Finance and Government Services — Issue No. 75 — Monday, September 28, 2015 (HTML)

Present: Wm. Scott Hamilton, MLA (Chair); Carole James, MLA (Deputy Chair); Dan Ashton, MLA; Spencer Chandra Herbert, MLA; Eric Foster, MLA; Simon Gibson, MLA; George Heyman, MLA; Mike Morris, MLA; Claire Trevena, MLA

3. The following witnesses appeared before the Committee and answered questions:

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

REPORT OF PROCEEDINGS
(Hansard)

SELECT STANDING COMMITTEE ON
FINANCE AND GOVERNMENT SERVICES


CONTENTS
Page
Presentations	1775
J. Brown
S. Gregson
S. Bouman
J. Moorhouse
A. Kaiser
S. McDonald
B. Le Clair
L. Gadsby
G. Li
E. Yung
B. Barrable
P. Clarke-Richardson
M. McLoughlin
M. Fromberg

S. Hamilton (Chair): Good morning, everyone. My name is Scott Hamilton. I’m the MLA for Delta North and the Chair of the Select Standing Committee on Finance and Government Services. We’re an all-party parliamentary committee of the Legislative Assembly with a mandate to hold provincewide public consultations on the next provincial budget.

The consultations are based on the budget consultation paper that was recently released by the Minister of Finance. The committee will issue a report by November 15, 2015, with recommendations for next year’s budget.

We’ve had to modify our planned schedule of in-person community meetings this year, as the Legislature has been called back for a fall session commencing today. In order to accommodate as many presenters as possible, we’re holding public hearings in communities across the province through in-person sessions or via teleconference, video conference or Skype.

British Columbians are also invited to participate by sending in a written, audio or video submission or completing an on-line survey. You can make a submission or learn more about the consultation in general by visiting our webpage at www.leg.bc.ca/budgetconsultations. We invite all British Columbians to make a submission and contribute to this important process. For those in attendance, we thank you again for taking the time to participate today.

All public input will be carefully considered by the committee as it prepares its final report to the Legislative Assembly. As a reminder, the deadline for submissions is Thursday, October 15, 2015.

Today’s meeting will consist of presentations from registered witnesses. Each presenter will have ten minutes to speak, followed by five minutes for questions from the committee.

Today’s meeting is being recorded and transcribed by Hansard Services. A complete transcript of the proceedings will be posted to the committee’s website. All of the meetings are also broadcast as live audio via our website.

C. James (Deputy Chair): Good morning. Carole James, MLA for Victoria–Beacon Hill.

S. Chandra Herbert: Good morning. Spencer Chandra Herbert, MLA, Vancouver–West End, Coal Harbour.

S. Hamilton (Chair): Also assisting the committee today are Susan Sourial to my left, Lisa Hill and Stephanie Raymond from the Parliamentary Committees Office as well as Ian Battle and Alexa Hursey, who are from Hansard Services and here to record the proceedings. Finally, Rob Froese is going to take care of the technical Skype issues as we go forward today.

Without further ado, I’d like to welcome, via teleconference, Jesse Brown, the YouthCo HIV and Hep C Society.

J. Brown: Hi, everyone. Sorry I can’t be with you in person there today, but I hope this works out okay.

As I mentioned, you have ten minutes for your presentation. I’ll rudely interrupt, because I can’t signal you while you’re doing your presentation, when there are about two minutes left, just so you can summarize, and then we’ll go to questions from the committee. So if you’re ready, the floor is yours.

J. Brown: Okay, great. Thank you. Again, my name is Jesse Brown, executive director at YouthCo, a youth-driven, community-based sexual health and education organization that for the past 20 years has worked to lessen the impact that HIV and other sexually transmitted infections have on the youth of British Columbia.

I’m with you today to recommend and to implore that the British Columbia government move swiftly to expand its HPV school-based program to extend equal protection to all British Columbia boys. This is the right thing to do, both ethically and economically.

This government knows that preventative health measures work. Just look at the example of the often-celebrated work of Dr. Julio Montaner and the B.C. Centre for Excellence in HIV. By pushing for universal access to HIV treatment and having the support of the provincial government, British Columbia is one of the few places in the world that could see an AIDS-free generation.

It’s a program that saves the patient and protects the public from a potentially deadly virus. It’s a common-
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sense approach based on science, economics and compassion. We need to maintain our reputation as leaders in preventative public health and to follow suit with a universal HPV vaccination program.

Now, you might be thinking of the recent development that British Columbia just funded a boys program for select young men who have sex with men and for street-involved youth and that, therefore, we have a program that protects our men. While it is a step in the right direction, that policy is problematic for a number of important reasons. But before I comment on those, I’d like to let you know some facts about HPV.

HPV is common, and it’s easy to transmit. When sexual activity starts, HPV risk increases. It is estimated that 65 percent of sexually active males in British Columbia have HPV, and HPV can lead to serious conditions like cancer, genital warts and genital lesions.

Globally, we know that HPV is responsible for virtually 100 percent of cervical cancers, which is why it’s so important that we have the girls program in place. It’s responsible for 88 percent of anal cancers, 50 percent of penile cancers and 26 to 60 percent of head, throat and neck cancers, and it’s the cause of almost all cases of genital warts.

We know that the incidence of certain HPV-related cancers and diseases is increasing and that numerous groups, including the National Advisory Committee on Immunization and the Canadian Medical Association, have called for universal coverage of the vaccine for boys.

A program such as this will cost approximately $4 million per year, while genital warts alone cost the province an estimated $3.4 million per year. It’s common knowledge that vaccines are inexpensive compared to the long-term care required for disease treatment and that they are the most cost-effective health intervention available. We need a program that includes all boys in order to adequately protect our population and the health care system from the burden of cancer.

The current program for girls and the newly adopted policy targeting young gay men is inadequate to actually protect boys and men at risk. The HPV vaccine is the only vaccine in B.C. that requires disclosure of sexual orientation, and it is discriminatory to (1) single out gay youth and (2) assume youths fully know their sexual orientation or are able to or want to disclose this publicly.

Singling out young men who have sex with men for a publicly funded program is out of touch with the reality of coming out as gay, bi or trans in 2015. Many boys and young men at risk are not out to their health care providers when they will be exposed to HPV, and many who have been exposed through male contact will never be out.

A school-based program for all boys will protect everyone, regardless of the type of sex they’re having, as it is common sense that HPV transmission in young men doesn’t just occur through male-to-male contact.

The herd immunity argument — that the girls program protects young heterosexual men in B.C. — is false. Young men do not live within a bubble in this province, and the girls program isn’t perfect. B.C.’s average HPV vaccination last year was 65.8 percent, with some regions much lower than this, while herd immunity requires 75 percent coverage. Furthermore, young British Columbians travel within Canada and internationally, so they deserve the same protection that other boys in Canada receive.

Again, this isn’t just an ethical issue. It makes economic sense, as HPV-related cancers will need to be treated in our already overburdened health care system. Toronto researchers at the Princess Margaret Cancer Centre created a comprehensive model that including boys in the vaccination program could save the health care system between $8 and $28 million in their lifetimes.

Let’s look to Alberta, as they recently added boys to their HPV vaccination program. According to Dr. Ada Bennett, Alberta’s deputy medical officer of health, extending the program to boys will cost $4 million a year but ultimately save their health care system $13.4 million. She stated that “expanding the HPV program to males will save lives, reduce disease and reduce future health care costs in Alberta.”

This program is expected to prevent 440 cases of head, neck and throat cancer in Alberta, and the cost savings from this preventative effort could represent savings to the health care system of over $13.4 million. Other provinces, including P.E.I. and Nova Scotia, are following suit. It’s time for B.C. to get with the program.

We know that universal vaccination works, that it’s the right thing to do and that it will save our overburdened health care system much-needed financial resources. The time to act is now. We need a publicly funded HPV vaccination program for boys.

To conclude, we all know a young man in our lives — someone who we love dearly. Now imagine that son, brother or boyfriend comes to us for support after he’s diagnosed with mouth, throat or anal cancer and we know this suffering could have been prevented by a simple vaccine.

It’s a fact that HPV and these related cancers can be prevented in British Columbia, and it’s our shared responsibility to prioritize a universal vaccination program to protect all of our citizens and loved ones from the burden of disease.

S. Hamilton (Chair): Thank you, Mr. Brown. I appreciate your presentation. I’ll go to the committee for questions.

S. Chandra Herbert: Thank you so much, Jesse. I really appreciate the argument. It’s one that I’ve had with a Health Minister. We’ve heard, as well, in Kelowna, sim-
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ilar arguments. I just want to thank you for bringing forward evidence, bringing forward a compelling argument for the need for equality, as well as: if you don’t care about equality and you just care about dollars and cents, it makes sense on the financial side as well.

I just want to thank you for that and thank you for YouthCo’s ongoing innovative work to reach people who sometimes can be hard to reach but who are just as deserving of health care as everybody else and need that strong voice. Thank you for being that voice.

C. James (Deputy Chair): Thank you, Jesse for your presentation. You mentioned that the average takeup of the vaccine in B.C. is about 65 percent. I wondered if you have stats in other provinces, first, around the takeup of the vaccine.

Then second, is it too early yet to…? I certainly agree — I want to say that first — with all your points around the universality for boys and girls and a targeted program being not successful. But is it too early to know what the takeup is for the specific target group here in B.C., for boys?

J. Brown: The question was…. The stats from the uptake for B.C. comes from the B.C. Centre for Disease Control. I don’t have stats for other provinces in front of me. Again, I can refer you to some health care providers that might have more of the numbers. I’m coming from a community-based organization.

This is an issue that we hear…. Repeatedly, it’s come up from our members and from youth that we speak with in the community that they would like access to the HPV vaccination, but they don’t have it yet. You’ve seen articles as well. On Global B.C., there were two young guys — young twins, actually — which I think might have made the news. They made a little presentation about just how unfair it really is.

Yeah, the B.C. Centre for Disease Control has specifics on the uptake in grade 6 students from 2002 to 2014. I can forward some further resources to Mary at the Finance Committee.

Seeing none, Mr. Brown, thank you very much for taking the time to present to the committee. It’s always a little difficult by teleconference, but you did an exceptional job, so thank you very much.

J. Brown: Thanks very much for having me, and good luck with the rest of the presentations.

The committee will take a short recess until our next teleconference has been set up. I’d ask everyone to stay in the room, please. This will only take a few minutes.

S. Hamilton (Chair): We have our next presenter. On the line, hopefully, we have Sharon Gregson of Coalition of Child Care Advocates of B.C.

S. Hamilton (Chair): Good morning, Sharon. Just to get you started, you have ten minutes for your presentation. I’ll interrupt you with about two minutes left just so you can summarize. Then we’ll go to the committee for questions. When you’re ready, the floor is yours.

S. Gregson: Thank you very much. It’s a pleasure to present to you this morning — my first time presenting through conference call. Usually, it’s nice to be in the same room, but I appreciate this opportunity on behalf of the organization I work with.

Hopefully, before you, you have a copy of this submission. It was e-mailed just a short while ago this morning.

S. Gregson: Excellent. And an accompanying list of supporters of the $10-a-day child care plan. Hopefully, you’ll have that, and we can refer to that through the presentation.

You’ll note we start out with a great quote from a local investment banker, that “reducing the child care cost strain for families in British Columbia will produce many net benefits to our society, and that belongs to neither the left nor the right but to the 21st century.” I think that’s now the approach that we would like to frame this presentation with. This is beyond politics. The child care issue is so huge.

You’ll note that in your report, in 2014, there was a recommendation to the Legislative Assembly that the provincial government provide funding and support for the development and implementation of a child care plan, which was your recommendation 40. However, sadly, to date, the government has not responded in any meaningful way to implement the plan that would respond to the current child care crisis and has, in fact, made moves that, unfortunately, will result in child care being less affordable for families in B.C.

A bit of a backgrounder for those who are not aware of the current child care crisis in our province. British Columbia invests less in early education and care than
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the Canadian average, which is already one of the lowest among developed nations and far short of the minimum public investment levels recommended by both UNICEF and the OECD. The result is a fragmented patchwork of programs that fail to meet the needs of most families.

The problems with that patchwork include high costs. Any of you who have got young children or young grandchildren will know that B.C. has the second-highest fees in Canada, with median fees in 2012 — so a slightly outdated number — ranging from $760 to over $1,000 a month. Certainly, in some of our larger urban areas, fees are far higher than that today. Subsidies for low-income parents have been frozen for ten years, while fees have actually risen faster than inflation.

Long waiting lists — not enough supply to meet demand. B.C. only has enough regulated child care spaces for approximately 20 percent of children. So women are forced to abandon paid work and their career goals. The lack of affordable child care spaces is a significant barrier for mothers who want to return to work or pursue education. This contributes to gender inequality and weakens our B.C. economy. It’s estimated that work-life conflict among employees costs B.C. businesses more than $600 million per year.

Sadly, there’s a reliance, then, on unregulated child care. Because of these high costs and the lack of spaces, some working parents have no choice but to turn to unregulated child care that has no training requirements for caregivers, little or no health or safety standards and no monitoring or oversight — clearly, not what any of us want for B.C. children.

