2009
Legislative Session: First Session, 39th Parliament
HOUSE BLUES
This is a DRAFT TRANSCRIPT ONLY of debate in one sitting of the Legislative Assembly of British Columbia. This transcript is subject to corrections, and will be replaced by the final, official Hansard report. Use of this transcript, other than in the legislative precinct, is not protected by parliamentary privilege, and public attribution of any of the debate as transcribed here could entail legal liability.
(HANSARD)
THURSDAY, NOVEMBER 19, 2009
The House met at 1:34 p.m.
[Mr. Speaker in the chair.]
Routine Business
Introductions by Members
L. Popham: I have friends and family in the gallery today. I have Jenny Popham; Sandra Jakes; Dennis Jakes; Lorna McClintock, my mom; and Lori-Anne Meyersco. I would also like to welcome Chris Malinoski from the Oak Bay fire department; his son Joe; and his father-in-law, Sam Holden. Please make them welcome. [DRAFT TRANSCRIPT ONLY]
Hon. J. Yap: In the gallery today are two good friends and constituents, Andy Hobbs and Lynn Hobbs. Would the House please make them very welcome. [DRAFT TRANSCRIPT ONLY]
J. Brar: Visiting us today are two very special guests from India. We have with us Joginder Pal Jain, hon. Member of the Legislative Assembly of Punjab, and he is also a very successful business person from Moga. [DRAFT TRANSCRIPT ONLY]
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He is also accompanied by his wife, Mrs. Swaran Jain, who has served first as a councillor and then as the mayor of the city of Moga. There seems to be some sort of competition going on in the Jain family in that way. [DRAFT TRANSCRIPT ONLY]
They're accompanied by two good friends of mine, Dr. Bhupinder Singh Dhaliwal and Dr. Pavitra Singh Basi. I would ask members from both sides of the House to please make them feel welcome. [DRAFT TRANSCRIPT ONLY]
Hon. M. Stilwell: I'd like to introduce two special guests and good friends who are here today from Vancouver: Mr. Larry Garfinkel, previously a social worker and now a publisher of first nations art, and his son Daniel. I ask the House to make them welcome. [DRAFT TRANSCRIPT ONLY]
N. Simons: Joining us in the House today is Matthew Louie, member of the Cowichan Tribes and currently community development office coordinator for the Institute for Child Rights and Development. Would the House please make him welcome. [DRAFT TRANSCRIPT ONLY]
Hon. R. Hawes: Today on the floor visiting us is no stranger to any of us, a man whose career here in the Legislature spanned some three decades. He has served in almost every ministry there is and served a term as a very, very distinguished and admirable Speaker. No reflection, Mr. Speaker, on your great abilities. Mr. Claude Richmond joins us on the floor of the House. Could we all make Claude feel most welcome. [DRAFT TRANSCRIPT ONLY]
M. Farnworth: I want to join with my colleague from Mission-Abbotsford to welcome the former member from Kamloops. We can only assume that he's here to pitch in for cabinet during question period. [DRAFT TRANSCRIPT ONLY]
Hon. K. Krueger: We have some guests from Kamloops that I'd like to introduce on behalf of the member for Kamloops–North Thompson and myself and all our constituents. They are so important that we reserved the entire west gallery for them. They are from Domtar, a pulp mill that has not only survived but is thriving in the tough economic times, a pulp mill that serves two dozen sawmills in our region and has diversified its markets in incredible ways. We're very proud of them. [DRAFT TRANSCRIPT ONLY]
With us we have Eric Ashby, who is the mill manager; Bill Adams, who is the manager of engineering services; and Bonnie Skene, who is the public affairs manager and hails from the frozen part of Canada in the east. I ask the House to join us in bidding them a really warm welcome. [DRAFT TRANSCRIPT ONLY]
J. Kwan: I have some very special guests visiting us today in the gallery. They are instructors and students from the SFU interpretation and translation program. The five instructors are Heather Charest, Winnie Cheng, Sandy Shea, Grace Lee and Wendy Steinberg. [DRAFT TRANSCRIPT ONLY]
I should just pause for a moment and say that Grace Lee was a former student of this program who later on came to my office and worked as my constituency assistant and is now the instructor of that program. [DRAFT TRANSCRIPT ONLY]
They are here to learn about the Legislature and to see the legislators in action. I hope that members will use language that they could easily interpret and translate. Would the House please make them very welcome. [DRAFT TRANSCRIPT ONLY]
D. Hayer: I would like to introduce two very special guests and friends, Morry Hubburmin and his son Ethan. Ethan Huberman was instrumental in helping us advocate for hundreds of millions of dollars of additional federal funding we received from the federal government for the South Fraser perimeter road. This was a result of his hard work with many MPs, MLAs, several chambers of commerce and many boards of trade, including the Canadian Chamber of Commerce. Would the House please make them very welcome. [DRAFT TRANSCRIPT ONLY]
G. Gentner: It's with a great deal of pleasure that I introduce to the House today a constituent of mine and also a teacher for the North Delta high school. He's also now the president of the Delta Teachers Association. Could the House please welcome and give a cordial welcome to Mr. Paul Steer. [DRAFT TRANSCRIPT ONLY]
L. Reid: On behalf of Mr. Speaker, I would like to welcome two representatives from the British Columbia Automobile Association who are in the gallery this afternoon. Craig Edmondson, Advocacy and Government Relations, and Trace Akers, Communications and Government Relations, are visiting Victoria from their base in Burnaby. I ask the House to extend a warm welcome. [DRAFT TRANSCRIPT ONLY]
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H. Lali: Hon. Speaker, I too would like to join the Minister of State for Mining and the NDP House Leader in welcoming back to this hallowed hall of fame the former member — a long-time member — for Kamloops, the silver fox from Kamloops, Mr. Claude Richmond. [DRAFT TRANSCRIPT ONLY]
Also, I would like to join my fellow member for Surrey-Fleetwood in welcoming the guests from India, MLA Joginder Pal Jain and his wife, Mrs. Swarn Lata Jain, as well as Bhupinder Singh Dhaliwal and Pavitra Singh Basi. I would like to join my colleague in welcoming them — both sets of introductions that were made earlier. Would the House please make them welcome. [DRAFT TRANSCRIPT ONLY]
D. McRae: I'd like to make two introductions today. First of all, I'd like to introduce Nicole Murillo from the Comox Valley. She's here visiting today. I'd like the House to make her welcome, please. [DRAFT TRANSCRIPT ONLY]
Second of all, from my wife Deanne and my daughter Gracie, we would like to announce the birth of our baby daughter born on November 6 this year, 7 pound 2 ounces, healthy. And for goodness' sake, she looks like her mother. [DRAFT TRANSCRIPT ONLY]
Hon. M. Coell: There are a number of members of the Association of Canadian Mountain Guides in the gallery today. Mountain guides are often involved in saving lives in the back country of British Columbia. With the winter avalanche season fast approaching, I think it's appropriate that we thank them for their hard work and dedication in making our mountain activities safe. Here today are president Keith Reid, executive director Peter Tucker, board members Craig McGee, John Furneaux and Kimanda Jarzebiak. Would the House please make them welcome. [DRAFT TRANSCRIPT ONLY]
Mr. Speaker: I think the member for Comox Valley forgot something. [DRAFT TRANSCRIPT ONLY]
D. McRae: I was so excited, and it probably won't happen again, but my daughter's name is Chloe Stella McRae. [DRAFT TRANSCRIPT ONLY]
G. Hogg: There's clearly a degree of excitement and anticipation when one is elected to have their first session in this august chamber, and when that is sometimes tempered a little bit by the daily proceedings here, it's nice to know that that can be bolstered by the joy of actually having your birthday here as well. [DRAFT TRANSCRIPT ONLY]
We have, I believe, two members having their birthdays here today, and I would ask that we give great congratulations and joy, because I'm sure we're now their very best friends. It is the Solicitor General who's having his birthday today, as well as the member for Surrey-Panorama. [DRAFT TRANSCRIPT ONLY]
Mr. Speaker: Well, we certainly wish the two a happy birthday. [DRAFT TRANSCRIPT ONLY]
Hon. P. Bell: Speaking of birthdays, I can never resist the opportunity to make sure that I honour my colleague from Prince George–Valemount. Although her birthday is not today, it would fall on Saturday. I would ask that the House please congratulate the member on the fourth anniversary of her 49th birthday. [DRAFT TRANSCRIPT ONLY]
Statements
(Standing Order 25B)
Mr. Speaker: Would the Minister of Transportation wish that I'd get the Minister of Forests to withdraw those remarks? [Laughter.] [DRAFT TRANSCRIPT ONLY]
K. Conroy: I wonder what was happening nine months ago, but there's a birthday on our side of the House too. That would be my legislative assistant Amber Nash, who's celebrating her 30th birthday. [DRAFT TRANSCRIPT ONLY]
Private Members' Statements
TEN THOUSAND VILLAGES FESTIVALS
IN NORTHWESTERN B.C.
D. Donaldson: Hon. Speaker, we have become a culture that defines itself in terms of retail consumption. That was epitomized after the 9/11 bombings when the U.S. President said that the best thing people could do was to go out to the shopping malls. Likewise the strategy advocated by many advisers to address our current economic crisis is to go out and buy more stuff, despite the fact that overspending and greed was what led to the crisis in the first place. [DRAFT TRANSCRIPT ONLY]
Yet we remain a consumer culture, so reflecting on how we spend our retail dollars deserves attention. That is why I'm very happy to talk about the Ten Thousand Villages festivals taking place this week in the Hazeltons and next weekend in Smithers. [DRAFT TRANSCRIPT ONLY]
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Started by a Mennonite Central Committee worker more than 60 years ago, Ten Thousand Villages defined the fair trade concept long before it became a familiar term. [DRAFT TRANSCRIPT ONLY]
The festivals provide consumers access to products that have been fairly purchased from sustainable sources. The subsequent retail exchange is designed to benefit artisans, not maximize profits. [DRAFT TRANSCRIPT ONLY]
Ten Thousand Villages typifies fair trade, which is part of a bigger movement — community economic development. CED supports initiatives based on the triple bottom line — environment, social and economic — but also uses a lens about who benefits most from the transaction. After all, wouldn't it be better if the primary benefit of a retail transaction, whether it is artisan wares or natural resources, is to the local worker and producer of the goods rather than faraway shareholders? [DRAFT TRANSCRIPT ONLY]
That brings us back to the Smithers and Hazelton festivals. The volunteer coordinator in Smithers is Ann Marie Findlay, and in the Hazeltons it's Marian Penner, who says that spending money at Ten Thousand Villages provides income for poor folks in other parts of the world who have spent most of their lives on the street, mainly women. [DRAFT TRANSCRIPT ONLY]
As many of us make additional purchases leading up to the Christmas season, reflecting on who benefits the most from that retail exchange is vital. That is what the fair trade movement and Ten Thousand Villages are all about. [DRAFT TRANSCRIPT ONLY]
CHILD AND YOUTH DAY
AND RIGHTS OF CHILDREN
J. McIntyre: I rise today to speak in recognition of child and youth day in British Columbia and National Child Day in Canada on Friday, November 20. The national day has been celebrated across Canada since 1993 to commemorate the UN adoption of the United Nations convention on the rights of the child on November 20, 1989. [DRAFT TRANSCRIPT ONLY]
The UN convention has been ratified by Canada and endorsed by the province of British Columbia. This year marks the 20th anniversary of the convention, and in recognition, B.C. has also proclaimed tomorrow Child and Youth Day in British Columbia. [DRAFT TRANSCRIPT ONLY]
The adoption of the convention and the establishment of Child and Youth Day here in our province reflect the important recognition of the basic human rights that all children and youth are entitled to — that children are important and valued members of our society. [DRAFT TRANSCRIPT ONLY]
By endorsing the convention, British Columbia made a commitment to do our best to ensure that all children are treated with dignity and respect. This includes commitments to ensure that our children and youth are provided with their basic needs, are protected from harm and are given the opportunity to have a voice. [DRAFT TRANSCRIPT ONLY]
Celebrating Child and Youth Day is about celebrating children as active participants in their own lives and communities, as active citizens who can and should have opportunities to meaningfully contribute to the decisions being made that affect their lives. Above all else, this proclamation reminds us that children need love and respect to grow to their full potential and that we must always act with their best interests in mind. [DRAFT TRANSCRIPT ONLY]
The convention acknowledges that while parents have the primary responsibility for the development of their children, governments and communities have an important role to play in supporting and protecting our children. [DRAFT TRANSCRIPT ONLY]
I urge you all to take time on November 20 to celebrate the children and youth of British Columbia within your homes and your communities and to acknowledge the efforts of all those in our society who care for and serve our children lovingly each and every day. [DRAFT TRANSCRIPT ONLY]
WIND TURBINE MANUFACTURER
IN PORT McNEILL
C. Trevena: I travelled through northwestern Spain a few years ago and was exhilarated by the sight of the wind turbines slowly and silently turning along the ridges facing the Atlantic. They're like giant sentinels marching through the countryside. You see them in Denmark and Germany and Texas. They're wind farms. [DRAFT TRANSCRIPT ONLY]
And in Port McNeill you can visit B.C.'s only wind turbine maker. CLN Machining and Fabricating is a small operation tucked in a back street of town distinguishable by the wind turbine on its roof. [DRAFT TRANSCRIPT ONLY]
When we talk about alternative energies, the green economy and transition, CLN is the reality of that. It used to be a machine shop catering to the forest industry. Working out of Port McNeill, it was always busy. [DRAFT TRANSCRIPT ONLY]
When one of the machinists was sick, he started to play around with designs for wind turbines and, on his return to work, started to fabricate them. With the downturn in the forest sector and the increasing interest in alternative energy production, CLN started to make the switch from working for the forest sector to building wind turbines. [DRAFT TRANSCRIPT ONLY]
Their turbines are at the airfield outside McNeill, at lodges, and soon the Alert Bay School, perched on a hill in the middle of Cormorant Island, will also have a wind turbine powering its energy needs. [DRAFT TRANSCRIPT ONLY]
Unlike the wind farms in Europe or across our continent, CLN's turbines allow individual consumers to plug into the natural energy of the winds and, if there's excess energy produced, flip the switch so it can go back into the grid. [DRAFT TRANSCRIPT ONLY]
They aren't cheap, and the returns of putting excess back into the grid aren't huge — particularly compared with other provinces — but the interest is there, and the work for the company is steady. [DRAFT TRANSCRIPT ONLY]
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I would hope that most of us in this House believe that climate change is a reality and that we all need to find new ways of doing business, living our lives and sustaining our communities to reflect that. The vision and energy provided by CLN is a small part in a shift to a green economy. But we all have to do so much more in our communities, here in our province, our country and across our continent. [DRAFT TRANSCRIPT ONLY]
RICHMOND PEACE LABYRINTH
L. Reid: The Richmond Peace Labyrinth is located on the north side of St. Alban's Anglican Church Hall and is built from bricks in a single winding, purposeful path from the edge of the circle to the centre. It is 42 feet in diameter with a 16-inch-wide path. It is a replica of the 11-circuit labyrinth of Chartres Cathedral in France, which was constructed sometime between the year 1194 and 1220. [DRAFT TRANSCRIPT ONLY]
Labyrinths are known to help promote meditation, a quiet mind, health, balance and insight. They are used in celebrations, in uniting community, supporting mental health and as a path of prayer. The health benefits of walking labyrinths have been proven by their use in hospitals, schools, and respite and palliative care facilities. They've also been found in parks, churches, memorial parks and retreat centres around the world. [DRAFT TRANSCRIPT ONLY]
Research conducted by Dr. Herbert Benson from Harvard Medical School's Mind-Body Medical Institute has found that labyrinth walking is among the simplest forms of meditation. He found issues around reducing anxiety and reducing other issues around health and the heart. [DRAFT TRANSCRIPT ONLY]
The Richmond Peace Labyrinth provides a calm, peaceful and beautiful environment in the heart of Richmond. Many walkers also attend the St. Alban's community meal, served every Tuesday in the church hall. The meals started 12 to 15 years ago and serve between 20 and 40 people. It's also an opportunity for people to socialize. They come together. St. Alban's meal is set up and served by volunteers. Sunrise Rotary and Steveston Rotary both do one Tuesday a month. The other Tuesdays are covered by members of the congregation and members of the community. [DRAFT TRANSCRIPT ONLY]
Rev. Margaret Cornish leads an amazing church congregation. I would ask the House to join me in thanking this lovely woman for her dedication to community. [DRAFT TRANSCRIPT ONLY]
CAREGIVERS ASSOCIATION IN
MAPLE RIDGE AND PITT MEADOWS
M. Sather: I stand in the House today to acknowledge a special group of citizens from my community. The caregivers of Maple Ridge–Pitt Meadows are a support group comprised of individuals, often but not always senior citizens, who have taken it upon themselves to care for their loved ones regardless of the personal cost. These loved ones have chronic or terminal health conditions that require a substantial commitment of time and resources. [DRAFT TRANSCRIPT ONLY]
The caregivers supervise, monitor medical conditions, take those in their care to and from appointments, and administer any necessary medications. They do this without any expectation of recognition or compensation, only to ensure their loved ones have the best quality of life possible. As one can imagine, such demanding and selfless action takes a toll on one's physical and mental well-being. Twelve years ago a group of caregivers got together to share their experiences with one another and to provide mutual support. [DRAFT TRANSCRIPT ONLY]
I did say that they do what they do without the expectation of recognition, but I believe they should be recognized. Not only is what they do a sterling example of compassion and commitment, but their efforts in keeping individuals from being institutionalized is a valuable service to our communities. They keep seniors out of hospital beds and care facilities, thus substantially reducing the load on our health care system. [DRAFT TRANSCRIPT ONLY]
Even when it has gotten to the point where their loved ones have to be institutionalized, the caregivers stay close by, typically supplementing the institutionalized care with their own time and limited resources. [DRAFT TRANSCRIPT ONLY]
It wasn't long ago that the system recognized their contribution and, through the home care services, provided some respite. Sadly, this service was cut. But the caregivers still soldier on, taking personal responsibility for their wives, husbands, mothers and fathers because they care. [DRAFT TRANSCRIPT ONLY]
FUNDRAISING ACTIVITIES FOR
SURREY MEMORIAL HOSPITAL
S. Cadieux: On November 2 the South Asian community in Surrey came together in an enormous show of support for Surrey Memorial Hospital Foundation. Surrey-based radio station Red 93.1 FM, spearheaded by station owner and Surrey Memorial Hospital Foundation board member Kulwinder Sanghera, established an annual radiothon in 2007 with a pledge to the foundation of $2 million. The third annual 16-hour broadcast this year resulted in pledges totalling $900,000. [DRAFT TRANSCRIPT ONLY]
The South Asian community has shown great generosity towards Surrey Memorial Hospital and has now well surpassed that $2 million goal. Donations this year included a $50,000 matching pledge by Tony Singh, owner of Fruiticana, who challenged the community of radio listeners to match his contribution. Red FM stepped up and donated $25,000. [DRAFT TRANSCRIPT ONLY]
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Whether it was the children who donated their piggy banks or the Atwal family or Rai Plumbing, who have donated every single year, approximately 2,200 people personally visited Red FM to contribute and show their support. [DRAFT TRANSCRIPT ONLY]
The new emergency centre at Surrey Memorial will be named the Guru Nanak Emergency Services Front Entrance in recognition of the South Asian community's contribution to the foundation over the years. [DRAFT TRANSCRIPT ONLY]
The Surrey Memorial ER is the busiest in B.C. at 77,000 visits a year. Red FM's leadership and the South Asian community's support in Surrey are truly demonstrating their appreciation for Surrey Memorial and its continued expansion. [DRAFT TRANSCRIPT ONLY]
I'd like the House to help me recognize and congratulate Red FM and all of the donors for their immensely successful and very appreciated support of Surrey Memorial. [DRAFT TRANSCRIPT ONLY]
Oral Questions
B.C. HYDRO PURCHASE AGREEMENT
FOR PORTION OF WANETA DAM
J. Horgan: This past summer B.C. Hydro negotiated a deal with Teck Resources to buy a one-third stake in the Waneta dam for $825 million — $825 million of ratepayers' money to buy an aging facility that analysts predict was worth somewhere in the neighbourhood of $500 million. A review of the National Energy Board export permits reveals that before Teck Cominco could move any of their surplus power to the United States, they had to first offer it to B.C. Hydro. [DRAFT TRANSCRIPT ONLY]
My question to the Minister of Energy is this. Why did he allow B.C. Hydro to put $825 million of ratepayer money at risk when he can already buy the power? [DRAFT TRANSCRIPT ONLY]
Hon. B. Lekstrom: I can tell the member that this is a tremendous deal for British Columbians. We talk about B.C. Hydro and their heritage assets, the ability to expand upon what they own today on behalf of British Columbians, which is you and I in this Legislature — everybody right across. [DRAFT TRANSCRIPT ONLY]
The deal for the one-third share of the Waneta dam…. When you refer to the price, the price per megawatt hour comes in substantially lower than any power that's on the ability to be developed today. We're extremely excited about this. [DRAFT TRANSCRIPT ONLY]
We are looking forward. We have an opportunity in British Columbia to have B.C. Hydro not only grow its assets on behalf of British Columbians but to provide cost-effective electricity for British Columbians, and that's my first priority. [DRAFT TRANSCRIPT ONLY]
Mr. Speaker: The member has a supplemental. [DRAFT TRANSCRIPT ONLY]
Interjection.
Mr. Speaker: Minister. [DRAFT TRANSCRIPT ONLY]
J. Horgan: The minister has just said that putting at risk $825 million of ratepayers' money is a good deal when the power produced by the dam, if it is surplus to the smelting needs of Teck Cominco… [DRAFT TRANSCRIPT ONLY]
Interjections.
