses and other health professionals. He says that there are going to be 50 nurse refresher seats in post-secondary institutions. They're going to put $275,000 into that program, and it's going to open in three different institutions.

Based on the institutions' capacity to accommodate the additional seats, how did you come up -- through the Chair -- with the 50 seats? Are they going to be accommodated right away? Or do we have to wait? Are they ready to go? Have we screened these applicants already? Is that starting January 1? When is that money going to be released? Can he put some meat around those bones for me?

I am interested in these 50 refresher seats. There are a lot of nurses out there that are looking for opportunities to come back into the profession. I'm interested in how much homework this minister has actually done in coming up with this 50 number and when we're going to see those refresher positions open.


Hon. G. Janssen: While the minister is debating the question and coming up with an answer, it is fortuitous that I'm in the House when the member for Okanagan West is on her feet, and she has statements like: "The chickens have come home to roost" or "Put some meat around the bones." Well, some years ago she was in Alberni, and she made a statement while she was on the radio that if the hospital in Port Alberni -- which is nearing completion, by the way. . . .

S. Hawkins: We fought for that.


[ Page 17277 ]

Hon. G. Janssen: Hold it, folks. Wait for it, wait for it. Her statement was: "If this hospital is built during this time of government, I'll eat crow." Well, would you like it fried or boiled? Or is it just another broken Liberal promise?

The Chair: Before I recognize the member for Okanagan West, it might be a bit late, but members, we all know that props aren't allowed in the House.

S. Hawkins: That isn't even edible crow. They can't even bring a real crow in the House. They can't even promise to bring the real thing in.

I am so happy for the residents of Alberni. We went there several times. That hospital was a fire trap. It was something that we debated before three ministers, and I'm so glad that something we did on this side of the House actually forced the government to do something for those patients. You know what? It was patient safety that was a priority there. And I don't think those patients would have gotten a hospital if members on this side of the House hadn't advocated for them. And do you know what? We'll see if that hospital actually opens before those members get booted to this side of the House.

Hon. C. Evans: The answer to the hon. member's question about the 50 refresher seats is yes. They are ready to go. The allocation is to Malaspina University College, Open Learning Agency -- which, as the hon. member probably knows, often delivers courses with the college system -- and Kwantlen University College.

And the hon. member wanted to know if we knew the names of the people that would be taking those seats. I have to admit that I don't, and I don't know if the colleges do. And it would be somewhat difficult to get the answer to that question, because we are funding the seats. I don't know if the colleges have interviewed the people.

S. Hawkins: What I wanted to know was when those refreshers were actually going to start. Is that January 1? And is that 50 for January 1 between the three? I think I did meet with Open Learning Agency, and they were setting up a program. So I'm wondering if their program is actually on the go. How many are going to each of those institutions?

Hon. C. Evans: I don't have the allocation per institution, although I may in a little while. The answer to the timing question is that they will begin in January, and the number is based on the institution's capacity to accommodate the additional seats right now. And the cost is a quarter of a million dollars.

S. Hawkins: In addition to that, the minister is announcing 400 new nursing seats for 2000-01 and 400 more in 2001-02. And I'm wondering where those are going -- if any of those plans have been made. You know, it's easy to make these announcements, to come up with these numbers and say: "We're going to add 400." But I'll tell you that the challenge is -- and I know the deputy minister is a former nurse herself -- to find the instructors, to find the professionals, to find the mentors and to provide capital to those institutions. You can't just add eight here, ten there, 15 there, 20 there. There are other costs involved.


I want to know how much planning has gone into putting those plans into action. When I speak to the post-secondary institutions, they tell me that there is a real challenge to find the trained professionals that are going to teach those extra nurses, to find the classroom space, to find the lab space, to find those facilities. So I want to know how much of that planning has been put into place and if any thought has gone into the capital that's going to be needed in those institutions to actually fund those positions.

Hon. C. Evans: The hon. member is right that it's somewhat difficult to answer all the questions, because of this split of responsibility between the Ministry of Advanced Ed and the Ministry of Health. We are advised that the space exists. I personally have met with two institutions over the course of the last two weeks that are applying to offer these courses. I was advised by the Ministry of Advanced Ed that there are four institutions that have applied already to offer them and that there is not a capital issue. But I am unable at this time to answer exactly which institutions will offer how many of the seats.

On the other hand, I would like her to have some comfort, in that we do have a record here. We said that we would offer 400 seats in this year, and to the best of my knowledge that has been met.

S. Hawkins: I have some trouble. . . . I have very little confidence in the results of the Health ministry and the promises they make, because, if I recall, they were going to hire 1,000 nurses over three years, and they were going to hire 400 the first year. I think the Health critic just told me they hired 104 in the first year, out of 400. I know, because I've spoken to the institutions about training spots and positions, different seats in different institutions. . . . We just met with some presidents of universities, and capital was an issue. They can accommodate so many seats; there are only so many places in the province that train nurses.

I'm wondering how much thought has gone into. . . . You know, it just makes me angry when I see these numbers: "We're going to hire 400. We're going to hire 1,000. We're going to add 400 seats." What planning has gone behind that?

This, I think, has been a hallmark of NDP governing by press releases and photo operations. We get these fancy announcements, but we get no meat on the bones around them. I think one of the best examples was the $125 million mental health care plan.


S. Hawkins: A member across the way says: "Shame." Shame on them, because you know what? The Minister of Health. . . . Oh gosh, she's not even sitting in cabinet anymore. The member for Surrey-Newton stood up in the House and admitted that they didn't have a plan; there was no money in the budget that year to actually fund the plan.

So when I see 400 new nursing seats for this year and 400 in 2001-02. . . . How much money? Where are they going? What capital expenditures? Have we found the trained professionals to teach? What are we doing to assist these institutions? You don't just crank out a nurse. You've got to find the ones who are trained to teach; you've got to find the ones who are trained to mentor.

It's frustrating to sit here and try and get answers out of the minister, and he says that I can be assured that there are

[ Page 17278 ]

going to be 400. Well, we were assured that there were going to be 1,000 nurses hired over three years and 400 in the first year. We got 104. So that's why I'm asking the minister to give me more than just his assurance. Give me the plan and the institutions where they're going, if they're even at the part of the plan that includes the capital, that includes the lab facilities, that includes the contracts with the hospitals to accommodate those nurses for training -- those kinds of questions. Are we down that road yet, or are we just at the fork in the road that says: "We want 400"?


Hon. C. Evans: The hon. member's question is basically a question of accountability. She doesn't like my answer. She wants to know exactly where these people are going to school. Hon. Chair, we said that we would increase the number of seats last year by 400, and the hon. member is correct: we didn't actually hit 400. We created 449.8 seats.

The institutions are BCIT, last year or this year, 96 seats; Camosun, 103; UCC, 56; Douglas College, 103; University College of the Fraser Valley, 35; Kwantlen, 43; Langara, 102; Malaspina, 30; CNC, 57; North Island Community College, 22; Okanagan, 54; one institution -- I don't know what it is -- Selkirk College, 23. The breakdown of the increased seats is diploma stream, 157; BSN at the university-college system, 85; BSN at the universities, 40; psychiatric nurse, 16; refresher courses, 151 -- for a total of 449.8.

It may be that we don't know exactly which institutions will take us up on the offer to increase by 400. But the record of the institutions last year outdid the request, and so I'm comforted that they will once again deliver.

S. Hawkins: Well, hon. Chair, I think the minister didn't understand what I said. We talked about. . . .

An Hon. Member: She's asking something different.

S. Hawkins: What I was referring to was his party's promise, his government's promise, to hire a thousand new nurses over three years. They didn't meet their targets. They said they were going to hire 400 in the first year. That's the 400 number I was talking about, not the 400 and some that were trained -- and the institutions took -- last year. That certainly wasn't 400 and some new seats; that was how many nurses were trained.

I'm talking about their promise to hire a thousand new nurses over three years, 400 in the first year. And they fell way below their mark; they hired 104. What they're talking about now in this announcement is 400 new seats for nurses for training, not what they had last year or exceeded -- like, 400 new seats.

I wonder if the minister knows how many instructors it takes -- trained professionals, mentors, instructors, whatever -- to train those kinds of nurses. Do we? You know, we can't even hire nurses in the hospital. We've got to find nurses with the experience and training to train these new 400. You can't just make announcements to do this, unless you've got all that in place.

You know what? I'm beginning to think. . . . And call me cynical. This time of day -- it's almost suppertime -- maybe I'm hungry. But I'm getting cynical. I'm starting to think that maybe they don't have the plan; maybe they don't. Gee, maybe they don't have the plan to train those 400 nurses.

Maybe they haven't really met with the institutions, because I know there are concerns about capital. There are serious concerns in the north at UNBC and the colleges for adding new lab facilities and capital, because we heard from civic leaders and health leaders up there, when we were there, that their lab facilities aren't adequate. And they are inadequate to train the professionals that they're trying to train now. And if you're going to add more, they're going to need that capital.

We heard from universities just yesterday morning that, yes, they want to take the nursing positions. They recognize the need. In fact, they've been lobbying government for the last umpteen years that they have seen the need to develop that human resource in the medical and nursing field. And they weren't really getting the cooperation from government. But now we see a plan that says we're going to add 400 new nursing seats into the system in 2001 and 400 more in 2002. But what we heard from the presidents was: "We don't have the professionals. We need capital. We need time to get this program into place."

So, you know, is this a realistic goal? Are we going to get the 400, or is it going to fall short again? Call me cynical again. I think it is -- just like the announcement that this government was going to hire a thousand new nurses, 400 in the first year, and we got 104. So again, I mean, the minister can confirm or not confirm for me -- and I'll move on -- whether that detail of planning has taken place yet.


J. Pullinger: Hon. Chair, I wanted to take the opportunity, while we're waiting for the minister to answer that question, to ask a question of my own. I've been travelling the province on the Finance committee and listening in every community to the fact that there is a global shortage of nurses. It's going to be a big problem when all we baby-boomers retire. There is in fact a global shortage. I know that we had the money there, and it's difficult, but. . . .

You know, close to my riding in Nanaimo a few years ago, the Leader of the Opposition stood up when the budget was over $7 billion for health care, and he said that $6 billion was enough. We were all quite appalled at the time, because he was pretending he wouldn't cut health care. Before that, when the federal cuts happened, the opposition stood up and said: "Gee, those cuts didn't go far enough. We should have cut more out of health care." And we were appalled at that. We really expected that the opposition, who always say they care about health care, always bring individual issues forward, always demand more money in their ridings, come here and say we should cut more.

We kind of thought maybe they would support us in trying to get the federal government to not cut health care. It was a shortsighted move, as we all know now. Our Premier has played a significant role, and this government has played a significant role, in terms of getting some of that money back. And today we learn that the Leader of the Opposition has again committed to cap funding at 40 percent of the budget. It's grown from 33 percent to 40 percent of the budget under our government because of the federal cuts that the opposi

[ Page 17279 ]

tion applauded. Today we find out that the Leader of the Opposition would cap health care spending at 40 percent of the budget.

But we also know that the opposition has committed again and again and again to the Business Summit -- to all of their corporate backers, such as TimberWest, for example -- that they will cut $2.9 billion in taxes for those people. And if you cut $2.9 billion in taxes, that equals a $1 billion cut in health care. That's kind of the same as what they said in 1996. I'm pleased they have some consistency at least. We know that they have a $1 billion cut. Now, I would love to ask the Minister of Advanced Education about what effect the other $1.9 billion that will be lost in government revenue as a result of their tax cuts would have on advanced education, for example, and the ability to provide seats. But I can't ask that, because this is Health.

So I would like to ask the minister: how many nurses would be laid off in British Columbia if we had a $1 billion cut to health care as the B.C. Liberal opposition is proposing? I think my constituents would like to know that.

An Hon. Member: You said you wanted to be serious -- no more. . . .

Hon. C. Evans: The absolutely serious answer to that previous question, for which staff take full responsibility for the credibility of the answer, spoken by me right now, is -- there's a calculator here -- 13,333 nurses.

That would assume, though, a fairly. . . .



The Chair: Could we have some order, please.

The hon. Minister of Labour. . . .

The Chair: No, not any longer. I'll figure it out. Without a program, members, it's really tough to keep up.

The hon. Minister of Education would be reminded that speaking from the seat is the generally accepted practice of the House.


Hon. C. Evans: The previous speaker was questioning our ability to deliver the nursing program seats that we had set as a target. As I said, we exceeded our target last year, so I have full faith that the Ministry of Advanced Education and myself can deliver. And if we meet the same target we did last year, we'll exceed it by almost 100 over the two years.

She asked if we can account for a thousand new nurses in the system, and the number at present that I can account for is an increase of 431. However, the number is somewhat suspect, because as I'm sure the hon. member knows, some people are working part-time, some people are working casual and some people are working full-time. Nurses come into the system, and nurses leave, so 431 is just the number of FTEs that I can account for.

S. Hawkins: Again, it's fascinating to hear some of the back bench get up finally and talk about health care, since I never heard it in the last four and a half years -- especially the member for Cowichan-Ladysmith. You know, in her community they were fighting for a CAT scan for years and years, and she finally got one. But she flip-flopped like a hooked salmon before she ever came to get in that photo op to finally announce it.

Anyway, I'm interested in this nurse education bursary program. It looks like there's going to be half a million dollars available from this fund starting January 1 and then a further $2 million available in April 2001 for the following year. Again, I'm wondering if this ministry has worked with the Ministry of Advanced Ed, Training and Tech to work out the details of this scholarship, this bursary, and if there's a top cap on what will be allotted to nurses that want this assistance.

Hon. C. Evans: I'm advised that the cap is $5,000.

S. Hawkins: There's also a mentoring support program that's been announced. One of the things that we certainly heard when we toured across the north was how stressed out the nurses were, how overworked they were. A lot of them are working overtime; a lot of them have fallen ill. It's nice to announce a mentoring program. I wonder where we're going to get those mentors from. There's a lot of opportunity for new seats, and there's a lot of opportunity for nurses to be trained, again, in clinical settings. But where are we getting these mentors from? What's the recruiting process for that?

Hon. C. Evans: There are several sources. Firstly, there are many nurses in the system who desire to or who already are taking early retirement and who can come back as mentors. There are nurses with the capabilities who desire to or already are working part-time and can move up to full-time to offer mentoring capability. There are full-time nurses who desire to move into a mentoring role, and we will allow the health authority to backfill that position with a non-mentoring nurse.

S. Hawkins: So this mentor is over and above the nurses that are already working at the bedside. When I used to teach or train or manage, we used to pair up the students with nurses that were on the ward, and they were the mentors. So the minister is telling me is that this is a new program that's going to take nurses out of the casual or part-time pool or nurses who wish to work over and above what they're doing to work as a student mentor. I'm trying to figure out how this program is going to work. If the minister has a model from another jurisdiction, I'd be interested in knowing about it. So these are going to be extra nurses on the ward providing mentorship for students who are coming through programs and training in those clinical settings.


Hon. C. Evans: The answer to the hon. member's question obviously is no. The minister does not have a model that he wishes to impose on the system. The individual institutions or health authorities, I hope, will design models that work for them and will negotiate them with the ministry. Like the hon. member, I have visited lots of different people with lots of different ideas, and I think to impose a model and say, "You'll do it the way the minister tells you to do it," would be a little bit inappropriate.

S. Hawkins: Does the minister have any idea how many FTEs it's going to require for this mentorship program?

[ Page 17280 ]

Hon. I. Waddell: While the minister is getting the technical facts of that question, I'd like to pose an additional question and make a quick comment on the member for Okanagan West's questions and preambles to them. She started out by suggesting that some of us should be asking some of these questions that we're asking now and bring them up in question period -- which is, it seems to me, absurd.

S. Hawkins: No. Ask him in estimates.

Hon. I. Waddell: It seems to me a bit of an absurd question, because the opposition wants time to ask questions themselves in estimates.

I just want to tell the hon. member -- to give her an example. . . . In my riding of Vancouver-Fraserview, in the south part of Vancouver, we have a seniors home run by the United Church called Fair Haven. I was pleased, as a backbencher and then later as a cabinet minister, to pressure the government to work with the United Church and to give a grant of $8.3 million, which they take. . . . It's a seniors home, seniors housing, some acute care for the old folks, and we've moved it now and expanded it. The United Church has built facilities in Burnaby so people will get acute care.

I want to put that to the minister. It seems to me. . . . I gather that's part of his plan: to get people out of the hospitals who are in the hospital beds -- seniors who are in the hospitals -- get them into some of these acute care facilities rather than the hospitals. I just want to tell the hon. member that here's an example of it actually working in my riding of Vancouver-Fraserview through a government grant. I just want to. . . .


Hon. I. Waddell: If the hon. member will permit me to finish. . . . I permit him to ask questions without heckling him.


The Chair: Order, hon. members. The debate through the Chair is the practice in committee.

Hon. I. Waddell: Now I'm putting on my hat as the Minister of Environment. I asked the minister: would the minister acknowledge that this government has just put 12 percent of the lands in the province of British Columbia -- public lands -- into parks and protected areas, which is a whole legacy. . . ? It's the first. . . . It's the Brundtland commission. . . .


The Chair: Order, hon. minister.

Hon. I. Waddell: What they wanted. . . . It means. . . .

The Chair: Order, minister.

Hon. I. Waddell: I want the minister to comment on this. It means good health for the future in British Columbia. And would the minister acknowledge that in the end. . .

The Chair: Minister, order! Order!

Hon. I. Waddell: . . .the way to have good health is to make sure the young people are well brought up and. . .

The Chair: Minister of Environment, please take your seat.

Hon. I. Waddell: . . .have in fact a good environment and that we have the best environment protection in the world in British Columbia?

The Chair: Minister of Environment, please take your seat.


The Chair: Hon. minister, if the din. . . .

Hon. C. Evans: Yes, I acknowledge that. That's a true fact.


The Chair: It's not exactly within the relevancy statutes.


Hon. C. Evans: No, but it's good for the health of the people.

A total of $3.78 million will be made available for the mentorship and preceptorship programs. I'm going to reiterate that exactly how the health authorities decide to assign that money will be according to the design that works best for them. The note suggests that in the norm, it is assumed they will attempt to reduce patient care load for appropriate mentors by 20 to 30 percent during their participation. However, there is not a model. We assumed and hoped that we'd get different programs from different health authorities according to their own needs.

S. Hawkins: This is absolutely bizarre. I've never been in a debate like this before where I'm asking the minister a question, and while he's thinking of the answer or getting it from staff, I have another member from that side stand up and assault the minister with another question. I don't know if he's listening to me ask my question or getting the answer for the other member.

Anyway, I hope we can continue with the line of questions. And I'm getting confused about which question the minister is going to answer.


The Chair: Order please, hon. members.

Would the Minister of Environment come to order, please.

S. Hawkins: I'll try to stay on track here, hon. Chair. I was asking the minister if he knew how many FTEs, because what I see, reading the backgrounder that the ministry put out. . . . I know the minister has just said that they don't have a model they're imposing, but they're announcing money for a program, and what they're saying in this program is that they're looking for mentors. And for the nurses who are

[ Page 17281 ]

engaged in the mentoring program, this money includes lessening their patient care load by 20 to 30 percent during their participation. I'm wondering what kind of mechanics they've worked out, because if we take a quarter or a third of those nurses out of their practice, we're going to have to find nurses to put into that practice.

Have we thought about reimbursing the regional health authorities for those kinds of costs? What's going to happen -- and believe me, I've been on the front lines and tried to staff -- for those 20 to 30 percent that come out is that we're going to have to fill them with casuals or other nurses who are going to be working overtime, or we're not going to be able to fill those spots, or the students won't get the mentoring because those nurses are actually needed on the floor and won't be able to work with the students. So I'm just wondering.

It sounds like a great program, but at what stage are we in developing this and thinking about those kinds of things? It looks like there's almost $4 million available over two years, and I don't know, again, how that's split. How much of that is going into 2000-2001, which is ending in March? How much of this almost $4 million is going into this budget year? How much in the next? And how are we going to recover the costs for staffing those 20 to 30 percent? Is that included in this $3.78 million that the minister's announcing today?

Hon. C. Evans: The answer to the first half of the question is yes. The answer to the second half of the question is that the present fiscal year allocation is $1.5 million, and the next fiscal year is $2.28 million.

S. Hawkins: How is that distributed to the regional authorities? How much money to each authority?


Hon. C. Evans: The answer to the question is that it's not like community care or equipment allocated on a preordained mechanism. The health authorities are going to be allowed to apply for funding as they perceive it appropriate to do so, and we will allocate the funding based on the applications that come in.

S. Hawkins: What I'm concerned about is that we've got a great idea here, but we haven't thought through this program. Again, I think of myself as a manager on a nursing floor and looking at reducing my nursing staff by 20 percent to 30 percent because they're going to mentor. Then where am I going to find those other nurses to fill that staffing need and provide the continuity of care for those patients? It's something, hopefully, that the ministry will put some thought into. I don't know if it's doable, because right now we don't have the casual nurses.

In my area, I'm told that because we come from God's country -- it's a wonderful place to live -- we get full-time nurses. They're there, and they work. We have trouble with casuals, partly because of the way the contracts are set up -- casuals can't find the work -- and partly because nurses want to work full-time, and there is a shortage of casual hours. I think we are going to have problems finding casuals to fill this 20 percent to 30 percent that the ministry is looking at for the mentor program, because we just don't have the nurses to cover that. Anyway, that's food for thought for whoever's developing the program. I'm concerned that the money is going to be allocated, but unfortunately it might not be utilized, because we're just not going to find the nurses to do that. We don't have that proportion of nurses in B.C. to do that right now.

I'll just move on to the rural nurses and health care providers initiatives. I'm wondering, because the ministry has allocated quite a bit of funding to this as well -- about $5.3 million to health authorities, it says, in rural and remote regions. . . . Perhaps the minister can tell me what the ministry defines as rural. What regions are getting this? Have we got a definition of rural that the Ministry of Health is applying to this funding?

Hon. C. Evans: Yes, we have a definition of rural. However, it's a list of communities, and I would just like to suggest that these are exactly the same communities that I read off in answer to a question from this side earlier in the day -- basically, that people who aren't in South Fraser, aren't in Simon Fraser, aren't in Vancouver-Richmond and aren't in the capital district. Is that correct?


S. Hawkins: Again, the $5.3 million. . . . How is that going to be allocated across these rural communities?

Hon. C. Evans: We have the application process to go through.

Noting the hour, I move that we rise, report progress and ask leave to sit again.

Motion approved.

The committee rose at 5:54 p.m.

The House resumed; the Speaker in the chair.

D. Streifel: The Committee of Supply rises, reports progress and asks leave to sit again.

The Speaker: When will the committee sit again, Government House Leader?

Hon. G. Janssen: Later tonight, at 6:35 p.m.

The House recessed from 5:56 p.m. to 6:40 p.m.

[The Speaker in the chair.]

Hon. G. Janssen: Hon. Speaker, I call Committee of Supply. We were debating the estimates of the Ministry of Health.

The House in Committee of Supply B; J. Sawicki in the chair.

The committee met at 6:41 p.m.


On vote 36(S2); ministry operations, $212,000,000 (continued).

[ Page 17282 ]

S. Hawkins: Just before the break we were talking about the rural nurse and health care provider initiatives, and the minister gave us some information of the definition of rural. We asked who was eligible for this program, and it's people in those communities. Will he provide us with that list?

Hon. C. Evans: Yes, I will send you pieces of paper.

S. Hawkins: This program is for nurses and other health care providers. Can the minister tell us who is included in the list of other health care providers?

Hon. C. Evans: The other health care professions that the hon. member describes. . . . The examples staff provide me with are pharmacists, X-ray technologists, imaging technologists, lab technicians, physiotherapists and rehab therapists. However, those are examples, and as the hon. member knows, I think there are something like 120 different professions represented, for example, by HSA. I do not have an exhaustive list, and I am under the impression that the "other health professions" language means anything in that list of HSA represented that the hospital might deem as necessary for the delivery of service.

S. Hawkins: That's interesting, because there is a pot of $5.3 million, and it starts thinning out as we include more and more details into it. I asked earlier, as well, about who is eligible, and the minister said the communities that he read out. I think I asked -- and if I didn't, I'll ask the minister -- how the money is going to be sorted region to region. I believe he might have answered that before the break, saying that it was as the regions applied.


Hon. C. Evans: You did ask before the break, and the answer I gave was: through a grant program rather than an allocation.

S. Hawkins: In the backgrounder that was provided in the announcement for this most recent plan, there are five distinct areas that the $5.3 million is targeted at. And it says "including but not limited to. . . ." But the five distinct areas are: financial support for nursing students; increased access for rural nurses and health care providers to educational opportunities; support access to clinical expertise; professional development for on-site opportunities for Internet usage, telehealth, etc.; support for current and future aboriginal nursing, etc., and for recruitment and retention strategies. Can the minister tell us: of the $5.3 million, have they decided how it's going to be broken up into those areas? How much funding is going into each of those areas?

Hon. C. Evans: The money will be allocated by a grant program. The ministry has advised the health authorities that the money will be distributed equitably around the province. However, the authorities themselves will decide which of the list that the hon. member read off are their primary needs -- or several -- and will design their application accordingly.

S. Hawkins: I always wonder how we come up with a number like $5.3 million. We've got five distinct categories, but it says it's not limited to those. And we've got nurses and other health care professionals, but it could include 120 health care professions. Then it's through a grant program and will be allocated as rural communities apply for it. I guess it's interesting to me because I want to know: has the ministry thought of which areas. . . ? Have they prioritized this list? Is there a pot of money that's going to go to retention and recruitment strategies that will force the regions to think about stuff like that, so they can use that money? Or is a portion of this allocated towards educational opportunities, so the regions will think about that? Or is it: "As we come up with a strategy, let's see if we can apply for it. Maybe we've got something on the back burner, and here's a pot of money"?

What thought has been given to prioritizing this list and divvying up the money? It sounds like that hasn't happened. The ministry's going to allow the regions to do it, and someone sitting there in the grant program is going to sign the cheque. It just seems like a funny way of distributing $5.3 million.

And I don't know how the $5.3 million comes up. It's, you know, $5 million, $4 million, $5.3 million. How did we come up with that number? Or have we not thought through how exactly the money's going to be allocated through these five priorities that have been identified?

Hon. C. Evans: I'm advised that the number comes up with surveying the health authorities to consider their demand level for these programs and the educational institutions on their delivery capability in the short run. I nevertheless would have to say that I kind of agree that $5.3 million is a fairly specific figure if it's based on the surveying of authorities all over the province.


On the more philosophical part of the hon. member's question, I get these kinds of questions all the time, especially from workers. Whether it's physicians or HEU workers, there's a tendency for the people in the system to say: "Why don't you tell the health authority that this money has a hard envelope to it and you have to spend it this way?" If you're responding to us. . . . Suppose you are HEU workers and you are concerned with repetitive strain injuries or lifting questions. They say to me: "Why don't you tell the health authority: 'Here's $10 million, and you can only spend it on safety equipment?' " Doctors, on the other hand, will say to me, "Why don't you direct the health authorities that they have to spend X amount of money on ICU?" or what have you.

There isn't really a hard and fast rule in the ministry in answer to that question. We have been known. . . . In the health action plan there are some dedicated funds, and as I read off to quite a few of the members earlier, we are saying there is X amount for continuing care. But wherever possible, either we let regional authorities make decisions and have ideas, or why have them? I mean, we don't have them just to screen government from responsibility; we have regional health authorities on the assumption that bringing various levels of care together in a region under one management would allow innovation, cost-efficiency and creativity in the region. In a way, that's also how the Canada Health Act works. Different provinces do different things, so that's how you get ideas.

My own bias is not to tell the authority you have to spend this money on retention and you have to spend this much money on training, but to say: "Here is the basket, here are the

[ Page 17283 ]

objectives that the province is trying to achieve, and you tell us what your priorities are in your region and how you would deliver them."