We have low wages for early childhood educators. Their median wage is 19 percent lower than that of other B.C. workers, which leads to high turnover and chronic staff shortages, contributing to the financial insecurity of those caregivers with their own families.

The good news is it doesn’t have to be this way. A universal $10-a-day child care program would solve the affordability crisis and ensure all families could access high-quality early childhood education and care.

What does the solution look like? Well, it’s the $10-a-day plan, and it was developed by the Coalition of Child Care Advocates in partnership with the Early Childhood Educators of B.C. and is supported by municipalities and organizations now representing two million British Columbians. You’ll see that the list you have in front of you is a list of the municipalities and regions and organizations supporting the plan.

The formal name of the $10-a-day plan is the Community Plan for a Public System of Integrated Early Care and Learning. It provides for a quality, affordable child care system. It would require public investments in three main areas. The first one being to increase capacity to ensure access to care for all families who need it. Participation would, of course, be optional and open to all.

The second required area of investment would be to improve affordability, with fees set at a maximum of $10 a day for full-time care, $7 a day for part-time care and user fees waived for families with incomes under $40,000 a year.

The third area of public investment would be to ensure higher quality through higher education levels of caregivers, fair compensation and better monitoring and accountability mechanisms.

Momentum for the $10-a-day plan continues to build. Just today I got notice that Unifor B.C. Regional Council has also endorsed the plan. There has been new development since we presented to you in 2014. In October last year, there were just 31 local governments and 22 school districts supporting this plan. Today, this month, there are 45 local governments and 30 school districts, as the plan keeps on growing as the obvious solution to B.C.’s child care crisis.

In March of this year, results of a provincewide Insights West poll were released which clearly show that child care is even more popular than LNG in British Columbia. Three in four B.C. residents support the $10-a-day proposal, including 83 percent of those who’ve had recent experiences in child care. Three in five B.C. residents would both consider voting for a political party that implemented a $10-a-day plan and believe the plan to be realistic.

Importantly, just a couple of months ago the Canadian Centre for Policy Alternatives economist Iglika Ivanova released a report that provided various options to the B.C. government, and each of you will be receiving a copy of that report, for financing a $10-a-day plan over a ten-year implementation period, which we think is a reasonable period of time to implement this system. The report also included an analysis of the returns that both federal and provincial governments can expect in the near term from investments into this plan.

Important for you to know: UBC researchers estimate that a fully phased-in plan would require $1.5 billion in additional public funding to cover operating costs after accounting for parent fees. We know that these upfront costs have been a significant barrier to government’s willingness to implement a child care plan, despite the well-documented social and economic benefits. However, phasing in the $10-a-day plan over a period of ten years would allow governments to provide immediate relief to families while scaling up the full plan and its associated costs in stages.

If the economic benefits of the $10-a-day plan in B.C. are similar to those in Quebec, and we have no reason to expect that they wouldn’t be, B.C. could expect an almost immediate boost in economic activity. The estimates are that the increased workforce participation of mothers of young children would grow our economy by $3.9 billion per year and would generate approximately $1.3 billion in revenues to the provincial and federal governments.
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I’ll jump down to the federal support for child care. A joint federal-provincial investment in child care in B.C. would almost pay for itself, generating 86 cents in government revenue for every dollar invested in the program. You’ll see a short table here in the submission we have for you that shows up front that the new public funding needed after the $10-a-day fees would be $1.5 billion. Estimated increase in revenues to the B.C. government would be $630 million to offset that investment. The increase in revenues for the federal government would be $668 million, so clearly the federal government is also a beneficiary when more women are able to work.

We know, then, that with federal investment, the B.C. contribution would need only to be $202 million, a very affordable sum. Even without federal investment, the B.C. government’s requirement would only be $870 million — still very affordable.

We know the $10-a-day plan is inevitable. The goals of the plan are now corroborated by the chief economist of the TD Bank of Canada. We know that the Canadian Chamber of Commerce unanimously passed a motion requiring an examination of a national child care plan. And important for you to know, the United Way of the Lower Mainland has recently also indicated their support for the $10-a-day plan. As I mentioned, 45 municipal governments, boards of education…. A long list of support is attached.

Quickly, to get to the recommendations, we know that with or without federal support, B.C. can move forward.

Two, put child care at the top of the agenda in discussions with the federal government.

Three, follow the lead of the majority of provinces and territories by moving child care out of the Ministry of Children and Family Development and into the Ministry of Education.

Four, implement an immediate moratorium on public funds being given to commercial child care chain expansion.

Finally, immediately reduce fees to $10 a day in all licensed infant and toddler programs that embrace accountability requirements.

That’s the submission from the Coalition of Child Care Advocates of British Columbia.

S. Hamilton (Chair): Thank you, Ms. Gregson. We cut into your ten minutes, but we still have some time for some questions. I’ll go to the floor.

C. Trevena: Thank you very much for the presentation, Sharon. I’ve got a couple of questions. One is the costing that you’ve done. You talk about a ten-year implementation, so is this $1.5 billion — broken down, as you have done — spread over ten years?

My second question is on recommendation 4, implementing an immediate moratorium on public funds for commercial child care chain expansion. Do you know how much money is going into the commercial field at the moment?

S. Gregson: To answer your second question, there were just announcements made about a second round of capital funding for an increased number, about 1,000 new child care spaces — which, in and of itself, is not enough. We know the city of Surrey alone needs 30,000 new spaces. But we’re very worried to see that the majority of those funds will be given to commercial child care expansion. We’re seeing that those are the organizations that have the highest fees, so creating less affordability for families.

To get to your first question, the $1.5 billion is what would be required for full implementation at the ten-year mark. That, of course, would then be offset by the $630 million being returned to the provincial government in the increased revenue stream from more parents, particularly women, able to work.

I guess my question is why $10 a day. I notice from the documents on page 2 that if the incomes are under $40,000, then that’s waived. But if somebody’s going back to work and they’re, say, working as a physician and making $300,000 or $400,000 a year…. I’m trying to understand the relevance of $10. Why wouldn’t it be a ratio related to the income? It seems like some people will benefit dramatically and some will hardly benefit at all.

S. Gregson: Well, we’d like to start to think about child care the way we think about elementary school. That physician who is earning $300,000 a year is still entitled to enrol their kindergarten child at the local elementary school and pay no user fee at all, the same way that somebody who is a cashier at Superstore would have that same ability. There are lots of reasons for that, primarily because in Canada and in B.C., we have a progressive income tax system. That physician is expected to and required to pay more income tax on their earning than the cashier at Superstore.

There’s also a lot to be gained from those children being at the same elementary school together and benefiting. In child care, we don’t believe that we should be income-testing families at the door of the child care centre any more than we would income-test families at the door of the grade 2 classroom or grade 11 classroom. This is about equality of access, but it’s also about ensuring our progressive income tax system does the job that it’s supposed to do.

G. Heyman: Hi, Sharon. I have two questions. The first one I expect you won’t have the answer to, but it would be useful to the committee, if you get it over the next couple
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of weeks and are able to submit it through the Clerk.

My memory, if it’s correct from about ten years ago…. I think it was the Toronto-Dominion Bank that did a study that showed the return on investment in child care was more than 1 to 1. I forget the exact number. It might have been 1½ to 1, per dollar.

Ms. Ivanova’s numbers are a bit different. It’s not clear to me if she is just dealing with increased income tax revenue or overall revenues and economic benefits or whether she’s being more conservative than the bank was, or whether the numbers have actually changed.

Breaking that down a bit, with a bit of analysis, would be useful. So maybe we should just get the study. But if you forwarded it, it would form part of your submission.

Finally, your fifth recommendation talks about embracing accountability requirements for centres that would have reduced infant and toddler fees. Can you give us some idea what those accountability requirements would look like?

S. Hamilton (Chair): I’m sorry. Ms. Gregson, if you can provide that in writing as part of your submission, it can form part of the record. But I’m afraid that as of now, we’re out of time.

S. Gregson: I will provide those documents and answer those questions — absolutely.

S. Hamilton (Chair): I appreciate that. Thank you very much for taking the time to present, and have a good day.

S. Hamilton (Chair): Next we have, via Skype, Sheila Bouman of ViaSport British Columbia.

Ms. Bouman, welcome. You have ten minutes for your presentation. I’ll try to give you a heads-up with about two minutes to go, and you can summarize. Then we’ll go to the committee for questions. If you’re ready, the floor is yours.

S. Bouman: I am ready. Thank you very much for having me today. My name is Sheila Bouman, and this is my 20th day as the new CEO of ViaSport. I’m definitely on a learning curve. I hope I can answer your questions. I’m really excited to have this opportunity to appear before you, and I’m extremely proud and humbled to be part of an organization whose mandate is to truly improve the quality of life of British Columbians via sport and physical activity.

I’d like to start by telling you a little bit about our mandate, and the part that really excites me, and helping explain the impact that the investment made, to date, is having on British Columbians.

ViaSport is still a very new organization. We were created in 2011 with support from the provincial government to lead a united sports sector in a culture of achievement and to make sport and physical activity relevant to every British Columbian. To me, it’s more than an organization, but a network of leaders in sport, health, recreation, education and aboriginal communities who believe that through sport and physical activity, people of all ages can challenge themselves to be their best.

Our network of leaders wants to bring more families to the field of play, more fans to the stands, more athletes to the podium and more sporting events to the province. We believe that via sport, we can foster the personal growth of people of all ages, as well as unite and energize communities as they cheer on their teams and host events.

Today, in my ten minutes, I want to thank you for the investment the provincial government has made in sport and demonstrate to you the impact that that investment is having and, of course, how we might do more.

In terms of return on investment, the funding for sport has been fairly consistent over the last few years. This has been very much appreciated by our partners. Through unification, strategic partnerships and innovation, it’s ViaSport’s goal to optimize this investment to deliver improved results year over year. To date, the province is our primary funder. Although still an early-stage organization, we do have initiatives underway to leverage this investment for additional funding through relationships with business and with national organizations like the Canadian Olympic Committee.

Last year, ViaSport received $16.3 million from the Ministry of Community, Sport and Cultural Development to increase participation, high performance and sporting events. Let me share some of the results of that investment. Over the past year, sport participation has grown by 3.6 percent, with more than 670,000 registered members in provincial sport organizations. Communities have hosted 115 events in B.C., and more than 16,000 coaches received comprehensive training. Proudly, B.C. athletes competing in targeted, high-performance sports represented 34.8 percent of Team Canada.

Other benefits are a result of new partnerships through ViaSport. One example is that last year’s regional sport delivery network has expanded from five organizations to nine and has evolved to become the ViaSport regional alliance. This expanded scope will give more communities coordinated access to sport development resources and programming.

We also see the potential for each region to be a hub fostering better integration between health, education, parks and recreation, and local businesses to have more relevant, significant impact on the citizens in their respective communities. Through this alliance, ViaSport will think provincially but be able to deliver locally in a way that matters to communities large or small, urban or rural.

Another partnership is with the Coaching Association of Canada. ViaSport was selected to deliver the first PSO
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coaching administration session in Canada. This successful initiative empowers provincial sport organizations to implement national coaching certifications and be a template for other provinces. Another goal of ours is to help B.C. be recognized in sport and to lead more nationally recognized initiatives like this.

One more example. ViaSport’s media platforms enhance sector communication and global awareness of the B.C. sports sector. Not only does our website — really, a portal for sport — welcome over 11,000 viewers a month, but our live streaming and sports features have reached over 600,000 people and more than 120 countries. In fact, it’s through a partnership with BCIT, Canada Games and Destination B.C. that ViaSport produced daily on-line shows in French and English to highlight the 2015 Canada Winter Games in Prince George.

Last year, we distributed $3 million over a 102 different communities across B.C. to help local leaders deliver programs that matter to their citizens. For example, HUB Cycling received $1,625 from us, from our FAB 55 grant program to teach women over 55 in Coquitlam to ride a bicycle. It’s local impact like this that we’re enabling, through a coordinated approach, sport delivery and physical activity.

I do have an ask. I’m not here asking for more money. As a business person, most recently an executive in a global technology company, I’m very aware of the impact of the global downturn on our economy. More than ever, it’s important that we look for efficiencies, opportunities and synergies between sport, health, education and communities to really drive improved results for sport and physical activity.

I would be remiss if I didn’t mention that there has been a decline in our funding over the year. Over the last three years, we’ve seen a $1.7 million decrease due to the impact of the global economy on the physical fitness and amateur sports fund, and this decrease is expected to continue. Cuts such as these impact our ability to change lives through physical activity. They impact our ability to ensure that individuals are able to access sport, no matter where they reside in our province or their socioeconomic status, and they restrict our ability to foster physical activity for people from childhood through senior years.

My request is that you take our track record, our broad and inclusive vision, under consideration. The province can continue to count on us to lead positive changes that impact every community in B.C., as we maximize investment to integrate and strengthen the many, many efforts around participation, performance and hosting.

S. Hamilton (Chair): Wonderful. That worked out very well. Thank you, Ms. Bouman.

M. Morris: Good presentation. I’m just wondering what your relationship is with Pacific Sport. We’ve got a lot of involvement with Pacific Sport throughout the province. I’m not clear on what that relationship is.