Mr. Speaker: Members. [DRAFT TRANSCRIPT ONLY]
J. Horgan: …is available to B.C. Hydro at market rates. Last year when Teck Cominco exported power to the United States, they got $37 a megawatt hour — $37 a megawatt hour on the spot market. [DRAFT TRANSCRIPT ONLY]
Again, my question is to the minister. Why did he allow a transfer of $825 million of ratepayer money to a private company when he could already buy the power? Where's the economic sense in that? [DRAFT TRANSCRIPT ONLY]
Hon. B. Lekstrom: It's surprising. I know the opposition is opposed to the independent power producers in this province. Now it appears they're opposed to B.C. Hydro. That just doesn't hold water. [DRAFT TRANSCRIPT ONLY]
The actual issue that we're looking at here is an acquisition by B.C. Hydro for a one-third interest in the Waneta. That is not going to put the smelter at risk. If the member has done his homework, he would see that that power wasn't utilized by the smelter. [DRAFT TRANSCRIPT ONLY]
This is cost-effective electricity — something I have heard numerous times called for by the opposition. We fully support ensuring that we have the ability to be electricity self-sufficient by 2016 as we've committed to. We are committing to do it through the use of B.C. Hydro expanded facilities — B.C. Hydro's ability to actually look at new acquisitions, such as the Waneta one-third purchase, as well as cooperation and enhancement with our independent power producers of this province. [DRAFT TRANSCRIPT ONLY]
We have a lot to be proud of. I can tell you, British Columbians are exceptionally fortunate to be served by between the second- and fourth-lowest electricity rates in North America. We're going to maintain that. [DRAFT TRANSCRIPT ONLY]
Interjections.
[1400]
Mr. Speaker: Members. [DRAFT TRANSCRIPT ONLY]
The member has a further supplemental. [DRAFT TRANSCRIPT ONLY]
J. Horgan: The Columbia Power Corporation is a public utility. The shareholder for that utility is the Minister of Finance. Columbia Power owns the expansion rights to the Waneta facility. The cost-effective thing for a prudent government to do was to look at the two utilities they control, B.C. Hydro and Columbia Power, and say: "Which of these two is better suited to own a one-third interest in Waneta dam?" The easy answer — Columbia Power. They weren't allowed to bid. [DRAFT TRANSCRIPT ONLY]
Is it true that the $664,000 in political contributions from Tech to the B.C. Liberals directly related to an $825 million boondoggle on the back of the ratepayers of B.C. Hydro? [DRAFT TRANSCRIPT ONLY]
Interjections.
Mr. Speaker: Members. [DRAFT TRANSCRIPT ONLY]
Just wait, Minister. [DRAFT TRANSCRIPT ONLY]
Hon. B. Lekstrom: This is an incredible deal for British Columbians. I know he may differ. We have made a commitment, and it's somewhat…. [DRAFT TRANSCRIPT ONLY]
Interjections.
Mr. Speaker: Just take your seat. [DRAFT TRANSCRIPT ONLY]
It's going to be a long question period. [DRAFT TRANSCRIPT ONLY]
Continue, Minister. [DRAFT TRANSCRIPT ONLY]
Hon. B. Lekstrom: I'm somewhat surprised by the question, referring that a contribution could lead to a deal like this when, in fact, I think the member knows very well that as the minister responsible, I take my job extremely seriously. I can tell you that I act on behalf of British Columbians each and every day in a way that I'm proud of. [DRAFT TRANSCRIPT ONLY]
What this is about is the ability to maintain one of the greatest Crown corporations, I believe, in North America, if not the world. It's the ability for B.C. Hydro not only to maintain and enhance its existing infrastructure but to acquire new infrastructure on behalf of the residents of British Columbia, the people that they actually provide electricity for, at a cost-effective rate. [DRAFT TRANSCRIPT ONLY]
I've heard this numerous times from the opposition. I think they'll be extremely happy with the price of the power that comes in, the ability for B.C. Hydro to move forward. I can tell you that not only on this side…. I have to believe that you have to be supporters of B.C. Hydro, but with questions like that, I have to question that. [DRAFT TRANSCRIPT ONLY]
K. Conroy: It's obvious that the minister is concerned about certain taxpayers, but it's taxpayers in B.C. in and about the region that I come from that are very concerned about this sale. The mayor of Trail, Dieter Bogs, in his brief to the B.C. Utilities Commission hearing, said that this transaction will jeopardize the future of Trail and the future of Trail Operations. [DRAFT TRANSCRIPT ONLY]
The hearings to allow this sale to proceed are still ongoing. Will the minister do the right thing and stop this transaction that will benefit so few? [DRAFT TRANSCRIPT ONLY]
Hon. B. Lekstrom: I'll start by clarifying. The member indicated that this would benefit so few. We have over four million people in British Columbia, and this transaction will benefit each and every one of them. [DRAFT TRANSCRIPT ONLY]
As the member rightfully said, there is a process ongoing at the present time. I want to assure the member and to assure all British Columbians that this is not going to put Trail in jeopardy, as the member has said. If she had looked and done her homework, based on the excess electricity that had been generated, she would see that that wasn't utilized at the smelter. [DRAFT TRANSCRIPT ONLY]
In closing, I do want to say this. We're committed to building an energy- and electricity-self-sufficient province. We will be there by 2016 to meet our commitment. That includes new generating activity produced by B.C. Hydro as well as through our independent power producers of British Columbia. [DRAFT TRANSCRIPT ONLY]
[1405]
Together, this balance is going to lead us to be a clean energy powerhouse, to lead North America in the reduction of greenhouse gas emissions, to do it in a way that creates electricity. I'm somewhat surprised that when cost-effective electricity is there, you're opposed to it. [DRAFT TRANSCRIPT ONLY]
Mr. Speaker: The member has a supplemental. [DRAFT TRANSCRIPT ONLY]
K. Conroy: That diatribe isn't going to do the minister any good because it's not only the city of Trail that is concerned. It's the regional district of Kootenay Boundary, it's United Steelworkers, and it's people from throughout the region who are also quite worried. Doug Jones, the president of Local 480, said at the same hearings that the transaction will jeopardize the continuation of existing operations. [DRAFT TRANSCRIPT ONLY]
What is it, Minister? You have to do the right thing. Save taxpayers' dollars, and tell B.C. Hydro to call off this deal to your friends. [DRAFT TRANSCRIPT ONLY]
Hon. B. Lekstrom: Going back, the issue is before the BCUC. They're reviewing it. There is opportunity and has been, as the member has rightfully said, for people to make that. But the ability for B.C. Hydro to enter into this purchase agreement for one-third of Waneta…. [DRAFT TRANSCRIPT ONLY]
Interjections.
Mr. Speaker: Minister, just take your seat for a second. [DRAFT TRANSCRIPT ONLY]
Continue, Minister. [DRAFT TRANSCRIPT ONLY]
Hon. B. Lekstrom: I do want to go back to the point that we talked about — the ability to develop an electricity-self-sufficient province in British Columbia by 2016. We're doing that through the purchase of independent power producers' electricity, if it is cost-effective electricity — something I've heard the opposition speak loud and clear about. [DRAFT TRANSCRIPT ONLY]
Here we have an incredible opportunity for B.C. Hydro to acquire an asset that will bring in extremely cost-effective electricity and will benefit all British Columbians, including Trail and the residents of your riding. We're in favour of it. If you want to oppose all electricity, go ahead. But we're going to keep our lights on in British Columbia, and we're going to do on behalf of…. [DRAFT TRANSCRIPT ONLY]
ACCESS TO B.C. FERRIES INFORMATION
D. Routley: This government has a habit of making big statements and commitments without any follow-through. In a joint press release on Monday from three organizations, including the B.C. Freedom of Information and Privacy Association, Executive Director Darrell Evans said: "I doubt B.C. Ferries officials would have been paid these outrageous salaries and bonuses if they knew citizens or the media could ask for them through freedom of information." [DRAFT TRANSCRIPT ONLY]
Will the minister commit today to making B.C. Ferries subject to the Freedom of Information Act? [DRAFT TRANSCRIPT ONLY]
Hon. S. Bond: As I've said repeatedly in this House and outside of it, the comptroller general was asked for advice. She provided it to us. We will consider every single recommendation, including that one. [DRAFT TRANSCRIPT ONLY]
Mr. Speaker: The member has a supplemental. [DRAFT TRANSCRIPT ONLY]
D. Routley: The interesting part is, though, that in 1998 the Premier, then in opposition, wrote a letter to Mr. Evans. He said: "Freedom of information is not just a tool of opposition. The fundamental principle must be this: government information belongs to the people, not the government." [DRAFT TRANSCRIPT ONLY]
Taxpayers have a right to know what's going on behind those closed doors of B.C. Ferries. Will the minister quit stalling and commit today to submitting B.C. Ferries, bringing B.C. Ferries under the Freedom of Information Act and bringing back accountability to the people of B.C.? [DRAFT TRANSCRIPT ONLY]
Hon. S. Bond: And 1998 certainly brings back memories to members on this side of the House. In fact, that was the year…. [DRAFT TRANSCRIPT ONLY]
Interjections.
Mr. Speaker: Take your seat. [DRAFT TRANSCRIPT ONLY]
Members.
Continue, Minister. [DRAFT TRANSCRIPT ONLY]
Hon. S. Bond: I'm glad the member opposite brought up 1998 because, in fact, that was one of the years where B.C. Ferries was actually teetering on the brink of bankruptcy, thanks to the members on the other side of the House. [DRAFT TRANSCRIPT ONLY]
[1410]
G. Coons: The comptroller general is only the latest of many voices calling for B.C. Ferries to be accountable to the public. In 2003 after this government privatized B.C. Ferries and removed them from public oversight, the Information and Privacy Commissioner of B.C. wrote a letter to the Transportation Minister at the time calling on B.C. Ferries to make safety reports and "other pertinent information available to the public on a website." [DRAFT TRANSCRIPT ONLY]
Will the Minister of Transportation finally make B.C. Ferries subject to the Freedom of Information Act? [DRAFT TRANSCRIPT ONLY]
Hon. S. Bond: One thing we do know that the comptroller general actually said.... Perhaps the member opposite would like to read the rest of the report. The comptroller general actually said that B.C. Ferries was run in an effective and efficient manner. In fact, the only thing the members opposite should be concerned about is that under their leadership, the debt for B.C. Ferries actually increased by 1,800 percent — 1,800 percent. [DRAFT TRANSCRIPT ONLY]
We've made a commitment to consider every single one of the recommendations seriously. We asked the comptroller general for advice, and we intend to review every recommendation. [DRAFT TRANSCRIPT ONLY]
Interjections.
Mr. Speaker: Members. [DRAFT TRANSCRIPT ONLY]
Member has a supplemental. [DRAFT TRANSCRIPT ONLY]
G. Coons: It was this Premier, this government that gave B.C. Ferries a green light to excessively spend and to operate in secret by exempting them from FOI. This Premier created this B.C. Ferries gone wild with no accountability and no scrutiny. This government is stalling, hoping the issue will go away. It was a mistake. It was a mistake to hide B.C. Ferries from the public. [DRAFT TRANSCRIPT ONLY]
Interjections.
Mr. Speaker: Members. [DRAFT TRANSCRIPT ONLY]
Continue, Member. [DRAFT TRANSCRIPT ONLY]
G. Coons: It was a mistake to hide B.C. Ferries from the public. Even the Minister of Transportation was surprised when she found out that the CEO made over a million bucks. Again, will the minister stop dithering? Will she act on the comptroller general's recommendations to make B.C. Ferries subject to the Freedom of Information Act? [DRAFT TRANSCRIPT ONLY]
Hon. S. Bond: What I'd like to do is refer the member opposite to page 29 of the comptroller general's report, which actually points out and makes this statement: "B.C. Ferries has successfully acquired independent financing and has dealt with one of the major challenges it inherited." That would imply the 1990s when it was established — a seriously aging fleet. In fact, the vessels that the member opposite is talking about were on average over 30 years old. They bankrupt B.C. Ferries. We're not going to take one minute's worth of advice from the member opposite. [DRAFT TRANSCRIPT ONLY]
Interjections.
Mr. Speaker: We're not starting. [DRAFT TRANSCRIPT ONLY]
REVIEW OF B.C. RAIL
H. Bains: Mr. Speaker, you notice and observe the members opposite — how good they are at defending the minister who was defending secrecy in her Transportation Ministry. Let's see how she defends the waste. Let's see how she'll defend the waste under her ministry. [DRAFT TRANSCRIPT ONLY]
Everyone except the minister knows that millions of dollars are wasted at B.C. Rail every year. Four executives have been paid over $6 million since B.C. Rail was sold. Now only after the pressure from the opposition, the minister is calling for the review. [DRAFT TRANSCRIPT ONLY]
[1415]
What review? A review to find out that they are managing less than 30 employees at a cost of $1.2 million a year? A review that there are no trains except the gravy train that existed in there? My question to the minister is this. Why doesn't she show some leadership? Why doesn't she cut them loose? Why doesn't she manage that asset through her ministry office? [DRAFT TRANSCRIPT ONLY]
Hon. S. Bond: August 25, 2009. I'm sure the member opposite…. I'm positive he could probably pick up his copy of the throne speech, dust it off and read this paragraph: "Health authorities, boards of education and Crown corporations will be subject to reviews in the coming year." [DRAFT TRANSCRIPT ONLY]
Sorry, Member opposite. We started the review of B.C. Rail Properties after the throne speech. That work is underway. We will continue to look at the mandate of B.C. Rail Properties. [DRAFT TRANSCRIPT ONLY]
Mr. Speaker: The member has a supplemental. [DRAFT TRANSCRIPT ONLY]
H. Bains: It's obvious that the minister doesn't get it, like all other ministers on the other side. She is continuing to defend the indefensible B.C. Rail waste. When pressured, she hides behind the review. The fact of the matter is that we do not need another review to find out that there is $1.2 million per year needed to sell off real estate. [DRAFT TRANSCRIPT ONLY]
My question to the minister is this. Why doesn't she do the right thing and tell these executives that the gravy train is no more and save the taxpayers $1.2 million a year? [DRAFT TRANSCRIPT ONLY]
Hon. S. Bond: I guess, first of all, the member should sort out…. First he wasn't sure we'd called for a review, which in fact we did in August of 2009. So he didn't get that right, and he didn't get the rest of his statement right either. [DRAFT TRANSCRIPT ONLY]
In fact, let's take a look at one transaction that B.C. Rail Properties has managed. Let's look at the quarter-billion-dollar lease arrangement that B.C. Rail Properties has actually managed. The member opposite might want to…. [DRAFT TRANSCRIPT ONLY]
Interjections.
Mr. Speaker: Minister, just take your seat. [DRAFT TRANSCRIPT ONLY]
It's your time, Members. [DRAFT TRANSCRIPT ONLY]
Continue, Minister. [DRAFT TRANSCRIPT ONLY]
Hon. S. Bond: Let's talk about the quarter-billion-dollar transaction that actually saw not only that investment for British Columbia's taxpayers but drew additional private sector investment of over $200 million. [DRAFT TRANSCRIPT ONLY]
The member opposite might want to trivialize private sector investment in British Columbia. We're going to take advantage of every single opportunity to deal with private sector investment and advance our Asia-Pacific strategy every opportunity we get. [DRAFT TRANSCRIPT ONLY]
GOVERNMENT HANDLING OF TOURISM B.C.
S. Herbert: The opposition filed an FOI seeking records related to the B.C. Liberal decision to axe Tourism B.C. The request included all records, reports or assessments that had been carried out on Tourism B.C. that in any way informed the decision to close it. [DRAFT TRANSCRIPT ONLY]
Today we learned that there are no records, no reports and no reason to justify eliminating B.C.'s industry-led award-winning marketing agency just six months before the Olympics — a decision that the head of Canada's national tourism association has called a real setback. [DRAFT TRANSCRIPT ONLY]
So to the minister: how could the minister make a decision that puts our tourism industry at risk with no records, reports or assessments to back him up? [DRAFT TRANSCRIPT ONLY]
Hon. K. Krueger: We are on the brink now, just over 80 days from the greatest marketing opportunity that British Columbia will ever have — three billion pairs of eyes focused on British Columbia. [DRAFT TRANSCRIPT ONLY]
[1420]
Interjections.
Mr. Speaker: Minister, just take your seat. [DRAFT TRANSCRIPT ONLY]
Hon. K. Krueger: Three billion pairs of eyes focused on British Columbia…. [DRAFT TRANSCRIPT ONLY]
Interjections.
Mr. Speaker: Minister, please take your seat. [DRAFT TRANSCRIPT ONLY]
Continue, Minister. [DRAFT TRANSCRIPT ONLY]
Hon. K. Krueger: Three billion pairs of eyes focused on British Columbia –– 15,000 foreign journalists covering our jurisdiction for months. Faced with the biggest marketing opportunity we'll have in our lifetimes for British Columbia, in the toughest world economic climate of our lifetimes, we brought together the 146 people of Tourism B.C. with a similar number in the ministry. They're working flat-out. There are 35 teams of people who are ready to maximize the post-Olympic opportunities. It's nothing but good news, and we can't understand why they don't like good news. [DRAFT TRANSCRIPT ONLY]
Interjections.
Mr. Speaker: The member has a supplemental. [DRAFT TRANSCRIPT ONLY]
S. Herbert: The minister talks about a great opportunity to market B.C., but then he takes the industry-led marketing group which is supposed to do that marketing and takes the axe to it, shuts it down, kicks it to the ground –– the award-winning industry-led marketing department. [DRAFT TRANSCRIPT ONLY]
The minister has said the decision to do so was about cost savings and efficiencies, but according to his ministry's response to the FOI, there are no records, reports or any assessments which show that there are any savings at all. [DRAFT TRANSCRIPT ONLY]
Again to the minister. So we've got B.C.'s Council of Tourism Associations, the Tourism Association of Canada, Tourism Victoria, Tourism Vancouver, the Wilderness Tourism Association –– all unanimous that this was a stupid and devastating decision, on one side. And then on the other side, we have the Minister of Tourism caught naked with no study or analysis supporting his axing of Tourism B.C. [DRAFT TRANSCRIPT ONLY]
Who should we believe, Minister? I know it's a disturbing image, but who should we believe, Minister? You? Or should we believe the tourism industry? [DRAFT TRANSCRIPT ONLY]
Interjections.
Mr. Speaker: Members. Members. [DRAFT TRANSCRIPT ONLY]
Interjections.
Mr. Speaker: Are you finished, Member? [DRAFT TRANSCRIPT ONLY]
Interjections.
Hon. K. Krueger: My colleagues are urging me to resist the temptation. Oh, the burns that spring to mind. But faced with…. [DRAFT TRANSCRIPT ONLY]
Interjections.
Mr. Speaker: Continue, Minister. [DRAFT TRANSCRIPT ONLY]
Hon. K. Krueger: But it only makes sense when you've got a huge opportunity and limited resources to make sure you combine those resources, to make sure you focus them on achieving the goals that are set out before us –– the fantastic opportunity we have. [DRAFT TRANSCRIPT ONLY]
We don't want to waste a dollar. We don't want to waste any human effort. We're ready. The ministry, with Tourism B.C. melded into it, is ready for this huge opportunity, and I hope the members opposite will join us in really taking advantage of that opportunity. It's going to be wonderful. [DRAFT TRANSCRIPT ONLY]
S. Simpson: The minister says that they're ready, yet what we know now is that this decision to scrap Tourism B.C. was done with no analysis, no assessment, no reports to support this. [DRAFT TRANSCRIPT ONLY]
[1425]
The minister might think he's ready, but the president of the tourism association of Canada says: "I was absolutely floored when I heard the news…. I'm just not sure the post-Games opportunities will be as accessible to government as they would have been before." [DRAFT TRANSCRIPT ONLY]
The reality is this. This minister, this government, scrapped an effective, award-winning agency that would make this successful, and he did it with no support. How does the minister justify making that decision with no intelligence at all? [DRAFT TRANSCRIPT ONLY]
Hon. K. Krueger: This government has been building for the Olympic opportunity for years. There is brand-spanking-new infrastructure throughout British Columbia getting ready for this. Whether we look at the Kicking Horse Canyon bridge or the expanded airports around the province, the Sea to Sky Highway, the Canada Line, we're ready. Tourism B.C. people and Tourism, Culture and…. [DRAFT TRANSCRIPT ONLY]
Interjection.
Mr. Speaker: Member. Member for Fraser-Nicola. Member, do you want to apologize to the House. [DRAFT TRANSCRIPT ONLY]
H. Lali: I apologize to the House, hon. Speaker. [DRAFT TRANSCRIPT ONLY]
Mr. Speaker: Continue, Minister. [DRAFT TRANSCRIPT ONLY]
Hon. K. Krueger: All of that infrastructure is ready. The team is united. Jurisdictions everywhere in the world that have hosted Olympics say to our teams that nobody has ever exploited the post-Olympic opportunity the way that we could have. Salt Lake City and Sydney, Australia, are considered some of the leaders, but they say that they did not prepare for the opportunity the way that they could have. [DRAFT TRANSCRIPT ONLY]
We got the teams together. We're ready. The members opposite are going to really enjoy it. [DRAFT TRANSCRIPT ONLY]
[End of question period.]
