2011 Legislative Session: Third Session, 39th Parliament

SELECT STANDING COMMITTEE ON HEALTH

MINUTES AND HANSARD

MINUTES SELECT STANDING COMMITTEE ON HEALTH

Wednesday, June 22, 2011

2 p.m.

Douglas Fir Committee Room

Parliament Buildings, Victoria, B.C.

Present: Norm Letnick, MLA (Chair); Mike Farnworth, MLA (Deputy Chair); Ron Cantelon, MLA; Guy Gentner, MLA; Sue Hammell, MLA; Colin Hansen, MLA; Dave S. Hayer, MLA; Dr. Margaret MacDiarmid, MLA; Dr. Moira Stilwell, MLA

Unavoidably Absent: Katrine Conroy, MLA

1. There not yet being a Chair elected to serve the Committee, the meeting was called to order at 2:05 p.m. by the Clerk Assistant and Acting Clerk of Committees.

2. Resolved, that Norm Letnick, MLA be elected Chair of the Select Standing Committee on Health. (Mike Farnworth, MLA)

3. Resolved, that Mike Farnworth, MLA be elected Deputy Chair of the Select Standing Committee on Health. (Ron Cantelon, MLA)

4. The Committee reviewed its Terms of Reference.

5. Resolved, that a steering committee comprised of the Chair, the Deputy Chair and Dr. Margaret MacDiarmid, MLA undertake preliminary work with respect to item 1 of the terms of reference.

6. The Committee adjourned to the call of the Chair at 2:23 p.m.

The following electronic version is for informational purposes only.

The printed version remains the official version.

REPORT OF PROCEEDINGS
(Hansard)

select standing committee on
Health

Wednesday, June 22, 2011

Issue No. 1

ISSN 1499-4232

[ Page 1 ]

WEDNESDAY, JUNE 22, 2011

The committee met at 2:05 p.m.

Election of Chair and Deputy Chair

K. Ryan-Lloyd (Clerk Assistant and Acting Clerk of Committees): Good afternoon, Members. As this is the first meeting of this committee in the present session, I would call upon members for nominations to the position of Chair of this committee.

M. Farnworth: I nominate Norm Letnick.

K. Ryan-Lloyd (Acting Clerk of Committees): Norm, would you accept nomination?

N. Letnick: Yes.

K. Ryan-Lloyd (Acting Clerk of Committees): Okay. Thank you.

I will seek any further nominations. Are there any further nominations? Any further nominations? Seeing none, I'll put the question to the committee.

Motion approved.

[N. Letnick in the chair.]

N. Letnick (Chair): At this point I'd like to call for nominations for Deputy Chair.

R. Cantelon: I'd like to nominate Mike Farnworth.

N. Letnick (Chair): Mike, would you stand?

M. Farnworth: Yeah.

N. Letnick (Chair): Any other nominations? Going twice — any other nominations? Any other nominations — third time?

Motion approved.

N. Letnick (Chair): I declare Mike Farnworth Deputy Chair.

Thank you, Mike, for doing that. Congratulations.

We have an agenda in front of us. We've already done two of the items. Number 3 is review of the terms of reference, and No. 4 is any other business.

Experience and Qualifications
of Committee Members

N. Letnick (Chair): At this point I'll take a Chair's prerogative and just make a brief statement of introduction, since it is our first meeting. I just say thank you very much to all the members here and on the phone and those who couldn't make it to the phone but who will be attending future meetings.

The work of this committee is extremely important in the long-term sustainability of our publicly funded health care system. The people around the table, both physically and via distance, are an excellent group of people with outstanding credentials to be leading the process for not only the Legislature but all of British Columbia.

I'd just like to highlight a few of the points that I found just by looking at people's bios on the website. You have to be careful what you put on your bio sometimes.

Our Deputy Chair, Mike Farnworth, serves as opposition critic for Health and has previously served as Minister of Health for the government of British Columbia.

We have Dr. Moira Stilwell, who is a radiologist and nuclear medicine physician who's also been working at B.C. Women's Hospital for nearly a decade before getting elected. She has a long list of credentials as well, of course, being a former minister of government.

These are in no particular order.

Dr. Margaret MacDiarmid. Margaret is Parliamentary Secretary for Seniors to the Minister of Health. Margaret has served as a family physician for 23 years, served on the board of the B.C. Medical Association for 12 years, was president of BCMA from '06 to '07 and has numerous other credentials as well.