S. Bouman: Absolutely. Pacific Sport is probably one of the most established regional centres in B.C. — one of the original five. It’s absolutely an example of what we’d like all regional centres adopt. They are one of the members of our new regional sport alliance. The CEO, executive director, also sits on our sport leadership committee and provides advice to strategy and priorities — again, fostering that integration.

We are a funding partner of theirs. We’re also the primary funding partner provincially for Canadian Sport Institute Pacific. By working together, we look at how to really, again, optimize that funding so that it’s better integrated — though PISE, specifically, is almost a role model for the other eight regional alliance partners — how we can replicate that from north to south and east to west in the province.

Continuing on around partnerships, I wonder what your relationship is with B.C. Aboriginal Sports and the work that they do.

My second question is related to the community grants. You mentioned community grants to increase participation in physical activity. I wondered if you could let us know how many of those grants go out each year and what kind of portion of the budget goes to the physical activity portion compared to, perhaps, the elite sports or the other sports.

S. Bouman: Let me start, first, with our relationship with the partners council. We work quite closely with them. We’re looking, right now, at: how do we help them leverage our data management capability so they have better information? We have information provincially around participation and performance in the aboriginal communities.

We’re also looking at how we increase alignment so that they can leverage our experience. We can also help them with their local and immediate priorities and also be advocates for them as they try and support their own communities — but also integrate, again, with education and health and local delivery where it makes sense. They also sit on our sport leadership committees and are regular partners of ours.

There’s lots of opportunity there, particularly with the Premier’s recent announcements, and both organizations are very excited. We have no shortage of ideas, and to have that level of sponsorship is quite exciting for us.

In terms of the grants, right now…. I mentioned about
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$17 million, $16½ million, that we allocate through the government funding. About $6 million of that goes towards performance; $8 million is for participation, or more on the participation side, looking at it quite broadly. And $3 million of that aid is targeted specifically for grants. Those are grants that local communities apply for based on some different criteria. Then $3 million of that $16½ million is to support event hosting.

Seeing none, Ms. Bouman, thank you very much for taking the time to present to the committee. I think, if I’m not mistaken, this is our first Skype interaction, and it went off without a hitch.

We’ll just take a very brief recess while we re-establish the next Skype call.

S. Hamilton (Chair): Now we have our next Skype call. From Clean Energy Canada, Jeremy Moorhouse.

Jeremy, welcome. I’ll let you know you have ten minutes for your presentation. I’ll try to give you the high sign with maybe two minutes left, and then we’ll go to questions of the committee. So if you’re ready, the floor is yours.

J. Moorhouse: I’m ready. I guess one first question is…. I sent off a presentation. Did you receive that?

J. Moorhouse: That’s okay. I’ll operate as though you’re not seeing it, and we’ll have it for afterwards.

Jeremy Moorhouse. I’m with Clean Energy Canada. For those who aren’t familiar with our organization, we’re a program of Simon Fraser University, the Centre for Dialogue here in Vancouver. We work to accelerate a transition to renewable energy across Canada.

In British Columbia our work over the past four months has focused on the climate leadership team. My executive director, Merran Smith, is part of the climate leadership team, appointed by Premier Clark to be part of the team.

Parallel to our work on that team, we’ve been trying to answer three questions. How does British Columbia meet its carbon pollution targets? What are the mechanisms for meeting it? What does that mean for B.C.’s economy in terms of jobs and economic growth? And then what does that mean for affordability for individuals within British Columbia? I’m going to share some of the outcomes from that work and some ideas that we’d like this committee to consider.

This is part of a big research project. There’s a large report we’ll be releasing in a couple of weeks. If you’re interested in more detail, I can share that with everyone in the room today.

The three primary ideas out of that work that we’d like this committee to consider are, first, increasing the carbon tax at a rate of $5 to $10 a year, with a review after five years. The second element is continuing with the clean vehicle program. There’s a series of rebates in place that was put in during the last budget. Three is establishing a clean economy fund to help with families and businesses and to invest in infrastructure to help reduce carbon pollution.

To justify some of those ideas, I’m going to go through five different things. First is B.C.’s experience with these approaches in the past. Second is the problem that we’re trying to solve. Third is why, from our research, in solving that problem, we still see British Columbia, in the future, looking similar in a lot of positive ways to today. Fourth is affordability for British Columbians. Then I’ll go into some of the details of this work.

British Columbia’s experience to date with reducing carbon pollution has been quite successful. From 2007-2008, with the original climate plan, a number of policies came into place, like the carbon tax, which, by and large, have been successful. By 2012, British Columbia had met its carbon targets. Fossil fuel use was down in the province by 16 percent during that same time period, and British Columbia’s economy grew during that period quicker than the rest of Canada.

We’ve also been quite successful at attracting the solutions to this province. Electric vehicle adoption across the province is higher than any other province in Canada, and we’ve attracted $5 billion in renewable energy investment over the last five years. And to top it all off, British Columbia has received international recognition for these efforts from groups like the OECD.

As we look into the future, there’s a problem. Environment Canada expects our carbon pollution to increase out to 2020. We have a legislated target to reduce those emissions, but it’s more than just the legislated target. It’s also a problem for individuals within British Columbia. I think, over this past summer, everyone has had some experience with the forest fires, drought and heat across the province, and this is a glimpse into some of the changes that British Columbia may see if we don’t address this issue.

Fortunately, we’ve got a lot of different tools to do that. Some I’ve already mentioned that B.C. has experience with. I look at these as three gears that work together to drive down carbon pollution. One is the carbon price, which we have in place. Second is a clean economy fund, which helps that work more easily by helping families and businesses adapt. And the third component, which I won’t discuss in detail in this presentation, is standards
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— things like a clean electricity standard, which British Columbia has, that requires that our electricity come from clean sources.

In the research that we’ve done, when we’ve put in those policies and driven down carbon pollution in the province, when we look out to 2020, 2025, all the way out to 2050, the British Columbia that we see is similar in a lot of ways to what we have today. It would seem familiar from an economic perspective. We expect that GDP would continue to increase at a similar rate that we’ve seen historically and that British Columbia businesses would still be able to compete in a global market.

When we then look at the types of jobs that would exist in British Columbia…. If we look today, the majority of people are employed in the service sector. There’s another big group within the traditional resource sector — forestry, mining, natural gas, agrifoods. But as we go out to 2025, driving down carbon pollution, our research shows that jobs increase by about 300,000 by 2025. That breakdown between the service sector and the resource sector stays quite similar. As we go out to 2050 — the same thing. That breakdown between the service sector and the other sectors remains the same.

Part of that is because British Columbia has a clean electricity sector and great resources in that sector that allow businesses to adapt and reduce their carbon pollution while still being able to compete. In fact, for a lot of industries, they’re able to compete better in a low-carbon world because of that resource within British Columbia.

We then asked ourselves: what does this mean at the individual level? What does that mean to families, people living in British Columbia? There are lots of different types of households. Some people live in apartments. Some people live in detached houses. Some people drive a truck. Other people might not even own a car. So we looked at two base cases of someone who’s living in an apartment in downtown Vancouver with access to a small car and then: what if you lived up in the Peace region and you had a house with a pickup truck? What do these changes mean for you?

In both situations we found that as you go into the future, energy bills actually go down in these scenarios, whether you’re in the city or whether you’re living out in the northeast of British Columbia. The savings in the northeast of British Columbia are about $100 a month for energy prices. Then, if you’re living in an apartment in downtown Vancouver, it would be about $7 per month.

The reason for that savings is that people are simply using less energy because they have access to more efficient technologies for heating. It could be a wood furnace, or it could be a heat pump that runs on electricity to heat homes efficiently. But in either case, prices go down.

Three critical policies to that…. I mentioned one of them — the carbon tax. A bit more details on what we’ve looked at, or the elements that we’d like to see, are first, the schedule — to have a ten-year schedule of increase. That lead time is so that businesses and individuals can know what to expect in the future and plan for it for technology they’re investing in and the projects they’re building. The rate of increase should be about $5 to $10 a year, with a review after five years, and indexed to inflation so that that cost doesn’t actually decline over time.

To continue with the low-income tax credit to keep pace with those increasing costs for those that are least able to adapt within the economy. In the use of the funds, where right now a lot of those funds have gone into tax breaks, as the price goes up, those incremental funds could be used for a variety of things, including tax breaks. But they could also be used for the clean economy fund, which I mentioned.

That clean economy fund — some of that could come from the carbon tax revenue. Its purpose would be to invest in the infrastructure that’s necessary to help people and businesses adapt and also to help individuals themselves through rebates like the clean vehicle program and also to help emission-intensive, trade-exposed industries like the cement industry, which received some support last year, reduce emissions so that they could compete more effectively while cleaning up their industry.

I’ll end it there. The three ideas are re-initiating the carbon tax, maintaining the clean vehicle program and then establishing the clean economy fund.

S. Hamilton (Chair): Thank you, Mr. Moorhouse. For your information, your presentation was…. Partway through your presentation, your paper copy here was distributed, so we were able to follow along a little bit.

Anyhow, I will go to the committee for questions. I’ll start with George, please.

G. Heyman: Thank you very much for your presentation. I have a couple of questions. One might really be a request for you to submit some other documentation. We’ve had, I think, three presentations from chambers of commerce that claim that the original intent of the carbon tax to be revenue-neutral has been abandoned for niche tax credits — I’m not saying I agree with that — and that we need to return to revenue neutrality and only use proceeds of the carbon tax for tax cuts.

You’ve suggested that with an increase in carbon tax, money could be devoted to a variety of activities that could form part of the clean economy fund. I’m wondering if you have examples from other jurisdictions that have used proceeds from some form of carbon pricing, not for tax cuts per se but for various programs that help individuals and industry lower their carbon output and
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whether there are economic growth figures or impact figures attached to that.

My second question has to do…. You may or may not be able to answer this. You mentioned that your executive director, Merran Smith, is on the climate leadership team. I know the terms of reference for the team excluded looking at LNG in terms of actions to lower GHG emissions. I’m wondering if that extends to the question of how LNG compressors would actually be powered, whether they’re powered by renewable energy or powered by gas drive.

J. Moorhouse: They’re two different questions. We’ll start with the first one, other jurisdictions. My mind goes to California and the proceeds they’ve used from cap-and-trade revenues. I’m trying to remember. They have several buckets for investment for those funds, including transportation, and then investment into different companies as well. I haven’t seen economic data on that, but I would turn you to the Pembina Institute, which has recently looked at….

If you increase the carbon price in B.C. and use that revenue for things like transit, investment in electric vehicles…. They have some economic analysis that shows that GDP continues to grow throughout the province with that kind of approach as well.

The second question…. I’m not on the climate leadership team, and the discussions are all confidential. So I’m not…. From what I understand, LNG is part of that discussion, as are technologies and options to reduce emissions from that, which would include technology options at the terminal. There’s already the Greenhouse Gas Industrial Reporting and Control Act in place for the terminals, so I’m not sure where the discussion is at the terminal level.

I’m curious. What size do you think…? How much money would have to be in a clean economy fund to do the job? What are we looking at in terms of budget numbers, if you’ve done them?

J. Moorhouse: We don’t have a number yet. But with the carbon tax increase that I’ve included here, revenue from the carbon tax climbs to nearly $3 billion by 2025 and then starts to decline as emissions and the economy decline. That’s a $2 billion-ish increase from what revenue is in the carbon tax right now. That, once you take out the low-income tax credit, would leave a sizeable amount that could go into further tax reductions and then also into a clean economy fund.

I don’t have a number yet of what that fund could look like — a dollar value.

S. Hamilton (Chair): Thank you, Mr. Moorhouse, for taking the time to present to the committee. Very much appreciated, and it went off without a hitch again. So thank you again. Take care.

Moving right along, we have friends at Prospera Credit Union via teleconference. We have Angela Kaiser on the line.

A. Kaiser: Good morning. Thank you, Mr. Chair and members of the committee, for this opportunity to provide some comments on the 2016 budget.

My name is Angela Kaiser, and I am the former chair as well as a longtime director at Prospera Credit Union. I wanted to tell you about some of the really great things that we’ve been doing at our credit union as well as demonstrate how the money that we earn stays in B.C. and continues to work for B.C.

Prospera is proud to be a business that’s headquartered and operating exclusively in British Columbia. We are committed to reinvesting all the money we make into the communities we serve to strengthen the provincial economy while also serving the needs of our member owners, who are also your constituents.

Being a cooperative financial institution is really great, but what is even better is being part of that really strong network that includes 42 other B.C.-based credit unions. Together, as a system, we have over $60 billion in assets, and we represent over 1.9 million British Columbians. I really believe that the B.C. government and B.C. credit unions have the same goals in mind — working to strengthen the provincial economy while also improving the quality of life for British Columbians.

I’ll give you a little bit of background on Prospera. As a credit union, our roots emanate from two founding groups. Edelweiss Credit Union was first incorporated in 1943, and Fraser Valley Credit Union has been serving local communities since 1949. Edelweiss Credit Union actually started off with just 13 members and for the first 14 years was operated out of the home of one of the founders.