K. Conroy: I'd like to present a petition. [DRAFT TRANSCRIPT ONLY]
Mr. Speaker: Proceed. [DRAFT TRANSCRIPT ONLY]
Petitions
K. Conroy: I have over a thousand signatures from people from West Kootenay asking the government to stop the implementation of the HST. [DRAFT TRANSCRIPT ONLY]
D. Routley: Permission to present a petition. [DRAFT TRANSCRIPT ONLY]
Mr. Speaker: Proceed. [DRAFT TRANSCRIPT ONLY]
D. Routley: I have a petition with hundreds of signatures by constituents of the province of British Columbia demanding that the province halt the implementation of the HST. [DRAFT TRANSCRIPT ONLY]
R. Austin: I rise to present a petition with hundreds of signatures from the riding of Skeena opposing the implementation of the HST. [DRAFT TRANSCRIPT ONLY]
G. Gentner: I rise to present a petition from constituents of mine and others throughout the province, those who are opposed to the implementation of the government's HST. [DRAFT TRANSCRIPT ONLY]
A. Dix: I am pleased to present a petition from hundreds of parents and community members in support of the early psychosis intervention program — that it stay at the University of British Columbia. [DRAFT TRANSCRIPT ONLY]
Orders of the Day
Hon. M. de Jong: I call, in Committee A, Committee of Supply — for the information of members, the ongoing estimates of the Ministry of Energy, Mines and Petroleum Resources — and in this chamber, the Committee of Supply, the estimates of the Ministry of Health. [DRAFT TRANSCRIPT ONLY]
[1430]
Committee of Supply
ESTIMATES: MINISTRY OF HEALTH SERVICES
(continued)
The House in Committee of Supply (Section B); L. Reid in the chair.
The committee met at 2:33 p.m.
On Vote 34: ministry operations, $14,008,318,000 (continued).
A. Dix: Before the break we were talking about the impact of surgery cuts in the Fraser Health Authority by hospital. What we had ascertained was that those surgery cuts will happen across hospitals and that each hospital would have its own plan to reduce surgeries in that particular hospital. [DRAFT TRANSCRIPT ONLY]
For example, some hospitals obviously do neurosurgery, only three in Fraser Health — Burnaby Hospital, a little bit; Royal Columbian Hospital; and Eagle Ridge Hospital. Most hospitals, of course, don't do that. [DRAFT TRANSCRIPT ONLY]
I guess I wanted to ask the minister whether he would be able to provide for us the elective surgery reduction plans for each hospital — the plans that are now in effect, and the plans that obviously are in the possession of people, the Fraser Health Authority, for whom he's responsible in the House. [DRAFT TRANSCRIPT ONLY]
[1435]
Hon. K. Falcon: As I said to the member earlier, we haven't got all of that information here with us, but we will endeavour to acquire that from the health authority and share that with the member. [DRAFT TRANSCRIPT ONLY]
A. Dix: Sorry. I don't think…. The minister in his last answer gave a rhetorical answer. I don't think I quite got that answer, so I'm delighted to hear that he'd be prepared to share it. Would it be possible to learn from the minister whether he'd be able to share it before the end of estimates so we'd have a chance to discuss it? [DRAFT TRANSCRIPT ONLY]
Hon. K. Falcon: Certainly, if the information is gathered and assembled in the manner that the member was discussing and we have that available, we'll be happy to do that. [DRAFT TRANSCRIPT ONLY]
A. Dix: I think that was yes. The question I have overall.… The minister talked about 4.6 percent of elective surgeries. Does that include the reductions taking place between September 15 and March 31 and what are called the Olympic reductions, which are a further 2,200 surgeries, or do they just…? Is that a total number, in fact — the reduction of 4.6 percent of the annualized total, which obviously is much more in the next little while? Just a clarification from the minister. [DRAFT TRANSCRIPT ONLY]
Hon. K. Falcon: The answer is yes. It does. [DRAFT TRANSCRIPT ONLY]
A. Dix: I understood from a Fraser Health document that the number of surgeries that'll be cancelled or reduced during the Olympic period — how it's proportioned out — was originally said to be 2,200. Is that the right number? [DRAFT TRANSCRIPT ONLY]
Hon. K. Falcon: That is correct. [DRAFT TRANSCRIPT ONLY]
A. Dix: If the number is 4.6 percent — so that I understand correctly the numbers involved…. So 2,200…. Obviously, what we're talking about is, as I understand it, a 35 percent reduction during that period and a further reduction, I think, in the extension of a Christmas break period, if I'm correct on that. [DRAFT TRANSCRIPT ONLY]
That would mean that the remaining surgeries…. Well, I'll just ask the minister. How many more surgeries will be cancelled in addition to that Olympic period? [DRAFT TRANSCRIPT ONLY]
[1440]
Hon. K. Falcon: For the member's benefit, those would be the cases we talked about publicly before, where during the Olympic period…. This has been the experience in other jurisdictions, too, where you have a reduction in cases that typically will take place during an Olympic period, when people generally aren't scheduling their elective surgeries — both on the medical side, the professionals, but also by the people that are wishing to have surgeries. [DRAFT TRANSCRIPT ONLY]
There tends to be…. At least, the historical experience for Olympics has been that there is a reduction. That we talked about, I think, a couple of months ago. We mentioned publicly that there would be surgical slowdowns during the Olympic period leading into the spring break period. [DRAFT TRANSCRIPT ONLY]
A. Dix: The question is…. If 2,200 surgeries are being cancelled during that period because, of course, people in Chilliwack won't want to go and get their elective surgery done because the Olympic Games are on…. If that's the number in that period, how much is in the period other than that period between September 18 and March 31? [DRAFT TRANSCRIPT ONLY]
Hon. K. Falcon: Just to correct the member, they're not being cancelled. It's more a case of their not being scheduled. They're not being scheduled because, again, the historical experience is that when you have a major international event like the Olympics that takes place in your jurisdiction, typically what you have is a desire by people — both people within the system, frankly, and without the system — to attend or participate or what have you. [DRAFT TRANSCRIPT ONLY]
It's typically not a time…. At least, based on the historical experience that other jurisdictions have informed us on, there's a reduction in demand. People aren't wishing to be scheduled to have their elective surgeries undertaken during that period. So they've done a planned, scheduled reduction in the amount of contemplated surgeries. It is not cancellations of anyone's surgeries. [DRAFT TRANSCRIPT ONLY]
A. Dix: The instruction from VIHA is to reduce OR hours by 14 percent in all hospitals in all periods between…. [DRAFT TRANSCRIPT ONLY]
Hon. K. Falcon: Fraser. [DRAFT TRANSCRIPT ONLY]
A. Dix: In Fraser Health, yes; sorry. It's in Fraser Health between September 18, which is the period the cuts happen, and March 31. This is both in internal documents and on the public record. That's the instruction. So presumably, these 2,200 cancelled surgeries during the Olympic period are part of that 14 percent. [DRAFT TRANSCRIPT ONLY]
What I'm asking the minister…. If you look at the period between September 18 and March 31 — and the minister, I'm sure, will have this detailed information in front of him — you will see that the base OR hours for that period were 47,880. That's going to be reduced to the new OR hours, which is 41,177, according to the Fraser Health Authority. [DRAFT TRANSCRIPT ONLY]
I'm asking a very simple question. When you're seeking that 14 percent reduction or what the minister tries to characterize, annualized, as less than that…. That's what it is in this period — right? To get to those numbers, how many surgeries are you cancelling? So 2,200 in the Olympic period. How many in the rest of the time? [DRAFT TRANSCRIPT ONLY]
I guess on top of that I'll give him a second question. I'll give him something to think about. How many operating rooms are being mothballed? [DRAFT TRANSCRIPT ONLY]
If the suggestion is that a majority of the surgery cancellations are taking place in the Olympic period, which I think is what he was suggesting before, why are they mothballing operating rooms in Chilliwack, Coquitlam and Surrey? [DRAFT TRANSCRIPT ONLY]
Hon. K. Falcon: Look, I recognize that I'd probably be doing the same thing if I was in the member's position. You try to take something, build it up and try and make it something it's not. The fact of the matter is that I tried, in previous answers prior to the break, to explain to the member that there has to be a perspective around the very modest surgical reductions that are taking place — on two notes. [DRAFT TRANSCRIPT ONLY]
The first is: how are the health authorities doing, generally, with respect to reductions and wait times? In fact, we've seen, on average, an almost 50 percent reduction in median wait times for hips, knees and cardiac procedures in the province of British Columbia — including, in Fraser Health, dramatic reductions in wait times. [DRAFT TRANSCRIPT ONLY]
In the context of that, we have…. Fraser Health Authority, in an attempt to manage a 3½ percent pressure on their budget, has said that they will do 4.6 percent fewer elective procedures for the year. [DRAFT TRANSCRIPT ONLY]
[1445]
The member is right to point out that earlier we had publicly a discussion about the fact that there will be a surgical reduction that will take place on the order of, I think it was, 2,200 cases. Not cancellations. Nobody that was scheduled has now been cancelled. Planned reductions to reflect the fact that during the largest event that has ever been hosted in the history of the province of British Columbia…. It's far bigger than Expo 86, for example. The historical experience of other jurisdictions is that you see a decline in the requirements for elective surgical procedures. [DRAFT TRANSCRIPT ONLY]
Obviously, urgent and emergent are dealt with. They always will be. But the people who have some flexibility as to when to have their procedure done generally don't choose to schedule it during events of major international significance. Based on that, that's why we discussed some months ago publicly that the health authorities, Coastal and Fraser in particular, were going to have planned reductions in the numbers that they were planning on doing — as a result of that reality. [DRAFT TRANSCRIPT ONLY]
In terms of the reductions in the elective surgeries that are being proposed, it's 4.6 percent in the number of procedures. He is correct in pointing out that the reduction in the OR budgets is about 14 percent, but there is not a direct correlation between the OR budget and how many procedures get done. [DRAFT TRANSCRIPT ONLY]
They have found and continue to find ways of delivering services that sometimes can actually increase the number of procedures with the existing amount of dollars. That's obviously not infinite, but that has been the experience as we've been working and particularly learning from some of the investments we've been making on the health innovation side. [DRAFT TRANSCRIPT ONLY]
A. Dix: The minister has offered to give us the hospital-by-hospital information on that, but what I'm asking is: if it's a 4.6 percent reduction you see…. This is where it becomes easy, because the minister has the information before him. [DRAFT TRANSCRIPT ONLY]
I think he thinks I'm asking something diabolical here. I'm not. I'm asking for the actual information — like, the actual information. [DRAFT TRANSCRIPT ONLY]
Given the reduction he's proposing…. How many elective surgeries have they decided to do this year, based on it? It's because 4.6 percent has to be 4.6 percent of something. The minister has the numbers. I'm just asking him to share those numbers with the House. [DRAFT TRANSCRIPT ONLY]
Hon. K. Falcon: As I indicated earlier, just before the lunch break, in '08-09 Fraser Health did a total of 83,600 surgical procedures performed in all of Fraser Health. Of this, 65,716 were elective. [DRAFT TRANSCRIPT ONLY]
As I say, the proposal that the experts within the system — the surgeons, the OR managers, the administrators — came up with was a 4.6 percent reduction in the elective component. I think that's about 3,000 or just under 3,000 procedures out of a grand total of surgical procedures of 83,600 that were performed in '08-09. [DRAFT TRANSCRIPT ONLY]
A. Dix: This is a Fraser Health document here. Fraser Health doesn't estimate. It stated its number of procedures were 70,469 in '08-09. That's from Fraser Health documents here. [DRAFT TRANSCRIPT ONLY]
[1450]
I guess 4.6 percent on that…. You don't need too much of the detail, but that's less than 3,000. What would be suggested…. If you're counting the 2,200 in that, there'd just be a few hundred surgeries on top of that. But when you take account of the fact that they're closing…. [DRAFT TRANSCRIPT ONLY]
The number of surgeries, therefore…. I guess what I'm asking for is: what's the number? What is the number of elective surgeries this year? You have to have that number, or you wouldn't know 4.6 percent. So what is the number of elective surgeries being budgeted this year? You know, we've been raising these issues for months, so the ministry obviously has this information. I would just like to know that number, and we can move on. [DRAFT TRANSCRIPT ONLY]
Hon. K. Falcon: I'm trying to provide the member with that information. As I mentioned, the total surgical procedures performed, at least I'm informed…. I have to go…. I don't know what the member is referring to. I can only tell you what I'm being provided. In '08-09 they completed 83,600 surgical procedures, and some portion of those are elective procedures. A 4.6 percent reduction means, on average, about 3,000 less surgical procedures out of the total procedures of 83,600. That's what I'm informed of. [DRAFT TRANSCRIPT ONLY]
A. Dix: Perhaps we're just not understanding each other properly. I just want the number now of elective procedures that they're going to do this year, and the minister can provide that number to me elsewhere. I don't want to get stuck on it. I think he just said, "4.6 percent of the 84,000" and not "4.6 percent of the 65,000." I think he meant: "…of the 65,000." I think that's what he meant. If he could just provide us with the number they're expecting to do after these cuts — or changes, as the minister likes to call them — this year, then we can move on to that. [DRAFT TRANSCRIPT ONLY]
Perhaps the minister can tell us, then — just because it's the same broad subject; then we'll come back to Fraser Health — how many fewer surgical procedures are going to take place in Vancouver Coastal Health this year? [DRAFT TRANSCRIPT ONLY]
As the minister will know, we released some information about one plan out of Vancouver Coastal Health, which saw a dramatic cut in surgery. It's a plan, I'm happy to say, that I believe the health authority abandoned. Far be it from me to take credit for that. It was good news, anyway, for people waiting for surgery in Vancouver Coastal Health. They seem to have abandoned the worst parts of that plan. [DRAFT TRANSCRIPT ONLY]
Presumably, the same thing is going on in Vancouver Coastal Health with respect to the Olympics. There are, if I remember correctly, between 1,000 and 2,000 elective surgeries not going ahead because of the Olympics. What is happening at Vancouver Coastal Health with respect to elective surgeries? How many fewer are they doing this year than last? How many are they cutting in the last five months of the fiscal year to meet the new targets of the health authority? [DRAFT TRANSCRIPT ONLY]
[1455]
Hon. K. Falcon: Very optimistic news on this front. First of all, Vancouver Coastal Health has provided record levels of surgeries, as of course we've seen across the province. But over 67,000 surgeries last year, which was about 6,500 more procedures than they had done in the previous year — and worth noting. I want to take a moment to recognize the leadership of the administration, the board, the executive and the front-line teams that have actually seen that Vancouver Coastal wait times already are 25 percent lower than the provincial average. So certainly some great success. [DRAFT TRANSCRIPT ONLY]
The only change that will be taking place in Vancouver Coastal, I am informed, is that which was discussed earlier in line with Fraser Health, which is that they will be doing some planned reduction during the Olympic period and the spring break. I am led to understand, relatively modest savings, certainly in the scheme of their budgets, about $400,000. That's not even a rounding error in Vancouver Coastal Health. So they are forecasting about 450 surgery cases that are planned not to take place during the Olympic period and the spring break, which is the typical period spring break where they also plan for some surgical elective reductions. [DRAFT TRANSCRIPT ONLY]
A. Dix: I think it makes sense, and I think the minister would agree with that, that the 70,000 surgeries that a health authority does, given that would come from a range of the surgeries, would be cheaper than the first surgery it does. My colleague from Surrey–Green Timbers is going to ask some of the other questions just for a few minutes after this one. [DRAFT TRANSCRIPT ONLY]
I guess it raises the question: why is the Fraser Health Authority cutting thousands of surgeries to save $5 million, when it would appear, I think, to most people in increased wait times and all the consequences that will come from that? Really, it's not savings, as the Minister of Health well knows. What the Fraser Health Authority is doing is, in fact, fewer surgeries this year, saving $5 million in this fiscal year. But all of those people that don't get it done this year will have to get it done in the future. So the wait times are increasing by however many surgeries the minister doesn't do. [DRAFT TRANSCRIPT ONLY]
I'm just curious to know, because the incremental savings…. To get a lot of money in savings and surgery cancellations, you have to close a lot of operating rooms. I guess the question is, in terms of both health authorities…. We're talking about thousands of surgeries cut and the significant impact that will have across the board that doctors have talked about. I think the minister will agree that they're very concerned. They will have written him and the Fraser Health Authority. Why would you do that for what appears to be relatively little in the way of savings? [DRAFT TRANSCRIPT ONLY]
As I say, to the minister, my colleague from Surrey–Green Timbers will have a couple of questions for him. I'll be delighted to read his answer in Hansard. [DRAFT TRANSCRIPT ONLY]
Hon. K. Falcon: Every health authority and their capable executive team and front-line workers — because they're not monolithic, they are in fact separate health authorities — will deal with the challenge of managing their pressures differently. I acknowledge that. As I say, in the case of Vancouver Coastal, you can see that they are having virtually no impact on the number of surgeries they have done over last year, which was a record level. [DRAFT TRANSCRIPT ONLY]
I think what I would say to the member, just generally speaking, is that the perspective is important. You know, when I talked about average wait times reducing by almost 50 percent in the key areas of cardiac, knee surgeries and hip surgeries in the province of British Columbia, it is within that context that Fraser Health is making a very modest — albeit, they're real — reduction of 4.6 percent in elective surgeries. [DRAFT TRANSCRIPT ONLY]
The important thing to note, too, is that the Wait Time Alliance, which is an alliance made up of physicians represented by the Canadian Medical Association, which is physicians from one end of the country to the other, have actually put together a scorecard where they are measuring the wait times in every province right across Canada. [DRAFT TRANSCRIPT ONLY]
I think it is worth noting that the Wait Time Alliance has recognized British Columbia as among the very best in the country in terms of the wait-time reductions we've seen in the areas of cataract, cardiac and, of course, hips and knees. [DRAFT TRANSCRIPT ONLY]
[1500]
So while I recognize that, in the case of Fraser Health…. They are having a very modest reduction this year in the midst of very challenging economic circumstances externally. The fact that they are trying to manage their budget with a 3½ percent pressure on their budget, even with a 20 percent budget increase over the next three years…. I think that all of the health authorities are trying hard to look at the decisions they're making in recognizing that they are trying to minimize the clinical impact as much as humanly possible. [DRAFT TRANSCRIPT ONLY]
That varies between each of the health authorities. I acknowledge that. But I do think it is worth noting that whether it's Fraser Health, Vancouver Coastal, Interior, Northern or PHSA, they are all working very hard and doing a good job in trying to do that, recognizing that these are difficult circumstances even with 20 percent budget increases. [DRAFT TRANSCRIPT ONLY]
S. Hammell: I'll just carry on this line of questioning around the Northern Health Authority. We'll move to Northern Health and to VIHA, but I would just like to put this into context. [DRAFT TRANSCRIPT ONLY]
It is interesting that the minister acknowledges there are individual differences within each health authority based on their activity. They make different decisions in terms of cutting or reducing their activity based on the challenges they're faced with, which seems to me to lead to the reflection of a conversation earlier today. We talked about how the standardization of service plans was making things uniform across the board when, in fact, there is quite a significant difference in activity and action going on within each health authority. That would seem to indicate that there possibly should be some variations in terms of service plans because there are different activities. [DRAFT TRANSCRIPT ONLY]
My question, though, to the minister is around…. We'll start with the Northern Health Authority. Could you tell us in the House what the total number of surgeries is? What elective surgeries are being planned, and what is the reduction? [DRAFT TRANSCRIPT ONLY]
[1505]
Hon. K. Falcon: We're now talking about the Northern Health Authority. Again, this is a health authority that is seeing an operating budget increase of 20 percent over the next three years. In their case, they are managing a pressure that is somewhat less than the Lower Mainland — nonetheless, still a pressure of 2.1 percent. [DRAFT TRANSCRIPT ONLY]
I'm advised by staff that the number of acute care in-patient surgical procedures performed in NHA is 8,481. I'm advised that there are no plans for reductions to the elective surgeries in this year. [DRAFT TRANSCRIPT ONLY]
A. Dix: Because we're trying to get a sense of the nature of the reductions, if we can, in Fraser Health…. I think we've talked about Northern Health a little bit, and we know that on Vancouver Island the reduction is in the neighbourhood of a thousand, I think — maybe a little less, maybe 760 in terms of surgical reductions. I think that's right. [DRAFT TRANSCRIPT ONLY]
In Interior Health it's a little more opaque. It's seemingly done by regions. There are some surgeries cut, but it's in the same area, I think — 800. In Northern Health the minister is saying that it's flat. In Fraser Health we're saying that it's 4.6 percent, and we'll find out of what. That's the nature of the surgical or elective surgery cuts. Cumulatively, we're talking about probably a very small number of savings, although obviously a very significant impact for people. [DRAFT TRANSCRIPT ONLY]
In terms of MRI procedures just in this period, we know that we're going from 22,500 in VIHA to…. They initially said 18,100, and I think they've restated that as 19,100. Going back to Fraser Health, my understanding is that they are planning to stick to the same number they did last year. Is that a correct understanding? [DRAFT TRANSCRIPT ONLY]
[1510]
Hon. K. Falcon: I'm advised on two things. First of all, the number of MRI machines from 2001 to 2008 in the Fraser Health region…. There have been 12 new MRI scanners added, which increased the total from nine MRIs in 2001 to 21 today. [DRAFT TRANSCRIPT ONLY]
I'm further advised that the CEO, Dr. Nigel Murray, earlier this year in a progress report suggested that the Fraser Health Authority was going to hold the health authority's MRI volumes at last year's volumes, which are 10 percent higher than the previous year and — again, to put it in perspective — about three times as many as were performed in 2001. [DRAFT TRANSCRIPT ONLY]
A. Dix: So just to understand…. The public fundraised in Burnaby and at Peace Arch for two new MRI machines this year. There were large public fundraising campaigns at both of those facilities. If the number of MRIs is the same, and you add two machines, by definition you are reducing the number of MRIs done at each individual facility. Is that an accurate description of what's going on? [DRAFT TRANSCRIPT ONLY]
[1515]
Hon. K. Falcon: The member is right to note that there are indeed even more now — two additional MRI scanners, which allow those folks in that area to be able to have local access to MRI scanners. But as the member would know, even in a perfect world there is…. In our publicly funded systems, often it's the case that we don't have an unlimited amount of dollars to run an unlimited amount of MRIs. [DRAFT TRANSCRIPT ONLY]