S. Hawkins: Maybe the minister misunderstood me again. I didn't intend to ask him if he was going to direct the health authorities to spend the money in a manner the ministry required them to. I'm wondering if the ministry has prioritized. Is this list in order of priority on the way the money is going to be allocated?

Certainly recruitment and retention strategies, I think, from what we heard around the province, are priorities. A lot of communities can recruit professionals, but they can't keep them there. Part of the reason they can't keep them there is because there are not enough workers around to support the staff there. Say, for instance, you do recruit a couple of ICU nurses. You burn them out because you haven't been able to recruit others, or you're not giving them enough of the kind of work they need to keep them interested in that work or to keep their skills up to date.

Those are the kinds of things I'm asking for. Is this list in order of priority? If it isn't, does the ministry have an order of priority? Say you get 400 applications in, and it takes in all of this money. Does the ministry have a plan on how it's going to allocate first? You may get applications that exceed this pot of money. How is the ministry going to make the decision to allocate the money to where it should go? Have the minister and his staff worked out a plan for priority? Is it going to go to recruitment and retention strategies first, then to upgrading skills, then to telehealth? Or is it just going to be as-it-comes-in basis until the money is gone?


Hon. C. Evans: The short answer to the question is that it is a neutral list, listed on a piece of paper without prioritization by the ministry. I would like to defend that a little bit.

The hon. member herself said, and I have also heard, that there is not a nursing shortage in the Okanagan. She said, and I have heard, that's because it's such a lovely, desirable place to live -- and that there is a casual nursing shortage. Meanwhile, there are -- what is it? -- 320 or 370 full-time positions available at VGH, where the stress levels are completely different. The transportation time, commute time to work is completely different; the acuity level is different; everything is different. And they have a difficult time attracting people. These are just nursing examples. It's different by region.

In her own region in the Okanagan, there may be another whole problem around another profession which I don't know about but they do. One authority proposes, for example, to put a day care in the workplace as a retention initiative. Per se I think that would be a good idea, but probably not applicable everywhere.

I'll just read off the criteria, however, of the nursing strategy part of it only. The criteria are that it must be specific to one or more of the following: support nurse recruitment, education and retention; or improve professional practice environments; or promote healthier work environments; or facilitate accessibility of education. And it goes on, hon. member. So what we are saying is: "Here are the legitimate criteria." And we're not going to judge the application on whether or not it fits a list of priorities by us. We're going to judge it by the outcome -- whether or not it solves the problem of having appropriate human resources on the job in the region involved.

S. Hawkins: I think the minister and I are almost on the same wavelength here. In the rural areas I think one of the biggest priorities is recruitment and retention, or retention and recruitment -- get them there and try and keep them there. Whether it's downtown Vancouver where they're short 300-and-some FTEs or in the Okanagan where we're short casuals, that's a recruitment and retention problem. So that's why I was asking, out of the 5.3 million bucks, as the applications come in. . . .

The day care situation that the minister gave an example of is a retention issue, because some of those individuals have children and have nowhere to put them when they're doing their shiftwork. So the way to keep them on the job is to run a 24-hour day care, which we've seen other jurisdictions around the world implement. That's why I'm asking.

There is a list that gives five different areas of where this funding will be targeted. I was just wondering if it was on a list of priorities the way it was set up or if, as the applications come in, maybe some of these are interchangeable, because some of them are education and some of them are professional support.

I know, as we travelled the province just in the last few months, that retention and recruitment is a priority; it's a huge issue in the rural areas. It's very difficult to keep people there. They will come there. There's one. . . . Just a physician example in Quesnel. They've had 75 doctors, I believe, in the last two or three years. So that tells me they can get them there, but they can't keep them there. Once they get there, for whatever reason they don't stay there. It's been a real turnstile for physicians, and we see that with nurses in the rural areas as well.

So, you know, it's just something for the minister to consider -- how they're going to prioritize the applications as they come in for that funding. I can tell you that if that funding is made available, there is going to be a lot of applications for it. There's great need out there, and I think we have to decide where that money is going to go first.

I want to just talk about foreign nurse recruitment as well, because the minister talks about targeting, hitting a target of 400 foreign-trained nurses. And I'm wondering: what countries are we recruiting from? What countries are we targeting?


Hon. C. Evans: There isn't a list of countries that are acceptable. The obvious attempt is to recruit from countries with a history of being able to pass the Canadian exam. The countries that come to mind are of course the Philippines, South Africa, England, United States, Australia. Personally, my favourite is other provinces in Canada, because I know that they aren't literally foreign. But the Rockies do tend to create a great divide, and I think we ought to take more benefit of the Super, Natural B.C. element and recruit or even raid in eastern Canada.

S. Hawkins: I note, as well, that there are going to be three criteria for qualified candidates: they will have received

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a job offer from a B.C. health employer, met the requirements of the RNABC -- the professional association. And then it says: ". . .have union endorsement." That's the third criterion.

I'm wondering in what circumstances a nurse would be denied union endorsement. Why is that attached there, and in what circumstances would we lose a nurse when a union didn't endorse her or him?

Hon. C. Evans: Hon. member, I am advised by staff that the only instance in which the BCNU would use that, essentially, veto is in an agreement that they have, I believe, with the federal government, which says that where training is required to upgrade a foreign nurse, the job application has to be offered to eight British Columbia nurses before it can be filled with a foreign nurse. I'm also advised that the BCNU is quite flexible in its interpretation of the rule and that it has not been applied in rural areas in recent times.

The Chair: Before I recognize the member, I will ask those who are having other conversations to either keep them down or have them elsewhere.

S. Hawkins: This foreign nurse recruitment program isn't just for rural nurses. It's for nurses across the province, and I understand there was quite a high-profile case of an American nurse who was denied. I believe it was Vancouver Hospital in the last year, and it was because she was denied the union endorsement. I wonder if the ministry is looking at that and what they're doing to resolve that issue. We can offer that job to eight different Canadian nurses, but if the RNABC is qualifying that nurse and they do have a job offered by a health employer, why would we deny that nurse? In most cases, it just doesn't make sense to me, so I wonder if the minister would think about. . . . I can't recall the exact month when that case was being profiled, but we did turn away an American nurse because of that clause. I didn't realize it was a federal clause. If the minister has information on that, and he could pass it on to this side of the House, I'd appreciate that.


Hon. C. Evans: I have to admit to some ignorance. I'm answering these questions based on a little bit of hearsay. I don't know of the case that the hon. member is talking about, and neither do staff.

Also, I kind of agree with her assertion that it doesn't make sense. If a nurse passed an exam and registered nurses said she was okay, why would there be an agreement in place that says the nurses union would essentially have a veto? I believe this has to do with wanting to give assurances to Canadian and British Columbia workers that the federal program that allows recruitment will not be used to take jobs away, essentially, from British Columbia nurses who might be, at some moment in history, in excess. That kind of makes sense. We're discussing it at a moment in history where we all understand that there is a vacuum; there is a need for nurses. But it does make sense that Canadian workers would not want to give the federal government or the province carte blanche to go out and flood the workplace with workers from away, if there were Canadian workers that wanted those jobs.

S. Hawkins: I recall -- and this is several years ago. . . . The minister mentioned the federal program. The federal program required us to post that position for several months before we could fill it. We had to draw up the job description to be very precise for the kind of nurse that we needed. I don't know if this is an opportunity to review that again -- perhaps with the feds, perhaps with the union -- and look at this issue. It didn't always make sense to me, if you're in a very specialized area and you do have nurses that you're recruiting from away with that kind of experience, why one has to wait five or six months to post it across the country to get those kinds of positions filled, when we know that there's no one in the country that will fill them. It doesn't make sense. In fact, it's going to slow up the kinds of targets the minister is hoping to achieve here. I will move on.

There is also a nursing workplace innovation program that the minister has put $11.7 million into. This is for innovative recruitment and retention initiatives. I'm wondering how that's different from the $5.3 million pot we talked about just a few minutes ago. How is this program different from the recruitment and retention strategies under the grant program that's targeted at $5.3 million?

Hon. C. Evans: There is a subtle difference, in that the first program that the hon. member mentions, the $5.3 million program, is relatively open-ended on how health authorities would achieve the goals, while the $11.7 million program is in direct response to the recommendations in the nurse recruitment and retention committee final report called "Access and Intervene," March 2000.

But the real difference is that the $5.3 million program is an attempt to deal with rural nursing recruitment and retention, and the $11.7 million program is open to health authorities anywhere in the province.


S. Hawkins: Okay. I hope the minister, sometime in the next few months, will actually have a more detailed plan for this. I had asked him, of that $5.3 million, how much was going to go towards nurse recruitment and retention. He said it was going to be on a first-come, first-served basis, and we didn't really have a priority list there. Now he's telling me that the $5.3 million in this pot is for nursing recruitment and retention in rural areas, but he doesn't tell me how much. And the $11.7 million in this envelope is for the rest of the province or across the province, including rural. I guess I get confused when I see two different pots, and I don't know how much of each is going to go into the programs that the minister is saying they're trying to target.

So again, it's a little confusing, because we've got almost $20 million -- well, $17 million -- between the two programs, and I don't know, out of the $5.3 million, how much is actually going to go into rural nurse recruitment and retention. Anyway, I just wanted to make that point.

I am also interested in the nurse transition to professional practice. I think that's the last part of the nurse program that the minister announced, and he is announcing $3.5 million made available over two years -- again, starting in this year's budget and then over next year's budget. This one is to provide nursing students with extended practice opportunities in a wide variety of health care settings such as hospitals, long term care facilities and community health programs.

I'm wondering if the minister can tell me how much of this money, then -- $3.5 million -- is going to be spent this

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year and how much is targeted to next year. Some of this is for laddering programs, I understand. How many positions, then, are we funding this year in the laddering programs, and how many are we setting up next year?

Hon. C. Evans: Three parts to the question. I think the first was: really, what is it? The hon. member will know that one of the things that health authorities and nurses themselves say is that the best way to get nurses in rural areas is to have them come from the community and/or be initiated into nursing in the community. This program is essentially a co-op program intended for that moment of transition.

The second part of the question was: how much is for this year? This fiscal year is $1.5 million, and next fiscal year is $2 million.

And the third part of the question was: how many nurses will it assist -- or young people? I don't have an answer to that question, hon. member. We expect that to be answered by the applications from the health authorities themselves, working with the educational institutions who will assign those co-op students.

S. Hawkins: Two questions from my local region -- or one specific one, anyway. I'm interested in the MRI acquisitions. Prince George and Kamloops are getting a fixed MRI, and I'm wondering if the minister can tell me what's going to happen to the mobile MRI. What's the plan for that -- the one that's been travelling up and down?

And secondly, there are 2,000 continuing-care beds that have been announced. Apparently my region is receiving 230, and I understand that we still have to go to the regional health district -- hospital district -- for 40 percent of the funding to get those beds. I'm wondering what planning the ministry has done towards that. I mean, it's nice to announce 2,000 beds and allocate 230. But again, it gets to be a pretty hollow announcement when we don't know what the plans are to get them in place. I wonder if the minister could just address those two questions.


Hon. C. Evans: The answer to the first part of the question is: I don't know -- that is, the future dispensation of the mobile MRI. Staff gave a different answer than that, but one that I thought might make for future political problems, so I'm not going to deliver it.

An Hon. Member: Secret agenda?

Hon. C. Evans: Yeah, we're going to figure out where it goes in future. What I was advised by staff was to name some of the places it might go. You can understand, hon. member, that that might be a lousy answer to give. The dispensation hasn't been determined.

The second part of the question was: does a health authority have to go to municipal government for 40 percent of the capital funding of the 230 beds? Yes -- maybe. That is one alternative. I was trying to say, in answer to an earlier question, that if it is the desire of the government that these beds be built approximately one-third by government, in which case that would be on the 60-40 model, one-third by the non-profit sector and one-third by the for-profit model. I do not know the preference of the hon. member's health authority. But only one of those thirds requires the 40 percent funding from municipal government.

The capital plan for next year, which would be the provincial government's share of the funding, is not part of the health action plan, so I cannot assist her or any other hon. member to know where the province's capital funding is likely to go next year.

V. Roddick: When our general practitioners are being forced to do crisis intervention in their offices and their office staff are forced to do procedures that should be done in a hospital ward, it is astounding to hear our Premier say that he did not realize the enormity of the problem, when referring to the state of our health care system. His credibility, as shown yet again in question period today, is completely shattered.

I have a question for the minister. The government constantly harangues against a two-tiered health system, yet layer upon layer of bureaucracy and bungling has led to a multi-tier system. A current example in my own riding of Delta South: a young lad was having problems in the school system and could not get help. The parents took it upon themselves -- they actually accepted responsibility -- and put this child into a private school facility, hoping this would help their young son. It rapidly became apparent that there was something definitely wrong with the lad. The parents took him to their local GP for analysis. The GP prescribed for him to go to the Children's Hospital attention deficit hyperactivity disorder clinic. Here is where the bureaucracy and the two-tiered system jumps in.

The clinic is hugely overworked and underfunded, I understand. They have been forced to push back onto the school system the psychological analysis procedure required to register patients in the ADHD clinic. Therefore the boy has to have this analysis done before they will accept him as a patient. The private school doesn't have a psychologist, and the public school he initially attended isn't allowed to help him.

The parents are faced with the unbelievable dilemma of putting their child back in the public school system and waiting, at the very least, a year before he can get an assessment or paying $1,200 for a private analysis. What are these responsible and desperately concerned parents to do -- pay the $1,200 to help their son or throw him into this hapless catch-22 situation to drown?


Will the minister bring some common sense and decency back into these people's lives and ensure that this family is covered by MSP for the $1,200 psychological analysis to allow him an appointment at the ADHD clinic at the Children's Hospital? The clinic itself is covered by MSP; it's just the analysis that isn't. So I ask that the minister carry this forward and make sure this family is covered.

Hon. C. Evans: I will try to understand the situation with that particular family. I'll ask staff to do some research and see what I can do.

But I want to address the common sense part. Let me see if I can get this straight. This person stands up, hon. Chair -- I'm pretty sure this person is a Liberal -- and she's asking me, a social democrat, who is provincial government: why is some

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family having trouble with the health system and the education system? And then she asks me to solve it with common sense. So here's my idea, hon. member.

Maybe talk to your sisters and brothers -- those Liberals, who used to be our 50-50 pals in the delivery of education and health care in Canada -- and ask them why they left home, and exactly how anybody is going to govern in any province and deliver the kind of services you're asking for in the absence of a country. I'm not a Liberal. I'm not the sister and brother of those people who decided to take a walk from your constituents. We're trying to hold up the whole sky by ourselves. You go ask the people who abandoned your constituent to come back in, and you bet, we can get the services we need.

[D. Streifel in the chair.]

Common sense? You're asking for common sense? How can you stand up and ignore the fact that your political party walked from your constituents? That's what this entire debate is about: common sense. . . . You made me a little bit grumpy, because you're asking not for a technical answer, like. . . . Common sense. The common sense is: look in your heart, look to your leader, look to your party, and ask them the question you're asking me today. [Applause.]

V. Roddick: That was quite a show.

You are the minister. I have asked you on behalf of my constituent. . .

An Hon. Member: Through the Chair.

V. Roddick: . . .through the Chair, to help the constituent. They have the problem, not me.

Through the Chair to the minister, $66 million on equipment doesn't even bring us up to where we would have been if the current government hadn't declared war on doctors and nurses over the past nine years. Who has suffered here? The people of B.C. The workers of B.C. The very ones that the current government say they stand for. The so-called rich, for heaven's sake, can leave this province; the rest of us can't.

You have betrayed your mandate. This cash windfall. . . . You can make no long-term commitments with a windfall, and health care is long-term. This windfall -- where has it come from? From the backs of our B.C. working people. From the elderly on fixed income. From single parents struggling to survive. From the out-of-work miners, foresters and fishermen. Every single one of us has contributed to this windfall by paying our natural gas bill.


There are approximately 125 hospitals in B.C. Alberta, interestingly enough, has 129 hospitals and a million fewer people. The average heating bill could actually be compared with greenhouses, because they are both dealing with rather delicate clients. I know the minister is familiar with greenhouses, so I will use this analogy.

First, I would like to put the term gigajoule into layman's language. The average gas fireplace burns one gigajoule a month just to keep the pilot light lit -- nothing else, just the pilot light. My gas fireplace, over the space of eight months, has gone from $6 to $13 a gigajoule just to keep the pilot light lit. A greenhouse or a hospital could easily burn in the cold months, say, 90,000 gigajoules over a four-month period between December and March. Last year's actual price on 90,000 gigajoules was $359,000. Today's possible contract price, if you were bright enough to get it at $10, is $900,000. Today's spot price, in fact, tops $50 in one area. But I'm going to go at $27 for the spot price. That's $2.43 million.

And I'm only asking the minister about hospitals. There remains all the other public institutions such as long term care centres, schools, seniors housing, social housing, etc. If you take these figures that I've just given you and multiply them by 125 institutions, they read as follows: last year's actual would have read $4.5 million, today's contract at $10 would be $12.5 million, and today's spot at $27 is $304 million.

How have the 125 hospitals throughout B.C. budgeted for their heat this year? Have they anticipated this fuel crunch? Did they contract-buy everything? If they did contract-buy everything, at what price? Or are they facing the same spot market costs that greenhouses are? If they are, $180 million won't even touch their heating bill, let alone do all the things that this so-called plan has promised. The government is faced with a provincial catastrophe here. You're not really tackling the problem at hand. The question is: how are these hospitals and clinics going to pay for their heat this winter and beyond? Will they be using the $180 million to do so?

J. Pullinger: I just couldn't resist getting into the debate here, because I am so absolutely astonished to hear the free-enterprisers over there complaining about the results of free enterprise. Wasn't it the people opposite who were on a privatization, deregulation, trade deal crusade to say: "Let's open it all up to the marketplace; let's hand it to the private sector"?

Honestly, I'm having just a small amount of trouble. . . .



The Chair: Order, hon. members.

J. Pullinger: I'm having just a small amount of trouble. . . .


The Chair: Order, hon. members. Come to order. The member will take her seat, please.

Interjections are not helpful at this stage in this debate, hon. members. This goes for all sides of the House. We all understand that the debate is passionate. The previous speaker was listened to with a certain amount of respect. That's the decorum of the House, and that's what the Chair requires for this entire debate.

J. Pullinger: Thank you, hon. Chair. I appreciate that.

As I was saying, I find it so amazing that the self-proclaimed free-enterprisers on the other side of the House suddenly seem to be against free enterprise. We're just hearing this litany of complaints about the effect of throwing things to the marketplace. And yet we've seen their supporters and their think tanks and their members come forward to basically say we should privatize everything that moves.

Similarly, I was sitting in my office and listening with utter amazement to another one of the members opposite

[ Page 17287 ]

complaining about the fact -- or suggesting -- that we should fund child care, which is very amazing. Their critic and their members have said that child care is not a priority for the other side of the House. Apparently, they don't know enough about the B.C. budget to be able to make such a commitment. However, they do know enough to make a commitment to a $2.9 billion cut for their corporate backers.

So, hon. Chair, I would just simply like to interject at this stage. We all know that the opposition has committed today again, as they did in Nanaimo, to a billion-dollar cut in health care. And we know that's over 13,000 fewer nurses that'll get fired or laid off. But I wonder if the minister could tell us what would happen if the Liberals had their way, on top of their billion-dollar cut and privatizing B.C. Hydro as they've suggested they would do, and sent that to the marketplace as well -- to go through the ceiling. Perhaps we could have an estimate of that.

The Chair: Hon. minister, before I recognize you, the question as I understood it -- if the Chair could hear over the interjections from time to time -- had to do with B.C. Hydro. I would remind the committee, all members of the committee, that the standing order 61 requires the debate in committee be relevant to the issue in front of us. I hope that is a guide for the minister during the response, and that will be the guide for all the members during their presentations during this debate. The heating costs of greenhouses or the sale of Hydro are not relevant in this debate -- standing order 61.

Hon. C. Evans: I do not know how much B.C. Hydro contributes to the health care budget, although I will attempt to get that information. The other question was. . . .


Hon. C. Evans: I'll find out; I'm going to. I'll find out what B.C. Hydro contributes to the health care budget. The other question was about the cost of heating to hospitals. Hon. member, the fall contribution to health authorities contained in it precisely $16 million to address non-wage expenses, primarily related to the cost of drugs and oil and natural gas.

V. Roddick: Hon. Chair, a question for the minister: how are you budgeting? I cannot see anything in this for the cost overruns. You really haven't answered the questions. Has the health system purchased natural gas via contracts? Or are you buying on the spot market? If you aren't contracting, and you are buying on the spot market, there isn't enough money in here to satisfy the cost overruns on the fuel, the natural gas. So I'm asking again: will you be using the $180 million to finance the overrun in the fuel bill?


Hon. C. Evans: The answer to the question is no. And the question, the hon. member's preamble, is based on a false assumption. The hon. member asked whether or not this -- or claimed that this -- increase would not be sustainable except for the temporary, she felt, increase in the cost value of natural gas and electricity. "Windfall," she called it.

The increases to the health care budget are not one time only. In the main, they are increases to the base. There are some one-time-only increases. And if she wishes, I'll break it down for her.

But I believe that British Columbia's economy can afford a healthy health care system not only this year but all years into the future. We are no longer a boom-and-bust economy; we are a diversified economy. If, this year, electricity is worth a lot, I'm sure that in two years' time we'll be seeing similar increases in the value of lumber, or the price of silver will go up, or increased film-making or high-tech. We are a healthy economy, and that's exactly what this debate is about.

This is not about a one-time infusion into the health care system. This is about a Premier who walked in here and passed a law that said we'd balance the budgets. We got a benefit from that that constituted a surplus, came in here in the fall and allocated it to health care; came in, in another quarter and got another surplus, walked in here and gave it to health care. You don't get it. This is about substantive change to how we run British Columbia. It's not about any kind of windfall to the province or the health care system.

V. Roddick: I don't get it? You haven't answered my question. Is the ministry tracking these increased costs due to the higher natural gas prices? If so, how are you having it in here? And if you don't have in here, what are you going to do about it in the future?

P. Calendino: I've been listening to this debate all day, and I'm fascinated by the fact that now the debate has shifted from health care into the cost of gas. I asked myself whether the pilot light had gone out on that side.

We are here to debate a plan that has been brought together after a month of consultation by the minister and the Premier with health employers, with people who provide services in health care. They brought a plan which is simple, a plan which is doable, a plan which is practical. I'm wondering: where is the plan from the other side? Their Leader of the Opposition -- their leader, the man without a plan -- is not even here to show us what his plan is. Now, we have a plan here that addresses the challenges that this province has faced for the last few years, and they are challenges that are not specific to British Columbia, as the opposition wants people to believe.

I've been around the country. I was in Quebec, and the front page of the newspaper said: "Quebec needs 6,000 nurses, and they can only find a few hundred." I was in New Brunswick, and guess what the headline story was in New Brunswick: "Doctors are walking out and withdrawing services." We heard today on the radio and on television in the last few days that in Alberta, doctors are walking out and not providing services. So the problems we're facing in British Columbia are not singular to British Columbia. They're all over the country; they're all over North America; they're all over the world. Shortages of nurses are everywhere -- here, in the U.S., in England, in Australia, in continental Europe. Shortages of doctors are everywhere.


I have a question. We are here because the Premier has decided to address the challenges of the health care system, and we are now able to do that because our economy has finally turned around. Our economy is performing much better than it was even predicted. We have a surplus. The Premier has two priorities: (1) to put our house in order, and (2) to address the health care problems that we have. That's what we are here for, to address the issues of health care. Whether those people want to understand that or not, it really doesn't

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matter. This government, this side, is addressing the problems of health care, and we are putting $200 million in it, after nearly $300 million that we put in two months ago. You may not believe that this is good news, but look at what the head of the B.C. Medical Association has said: "They have collected a lot of good ideas and put them together in a plan." We have a plan.

Where is the opposition's plan? We haven't heard anything. The only plan I've heard from them is that they're going to cut taxes for the wealthy and for corporations -- $2.9 million -- and that they're going to limit spending on health care to 40 percent of the budget. So if we take $2.9 million in cuts and we calculate 40 percent, that's a $1 billion cut in health care.

The member for Delta South is complaining about the cost of gas and the cost to hospitals and institutions. I wonder how she would reconcile the fact that there was $1 billion less in the health budget to address things like that, and those are not even health issues. How are the Liberals going to provide more nurses and more equipment and more doctors when they are taking away $1 billion?

But to make my intervention short, I have a question for the minister. Mr. Minister, in my community we are facing. . . .

The Chair: Through the Chair, hon. member.

P. Calendino: I'm sorry. Through the Chair to the minister, I want to ask the minister. . . . In my community of Burnaby, we have had a dental clinic for providing services to school children, kindergarten, grade 1 -- primary children -- for the last 50 years. The school board has been able to fund part of that because they had revenue from rental properties in the past. They can't do that anymore because they don't have any more free properties to rent.

The ministry has been allocating a certain portion of the cost of running the health clinic. By the way, the dental clinic provides services to 4,000 children aged five to eight years old every year. . . .


P. Calendino: This is part of the question.

Which eventually would save a lot of money for the health care system -- 4,000 children that may be deprived of the dental service, preventive care. Would the minister commit to looking into the issue of retaining this dental clinic, not just for Burnaby but for the whole Simon Fraser health region, with a small amount of about a quarter of a million dollars?

Hon. C. Evans: Yes, the minister will commit to looking into the matter of attempting to retain the dental program. I don't have an answer, and I'll find out about it.

V. Roddick: With all the ranting and raving that's been going on, I still don't have an answer to my question. What is the ministry's estimate for how much the skyrocketing natural gas prices will cost the health care system? I am concerned that this $180 million that you have committed will be used to cover the cost of the natural gas and not go into the programs that you have promised. We need an answer, because if you don't have an answer, I'm doubly worried.


Hon. C. Evans: I would like to say that we do not buy gas in bulk. We are not actually a buyer of the gas. Gas is bought by the hospital or the health authorities themselves. Neither do I micromanage the hospitals or the health authorities. My answer earlier about the nurse retention issue is precisely the same. We don't tell them what to do, and they haven't asked for an increase for natural gas. They were given a lift of $16 million in the fall, part of which was to cover increased heating costs, and they haven't asked for an increase. They will deliver health care with the $180 million. I very much appreciate the hon. member's concern, and I will watch for a letter from any health authority that cites inability to deliver health care because of their heating costs.

K. Krueger: I just wanted -- for the sake of my colleague who tried so hard to get that point across -- to make the point to the minister that it really isn't a windfall to the province, if we're deriving substantial increased revenues from natural gas sales, if the public institutions that have to be paid for through the province's annual budget are incurring a similar expense that they haven't been able to budget for because they had no way if anticipating this. I don't know why it took so long for the government to understand that point.

The minister responded to one of my other colleagues earlier, who had asked about how long it would take before the new continuing-care beds were likely to be opened in the various health regions around the province, that the speed with which the new beds would get there is largely a function of the individual health authority's ability to get the job done. That's a paraphrase, but I think it's pretty close.

With respect, I want to put it to the minister, through you, Mr. Chair, that that isn't always the case. For example, the Thompson health region administers the Clearwater area. Clearwater was promised a new multilevel health care facility, which includes extended care and continuing-care beds, in 1995 -- eight months before the 1996 election. It wasn't just the classic NDP-runaround-promising-to-get-votes promise; it was actually a business decision promise. It was recognized by the ministry and the government, after having apparently followed all the due processes, that Clearwater needed and deserved a new multilevel health care facility. And it hasn't been built. There hasn't been a spade in the ground. The only work that has been done on the site is work that's been done on a voluntary basis by loggers from Clearwater who came, cut the trees down on the site voluntarily, sold them to the forest licensees and put the money into the local community fund for that facility.

In spite of what the minister said about it being up to the health authority's ability, right after the '96 election that project was frozen, along with others, and the person who is now the Deputy Premier, the Minister of Education, who was the Minister of Health. . . . In estimates when I asked her how that could happen -- when a promise like that could be broken so quickly after the election -- her answer, on August 13, 1996, was this: "Things changed during the election." Things changed, and that's what the constituents in Clearwater have been living with ever since.

