Official Report of

DEBATES OF THE LEGISLATIVE ASSEMBLY

(Hansard)

FRIDAY, JULY 3, 1992

Volume 5, No. 14

[ Page 3435 ]

The House met at 10:05 a.m.

Prayers.

B. Jones: Hon. Speaker, it's with some reluctance that I introduce an old friend and former colleague. I'm reluctant because I think he, while being a very wonderful gentleman and a vice-principal in the Coquitlam school district, is very, very misguided politically. I think he was one of the three or four campaign workers for the member for Delta South. And to show how misguided he is, he's beginning his summer holidays by coming here and viewing the proceedings. Would the House please welcome Doug Ebbett.

F. Jackson: In the gallery today is a young woman who is a very good friend of mine and is visiting from Kamloops, Miss Debbie MacAulay. She just finished a Bachelor of Business Administration at the University College of the Cariboo. Please make her welcome.

Oral Questions

BUDGET DEFICIT

F. Gingell: My question this morning is for the Minister of Finance. Given that the minister has acknowledged that his expense projections are now off the scale and his budget deficit is mounting, will he now agree that it is time to call in Peat Marwick Thorne for another independent review to determine if the taxpayers are getting value for this outpouring of money?

Hon. G. Clark: It's ironic, because every single day in this House that opposition has asked for spending more money on every single matter of government expenditure. In particular, they've asked us to spend more money on doctors, and on top of that they have opposed every single tax put in by this administration. They have no ground to stand on when it comes to trying to deal with this question. Everybody knows that if we followed their advice, we'd be significantly overbudget.

F. Gingell: Recognizing that this year's expenditure plan is $17.980 billion, and last year's revised forecast was $17.169 billion, which is a difference of $811 million, and that there is a car that sits outside between the Premier's office and the Minister of Finance's office that has a licence number that reads "TAX 811," would the minister please talk to the Attorney General and arrange for the owner of that car to get a licence plate that reads "TAX 000"

Hon. G. Clark: I know that it's the last day, but those are frivolous questions on a very serious topic. This opposition has not put forward one constructive suggestion this session on cutting spending or on dealing with revenues. We have heard spend, spend, spend with respect to every area of government, in particular when it comes to doctors.

Interjections.

The Speaker: Order, please. Would the minister conclude his reply.

Hon. G. Clark: Every day of this session they have stood up and asked for millions and millions of dollars, and then they have the gall to come in here today and ask some frivolous questions dealing with a very tough fiscal situation that we inherited from the previous administration.

HOSPITAL EMPLOYEES'
UNION SETTLEMENT

L. Fox: Obviously the Finance minister wants to use this last day in order to gain some more exposure, so I will give him that opportunity. It has been reported that the government is already tens of millions of dollars over budget, partially because of the higher costs incurred as a result of the HEU settlement. Can the minister advise this House how much the HEU settlement was expected to cost the treasury and what the actual cost has been to date?

Hon. G. Clark: I will try to deal with that question seriously. I don't know the precise answers. Because it's an arm's-length relationship where we provide a block amount of funding to hospitals, mixed in with that is the wage question. As you know, we increased funding to hospitals by 5.5 percent -- the highest increase in the country. Within that budgeted increase we expect the hospitals to manage, and we expect the hospital labour relations association to negotiate a collective agreement.

All members on that side of the House have been asking us not to close hospital beds but to spend more money on hospitals, to make sure that they are fully funded and to ask for more money for the health care sector. It's obvious that when you provide a block amount to hospitals, they manage within that fund. We anticipate them doing that, but it's clear from their projections that the settlement they ultimately arrived at was slightly more than they had budgeted. That simply results in increased strain on the health care system.

L. Fox: For the record, I should suggest that the minister is incorrect. This particular Social Credit caucus has not once asked for more money to be spent. We've asked for a shift in priorities.

A supplementary. The compensation fairness commission's annual report devotes an inordinate amount of space to the numbers of employees earning in excess of $79,000 a year in our schools, colleges, municipalities and universities. However, the report fails to record the cost of reversing the commission's earlier rulings to hold the public sector wages to an average increase of the private sector. Can the minister tell us how much extra the decision to award a retroactive 7 to 9 percent 

[ Page 3436 ]

wage hike will cost the taxpayer in the last fiscal year, and what the extra bill will be this year?

Hon. G. Clark: The answer is zero. It costs nothing, because in the negotiated settlements between the teachers and the school boards there was no funding from this administration for that, in spite of the fact that the Liberal opposition has demanded more and more money for education. In spite of that, there has been no funding, because we believe in local autonomy and local accountability. We give a budget, the school boards negotiate the wage with their employees, and they're accountable to people and voters in their constituency. We intend to make that system work.

L. Fox: Final supplemental. Once again the minister has, I believe, attempted to mislead me in the House. In fact, they allowed school districts....

The Speaker: Honourable member, would you like to withdraw those words and rephrase your comment?

Interjections.

The Speaker: Order, please. I'm sure the hon. member did not intend to imply that the minister had deliberately.... Would the House come to order, please.

[10:15]

L. Fox: Hon. Speaker, obviously, if it offends the House, I will withdraw that statement. However, I should point out to the House that school boards were allowed to go for the first time into deficit financing in order to allow for those wage impacts. Given the state of the provincial finances and the massive burden this government has already foisted upon the taxpayers, why won't the government take as tough and clear a stand with all public sector employees as it's doing with the doctors? Why doesn't the Minister of Finance say right now that the taxpayers can't afford to pay one cent more for public sector wage increases than the rate of inflation? Why should the taxpayers in the private sector have to bite the bullet on their own wages, only to see their take-home pay being gobbled up for public sector wage increases?

Hon. G. Clark: As long as we're in power, public sector employees will not be the sole source of dealing with fiscal problems of any administration. Every time there was a fiscal problem, the previous government dealt with it by hammering their public sector employees. That is not a fair approach. We have been fair. I'll tell you, if we dealt with our public sector employees the same way we're dealing with the doctors, which is 4.7 percent in this fiscal year, we'd have serious problems. We have not been tough on doctors. We have been generous with doctors. It's only the members opposite who want us to be even more generous to doctors.

NANAIMO COMMONWEALTH
HOLDING SOCIETY

W. Hurd: This being one of the final question periods of the session, I'd like to thank the government for the forthright manner in which they've answered our questions in the past.

I have a series of questions which reflect the appreciation of the opposition. My first question is to the Minister of Economic Development, Small Business and Trade. It's about investment opportunities in the province. Can the minister advise me: if I invest my constituency allowance in the Nanaimo Commonwealth Holding Society instead of the Working Opportunity Fund, will I get a better return on my investment?

The Speaker: Order! Does the hon. member have another question? I recognize the hon. minister to address the part of the question that comes within his jurisdiction.

Hon. D. Zirnhelt: The part that comes within my jurisdiction is advising him to see a professional investment counsellor.

W. Hurd: I have a supplemental question for the Attorney General. Can the Attorney General assure this hon. member that if I drop into Nanaimo for a bingo game this summer, I will not be making a contribution to the New Democratic Party?

Interjections.

COMPENSATION FAIRNESS REVIEW

C. Serwa: My question is to the Minister of Finance. Yesterday the Minister of Finance tabled the final report of the compensation stabilization program. The outgoing commissioner was quite critical of a number of practices that were involved with school boards, municipalities and Crown corporations. Has the minister decided to review that report and take some appropriate action to protect taxpayers?

Hon. G. Clark: That's a good question. We are reviewing those questions under the Korbin commission right now. In addition, I'm hopeful that disclosure of that kind of information will provide pressure on elected school boards to review their practices, particularly in light of the fiscal situation. I would hope and expect that the public, upon reading some of the situations that exist, would apply appropriate pressure to those elected school boards who are responsible in their jurisdictions.

C. Serwa: I have a supplementary question. One area that he wrote quite extensively about was the apparent conflict of interest not only with the elected officials in many cases but actually with the wage settlement procedures involving senior administrators. Will the minister undertake a responsibility to assure 

[ Page 3437 ]

this Legislature that he will endeavour to attend to those conflicts of interest?

Hon. G. Clark: As I said, we are reviewing that practice. The notion the commissioner suggested was that superintendents who negotiate with their employees then go to the boards and ask for similar or higher money for themselves and for their management personnel.

Again, there are several reviews underway. First, there is the Korbin commission looking generally at this question among others. There's also a review taking place right now with the B.C. School Trustees' Association, the Ministry of Education, the BCTF and other stakeholders. They are reviewing these practices because we have expressed concern about them. The information contained in the report of the commissioner heightens that concern. We believe in working with those stakeholders as best we can to try to deal with this situation, but obviously it's a concern -- the concern addressed by the commissioner -- and I share that concern.

POLYGAMY

D. Jarvis: My question is to the Minister of Women's Equality. It's been three weeks now, Madam Minister, since the Attorney General passed the Human Rights Amendment Act and stated at that time: "Any initiative against polygamy is unconstitutional." Has the minister taken any steps in her ministry to make polyandry acceptable as a family form?

Hon. C. Gabelmann: Hon. Speaker, I think it's appropriate for me to deal with the question, given the clear misunderstanding on the part of the member and, in fact, on the part of many members of the public.

Members need to know that while the view is that section 293 of the Criminal Code respecting polygamy may not be able to withstand either a Charter challenge or a court challenge, section 290 of the Criminal Code still remains in place, and that's the bigamy section. Bigamy makes it illegal -- and it still is illegal in this country -- for one or more marriages to exist at the same time. The member should understand that the bigamy section is not at risk whatsoever as a result of the decision not to prosecute under the polygamy section. Therefore multiple marriages are not legal in this country, despite much press comment to the contrary.

D. Mitchell: Hon. Speaker, I'd like to ask for leave to move a motion of substitution on one of our select standing committees.

Leave granted.

D. Mitchell: Hon. Speaker, by leave, I move that the names of Ms. Tyabji and Mr. Hurd be substituted for those of Mr. Wilson and Mr. Mitchell on the Select Standing Committee on Aboriginal Affairs.

Motion approved.

Hon. A. Charbonneau tabled a report from B.C. Railway under the Financial Information Act. Motion without Notice

CONFLICT-OF-INTEREST COMMISSIONER

Hon. C. Gabelmann: With leave, I would like to move a motion, which I'll read because it's not on the order paper.

Leave granted.

Hon. C. Gabelmann: The motion would read that pursuant to section 15.1 of the Members' Conflict of Interest Act, the Legislative Assembly requests the following of Mr. Ted Hughes: 1. To review all constituency allowances received by current members of the House from the time of their first election until the present, to include (a) dates and amounts received since first being elected; (b) the source to whom each payment was made by government; (c) a statement of disbursements showing when and to whom all moneys were disbursed and the nature of the goods, services or premises for which each payment was made; (d) a statement of investment income earned on constituency allowance funds and the disposition of it; (e) the status and location of any unexpended allowances. 2. To develop a statement of purpose of constituency allowances embodying permissible spending criteria, and to opine on the adequacy of the current level of these allowances to allow for a reasonable fulfilment of the requirement of that statement of purpose. 3. To determine appropriate methods of claiming from and payment by government. 4. To determine a method for accountability for all allowances received, including when and to whom and in what form accountability shall occur. 5. To determine ownership and disposition of investment income earned on allowances following receipt from government by the payee. 6. To decide on disposition of allowances not spent pursuant to criteria at year-end.

Hon. Speaker, if I may I'll make a couple of very brief comments. Members know this has been an issue of some concern, certainly recently, with several events of this year. Members should know that following the sentencing in the Jack Kempf trial, I wrote to the hon. Speaker expressing my concern about the inadequacy of guidelines in and around the question of constituency allowances and their use by members. Following that, there were other issues raised, as members know, concerning the procedures by which constituency expenditures were potentially being dealt with by members. The Premier, following that, indicated that he would like Mr. Ted Hughes to review the entire question. We on this side of the House very much agree with that initiative. Following that, the House approved and passed amendments to the members' conflict-of-interest legislation, which include a new provision which will allow Mr. Hughes, in his capacity as conflict commissioner, to review questions such as this.