What we try to do is maximize as many as we can. As I pointed out, in the Fraser Health region we've seen since 2001 — the year that I first got elected — a 333 percent increase in scans. That is a pretty dramatic increase. Of course, the number of MRI scanners, as I mentioned, has gone from nine to 21. [DRAFT TRANSCRIPT ONLY]
The Fraser Health Authority, again, I am advised, is going to be attempting to meet the same number of MRI volumes as they did last year, which are at a record level and indeed are 10 percent higher than the previous year and, as I mentioned, are three times the volume that was being undertaken in 2001. [DRAFT TRANSCRIPT ONLY]
A. Dix: The minister will know that it's true in every jurisdiction, because MRIs are used more than they were ten years ago — that that would be the case. [DRAFT TRANSCRIPT ONLY]
He also knows, because of the Canadian student health information and the Canadian Medical Association, that MRI wait times in Canada are roughly five times longer in British Columbia as they are in Ontario. [DRAFT TRANSCRIPT ONLY]
All of that is very interesting, I suppose, but what the minister didn't answer was the question. I mean, I might have asked about MRI machines since 2001, but I happened not to. What I asked was…. Burnaby and Peace Arch went on a large fundraising campaign, and those machines are going to be used not even not at capacity but nowhere near capacity, after a huge public effort. In fact, the bringing on of those machines will mean a reduction at all the other hospitals in the region — every other MRI in the region. [DRAFT TRANSCRIPT ONLY]
It just follows that if you're freezing the number of MRIs, and you're adding machines, the number of MRIs per machine drops. That's the point I'm making to the minister — that, in fact, we have dramatically longer wait times for MRIs than, say, in Ontario. This is a fact that is established by those reputable bodies. [DRAFT TRANSCRIPT ONLY]
We have this new capacity, and it has no effect on wait times. It will have no effect on wait times because they're not doing any more MRIs this year, even after the two machines come on. That's the point I was making to the minister. I think it will be evident to everyone. [DRAFT TRANSCRIPT ONLY]
I want to ask the minister briefly about what his plans are for the Mission Memorial emergency department. [DRAFT TRANSCRIPT ONLY]
Hon. K. Falcon: Just to finish off on our last discussion, it is important to point out that, again, record levels of MRIs are taking place in Fraser Health. I think the member would know, because I know he certainly reads up a lot on health issues. [DRAFT TRANSCRIPT ONLY]
[1520]
But you always have to be careful to even equate the number of procedures with outcomes. I would gladly put our health outcomes up against Ontario's health outcomes here in British Columbia anytime. I'd be very, very pleased to do that. [DRAFT TRANSCRIPT ONLY]
With respect to Mission Memorial Hospital, as the member knows — it's certainly been publicly discussed — Fraser Health is in a conversation with the community to look at the operation of the emergency department. I have personally met with Mayor Atebe from Mission to speak about this issue. They are developing options on what to do with the emergency department. [DRAFT TRANSCRIPT ONLY]
One of the issues that I assured Mayor Atebe of when I met with him and some of his staff is that my responsibility as Minister of Health is to make sure that the decisions they make are going to be based on facts that will be shared to everyone so there is no surprise on which the foundation of a decision is being made. [DRAFT TRANSCRIPT ONLY]
As I have since pointed out, one of the challenges with the emergency department at Mission Memorial is that it sees very little activity, particularly in the overnight hours, where, on average, it will receive nine patient visits after 11 p.m. In fact, only one of those visits would actually present by ambulance. [DRAFT TRANSCRIPT ONLY]
I say that not to denigrate those nine visits, because they are still important visits, even if they are not of a high-acuity nature, generally speaking. But we have to understand, again, in the context of the fact that Mission Memorial Hospital doesn't operate in isolation. [DRAFT TRANSCRIPT ONLY]
Our health system is a network of health systems. One of the things that we do know is that 20 minutes away across the river, over the bridge, is a brand-new $355 million Abbotsford Regional Hospital and Cancer Centre, the first new regional hospital built in the province of British Columbia in 35 years, which has opened up. [DRAFT TRANSCRIPT ONLY]
In addition to that, in the other direction, almost an equivalent amount of time, is the Ridge Meadows Hospital, which has seen a tripling of the emergency department during the last number of months. [DRAFT TRANSCRIPT ONLY]
It is within that context that the health authority, on looking at how it is going to deliver services, recognizing that typically, high-acuity patients are being diverted already to those other emergency departments, has suggested as one of their options on Mission Memorial Hospital that having the emergency department closed during the overnight hours of between 11 p.m. to, I believe it is, 7 a.m — it might be 8; I'll double-check that — is one of the options that they are in consultation on. [DRAFT TRANSCRIPT ONLY]
Now, this is a very difficult issue for the community. I recognize that, because we all become very attached to our respective hospital facilities. But I do think, within the context of the massive investments that have been made and recognizing that the health system is a network, that those options do need to be considered and are being discussed. [DRAFT TRANSCRIPT ONLY]
A. Dix: Yeah, and I think the minister will agree with me. I mean, the Abbotsford hospital is a bigger hospital, as was MSA. They get, according to the same report, four ambulance visits a night, which in absolute terms doesn't seem like a lot, although if you're in one of the ambulances, I think it would be pretty important. [DRAFT TRANSCRIPT ONLY]
In the case of Mission Memorial Hospital, I understand that between the hours of 11 and seven, like every other hospital in the province, they get less patients. They get about 3,500 a year, I understand. The minister is talking about nine a night, which roughly will bring you there. [DRAFT TRANSCRIPT ONLY]
I guess the question is…. The minister will understand that Abbotsford hospital — which was running at 260 and, now that they've created 24 PATH or long-term care beds within the hospital, is operating at 236 — has a relatively poor record right now in the key standard in emergency room care, which is admittance within ten hours. [DRAFT TRANSCRIPT ONLY]
I guess that. and a number of other reasons — significant risks — underlined in the report that the minister himself commissioned, would indicate to me that it'd be a good idea to keep Mission Memorial Hospital open. [DRAFT TRANSCRIPT ONLY]
I guess what I want to ask the minister, and we can have the debate about that…. I've expressed my view, and he's expressed his view. What I would like to know is where we are now. [DRAFT TRANSCRIPT ONLY]
[1525]
Clearly, this is being done to seek savings. I wouldn't be suggesting that the minister would be closing this just because he wants to close it. He's seeking financial savings, and they've asked for financial savings. They say specifically in the report, and I highlight this to the minister, that if you don't like closing the ER, you have to find other savings in the hospital. [DRAFT TRANSCRIPT ONLY]
I guess what I want to ask the minister is where the process is at and when he expects to have a decision in this case. Will he, for example, visit Mission for a public meeting to discuss that with the citizens of Mission? [DRAFT TRANSCRIPT ONLY]
Hon. K. Falcon: I know that those discussions are ongoing. I didn't put a timeline on those discussions to the health authority. They're going to have those discussions with the community and with the surgeons. I acknowledge that these are not easy decisions. I also acknowledge, and I think it's right to acknowledge to the member, that yes, there are savings that are realized by doing this. They're certainly not doing it because it's a fun thing to do. [DRAFT TRANSCRIPT ONLY]
But I do think we have to recognize that this is being made in the context of us saying to the health authorities: "Look, with a 20 percent funding increase, you still have a 3.5 percent challenge, a pressure. In managing that pressure, we want to make sure that you are utilizing the facilities that you have in a manner that makes the most sense; that doesn't take away from patient care; that, in fact, can be informed by best practices or practices that we've seen elsewhere." [DRAFT TRANSCRIPT ONLY]
As I pointed out to the member — it may have been during a previous question period; I'm not sure exactly the form, likely a question period — near the member's own riding is the Mount Saint Joseph community hospital. It's another hospital facility that has two other facilities nearby — VGH and St. Paul's Hospital — that have 24-hour emergency departments. Now, Mount Saint Joseph's does not have an emergency department open in the overnight hours. [DRAFT TRANSCRIPT ONLY]
What Fraser Health is proposing is very similar to what is taking place in Vancouver. The one thing I can assure the member of…. I know the change itself is difficult, and I know that many in the community will view that change in a negative sense. [DRAFT TRANSCRIPT ONLY]
I think that if we look at the experience of other health authorities and, indeed, other jurisdictions maximizing the use of their facilities, recognizing also when significant investments have been made, as have been made in this case on both sides of Mission Memorial Hospital — on the tripling of the emergency department at Ridge Meadows Hospital on one side and, of course, the $355 million construction of a brand-new, state-of-the-art hospital, Abbotsford Regional Hospital and Cancer Centre, on the other side…. [DRAFT TRANSCRIPT ONLY]
Given that context, and given the fact that the Fraser Health Authority is looking at its budget and saying, "Even with the 20 percent budget increase, we need to manage the dollars we are currently spending more efficiently and effectively," they have looked at that emergency department at Mission Memorial and said: "You know, this is an emergency department that, on average, will see overnight visits of about nine per night. Only one of those, on average, will arrive by ambulance." [DRAFT TRANSCRIPT ONLY]
Now, given that reality, Member, and even though the politics of it may be difficult, I do not think that as a Minister of Health, when I have a health authority suggesting that they can manage their facilities more efficiently with some pretty significant savings to the health authority, that that is not something that I should not be supportive of. [DRAFT TRANSCRIPT ONLY]
So they are having a continued discussion with the community, through the mayor and council. I understand that there are a number of proposals going back and forth. But very clearly, what the health authority position is, is if there are other alternatives that are being presented, they certainly want to make sure that they demonstrate equivalent savings for the health authority on a go-forward basis. [DRAFT TRANSCRIPT ONLY]
A. Dix: The minister talked about what's clearly his preferred proposal, which is to reduce the hours at the ER at Mission Memorial Hospital. I just note to him that all of this has been in the period, as he likes to say, since he was elected a member of this House. The Mission Memorial Hospital has lost the maternity ward, lost more than half its acute care beds, lost ICU. [DRAFT TRANSCRIPT ONLY]
Now he's proposing to downgrade the emergency room, and none of these things have come back. In fact, this is capacity that has been lost by that community. So the community is legitimately questioning the plans that the minister has for the hospital. [DRAFT TRANSCRIPT ONLY]
[C. Trevena in the chair.]
Those are 3,500 nighttime visits — 19,000 visits overall, which is not a dissimilar number to the Ridge Meadows number. It's the hospital that people in Mission go to when they need care. That's the reality of it, and you see that reflected in the report. [DRAFT TRANSCRIPT ONLY]
[1530]
So if it was just a question…. I guess the minister has confirmed that it's basically a budget question, that if they don't like that, then they're going to have to take some other service out of the hospital. [DRAFT TRANSCRIPT ONLY]
That's what the report says. That's what the authority says. That doesn't seem to me to be an evidence-based approach, but there it is. Then maybe the minister could address or has addressed or would address the idea of the risks, because when you lose an ER, of course, it creates other risks in the hospital, and the other risks to patients at Mission Memorial Hospital are underlined in the report. [DRAFT TRANSCRIPT ONLY]
He seems to be advocating for an option that would see, really, yet another major downgrade. Sometimes I think it's five major downgrades, and sometimes I think it's six. But it depends. One, I think, can be counted in two phases. But it would be the sixth major downgrade of an important hospital in that region, and it sure matters to the people of Mission. [DRAFT TRANSCRIPT ONLY]
I agree with the minister to this extent. This is not an easy decision, but it sure matters to the people of Mission. We have seen time after time after time the Fraser Health Authority come looking for savings only from the people of Mission. [DRAFT TRANSCRIPT ONLY]
Hon. K. Falcon: Look, I think every government has to occasionally make difficult decisions. I know that the member would know that when the NDP took office, there were 84 acute care beds at that hospital. When they left office, there were only 42 beds. I don't doubt for a second that those probably were not easy decisions for that member while he was in the government of the day, nor for the Minister of Health of the day. [DRAFT TRANSCRIPT ONLY]
One thing I do know and am learning rapidly and am informed on as I meet with more and more medical professionals — and, I think, something that we have to keep in mind — is that the practice of surgical and surgery for physicians is a very, very important practice. Actually, best practices, particularly in areas of maternity, because the member mentioned that…. Volume is very, very important for the best outcomes for the women that are receiving birthing from a medical professional, from an obstetrician or a physician. [DRAFT TRANSCRIPT ONLY]
There's no question, Member, that these decisions are a challenge and can be a challenge, but I do think that we have to listen to some of our medical experts and the things that we have learned, not just here but around the world, in terms of operation of our medical facilities. [DRAFT TRANSCRIPT ONLY]
You know, one of the things that I said at the beginning of my remarks is that this is a health system. In my community of Surrey, for example, when the Abbotsford Hospital and cancer care centre opened, that actually provides a benefit to the system, including in Surrey. None of these hospitals operate in isolation, whether it's Peace Arch or Surrey Memorial or Abbotsford Regional Hospital and cancer care centre or Mission Memorial or Ridge Meadows, they are all part of a system. We have to look at what's happening across the entire system. [DRAFT TRANSCRIPT ONLY]
As I mentioned, we have a situation in this case where we've got significant investment made in the tripling of the emergency department at Ridge Meadows on one side of the Mission Memorial Hospital, and on the other side, we've got a situation where we've got a brand-new hospital, the $355 million Abbotsford Regional Hospital and cancer care centre. [DRAFT TRANSCRIPT ONLY]
Why is that important? That is important because when we think about patients and the kind of care that we want to have those patients receive, I can tell you that one thing we do know from the numbers that are presented by Fraser Health is that the overwhelming number of visits to the Mission Memorial emergency department are taking place during the daylight hours. There's just no question about that. The number of visits that take place in the overnight hours is very, very modest — as I mentioned, nine on average and one presenting, on average, by ambulance. [DRAFT TRANSCRIPT ONLY]
When we are asking our health authorities to manage their dollars responsibly, I do think they do have an obligation to say: "Well, you know what? We just made a massive investment over here. We made another massive investment over here." [DRAFT TRANSCRIPT ONLY]
[1535]
This is a system that we are providing, and the best practices suggest, particularly on high-acuity patients that have been involved in serious incidents, that you certainly want them to be presented at the high-volume tertiary facilities that can provide the best possible services to those particular individuals. Is it difficult politics? I absolutely acknowledge it is. No question about that. [DRAFT TRANSCRIPT ONLY]
But I have to point to the experiences, as I mentioned, in Vancouver, where we've got very similar situations. If you look at the service that's being provided in Vancouver today, whether at Mount St. Joseph's or VGH or St. Paul's, it is an exceptional level of service. We are recognized by the Conference Board of Canada as having the best health system in the country. I do not believe that the options they are discussing with Mission Memorial are taking away from that one bit. [DRAFT TRANSCRIPT ONLY]
A. Dix: Well, the continued cuts to Mission Memorial Hospital have taken away from it quite a bit. I just note to the minister that according to his own chair of the board, he gave the fastest-growing health authority, maybe, in the country — certainly in the province — a 2.9 percent lift this year. That's what he gave them. That's what the chair of his health authority says he gave. [DRAFT TRANSCRIPT ONLY]
Naturally, since they barely balanced the budget last year — they, essentially, were right on the number — this meant that there were going to be cuts. This government signed many contracts between 4 percent and 5 percent for workers — there were reasons for that three years ago, and they took lots of credit for that — which they haven't funded. [DRAFT TRANSCRIPT ONLY]
Other inflation in health care is very high. You've got a very fast-growing health authority, and there's a shortfall, and that's why. Surely the minister isn't suggesting that there was a $160 million shortfall because people were incompetent. That's the issue we're facing. [DRAFT TRANSCRIPT ONLY]
I would say, in the case of the Mission hospital…. I was very interested to hear the minister talk about maternity beds. This will allow us, perhaps, to transition to another question. [DRAFT TRANSCRIPT ONLY]
The minister will know that the Fraser Health Authority produced a plan that suggested that they were going to consolidate pediatric units and maternity units. He just referred to what he called best practice. I'll just read what that plan says. It says: "The research in pediatrics supports maintaining critical mass at specialized sites as a good threshold for safety for our child patients." [DRAFT TRANSCRIPT ONLY]
Since the minister is mentioning that, perhaps the minister can tell us the progress or the results of the review of the pediatric unit at Langley Memorial Hospital. [DRAFT TRANSCRIPT ONLY]
Hon. K. Falcon: I know that the member and I will disagree about this continually, but I do want to put on the record that the increase, again, to the health authority budget this year is 5.9 percent. [DRAFT TRANSCRIPT ONLY]
It's worth noting that since 2001 the Fraser Health Authority has seen a budget increase of over 62 percent. So this is not really a discussion about whether more money has been added. That is very, very clear. It is really a question of…. In spite of the massive increases in funding that have been provided, there are still challenges in the system. [DRAFT TRANSCRIPT ONLY]
With respect to the member's reference to reviews that are underway, my understanding is that they are still working on those reviews. We expect that we will see those in the coming weeks, and then we will have a discussion about them. [DRAFT TRANSCRIPT ONLY]
A. Dix: The minister and I had a brief exchange in the Legislature this week about the closing of the adolescent psychiatric unit at Abbotsford Regional Hospital and the six beds involved in that. Obviously, that has real implications. [DRAFT TRANSCRIPT ONLY]
[1540]
Just a year ago, a previous Minister of Health and the health authority were talking about this as an important innovation, as a crucial innovation to health care. What we're seeing, therefore, is a shift. They went up to 16 beds. There's clearly demand. I think the minister would agree there is acute care demand for psychiatric beds for adolescents in the Fraser Health Authority. In fact, in some respects, the Fraser Health Authority is, if you take the same comparative view, under other health authorities in terms of its access to mental health services. [DRAFT TRANSCRIPT ONLY]
I want to ask the minister — the minister talks about transferring patients to Surrey — if he is aware of what kind of wait times there are for the beds in Surrey, whether he is aware there are no acute beds that teens can be admitted to on the weekend in all of Fraser Health, and whether he is aware that, in the case of the ten-bed Surrey unit, two psychiatrists recently resigned, which has put that unit under stress as well. [DRAFT TRANSCRIPT ONLY]
I guess what I'm asking the minister is — because there is a strong evidence-based argument to open the unit not 15 years ago but last year — why the decision has been taken not to continue to recruit and find people for that unit, why the decision has been taken to close that unit given the critical shortage of those services and the wait time to get into that facility in Surrey. [DRAFT TRANSCRIPT ONLY]
Hon. K. Falcon: As I mentioned in the previous exchange we had with respect to this, since the adolescent psychiatric unit opened last year at Abbotsford Regional Hospital and Cancer Centre, they've faced real difficulties in staffing that unit. It's one of the reasons why just two of the six beds have been occupied. So it's been operating at 30 percent of its capacity. [DRAFT TRANSCRIPT ONLY]
The challenge of staffing is a very real and significant one. Just so the member knows, only two of the beds were occupied. So it doesn't mean that everyone necessarily has to be transferred over to the Surrey psychiatric ward. [DRAFT TRANSCRIPT ONLY]
In fact, what they are also doing, as I mentioned in the previous response to the member, is investing $400,000 to enhance the local adolescent crisis response program and also develop an adolescent day treatment program locally for residents that are impacted with issues of mental health. [DRAFT TRANSCRIPT ONLY]
Now, the challenge that they've been having at the adolescent psychiatry side is finding the medical professionals necessary to staff. The member just talked about a couple more that have been lost in the Surrey area. The Fraser Health Authority is attempting to develop a pool of adolescent psychiatrists so that they have a pool they can draw from to more appropriately utilize, whether on a day treatment program or in the case of in-patient beds. [DRAFT TRANSCRIPT ONLY]
Is it a challenge for them? It certainly has been. It's been a real struggle in staffing that unit. As I say, only two of the six beds were actually utilized. They've made these decisions — again, though not easy — to try and respond to the reality that they're facing, particularly in having difficulty attracting the medical professionals they need. [DRAFT TRANSCRIPT ONLY]
A. Dix: The fact of the matter is that this is a cost-saving initiative. They're saving $1.1 million. Fraser Health is claiming it's going to reinvest some of that money — a smaller share of that money, less than half of that money — in other services. That's the claim, I guess. But the savings is $1.1 million from those services. [DRAFT TRANSCRIPT ONLY]
I'll just read to the minister, because I think it's important to refer to the experts. Who are the experts? Well, I hate to say it. We'll start with the Ministry of Health Services itself. What does it say? It says that a new adolescent psychiatry unit means earlier admission and quicker access to treatment for adolescents with challenging mental illnesses. That's what they say. That's what the ministry said when the unit opened only one year ago. [DRAFT TRANSCRIPT ONLY]
What does a teacher working on the unit, Bruce Dugdale, say? Over 70 adolescents went through that unit in its first year of operation. As you know, these are critical cases. They're critical cases because of what they mean. We talk about these things in terms of savings sometimes. [DRAFT TRANSCRIPT ONLY]
[1545]
I have talked in the last few days, I'll tell the minister, and had incredibly moving stories from some of the people who have actually been on the unit and received care and, in their minds, got better as a result of the care they got there and thought it was essential for them. Seventy adolescents went through the unit. [DRAFT TRANSCRIPT ONLY]
What does Mr. Dugdale say? [DRAFT TRANSCRIPT ONLY]
"For the past year I have worked on the unit as a teacher. During that time I have seen many young people arrive at the unit extremely ill and unable to function in their communities. Certainly, many were incapable of continuing successfully with their schooling.