On June 28, 1999, I was questioning the then NDP Health minister, the member for Surrey-Newton. I asked her when it was going to be built, and she said: "It will go to tender in November." That's November 1999, and then she said a little bit later that same day, "You raised this with me last year," and I had.

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This year in estimates the then Health minister, who is now the Minister of Social Development. . . .

G. Farrell-Collins: It's hard to keep track of them.


K. Krueger: It's a revolving door -- a merry-go-round. I'm astonished anybody on that side of the House gets anything done in cabinet, and many people don't feel they do. One of the reasons is probably this constant disorganization, another demonstration of NDP incompetence in government.

The minister this past summer, on May 15, 2000, when asked about the same issue, said: "Construction should start in the fall of this year." That's this year, and now we are well into December. Most people would say that according to the seasons in British Columbia, certainly up where I live, fall is pretty much over, but construction has not started.

The member for Kamloops, the current Minister of Advanced Education, had this to say on June 26 in the local media, the Clearwater North Thompson Times: "I am looking forward to seeing construction proceed later this fall. I'm hoping to come up in the fall for a groundbreaking," she stated. "It is wonderful to know we will be breaking ground before the end of this year."

We're awfully close to the end of the year, and this government has not delivered on any of those promises. So I don't think it's fair to say it's up to the health authorities to demonstrate ability. Something is clearly wrong when this government has taken more than five years to break ground on something that was promised eight months before the last election.

I'd like to ask the minister, to begin with: what is the status of the Clearwater multilevel health care facility? Why has the ground not been broken? Why is construction not underway?

Hon. C. Evans: Showing a great deal of calm and patience, I will pass on all the pejorative nonsense in that question and answer the substance.

The hon. member, after his rant about myself and the government, asked the status of the Clearwater care centre. The Clearwater care centre project has been approved as part of the province's consolidated capital plan. It proceeds as per schedule and is currently in design development. Construction is anticipated to begin in the fall of 2000. I actually think that the hon. member knows exactly where it's at.

The Clearwater health care centre project is going ahead. I know of no reason to stop that. All those commitments you describe -- I know of no reason, nothing in the way of building the project.

K. Krueger: If there's anything pejorative in the quotes I read, they were all quotes from the minister's colleagues. The fact is that it's not fall anymore in British Columbia; it's winter, and the project hasn't been started. Clearly the minister was reading from the same briefing notes as his predecessor read from in May. It hasn't happened. That is the point I made.

I do know the status of the project. It's a frozen piece of ground. And the only work on it has been done by volunteers in the community. One of the ironic things about this for the people of Clearwater is that that is one of the few areas of my whole constituency that actually voted NDP in 1996, largely because they were hoping to get this hospital. They've been bitterly disappointed in the government of the day, let me tell you.

When the minister says that 2,000 new continuing-care beds are going to be added with this funding, given the fact that that facility hasn't even been started, are the continuing-care beds that are going to be part of that facility included in the quota of 2,000 the government is saying this money is going to fund? Are they included in that 2,000?

Hon. C. Evans: I'm going to try and say it better than I did last time, hon. Chair. The planning money could not have been advanced if the construction cost was not guaranteed, and the health authority knows that. I would ask the hon. member to check with the health authority and to check the veracity of what I just said.

If it turns out that the health authority agrees with what I just said, then it could be that the absence of a physical plant has something to do with the completion of the planning project. It may be that the health authority is satisfied with development thus far. They may even like the planning that's going on.


Hon. C. Evans: The hon. member asked me if the province was impeding the construction. My answer is that the planning money could not have been advanced if construction money wasn't guaranteed. If the hon. member finds out anything different than that, let me know.


The other part of the hon. member's question was whether the beds that are intended to go in the Clearwater health care centre are part of or in addition -- whether the announcement is in addition to or includes them. It is my belief, and I am advised, that the number I just announced is in addition to the beds that are included in the Clearwater health care centre.

K. Krueger: And our House Leader makes the next point that I think the government really needs to address. We're called in for an emergency session today to talk about this alleged new spending with this alleged surplus and these alleged commitments. And it has taken more than five years. . . . This project has been announced over and over again. I only read a tiny fraction of the quotes I could have read from the local media and from Hansard. It's been announced all those times, but nothing has happened.

And if we follow that same performance trend for this government -- if, heaven forbid, this government remained in power -- judging by this example, none of the 2,000 beds we're talking about would be open before the year 2006. Is that a fair statement?

Hon. C. Evans: It is true that British Columbians have a history of having things announced in the absence of planning and construction money being guaranteed. The hospital in Nelson, for example, that people there are trying to build was first announced in 1989 without. . . .


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Hon. C. Evans: It has never been announced under this administration, hon. member, or by this person. And that is why the rules have been changed so that planning. . . . You can't enter the planning process unless the construction money is guaranteed, in order to avoid the situation that the hon. member is talking about.

All the rest of your question I take as a non-question, so I'll not address it.

K. Krueger: So the minister just said, as I understand it, that the money really isn't there until the construction is approved.

An Hon. Member: It's never been.

K. Krueger: And it never has been. We're talking about 2,000 alleged new beds. And if that's the guideline, those 2,000 beds are a myth, because that construction hasn't been approved at all. The planning is nowhere near done. Everybody's just barely at the start of the whole initiative with regard to adding those 2,000 beds.

These aren't facetious questions at all. I've come to this government year after year and pointed out that we've got more people on the waiting list for extended care in the Thompson health region than we presently have beds. If all those facilities were emptied tomorrow, heaven forbid, there would only be enough room to take in the people off the waiting lists, people who have already been approved as being admissible to those facilities. So we're in a terrible bind up there. And in some of my questions later I want to explain to the minister what a mess things really are in, in extended care in the Thompson health region.

But if this is just one of those NDP announcements for never-never land, and it's never actually going to happen, this is a very cruel spoof on the people of British Columbia today. And this session of the Legislature is another abominable waste of time and money, as was the announcement where 250 people were flown in this week to Vancouver to hear about these plans.

I'm going to surrender the floor to my colleague the Health critic for some further questions and come back later. But I respected the minister's candour when he said this in the Times Colonist on January 17, 2000: "We made announcements about things we weren't even going to do." And that's the truth. That's happened a lot with this government, under this government's watch. I recognize full well that the minister only just became the Minister of Health. But he's answerable for his whole team and for their track record and their performance, and a shoddy performance it is.

Just before I surrender the floor to the Health critic for the official opposition, I'd like the minister to give the people of Clearwater and the Thompson health region and the North Thompson Valley and Kamloops his firm commitment that this construction will proceed forthwith. It's hardly fall of the year 2000 anymore. As I understand, all those hurdles have been cleared time and again. Those announcements have been made over and over. The only reason not to have proceeded is government incompetence. And if this minister is determined to make things happen -- as he has said he is, publicly; as he has said he is with the issue of nurse immigration and so on -- I'd like this minister's commitment that this thing will happen before the end of this year.


Hon. C. Evans: The planning money couldn't have been advanced unless the construction funds were guaranteed. The constructions funds are there. I do not actually know what stage the health authority is at. I'd be pleased to find out for the hon. member. The hon. member wants a commitment that the government portion of the project is there. It's there. He wants a date on which it will be constructed. I guess I would have to talk to the health authority, and I would encourage the hon. member to do so as well.

C. Hansen: My colleague from Kamloops-North Thompson made reference to the big, splashy health care announcement that was done in Richmond on Tuesday. I wanted to raise the issue of where this government puts its priorities. Certainly the estimates that have come out -- of the cost to taxpayers, not the direct cost to the ministry's communication budget -- of that big extravaganza in Richmond is in the neighbourhood of $75,000 to $80,000. Some say even that is conservative.

Well, tonight on BCTV news, we saw a case of a woman by the name of Barbara Izatt from the Sunshine Coast. She is 55 years old, and she has a tumour on her left kidney. She is in urgent need of surgery, and for her it is a life-and-death struggle. If she starts to bleed, she will die. Her doctor has told her that they have looked everywhere to find her a bed, and what she is facing is a three-month wait-list for surgery.

Mrs. Izatt is probably watching tonight, and I want to put to the minister the question that she wants put. Her question is: "I want to know why." Why do they fly people into Vancouver, when they could have used that money to get her the surgery that she desperately needs?

Hon. C. Evans: The hon. member's question mixes the plight of an individual which needs resolution. . . .

I think he and everybody accept that the health care system's responsibility to all the citizens is to deliver the care they need when they need it. All day long we've been discussing the contents of the health action plan that might apply to a similar person's need: a bed management system that would allow her doctor to find the appropriate bed and the appropriate care without having to make individual telephone calls; the continuing-care initiative to free up the acute care beds; the increased ICU locations in the lower mainland, in case she was in need of one of those facilities; the attempt to deliver the appropriate workers and appropriate equipment to those surgeries, so that anyone who needs them would find that the equipment and the people were there at the moment. All that stuff is intended to address the plight of people anywhere in the province waiting for any procedure.

The second question, about the nature of the announcement. . . . I will wait and see if the hon. member has a specific question about how the event was planned or costs, or whatever he might wish to ask.

C. Hansen: The minister is trying to separate these two issues, but they're not separable, because this is a question about priorities. It's a question about the minister's priorities. I would like to ask the minister: what is a higher priority -- getting Barbara Izatt access to two hours of operating room time so she can have the surgery that she needs, or spending $80,000 on a press conference in Richmond?


Hon. C. Evans: The absolute priority of the government is to provide the appropriate bed whenever any citizen -- this

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hon. member's constituent or any other -- needs it; the appropriate staff to staff that surgery; the equipment necessary so that the people who come to do the work can provide the level of care that they were trained to provide; and lastly, to make it so that that bed is actually available at that moment. All of the parts of the health action plan, except for the prevention, can really be boiled down to attempting to provide those four factors for the citizen that he describes and every other citizen.

I can't give him the date when the IC unit will be open, and I can't give him the date when a particular piece of equipment will be available. But that's the purpose of everybody who's here today: trying to allocate the money to solve this patient's issues -- and every other citizen of British Columbia.

C. Hansen: A very conscious decision was made by this government for a splashy photo opportunity that was going to divert dollars away from patient care. We know there's not enough money to do everything that needs to be done in patient care in British Columbia, yet those scarce dollars were diverted for the purpose of an NDP photo op. I would like to ask the minister: when the decision was made to put on that splashy photo op, was the minister conscious of the fact that it was going to divert many tens of thousands -- if not hundreds of thousands -- of dollars from patient care? And the second point is: the decision to put on that photo op. . . . Was that a decision that was made by this minister, or was it a decision that was directed from the Premier's office?

Hon. C. Evans: The components of the health action plan are really intended to make sure that there's a bed for the citizen that the hon. member is talking about, that the staff are there to service that bed, that the equipment is there that the staff require to do the job to deliver the level of care and that they can find the bed -- which is why we're having a bed management plan. The ICUs, the training and the equipment will be delivered over time. We are here to discuss allocating the funds so that we can begin to deliver the resources. It's my hope that the citizen that the hon. member is talking about can get the care that she needs in a timely fashion.

C. Hansen: The minister is avoiding what was a very direct question. The decision to put on a very expensive photo op the day before yesterday was made by either the minister or the Premier's office. Can the minister tell us whether he is going to take responsibility for that very inappropriate decision? Or was that in fact directed from the Premier's office?

Hon. C. Evans: I'm very pleased that the hon. member has now asked his question as a single entity, and I'd be pleased to answer it as a single entity. The fifth day, I think, that I had this job -- perhaps the fourth day -- I addressed the Health Employers Association of British Columbia. The hon. member was in attendance. And on that day, I committed to the Health Employers Association of British Columbia to consider their issues, to tour the province, to meet their members where they live and work, and to return to them within one month. The meeting that took place in Richmond was my decision and pleasure, because it constituted keeping a commitment, keeping my word, doing what I said I would do, and it was my decision only. I have a great deal of pride in the fact that I was able, 30 days from the day I said I'd do it, to come back with the plan that I said I'd have.


The hon. member may not realize this, because I get it that there are those here who think getting here is a simple chore. But the truth is that the province is a really big place, hon. member. It is necessary, if you're going to attempt to govern, that you govern for everybody. And that means you've got to make it possible for the people from Prince George and Castlegar and Cranbrook and Kelowna to get somewhere. The Health Employers Association of British Columbia includes all those people. I sent them an invitation and invited them to come back to the same town where I met them on the day I promised to be there, delivering the plan that I promised to have. And, hon. member, I'm really proud of that.

Now, my question to you is: are you real proud to be sitting there criticizing all night long without a plan of your own? Are you satisfied to simply criticize forever? If you got those people in a room, would you have anything to tell them? And would you tell them what you actually intend to deliver to them?

C. Hansen: Could the minister tell us if there is a communications plan that accompanies this health action plan? And how much is being budgeted for that communications plan?

Hon. C. Evans: The health action plan does not have a communications plan attached to it in budget. The Ministry of Health will certainly be, and has already been, engaged in the communication of the health action plan. I will attempt to get the hon. member information about the cost of that.

C. Hansen: So not only have we had $70,000 or $80,000 spent on the minister's and Premier's photo opportunity, but in addition to that, we're now going to see many, many thousands of dollars spent on advertising of this health action plan. Meanwhile, I would like to ask the minister again a direct question that I asked him earlier: are photo opportunities and advertising a higher priority than getting the surgery that is needed for Mrs. Izatt to once again be able to live a quality of life in this province?


The Chair: Order, hon. members.


The Chair: Order, hon. members. Order.

Hon. C. Evans: Through the Chair to the hon. member, the citizen that you mention requires -- like every other citizen in the province -- a bed when she needs it, the trained staff to service that bed, the equipment that those trained staff need to look after her needs. She needs the bed to be available, which requires that people who are in acute care beds now be managed somewhere else -- either at home or in continuing care. That bed needs to be findable through a bed management system that is electronically communicated around the province so that when she has need, the doctors that are looking after her can find the bed.

All of these components are in the health management plan. It is the government's plan to address the health care

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issues in British Columbia today, which the hon. member quite rightly describes as needing to be resolved in order to look after this citizen's needs.

C. Hansen: I want to remind the minister of something that he said in January of 1996, referring to an individual by the name of Karl Struble, who was an NDP spin doctor. The minister's quote is: "You've got to get Karl Struble and Now Communications out of the way and talk directly to the people." So when the minister was travelling around this province and meeting behind closed doors with health care providers and others, did anybody in those meetings tell him that photo opportunities and advertising campaigns were a higher priority than the kind of patient care that Mrs. Izatt needs?


Hon. C. Evans: Pretty insulting. First I've got to answer a whole bunch of questions about how come we brought people together to talk to them, and next the hon. member gets up and says: "Why would you talk to people in public?" You can't have it both ways. Either it's wrong to carry on democracy by gathering people together and talking to them, or it's right.

I'm proud of the fact that I travelled around British Columbia, to Prince Rupert and to Quesnel and to Castlegar and to Nelson and to New Westminster, to talk to people. I don't hide from that; I'm proud of it. I'm proud that on the fifth day I had this job, you, the hon. member, and I went and talked to the Health Employers Association. I'm proud of the fact that we brought them back together to say: "Here's the outcome of our conversations."

I don't duck from it or hide from it. It's a good thing to do. It's a big province. It's not all enclosed in that little area that you can get to from the helijet. There are people out there. We govern for those people; we've got to look after them. And once in a while it's a good idea to bring them together.

C. Hansen: What took place in Richmond two days ago was not a consultation. It was a photo op for the minister and the Premier; it was nothing more. You flew dozens and dozens of individuals from all over this province, not on charter-class fares, because you didn't give them enough notice. You flew them down to Vancouver at full air fares, so that they could sit and listen to the minister and the Premier pontificate to them about this new plan, which they hadn't even had a chance for input on that day. They were props in a photo op and very expensive props at that. And those dollars came directly out of patient care.

Hon. C. Evans: I saw in the front row that day the chair of the health board, Simon Fraser health authority. I would suggest that the hon. member go phone him and tell him that he's just been described as a prop and tell him to turn on the television. Hon. Chair, I saw the CEO of the hospital in Prince Rupert. I would suggest that the hon. member for Skeena go and phone the CEO and tell him he's just been called a stooge or a prop at a photo op.

We saw representatives of most of the constituencies represented opposite. They came together voluntarily to hear what the government was going to do about health care. And I don't think that they like the pejorative nature of the hon. member's comments about them and their free will and their decision of how to do their jobs. I saw in that room representatives of RNABC, I saw the B.C. Nurses Union, I saw HSA people there, I saw the College of Physicians and Surgeons there and I saw the BCMA there. Are these people stooges of the government? Are they props?

All those of you folks out there watching who work in the health care system, this hon. member thinks you've just been used. I would suggest you that phone the Liberal caucus room and tell them what you think.

The Chair: Hon. members. . . .


The Chair: I'll work on it.

The hon. member for Malahat-Juan de Fuca -- the floor is yours, hon. member.

R. Kasper: Okay. I'm not going to get into any rants, because I don't think that's going to solve anything. My question to the minister deals with. . . . As of December 6 there are 83 bed closures under the category of seniors health -- 83 bed closures in the capital region for seniors health. That would include intermediate and extended care. Now, 29 of those bed closures will be reopened in December, and that's at the Gorge Road Hospital. But that leaves a net of 54 beds that are closed as a result of the nursing shortage.

What I'm asking is: if in the plan and the announcements that were made on Tuesday, what is the time frame in alleviating these bed closures?


Hon. C. Evans: I do not know the answer to the specific beds that the hon. member is referring to, although staff are taking note of his comments, and we'll see if we can get an answer. The most immediate or short-term solution, I would suggest, may be the home care allocation to the capital regional district, because if individuals can be found in acute care who can be sent home -- if we can find the appropriate nursing and home care -- then those beds are freed up for the services the hon. member is talking about. And I say that's more immediate because faster than the continuing-care allocation -- which are facilities that may yet need to be built -- the home care component of the plan can reduce the pressure on acute care beds in the short term.

Hon. member, the allocation for the capital regional district for home care is $1.124 million. The specific facilities that you're asking about. . . . We'll see if we can get you information over the course of the evening or the next few days.

R. Kasper: My other question deals with the issue of respite care. What happened out at the Juan de Fuca Society's Priory Hospital was that there was a respite care bed for that particular facility; that bed is now closed. There is no longer respite care to give families relief when their family member is required, because of other circumstances, to actually go into a facility for a very short-term period, be it a weekend or a week. What I'd like to know is: is there funding available to actually enhance the respite care level that we had previously in Victoria's western region?

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Hon. C. Evans: It sounds to me like the respite care bed that the hon. member is referring to has probably not been closed but, my guess would be, has been allocated to another use. Do you want to nod your head, if that could be true?

The likelihood is that in the home care allocation, that bed could again be relieved for respite care -- or perhaps in the flex-bed allocation. The flex-beds are intended to create sort of a safety valve for times of high use, such as flu season, of the acute care facilities. The flex-bed allocation for the capital region might also be something that the local hospital could use to get the respite care bed back. It is $813,418.

I also wanted to highlight the palliative care component of the health action plan for you, since you brought up the respite care bed. Occasionally there are acute care beds and respite care beds that are occupied by somebody who is going to die, and whose doctor and family know that they're going to die, but they don't have enough money to go home. So they have to stay in the hospital until they die, in spite of their wishes, because the equipment and the drugs that they might need to be comfortable have hitherto been unavailable except in the hospital.


So we are going to -- starting, I think, in February -- allow costs for equipment, medicines and drugs to allow palliative care patients to go home or to the place of their choice and die in dignity, regardless of whether or not they are wealthy. I don't have a number, but I expect that also to reduce the number of acute care beds all over the province that are being used for other purposes.

The last thing I wanted to say is that all these components -- the home care, the flex-bed components, for example. . . . The cash will flow to your health authority, depending on the outcome of tonight's debate, on December 15.

R. Kasper: The other issue -- I hope the Chair doesn't rule me out of order -- deals with the idea I submitted to the parliamentary committee making some recommendations on budget. I know we're not allowed to talk about future things or plans of government. But has the minister considered the issue that I've raised publicly on the fact that the health regions, health districts, health councils pay provincial sales tax on commodities they have to secure in order to fulfil their obligations of providing health care?

I ask that, bearing in mind. . . . The numbers have been given to me by, for example, the capital health area. Their staff, their financial comptroller, advise that their guesstimate -- and it's a rough estimate -- is that out of the expenditures they make out of their operation, $2.7 million of their budget goes back to the provincial government in the form of provincial sales tax. When an inquiry was made with the Vancouver-Richmond health board, the estimate there was that of their expenditure dealing with their annual budget on supplies they are required to purchase, they paid some $15 million in PST.

I raise this in light of the fact that when I ask the question what about the GST. . . . And I know all of us at some day in our time in this place have slagged the federal government on the issue of not providing sufficient funding for health care. But I found out that they get a rebate on the GST portion, and it's as high as 80 percent on the GST paid by these health regions and health councils.

When I asked the Ministry of Finance if they had any idea as to what the exact amount was, the answer I had received was that it would be too much of a burden and that they don't track these items. What I would hope is with myself raising this issue publicly, submitting it to the parliamentary committee that's going to hopefully make some recommendations that government would take seriously, that through your ministry you could actually come up with some figures that are perhaps more accurate.

They assured my office that the numbers I was given were estimates, but they also gave assurances that when they do make their purchases, they have to pay PST and GST. I think that perhaps it's a novel way to give a tax break and at the same time make sure the dollars are in the hands of the people who are providing the health care services.

You may want to respond. I'd hope you would respond. But it's something to consider.

Hon. C. Evans: I think we should give an award to the hon. member. It is 8:30 at night, and I'm pretty sure he just asked the first question that was about a really good idea and how come we hadn't done it yet, instead of some criticism of the things we were trying to do.



Hon. C. Evans: The good news is that I liked the hon. member before he sat over there, so I can't be accused of trying to butter him up.

Hon. member, you might be pleased to know that yesterday I was at the Times Colonist, the main newspaper in this town, and the Times Colonist said to me: "What do you think of the hon. member from Malahat's idea" -- they called you by name -- "of taking the PST off health care stuff?" I said: "I think it's a great idea, and it follows on the heels of lots of other good ideas that hon. member's had." I asked my staff how come we make people pay PST on stuff that is essentially the government's or health authorities' and do all that paperwork. And staff advised me that the Ministry of Finance advised them that of course it would cost more money not to collect the tax than it costs to collect the tax.

With all due respect to the Ministry of Finance people who I have to see at Treasury Board periodically. . . . And I know they're really good people, but I actually think that here they're wrong. It only makes sense that not doing the paperwork would save everybody money. As the hon. member knows, we do that for farmers already. So I have no idea why we couldn't do it for the health care system as well, and I would like to become your advocate to try and help you make it happen.

[G. Mann Brewin in the chair.]

R. Kasper: My last question cum suggestion. . . . The minister may want to pursue this. I had the opportunity of reading an article from the Guardian newspaper in Britain, October 3. What I found interesting was that the National Health Service in Britain was going to a place like Cuba to find out what they're doing in providing the level of training, the number of nurses and the level of training and the number of doctors within that country. They felt that based on a weighting system and cost-benefit analysis, the ability of that country to produce highly trained, skilled health care professionals was of interest to them because they, like British Columbia, Europe -- all of North America, in essence -- have a shortage.

[ Page 17294 ]

So I throw it out as a suggestion. Perhaps we should look beyond our borders to find out what other people are doing. Maybe there are some opportunities for us to pursue. I'm not going to say that Cuba has a better health care system than British Columbia. But at the same time, I'm suggesting that there may be some ideas far afield. And I don't recommend that you send off some contingent of bureaucrats to kind of find out what's going on. I think that we have an opportunity in this province to actually talk to some health care professionals from outside our borders, and maybe there are opportunities we can benefit from. If we really put our heads together, maybe we can solve the problem in a quicker time frame than perhaps what the government anticipates it could accomplish. So I thank you for the opportunity.

Hon. C. Evans: I thank the hon. member for his excellent suggestion. I would like to learn more about the Cuban system. Perhaps the hon. critic and I could go together and investigate what Cuba is doing right. I just would like to suggest to the hon. member that there is an organization called HealthMatch, which is sort of doing what you're suggesting in the recruitment field. But if I'm able to follow up on your suggestion with Cuba, I'd be pleased to do so.


K. Krueger: When the official opposition Health critic and the minister were engaged in that debate about the cost of the photo op and the press conference, the point that the government sincerely doesn't ever seem to understand but everybody else does -- we do, the public, the taxpayers, the patients, the administrators, the health care providers. . . . Everybody else understands that it's all money. What you spend on communication and photo ops and advertising is real money, and if you spend it on that, you don't actually have it for the things that you're supposed to be doing with it.

This government always tries to measure itself and brag about its achievements in terms of how much money it's spending. So now we're hearing: "We're the first government to go over $9 billion a year in British Columbia for health care." But the point is that the way everybody else in the world measures this government is by the results they achieve and whether or not they're delivering the services to the patients when they need it.

That's why we always say to this government: "You've got to learn to make your decisions with the patient at the centre of your concern, at the very beginning of all your decision-making, and focus on them." And every time there's one of these demonstrations of incompetence, demonstrations of waste, that takes away from your ability to provide those services. It's as if you're pouring all that money into a bucket, but you're drilling holes in the bucket through your own incompetence.

That's what you do every time you have one of these phony exercises that wastes the people's money. But it's clear to us, and it's clear to the public, that you just don't get it. And that's why we so sincerely want to have an election -- so that British Columbia can start afresh and get on with turning this province back into the powerhouse that it once was economically and providing the services to British Columbians that they deserve.

Every year I'm invited to come and speak to the fourth-year nurses in the University College of the Cariboo bachelor of science in nursing program, and this year's visit was last month. I went and talked to the nurses, and they're very clued in to what the problems are in the hospitals and in the health care system. They see that the colleagues who they are training to join are burnt out. They see that they get hurt because they don't have adequate lifting equipment. They don't get adequate backup. They don't have the support staff that they used to have. Their average age is 47. They're burnt out, they're injured and they leave, and it adds stress to all the rest.

These students say to us: "We run up these huge student loans while we're in the program. We're not allowed to work in the hospitals and be of assistance. We have to go work for minimum wage for the hospitality industry or elsewhere. We have these debts when we come out, but we can't get a permanent job." Why? Because the health region doesn't get its budget until so far into its budget year that it doesn't have the ability to be sure that it will have the money to employ them on a permanent basis. So they can't get mortgages. They can't buy cars. They can't get a fair start in life. And that's why, hon. minister, they are going elsewhere.

Chair -- through you to the minister -- I wish he would listen to me instead of the member for Powell River-Sunshine Coast, who has time and again demonstrated that his counsel is not worth having. That is why our graduates are leaving British Columbia. It's absolutely pointless to open up more spaces and continue to pour more money into programs, if you aren't creating an environment in British Columbia where health care professionals will feel valued and secure, so that they actually want to stay.

So out of one of the recent classes at UCC, 31 graduate nurses, only five remained in British Columbia, in our area. And that's been the case year after year. They leave. The class I just talked to. . . . One nurse was going to Halifax, where they'd given her a signing bonus, and they were offering her a permanent job. Others were going to the States. We're losing those graduates right, left and centre, as fast as we graduate them.

They were talking to me about the health care crisis, and I said to the class: "Only a fool would say that there is not a health care crisis in British Columbia." And they all burst out laughing. What a strange reaction, I thought. But it turned out that one week previously the member for Kamloops -- the present Minister of Advanced Education -- had told them there was no crisis in health care and had used the personal example of how she got her sore knee looked at and dealt with in three months.

Hon. Chair, I ask the minister through you: if this government will not accept those approaches. . . . Its inability to grasp the problem; a Premier that has admitted that he never realized, until he recently personally went out and looked at the situation, the enormity of the problem; a Minister of Advanced Education who says there is no crisis in health care, to the derision and ridicule of the students -- the very educated and informed students she's talking to. . . . Until this government wakes up and realizes that the problems are very real and does the things it has to do to fix them, then it's just wasting its money -- wasting its money, pouring it down the drain.