In the over 70 years that we’ve now been around, Prospera has grown to be the fourth-largest credit union in B.C., with combined assets of more than $3.6 billion under administration. We have over 62,000 members, and they benefit from our 16 branches and our commercial banking centres that serve communities right from the Lower Mainland through the Fraser Valley and into the Okanagan. We also have a locally based contact
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centre which is located in the heart of Abbotsford along with our head office.

At Prospera we have a commitment to really help our members thrive. This has always been so much more than just words. Our attitude and our mission really echo this commitment to listen to our members when they tell us what it is that they want and what it is that they need from their financial institution.

As a cooperative, we’re what you would call a grassroots, locally based financial organization that is run by the people, for the people. We believe in building a sustainable organization by putting people before profits. Unlike other financial institutions, credit unions don’t have a mandate to provide value for shareholder investors. Instead, we create value by helping our local members to succeed and to prosper.

I thought I would tell you a story about one of our members, Tom. Tom came to Prospera about seven years ago, and at that time, he really didn’t have a lot of hope that he would walk away with the money that he needed to get his dream off the ground. Tom was a competitive powerlifter, and he was working a full-time job as a commercial baker. At the same time, he was operating his tai chi school, a personal training and health consulting business, out of a basement gym in Mission.

He’d already approached every bank that he could think of, and they all gave him the same answer: no. We found that Tom had a really strong business plan when it came to what he knew about his fitness and rehab business, but we found he didn’t really have such a good handle on the numbers.

So when Tom came to Prospera and we said yes, he walked out with a $30,000 line of credit. You can imagine how surprised he was. But he was more surprised when the commercial account manager seemed to be more interested in understanding what were Tom’s real goals and what was his plan to reach them rather than just being concerned about seeing if the numbers worked.

Tom’s business, we’re happy to say, has come a long way. A year later, a building became available in downtown Abbotsford that was going to be the perfect home for his Fraser Valley school of tai chi and Core Fitness and Rehab. Tom signed a lease with the option to buy. Two years later, he became the proud owner of that building at one-third of its assessed value. This was an excellent business decision, and we at Prospera were so happy to be able to support Tom and help his dreams come true.

You know, our staff are not just employees; they’re actually member owners of Prospera, and our desire to make a real meaningful difference in the financial well-being of our members starts with them. We have over 435 employees, and they are committed to our purpose and the values that guide us in everything that we do. For them, helping members isn’t just about doing their job; it’s about building relationships and trust.

Here’s another story, about Dylan, who is a young man who works out of our west coast branch in Abbotsford. A few months ago, our member, who owns a local coffee shop down the road, came into the branch to do his regular deposit. Then Dylan, while doing the transaction, noticed that the member was paying quite high service charges. He said to the member: “Let’s review your package and see if we can find something better.” He ended up saving the member $10 a month.

Well, you know what? It may not seem like a lot, but it really is an example of how we at Prospera put people before profits, because we believe that our members will win — no matter how big or small — and we will also win.

Helping youth get the education and skills needed to be successful is something else that we are really passionate about. We have several programs that support this goal. It includes sponsoring 16 youths every year for the YES leadership camp. We provide over $20,000 per year in scholarships for post-secondary students. As well, we support Junior Achievement’s Economics for Success program, not just through sponsorship dollars but also though Prospera volunteers who go into the classrooms and share their knowledge on financial literacy with our youth.

At Prospera, we’re also committed to economic development in our communities that we serve. A significant part of this involves helping small business access the financing and the support they need to get established. This, in turn, translates into more local jobs, more local investment, and they all add to the prosperity in B.C.

In fact, B.C. credit unions are the largest lenders to small businesses, and that is significant when you think that 98 percent of all businesses in B.C. are our small businesses. So in addition to helping others create jobs, as an employer, Prospera is also proud to provide good-quality jobs in the local communities that we serve.

As credit unions, you can tell we’re deeply invested in the well-being and the future prosperity of B.C., and that is why I would now like to take a few moments to talk about the phase-out of the preferential tax treatment for credit unions. It’s something that I believe will have a profound impact on our ability to do some of the really great things that I’ve been telling you about today.

First, let me just say thank you to you, the committee, for your recommendations to the government over the past few years that the current provincial income tax rates for B.C. credit unions be maintained and that the temporary deferral of the tax increase be made permanent.

Now, 2016 is going to be an especially significant year, as this is the year when the preferential tax rate is set to begin phase-out. I really hope that you will support us again this year and urge the Minister of Finance to make the preferential tax permanent.

For Prospera, it is estimated that the phase-out of the preferential tax treatment will decrease our retained
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earnings by over $796,000 each year. This will mean a decrease of over $16 million in loans to small households and small businesses.

I need to stress that growing our retained earnings is not something that happens overnight because, unlike banks, credit unions don’t have access to capital markets to raise money. So it’s no surprise that it’s actually taken us decades to get the quality retained earnings where they are now. At the same time, the regulator is asking us to set aside increased levels of capital as a contingency so, in a way, we’re getting hit from both sides.

Phasing out the preferential tax treatment will result in slower growth for the future. With our retained earnings as the main source of our funding for the good things we do in our community, I’m really worried that a hit to our retained earnings on an annual basis is going to limit our ability to do what we’ve been meant to do and what we at Prospera have been doing for over 70 years.

Mr. Chair and members of the committee, Prospera is just one of 42 credit unions, and we’re going to feel the effects of the preferential tax phase-out. My purpose today is not to ask for money but instead to ask the committee to continue to support credit unions and what we’ve been doing: using the profits we make and reinvesting them to fuel the B.C. economy to create local jobs and to support the future of this great province.

Mr. Chair, thank you and your colleagues for your attention this morning. I am very happy to take any questions you may have at this time.

S. Hamilton (Chair): Thank you, Ms. Kaiser, for the presentation. We’ve heard a lot from credit unions around the province. In every town we’re going to, we’re hearing different vignettes, so I appreciate you taking the time to share yours.

G. Heyman: I don’t actually have a question, but I wanted to echo the Chair’s comment. Thank you and the other presenters for giving very concrete examples of contributions of credit unions to the local economy and their communities. I think this committee has heard a lot over the two years I’ve been on it.

I think we all are quite aware of the very important and unique role that credit unions play. I spent a number of years working in the north, and I saw the impact when banks made a purely economic decision to pull out of small communities and how important it was that credit unions were there to fill the gap.

Finally, I just want to thank you for your particularly enthusiastic approach to presenting. You’ve certainly perked us up this morning. Thank you very much.

C. Trevena: Thank you very much for your presentation. To echo what’s been said, we are hearing very clearly the importance of credit unions.

My question is…. You mentioned the investment in businesses in the community, and you also talked about the scholarship. I wondered if you have, actually, a dollar figure of how much you’re investing in the community itself through the good works that credit unions do — scholarships and beyond — and what the impact you think that would be — if you have, again, a dollar figure — if you lose the tax benefit there.

A. Kaiser: The contribution that we give to our communities directly in dollars equates to about 6.5 percent of our net operating income, and that currently is about $650,000. Our scholarship contribution is the $20,000 that I mentioned.

But I think what’s even more important, and it’s really hard to put a dollar value on this, is that at credit unions our people provide so many volunteer hours. We don’t just throw those dollars at events or organizations. We use the power of the people to get out there and to really interact with our communities, and I think that’s how we can really make a big difference. I think that’s important, and I can’t quantify that.

S. Gibson: Thank you very much for your presentation. As someone who worked in the credit union system for eight years, I’m very proud, too, of the fact that your head office is in my community and you’ve got lots of branches throughout the valley.

What about continuing consolidations? When I worked in the system many years ago, there were a lot more credit unions than there are today. It seems like we’re centralizing more and more. I’m wondering if you have any comments on that.

A. Kaiser: Great question. I think that credit unions would always take a look if there’s an opportunity to create a better credit union for their members. I think that’s our primary mandate. Consolidations — they may have been, or they may not. It depends on what communities they are serving.

S. Gibson: With a goal for more efficiency. I guess the lament sometimes from smaller communities is that decisions are, therefore, made outside the community. It’s not a criticism, just more of an observation.

A. Kaiser: Yeah, decisions…. At the end of the day, credit unions are based on a member-owned, cooperative economic model, and it is based on one member, one vote. So I think the member will always have a say in, especially, the big decision-making.

D. Ashton: Good morning, Angela. It’s Dan Ashton. I just want to thank you for your presentation and also thank you on behalf of myself for your incredible contri-
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butions to Penticton. I know that you’ve been very, very active, and your employees have been very active, in the well-being of our community and made a huge difference.

S. Hamilton (Chair): With that, Ms. Kaiser, thank you very much for taking the time to present to the committee. Thank you for the work that you do on behalf of the credit unions in B.C. All the best for the day.

S. Hamilton (Chair): On the line, we have Scott McDonald via teleconference — the British Columbia Lung Association.

S. Hamilton (Chair): Good morning. I’ll just let you know you have ten minutes for your presentation. I’ll try to interrupt you and let you know when there are a couple of minutes left so you conclude your thoughts. Then I’ll go to the committee for about five minutes’ worth of questions after that. If you’re ready, the floor is yours.

S. McDonald: Okay. I appreciate that. Thank you for the opportunity to appear before you today to provide some comments from the lung-health perspective for your consideration as you seek public input on next year’s provincial budget.

The British Columbia Lung Association, which I represent, is one of Canada’s most respected voluntary health agencies, with its roots dating back to the turn of the last century, when tuberculosis and other infectious diseases were, by far, the most serious public health issue facing British Columbians and, in fact, the entire world. Our organization’s name then was the British Columbia Tuberculosis Society. It was later changed to the British Columbia Tuberculosis–Christmas Seal Society.

With the relatively modern discovery of antibiotics by Sir Alexander Fleming in the late 1920s and their subsequent refinement to enable the effective treatment of many infectious bacterial diseases, including tuberculosis, our organization’s focus moved to include all lung diseases and their causes, with a particular interest in prevention.

In 1979, we became the British Columbia Lung Association. We are a volunteer-driven, donor-supported organization with representation throughout the province and tens of thousands of supporters.

We represent the lung-health interests of all British Columbians, and we do this largely through the support of science and the development of clinicians and scientists, programs of public and professional education, lung-health advocacy and patient education. Our mission is to improve the lung health of British Columbians, and our focus is on lung health and preventing lung disease.

We are a provincewide, evidence-based organization whose primary interests are lung cancer, asthma, emphysema, pulmonary fibrosis and tuberculosis, although we are also active in the areas of sleep apnea, influenza, pneumonia, cystic fibrosis and all other lung-health issues.

As I have said, we are particularly interested in prevention. As such, we have a very strong organizational focus on tobacco and protecting the air we breathe.

Tobacco use, although down dramatically in the past few decades, remains the single most important threat to lung health in our province, with over 500,000 British Columbians continuing to be regular tobacco users and, unfortunately, tens of thousands of young people taking it up every year. With continued use, more than half of them will suffer dramatic and unforgiving consequences that will affect their families, their careers and their lives.

As a direct result of their smoking, thousands will suffer from lung cancer, emphysema and heart disease. We therefore urge you to recommend committed and continued leadership and investment by our government in the fight against tobacco and continued dedicated efforts to prevent young people from taking up the habit, as well as programs to help smokers to quit.

Provincially funded programs like the tobacco cessation program and QuitNow are vital to the lung-health future of British Columbians. Our view is that they should be continued and expanded to reach the widest possible number of people.

Protecting the air we breathe is also vital to the lung-health future of British Columbians. We are fortunate to enjoy some of the cleanest air in the world, but there are threats to that clean air that need all of us to do our part and that also require the close attention, leadership and investment by government.

We therefore ask that your recommendations to government with respect to the upcoming provincial budget include provisions for protecting our air through every means available and in such ways as expanded investment in mass transportation initiatives, energy conservation efforts, wood smoke reduction and finding alternatives to forestry, industry and agricultural practices that involve burning waste or fuels that are known to be highly polluting.

One in five British Columbians suffers from a lung disease. Most lung disease, once diagnosed, is managed largely by the use of effective medicines.

Lung disease patients who work in partnership with their family doctors, respiratory specialists and other health professionals to manage their disease are able to work, play, be a part of our community with their families
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and contribute to our community and to our economy. When they are not well managed and they can’t breathe, they are in distress and are very anxious and under great pressure, and so is everyone around them, from family members and employers to the health care system.

Investment by government in the most effective medicines available and prescribed by physicians who understand that particular patient’s specific needs will improve the lives of patients and those around them. Patient access to the best medicines available for them will reduce financial pressures on the health care system caused by patients who need to visit doctors or emergency rooms because government policy restricts access by them to the most effective medicines.

None of the knowledge, strategies or tools that will be required to assure the lung-health future of British Columbians would be possible without the people, science, research and innovation that will make it possible. So we also ask that the new budget include significant tangible and philosophical investment and a commitment to science, innovation and strategies for improved health for all British Columbians, throughout government.

To summarize, we ask you to recommend that the new provincial budget contain provisions to expand efforts to reduce the harm caused by cigarette smoking. We ask that you recommend investment in protecting the air we breathe. We ask you to recommend that patients have access to the best available medicines, and we urge you to recommend to government that support for science, research and innovation be a foundational aspect of the new budget.