We have Dave Hayer. Dave served as caucus liaison for the Minister of State for Mental Health and Addiction Services, member of the caucus committee on health and a longstanding member of the Legislature as well.

Sue Hammell. Sue currently serves as the deputy Health critic and from '05 to '09 served as Assistant Deputy Speaker of the Legislature.

Guy Gentner. During the last parliamentary session Guy served as the opposition critic for seniors health.

We have Colin Hansen, Minister of Health Services from '01 to '04, along with Minister of Finance experience, of course, and numerous other portfolios.

So as you can see, the quality of people around this table is immense.

Interjection.

N. Letnick (Chair): I'm not finished yet. I've got two more to go, two more important people.

[1410]

Katrine Conroy has worked and volunteered in her community on a hospital board — a hospital board member. I know that Katrine couldn't make it with us today, but I'm sure she'll get up to speed very quickly.

Last and definitely not least, we have Ron Cantelon. Ron was Chair of the Select Standing Committee on Children
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and Youth, and Ron also has a longstanding interest in health and seniors issues throughout British Columbia.

It's just an outstanding team that we have here, and it indeed gives me honour and privilege to be working with all of you to address the very serious terms of reference that we have in front of us.

Committee Terms of Reference

N. Letnick (Chair): If you don't mind, what I'd like to do is read out the first three bullets of the terms of reference and just quickly give you an overview and then talk about what I anticipate we can do over the next two or three months because of the summer season.

We've been empowered to do three things. One is to examine the projected impact on the provincial health care system of demographic trends to the year 2036 on a sustainable health care system for British Columbians, two is to outline potential alternative strategies to mitigate the impact of the baby boomers on the provincial health system, and three is to identify current public levels of acceptance toward the alternative strategies.

When people ask me at home, "What does this all mean? What are you really going to do?" since I was asked to be on this committee, the way I explain it to them is that we're doing it in three parts.

The first part is to identify the numbers so we can have an understanding as to where we're going over the next 25 years — what the stressors will be on the system, what the demands will be, given the current methods by which we provide health services — to identify if there are any hurdles that we're going to have to face, any challenges based on the demographic shift.

As we all know, the boomers are starting to turn 65 this coming year. Being about 20 years of a generation, that puts me, actually, right smack in the middle of it at 53. I look around the room, and I see other boomers here as well.

As the boomers move through, there are differences of opinion in the literature and in the public as to what kind of impact those boomers are going to have. Some believe that it's going to be a little bit more money, a little increase in GDP. The OECD estimates that about 2 to 3 percent of GDP would take care of the boomers. Others believe that the system is not sustainable.

It's very difficult to come up with a long-term strategic plan for health care if we don't agree on the numbers in the first place. That's what the first piece is for — to come up with more of a health economics exercise, to come up with an analysis as to where we're going over the next 25 years that we can all agree to.

The second piece is — assuming from the first piece that we conclude that there are going to be a lot of stressors on the system, then — what alternative strategies would we propose to mitigate those stressors? Even if we discover during the first piece that the system is sustainable, maybe with some adjustments, then what are those adjustments that we would propose?

Then the last piece, the third piece, just as critical as the first two, is to go to the public and say, "Here are the numbers that we're facing over the next 25 years. Here are the long-term impacts of the boomers moving through their peak health years. Here are some strategies which we've received from the public, from experts, looking at other jurisdictions, looking within ourselves, trying to make things better," and then ask the public which ones of these they would support more than others.

We can come back to the Legislature at some point and say: "Here are the numbers we all agreed to, here are some of the strategies that we may or may not agree to, and here are what the public believes should be the different mitigations or line of attack to take care of the problems that we have identified in No. 1.

That's how I explain it to people back home. Hopefully, that's what you received, as well, for yourself as you went through the three pieces here.

With that, what I'd like to do is open the floor to any comments, questions or suggestions on where we're going with the mandate and then after that specifically talk about No. 1. I have some ideas on how we can begin the task of addressing No. 1, because No. 1 is the what. The question is the how — how do we actually deliver on the first one? — and then save the how of No. 2 and No. 3 for later, once we've come up with our conclusion on No. 1.

[1415]

What you'll also find as a member of this team is that, as I found, a lot of people are already coming up with solutions for No. 2 and No. 3. They're coming up with all these ideas. I've been forwarding them, basically, to Sue and Kate and saying: "Please put them in the parking lot. Acknowledge that we've received them, and tell them what our mandate is, the different steps and what we want to attack first, which is No. 1. We'll get back to them when we're looking at mitigations or solutions in No. 2."