And there's the member for Powell River-Sunshine Coast heckling me -- the fellow who said it was outrageous that we would challenge the cost of the photo op, the communications exercise. The fellow who's demonstrated time and again his total inability. . . .

[ Page 17295 ]


The Chair: Members, come to order, please. Minister, minister, minister. The hon. member for Kamloops-North Thompson might wish to take his seat. Hon. members.


The Chair: Member for Matsqui, Minister of Forests, come to order, please.

K. Krueger: That member has consistently demonstrated that he's not good with manners and he's not good with money.

The point that I was making is that we lose people because this government doesn't demonstrate that it values them. I would like to acquaint the minister with a constituency example of mine. This is a very sensitive matter, a very tender matter. It's a matter I've written him on. He hasn't had much time to work on it, but I wrote his predecessor on it. I wrote the current Labour minister, and I wrote the previous Labour minister.

A woman walked in my office one day and sat down and said to me: "My husband was a paramedic for 27 years. His name was Ken Wolf." My constituent's name was Sherri Wolf. In the service they called him "Airwolf," because he would never turn down a mercy flight. He made more money than any other paramedic in the province a couple of years running, because he would always go. No matter what the weather, no matter what the risk, he would go. He was so good at his job that he trained other people to do it.

That man had an injury lifting a patient, and it damaged his shoulder -- a very genuine injury, huge surgical scars. I've seen the pictures from having it fixed. He was on Workers Compensation for a while, and then they abruptly cut him off. They cut him off for nine months. He had no income. It took three years in the appeal process for WCB to decide it had done him wrong and reinstate him and pay the benefits it should have paid him. In the meantime, like many WCB claimants, he went through terrible financial and emotional grief. His employer, the Emergency Health Services, who should be treating these paramedics like gold. . . . I'm glad to see there's more money for paramedics in this funding. But this employer didn't treat him well at all.

He got back to work when he could, and he injured his other shoulder. And WCB and the Emergency Health Services abused that man so badly over a period of ten years that he hung himself after his most recent conversation with WCB.

If we are going to continue to lose nurses, to lose ambulance attendants, to lose doctors from this province because the province doesn't demonstrate that it values them, there is no point in training more. What does the minister have in his plan to deal with this problem of not treating our health care professionals in British Columbia in the ways that we should?

Hon. C. Evans: There is training money for, I think, 73 paramedics in the lower mainland and 17 in rural communities, because of the recognition of the importance of these workers to the health care system. The specific matter that the hon. member raised. . . . I will research the matter, find the letters and get back to him.

K. Krueger: Well, I'd really appreciate that. The widow is waiting for our resolution of this. She wants to make sure it doesn't happen to any more paramedics, and so do I, and I'm sure the minister and the government do too.

I was pleased to see that the Thompson health region is having an MRI funded in this package. I'd like to ask the minister if there are also operating funds provided in an ongoing way for that MRI. I've heard of this government turning down private contributions for the purchase of MRIs in the past, because the government had no money to fund the ongoing operation of the equipment. Is there accompanying new funding for operating with the cost of the capital acquisition?


Hon. C. Evans: Yes.

K. Krueger: I'd like the minister also to give me the status of the tertiary psychiatric facility, which is supposed to be under construction -- and again no spade in the ground in Kamloops, again multiple public announcements that it's going ahead -- and promised for years now, since way before the last election.

Our local Member of Parliament, Nelson Riis, a staunch NDPer, was turfed out by the voters in the recent federal election. One of his key people, Rob McDiarmid, a local lawyer, a long-term New Democrat, said that Nelson Riis was running against this provincial government. Nelson Riis had said, when this government betrayed its promise to build a cancer clinic in Kamloops, that he felt as though he'd been bitten by his own dog, that he felt the people of Kamloops and the region had been shafted by this government. It makes everybody wonder, when year after year these announcements go on and the psychiatric facility doesn't start construction, whether they're being shafted again.

So I'd like a straight answer from this minister, who prides himself on straight answers, and I respect that. Is the facility going to be built? Why hasn't it been started yet? When will it start?

The RCMP tell me that when they pick people up who they know are accused of crimes because of mental health problems, they have nowhere to take them, and that's the case throughout the interior. It's way overdue. We've heard time and again about the $125 million that was promised for programs and never delivered. What is the minister's report to this House and to the people of the Thompson health region? Is that facility going ahead, and when?

Hon. C. Evans: The capital plan is not part of this estimate process. I will, if possible, get back to the member with news thus far, but I cannot put forward the capital plan in these debates. It's about the health action plan, and there is not capital funding in the health action plan.

Hon. G. Wilson: I don't know if the minister had the benefit of watching the BCTV news tonight, because he was in this House debating it. But I've heard the member for Vancouver-Quilchena and recently the member for Kamloops-North Thompson talking about the money that has been spent to bring health officials down to be properly consulted on what is, I believe, a very good-news budget increase to be able to look after the difficulties that we have in the health care field.

[ Page 17296 ]

On BCTV news tonight, what the minister wasn't able to see were BCTV cameras interviewing someone who I believe they claim is a constituent of mine and who had tears in her eyes because she was unable to access surgery for what the physicians have said is a non-malignant tumour.


Hon. G. Wilson: Oh, the member from Quilchena seems very informed on this matter. They say: "They believe it to be. . . ." That was how it was reported.

Hon. Chair, my point is this -- and my question to the minister. . . . My question is this. You talk about photo ops. How much more outrageous is it for this member opposite, who pretends to be a Health critic concerned about the well-being of British Columbians, to drag in individual cases that BCTV trucks out, night after night after night, to try, in their campaign against this government, to persuade British Columbians that their system is in crisis? Where is BCTV talking about the hundreds upon hundreds of British Columbians who get good, sound health care? Why aren't they doing that, hon. Chair? Why is it they can't?

You talk about photo ops! That was the most obscene photo op I have seen yet. This member has the audacity to stand up in this House now and try and accuse us in terms of photo ops. That bunch over there is not interested in health care and the well-being of British Columbians. They're interested in an orchestrated, political campaign, because they're so thirsty for power that all of these people are simply trying to obscure the truth.

We know the Leader of the Official Opposition passed a private member's bill saying that all surplus should go to the debt retirement, so we fully expect him to vote against this extra money for health care. But I'd like the minister to answer this simple question: do you not think it a little bit hypocritical that when you're attached to BCTV's nightly campaign against this government, dragging out individual cases, as tragic as they may be. . . ? It's that member who should be accused of outrageous photo ops, not this side of the House.



The Chair: I will be happy to recognize the member in a minute, when everyone has calmed down just a little.

K. Krueger: Before the member for Powell River-Sunshine Coast interrupted me, I think I had the minister's assurance that he will personally look into the case of the loss of Ken Wolf, as I've written and requested both his predecessor and himself to do. If he'd just nod, I would. . . . And he does nod. I accept that.

There's one last area that I want to touch on and that I began with earlier, and that is the whole matter of continuing care in the Thompson health region -- the fact that there hadn't been a single new bed built by this government in its decade in power until recently. The government did fund the creation of a temporary kind of holding facility in the acute care facility at Royal Inland Hospital to move people into those beds so they wouldn't be blocking acute care beds and creating longer waiting lists for elective surgery and so on. So 25 beds were opened, but I was told at the same time that 20 acute care beds were closed, so it wasn't much of a gain. The fact is that we need more beds in the region, and I would like to know how many of the 2,000 beds are allotted to the Thompson health region.

I'd just like to tell the minister some details of the situation as it is there right now. We have two very large facilities. One is called Ponderosa Lodge. The other is Overlander Extended Care Hospital. Overlander was built for expansion. Overlander has a whole wing that's only roughed in and has never been finished in the interior. Surely its interior could be finished a lot more cheaply than constructing new facilities there or anywhere else. I would think that would be the first thing we'd do.

One of the problems is that when this government fired the Royal Inland Hospital board and appointed people -- its choices -- and those people hired other people, what we ended up with were some managers who've been getting very bad results, particularly in this area of continuing care and extended care. There's a woman named Claire Ann Brodie who was appointed to run continuing care in the area, and her staff tell me terrible things about how she's doing things and how she's done them. I've been around and around on this in estimates and with the health region, and finally the health region appointed a consultant to look into all these employee complaints and deal with them.

We had the very sad and tragic loss of our CEO for the health region, Mr. Garry Olsen -- a fine man who was struck ill for some months and died very recently. The staff tell me that since Mr. Olsen was out of the picture, that consultant has disappeared. Nobody knows what's going to happen with all the hard work he did, and he had impressed the staff with what he was doing. I'd like to know from the minister that he'll make sure that none of that consultant's work goes to waste; that neither Ms. Brodie nor anybody else in the health region will be able to bury his results; that they will be acted on to address the very real concerns of the patients, their families and the staff and their families in those facilities; and that the examples that have been documented of waste and of improper management of that part of our health care system in the region will be dealt with and dealt with expeditiously.

One very concrete example for the minister is that there was a huge boiler in the Overlander Extended Care Hospital that had never been used because it was built for the growth when new wings were added. I'm told that this administration had welders come in and cut that boiler up and truck it away as scrap, and it had never been used. When I asked to see the room where the boiler had been kept, they claimed they couldn't find the key. They couldn't let me in the door. They couldn't show me where it used to be.

Well, that's incredible waste -- a very, very unwise, foolish waste of public dollars. These are the sorts of things the staff told me, told the Health critic when he came up to hear their complaints. I expected a dozen people at the meeting, and 96 people came out to the meeting to talk to the Health critic and myself -- very real complaints, very legitimate complaints. I want to know that Mr. Olsen's work and the consultant's work won't be buried now that Mr. Olsen's gone and the consultant's been caused to disappear by someone. I'd like the minister to have a really hard look at making sure that those problems in continuing care in the Thompson health region are dealt with once and for all. And I'd like him to tell me what the allotment of continuing-care beds to the Thompson health region is.

[ Page 17297 ]


Hon. C. Evans: The allotment is 71. On the question of an individual employee I have no comment. We've gone now from individual patients to individual employees and whether people like them or don't like them.

I would like to encourage members. . . . The debate is about the health action plan. If you decide that you don't like it, you vote against it. If you decide you do like it, you vote for it. If you vote for it, the money will flow on December 15. It's not about an employee of the Thompson health region and whether or not I think this person is a good person or a bad person.

K. Krueger: The problem is that this government fired the competent board. This government appointed the replacements. The replacements fired some competent people and appointed some other replacements, and they fired some people and appointed some other replacements. The chap who was running Ponderosa is considered a visionary, a wonderful man who did really innovative things. Ms. Brodie fired him after she was put in authority over him. Do you know where he is now? He's the CEO of the health region in the Queen Charlottes -- obviously a competent man. He didn't want to leave Ponderosa, but he was fired by the appointee of the appointee of the appointees that this government appointed. Now this minister stands up and says: "You can't talk to me about patients; you can't talk to me about staff, because I give all that authority to the health region."

But this government created the health region and all of its problems. So will the minister not commit that he will at least make sure that the good work done by Mr. Olsen before he died and by the consultant that he caused to be hired will not be wasted work and that these problems will be addressed by a competent person? I would suggest that the deputy minister is a good person to assign to make sure that that work isn't buried, that consequences flow to the ones who deserve it and these problems are cleaned up in the Thompson health region once and for all.

Hon. C. Evans: I commit to do my job to the best of my ability, and the nature of that job is different to some people. I consider it to be to deliver care and manage my budget.

L. Reid: I rise today to speak to participate in these supplementary estimates because there are a number of British Columbians today who don't believe they have a choice in health care. They frankly believe they do not have choices. Yet when I look at the spending of this government and where they do choose to place their priority, I have to ask if indeed there's any ministry that's on budget. I reference today's article in the Vancouver Sun: $29 million, Social Development and Economic Security, an overrun; $35 million more for the Ministry of Attorney General; $25 million for Forests; $10 million for other programs; $9 million for Environment; $6 million for Municipal Affairs; $3 million for Education; and the list goes on.

Is it any wonder that British Columbians don't believe this government knows how to manage effectively on their behalf? It should be no surprise to the members opposite, and it shouldn't be any surprise to the minister, that we are skeptical of the ability of this government to deliver. The incongruities in this action plan abound -- absolutely abound. There are no remedies today for British Columbia patients. Somehow it's considered appropriate to keep them on a wait-list endlessly -- just endlessly. The minister refers to himself as a social democrat. Well, this is a social democrat government that is making the lives of British Columbians today more difficult -- doing it extremely well, but doing it.

I can tell you that there is a particular family that I referenced the last time we sat in this House for an emergency debate on supplementary estimates for the Ministry of Health, months ago now. September 17, I believe, was the date. The then Minister of Health agreed to look into it and to seek some resolution.

I can tell you this is a family that has waited more than two years to have a single letter answered from this government, who waited more than a year for very critical heart surgery for their son. Their wait time, frankly, expired. This young man was sent to Toronto, to the Hospital for Sick Children in the province of Ontario, because his life would have been compromised had he continued to wait. This ministry has this file.


What astounds me is that no consideration was given to the finances of this family. Their costs to travel to Ontario, to provide accommodation for themselves, to provide food for themselves, are borne by them alone. This ministry would not accommodate them in this province. They simply washed their hands of this family and said: "Your finances are your own problem. Bye-bye."

The mismanagement of the health care system that required them to leave this province is solely at the hands of this government -- solely. And it's not that this government didn't have ample opportunity. They had two years while this young man waited for heart surgery -- two years.

If this were the only time I were bringing this up. . . . I wish that were the case. I have brought this issue up with minister after minister after minister. The family has written. There is no compassion demonstrated toward this family. They are out of pocket thousands and thousands of dollars. The cost of airfare to Toronto -- thousands of dollars. The disruption to their family. . . . They were out of this province for eight weeks -- eight weeks. And is there any compassion demonstrated on this family's behalf by this government? Absolutely none.

You talk about support to working families. This is a working family in the province of British Columbia. I am happy -- yet again -- to share this family name with this Minister of Health. But I can tell you that your predecessors have not addressed it.

So my question is on behalf of this family and on behalf of other families who seek service -- because there is no service available to them, who must seek it -- outside the province. What is this minister's response to the personal costs they bear for flights and for accommodation? What is this minister's response?

J. Pullinger: I was inspired by the last member's comments to ask some questions of my own. I was very interested to note the member complaining that this government had damaged health care. So I have a series of questions for the minister.

We all know that the federal government cut 70 percent of its share of health care funding in 1993, and we know that

[ Page 17298 ]

the opposition applauded those cuts and said they didn't go far enough. I have a question: had they cut. . . ? I mean, I don't know how much the opposition wanted -- perhaps all of it. Maybe the minister could tell this House, if the opposition had had their way and we'd had a whole lot more cuts from the federal government, what effect that would have had.

We know that the opposition has a piece of legislation before this House saying that 100 percent of any surplus -- which is what we're dealing with here -- must go to debt reduction. We have the second-lowest per-capita debt in the entire country, but it must go to debt reduction as a priority. Maybe the minister could tell this House what not putting this money to health care means for British Columbia. If the opposition had its way, what would that mean?

Of course, we had the amazing admission once again today, the same as in 1996, that the B.C. Liberals are prepared to cut $1 billion from health care and $1.9 billion from somewhere else -- God knows where; probably education and social services -- in order to finance a massive tax break to their corporate buddies, their backers, such as TimberWest, such as a bank, such as all the rest of them. Maybe the minister could tell us what a billion-dollar cut to health care in British Columbia would mean, because that's what this opposition is promising.

Then I listened quietly to the member from North Kamloops. And North Kamloops made the claim that we weren't supporting workers enough, and that was the problem with health care: the darn old NDP wasn't supporting workers enough. Well, maybe the Minister of Health could tell this House what labelling hospital workers as toilet cleaners would do to the morale of staff and how that helps workers to stay in British Columbia.

Or perhaps, on the other hand. . . . That same member, it seems to me, said he believed in something called progressive discipline. That means, in his words -- and this is a paraphrase, but it's pretty close: "You whack 'em once, and if they don't behave, you whack 'em again, and then if they don't behave, you toss 'em right out." Maybe the Minister of Health would tell us how that would attract health care workers to British Columbia.


But then on the other hand, maybe what the Liberals are talking about is the fact that although they don't know enough about the budget to make a commitment to children, for child care -- although it's desperately needed and they admit it -- they can make a $100 million commitment to the doctors. I have no idea where they're going to get it from -- $100 million. And to prove that they meant it, they followed up that commitment right away with a fundraising letter for the B.C. Liberals. I am sure there's no connection, but maybe the minister can tell us how that helps health care in British Columbia.

Of course, you know, we hear all sorts of cries for more capital spending. We know 70 percent of the debt in this province -- 70 percent -- is schools and hospitals and highways and things like that. But they said: "No more debt." No more debt -- that means no more capital spending. It's kind of like Alberta, where the auditor general was ringing the alarm bell, saying: "Come on, you guys, if you don't spend, you're going to have such a huge social deficit that you'll never be able to catch up." Is that going to help health care? Hon. Chair, maybe the Minister of Health could tell us how that would help health care.

But then, of course, we hear that you should educate more workers. You should educate more people. But gee, you know, they forgot Advanced Education in their platform in 1996. And when they found it -- when we pointed it out to them -- gee, it had a 14 percent cut, didn't it? I wonder how that would help. Gee, I wonder how that would help.

And we know that they're going to cut $1 billion out of health care, but that leaves $1.9 billion. And given that 95 percent of the provincial budget is health, education, social services and things like policing, where's that other $1.9 billion going to come from? Gosh. Is 14 percent cut from health and education, or would it be more? How in the world is that going to help health care in British Columbia?

But then, of course, the other problem that they point out is that students have high debt loads, and that's true. That's why we have led the country in terms of reforming student loans and tuition freezes. And what do they say? We shouldn't freeze tuition. We should be like Alberta and Ontario, where they throw it to the marketplace, that same marketplace that creates the problem in gas prices. So we should throw education to the marketplace, and maybe that would help health care. But the problem is that in Ontario it's 42 percent more expensive to go to university. In Alberta it's 40 percent more expensive to go to university. But maybe the minister can tell us how that would help health care.

I have one more question for the minister. We've heard the opposition stand up and say: "Child care's not a priority. We think tax cuts to business are a priority, but not child care. We understand the budget enough to promise $2.9 billion in tax cuts to our buddies that back us, but we don't understand the budget enough to commit a few dollars to child care, for kids." And we know that the social determinants of health and all of the evidence says that if you put that money into little kids, you won't have to spend it later on. Now, even if they don't give a damn about the kids and the single parents -- if you don't care about that -- at least they should understand the economics. If you put money into children, not into undermining our tax base and giving tax breaks to those who need it the absolute least, you know what? That will pay back $2 for every $1 invested right now, unlike their phony tax cut arguments, and at least $7 to $1 later on, because of all the difficulties we won't have.

So, hon. members and hon. Chair, I know that this is a challenging question. And if the minister doesn't want to answer it, maybe the opposition would answer those questions, because I'm sure the public would love to hear their responses.

Hon. C. Evans: In answer to the question about the province's policy in respect to people who leave the province to receive health care, I believe it is the provincial policy at present to pay for the health care costs only, out of province.

The other thing that the hon. member said was that this family had never gotten an answer from the ministry or the minister, and I've committed to finding the file and correspondence and seeing to it that this person gets an answer.


Now, the answer to that other question, about what it would mean if the billion dollars proposed by the Liberals

[ Page 17299 ]

was cut from the Ministry of Health. . . . I'm not going to answer in the same way, by telling you that the hon. member's constituency's health care and mine and all the other rural people would be wiped out -- or the South Fraser and all that. What if a future government decided to attempt to apply that billion dollar savings kind of across the board, with what some people might call good management? "Tighten your belt. Be fiscally responsible." Well, then my guess is that the continuing-care issue in North Thompson and the natural gas or heating issue in the hospitals around the province and the issue of acute care beds raised by the hon. member, the critic, and the entire breadth of the questioning over the last six hours would be a reduction. . . .

You can do the math. If the budget is approximately $9 billion and you take away $1 billion, that's more than 10 percent. It means that instead of having 79 continuing-care beds in North Thompson getting built over the next three years, it's over the next five years. It means that instead of giving $14 million to help them with their heating costs, you give $12 million.

And across the board. . . . Look up, hon. critic. Where are you going to get the money? Excuse me -- through the Chair to the hon. critic, I was wondering how you'd deal with it if you rose someday to the lofty position of actually having to answer the questions with 10 percent less? You couldn't do it, hon. critic. You couldn't even think about it. You can't even make eye contact. You're toast. . .

The Chair: Through the Chair, minister, through the Chair.

Hon. C. Evans: . . .because you can't cut the budget and deliver the care at the same time. That's what it means. Never mind geography. It means they can't keep their word. Either they wipe out the system or they wipe out the tax cuts. One or the other has to go.

So, hon. member, I guess what it really means is. . . . We walked in here today with a health action plan. It might be flawed, there might be stuff we haven't thought of, it might not be perfect, but it's a plan. And, hon. member opposite, we appear to have two plans. One is: cut the budget. And the other is: deliver the care somehow without the money. Now, I guess the people everywhere are going to have to decide, aren't they? Politics ultimately is about decisions. Do you like the idea of the people who have a plan? Or do you like the idea of the people whose plan is doubletalk -- it's hidden from the public?

All night long you're asking the questions. They're good questions: "I wonder about the heating issue; I wonder about the patient." We all wonder. We're trying to do our best to deliver the care. But look up, hon. member. How are you going to do it when your leader cuts the budget by a billion bucks? Look inside your heart. How would you do. . . ? I guess you can't answer the question. I rest my case, hon. member. What it would mean is that you can't govern on the policies of the opposition.


The Chair: Members, member for Matsqui, the Chair would like to recognize the member for Richmond East and will do so when it's quiet.

L. Reid: I would ask the minister to actually focus on the question that I put to him a couple of moments ago. The ranting and the raving is not warming the hearts of this family or any other family, frankly, that's been sent out of this province for health care. And you are correct: your ministry now pays the actual cost of the care.


But it's ten times that amount for families who bear their other costs themselves. And they bear them because they cannot find the service in this province. They didn't choose to go to Ontario. Your government sent them to Ontario for a service, for a procedure that was available in this province, in a province where they would have had support, a support system, a network. They would not have been out of pocket for accommodation, for meals, all of those things.

So when the minister stands up and cites the policy to me, I would prefer that he actually stood up and cited a remedy. It is this government that is sending extraordinary numbers of people out of this province, because they cannot put the patient first in the province of British Columbia. So the minister's answer. . . . Frankly, the information he provided is known. What I was looking for was a remedy, a solution.

Hopefully, the minister will get to his feet and commit to examine this issue in some detail. When it is his government's choice to send people out of province, will this government share in the cost of the expenses they bear because this government was not able to manage their health care system effectively? That's the question.

[D. Streifel in the chair.]

Hon. C. Evans: Focusing on the question, there are foundations and organizations in British Columbia, like the David Foster Foundation, that attempt to provide assistance to families who have to leave the province. It is the province's position to pay for care outside the province. I would like to be the minister someday when it's the province's position to pay for all costs of living, housing costs, costs of lost time at work.

But, through the Chair to the hon. member, I ranted at my sister, my fellow government member. I didn't rant at you. But I have to express some dismay. I ranted at her as a way of letting off a little bit of steam, because I don't understand it. I agree with you that the day should come when we can cover more of the costs of out-of-province care. But how will we get to that day unless we get more money into the system? And that's what I'm doing here. I'm trying to pass a supplementary estimates bill to get $180 million more -- $212 million.

The hon. member asked me to look into the situation. I commit to looking into the situation. I will come back here at the next estimates process and tell you what it would cost, in terms of an increase, to change the policy, because I think we'd all like to change the policy. In exchange for my commitment to look into it, I would ask you to commit to trying to figure out what would ever happen if the folks you're sitting with implemented what they want to do to the people you actually care about.

The Chair: Just before I recognize the hon. member, I'll caution the minister and other members of the committee to direct the debate through the Chair, please.

L. Reid: The minister referenced the David Foster Foundation. Let me put another issue on the record where I believe this government has abandoned their responsibility, and it

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specifically references the at-home program. The minister will tell you that there are other charitable funders out there who step up to the plate when the ministry, frankly, abandons their responsibility. I can tell you that whether it's equipment for palliative care patients today or whether it's braces for little guys who have cerebral palsy, this government is turning them down in record number -- turning them down and saying to them: "Visit the Lions, visit the Elks, visit the Rotary, visit the David Foster Foundation."

That's not on. This government continues to provide a static sum of money for an ever-increasing, burgeoning population of special needs children in the province. The e-mails that go back and forth and around -- freezes the dollars, suggests there's $6 million, suggests there's $9 million, freezes $3 million. . . . None of it's distributed. That was the most recent announcement, April 7, and not a cent has gone.

I appreciate the minister's direction that these families can somehow look to outside foundations. The bottom line is that this family wanted to receive the service in British Columbia, where they pay tax. This is where they live. It was your government who chose to send them out of province and then said to them that the additional $10,000 of expense was theirs and theirs alone. Again, the minister has some reckoning to do on that question.


The mental health funding for this province. In 1998, $125 million. . . . It's referenced regularly in the press that the money has not been available to patients. The funding is minuscule, and the problem is huge. Most recently, in today's Times Colonist: "It was later revealed that Treasury Board had not actually approved the $125 million promised. . . ."

Members opposite who are heckling as we speak made the promise. If you're going to stand in this Legislature and make a promise, you must act on it -- not the vacillating, waffling and, frankly, deception, where the vote was never taken at Treasury Board to put those dollars into the hands of individuals in this province who require legitimate services because they suffer from a mental illness. It was $125 million. How many times did we as a Legislature see that announced -- four, five, six times, at minimum?

So again, the grandstanding, the announcement, the photo op -- "Aren't we great?" -- is not doing it. You have not delivered. Your government collectively has not delivered on the promise you made to the mentally ill in the province of British Columbia. And you know you haven't. Stand up and tell me that you have actually allocated the $125 million that you promised repeatedly, over and over again. We know you haven't delivered. Give some honesty, some legitimacy, to these debates. I have been in this House for nine years. I have heard this discussion many, many times.

When there are sufficient numbers of individuals whose lives could be better as a result of a promise that your government made, there's some optimism around that. The mental health community was optimistic about the announcement. They believed you. It's heartbreaking, absolutely heartbreaking, for that community and their families and their support systems and their siblings and their spouses. This is a big, big problem.

And, I believe, in this B.C. health action plan today you're allocating $2 million. The promise was for $125 million, and I believe there's $2 million that's being promised. Does the minister have a response for the mental health community today? Will they see, in the mandate of this government, anywhere near the $125 million that they were promised?

Hon. C. Evans: The health action plan -- the hon. member is correct -- allocates $2 million to be made available in this fiscal year for mental health services and $4 million in the next fiscal year.

I remind the hon. member of two comments I made earlier in the day. The first one is, hon. member, a 100 percent increase in this decade for mental health. And the second one, in answer to a question of another hon. member earlier in the day, is yes, the government remains committed to the dollar increase. But please acknowledge that 69 out of 71 recommendations have had significant progress.

And here today, I hope this evening, we will vote a supplementary estimate to increase mental health services again -- in this particular case, 275 supported residential care spaces, supported independent living units, acute diversion and crisis response in 18 additional communities by 54 mental health clinicians, allowing intensive community support to an estimated 700 individuals.

I acknowledge to the hon. member that there's a long ways to go. All I'm asking is that you vote for the commitment to go this far this evening. And yes, you have my commitment that the government intends to continue to deliver and accelerate delivery on the mental health plan.