Thank you for your consideration of these comments. I look forward to any questions you might have.

Of course, I’m advocating that we reduce the number of human-caused forest fires in B.C., and maybe that might help. Just about 50 percent of all fires are human-caused, so if we can nip that one in the bud, we are a good way down the road.

My question to you, sir, is…. Although we’ve reduced cigarette smoking substantially in B.C., and perhaps across the country, I’m concerned about the increase in marijuana smoking. It seems to be becoming quite a popular trend in the Lower Mainland and here on the Island. Have you done any research, or are you privy to any research, to indicate whether marijuana smoking is as harmful or more harmful than cigarette smoking to individuals?

S. McDonald: We haven’t done research ourselves, but there is plenty of research that shows that inhaling anything other than the air we breathe is not going to be good for you. In the case of marijuana, people are inhaling burning material. It’s not going to be good for them.

Usually with marijuana cigarettes, users do not smoke 20 a day as cigarette smokers do, so the harm there is probably somewhat lessened. On the other hand, there is some control on the manufacture of tobacco, so we have a pretty good idea of what is in cigarettes, but we have no idea what might be in the marijuana that people are inhaling.

S. McDonald: E-cigarettes are a relatively new phenomenon. Just a little background. They are an electronic device that looks kind of like a ballpoint pen — a little bit of a fat ballpoint pen. The user will put usually a liquid material, which comes in some sort of vial or a dropper, into a chamber within that device, and they will press a button which causes that material to vaporize, and they inhale that material.

Now, in e-cigarettes, we really have no idea what is in the material that people are inhaling, other than that it’s probably a vegetable oil for the most part. But many, many other materials could be in the material that’s vaporized. Many of those vaping vials come from offshore, and we just don’t know what’s in them. We don’t know the long-term effect of people inhaling that material.

Again, inhaling any material, whether it’s a vegetable oil or anything else, is probably not good for you in the long term. Unfortunately, there’s not a large body of evidence about the good or evil of e-cigarettes at the present time. Some say that it does reduce the harm. We know the harm that cigarettes cause, and this may be less harmful. But honestly, we just don’t know about it.

We have urged government, through the Ministry of Health, to undertake research to better understand e-cigarettes and to control e-cigarettes much like cigarettes are controlled today — that is, access by minors, where and when they can be sold, advertising and that sort of thing. It definitely is an issue that’s of concern to the Lung Association.

S. Hamilton (Chair): I just want to follow up on that line of questions from Simon.

I guess I’m quite shocked that these products can be imported into this country and we don’t know what’s in them. It’s a food or a drug, and there are administrative bodies in this country that are responsible for making sure that anything that does come in that’s consumed by Canadians is in fact safe, or at least, if it’s not safe, it’s identified and controlled at some level. That really does
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come as quite a surprise to me. I just wanted to make that comment for the record.

S. McDonald: Also, the fact is that people are ordering these materials on line. They’re being delivered by mail or parcel, or they’re being carried into the country, and they’re being distributed in a variety of ways. Health Canada prohibits the importing of vaping materials that contain nicotine. That is against the law. Nevertheless, they are fairly readily available. So there’s a need for additional controls on the e-cigarette issue.

C. Trevena: Thank you very much for your presentation. I was interested…. You were talking about the need for prevention, and you mentioned the air that we breathe, particularly in urban areas, with the need to invest in transportation. I’m wondering where you would put this on the scale of importance — the need to invest in public transportation to improve air quality and, therefore, everybody’s public health?

S. McDonald: It’s probably of the utmost importance to enable people to have alternatives to their one-passenger vehicle, especially commuting in urban centres — not so much up-Island or in the Interior, where it may not be practical for people to get around without their own vehicle.

But in the urban centres, most people, by far — you can see it on the highways — are in single-passenger, single-occupant vehicles on the freeways coming into the centre of the city. There needs to be an investment in transportation that would allow those drivers to conveniently use mass transit as their primary way to get back and forth to their business in the urban settings.

Mr. McDonald, thank you very much for taking the time to present to the committee. Enjoy the rest of your day.

Before we take a brief recess, I’ll acknowledge the presence of our member for Delta South, Vicki Huntington. Good morning.

S. Hamilton (Chair): On the line, I hope we have Brenda Le Clair and Leona Gadsby from Decoda Literacy Solutions. Hi, folks.

Just to let you know, I’ll give you ten minutes for your presentation. I’ll interrupt a little bit when you have about two minutes to go, so you can conclude your thoughts. Then I’ll go to the committee for questions. If that works for you, the floor is yours.

B. Le Clair: That’s great. I’m Brenda Le Clair, the CEO of Decoda Literacy Solutions. With me is my colleague Leona Gadsby. She’s the lead director of programs and services.

Decoda, as I believe many of you know, is the provincial literacy organization. It provides resources, training and supports to literacy programs across the province. You should have a handout with you. We’re now on page 2.

First things first. Thank you for travelling and listening to people around the province. It is really appreciated that the committee is taking that time and effort to carefully hear. Thank you also for listening to us again.

We know that you’ve heard from people in several communities to date about community literacy work and the good coordination that’s going on. We are so pleased to be able to work with passionate people who are making such a difference in their communities. We want to add our gratitude to theirs about the recommendation that you unanimously provided last year in this committee — to provide $2.5 million, annually, for community literacy work.

Page 3. Some good news has happened as the result of that recommendation. We did receive the $2 million, and presently, the Ministry of Education is leading a strategic consultation with a number of communities across the province to look at the coordination of the community literacy work. We are encouraged by this and trust that it will result in good recommendations, and we are happy to participate in this process.

However — on the next page — there is still no funding committed for community literacy support in the 2015-16 budget or beyond. Literacy work in the province is becoming more unstable and more uncertain.

L. Gadsby: Hello, I’m going to take on the next part. We’re on page 5, which says: “What are literacy and essential skills?”

We just want to review for a second what we’re talking about. To be clear, literacy is more than reading and writing, though of course those two skills are at the heart of literacy.
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In Canada, we also talk about essential skills. Literacy and essential skills are those basic skills that provide the foundation for learning other skills. For this reason, we sometimes call them the velcro skills, because other learning sticks to them.

We’re talking about reading, writing, oral communication, digital skills, math, critical thinking, problem-solving — all of those kind of very basic skills that help with other learning.

On to page 6. Why are we concerned about literacy in B.C.? Internationally, literacy is measured in levels 1 to 5, with 5 being the highest. Level 3 is considered to be the level at which people need to be in order to participate well.

In B.C., more than 500,000 adults have reading skills at the lowest level. That’s level 1. That means their reading is quite poor. And 45 percent of people in B.C., age 16 to 65, have skills at level 1 and 2. This means that they would have trouble reading and using the directions on a medicine bottle.

You can see on your paper that 52 percent have level 1 and 2 numeracy skills. That’s more than half the adult population between 16 and 65. These are statistics from Statistics Canada, part of an international survey on literacy.

Page 7. We just want to talk for a minute about why skills are increasingly important to the economy. The B.C. and federal chambers of commerce have released a series of reports about the concerns of industry and business related to skill shortages. As a province and as a country, we can’t afford not to be competitive in terms of human resources and skills.

On to page 8. The particular problem for B.C. is that we are not producing enough children to replace ourselves. No matter what our skill level is, the overall supply is not developing quickly enough. We are going have to rely on immigration to some extent.

There are huge increases in information and communication technologies, and that really magnifies the skill-based inequalities. The pending labour shortage in B.C. will force employers to hire more low-skilled workers. The poor state of government finances — that is, the decreasing revenue from oil and resources and that sort of thing — makes it difficult to invest in skill development.

But what are the implications of inaction? For people with lower skills, there could be massive job losses, particularly as technology increases and we don’t have as many people in resource-based industries, like logging and fishing. Then, we have falling incomes. We have rising income-support costs, rising health costs. You can see the list there. So a skilled population is really important for our economy.

B. Le Clair: We’re on slide 10. We are working to address these issues by supporting skill development in communities across the province. The very best way to ensure skills in British Columbians is to meet people where they are and assist them to improve their skills in the context of their communities. It is also very important to support the learning of our children. They are the next generation of adults who will support the province.

Page 11. Community literacy work provides a unique service to a segment of the population that is not currently served by the formal system. Those people need another chance. Some people need many chances.

The informal network also supports formal systems of education. However, these days literacy work everywhere is being eroded by funding cuts, provincially and federally. The irony is that there has never been a more pressing need and demand for people to have basic skills. Without basic literacy and numeracy skills, people will not be able to participate in training opportunities for employment. Many people in British Columbia are in danger of being left behind, left out.

L. Gadsby: On to page 12. Last year through the coordinated community literacy network, over 121,000 children and adults attended community-based literacy programs. Of those, more than 12,000 were adults who were increasing their basic literacy skills specifically so that they could go into trades training, better jobs, further education. So we know that there is a demand. We’re trying to meet that demand as best we can.

On to slide 13, “Funding for the Future.” We know that these are difficult times, financially, for any government. Our request is the same as it has always been. We know that government funds are under increasing pressures, but we need to have, at least, the minimum of $2.5 million to support the community literacy network and the work of our organization, which supports that network. We need that funding to be multi-year so that we can stop worrying about it and focus on the work, which is so important.

Thank you very much for listening to our presentation. We’re happy to answer any questions.

S. Hamilton (Chair): Well, thank you very much — appreciate that. I do have a couple of questioners, so I’ll go to the committee.

C. Trevena: Thanks very much for your presentation. Very interesting. We’ve heard from others in communities discussing this. I know that in my own community in the north Island, I get regular presentations from the literacy group, who do great work.

I find that the figures you had are quite staggering when you had the five levels and how low our level of numeracy and literacy is in the province. It really is frightening.
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I would say — if I might make a comment — that it’s not just an issue for our economy, but it’s an issue for our whole society that we are leaving so many people behind, or without this opportunity, because they don’t have literacy. This isn’t just an economic issue. It is a fundamental right of our citizens in B.C. to have the opportunity to become literate.

My question goes directly to your recommendations — the $2½ million that you’re requesting, that you requested last year and you continue to request. I have two parts for this. One, it’s $2½ million per year over a three-year funding cycle or $2½ million split over a three-year funding cycle, if you were able to get the three-year funding cycle ingrained into the process?

Secondly, is there any specific area — either geographically or socially — within the province where you would be wanting to target those funds?

B. Le Clair: Well, the literacy need is great throughout the whole province. There are some areas of the province — for example, in northwestern B.C. and northeastern B.C. — where the literacy levels are significantly lower than other places.

The $2.5 million request is an annual request, that it be $2.5 million per year. When you divide that out with 100 coordinators that serve 400 communities in the province, that is not a lot of yearly money for them to sustain the work. In some of the smaller communities, it’s as low as $5,000 a year, and I can’t imagine how somebody could stretch the dollars that far. But that is what’s happening in some places in British Columbia.

Some communities, like a Surrey, would get about $20,000, and so, as you divide up the money, there’s not really very much anywhere, and the need is so much greater than what we’re presently funding communities for the work.

L. Gadsby: I want to stress that $2.5 million is the minimum that we need. It would be wonderful if we had more — and probably really necessary to have more funding per year — but again, we’re recognizing the difficult times, and we just really need that stable minimum amount at least.

C. James (Deputy Chair): Thank you for your presentation. I also want to say thank you for your good work, because your partners who work with you around the province have been presenting to us and speaking very highly of the support that they get through Decoda. I think that speaks volumes — when they’re doing presentations, to say thank you to you.

I think you’ve covered a piece of what I was going to ask and Claire’s question. But I just wondered if you were seeing extra funding, if extra funding was coming in the area of literacy, is there a particular area that you see the greatest pressure in, that you would look at, perhaps, putting those resources in? Is there a particular target group? Is there a particular area? Is there a greatest pressure coming?

We’ve heard in some of your communities that it’s the seniors’ area, and some people, it’s going back to work. I just wondered, generally, if there’s a particular area that you feel needs a focus.

L. Gadsby: These are really good questions. We know, for example, that the aboriginal population has more serious literacy requirements than the rest of the population and that immigrants and seniors also need more help. But our focus has always been on communities, specifically because the community knows its makeup. The community knows what it needs.

If we got extra funding, I think what we would try to do is to keep working with individual communities so that they can address the issues that they see. It varies from place to place, as you probably know. Really, each community is best positioned to think about: what have we already got and what do we need?

M. Morris: Good presentation. I’m interested in the comments about the northeast and northwest of B.C., and I’m wondering whether you are focusing your budgets and stuff to try and address those great needs that we have in northeast and northwest B.C.

I’m just also curious about the comment that Leona made about the poor state of government finances here in B.C. and exactly what you meant by that.

L. Gadsby: Yeah, poor state of government finances, both provincially and federally, just in terms of…. The return on investment isn’t great for anyone, including government. The cost of oil…. I think oil returns are less, so government is saying that it doesn’t have a lot of money. It has to cut back. That’s what we’re seeing federally and provincially.

S. Hamilton (Chair): Well, thank you. I appreciate you taking the time, Ms. Le Clair, Ms. Gadsby to present to committee. Enjoy the rest of your day.