[ Page 3438 ]

Therefore we are, with the unanimous agreement, as I understand it, of all members of the House, referring the question of constituency allowances under this new statute to Mr. Hughes. He can do a wide-ranging review of how they have worked in the past, with his opinions as to what procedures should be used in the future. Mr. Hughes will also have the opportunity to make comments in more general terms about the appropriateness of the levels of constituency allowances.

We think that this initiative is long overdue. We're delighted that Mr. Hughes has agreed to do this for all members of the House. I'm certain that following this review we will have a system in place that will ensure that there are no questions of any kind about this particular allowance.

D. Mitchell: I am pleased to rise today in the House to support the motion moved by the hon. Attorney General to refer the review of constituency allowances to the conflict-of-interest commissioner.

The hon. Attorney General refers to the fact that there was all-party consultation on this matter, and indeed that's true. He referred to the fact that the hon. Premier wrote to the conflict-of-interest commissioner requesting an inquiry into this matter. Indeed, the Leader of the Opposition wrote to the conflict-of-interest commissioner on the very same matter at almost the same time -- if not before the Premier. I believe that the third party made representation as well. It is the consequence of all parties requesting the conflict-of-interest commissioner to look into the uses and possible abuses of constituency allowances.

We came to this new parliament as new members. While we're not quite as new as we were some three or four months ago, we are still concerned about what and how constituency allowances may have been used in the past. We do require some guidelines for this. We're concerned, as relatively new members, that constituency allowances may have been used in the past for reasons that were never intended.

We must remember, from the official opposition's point of view, that what presaged all of this was one of the big topics of this session, the Nanaimo Commonwealth Holding Society scandal. That event caused some confusion in the public's mind and among the members as to how constituency allowances have been used or possibly abused in the past. We know that the hon. Attorney General's ministry has a special prosecutor who's looking into that matter. Simultaneous with that, we think it's important for the conflict-of-interest commissioner, Mr. Ted Hughes, to look specifically into the issue of constituency allowances and provide some guidelines, so that abuses which may have existed in the past will not occur in the future.

For those reasons, we support this motion. We would hope that the conflict-of-interest commissioner can do his work expeditiously, and we certainly support him in his efforts.

[10:30]

C. Serwa: I'll be fairly brief. I think the Attorney General has covered the matter quite comprehensively.

I've had the pleasure of representing our caucus at two meetings with Ted Hughes on this particular issue: once on the government side, attended by the Minister of Forests, and the second time by the Minister of Labour and Consumer Services. The meetings were very good. There was certainly a common wish for clarification of the rules and for guidelines for all hon. members, because we're recognizing that the public's perception of politicians and politics is at stake here. This is clearly the right direction to go, and I applaud the government for its willingness to proceed in this direction.

Motion approved.

Orders of the Day

Hon. G. Clark: Committee on Bill 14, hon. Speaker.

PROFESSIONAL RETIREMENT SAVINGS
PLAN AGREEMENT EXTINGUISHMENT ACT

The House in committee on Bill 14; E. Barnes in the chair.

On section 1.

L. Reid: It's my understanding that we're referring to section 1 of Bill 14, Professional Retirement Savings Plan Agreement Extinguishment Act. I have a question for the minister. Under section 1, the interpretation section, it says that "agreement" means the professional retirement savings plan agreement. That statement suggests an understanding on this government's part that they do know what the term agreement means. British Columbians today need to know what happened to that level of understanding.

Hon. G. Clark: I'm not quite sure what the question is. You will notice that this perpetual contract, dated October 10, 1991, was entered into seven days before the election. Clearly it was an attempt to sign the agreement before the election, in a perpetual way, in order to foreclose the option the government would have in any normal agreement to renegotiate this, as we intended to do, and as we announced we would do during and prior to the election campaign in the Legislature.

L. Reid: My comment to the minister is that that answer is absolutely unacceptable. This agreement was a culmination of 11 years of work -- not seven days, as you would have this House and British Columbians believe. How can any NDP government stand up and suggest that an agreement does not exist because you deem it not to exist?

The Chair: Before the minister responds, I would remind the committee that we are in committee and not in second reading, so it would be of great assistance if we could be specific in terms of our dialogue or questions.

[ Page 3439 ]

Hon. G. Clark: I want to make the point again that it was Premier Vander Zalm that cut this deal privately in his office. The original deal was not....

Interjections.

Hon. G. Clark: I want members to know that this was not on the table; it was not contemplated; it was a sweetheart deal reached by the Premier; and after it was rejected by Revenue Canada, it was quickly cobbled together seven days before the election campaign.

I want to make the point that parliament has the power and has exercised that power on a variety of matters to deal with these kinds of contractual arrangements. Obviously this particular case is a difficult one. It is a power that was not exercised very lightly and is rarely exercised in parliaments, but from time to time it is exercised. We believe this is one of those times, particularly in light of the fact that we've enhanced the budget for medical services significantly.

The member asked when other parliaments.... A couple of months ago the Saskatchewan government brought in legislation to make illegal sweetheart contracts entered into by the Devine administration.

In this House there are lots of cases where governments have entered into legislation which interferes or fetters in some way contractual rights entered into by the parties. In fact, many laws we pass in this House retroactively change sections of contracts signed. I'm sure members know that. It is a routine matter when the House has to act in the public interest, and this is one of those occasions.

L. Reid: Again, if I might direct my comments to the minister. He discusses power. I would suggest that we have today an abuse of power. This is not justifiable by any government.

The Chair: Hon. member, as I pointed out earlier, we're dealing with committee and not second reading, so motives, intentions, etc. are not appropriate in committee. We should be addressing the wording and the specifics of the sections. So if the member could address her remarks in that regard, it would be most helpful.

L. Reid: I will speak directly to the term agreement, because it is my understanding that section 1 of the Professional Retirement Savings Plan Agreement Extinguishment Act is critical. There has to be some understanding about what that word means for us to understand this entire section.

Again, in the words of the Premier of this province: "...British Columbians should know that the election of an NDP government in the next few months would not erase a legally binding contract." This is a contract, this is an agreement as set out in section 1. My question to the minister: who is in charge? The Premier of this province said he would not erase a legally binding contract. Who is in charge?

L. Fox: I want to ask the minister to confirm that what really took place on October 10, 1991, was that the handshake agreement of December 20, 1990, was formalized. It took considerable time, almost two years, for that agreement to reach its formal stage with Revenue Canada and meet the tests of legalities and legislation that was required in order to put this act forward. I think the minister would have to agree that the actual agreement between the doctors and the government took place on December 20, 1990.

Hon. G. Clark: There was a handshake agreement in December between the Premier and the medical association for a pension plan, but that was subsequently nullified by the federal government.

Interjection.

Hon. G. Clark: Yes, it was. The deal fell apart. In spite of that, I am advised that Minister Jansen -- my predecessor -- wrote a comfort letter to the BCMA saying: "If the deal falls apart, we'll give you the money anyway." They cobbled together a way to give them the $25 million in spite of the fact that the deal agreed to by the Premier and the BCMA was found to be unsatisfactory to Revenue Canada. If I can be candid, I must say that the final deal is not as offensive as the original deal Premier Vander Zalm and the BCMA entered into, because the original deal would have given the doctors a deferred income plan tax free and an ability to pay into an RRSP up to the maximum. This was essentially a double-dip kind of approach.

Interjection.

Hon. G. Clark: Yes, you Social Credit members know all about that, especially you car dealers over there.

The Chair: Order!

Hon. G. Clark: That was thrown out by Revenue Canada, so they cobbled together this second deal to give them the money that was agreed to.

I agree with you, there was an original deal, but that fell apart. The government had an opportunity to not pay that $25 million. They chose seven days before the election to figure out a way to give it to them in any event. Then they wrapped it up in a contract that never expired, which made it extremely difficult for government to negotiate.

K. Jones: This agreement that was entered into by the previous government over the last year is a true contract with the doctors. It was an agreement, as with an agreement with any labour union, to provide a benefit. In any other contract this benefit is required to be taken on by the next management organization in true faith and honesty under the labour practices of this province. It is the contractual requirement of the new government to take this on and carry it through to the extent of the term of that contract. This is how any other contract is ordered under the Industrial Relations Act. It is a requirement for a company to continue when the management or the ownership of the company has 

[ Page 3440 ]

changed -- that the workers' contract with that organization still continues. I believe the hon. minister fully supports that concept. It's one that is the basis of labour peace and agreement within the province of British Columbia and within North America.

D. Schreck: On a point of order, hon. Chair. We concluded second reading last night; we're now on section 1. While the remarks of the member may be interesting, they are completely out of order.

The Chair: Your point of order is very well taken, and I would ask the member to address his remarks to the section before us.

K. Jones: I appreciate the member for North Vancouver-Lonsdale bringing forward a very important point of order. I will just ask the Minister of Finance to give us a reason why in one case he supports the concept of contractual continuity and in this case he feels it's one that can be broken.

Hon. G. Clark: It's not really on topic, but let me just.... So the member knows, there's a decision called the Paccar decision, which ended what's called the bridging clause between collective agreements. When collective agreements expire, they are no longer valid, and the employer has the right to make unilateral changes. This contract never expires, and that is what is fundamentally different between a labour contract and this contract.

K. Jones: The minister is absolutely right. This contract has not expired; it has been extinguished by this bill.

Section 1 approved.

On section 2.

D. Mitchell: Just a question to the minister on section 2, which deals with the extinguishment of rights and obligations under the agreement. Could the minister describe what goes into this section, because we're talking about an agreement that was negotiated between the previous administration and the doctors through their association, the BCMA. Could the minister describe what kind of consultation took place with the BCMA prior to deciding to extinguish the rights and obligations under the agreement?

[10:45]

Hon. G. Clark: There was no consultation specifically on this question; that's correct. But as you know, I was travelling the province explaining to the people the financial situation of the government. In a place like Saskatchewan, the doctors voluntarily came forward and asked for minus 5 percent. Unfortunately, in British Columbia we have given them almost 5 percent, yet that doesn't seem to satisfy either them or the opposition.

D. Mitchell: Mr. Chairman, I understand from what the minister has said that there was no consultation with the physicians with respect to the extinguishment of the rights and obligations under the terms of the agreement that this bill seeks to nullify. I find that surprising. Is the minister saying that this administration came into office, looked at an agreement that was made between the Crown and the physicians of our province through their professional association, the BCMA, and decided to unilaterally extinguish that agreement without any consultation whatsoever with the physicians involved?

Hon. G. Clark: No, originally our intent was to try to renegotiate this contract. We assumed that it was like any other labour contract that had a date and would then come up for negotiations, and we would do it that way. It was absolutely a shock when we found out just before the budget, to be candid, that it was not possible to renegotiate this contract, and that they had a perpetual contract. That's what spawned this kind of action in terms of trying to deal with it.

In addition, the doctors were concerned about the fact that they were $30 million over budget. As per the previous agreement, that had to be clawed back from them, so to speak. We assumed -- naively, I suppose -- that doctors would be happy that, while extinguishing this pension, which was terribly unpopular, we took that money and put it right into the base so they didn't have to pay back their debt to the government. We assumed that that was more than generous and that they would be very happy with it. On top of that, there was another lift for inflation. So, given the pace of events and in trying to deal with the situation and the enormous financial debt left behind, I frankly -- and, to be candid with you, naively -- thought that doctors would, as they had in other provinces, realize how generous this offer was. Then we could have proceeded to discuss it with them and discuss how we would deal with the more fundamental changes we brought in in Bill 71.

D. Mitchell: I don't understand. I have to go back to the minister on this one again. The minister, then, is saying that his original intention was to renegotiate with the physicians, but that upon assuming office and taking a look at the agreement he concluded that the contract could not be renegotiated, because it went on forever. I find that hard to believe and hard to understand, because the minister must know -- surely he must be aware -- that any deal can be renegotiated, any deal can be reopened at any time. Certainly that's a basic principle in the business world, and it would apply in the public sector as well.