L. Reid: I believe I heard the minister say that out of a $125 million commitment, they have allocated $2 million. If there was no intention to deliver on a $125 million promise, why in the world make that promise? The energy, the optimism, the hope that emanated from the community around that announcement was heartwarming, absolutely heartwarming. But you didn't deserve the accolades if you're not delivering on the program. And $2 million this year and $4 million next year is absolutely shy of $125 million.


The minister referenced 275 supported nursing units to enable people with mental illness to live independently with a range of support services. There were 2,600 promised in the mental health plan -- 2,600 -- and the minister is delivering on 275 of the 2,600. Does the minister not appreciate how demoralized this community is when they try and reconcile 275 with 2,600? It was a promise, and it was a promise to a community that needed to believe in the promise, that still needs to believe that the services will be available to them. The $2 million and 275 supported housing units. . . .

It tells us today that there are 6,000 people with serious mental illness in the capital region alone. So am I dismayed that the minister is telling me that $2 million is a firm commitment? This government told me that the $125 million was a firm commitment. So I have enormous dismay. The community, who was promised 2,600 beds, is now being told to expect 275. Why does this minister continue to allow this community to be demoralized?

We had confirmation from this government that the $125 million did not even make it to Treasury Board for approval. So it was announced, it was reannounced, it was announced again, but there was no real commitment. So, minister, if you

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believe in it, fund it. And you need to fund it beyond $2 million, because that does not match the commitment that your government says they have to the mental health community. I would ask for your response.

Hon. C. Evans: The level of mental health funding at the time of the mental health plan -- fiscal year '98-99 -- was $333.4 million. It stands, at present -- or it will after tonight, I hope -- at $368.4 million. The hon. member is quite right that there's a long way to go. We are committed to improving that record through this mandate and the next mandate.

I want to say this gently and quietly: we need to make progress. Look inside your own self and your party there. Imagine how you will make the progress. . . .

The Chair: Through the Chair, hon. minister.

Hon. C. Evans: Hon. Chair, the increase since 1998-99 is from $333 million to $368 million. We are committed to making more progress. We are making progress, I hope, here tonight and will continue to do so. There is no difference between the hon. member's position and mine in terms of the need of the government to deliver on its commitment, and tonight we're delivering a small amount of it -- and that's good news.


Hon. C. Evans: I want to ask if we can have a short recess, but I want to let all the hecklers go first.

The Chair: Hon. minister, in the interests of the restoration of the natural order of things, we'll just call a ten-minute recess. So ten minutes from now.

The committee recessed from 9:30 p.m. to 9:39 p.m.

[D. Streifel in the chair.]

L. Reid: Referring back to the health action plan on page 26 -- the new palliative care benefits program and, in your words, minister, "building a continuum of care that offers people the levels of care they need outside a hospital setting. . . ." You appear to support that. I can tell you that in the community of Richmond, my community, we have been fighting to build a hospice for nine years. It is the government, it is the regional health board, who have not been particularly supportive of that initiative over the past nine years that I have been in elected office.

I'm hoping, by the very fact that this reference is in this health action plan, that the commitment of this government is -- to individuals who choose not just to die in hospital or die in their home but actually might choose hospice -- that they will receive support to do that, for the very things that this minister references in his document: palliative care, drugs, medical supplies and equipment benefits. So my specific question to the minister is: will those three options of drug care, medical supplies and equipment be available to individuals who choose hospice?


Hon. C. Evans: Yes, I just would like to add that in terms of the hon. members. . . . They are working on a hospice initiative. My community, as well, is becoming somewhat enlightened and is trying to move in this direction.

L. Reid: If I might, I'll take a minute to tell the minister that it's the Richmond Rotary Hospice House. The land has been purchased, and we will break ground early in the spring, and I trust that it will open next fall. It has been an undertaking of some ten years. The lead community spokesperson, if you will, has been Nancy Yurkovich -- a long-time nurse, a long time community leader, someone who believes passionately in this exercise. Because of the lack of support, they have gone to partner with other members of the community. And I applaud that; I think that we do better if we partner and do some things in concert.

The Rotary Club of Richmond has come onside in spades. They will do very, very good things in terms of the construction costs of this place -- the capital costs of this place. They have purchased the land. And I trust that the benefits that are available to others will be available to individuals who reside in hospice. I take the minister's nod as affirmation of that, and I thank you most sincerely.

In terms of other issues before us when we talk about priorities in health care spending, one of the most significant for many, many, families of this province is autism services -- services for individuals who have autism and their families -- because it's a package. It is not something that happens to a family in isolation. . . . The impact on the parents, on the siblings, on the community, on the school -- all of those things require immediate, urgent attention. And I can tell this minister that these families are desperate -- absolutely desperate -- for service. I don't see any reference -- or not an extensive reference -- to funding for autism in this document. I would certainly hope that there is something else funded other than the costs of the appeal, that there in fact will be on-the-ground dollars for these families in the very near future. Can the minister reference that in the context of this health action plan?

Hon. C. Evans: Yes, although it's a little bit outside this estimates debate, the autism issue is of concern to the ministry -- not only to the ministry but to government generally. We're working on a pilot. The Ministry of Attorney General, the Ministry of Health and the Ministry for Children and Families are working on a joint submission to attempt to bring government's resources generally to bear on the issue of autism. And I hope that we can get back to you with the details of the pilot and also of the initiatives that we're working on, as soon as we get them prepared for public dissemination. public dissemination.

L. Reid: I am indeed attempting to reconcile both documents today -- the one that's the NDP plan, because under "Special Needs Kids" it does say: "Autism treatment is also a major focus of activity." So if that's the case, I would have expected it to be in the health action plan in some detail. And I am not alone in that expectation.

Monika Lange writes today that as you're already aware, the children need this service. It's been established that it's medically required. And she writes: "I was always told by the NDP government that the reason my child couldn't receive funding for this treatment was that there wasn't enough money. This situation proves that underspending is a form of fiscal mismanagement too, especially when it occurs. . .at the expense of mentally disabled children."


The minister has taken many opportunities today to talk about a surplus. If indeed there is some opportunity to recon-

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cile the stated commitment in the NDP document that autism treatment is the focus of activity, surely there would be some funding allocated under a health action plan in that this service is medically required and the fact that these families are absolutely desperate.

These are children that are very difficult to parent, very difficult to educate. These are children that may sleep one or two hours a night. So this is not just being on task eight or ten hours as a parent; this is being on task 20, 24 hours, 24-and-seven. Finding appropriate respite care is an ongoing issue for these families. If we're talking about supporting families, keeping kids intact, keeping families intact, there has to be some accommodation, some ability of this minister to reconcile the party's stated commitment with an implementation plan, because these families can't do it alone. If they could, they would have done it by now.

The bottom line is that these are enormous challenges and the government, I believe, walks around it in terms of a pilot project or a reference to it. This is where the rubber hits the road in terms of a stated commitment that has some solid implementation to it.

That's what these families are looking for today. That's certainly what I'm looking for. This is a very extensive health action plan. On Tuesday it was $180 million; today it's up to $212 million. Any contribution to support these families is a good investment. These are families today that can't find appropriate respite care, so the burnout rate is enormous. These are kids that, if they are not supported in their families, will end up in foster placements at a far greater price, far greater cost to the taxpayer and a far greater cost to the quality of life for that family and that child.

Is it a health issue? Most definitely. There has to be an opportunity for this government to come to grips with the urgency and the immediacy of this problem. I have been directed to every possible ministry of this government. The bottom line is that you folks are in government. Pull together. Decide who's taking the lead, and then implement a plan.

I've been directed to Social Development and Economic Security, to Children and Families, back to Health and around. You have an obligation, but I also think you have an opportunity today with this funding to make a plan that includes all the ministries but actually delivers the service. Would the minister comment?

Hon. C. Evans: I explained before that we have a pilot underway. I'm advised that there was a similar pilot in Alberta that excluded a therapy called Lovaas therapy and that the pilot that we are working on in British Columbia as an experiment includes other therapies already available plus Lovaas therapy.

I'm also advised that the hon. member once expressed some concern that she would go to different ministries and they were not responsible or didn't solve the problem. What we are working on is a joint effort between the Ministry of Health and the Ministry for Children and Families, so instead of one ministry saying another is responsible, we deliver the service together.

We are working on bringing forward an initiative which is not funded by the health action plan, but I want the hon. member to take comfort in that, because it means that new services for autistic children will be delivered with a different and additional budget allotment if all goes well. I will be pleased to share developing information with her as the pilot reaches fruition and when our new initiatives come to some conclusion and we can fund them. It is not part of today's estimates, because today's estimates are for the initiatives that are described in the documents. But nothing in what I'm saying should be interpreted as precluding additional initiatives to deal with autism issues.


L. Reid: I appreciate the minister's comments. I want to be absolutely clear that the applied behaviour analysis, what is considered ABA, is an umbrella. Under that are a number of different strategies and techniques. If we as legislators. . . . And certainly this government has said that it respects the choices parents make for their children. If that's the case, we have to recognize that individual children with autism have individual needs, that not one therapy, not one pilot is going to address all those needs. I can assure the minister that this pilot phase. . . . This government's been in it for some time. It's time, actually, to offer programming that parents can avail themselves of -- not selectively; i.e., chosen for a pilot -- so that they can actually choose some support that makes a difference in their home, hopefully tomorrow.

We don't have it today. I trust that the minister will take the lead and move on that, which is frankly a matter of life and death for lots of these families. They haven't slept in months. They don't have support; they don't have respite. So I'm leaving it with the minister, because I trust that Health will take the lead on what is indeed a very, very serious concern for many, many, many British Columbians today.

G. Plant: I wanted to pursue a couple of issues in this debate. I've had a letter from a constituent that both identifies the problem and offers some solutions to it. The problem that she identifies and talks about is the issue of doctor shortage. And as the minister obviously knows, physician education is one of the components of the latest announcements of the government. My constituent is in fact someone who is about to go to medical school. Unfortunately, she didn't get into the University of British Columbia medical school, so she's off to the University of Sydney medical school in Australia.

She'll go there as a Canadian. Part of her identification of the problem is that which has been discussed, I'm sure, already today, although I didn't hear it. It's certainly well known that UBC doesn't take in as many medical students as fills the need for doctors in the province of British Columbia. She points out that -- and I don't know if the numbers are right -- in Australia their medical school enrolment is something like one student per 13,500 people in the country, whereas in British Columbia our medical school graduates something like one student per 34,000 citizens. So in Australia they seem to be able to produce three times as many medical students per capita as we can here in Canada.

There's talk, and it's good talk, about looking for ways to increase the intake of physicians from outside the province and outside the country. I'm not going to revisit that part of the issue. The interesting situation that is presented by my constituent -- and she's not alone -- is that. . . . Of course, you could call her an example of the brain drain, but she's somebody who would like to be a doctor in British Columbia but has not been able to find a place in a medical school in British Columbia or anywhere in Canada. I think she's even gone to the trouble of bringing her situation to the attention of

[ Page 17303 ]

the ministry -- and also her solutions. But I think they're important enough that they warrant giving it the little bit of public profile that this debate has, to make sure the minister has these issues along with the many others that he has.

In order for this constituent to come back to Canada at the end of her medical studies, she will have to go through a number of hoops. These are not hoops that are set unilaterally by the government of British Columbia, but I understand that they're established by organizations like the Medical Council of Canada. The challenge, I guess, for a provincial government is: how can this government, this minister, work with these other agencies that are responsible for accreditation and qualification to try and see whether there are some steps that can be taken to open the doors a little bit more easily, without compromising the objective of making sure we have the best-quality physicians? We might be able to make some progress on this front without spending a whole lot of money, frankly -- in fact perhaps without spending any money, which would be a reasonably good thing.


She makes two or three recommendations that I think I'll just read out, in the letter that she's written to me. One is to permit Canadian students at international medical schools to write the Medical Council of Canada qualifying exam part 1 in their final year of medical school, in line with students at Canadian medical schools. If I pause for a moment just to understand that, that would mean that she could conceivably get a year head start on the process of getting back into Canada, rather than getting the degree overseas and then coming into Canada and having to take this exam. That would probably be a good thing if it could be done without, as I say, compromising the quality issues.

She also suggests that we should permit Canadian international medical graduates to write that exam without completing certain other examinations. And she's really making suggestions that are aimed at trying to reduce the unnecessary barriers to access to the medical profession in British Columbia. Identifying what's necessary and what's unnecessary is not always all that easy. I think, though, that this is an area that the minister could do some work on.

The second broad brush, the second branch of her suggestions, has to do with increasing the number of postgraduate training positions. There is an element of the minister's strategy that deals with residency requirements and will hopefully open up more residency positions, and I think that's what she's talking about -- although she has a technical suggestion that I'll just put on the record, as it were. Perhaps at some point the minister's staff may want to follow it up.

She suggests that we could permit Canadian international medical graduates to apply for something called the first iteration match of the Canadian Resident Matching Service. It basically, as I understand it, means that people in her position could be put in the same pool of applicants as people who have Canadian degrees who are looking for residency in order to get qualifications.

Sometimes there are hurdles in the way of delivering high-quality health care that don't necessarily involve spending a lot of money but actually involve coming to grips with some difficult technical challenges around barriers to access to the profession -- in this case doctors. I'm hoping that the minister would at least acknowledge that these are questions worth considering. And if he has any particular additional response, I'd be glad to hear it.

Hon. C. Evans: Those are good ideas. And not only would I like it if we could maybe take it off the record, I was wondering if the hon. member could share the letter with us, because I'd never heard of the particular exam before.

The idea of offering Canadian competency exams overseas is an idea whose time has come. That is what is happening in Manila almost as we speak, for nurses, in order to avoid all that trouble of people having to come to Canada in order to be able to write the exam. And sometimes, getting into Canada, they are certified as domestic workers or something and then can't work as nurses.

I had never heard a suggestion before of offering exams to Canadians overseas, and that at least ought to be able to be coordinated through embassies around the world. I myself have known people to go to Ireland, for example, to go to medical school.

On the subject of whether or not this young woman will automatically be deemed competent, I met with the College of Physicians and Surgeons in preparation for the development of the plan and asked a series of similar questions. I was advised that if a student graduates from a school that is recognized by the British Columbia College of Physicians and Surgeons, their degree itself is considered to be a statement of competency.


I did not, however, have a lot of comfort that the B.C. College of Physicians and Surgeons had experience with every medical school in the world. So it tends to be the list of schools that people have come from in the past that determines where they're expected to come from in the future. It may be that the university that the student is going to already is on the list of competency, in which case she will be deemed competent on return to Canada.

I really like the idea of writing the exam away, because in the third year. . . . I don't pretend to understand it well, but it would appear that anything we can do to make job-hunting in Canada attractive and easy to Canadian young people overseas is to our benefit. The risk is that they are overseas in Australia or Ireland or England or the United States and then are snatched up by someone, and they set up residency in that country.

The last thing I want to say is that part of the health action plan is aimed precisely at foreign doctor registration. I'm not going to go into the chapter and verse, but the Human Rights Commission and the college have been engaged in a dialogue about why it is that people are invited to come to Canada from certain countries and not from others as physicians.

There is a solution proposed, and I quite like the solution. The college proposes a 90-day competency review at UBC. For members' information, there are approximately 1,000 doctors -- or graduates -- a year around the world who write to the college and ask to become British Columbia physicians. Obviously, if they were all good physicians, we'd clear up any shortage in quite a hurry. The college winnows those applications down to those that it considers legitimate. But then there is no way for those people to come to British Columbia and be examined in terms of competency.

UBC has proposed a very streamlined, very rational process where those candidates would be invited to come to UBC. They'd put in 90 days working side by side with a doctor on the teaching staff, I believe, who would at the end of

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90 days sign off that they're competent or not. And if competent, they would automatically be registered by the College of Physicians and Surgeons. The Human Rights Commission says that's a good system. I think it's a good system.

I agreed that our staff would consider funding the process, which is $10,000 per applicant, if we could negotiate with the college an acceptable term that those acceptable applicants would then agree to go and work for a period of time in a community that needs them. Our problem is. . . . I mean, there's a lot of argument back and forth, and I have no official opinion on whether or not British Columbia has enough doctors. But the issue for sure is that we don't have enough doctors in particular places. The Burns Lake example comes to mind. And what we need is a legal way to say, "Okay, you're now a legitimate British Columbia doctor, and you will go work in Burns Lake for five years," or something. We're negotiating that with the college right now.

Please send me the letter. I hope that I've successfully convinced you that we are attempting to address the issue of making Canada and British Columbia a welcoming environment for our own students and others.

G. Plant: I think I will be able to give the minister a copy of the letter, because it's clear from the letter that she wants this issue raised. There may be a copy of it somewhere in some file in the ministry already. I mean, in relation to one small part of the minister's answer, if there is an ability to set up qualification exams outside the jurisdiction, that obviously has a potential benefit in terms of attracting people who, to use this particular example, are Australian and grew up in Australia but may want to come to Canada, as well as keeping or getting back the people who left Canada to go to medical school. So there may be two groups of people that we can attract, in as many countries as we can possibly do it.


I knew a little bit about the Human Rights Commission thing. It's interesting to hear a progress report, and I'll watch that one with interest.

The second issue I want to raise has to do with capital equipment spending, and it is a Richmond issue. When we were here in September, the minister -- who was not then the minister -- will know that there was a chunk of money that was part of the package on the table in September that was dedicated to the purchase of new capital equipment. The minister may not know, but the aftermath of that general announcement created some problems in Richmond. Some physicians noticed that there wasn't very much of the money that was going to the Vancouver-Richmond health board that was actually going to end up in Richmond, being used to buy capital equipment. And the items that were on the list weren't on the Richmond Health Services list. They weren't at the top of the Richmond wish list.

One of the challenges -- and I have no expectation that we're past this challenge yet. . . . In the few weeks after this developed in Richmond in, I guess, late September, there was the problem for at least a week or so when the Vancouver-Richmond health board said: "Well, it wasn't us that made the decision about what equipment to buy; it was the Ministry of Health." And the Ministry of Health said: "Well, it wasn't us; it was the Vancouver-Richmond health board." And it went back and forth rather unhappily. I believe the resolution of it was that the decisions were made by the ministry, although using a list supplied to the ministry from the Vancouver-Richmond health board. But that list -- just to make the point from Richmond's perspective, of course. . . . It was nonetheless the case that the ministry selected items from the list that weren't necessarily what Richmond had at the top of its list.

There is a general issue here, but I don't want to spend a lot of time on it. I do want to move to two specific issues. The minister, earlier in the debate, did make the point that he doesn't want to micromanage the health care system. It did occur to me when I heard him make that remark -- in what was a completely different context, but nonetheless it was expressed as a general remark -- that when it is the ministry that makes the capital spending decisions around items of equipment, it could look like the ministry is micromanaging the health care system. What is an unfortunate consequence of this is that the decision of which equipment to buy immediately becomes political, especially in this particular case, when it was fed by this uncertainty about who actually was going to take responsibility.

All that, really, is by way of context to ask, I guess, two or three specific questions. As part of the fallout of this issue, according to a letter that the chair of the Vancouver-Richmond health board wrote to the mayor of Richmond. . . . The letter says that the ministry has agreed, in effect, to give Richmond Hospital approximately half a million dollars of additional capital funding in this fiscal year. One way of asking the question is to say: is that over and above or separate and apart from the money that we're talking about here today and that's the subject matter of this estimate? In other words, is it really an extra half a million dollars?

Hon. C. Evans: I believe the answer is that the additional $500,000 is a reallocation of the distribution of the Vancouver-Richmond health board itself and is not part of this tranche and is not an addition to the first expenditure.

G. Plant: So at the risk of restating it badly, it's money that. . . . From the minister's and the ministry's perspective, the Vancouver-Richmond health board has found a half-million dollars somewhere in its budget to reallocate for the purpose of capital spending to Richmond health services or the hospital in Richmond.

Hon. C. Evans: It is within the equipment envelope of the Vancouver-Richmond health board.


G. Plant: The set of papers that accompanies the announcement of this latest initiative by the government has a bit more detail around the equipment funding than we saw back in September. I guess the first question is in relation to the equipment funding of $66 million, which is announced as part of this package. Is the ministry doing the same thing this time that it did back in September, which is to say that it will make capital spending decisions, buying this equipment but using lists provided for this purpose from the health regions? Or is there some different plan this time?

Hon. C. Evans: I found it somewhat interesting, and I tended to agree when the hon. member used the word "political" earlier about the purchase of equipment. I find it highly unfortunate that mayors, rural directors of regional districts, MLAs, cabinet ministers, everybody. . . .

[ Page 17305 ]

Lobbying seems to be an element of equipment purchases to an extraordinary degree. It's almost as bad as blacktop politics, and I think it's unfortunate. Sometimes some of us lobby for things that we think we want that we don't understand and that are occasionally inappropriate or even aimed at completely different objectives than the delivery of care. So I look forward to a day when people in rooms like this are completely separated from the purchase of equipment costs in order to avoid that process.

The second thing I want to say is that my observation on the equipment issue would be -- and I think the Premier would agree -- that during the years of the serious cuts to the provincial transfer payments on health, in the early and middle 1990s, our instruction to the system, the health authorities and the hospitals was: "Take the money that we have and spend it on patient care. Reduce the amount of investment you might make in equipment renewal, replacing worn-out equipment, replacing technologically redundant equipment."

That has created a considerable deficit, which we're attempting to address here today, but I don't think anybody should be under any illusion that we're going to accomplish it with this amount of money. It will take considerable investment over a considerable period of time in order to replace technologically redundant or physically worn-out equipment around the province.

Lastly, the specific question that the hon. member asks. This allocation is not being made in precisely the same fashion as the last $70 million -- I think that's the number -- of equipment investment. We are only negotiating with the ministry and the health authority on that very high-tech equipment when where it is placed has provincial implications -- i.e., where the regional diagnostic centre is going to be for an area, or where the referral hospital is going to be for an area. All minor equipment purchases are being left completely to the health authority without ministerial influence.

G. Plant: Following up on that last part of the answer, then, if I read the documents right, of the $66 million of new funding being talked about today, $24 million is allocated to purchase the high-tech equipment that the minister talks about -- the MRIs and the CAT scanners and other equipment -- where the designation and the decision about location is going to be made by the ministry in the manner that the minister described. But the balance, which represents $42 million, will be allocated to health authorities. Can the minister say what the allocation would be, then, for the Vancouver-Richmond health board from that $42 million global clinical equipment grant?


Hon. C. Evans: It's $15.2 million.

G. Plant: Just to make sure I complete the picture here, the Vancouver-Richmond health board will then make its decision about how to spend that $15.2 million in accordance with its priorities, which won't be second-guessed or overridden by the Ministry of Health in this case.

Hon. C. Evans: The answer to the question is yes, with two provisos. One is that they have to meet the statutory obligations of the Ministry of Health to see to it that the acquisitions are achieved in a legal and legitimate way. The second, hon. member. . . . Yesterday in the announcement of the funding itself I asked health authorities to discuss those equipment purchases with their occupational health and safety boards or committees, in order to assure that a significant amount of expenditure goes into equipment purchase intended for the well-being of the health worker as well as the patient.

B. Penner: Hon. Chair, I appreciate the opportunity to take part in this debate tonight. However, I think it would be appropriate to pause for a moment before going forward, to recognize that exactly one year ago tonight ballots were being counted in Delta South to reveal that the current member for Delta South was elected with 60 percent of the vote. And I'm told that those results did not change at all as a result of the overseas absentee ballots.

I'd also like to note that the last time I had a chance to engage in any meaningful dialogue with the Minister of Health was just a few weeks ago, when he was then the Minister of Agriculture. He and I met in what can probably best be described as a fairly unique convergence in the political world, on the grounds of a farm belonging to John Jansen, a former MLA for Chilliwack and a former cabinet minister in the last Social Credit administration. So it was a fairly unique meeting of the minds that took place in the eastern part of Chilliwack a few weeks ago, when the former Minister of Agriculture, myself and John Jansen all got together to help open his new organic feed mill, which will be a real significant contributor, I think, to the agricultural industry in the Fraser Valley and hopefully throughout the province. I think it is a sign of things to come. And I appreciate that the Minister of Agriculture, as he then was, took time out of his schedule to come to Chilliwack for that event.

I'd like to address a couple of topical local issues which have arisen of late in Chilliwack. I'm going to start by referring to an article which appeared in the Chilliwack Times newspaper just this past Tuesday, December 5 -- a front-page story and headline: "Staff Suffers in Health Care Crunch." It's not only the patients that pay a price; a shortage of trained health science staff affects Chilliwack General Hospital.

I'll just mention a few paragraphs from that article.

"Chilliwack is facing chronic shortages of health science professionals, including physiotherapists at Chilliwack General Hospital. 'We're coping,' said John Campbell, the soft-spoken man who is the sole outpatient physiotherapist at the hospital. 'It gets a little bit stressful, because there's pressure to see everybody.' "

Further on, Campbell goes on to say:

"Shortages mean people wait a little longer for intervention, and their recovery might be delayed. This could result in longer hospital stays for in-hospital patients waiting for services -- a situation that backs up other health care services. It could also mean people at home have had to be admitted to hospital if they've become unable to care for themselves, or their families can no longer care for them."


A related article in the same newspaper has a quote as follows:

" 'Unless the shortages are addressed, the wait times for critical services, such as radiation treatments for cancer patients, ultrasound and rehabilitation, will grow,' said Audrey MacMillan, regional director of region 7 of the Health Sciences Association of B.C.

" 'It has huge implications,' said MacMillan, who is also a psychiatric nurse working at Chilliwack General Hospital. 'The shortages in health science professionals puts increased pres

[ Page 17306 ]

sure on other health care workers, such as pharmacy assistants or physiotherapy aides, who may not have the education, skills or training to provide the same level of care.' "

I'll just skip along here.

"A local doctor, Drew Young, agreed the shortages of health sciences professionals are affecting health care in the Fraser Valley region. 'In many ways, it takes longer to get things done,' Young said."

Then at the end of the articles it says:

"Conditions in Chilliwack are not as critical as in other parts of the province, but they're still creating problems for the people dealing with them every day."

That's a rather long preamble to a question that I have for the minister. My question is: what does the minister have for us in terms of an action plan to address the shortage of physiotherapists in British Columbia? I note that one of the articles says that there are immediate vacancies for 121 physiotherapists in British Columbia. That's nine vacancies for every physiotherapist who is looking for work, according to the Physiotherapy Association of B.C.

A related question that maybe the minister can answer at the same time is: what is the approximate cost of hiring one additional physiotherapist in British Columbia, so we can get a ballpark figure of what it would take to try and tackle this particular problem?

Hon. C. Evans: I have a couple of things to say in background. The first is that the hon. member forgot to say that the organic feed and organic chicken farm that we visited is excellent for health care. We should all be promoting good food as a health care prevention measure, because after all, you are what you eat.

Secondly, I agree with the hon. member that the health science professionals are in short supply not just in Chilliwack or British Columbia but around the world. And it's not just physios. I think that just about every single one of the 120 professional technologies related to health care in British Columbia is in short supply.

On the physio issue generally, I talked with Martha Piper, the president of UBC, about how to ramp up training opportunities in order to increase the amount of people that we graduate. But it isn't just physiotherapy; it's pharmacy skills, radiation therapy skills -- the works. The worldwide shortage of these skills was in part, I think, a simple accident of education planners, who apparently, all over Canada, mistakenly believed that there would be a reduced demand for these technologies in future and reduced openings 15 and ten years ago. We have to change that. There is $3.56 million in this funding for health care professional retention.

I'm just going to give you an example of why everybody has to take this seriously. We are at present training pharmacists at UBC. Before they graduate, the signing bonus in Texas that they're being offered is a BMW -- for a brand-new, untrained pharmacist. We are competing with a worldwide shortage in these technologies, and we need (a) to increase training and (b) retain those that we have.

B. Penner: One part missing from the minister's answer was the approximate cost of filling one physiotherapy position for a year. I'm trying to just get a handle on the scope of the cost implications of filling the reputed 121 vacancies. Perhaps the minister can also, then, confirm whether or not that number is accurate and whether, in the minister's opinion, there are actually 121 unfilled positions for physiotherapists in British Columbia, as indicated in the newspaper article I cited earlier.