Next, we have Mr. Gordon Li from the British Columbia Principals and Vice-Principals Association. Mr. Li, good morning.

S. Hamilton (Chair): You have ten minutes to present to the committee. I’ll try to give you a hand signal when you’re down to a couple of minutes, so you can conclude your thoughts, and then we’ll go to the committee for questions after that. If you’re ready, the floor is yours.

G. Li: Thank you so much, and I appreciate greatly the opportunity to speak to you on behalf of the 2,200 public school principals and vice-principals of this province.

The recommendations contained in our brief, some of which echo those you will hear from other partners, are related to the challenges our K-to-12 system faces rooted in finance and affecting services. They include funding increases that have been more than offset by costs transferred to school districts or other increases to operating costs not funded by government.

The B.C. Association of School Business Officials calculated the impact of unfunded demands created by inflation and other escalating costs to be nearly $200 million over the last two fiscal years. A particularly difficult challenge for districts is the requirement for administrative efficiencies in the amount of $29 million in 2015-16 and, in addition, $25 million in fiscal 2016-17. Over two years, the cumulative impact of these funding reductions is $83 million.

The 2015-16 K-to-12 budget increased by $101 million over the previous year, with $94 million of that increase targeted to costs related to collective agreements. This leaves $7 million, a little more than 2/10 of 1 percent, to maintain and improve service in the face of inflationary pressures and an ambitious change agenda for education.

These amounts may seem small in the overall funding for the K-to-12 public system. However, with more than 80 percent of the operating budgets of school districts tied to collective agreements, this amount presents a significant challenge for those who are charged with meeting the needs of the province’s 540,000 public school students and could represent a significant erosion of learning opportunities and student support in many communities.

I would like to focus my presentation on requests that address a significant system issue that we believe you may not hear from other educational stakeholders: the need to support and foster leadership in the K-to-12 system.

You are leaders in your community and in this province. You know firsthand the important role leaders play. This is particularly true in a learning community and in the context of the Ministry of Education’s learning transformation agenda. We have been through a period when much effort has gone into attaining labour calm and engaging our critical partners. It is time to invest in the leadership that will multiply the returns of that effort.

Principals and vice-principals are leaders in our schools, and there is ample research that indicates that school principals have a very big influence on student achievement. As school leaders, we are responsible for creating a cohesive team of educators and support staff dedicated to meeting provincial, district and school goals. We work in the space where policy meets the community and are critical to their success. We are the face of the public school system to parents, who entrust us with the care and development of those most precious to them.

In supporting and fostering leadership, compensation needs to recognize the increased demands of the role and serves to attract the most capable educators to assume leadership responsibilities. The exempt staff compensation freeze in place since 2012 and the compensation awards of the previous six years have created severe compression and, in many cases, inversion in the compensation of school principals and vice-principals.

Compensation levels are a significant deterrent to attracting experienced educators to leadership. We are observing a trend in this province of educators assuming leadership positions with significantly less experience in education than in the past.

Funding for districts needs to provide sufficient time to ensure that principals and vice-principals are able to attend to their administrative and educational duties. Fiscal pressures caused boards to reduce the number of administrators, reduce administration time and assign an increasing number of principals to multiple school sites.

It may come as a surprise to you to know that most of our members also assume teaching responsibilities. Vice-principals at elementary schools typically teach 80 to 100 percent of the time. The demands of this dual task, the absence of mentorship and a well-articulated leadership development program lead to a very difficult vice-principal experience and fail to prepare them for the principalship.

The position of vice-principal is also disappearing in many districts, and teachers are asked to become principals without the benefit of prior administrative experience.

Many districts lack the resources to engage in leadership development. There is a need for programs that build capacity in areas such as school law, leadership in a unionized environment, building strong relationships with parents and the larger school community, and most importantly, leadership skills to advance student learning in a changing world.

An example of such a program is the BCPVPA Supervision for Learning, a program that, over the last three years, has trained 450 principals and vice-principals to engage in learning-focused dialogue with teachers to improve student learning. BCPVPA is funding initiatives to promote aboriginal educators as leaders, which we see as an important priority if outcomes for aboriginal students are to continue to improve.

There is no shortage of research-based ideas, but there is a shortage of resources. Leadership development must be a priority, as it was from 2004 through 2011, when the provincial government provided $14.2 million over seven years to the B.C. Education Leadership Council.

I want to thank you for your time, and I would be happy to answer any questions you may have.

S. Chandra Herbert: One of the points which I found interesting that you raised was the question of com-
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pensation and leadership support for principals and vice-principals. Forgive me. I’m not aware of what the differential is in, I guess, salary for a principal versus a teacher, or something like that. Is it possible to get a bit of a range for that, some information on that — even nationally, how you compare across Canada as well?

G. Li: I think that information is published through BCPSEA’s publication, the three-R report on risks, rewards and reality.

But in terms of an answer to your question, we have scenarios in this province, currently, where we have vice-principals working in the system that earn less than the highest-paid teacher. I frame that as a systems issue, because as we work in our schools and our school systems and we identify leaders who would be ideal for leadership roles in our system, we ask them to take on more responsibility, to work a little bit more time, to leave the comforts of the collective agreement. We also ask them to take a pay cut. Those are big asks, in terms of people moving into this area of work.

That’s an inversion scenario. In terms of compression, we speak to leaders who are moving up the system, and they ask us the question: “Why do you want to get into this job?” Of course, we appeal to all the moral stewardship pieces that are clearly there. It’s a difficult ask in the context of the rest of their life. It’s a difficult ask in terms of families.

I believe that this is something that, over time, would chip away at the quality of one of the world’s top education jurisdictions. I think it is a piece that we are seeing indicators, in terms of the data we have access to in BCPVPA, that this is something we need to address fairly quickly.

C. Trevena: Just following up from that. I was wondering: are you seeing people moving backwards — that they have been vice-principals or principals and moving back into teaching? If so, do you have any numbers on this? I mean, I actually do know of a couple who have chosen to become teachers again, but I was just wondering if you have any provincewide stats on that.

G. Li: I don’t have a number for you right now, but we have supported a number of our members who have gone through that scenario. As you may well know, the context of education in B.C. is changing. We are looking at a transformation agenda that is asking of our leaders to acquire new skills and be lead learners in a system that is changing.

The requirements of that back onto some of the things that our members are feeling in terms of recognition of the role. It’s not about compensation, but recognition of the challenge of the leadership role. And it plays itself out in many ways.

We have a number of members who have come to the point where they ask, “For me, in the context of my family and my life, I need to take a step back,” which is a really sad scenario when I look at the children and where we hope to go and aspire to take them.

So in terms of number, currently it’s still relatively small, I believe. I know through our office over this past year we’ve dealt with a handful of those cases. But certainly that question is floating in the field.

C. Trevena: Quick follow-up. What about the support that is available to those principals…? I represent a rural riding, and I know that there are a number of principals who are responsible for two or three schools. In my riding, it’s usually two schools. What support is there for that? Now, you again, are seeing that add to the pressures for the principals. I’m talking principals here rather than vice-principals.

G. Li: I think it is a very difficult scenario. I can refer to a situation that I’m thinking of where one of our members had three schools, and the schools were over 200 kilometres apart. It is not possible, on any given one day, to be at those multiple sites. They schedule particular days where they are at one school or another.

So in terms of the support for the school and the community, it is not an ongoing piece, although the responsibility of that support still rests with that person. That is the biggest challenge for us. We have been working with our members in terms of how best to do that. One of our advocacy efforts is really with the district to look at ways to minimize those scenarios. It is absolutely a difficult challenge, and there are no good solutions to that scenario.

S. Hamilton (Chair): Mr. Li, thank you very much for taking the time to present to the committee, and enjoy the rest of your day.

Just with respect to our first presenter. YouthCo HIV and Hep C Society, Mike, you had something you wanted to put on the record in terms of a request?

M. Morris: I did, Chair. I was just wondering whether it’s possible for us to get some data on what the projected cost would be. I’m sure our Ministry of Health has looked at the HPV program and the costs of providing it to the young boys that we are and what the projected costs might be if we were to look at the entire population. I’d be interested in that.

S. Chandra Herbert: Just to clarify. I think what Mike means is if all boys would receive it or just the boys that they’ve selected, rather than all the population.

S. Hamilton (Chair): Thank you for that clarification. Committee will stand in recess until such time as we can contact our next presenter.

S. Hamilton (Chair): Our next presenter, via Skype, is the board of education, school district 38 — Mark De Mello and Dr. Eric Yung.

S. Hamilton (Chair): Good morning. I’m Scott Hamilton. I’ll let you know you have ten minutes for your presentation. I’ll try to give you a signal when there are a couple of minutes left so you can conclude your thoughts. Then we’ll go to the committee for questions. The floor is yours.

E. Yung: Thank you very much. Good morning, Mr. Hamilton and members of the select standing committee. Thank you for the opportunity to present on behalf of the Richmond school district. My name is Dr. Eric Yung. I am chair of the Richmond board of education. With me today is also Monica Pamer, our superintendent of schools, and Mark De Mello, the secretary-treasurer of our district.

As we have for the past five consecutive years, we are joined this morning by representatives from all of our stakeholder groups, because we collectively believe that in standing together for our public education, we reinforce the importance of our message to you.

With me this morning are fellow trustees Debbie Tablotney, the vice-chair of the board; Alice Wong; Sandra Nixon; and Ken Hamaguchi. As well this morning, we have Anne Chen, president of the Richmond District Parents Association; Al Klassen, president of the Richmond Teachers Association; Ross McLuskie, president of CUPE Local 716; Sean Herrington, president of the Richmond Association of School Administrators; and Wanda Plante, representing the Richmond Management and Professional Staff.

We’d like to start off by thanking the select standing committee for reflecting the input provided over the years by so many champions of public education, including ourselves. Your past recommendation that the public education system receive predictable, stable and adequate funding, as well as the recommendation to provide adequate capital funding to meet the needs of the education system, was consistent with what we asked for last year.

This year, we ask for the same: predictable, stable and adequate operating and capital funding. This is because our needs have not diminished in any way, and funding continues to be our biggest concern.

However, we’d like you to focus on additional areas that need attention. This year, we begin the implementation phase of the new B.C. curriculum, with its focus on core competencies and personalized learning. This is a positive change, but like any major change process, it needs to be properly resourced if it is to be successfully implemented. As a district, Richmond has already invested a significant amount of our own resources to begin the change process, but we ask that the provincial budget provide school districts with new and incremental funding for the implementation period of 2015 through 2018.

The new curriculum and the entire approach of personalized learning require rethinking of how school space is designed and utilized. Instead of traditional classrooms of students sitting in rows of desks focused on a teacher in the front of the classroom, modern classrooms need to be flexible, allowing for student collaboration and hands-on work. New supplementary learning spaces, such as breakout rooms that allow for small groups to collaborate; small, calm rooms for children with special needs who might need a place to self-regulate; and dedicated space for fine arts programs, such as music, are also essential.

School design standards also need to be updated to reflect the changing needs of our students, and districts need incremental funding to upgrade the existing facilities.

The need to improve access to computers and technology for student learning environments is vital. Opportunities for students to develop computer literacy require continued support from the Ministry of Education, as these skills not only prepare them for a society that increasingly demands these skills, but the process of learning provides the means for students to represent and express uniquely creative ideas as well as to deepen their thinking. Of course, all of these changes and additions will require staff training and support as our teachers and administrators lead our children into the new curriculums.

Our final request is for continued support of the seismic remediation program across the province but, in particular, in highly vulnerable areas such as Richmond. We ask, too, that when facilities are being seismically remediated, the scope of these projects be expanded to include infrastructure upgrades.

This is because it makes the most sense to take a holistic approach to capital projects by considering the seismic upgrades, capacity expansion and infrastructure replace-
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ments together. This will save costs in the long term because a single coordinated project will always be cheaper than undertaking several individual projects.

The Richmond board of education and all of our stakeholder groups are working together to maintain the B.C. public education system as one of the best in the world. We are proud of our students in Richmond and their consistently high levels of achievement. Predictable, stable and adequate operating and capital funding is essential for us to continue this level of achievement, so we thank you, once again, for this opportunity to advocate for them.

S. Hamilton (Chair): Okay, thank you very much. I appreciate that, Dr. Yung. I will go to the committee and see if there are any questions.

S. Chandra Herbert: I just wanted to say thank you for presenting a unified position of having all — whether it be parents, teachers, support staff, the school board — together in the same room making very clear arguments about the needs for adequate, stable, long-term investments, with good suggestions on where some of the money needs to go. It just really impresses me to see everybody working together this well. I wish we did the same provincially. Thank you very much.

C. James (Deputy Chair): I’ll echo those comments. It’s great to see the team coming together to be able to make a presentation.

I wondered if you could speak a little more about the seismic issue in your district and what it means to your district. I’m from Victoria, so it’s a very clear challenge in our area as well. I have heard a specific example regarding the upgrading and the seismic work — that the district really had to fight to be able to have approval of the boiler, for example, being replaced at the same time as the seismic upgrading, when everything is ripped apart, rather than a year later, when you’re going to go in and replace the boiler.

I wonder if you could speak a little bit more about the seismic issue and what it means in your district.