"Many of these adolescents became healthy enough to return to their families and schools in a very short time. Families who were devastated by their child's mental illness have been able to leave the hospital with hope, something they did not have."
So a year ago they opened the unit. This is what's happened. [DRAFT TRANSCRIPT ONLY]
Derek Smith — and I quoted this to the minister the other day — said: "This is a really unacceptable situation. The unit's just opened. Teens will continue to be underserved here. Having young teens admitted to adult units simply does not work. It's often a dangerous situation for kids." The recruitment problem, in his view anyway, is a sham — never seen evidence of a serious attempt to recruit doctors here. [DRAFT TRANSCRIPT ONLY]
I guess what I'm asking the minister is…. This seems like the wrong path. It really seems like the wrong path for the region. The right path would be to address these issues, because there's a need for the beds. We know there's a need for the beds because there's a wait time in Surrey and because this wait time can be very troubling for the people. [DRAFT TRANSCRIPT ONLY]
I guess I'm making an appeal to the minister. I mean, yes, he has decided to cut mental health care for adolescents and save $1.1 million. I understand that's what they're doing, because they've only increased the Fraser Health budget by 2.9 percent this year. But all of that said, this seems like the wrong decision and a decision that will lead to further costs in the health care system later on because adolescents, young people, children don't get the care they need. [DRAFT TRANSCRIPT ONLY]
Hon. K. Falcon: I thank the member for his comments. I have no question that the individuals he cited are probably correct in terms of the positive outcomes. When we do have the staffing, there's no question these folks do exceptional work. [DRAFT TRANSCRIPT ONLY]
I do think it is important to point out to the member that the spending in Fraser Health for mental health and addictions is not being reduced. It is actually increasing by 18 percent over the next three years. Again, I have to say to the member that when we are asking the health authority in an era of even 20 percent — or 18 percent in this case — budget increases, they are still finding themselves with pressures to manage. It is incumbent upon them to try and make sure that they look at how they deliver the services and determine and make sure they are doing so as responsibly as they can. [DRAFT TRANSCRIPT ONLY]
Now, in this case the adolescent psychiatry unit has had real difficulties in staffing the unit, in recruiting not just child and adolescent psychiatrists but also the qualified and very specialized nurses that are required to oversee the adolescent psychiatry unit. In that case there has been difficulty in identifying and finding two specialized nurses. Those positions remain vacant. As I mentioned earlier, there is a real challenge in finding the youth and adolescent psychiatrists. [DRAFT TRANSCRIPT ONLY]
So what are they doing? Looking at that challenge, they're saying: "Okay, why don't we invest some dollars in an adolescent day treatment program and also enhance the adolescent crisis response program with a $400,000 investment?" That's locally. Well, recognizing that, again, only two of the in-patient beds were utilized…. But should there be an in-patient bed requirement, then they would transfer, at no cost to the individual of course, that individual or individuals to the ten-bed unit at Surrey Memorial Hospital. That's something they're doing. [DRAFT TRANSCRIPT ONLY]
[1550]
What's the second thing they're doing? They're not saying that they're not going to reopen the APU. They very likely will. But prior to doing that, what they are going to do is make sure that through a continuing aggressive international and national outreach program, they are going to try and build a child and youth psychiatrist pool that will be available so that we know we've got the medical personnel, including the specialized nurses that are required to operate the APU, so that they can reopen the APU and know that they've got the appropriate staffing levels to support that. So that is a challenge for them. [DRAFT TRANSCRIPT ONLY]
I wish I could say that this was the only area of the health system where we have real challenges on trying to hire particularly specialized medical professionals, but it is not. They are trying to deal with this in a manner that is both responsible and understanding of the challenges that these young folks obviously face. They are real, and I think that the investments that they're making in the adolescent day treatment program and the adolescent crisis response program are, in some ways, to address those real issues. [DRAFT TRANSCRIPT ONLY]
A. Dix: The minister will agree with me, though, that it's a net savings to the health authority of $750,000. That's presumably the reason it's taking place and announced with all these others, this array of cuts, particularly to mental health, to long-term care, to addictions, to seniors services, to other services, to hospice care across the Fraser Health Authority. Presumably, that's the purpose for them. [DRAFT TRANSCRIPT ONLY]
Maybe the minister can just help me, because he mentioned it and mentioned the increases that he talks about. Maybe the minister can just help me here by describing the recruitment efforts that did not succeed, because when the ministry and the Fraser Health Authority opened this unit, clearly, they did so believing they'd be able to staff the unit. It would have been ridiculous to open the unit if that wasn't the case. Can the minister perhaps describe, if he can, what those recruitment efforts were? [DRAFT TRANSCRIPT ONLY]
Hon. K. Falcon: That would obviously be a good question to pose to the Fraser Health Authority and the management with respect to that unit. I obviously don't have that kind of information at my fingertips. What I do know is that they had an aggressive national and international recruitment effort. In spite of that, there was only one child and adolescent psychiatrist that was available to provide 24-7 coverage, and that is a big challenge. [DRAFT TRANSCRIPT ONLY]
They also had two specialized nursing vacancies that are necessary for the operation of that APU unit — the adolescent psychiatric unit — at Abbotsford hospital, and they have been unable to fill those two positions. So, Member, yes, they could keep operating it at 30 percent capacity with the challenges associated with that, having only one adolescent psychiatrist available to provide that 24-7 coverage, but that is obviously very, very difficult to do. [DRAFT TRANSCRIPT ONLY]
What they have tried to do is to say: "What we want to do is move forward on the basis of…. First of all, let's take some of those savings." The member is right to note that there are savings. There's no question that the health authority is trying to manage their budget in a responsible manner, even recognizing that with an 18 percent increase in mental health and addictions over the next three years in Fraser Health, there are still challenges. They're trying to manage that responsibly. [DRAFT TRANSCRIPT ONLY]
They are investing a portion of that $400,000, as I mentioned, to make sure that there's an adolescent day treatment program available right there in Abbotsford to help deal with some of these cases and also enhancing the adolescent crisis response program. I don't pretend that this is the perfect solution. But they are, at the same time, going to again continue with a very aggressive national and international campaign to hire the specialized nurses and the specialized child and adolescent psychiatrists to create a pool that will be available. [DRAFT TRANSCRIPT ONLY]
Once they have that pool available, and they can know they can rely on that expertise, they will reopen the beds at the adolescent psychiatric unit at Abbotsford Regional Hospital knowing that they've got the pool of medical professionals necessary to continue to operate it. [DRAFT TRANSCRIPT ONLY]
A. Dix: I didn't think it was an unreasonable question, given that we'd asked the question in the Legislature and he'd referred to the aggressive campaign, to ask what the campaign was, but it is a level of detail. [DRAFT TRANSCRIPT ONLY]
[1555]
I wonder if the minister could just agree to get from Fraser Health, who may well be watching as we speak, the information as to what that aggressive campaign consisted of: what they were doing, why they decided to essentially abandon and give up the unit now and perhaps a detailed explanation for that. If he could provide that, it would make things easier. [DRAFT TRANSCRIPT ONLY]
Hon. K. Falcon: I will certainly endeavour to get that information for the member prior to the ending of estimates. [DRAFT TRANSCRIPT ONLY]
The one other thing I would point out to the member that might be useful for the member to know is that I'm advised by staff that the Surrey adolescent psychiatric unit, which I mentioned earlier and which has ten beds, is operating at 80 percent occupancy with no wait-list. [DRAFT TRANSCRIPT ONLY]
I think that is important for us to know in terms of, again, the health authority trying to make sure that they manage the assets they have in a manner that provides the best possible results. That means that at the Surrey adolescent psychiatric unit, the staff are advising me that there is no wait-list and that they're running at 80 percent occupancy. [DRAFT TRANSCRIPT ONLY]
There you have, over at the Abbotsford psychiatric unit, six beds with only two that are being occupied and extreme challenges in terms of filling some specialized positions. [DRAFT TRANSCRIPT ONLY]
So the decision they are making certainly is difficult. What they are doing is that if a patient presents that requires in-patient bed requirements — in other words, is not a patient that can be dealt with through the adolescent day treatment program that they're investing dollars in to create for the benefit of youths locally and the enhancement to the adolescent crisis response program…. If they do require an in-patient bed situation, they will be transferred, at no cost, of course, to the Surrey adolescent psychiatric unit which, as I say, has no wait-list and 80 percent occupancy. [DRAFT TRANSCRIPT ONLY]
A. Dix: I don't want to be too precise with the minister, but the 80 percent occupancy right now — 80 percent on average or 80 percent median? What is that? I'll give him a second question while he's thinking of that, while he's getting that answer. [DRAFT TRANSCRIPT ONLY]
As he knows, there's a committee of both the Ministry of Children and Families and the Ministry of Health that guides child and youth mental health in the province. Was the decision to close this unit referred? Was their opinion sought before Fraser Health made a decision to shut this unit? [DRAFT TRANSCRIPT ONLY]
That is a question that I know the minister will have an answer to, because it was asked and not answered in question period just a couple of days ago. [DRAFT TRANSCRIPT ONLY]
Hon. K. Falcon: With respect to the first point the member made, the 80 percent occupancy is on average for year to date. It typically averages about 80 percent occupancy. [DRAFT TRANSCRIPT ONLY]
With respect to the Ministry of Children and Family Development, I am advised that we are often in conversations and discussions with the Ministry of Children and Family Development. But they manage community-based children and youth mental health and addiction services. We handle the acute in-patient services, which are completely managed under the purview of the health system, though I understand that, in spite of that clear separation of duties, still there are usually ongoing conversations that take place. [DRAFT TRANSCRIPT ONLY]
[1600]
A. Dix: So there is no comment from that unit. I want to ask the minister about closure of another unit in Chilliwack that deals with addictions, the ten-bed withdrawal management unit at Chilliwack General Hospital. Again, this is an issue where the ministry is claiming, anyway, that it's not running at full capacity, but it's eliminating all of the capacity here. [DRAFT TRANSCRIPT ONLY]
I just wanted to ask the minister, because people in Chilliwack, anyway, including the Salvation Army and other people who deal with these issues, are extremely concerned, in fact, with this particular cut. Can the minister explain why he thinks it's a good idea to be cutting addiction services here and all over the Lower Mainland? [DRAFT TRANSCRIPT ONLY]
Hon. K. Falcon: Both the withdrawal management unit at Chilliwack General Hospital and the similar unit at Creekside in Surrey are operating at between 60 and 70 percent capacity. Fraser Health has made the decision to centralize the detoxification and withdrawal services at Creekside in Surrey. [DRAFT TRANSCRIPT ONLY]
Now, to help offset some of the issues that that may raise in the eastern Fraser Valley, Fraser Health will be expanding home detox services that could support up to 250 clients a year as well as to, of course, support clients that may require transport to the Surrey facility. [DRAFT TRANSCRIPT ONLY]
I am advised that Fraser Health is also investing in increased access to stabilization and transitional living residences in Fraser East for homeless clients who need a safe and stable environment for detox and support to transition to other levels of support. They are also maintaining an addiction outreach worker to facilitate access to the home detox services in the Creekside withdrawal management unit. [DRAFT TRANSCRIPT ONLY]
A. Dix: So you closed one unit in Abbotsford and moved it to Surrey; closed a unit in Chilliwack and moved it to Surrey. Can the minister tell us how much money is being saved by the closure of this unit? [DRAFT TRANSCRIPT ONLY]
Hon. K. Falcon: I am advised that the savings for this year will be $250,000 on an annualized basis. That would be a net savings of $800,000 in '10-11. [DRAFT TRANSCRIPT ONLY]
I do think, Member, that, again, this is one of those areas where if you are operating similar facilities at 60 or 70 percent capacity, you are, of course, responsible for all of the overhead and staffing costs associated with those two separate, distinct facilities operating at less than their total capacity. [DRAFT TRANSCRIPT ONLY]
So the decision of Fraser Health is…. While they are closing the withdrawal management unit, some patients may end up, of course, in the Surrey facility at Creekside, but as I say, they are taking some of those savings to expand the home detox services that will potentially serve up to 250 clients a year as well as investing in, as I mentioned, the increased access to the stabilization and transitional living residences in Fraser East for homeless clients who need a safe and stable environment for detox and to support their transition to other levels of support. [DRAFT TRANSCRIPT ONLY]
[1605]
A. Dix: The decision in this case has, I think it's fair to say, been greeted with some alarm in the community. [DRAFT TRANSCRIPT ONLY]
Of course, the minister is not ensuring that a service…. He's saying that it's running at two-thirds capacity and that's a bad thing, so he's going to close the whole thing. For people in Chilliwack there are significant issues. If you look at the overall assessment and the reviews done by Fraser Health of health needs in the region, you'll see that that region has significant mental health and addiction needs, especially addiction needs. So it seems perplexing that the government would close the unit that they again just opened, really, just a few years ago –– that that decision would be made. [DRAFT TRANSCRIPT ONLY]
So I'd ask the minister again to review it because, in this case, this isn't an issue, presumably, of lack of capacity based on lack of staffing. I assume that's the case. It's the decision made because the minister's arguing there's insufficient demand. But what people in Chilliwack say about it who refer and deal with people suffering and dealing with substance abuse is that it's a key part of their community services. This is an essential part of their community services in that region. [DRAFT TRANSCRIPT ONLY]
Surely it's not easy for people in Chilliwack, which…. The minister will agree with me…. He was talking about some places being close to one another recently. It's a big health region, at least for a suburban health region. Fraser Health's a big health region, and Chilliwack's a long way from Surrey. Doesn't he think that that's a real blow to addiction care in the Chilliwack community? [DRAFT TRANSCRIPT ONLY]
Hon. K. Falcon: I appreciate the member acknowledging that many of these services, the whole range of them through Fraser Health, are, of course, all new services since 2001. [DRAFT TRANSCRIPT ONLY]
We're proud of the fact that even with changes made for the system to manage the budget pressures and make sure that they utilize the facilities they have in the most responsible and financially responsible manner, there are occasionally changes that have to be made to try and deal with some of the pressures that the authorities are dealing with, in this case Fraser Health, in spite of the fact that the mental health and addictions spending is increasing over the next three years by 18 percent. [DRAFT TRANSCRIPT ONLY]
I think it is important to note, and I'm advised that it's very important to point out, that not all clients that are needing detox treatment need or want to go to a withdrawal management unit. For some clients, home detox is very much a viable and, indeed in many cases, a preferred option. That's why when the member just talks about it closing as if nothing else changed, that is actually not the case. [DRAFT TRANSCRIPT ONLY]
What is happening is they are investing in expanding the home detox services which, as I mentioned, can support as many as 250 clients a year, and this is often the preferred option for many of the clients that do not wish to spend their time in the withdrawal management unit. [DRAFT TRANSCRIPT ONLY]
They're also, as I mentioned, investing in increasing access to the stabilization in transitional living residences in Fraser East for the homeless clientele, which is a particular subgroup that requires a safe and stable environment for detox and then ultimately support to transition to other levels of support. [DRAFT TRANSCRIPT ONLY]
So I recognize it is a change, for sure. In fact, I acknowledge that the easiest decision, of course, would be to do absolutely nothing and continue to operate both facilities at under capacity, but I think what they have done is say: "Look. We recognize that we don't have unlimited funds in Fraser Health." We recognize, as the CEO has acknowledged –– and is doing an exceptional job, by the way –– that the 20 percent increase they're seeing in their budget over the next three years is extraordinary, and he appreciates it. But in spite of that, there is still a challenge. There are still pressures. [DRAFT TRANSCRIPT ONLY]
So we have said, and certainly I will, as a member of this government, as the Minister of Health…. It is us that have said to the health authorities: "We expect you to manage within that 20 percent budget increase." [DRAFT TRANSCRIPT ONLY]
[1610]
That means they have to look at all the services they deliver to ensure that they are maximizing the dollars they spend to ensure that they are providing the best possible treatment with the dollars that are available. I acknowledge they are not unlimited dollars. [DRAFT TRANSCRIPT ONLY]
As I say, I think in this case that while they are indeed closing the withdrawal management unit, they are doing so recognizing that they've got excess capacity at Creekside in Surrey while, at the same time, taking some of those savings that are generated and reinvesting them in the eastern Fraser Valley to expand opportunities on home detox services, which I understand is often not only a viable but a preferred option for many of those who struggle with addictions issues. [DRAFT TRANSCRIPT ONLY]
Of course, I talked about the initiatives that are being invested in further on the transitional-living residences in Fraser East for that subgroup of the population that is homeless and requires a safe and stable environment for detox and, ultimately, transition. [DRAFT TRANSCRIPT ONLY]
A. Dix: Indeed, as the minister noted, Dr. Murray has also agreed with the chair of his board that the lift this year is 2.9 percent, just as the chair and the CEO of the Vancouver Coastal Health Authority have acknowledged that their lift is 2.4 percent. [DRAFT TRANSCRIPT ONLY]
They've done it again and again. They're facing these difficult circumstances. The minister might reasonably argue that 2.9 percent is a generous increase. That's what he may want to argue. But to say, since we're talking about this year's budget, that 2.9 percent, given the collective agreements and everything else, does anything but lead to service reductions is wrong. [DRAFT TRANSCRIPT ONLY]
We said before the election that it would lead to service reductions. The government denied it, and here we are. What do we have? [DRAFT TRANSCRIPT ONLY]
Well, we have the closure of the adolescent psychiatric unit and the closure of the withdrawal management addictions in Chilliwack. We have the closure of hospice beds and of a convalescent care unit in New Westminster. We have the closure of beds at Peace Arch Hospital, the closure of what are called temporary long-term care beds all over the Fraser Health Authority, and on it goes. There's the closure of residential care beds at Bear Creek Lodge and then the cuts in surgeries that we've talked about and so on. [DRAFT TRANSCRIPT ONLY]
This is where we're at. I just want to ask the minister, in light of all those closures to really important services in Fraser Health…. He said, and I believe him, that he doesn't like cutting mental health services, cutting surgeries, cutting MRIs — or freezing them and cutting them at every hospital in the region but two. He doesn't like closing hospice beds. He doesn't like closing the convalescent care unit. He doesn't like any of these things, and I believe him. I believe he doesn't like that. [DRAFT TRANSCRIPT ONLY]
I guess the question it asks, because he referred to it…. This is an important statistic if you look at the Fraser Health budget. If you look at the Fraser Health plan, the share of corporate expenditures, which are broadly administrative expenditures — they're not all the administrative expenditures, but they're broadly the expenditures — is actually going to increase as the share of the budget. [DRAFT TRANSCRIPT ONLY]
In fact, in the Fraser Health region and in many other regions it's going to increase faster, that share of the budget, because when that thing increases its share of the budget, other things decline as a share of the budget. [DRAFT TRANSCRIPT ONLY]
There's only 100 percent, and it's going up from 7.77 percent to 9.48 percent in the next two years. That's what's happening in Fraser Health. Oddly, it's happening in Interior Health as well. Oddly, it's happening in Northern Health as well. [DRAFT TRANSCRIPT ONLY]
When the minister talks about making these tough decisions and cutting administration and so on, the reality is that the plan that he himself has presented to us shows an increase in administrative costs as a share of the budget. [DRAFT TRANSCRIPT ONLY]
I appreciate that he says they're tough decisions brought about by, as the chair of the board of Fraser Health says and as the CEO of Fraser Health says, a 2.9 percent lift that doesn't cover increasing costs in health care. I appreciate that. But I'm perplexed, I guess, as to why the corporate share of the budget is increasing so dramatically. [DRAFT TRANSCRIPT ONLY]
[1615]
Hon. K. Falcon: Again, it's one of the things that I've tried to point out as we've had this discussion, an important discussion in the debate, about how do you have a health system manage in an era where a 20 percent budget increase is still not enough. The perspective is important because we've just been, as you know, talking about mental health. [DRAFT TRANSCRIPT ONLY]
The member is criticizing changes that have been made in mental health, some driven by best practices, depending on which program you're talking about. But he cannot argue with the fact that the budget increase for mental health in Fraser Health is increasing by 18 percent over the next three years. In fact, he was chief of staff of the government that I do have to point out promised a $125 million mental health plan that did not have one dollar associated with it — not one dollar associated with it. [DRAFT TRANSCRIPT ONLY]
I will absolutely accept criticism for decisions being made by health authorities as they struggle to manage within a 20 percent budget increase, but I will have to…. I know it will annoy the member, but I will put it in a perspective. [DRAFT TRANSCRIPT ONLY]
The member talks about hospice beds. Well, I think it's interesting to note that in Fraser Health there was a grand total number of hospice beds when we were elected in 2001 — so following a decade of the NDP government — of zero hospice and tertiary palliative care beds in Fraser Health. Zero. There wasn't one. [DRAFT TRANSCRIPT ONLY]
What is there today? Today we've got 96 hospice beds and 30 palliative care beds in Fraser Health. You know, that's why perspective is important. These members like to…. It's kind of like if you're an accountant and you only focused on one side of the ledger. That's typically what the NDP do. They like to focus on one side of the ledger and try and define everything as cuts even when the evidence in the budget…. The member keeps talking about a 2.9 percent increase. We know it's 4.9 percent. It's in the blue book. That is the base budget of Health from one year to the next. [DRAFT TRANSCRIPT ONLY]
I pointed out to the member that yes, one-time dollars were provided midway through the year last year. We were fortunate that we were in an era where the government was seeing dramatic increases in revenues. The economy was the strongest in the country. Things were looking very, very good. It was great that we were able to provide those one-time dollars to the health authorities — much of it targeted to encourage innovation and to continue to try and do new and better things within the authorities. [DRAFT TRANSCRIPT ONLY]
But this year is a very different year. The whole world has changed since last year. Apparently, it hasn't changed for the members opposite, but I can tell you that in every part of the world we are going through one of the most challenging economic circumstances we have ever seen. In spite of that, it was a decision of this government that we are still going to…. While we are reducing in many other ministry budgets, we said that in health care and in education we would increase the budgets. [DRAFT TRANSCRIPT ONLY]
As I say, we are increasing them in Health, and I'm proud of it. I acknowledge — I have been very up front with the fact — that in spite of that, there are still pressures, and we are asking them to manage that 3½ percent pressure. It varies between each health authority. As I mentioned, up in the north it's 2.1 percent. It will be different depending on which section or which health authority you're talking about, but on average, it's a 3½ percent pressure. They're doing a very good job in managing it. [DRAFT TRANSCRIPT ONLY]
The member now talks about administrative expenses. I am informed that to the period up to the end of August, the Fraser Health Authority administration, which is their admin and support expenditures as a percentage of their total expenditures, in '08-09 was 10.7 percent. In '09-10 it is 10.3 percent. We've also seen reductions in Northern Health. We've also seen reductions in VIHA. We've seen reductions in Vancouver Coastal. [DRAFT TRANSCRIPT ONLY]
Keep in mind that it's interesting the member mentioned that fact, because any time we do see administrative reductions, the first people to jump up and talk about health care cuts are the same NDP members of the opposition. It is indeed an interesting perspective that they often take on these things. [DRAFT TRANSCRIPT ONLY]
I will tell you that I do think the health authorities, under the leadership of very competent and able leaders like Dr. Nigel Murray in Fraser Health, are doing an exceptional job in challenging circumstances, because they are challenging. [DRAFT TRANSCRIPT ONLY]
[1620]
They are trying to make sure that the decisions they make are respectful of the increased taxpayer dollars they are receiving but also recognizing that there are not unlimited dollars. They are trying to manage as best they can and doing a very good job. [DRAFT TRANSCRIPT ONLY]
A. Dix: I know it's unfair to ask the minister about what's actually in his own plan for health care. I think that might be seen as unfair. Corporate line: Fraser Health Authority, $192 million, 2009-10; 2010-11, $248 million; 2011-12, $264 million. That's the Fraser Health Authority. [DRAFT TRANSCRIPT ONLY]
The Interior Health Authority, which he happily neglected to mention there, is going up as a share of the budget. In fact, in both of those health authorities, the corporate line is going up faster over the next three years than the mental health line. So there you go, but they're cutting mental health. [DRAFT TRANSCRIPT ONLY]
I know it's unfair. This is just the information the minister himself provides. In fact, Northern Health acknowledges that there's an increase in corporate costs, which go from 13.33 percent to 13.62 percent of overall expenditures. So we all sort of look at it with a sense of wonder and mystery when the minister talks about all the reductions they're making in corporate and administrative expenditures, and the budgets are actually going up in those areas faster than they are in small little things like — oh, I don't know — acute care, like community care, like population health and wellness and so on. [DRAFT TRANSCRIPT ONLY]
I don't want to dwell on the minister, as he attempts to wrestle corporate expenditures to the ceiling…. [DRAFT TRANSCRIPT ONLY]
Interjections.