Hon. C. Evans: I cannot confirm the figure of 121. However, if you took $80,000 as a mid-range for wages plus benefits and the cost of administration of one FTE, that would be a $9.7 million increase to the base.

B. Penner: I'll take it from the minister's answer, then, that the approximate cost of hiring one physiotherapist for one year is approximately $80,000.

Hon. C. Evans: I was loath to use that figure. I was loath even to answer your question, because bargaining can be skewed by whatever it is that we say here. Understand that a physio, like any worker, is paid on a different scale according to their experience and the like. There is also a cost of benefits and administration that goes along with an FTE. So I used $80,000 as a generalization. I do not know the precise answer to your question.

B. Penner: Yesterday I was supplied with a copy of the minutes of the South Fraser Valley regional health board from their meeting of November 1. Brought to my attention was the fact that the CT scan wait-list at the Chilliwack General Hospital is "increasing again." The new CT scanner is not working at capacity. Also, the same minutes indicate that the opening of an additional operating room in Abbotsford has been deferred due to the shortage of specialized nursing staff.

I mention those two items just to bring these local Fraser Valley concerns to the minister's attention. I know from past discussions with staff at the hospital in Chilliwack that there's considerable frustration involving the CT scan facility. They have the facility there, but there are many hours of the day when it could be operating when it's not operating. And it's certainly not operating due to a lack of demand from people needing that service but rather due to an apparent lack of people to operate the equipment to provide that service. This has been an ongoing challenge in Chilliwack, and from what I can see here, it appears that the problem, according to the minutes, is getting worse.

I look forward to hearing what the minister has to say about that and also, again, about the commitment that had been made in Abbotsford to open an additional operating room. I think that announcement had been made with some fanfare, and now it appears that the opening of that additional operating room has been deferred due to the shortage of specialized nursing staff. So that's an extra service that had been communicated to the community which has actually not materialized. So, again, I want to bring those two issues to the minister's attention, and I look forward to his remarks.

Hon. C. Evans: I'm advised that there is funding in the CT unit that the hon. member refers to for one full shift per day. Also, the health authority has the authority to shift funding away from other costs towards increasing the hours of operation of the CT scanner, should they choose.

The hon. member's other question was about the shortage of skilled nurses in the Fraser Valley to be able to make full utilization of operating theatres and the like. That's the gist of the argument that we've been having here all day long

[ Page 17307 ]

-- attracting and retaining and upgrading nurses and health care professionals so that when there's a bed and there's equipment, there are also people to run it. It's hugely challenging.


Anecdotally I'll offer this. I met nurses at VGH and New Westminster who were working casual. When I asked them why they didn't take full-time jobs -- not to speak generally -- a couple of the individuals I spoke to said: "Well, we live up the Fraser Valley, and we have to commute for so many hours a day that there's only time for part-time work when we get here." So there might be opportunities for the Fraser Valley to recruit out of downtown Vancouver in order to save people the two hours' travel time each way.

B. Penner: Anything we could do to encourage people to stay off the freeway and reduce air pollution from vehicle emissions, I think, is a good thing and contributes to healthy lifestyles.

My last comment I'd like to leave with the minister springs from the discussion that the minister had earlier with my colleague from Delta South regarding the impact of natural gas prices on the cost of operating health facilities in the province of British Columbia. It's my understanding that a great number of hospitals and other health-related facilities rely extensively on natural gas to heat those facilities and to provide hot water. We all know that many hospitals are very large. So logic would tell you that they therefore consume a great deal of natural gas and that any significant increase in price will have a significant impact on the bottom line of the budgets for those health facilities.

There's an article in today's Globe and Mail that quotes a number of industry leaders as saying: "Everyone is going to experience higher bills this winter because of the price of natural gas." That's according to Damian DiPerna, a director with the rating agency Standard and Poor's Corp. in Toronto.

The article goes on to mention that business leaders are warning of layoffs as industrial gas users slash production to cut costs. "I think it's a major crisis" said Jayson Myers, chief economist for the Canadian Manufacturers and Exporters Association in Calgary. It appears that industry and certainly people across the country are realizing that natural gas price increases are going to have a dramatic impact.

Just today I've learned that 28 people in Chilliwack have been laid off due to a spinoff effect of increasing energy prices in Washington State. A facility in Chilliwack that grinds up poor quality logs for wood chips and then ships those to a pulp mill in Bellingham announced today that they will be closing, because the Georgia Pacific facility in Bellingham is closing to lay off 450 of their workers due to an increase in the price of energy in Washington State.

So clearly the increase in natural gas prices is having a ripple effect across the country and probably across North America. I think it would be extremely prudent for the Ministry of Health to get some idea of what this increase in natural gas will do to the budgets of those health facilities around the province. I realize that it might be up to those local agencies to tackle that, but perhaps it's time to send out a directive.

By the way, what do those various regional entities anticipate will be the impact? Everything we've seen tells us that there will be a very significant impact. I've no way of guessing how many millions of dollars in extra costs it will mean, but it could have a significant impact. I've no way of guessing how many millions of dollars in extra costs it will mean, but it could have a significant impact. I just want us to be prepared for that.

Hon. C. Evans: Thank you for bringing the issue to my attention. I didn't really observe a question. The member from Delta helped me to understand this natural gas issue earlier, and I assure you we've taken it under advisement.

R. Thorpe: I'll try to be as quick as possible here tonight.

With respect to orthopedics in the South Okanagan district, we've talked about that for some four years now, almost five years. What is in this action plan to help alleviate the tremendous waiting lists for those needing orthopedic surgery?


Hon. C. Evans: It would appear that having supplied the questions before asking them didn't necessarily cut the amount of time it takes to answer the question. I do not have a specific answer on orthopedic surgery in Okanagan-Penticton. The only specific funding that I see in the health action plan for access questions in the area is $800,000 for access issues at Kelowna General Hospital for advanced coronary care and medical surgical care. So I could answer the hon. member's question with the generalized bed access answers and stuff that I've given earlier, but I don't think that's what he's looking for.

R. Thorpe: I'd really appreciate it if we could both be real candid and get to the questions, get to the answers and move on.

This is very troubling, because this issue has been raised in this House for at least four and a half years. As I've said to a number of Ministers of Health, I happen to live in a part of the province that has a disproportionate number of seniors, and I'm particularly troubled. I notice on this letter that I actually received on December 5, in which the minister is copied. . . . No doubt it will work its way through his office. But when you get these kinds of letters from constituents, they're very, very troubling. I'm just going to very briefly read this letter. It's addressed to myself, with a copy to the minister.

"I'm writing on behalf of my husband, Maurice Howe, who was 76 in November. He is waiting for a hip replacement operation. He has been in pain and has found it difficult to walk for years. It has gradually got worse over the last six years. This last year has not been tolerable; in fact, he has trouble lying down. Sitting and walking are impossible without a cane or a walker. His muscle tone is deteriorating to the point that I believe it is now going to take longer just to get over the operation. He no longer sleeps at night, as he is up and down constantly. So he is always tired. Dr. Clark put him on a waiting list."

It goes on to talk here about some of the problems. He's been on the waiting list, hon. Chair, for one year. I know in my heart of hearts that the minister does not find that acceptable, when I have been told in this House, year after year, that our average wait period is 14 weeks.

Could I please have the commitment of this minister that they will seriously look at this issue, which has been brought up time and time again in this House? This minister, hon. Chair, says he wants to be different, says he wants to have

[ Page 17308 ]

action. Can I have a commitment from this minister that they will look at the situation in the South Okanagan with respect to the tremendous wait-list for orthopedic surgery in that part of our province?

Hon. C. Evans: Yes. And I'd ask you to share the letter with me in order that I can follow up.

R. Thorpe: Thank you. I'm going to take it that the minister has made a commitment and that we're going to work together on this, and I'm going to work very hard on behalf of my constituents.

Some of my colleagues have asked about long-term care. Again, this is a subject that I have raised in this House, along with my colleagues from all over the Okanagan. We currently have a shortage of between 600 and 800 beds. Let me just read into the record, hon. minister -- because you weren't the minister at the time, of course -- what was said on September 17 in this House by the then minister.

I said this: ". . .on May 16 we were talking about the 600-bed shortage in long-term care." Let me quote what the minister said on May 16: ". . .we are working on a long-term plan, which should be ready in the next couple of months." I asked what had happened. Here is the answer I got from the minister on September 17: "We are putting the final touches on it, and as soon as I am able to give it to you, I will do so."


Now, what I've heard. . . . This is a health action plan. I've heard today that there are 230 beds in the entire Okanagan, out of 2,000. I want to ask you a question. Is any capital funding provided for that 230? If so, what percentage and what amount?

Hon. C. Evans: This is not the health capital plan, and so the specific allocation of capital is not included in this plan in any region on any issue. It is the expectation of the Ministry of Health that these facilities will be built on a one-third, one-third, one-third basis between the government, the non-profit sector and the private sector. Some facilities may be in the capital plan of the Ministry of Health for the hon. member's constituency, the same as for other people that are asking questions. But this is not a capital plan, and I'm not bringing that forward tonight.

R. Thorpe: One-third by non-profit, one-third by the ministry, one-third by private -- is that what I heard? Could the minister explain to me what his definition is of private?

Hon. C. Evans: Well, the government is the government, and I would say that that's obvious. The non-profit sector I consider to be the Kiwanis Club or a church or the health authority itself, acting as a non-profit. The private sector are individuals who build a building and hire people and contract to the government to deliver care.

R. Thorpe: Is that what the minister would characterize as a public-private partnership?

Hon. C. Evans: Yes, and staff advise me that it is not clear whether or not the health authority can be a non-profit as I just said, so that might be a government. . . .

But in answer to your last question, the answer is yes.

R. Thorpe: So the government is pursuing a public-private partnership with respect to providing long-term care facilities in the province of British Columbia.

In talking to officials -- and my colleagues have touched on this earlier -- that attended the announcement, they. . . . I don't know where they got this information, but in particular in Penticton, we have, and they have, bought a piece of land. It's identified; it's right there; it's waiting. Everybody has been anticipating building a 100-room unit. I don't know where they got this indication, but when they were coming down to Vancouver, they were led to believe that that funding was going to be part of that announcement. They were surprised and shocked that it didn't happen. Can the minister confirm that it was the ministry's intention to give the funding for that 100-unit long term care facility in Penticton but that something at the last minute got changed?


Hon. C. Evans: The event in Richmond never had a capital component. There was never a capital announcement involved in the health action plan to my knowledge, for any region.

R. Thorpe: I'm troubled, and I hope the minister will be patient with me. I can't understand how health officials, very senior health officials, in the South Okanagan would have this feeling. They know they have the land, and I'm sure senior officials in the Ministry of Health know they own the land. I'm sure that they've been working on developing plans together. I don't think we're in another orbit up there. So I just wonder: does anyone accompanying the minister today have any knowledge of this facility for the South Okanagan?

Hon. C. Evans: The simple answer is no. But I think that since the hon. member sort of repeats his question in a different way, I'm tempted to speculate. So I want to put that on the record and everything so that everybody understands it is pure speculation. Perhaps the idea that we are funding 2,000 beds' operational funding got someone excited somewhere, and they believed that we were going to announce capital projects. Because 2,000 beds sounds like physical beds. No staff person here knows of any way that anybody, anywhere, would have been advised that any capital project was going to be announced. But I don't think the hon. member's constituents. . . . I think they could be forgiven for believing that operational funding and capital funding was the same thing. I think there are lots of people who don't understand that.

R. Thorpe: I'll share that information with the folks at home when I get back home and see if we can't clarify either how they were misled or misinformed or misunderstood. I don't know; I'm just knowing what they passed along to me. And when I get to the bottom of it, I'll share it with the minister.

The next area I want to talk about quickly is brain injury. We had a commitment in this House, and in fact, some folks travelled up to Penticton and I think were quite frankly overwhelmed on September 14 with the attendance of some 100 people. Attending, I believe, from the ministry was an employee by the name of Mr. Underwood.

Also, on November 28, before the Select Standing Committee on Finance and Government Services, we had a representative -- a Ms. Lisette Shewfelt, executive director of the

[ Page 17309 ]

brain injury society in the South Okanagan -- appear before the committee. I'm sure you could check with the member for Nanaimo. Ms. Shewfelt was rather passionate in her presentation on behalf of those she works for and advocates for, but she was very, very straight and clear that they think they're just getting bounced around like a rubber ball.

Does the health action plan include any funding to assist those who fall through the cracks with brain injury? As a result of Mr. Underwood coming up, meeting with over 100 folks involved, coming back, reporting, and you all developing this plan, is there any money in this health action plan for the brain-injured folks of British Columbia?


Hon. C. Evans: The answer is yes -- $383,000 in this fiscal year and $1.148 million in next fiscal year. The total for two years' funding for brain injury patients is $1.53 million -- new funding.

R. Thorpe: I heard the word "new" at the end, but I didn't hear it at the beginning. I'd like to clarify it. Are the amounts of money -- $380,000 and $1.3 million, if those were the numbers -- are they new moneys in this action plan right now on top of all the moneys -- or the little bit of money, quite frankly -- that is being spent on brain injury? Is it all new money?

Hon. C. Evans: Yes.

R. Thorpe: How will that new additional money be dispersed to the various brain injury organizations throughout British Columbia?

Hon. C. Evans: I think that the majority of the funding is for brain injury work at Vancouver Hospital.


Hon. C. Evans: No? I'll get the answer for the hon. member and get back to him.

R. Thorpe: This is a very, very important subject, so I'll just wait for the minister to. . . .

This is a very, very important subject -- very, very important. I've had the privilege to work with the brain injury society. I've had the unfortunate situation of having my assistant incur a significant brain injury and be off work for seven months. I'm happy to say he's recovering. He's coming along. But without the help of all these folks and these volunteers out there, it would have never happened.

My real question to the minister. . . . I would like to know how much money, and how is the money getting out to the people throughout British Columbia -- not being tied up in Victoria or being tied up in Vancouver -- because it is a desperate situation in the interior and in the north.

Let me just say that in investigating this subject, the wait-list with brain injuries. . . . Early intervention, quick intervention, is one of the keys to helping people recover and rebuild their lives. Ninety percent of those people who suffer brain injury end up losing everything they have, including their families. So I would like to know the details of how it's going to get out to folks that work with those affected individuals and their families. This is a tragedy in British Columbia that has to be addressed, and the moneys are not significant moneys compared to what we're spending.

Hon. C. Evans: I'm advised that money is being earmarked for services to people around British Columbia, and we will be seeking proposals from health authorities working with the various groups that assist people with brain injuries. I will share the dispensation of these funds with the hon. member as soon as proposals are received and decisions are made.


The other question he asked was: how much? And I'll simply repeat: in this fiscal year, $383,000, and next fiscal year, $1.148 million.

[J. Sawicki in the chair.]

R. Thorpe: What I would also ask if you could do or have your staff do is, if you could, get the information to my office on these requests for proposals, so I can make sure that, in my particular area of British Columbia that I represent, those folks can get into preparing the proposals. I would like the minister to undertake that, so that I receive that information as quickly as possible, so that I can work with my colleagues in my regional health district and the South Okanagan-Similkameen Brain Injury Society and the Central Okanagan Brain Injury Society -- to make sure because, as you know, the competition for funds is tremendous. And this money is needed. If I could get that commitment, I'd move on.

Hon. C. Evans: Okay. I think this is a little bit dicey. We're not going to send these application forms through the MLAs and kind of politicize the thing. But I understand that the hon. member has a special interest. And what he wants to make sure is that the health authorities in his area know that they can apply. So what I am going to commit to is that when the information is transmitted to the health authority, we will advise the MLA so that he can go and talk to them.

R. Thorpe: One of my colleagues said, "I'm sure it'll be transferred to all the health authorities," and I'm sure that will be. But I appreciate the undertaking. Thank you, minister.

Of the capital funds here that are identified, the global clinical equipment grants, how much of that is earmarked for the South Okanagan-Similkameen health region?

Hon. C. Evans: There's $2,150,622.

R. Thorpe: And that's a 60-40 split. Is that correct -- to move forward on the projects?

Hon. C. Evans: Yes.

R. Thorpe: How many new nursing spaces in the Okanagan, and when will they be ready for students to occupy them?

Hon. C. Evans: I'm not positive if I have the question right. I think that the hon. member is asking the question: how many of the new 400 nursing seats are going to go to Okanagan University College? Those are the seats which I said, in response to earlier questions, that we haven't allocated those to university colleges. Dialogue is going on with the

[ Page 17310 ]

Ministry of Advanced Education and with the universities themselves about who desires to offer the course.

R. Thorpe: One of the things that I had the privilege of hearing time and time again as I travelled around in the all-party budget and finance committee was: "Can we make sure that we can train folks close to our home, because they want to stay at home?" So I would trust -- I would hope. . . . I would ask that when you're allocating the 400 student spaces around British Columbia, you take into account the various regions of British Columbia. We don't want more than our share in the Okanagan. But we sure want our share so we can teach and train and develop our young people at home, because we'll have a much better chance of having them stay at home, stay together with their families, work and care for people in our community. If I could have that commitment from the minister, that'd be greatly appreciated.

Hon. C. Evans: The message that the hon. member just gave me is the same message I got in every region of the province. I assure him that I understand. It is not necessarily true, however we had a question earlier from an hon. member who was suggesting that at some school in his constituency, five out of seven students were leaving the region. So it's not just a matter of where we train them; we also have to make them stay.

Also, I wish to clarify for the hon. member my previous answer. I gave him a figure for the amount of equipment. He asked me if it was a 60-40 split. I wanted to clarify that the figure I gave you is the province's share. If you want to know its buying power, you would add another 40 percent.


R. Thorpe: I appreciate the minister clarifying that. With respect to palliative care, I noticed in the health action plan that there are some changes proposed. Does that mean that people that are, for instance, in the Moog and Friends Hospice House in Penticton will no longer have to pay for their medications when they're there? Is that how I read this new health action plan?

Hon. C. Evans: Yes, although I would like to caution that the program doesn't kick in until, I believe, February. I think it's February 1. I just don't want anybody to leave here or anybody watching. . . . I mean, this is a somewhat sensitive issue. We have to build the program, and there will be people who need it between now and February 1, and we won't be able to supply it. But I believe the answer to the hon. member's question is: after February 1 the answer is yes.

R. Thorpe: I don't know if the minister has ever been to the Moog and Friends Hospice House in Penticton. That's a fantastic facility in our community, built by the folks of the community. I've always been troubled, though, that when someone is very sick in the hospital, everything's paid for when they're in the hospital, but when we move them over to the Moog and Friends Hospice House so they can pass on in dignity with their family around them, we make them pay for their drugs. I've never quite understood that. This plan cannot get in place, because the last thing we need to do in those last days and weeks -- in some cases, months -- of their lives is put their families through that. It doesn't click; it doesn't work. So whatever we can do to make that happen, that's greatly appreciated.

My colleague from Richmond talked a little bit about autism. As some of the staff will know, it's a subject that I work on quite a bit. Some of my questions may be repeats of my colleague's, and if that's the case, I apologize for that. I thought I heard, because I came in at the tail end, that the Health ministry and Children and Families are going to work together on some new program to deal with autism. I think that's what I heard. Perhaps if the minister could just give me a nod, then I could carry on. Thank you. So that's what I heard.

I'm a little bit troubled by that, because I heard the Premier on the "Rafe Mair Show" when he was questioned about autism. The Premier clearly stated that autism and the treatment of autism should be in health care. That's what the Premier said. He also said that if the pilot projects had been completed, he saw no need to continue with pilot projects. Are we continuing with pilot projects, or are we rolling out autism treatment for those unfortunate children that suffer from this disease and, as importantly, for their families? When are we rolling this out? When is it going to happen? And why isn't it in the Health ministry, where the Premier said it would be?

Hon. C. Evans: I didn't hear Rafe Mair, and I don't have any opinion of whatever was discussed there. The Ministry of Health and the Ministry for Children and Families and the Attorney General are working together on bringing forward an initiative for autism. There is a pilot going on, but I don't want the hon. member to believe that the pilot presently going on in the treatment of autism is an impediment to delivering treatment in British Columbia. In fact, the opposite is true. We are proceeding to develop a program. I hope to be able to bring it forward in the near future. I cannot give the hon. member a date, except to say that we are seized of the issue, the ministries are working together, and there is no impediment except putting the program together.


I will explain for other people's benefit. Historically the Ministry of Health has been responsible for developing adequate capacity for diagnosis and assessment, while the Ministry for Children and Families has been responsible for providing treatment. That gap is one of those things in government where there's kind of not a centre in the delivery mechanism, and so that is what we are attempting to eliminate.

Just to cut to any other questions. . . . I gave the previous hon. member the answer that funding for the autism initiative, when it comes, will be above the health action plan. There is no risk to the money in the action plan in moving forward with autism, nor is the autism initiative dependent on the vote tonight.


The Chair: Before I recognize the next member, if I could just ask for a little more quiet in the House so that we can hear the debate.

R. Thorpe: I'll try to move quickly here. Is it envisaged at this point in time that the Lovaas treatment will be available as part of this program?

Hon. C. Evans: That is part of what is being considered. The Lovaas treatment that the hon. member references is part of the pilot, and that would indicate to me that we are hoping

[ Page 17311 ]

that it will be part of the program. But I don't wish to predict or prescribe what will be brought forward, only to say that we're moving as quickly as possible. And I think the hon. member's desired direction and the direction that it's going in are pretty close at the present time.

R. Thorpe: Well, you know, hon. Chair, I'd like to say to the minister: "Thank you." I'd also like to suggest strongly to the minister that the most important people, in my opinion -- and I'd be surprised if it isn't also his opinion -- are the parents, are the guardians of the children. I would ask, because this minister has tried several times tonight to tell us how he travels around this vast province -- as some of the rest of us do. . . . The most important thing we can do to enable those folks that love their children so much and want to care for their children so much is get out of their way and stand beside them and support them.

There are no magic pills. So I would just ask that the minister ensure that his staff and the other staff are truly listening to the parents of those loved ones and that their voices are heard, because the most important thing in dealing with these children is early intervention. Early intervention can give them the quality of life that we want to give our loved ones. So I would ask the minister to please convey that to staff that are working on this project: to listen hard and give the parents a chance. Thank you, minister.


The Chair: Order, hon. members. Order. Could the House come to order so we can recognize the next speaker?


The Chair: I have asked the members to come to order, please.

V. Anderson: First of all, I'd like to follow up on the present topic -- autism -- because I also agree that this is fundamentally important. I think it's fundamentally important that there are a variety of ways that families may deal with this. There needs to be choice, and that's a support to the family. I think it's fundamentally important that we're not only treating a child, but we're treating a family. The child is part of the family, and the adults are part of the ongoing caregiving of the child. There's a connection there that is fundamentally important.


The same is true when dealing with persons who have other disabilities -- blind children or children with handicaps. The parents need to learn, and when working with them, it has to be a unit. I stress that there has to be variety and not just one package that fits everybody. It must take the parents and the children into account.

I'd also like to stress that what has been a habit of this government over the last number of years is that in order to start new programs, they have closed down already existing and effective programs. I hope that the government will support programs that are underway at the same time that they are beginning new programs. The programs underway may not be perfect, but the new programs won't be perfect either, and we waste all of the tradition and expertise in developing the programs we already have and discourage people in going into new programs. I just pass down from past experience that that has happened.

Another area I want to comment on is the area of the nursing shortage. Just this week I was contacted by a program in New Westminster -- Options Unlimited. It's a program that I have known for quite some time which is very effective in helping new immigrant persons who are professionals to adapt and become able to make the transition into the professional community of their particular skills -- getting the language skills, the cultural skills and the adapting skills so they can bring their professional skills into the new circumstance.

They phoned me particularly because of my history with them to ask if there would be some help in bringing to the government's attention that they have, ready to go, a program to enable immigrant persons who are trained as nurses in their own countries and who are already living in our communities, to prepare themselves for the bridging programs that they need to go into their nursing program. They have a 12-week program which is ready. They have been contacted by the skills training ministry.

What I want to ask the minister is if he will give consideration to this 12-week program, which stresses the English language, which they need within their professional work in order to do the other retraining programs or upgrading that they may need. This program has two skilled and qualified nurse-trainers ready to go to work. This week the minister may have received information from them, and I wanted to highlight it today to make sure that it gets proper notice and review as a possibility for part of this process.

I understand from the Filipino community itself that just in the Filipino community, not counting other ethnic people who are here, there are some 7,000 trained nurses here in Canada of Filipino origin, many of whom are working as nannies and other professionals and until now were not able to move into their chosen skilled profession. This is a real opportunity for us and this Options Unlimited program in New Westminster, trained and competent in this area, well recognized in HRDC, with whom they've worked for years. I've mentioned it to the minister and wonder if he will give it consideration.

Hon. C. Evans: I thank the hon. member for his suggestions, and I certainly will consider them. I advise him to advise his constituents to contact the organization called HealthMatch, which is the coordinating body that helps hospitals and authorities to search for nurses. I assure him that there are ESL funds in the package and thank him for his advice.


V. Anderson: I didn't quite catch the name of the organization. If the minister could. . . .

Hon. C. Evans: I'll send a note. Go ahead and ask your next question.

V. Anderson: Another area that I've been contacted about -- and I've had contact with a number of groups in the same areas. . . . When they were working on the macroprojects -- let me just call it that -- of hospital waiting lists and bed lists and opportunities for people who have mental ill-

[ Page 17312 ]

nesses or mental difficulties. . . . One of the things that may get overlooked is the services that are provided within the community on a day-by-day basis to what may be called, in one description, the street people, the other people who are living in rooming houses or in. . . . They come together into service agencies, mental health agencies and neighbourhood services like the Kettle Friendship Society and many others in the lower mainland and across the province.

These are the people who, day by day, when they're living in the community. . . . They are the places they go to maintain their orientation, to maintain their well-being, to maintain their ability to function within the community. When these services are not available, then they end up in the hospital needing the long term care beds. So what I wanted to ask the minister is: in this program, are there funds that are dedicated to the neighbourhood societies and organizations and front-line mental health groups that meet these people on a daily basis in their community functioning, that provide the social activities for them, the oversight activities, the counselling activities? Are these funds available from this program for these community agencies?

Hon. C. Evans: I think that the straight answer to your question is: not as such. However, there is funding for initiatives similar to what the hon. member is talking about through the health authorities. I would advise that the agencies that he's referring to apply to the health authorities -- given where he lives, that would be the Vancouver-Richmond health authority -- and see if they can obtain some of the funds.

V. Anderson: One of the other things I wanted to highlight, because it's been an ongoing concern -- the minister may give the same answer this time, but I do think it needs to be highlighted -- is that in many of the care facilities for long term extended care, it was the practice to make available to them resources that provided equipment and care products that were used in caring for people. Those funds have been cut back drastically. So the comfort and the care and the health care and the supplies that are used by the staff to care for the people have no longer been available for the last year or so. This has caused a great deal of hardship and difficulty, both for the staff and for the members whom they're trying to care for in the hospital. I wanted to take this opportunity to highlight this and to ask if this program, in working on the macro, is again aware of the individual needs of caring that are required.

Hon. C. Evans: I thank the hon. member for his intervention. There has been no provincial policy decision that would affect those supplies whatsoever. It must be a local decision, and we'll see if we can understand it.


V. Anderson: Thank you. I'll supply some information to the minister, then, as a follow-up.

Another area I wanted to raise is growing in importance. Last week I was privileged to attend a program that was put on by From Grief to Action, which is a program which has been started by parents who are concerned about the addiction problems that have come to their children. Now, these are adult children -- 25, 30, 40 years of age -- who they have tried to get resources for, without the ability to do so. Some of their young people have died or committed suicide in the process of their trying to get support. This is a growing awareness of the families, who are coming together to say that: "We need help right across the province in the area of addiction treatment as a sickness, as a health issue." I'm wondering if, in this plan, there are funds to extend and increase the support that these parents are asking for in dealing with their children.

