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)
MONDAY, NOVEMBER 23, 2009
The House met at 1:35 p.m.
[Mr. Speaker in the chair.]
Routine Business
Introductions by Members
C. James: I have three guests who I'm pleased to introduce today: Matthew Payne, the artistic producer for Theatre SKAM; Sarah Jane Peltzer, actor and singer; and Edna Joyce, who's here from the Victoria Choral Society. They're here to show their support for investments in funding for arts, culture and heritage. Would the House please make them welcome. [DRAFT TRANSCRIPT ONLY]
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Tributes
ART COWIE
Hon. G. Campbell: I rise today simply to inform the House of the passing of Art Cowie, former MLA for Vancouver-Quilchena. Art was a passionate observer of public life in British Columbia and worked tirelessly as a park commissioner, as a city councillor and as an MLA to improve the quality of life for people in communities all over the province. [DRAFT TRANSCRIPT ONLY]
He was an early advocate of sustainable communities, communities that actually worked with our natural environment to enhance the quality of life for those who lived here. He was struck with a sudden illness in October, and unfortunately, he passed away just recently. I hope the House will take the time to send our condolences to the entire Cowie family. [DRAFT TRANSCRIPT ONLY]
Introductions by Members
L. Popham: I would like to take this opportunity to welcome to the House my wonderful brother Guy McIntock and his friend, Nancy Friesen. Guy is a firefighter from Delta. Please make them welcome. [DRAFT TRANSCRIPT ONLY]
Hon. R. Hawes: Today in the gallery we have a number of what I consider to be and I'm sure all of us consider to be very important people to British Columbia. They're from the mining industry. They're headed by Pierre Gratton from the Mining Association of British Columbia, along with Zoe Carlson from the Mining Association of B.C.; Peter Holbeck, VP of exploration with Copper Mountain; Glen Wonders, VP, Terrane Metals — that's the Mount Milligan project; Scott Jones, VP, Taseko Mines; Pierre Lebel, chairman, Imperial Metals — that's Red Chris; Doug Smith, president and CEO of First Coal; Craig Dirk, CEO of Western Canadian Coal; Allen Wright, president and CEO of the Coal Association of Canada; Brian Abraham; Fraser Milner; David McLelland, director with the Association for Mineral Exploration; Dave Sharples, chairman of the Mining Suppliers Association of British Columbia; and Kathy Pomeroy, director of environment for Western Canadian Coal. [DRAFT TRANSCRIPT ONLY]
Between all of these folks, they are responsible for thousands and thousands of jobs and thousands and thousands of hip operations in British Columbia. I'd like all of us to make them welcome and thank them for the work they do. [DRAFT TRANSCRIPT ONLY]
L. Krog: Joining us in the gallery today is a strong supporter of arts and culture in our province. I'd like the House to welcome Junko Sakamoto, executive director of the Assembly of B.C. Arts Councils. [DRAFT TRANSCRIPT ONLY]
Hon. M. Polak: Today in the gallery we are joined by a constituent of mine, who might prove very useful to this Legislature. Judi Vankevich is the national director of the Canadian Project for Manners and Civility and is best known as Judy the manners lady, Canada's award-winning singer, educator and entertainer. [DRAFT TRANSCRIPT ONLY]
Her mandate for the past year and a half has been to travel across the province as part of an entertaining program called Building Team B.C. — training the families and children and teens of B.C. in multicultural hospitality and manners as a proactive way of dealing with crime and racism and to help inspire B.C. to become the friendliest and safest province to ever host the Olympics. May the House please make her welcome. [DRAFT TRANSCRIPT ONLY]
M. Karagianis: Again, on the theme of the arts that we have going on our side, I would like to introduce some guests in the House today from the Victoria Choral Society — the president Mary Chu and musician Wendy Stofer. And from Intrepid Theatre, a good friend and colleague, Ian Case, the general manager. Please make them welcome. [DRAFT TRANSCRIPT ONLY]
J. McIntyre: I'm delighted to be joined in Victoria today…. At the Legislature with us are two friends, supporters, constituents from Whistler: John Nadeau and Mary Scott. John is the regional branch manager for the TD Bank in Whistler and volunteers for the Community Foundation of Whistler and as treasurer for the Saint John Ambulance provincial council. Mary works at the Whistler Eye Clinic and has donated a lot of her time for the brand-new sliding centre in Whistler. I would like the House to please make them feel most welcome here in Victoria. [DRAFT TRANSCRIPT ONLY]
D. Routley: Chemainus is known as "the little town that did," and that's because it has revitalized and resurrected itself after great challenges in losing its mill. One of the main forces in that revitalization has been our arts community generally. The town is populated by dozens of murals of the history of the area. The last one was just unveiled last year. [DRAFT TRANSCRIPT ONLY]
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A large part of that arts community is the Chemainus theatre. From the Chemainus Theatre Festival Society, the artistic director, Mark DuMez and the managing director, Randy Huber join us. They're both here in order to promote funding for the Chemainus Festival. If any of the members or their families are looking for a great show, the Christmas show at the Chemainus theatre, Anne of Green Gables, will be featured in the community over the next few weeks. [DRAFT TRANSCRIPT ONLY]
I'd like us all to make them welcome to the Legislature and to support the Chemainus Theatre Festival. [DRAFT TRANSCRIPT ONLY]
M. Sather: There are four members from Maple Ridge–Pitt Meadows here in the gallery today: Jim Bradshaw John Castiello, Mike Gildersleeve and Yukiko Tanaka. They're here to discuss with government an important issue in Blue Mountain in our community. Would you help me welcome them to the House. [DRAFT TRANSCRIPT ONLY]
M. Dalton: I'd like to recognize in the House today Terri Rainey. Terri is the past constituency president for Maple Ridge–Pitt Meadows. Would the House please make her feel welcome. [DRAFT TRANSCRIPT ONLY]
R. Fleming: I want to introduce a number of representatives from the arts and culture sector in greater Victoria today. With us is Scott Walker, who's the coordinator of the ProArt Alliance. Accompanying him are Melissa Blank, who is an actor locally; Juliana Saxton, who's an actor, director and educator in our community; as well as Megan Newton, who is the administrator for Theatre BOMBUS; and Judith McDowell, who is artistic director with Target Theatre and a board member of the PUENTE Theatre Society. Would the House please make all of these guests feel welcome here. [DRAFT TRANSCRIPT ONLY]
Tributes
MARY SMITH
D. Routley: I would like the House to help me remember a remarkable young woman. Her name was Mary Smith. She was 28 years old when, very unfortunately, H1N1 shortened her life this past week. [DRAFT TRANSCRIPT ONLY]
Mary Smith was an extraordinary young woman who suffered a developmental disability, but that didn't slow her down. She and her parents owned a farm. Every weekend she could be found in the farmers' market selling sausages and meat products that they produced. [DRAFT TRANSCRIPT ONLY]
Her parents spent their entire lives preparing Mary to be without them, and so very sadly now they are without her. She was an extraordinary supporter of the Cowichan Capitals hockey team. They raised an honorary jersey in her name last week. She became a friend to many of us, including me. [DRAFT TRANSCRIPT ONLY]
We're all so very sad that Mary has succumbed to this illness. She was one of those people who was absolutely present when you met her. She was absolutely there, and she was a wonderful young woman. I hope the House can help me extend condolences to her family and to the community. [DRAFT TRANSCRIPT ONLY]
Introductions by Members
Hon. K. Falcon: I have two groups of individuals I'd like to recognize, Mr. Speaker. The first is John and Bev Bandstra. John and Bev Bandstra are part of the Bandstra Transportation group, John in particular. [DRAFT TRANSCRIPT ONLY]
This has been a family business that many of us will be aware of that's been involved in British Columbia's economy since 1955. It's got its roots in northern B.C. In fact, it started out in Smithers, British Columbia, and through its 150 employees continues to provide a very high level of moving services right across the province. I'd ask that the House please make them both welcome. [DRAFT TRANSCRIPT ONLY]
I'd also like to welcome three pharmacy students who are here with us today that are doing their four-week rotation at the drug use optimization branch of the pharmaceutical services division. I would like the House to please welcome Arden Barry, Trana Hussaini and Amneet Aulakh, who are with us today. I would ask the House to please make them welcome. [DRAFT TRANSCRIPT ONLY]
L. Reid: I have lovely guests in the gallery today. There's Andy Baxter. There's Barbara Penty. There is my dear daughter Olivia Reid-Friesen and her friend Lauren Baxter and Marg Robbins. Those lovely girls play glorious softball together, and I'd ask the House to please make them very welcome. [DRAFT TRANSCRIPT ONLY]
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Statements
(Standing Order 25B)
CHINESE-CANADIAN
COMMUNITY ORGANIZATIONS
R. Lee: Yesterday I attended the celebration of the 70th anniversary of the Yue Shan Society in Vancouver. Nearly 1,000 British Columbians originating from the county of Panyu, now part of Guangzhou, their friends and community leaders came out to a gala dinner to celebrate this auspicious occasion. Guangzhou is Vancouver's sister city and the capital city of B.C.'s sister province, Guangdong, China. [DRAFT TRANSCRIPT ONLY]
There are many other county associations in the Chinese-Canadian community. The Shon Yee Benevolent Association was formed in 1914 to help people from Zhongshan County, the birthplace of the founder of the Republic of China, Dr. Sun Yat-sen. [DRAFT TRANSCRIPT ONLY]
Sometimes several societies were established from the same county to further differentiate interests. Also, from the Zhongshan county are the Vancouver Zhongshan Alliance Association, Vancouver Zhongshan Secondary School Alumni Association, Zhongshan Hoo Tow Society, Zhongshan Lung Jen Benevolent Association and Hang Mei Society. [DRAFT TRANSCRIPT ONLY]
Many family or clan societies contribute to the community as well, including the Chin Wing Chun Tong Society, Lee's Association of Canada, Wong's Benevolent Association, Cheung's Association, Mah's Society, Leung's Benevolent Association and Yee Fong Toy Society. [DRAFT TRANSCRIPT ONLY]
Members of this House may be familiar with some larger organizations which embrace the entire community, for example, SUCCESS, the Chinese Benevolent Association of Vancouver, the Chinese Cultural Centre and the Chinese Freemasons in Vancouver. However, many more Chinese-Canadian businesses, athletic, recreational and service organizations can be found all over B.C., especially in Metro Vancouver. [DRAFT TRANSCRIPT ONLY]
I would like to ask the House to join me in recognizing the hundreds of Chinese-Canadian non-profit organizations for their contributions to our province's economy, trade, culture, social services and charities. [DRAFT TRANSCRIPT ONLY]
david vickers
C. James: I rise today to mark the passing of a great British Columbian. David Vickers was an accomplished lawyer, esteemed judge and a passionate advocate whose work truly embodied the words "public servant." [DRAFT TRANSCRIPT ONLY]
As a lawyer, he fought for the rights of those with physical and developmental disabilities. As a justice of the Supreme Court, he spoke out about the challenges facing those with mental illness and addictions in our justice system. Some of you may know that David Vickers served as Deputy Attorney General under Premier Dave Barrett. He also made several forays into B.C. politics, including a bid for the leadership of the NDP in 1984 and as an NDP candidate for Saanich and the Islands in 1986. [DRAFT TRANSCRIPT ONLY]
While I have no doubt that David would have made an incredible contribution to this Legislature, David's work since then has left a mark on our province. Most recently David became known by many in my community for his work on homelessness. He was a member of the Greater Victoria Coalition to End Homelessness and just this last month participated in Project Connect, an event to help raise awareness about homelessness in Victoria. This was despite his diagnosis of pancreatic cancer, which ultimately took his life. [DRAFT TRANSCRIPT ONLY]
David's many contributions to our province cannot be measured by the number of cases he tried, the number of decisions he penned as a judge or the countless hours he dedicated. As a former partner and colleague said about Vickers: "Social justice wasn't a cause he adopted. It was who he was and how he lived." [DRAFT TRANSCRIPT ONLY]
British Columbians from all walks of life have benefited from the passion and the commitment that David brought to his work. He will be missed, but B.C. is a better place because of David Vickers. I would ask the House to join me in expressing our condolences to the Vickers family. [DRAFT TRANSCRIPT ONLY]
ABORIGINAL YOUTH INTERNSHIP PROGRAM
J. McIntyre: A few weeks ago, I joined the Ministers of Citizen Services and Aboriginal Relations as well as leaders from the first nations community for the aboriginal youth internship program's completion ceremony here in Victoria. [DRAFT TRANSCRIPT ONLY]
We spent the evening honouring the past year's interns as they marked the completion of the '08-09 internship program, and we welcomed this year's new interns, the third group. As I'm sure the House remembers, the aboriginal youth internship program, run by the B.C. Public Service Agency, was created based on a dialogue with government, aboriginal communities, aboriginal youth groups and aboriginal leadership. [DRAFT TRANSCRIPT ONLY]
It's designed to develop professional skills and leadership abilities through a nine-month placement in a ministry or government agency, followed by a three-month placement in a selected B.C. aboriginal agency. [DRAFT TRANSCRIPT ONLY]
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The program offers strong structure, learning opportunities and ongoing support and guidance to all interns and participants. The First Nations Leadership Council provides ongoing support, as does as Métis Nation British Columbia. [DRAFT TRANSCRIPT ONLY]
I would like to recognize Sasha Hobbs, the program lead who has been with the program for all three years, for all her hard work and dedication and the passion she clearly brings to the job. [DRAFT TRANSCRIPT ONLY]
On May 29 the program and all those involved suffered the tragic loss of one of its interns, Marshal Boucher. He was a much-loved member of his community, and the award that the interns bestowed on Anthony Mack will ensure that Marshal's name lives on. [DRAFT TRANSCRIPT ONLY]
Congratulations to all the interns, and best of luck in their future journeys, wherever they take you. To the new interns: work hard and have fun. I would just like to name the graduates, because I think they deserve recognition for their significant achievement: Courteney Adolph, Carmella Alexis, Nicole Big Sorrel Horse, Mikah Fox, Candice George, Kristi Jinnouchi, Kristina Leon, Sashia Leung, Dawn Lindsay-Burns, Kelsey Louie, Anthony Mack, Danielle Myles, Chris Nelson, Chris Roberts, Sarah Robinson, Scarlet Sounders, Cedar Shackelly and Toni Williams. [DRAFT TRANSCRIPT ONLY]
UNITED NATIONS CONVENTION
ON THE RIGHTS OF THE CHILD
M. Elmore: I rise to recognize the 20th anniversary of the United Nations convention on the rights of the child, adopted by the United Nations on November 20, 1989, and ratified in Canada in 1991. [DRAFT TRANSCRIPT ONLY]
The convention sets out the fundamental rights of children. The idea behind the convention is simple. Every child has the right to a healthy, secure upbringing; to basic levels of nutrition and education; to play and rest; and to have their point of view respected when it's appropriate. [DRAFT TRANSCRIPT ONLY]
I had the opportunity to attend an event here in Victoria at the Metropolitan church, which was hosted by Success by 6 Victoria and south Vancouver Island. I'd like to recognize Jan White and all members of the Council for Partners who put on this event. They invited the performer Raffi Cavoukian to perform for parents and to actually talk about his philosophy, the child-honouring philosophy to put children first, a child-first approach to healing communities, restoring ecosystems and creating a sustainable future. Also, we had a great performance by the choir kids on that night. [DRAFT TRANSCRIPT ONLY]
I'd just like to recognize article 27 of the convention, which states that recognizing the right of all children to live and have adequate access to physical, mental, spiritual, moral and social development, and also to join in the commitment of all the children, the parents and providers of early childhood education working towards eliminating poverty for children and also recognizing article 18, which recognizes the importance of providing comprehensive child care for children and also early learning opportunities. [DRAFT TRANSCRIPT ONLY]
MINING INDUSTRY IN B.C.