The minister says that it was the government's initial intention to renegotiate the deal. Is he saying, though, that they concluded they didn't want to, that no attempt was made to renegotiate, that there was no consultation whatsoever with the physicians? He said that there was an issue of time, that events moved quickly. I would remind him that this Bill 14 we're being asked to approve in committee today was put on the order paper of this Legislature some three months ago. It's been sitting there for three months. Has there been any attempt during that three-month intervening period to 

[ Page 3441 ]

renegotiate the pension agreement with the physicians? Could he document for the benefit of members of this committee where those efforts went, why they failed and why we've come to this sad state today, where we have to deal with a despicable piece of legislation like this?

Hon. G. Clark: Any member in the House knows that there has been an endless series of discussions between the Minister of Health and the BCMA. We have agreed that we're prepared to negotiate a cost-shared pension arrangement with them. I would submit that it's probably because this bill and other bills are in the House that in fact we came to the table to even discuss the question. Unfortunately, to date -- and I say that with all sincerity -- no agreement has been reached. I remain very hopeful that over the coming months, once these bills have been passed and they realize that Bill 71, in particular, is one which really makes doctors partners with government in this endeavour, we can come to some understanding.

I don't have any objection to then trying to renegotiate a pension plan the way other employees have pension plans -- which is a real pension plan that is cost-shared between the government and the doctors. Certainly we can do that. But in order to do that and in order to deal with the $30 million which they owed us and which we didn't collect, we were required to extinguish this agreement. We now will sit down and negotiate something more reasonable, within the taxpayers' ability to pay, and which is a real pension plan that's contributory. I think the public would then accept that. We on this side certainly have no problem with it.

D. Mitchell: What I hear the minister saying is that he would like to see some cooperation with physicians. Certainly that hasn't been demonstrated by this government in their belligerent approach to dealing with physicians. But the minister says that he would like to see a fair agreement negotiated. He'd like to see a pension plan that perhaps he could agree with. Then why not renegotiate the existing pension plan, rather than extinguishing this one and saying that it never existed, that there's no recourse to the courts and no right of appeal? Why not take that kind of a consultative approach -- which the minister's party said they were going to take when they were in opposition -- rather than this heavy-handed approach with this very heavy-handed piece of legislation?

The minister says he still hopes it's possible to enter into an agreement with the physicians that would be a better agreement. I would ask him then: why did the government bring in Bill 14 early on in the session and put it on the order paper? Was it there as a threat? Was it there as a hammer to hold over the heads of the physicians, to say: "Come to an agreement with us on our terms or else we'll pass this bill"? It has now finally come to the government trying to ram this bill through in the dying hours of this session.

Hon. G. Clark: No. I thought I'd explained this. We assumed that by forgiving the $30 million debt that they owed.... Obviously this agreement is not acceptable to British Columbians or to the government. We have made that clear all the way through. They had this debt that they owed us. We were looking at dealing with cost containment and with some changes to work with doctors, so we extinguished this agreement, took the money and put it into fee-for-service. We're now prepared to negotiate, underneath the cap for next year, some kind of cost-shared and reasonable pension plan.

I honestly felt -- and I guess naively -- that we were being more than generous with doctors, given what we were doing with the total budget package. I know that other people feel we were too tough on them. I thought that when they saw the package and realized how generous we have been in terms of fee-for-service and when they realized that the public was clearly opposed to this.... I talked to many doctors who were opposed to it. I just assumed that if we did this and then got on with negotiating something more reasonable in the years to come, that would be an appropriate course of action.

Having said that, it's obviously important that we extinguish this agreement. This agreement is not acceptable. My understanding of the dealings with the doctors -- and I haven't dealt with them personally -- is that given that they had a perpetual contract which was not open to negotiations, it would have been extremely difficult to have them agree to open it. Unlike in Saskatchewan, the doctors didn't come to us and say: "We realize that you have a fiscal situation, so let's talk about how we can help each other." They had this $25 million in perpetuity, and they weren't about to renegotiate it, in our view. So it was unacceptable, and we rolled it in. Now we're prepared to look to the future.

D. Mitchell: We had a good debate late last night on second reading of this bill. I don't think it's necessary to revive any of the elements of that debate. We're dealing here with section 2, the extinguishment of the rights in the agreement and all obligations under the agreement. The minister is saying that he has had no personal contact with physicians of the province, yet the bill is in his name, and he's taking it through the House. I would assume that that's because of the financial implications of the bill -- the $25 million obligation that the government has under the terms of the bill.

It would have been preferable if the hon. Minister of Health had taken this bill through the House, because then she could have answered some of the questions as to why there have been no consultations with physicians or, if there have been consultations on renewing and amending this agreement and making it more acceptable, why they haven't been successful. The Minister of Finance clearly can't answer those questions, because he's admitted to the committee this morning that he has had no personal contact with the physicians.

The Minister of Finance seems to have admitted in his comments that the bill was brought in early in the session, in a threatening manner, as an attempt to bully and menace the doctors a little, to show that the government was very serious and that if they didn't toe the line, this bill would be passed. Now we've come to 

[ Page 3442 ]

that sad day when the government is actually going through with their threat, their bullying and their menacing action, by bringing in Bill 14 and trying to have it made a statute, basically extinguishing an agreement. The minister has indicated that that was the intention of the government when they brought it in. They're now following through on that.

He hasn't addressed the crucial issue: why extinguish the agreement; why not renegotiate? Why not seek to make an agreement that was less than perfect -- in his words -- more acceptable? Surely a much more reasonable approach to take on the part of a government that represents all British Columbians would be to seek to amend the agreement and negotiate fairly and freely with the physicians of British Columbia and their association, the BCMA, to make the agreement more acceptable. If the minister could just answer that, we could move on to other sections of this bill. But I haven't had an answer to that question, Mr. Chairman.

Hon. G. Clark: A couple of things. First of all, I'm advised that the Minister of Health did meet to talk about renegotiating this agreement and did work on some options in that regard. Secondly, the reason it's in my name is that by March 31 we would have had to pay $25 million. So this bill saved us $25 million in this fiscal year. Although we rolled it into the base to cover what they owed us, we needed this bill now to deal with that specific $25 million. That's why it is a Finance bill and is brought in by me. And it does have a direct price tag. The option of negotiating and talking to them nicely would have been possible had we paid that first instalment of $25 million which was due March 31.

D. Symons: I'm very pleased that the government member admits that they were naive in this -- I would agree with him wholeheartedly on that. It's one of the few things on which we can agree with the government. You are indeed naive if you think this is a fair bill. I think naivety covers very well many of the government's activities during this session.

I'm rather ambivalent about this bill, actually. On the one hand, what I see here is that the previous government has been very generous -- overly generous -- in giving this pension plan to the doctors. In that, I would agree with you. However, on the other hand, the fact is that we had a signed legal, binding contract. This is an agreement. Our responsible, democratic governments are founded on the idea that an agreement is an agreement; you honour agreements. It's banana republics where you can't believe, when an agreement is signed, that tomorrow it may not be an agreement, because the government has changed. That's precisely the problem we have here. We had an agreement by the previous government, but the current government is simply going to negate it.

What I find particularly offensive are the words in section 2(3): "The professional retirement savings plan referred to in article 2.1 of the agreement shall be deemed not to have been established." That sounds to me exactly like the 1984 Ministry of Truth. You can simply erase the past. I don't think this is the way we handle a disagreement or renegotiate a contract. We must enter into agreements and negotiate with them, not go about holding a club over their heads, beating them to death and then saying we've somehow negotiated an agreement.

Resource industries are not likely to come into B.C. if you're going to give them resource exploration rights and then take them away without any compensation. You're not going to have the forestry industry feeling too comfortable if you give them timber rights to Crown lands and then take them away.

[11:00]

The Chair: Order, hon. member. The line of debate you are engaging in was quite appropriate last evening when we were in second reading, but we are in committee, and we should be precise in addressing the questions. Deal with the wording and not the philosophy or the principle. We're concerned now about dealing with the effect, the text, of the sections before us.

D. Symons: I thank the hon. Chair for that caution, but I am talking about agreements and their being extinguished. I was simply trying to give a couple of examples in other areas in the province, where it would certainly be inappropriate for the government to negate agreements that had previously been made and not give appropriate compensation. It seems that is the case in this particular bill. The minister says he gave compensation, but what you're really saying is: "We took away your pension plan over here, but we put it in over here." But not with their agreement. You simply arbitrarily said that you were going to take it out of one hand and give it over here. That is not an agreement, and that is not the way one negotiates. I certainly hope it's not the way that we're going to see the rest of the term of this government, short as it may be, where they're going to react and handle people. It's not the way to behave. I don't think you gave it to the doctors in quite that sense. You simply put it in the pot over there, which isn't quite the same thing as what you're taking away.

As I said when I began, I don't necessarily agree with that plan that was given to them. It was, as I said, quite generous. Nevertheless, it was an agreement, and I believe that it's incumbent upon the government that they must renegotiate that agreement, because our whole democratic system really evolves around the idea that agreements should hold. A gentleman's agreement, whether it be a handshake or a written document, is a document that must be abided by until the parties relative to that agree.... I think you could have negotiated with the doctors. Indeed, you said they didn't want to, but I think if you approached them long enough and took time at it, rather than at the beginning of this very session, telling them you were going to do that in the budget address -- actually, I think it was even in the throne speech -- letting them know months ago that this was coming down the tube, and they'd better kowtow.... That's not the way you enter into agreements. It's just a wrong bill. It's the wrong way to go about it, and I'm against it.

[ Page 3443 ]

C. Serwa: On section 2, the minister indicated that it was in the public interest to extinguish or cancel an existing contract between government and a group of individuals, in this case medical doctors. Perhaps the minister could briefly explain to me why it's in the public interest to cancel an agreement.

Hon. G. Clark: First of all, I want to remind the member that the government that he was part of brought in Bill 19, which retroactively changed thousands of contracts, literally made illegal whole sections of contracts -- just to make it clear that elected governments act in what they perceive to be the public interest. We know that the public was opposed to this pension deal. We campaigned against the pension deal. Doctors told me they were opposed to this pension deal. We took the money saved from that and put it into the base. In fact, they're better off as a result of this bill because we put the money back into the base. I understand this is not done very often. It's not the kind of measure which governments should do lightly. We don't take it lightly. It's not something which would be repeated routinely in the House, but parliaments do have that power and we've chosen to exercise it because we perceive this to be in the public interest.

C. Serwa: I don't for one instant think that the minister or the government takes this issue very lightly. I think it's contrary to all that they have traditionally stood for and believe in, so I'm quite confident that they haven't taken this matter lightly. But in the matter of attending to the extinguishment in section 2, and the public interest, fundamentally we're talking dollars. It appears, from the conversation with the minister, that he has a great deal of difficulty with the term "in perpetuity." I believe the minister referred to that context. Perhaps in the extinguishing of this, the minister and the government are jumping from the frying pan into the fire.

Let's look at the cost -- and bear with me briefly -- where purchasing power decreases as the percentage of gross billings decreases. Look, in contrast, to the generally established principle. The minister clearly stated that a normal arrangement is where the employer and beneficiary contribute equally. If we look at that and at the $25 million, we see that it represents approximately 2.25 percent of gross doctor billings to the Medical Services Plan. If we look at the government commitment to public sector employees, we find that for the first $32,000 of income, the commitment on the part of the government is 8 percent. If a public sector employee makes over $32,000, the commitment on that part above the $32,000 is at 9.7 percent. The net result if you split that is that you're probably looking at 8.75percent of gross earnings as the government's contribution to the pension plan. I would suggest that no matter how a pension plan is funded, it will cost the taxpayers substantially more than the $25 million of deferred income. Perhaps the minister will advise me on that.

Hon. G. Clark: I think those are fair comments. One wonders why doctors are so upset.