A. Dix: I'm glad I'm inspiring the minister, because far be it from me to use the actual materials that the government attempts to share with us. I get other materials as well. I should say this to the Minister of Health. I get other materials, as well, from time to time, that give us some insight into what's going on in the health authorities, but that's the reality. That's what the budgets say. That's what they say the direction is going in as we go over the next few years, and there may be justification for that. [DRAFT TRANSCRIPT ONLY]
But, you know, I'd note to the minister that when it comes to other agencies funded by the health authorities, they take an arbitrary…. They don't look at each expenditure line. In Northern Health, they say the increase in administrative costs are a result of the additional costs of managing P3s and of planning. That may be what they say, but when they cut Coast Mental Health by $900,000 in their grant, they don't mention that. They just say, "You're cut," and the minister lectures them in the House about spending too much on administration — community providers that do an excellent job. [DRAFT TRANSCRIPT ONLY]
So there are no explanations. "Well, you've got to understand that it's going up from 7.7 percent this year, and it's going to go up to 9.48 percent in two years. But, you know, you've got to understand the difficulties we face." That doesn't happen when they're cutting every mental health program in the Vancouver Coastal Health Authority. That doesn't happen when they get rid of every seniors program on 30 days' notice in the Fraser Health Authority. That doesn't matter then. None of those things matter then. [DRAFT TRANSCRIPT ONLY]
In fact, you know, it's just the way it's got to be. We funded them every year. These programs came before us every year, and they went through Treasury Board every year. We said we were going to do them every year because they are valuable programs in the community — those seniors programs, those mental health programs. [DRAFT TRANSCRIPT ONLY]
Now this year they're cut, and they're cut mid-year because the government's scrambling around to deal with a budget problem that their own service plan said they knew about 18 months ago, and they didn't start dealing with until July of this fiscal year. That's the situation we're in. [DRAFT TRANSCRIPT ONLY]
So I think that when you talk about the situation in Fraser Health and the struggles people are having in this fast-growing health authority where the government is withdrawing services…. Withdrawing services frequently delays care. The fact that wait-lists will grow in Fraser Health doesn't mean that people won't get the surgery they need, eventually. They'll just have to wait longer, in pain, and more of them will end up in emergency rooms. That's the reality of it. [DRAFT TRANSCRIPT ONLY]
I think that when we're talking about these things, it's reasonable to ask why it is, for example, that the corporate line…. The minister talked about the corporate line. He says it's going down this year a little bit, and then it's going up like this — in the actuals. The corporate line in their own service plan, the Fraser Health Authority, is $202 million — the corporate line in the Fraser Health Authority, in the actuals of 2008-2009 is $202 million. [DRAFT TRANSCRIPT ONLY]
[1625]
You know what it is, hon. Minister, in 2011-12, according to the plan? It's $264 million. So we've gone from $202 million to $264 million for the corporate line. That's what they're doing in the next two years. [DRAFT TRANSCRIPT ONLY]
Somehow, magically, 95 percent of the cuts are administration — right? So these are serious questions. And I agree with the minister. The cuts are very difficult, and I understand, for the officials making the cuts, they are sometimes heart-wrenching. [DRAFT TRANSCRIPT ONLY]
But it seems to me that we can do better than this. We should acknowledge, at least, what's happening in Fraser Health. Acknowledge that Nigel Murray says that they're getting a 2.9 percent lift. Acknowledge the chair of the board saying, "We're getting a 2.9 percent lift," and that that doesn't come close to covering the inflationary impact of the collective agreements the government itself signed — those collective agreements. [DRAFT TRANSCRIPT ONLY]
It doesn't come close to that because we're in the third year, the most expensive year, of the packages the government signed three years ago, and it doesn't come close to dealing with inflation in health care. So they are cutting services to people that people need. [DRAFT TRANSCRIPT ONLY]
Care will be delayed. This is the consequence. This is what's happening. We're going to see, under this minister, a decline in care for Fraser Health. I'll just finish, and then I'll let him start, because I know he's inspired to speak. I think I'm inspiring him now to say more, because he talked about…. [DRAFT TRANSCRIPT ONLY]
Interjection.
A. Dix: The member from Kamloops. I'd be delighted to hear him speak as well. We'll be talking about the 10 percent cuts to surgeries in Kamloops in a little while, and I'm sure the minister will be on this side urging me on to raise these issues and ask the minister to explain why he's gutting health care services in the Kamloops region. But that's for later. [DRAFT TRANSCRIPT ONLY]
I just say this: the very Conference Board reports that the government mentions all the time show that number one in health care in 2001 was the province of British Columbia. Those very reports show that. We were number one when this government took office. [DRAFT TRANSCRIPT ONLY]
They show, also, contrary to jurisdictions across the country, that health care was protected in British Columbia more than in any other jurisdiction in the country at that time. That's what they show. That's what was inherited here — number one in the country, according to the Conference Board of Canada. That's what was inherited by this government. [DRAFT TRANSCRIPT ONLY]
What we're teetering on here with increases in wait times, it seems to me, and with cuts in community services is something that sends us down a different path. And yes, I don't agree with the minister about that path. [DRAFT TRANSCRIPT ONLY]
I respect his right to have a different point of view and to engage in a different policy, but what we're seeing in Fraser Health is a government that gave the health authority 2.9 percent this year, because you've got to count the estimates in the supplementary estimates last year. You kind of do that. [DRAFT TRANSCRIPT ONLY]
I know that Fraser Health does. They count them. They count them together. When they present a service plan, they count them together. When Nigel Murray speaks, he counts them together. When Gordon Barefoot speaks, he counts them together — right? So 2.9 percent. He counts them together, and that's what he says it is. [DRAFT TRANSCRIPT ONLY]
As an inevitable consequence of that, the government and the Fraser Health Authority are having to cut real services to people, including the ones we've mentioned here. [DRAFT TRANSCRIPT ONLY]
So I think in terms of a question…. Does the minister need a question at the end, or would he like to respond to some of these remarks? [DRAFT TRANSCRIPT ONLY]
Hon. K. Falcon: Yes, the minister would certainly like to respond. It would appear that the NDP's particular abilities with numbers have not improved over the years. That's unfortunate. It is amazing the incredible gymnastics that they will try to undertake to try and suggest that increases — in fact, massive increases — in not only services but budget are still not enough. [DRAFT TRANSCRIPT ONLY]
The member talks about an increase in the corporate budget. What he is trying to suggest is that, "Oh, my goodness, they must be somehow increasing their administrative costs," when we know the opposite is true. [DRAFT TRANSCRIPT ONLY]
So '08-09. He talks about the $202 million. But then, very strangely, the member jumps ahead three years. We're here to discuss the budget of '09-10. Why would the member suddenly be talking about '11-12? The people that are listening are probably confused by that too. It just doesn't seem to make sense. [DRAFT TRANSCRIPT ONLY]
Here we are debating the estimates for the Ministry of Health in '09-10, and — oh — I think I figured out why. Because when I look at the line for corporate in '09-10, it is actually $192 million. That is a 5 percent reduction. That means it went down. [DRAFT TRANSCRIPT ONLY]
[1630]
Why would the NDP member, the critic for Health, knowing that this is the budget year that we're having a discussion, jump from a corporate number in '08-09 and leap forward to '11-12 to try and suggest an increase? Well, I would suggest that it's playing with numbers. He's clearly trying to suggest something that is not the case. [DRAFT TRANSCRIPT ONLY]
The fact of the matter is that in '11-12 there is a higher number in corporate. You say to yourself: "Now, why is that?" Well, it may be — and this would be understandable for the NDP not to know about this, because they didn't build anything in the 1990s — because we are actually opening a brand-new $240 million ambulatory centre in Surrey that is currently under construction. [DRAFT TRANSCRIPT ONLY]
It may be that, in fact, they need to put aside, as you would responsibly do, just like you have a contingency in a budget. In corporate, you definitely put aside a contingency for the planning dollars that are going to be realized when you are building a new five-floor tower at Surrey Memorial Hospital. When you are expanding the emergency department at Surrey Memorial Hospital five times larger than what it is today and when you're increasing the number of acute care beds by a third, certainly in the outgoing years you would want to have the kind of planning dollars for the facilities and the construction of those facilities in those out-years. [DRAFT TRANSCRIPT ONLY]
You know, the member mentions Northern Health, and again, he makes that leap forward. Why would he do that? Well, maybe it's because they are engaged in a planning process to see a brand-new several-hundred-million-dollar Fort St. John Hospital, for example. No kidding that they are going to allow some planning dollars to be reflected in the corporate budgets in the out-years. [DRAFT TRANSCRIPT ONLY]
It is interesting to me that this member…. I know — try as you might, Member — that you cannot create, with the numbers that are in front of us, any suggestion that there have been reductions when there are dramatic increases. [DRAFT TRANSCRIPT ONLY]
I know that they will try everything. The member will say: "Well, I want to take the one-time dollars that were given to the health authorities last year — midyear, by the way, on a one-time basis — and somehow pretend that that was the real budget base that they started out with at the beginning of the year and that that's the level that we should employ as the base budget." Well, that's not how it's done. The member knows that. [DRAFT TRANSCRIPT ONLY]
He can go to the blue books that are audited by the Auditor General of this province and see what the increase for Fraser Health was this year — this year's base budget over last year's base budget. It clearly was 4.9 percent. [DRAFT TRANSCRIPT ONLY]
I think that when the member tries to suggest that corporate expenditure has gone up, when we are looking right here right now at the fact that in Fraser Health last year, $202 million…. This year in '09-10 — for the benefit of the members in the Legislature here; the members would know that that's the year of the debates on estimates that we're currently debating — it's actually $192 million. That is a 5 percent reduction. [DRAFT TRANSCRIPT ONLY]
As I say, why did the member leap forward several years? Because he wanted to try to create an impression that corporate is going up for no apparent reason. He's trying to suggest that: "Oh, here's this terrible health authority that is in the midst of a 20 percent budget increase, trying to manage their dollars appropriately, trying to make sure they utilize their facilities appropriately." He's trying to suggest that at the same time they're doing that that there is somehow an increase in corporate when the opposite is the case. [DRAFT TRANSCRIPT ONLY]
The reason why in the out-years they put contingency planning dollars in place — why? — is because we and they are in the midst of some of the most massive capital expansion ever seen in the history of the province of British Columbia, and it's taking place in my community of Surrey. I'm very proud of that. [DRAFT TRANSCRIPT ONLY]
I can tell you that $239 million that is under construction today — I would encourage the member to go see it — is actually proceeding ahead of schedule, on budget. That project is going to be tremendous assistance to the existing Surrey Memorial structure, which is under pressure from a growing community. [DRAFT TRANSCRIPT ONLY]
Yet they are also, in addition to the $239 million out-patient facility, planning on constructing a new, expanded Surrey Memorial Hospital that will include a new patient tower, will include 85 new in-patient beds, will include a new 48-bed neonatal unit to build on the fact that Surrey Memorial is recognized as one of the most efficient, effective places to deliver babies anywhere in the world. They do an outstanding job. [DRAFT TRANSCRIPT ONLY]
[1635]
Of course the health authority will make sure that in their corporate line item they have in the out-years planning dollars available for all of those new facilities that are going to be constructed. [DRAFT TRANSCRIPT ONLY]
Member, I don't mind having a debate about that, but I think there is an obligation on the member to make sure that he is referring to numbers that are accurate. I don't for a second believe he was intentionally trying to mislead, but certainly it is curious that the member would not refer to the line item for this year in the budget that we're describing, the corporate line item that shows a 5 percent reduction. [DRAFT TRANSCRIPT ONLY]
I've just given the explanation why in the out-years that number increases to reflect the largest capital program ever undertaken in Fraser Health, and obviously they want to make sure they've got the planning and dollars available for the facilities they are currently planning. That will be the case in out-years in other health authorities because we are, after all, involved in the most massive capital expansion program in our health sector that we've ever seen. [DRAFT TRANSCRIPT ONLY]
As I mentioned, that is additional dollars, an additional almost $3 billion over the next three years in every part of the province, whether it's Vernon, Kelowna, Fort St. John or, indeed, in Surrey — massive expansions. This budget reflects that. I appreciate the fact that we've got a Premier and a Finance Minister committed to providing these kinds of record-level increases in both capital and operating at a time when we are facing the most challenging economic circumstances we've seen in a generation in British Columbia. [DRAFT TRANSCRIPT ONLY]
A. Dix: I'm delighted, because I did something in preparation for my first mention of an out-year, which is to mention how many times the minister has referred to the out-years since we started this debate. The number is 25. [DRAFT TRANSCRIPT ONLY]
The minister may find it unfortunate that we're talking about his own service plan, but that's what we're doing. That's what we did in this case. [DRAFT TRANSCRIPT ONLY]
Now they are taking out of commission 235 beds in Fraser Health. In his own community of Surrey they're cutting seniors care. They're cutting surgeries. They're closing operating rooms at a time when there's growing demand and when his own acute care capacity initiative says there's dramatic new demand in the future. [DRAFT TRANSCRIPT ONLY]
It doesn't add up; 2.9 percent this year doesn't add up. That's not what I say. That's what Dr. Murray and Mr. Barefoot say. [DRAFT TRANSCRIPT ONLY]
Now, I don't want to distract the minister too much, but just to let him know how we're going to proceed from here, because I know that officials in the back, especially, are always interested in trying to provide the accurate, up-to-date information for the minister. [DRAFT TRANSCRIPT ONLY]
For the next little while we're going to go to questions from MLAs about their constituencies. We're going to focus, as I told the minister earlier, on the Vancouver Island Health Authority today and, after that, the Interior Health Authority for the last hour and 20 minutes of estimates. Then we'll continue on Monday through the health authorities, and I'll continue my discussion, finish with Fraser Health and go on to the other health authorities on Monday. [DRAFT TRANSCRIPT ONLY]
Then on Tuesday we'll deal with issues at the ministry, Pharmacare and a whole list of other issues. We might even touch on E-Health for a little bit, just because I know the minister was looking forward to that debate. [DRAFT TRANSCRIPT ONLY]
I wanted to introduce, unless the minister has something else to say…. The member for Alberni-Qualicum is going to ask a few questions. They'll be to do with issues in his constituency. We'll have a series of members ask questions from now until the end of the day. I'll just leave the floor to him. [DRAFT TRANSCRIPT ONLY]
S. Fraser: Hello to the minister and his staff. Thanks for being here today. [DRAFT TRANSCRIPT ONLY]
First line of questioning, just around the recent surprise announcement that the crisis lines on Vancouver Island — there are six of them that have been established — will be shut down, and there will be a lowest bidder who will take over that job, a 1-800 line. [DRAFT TRANSCRIPT ONLY]
We've already established and probed this in question period, so we do know that the minister and VIHA have not consulted. They have no studies to show how this will benefit or how it will not hinder or harm people. We also know that there was no consultation with front-line workers. We also know there was no consultation with community leaders. We also know that there was no consultation with health care workers, mental health workers, doctors, the police. [DRAFT TRANSCRIPT ONLY]
[1640]
We also know that there was no consultation at all, as far as I can see. The decision to shut down the six crisis lines on Vancouver Island in favour of a generic 1-800 line has been based on nothing that I can tell. There have been no statements about what sort of savings this could possibly do. [DRAFT TRANSCRIPT ONLY]
The question to the minister: what consultation happened with first nations regarding shutting down the crisis lines that they also so rely on? [DRAFT TRANSCRIPT ONLY]
Hon. K. Falcon: The member knows that we actually canvassed this in question period. I'm happy to spend more time on it for the benefit of the member. But you know, Member, the health authorities, I would remind the member…. We ask them to make decisions every day that are going to deliver better services and do it in a smarter manner that is respectful of the taxpayer dollars that go into it. [DRAFT TRANSCRIPT ONLY]
I get that the member for Alberni–Pacific Rim disagrees with the decision and believes it is best to continue with having six different crisis lines operating on Vancouver Island, but that is not supported by the lessons we've learned elsewhere in the province. It's not supported, as I mentioned, virtually anywhere else that I can find. [DRAFT TRANSCRIPT ONLY]
The fact of the matter is that we have found in British Columbia that when you have a single line of entry as…. An example I used earlier — one was the northern health line, another was what used to be called the NurseLine and is now often called the 811 HealthLink line. That is something that is easier for folks to access, easier to remember. There's a single number that they can access to deal with crisis line issues. The consolidation of six crisis lines with all of their attendant, administrative and operational expenses into a single crisis line actually makes eminent sense. [DRAFT TRANSCRIPT ONLY]
No, of course, I rather doubt…. I can't speak for them, so I don't know whether they engaged in widespread consultations prior to doing something that makes administrative sense. I would imagine it would be very difficult to manage any large organization if you couldn't make commonsense decisions on how to better utilize the dollars you have to provide a better service. [DRAFT TRANSCRIPT ONLY]
In the case of VIHA, I know they looked at the fact that they had six different lines, six different administrative overheads in six different areas, and said: "I think that we could probably deliver that service, as is being done elsewhere in the province, through a single line with significant administrative savings, a reduction in administrative duplication, with increased services to those that are utilizing the line. [DRAFT TRANSCRIPT ONLY]
S. Fraser: The minister speaks about common sense, so I'll go right to common sense. The only facts we have in this issue are that the six tried-and-true crisis lines on Vancouver Island, like KUU-US out of Port Alberni that services the entire central Island and the west coast, have been a huge success, and they've levered every meagre dollar they get from the province into huge benefits through volunteerism, fundraising, community involvement and developing community trust. [DRAFT TRANSCRIPT ONLY]
The minister didn't answer my question. What consultation did the minister or VIHA take with first nations before they made this very, very damaging decision? [DRAFT TRANSCRIPT ONLY]
Hon. K. Falcon: As I mentioned in my previous answer, I don't know whether they took any. I would be amazed if they did. This is an administrative decision that the health authority undertook. They're trying to make sure they manage their resources in a manner that makes more sense. [DRAFT TRANSCRIPT ONLY]
The member actually just reinforced the whole reason why they're doing it. He said that there are meagre dollars available. Well, it may be that there are meagre dollars available because you've got six different services with six different administrative overheads, six different structures. Actually, having a single unified structure can not only generate significant savings but can make it easier for people to access the line. [DRAFT TRANSCRIPT ONLY]
I don't know what consultations they undertook. I rather doubt they would have. These are administrative, operational decisions. They have to make decisions like this every single day in managing a very large budget in a very large region, and that's what they do. [DRAFT TRANSCRIPT ONLY]
[1645]
S. Fraser: Well, I have letters from the 'Namgis, north Island, and from the Nuu-chah-nulth. I was in contact earlier today with the president of all Nuu-chah-nulth. That's Cliff Atleo. He is outraged. Nuu-chah-nulth are outraged. Nuu-chah-nulth took a huge role in bringing about the KUU-US crisis line for central Island. [DRAFT TRANSCRIPT ONLY]
What the minister fails to recognize is that first nations on Vancouver Island had a say in creating this particular crisis line, and I would dare say other crisis lines on Vancouver Island are similar. That level of trust that's been developed over the years or decades is invaluable, and the value of that alone should not be discounted by the minister. [DRAFT TRANSCRIPT ONLY]
Cliff Atleo, the president of all Nuu-chah-nulth, would like a meeting with the minister on this. We want to stop this RFP process. This will hurt first nations and aboriginal peoples in my constituency. [DRAFT TRANSCRIPT ONLY]
The minister is failing, dismally, to recognize that he is defiling the so-called new relationship that this Premier has boasted about so often. I don't have enough time to read thoroughly through this for the minister, so I'll just start with the first paragraph of the vision statement for the new relationship. [DRAFT TRANSCRIPT ONLY]
"We are…here to stay. We agree to a new government-to-government relationship based on respect, recognition and accommodation of aboriginal title and rights. Our shared visions include respect for our respective laws and responsibilities." [DRAFT TRANSCRIPT ONLY]
The Nuu-chah-nulth took responsibility for a surge in a crisis within the aboriginal community, the Nuu-chah-nulth community, including a surge in suicide attempts, and the result of that was a huge success story known as KUU-US out of Port Alberni. [DRAFT TRANSCRIPT ONLY]
Will the minister adhere to the spirit and intent of the new relationship? Will the minister adhere to the words of the new relationship, stop this RFP process, at least temporarily, and meet with the president of Nuu-chah-nulth, Cliff Atleo Sr.? [DRAFT TRANSCRIPT ONLY]
Hon. K. Falcon: No, I won't be stopping the process. I get that the member opposite disagrees with the decision that VIHA is making. But you know, again, Member, it is founded on some pretty solid evidence that that's a better way to go. There's already on Vancouver Island some degree of centralization. I hate to break it to the member, but Victoria serves not only the greater Victoria area but also the Gulf Islands. I guess if we followed the member's logic, we should have separate crisis lines on each of the Gulf Islands too. That is the logical extension of what the member is saying. [DRAFT TRANSCRIPT ONLY]