R. Sultan: As we recognize the leaders of the mining industry in the Legislature this afternoon, all of us need to understand the importance of this key economic driver, creating jobs and wealth right across our province. [DRAFT TRANSCRIPT ONLY]
Recently a journalist ranked the ten strongest companies in B.C. Eight of them were mining companies. If asked to list the industries most represented among the top 50 companies, many would guess telecommunications or forestry. In fact, the mining industry represents almost two-thirds. [DRAFT TRANSCRIPT ONLY]
Many are giants on the world stage. Teck's market cap is almost three times larger than CPR's. Goldcorp's is three time Teck's. We've all heard of Telus and the Royal Bank. How many of us know First Quantum Minerals, Quadra Mining or Silver Wheaton? [DRAFT TRANSCRIPT ONLY]
We seldom give them the respect they deserve, and we don't always make it easy for them to do business right here at home. Having two parallel federal and provincial permitting processes doesn't make much sense, and first nations negotiations are seldom simple. Aggressive pricing by port and rail operators is another steep hurdle, but government is trying to help. [DRAFT TRANSCRIPT ONLY]
The Highway 37 powerline will soon be a reality. New projects are underway: Copper Mountain, Red Chris, Mount Milligan, Prosperity, New Afton and South Central near Chetwynd, just to name some of them. These new projects build on the solid employment base of Teck's 40 percent share of the world market for steel-making coal, an incredible achievement. They will generate thousands of new jobs — union jobs frequently, I might point out for the folks opposite — for British Columbians for decades to come. [DRAFT TRANSCRIPT ONLY]
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All MLAs should encourage their communities and their federal MPs to get on board, pitch in and help these projects succeed. [DRAFT TRANSCRIPT ONLY]
B.C. FEDERATION OF LABOUR
K. Conroy: The B.C. Federation of Labour represents more than half a million workers through over 50 affiliated unions and more than 800 locals working in every aspect of the B.C. economy. Established in 1956, the B.C. Fed, as it is most commonly known, has a long and proud history of fighting for the rights of all working people. The goals of the federation are best exemplified by its slogan: "What we desire for ourselves we wish for all." [DRAFT TRANSCRIPT ONLY]
They bring together the majority of unions in B.C. to provide a single voice on workers' rights. Every year hundreds of rank-and-file trade union members elected from their locals across B.C. gather in Vancouver to set the direction of the labour movement. This year the 53rd convention in their history as a modern federation started this morning at the Vancouver convention centre. [DRAFT TRANSCRIPT ONLY]
Today's B.C. Federation of Labour is actually the second organization by that name. The first was formed in 1910 as workers across the province united in a single body to pursue political change in the provincial Legislature. That first federation was worn down by the battles and divisions that afflicted working people during the period between the First and Second world wars, particularly the Great Depression. But by 1956 the need for unity was obvious, and the two main labour centrals of that area joined forces to create today's B.C. Fed. [DRAFT TRANSCRIPT ONLY]
The fed is made up of a number of officers and staff, but I want to make special mention of two of them: Jim Sinclair, the president who has led the Fed since 1999, and Angie Shira, the secretary-treasurer — a position held since 1989 and the first woman to ever hold that position — who last November was re-elected to serve a tenth full two-year term. [DRAFT TRANSCRIPT ONLY]
These two officers are an example of the incredible women and men who serve on behalf of all working people in this province. I want to thank them as well as all the other officers for their commitment to the cause of working people. [DRAFT TRANSCRIPT ONLY]
Oral Questions
STAFFING AT SENIORS FACILITIES
C. James: It was over two years ago that I stood in this House to raise the concern around the neglected seniors at Victoria's Beacon Hill Villa. This past Friday 200 employees, including nursing staff, at Beacon Hill Villa were told they will no longer receive their wages from the facility's subcontractor. Today the facilities operator indicated they may be willing to offer a temporary fix, but in the meantime seniors and their families spent the entire weekend concerned about what's next, worried about care at the facility, where they would go — going through instability that they do not deserve. [DRAFT TRANSCRIPT ONLY]
My question is to the Minister of Health. For years concerns have been raised about a crisis in seniors care. Can the minister explain what good the constant flipping of staff and a revolving door of subcontractors does to care for seniors? [DRAFT TRANSCRIPT ONLY]
Hon. K. Falcon: Naturally, I'm always concerned when there's any kind of contractual dispute or public sector labour strike, whether in the public or the private spheres. Anytime there's a disruption, of course you ought to be concerned about it. [DRAFT TRANSCRIPT ONLY]
The fact of the matter is this is a contractual dispute that the operator was having with the subcontractor. It was real — no question about that. Licensing staff over the weekend visited the facilities to make sure that care wasn't being impacted. I'm informed it was not. I think that's very positive. [DRAFT TRANSCRIPT ONLY]
I also understand, to the member's point…. She's correct in pointing out that the operator has entered into an agreement with the Hospital Employees Union employees. I understand they're going to be working directly for the operator at the same wages and benefits that they were receiving before. [DRAFT TRANSCRIPT ONLY]
Mr. Speaker: The Leader of the Opposition has a supplemental. [DRAFT TRANSCRIPT ONLY]
C. James: The minister left out one fact — that it was, in fact, this government that created the chaos, through Bill 29 and Bill 21, that is causing the problems we see for seniors right now. [DRAFT TRANSCRIPT ONLY]
It's not only Beacon Hill Villa. Residents and staff at Nanaimo Seniors Village and at Dufferin Care Centre also went through the same chaos over the weekend — seniors and families wondering about their care, wondering what was going on. [DRAFT TRANSCRIPT ONLY]
Now it looks like the Lodge on 4th in Ladysmith and facilities in North Delta and Vancouver may be next. Again, my question is to the Minister of Health. Will he admit today that when he stripped away the rights of health care workers, he also stripped away the care for the seniors that they serve? [DRAFT TRANSCRIPT ONLY]
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Hon. K. Falcon: I know that the Leader of the Opposition likes to create a situation where she can try and pretend that everything is going wrong in every sector of the health field. That's simply not the case. The fact of the matter is that what we have done is actually build 6,000 new state-of-the-art seniors residences right across the province of British Columbia. [DRAFT TRANSCRIPT ONLY]
We were investing in record levels for residential care — up 40 percent since 2001. You know, for this member to…. That's over $100 million this year alone. [DRAFT TRANSCRIPT ONLY]
The fact of the matter is that on a massive system like this, unfortunately, there are bound to be occasional disputes, contractual issues that come up just like in the public sector. Unfortunately, there are occasional strikes at times when people withdraw services, and that is unfortunate in both cases. The issue for me is to ensure that the seniors are getting the care they deserve. That's why, as I say, licensing staff are going through those facilities to make sure the care is being provided, as it is. [DRAFT TRANSCRIPT ONLY]
Mr. Speaker: The Leader of the Opposition has a further supplemental. [DRAFT TRANSCRIPT ONLY]
C. James: If the minister had been paying attention, he would recognize that this isn't an isolated incident. This happens over and over and over again, for the last eight years, under the B.C. Liberals when it comes to seniors care. [DRAFT TRANSCRIPT ONLY]
The staff in those facilities are more than simply numbers. Staff provide care and are family for many of the seniors in those care homes. [DRAFT TRANSCRIPT ONLY]
It was this B.C. Liberal government that brought in Bill 29. It was this government that tore up contracts negotiated in good faith. It was this government that moved to privatize our public health care system. The consequences can be seen all across British Columbia including right here, steps from the Legislature, at Beacon Hill Villa. [DRAFT TRANSCRIPT ONLY]
My question again is to the Minister of Health. Why is he still refusing to act to stop the neglect of seniors in Victoria, in Nanaimo, in Port Coquitlam, in Ladysmith — all across this province? Why does this government refuse to make seniors care a priority? [DRAFT TRANSCRIPT ONLY]
Hon. K. Falcon: Well, it is a priority. It's one of the reasons we've added over 6,000 new beds right across the province. It's another reason why we rehabilitated or completely renovated another 6,000 in addition to that. [DRAFT TRANSCRIPT ONLY]
You know, sometimes the Leader of the Opposition allows her rhetoric to get ahead of her. I would refer the member to the Nanaimo Daily News — front page, actually — on December 4, 1999, when it was announced that "a partnership between two private corporations and the Central Vancouver Island health region will open 125 new multilevel-care beds in Nanaimo within two years. The new project will see Retirement Concepts of Vancouver partner with the region to build a new state-of-the-art facility." [DRAFT TRANSCRIPT ONLY]
Here's the best part. It goes on to say: "The beds are being constructed under a public-private partnership model as a result of a 1997 policy adopted by the province that demands such partnership be explored when planning new health care facilities." That was the NDP government. [DRAFT TRANSCRIPT ONLY]
A. Dix: Ten times — ten times — the workers of just these three care homes alone have been hired and fired — hired and fired, hired and fired. Ten times. That tells you something about the system that this government set up that creates instability in this sector and undermines seniors care. That's what it says. [DRAFT TRANSCRIPT ONLY]
Will the minister take action today? Will he take action today? Seniors have been jerked around by this government long enough. This policy that gives health care workers fewer rights than virtually any other worker in British Columbia has led to this chaos in health care. [DRAFT TRANSCRIPT ONLY]
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Will the minister acknowledge today that the chaos caused by Bill 29 and Bill 94 has damaged seniors care in British Columbia? Will he take action to restore successorship rights to health care workers in British Columbia? [DRAFT TRANSCRIPT ONLY]
Hon. K. Falcon: The only chaos is in the fevered imagination of the NDP opposition. There have been far fewer labour disruptions in the last eight years than there ever were under the NDP government. I can tell you that, Mr. Speaker. [DRAFT TRANSCRIPT ONLY]
You know, I find it interesting that the very company that they are apoplectic about is the very company that they in fact…. That critic was the chief of staff of the government of the day that decided they would enter into a private-public partnership with Retirement Concepts in the Nanaimo Seniors Village. [DRAFT TRANSCRIPT ONLY]
It's interesting how their position has changed, apparently very dramatically, since they were in power. But the fact is that we have got an exceptional record of investing in seniors care. I'm proud of that record. It's record levels of funding and record levels of new units. [DRAFT TRANSCRIPT ONLY]
Mr. Speaker: The member has a supplemental. [DRAFT TRANSCRIPT ONLY]
A. Dix: Well, let's see what the minister is proud of –– the lowest care standards in the country apparently… [DRAFT TRANSCRIPT ONLY]
Interjections.
Mr. Speaker: Members. [DRAFT TRANSCRIPT ONLY]
A. Dix: …according to Statistics Canada. Oh, I know. I know. The Harper government — they're part of some sort of socialist conspiracy. [DRAFT TRANSCRIPT ONLY]
The lowest care standards in the country — that's what they brought to bear. A health care system that denies workers basic rights, which has led to the chaos –– ten total layoffs at this facility alone. It's a disgrace, and the minister should be ashamed of it. [DRAFT TRANSCRIPT ONLY]
Can the minister explain how the constant turmoil and turnover of staff…? And you know what, hon. Speaker? The minister talks about labour disputes. He doesn't think the largest layoff of female workers in Canadian history is a labour dispute. That's his problem. [DRAFT TRANSCRIPT ONLY]
My question to him is: how does it help seniors to have instability like this in the sector? How does it help seniors to have a dispute between two subcontractor friends of the government lead to the layoff of all the care staff? How does it help seniors to have this kind of instability in health care facilities and seniors care across British Columbia? [DRAFT TRANSCRIPT ONLY]
Hon. K. Falcon: The fact of the matter is I wish there was never instability anywhere in the private or public sector. I think that would be an ideal world, but the reality is that there are occasionally disputes that take place both in the public and the private sector. The issue for me is how the seniors are being looked after, and that's why we had staff going through the facilities to make sure there was no impact on the seniors. [DRAFT TRANSCRIPT ONLY]
The member, maybe, is not up to date. I thought I mentioned the fact that apparently the operator has entered into an agreement with the Hospital Employees Union to ensure that they will continue to provide services at those facilities. [DRAFT TRANSCRIPT ONLY]
The member then goes on to provide Stats Canada figures. What he forgets is that the Stats Canada figures — which, by the way, they've been reporting out since 1984 — exclude the extended care facilities that are attached to the hospitals. That's where the highest level of care is typically required. [DRAFT TRANSCRIPT ONLY]
What the member may also know is that while his government was in power –– the entire decade –– the Stats Canada figures said exactly the same thing as they do today. [DRAFT TRANSCRIPT ONLY]
SUCCESSORSHIP RIGHTS FOR
HEALTH CARE WORKERS
L. Krog: You know, hon. Speaker, people can handle an occasional dispute. Four times in eight years in my community, the seniors at Nanaimo Seniors Village have faced this crisis again and again. I want to say to this minister: he can end this chaos today. He can do the right thing for the workers who work in that facility and care for the most vulnerable amongst us, our seniors. He can bring back successorship rights and do the right thing. [DRAFT TRANSCRIPT ONLY]
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Will the minister today commit to this House that he's going to bring back successorship rights and get rid of this crisis once and for all? [DRAFT TRANSCRIPT ONLY]
Hon. K. Falcon: Once again, it is not a crisis. The fact of the matter is that it's a dispute. I will happily put our labour relations record since 2001 against the NDP's chaotic labour relations record any day of the week. I mean, there comes a point where the rhetoric just becomes ridiculous. [DRAFT TRANSCRIPT ONLY]
It was chaotic in the 1990s in the labour relations field. Even that government couldn't control the unions that were supposed to be their best friends. They were so busy legislating them back to work and having to deal with all the outbreaks of conflagrations and union strikes left, right and centre. [DRAFT TRANSCRIPT ONLY]
The fact of the matter is that it is a dispute. It is a dispute that I understand has now been settled two days after it started. These members want to call it a crisis. It is not a crisis. It's a dispute. It has now been settled. I'm pleased to see that, and the members shouldn't panic every time there's a dispute, public or private. [DRAFT TRANSCRIPT ONLY]
Mr. Speaker: The member has a supplemental. [DRAFT TRANSCRIPT ONLY]
L. Krog: This is a bit much coming from the government that was condemned by the Supreme Court of Canada. It's a bit much coming from a government that was condemned by the United Nations. It's a bit much for this minister to tell this House and tell the seniors who live in my community and their families that it isn't a problem. [DRAFT TRANSCRIPT ONLY]
Four times in eight years the workers have been laid off and have seen their jobs potentially disappear. The seniors they serve, who are often in the end days of their lives, deserve better, and there's a solution. I suggest to this minister — and I ask him today once again: commit to this House to bring back successorship rights. Do the right thing for the seniors in my community, and do the right thing for the workers who support them. [DRAFT TRANSCRIPT ONLY]
Hon. K. Falcon: The fact of the matter is that it is a dispute. I understand it's a dispute that has now been resolved. A two-day dispute is hardly a crisis. The fact of the matter is…. He talks about Nanaimo Seniors Village, which is in his riding. I acknowledge that. [DRAFT TRANSCRIPT ONLY]
It was their government that entered into the arrangement in the first place. By the way, this is the same NDP that apparently is horrified at the very prospect of public-private partnerships, but they were the ones that entered into it. [DRAFT TRANSCRIPT ONLY]
I quoted it to the member — the front page of his local paper, for goodness' sake. It said very clearly that the beds are being constructed under a public-private partnership model as a result of a 1997 policy adopted by the NDP government that demands that such partnerships be explored when planning new facilities. [DRAFT TRANSCRIPT ONLY]
You know, Mr. Speaker, he was a member of the government that brought it in. Now he's outraged by the fact that there's a dispute. Disputes will happen. Investment is up 40 percent. Over 6,000 new seniors beds across the province — a record that they never came close to matching. [DRAFT TRANSCRIPT ONLY]
STAFFING AT
LODGE ON 4TH SENIORS FACILITY
D. Routley: This isn't just a back-and-forth between the minister and this side of the House. This is about real people — seniors. This is about the people who built our province. This government took away the successor rights in contracts with health care workers. This government exposed our seniors to that upheaval and instability, and this minister can do nothing but deny. [DRAFT TRANSCRIPT ONLY]
After years of chaos and instability in Ladysmith, now seniors there face even more unstable futures as the workers at Lodge on 4th have now been handed their layoff notices or notices that their jobs might be contracted out. That's not just a simple dispute. That means they may lose their jobs. Those seniors may lose the people they care for. [DRAFT TRANSCRIPT ONLY]
[1415]
The minister owes those seniors more respect. The minister owes those seniors a respectful answer, and he owes it to B.C. to deal with this problem and bring back some stability to seniors' lives. [DRAFT TRANSCRIPT ONLY]
Will he promise them today to intervene in that situation and guarantee that those seniors' lives aren't thrown into chaos in Ladysmith? [DRAFT TRANSCRIPT ONLY]
Hon. K. Falcon: Let's compare records here. Let's actually go right to the very heart of it, which is not the rhetoric but the actual facts and numbers. How many seniors residences were built by the NDP in a decade in power? It was 1,400. How many were built and totally renovated by the province and this government since 2001? Over 12,000. [DRAFT TRANSCRIPT ONLY]
Our priority is that we take care of patients and seniors. Their priority is that they take care of public sector unions. That is the difference. [DRAFT TRANSCRIPT ONLY]
Mr. Speaker: The member has a supplemental. [DRAFT TRANSCRIPT ONLY]
D. Routley: The difference is that we now have a government that will do anything to evade its responsibility, which plays with numbers that defy the reality in people's lives. Throughout this province, seniors and the people of B.C. are calling out to this government and this minister to hear them. All they get is: "Next window, please. It's the operator's fault. It's someone else's problem. It was worse in the past." [DRAFT TRANSCRIPT ONLY]
We want to see this minister stand up and take responsibility and improve those people's lives. In fact, the people who are served at Lodge on 4th are about to see those who serve them lose their jobs. Can the minister simply stand up and acknowledge that fact and promise those seniors that he will step in and ensure stability in their lives and bring them from chaos back to some stability, guarantee that those workers will not be displaced and will continue to serve Ladysmith? [DRAFT TRANSCRIPT ONLY]
Hon. K. Falcon: This is a fascinating back-and-forth, because just a couple of weeks ago I had to sit and listen to 36 hours of how we shouldn't get involved in the paramedic strike — that the end of the world as we know it would happen if we got involved. We couldn't possibly interfere with that. Now in this dispute, government apparently should get involved and interfere. So the NDP, depending on.... [DRAFT TRANSCRIPT ONLY]
Interjections.
The Speaker: Minister, just take your seat for a second. [DRAFT TRANSCRIPT ONLY]
Continue, Minister. [DRAFT TRANSCRIPT ONLY]
Hon. K. Falcon: If I'm understanding the logic of the NDP opposition on a public sector labour dispute, it's do not get involved, travesty of democracy, can't possibly touch it. On a private sector dispute, government must get involved and get involved immediately regardless of the fact that it's being resolved by the parties themselves. We apparently need to jump right in and interfere. [DRAFT TRANSCRIPT ONLY]
It's a remarkable display of NDP thinking — incoherent, hard to understand, doesn't make any sense. I'll tell you what we'll do, Mr. Speaker. We'll stand on our record of over 12,000 new units for seniors, a 40 percent increase in funding since 2001 — a record that puts theirs to shame. [DRAFT TRANSCRIPT ONLY]
STAFFING AT NORTHCREST CARE CENTRE
G. Gentner: Let's address this Pollyanna view from members opposite, particularly the minister. This decade of deceit.... [DRAFT TRANSCRIPT ONLY]
You know, we can talk about how wonderful things are on this side, but the facts remain the same. We are undergoing the most comprehensive study conducted by the Ombudsperson in the history of this province on the poor, despicable relationships they've had with seniors — how there's no compassion left for the people that built this province. Our Ombudsperson is conducting a thorough investigation because of this disgusting effort by this minister. [DRAFT TRANSCRIPT ONLY]
[1420]
Mr. Speaker: Member. [DRAFT TRANSCRIPT ONLY]
Interjections.
Mr. Speaker: Members. [DRAFT TRANSCRIPT ONLY]
Member, would you choose your words a little more carefully. [DRAFT TRANSCRIPT ONLY]
G. Gentner: Thank you, hon. Speaker. [DRAFT TRANSCRIPT ONLY]
Interjections.