There are two things. First of all, rolling it into the base means that they're actually better off. In some respects it's more expensive to do what we've done than leave the pension. Secondly, any alternative arrangement that gave them a genuine pension plan might cost more down the road. I agree with those two comments.

My view is that this was an unconscionable deal that everybody was opposed to, so we had to get rid of it. If we were to move into a cost-shared -- albeit a likely more expensive -- pension arrangement, as long as it's under the global cap, and they essentially have to buy it the way other employees have to buy theirs, then I don't mind. In the construction industry they say: "We'll give you a buck an hour." They say to the union: "You decide how to spend it." The union could decide to put it all into pensions or to put half of it into pensions. That's their call. That's the kind of approach I'd prefer.

We're going to raise the medical services budget next year by inflation, say 2 percent. I hope 2 percent is a reasonable settlement next year for doctors. If they said, "We'd rather put that all into a pension fund and take no fee increase," then we'd say fine. If they did that every year for a while, it may end up costing a lot of money, but they'd have a real, sound, substantial pension. That would be their choice in negotiations with the government.

I agree with your general premise that if we just left this and did nothing else, at the end of the day it may have been cheaper. With the provisos that any negotiated agreement comes out of their arrangement, and that it's a real pension plan, I think the public would be more accepting of this sort of gift, which was given to them last time in the dying days of negotiations and by the Premier intervening directly.

C. Serwa: I appreciate the remarks from the minister. Perhaps it would be more acceptable to the general public because it would follow established criteria. The justification for the section 2 extinguishment of the contract is one that is primarily perception rather than reality. In fact, the public interest over the long term will not be well served by the extinguishment of this contract. Over the long term the cost to the taxpayer will be substantially greater.

I do know that doctors have tried for many years to establish some form of pension. I would suggest that they will and must continue to strive to establish some sort of pension arrangement. I am confident that they will be successful, either with this government or a subsequent government.

I really believe that the net result of this -- and the minister has basically confirmed this -- is that if you fit it into the generally accepted parameters, while the extinguishment may be publicly acceptable, it will ultimately result in much higher costs to the taxpayers of the province.

L. Reid: My comment is to the Minister of Finance. This individual sponsored this bill, and yet he admitted today in this House that he did not speak to doctors. Does anyone in your caucus or cabinet understand the word "consultation"

[ Page 3444 ]

The Chair: Shall section 2 pass?

L. Reid: I am speaking specifically to section 2(2), "Extinguishment of rights and obligations under this agreement." This is the obligation of the government. I am interested to know if any of this obligation has been paid.

Hon. G. Clark: No.

L. Reid: It would be my understanding, then, that this government is in default at this time, because the date of March 31 has come and gone. Are you able to somehow deem something not to have existed, then also deem retroactively that something did not exist?

Hon. G. Clark: You're right, and this bill is retroactive.

L. Reid: Every member in this New Democratic government should find this bill repugnant. To suggest somehow that it didn't exist months ago is unacceptable. I need to hear from this minister why he believes that this bill has any credence at all.

The Chair: Hon. member, with the greatest respect, that is not part of the section. It is part of second reading.

Section 2 approved on the following division:

[11:15]

On section 3.

L. Reid: I would speak to section 3 in some detail. "The plan is terminated" is the actual wording in section 3(1). I would commit to the record, hon. Chair, the words of the Premier of British Columbia: "I referred to it as a 'done deal' because British Columbians should know that the election of an NDP government in the next few months would not erase a legally binding contract."

Again, hon. Chair, to the minister: who is in charge?

Hon. G. Clark: Just so the members will know, section 2, 3, 4 and 5 really are the same thing. I'm advised it is legislative counsel's way of ensuring certainty in the matter. That is why this section, which is really identical to the previous section, is saying that the plan is extinguished, and in this section says: "The plan is terminated." It does seem to be overkill, but that's the legislative counsel's way of ensuring that the wishes of parliament are undertaken.

I also just want to advise the members that until after the election, no one realized that a plan had been entered into which had no termination date -- and that, I think, is a fundamental difference.

Sections 3 and 4 approved.

On section 5.

L. Reid: On section 5: "No damages arise. No action for damages or compensation against the government, the commission or any person arises by reason of this act."

Hon. Chair, I would submit to you today that this government cannot play with people's lives and then somehow say: "You can't sue us." How can this government render invalid a court challenge?

Hon. G. Clark: That's the way the law works. It's quite common. We're extinguishing a plan; deeming the plan to never have existed; deeming that no other contracts existed which impact on that plan, which didn't exist; and then saying that there's no right to recourse in the courts. This is legislative counsel's way of ensuring that the wishes of the government and the public are accepted. It would be ridiculous to be extinguishing the act without ensuring that they could not then sue for damages. Parliament is supreme, and this is the legislative counsel's way of ensuring that no court action is possible.

L. Reid: I cannot accept the notion, hon. Chair, that somehow this government can deem rights and obligations not to have existed. I need some explanation for that. I think the arrogance today has gone well beyond anything we've seen previously. Hon. Chair, to the minister, tell this House and assure British Columbians that somehow you believe you have every right to play with their lives and then deem something not to have existed.

Hon. G. Clark: I just want to make sure members of the House realize that this is a fairly standard provision.

L. Reid: No, it's not.

Hon. G. Clark: Yes, it is.

L. Reid: This provision is not standard.

[ Page 3445 ]

The Chair: Order, hon. members.

Hon. G. Clark: The provision that no damages arise, or that the Crown cannot be sued in the event, is fairly standard in all kinds of laws in the House. When you extinguish an act, this is like a consequential amendment. This is a consequence....

Interjection.

Hon. G. Clark: No, this is housekeeping. It is housekeeping when it comes.... Once you've made the decision and passed the section saying that the act is terminated, or that those rights or laws don't exist, this is essentially a consequential amendment ensuring that the Crown is protected.

J. Tyabji: This minister has been constantly referring in this House to the mess the previous administration left him with, yet he is proceeding with the same kinds of actions that made the previous administration so unpopular, which is why their numbers have been so dramatically reduced. I put to the minister that this clause is a typical example of the kind of activities that the people of B.C. cannot support. With this clause you're trying to negate something that's already in effect, and you're trying to rewrite history, which you cannot possibly do. By taking away people's rights in court to follow an action that should duly proceed from a legal contract and by breaking a legal contract, you're taking away the rights to even have any kind of recourse on that. That kind of activity is shameful, and it put the previous administration out of government. I put to this minister that this is the kind of activity that he should not be participating in, and that he should repeal this clause.

Hon. G. Clark: Well, I know the members opposite are opposed to this; I know they support the pension plan for doctors as it was constructed. I know that members of the opposition have voted against previous sections. I understand that. But once you have terminated the plan, then it would be silly not.... This is what's required to terminate the plan. Otherwise we will sue and they will sue, and we'll pay the $25 million in any event. That would defeat the purpose, would it not?

So I understand the concern of the members opposite, but please don't overstate the case. You're right; you've made the case. I understand the point you've made, but this section is simply a way of ensuring the Crown's interests are protected in light of the previous sections: the decision to eliminate this agreement.

K. Jones: I'd like to ask the minister how many persons would have been affected or would have been eligible for retirement under this act up until now.

The Chair: Hon. member, the question does not fall under section 5.

K. Jones: It's in order to find out the effect of this decision that I'm trying to find out this information. This is a pretty serious impact.

Hon. G. Clark: This section is really out of an abundance of caution. It's hard to sue when a plan has been terminated and has been extinguished by legislation. So the legislative counsel has asked us to include this, out of an abundance of caution, to forestall any possible suit, even though a suit would be extremely unlikely to succeed, given that we've extinguished the plan by legislation.

Nobody has received any money. The plan never got off the ground. No money has been paid, so nobody is eligible.

K. Jones: The minister does make a point that it's extinguishing, but we're trying to find out how many doctors' pensions would have been eligible if this had been proceeded with rather than eliminated retroactively.

Hon. G. Clark: It's not a pension, as you know. It was some kind of RRSP plan at the end of the day. There are 6,000 doctors, and I assume all 6,000 were eligible.

F. Gingell: I appreciate, Mr. Minister, that Bill 1 did say, "An Act to Ensure the Supremacy of Parliament," and you mentioned that. But isn't the real supreme factor that we should recognize the rule of law? Without the rule of law, the whole of civilization collapses. Contracts are made to be kept, not to be broken.

Is it not true, Mr. Minister, that section 5 just recognizes that the action you have taken in Bill 14 is illegal and improper?

Hon. G. Clark: It is not illegal. You've made the point that parliament is supreme. We're now bringing in legislation, and this makes it legal. This recognizes the fact that we have extinguished the plan. In order to ensure that there aren't any attempts to seek recourse in the courts -- even though they would not succeed, by and large, because the act was deemed never to have existed -- legislative counsel have suggested that this is a safety precaution to ensure that the interests of the government are protected. That's all it is.

D. Symons: I have concerns about the last few words that the hon. member said. He said he was quite sure that in most cases court challenges wouldn't succeed. But it would seem that by putting this particular section in here, the minister does not believe his own words. He's saying that court challenges wouldn't succeed, but we're going to make damned sure they don't by putting this phrase in here saying that you can't go to the courts. Let's have it one way or the other. If you say that they're not going to succeed, then you don't need this; if you think they are going to succeed, then you are obliterating their right to go to courts. You can't have it both ways.

[ Page 3446 ]

Hon. G. Clark: This would save any legal fees that might be required. Given what we've heard, I wouldn't be surprised if they would have tried to sue, even though they have no chance of success. That would have been expensive for all concerned. Again, this was on the advice of the legislative counsel to ensure that the wishes of parliament prevail.

[11:30]

J. Tyabji: The minister's comments about parliament being supreme over the rights of individuals to sue for damages that result from legislation passed in this House.... To me this section indicates a dangerous move toward a form of dictatorship, where the parliament can arbitrarily legislate away people's rights for damages incurred as a result of legislation brought forward in this House. Obviously this minister recognized that there will be damages from this contract and that this contract is going to injure a large portion of the population. They have had their rights taken away by this section. Preceding this section, we have an act that broke a legal contract which was duly negotiated.

As we mentioned repeatedly last night, we feel that the number one thing that has to be supreme in this House is the rights of individuals through the entire democratic process, and the democratic process does not allow for legislating away the rights of people who have injuries incurred through the actions of this House. We recognize that we have to be fiscally responsible. But in the first place, it would have been fiscally responsible to renegotiate this deal so that we didn't end up here at the eleventh hour debating these bills in the committee stage. They shouldn't have been brought forward in the first place.

The Chair: Before recognizing the minister, I would remind the committee that we are, unfortunately, moving back to second reading of the bill. We are in committee stage, and I would remind members to keep that in mind.

Hon. G. Clark: I would just like to briefly respond to the previous member, with your indulgence, Mr. Chair. When city councils rezone property and it affects someone's property rights, they don't have the right to sue. The Crown takes action. When the Crown wants to build a road through someone's property, the Crown has the prerogative. That's what parliament does. I agree that it's done very carefully. It's not done routinely. Thousands upon thousands of contracts are entered into yearly by government. This is an extraordinary act to deal with something which we feel must be dealt with -- this particular pension plan -- because we think it's unacceptable.

J. Tyabji: Since this minister feels that this section is only in extreme and extraordinary circumstances, did this minister approach the people who would be injured by this bill prior to bringing the bill through the House to try not to bring this bill before the House and to not have to take this extreme and extraordinary action?

The Chair: Hon. member, we're dealing with section 5. Perhaps I misunderstood you, but I thought you were referring to the bill. I thought I heard you referring to the people who would be affected and whether or not the bill should be brought forward. In that case, that would be out of order. If you're speaking of section 5, then that this in order.

Hon. G. Clark: No, we did not.