There is an operational decision that has been made by the Vancouver Island Health Authority. They are making operational decisions every day, as you must do when you're managing a very large budget. They are trying to manage within — in the case of Vancouver Island — a 23 percent budget increase, a very significant budget increase. But in spite of a 23 percent budget increase on Vancouver Island Health Authority, they still have pressures. [DRAFT TRANSCRIPT ONLY]
What they are doing is looking at all the operational services they offer to see whether there are better ways to deliver services that can also save costs. In the case of the crisis lines, they have identified the fact that having six different administrative structures in six different areas being staffed, albeit with volunteers…. I acknowledge that volunteers can play an important role. They have said that they want to have a single line and follow the best practices that have been utilized elsewhere in the province, including the provincial 811 line, to deliver what they believe and what I believe will be a better outcome. [DRAFT TRANSCRIPT ONLY]
That's what they're doing, and I'm not going to interfere with that process. That process will continue, and I think the Vancouver Island Health Authority is right to look for opportunities where they can consolidate and reduce administrative duplication to try and deliver better services. That's what they're doing. [DRAFT TRANSCRIPT ONLY]
S. Fraser: I don't have time to go further on this right now, but the minister can be sure the issue is not over. Ministers of the Crown are not allowed to ignore and disrespect first nations leaders in this province. The Premier has made comments to that, and the minister is defiling those comments, so we will continue with this another day. [DRAFT TRANSCRIPT ONLY]
[1650]
I have one other issue that I need confirmation of from the minister — a totally different issue, and I'll just refer to a delegation that came into the audience here in the gallery on Monday. They are the Federation of Oceanside Residents Associations, and they were here to witness the…. There was an attempt by the member for Parksville-Qualicum to deliver some petitions, 6,000 of them, regarding an Oceanside health centre. [DRAFT TRANSCRIPT ONLY]
This is the highest-aged demographic in the province, if not the country, that's in the area of Parksville, Qualicum, Bowser, Deep Bay, Coombs and Errington — the east side of Vancouver Island. There is no hospital, and it's a 40-minute drive to any primary care facility. [DRAFT TRANSCRIPT ONLY]
There was an assurance made by the government in 2001 for the election that there would be such a facility. Can the minister confirm that there will be a public facility built in Oceanside that will include urgent care, primary care, ambulatory care, diagnostic and treatment and in-patient services? I am referring to a public health care facility for the people of Oceanside. [DRAFT TRANSCRIPT ONLY]
Hon. K. Falcon: Indeed, I am familiar with the great work that the folks in the Oceanside area have been doing. I have to point out the incredible work that the MLA for Parksville-Qualicum has been doing, working with these folks. I had an opportunity to meet with them, not only in my office but also on the day they were here to demonstrate their support and continued support for the new primary health care and urgent care centre that they wish to see. [DRAFT TRANSCRIPT ONLY]
The good news for the member is that we are moving forward very steadfastly in that process. As the member knows, back in June there was an expression of interest for a comprehensive primary health care centre in Oceanside that was posted on B.C. Bid. I understand they received six expressions of interest. They are now working to move forward on the next stage, which is the request-for-proposal stage. [DRAFT TRANSCRIPT ONLY]
As I say, I want to take this opportunity to congratulate the member for Parksville-Qualicum, who has been so instrumental in working with the members of the community and government to ensure that this important process does go ahead, as it will. [DRAFT TRANSCRIPT ONLY]
R. Fleming: I wanted to ask the minister questions, and I'll apologize in advance for just jumping around. They're to do with health services in my region and touch on different aspects of the authority's health care services. [DRAFT TRANSCRIPT ONLY]
I wanted to ask him, first, around plans and announcements by the Vancouver Island Health Authority to sell off a number of public properties. First of all, the wisdom of doing this. These are properties that the health authority has come into ownership of over a number of years. Some of them have historical significance in terms of health care provision decades ago when we had an evolving health care system to the one we have now. We had different health authorities and hospital societies and all the rest. [DRAFT TRANSCRIPT ONLY]
This budget, to make up for operating shortfalls, is selling off properties, including what has probably been canvassed best in the media recently, the Mount Tolmie hospital and the Oak Bay Lodge. I know there is a replacement plan underway for those facilities. I think there's a lot of debate that could happen around the efficiency of that, given that those facilities were recently renovated to a higher standard. But disposing of those properties for all time is the question I want to ask the minister. [DRAFT TRANSCRIPT ONLY]
[1655]
There's another property near Victoria General Hospital — whose name escapes me, except that it has the word "farm" in it — that is also being disposed of. It's quite a large parcel of land near Victoria General. [DRAFT TRANSCRIPT ONLY]
Now, the capital regional district projects that the percentage of seniors in our community will grow from 17 percent today, or approximately one in seven residents of the south Island region, to 29 percent by 2030 — nearly one in three residents. So demand for property, land, residential care facilities, assisted living…. All of those forms of seniors living in our community and remaining close to family are going to require property. [DRAFT TRANSCRIPT ONLY]
Land is not getting any cheaper in this region, as we know from history. Acquiring property and finding sites is made that much easier when they are under the control of the province or local government or some other site. That's what helps projects come together. [DRAFT TRANSCRIPT ONLY]
Why would we be disposing of assets, land assets, when we know that there is going to be an incredible need for them — indeed, there is already today? [DRAFT TRANSCRIPT ONLY]
Hon. K. Falcon: This is actually a very great news story that I'm excited about. As the member knows, and he's right to point out that we do have…. Everyone knows there are a growing number of seniors in the province of British Columbia. It's one of the reasons why, since 2001, we've opened over 6,000 new residential care, assisted-living and supportive housing units to help support our seniors. [DRAFT TRANSCRIPT ONLY]
In addition to that, there've been a further 6,000 units that have either been completely replaced or totally upgraded and remediated so the seniors can have the kind of care they deserve. [DRAFT TRANSCRIPT ONLY]
One of most important things is to recognize that there is a continuum of care that seniors require. In the case of Vancouver Island Health Authority, what they are doing is putting out a request for proposals on two sites where they've got aging facilities that don't meet the new standards that seniors certainly would expect and like to have. They are offering the opportunity to have those facilities replaced to create increased capacity. [DRAFT TRANSCRIPT ONLY]
They may not own the land anymore, but you will have new facilities providing the same service but with better, newer, more modern facilities along the lines of the kinds of things that we have seen in the 6,000 other new units that we've built across the province, where you've got individualized rooms with spacious quarters that are wheelchair-accessible and allow accessibility for lifts, etc. [DRAFT TRANSCRIPT ONLY]
This is something that we're very excited about. What VIHA is doing is going out with a request for proposal to see what the marketplace will offer in terms of the best possible solutions that provide better service and increased capacity for seniors in Victoria. [DRAFT TRANSCRIPT ONLY]
R. Fleming: Well, I don't accept the minister's answer in respect to long-term planning. I've given him some numbers about the aging society. He acknowledged that in part of his response. I think what he is doing for short-term operating cash shortages is selling off land assets that will help us respond to the aging society. He's constricting options in the future that will enable partnerships and new facilities to emerge. [DRAFT TRANSCRIPT ONLY]
I will move on and ask him another question related to seniors health in my region, and that is the announced closure of the geriatric assessment ward at Victoria General Hospital. [DRAFT TRANSCRIPT ONLY]
Now this is a specialized unit, 36 beds at that hospital. The criteria for people to be admitted to the unit…. They must be 75 years or older. They have to be, at that point in time, medically and surgically stable. It is a service that fulfils a function, allows seniors to determine the next steps in their lives and keeps them out of more expensive options that we've discussed earlier. It is part of providing excellence in care, yet it is threatened with closure in this budget. [DRAFT TRANSCRIPT ONLY]
[1700]
Given that that service is going to be cancelled, given that that service is where referrals are made in geriatric medicine in my region, what can the minister tell me about what he envisions or what will in fact be in place to replace the geriatric assessment and rehabilitation unit? [DRAFT TRANSCRIPT ONLY]
Hon. K. Falcon: The primary change is that they're moving more into a community care model in the Victoria area. So that is a change, but it is certainly an appropriate change for the Vancouver Island Health Authority to move forward to. [DRAFT TRANSCRIPT ONLY]
The other issue that they've had with the geriatric assessment unit has been difficulty staffing it over the past year. It has certainly been operating under capacity. VIHA believes, I believe correctly, that with appropriate supports, these clients can be better supported in community-based settings. So there is going to be a new model for the delivery of seniors specialty services that will be implemented and will provide appropriate community supports for seniors. [DRAFT TRANSCRIPT ONLY]
For example, VIHA is going to offer more of the rehabilitation services within the community. That will free up more resources that can be reinvested to provide additional and enhanced community-based supports and services. For example, VIHA's model includes using some beds in facilities like Aberdeen, where clients will receive more appropriate care than they would receive in an acute care setting. [DRAFT TRANSCRIPT ONLY]
But I do think we need to be clear that funding for the Vancouver Island Health Authority home and community care programs is at record levels and, in fact, is increasing by 10 percent over the next three years. As I say, there is no question that they are trying to move more towards a community care model and not have the geriatric services be provided only within, of course, an acute care model. [DRAFT TRANSCRIPT ONLY]
R. Fleming: Well, I think the minister is missing a couple of points in the discussion on this. This is a unit where the average length of stay is three weeks. It's one where all of the other points within our seniors health care system, within geriatric medicine, rely on and receive referrals for their services. So to say that you're moving to a community-based therapeutic model…. Well, this is part of that already, and it's being taken out. [DRAFT TRANSCRIPT ONLY]
I asked him what would be replacing the work being done there, and he didn't have an answer for that. Fair enough. Maybe he doesn't have an answer. But if he has other details to add and what will replace that service, I would be curious to hear them. [DRAFT TRANSCRIPT ONLY]
I wanted to ask him, though, about assisted-living facilities, because the government in this area and in different parts of the province has changed the mix between residential care facilities and assisted-living arrangements and, for the most part, has closed residential care facility beds and opened or replaced them with assisted-living units where there is a reduced scope of care and there simply are less distinctions between this much lower level of acuity. Sometimes it's inappropriately so. [DRAFT TRANSCRIPT ONLY]
The question I wanted to ask him is around a licensing and inspecting regime for assisted living. There isn't a rating system for residential care facilities on southern Vancouver Island. Now that we have a different mix of residential care and assisted living, does he plan on bringing in a rating system that is tied to licensing, inspecting and creating that for the assisted-living sector? [DRAFT TRANSCRIPT ONLY]
[1705]
Hon. K. Falcon: The last point is no, we are not at this time considering additional licensing on the assisted-living side. I do think it is important. I'm glad the member pointed out the issue of assisted living, because one of the things we found when we formed government in 2001 is that during the entire decade of the '90s there had been only 1,400 new beds added across the province. [DRAFT TRANSCRIPT ONLY]
The challenge was that the beds available were all residential care–type beds, which really are there to manage the most complex cases for seniors. The problem is that we know that as individuals age, their requirements for care aren't necessarily at the complex end of the spectrum. [DRAFT TRANSCRIPT ONLY]
It is a continuum where in many cases, with home support, individuals can do quite well. In an assisted-living setting, you will find that with very little support in some cases or in some cases quite a bit more support, seniors can do very well in assisted care living settings. [DRAFT TRANSCRIPT ONLY]
[L. Reid in the chair.]
The addition, as I say, of 6,000 new units across the province on top of an additional 6,000 units that were either entirely replaced or completely rehabilitated has now got a much larger complement of beds and options for beds that meet the needs of seniors, which are varying. I think that is absolutely appropriate. It is certainly built on a foundation of best practice. [DRAFT TRANSCRIPT ONLY]
I'm very proud of the record that we're doing, and we are going to continue to do more, including on Vancouver Island. That's what the discussion we were just having with respect to Oak Bay Lodge and Mount Tolmie is all about. It is about saying: "Look, let's not get fixated on the fact that the health authority owns the land that the buildings are operating on." [DRAFT TRANSCRIPT ONLY]
We want to make sure there are brand-new facilities put in place that will be funded by the health authority and can provide additional capacity for seniors to meet the needs of seniors in brand-new, very specialized facilities. [DRAFT TRANSCRIPT ONLY]
R. Fleming: I would like to ask the minister one question — in fact, two. It's about mental health and addictions services in Victoria. [DRAFT TRANSCRIPT ONLY]
The first is about a fixed-site needle exchange. Victoria served its estimated 2,000 or more IV drug users with addictions, often dual diagnosis with mental health issues as well, through contract service in a setting that was operated by AIDS Vancouver Island. That closed. The private landlord, in litigation, essentially forced its closure. [DRAFT TRANSCRIPT ONLY]
VIHA has long identified this as best practice in terms of curbing and controlling the spread of diseases like hepatitis C, like HIV and AIDS. In terms of reducing the incidence of that in the population, having a needle exchange has been seen as very beneficial not only for those struggling and living with addictions but, obviously, for everybody concerned with how efficient and well the health care system is managed. [DRAFT TRANSCRIPT ONLY]
It's been a couple of years now where no fixed-site needle exchange has existed. The health authority still, to my knowledge, acknowledges it as something that would be desirable. Of course, it costs money. They do not have a site or a location now to re-establish that service. I want to ask the minister whether the health authority is planning on pursuing that over the service plan of the budget that we're debating here today. [DRAFT TRANSCRIPT ONLY]
The second question, which is related in the sense that it deals with a population in Victoria that is struggling with and living within the community with supports. Those are a population of people who are living with mental health issues. There are an estimated 1,200 persons that access and use the Citizens Counselling Centre. [DRAFT TRANSCRIPT ONLY]
Now, this is something that's jointly funded by the United Way, has had a long partnership with the Island Health Authority and is losing its funding — approximately $80,000. They will lose their ability to have limited staff such as they have right now, and with that will go all of the volunteers who for years have put their compassion, their expertise and their counselling services into maintaining that society. [DRAFT TRANSCRIPT ONLY]
[1710]
Incredibly cost-effective service — I think it costs about $57 per client per year. These are people who are on low incomes, who cannot afford counselling services of any kind. This is a complementary service to the crisis lines that we talked about earlier. This was part of the original promise when government said it was going to move from an institutionalized mental health service model to deinstitutionalization — to give these kinds of community supports that are afforded by the Citizens Counselling Centre. [DRAFT TRANSCRIPT ONLY]
It is under threat of closure because the health authority has said that the grant that it has enjoyed for many years — many decades — will no longer be available. I want to ask the minister if he will have a second look, if he will conduct consultation with the 1,200 persons that use Citizens Counselling Centre, with their families who take them to appointments, who rely on their stability and their well-being and their transition to a better quality of life and full mental health. [DRAFT TRANSCRIPT ONLY]
Will they consult with the people who have put their heart and soul into this institution in our community and all of the patients who've come to rely on it and are getting well and better in our community in terms of their independence? Will he consult with them and save this centre from being cut and therefore eliminated? [DRAFT TRANSCRIPT ONLY]
Hon. K. Falcon: The member covered a pretty broad range of area. The member might help me by mentioning — I didn't catch the name — the agency that he's referring to. What I will say generally is that one of the things VIHA has discovered is that they are funding an enormous number of grants and services, and many of them are good services. There's no question about it. But many of them can be duplicative. Many of them are not direct health care where they're trying to focus their dollars, as I mentioned earlier. [DRAFT TRANSCRIPT ONLY]
In an environment where the Vancouver Island Health Authority is seeing a budget increase of 23 percent over the next three years, there are still pressures on their budget. So what they are doing is looking at the whole universe of grants. My goodness, when I looked at the scale and scope of some of the grants they provide…. There is no question that there are a lot of them. They have taken the view as they looked at that wide universe of grants that they've been providing, some in varying amounts…. [DRAFT TRANSCRIPT ONLY]
In some cases, they've just reduced the levels of grants provided. In some cases where they believe there's been duplication or the services do not provide a direct…. Not necessarily unimportant, but as important as other direct services that are being provided by the Vancouver Island Health Authority…. They have made decisions to stop some of those grants. [DRAFT TRANSCRIPT ONLY]
As I mentioned, I didn't catch the name, and the member can no doubt provide that for me, but I suspect that it must have fallen into one of those two categories. [DRAFT TRANSCRIPT ONLY]
In terms of the issue of a fixed location for a needle exchange program, there's no question that the health authority has had tremendous difficulty. I can tell you that it's not a budget issue. It is a significant neighbourhood opposition issue that has been very, very vociferous, strong and sustained in many neighbourhoods. I applaud the health authority for being sensitive to the fact that many of these neighbourhoods harbour some very significant concerns. [DRAFT TRANSCRIPT ONLY]
What they have tried to do, alternatively, is provide multiple sources that those with addiction challenges can receive new needles at — multiple different locations, including public health units. That is how they are ensuring that those addicts that require new and clean syringes are able to do so without creating the volcano of opposition they have discovered when they've looked at locations that may be potential locations for a fixed needle exchange facility. [DRAFT TRANSCRIPT ONLY]
D. Routley: My first question is to the minister. Thank you to the minister for the opportunity and to the staff for attending in support of the minister. [DRAFT TRANSCRIPT ONLY]
My first questions relate to the decision to collapse the current crisis line model on Vancouver Island with local management and local delivery of service down to the 1-800 number service that's being proposed by the minister. He's used as justification for this the efficiencies of B.C. NurseLine. [DRAFT TRANSCRIPT ONLY]
[1715]
I wouldn't suggest that that isn't a valuable service, but it's obviously a very different service than crisis line services. NurseLine services provide all sorts of information ranging from my partner Leanne's high temperature when she apparently might have had H1N1 to very general questions, as well as potential emergency questions. [DRAFT TRANSCRIPT ONLY]
But the range of questions directed to the NurseLine can hardly be compared, I would suggest, to what crisis line workers experience. By the very definition, their calls are related to an immediate crisis. Mental health workers, professionals throughout the Island, first nations and those people who have received services have spoken very loudly and clearly that they disagree with this decision. [DRAFT TRANSCRIPT ONLY]
Can the minister explain how he justifies this decision through comparing it to the NurseLine number, when there is that obvious difference in the service provided? [DRAFT TRANSCRIPT ONLY]
Hon. K. Falcon: The member is right to point out that it is a different service. I absolutely acknowledge that, but the principle does not change in terms of access to service and the kind of service you have the ability to provide. I think the member wouldn't be aware, so it's not fair, but I did spend some time canvassing this earlier with the member for Alberni–Pacific Rim. It's one of the reasons why we go to an RFP. Through the request-for-proposal process, there's an opportunity for, in fact, existing service providers to also bid on this — and any service provider. [DRAFT TRANSCRIPT ONLY]
I can tell you that what Vancouver Island Health Authority will be looking for is who can provide the best, most comprehensive level of service for the benefit of the entire Island. The challenge I have with the position that the member takes — and I know it's a position taken in good faith, for sure — is that the principle that the member is attempting to support is that it is better to have the six different service providers throughout Vancouver Island. I have a challenge with that. [DRAFT TRANSCRIPT ONLY]
I'm not saying that there are not good services being provided by all six of these different crisis lines. But if you think just of the Victoria crisis line, for example…. I mentioned to one of the previous members, from Alberni–Pacific Rim, that the Victoria line actually is partially centralized itself in that it serves the Gulf Islands. Indeed, they are somehow able to provide services to other areas — in fact, all of the Gulf Islands — through the Victoria crisis line. [DRAFT TRANSCRIPT ONLY]
That is exactly the same model we were talking about but taking that model and making it, you know, Islandwide. Although if I followed the direction of the members opposite, if you followed it to its logical conclusion, what we should be doing is having a crisis line on every single one of the Gulf Islands too, because you would use the same rationale that they're using to demand that VIHA maintain six existing crisis lines. I just fundamentally don't accept that. I don't accept it on the basis that it's a good use of dollars. [DRAFT TRANSCRIPT ONLY]