Mr. Speaker: Members. [DRAFT TRANSCRIPT ONLY]
Continue, Member. [DRAFT TRANSCRIPT ONLY]
G. Gentner: The Minister of Health has now approved Northcrest Care Centre's application to contract up to 33 full-time equivalents. My question is simply this: why is the government sanctioning layoffs that create turmoil and further instability for patients and the workers who care for them in Delta? [DRAFT TRANSCRIPT ONLY]
Hon. K. Falcon: Again, as I said in an earlier answer, we have a disagreement with the NDP often. Our view is that the issue that is most important is actually the care of patients or the care of seniors. That should be the guiding principle. Theirs is very straightforward, and they certainly evidenced that during a decade in power. Their primary concern is what is in the interest of public sector unions. [DRAFT TRANSCRIPT ONLY]
I understand that that is their priority. I get why it's their priority. But the fact of the matter is that our priority is delivering results to the patients and to seniors within the system. [DRAFT TRANSCRIPT ONLY]
As I indicated, that can be evidenced very clearly by just what's happened in the last eight years — over 12,000 new or totally rehabilitated units for care for seniors right across the province of British Columbia. In the entire decade that the NDP had to actually demonstrate their commitment to seniors care, they managed to build a grand total of 1,400. So you can understand why I'm not going to take lectures from the NDP on how to deliver first-class seniors care in the province of British Columbia. [DRAFT TRANSCRIPT ONLY]
Mr. Speaker: The member has a supplemental. [DRAFT TRANSCRIPT ONLY]
G. Gentner: You know, we've seen the example from the minister opposite. We saw what he did to his own constituents, pushing them out of Zion almost a year ago today — dis-relocated, shut them down and moved them. [DRAFT TRANSCRIPT ONLY]
Here we are again. I want to ask the question again, because it was not properly answered. The government continues to push contracting, like in the case of Northcrest Care Centre in Delta. Can the minister explain why this government is endorsing more instability for frail seniors? Please answer the question. [DRAFT TRANSCRIPT ONLY]
Hon. K. Falcon: Again, in the NDP world nothing should ever change — doesn't matter what's happening in the system, doesn't matter what the pressures are. [DRAFT TRANSCRIPT ONLY]
The fact of the matter is, as you well know, we are increasing the Health budget by almost 20 percent over the next three years. We also know that even with a 20 percent budget increase, there are still pressures in the system. Naturally, the system will always look to ways that they can deliver those services cost-effectively to the benefit of their patients. [DRAFT TRANSCRIPT ONLY]
I don't have the specifics of what he's talking about, but I wouldn't be surprised if there was a contracting-out exercise taking place to look for opportunities to save dollars and put that directly into patient care. That's what they'd be doing. [DRAFT TRANSCRIPT ONLY]
REGULATION OF DODA
H. Bains: Last week during a raid a Surrey RCMP drug section seized hundreds of pounds of poppy pods and finished product, along with crushing and grinding equipment. They describe this facility as a very busy commercial enterprise. [DRAFT TRANSCRIPT ONLY]
This product, called doda, is openly sold in corner stores in many parts of the Lower Mainland, but this product is regulated under the Controlled Drugs and Substances Act. My question to the Solicitor General is this: why is this product allowed to be sold openly in stores where even a minor can walk in and buy it, no questions asked? [DRAFT TRANSCRIPT ONLY]
Hon. K. Heed: We've seen the devastation that these illegal drugs cause on societies. This particular drug, known commonly as doda, is actually under the Controlled Drugs and Substances Act, which is a federal statute. It's up to the federal government to regulate that particular statute. [DRAFT TRANSCRIPT ONLY]
[1425]
We work within that particular statute, as law enforcement agencies throughout British Columbia, but it's a federal law, and doda is governed by that federal law. [DRAFT TRANSCRIPT ONLY]
IMPACT OF HARMONIZED SALES TAX
ON TOURISM INDUSTRY
S. Herbert: The Council of Tourism Associations has said that the HST will cost up to 10,000 jobs in the tourism sector, and tourism operators large and small have been unanimous in their opposition to the HST imposition on their sector. [DRAFT TRANSCRIPT ONLY]
Ecotours-B.C.'s Peggy Zorn had this to say about the HST. She wrote: "Tourism visits will not increase with this tax. In fact, they will decrease as tourists from beyond our borders boycott British Columbia based on the additional tax expense on an already expensive destination." [DRAFT TRANSCRIPT ONLY]
My question is to the Minister of Tourism. Before the election the B.C. Liberals said no to the HST. Right after the election they slammed B.C. with it. Will the minister do the right thing and support the tourism industry's opposition to the HST? [DRAFT TRANSCRIPT ONLY]
Hon. C. Hansen: As we have heard from all of the leading economists across Canada, the move to the HST is the single biggest thing that we can do in British Columbia to stimulate the economy and create jobs. [DRAFT TRANSCRIPT ONLY]
Interjections.
Mr. Speaker: Members. [DRAFT TRANSCRIPT ONLY]
Just sit down for a second. [DRAFT TRANSCRIPT ONLY]
Interjections.
Mr. Speaker: Members. [DRAFT TRANSCRIPT ONLY]
Continue, Minister. [DRAFT TRANSCRIPT ONLY]
Hon. C. Hansen: We know that when the economy is doing well, the tourism sector does well. This initiative will help to actually stimulate the economy and make sure that there are more jobs created in British Columbia in every single corner of the province, including in that member's community. [DRAFT TRANSCRIPT ONLY]
Interjections.
Mr. Speaker: Members. [DRAFT TRANSCRIPT ONLY]
Continue, Minister. [DRAFT TRANSCRIPT ONLY]
Hon. C. Hansen: I've had the pleasure of meeting with representatives of the tourism association over the last number of months — the various tourism associations. One of the things that they indicated to me early on, from one of the organizations, was that they felt that it was important, as we come out of this economic recession and take our place as one of the leading economies in North America, that we put additional dollars into tourism marketing. That's exactly why, in the September budget update, we announced an additional $39 million for tourism marketing. [DRAFT TRANSCRIPT ONLY]
[End of question period.]
C. James: I rise to present a petition. [DRAFT TRANSCRIPT ONLY]
Mr. Speaker: Proceed. [DRAFT TRANSCRIPT ONLY]
Petitions
C. James: I present a petition signed by 918 British Columbians who oppose the HST. [DRAFT TRANSCRIPT ONLY]
Tabling Documents
Hon. B. Stewart: I have the honour to present the 2007-2008 report on multiculturalism and the 2008-2009 report on multiculturalism. [DRAFT TRANSCRIPT ONLY]
S. Simpson: I rise to present a petition. [DRAFT TRANSCRIPT ONLY]
Mr. Speaker: Proceed. [DRAFT TRANSCRIPT ONLY]
Petitions
S. Simpson: I present a petition signed by hundreds of constituents of Vancouver-Hastings calling on the government to stop the HST. [DRAFT TRANSCRIPT ONLY]
N. Macdonald: I have two petitions. First, I would like to present a petition on behalf of constituents concerned about expulsions from the Whitetale Estates near Radium. They're calling for strengthening of the tenancy act to provide protections for people being displaced from mobile home parks. It's signed by 220 people. [DRAFT TRANSCRIPT ONLY]
Can I do a second? [DRAFT TRANSCRIPT ONLY]
Mr. Speaker: Proceed. [DRAFT TRANSCRIPT ONLY]
N. Macdonald: The second is from 120 individuals in the Revelstoke area. They're petitioning this House, asking legislators to address the critical condition of the ambulance service and to work towards recruitment and retention of skilled paramedics who provide the community with vital emergency services. [DRAFT TRANSCRIPT ONLY]
L. Krog: I seek leave to table a petition. [DRAFT TRANSCRIPT ONLY]
Mr. Speaker: Proceed. [DRAFT TRANSCRIPT ONLY]
L. Krog: I table a petition in support of the ambulance paramedics, signed by the people of central Vancouver Island. [DRAFT TRANSCRIPT ONLY]
N. Simons: I have a petition signed by approximately 800 people opposing the government's HST. [DRAFT TRANSCRIPT ONLY]
[1430]
R. Chouhan: I seek leave to present a petition. [DRAFT TRANSCRIPT ONLY]
Mr. Speaker: Proceed. [DRAFT TRANSCRIPT ONLY]
R. Chouhan: I have a petition signed by more than 600 people asking the government to address the issues of poor wages and working conditions of paramedics. [DRAFT TRANSCRIPT ONLY]
R. Fleming: May I present a petition from residents of Victoria and Saanich — a petition to address the critical condition of the Ambulance Service, to improve service levels in our communities, and to ensure recruitment and retention of skilled paramedics, who provide us with these vital emergency and health care services. [DRAFT TRANSCRIPT ONLY]
Hon. M. de Jong: Might I have leave to make a quick introduction? [DRAFT TRANSCRIPT ONLY]
Mr. Speaker: Proceed. [DRAFT TRANSCRIPT ONLY]
Introductions by Members
Hon. M. de Jong: In the gallery — and I'll meet with her soon enough — is a gifted local artist, Cathy Thompson, and her son David Thompson. I hope the House will make them welcome. [DRAFT TRANSCRIPT ONLY]
Orders of the Day
Hon. M. de Jong: I call, in Committee A, Committee of Supply — for the information of the members, the estimates of the Ministry of Finance — and in this chamber, Committee of Supply, estimates of the Ministry of Health. [DRAFT TRANSCRIPT ONLY]
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.
Introductions by Members
R. Fleming: Chair, I seek leave to make an introduction. [DRAFT TRANSCRIPT ONLY]
Leave granted.
R. Fleming: It's my pleasure to announce somebody who is watching Hansard today, who is retiring. That is David Turner, who is a decades-long professor at the school of social work. He is having a sizeable retirement party. I see some people who will be attending tonight at the University of Victoria to ensure that it is true and many to wish him well. [DRAFT TRANSCRIPT ONLY]
David has had an outstanding career at the University of Victoria. Of course, he was there back in the days when there were still Quonset huts and unexploded munitions at the campus. He's seen it grow from a few thousand students to over 25,000 students today. [DRAFT TRANSCRIPT ONLY]
He's had a distinguished career not only in the school of social work, but of course, he served as Victoria's mayor from 1990 to '93. The downtown of Victoria is a better place for it. Many of the heritage improvements we owe to David's touch — and many of the improvements to our public transit system. Would the House wish David Turner well in his retirement. [DRAFT TRANSCRIPT ONLY]
[1435]
Debate Continued
On Vote 34: ministry operations, $14,008,318,000 (continued).
A. Dix: On Thursday, when we previously debated these estimates, we were discussing the cuts and reductions to elective surgery in the Fraser Health Authority. To remind the minister and just to quote again from Mr. Barefoot's message to him: "In 2009 Fraser Health had budgeted for total revenues of $2.47 billion, representing an increase of 2.9 percent over the revenues for 2008-2009." [DRAFT TRANSCRIPT ONLY]
The minister will recall that I asked him questions about what the impact of those cuts would be at hospitals in the Fraser Health Authority. He said he'd endeavour to bring that information back to me, and I'm wondering if he has been able to find that information. [DRAFT TRANSCRIPT ONLY]
[1440]
Hon. K. Falcon: Staff is arranging to have that collated and brought in. [DRAFT TRANSCRIPT ONLY]
A. Dix: My appreciation to staff as well. Would the minister be able to share that information with me? Is that the intent, so we don't have to go through hospital by hospital? That's wonderful news, I think, not just for us — for the small but hardy viewing audience at home. [DRAFT TRANSCRIPT ONLY]
I just want to move on to a question about Vancouver Coastal Health, because we focused attention, and we have a short period of time here in this session…. First of all, it's my understanding that in the last few weeks, Vancouver Coastal Health served layoff notices to technologists that perform MRIs for patients in Vancouver Coastal Health. Can the minister tell me how many people were laid off? If we look at the MRI numbers for the rest of the year, what impact will that have on the number of MRIs performed in Vancouver Coastal Health? [DRAFT TRANSCRIPT ONLY]
[1445]
Hon. K. Falcon: I apologize for that delay, Member. In a $2½ billion Vancouver Coastal budget, we're digging around trying to find the four technologists that the member is referring to. [DRAFT TRANSCRIPT ONLY]
These four technologists were employed in a pilot project that was being governed under the Lower Mainland Innovation and Integration Fund, which was a pay-for-performance model. We're testing out how, by doing activity-based funding, we can see whether we're generating additional procedures and new innovations. The pilot project itself has wrapped up, but we will continue to analyze the success of that project as part of a larger review we're doing for pay for performance. [DRAFT TRANSCRIPT ONLY]
What I can tell the member is that thus far Vancouver Coastal has provided more than 10,000 additional MRI procedures since late 2008, which is certainly dramatic. It's important to recognize that eliminating these positions, I am advised by Vancouver Coastal, will not impact access to MRIs at Vancouver Coastal. They remain absolutely on track to complete their 18,000 budgeted procedures this year, which is over and above the 2,500 additional procedures they've provided. [DRAFT TRANSCRIPT ONLY]
A. Dix: So the budgeted amount for MRIs in Vancouver Coastal Health is 18,000 this year. What was the budgeted amount last year? I don't think the minister meant to say that the laying off of MRI techs and the reduction of capacity wouldn't have an impact. Obviously, it would have an impact. But if 18,000 is the budgeted number this year, then what was the budgeted number last year? [DRAFT TRANSCRIPT ONLY]
[1450]
Hon. K. Falcon: I appreciate the member's patience as we gather the information. [DRAFT TRANSCRIPT ONLY]
Again, the four technologists the member refers to were part of a pilot project that was being run to demonstrate whether, through a pay-for-performance initiative, we could increase the number of MRIs in a meaningful way. What I can tell the member is that in '07-08, the base budget for MRI procedures was also for 18,000 procedures. As a result of the pay-for-performance initiative, they undertook an additional 7,500 MRIs conducted in '08-09. [DRAFT TRANSCRIPT ONLY]
This year they have also budgeted for 18,000 MRIs, but my understanding is that they will be doing an additional 2,500 procedures with the same budget as a result of some of the lessons they've learned as a result of the pay-for-performance pilot project, which will now be reviewed to determine whether some form of that will continue into the future. [DRAFT TRANSCRIPT ONLY]
A. Dix: I'll be delighted to hear the news of the study where you hire more technologists who spend more hours doing MRIs and you discover that you get more MRIs done. I'll be looking forward to the results of that study. It'll be fantastic. [DRAFT TRANSCRIPT ONLY]
I assume that some other things came out of that as well, but presumably the 2,500 figure this year means that those extra technologists were annualized and that they're now not annualized. Is that the difference? [DRAFT TRANSCRIPT ONLY]
Presumably, the extra 2,500 would include the work done by those technologists who were working from April 1 to at least, I believe, on or around November 1. Their work would be included in those totals, and they've now been laid off. There would actually be the equivalent in the next few months of the 18,000 over the final months of the fiscal year. Am I understanding that correctly? [DRAFT TRANSCRIPT ONLY]
[1455]
Hon. K. Falcon: Again, the four technologists that were hired for the pilot project, I understand, were essentially re-engineering how they deliver MRIs to try and determine whether there was a way, with appropriate financial incentives, to deliver more MRIs in a manner that would provide ongoing improvements after the pilot project came to an end. The member is right that while they were there, obviously the four technologists were able to help provide a portion of the 2,500 additional procedures, but their positions run out. If memory serves me correct, I think it's at the end of December, and they will continue to provide MRIs through to the end of their fiscal year, the end of March, which will allow them to do 2,500 more MRIs than was budgeted — the 18,000 that were budgeted for. I think that's exactly the kind of thing we're looking for as we examine the different pay-for-performance projects. [DRAFT TRANSCRIPT ONLY]
A. Dix: Just to clarify with the minister. We did 25,500 in '08-09, and we're doing 20,500 in '09-10. Is that an accurate way to distil what he just said? [DRAFT TRANSCRIPT ONLY]
Hon. K. Falcon: Yes, that would be basically right. [DRAFT TRANSCRIPT ONLY]
A. Dix: I won't even get into a debate with the minister about whether that's a cut or not. We'll just move past that one and on to another question. [DRAFT TRANSCRIPT ONLY]
The next question I have for him is about acute psychiatry beds and what's going on now. It's obviously for us, especially those of us who represent constituencies in Vancouver Coastal Health, but I think everyone on the Lower Mainland, a really key question. [DRAFT TRANSCRIPT ONLY]
I want to ask the minister to explain what's going on now. I have in front of me…. It's not a secret memorandum or anything. It's a document that was sent out by Lorna Howes and by the medical director of Vancouver Coastal Health, Soma Ganesan. The memorandum says that the government is transferring 20 beds from UBC to Vancouver General Hospital, and those beds include complex disorders intervention unit beds — 15 of those and five early psychosis intervention beds — and that the government then is planning to effectively reduce 20 what are called general psych beds by consolidating E-1 and W-1 at Vancouver General Hospital health centre. [DRAFT TRANSCRIPT ONLY]
I want to ask the minister because, on the face of it — and I think that's what the memorandum says, at least in the short run…. I think this is probably linked to the new tertiary model in the area, but in the short run there'll be 20 fewer beds. Is that an accurate reflection of what's going on in Vancouver Coastal Health? [DRAFT TRANSCRIPT ONLY]
[1500]
Hon. K. Falcon: Vancouver Coastal has been engaged in a yearlong, evidence-based process to review its psychiatric programs and bed capacity to ensure it is best meeting the needs of their patients. [DRAFT TRANSCRIPT ONLY]
Vancouver Coastal Health Authority is planning to combine two of their early psychosis intervention programs, now located at the UBC Hospital and on Commercial Drive, into one site on East Hastings in order to create a more robust early psychosis intervention program. That then allows them to take the beds vacated at UBC, for example — I believe there are 18 beds vacated at UBC — and renovate those for the new patients that will be coming from Riverview Hospital as a result of the completion of the Riverview devolution. [DRAFT TRANSCRIPT ONLY]
[1505]
A. Dix: But the question was…. Vancouver Coastal Health is reducing by 20 right now — well, it says November 2009, and we're in November 29, so it's conceivably not right now; it may be in the coming weeks — the number of acute care, what are called general psych beds, by 20 at Vancouver General Hospital. [DRAFT TRANSCRIPT ONLY]
I guess the question is: are those beds presently used to capacity? That's what they're doing. They say so. My question wasn't about the early psychosis intervention program, although I'll be getting there. My question was about those 20 beds. Were they being used now? Is this a reduction, at least in the short term, in capacity? What impact will that have on patients? [DRAFT TRANSCRIPT ONLY]
Hon. K. Falcon: I just want to make sure I correct the member so that the member doesn't construe a change being a reduction. What is happening is there are a total of 117 acute psychiatry beds located at both VGH and UBC Hospital, which provide a mix of tertiary, secondary and emergency care. There is, as I say, a plan to combine two of the intervention programs at two different locations into one at a site on East Hastings. [DRAFT TRANSCRIPT ONLY]
The reason we are moving those clients out of those 18 beds is to allow a renovation to take place for those beds to ensure that they are capable of then taking the new patients who will be coming from Riverview as part of the Riverview devolution plan and to make sure those beds are there and capable of handling those folks who will be coming from Riverview. [DRAFT TRANSCRIPT ONLY]
It is a change. I acknowledge that. But it is a change which is part of a yearlong effort as they've been looking at how they are going to manage, on an evidence-based process, their psychiatric programs and bed capacity. [DRAFT TRANSCRIPT ONLY]
A. Dix: I'll just read it because I feel the minister and I are getting stuck, and I don't mean us to be. I'm just reading from his document or the Vancouver Coastal Health document. [DRAFT TRANSCRIPT ONLY]
I'm reading from this. This is from Lorna Howes, and it said: [DRAFT TRANSCRIPT ONLY]
"Beginning in November we'll begin to make these changes: transfer 15 complex disorder intervention unit beds from UBC Hospital to VGH; transfer five early psychosis intervention beds from UBC Hospital to VGH; add two beds to brief intervention unit at VGH; and then consolidate E-1 and W-1 at VGH health centre and reduce 20 general psych beds to facilitate the transfer of beds from UBC."