Hon. C. Evans: Not in the main, I'm sorry to say. The two health crises, I would say, that are not addressed primarily by the health action plan are first nations, especially health care on reserves, and the downtown east side and drug issues. I thank the hon. member for raising the issue. Like the mental health issue, I think it is kind of the next section of health care generally that needs to be addressed. As the hon. member is aware, the health action plan is primarily about provision of beds, tools and people in the acute care sector -- largely by diversion, but nevertheless it does not include addiction services.

V. Anderson: I appreciate the minister's response. Regarding addiction, though, it's not just a downtown east side problem. This is a provincial problem, right across the whole province. The downtown east side has been getting some publicity lately about it, but these are families that come from right across the province, across the lower mainland. So it's a health problem. It takes bed care. It's one that I hope will be highlighted and would come soon as a higher item on the agenda.

The one other item I would like to ask the minister, which I don't think has been touched, is a program here that he has brought before. Does it have an effect on the reallocation of resources to Riverview Hospital, to be able to touch some of the mental health needs? In a way, at one time we were moving away from Riverview, trying to close it down. I think we've reversed our decision on that to say that Riverview has a unique and new place to deal with those who have need of it and also as a transition place for people to come and go from when they have need of it. It can serve a constituency right across the province from that location.

Does this plan pick up, as part of its mental health component, a revitalization of a new role for Riverview in the mental health field?

Hon. C. Evans: The hon. member is correct in terms of his general perception of the evolving thinking about the future of Riverview. But no, the health action plan does not assist in that transition.

V. Anderson: To the minister: in the mental health portion of this initiative, is there a plan and a time line so that the community can be aware of what the initiatives are? When are they going to come forward? Is there a plan and a time line that is available, so that we in the community can say: "These actions will occur in the next three months, in the next six months, in the next year"? This would be helpful for community response and planning.

Hon. C. Evans: Yes.

V. Anderson: Is that available? How is it to be made available? How can we get it and others get it?


Hon. C. Evans: All of the documents that were available in Richmond the other day are now available on the ministry

[ Page 17313 ]

web site. And we can supply any hon. member with any particular group of information that they might require. The hon. member asking the question is interested in mental health provision. The previous member was asking about the autism provision. We can supply those, member.

J. Reid: Hon. Chair, I have a few questions that pertain particularly to my constituency, going through some of the details of this health proposal. I'd like to start with some questions about the primary health care suggestions and in particular a proposal that has been put forward from Qualicum Beach, for Qualicum Beach. It has been in the works for quite some time and identified many, many years ago. The health region put it in as part of their 15-year plan, and in fact they have requested, from the ministry, funds to be able to investigate the details of the proposal.

We're looking at a facility in Qualicum Beach that not only would provide primary health care, which is one of the proposals here, but it goes further than that. I'm sure the minister is interested in innovation and advancements. Seeing that Nanaimo Regional General Hospital has a physical limit to what it can expand, seeing that there is a requirement for more beds and seeing that not only do we need the primary care but we need 24-hour and also some convalescent care as part of that integration into the community, where would a proposal that's already gone into the ministry, that's already been put forward as we're looking at a start of five sites, now sit? How would it fit in with this idea for this funding?

[D. Streifel in the chair.]

Hon. C. Evans: It sounds, from the hon. member's description, like it would fit well in the entire vision of the health action plan. Firstly, the hon. member says that it has a primary care component. We had over 100 applications for primary care; I assume it's one of them. We will be reviewing those applications; we funded seven of them. We'll be reviewing them and looking to fund five more immediately. We'll also be having a request for proposals for an additional five.

I assume from the hon. member's comments that the health authority is involved in the design of this innovation, so they will know whether or not they have applied for capital funding. If they have, then I would defer to the capital plan.

Lastly, it sounds like there's independent living or assisted living or continuing care, or all three. In that case, if capital exists or can be raised to build the facility, the continuing-care part of the facility might very well be funded through the provision of continuing-care operational costs for the mid-Island.


J. Reid: So a proposal that, rather than fitting into the narrow confines of what's suggested here -- just looking at primary care -- actually goes further and integrates more aspects. . . . I want the assurance that the proposal that's already in, which has already been endorsed by the health region, will fit the blanks -- that this isn't so narrow that it would be excluded because it goes beyond just primary care; it goes further. I just want the assurance that because it goes further, it won't be excluded from these dollars.

Hon. C. Evans: I can give that assurance. There are other primary care facilities that are funded elsewhere in the province, I believe, which are part of larger operations. Continuing-care funding applies for various degrees of care, so I see no reason why a complex initiative might not find independent envelopes of funding. Surely the hon. member isn't asking me for my commitment to do something that I've never seen. But in a structural or policy sense, everything she's suggesting is thoroughly doable.

J. Reid: Following up with primary health care, there has been a problem in Parksville with an after-hours clinic that has been very vital to the community. But it has been restricted because of the present funding -- when a capacity is reached, then the clinic closes. I notice in this document. . . . Looking at being able to extend that and being able to find other ways of payment to compensate physicians so that we can extend these kinds of facilities -- would that be the proper interpretation?

Hon. C. Evans: I don't know if it'll work in extending an existing clinic or not. I presume. . . . Well, instead of using up our time with my presumptions, let me say that if there is a clinic operating that desires to become a primary care clinic, there will be five more funded this year, and I would advise the community to make application. There will be a request for proposal soon, and then we could avoid my speculation on this particular site.

J. Reid: There's a certain frustration here, then, because we're looking at new proposals. But ones that already exist, which have restrictions placed on them so that they're not able to fully service the community, are being ignored. I'm having a hard time understanding the logic behind that. Is there something else, then, that covers off being able to provide the funding to enable these clinics that are already operating, already have the dollars invested, are already serving the community but are limited because of the current structures of compensation -- whether there's anything else in here that's going to assist those kinds of facilities and operations?

Hon. C. Evans: I'm advised by staff that the clinic the hon. member is discussing is a fee-for-service clinic. If that is true, it might be difficult to see how it would become a primary care clinic, unless the doctors there desired that. We're not imposing the primary care or capitation or per-population payment model on health care providers that don't wish to. . . . And I think, from the description and from what staff understand, the clinic that the hon. member is referring to operates and apparently prefers to operate on a different payment model.


J. Reid: Also in our area, with the distance of facilities we have a great concern about ambulance service. I notice that in the health proposal, there is a position that will be added to Qualicum Beach. My question refers to what already exists in Parksville. We have a full-time person in Parksville, but it's daytime. It's not 24-hour, and I've had some complaints coming into my office about the length of time for the ambulance to respond. I know that sometimes all our ambulances could possibly be busy, which would cause a delay. But there's also, when we're looking at people on call, a delay. And since we don't have any other facilities -- we just have the hospital in Nanaimo -- this is of primary concern in my area. So is there anything in this with regard to ambulances to extend existing service to 24-hour, full-time?

[ Page 17314 ]

Hon. C. Evans: The ambulance component is primarily the increased training of paramedics. I believe that it's about 70 in the lower mainland and about 17 for rural British Columbia. I do not believe that there is funding to expand the hours of particular services, like where I live or where the hon. member lives. Where I live the ambulance is operated on an on-call basis 24 hours a day, and it sounds to me like for some part of the day, it's similar for the hon. member. The health action plan does not address that.

J. Reid: In looking at relieving seasonal pressure on hospitals, it mentions that certain hospitals will be eligible for this extra funding. So my question, looking at Nanaimo Regional General Hospital, is: what are the requirements? How will the decisions be made with regard to those hospitals? We're looking at a four-month period, December 1 -- obviously past -- to March 31. Is Nanaimo Regional General Hospital one of these hospitals that would be referenced here?

Hon. C. Evans: Whether or not Nanaimo receives funding will be up to the Central Vancouver Island health region. They are receiving $592,321 for the flex-bed initiative, and they will submit a proposal to the ministry to say how they intend to spend the money. The ministry, if they agree that it provides a service, will release the funds. But I am not going to say how they'll decide to spend it.

J. Reid: In community living support workers, again it talks about seven community living support workers through the health authorities. So the question, again specifically, is: will the Central Vancouver Island health region receive any of these community living support workers?

Hon. C. Evans: The answer is pretty much the same. The Central Vancouver Island health region will receive $104,400 for the mental health initiative announced. They will determine how best to spend it within the guidelines and make application, and we'll release the funds.

J. Reid: We're looking at the plan for the management of hospital beds to prevent the difficulties when a doctor is trying to find a bed for a patient. In my constituency, I remember -- I think last spring -- the proposal for managing wait-lists. . . . There was going to be a person who was going to. . .and a phone number, so people could phone up when they had concerns with wait-lists. This has turned out to be a huge frustration and has done no good for anybody that I've been able to see. People have phoned me back and said that it was just a PR exercise and that nothing was actually accomplished by their phone call. I'm wondering, with the proposal for managing these beds and setting up a system to register beds, what's going to be involved in that. How is it going to work? What kind of assurance do we have that it's going to work better than the system for managing wait-lists?

Hon. C. Evans: The accountability provision in the health action plan is that the provincial health officer, Dr. Perry Kendall, is preparing terms of reference and an advisory group to work with him and me to give periodic outcomes in order to assure the hon. member and everyone else that the provisions of the plan are delivered.


J. Reid: Does the minister have any details about how that is actually going to be technically set up in registering those beds and managing that list? It sounds like an awful lot of bureaucracy to me. Is there a simple explanation of how this is going to work?

Hon. C. Evans: Yes, there is, and I don't think that it's bureaucracy at all. The people who asked for the service are primarily doctors. Frankly, it seemed pretty bizarre to me that it doesn't exist already. The system that it will be modelled on is the Ontario critical call program, essentially a computer system with a connection between providers in rural British Columbia and providers in urban British Columbia, especially at the referral hospitals.

The hospitals will have, on the software, beds available and staff available. Say the internist in Nelson was one of the people who asked for this, Dr. Malpass. . . . He says that the nature of his job in a rural community is largely stabilization and referral. When it comes time that he has to find a bed, he has to phone the institution and then probably the surgeon. His chances of finding the bed or the surgeon is -- in his opinion -- partially: who does he know? Does he know the surgeon? Did he go to school with him? We're trying to eliminate that by having a computer program that says if you have somebody with a particular acute need, you enter that into the system, and the system is supposed to tell you where that need could be served in British Columbia.

To characterize such a system as bureaucracy would be unfortunate, and I would go back to my earlier answer about Dr. Kendall. Whatever concerns the hon. member has that it won't work, I would advise her to bring to Dr. Kendall to say we want to judge the outcome of this thing. We want to watch you build it. We want to know when it's going to be ready, and we want proof that it works.

J. Reid: I'm sure we will get proof that it works or doesn't work when people try to use it. I'm certainly hopeful that it will work, and I'm glad to hear that it's built on a model that it sounds like is already existing and already successful.

With regard to long-term care, extended care and the plans for that, I'm somewhat troubled by, it seems, a lack of planning for what we call aging in place or seniors campuses. Especially in my area, I have a seniors' advocate that has been working on this and working to educate the community. I've met with a number of nurses now who have worked in these kinds of facilities, and they extol the virtues. Rather than just a long-term care or extended care, they also have living accommodations for people who don't require any care at all, so that as they age they stay within that community.

Right now there's a proposal in for the Parksville area for long term care, and it doesn't seem to be including this extra piece of living accommodation, where people who don't require care can move into the facility. And certainly the dollars generated should help maintain the integrity of the whole proposal. Instead we seem to be favouring, once again, restricted facilities that are specifically long term care, extended care, rather than people who don't require any care at this stage and then integrate them all the way through. I'm wondering why I'm not reading more of this and why I'm not seeing this promoted by the ministry.


Hon. C. Evans: I'm not sure I discerned a question. But the model doesn't seem to preclude the hon. member's suggestion. I think what she's talking about is essentially rental

[ Page 17315 ]

units for people not in need of any form of care and then assisted living to allow those people to move into a minimum form of care and the like. That is essentially the model that most of British Columbia is moving to.

J. Reid: That sounds like a simple, logical model. But it's not what we're seeing. I'm seeing a development go into Nanaimo; I'm seeing a development go into Parksville. I've talked with the health authority about this. Why are we not seeing this integrated model where there is this longer vision?

It appears, with some frustration, that there isn't the support for this larger vision -- that as long as the funding is tied to the specifics, it's very difficult for, say, not-for-profits to be looking at building rental housing that doesn't have dollars attached for beds. So again, it sounds like it should be logical, but it isn't happening. Could the minister explain to me, perhaps, if it is happening somewhere in the province and why it's not happening everywhere?

Hon. C. Evans: We only have so much money, so we tend to aim that money at people who need care. It's not very complicated. But many, many communities in the province are attempting to assemble various levels of care, and they're even accessing various funding mechanisms in order to make it happen -- even private ownership, private renting, assisted living and continuing care in a continuum. I don't know why it can't happen, I mean, in your community.

But I'm certainly not going to apologize for the fact that the province tends to aim its money at people who need some kind of care. They're in the acute care bed now; we're trying to get them out of the acute care bed. I don't really think you want us to take this money and apply it to people who can live on their own. So please go home and say to your community: "Let's do it together and get all these levels of care in the same place." But the province's money is going to go to the people who need some help.

J. Reid: Obviously the money has to go to the beds and to the care. The problem is that when the province is attaching that money and attaching these projects with, again, this narrower vision, the difficulties of being able to include perhaps a private component to provide this other care. . . . It's not happening. What I would like to see is encouragement and some imagination on the part of the ministry to look and realize that it is what is desired. Perhaps because of the way the dollars are being administered, it's not happening. So it's not happening; it should be happening. There are some problems there. Let's work together and see that they're overcome.

In looking at another aspect of long term care, it's to do with mental health. I've been told over and over that there aren't the facilities to deal with people who need long term care and are also suffering from mental health problems. Within this proposal, are there dollars to be able to direct towards facilities or anything else that takes that into account specifically -- that people with long term care needs and mental health needs are going to be looked after?

Hon. C. Evans: I think that the hon. member is talking about the need for rental supports for people with mental handicaps who may also need extended care. There are 275 supported residential care spaces.


J. Reid: Let me explain this. People who have aged with mental illness. . . . They're not living on their own. They need to be in a facility, but they do have acute mental illnesses. The current facilities, the long term care facilities -- extended care facilities not so much, but especially intermediate and long term care facilities -- are not designed to handle people with acute mental illnesses. We are seeing larger numbers, and I'm seeing this in my community -- that it's actually a difficulty. So is this part of the plan? Is there a component of this that addresses that problem? This isn't independent living.

Hon. C. Evans: Thank you for assisting me to understand this need. I don't think there's a specific envelope in the health action plan that addresses it. We'll have to come up with creative solutions over time.

Also, I wanted to say that staff advised me that maybe one of the best examples of the kind of housing you were talking about, where various levels of care are available in one site, is represented by the member from White Rock. Maybe you can talk to him and find out what he did, and then we'll work it out.

J. Reid: Because of different issues I've dealt with in the community, there are some specifics here. Eating disorders program. Now, I'm familiar with the program at St. Paul's. I'm familiar that there's supposed to be, I believe, a six-bed expansion slated for January or February. Since this is a new proposal on top of that, I'm wondering what is being provided here for the eating disorders program.

Hon. C. Evans: There is no provision for special funds for eating disorders in the health action plan.

J. Reid: Well, I've got the backgrounder, and it says: ". . .will fund initiatives such as. . . ." And it goes on, and it mentions eating disorders programs. So I'm wondering where the confusion lies here.

Hon. C. Evans: I'm especially amazed that the hon. member who is asleep couldn't help me figure out how to do this.

It is true. The tertiary care programs itemized in the backgrounder include about 20 different programs, the last one of which is eating disorders and severe anxiety. Now, the tertiary care funding will provide $0.337 million incremental funding. . . .


Hon. C. Evans: That's actually in the book -- $0.337 million in next fiscal year's budget for eating disorders.

J. Reid: Since I'm quite interested in this, is there anything more than just that there's some money there? How will it be directed? Is it directed towards St. Paul's? Is it directed towards community? Could the minister give me something more to go on with this?

Hon. C. Evans: The money is targeted for St. Paul's and if it is disseminated farther, it will be in conjunction with the St. Paul's proposal.

J. Reid: I want to ask a question about the creation of the hepatitis secretariat. I'm just wondering: with the dollars, how much is going toward that? And how much of those dollars is going towards programs or actual care for people with hepatitis?

[ Page 17316 ]


Hon. C. Evans: The hepatitis strategy will provide prevention enhancements of $3.75 million this year, including a universal infant and child catch-up hepatitis B immunization program and a hepatitis A vaccination; targeting persons infected with hepatitis C and injection drug users; co-access to care and quality-of-care enhancements for those infected by viral hepatitis of $1.25 million this year, including a hepatitis strategy secretariat to improve and coordinate health services; and enhanced laboratory testing to better integrate data between organizations and improve the quality and efficiency of surveillance and care.

J. Reid: Well, I appreciate the minister reading the information that I was able to read myself. The question was: how much of that money is going towards the secretariat? How much is going towards programs?

Hon. C. Evans: I'll get that information for you. It's not in my documents either.

J. Reid: I guess I just want to express with this particular point the frustrations that people in my community with hepatitis C have felt with the difficulty of accessing programs and the shortfall of dollars. So of course there is a great interest if there's a secretariat. And again, if there is, if these people. . . . If the information they've given me is correct, then there is a lack of programs to access.

Having a secretariat there is not going to do much good if we're also not providing the services that these people need -- therefore the question of the balance between the money going towards a secretariat. I can imagine some of the people that I've come to know fairly well and their reaction to an announcement that there's going to be a secretariat. So I certainly will be looking forward to receiving that information and getting those details, and I'm sure there will be a lot of people in this province looking at that as well.

My last question concerns the nurse line that is going to be set up to offer 24-hour toll-free access. I know that this is the result of a pilot project that took place. And I did do some reading about that pilot project.

The piece of information that I'm missing is that with the pilot, how many. . . ? What kind of savings were realized through that? Were there actual. . . ? Was there any way of determining whether there were doctor visits saved or visits to emergency saved through that project? I guess to extend that is looking at what kinds of benefits other than general information benefits. But will there be a real benefit, by number, of decrease in visits to emergency wards or to doctors? Did that come out of this pilot project?

Hon. C. Evans: Hon. member, the answer to your previous question -- obtained -- is $300,000 to the secretariat. The location is the B.C. Centre for Disease Control. And the function is coordinating all the various hepatitis initiatives.

The answer to your second question. . . . I don't have the figures right here of the savings in the pilot, and we will attempt to get them. I'm not sure if they're here in this room tonight, so I'll get them to you over time if not.

J. Reid: The general question, then, at this point in time: is there an expected saving as far as visits? Or is it just an education component? Where there is an indication, is there an expected savings in actual visits?

Hon. C. Evans: There is the expectation of a savings. However, that's the information that I can't document here tonight. It was part of my comments earlier, in introduction, when I was trying to say the booklet costs $8 per household, and we expect to save at least one visit, which is $12. But the specifics of a pilot I don't have here, and I'll try and get that.

J. Reid: My last question has to do with nurse practitioners. I was listening earlier, and if this has been covered, I apologize, because I didn't hear about it. I do know we have nurse practitioners in the province already. Is this looking at working together with other partners to understand how best to educate, regulate and deploy? Since we already have them, are we trying to reinvent the wheel here? Is there something that already exists that we should be tapping into?


Hon. C. Evans: We have people in the province, hon. member. . . . This is a really good question, because I've been asking this question for weeks, actually. We have nurse practitioners who are called nurse practitioners by themselves and by the doctors they work with and aren't paid as nurse practitioners because the province doesn't have such a designation. We have nurse practitioners who used to work for the federal government -- this is the case in the Cariboo -- who are devolved away from the federal government, because they have abandoned that job. So we are going to develop a nurse practitioner category and try to coordinate what's going on in the province.

We have nurse practitioners right here in this city -- right next door at the James Bay clinic -- doing the kind of work that's done elsewhere by doctors. And that happens all over rural B.C. In Nelson, the internist has nurse practitioners working with him. But it's essentially an agreement between the nurse and the doctor. We are going to attempt to formalize that, because we perceive an excellent opportunity in expanding the work that RNs can do by getting training for the nurse practitioner designation.

J. Reid: Just as you mentioned earlier about the registry for hospital beds and being able to look at another model and copy that model. . . . Nurse practitioners, as you say, were under the federal government program. I believe we do still have them in British Columbia. I believe there's still a nurse practitioner in Anahim Lake, from the last I heard. Again, is there a model, then, that we're looking at so that we're not reinventing this? Obviously if there is a need, if there are people who are willing to be trained, we would like to be able to get this going as quickly as possible. I would join with the minister in saying that yes, it's a question that's asked quite often. Because these programs exist in other places, it sounds like we should be able to use that example and roll that over and get this going fairly quickly.

Hon. C. Evans: I think it's more of a case of formalizing for the ministry what is already happening, as you point out. We will assist you with the answer as we move to figure out what the designation is.

The Chair: I guess the natural order of things is out of order again. We're going to have a ten-minute recess.

[ Page 17317 ]

The committee recessed from 12:04 a.m. to 12:14 a.m.

[D. Streifel in the chair.]

J. Dalton: I just have two issues to take up with the minister. The first is some of the initiatives that the health report has addressed dealing with stop-smoking programs -- two in particular. I think the minister can certainly respond to the status of these: Quit Line and Kick the Nic 2000. Now, the provincial health officer says that specific targets for accessibility and program usage have not yet been set. Of course, this is the '99 report, but we are now near the end of 2000. Can the minister advise us as to the status of those two stop-smoking programs?


Hon. C. Evans: I can't. They're not part of the health action plan. We'll try to assist the member in future with getting the information he requires.

J. Dalton: The other issue that I want to address. . . . Perhaps at least indirectly the stop smoking may be in this. It's the health guide program, which is in the action plan. We're advised that early next spring -- one might speculate on when that will be -- every household in this province will be receiving a health guide. The health guide, we're told, will cost $8 per household, and there are 1.5 million households in the province that will be covered with this. The initial start up cost of $13 million and an $8 million annual operating budget. . . . My first question to the minister on this would be: does this in fact cover every household in the province, including apartments and all the other things that people dwell in? I'm just rather curious as to whether 1.5 million households actually would cover all British Columbians.

Hon. C. Evans: It is our anticipation that a household will get a booklet even if they don't have a house.

J. Dalton: Well, perhaps in a way the minister anticipated my next question. Are we also addressing the homeless and itinerants and people who don't normally have a residence in which they can receive mail or documentation?

Hon. C. Evans: That was a really good idea, and it never it occurred to me. We'll take it under advisement.

J. Dalton: Can the minister advise us as to -- maybe not exactly when but within a reasonable target -- when these guides will actually be sent out to every household in this province?

Hon. C. Evans: I'm advised that the first booklets are supposed to go out in the middle of January. We will aim for that -- and the hon. member won't hold me to a specific date. I'm also advised that the chair of the mid-Island health council thinks it's the best investment we could make. I think that is a perception shared by lots of people on Vancouver Island who have seen the experiment in the pilot.

J. Dalton: One other aspect of this. I also read that there was a pilot project in the capital region, and 11,000 households were covered in this pilot project, including providing access to a nurse advice line from 3 p.m. to 11 p.m. Does the ministry have any stats or figures as to any evidence that there might be any health savings realized by this pilot project?

Hon. C. Evans: Not here tonight.

J. Dalton: Would I take it that "not here tonight" means that they may be available and we could expect them at a future date? All right, fine.

Just one other point and I'll be finished. The $13 million startup. . . . Now, my math -- and I think I'm reasonably accurate -- is that $12 million is for the handbooks, because they're $8 times 1.5 million households. What is the other $1 million for? And the $8 million annual -- what expenses would that cover?

Hon. C. Evans: It is my belief that it is the startup costs of connecting the booklet to the phone-line service. The annual cost is the cost of the 24-hour telephone service, which is part of the booklet.

K. Whittred: I would like to concentrate some questions on the home care services specifically itemized in the action plan. First of all, I wonder if the minister can tell me: how much is the total amount in the budget for all home care services?

Hon. C. Evans: Ask your next question while we look up that first answer. I don't have it right in front of me.


K. Whittred: Where I'm trying to go with this is to get a clear picture of how much is being added. It says in the home care backgrounder that there is $9.3 million being added. Now, I recollect that there was also an addition in the September Health special session that we had. What I'm really wondering is: is this the same money? Is this additional money? You then in the backgrounder talk about $32.3 million being added. So I'm just wondering: what is the budget, and how much of this is actually new money now?

Hon. C. Evans: The 1998-99 budget for home support was $216 million. This is an addition of $9.3 million, and it is new money, not related to any previous announcement. The hon. member could do the math. It looks to me like 4 or 5 percent.

K. Whittred: I wonder now if the minister could explain to me: what, then, is the $32.3 million that is to be made available?

Hon. C. Evans: The $9.3 million is this fiscal year; the $32.3 million is the annualized cost for next year's budget of increase to home support. I beg your pardon, over two years -- $32.3 million is the increase over two years. Next year's increase will be $23 million. . . . The $9.3 million is this year's fiscal increase. Next fiscal year it'll be $23 million. The total increase over the next two years is $32 million. Does that answer your question?

K. Whittred: So just to reiterate, then: the $32.3 million would include the $9.3 million that is going in this year, plus the increase that's going to come next year and the subsequent year. I see the minister shaking his head, so I'm going to assume that is correct.

Now, following out of that, we have this home care budget. I wonder if the minister can tell me the breakdown of

[ Page 17318 ]

those expenditures. For example, does the home care budget include adult day care, or is that a separate budget? Or does it include some aspects of residential care where you have group facilities and meals, for example, being prepared? Is that part of the home care budget?

Hon. C. Evans: No.

K. Whittred: The Coalition of People with Disabilities estimates that there have been some 20,000 people that have been eliminated from home support since 1994. And I'm wondering: does the ministry have any idea? Have these people been trapped? Does anyone know what has become of these 20,000 people who in 1994 were receiving home support and in the year 2000 are not?

Hon. C. Evans: No. And in saying no, I do not wish to authenticate or argue with the number. I can't. We haven't tracked those people. And I am not authenticating or arguing with the hon. member's assertion that 20,000 people lost home care.


K. Whittred: Will the minister acknowledge that in the changes to the requirements for home care there have been significant reductions in the number of home care clients, while at the same time there have been increases in the moneys and hours available for home care clients?

Hon. C. Evans: Yes.

K. Whittred: All right. Going to the next question, now, the backgrounder claims that there are going to be sufficient moneys to help some 1,800 British Columbians. This is the number that is used in the backgrounder. And it says: ". . .enhanced home support to help more than 1,800 British Columbians move from hospitals to supportive home environments." Now, can the minister tell me what level of care -- an approximation, I suppose -- these 1,800 people, who are currently in hospital, are receiving? And when I say level of care, I mean within the normal vocabulary that is used within the continuing-care system.

Hon. C. Evans: No, I cannot. However, I didn't anticipate the question. And I assume we can get the information for the hon. member.

K. Whittred: All right, then, going on from there, would it be possible for the ministry to give any kind of evaluation of the kind of home support that these 1,800 people, who are currently in hospital, are apt to need if they are to be moved into a home setting? Do you think that it is a possibility?

Hon. C. Evans: It's a really difficult question to answer. I think, hon. member, the individuals would not be released from hospital unless they're assessed -- and assessed that they can and would do well in a home care setting. My guess is that the assessment level of care will vary with the 1,800 people. But making a great generalization here, it is assumed that in the main, these will be people who are not suffering from an illness or an injury that requires the acute care facility but have recovered from whatever brought them to the hospital in the first place.

K. Whittred: The reason for these questions to the minister is that I sense that this money is not probably adequate to supply the kinds of services that are necessary. I recognize that the questions I've asked the minister are very difficult for the ministry to answer, because they're talking in populations rather than in specifics.