I will grant the member that if dollars were unlimited and there were no concern in the health system — they just had oodles of dollars and no pressures whatsoever, in spite of a 23 percent budget increase — then maybe you could just continue doing some of these things without considering any change of operation or delivery of service. But that's not the situation that VIHA finds itself in. They find themselves in a situation where even a 23 percent budget increase over the next three years is a challenge, and they still have pressures. [DRAFT TRANSCRIPT ONLY]
They are, I believe, doing exactly the right thing here. Rather than fund six different individual crisis lines with all their attendant support and administrative costs, they are looking for a single provider that will cover the entire Island, ensuring that every community on Vancouver Island is covered with a crisis line. They're going to do that by going through our request-for-proposal process, which will invite submissions from the existing, current providers so that they will have the opportunity to provide that more comprehensive service for every resident right across the Island. [DRAFT TRANSCRIPT ONLY]
I do think that's the right way to go, and I support them in it. That's why I just respectfully disagree with the members opposite that we ought to continue with the existing model. [DRAFT TRANSCRIPT ONLY]
[1720]
D. Routley: I represent a constituency that overlaps many first nations. The Hul'qumi'num Treaty Group represents seven of those. There are the Cowichan people, the Halalt, the Penelakut. There is the Snuneymuxw people, and there's the Chemainus band in Ladysmith. I wonder if the minister consulted with any of these first nations before this decision was considered. [DRAFT TRANSCRIPT ONLY]
Hon. K. Falcon: I apologize to the member. Sadly, we went through the exact same series of questions with an earlier member of the opposition. I will repeat for the benefit of the member because he probably wasn't here. I will repeat to the member that these are operational decisions that the health authority makes. [DRAFT TRANSCRIPT ONLY]
I can tell you that the health authority makes decisions every day. They're managing a very large budget. They've got to make operational decisions as they manage their budget to ensure that they are delivering the most comprehensive level of services possible within their budgets. [DRAFT TRANSCRIPT ONLY]
I don't know what level of consultation they undertook. I would be shocked if they were able to undertake consultations on something like this. These are decisions they have to make every day. If they engaged in a comprehensive consultative process before making any operational decisions on their budget, I guarantee they wouldn't be able to make decisions. [DRAFT TRANSCRIPT ONLY]
I think what we have to do, first of all, is recognize that there are very good folks out there, very well-meaning folks who would like to have things stay exactly as they are. I understand why. I understand the argument. I understand how important it is to the volunteers that are involved in their respective communities. [DRAFT TRANSCRIPT ONLY]
What I would say to them is that the Vancouver Island Health Authority is facing pressures even with the 23 percent operating budget increase, which doesn't include the hundreds of millions of dollars that are going to be spent on capital — just the operating pressures. Given those operating pressures, what they are doing is saying: "You know what? We cannot any longer continue to fund six different crisis lines for six different communities with all of their attendant overheads and administrative duplication." [DRAFT TRANSCRIPT ONLY]
What they are going to do is move to a new crisis line that will cover every community on the Island, a comprehensive service covering every single community. That in my view is the right thing to do. It's the responsible thing to do. It's financially sound in terms of doing it. I get that it's difficult for those who would like to see things exactly as they are, but that's not the decision VIHA made. I support them in the decision they made. [DRAFT TRANSCRIPT ONLY]
D. Routley: In fact, we don't want to see things exactly as they are. We'd like to see them improved. We'd like to see change that would bring an improved level of service throughout our communities. That's the sort of change that members on this side of the House have always desired, and that's the kind of change we've heard calls for from our communities. [DRAFT TRANSCRIPT ONLY]
The minister takes the approach that if it ain't broke, fix it. It's not broke. It works very well. It is a service that people have depended upon and have claimed, in fact, that it has saved lives. If the minister claims there's been such a huge increase in operating budget allowances, then it really mystifies me as to how such a beneficial service should find itself being challenged this way. [DRAFT TRANSCRIPT ONLY]
Clearly, any kind of removal of the local nature of the service delivery will challenge those benefits that have been pointed to by the people who deliver the service and the people who provided it. They talk about how local service delivery that's in touch with their problems can actually follow people through these crises. These are people who have their fingers on the pulse of the community. [DRAFT TRANSCRIPT ONLY]
For the minister to suggest that there shouldn't be a consultation when such an operational change is considered really flies in the face of everything that's been claimed by this government in terms of a new relationship. They've claimed that there will be a governmentwide change in the way government operates, in the way services are delivered, in the way that government's relationship will function with our first nations. [DRAFT TRANSCRIPT ONLY]
[1725]
Yet this minister, who presides over the largest budget in the provincial government's annual outlay, has no idea whether first nations were consulted. It seems hard to even comprehend that that could happen — that a crisis line service to communities that have an extremely high rate of suicide and have crises that are obviously being unmet…. Now they're being told they're just going to have this operational change imposed upon them without consultation and without consideration. [DRAFT TRANSCRIPT ONLY]
Can the minister explain how this decision in any way supports the government's claims to a new relationship in the way it does business with first nations? [DRAFT TRANSCRIPT ONLY]
Hon. K. Falcon: Let's understand what's being proposed here, because I think with respect to the member opposite, the member has lost sight of what Vancouver Island Health Authority is doing. You know, these crisis lines are not exclusive to first nations communities. I am sorry to say that mental health challenges respect no particular ethnic community. They impact all communities. [DRAFT TRANSCRIPT ONLY]
So let's understand what this member is proposing. The member is proposing that we have six crisis lines in six communities. What is Vancouver Island Health Authority doing? They're saying no: "We need a crisis line for every community on Vancouver Island. Every single resident of Vancouver Island deserves a crisis line." [DRAFT TRANSCRIPT ONLY]
I cannot believe that the members opposite are so wedded and so resistant to any change. Even if it provides an improved benefit to cover more people — in fact, every community on the Island — they will still stand up and vociferously oppose it. It is incredible to me. [DRAFT TRANSCRIPT ONLY]
The fact of the matter is that the member should know that instead of having just six lines in six communities, there's an opportunity for a single line covering every community on Vancouver Island. That's the right thing to do. I applaud Vancouver Island Health Authority for doing that. When they go to a request for proposal, that request for proposal offers the opportunity for even the existing service providers to look at whether they can provide that service comprehensively to every community on Vancouver Island. [DRAFT TRANSCRIPT ONLY]
I pointed out an example to the member opposite. Apparently, he doesn't like it, but the fact of the matter is that even one of the six that the member is talking about is actually providing services outside of its area. The Victoria crisis line is providing services to the Gulf Islands. Again, following that member's train of thought, what we should be doing is having crisis lines in every one of the Gulf Islands. In fact, apparently we have to have one in every single community on Vancouver Island. [DRAFT TRANSCRIPT ONLY]
Well, that is a fascinating, fascinating approach, but I can tell you this. In an era where there's a 23 percent budget increase in the Vancouver Island Health Authority budget and there are still pressures, you bet that we are going to ask them to look at how they can deliver a service more comprehensively to cover more people, to cover more communities, to do it with savings, to eliminate administrative duplication. I know the NDP will always oppose every change, but it is the right thing to do. I support them in doing it. [DRAFT TRANSCRIPT ONLY]
C. Trevena: I wanted to talk a little about the Campbell River Hospital, if I might. I think the minister is most likely aware of the ongoing problems we've had with the intensive care unit at the hospital. This is an issue that the previous Minister of Health had to deal with a couple years ago, but it's reared its head again. [DRAFT TRANSCRIPT ONLY]
There has been a call group of four doctors working in the intensive care unit, but now we've got two who won't be working anymore. One is elderly, and he's going to retire. The other wants to leave the call group, which leaves just two people in the call group. That means that effectively as of January 15, we have two people trying to staff the intensive care unit, which is going to be impossible. [DRAFT TRANSCRIPT ONLY]
VIHA has found a new doctor to come in, but they are going to have to come through immigration. They are trying to expedite that, but it's still going to be a few months. So a locum is needed quite desperately. I know that VIHA has been discussing with the ministry about whether we can get a locum through the rural locum program. But there's a bit of a catch-22, because there are four doctors in the area who could be in the call group. Even though there are only two, there are signs that we might not get the funding through the rural locum program. Obviously, if we have problems in the ICU, there's a trickle-down effect of where those patients are going to go, what's going to happen to other surgeries — the pressures that are already on the hospital. [DRAFT TRANSCRIPT ONLY]
[1730]
As I say, I know discussions are underway — three ways — between the BCMA, the Ministry of Health and VIHA. I would urge that the minister, if he can in any way, give some commitment that we can get doctors through the rural locum program. I would very much appreciate it. [DRAFT TRANSCRIPT ONLY]
Hon. K. Falcon: Member, I'll be happy to address that, but I wonder if I might just take a five-minute recess. I've been going now for a few hours, and I require a brief break, if that's okay. [DRAFT TRANSCRIPT ONLY]
The committee recessed from 5:31 p.m. to 5:39 p.m.
[L. Reid in the chair.]
Hon. K. Falcon: I thank the member for the forbearance with the break. [DRAFT TRANSCRIPT ONLY]
I'm informed by staff that our staff have been meeting with VIHA to work through this issue. It is a very real issue, and I appreciate the member has been very constructive in helping to try and solve this. [DRAFT TRANSCRIPT ONLY]
My understanding is that staff will be going forward to the joint committee — there's a joint committee of the BCMA and ourselves — with respect to providing locum coverage to rural and remote communities, with a recommendation that the ICU program will have access to the maximum locum coverage right through till April. [DRAFT TRANSCRIPT ONLY]
That will, I think, assist quite considerably in dealing with the short-term problem while they deal with the more intermediate, longer-term care problem of trying to bring in a new internist into the ICU. [DRAFT TRANSCRIPT ONLY]
C. Trevena: I thank the minister for that. Second point, again, in Campbell River hospital…. I don't think it's really such good news, but maybe the minister can give some assistance on it. [DRAFT TRANSCRIPT ONLY]
[1740]
In his opening remarks he talked about the importance of cancer care and how good it is in B.C. I think everybody is aware of how vital prevention is. [DRAFT TRANSCRIPT ONLY]
I believe the minister is aware of the cuts in endoscopies at Campbell River Hospital. Surgeons are having to cancel 200 endoscopy bookings, 50 surgical bookings. Currently, there is a wait-list of 800 patients for diagnostic endoscopies. I have a letter from Dr. Piotr Juszkiewicz, who says that some patients are already at risk of delayed diagnosis of colorectal cancer. [DRAFT TRANSCRIPT ONLY]
While I know that this is part of the VIHA financial cuts that came by, whether the minister can do anything to intervene to make sure that we can carry on having this very important preventative medicine continuing to the level it has been in Campbell River…. [DRAFT TRANSCRIPT ONLY]
Hon. K. Falcon: For the benefit of members, endoscopies are minimally invasive diagnostic procedures that are frequently done to provide images and take biopsies in the respiratory and gastrointestinal tracts, among other uses. Across British Columbia the provincial average for endoscopies is about 18 procedures per thousand population. [DRAFT TRANSCRIPT ONLY]
What VIHA has found is that Campbell River, West Coast General, and Cowichan District hospitals have usage rates in endoscopies that are as high as 25 percent above the provincial average. VIHA is bringing those facilities closer to the provincial average and the averages that are seen at other VIHA sites. [DRAFT TRANSCRIPT ONLY]
At the same time, VIHA is also going to be introducing a consistent classification and booking system across community hospitals so that we can ensure that residents across the Island are going to receive equitable service with respect to things like endoscopies. [DRAFT TRANSCRIPT ONLY]
C. Trevena: I think the chief of surgeons in Campbell River Hospital would like to continue to be able to keep the numbers at that 25 percent higher level. [DRAFT TRANSCRIPT ONLY]
My next question. I know it's a bit scattershot, but I'm very aware of the time. Obviously, the minister is very aware of the plans for two new hospitals — one in Campbell River, one for the Comox Valley. VIHA at the moment is developing its business plan. I think everybody is agreed that there is an urgent need for the two new hospitals in both communities. [DRAFT TRANSCRIPT ONLY]
I would like from the minister that there is a commitment from him that he will be taking forward to Treasury Board that we do get this funding for the two hospitals. Also, in Campbell River there is a commitment for an extra 40 long-term-care beds as part of that plan. So we need to have that commitment, as well, going forward into…. I think this would be planning for the next financial year rather than the present one. [DRAFT TRANSCRIPT ONLY]
Once again, I would like to very much invite the minister to come to Campbell River to tour the hospital and see for himself the urgent need there. [DRAFT TRANSCRIPT ONLY]
Hon. K. Falcon: They are working on a business case. I haven't yet seen the business case. I'm not even sure they've concluded it, but the moment they have and I have an opportunity to be briefed, I will certainly take a hard look at that. The only criteria I will be applying is to make sure that they are doing a thorough and rigorous business case that comes up with a solution that will be supported by the best medical evidence to ensure that we can deliver services to folks on the north Island in the best possible manner. But I have yet to see the business case. [DRAFT TRANSCRIPT ONLY]
C. Trevena: We're very lucky in the north Island and, I have to say, the Comox Valley that these are, for VIHA, their priorities for the coming year. So we're hopeful when VIHA presents it, they will be very persuasive with the minister. Again, I do invite him to come and see Campbell River Hospital for himself. [DRAFT TRANSCRIPT ONLY]
I have been listening to the discussion about the crisis lines, and I'm very aware of what the minister's views are on the crisis lines. I've just got a couple of very quick points. The minister talks about how it makes administrative sense to have a 1-800 number, but I think what we're hearing from the people who operate the crisis lines is that they're looking at health outcomes rather than the administrative sense. [DRAFT TRANSCRIPT ONLY]
I've had letters, and I think he has also had letters, from the 'Namgis First Nation, from the child and family services there, saying that they really need these kept. And also from the Sacred Wolf Friendship Centre in Port Hardy, which has developed suicide protocols that rely solely on this crisis line. [DRAFT TRANSCRIPT ONLY]
[1745]
I know that the minister has had a letter from the Sacred Wolf asking him to commit not to pull the funding for the North Island Crisis and Counselling Centre until a proper review of the service is provided and the plans outlined in the letter from the Sacred Wolf have been done. [DRAFT TRANSCRIPT ONLY]
I would just like to say that these are very important for first nations. I'd just like to confirm with the minister that he has assurances from VIHA that full consultation with the first nations who have been doing things like developing suicide protocols took place. [DRAFT TRANSCRIPT ONLY]
Hon. K. Falcon: The member, I know, wasn't here, or maybe the member was here. I don't want to put words in her mouth. But I have now canvassed this on a number of occasions. Perhaps what I can do for the members opposite is get a copy of the Hansard with respect to this one and share it widely. [DRAFT TRANSCRIPT ONLY]
Not to be dismissive of the fact that these are important issues for some of these communities — any of the six communities that currently enjoy the crisis line. However, as I have said, the Vancouver Island Health Authority, in spite of the fact that they are seeing their operating budget increase 23 percent over the next three years, which, you know…. I mean, in any world, a 23 percent increase in an operating budget is pretty massive. [DRAFT TRANSCRIPT ONLY]
In spite of that, they still have pressures. So they're achieving two things by consolidating the crisis lines. As difficult as I know it is for the six communities that are affected, that would like to see it stay exactly the same, I have to support and continue to support the decision that VIHA is making, because it is the right decision. [DRAFT TRANSCRIPT ONLY]
They are saying that rather than have the six duplicative administrative processes in six different crisis lines, they are going to move to have a single crisis line that doesn't cover just six communities but every community on Vancouver Island, so that every resident of Vancouver Island who finds themselves in a position of dealing with a crisis, a mental health crisis, has an opportunity to phone one single line where they know they can get comprehensive service delivered to every single part of Vancouver Island. [DRAFT TRANSCRIPT ONLY]
I think that at this point I'll just have to say that we will agree to respectfully disagree with the members opposite with respect to this issue. I do think it is the right decision, and I continue to support it, and I won't be asking them to move away from that decision. [DRAFT TRANSCRIPT ONLY]
H. Lali: I notice there's not a lot of time. I've got two questions I will ask. I will ask the first one to the minister. I'm not going to get into this issue of the opposition saying, "There are cuts to health care," and the minister's going to say: "No, we're putting in record funding." We're not going to go there. [DRAFT TRANSCRIPT ONLY]
What I would like to talk about is some of the shortages that are taking place in rural British Columbia, in the IHA area specifically, where I live and my constituency is. I want to talk about ambulances and paramedics and the minister's future plan to make sure that there is adequate coverage for that. [DRAFT TRANSCRIPT ONLY]
When it comes to small communities throughout rural British Columbia, obviously my constituency is no different from some of the other ones in the Cariboo and up in the north as well. The smaller communities like the Lyttons and the Clintons and the Ashcrofts of the world are less able to cope with the issues that surround the lack of ambulance coverage or having not enough paramedics available or trained paramedics available and then, of course, the ministry's refusal to actually pay for the training for the paramedics. [DRAFT TRANSCRIPT ONLY]
We won't get into the legislation and the strike and all of that either. What I'd like to know is…. What's happening is that a lot of these small communities that are incorporated but also the unincorporated territories within the regional districts, specifically the first nations, that often form a ring of reserves around municipalities, as throughout my constituency. So obviously, in order for first nations to actually get medical attention, they have to not only get into town, but if it's not available there, then they have to be transported to Kamloops or Kelowna or some of the other areas. [DRAFT TRANSCRIPT ONLY]
[1750]
What I would like to ask the minister is: what concrete plan does he have, or is he willing to put forward, to make sure that my constituents living in the small communities that I've mentioned — and others and in the unincorporated areas of the regional districts plus the first nations reserves — can get adequate coverage from the Ambulance Service when they need it and where they need it, as well as adequate numbers of paramedics and, especially, the training that is needed for a number of paramedics. [DRAFT TRANSCRIPT ONLY]
What's the minister's plan to make sure that my constituents get their service? [DRAFT TRANSCRIPT ONLY]
Hon. K. Falcon: I thank the member for Fraser-Nicola for the question, because it is, I think, a very, very important question. As difficult and challenging as it was to have to introduce legislation to send the paramedics back to work, even with a 3 percent wage lift, it still did not solve the challenge and the problem that the member opposite has mentioned, and that is the unique challenge of providing paramedical services in rural remote communities. [DRAFT TRANSCRIPT ONLY]
Now, the member may or may not know, but earlier today the Minister of Labour announced that there will be an industrial inquiry commission that will undertake a review of virtually every issue that the paramedics raised with respect to some of the staffing and issues of recruitment, particularly in rural B.C. That is going to go forward under the very capable and effective leadership of a highly regarded long-time former civil servant, Chris Trumpy. That is very appropriate. [DRAFT TRANSCRIPT ONLY]
I have to be honest with the member. I don't know. I can't predetermine what the outcome is. I know that the Minister of Labour has tasked this eminent former public servant to come forward with options for government to consider as we go forward. [DRAFT TRANSCRIPT ONLY]
But I will say to the member that I am keenly aware of this issue. I have a family member who lives in Lac Le Jeune, a family member who was involved in the Ambulance Service. I understand uniquely what a challenge it is for rural paramedics in particular. I think they have unique challenges. [DRAFT TRANSCRIPT ONLY]
I think that I won't be happy unless we come forward with a solution, nor will my colleagues be happy unless we come forward with a solution that addresses that. I know that many of the members and my colleagues have been working with me to try and deal with this issue. [DRAFT TRANSCRIPT ONLY]
The commitment I made, even during the very difficult debate that we had over the legislation that unfortunately had to send the paramedics back to work…. Even during that, I made it very clear in my remarks that the situation faced by rural paramedics was a unique situation and that it was something that we were going to deal with. [DRAFT TRANSCRIPT ONLY]
I know that the Minister of Community and Rural Development is someone that has been particularly outspoken in terms of making sure that as we go forward, we help deal with that. I know that the member opposite — as I've worked with him in the past on many issues that are very important from when I was the Transportation Minister for rural and remote British Columbia, including his riding — will work with us in a very constructive way to deal with this. The member has my personal commitment to ensure that we do that as we go forward. [DRAFT TRANSCRIPT ONLY]
Hon. Chair, noting the hour, I move that the committee rise, report progress and seek leave to sit again. [DRAFT TRANSCRIPT ONLY]
Motion approved.
The committee rose at 5:54 p.m.
The House resumed; Mr. Speaker in the chair.
Committee of Supply (Section B), having reported progress, was granted leave to sit again.
[1755]
Committee of Supply (Section A), having reported progress, was granted leave to sit again.
Hon. B. Penner moved adjournment of the House.
Motion approved.
Mr. Speaker: This House stands adjourned until 10 a.m. Monday morning. [DRAFT TRANSCRIPT ONLY]
The House adjourned at 5:56 p.m.
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