So the 20 beds go from UBC to VGH. VGH stays the same. It accommodates the 20 beds, and it reduces 20 of its own beds. So it's a minus 20 or, if you count the added two beds, a minus 18. I just want to understand if that's correct in the short run. I'm not trying to trick the minister here. This is just what it says. I'm trying to understand what it says. So it's a minus 18 in the short run. [DRAFT TRANSCRIPT ONLY]
What I'd like to know is whether those 20 general psych beds are, as was suggested in the case of Abbotsford, underutilized and whether they're in fact fully utilized now. [DRAFT TRANSCRIPT ONLY]
Hon. K. Falcon: The member is right. It is a net reduction of 18 that are being renovated in anticipation of the new clients moving in as part of the Riverview devolution. Also in the plans as part of the Riverview devolution, of course, will be the addition of even more beds, again as part of the Riverview devolution project. [DRAFT TRANSCRIPT ONLY]
A. Dix: It's a net reduction of 18 for how long? The minister talks about the beds in the future, but for the moment we're talking about a net reduction of 18 beds at a time when there's real pressure on those beds. [DRAFT TRANSCRIPT ONLY]
I understand that changes have to be made all the time. But I guess the question is: how long will that net reduction of 18 beds be in place? [DRAFT TRANSCRIPT ONLY]
[1510]
Hon. K. Falcon: In discussing with my staff and getting my head around a series of changes that are taking place here, essentially what is happening is consistent with what the member and I have been discussing. [DRAFT TRANSCRIPT ONLY]
[1515]
They are doing a program to review their psychiatric program and bed capacity to not only meet the emerging evidence-based process that follows a yearlong review they were doing on delivery of psychiatric programs and services, but at the same time, they were doing it to meet the direction that we're moving in terms of the Riverview devolution. [DRAFT TRANSCRIPT ONLY]
The member will note that part of that involves a consolidation of bed services to the site on East Hastings. That 18 net reduction in beds — those beds will then be renovated in preparation for the new clients that will arrive from the devolution of Riverview. [DRAFT TRANSCRIPT ONLY]
In addition to that — and I'm just attempting to get the number for the member — there will be new additional beds added as part of the Riverview devolution program. I'm just endeavouring to get at least a good estimate of that number for the member. [DRAFT TRANSCRIPT ONLY]
A. Dix: Maybe since the minister is getting that, I'll move on to the next question, and then we'll come back to it. I guess the number I want to know is…. What I'm interested in is: minus 18 for how long? That's the question I want to know. [DRAFT TRANSCRIPT ONLY]
Then I can ask the minister a question about other aspects of the early psychosis intervention program. In that case, he was talking about beds coming forward. I wanted to ask him, because I think the minister may have met — he's certainly heard from — parents and families involved in the program at UBC. I'm referring, in this case, not to the in-patient beds but to the day program. [DRAFT TRANSCRIPT ONLY]
What they say is — and I think this is true — that this is a levelling of service that we've seen in other places and that the day program is going to see reduced service. Instead of five days a week, it will be one morning a week. Obviously, that's a different program, and it's a cut related to budgetary concerns. [DRAFT TRANSCRIPT ONLY]
I think the argument Vancouver Coastal Health has made is that if you reduce the services each person receives, you can provide it to more people. But the truth of the matter is that this program, the day program I'm referring to now, is an incredibly successful program. [DRAFT TRANSCRIPT ONLY]
I have two questions for the minister, I guess. One is: will the minister be prepared to meet with the parents and families of people involved in this program? I've met with them, and they make a really compelling case around the program — around its value, around the money it saves in the long run, around what's happened. And then explain, I guess, here in the House, if you agree to meet with them…. That would be an important thing to do. [DRAFT TRANSCRIPT ONLY]
I'm referring here to the day program, not to the acute program. Would he agree to meet with those parents? I think when he does and when he hears from them, he'll understand that while you can make an argument — as has been made, for example, by the Minister of Children and Families on EIBI — that the reduction allows a spreading out of the benefit, the truth is that for the people involved, it appears to have a dramatically negative effect on them. The care and help they're getting has actually been — if you look at the results of that, the evidence-based results of that — very successful. [DRAFT TRANSCRIPT ONLY]
I wanted to ask the minister: (1) would he meet with the parents and the families and the people in the day program, the early psychosis intervention program which is being moved from UBC? And (2) will he tell the House — the question of the move is one thing — why he thinks the reduction in the breadth of this program is a good idea? [DRAFT TRANSCRIPT ONLY]
Hon. K. Falcon: If the member could help me. In the universe of health authorities there are literally hundreds and hundreds of different programs. This sounds suspiciously like a program that was a contracted program, but I'd need a little more detail from the member to make sure we're talking about the same program. If the member could do that for me, I'd appreciate it — particularly a name of the contractor or the program or something that could give us some help in identifying what it is. [DRAFT TRANSCRIPT ONLY]
[1520]
In terms of the beds that we were talking about, the in-patient psychiatric beds. The member will be pleased to know, I'm sure, that as part of the Riverview devolution I talked about, not only will those 18 beds that are being renovated be utilized by folks from Riverview, we will also next year be adding an additional 22 beds on top of that, for a grand total of 40 beds being added next year. [DRAFT TRANSCRIPT ONLY]
I'll wait for the information, the clarity, on the other contracted organization to provide an answer there. [DRAFT TRANSCRIPT ONLY]
A. Dix: Next year. Presumably we mean next fiscal year, so between April 2010 and March 2011. I just want the minister to be more precise. I'm just genuinely curious as to how long this current net reduction of 18 beds will last. As the minister will know, sometimes projects take longer than the government says they will, so I'd be curious about that. [DRAFT TRANSCRIPT ONLY]
The program I'm referring to is the UBC out-patient EPI program. That's the program I'm referring to. The minister will have received, I think, quite a bit of correspondence around the question. [DRAFT TRANSCRIPT ONLY]
Hon. K. Falcon: I'll just give a quick answer on the first point while I gather information on the organization the member mentioned. [DRAFT TRANSCRIPT ONLY]
The member is right. Those additional 22 beds would be added in fiscal '10-11. I can tell you the schedule in terms of the 18 beds that are being pulled out to do renovations on. That's essentially the construction schedule, but I can tell you that Vancouver Coastal is very anxious to get the construction work completed and the moment it is completed to then have those beds filled and the additional 22 beds added beginning on April 1 of the new fiscal year. [DRAFT TRANSCRIPT ONLY]
None of my staff are familiar with the program. It doesn't mean that it doesn't exist or that it's not important, just that they don't have that information. They will try and get that, and we can answer that as soon as we get it. [DRAFT TRANSCRIPT ONLY]
A. Dix: This one, I think, the minister will be delighted to answer because I think they have all the information here. Vancouver Coastal Health has got a lift of 2.4 percent this year. If you take it on last year's actual — because, as I understand it, the health authority ran a deficit last year, as they had for the previous two years — that would mean a somewhat smaller increase, even, based on last year's actual expenditures. [DRAFT TRANSCRIPT ONLY]
I just want to ask the minister, first of all, what the accumulated deficit is over the last three years. What happens to that accumulated deficit? Are there any plans for the government to actually reimburse the health authority or deal with that deficit, because really, it's the deficit of the province? [DRAFT TRANSCRIPT ONLY]
My assumption is that at the beginning of each fiscal year the health authority deals with that as a matter of cash flow, but I presume that at a certain point, once the deficit becomes big enough, that will become impossible. [DRAFT TRANSCRIPT ONLY]
I wanted to ask the minister specifically how big the accumulated deficit is. Is it his expectation that there will not be a deficit this year? I think these are important questions, of course, for the health authority because, as the minister will recall, in January 2007 the chair of the health authority was fired for not being able to deliver a balanced budget. Then in the subsequent three years the government hasn't been able to deliver a balanced budget in the health authority. [DRAFT TRANSCRIPT ONLY]
I want to understand what the government has learned from those deficit budgets and whether the minister is prepared to give us the assurance that there won't be a deficit budget in Vancouver Coastal Health this year. [DRAFT TRANSCRIPT ONLY]
[1525]
Hon. K. Falcon: In the case of Vancouver Coastal, I understand they ran a deficit in '07-08 of just over $35½ million. In '08-09 they ran a deficit of $20.187 million. This year I am pleased to report that they are on track to balance their budget. Of course, the member would know they are seeing an increase in their budget for fiscal '09-10 of 4.3 percent. [DRAFT TRANSCRIPT ONLY]
I will also say that they have, I think quite dramatically, improved their cash management at Vancouver Coastal, and the leadership of the chair and the board is worth noting. The chair, David Thompson, and the board, I think, have done an exceptional job working with Vancouver Coastal and Providence Health Care in ensuring they stay within the budget increases that have been budgeted. [DRAFT TRANSCRIPT ONLY]
A. Dix: With respect to that money, though, there isn't anything contemplated. Is it the government's position that eventually Vancouver Coastal will run some year a $70 million surplus and then be dealing with that money? Is that his position? Or is it that at some point, given that all these budgets were approved –– and I think it's pretty clear that Vancouver Coastal has gone through some difficult periods –– the government will come to its aid? Is it their position that they're just going to leave that money out there as a debt? [DRAFT TRANSCRIPT ONLY]
[1530]
Hon. K. Falcon: It's an expectation of this government and this minister that they will balance their budget on a year-to-year basis. We fully expect and indeed anticipate that they will do exactly that. [DRAFT TRANSCRIPT ONLY]
A. Dix: It's been three years in a row since that happened. I know there was a previous minister there, so there may be change. Who knows? [DRAFT TRANSCRIPT ONLY]
My question was very precise. What happens to that accumulated deficit? Part of it is Vancouver Coastal, and part of it is Providence. What happens to that accumulated deficit? How is that dealt with by the government? That's my very straightforward question to you. [DRAFT TRANSCRIPT ONLY]
Hon. K. Falcon: Those deficits would be consolidated as part of the consolidation of government's books at the end of that fiscal year. The surplus would have reflected…. They would net it out, obviously. There would be whatever the surplus was that year. I forget. It was a record surplus, if my memory serves me correctly. They would net out that deficit from the health authority in terms of the consolidated books. [DRAFT TRANSCRIPT ONLY]
[C. Trevena in the chair.]
As I say, on a go-forward basis, this year, as I mentioned, Vancouver Coastal is very much on track to balance its budget. I am just very pleased with the fact that they've done some very good work to ensure they do exactly that. [DRAFT TRANSCRIPT ONLY]
A. Dix: As the minister will know…. Given the 2.4 percent lift they're getting this year, that's all very interesting. That information, of course, comes from the chair of the board, so it couldn't possibly be wrong. [DRAFT TRANSCRIPT ONLY]
My next question to the minister is about contracted agencies, particularly those providing addiction services. As the minister will know, a somewhat different approach was taken within the Vancouver Coastal Health region, as between North Vancouver and Richmond on the one hand and what's called, I think, Vancouver coastal or the city of Vancouver–based services. [DRAFT TRANSCRIPT ONLY]
Can the minister explain why — I think he knows and I think people in Richmond know that the Richmond Addiction Services Society has done outstanding work over the years — this contract was completely gutted? In addition, why has the Canadian Mental Health Association in Richmond seen a funding reduction in 2010-11 of $53,000? That's annualized on $20,000 this year, in this estimates period. Why has the Kinsmen adult day program received a cut? Why has virtually every contractor in Richmond and on the North Shore received significant cuts? [DRAFT TRANSCRIPT ONLY]
I guess I'm asking the minister, just in terms of detail, if he can lay out for us the contractors — in particular, the list of contractors in Vancouver, on the North Shore and in Richmond — and if he can provide to this House a summary of all the contract reductions. Some of the contract reductions have to do with a standard that was set by the health authority with respect to what is called administration — of course, ignoring that some of that administration cost is fundraising cost. [DRAFT TRANSCRIPT ONLY]
That's one set, and then other agencies, such as West Coast Alternatives and RASS and others, got fully cut. [DRAFT TRANSCRIPT ONLY]
Can the minister just commit — because we don't want to have to go through all of them — to letting us know what all the cuts are, in one place? Could he commit to do that so that we can see them together and people on the North Shore, people in Richmond and people in the city of Vancouver and up the coast can understand what the funding was last year, what the cuts are this year and what the total savings are? [DRAFT TRANSCRIPT ONLY]
Hon. K. Falcon: We're apparently going to have this discussion again, because the member refers to changes as cuts, when they're not. They are changes to how we are delivering mental health and addiction in the province of British Columbia, particularly in the Lower Mainland. [DRAFT TRANSCRIPT ONLY]
[1535]
It might help for the member to know that since Vancouver Coastal was formed in 2002, spending on mental health and addictions has actually increased by 63 percent. That is an increase in mental health and addictions spending alone of 63 percent, and spending is increasing again this year to record levels. [DRAFT TRANSCRIPT ONLY]
Now, within the context of that record level of increase in mental health and addictions spending, Vancouver Coastal is also making sure that as research emerges demonstrating that…. Increasingly, we see the kind of clients that present with mental health challenges or with addiction challenges are often one and the same. It is what we call concurrent disorders. [DRAFT TRANSCRIPT ONLY]
No one is saying that Richmond Addiction Services wasn't providing important addictions services, but they were not providing concurrent-disorder services. What Vancouver Coastal has done is…. They will be delivering those services through Vancouver Coastal directly, and they will be providing the concurrent-disorder services that they believe, and clinical best practices and evidence demonstrate, is the best way to go forward. [DRAFT TRANSCRIPT ONLY]
The clinical staff from Richmond Addiction Services, my understanding is, have been offered positions, as they transition to Vancouver Coastal Health, delivering those programs. [DRAFT TRANSCRIPT ONLY]
But you know, Member, it is totally wrong for you to call that a cut. I get that for the Richmond Addiction Services agency, which has provided these services for many, many years, it certainly is to them. I acknowledge that. [DRAFT TRANSCRIPT ONLY]
As I say, what they will be doing is delivering those services in the manner that best practices suggest they should be delivered — in other words, concurrent disorders, recognizing that those are the kinds of individuals that are increasingly presenting with addiction problems. Once they strip away the addiction challenges, they find that there are often significant mental health issues underlying that. That is indeed a change. [DRAFT TRANSCRIPT ONLY]
Naturally, Vancouver Coastal is doing this uniformly across its service delivery area, and there are other similar agencies. They are ensuring that Vancouver Coastal is moving forward with new programs that reflect the concurrent-disorder model that suggests that that is the best way to treat these individuals — in other words, individuals that are suffering from both addiction and mental health issues. [DRAFT TRANSCRIPT ONLY]
Similarly, with West Coast Alternatives, the contract is being repatriated to Vancouver Coastal. Vancouver Coastal will be delivering under a new program that reflects the best evidence and the concurrent-disorder nature of the delivery of the service so that the clients will be better served, based on the additional evidence. [DRAFT TRANSCRIPT ONLY]
In the case of West Coast Alternatives, as I said to the member — I think this may have come up in the House during question period at one point — clients who are currently receiving one-on-one counselling through West Coast Alternatives will continue to receive one-on-one counselling through Vancouver Coastal. [DRAFT TRANSCRIPT ONLY]
I think it's important to recognize that while that is a change, it certainly is a change that is governed and predicated upon some of the things that we are learning. It is certainly not a cut when you are increasing the budget for mental health and addictions in Vancouver Coastal, as I say, by 63 percent. [DRAFT TRANSCRIPT ONLY]
Having said that, one of the things we have to do in Health is that when new evidence starts to emerge that suggests there's a different way we can treat some of these folks that are dealing with substance abuse or mental health issues, we ought not be afraid to pursue that. We can't just keep doing things…. I know that some of the opposition members have suggested we just keep doing things the way we've always done them, but that actually, certainly, isn't consistent with what the best practices would suggest. [DRAFT TRANSCRIPT ONLY]
Within that 63 percent budget increase for mental health and addictions, are they making changes? They are. Are those changes difficult for the contracted service providers that used to provide a portion of the services? Yes, they are. [DRAFT TRANSCRIPT ONLY]
I know that the staff at Vancouver Coastal is working with the contract service providers to try and ensure that the transition will be as smooth as possible. [DRAFT TRANSCRIPT ONLY]
A. Dix: The minister will know that what they said on Vancouver Island was that you had to be sicker to get care. Presumably, that's what's being said here — that the focus on concurrent disorders means that inevitably…. [DRAFT TRANSCRIPT ONLY]
[1540]
There are arguments around these questions. They're not simple arguments, and the minister simplifies them to the point of it being ludicrous. [DRAFT TRANSCRIPT ONLY]
Let me just say it very simply to him: can he provide us with a list of all the contracted mental health and addiction agencies, so that we don't have to go through the details and everything else, for Richmond, for Vancouver and then for the North Shore now — the list of the contract they got last year and the list of the cut in those contracts? [DRAFT TRANSCRIPT ONLY]
I know the minister doesn't like the word "cut," but when you get less one year than the previous year, that's generally viewed as a cut, in English. If he wants to suggest another word…. "Negative change?" I'm willing to go with "negative change" as well. [DRAFT TRANSCRIPT ONLY]
Can the minister simply commit to laying out for us all of the contracted services? And if he can provide that document, which I'm sure the health authority has already prepared in any event, if you just provide that thing, then we can move on to the next topic. [DRAFT TRANSCRIPT ONLY]
Hon. K. Falcon: Just to discuss further, there are, I'm informed, 350 contracts currently held throughout the Vancouver Coastal Region. Approximately 240 of those contracts are under review and are engaged in mental health and addiction contracts, I believe. I hope I'm reading that correctly. [DRAFT TRANSCRIPT ONLY]
What they are requiring under the contract review is ensuring that there be a 10 percent limit on administrative overhead. That is consistent with what the health authority itself is doing. They are ensuring that they reduce their administrative and overhead support to no more than 10 percent of the total budget. They're requiring the same thing from the contract service providers. [DRAFT TRANSCRIPT ONLY]
They are taking a close look at discretionary spending, particularly around travel and consulting contracts. Vancouver Coastal is also looking to eliminate duplication and try and determine whether there can be increased productivity and efficiency in the delivery of those services by cooperating more with Fraser Health Authority and Providence Health Care. [DRAFT TRANSCRIPT ONLY]
One of the things that I do think we have to acknowledge, Member, particularly when there are over 300 contract service providers providing a whole ream of services, many that have been going on for many years, is that, as I mentioned in my earlier answer, as more information comes to the fore in terms of how best to treat and look after patients that present with addictions and mental health challenges, we do want to make sure we follow best evidence. [DRAFT TRANSCRIPT ONLY]
I remember in a previous time here the critic had asked what evidence that's predicated upon. I do think that…. There are a number of reviews that I could certainly read into the record, but certainly the 2004 article published in the Psychiatric Rehabilitation Journal. It stated that: "The cumulative evidence from experimental and quasi-experimental research supports integrating outpatient mental health and substance abuse treatments into a single cohesive package." [DRAFT TRANSCRIPT ONLY]
The 2008 article published in the Administration and Policy in Mental Health and Mental Health Services Research again showed both concurrent disorders treatment — and that includes the use of assertive community teams; as you know, something that we've been doing and expanding in the province — and integrated assertive community produced better consumer satisfaction and stable housing outcomes than do the standard care models. [DRAFT TRANSCRIPT ONLY]
[1545]
It goes on and on — in the American Journal of Orthopsychiatry, the Community Mental Health Journal, the Psychiatric Services Journal, the Canadian Journal of Psychiatry. And on and on it goes. But essentially, the common emerging consensus is that that is the appropriate approach. [DRAFT TRANSCRIPT ONLY]
As Vancouver Coastal looks at how they're delivering those services, it is certainly incumbent upon them in some cases — and as the member pointed out clearly, with Richmond Addiction and West Coast Alternatives, that means a change. It's not a question of being cute about whether it's a negative reduction or whatever it is. [DRAFT TRANSCRIPT ONLY]
They're cancelling their contracts, so that has an impact on those agency service providers. I understand that, but they're not cancelling the service. The service is continuing to be delivered through Vancouver Coastal, and it will be delivered incorporating what the latest best practices and evidence tell us should be included when treating these individuals that present with concurrent disorders around mental health and addictions. [DRAFT TRANSCRIPT ONLY]
I think, though, that it is difficult to make that change, particularly for the contract service providers. I understand how passionately they feel their current addiction services provide important services, and they do. They just don't provide the concurrent service that is governed by the studies that demonstrate that that is the best model for treating those that suffer from both mental health and addictions issues. [DRAFT TRANSCRIPT ONLY]
A. Dix: Well, I defy the minister to find a study that says that you cut one group of people and add the money to another group of people. Anyway, it's just what it is. [DRAFT TRANSCRIPT ONLY]