L. Reid: My comment to the House is that this section cannot pass in all good conscience. This section, as my colleague from Okanagan East has stated, invalidates the rights of British Columbians. No consultation. No process. No understanding that even the minister had an obligation to sit down with the parties in question. He cannot shift responsibility at this stage to somehow suggest his bill was left in the hands of the Minister of Health. That is passing the buck, somehow suggesting that obviously he didn't have time. He was too busy to consult with British Columbians in terms of removing their rights. That is unacceptable to the members of the Liberal opposition. We want a government that is going to bargain in good faith. This section and this bill constitute bargaining in bad faith by the New Democratic government in the province of British Columbia.

Section 5 approved on the following division:

Title approved.

Hon. G. Clark: I move the committee rise and report the bill complete without amendment.

Motion approved.

The House resumed; the Speaker in the chair.

Bill 14, Professional Retirement Savings Plan Agreement Extinguishment Act, reported complete without 

[ Page 3447 ]

amendment, read a third time and passed on the following division:

Hon. G. Clark: I ask leave of the House to table the annual report of the auditor general.

[11:45]

Leave granted.

Hon. C. Gabelmann: With leave, I would move a motion in respect of the appointment of an ombudsman.

Leave granted.

Hon. C. Gabelmann: I move that this House recommend to the Lieutenant-Governor the appointment of Ms. S. Dulcie McCallum as ombudsman for the province of British Columbia pursuant to section 2(1) of the Ombudsman Act, effective August 4, 1992.

Motion approved.

Hon. G. Clark: I call committee on Bill 72.

TOBACCO PRODUCT
AMENDMENT ACT, 1992

The House in committee on Bill 72; D. Streifel in the chair.

On section 1.

L. Fox: I was just going to suggest to the Chair and to the minister that I really have no wish to comment on all sections of this bill. The process has been outlined by the minister and by the House with respect to the development of regulations that this bill will cover. I support the process, and I look forward to being part of that.

L. Reid: Hon. Chair, I would propose an amendment to the interpretation section. I believe we need a definition there that pertains....

Section 1 approved.

On section 2.

L. Reid: I would propose that we need a definition of the term "vendor" to fall in subsection (1) for this bill to be clearly understood by all the parties in this province that it may affect. I would move that section 1 is amended by adding the following: "vendor means any business that sells tobacco products directly to members of the public."

On the amendment.

Hon. E. Cull: Mr. Chair, I'm going to be making this comment on all of the amendments the member is tabling today. The intent of the act is to provide enabling legislation; the details of the act are to be worked out in the regulations. For us to start now with putting in a definition before the regulations are fully fleshed out is going to be imprudent. We may find out afterward that the definition of vendor is not what we need, once we've got into the details of the regulations. Then, of course, we would have our hands tied, and we'd have to come back and amend the bill, as opposed to simply dealing with it through the regulations.

D. Mitchell: Mr. Chairman, speaking to the amendment for a second and recognizing what the hon. minister has just said, we understand that the regulations pursuant to this bill when it becomes an act are going to be dealt with by a select standing committee of the Legislature. Surely that committee needs to have some parameters in terms of basic definition. I think the amendment is actually worth considering, simply because the term "vendor" itself is a key part of this bill.

We had a good debate last night, and I don't intend to revive any of that debate. But who is a vendor? Clearly "vendors" could apply to wholesalers, retailers, exporters, importers and people who run vending machines. It would be useful to have some parameters and guidelines as to what is implied by "a vendor of tobacco products" under this act. For precision's sake that would be useful. Could the minister, in her comments at least, enlighten us as to what the intention is of the bill? No comments whatsoever?

Amendment negatived.

On section 2.

L. Reid: I would speak specifically to section 2, where it suggests section 2.2. I would propose the following amendment. Actually, let me speak to the amendment first. What I'm going to refer to is the age. The minister's response is going to be that we will allow that to go to the committee that is going to structure regulations.

[ Page 3448 ]

To my view, age at which a person may purchase tobacco is the most significant aspect of this bill. If this is truly about access and restricting access, it is important to have something as weighty as an age limit incorporated in the bill. I would not be comfortable with allowing that to be formed by the committee in terms of regulation. If it's that important to the basic intent of this bill, it needs to be covererd in the bill as opposed to the regulation.

I would move that we amend section 2.2 by deleting the words "if a regulation under section 4 forbids" and replacing them with the word "the" and deleting the words "specified in the regulations" and replacing them with the words "of 18 years is forbidden and...."

On the amendment.

Hon. E. Cull: Again, contrary to the amendment, there are a number of considerations around the age. We could tie the age to the age of majority, which has just been changed in this province in terms of voting. We now have a different age for buying alcohol. Right now cigarettes are purchasable at the age of 16. There are a number of considerations with respect to age. We need to have a look at how age has been handled elsewhere in Canada. The select standing committee is well qualified to handle this matter.

L. Reid: I'm not quibbling over the competence of the select standing committee, but if we are going to put some weight behind this legislation.... I understand that you believe this to be really important legislation, as do members of the official opposition. If it's important, and if we suggest that somehow minors having access to tobacco is a problem -- and this bill suggests that we need to reduce access -- then the age of 18 is a prudent time to allow young people to make choices as to whether or not they purchase tobacco. We in this House just decided that 18 will be the voting age. I have no difficulty with the age of 18. I would suggest that to make this bill credible at all, it has to have some power, some weight behind it. To suggest that regulations can replace the power of this Legislature is not acceptable. Please comment.

Hon. E. Cull: I think the select standing committee is well qualified to deal with this matter. It's quite conceivable that the age of voting could change in the future too. Rather than tying it to a particular age, we should have the ability -- and regulations -- to have a closer look at this.

D. Mitchell: I notice that some members of the government wish to support the amendment. Before we take the vote on it, I just have a question.

The minister suggested that we should leave this up the select standing committee. We support the process and the subject matter of this bill going to the select standing committee, but as was raised last night, there's a question of procedure. The hon. member for Richmond East suggested that perhaps some guidelines should be put into the bill. If the government wants to pass this bill before we bring it to the select standing committee, perhaps there should be some guidelines in there. Perhaps 18 would be a reasonable age. Could the minister just comment on whether or not she would support that? Is that the direction that she would like to see us head? If we're going to be setting an age restriction, would 18 be the appropriate age?

Hon. E. Cull: I think it might be useful to look at the age of majority so that there's a common age for a number of things. Again, the select standing committee will have to consider this in the context of all of the considerations around access to tobacco and what's happening elsewhere in Canada.

D. Symons: On the amendment, it would appear that if we are moving the age of majority, which we have done to age 18, then all of these decisions.... Even if you want to change the liquor laws, it seems that if you're giving the person the right to vote, at that stage you're saying that this person has the right to make a decision. That seems to be the age at which they should make decisions for their lives. To shilly-shally around and not decide, as seems to be the case here.... "We're going to leave it open, and we'll sort of decide later on. We'll test the ground and see what the results are." It seems that they don't have a handle on where they want this bill to go and who they want to affect by it. The people of this province have the right to know exactly who you are targeting by this particular bill. Rather than avoid that question, let's hear it now.

[12:00]

L. Reid: Further to the point of my colleague for Richmond Centre, British Columbians are looking for some leadership in this. We are asking the minister to come forward today and suggest that it is absolutely important enough to incorporate into the body of the bill the age at which someone may purchase tobacco in this province, rather than leave it in the form of a regulation to be constructed by the committee. We are looking for leadership. I would ask the minister to rise and give her reasons why she is not prepared to demonstrate some leadership on this vastly important issue today.

Hon. E. Cull: Mr. Chair, I won't take up the time of the House by reading the many, many letters we've received commending this government on the leadership it has shown in bringing in this bill. Again, there are many matters of detail which I think can be well handled by the select standing committee.

Amendment negatived.

D. Mitchell: Mr. Chairman, I have a question about section 2(1)(c). Maybe the minister could help me with this one. It states: "A person must not deal in, sell, offer for sale, distribute, advertise or promote the use of tobacco...in a manner that interferes with initiatives by government...." I have a hard time understanding exactly what is meant by this section. For instance, it refers to: "...in a manner that interferes with initiatives by government...." How does a person "deal in, sell, 

[ Page 3449 ]

offer for sale, distribute, advertise or promote" a product in a manner that interferes with initiatives by government? Could the minister offer some examples of what she is contemplating there?

Hon. E. Cull: Yes. This particular section is designed to clarify the existing legislation. As the member is aware, this is an amendment to an act that already exists and so improves upon it. An example I can give is false advertising -- advertising that fails to note the toxicity of the product being sold.

D. Mitchell: Mr. Chairman, I have another question on section 2 of the bill. It deals with section 2(3), which says: "A person must not sell or offer for sale cigarettes from an opened package." I wonder if the minister realizes that this section is essentially a direct duplication of section 240(3) of the federal Excise Act. In that case, is it really necessary to have it in this statute as well?

Hon. E. Cull: Yes, I am aware that it is also contained in federal legislation, but by having it in this act, we are able to enforce it through our licensing procedures. The difficulty with the federal legislation is that the enforcement procedures are extremely weak. I believe they carry fines of a very small amount -- $10 -- so they are essentially ineffective. By putting this into our legislation, we can then use the force of this act to enforce the provision.

D. Mitchell: Does the minister then contemplate that matters dealing with federal legislation, such as the federal Excise Act, would also be reviewed by the select standing committee of the House which is going to be reviewing this bill when it becomes an act?

Hon. E. Cull: Mr. Chair, the motion passed by the House is quite explicit in terms of the terms of reference. I don't believe that that matter is included in the terms of reference.

D. Symons: I must say at the outset that neither I nor anybody in my family smokes. I have to agree with the bill's intent because of that. I don't believe young people -- or old people, for that matter -- should smoke. It's not good for their health, and it's not good for our Health budget that we were discussing earlier. But I really think that a bill of this sort misses the mark. It's covered in section 2(2) and I guess part of (3) as well, if you want me to stick to the bill. If you hit these things by almost making them illegal, like narcotics in that sense, it's going to be very restricted, and that's counterproductive to what you're trying to achieve with the bill. I think what we really want to do.... What has been happening gradually over the last decade or so is that cigarette smoking has become an unsociable act. More and more places restrict smoking. The health hazards have become better known. When we investigate the smoking habits of young people, we find a reduction in the number of boys, young men, who smoke. Unfortunately, the girls have not caught up to the young men yet. They are staying the same or increasing slightly. If we keep that up rather than trying to pass legislation, we'll win more in the long run. In this sense, I do believe that the bill, although well intentioned, is going to miss the mark. We should be looking more at the education side of it. Chuck this, and deal with the education side. It has been effective, and it is working. It just takes time. This isn't really going to accomplish anything.

Hon. E. Cull: I'm surprised that this member is speaking contrary to the position his colleagues took last night, when we were in second reading debate. I have to assume that the member wasn't here yesterday evening when we talked about the impact of education versus legislation. The decline in smoking has been a direct result of legislative measures, not educational measures. As much as we would like to believe that education is effective -- and it certainly has its role and has to complement legislation -- the evidence shows otherwise.

The one that I will cite again is from Woodridge, Illinois. They introduced vendor licensing. The number of children who were regular smokers decreased by two-thirds, and the proportion of children who experimented with smoking decreased by one-half. Education did not have that impact until legislation was brought in.

We're not making it illegal for children to have cigarettes; we're making it illegal for people to sell cigarettes to children. It's a question of regulating the accessibility and the attractiveness of cigarettes so that children will not have such easy access to them. That will complement the educational efforts that have been underway for many years but have unfortunately not had quite the health impact that we would have liked them to have.

L. Reid: I would speak to section 2(2)(b): "Tobacco is not sold or offered for sale from a vending machine if access to the vending machine is not controlled and supervised to prevent persons who have not attained this specified age from using the vending machines." Hon. minister, you spoke about legislated access having a far greater impact on the reduction of smoking in this province. I have to understand, before we leave today, how it is that you plan to monitor or supervise vending machines to ensure that we restrict access. I would like a plan to suggest that this is somehow reasonable legislation to enforce. Is this just an absolute mockery that we will never be able to enforce?