But if we take the money that is to be added to the budget, $9.3 million, there's a couple of ways that we could talk about this scenario. If all 1,800 of these individuals or even a significant portion of these individuals were extended-care-level people, and there has been a suggestion to me that is in fact what they are. . . . An extended care person on home support costs about $250 a day. If you multiply that by 365 days for the year, we're talking about $164.25 million. I simply throw that out to the minister.

Another way of doing it, which is perhaps even a little less onerous to the ministry, would be to just hypothesize that each of these 1,800 people would be assessed for four hours of home support a week. Four hours of home support a week is not very much. But if we took four hours -- and I'm not sure what it costs -- and worked it out at a simple number of $25 an hour, which would be $100 a week per client, we'd come up with a figure of $9.36 million per year.

I am questioning the feasibility of this statement in the health action plan that 1,800 people can actually be moved out of hospital. I'm assuming that these are long-term residents in hospitals that are to be moved into a home care situation. I seriously question whether or not the numbers given in the action plan are feasible.


Hon. C. Evans: I really support and agree with the hon. member's line of questioning. We need more money, as she knows. That's why some home care services were eliminated in order to provide more services for other people. I would encourage her to vote for the measure when it comes up and then continue to support increases in future until we have adequate home support for everybody that needs it. Her math, I think, is defensible.

K. Whittred: I do thank the minister for commenting on my math. I've always considered myself to be a wee bit mathematically challenged.

I wonder if the minister could give us some sense in the health action plan. . . . What would be the intent, what would be the expectation of what would be a reasonable level of care for home care clients?

Hon. C. Evans: No, I can't. There's nothing I can say in a global sense that would apply to the individual, and I refer to my earlier comment. As people are discharged from the hospital, they'll be assessed, and they will receive the level of care that the assessment says they require.

The question, I think, relates to the estimate of how many people we can move out of the acute care facility. But I think the hon. member would agree that we need the $9.3 million in order that some people leave the acute care facility. And I'll agree, if it helps her, that the number that is put forward in the plan is theoretical. We may not meet that target, and we'll need more money next year and the year after and every year in future as the population ages.

K. Whittred: I will shift gears a bit now and move to just a couple of questions about the North Shore region, if I might.

[ Page 17319 ]

The North Shore region, as I understand it from speaking to the health authority, has been allocated 53 residential beds, and these are to be provided in any of the public facilities in the region. I'm just pointing out that the North Shore region is one of the areas that has a higher-than-average-aged population, and the need is much greater than 53. I think that this has been pointed out in many other cases. The North Shore region does have a site, and it is ready to go ahead with another facility should moneys be forthcoming.

One of the questions that I was asked to put to the minister by the North Shore health authority regards the promise of funding. I am assured by the health region that they have been promised renovation money for the MRI -- which, quite thankfully, we got in the last Health funds -- and for operating funds for the MRI. However, that is simply a verbal agreement. I'm wondering when the North Shore could expect to have that promise of renovation money and operational money in a written agreement.


Hon. C. Evans: The short-term answer is: after we allocate the funds, which hopefully will happen in a few minutes. The middle-term answer is: when we get a delivery date for the equipment. The long-term answer -- and I think what the hon. member wants -- is yes. The unit will be funded with operational costs when it's delivered.

K. Whittred: My last question that arose out of my conversation with the health authority is that. . . . Apparently there is real need in the province for some guidelines for hospitalists, which are apparently becoming more common. These are in-house physicians, which are being utilized in a number of hospitals, including Lions Gate. But there is a problem, because guidelines around the sort of contractual arrangements that are used for physicians are not in place on a provincial scale. I wonder if the minister could suggest when the regional authorities might expect some sort of guidelines.

Hon. C. Evans: Pretty soon.

J. Wilson: It's been a long day and a long night, and I'll be brief. I'm sure the minister would appreciate that too.

We have been reviewing this health action plan all day. Short of some equipment purchases which I believe are coming fairly soon, the rest of this plan is geared to kick into effect a few months to several months down the road. Is there anything in here that is going to give some immediate relief to the health care crisis which we face in G. R. Baker Memorial Hospital in my riding? I'm going to deal specifically with a local issue; I'm not going to go into the generalities of this policy. Is there anything in this plan that will give us any immediate relief in our crisis there?

Hon. C. Evans: The staff is looking for specific increases to the health authority region or the Quesnel hospital. But I'll say generally, while they do that, that I wasn't. . . . In our discussions with doctors and others in Quesnel when we were there, they spoke quite eloquently of the need to make the whole system work. A great deal of our conversation was about the capacity of rural doctors to refer their patients either north to Prince George or south to Vancouver. A great deal of the health action plan -- I won't go into it, but I'm sure the hon. member knows -- is aimed at dealing precisely with that, either with bed access when they get where they're going or with the difficulty that Quesnel doctors have locating an appropriate bed.

The hon. member will know high-profile cases in Quesnel where that time difference, that difficulty, had an impact -- quite a serious impact -- on individuals. So in a systems sense, I hope the hon. member knows that the debate all afternoon will have impact in Quesnel, just as it will in Nelson or Castlegar.

The precise funding for the Quesnel and district equipment is $118,000. The precise funding for Cariboo in home care is $113,000. And the precise funding for Cariboo in mental health is $24,633. Each of those, I think, will have a direct impact either on Quesnel or in the region in the short run.


J. Wilson: Does the minister have a breakdown as to what equipment that will involve?

Hon. C. Evans: No, I don't. As we said before, it's for the region to make that allocation.

The other thing I'd like to point out is that the Quesnel and district health council has requested funding for ICU upgrading for up to ten nurses. And as the hon. member no doubt knows, providing that training requires us to find backup funding for those nurses, to backfill while they receive the training. We haven't heard yet on the outcome of that request.

J. Wilson: I thank the minister for his answers. So the short answer is that in the immediate future, the next month, there will be no benefit from this package. That's my take on this. I see nothing that's going to give us immediate relief.

The ICU has been shut down since last spring. I've had some friends that have died. We had no ICU there; had we had one, there is a good chance that they would be alive today. We are suffering in that hospital; the health care there is suffering. I know we've heard about wreck after wreck after wreck today, all over this province, and they are real. We are suffering there as much as, if not more than, most areas in this province. And to wait a few months may be too late. We've waited six or seven months now. Nothing is happening.

We're talking about retraining. Is there not anyone out there today that this ministry could employ to come in and get that ICU up and running again? Is there no one available that they can hire to bring in trained nurses, hire them, employ them there to get the ICU going again? Can that not be done? Do we have to spend more months -- many more months -- retraining nurses to run it? Is the supply of nurses so short in the province of British Columbia that there is no one available to be hired?

Hon. C. Evans: The issue that the hon. member raises is precise and precisely critical. He is correct that it requires ten trained nurses to reopen the ICU, or at least that's what I heard when I was in Quesnel. There are nurses there who desire that training. What the nurses said and told us is that they desire to be able to upgrade and receive that training and deliver that care themselves. That does not preclude looking in the province for nurses to come there and provide the service in the short run. But I personally believe that Quesnel is better served if the nurses that are already there can provide

[ Page 17320 ]

the work. We need to look in the short run for nurses from elsewhere to provide the short term, but I still think we need to find ways to provide upgrading to the nurses in Quesnel who desire the training. They are the staff who have chosen that community, who want to live in that community, who want to do that work and who asked us, in the health action plan, to create more training spaces for upgrading and create funding to backfill so that existing nurses can get it. And that's what we've done.


J. Wilson: I don't disagree that the people who live there should be retrained, should get the upgrading to be able to operate the ICU. But in the interim we need some locum replacement to get it running. We can't wait. I live there; I know what goes on there. I know the things we're faced with. We need to hire some locum nurses to come in, to be able to get it going while these nurses are being retrained. We don't want to wait till next year to see it open again. We have to get it going again. This is critical. These are lives we're talking about here.

I've heard all day how you're going to bring in foreign-trained nurses. The straw that broke the camel's back in this ICU was a Canadian-educated -- not a Canadian. . . . She was educated right in Quesnel. She was forced to leave Canada with her children because she was Australian. Her husband died; she married a Canadian and has a Canadian family. With this program she tried to stay here. Immigration said: "You go back. You cannot work here." She was trained right here in British Columbia as a nurse. Why are we not doing something to keep her here? She has three children. One is old enough to be on their own; the other two have to leave with their mother.

This is what's happening. It's crazy. Why are this government and this ministry not doing something immediately to try and get her back to work in this hospital where she's been working for years, instead of saying: "You don't have the proper papers, so you leave the country"? This is, mind you, a federal matter, but I'm sure that the province has some say on these issues. We've got a program in place to bring people in. Here's one that's already here, already working and already trained, and we're throwing her out of the country with her children, who are Canadians. Where has common sense gone to? There is none.

Dialysis. In a hospital as large as G.R. Baker, there is no dialysis unit. I have an elderly gentleman. He's 78 years old. He has to drive 800 kilometres a week, on treacherous roads all winter, to get dialysis treatment. That is not right. We need a unit right there in that hospital. That's a piece of equipment that could be used, and we need the people to operate it.

Chemotherapy. What do you do if you need chemotherapy in Quesnel? You order it out of Williams Lake on a bus. They send it to you on the bus. Sometimes they lose it. When you go in for a chemo treatment, it takes a lot of mental preparation on the part of the patient. It's serious. You go in for a chemo treatment. You can't be sure it's going to show up on time when you're there. Maybe they have to send it again the next day, and you come back in.

That's not the way you run a health care system. It's stupid. For the sake of some more people in that hospital to be able to operate it. . . . I know of some nurses that are going to be 65 years old in a little while, who can't work any longer. They are perfectly fit; they want to work. They want to continue to work for another year or so. They're being told: "No, that's it. You're 65. Thank you, and goodbye." Why are we not allowing them to continue? We have such a shortage of nurses in that hospital. We need them; we desperately need them. Yet we're saying: "We can't keep you around any longer. You've reached that magical number. You're 65, and you can't be employed here any longer."


These are some of the issues that we're faced with. It is not serving the people in any way, shape or form. The issues of referrals have been a big problem. Prince George Regional Hospital is overflowing. You cannot depend on it as a referral centre. These are the short-term things. These are short-term measures that have to be dealt with -- not in six months, not in a year. They have to be dealt with right away -- right up front and right away.

When I go through this action plan, I see a lot of good stuff in here, but the thing that comes back to me. . . . You're going to train more nurses to work in rural settings, in the hospitals in these smaller centres. How are you going to keep those nurses there once they're trained? What is the thing that will keep them in that community to work there instead of moving to larger centres or elsewhere out of the country to get a job? Is there anything in place -- and I don't see it in here -- that is going to make them want to stay in that community and want to work there?

Hon. C. Evans: Thank you for your comments. Every single one of them I consider absolutely valid -- the need for short-term resolution of the ICU issue, their need for a dialysis machine, their need to resolve the referral situation both north and south, and the need to attract and then retain rural nurses.

On the issue of retirement-age staff, I believe there is some local health authority flexibility there, and I would encourage the hon. member to tell his constituents to discuss it with the authority. I am not aware of a provincial policy that requires these people to retire at 65.

His last item was whether or not there are retention initiatives for rural nurses in the health action plan. My observation in Quesnel and elsewhere was that the need for upgrading was the greatest retention issue that I heard in the rural areas. Nurses said: "Our industry is changing so fast that even if we enter with ICU skills or surgical skills, within a short time, if we can't upgrade, we lose those skills, and we can't afford to go to the city, take time off work to get those skills again." So the health action plan is attempting to say that there will be no prejudice, that we will backfill the training for rural nurses so that they can maintain their skills and stay where they are without having to move to the city.

J. Wilson: I appreciate that if you can supply the job and the training and the proper hours. . . . A big factor is not to burn out these people on the job. Today they're all burnt out. They're tired; they're overworked. There are a few nurses out there that refuse to work in emergency. They won't work under these conditions, so they go into other jobs in the community. If the working conditions in the hospital were better, we might be able to attract a few more back in. But I don't think that this is going to keep them there.

I don't see anything that will attract or work in favour of keeping a young person, who perhaps comes from a rural community and goes into a nursing program, graduates. . . .

[ Page 17321 ]

There will be some help, yes, through bursaries. It won't be everything to cover the education, but it will help. And when that person graduates, there is nothing I see here that is going to entice them to stay in that community and work there, when the demand for nursing is so great that they can probably go anywhere in Canada or the United States and end up with a better job or better working conditions than they're going to face right here in British Columbia.


Now, the same thing applies to medical doctors. We've got a few training positions opening up. This is long-term; it's down the road a long ways. But with what's been added in, we're still probably about 300 doctors short on this plan. So how are we going to attract them? Is there going to be a program to bring in foreign-trained doctors along with foreign-trained nurses? Somehow we have to fill the void that we've created here in this province. And I don't see where we're going to be able to do that, unless we really increase the training facilities right here in the province. Could the minister comment on that?

Hon. C. Evans: Yes. We've canvassed it earlier this evening. We've met with UBC and with the College of Physicians and Surgeons. There is going to be a 90-day evaluation program at UBC for foreign doctors. And then we're going to negotiate a requirement that those people work in rural areas or areas of need in exchange for coming to British Columbia.

J. Wilson: So they will get like some type of a bonus if they locate in an area where they're really needed. Is that what I hear? Or will it be sort of like a transition payment for them to help them move? How will it work?

Hon. C. Evans: No, it's not a question of a signing bonus or something. We are attempting to negotiate with UBC and the College of Physicians and Surgeons a system whereby foreign doctors who wish to move to British Columbia would go through UBC for 90 days. Their proficiency would be evaluated, and in exchange for being given an entry and a billing number, they would agree to go and work in a place where doctors are needed in British Columbia. So it would be like a period of time that they would serve in a community of need instead of having the ability to move anywhere they want in the province.

The Chair: Before I recognize the member for Cariboo North, there's a lot of ambient noise in the background -- a lot of conversations. It's making it difficult to track the debate. So if the members that are in deep conversation would take it down about 45 decibels, it would help the House tonight.

J. Wilson: So what time frame are we going to put on? I'll let the minister finish yawning, and then he can hear me. When a foreign-trained doctor comes in, how long will they be asked to work in a certain area before they can then move anywhere in the province? What is the time frame we're looking at?

Hon. C. Evans: Well, we're just in discussions with the college on that very question. A couple of ideas in the meeting that I had was 3 1/2 years and five years, but I can't give you a specific. We can't indenture someone forever. On the other hand, I personally feel it has to be a long enough period of time to allow the hospital to plan and allow them to get acquainted with the community in the hopes that they would then stay.

J. Wilson: Chair, I just have one further question: is the minister prepared to do something to try and keep the nurse that I referred to earlier, who's been asked to leave Canada with her two children -- to try to get her back here, back in her job where she was working last spring, in June? Is the minister prepared to take this on and try and get that person back in that job? You'll have to deal with the federal government on it, but it's something that has to be done. I mean, what happened here is wrong. Will the minister give me his personal commitment that he will deal with this in the next few days?


Hon. C. Evans: Yes, hon. Chair, if the hon. member will send me the person's name, I understand. I should probably know already, but I don't know the person's name. I don't want to give any guarantee that I can fix it. And I'm not the federal government. But I will work with staff to see what the story is and if the province can intervene.

J. Wilson: The other issue was on the retirement age. I know it's not government policy. They don't set any direction there; it's done by the CHC. But I'm sure that the government directive to the CHC is something that the CHC would weigh very heavily. So perhaps the minister could flesh that one out. This is a prime example of being able to retain a nurse or two that will help. It'll make a great deal of difference right there in that community if somehow the ministry could convince the policy-makers on retirement age that maybe they should make allowances for people if they're capable of working.

Hon. C. Evans: Well, I think the hon. member is saying that the CHC might have a policy around retirement. I will try to understand. I will not commit to changing their policy. But I will try to understand if there's some local impediment in the way.

G. Abbott: Hon. Chair, I know it's getting very late. I've sent a note to the minister to advise that my questions would be specific to the North Okanagan health region, which of course contains the constituency of Shuswap. So I hope that he will be able to readily answer the questions, which I will attempt to frame in as brief a fashion as possible.

One of the principal concerns of the North Okanagan health region is multilevel care. We are currently, in the North Okanagan health region, over 150 beds in deficit in long-term care. In many cases people are occupying acute care beds necessarily but inappropriately. It is expected that by 2005 we will be more than 400 beds in deficit for multilevel care, so obviously it's a big concern. My understanding is that the North Okanagan health region is being allocated 126 beds, multilevel care.

The information I would like in my first question is: are there planning funds available to the North Okanagan health region for multilevel care in the current budget year and for the coming budget year?

Secondly, are there dollars available for capital in the current budget year or in the coming budget year? I ask this

[ Page 17322 ]

question based on the backgrounder provided by the minister, which says, about continuing-care beds: "The first of the beds are expected to open in April 2002. All beds will be open before the end of 2005." Can the minister advise what the North Okanagan health region can expect on multilevel care?

Hon. C. Evans: The allocation of operational funding of 126 beds is correct. On the question about planning, we have a global budget in the ministry of $2 million to work with health authorities to do long term care planning. And we have a dedicated staff available to assign to that function. However, I think the hon. member's question about planning may be capital planning. If it's capital planning, I can't answer that question today; I don't have the capital plan here today.


The health action plan doesn't have a capital allowance, and I will attempt to get for the hon. member and share with him whatever planning funds are in the works or whatever capital funding is in the works for the North Okanagan region at this time.

G. Abbott: I'd be most appreciative of that, as I'm sure the North Okanagan health region would.

In response to a question from my colleague from Okanagan-Penticton a little earlier this evening, the minister laid out what I understood to be a formula for multilevel care funding for the future. As I understood that formula -- and hopefully I can get some clarification on this -- the minister said one-third B.C. government, one-third non-profit society and one-third private sector. Now, is that a tentative formula, a conceptual formula? Or is this strictly the way we are going to be going in the years ahead, in terms of funding those beds and those facilities?

Hon. C. Evans: Let me say that it's a target. It is the desire of the government to deliver this program on the one-third, one-third, one-third basis. It is assumed that there is probably unused capacity in some private facilities right now. There's probably some unused capacity in some public facilities right now, and those will probably be the first ones filled. It's also presumed that the non-profit sector desires, or may have a capacity or desire, to put up new buildings. But it's a target, not absolute.

G. Abbott: I appreciate that clarification from the minister.

With respect to new equipment, my understanding is that $800,000 is earmarked for the North Okanagan health region. Could the minister advise what portion of that, if not all of it, is in the current budget year? What is allocated or earmarked for the 2001-02 budget year for equipment? And can the minister advise whether the equipment will be reflecting the priorities of the North Okanagan health region?

Hon. C. Evans: The answer to the first question is yes; $803,000 is the correct number. The answer to the second question is that, unlike most of the initiatives -- home care, flex-beds and the like, which are multiyear funding because those are program initiatives that you have to be able to deliver with staffing and the like -- the equipment budget is one-time only. You'll have to wait until next year's budget to see what the equipment funding for next year would be.

The answer to the third question is the same answer I've given earlier today. The only proscription that the ministry has placed on it is for very expensive equipment, like MRIs and CT scanners. The main allocation of equipment is up to the health authority.

G. Abbott: My final question here with respect to the expectations of the North Okanagan health region. . . . I understand that the region will be invited to submit proposals for other dollars: in the case of NOHR, in the neighbourhood of $600,000 -- that being for things like home care, mental health diversions and so on. If that is the case, perhaps the minister can confirm that and advise what constraints or parameters will be placed around that allocation for the North Okanagan health region.

Hon. C. Evans: I think that, if I heard correctly, the member is absolutely right. The North Okanagan can apply for $312,000 in home care, $288,000 in flex-beds and $67,000 in mental health. The criteria are essentially meeting the objectives. It's sort of outcome-based funding. We're looking for the best plan to create flex-beds. We're not telling the people how to do it. We're saying: "Tell us for the outcomes."

R. Neufeld: Minister, I only have a few questions also; they'll be fairly brief. The first one is: can the minister tell me how much money for equipment funding will go to the North Peace CHC and also the Fort Nelson CHC?


Hon. C. Evans: The Fort Nelson envelope funding is $19,886, and the North Peace is $123,554 -- for equipment.

R. Neufeld: Does the minister have what that equipment would be -- the $123,000 for the North Peace community health council?

Hon. C. Evans: No. We're not prescribing the equipment purchases except for the larger items.

R. Neufeld: On the backgrounder for the South Peace CHC, I see a CT scanner for Dawson Creek. Is that a new CT scanner to take the place of the present one? Or what is that for?


R. Neufeld: We'll do that.

I see also in the backgrounder information that Fort St. John will get two positions for ambulance service, which is appreciated -- long overdue. I know it's a stretch, but I want to ask something about air ambulance service out of the north. We rely so much on air ambulance service, and I know that's not part of the Ambulance Service. But I want to tie it together, Chair, simply because we have so many people flown out of the North Peace and South Peace area to Alberta for health care. I had a patient just yesterday who had a heart attack. They could not find a bed in Vancouver or anywhere in B.C.; they didn't have one in Edmonton. They had one in Calgary.

They refused to fly to Calgary because, I'm told, air ambulances now won't fly into Calgary; that's what the lady was told. She had to wait a period of time in Fort St. John. And they finally took her to Edmonton, where they made room. Can you tell me when that change took place?

Hon. C. Evans: The answer to the previous question is that the CT scanners are replacements.

[ Page 17323 ]

Staff don't appear to be able to come up with a rationale for what appears to be. . . . The hon. member is saying it's a policy decision. We don't know of any such policy decision. I'd appreciate the particulars of the case, and then I'll trace down what happened there.

R. Neufeld: Can the minister tell me how much the new CT scanner is going to cost for Dawson Creek-South Peace CHC?

Hon. C. Evans: It's $1.2 million, and I'll tell you if it's anything different.

R. Neufeld: It's $1.2 million. And there are funds allocated along with that to operate the new CT scanner, I assume.

Hon. C. Evans: Yes.

R. Neufeld: Thank you. We're moving right along. I have one more question, and again it's to do with some comments the minister made in his introductory remarks -- that British Columbians should get the care they need in British Columbia. Apparently another change in direction. . . . I have a gentleman who needs a lung reduction in Fort St. John. The ministry no longer funds lung reductions. After the doctors in Fort St. John made arrangements for this person to go to Vancouver, the person was informed that British Columbia does not fund it: "Go look someplace else."

It's absolutely amazing, because I listened to the minister, and I believe he meant what he was saying -- that British Columbians should receive the help that they can within British Columbia. Can the minister tell me: do I have to, through my office, make arrangements in the U.S. or in Alberta for this gentleman to get this work done? Or are we going to actually look after getting this kind of work done within British Columbia, as I think it should be done?


Hon. C. Evans: I'm unable to answer the question of whether or not a lung reduction is a funded operation in British Columbia. Again, I'll seek the information and share it with the hon. member. I'm also unable, in the short run, to say whether or not it used to be, so I'll have to get back to you.

R. Neufeld: To the minister, quickly: I notice the funding again, and it seems to be constant. It was in the budget last year. And I know we need money all over the north. South Peace, just by CT scanner, gets $1.2 million; North Peace, $123,000; Fort Nelson, $19,000 for new equipment.

I know the hospital in Fort St. John needs a lot of work. And I just wonder: did the CHC in North Peace actually have the opportunity to present to the ministry what they needed for equipment and funding for capital projects in North Peace, the same as the South Peace did? And how was the decision made to again spend vastly more dollars in South Peace than in North Peace?

I tell you, when you look at it -- I'm sure you know the demographics; you've travelled around the province -- if there's any part of the province that's growing with people and has been growing with people over the last while, it is North Peace. In fact, that's been proven by having to take people from North Peace, from my constituency, and move them into South Peace in the reallocation of constituencies so that they had enough people in South Peace. So I continually see a draw going south of the river in a huge amount. North of the river we get less, yet we're growing. We have a younger population and a population that works in a huge industry, the oil and gas industry, which is very dangerous, and in the forest industry -- not so much in Dawson Creek.

I just wonder. I've asked for that rationale from every minister going. I guess there are six of them that I've asked, and I'm going to ask you for your input into why you think that continues to happen.

Hon. C. Evans: In the interest of the hour, let me say that I don't know. I'll try and figure it out, and maybe you can help me understand.

Vote 36(S2) approved.

Hon. C. Evans: I move that the committee rise and report resolution -- with thanks to the staff.

Motion approved.

The committee rose at 1:17 a.m.

The House resumed; the Speaker in the chair.

The committee reported resolution.

The Speaker: When shall the report be considered?

Hon. P. Ramsey: I move that the report of resolution from December 7, 2000 -- actually, I guess it's December 8, 2000 -- be now received, taken as read and agreed to.

Motion approved.

Hon. P. Ramsey: I move that there be granted from and out of the consolidated revenue fund the sum of $212 million. This sum is in addition to that authorized to be paid under section 1 of the Supply Act, 2000-2001 and section 1 of the Supply Act, 2000-2001 (Supplementary), and is granted by Her Majesty towards defraying the charges and expenses of the public service of the province for the fiscal year ending March 31, 2001.

Motion approved.

Introduction of Bills


Hon. P. Ramsey presented a message from His Honour the Administrator: a bill intituled Supply Act, 2000-2001 (Supplementary No. 2).


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

Motion approved.

Bill 34 introduced, read a first time and ordered to proceed to second reading forthwith.

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The Speaker: We'll distribute the bill. If members can remain seated, please.

Hon. P. Ramsey: Hon. Speaker, this government is committed to seeking the approval of the Legislative Assembly prior to committing legally to additional funds. The use of supplementary estimates is consistent with the spirit of the Budget Transparency and Accountability Act and with the recommendations of both the Enns committee and the auditor general.

This supply bill is introduced to provide supply for the operation of government programs for the 2000-01 fiscal year, as outlined in Supplementary Estimates (No. 2) tabled earlier. The bill will provide the additional funds required to defray the charges and expenses of the public service of the province for the fiscal year ending March 31, 2001.

In accordance with established practice, the government seeks to move this bill through all stages this day.

The Speaker: Thank you, minister. In keeping with the practice of the House, the bill will be permitted to advance through all stages in one sitting.

(second reading)

Hon. P. Ramsey: Hon. Speaker, I move that Bill 34 now be read a second time.


Second reading of Bill 34 approved unanimously on a division. [See Votes and Proceedings.]

Bill 34, Supply Act, 2000-2001 (Supplementary No. 2), read a second time and referred to a Committee of the Whole House for consideration forthwith.



The House in Committee of the Whole (Section B) on Bill 34; D. Streifel in the chair.

Section 1 approved.

Preamble approved.

Schedule approved.

Title approved.

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

Motion approved.

The House resumed; the Speaker in the chair.

Bill 34, Supply Act, 2000-2001 (Supplementary No. 2), reported complete without amendment, read a third time and passed.

The Speaker: Members, if you could just wait. We're expecting the Administrator.

His Honour the Administrator entered the chamber and took his place in the chair.

Clerk of the House:

Supply Act, 2000-2001 (Supplementary No. 2)

In Her Majesty's name, His Honour the Administrator doth thank Her Majesty's loyal subjects, accept their benevolence and assent to this act.

His Honour the Administrator retired from the chamber.

[The Speaker in the chair.]

Hon. G. Janssen: I move that the House at its rising do stand adjourned until it appears to the satisfaction of the Speaker, after consultation with the government, that the public interest requires that the House shall meet or until the Speaker may be advised by the government that it is desired to prorogue the fourth session of the thirty-sixth parliament of the province of British Columbia. The Speaker may give notice that he is so satisfied or has been so advised, and thereupon the House shall meet at the time stated in such notice and, as the case may be, may transact its business as if it had been duly adjourned to that time and date. And in the event of the Speaker being unable to act owing to illness or other cause, the Deputy Speaker shall act in his stead for the purpose of this order.

With that, I wish everyone a joyous and safe holiday season.


Motion approved.

Hon. G. Janssen moved adjournment of the House.

Motion approved.

The House adjourned at 1:36 a.m.

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