But the question really was: will he provide us with the list of the contract agencies, a spreadsheet that I'm sure Vancouver Coastal has, that shows the reductions by agency so that we can see that and so that this House, which votes the money used for that, can see that? That's the simple question I asked, which he just answered, apparently. [DRAFT TRANSCRIPT ONLY]
Hon. K. Falcon: I'd be happy to get the member a list of all the contract service providers. [DRAFT TRANSCRIPT ONLY]
Again, I should let the record note that the requirement that they are asking of all of the service providers — to limit their administrative costs within the same framework and discipline they put themselves under — is something that I very much support. I expect — quite rightly, I think — Vancouver Coastal to apply the same standard to their contract service providers that they are applying to themselves. [DRAFT TRANSCRIPT ONLY]
I will get that member a complete list of the contract service providers. [DRAFT TRANSCRIPT ONLY]
A. Dix: And the reductions in their contracts. [DRAFT TRANSCRIPT ONLY]
I'd just point out to the minister that it's not comparable. I mean, having run a non-profit, he knows— he has worked with non-profits in the past — that some of what's called administration is fundraising. The reason that some of these agencies are extraordinarily successful is that they do a lot of things that are broadly called administration but that expand their capacity to do more than what they are funded to do. [DRAFT TRANSCRIPT ONLY]
With that, with the minister's agreement to provide the list of those cuts, I just have one question from my colleague for Vancouver–West End. [DRAFT TRANSCRIPT ONLY]
S. Herbert: Just a quick question for the minister. I'm wondering if he can tell me what budget amount is currently being spent to keep the lands down by Station Street. The Esperanza Society, I believe, holds them, and I've heard that the government is paying the taxes for those lands. If you could give me that figure, and also if you could give me an update about where we are in the process to revitalize St. Paul's Hospital on site in the West End, as I've been calling for, for some time. [DRAFT TRANSCRIPT ONLY]
Hon. K. Falcon: The property taxes that are being covered for the lands that are owned by the Esperanza Society are in the amount of approximately $800,000 annually. [DRAFT TRANSCRIPT ONLY]
S. Herbert: Just the second part of my question for the minister: where are we in the process to revitalize St. Paul's Hospital on site, and can I get some assurance that it will happen in the West End? [DRAFT TRANSCRIPT ONLY]
[1550]
Hon. K. Falcon: I'm advised by staff that it's still very early days in terms of contemplating the role that St. Paul's will play within the larger context of the entire Vancouver Coastal Health region. [DRAFT TRANSCRIPT ONLY]
This is something that certainly is near and dear to my heart, as my mother worked at St. Paul's for some 25 years as a nurse. But again, I'm advised by staff that this is still very, very early on. We continue to have discussions with the health authority and with Providence Health Care as we look to the future and determine what is the best way to deliver top-quality health services for the Vancouver area. [DRAFT TRANSCRIPT ONLY]
A. Dix: I'm not sure how early on it is in the process which started in 2002, but you know, we'll take that to mean that it's going to be a long process. [DRAFT TRANSCRIPT ONLY]
Just a couple of questions to the minister about the situation in the Interior Health Authority, which will allow for a shuffling of binders, I think. I guess the first question I had to the minister is…. I'll start simple for the minister. The Vernon surgical review has been ongoing for some time. Can the minister tell us what the results are of that review? Has the government concluded that it was right or that the Vernon surgeons were right? [DRAFT TRANSCRIPT ONLY]
Hon. K. Falcon: I'm glad the member mentioned Interior Health. I can tell you that today, for the benefit of members in the House, there are about $433 million worth of construction projects underway for Kelowna General and Vernon Jubilee Hospital. This is, indeed, a very exciting time. The seven-storey Vernon Jubilee tower is going to dramatically improve the manner and method in which care is being delivered in the Interior. [DRAFT TRANSCRIPT ONLY]
In fact, ironically, on Friday of last week I had the incredible, really emotional and moving opportunity to be at the Kelowna General Hospital, where the first patient that underwent an angioplasty…. The first cardiac surgical procedure that has taken place at Kelowna General as a result of the $27 million in funding that we provided to get the new cardiac surgical unit up and running…. It will form the basis for a new ongoing surgical suite and services that will be provided for the entire Interior and, indeed, perhaps even northern parts of the province in terms of top-notch cardiac care in the province of British Columbia. [DRAFT TRANSCRIPT ONLY]
The first patient, Ron Kaerne, was really quite something. Here was a young man of age 51 who was born in Kelowna General Hospital, had a heart attack –– you can imagine how terrifying that would be –– and was able to go and be the first patient to receive an angioplasty. He was awake the entire time the service was being delivered, and it was successfully delivered for the benefit of Mr. Kaerne. [DRAFT TRANSCRIPT ONLY]
I can tell all members of this House just what a moving experience it was to be there with the surgeons, with the nurses, with all of the care aides and the staff and the family that were just so excited about these new services taking place at Kelowna General. I did want to mention that, because I do think it is a testament to the great work that is taking place at Interior Health. [DRAFT TRANSCRIPT ONLY]
Now, with respect to the issue that the member mentions in Vernon…. Actually, in the summer I met with a number of the surgeons at Vernon Jubilee with respect to issues and recommendations and suggestions they had in terms of how some of the surgical challenges that they face could be dealt with as a result of that. [DRAFT TRANSCRIPT ONLY]
The staff went away and were preparing a report. I'm not at all certain that the report has been completed. If it has, I haven't had the opportunity to see it yet, but essentially, coming out of that meeting with the surgeons, I committed to make sure that the report is undertaken with their input and that that report would hopefully make some recommendations that could help deal with some of the issues that were raised by the very, very good surgeons that I met with while in Vernon. [DRAFT TRANSCRIPT ONLY]
A. Dix: Just for people watching at home, the answer to that question was: "I don't know." To follow up on that, will the minister let us know when we can expect results of the review that was requested? [DRAFT TRANSCRIPT ONLY]
[1555]
A question on the Interior Health Authority. Can the minister tell us, to begin with, whether it's his expectation now that the Interior Health Authority will balance its budget? As you'll recall, when we raised these issues in March, the previous Minister of Health and the head of the Interior Health Authority said that there wouldn't be cuts in patient services and that there wouldn't be any prospect of a deficit. As we had predicted, both those proved to be untrue. [DRAFT TRANSCRIPT ONLY]
Of course, there have been very significant cuts to patient services that we've seen across Interior Health, including at the very hospital the minister was just referring to — the continued year-long problem of code purples at Vernon Jubilee Hospital. In any event, can the minister tell us whether it is his view that the budget will now be balanced in Interior Health in this 2009-2010 fiscal year? [DRAFT TRANSCRIPT ONLY]
Hon. K. Falcon: I do appreciate the member recognizing that my last answer was lengthy. In addition to answering his question, I did talk about some of these other things, because I do think it is important to recognize what is going well within our system. We have an outstanding health care system in British Columbia, quite aside from the fact that sometimes members of the opposition and some in the public sector union feel or try to suggest that we have a terrible system. [DRAFT TRANSCRIPT ONLY]
We have an exceptional system, and that was reinforced to me at Interior Health when I had the opportunity at Kelowna General to visit and be part of the new surgical unit and talk to the surgeons there, Dr. Richard Townley and Dr. Dick Hooper — two eminent British Columbians who just do outstanding work and are so genuinely excited and thrilled about the new services that are offered. [DRAFT TRANSCRIPT ONLY]
In fact, subsequent to that visit — it might just be interesting, because it puts it all in perspective to know that — we received a follow-up note from Dr. Dick Hooper, who advised that a client in Interior Health who presented with a serious heart attack which, in most cases, this individual would not have survived…. Given the time frame as a result of having the cardiac response now available as quickly as it is available, this individual today is alive and well as a result of those services. I think that that really puts a very human dimension on some of the improvements that are being made. [DRAFT TRANSCRIPT ONLY]
Directly to the member's question now, with respect to specifically Interior Health, under the very capable leadership, I must say, of Murray Ramsden, the outgoing CEO — and I'm very sorry to see Murray go, because I think he's probably one of the best individuals that I've had the pleasure of working with, even in my brief time as Minister of Health — they are also on track to balance their budget. I think that is very much a testament to the leadership of Murray, his executive team and all of the staff, indeed — front-line and otherwise staff at Interior Health. They are on target to balance their budget. [DRAFT TRANSCRIPT ONLY]
K. Conroy: Heading over into the Kootenays part of the Interior Health Authority, there were a number of cuts of nurses announced just in the last few weeks, who are going to be losing their jobs or being displaced. The rationale was utilized that they're reconfiguring the hospital to accommodate seniors in the acute care facility in Trail at the Kootenay Boundary Regional Hospital. We're looking at, at least, six registered nurses being laid off. We know that there's a shortage of nurses right now in this province, and it's a real concern in our area. [DRAFT TRANSCRIPT ONLY]
We also know that seniors are being housed in the psychiatric ward at the regional hospital. They're being housed on the acute care floor in Trail at the regional hospital. Nurses are being laid off, and other long-term care aides and LPNs are being brought in. They're changing the way staffing is going to work to accommodate this. [DRAFT TRANSCRIPT ONLY]
[1600]
We know full well in our area that we have residential care facilities with openings, and it seems to me that we should be placing seniors in residential care beds and keeping our nurses in our facilities rather than reconfiguring to meet the needs of seniors in acute care. I just wonder if the minister could address that. [DRAFT TRANSCRIPT ONLY]
Hon. K. Falcon: The member, in the latter part of her question, actually nailed it pretty much bang on. It is a staffing change. So why is the staffing complement changing, which is, in the short term, impacting a number of nurses? There will be less RNs that will be servicing some of these folks, but there will be more LPNs, as the member correctly pointed out, and care aides. [DRAFT TRANSCRIPT ONLY]
Well, the reason is that alternative-level-of-care beds…. Typically, what is happening in health authorities, including Interior Health, is at the hospitals, including Kootenay regional that the member mentions…. What they are doing is putting those patients…. [DRAFT TRANSCRIPT ONLY]
These will be patients that likely receive some form of acute care treatment. In most cases, generally, they are seniors, and some cases may be those with mental health issues. They're waiting to transition them back into the community, whether in a residential care bed or depending on what their specific case management officer will suggest is the appropriate level of care for those individuals. [DRAFT TRANSCRIPT ONLY]
What they are doing is aggregating those ALC — alternative-level-of-care — patients into one defined area, a ward or a defined part of the hospital so that they can change the staffing level that's required to look after them to a more appropriate staffing level. You don't need doctors and RNs looking after ACL patients. You can use LPNs, who are licensed practical nurses, or care aides to provide that level of care. [DRAFT TRANSCRIPT ONLY]
This is an appropriate way of dealing with ALC patients. The level of ALC patients within the system will fluctuate depending on time of year, etc. Typically, when we came into power in 2001 an average of 15 percent of patients in acute care beds were alternative-level-of-care, or ALC, patients. Today that average hovers around 11 percent. [DRAFT TRANSCRIPT ONLY]
There has been some increase, but there will always be ALC patients. I think that what is happening at Interior Health and the other health authorities is that they are making sure the staffing complement reflects the needs of those patients so that you're not requiring an acute level of staffing for patients who don't require an acute level of staffing. [DRAFT TRANSCRIPT ONLY]
In terms of the nurses, the good news, I can assure the member, is that any RN that may be displaced as a result of a change like this…. We have lots of demand for RNs in the health system in British Columbia, and they won't have any trouble finding new positions somewhere in our health care system in British Columbia. I can assure you of that. [DRAFT TRANSCRIPT ONLY]
K. Conroy: I'm sure that's very comforting for nurses to be told that you can go anywhere in the province and find a job when you've lived in the Kootenays all your life or lived in Trail all your life. That's a bit of a concern. [DRAFT TRANSCRIPT ONLY]
Also, the alternate level of care…. The seniors that are waiting in the psychiatric unit are not dealing with mental health issues. They're waiting for residential care beds. They need a residential care bed. There are openings in the residential care facility in the region, one very close to the regional hospital. It's unfunded. It was briefly funded a few years back, but that funding was taken away. [DRAFT TRANSCRIPT ONLY]
It's beds sitting there. It's proper care for seniors. It's in a long-term-care facility. It's not in the acute care facility. We know people that aren't getting into the acute care facility, and there are wait-lists for acute care for surgeries. There are seniors in the beds, and they could be in a long-term-care facility. They could be in a facility where not only would there be the proper level of care for them; it's also a facility that's geared for seniors. [DRAFT TRANSCRIPT ONLY]
Last time I checked, the psychiatric unit, although it's a great facility for persons with psychiatric issues, is not the greatest place for seniors to be taken care of. One of them has been there for six months. Six months in a psychiatric unit when you're waiting for an alternate level of care…. There are facilities. There are beds that are available. In the meantime, we're seeing this change of staffing. [DRAFT TRANSCRIPT ONLY]
One of the options for the five nurses that are being laid off is to go from steady days or shift work to steady nights. We're talking about nurses with an incredible level of seniority and skills, so that's not really an option. That's not a good option. It's not good enough to tell nurses, "Well, you can go anywhere in the province and work," when you've lived all or most of your working life at the same hospital. [DRAFT TRANSCRIPT ONLY]
[1605]
We need to look at ways of ensuring that seniors are adequately housed. I've been told by the management through the IH in the Kootenay region that it's in fact a lack of funding. They cannot fund the residential care facility, so it's a lack of funding. They're rejigging the staffing to meet the needs, and it's not meeting the needs appropriately. [DRAFT TRANSCRIPT ONLY]
Hon. K. Falcon: I think it's important for the member to know that every case of alternative-level-of-care patients that are in the system does not necessarily mean that those patients require a residential care bed. That is often not the case. [DRAFT TRANSCRIPT ONLY]
Every individual is different, and that's why there has to be an individual care plan in place for each of these individuals. You cannot and should not ever make the sort of sweeping assertion: "Oh, there is an alternative-level-of-care-bed patient here; therefore, they should be in the local residential care facility." That is not the case. [DRAFT TRANSCRIPT ONLY]
I do think, though, Member, that it is important to understand that we've always had ALC, or alternative-level-of-care, patients within the system. It was certainly an issue that the NDP during their ten years in power had to deal with. It's an issue that we have to deal with. One of the ways that you deal with it is by making sure you build additional capacity to provide continuum-of-care options for individuals who are looking for an assisted-living care bed to move to or a facility or a residential care facility for more complex needs or, indeed, even home support. [DRAFT TRANSCRIPT ONLY]
One thing I can tell the member is that Interior Health has added over 1,300 new residential care or assisted-living care beds in Interior Health alone since 2001. Frankly, that record, I think, compares very favourably to the 1,400 new beds that were added in the entire decade of the 1990s under the previous NDP government. [DRAFT TRANSCRIPT ONLY]
Have we achieved perfection yet? We certainly haven't. That's why we will continue to be investing in a very aggressive way in providing residential care options for seniors. But I do caution the member that those that are in an ALC setting aren't necessarily destined to residential care settings, so you don't want to make that direct line. [DRAFT TRANSCRIPT ONLY]
The other thing is that I do think it is fair to say that that is a change. It is a staffing level change. You have a case where registered nurses are no longer being required to look after patients that are not acute care patients. So yes, it impacts them, and it impacts the new staff that are being hired — the licensed practical nurses and the care aides that are being hired to look after those individuals. [DRAFT TRANSCRIPT ONLY]
It's hard for me to quibble with the health authority for trying to make sure that they align their staffing resources to better reflect the kind of care that is necessary and appropriate for individuals within the acute care setting. So I think that the decisions they're making…. In fact, other health authorities are making exactly the same kind of decisions to aggregate the alternative-level-of-care patients to a ward and ensure that they receive the adequate level of care for themselves. They do not require the same care that is required for those that are in acute care beds receiving acute care services from the medical professionals. [DRAFT TRANSCRIPT ONLY]
A. Dix: Just a question about the review of breast cancer tests in the Interior Health Authority. As you know, we've raised this issue on a number of occasions. I understand the B.C. Cancer Agency is now retesting the samples from Okanagan Health Services Area labs. I'm wondering where that's at and whether the results of that review will be published so that everyone in the area will know what transpired. [DRAFT TRANSCRIPT ONLY]
[1610]
Hon. K. Falcon: Interior Health, supported by the B.C. Cancer Agency, as the member would know, has been reviewing the issues raised regarding estrogen receptor testing in Kelowna in 2005. Interior Health completed the initial review and found no irregularities regarding the original diagnoses that were provided. [DRAFT TRANSCRIPT ONLY]
B.C. Cancer Agency then was brought in and supported that review by retesting the samples using a more modern, more sensitive test that wasn't available in 2005 when the original testing was completed. Not surprisingly, finishing that review, the Cancer Agency found that the IHA samples that they have done the testing on had some minor variation on some of those samples, and they're still reviewing the B.C. Cancer Agency control group as they complete that review. [DRAFT TRANSCRIPT ONLY]
The staff advised me, and the Cancer Agency advises, that the changes, the minor changes in some of the test results may or may not be clinically significant nor warrant treatment revisions. [DRAFT TRANSCRIPT ONLY]
But I understand that each of the individual patients has been contacted and that their oncologists are working with the patients and their primary physicians to determine if any changes to individual treatment regimes are recommended, based on the review and the testing and the retesting. [DRAFT TRANSCRIPT ONLY]
A. Dix: The question is: will the information be made public? The minister will know that these issues are brought to the…. I mean the aggregate data, obviously, not the individual data. Will the aggregate data…? Will a report be made, based on this retesting? [DRAFT TRANSCRIPT ONLY]
The minister will know that a long time passed after concerns were raised about this issue before action was taken. Concerns were raised in the fall of 2008 by a former employee, a former pathologist at the Interior Health Authority, Mr. Ready. The issues were even raised in this House in March, and the issue wasn't referred to the Cancer Agency until August. [DRAFT TRANSCRIPT ONLY]
[1615]
My question is: will the results, the aggregate data at least, in this long-delayed review and very seriously long-delayed review…? Will that information be published and made available to the public so that we can see what happened and what didn't happen with respect to this testing process? [DRAFT TRANSCRIPT ONLY]
Hon. K. Falcon: I'm advised by staff that, certainly, we…. I can tell you this. My position is that we should be as open as we can possibly be with respect to this situation. I don't have any problem with that at all. [DRAFT TRANSCRIPT ONLY]
I am informed by staff that we take our advice from the B.C. Cancer Agency with respect to this. This is a relatively small group of individuals, and there is some concern that we have to be careful about those individuals being individually identified. [DRAFT TRANSCRIPT ONLY]
These are individuals that are dealing with issues of cancer. They are working closely with their general physicians and their oncologists with respect to this. They've all been contacted individually. I am advised by staff that we have to be sensitive to the privacy issues that are at play here and that we are, as I say, making sure the B.C. Cancer Agency is the one that is providing us advice in terms of the level of information that can be provided. [DRAFT TRANSCRIPT ONLY]
I have actually tried to provide as much information as I possibly can with respect to this — to point out that the testing samples that were retested, using a new, more sensitive test that wasn't even available back in 2005, did identify some anomalies and that the feeling is that the change in test results may or may not be clinically significant or even warrant any treatment revisions. [DRAFT TRANSCRIPT ONLY]
Again, each of those individuals has been individually contacted and is working with their general physician and their oncologist as to what, if any, revision in their treatment program would be required. [DRAFT TRANSCRIPT ONLY]
A. Dix: So the minister is saying that, in his view, there will be no release of the aggregate data from this review done by the B.C. Cancer Agency of what happened in the Interior Health Authority, where very serious issues were raised about practices with respect to this testing. [DRAFT TRANSCRIPT ONLY]
Hon. K. Falcon: That would largely depend on the advice of the B.C. Cancer Agency. As I say, we're dealing with a very small client population here, less than 60 individuals. There is some sensitivity around their own circumstances and, obviously, making sure that if you start talking about individual cases in a small population like that, it can become apparent to someone doing the most cursory review what individuals you may or may not be talking about. That's what I'm advised by staff. [DRAFT TRANSCRIPT ONLY]
As I say, I can assure the member that whatever advice the B.C. Cancer Agency is comfortable releasing that is not going to cause them problems in terms of the privacy issues associated with it, I will happily and gladly release. I think the results speak for themselves in terms of what was identified. [DRAFT TRANSCRIPT ONLY]
G. Coons: I seek leave to make an introduction. [DRAFT TRANSCRIPT ONLY]
Leave granted.