Hon. E. Cull: Experience in other places shows us that this is not a difficult thing to enforce at all. It's a question of determining where vending machines can be located so that there is restricted access. Young people would not have access to the machines in a bar. It is conceivable that there are other places where vending machines could be located where they could be supervised or where young people would have limited or no access.

Rather than doing what was suggested last night, which was an absolute ban on vending machines, we should first look at how to regulate them and deal with 

[ Page 3450 ]

the objective of this bill, which is young people and tobacco.

L. Reid: This is indeed serious legislation. You must rise today and assure us that vending machines will be located on adult-only premises. I need to understand how you're going to handle the hotel lobby situation, where it's possible in thousands of places in this province to find vending machines which have random access. It is not an age-restricted situation as it currently stands. I need a response to that.

Hon. E. Cull: The member is a member of the select standing committee, and I'm sure that her contributions in developing this regulation will be very valuable there. Clearly in a hotel lobby.... If vending machines are in an open place that is accessible to people of all ages, those vendors will lose their licence.

D. Mitchell: I think that under this section I have an appropriate question, and it relates to comments that the minister made last evening in her closing remarks on second reading of this bill. I understand she was drawing a parallel between tobacco products and alcohol, as far as the restrictions on accessibility to them is concerned, and saying that tobacco, like alcohol, should not be available to young people. If that's the intention the minister was getting at in her closing remarks in second reading, I wonder if she could just clarify that and I think it does relate to section 2 of the bill. Is the minister saying, with the regulations which perhaps will be drawn up after the select standing committee has studied the bill once it's become an act, that tobacco will be much like alcohol? Will it be restricted in terms of its access by people under a certain age? From what I understand, this bill is really dealing with the selling of tobacco; it doesn't have anything to do with possession. I wonder if the minister could just clarify that.

Hon. E. Cull: The comments last night were made in response to the member for Prince George-Omineca, I think -- somewhere in that vicinity of the province, in any event. He was commenting on the fact that even though there are laws against selling alcohol to minors -- and, in fact, different from this, there's a law against possessing alcohol as a minor -- minors have access to alcohol, and so prohibition has the effect of creating a black market, if you like. So I was responding to those concerns. This is not parallel to the laws that restrict access to alcohol. The prohibition here is not on having tobacco under age or smoking it under age; it's on selling it to children and young people under a certain age.

D. Mitchell: Thanks to the minister for that clarification. So what this bill is seeking to do is deal with the selling of tobacco products to people under a specified age -- or an unspecified age at this point, because the bill doesn't really deal with what age we're talking about. That's going to be decided later.

Does the minister contemplate that the work of the select standing committee, which is going to be looking at this matter, might possibly go beyond the ambit of that and take a look at the issues relating to possession of tobacco by persons under a certain age?

Hon. E. Cull: The terms of reference of the select standing committee are to look at the regulations under this act and develop those to make recommendations.

Section 2 approved.

On section 3.

[12:15]

L. Reid: I would speak (d.1) under section 3: "...specifying the content, form and manner of presentation of a warning that must be displayed with tobacco at the time the tobacco is offered for sale or is sold to a purchaser...." I believe it's not clear in terms of what the act suggested. Does this warning only pertain to the warning currently found on cigarette packages, or will vendors in this province be required to post large signs over and above those currently found on packages to suggest that smoking is somehow unfavourable to your health? I would move to amend section 3 by deleting in the proposed section 4(d.1) the words "a warning," and replacing them with the words "any additional warnings," and adding after the words "must be displayed" the words "other than packaging at point of purchase."

On the amendment.

L. Reid: To speak to the amendment, my personal commitment and my suggestion would be that the larger the warning the better. We have not dramatically reduced the number of smokers in this province by ensuring that each package carries the warning. I would suggest that we need to broaden the mandate and ensure that any place that currently offers tobacco for sale in British Columbia find a large poster of some description that will educate the public as to the downsides of this particular habit.

Hon. E. Cull: Either I don't understand the member's amendment or the member doesn't understand the section of the act, because that is precisely what this section of the act will do. It will require, in addition to anything that might be on the package itself, the posting of a sign at the point of sale because the packages are small -- unless we get into some of the suggestions which have come from other places of generic packaging. The manufacturers have been very skillful at designing their warning labels into the design on the package. What this section will require is that there must be a sign at the counter that would clearly indicate to the purchaser that the product they're buying is harmful to their health.

D. Symons: In deference to the minister, I believe it really doesn't say that. I think that may be the problem that my hon. member was having here. It just says: "...specifying the content, form and manner of presentation of a warning that must be displayed...." If you have a warning hidden on a package, that's a warning 

[ Page 3451 ]

displayed. I think you want to be more specific. I agree entirely with intent of what you're saying, but I think somebody can interpret this wording as simply meaning: "I've given warning. The warning is there" -- invisible as it may be.

Hon. E. Cull: It's always a difficulty when you're looking at amendments to existing legislation. It helps if you have the existing act beside you when you're looking at it. This section is amending section 4 of the existing act, which is the power to make regulations. There will be regulations that can be made under the act that would do exactly what we're talking about doing here.

L. Reid: That is exactly my concern. I believe we are allowing regulations to determine something that should be found in the act. My amendment speaks directly to the act. Section 3: "allows regulations to be made requiring warnings with a specified form and content...." I have no difficulty with the fact that you would like to see it in a regulation. I'm saying it needs to be a weightier proposal and needs to be found in legislation. I would urge support of this amendment.

Amendment negatived on division.

D. Mitchell: Section 3 deals with some details of packaging of tobacco products and their sale by vendors. Could the minister indicate what consultation has taken place by the government, and by her ministry in particular, with manufacturers, retailers and other vendors of tobacco products prior to this bill being formulated and this section in particular being brought forward?

Hon. E. Cull: Mr. Chair, contact has been established with some of the retailers, but it is my understanding that the select standing committee would be carrying out this responsibility as they develop the regulations.

D. Mitchell: The minister's answer is a further indication to me that we've got the process here backwards. The bill shouldn't have been drafted prior to consultation, but should have been after the fact. The subject matter, perhaps by way of a government motion -- I think it would be appropriate -- should have been referred to the select standing committee, rather than a bill being drafted without any consultation whatsoever.

Having said that, while we're on section 3, I'd like to ask a question about (d.2), which deals with specifying the minimum number of cigarettes that should be in a package if it is offered to be sold to a purchaser. I understand that what's being driven at here is the whole issue of so-called kiddie packs, which are packages of 15 cigarettes that are sometimes sold. I believe that we're trying to restrict that, so only packages of 20 -- larger-size packages -- are available for sale. I wonder what the ultimate effect is here. We talked about this last night during second reading debate, but I think it's important for the minister, on the record in this committee, to address this issue. She did talk about it briefly in her closing remarks in second reading last night. But is the ultimate effect of this going to be that the so-called kiddie packs or packages of 15 cigarettes will not be available? So underage young people will now be buying larger packages of cigarettes or having access through direct or indirect means to larger packages of cigarettes? Is it going to encourage people to buy larger packages, and what is the effect of that going to be? Has the minister really thought this one through, or should this have been a matter left up to the select standing committee as well?

Hon. E. Cull: I cited some studies last night that show that with this kind of legislation the number of children smoking drops. Therefore the number of children purchasing cigarettes is dropping as well, as a result of them having to find more money to buy cigarettes. They are less attractive to children. The smaller the packaging and the cheaper the purchase price for a limited number of cigarettes, the easier it is for very young children with limited amounts of money to buy cigarettes. That's why the concern about the selling of single cigarettes from open packages is included in here.

Presumably there will be some youngsters, particularly teenagers, where money may not be one of their problems, who will have no difficulty finding the money to purchase a pack of 20. As I mentioned last night, the average age of initiation is 12. I think, particularly at that age, it will have an effective impact, and evidence in other states has shown that it does.

D. Mitchell: If what the minister says is correct, then I think we can be encouraged, because what we are getting at here is that the purpose of this bill is to discourage young people from having access to tobacco products, because we recognize that this is a powerful drug. It's a serious drug that has addictive qualities, and we want to discourage young people from having free access to this drug.

What concerns me is whether or not we are underestimating the resourcefulness of some young people who have access directly -- or indirectly is perhaps the greater concern here. I wonder if the minister would be able to provide the members of the opposition some of the studies to which she refers. I'd be most interested in seeing copies of these.

Hon. E. Cull: I'd be most happy to have my staff put together a package of studies and materials that the opposition could have a look at.

Section 3 approved.

On section 4.

D. Mitchell: I have a question on section 4, on the commencement of this act. It relates to the debate that we've been having about the usage of the select standing committee. Could the minister indicate whether or not it's the government's intention to give royal assent to this bill after third reading, or will they 

[ Page 3452 ]

wait until after the select standing committee completes its work?

Hon. E. Cull: I just had a quick chat with staff on this, and part of this bill is to clean up some things in the existing legislation, so I'm not certain of the answer to that. Certainly the act will have no force or effect until the regulations are there to put the teeth into it.

D. Mitchell: Given that answer, I understand the commencement clause. We are dealing with a bill that comes into force by regulation of the Lieutenant-Governor-in-Council. Would the minister then agree or be willing to make the commitment to this committee today that the bill will not be given royal assent until the work of the select standing committee is completed?

Hon. E. Cull: Certainly I understand the intent of what the member is suggesting. What I'd like to do is have another look at some of the specifics, such as the banning of, say, single cigarettes, which we could do right away. I'll take that suggestion from the member opposite under advisement, and we'll have a close look at whether there is any need to enact it prior to the regulations coming into force.

Certainly we need the regulations to be able to make the act work, but there may be some provisions in here that we may want to have right away. The committee is going to have a job ahead of it, and I assume that July and August are not going to be the most productive months for committee members to get on with the task at hand.

D. Mitchell: Thanks to the minister for that commitment. I would encourage her to take a look at this, because there is a principle here that goes beyond the subject matter of the bill. It's a parliamentary principle of not presuming to anticipate the work of a select standing committee of this Legislature, which in effect is a creature of this Legislature, and is the Legislature in miniature form. Rather than to prejudge that work or anticipate it, if the bill could be left at third reading approval stage, but not be given royal assent prior to the regulations being brought in, which are going to be recommended by the select standing committee, I think an important principle will be upheld.

I would hope that the government in future, when referring matters to select standing committees, would not take this approach of bringing forward a bill. It's an awkward process. When dealing with a policy issue, if the opinions of the Members of the Legislative Assembly are truly being sought, if consultation through the Legislative Assembly standing committee process with the general public is truly being sought, then I think we should not put the cart before the horse, and we should have the consultative process first and draft the legislation afterwards.

Section 4 approved.

Title approved.

Hon. E. Cull: I move that the committee rise and report the bill complete without amendment.

Motion approved.

The House resumed; the Speaker in the chair.

Bill 72, Tobacco Product Amendment Act, 1992, reported complete without amendment, read a third time and passed.

Hon. E. Cull: I call committee on Bill 71.

MEDICAL AND HEALTH CARE
SERVICES ACT
(continued)

The House in committee on Bill 71; D. Streifel in the chair.

On section 2.1.

L. Reid: I believe we inadvertently did not pass section 2 in its entirety yesterday evening when we were debating this bill. I would be prepared at this stage to return to the original discussion.

[12:30]

Section 2.1 approved.

On section 2 as amended.

L. Reid: The comment I wish to make was in reference to the earlier discussion. On the opposition side of the House, we truly believe that the new tripartite commission should have an administrator. That person was separate and distinct from the chairman of the tripartite commission, i.e., that the nine members of the committee selected someone to chair that particular body from one of their own.

Section 2 has not been carried forward in its entirety. The amendment would read: "The commission may employ at least one person to administer this act, and whose duties and responsibilities will be determined by the commission. This person shall report directly to the commission." This amendment is standing today because it's the heartfelt belief that for this to proceed as a democratic co-management model that it requires an administrator, but it also requires a chairman who is selected from the nine. We do not feel that the position can be carried forward by one person. We believe that those entities must be separate and distinct; that the chairman of the commission cannot be the administrator of the plan. Believing that, we have put forward this amendment to suggest that they need to be different people and that now the commission, under this amendment, will have the ability to hire someone to report directly to the commission.