E. Yung: We have a significant number of schools that, of course, are older and need to be seismically remediated, especially in elementary schools in the northwestern corner of Richmond. As you also know, as a river delta area, Richmond suffers from a soil issue, so seismic remediation is excruciatingly crucial as we update our schools.

We advocate for the holistic approach because, as you mentioned, what we’re looking at is…. In many cases, we’re not only just looking to remediate the supports of the building, but we may need to expand the capacity. Of course, at the same time, it would make sense, once the walls are down, to do the upgrades that are necessary to bring the building up to code — to modern code, of course — as well as any additions that need to be made for modern computing systems, etc. — instead of doing this piecemeal, doing the seismic upgrades first and then going in with secondary projects to retrofit it.

We’re advocating for a holistic approach, and we do have a significant number of schools. Almost a third of our elementary schools are probably going to be looking at seismic upgrades in the near future.

C. Trevena: Like the other questioners, thank you very much for doing this unified presentation. It’s good to see.

We’ve had presentations from a number of different groups over the last few weeks, including a group called Parents for Public Education. I was wondering, in the Richmond school district, whether there has been any discussion on trying to quantify the amount that schools are having to turn to parents for, for fundraising, both in capital and operating. Is there any way that you have been able to say: “We’ve had to ask parents to provide X amount of dollars for school books or X amount of dollars for playground equipment”? Have you got any cross-district figures on that?

E. Yung: I don’t have anything but anecdotal evidence in most cases. The one that we probably have most information on is playgrounds. Almost all of the playgrounds in recent history have been entirely parent-funded. The school district, at this point, does not have the resources to put new playgrounds into our schools.

In terms of anecdotal evidence, I know that parents are saying increasingly that they are finding themselves sources of fundraising, as opposed to really participating in PACs. I’m sure that our Richmond District Parents Association president would agree with me on that, but we do not have any specific figures to quantify this.

Just to say, going back to the playground issue, at an average cost of between $60,000 and $80,000 per playground, this is a significant cost being borne by the parents in our district.

With respect to playgrounds, Mr. Yung, in my community of Delta, we have a program that pairs…. We look at playgrounds as being a community asset, as opposed to an asset that’s just specifically used by the school. There’s a great partnership between the local municipality and the school district to help with the costs of playgrounds. I’d highly recommend possibly pursuing that option on behalf of your PAC. I know they work very, very hard in their fundraising efforts to build facilities like that.

E. Yung: We already have an existing, very healthy relationship with the city of Richmond. Many of our schools are actually on joint sites with the city of Richmond,
[ Page 1796 ]
where the green space is shared as part of a park amenity. In those cases, a lot of the play space…. In several instances, the playgrounds are, in part, funded by the city of Richmond. So we are exploring those opportunities.

S. Hamilton (Chair): My final question speaks to what Carole had brought up regarding the seismic remediation. Do you know, off the top of your head, how many schools you have that you would consider at risk and that have been assessed? Of course, there are different categories of assessment — immediate need or something that you could put off for a little while longer.

E. Yung: Based on the government’s own assessment of the H1, H2 scale, we have 25 projects, of which 17 are in the H1 category.

Seeing no further questions, I’d like to take the time and the opportunity to thank you for presenting to the committee. I appreciate all the effort that you put in on behalf of your school district. So thank you very much, and enjoy the rest of your day.

E. Yung: Thank you very much for the ability to present this morning. We look forward to your recommendations.

S. Hamilton (Chair): Next, via teleconference, we have the Rick Hansen Institute. With us today are Penny Clarke-Richardson and Bill Barrable.

B. Barrable: Good morning. I’m CEO of the Rick Hansen Institute. We’re also joined by Pamela Berg, who is our director of policy and resource development. Penny is our director of strategic implementation and is playing a leadership role in development of a provincial network for B.C.

I just want to check: does everybody have a copy of the slides that were sent on Friday?

S. Hamilton (Chair): I’ll start by letting you know you have ten minutes for your presentation. I’ll try to get your attention with about two minutes left so you can conclude your thoughts, and then we’ll go to the committee with questions.

Thank you very much for allowing us to present to you today. The purpose of our presentation is to give you an insight into some of the plans that we have and the opportunity that exists to improve health among people with spinal cord injuries and also reduce costs for the province. It’s a prelude to an ask that we will be preparing and will be making to the provincial government later in the fall. We’ll try and keep our comments succinct.

On the first slide — assuming everyone has a chance to have this available; I won’t read the slides — it gives you an insight into the financial impact that spinal cord injury has for individuals in the province and, rolled up, what it means for the province as well. Spinal cord injury doesn’t affect as many people as cancer and multiple sclerosis, for example, but the individual financial impact is huge, and the human impact is quite obvious, both for the individuals and their families.

Insofar as the health care system is concerned, on slide 3, you’ll see the annual costs of SCI in B.C. — $350 million overall. Secondary complications, like pressure sores, urinary tract infections and neuropathic pain are substantially more expensive than would otherwise seem to be obvious. People see paralysis. They don’t necessarily see the secondary complications when they see someone in a wheelchair, but it has a profound effect on them as individuals and also for the province in general, in terms of the utilization of the health care system.

For example, the average cost of a readmission to hospital for someone with an SCI is around $20,000, and this can stretch into several hundreds of thousands of dollars, depending on the severity of, let’s say, a pressure sore. A pressure sore is the number one most costly, preventable medical error in our health care system, and it also can be quite lethal. Christopher Reeve, you may recall, was the actor who played Superman. He was injured in a horseback riding accident, got a pressure sore and died from complications as a result of that. It’s a hugely significant secondary complication.

Moving onto page 4, our mission — again, I won’t read that. Our role is to take responsibility for this problem that besets people, who are an identifiable group with predictable needs. It’s like a chronic-disease model that we’ve established with the institute. Our purpose and our mission is to bring groups together, both in Canada and internationally. We have 32 sites across the country, and we have sites in international locales, such as China, Australia, New Zealand and Israel, which contribute patients in a registry so that clinical trials can be done more expeditiously and we can accelerate to a cure.

One example of a project that we’re sponsoring. On the fifth slide is some health self-management. It’s a technology that’s being developed here in British Columbia that will allow for the minimally invasive prediction of bladder infections — which, once identified as a high risk, can be dealt with before someone has to return to hospi-
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tal. It’s a great example of reducing the health care costs, keeping someone healthy.

You can see a little photograph of this scanner — on someone’s abdomen, in the photograph there. This is something that we’ve got outside funding for, in addition to work that we’ve done as an institute. It’s facilitating the project and has great potential as a digital health initiative.

On slide 6, we’ve identified the prelude to developing a provincial network to reduce the variation in the care that’s provided at the pre-hospital level, in the acute care setting, in rehab hospital and, as well, ultimately back into the community. It’s to reduce the variation in care, improve the health, reduce the cost and lead to better outcomes.

This is one of the initiatives that Penny Clarke-Richardson is leading on our behalf. Maybe what I’ll do is quickly turn it over to Penny to say a few words about that and what we are expecting to achieve.

P. Clarke-Richardson: On slide 7, on the top of the page, we see our initial group of stakeholders with whom we’ve consulted over the past six months — approximately 70 representatives. Missing here are the consumers. We call them consumers — that is, patients, their families and caregivers. Approximately a third of our consultations have been with that population.

Recognizing that while we have pockets of excellence, as we move to look after this complex and chronic long-term condition…. Just to be clear, so that we’re all clear, no one gets better from a spinal cord injury at this point. The work in basic science, clinical trials, human sciences continues, and at the moment, it is a long-term condition. There are pockets of excellence throughout the province. We have excellent care in pre-hospital, emergency critical care and acute, and excellence in rehabilitation. Then the person is discharged back into the community.

What is missing is integration across that continuum of patient care. One common theme throughout all our consultation is that whatever we do, we must achieve, measure and report on the impact on the patients’ lives. That comment was repeated from patients, from clinicians, from researchers, from educators.

As you can see, our initial leadership group leading this initiative is listed at the top, with the Centre for Brain Health, recognizing the similarities between brain trauma, brain fluid and spinal trauma; the ICORD research centre, a centre of research from UBC, the International Collaboration on Repair Discoveries; the Rick Hansen Foundation; the Rick Hansen Institute; Coastal Health; Coastal Health Research; G.F. Strong and the UBC faculty of medicine.

On the bottom half of slide 7 are the major stakeholders that we need to bring together — including all of the health authorities, all of the academic institutions, Doctors of B.C., WorkSafe B.C., ICBC — in an integrated network to realize the investment that we make in the acute care setting. A lot of money is spent on these patients, getting them to the right centre in B.C., treating them in the acute and critical care settings through rehab, and then their care gets lost due to a lack of integration throughout the rest of their lives.

Our goals are listed on pages 8 and 9. The goals of an integrated spinal-cord-injury network: focusing on the patient; recognizing spinal cord injury as a chronic, complex condition; looking after the transitions of care. Patients feel they’re dropped, that they’re a baton in a relay. Geographical integration. Expert care for non-traumatic…. This is the area of increased injuries, so this your tumours, cancer. We also need to decrease the 17-year gap that it currently takes to get clinical research findings into care.

On slide 10, measurable outcomes: improved health outcomes, reduced health care costs, getting the most return on investment for the costly acute care, bringing that citizen back to realize their full potential — this is not only the Ministry of Health; this is the Ministries of Social Development, of Citizens’ Services, of Education and training — and overall, improving the patient experience to return them to their full potential.

B. Barrable: Maybe with that, we’ll turn it over to questions. Happy to respond.

M. Morris: I think that’s a great idea, a great presentation. I’m just wondering what progress or what steps you’ve made with respect to your strategy of the integrated system.

B. Barrable: I’ll turn that over to Penny to respond. We’ve done much preparatory work. We’ve built a national network of specialized sites, which is kind of horizontal if you look at it spatially. What we want to build is a vertical network within the province to link all of the centres. Penny, maybe I could turn it to you to help describe an answer to that.

P. Clarke-Richardson: We’ve done a literature review. We’ve done an environmental scan of best practices. We have done stakeholder consultation.

We are in the process of defining the patient population, a critical step. Everyone knows what a spinal cord injury is. You could ask ten people, ten clinicians in the room: do we include pediatric and adult, or don’t we? Are we traumatic and non-traumatic? Certainly in critical care and in the pre-hospital setting with the Ambulance Service and emergency departments in the province, we
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need to define, in a robust, clinical way, the population we’re talking about.

We’ve identified the players, the stakeholders, the people we need to bring together. All of the people with whom we have consulted have expressed a willingness. All the pieces are in place, and no one can quite believe that it’s not handled in an integrated fashion, as the way that cancer or renal or transplant or any of the other chronic conditions are handled.

B. Barrable: I should also mention that we have built an information system platform — we call it the global research platform — which links the specialized centres in Canada with the ones in other countries. This is something that would serve as an infrastructure platform for the B.C. network.

So there’s been quite a bit of investment in this area that’s already in use, and it’s also used by some other disease entities for research purposes outside of SCI, because it’s a platform that can be used in different contexts. We’ve got that ready and waiting to be animated across the province.

P. Clarke-Richardson: That’s a wonderful link between the data that exists in the province in the Pop database and the research data that’s been developed over the past eight to ten years.

C. James (Deputy Chair): Thank you for your presentation, and thank you for your work. I think you’re quite right. I think most of us would expect that this was routine, something that already happened in the system, particularly for people who have gone through this kind of experience.

You’ve mentioned the sharing and the need for the coordination between the medical system, but you also talked a little bit about patient care. I think if you look at the cancer experience, for many patients who’ve gone through the cancer experience, one of the great strengths is the maps that they have to be able to navigate the system and for them to feel some control in being able to navigate the system.

I just wondered what kinds of areas you’re looking at in the patient care end for patients to feel that they have some ownership around the experiences that they’re going through.

P. Clarke-Richardson: Our focus is on the patient. The reason is because this all started with the patients telling us their stories. Every individual sees their silo and is giving excellent care. When we hear from the patients and we put it all together, that’s when we notice that the transitions and the lack of coordination are there.

We have a very dedicated and enthusiastic consumer engagement committee here at the institute. They’re involve in our research and our operational planning as we move ahead. We’re working with the academic health sciences network group and the B.C. SPOR Support Unit in building their patient engagement strategy and looking at other models — for example, the patient navigators for both cancer and the renal community, the transition from renal to transplant and back out into the renal community.

An excellent example is the work that was completed last year by the National Health Service and implemented this May. They have mapped out the entire patient journey, taking into account not only the patient’s physical and clinical needs but also the well-being and the messaging that needs to go to the patients and their caregivers.

We are developing a consumer resource, in conjunction with the Rick Hansen Foundation and Spinal Cord Injury B.C., to make sure that along every step of the way, the patients and their family have access to the information they need when they need it.

Just to let you know, we’re not inventing this information. There are excellent models across the country and around the world. Our role is collaboration, knowledge exchange and integrating that on behalf of British Columbians.

S. Hamilton (Chair): With that, our 15 minutes are up. I’d like to take the opportunity to thank you for taking the time to present to the committee. All the best for the future. Thank you again for the work that you do.