Introductions by Members
G. Coons: In the gallery today is somebody I've talked about before, Mae-Jong Bowles, from Prince Rupert. She's a teacher, a good friend of mine. If you remember, she was one of the candidates for Seafaring Person of the Year. Mae is down here for the aboriginal reference group meeting, to review all of the full-day kindergarten with ministry staff and other agencies. Please make Mae welcome today. [DRAFT TRANSCRIPT ONLY]
Debate Continued
A. Dix: I just wanted to follow up with the minister with respect to cuts to surgeries in the Interior Health Authority. Interior Health Authority made me aware and the public aware that there were cuts in the neighbourhood of 328 surgeries, just to hip and knee surgeries, and also made us aware that an operating room is closing in Kamloops. I believe an operating room is closing in Trail. I believe other operating rooms, such as the one at Shuswap Lake and others, are seeing a reduction in hours. [DRAFT TRANSCRIPT ONLY]
Can the minister tell us, in terms of meeting his budgetary targets this year, how many elective surgeries have been reduced in the Interior Health Authority? [DRAFT TRANSCRIPT ONLY]
[1620]
Hon. K. Falcon: I'm advised by staff that by the end of this fiscal year we expect to see a net zero reduction in elective surgeries. [DRAFT TRANSCRIPT ONLY]
A. Dix: Can the minister just take us through the data? Presumably, there is some purpose why Mr. Neuner, who is in charge of the Kamloops region, suggests that a 10 percent cut was required in that region. Maybe we'll focus on the Kamloops region for a second. Has there been a reduction in the number of surgeries in the Kamloops region, as suggested, again, not by me but by Mr. Neuner? [DRAFT TRANSCRIPT ONLY]
Hon. K. Falcon: Again, Interior Health is projecting to do the same number of elective procedures this year as last year. With respect to Royal Inland, they undertook a review and found that the second emergency and emergent operating room had a utilization rate of only 55 percent, meaning that staffing and other resources weren't being used to full potential. [DRAFT TRANSCRIPT ONLY]
What they're doing is that the second operating room is being closed, I believe, in the evenings, and the emergency and emergent surgical slate is being expanded during the daytime hours when they have a full complement of staff, so there's a better utilization of staff at that time. They are changing the way they do things to ensure that the staff they have in place during the daytime shifts are doing more procedures when they've got full utilization and complement of staff. [DRAFT TRANSCRIPT ONLY]
But again, overall, at Interior Health they'll be doing the same number of elective procedures this year as last. [DRAFT TRANSCRIPT ONLY]
A. Dix: The next question I had for the minister was…. As the minister will know, the Premier's Council on Aging has recommended a dramatic expansion of home care and home support services. Kelowna, in fact, has a significant demand for those services. Can the minister explain why so many home care and home support workers are being laid off in the Kelowna area? [DRAFT TRANSCRIPT ONLY]
Hon. K. Falcon: This is actually the result of a good-news story in the sense that because we've built so many new facilities, there is absolutely zero waiting list right now with respect to home care. [DRAFT TRANSCRIPT ONLY]
In fact, we now have a situation where there is a surplus of staff that are, as I say, with no new, or zero, wait-list in terms of home care, home support. As a result of that, some of those staff, if my memory serves me correctly — and I'll double-check — may be being redeployed to the residential care sector. I could be wrong about that, so I want to double-check. But as I say, again, zero wait-list whatsoever. [DRAFT TRANSCRIPT ONLY]
A. Dix: Of course, the minister will know that that can potentially do with a number of things, including eligibility, given that we've seen reduced eligibility and access to home care and home support services. [DRAFT TRANSCRIPT ONLY]
I just have a further question about diagnostic procedures. We're trying to get down to sort of the core facts. While the minister is answering this, maybe he can answer on this surgery question. What was the number of elective surgeries that were done this year, and what was the number of elective surgeries that were done last year? Equally, the same with MRI exams. [DRAFT TRANSCRIPT ONLY]
[1625]
Hon. K. Falcon: We're just gathering up, and as we jump to different subjects, I would ask the member to understand that we have to then try to find the information with respect to those new areas. [DRAFT TRANSCRIPT ONLY]
Going back to the home support, I just want to confirm that as a result of the opening of 400 new supportive intermediate- and long-term-care beds in the Central Okanagan as of the end of October, there was not one single assessed client waiting for a service. So there's no wait-list at all. We're obviously pretty pleased with that. [DRAFT TRANSCRIPT ONLY]
As a result, of course, you've got a reduction in the number of community homeworkers in the home support program to match the reduced client demand. However, I think, again, the perspective would be that, naturally, you've got more staff working as a result of the 400 new beds that have opened in the Central Okanagan. [DRAFT TRANSCRIPT ONLY]
I think the important thing to also point out that I didn't mention in my previous answer is that clients will not see any changes whatsoever to the number of hours in the service hours that they currently receive. They may get it from a different community homeworker, but they won't receive any change whatsoever to the number of hours. It is an adjustment reflecting the reduced demand. [DRAFT TRANSCRIPT ONLY]
I will now endeavour to answer the balance of the member's questions. [DRAFT TRANSCRIPT ONLY]
[1630]
The member can probably see that staff is trying to get that. I know this is the member's time, so I don't want to slow down the process unnecessarily. They're trying to find the breakout number for you, Member. [DRAFT TRANSCRIPT ONLY]
What I can tell you is that Interior Health is, apparently, currently up 3½ percent in surgical procedures this year over last year and, as I mentioned, they expect to do…. There will be no change in the number of elective surgeries they are undertaking –– zero change. But they are up this year over last year in terms of the numbers that they have done. [DRAFT TRANSCRIPT ONLY]
A. Dix: Perhaps the minister can just…. When staff get that information on MRIs, he can maybe provide it. Is what the minister has just said: that at this point in the fiscal year they're 3.5 percent ahead of last year and that their plan is to arrive and to land at the end of March 31 at zero percent? Is that what I am to understand from his answer? [DRAFT TRANSCRIPT ONLY]
Hon. K. Falcon: Interior Health is currently up 3½ percent in surgical procedures over last year. I am advised that they expect to have no change in the total number of surgical procedures they will be performing, so that hopefully will clarify that for the member. [DRAFT TRANSCRIPT ONLY]
In terms of MRIs, we are endeavouring to still get the number for '09-10. The only numbers I have right now, Member, are that the number of scans in '01-02 was 2,585. The number of scans that were completed in 2008-2009 were 11,937, so that's a 362 percent increase over '01. As soon as I have the current number for the expected numbers of MRIs to be concluded this year –– they'll have some sort of budgeted number somewhere –– then I'll share that with the member. [DRAFT TRANSCRIPT ONLY]
A. Dix: The minister will know that adult day programs, including all those that have seen their funding lost in the Fraser Health Authority, serve a really important role in ensuring that seniors don't end up in acute care and long-term care and are able to stay at home as long as possible. [DRAFT TRANSCRIPT ONLY]
I understand that cuts have been made to adult day programs in five communities in the Interior Health Authority, and that one community, Lillooet, has seen its program shut down entirely. What are the cuts? What communities have been cut? Why is the minister choosing to cut such valuable programs? [DRAFT TRANSCRIPT ONLY]
[1635]
Hon. K. Falcon: Again the member is throwing around the word "cuts." I want to remind the member that actually, the funding over the next three years for these programs is increasing by a further 24 percent in the Interior. There are absolutely no cuts to the dollars that are going into seniors care programs. [DRAFT TRANSCRIPT ONLY]
The program change, however, is driven by the fact that as Interior Health reviewed their adult day programs…. It's important to recognize that there are really two kinds of programs. There are the socialization programs that allow seniors to come together and do crafts or what have you, and then there are the medical adult day care programs, which I believe is what we're speaking with today. [DRAFT TRANSCRIPT ONLY]
That is where all the health authorities are focusing their dollars: to make sure that they are delivering concrete health services like bathing, physical therapy, occupational therapy — whatever the case may be. [DRAFT TRANSCRIPT ONLY]
In the case of Interior Health they reviewed their adult day programs and determined that the funded spaces were only 65 percent filled. What they want to do with these programs that have lower utilization and lower participation is to make sure that they set a target where at least 80 percent of the spaces will be utilized or used so that the staffing complement they're providing is appropriate. You want to make sure that you've got some patients there. [DRAFT TRANSCRIPT ONLY]
In the case of Lillooet, to put that in perspective, there were exactly two people that were attending the adult day program. That is a challenge, of course, when you have a staffing complement covering exactly two people. [DRAFT TRANSCRIPT ONLY]
[1640]
They are trying to be wise with the use of taxpayers' dollars, which we've debated in this House and pointed out that they are not unlimited. I wish we lived in a world where they were unlimited, but when even a 20 percent increase over the next three years in overall health funding is not enough — even in a world where in Interior Health they are increasing their funding for seniors programs by 24 percent, and that's still not enough — they look at their programs and say: "Well, it would be appropriate if we had a minimum level of participation in some of these programs." [DRAFT TRANSCRIPT ONLY]
As I say, in the case at Lillooet you had two individuals attending, and that represents a bit of a challenge. So they are, in the case of the delivery of their adult day care program, ensuring that there is an equivalent level of service, a standardized approach in delivering it, across the total service area. [DRAFT TRANSCRIPT ONLY]
Some areas will see increases in services. Others will see reductions if they haven't met the requirement for at least 80 percent attendance and utilization. That is the target they have set. They will work within that target to try and ensure that they do it in a manner that makes sense. [DRAFT TRANSCRIPT ONLY]
But I certainly would be hard-pressed to criticize them for trying to ensure that the 24 percent in increased dollars they're putting into senior programs is being spent appropriately and for ensuring that they have appropriate participation to justify the staff resources that are being applied. [DRAFT TRANSCRIPT ONLY]
A. Dix: What we're going to do now — just for the information of staff, who I always like to keep informed as things are going forward — is that the member for Delta South is going to ask some questions about health care in her community, and then we're going to follow that up with questions about the Northern Health Authority and the Fraser Health Authority from MLAs from those communities. [DRAFT TRANSCRIPT ONLY]
That's how we see the next little while. I'll turn it over to the member for Delta South. [DRAFT TRANSCRIPT ONLY]
V. Huntington: I just briefly wanted to apologize to the minister. I realized I had not forewarned you and your staff about the questions that I wanted to ask. They're all specific to Delta Hospital and the Fraser Health Authority, but primarily Delta Hospital. [DRAFT TRANSCRIPT ONLY]
At the moment, and I'm not sure whether it has happened at this point, the staff and the senior staff at the hospital are extremely concerned that the medical director is going to be or is about to be removed. Is it possible for your staff to advise you whether that is happening in other hospitals — whether it's unique to Delta Hospital — and of how they feel that incredible vacuum will be filled within the hospital administration and the medical administration? [DRAFT TRANSCRIPT ONLY]
Hon. K. Falcon: I'm not aware of any issues regarding the medical director, so that's number one, and number two, I would also be very loath — even if I was aware, which I'm not — to discuss individual personnel issues at specific hospitals. I don't believe that's the role of the Minister of Health, but again, I'm not aware of anything with respect to the medical director at Delta. [DRAFT TRANSCRIPT ONLY]
V. Huntington: Thank you for that answer. It's certainly not specifically a personnel issue — except that it's the role itself, the office itself, I understand, that is being considered for removal. [DRAFT TRANSCRIPT ONLY]
I just wonder…. Perhaps I can ask again: if that does happen, how does the administration or the FHA expect the hospital to cope with that medical-administrative vacuum? [DRAFT TRANSCRIPT ONLY]
[1645]
Hon. K. Falcon: Again, I want to emphasize that I'm not aware of this situation or issues with respect to the medical director, but what I can say is that any decisions like that, any personnel decisions, would be operational decisions of Fraser Health Authority. [DRAFT TRANSCRIPT ONLY]
They have to make those kinds of decisions every single day. I don't even begin to know the scope and scale of the personnel decisions they must make on a daily basis. But I am advised by staff that none of us are aware of an issue with respect to the medical director of the Delta Hospital. [DRAFT TRANSCRIPT ONLY]
V. Huntington: I'd like to thank the minister for that. I'm just hoping that not all of my questions fall into that category of operational decision-making. [DRAFT TRANSCRIPT ONLY]
The $150 million shortfall within FHA has led to a cascading 15 percent cut through all the programs, especially at Delta Hospital and in the system, one of which is to some of the elective surgeries. [DRAFT TRANSCRIPT ONLY]
My understanding is that the vascular surgery generally is considered an elective surgery. The medical staff are extremely concerned that this 15 percent cut to operating room time for what really are life-threatening situations, even though elective, is going to immediately create much longer wait-lists and much more serious operations as those waiting times carry on. [DRAFT TRANSCRIPT ONLY]
The issue for the FHA and for this hospital…. Apparently the aortic aneurysm program generally requires about a hundred surgeries. It has been set at 80. Now, with the 15 percent cut through the program, they're capped at 60. [DRAFT TRANSCRIPT ONLY]
My question is…. Apparently Vancouver General has not received any cap. Many of the patients, apparently, in the Fraser Health do go to the General. I'm wondering if you could advise why the aortic aneurysm program in Fraser Health has been capped. [DRAFT TRANSCRIPT ONLY]
Hon. K. Falcon: In a previous round of discussions we talked about the elective surgical volume reduction of 4.6 percent in Fraser Health. How Fraser Health is allocating those would obviously be a decision that they would make. The one thing I can assure the member is that all health authorities and all of the doctors involved prioritize their patients based upon surgical need. [DRAFT TRANSCRIPT ONLY]
There will be nobody who is requiring urgent or emergent care that will not be receiving it. The issue of wait-lists is decisions that are made by physicians in consultation with their patients, and I can assure the member that if there are individuals that require the care, they will get it. But the decisions as to how Fraser Health or, indeed, the health regions allocate the decisions around OR time and where they may decide to do surgeries are entirely operational decisions that they will be making. They're certainly not made by myself or my office in Victoria. [DRAFT TRANSCRIPT ONLY]
[1650]
V. Huntington: Perhaps I could ask, then…. I discussed very briefly with you the emergency room deficit that is existing at the Delta Hospital emergency room, where it has the highest FTE deficit in the province. I wondered if there was any opportunity you can provide us with how that is being resolved at the moment and whether the recent discussions have managed to redistribute some of those FTEs within the system. [DRAFT TRANSCRIPT ONLY]
The Chair: I'd just like to remind the member to ask questions through the Chair. [DRAFT TRANSCRIPT ONLY]
Hon. K. Falcon: Maybe I could ask the member to identify or explain what an FTE deficit is with respect to the Delta Hospital emergency department. [DRAFT TRANSCRIPT ONLY]
V. Huntington: It's an under-resourcing of the emergency room staffing. If your staff is not quite aware, perhaps…. There are 19 emergency rooms that operate under what is called an alternate payment plan. That's based on a workload model developed by the B.C. Medical Association. The deficit works against…. It's how many FTEs are needed for a specific level of patient care. [DRAFT TRANSCRIPT ONLY]
Delta Hospital right now has the highest percentage of under-resourcing in the province. The recent emergency medical committee meeting was, I believe, partially to discuss an agreement that was existing on the reallocation of FTEs among the different emergency rooms when they have high resource deficits. I'm using the ministry's own language here. [DRAFT TRANSCRIPT ONLY]
[1655]
Hon. K. Falcon: This is getting into some rather impressive minutiae with respect to the health authority, so I apologize to the member for some of the delay in pulling this together. [DRAFT TRANSCRIPT ONLY]
Individual health authorities are responsible for negotiating contracts with physicians for those ER groups. The parties essentially negotiate a contract within the alternative payments program subsidiary agreement outlined in the physician master agreement. As a result of the agreement, the Ministry of Health Services and the BCMA have a joint committee which collaborates in developing a more refined funding model for ER service contracts. [DRAFT TRANSCRIPT ONLY]
Essentially, what that means is that there are additional doctors that can be allocated to emergency departments, but those decisions are made on a case-by-case basis with the BCMA committee — which is called the emergency medicine section of the BCMA — working in collaboration with the Ministry of Health Services to determine the appropriate contract service levels. [DRAFT TRANSCRIPT ONLY]
That will be determined on a case-by-case basis, so naturally every hospital emergency department will make their case, as no doubt the emergency physicians at Delta are making to the member. But those discussions are ongoing, and I think it's appropriate that those decisions are, in fact, where they should be — with the emergency medicine section of the BCMA committee. [DRAFT TRANSCRIPT ONLY]
[1700]
V. Huntington: I'll accept the minister's comments that we'll wait for the decision to come out of the committee meetings, but I can assure the minister that if the mean under-resourcing of an ER is, say, 5.6 percent across the board, and Delta Hospital is 26 percent — the highest in the province, under-resourced — then if the committee doesn't resolve that in some way, shape or form, I'll be back asking the minister how we can fix that situation. [DRAFT TRANSCRIPT ONLY]
I think, Madam Chair, that some of my other questions will also be considered specific operational ones, so I'll sit down now and perhaps write the minister with some of those questions. [DRAFT TRANSCRIPT ONLY]
R. Austin: I'd like to ask a couple of questions that are pertinent to my riding of Skeena, the first one being in regards to the Kitimat hospital. [DRAFT TRANSCRIPT ONLY]
I don't know if the minister is aware, but we have two surgeons in Kitimat — an orthopedic surgeon and a general surgeon. The challenge that both these surgeons have been speaking about for quite some considerable time is that…. Of course, they operate in a fairly new hospital. It's a beautiful facility. The challenge for them, though, is in having enough beds available for them to do their work as surgeons. There is an overflow of elderly patients who are taking up acute care beds because there aren't enough facilities in the community for extended care. [DRAFT TRANSCRIPT ONLY]
My question to the minister is: is the ministry aware of that situation and the risk it poses? Of course, if two talented surgeons aren't able or feel they're being supported to do this important work, then they will look elsewhere around the province. Then we would be in serious difficulties in Kitimat. [DRAFT TRANSCRIPT ONLY]
My question is: is the minister aware of that ongoing situation, and are there any plans to build more extended care facilities in Kitimat? I would point out that over the last ten years more and more seniors are choosing to remain in the north. [DRAFT TRANSCRIPT ONLY]
[L. Reid in the chair.]