Hon. E. Cull: The intent of this particular section is to have the doctors and the public share in the decision-making of the Medical Services Commission, not to appeal the Medical Services Commission out of 

[ Page 3453 ]

government and remove it from the public service. The employees of the Medical Services Commission will continue to be employees of the public service.

Section 2 as amended approved.

On section 3.

L. Reid: We have some concerns regarding the subcommittee structure that will be in place under this section. In fact, we would amend section 3(1) by adding "and shall include representation appointed by the appropriate licensing body and from the public" after the word "exercise."

We believe the mandate must be of a democratic nature. We believe the mandate must be expanded to include and almost, if you will, diminish the powers of the subcommittee in that the licensing bodies should be well represented. This does not, in my view, give us the assurance that we will be able to trust in the work of these subcommittees as currently carried forward under this document.

Hon. E. Cull: The purpose of the subcommittees is quite broad, I guess. The first subcommittees that I expect to be created under this act will be the tripartite committees that the member refers to, with respect to the complementary practitioners -- the other health care practitioners who are not doctors. But it is conceivable that there will be other subcommittees that will not be tripartite and could be composed in different fashions. The purpose of this section is to give the Medical Services Commission and the Lieutenant-Governor-in-Council a broad scope. We have discussed with the complementary practitioners how this section will work for them, and my advice is that they are satisfied with it.

L. Reid: The act currently reads: "The Lieutenant-Governor-in-Council may, after consultation..." -- again, we do not seem to have agreement on what consultation truly means to every single member of this House, so that is a concern to us -- "...with the appropriate licensing body, establish one or more subcommittees of the commission composed of such members of the commission and other people as the Lieutenant-Governor-in-Council specifies to exercise." We need to see "and shall include representation appointed by the appropriate licensing body and from the public."

On the amendment.

L. Reid: This is not diminishing your act, hon. minister; it is in fact expanding its mandate and ensuring that none of the reasonable contributions made by licensing bodies can be excluded. This is an incredibly permissive clause -- you may do it, but again, you may not -- and as it stands, we would like some assurance that the licensing bodies will be recognized for their contributions under section 3(1) of this act.

I would ask the minister the number of subcommittees she would propose under this section, and indeed, what the cost will be to the taxpayers of each of these subcommittees.

Hon. E. Cull: The cost to the taxpayers of the subcommittees will be quite minimal, because there is no salary or remuneration considered for serving on the committees.

L. Reid: Thank you to the minister. I appreciate that remuneration will be limited, in your eyes. However, could you please comment on the number of subcommittees you would anticipate striking? If those decisions have already been reached, would you be so kind as to share those with the House?

Hon. E. Cull: It's six, should all complementary practitioners choose to go this route. There could be an equal number for appeals and hearings. There is nothing in here that would preclude the Medical Services Commission from recommending to the Lieutenant-Governor-in-Council the creation of other subcommittees to carry out specific duties.

L. Reid: Again, to speak to the amendment, it is vastly important that as well as justice being done in terms of representation, that it be seen to be done. My comment is that this is incredibly permissive. The minister may indeed do as she has suggested, but she is not required to under this section. The subcommittee creation is fundamental to the intent of this bill and to the behaviour that will be allowed under this act. We believe that this is a cornerstone document, and if we continually not articulate the exact powers under these subcommittees, we believe we are doing the entire medical system harm. Again, I would urge your support of this amendment.

Amendment negatived.

L. Reid: I would speak directly to section 3(1)(a). It says: "the powers, duties and functions of the commission under sections 10, 14, 28 and 32," etc. The issue I am taking here is with "the powers." It is my view that, if it is not possible to delete this entire section, there has to be some recognition on behalf of the minister as to exactly what those powers are. We need them cited specifically this afternoon, hon. minister. To say "the powers" is broad-based; it is a permissive section. We need some examples and specific citations as to what that would include.

Hon. E. Cull: The powers of the commission under sections 10, 14, 28 and 32 are explicitly set out in those sections.

Amendment negatived.

L. Reid: Again, in terms of where we're headed, this does not allow sections 10, 14, 22 and 32 to be all-inclusive. It certainly recognizes those, but it doesn't 

[ Page 3454 ]

preclude the powers of this committee extending into other areas. That is an extreme difficulty for us.

However, I would move on and speak directly to section 3(3): "A power, duty or function given under subsection (1) to one subcommittee may also be given under subsection (1) to another subcommittee." Again, the motion today to delete section 3(3) stands firmly behind the argument I made with the previous section. We are not doing any better job of defining a power at this time. I need the minister to give me some specific examples, where I can be reassured that this power, as it stands undefined, is not going to be abused.

On the amendment.

Hon. E. Cull: Section 3(3) has to stand. I will be opposing the amendment, because it's quite conceivable, and in fact intended, that various health practitioner subcommittees will exercise the same power, albeit it will be the power pertinent to their particular profession. But the powers of part 4 of the act would be implemented by all subcommittees representing a particular health care practitioner category.

L. Reid: Hon. minister, I appreciate the representation of power, but I need you to address the extent of the power in existence under this act.

Hon. E. Cull: The only power that anyone can implement under this act is the power that is given in particular sections. It is not necessary to cite the powers when another section is being referenced or when the act is being referenced. These sections are clear from a legal point of view, and it can be easily determined what power can be exercised by any given subcommittee because of the referencing and the legal words in this act.

Amendment negatived.

D. Mitchell: Did we have a proper vote on that? Did I have a chance to vote? It sounded like it was agreed to.

J. Tyabji: It sounded like there were "ayes" across this House.

D. Mitchell: On a point of order, for clarification here, some of the amendments have been going through very quickly. As a member of this committee, I have not had a chance to express a voice vote on them. I wonder if we could just move a little more slowly on the amendments to give every member of this committee a chance to express their support or lack of support for the amendments.

The Chair: Thank you for your words, hon. member. The votes were properly and duly constituted. The question was called, and the votes have been recorded.

L. Reid: I would speak directly to section 3(4). Allow me to read section 3(4) as it stands: "The Lieutenant Governor in Council must designate the chair of each subcommittee and may designate a deputy chair of each subcommittee." I would propose that section 3(4) be deleted. The amendment I would propose this afternoon is: "The members of each respective subcommittee shall, by majority vote, designate one member to act as the chair of each subcommittee and the deputy chair of each subcommittee."

On the amendment.

L. Reid: This is fundamental to where we're going as a parliament, and it is fundamental to our understanding of what it is to be in a democracy. We are not comfortable with this minister's continual abuse of power -- potentially. We would like to see these committees as effective working groups. They should be regarded with enough respect that they can choose their chair. If we're going to return to discussions on earlier sections and suggest that it's important and prudent to have licensing body representation on these committees, surely we can understand that it makes sense to have each of those respective committees select their own chair.

The language as it stands -- "The Lieutenant Governor in Council must designate the chair of each subcommittee..." -- is not the direction we wish to go in. This entire section is speaking to co-management. It is speaking to some tripartite arrangement whereby we believe that all stakeholder groups, all shareholders in care, are going to be directly involved in the delivery of this care. If that is truly the intent and if that is truly what this minister believes, she must allow some decisions to be reached by the committee. I believe that the most fundamental of those decisions is who chairs that committee.

We put a lot of respect in the chair of a committee, because we believe that they have been entrusted to do the work of this parliament. If the minister is going to refer any items to committee, surely the people who will come forward to sit on that committee will have enough ability to select a chair who will serve them well -- in the eyes of this minister. I would appreciate her comments.

[12:45]

Hon. E. Cull: We had a full discussion on a similar matter to this yesterday when we discussed the chair and deputy chair of the Medical Services Commission -- if you want to think of this as being the larger committee that would deal with the physicians. We went around that quite a bit. The other side expressed their opinion; we expressed ours. The amendment of a similar nature was defeated. And of course, for the same reasons, I'll be opposing this amendment, particularly considering the fact that the other amendment was defeated. Not only would all the arguments that I made yesterday still stand, but now I would also bring in the argument of inconsistency with the rest of the act.

L. Reid: This is not good legislation. If you were to be inconsistent with your actions of yesterday, we would finally believe that you had seen the light and 

[ Page 3455 ]

that you believe in democracy in British Columbia. We are not in favour of powers such as this having the potential to be abused. We can see that these committees can somehow impact on the role of the tripartite commission and, in fact, divert its work and direction. You have not addressed the question of how many of these subcommittees there will be. Certainly we can see some incredible machinations going on. The potential for abuse in this is rampant, and I would suggest that, given your comment of a moment ago, that you be inconsistent, see the light and support this amendment.

D. Mitchell: I'd like to lend a few words in support of this amendment and make a plea for inconsistency on the part of this minister. If she thinks it's going to be inconsistent to support an amendment that will improve this bill, then let's hear it for inconsistency, I say. This section allows cabinet to essentially designate the chair of any subcommittees of this new supercommission that is going to be established. It is a tremendous power that's centralized in cabinet, unfortunately. It allows for political interference in the operation of the new Medical Services Commission which is going to be governing our health care system.

We've talked a lot, both at second reading and also in committee, about the independence of the commission. The minister has said that the intention of the government is for the commission to be independent; yet these subcommittees that can be struck under this section of the bill will have tremendous power. The chairs of the subcommittees are not going to be elected from among the other members of the commission; they are going to be chosen by cabinet. It leaves room for political interference in the health care system of the province. The minister says that she believes in the independence of the commission. She could prove that by agreeing to the amendment and allowing the members of the commission to appoint subcommittee chairs. It's a very simple amendment; it should be non-controversial.

We look forward to the minister's comments on this with respect to the independence of the commission, which is so crucial.

Amendment negatived on division.

Section 3 approved.

On section 4.

L. Reid: I have a number of questions relating to this very extensive section with its many parts. I will start with section 4(1)(a): "...administer this Act on a non-profit basis." I would need some clarification for that. Does this preclude payment for service beyond primary care?

Hon. E. Cull: It means that the commission cannot operate or administer the act in such a way that creates a profit.

L. Reid: I would speak directly to section 4(1)(c): "...determine the services rendered by an enrolled medical practitioner, or performed in an approved diagnostic facility, that are not benefits under this Act." I would appreciate some examples of what would not constitute a benefit under this act?

Hon. E. Cull: The ability of the commission to determine the services rendered by an enrolled medical practitioner or in a diagnostic facility that are not benefits under the act is currently by regulation under the existing act. At the recommendation of the practitioners we have brought it into the act.

D. Mitchell: I can understand why someone needs to determine whether the services rendered should be approved.

Going back to section 4(1)(a), which says that the act should be administered on a non-profit basis, I heard the minister's response to that. Why would that section be in this bill? Why would that be necessary in this bill? Is the minister anticipating something in particular?

Hon. E. Cull: Section 4(1)(a) is there because the Canada Health Act says that provincial plans be operated in this manner.

L. Reid: It's an interesting question. I'm amazed that the minister would reference the Canada Health Act, because so much of what has been done in this House has absolutely disregarded the Canada Health Act.

However, if we look at how businesses operate in the province, profit is often tied directly to efficiencies. So what are we saying here -- that we are going to continue to operate on a non-profit basis and continue to have inefficiencies in the system? Or should it be our goal to operate this system as efficiently as possible and at some point turn a profit?

Hon. E. Cull: The Canada Health Act, under which this plan operates -- it's section 8(1)(a) -- requires that plans be operated on a non-profit basis. We would get ourselves into serious trouble with respect to federal transfer payments should we not be operating the plan in this fashion.

L. Reid: I would turn to 4(1)(h): "...determine whether a person is a medical practitioner or a health care practitioner...." Is this a useful clause, hon. minister?

Hon. E. Cull: Yes, it is.