Mike, did you want to make any opening comments?

M. Farnworth (Deputy Chair): I want to first thank you for your opening remarks and thank you for your comments. I think the idea of looking at the first-step part, in terms of what the problem is and what the impacts are in trying to quantify some numbers, is probably an important one to go.

What I was going to ask you is about your anticipated timelines and how you see this playing out, because it's a pretty big topic and a pretty big task. My sense is that it's not something you're going to be able to deal with in a couple of months. So if you've just got a sense of what timeline you're thinking of, that would be really good.

N. Letnick (Chair): You're absolutely right. We've had a discussion before, and I think I used the phrase: "I'd rather do it right and take a little longer to do it right."
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The benefit of this, once we've done it — a 25-year plan — is that it can be updated on a regular basis every five years or so, depending of course on the wish of the Legislature at the time. We ask cities to do long-term plans and update them, so here's an opportunity for us to follow the same kind of format.

On the specific question of timeline, where I see us going with this over the next two or three months is to put together a technical committee. Perhaps you, if you're open to that — we understand what's happening in your personal life, so that would be totally up to you — and myself and maybe one other member of the committee will work with people in our province who deal with the demographic issues on a regular basis, like the Michael Smith Foundation, UBCO centre for population data.

We also have KPMG, who I've already talked to, which does a lot in health care and would be willing to come in and advise us as to the how of it.

This work — I'm just gathering the information as to how we go about doing No. 1 — would probably take three to four months in itself. Then we'd come back to the committee of the whole in October with a plan of action for moving forward with the first part of the mandate.

I would see at that point bringing in kind of a meta-analysis process where we would invite groups, experts and individuals across the province and outside the province, like CIHI, OECD and other organizations that have data they can provide us with, so we can come up with a comprehensive analysis as to what the demands will be on the system as the boomers move through and also the supply that we have or won't have over the next 25 years as we see boomers retire.

My best guess on that would be that it would take a few months again. Then we would have to identify the gaps, the pieces we're missing that we didn't get. Then, depending on how deep we have to go into those gaps, whether we have to create new knowledge for ourselves — I hope we don't have to do that; I hope all the answers are there, and it's just a matter of accumulating it — I would suspect that we can get our report out by the summer of next year, the first part.

Any other comments or questions?

Establishment of Subcommittee

R. Cantelon: Chair, I hear you anticipate perhaps a subcommittee formed to do some of the heavy lifting to get things together, and I think that's a good move. I would move that we form a subcommittee of three members to tackle the demographic studies, to sort of act as a steering committee to do some of the preliminary work with respect to item 1 on the terms of reference.

N. Letnick (Chair): Would you mind including the names of the people that you'd like to see on this committee?

R. Cantelon: I haven't asked anybody, but I would say the Chair, the vice-Chair and a third person that the two of them can agree on. Alternatively, I would suggest…. Let me put a name to you, then. Colin Hansen would be the other name I'd put to it. Thrust Colin into this.

[1420]

N. Letnick (Chair): Colin, would you let your name stand for a technical committee?

C. Hansen: Well, I would probably defer to Margaret because I think she's probably got more recent experience in some of these things.

N. Letnick (Chair): This is your motion, Ron.

Margaret, would you let your name stand for working…?

M. MacDiarmid: Sure.

N. Letnick (Chair): Thank you very much, Margaret.

Motion approved.

N. Letnick (Chair): Number 4. Any other business?

D. Hayer: I think this is a good beginning. It's a very important committee. I mean, 50 percent of the budget goes into health care. I see lots of good experts in it, especially people who have served in the Health ministries. Also, we have doctors who have served in the health care system, and then there are ordinary people like us.

I think it will be a good report to have. I think people will look forward to having…. How is our budget going to be affected? Where is health care going over the next 25 years? I'm glad to see this is happening. I think this will go a long way — to have a report and analysis like this done.

M. MacDiarmid: Just a question about the first task here. You sort of made an oblique reference to this, I think, but I wanted to clarify. When we're talking about demographic trends, is one of the things we'll look at the fact that we have a shrinking younger population — so the demographics of the workforce and the challenges that may pose?

N. Letnick (Chair): Yes. The idea is to make sure we not only deal with the demand issues but also the supply issues.

Ron moves adjournment.

Motion approved.

N. Letnick (Chair): Have a great summer. Thank you very much.

The committee adjourned at 2:23 p.m.

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