It used to be, when I first moved up north, that people would retire, and then they'd go down south for sunnier climes. But that's changed, and people are staying in both Terrace and Kitimat. So that is what has made this situation worse. [DRAFT TRANSCRIPT ONLY]
[1705]
Hon. K. Falcon: Northern Health has advised that there are approximately five alternate-level-of-care patients in acute care beds in the hospital awaiting placement in residential care. I think we've…. As I mentioned in previous answers to this question, the addition of 6,000 new units across the province and an additional 6,000 completely renovated and rehabilitated units is helping to deal with the whole issue of alternate-level-of-care patients in their acute care setting. [DRAFT TRANSCRIPT ONLY]
Northern Health also advises that since the start of this fiscal year, of the 161 surgeries that were completed at Kitimat hospital, only one surgery was rescheduled due to all of the acute care beds being utilized. [DRAFT TRANSCRIPT ONLY]
I think it's fair to say that cases can be rescheduled due to patient decisions or clinical reasons, but I am advised that in terms of acute care beds being the reason, only one surgery had to be rescheduled thus far in this fiscal year. [DRAFT TRANSCRIPT ONLY]
They've also undertaken an operational review of the hospital that was completed last year. They're taking a number of measures to improve the operational flow of patients in and through the hospital. [DRAFT TRANSCRIPT ONLY]
They are utilizing the lean method, which is borrowed from the Toyota company, in terms of looking at every single step along the decision continuum and trying to figure out how you can eliminate unnecessary steps to ensure that patients can get dealt with more quickly, more effectively and efficiently. That is something that is being done not just in Interior Health but other health authorities. [DRAFT TRANSCRIPT ONLY]
We're hopeful that the implementation of the recommendations coming out of the operational review will make what is a great health care facility even better for Kitimat and the region. [DRAFT TRANSCRIPT ONLY]
R. Austin: I would just comment and say that I'm aware there aren't a lot of surgeries that are rescheduled. The problem is that the acute care beds are continuously in use with extended care patients. So operations aren't even scheduled in the first instance because obviously the management of the hospital realize that a number of these beds are in continual use as long-term care beds. That's the problem there. I just wanted to make that point. [DRAFT TRANSCRIPT ONLY]
My second question is about the ATLAS Youth facility in Terrace that is being closed at the end of next month. [DRAFT TRANSCRIPT ONLY]
This is the only 30-day youth detox facility in the province. In fact, a majority of the beds…. There are five beds, and one separate bed that's funded a different way. The majority of the kids who've been coming to this over the last nine years actually aren't even from the north. That is one of the reasons why Northern Health has told me they're shutting it, because as of two years ago, they took over the entire funding of this facility. [DRAFT TRANSCRIPT ONLY]
When it was initially set up nine years ago, it was with provincial dollars, recognizing that the kids came from all over the province. Two years ago it came under the auspices of the Northern Health Authority. It reached a point where these beds were being used by a majority of kids from outside the region, yet Northern Health care was having to pay for it. So they're shutting this down. [DRAFT TRANSCRIPT ONLY]
My question to the minister is this. Knowing that young people get into trouble with drugs — and, in some cases, extremely serious addictions — is it not to our benefit collectively as a province to have a residential facility of this kind? In fact, a year and a half ago, in a study that was done within the Northern Health Authority, the lack of detox facilities, especially residential care, was examined, and it said that we need to have more. That was the report that came out a year and a half ago. [DRAFT TRANSCRIPT ONLY]
I'm just wondering now whether the Ministry of Health agrees with Northern Health authorities to shut this down, when in fact it's going against the grain of what we've been told we need in northwest B.C., which is more detox facilities, especially residential care, especially for young people. [DRAFT TRANSCRIPT ONLY]
[1710]
Hon. K. Falcon: The mental health and addictions funding in the north is increasing by 12 percent over the next three years. The member is correct that the operations of the ATLAS facility were the subject of a review done by Northern Health. [DRAFT TRANSCRIPT ONLY]
What the review found was that the facility was operating at about 60 percent capacity. The member correctly points out that of that 60 percent capacity, only a third of that was actually from Northern Health clientele. However, Northern Health has been paying for 100 percent of the beds in that facility, even given the fact that it's been operating at 60 percent capacity. [DRAFT TRANSCRIPT ONLY]
Going forward, what they will be doing is providing the residential youth addiction services through the Nechako youth programs that are operated out of Prince George. They will provide an enhanced transportation travel plan to cover the costs of moving clients who may be currently receiving services in Terrace to the Nechako programs in Prince George. [DRAFT TRANSCRIPT ONLY]
D. Donaldson: Thank you for the opportunity to ask some direct questions on this budget estimate vote. I would like to continue on the theme of addiction services in the northwest, particularly. [DRAFT TRANSCRIPT ONLY]
I was checking my notes, and two years ago the Conversation on Health was held in Smithers. I know how important the Premier — the emphasis he put on that…. The Minister of Health at that point, as well, wanted to hear from the citizens of the northwest around what their priorities on health care were. What better way to do it than to hear from the people who were actually accessing the services and knew on the ground what the realities were. [DRAFT TRANSCRIPT ONLY]
I couldn't find any minutes on the government website around that meeting, but I attended the meeting along with about 70 other people from the northwest. One of the main recommendations that came out of that meeting was the need for a residential addiction service facility for adults in the northwest, not north central but in the northwest, where we face some severe issues around addictions. [DRAFT TRANSCRIPT ONLY]
So my question under this budget estimate vote is: is there an allocation now to create a residential addiction service facility in the north to support the advice of those experts who were at the Conversation on Health? [DRAFT TRANSCRIPT ONLY]
[1715]
Hon. K. Falcon: A couple of things. The first is that in 2001 the total number of addiction beds that we had in the province of British Columbia was 874. Today the total number of addiction beds that we have in B.C. is 2,662. In terms of mental health and addiction housing spaces in the north, in 2001 we had 195. Today we have 456. [DRAFT TRANSCRIPT ONLY]
What is happening in Northern Health is that they have begun the integration of the addictions and mental health youth services continuum to better reflect the concurrent disorders that we talked about earlier so that we reflect what emerging best evidence and practices are telling us in terms of how best to deal with a clientele population that increasingly is presenting with both mental health and addiction challenges. [DRAFT TRANSCRIPT ONLY]
They continue to also invest in community outreach teams. Now, these are similar to the assertive community teams that we have heard about and that we're continuing to add throughout the Lower Mainland, Vancouver Island, Interior Health and in the north. [DRAFT TRANSCRIPT ONLY]
The Northern Health Authority mental health and addiction community outreach teams, based in Prince George, have five clinicians that provide assertive outreach specifically for youth with concurrent disorders and also provide outreach services in the northeast. The northwest has clinicians on the mental health and addiction teams that provide youth concurrent case management. [DRAFT TRANSCRIPT ONLY]
There are a number of steps that are being taken to deal with the issue of mental health and addictions. I'm informed that over the next three years the expenditures for mental health and addictions in the Northern Health Authority are increasing by 12.3 percent. It's more dollars and, in some cases, a different way of treating the challenges, based on the concurrent model and also based on the community outreach teams. [DRAFT TRANSCRIPT ONLY]
I'm not specifically familiar with the meeting that the member opposite attended with respect to…. I think the member mentioned it was in Smithers. This, I hope, provides some sense of the larger picture of what the Northern Health Authority is attempting and the direction they're attempting to move in terms of mental health and addiction planning. [DRAFT TRANSCRIPT ONLY]
D. Donaldson: Thank you to the minister for that answer. I'd point out that the meeting was actually of the Conversation on Health, the government's own process to solicit interest from people in the province around what the government could implement as its policy. [DRAFT TRANSCRIPT ONLY]
I'm talking of an addictions facility — not beds but an addictions facility in the northwest — and I'm talking about adults, not youth. Perhaps the minister may know that the NHA, in speaking to its head of addiction and mental health services, very recently said the direction that they will be heading is to day treatment and not residential facilities. [DRAFT TRANSCRIPT ONLY]
My question to him on this budget vote then: is the NHA implementing government policy when it's focusing on day treatment, or is it the government's policy to follow its own Conversation on Health results and implement residential solutions? [DRAFT TRANSCRIPT ONLY]
[1720]
Hon. K. Falcon: I appreciate…. I didn't catch that the member was referring to the Conversation on Health. I mean, the Conversation on Health had literally hundreds of recommendations and suggestions that were made in various communities across the province. [DRAFT TRANSCRIPT ONLY]
I think the important thing for the member to know is that what the health authorities are attempting to do is provide a continuum of service in the mental health and addictions field that is consistent with what best practices are telling us in terms of the kind of clients that we increasingly see presenting with mental health and, increasingly, both mental health and addiction challenges. [DRAFT TRANSCRIPT ONLY]
The member is right that the direction that we are moving towards is less towards facilities with permanent beds and more towards detoxification in home settings. Again, the evidence is suggesting that many individuals are better off detoxifying within their home settings. Not every individual requires an in-patient bed at a facility. We still will have those beds, of course. For some people, that is the appropriate level of treatment, but it is not the appropriate level for all. [DRAFT TRANSCRIPT ONLY]
The Northern Health Authority is acting on the best evidence as it comes forward to ensure that we provide a continuum of services for folks to ensure that each individual will receive the appropriate kind of treatment for their individual circumstance. In some cases that may be an in-patient bed at a facility. For others, as I say, it may be a detoxification at a home setting and an out-patient treatment program that can just as readily deal with their situation. [DRAFT TRANSCRIPT ONLY]
So again, to summarize: more dollars; increased dollars, again, over the next few years; and some changes to reflect what emerging evidence and best practices are informing the health authorities as they move forward. [DRAFT TRANSCRIPT ONLY]
We, again, I think, always have to really operate from the premise that we're never going to get it perfect. We have to be open to the idea that if we learn something new that suggests that we need to make adjustments in how we're providing treatments in this very important area and that reflects the range of individuals that you, by necessity, have to deal with, then we need to make those adjustments. But this is certainly the direction that we have come thus far. [DRAFT TRANSCRIPT ONLY]
I might, if I could, with the forbearance of the member for Stikine, request from the Chair a brief recess for myself and staff to take care of some issues. [DRAFT TRANSCRIPT ONLY]
The Chair: This House stands recessed until 5:30. [DRAFT TRANSCRIPT ONLY]
The committee recessed from 5:23 p.m. to 5:30 p.m.
[L. Reid in the chair.]
D. Donaldson: Thank you for that answer, to the minister. Yes, I concur. We're never getting it perfect. [DRAFT TRANSCRIPT ONLY]
[1730]
What we're attempting to do on this side is help you get it better than it is. I've got a question along those lines, and that's about the microbiology lab services in the Smithers hospital and the Hazelton hospital. For time's sake, I'll ask a question that will have three parts to it. I hope you can keep track of them. [DRAFT TRANSCRIPT ONLY]
The first is that…. What we were advised by Northern Health was that it was a quality-of-service issue — the microbiology lab service cuts at the Smithers hospital. Then it was later revealed by Northern Health that it was cost savings. [DRAFT TRANSCRIPT ONLY]
I would ask the minister: what was it? Was it cost savings, or was it quality of service? If it was cost savings, then could he advise us how much cost savings were gained by this cut in service — not overall in the entire NHA region but specifically how much was gained in cost savings by the cut to microbiology lab services at the Smithers hospital? [DRAFT TRANSCRIPT ONLY]
Finally, the third part is if he could advise us of an analysis that was done on the cost savings. Did it take into account the cost of transporting the samples and the cost of increasing personnel at other areas, other hospitals, to deal with these samples? I'd appreciate some answers to those questions. [DRAFT TRANSCRIPT ONLY]
Hon. K. Falcon: This is, I think, a very important change, which is a very positive change on the quality side — better quality outcomes — and also savings from the health authority side. [DRAFT TRANSCRIPT ONLY]
[1735]
I just want to walk the member through that to help the member and others that are paying attention today understand what we're doing. [DRAFT TRANSCRIPT ONLY]
Essentially, what's happening is they're consolidating microbiology tests that are labbed in the northwest part of the province. That's the plating, the growing and the studying of bacteria to inform a diagnosis. It's important to note that microbiology is a specialized diagnostic service. We also know, and best practices support, that the quality of microbiology diagnostic services improves with consolidation and doing more and being able to have the staff doing more of the procedures. [DRAFT TRANSCRIPT ONLY]
Our approach is to keep as much of the laboratory work as possible at the local hospital level, but where quality can be improved demonstrably and supported by best practices, there will be some consolidation. This is consistent with what is being done in the rest of the province or has been done in the rest of the province and, indeed, even in Northern Health several years ago. [DRAFT TRANSCRIPT ONLY]
The critical thing that I think is very, very important — and this is why nobody in the public in the north would have noticed any difference — is that the people, the individuals, the members, the residents of the north will still get all of their tests, blood tests and swabs done locally. That doesn't change. This is about where the specimen will get sent to be analyzed. That's the only thing that does change. [DRAFT TRANSCRIPT ONLY]
As I say, the analyzing of the specimens will change. For example, just a referral. As I mentioned, it's not effective from a quality perspective or even a productivity perspective to process a few microbiology specimens at each facility. So Queen Charlotte Hospital and Northern Haida Gwaii Hospital in Masset will refer to the Prince Rupert Hospital for their specimens to be analyzed. Kitimat General Hospital will refer to Mills Memorial Hospital in Terrace, and Bulkley Valley District Hospital in Smithers will also refer to Mills Memorial Hospital in Terrace. [DRAFT TRANSCRIPT ONLY]
Again, I am informed by staff that that redesign is driven by the fact that not only is that a cost-effective and efficient way of doing the lab analysis on these microbiology samples, but it is absolutely consistent with providing a quality level of service for the patients and physicians in the northern and northwest region. [DRAFT TRANSCRIPT ONLY]
B. Simpson: I just want to start off quickly by saying that I appreciate the relationship I have had and my office has had with Northern Health last term and continuing this term. I find that they deal with my office's requests in a professional manner, so anything I have to say by way of questions to the minister has nothing to do with the relationship that I have with Northern Health. I get that they're under significant constraints, both in terms of some of the things they're being asked to do by the government and some of the financing that they're having allocated to them. [DRAFT TRANSCRIPT ONLY]
My first question to the minister is: when will the north actually see 24-hour coverage on crisis line? This is a question that has been canvassed in question period, and I think the minister now understands the question better — or should understand. [DRAFT TRANSCRIPT ONLY]
Currently service is 14 hours. The crisis line is closed between 11 p.m. and 9 a.m. The minister just pointed that out as a best practice in reference to what was happening on Vancouver Island. I don't want an answer relative to what's happening on Vancouver Island; I want an answer relative to the north. The question is very simple. When will we see 24-hour coverage on the crisis line for the north? [DRAFT TRANSCRIPT ONLY]
[1740]
Hon. K. Falcon: I'm advised by staff that the line does operate 24 hours a day. I think it's important to note that. In fact, I'm also advised that an e-mail from the executive director, subsequent to the question that came up in question period, pointed out that they normally operate 24 hours just in Northern Health — in other words, dealt with by the Northern Health staff and volunteers. [DRAFT TRANSCRIPT ONLY]
Since the first of September they had to reduce that to 14 hours a day because: "We do not have enough volunteers to run 24 hours." They are in the process, I understand, of training up additional volunteers to try and help get them to a point where the 24-hour level of service can continue to be provided — all of it — from the north. [DRAFT TRANSCRIPT ONLY]
At the end of the 14 hours a day that it currently operates, the calls are automatically redirected to Vancouver Coastal's crisis line. Remember, for the benefit of those listening today, when someone is calling in a crisis, they're looking for an answer, a voice on the phone to help them work through the issues, which are often very common in the case of crisis lines. There is always coverage available 24-7, including in the north. [DRAFT TRANSCRIPT ONLY]
As I say, that coverage, 14 hours a day, is delivered right there in the north where they have temporarily run into a shortage of volunteers. They're in the midst of training some up. In the interim, after the 14 hours a day in which it operates, it is forwarded to another crisis line which deals with the calls on their behalf. [DRAFT TRANSCRIPT ONLY]
The other thing I would note, Member, is that in the '08-09 budget, we increased their contract for the crisis line to $208,726. That amount remains exactly the same for '09-10, and that is up from the '07-08 budget year when the contract amount was $135,856. [DRAFT TRANSCRIPT ONLY]
B. Simpson: Time constraints prevent me from getting into debate with the minister, so I am going to have to move on. But I hope the minister takes his responsibility seriously to offer a crisis line service by people who understand the communities that the crisis is coming from. Of course, we've canvassed it in question period, and I doubt that very much from this minister. [DRAFT TRANSCRIPT ONLY]
The second question I've got — hopefully, it's a brief one, again because we are under time constraints — is with respect to HIV/AIDS, particularly in the north and first nations communities. Does the ministry have a plan in place to address what has been described by many, including one of the minister's colleagues, as a very serious issue, particularly in the younger population among first nations? Is there an HIV/AIDS-specific strategy for first nations, specifically along the Highway 16/97 corridor in the north? [DRAFT TRANSCRIPT ONLY]
[1745]
Hon. K. Falcon: I thank the member for his forbearance as I gathered the information. There's a lot of it, so I'll try and be as concise as I can responsibly be. [DRAFT TRANSCRIPT ONLY]
I think the first thing really worth noting is that AIDS research and the treatment of AIDS in British Columbia are at a level that is nothing short of…. Not the dollar amount, although the dollar amount is too, but the results that have been demonstrated, through the research and the trials and the delivery of HIV services in British Columbia, have made British Columbia a recognized leader internationally. [DRAFT TRANSCRIPT ONLY]