Finally, we have Dr. Mark Fromberg and Mike McLoughlin of Walk-In Clinics of British Columbia.

Good morning, gentlemen. We saved the best for last, I hope. Anyhow, you have ten minutes for your presentation. I’ll try to get your attention with a couple of minutes left so you can conclude your thoughts, and then we’ll go to the committee for questions. The floor is yours.

M. McLoughlin: We’re just handing out a report. I think we’re the last presentation of the day. Is that right?

My name is Mike McLoughlin. I’m the founding director of Walk-In Clinics of B.C. Association. With me today is Dr. Mark Fromberg. He is a principal with the Mission Medical Centre, a walk-in clinic in Kelowna. In a moment, Mark will speak to a few proposals we have developed for your consideration.

My wife, Sue, and I are the principals of Medi-Kel Family Practice and Walk-In Clinic, which is also based in Kelowna. Sue is a recently retired family doctor. She first began practising medicine in Kelowna in 1988. My background is in business. I hold a bachelor of science
[ Page 1799 ]
degree from the University of California and an MBA from UBC.

Owning and operating a walk-in clinic is challenging at the best of times, but these days, the challenges seem to be growing in number and complexity. At the same time, and perhaps even more importantly, I believe there are many new opportunities to improve and enhance the health care provided to British Columbians. Our purpose in joining together to found Walk-In Clinics of B.C. is to enter into a dialogue with policy-makers and others on how walk-in clinics may be one of the solutions to the challenges currently facing health care delivery in British Columbia.

I say this with all sincerity. Our aim as an association is to be problem-solvers, not problem-makers. Today, I’m pleased to provide to you a copy of our first report, entitled A Very Valuable Service. The title comes from remarks made by the Minister of Health, the Hon. Terry Lake, during the budget estimates debate in May. Twice he described walk-in clinics as providing a very valuable service. We agree. More importantly, so do many British Columbians.

As you will note from the chart on page 2 of our report, three of every five B.C. residents who do not have a regular medical doctor go to a walk-in health clinic when they are in need of medical attention. I’m sure we’ve all had that experience.

I would like, quickly, to go through our report. The first several pages highlight the significant expenditures made by British Columbians through our provincial government on health. I know that all of you, as members of the Finance and Government Services Committee, are aware that health spending next year will total $19.5 billion.

It is interesting to note, however, as we go to page 4, that despite rising every year, health spending as a proportion of our gross domestic product has remained constant. Back in 2001, according to the Ministry of Finance document Financial and Economic Review, Health’s expenditures represented 7.6 percent of B.C.’s GDP. Next year, according to this year’s budget, Health again is forecast to be 7.6 percent of GDP. Obviously, health costs are not soaring out of control, but given their size and importance, they do have to be managed carefully.

On page 6, you will note in the top chart that the number of physicians working in B.C. is increasing every year. Over the last decade, the number of doctors registered with the Medical Services Plan has grown from almost 8,300 to 10,200. That’s an extra 1,800 MSP physicians working in our province today compared to ten years ago.

However, the second chart on the same page shows that there has been a significant decrease over the last decade in the number of days worked by the average physician. Last year, B.C. physicians worked 11 fewer days on average than they did compared to ten years ago.

To again quote Minister Lake: “Today lifestyles are different. It is important to have that work-life balance.” I know that has been for my wife, who has raised a family while being a GP.

So a conundrum for policy-makers such as yourselves. B.C. today has more doctors than ever before, but on average they are working fewer days than previously.

On the next page is another conundrum for you to ponder. Both charts basically tell the same story. An increasing proportion of all MSP services are being provided by specialists. At the same time, a smaller proportion are being performed by general practitioners. I am sure everyone understands that medical services performed by specialists are more costly than those provided by GPs.

On page 8, we briefly look at the growing number of British Columbians without the services of their own physician. According to Stats Canada, which publishes an annual report called the Canadian community health survey, in 2014 an estimated 731,000 British Columbians aged 12 years and older did not have a regular medical doctor. I again refer you to an earlier section of our report which stated that 60 percent of people in B.C. who do not have a regular doctor use a walk-in clinic for their health needs.

On page 9, we examine the MSP cap on services that may be provided by a physician on a calendar day. In actual practice this cap on the number of patients that may receive treatment is incongruent given the very large number of British Columbians who do not have their own regular medical doctor. In practice, when an individual without their own physician seeks treatment at a walk-in clinic, they might be turned away because a doctor has reached his daily limit. Again, as mentioned earlier, the average physician in B.C. is working fewer and fewer days each year.

On page 10 of our report, we look not just at B.C.’s aging population but our aging physicians. Almost 2,200 of the province’s doctors are 65 years and older. That represents a phenomenal 19 percent of the physicians today working in B.C. Think about it. One in every five doctors is a senior citizen. It helps to explain why B.C. physicians are working fewer days than before and why greater flexibility is needed in how health care is delivered in our province.

Finally, we have a section on nurse practitioners. The tables on page 11 are from a remarkable report by two University of Victoria researchers. They found that the number of emergency room visits as well as the number of hospital admissions plummeted after the introduction of nurse practitioners in three B.C. communities. Put another way, the introduction of nurse practitioners resulted in a dramatic reduction in health expenditures by reducing both hospital admissions and emergency room visits.

We conclude our report with some modest recommendations for the Finance Committee to consider.

M. Fromberg: Thank you, first of all, for allowing us to speak here today.
[ Page 1800 ]

Just as a way of background, I’ve been in medicine for 30 years, all of it in primary care. For most of it I’ve also had the opportunity to do a wide range of family medicine, including walk-in clinic work. I’ve worked in four different provinces.

A couple of things that I wanted to share with you are my concerns about the current concerns with GP for Me. In the last five years, as you know, that process hasn’t gone well. I’ve been actively involved in that discussion in our community, and to some extent it’s one of the reasons I’m here as well.

As you know, walk-in clinics have been around for many years. They had been initially despised because they seemed to undermine family medicine. Today it’s just the opposite. They’ve become integral to health delivery. I think there are an estimated ten million people visits per year in British Columbia going to a walk-in clinic. That is not insignificant in terms of numbers.

Back then in the early 1990s, there was a cap set to try to protect, if you will, family medicine. That need has long gone. In my view, putting a cap on services completely undermines the family practice ability and the walk-in clinic ability to service the needs of increasing numbers of people who don’t have a doctor and, frankly, even those who do.

The second thing I wanted to bring up is the reality that physicians have very limited ability to delegate duties in a setting of their own family practice. The B.C. doctors association has long discussed the idea of a physician assistant — namely, nurse practitioners, as Mike mentioned.

We’re hoping to see that the delegable duties that are currently extremely limited in the fee schedule are widened to allow a GP to have, as his or her right-hand man or woman, a nurse practitioner who could do the work that she or he could do, without actually being supervised directly but indirectly. That would widen the scope of every family doctor as well as walk-in clinic, and the number of services could increase dramatically without actually increasing the number of doctors in the province.

Those two simple changes are actually strokes of a pen. One is to eliminate the cap. A GP could now see 75 people in a day, of which 30, say, could be done by a nurse practitioner if that was available. So two simple policy changes could strongly change how the GP for Me initiative could be affected.

In the meantime, of course, walk-in clinics continue to be a bridge between an emergency department and a family practice. As I mentioned, the numbers are staggering. In our clinics every day we have ten or 15 people at the door before we even start the day. This is not a problem going away. And then, as well.

S. Hamilton (Chair): I’ll let you continue. Your ten minutes are up. It’ll just cut into question period time.

Anyway, let me just finish off by saying that we encourage nurse practitioners. There are only 131 registered in this province. Ontario has thousands of them. Other jurisdictions have widened the net with various forms of physician assistants.

I appreciate, first of all, the recommendation with respect to nurse practitioners. I think that’s an important and useful one. I know there are a variety of walk-in clinics. Some of them are mixed walk-in and family practice. Some are pure walk-in. Some are community clinics with established physician-patient relationships.

I also appreciate that you didn’t simply call for the removal of the cap. You asked for a more flexible one. I’m wondering if you have ideas specifically on that, either now or in the future, that you might add. I think we’d all agree that at some point there has to be both a daily and a weekly cap. But if you disagree with that.

M. McLoughlin: That’s a great question. You can see that, with lifestyle and so on, doctors are working less. They want to have a work-life balance. Rather than capping the daily number, I think a flexibility in terms of capping it on, say, a weekly basis so that doctors could work two to three days — work hard and work some long hours — and then they would have those days off for their families. That’s the kind of flexibility we were thinking.

There are other ways in which you can implement a cap of sorts, but I think it’s just giving the doctors that flexibility. Most other specialists have that kind of capacity.

G. Heyman: I also wondered if you saw alternative payment methods as part of the solution.

M. McLoughlin: Well, certainly in a number of rural communities, alternative payment methods are important. I know that’s one of the things they’re considering in Fort St. John, where they have a walk-in clinic and they’re looking at having the health authorities take on that.

S. Gibson: A couple of brief questions that relate to this cap. If the cap was changed to what you would like to see, what would be the financial implications for that provincewide — approximately? There must be some dimension to that that will affect government finances in the Ministry of Health.

M. McLoughlin: There probably will be a financial consequence for that. But I think, too, that having a GP look after patients will avoid them going to an emergency room. An emergency room visit costs $500. Going to your GP costs $35. That’s basically the contrast between emergency room and walk-in.
[ Page 1801 ]

In your principles of walk-in clinics, you say: “To advocate for the interests of business people.” What is the business dimension? How are you compensated? I don’t quite understand that paradigm.

M. McLoughlin: Doctors are self-employed. A certain set of doctors band together to have a walk-in clinic. They’re all partners in that walk-in clinic. In my situation, my wife and I co-own Medi-Kel Family Practice and Walk-In Clinic. I have invested a lot of sweat equity in getting that clinic off the ground and making it a good business so that we can provide services.

There are a lot of other business owners in the community or in British Columbia that have an interest in walk-in clinics. We want to represent them as well as represent walk-in doctors.

S. Gibson: A supplementary, then. So the doctors pay you a commission of some kind. Is that how…? I don’t understand.

M. McLoughlin: No. We’re just basically shareholders in the company, and we benefit from the profitability of the business.

C. Trevena: You touched on it when George asked the question about the alternative payments as a solution to some of this. As I understand it, nurse practitioners are salaried and the doctors are on fee-for-service. I think nurse practitioners do a great job, and it does expand the opportunity. You’d be bringing in more salaried nurse practitioners across the province to work with the doctors.

I’m wondering how that would work. You’re raising the cap for the doctors to see more people, putting some to the nurse practitioners to see, and really, how to get that balance…. Cost-effectively, it could be that the nurse practitioners see more of them because they’re getting a salary, and that would be the most cost-effective way of doing it.

M. Fromberg: My sense of vision of this is simply that if a doctor’s office could see more than 50 people…. They say that a nurse practitioner can do roughly 80 percent of what a family doctor can do in terms of skills, so arguably, there are many, many patients that a nurse practitioner can see.

If a clinic could now see 75 patients, and the nurse practitioner saw, say, 30 of the easier ones, if I can put it that way, then if the delegable duties allowed for the full billing of that service under the GP’s billing number, the GP would be in a position to now pay that nurse practitioner to the tune of whatever is the current rate — 50 bucks an hour, or whatever it is.

S. Hamilton (Chair): Thank you, gentlemen, very much for taking the time to present to the committee. Enjoy the rest of your day. Appreciate it.

Committee stands adjourned until four o’clock tomorrow, when we’ll meet again.

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4) Clean Energy Canada	Jeremy Moorehouse
5) Prospera Credit Union	Angela Kaiser

Chair:	Wm. Scott Hamilton (Delta North BC Liberal)
Deputy Chair:	Carole James (Victoria–Beacon Hill NDP)
Members:	Dan Ashton (Penticton BC Liberal)
	Spencer Chandra Herbert (Vancouver–West End NDP)
	Eric Foster (Vernon-Monashee BC Liberal)
	Simon Gibson (Abbotsford-Mission BC Liberal)
	George Heyman (Vancouver-Fairview NDP)
	Mike Morris (Prince George–Mackenzie BC Liberal)
	Claire Trevena (North Island NDP)
	John Yap (Richmond-Steveston BC Liberal)
Clerk:	Susan Sourial

2) Coalition of Child Care Advocates of BC	Sharon Gregson
3) ViaSport British Columbia	Sheila Bouman

7) Decoda Literacy Solutions	Brenda Le Clair
	Leona Gadsby
8) British Columbia Principals’ and Vice-Principals’ Association	Gordon Li

9) Board of Education, School District No. 38 (Richmond)	Mark De Mello
	Dr. Eric Yung
	Monica Pamer
10) Rick Hansen Institute	Penny Clarke-Richardson
	Bill Barrable
	Pamela Berg
11) Walk-in Clinics of B.C.	Dr. Mark Fromberg
	Mike McLoughlin

REPORT OF PROCEEDINGS (Hansard)

SELECT STANDING COMMITTEE ON FINANCE AND GOVERNMENT SERVICES

REPORT OF PROCEEDINGS
(Hansard)

SELECT STANDING COMMITTEE ON
FINANCE AND GOVERNMENT SERVICES