I don't want to take credit for that as government. I'd like to recognize some of the individuals, particularly Dr. Julio Montaner from the Centre for Excellence in HIV/AIDS in the Lower Mainland, which is Canada's largest HIV/AIDS research and treatment facility. [DRAFT TRANSCRIPT ONLY]
[1750]
We have now gotten to a point with AIDS, which used to be effectively a death sentence for people that were diagnosed with AIDS…. Now, treatment advances that have been made have largely made the disease a chronic but manageable illness going forward. [DRAFT TRANSCRIPT ONLY]
The Centre for Excellence in HIV/AIDS has a therapeutics guidelines committee, which provides advice and guidance to physicians, available throughout the province to ensure that treatment guidelines are based upon the best available evidence. [DRAFT TRANSCRIPT ONLY]
I guess one of the best ways to understand just how significant Dr. Montaner's contribution to the field has been is the very fact that he has been appointed as the president of the International AIDS Society. [DRAFT TRANSCRIPT ONLY]
In northern B.C. they have a strategy called Meeting the Challenge: A Blood-Borne Disease Strategy for Northern Health. It's a blood-borne strategy that includes increasing capacity in HIV/AIDS prevention programs, which includes conducting community readiness assessments and working with community-based agencies across the region to provide outreach services to clients, particularly those — and this is often the case in first nations — that may not access conventional health programs and facilities. [DRAFT TRANSCRIPT ONLY]
Recognizing that, the Northern Health Authority has put together teams that reach out into those communities to try and identify those individuals and ensure they get the treatment they need. [DRAFT TRANSCRIPT ONLY]
Member, for the purposes of brevity, I'll just touch upon…. Of course, the member will probably be aware of the AIDS prevention program in Prince George that operates out of the 3rd Avenue site, which provides harm reduction supplies, immunizations, prevention counselling and basic health services. [DRAFT TRANSCRIPT ONLY]
They've also got an extension of that AIDS program, in partnership with the Carrier-Sekani Family Services and Positive Living North, to provide the mobile wellness van, which provides mobile harm reduction services including supplies, distribution and recovery. [DRAFT TRANSCRIPT ONLY]
We also fund the Central Interior Native Health Society in Prince George to provide integrated primary care services to the disenfranchised and those that are either street-involved or close to being street-involved and therefore at risk to blood-borne pathogens, including AIDS. [DRAFT TRANSCRIPT ONLY]
Member, it goes on and on here, including Positive Living North West in Smithers, in Prince Rupert, in Quesnel and right throughout the north. Hopefully, that's somewhat helpful. [DRAFT TRANSCRIPT ONLY]
G. Coons: Thank you, Minister and staff, for the opportunity. Realizing the time and trying to be prudent with it, I'll try to be as concise as possible. [DRAFT TRANSCRIPT ONLY]
A couple of questions, one dealing with dialysis and another dealing with — a thought-provoking one perhaps — addictions, and just touching on the audiology clinic in Prince Rupert. [DRAFT TRANSCRIPT ONLY]
As the minister and his staff know, there's a real concern with dialysis, especially for the first nations on the coast who have to travel at great expense and time. Their dialysis for first nations is three-times higher than the national average. [DRAFT TRANSCRIPT ONLY]
In Bella Bella, for example, a few people, including people from the band, are wondering if there are any initiatives or strategies or pilot projects out there to expand the kidney dialysis centres throughout the central coast. It's a huge cost, and it's something that's needed. [DRAFT TRANSCRIPT ONLY]
I'm just wondering if there are any initiatives, like a pilot project or something, for satellite dialysis unit or anything like that. [DRAFT TRANSCRIPT ONLY]
[1755]
Hon. K. Falcon: I thank the member for the question. The B.C. Renal Agency is the agency which plans and coordinates the care of patients with kidney disease throughout the province. [DRAFT TRANSCRIPT ONLY]
They've had some pretty significant accomplishments through early identification and intervention strategies that they have undertaken through B.C. Renal. They've reduced the annual growth of dialysis patients from 16 percent a year that we were seeing in the late '90s to 3 percent in 2008, despite the fact that there has been increasing incidence of the sort of feeder conditions like diabetes and heart disease. [DRAFT TRANSCRIPT ONLY]
They've also developed provincial renal program guidelines, which provide a kind of methodology and principles for health authorities to determine where, when and how to develop ongoing care programs. [DRAFT TRANSCRIPT ONLY]
One of the areas that I know of…. The chair of the PHSA told me in a recent meeting I had that they've increased the capacity for home hemodialysis. This doesn't work in all cases, but in many cases, instead of having to have the patients come to a dialysis facility, they are increasingly finding the ability to provide home hemodialysis, which allows for more independence among some of the groups that are impacted. [DRAFT TRANSCRIPT ONLY]
There has also been work on the integration of transplant databases into a renal database, making British Columbia the only jurisdiction in Canada to have an integrated information system to track patients across the continuum of renal care from early identification and treatment to dialysis care and transplant. [DRAFT TRANSCRIPT ONLY]
I think, though, when we look at the issue — if we step back a step or two — that one of the things that is very, very clear to me is that preventative health can actually reduce or even eliminate in many cases the incidence of dialysis that the renal agency is responsible for overseeing. Reducing diabetes, high blood pressure and obesity, particularly in the first nations communities, is something that can have a dramatic and significant impact on ensuring that people don't have to find themselves in a position where they require dialysis. [DRAFT TRANSCRIPT ONLY]
[1800]
That is an area on the prevention side that I am working on — having staff access and pull together all of the various programs and services being offered throughout the province to figure out how we're delivering this multiplicity of programs, services, information pieces, etc., on the health promotion and prevention side and determining whether, in fact, we are doing everything we can possibly do to ensure that we try to get people early on into health prevention and promotion programs that can make a big difference in terms of keeping them out of the lineup of people coming in and requiring renal dialysis. [DRAFT TRANSCRIPT ONLY]
G. Coons: There's a real concern in the isolated communities that the home treatments may not be quite appropriate, but that's something that we can follow up on. [DRAFT TRANSCRIPT ONLY]
I'm sure you've heard the gamut from the north about addictions. I just wanted to echo the concerns, especially from our community, Prince Rupert out to Haida Gwaii, where the coastal communities, in their community-to-community meetings –– Prince Rupert, Port Edward, Lax Kw'alaams, Hartley Bay, Metlakatla, Kitkatla — all saw alcohol and drug treatment centres as their number one priority. We seem to be going more towards a day program type of facility that…. In our region, in our community, we have lots of people working in that area, so there are concerns about that. [DRAFT TRANSCRIPT ONLY]
My question is…. The B.C. Medical Association had written a policy paper about eight months ago, dated March 2009, on addictions. They wrote a letter to the Premier and to the Minister of Health –– and I'm sure the minister has seen this –– to formally recognize addiction as a chronic, treatable disease under the B.C. Primary Care Charter and the B.C. chronic disease management program –– and that our health care dollars be invested the same way we do for diabetes and heart disease. [DRAFT TRANSCRIPT ONLY]
Again, if that happens, if the minister takes that approach, perhaps we can look at addiction programs as being all-inclusive to regions throughout the province. My question is: is the minister considering looking at the B.C. Medical Association's proposal? [DRAFT TRANSCRIPT ONLY]
Hon. K. Falcon: We certainly agree with the BCMA with respect to addictions being a chronic illness. I don't think there's too much doubt about that. Certainly the BCMA report will be looked at and studied. I haven't had a chance to review it personally yet, but it will certainly be looked at in the context of the preparation of finalization of the ten-year mental health and addictions plan that the province is currently putting together in cooperation with the entire sort of stakeholder world out there in terms of the mental health and addictions side. [DRAFT TRANSCRIPT ONLY]
We've tried to work very closely with stakeholder groups to make sure that we are familiarizing ourselves with their particular concerns and priorities and make sure that we align that with the best practices that are being suggested in terms of how best to deal with mental health and addictions as we go forward. Certainly, the BCMA report will form part of that information process that is helping us as we put together and finalize the ten-year mental health and addictions plan in the province. [DRAFT TRANSCRIPT ONLY]
[1805]
M. Sather: I wanted to ask the minister about the seniors outreach services in Maple Ridge that were cut earlier this fall. We have over 300 seniors in our area receiving services. Some of these services are volunteer handyman programs and rides to medical appointments, including dialysis and chemotherapy. As well, they provide telephone support, home visits and shopping assistance. Community services in our communities have been providing this service for over 30 years. When they were eliminated, the spokesperson for Fraser Health said that they weren't essential services. [DRAFT TRANSCRIPT ONLY]
I wanted to ask the minister if he agrees or disagrees with that. But more importantly, I want to ask him if he would reinstate these important seniors outreach services in Maple Ridge and Pitt Meadows. [DRAFT TRANSCRIPT ONLY]
Hon. K. Falcon: I think this is a very important discussion point, because the decisions that have been made are certainly not easy, and it's not an indictment of the socialization programs that were delivered by many of these groups — not at all — but more, frankly, a recognition that in an era where health budgets are increasing almost 20 percent…. That 20 percent increase, or 2.4 billion additional dollars being added over the next three years to health authority budgets, is still not enough money for them, and there are still pressures within the system. [DRAFT TRANSCRIPT ONLY]
One of the things that we said to the health authorities — and I, absolutely, and we as government take responsibility for saying this — is that we expect them to live within a 20 percent budget increase, in spite of the fact that we know that there were pressures. Those pressures were identified back in February on page 45 of the budget — 3½ percent budget pressure. [DRAFT TRANSCRIPT ONLY]
One of the things that the authorities have done in the case of Fraser Health is that they've looked at the socialization programs being delivered — as I say, not that they are bad programs. Seniors socialization programs, whether it's driving them to appointments or whether it's providing tax preparation in some cases or whether it's, you know, bringing them together for card games or whatever the case may be, are important socialization projects that have taken place. [DRAFT TRANSCRIPT ONLY]
The issue is that they are not direct health funding issues, and Fraser Health and the other health authorities, including Vancouver Coastal, have said that they want to continue to fund those programs which provide direct medical benefit — for example, bathing programs or occupational health programs or rehab programs. Those are considered to be medical programs, which will continue to be funded. [DRAFT TRANSCRIPT ONLY]
Those socialization programs, though important, are not considered to be…. Particularly in an era where 20 percent is still not enough for some of these health authorities, they will not continue funding some of the socialization programs. [DRAFT TRANSCRIPT ONLY]
What are the options? The options are that there's an opportunity for the community to look at participating and funding those programs. There's an opportunity to look at a user-pay system that can help fund those programs, where you can have a cost associated with it for those that are participating. [DRAFT TRANSCRIPT ONLY]
I recognize that none of those are easy issues, but it seems to me to be appropriate, however difficult, in an era where a 20 percent funding increase still has pressures, that they focus every one of those dollars towards direct patient care. That is what they are doing in the case of the programs the member is referring to. [DRAFT TRANSCRIPT ONLY]
He didn't mention a specific program, so if the member wishes to discuss specifics, I'm happy to do that. I would need to know which specific program, because there are, of course, a number of programs delivered by the health authorities. [DRAFT TRANSCRIPT ONLY]
[1810]
M. Sather: Well, I did mention dialysis and chemotherapy treatment, but it certainly wouldn't be a socialization program. [DRAFT TRANSCRIPT ONLY]
I wanted to talk to the minister about the seniors who act as caregivers in my community. They're providing care at home and also for friends, family and loved ones in care, to a degree. Respite for them is very important. You can imagine the stresses on them. This was cancelled a couple of years ago. Has the minister considered or will the minister consider reinstating those respite programs, respite dollars for senior caregivers? [DRAFT TRANSCRIPT ONLY]
Secondly, these caregivers say to me that a stipend for them would be really helpful so that they could get some education on things like giving medications and bathing. So the two things, then: reinstating the dollars and a stipend for education on medications and bathing for senior caregivers. [DRAFT TRANSCRIPT ONLY]
Hon. K. Falcon: I'm going to get the member a number on the respite beds. I'll get that for the member in a moment. [DRAFT TRANSCRIPT ONLY]
Two things that I would say. The first is that we have committed, as a government, to launch a caregivers website to provide increased support for family caregivers. That speaks to the issue the member raised in terms of making sure that we have an ability to provide caregivers appropriate levels of support and information so that they don't particularly feel isolated in the very important respite services that they are providing to loved ones. [DRAFT TRANSCRIPT ONLY]
[1815]
Also, as part of the Seniors in British Columbia: A Healthy Living Framework, which was released in September of 2008, the Ministry of Healthy Living is committed to exploring innovative and sustainable models to provide non-medical home support services. [DRAFT TRANSCRIPT ONLY]
It will be of interest to the member that the secretariat, which has been put in place under the Ministry of Healthy Living and Sport, will partner with the United Way of the Lower Mainland to develop and implement community action for seniors independent demonstration projects in up to five communities around the province. [DRAFT TRANSCRIPT ONLY]
The idea is that they want to try and see if they can develop a model for delivering services like this that engage community members and local organizations — including non-profits, faith and multicultural groups — to try to determine and develop an innovative service delivery model for these communities. [DRAFT TRANSCRIPT ONLY]
What will be of interest to the member is that three of the projects would be pilot projects that will be undertaken and will take place in Lower Mainland communities — in Surrey, Vancouver and Maple Ridge. [DRAFT TRANSCRIPT ONLY]
They are also going to be doing some community consultations. I understand they've gone through a round of consultations, and there is a second set of consultations scheduled. They will be doing a consultation in Maple Ridge on November 24, which I believe is tomorrow, if I've got my dates right. Hopefully, that will be of some help to the member, and I will just determine whether we've got the number of respite beds figure for the member. [DRAFT TRANSCRIPT ONLY]
H. Bains: I have a few questions about my area of health care in Surrey-Newton and the Delta area. As the minister will know, the decision was made to actually fast-track the expansion of the emergency room in Surrey Memorial Hospital. It originally was announced by the Minister of Health, then, and the Premier that it would be completed by 2010. Now my understanding is that it will not be completed until 2013 or 2014. [DRAFT TRANSCRIPT ONLY]
In the meantime, we get our constituents who tell us that when they take their loved ones to emergency wards, whether it's Surrey Memorial or Peace Arch or Delta, they are made to wait there for hours and hours. They all tell us that it's no reflection on the people who work in those emergency wards. It's that they are stretched beyond their capability to actually deal with them in a timely fashion. [DRAFT TRANSCRIPT ONLY]
My question to the minister is: what is being done now in order to make sure that the patients who walk into those emergency wards actually are seen in a timely fashion? Does the minister have what the average time is in the Surrey Memorial Hospital emergency ward from the time when the patient walks in, registers and is seen by a qualified doctor? [DRAFT TRANSCRIPT ONLY]
Hon. K. Falcon: This is extraordinarily good news. As you can imagine, the member is right in pointing out the initial date of completion being 2010. However, what changed along the road to the expansion of the emergency department is that we added significant new scope. [DRAFT TRANSCRIPT ONLY]
In addition to an emergency department which will be expanded five times larger than is currently there today, we're also adding a new hospital tower with 85 in-patient beds, including 48 neonatal intensive care beds in the hospital. Sixteen of those are net new beds, and as I say, 85 new in-patient beds. [DRAFT TRANSCRIPT ONLY]
That's why the time frame changes. It's because the scope increased dramatically to deal with exactly what the member is talking about. [DRAFT TRANSCRIPT ONLY]
[1820]
What's also taking place in Surrey — again, it's hard to believe there could be even more news that's good, positive news — is the fact that there's a new out-patient hospital under construction today, a $240 million out-patient hospital, which will be able to handle several hundred thousand more day surgeries that will not have to go to Surrey Memorial Hospital. [DRAFT TRANSCRIPT ONLY]
So you have a situation where some of the pressure that the member talks about, which is real in a fast-growing community, where individuals that are going to the emergency department to receive care will now be looked after at the out-patient hospital….The balance will receive the benefit of a new emergency department, which will be five times larger than the existing emergency department and, as I say, will include a number of new beds, an expanded lab, a new helipad to allow the helicopter to transport high-acuity patients there, 350 additional parking stalls — just a whole myriad of incredibly good news for the residents of Surrey. [DRAFT TRANSCRIPT ONLY]
Interjection.
Hon. K. Falcon: All that I know. The member from the north — I can understand his jealousy. But I do have to point out that there has been significant investment in the Prince George hospital, which is now a university hospital in Prince George — and, of course, the new cancer care centre in Prince George, which is also going ahead. [DRAFT TRANSCRIPT ONLY]
The final thing I'll say on that point, because it's an important point, and I know we're up against time here…. I think the other part that I do have to emphasize that's important, particularly in the South Asian community, where there are many, many patients who do not have primary care physicians to look after them and therefore, when they find themselves with a health issue, they typically are presenting at the emergency department…. [DRAFT TRANSCRIPT ONLY]
One of the goals that we are driving towards is to expand the primary care system model to ensure that we connect those patients with a primary care physician to provide them the care they need at the primary care–general practitioner level so that they aren't feeling a requirement to show up at the emergency department for many aspects of care that they require. [DRAFT TRANSCRIPT ONLY]
Madam Chair, noting the time, I move that the committee rise, report progress and ask leave to sit again. [DRAFT TRANSCRIPT ONLY]
Motion approved.
The committee rose at 6:22 p.m.
The House resumed; Mr. Speaker in the chair.
Committee of Supply (Section B), having reported progress, was granted leave to sit again.
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. tomorrow morning. [DRAFT TRANSCRIPT ONLY]
The House adjourned at 6:24 p.m.
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