D. Mitchell: I appreciate the minister's answer to that question. Could she tell us the distinction between the two categories, medical practitioner and health care practitioner. I'm not sure I understand it all that clearly.

Hon. E. Cull: The definitions are in section 1 of the act, but the easy definition is that a medical practitioner is a doctor, and health care practitioners are other practitioners, such as a physios, chiropractor, optometrist, etc., that are covered under this act.

[ Page 3456 ]

D. Mitchell: If the definition is there in the act, why would the commission need to have the power to determine whether a person is a medical practitioner or a health care practitioner?

Hon. E. Cull: Because some might be both, and for the purposes of the act they have to determine which they are -- to apply the various provisions of the act.

D. Mitchell: Is the minister then saying that should this bill become an act of this Legislature, no single practitioner in the province could be both a medical practitioner and a health care practitioner simultaneously?

Hon. E. Cull: No, I'm not saying that. It's just saying that if you are looking at a provision of the act which, say, applies only to a health care practitioner, and someone is both a doctor and a health practitioner of some sort, the commission then determines which category that individual is in for the purposes of the act.

D. Mitchell: Can the minister tell the committee whether or not this particular subsection has been inserted in the bill as a result of consultation with medical practitioners and health care practitioners in the province?

Hon. E. Cull: No, it hasn't, but, as the member knows full well, the provisions of the act have been discussed with both the doctors and the health care practitioners, and I'm not aware of an amendment that either has brought forward with respect to this particular section.

L. Reid: I would speak this afternoon to 4(1)(o), which currently reads:

"...establish advisory committees, including pattern of practice committees, to advise and assist the commission in exercising its powers, functions and duties under this Act, and may remunerate members of a committee at a rate fixed by the commission and pay reasonable and necessary traveling and living expenses incurred by members of a committee in the performance of their duties...."

My understanding is that these advisory committees currently exist. We have one which has representation by the B.C. Medical Association, the College of Physicians and Surgeons, the public and the government. The pattern-of-practice committee, I believe, is in existence, and I'm wondering why this section suggests the establishment of such a committee. Perhaps it would be more prudent to suggest recognition of such a committee. I would be interested in the minister's response in terms of allowing the word "establish" to be carried forward in this amendment. Are you indeed removing the existing committees and replacing them with something new? Should we not be recognizing the fact that these committees are in existence and, to my knowledge, performing just fine?

Hon. E. Cull: This section of the act recognizes the existing patterns-of-practice committees by doing it in law now, as opposed to having them operate informally. I've had some discussions with the chair of the BCMA patterns-of-practice committee about the problems that committee has in operating effectively.

L. Reid: I appreciate that comment, but if you could elaborate on the problems, perhaps I would be able to see the usefulness of this particular section. My recognition is that these committees are established. I need you to either recognize that they're working or suggest why the conversation you had suggested there are problems. How is this going to be different from the one that's currently in existence, if there are problems?

Hon. E. Cull: Mr. Chair, I was simply making a comment on the comment the member made with respect to the functioning of the patterns-of-practice committees, because she said that they were functioning just fine. I just wanted to point out to her that, while I have no personal knowledge of how they function, Dr.Hardwicke has told me of a number of problems with the functioning of their committee.

In any event, we think they are valuable committees, and they can certainly be very useful and no doubt improved. At the request of the B.C. Medical Association, we have put in this clause "including pattern of practice committees," so that we specifically and legally recognize their existing committees in addition to any other advisory committee that might be struck.

L. Fox: Section 4(1)(o) appears to give the committee the opportunity to appoint advisory committees that would include travel and several other cost items. Can the minister inform me as to what the control mechanism will be to control costs with respect to this section? Perhaps she could tell me how that might control how many advisory committees might be struck and how many individuals would be on the respective advisory committees.

Hon. E. Cull: There are two primary financial controls that I can point to for the member. One is the budget of the Medical Services Commission, which will continue to be established through this Legislature as it has always been established. You will appreciate that the commission manages a budget, but that there is also an operating portion paying for staff, pens, paper clips, travel and other things that would be required. It will still be the purview of the Legislature to determine that.

In addition to that, there is the Financial Administration Act, which has controls over these kinds of financial arrangements. There are many cases where reasonable expenses and a remuneration, particularly to avoid the loss of income, are part and parcel of how committees operate. With those kinds of safeguards we would have the same kinds of financial control over committees under this legislation as we do over committees that are established through other acts of this Legislature.

L. Reid: I will refer directly to section 4(1)(s), which says: "...establish guidelines setting the number of practitioners that a beneficiary may consult respecting the same medical condition within the period specified 

[ Page 3457 ]

in the guidelines...." The reason I'm raising this is that a number of constituents have come forward and asked if this precludes them seeing a different physician. Does this preclude a second opinion on the same condition? What if you choose to change a physician for some other reason? At some point will the government come back to them and suggest that they are not allowed under this act to see a different physician or to consult with a second physician for the purpose of receiving a second opinion?

[1:00]

Hon. E. Cull: The Medical Services Commission has the power to do this, not the government -- just to correct the member. The intention here is that we may want to limit beneficiaries to seeing no more than ten physicians -- ten second opinions, if you like -- on the same subject. While it is a very small number of beneficiaries who behave in this way, there are some who go from doctor to doctor to doctor for exactly the same condition. It has nothing to do with second opinions or wanting to change doctors or to seek treatment; often it has to do with other problems the beneficiary may have which have a financial impact on the system.

[R. Kasper in the chair.]

L. Reid: I would like to commit the following statement to the record: I appreciate the clarification, but what I'm hearing is that this will not affect patients, under the system as it stands, who would be receiving two or three opinions. This would be looking at people who had received, say, in excess of five opinions for the same condition.

Hon. E. Cull: It's looking at people who abuse the system -- for example, somebody who goes to ten different doctors to get ten separate prescriptions, or people who go to the doctor because they are lonely. Unfortunately, we have a lot of people who are lonely. While it's a serious concern that I think we have to give some attention to in our society, it can also be a very expensive proposition for our system.

L. Fox: With respect to (s) under section 4, I am to assume from the minister's statements that this will not so much be a limiting factor; it will be more of a clause that will allow you to deal with individuals who abuse the system. In other words, each case will be looked upon on its own merits. Is that correct?

Hon. E. Cull: That is the primary intent: to be able to tie some beneficiaries who, for various reasons -- some of them for mental health reasons -- are creating problems for the system. I won't say abusing, although you could interpret it that way. I think we have to deal with those individuals in a compassionate way with respect to their needs, but recognize that it can place an extraordinary burden on the system. In this case we need to recognize that there are some cases of utilization that doctors don't control, and this is a good example of one. We can put the responsibility, then, back on the beneficiary.

L. Fox: Just one brief concern with respect to (r). I'm actually quite surprised that the official opposition didn't deal with that particular issue. Much was said during second reading about patients' rights over their files.

In a recent court decision on June 11, the Supreme Court in the case of McInerney v. MacDonald ruled that the information in the files belonged to the patient and that although the doctor has the right to maintain those files in his office, nobody else has the right to access those files without either a court order or the permission of the patient. This particular section seems to take away the precedent of that ruling.

Hon. E. Cull: I'm having difficulty understanding the connection between the case that the member is citing and this section. The purpose of (r) is to be able to gather information concerning claims submitted by the practitioner to the commission.

L. Fox: Of course, I'm not a practitioner, but I would assume that in order to do that, you would have to access confidential files to substantiate the charge. Is that a wrong assumption? If so, I am incorrect.

Hon. E. Cull: I perhaps could counsel the member that his concerns would be better raised when we get to the audit provisions. This is not identifying individual patients in this case. It's the patterns of practice of a practitioner, as opposed to the confidential records that he is referring to. We will get to his concerns if we get to the audit sections of the act.

D. Streifel: I respectfully request leave for an introduction.

Leave granted.

D. Streifel: Visiting in the galleries today from the east coast of this country is the mother of our Clerk Brenda Fraser: Mrs. Agnes Fraser. I just have one question: did you bring any lobsters with you? Would the House make her welcome, please.

Section 4 approved.

On section 5.

D. Mitchell: With respect to the powers and responsibilities of the commission itself, and the fact that this bill refers to them in such an explicit way and says that the commission may do all of these things, is it the minister's intention that the commission will do all these things, or are these some of the things the commission might do, or will this represent an accurate reflection of the mandate, the responsibilities and duties of the commission as the minister would see them developing here?

[ Page 3458 ]

Hon. E. Cull: The intention of this section is to give the commission some flexibility to act so that nine individuals don't have to do everything and so that they can have others helping them with the immense job that we are going to be giving to them through this legislation. But there were some particular functions of the commission, and they all relate to orders that would affect beneficiaries or practitioners: establishing payment schedules, amending, suspending or cancelling the approval of a diagnostic facility and the recovery of money. These are very sensitive issues that we have explicitly prohibited the commission from being able to delegate to other bodies. We think that those are very important decisions that really do need to be made by the nine-person commission.

D. Mitchell: Could the minister tell us how she might anticipate the commission interacting with the new freedom-of-information and privacy commissioner being established by the government? How would she see the commission being open to scrutiny by such a commissioner of this Legislature?

Hon. E. Cull: The commission is part of government, and therefore is completely covered by freedom-of-information legislation with the protections that exist under that with respect to confidentiality, etc. Also, as we proceed through this act, we will come to the sections which deal with confidentiality. It will be treated exactly the same as any other part of government, or indeed as the Medical Services Commission would be treated now if we were not changing it through Bill 71 and if it were just to continue in force as it does right now.

D. Mitchell: With respect to the privacy commissioner, would the minutes of the commission itself or of any subcommittees of the commission, subject to the restrictions that the minister has mentioned, be available under the freedom of information legislation that has been developed here in the Legislature?

Hon. E. Cull: With the restrictions that are obviously needed to protect the confidentiality of patients and individual practitioners, I would hope that the work of this body would be open to the public and very accessible through freedom of information legislation. My intent is to try to open up the commission and not to keep it behind a closed door.

D. Mitchell: I'm trying not to be in too much of a hurry, because I'd like to make sure that we don't miss anything here. In terms of the powers of the commission to delegate that are listed under section 5.... This is a controversial section in the sense that we're establishing a commission intended to be independent from government, and the minister has spoken at length about that. The commission also has very broad powers under this section to delegate any of the commission's or the chair's powers or duties, other than the commission's power under certain sections, to a person named by the commission. Why would that be necessary? Why would those broad powers of delegation be required, given the nature and balance that's already been achieved in the commission, and what the minister has stated earlier about the mandate of the commission being fairly broad? Could she give us some examples?

[D. Streifel in the chair.]

Hon. E. Cull: The member will appreciate that the commission actually has some very significant tasks to carry out as it manages the Medical Services Plan for the province. It may not want to do all those jobs directly itself. It may not want to leave them all to staff to perform.

Let me give you an example. One of the things we want to do is to have a widespread public education campaign with respect to responsible use of the medicare system. As opposed to doing that directly, the commission may want to delegate that responsibility to an individual or another group to carry that out, to develop the plan, to give direction on the hiring of the advertising firm, if that was the way it was going.

There are many things that need to be done. I just picked that as one example, but you can imagine there would be other cases where the commission, as opposed to doing all the work themselves, would want to be able to delegate that and direct it to particular individuals.

D. Mitchell: I can see from what the minister has indicated that this section of the bill would provide tremendous management flexibility to the commission. Would there be a certain human resource pool that would be looked at as potential persons whom the commission may delegate to, or would it be open to just about anyone in British Columbia that the commission so chooses? Or would it be a pool of specialists who would be considered as people who might have some of the powers of the commission delegated to them?

Hon. E. Cull: There is a staff of the Medical Services Commission that exists right now. It is 450 people who are able to carry out the work of the commission. But the commission can look elsewhere. They may decide to delegate a responsibility to an academic at a university to look at something for them; they may want to take a group of practitioners and have them look at something. Within the operating budget that they have to function, the possibilities are there for them.

F. Gingell: I would not imagine that you believe you need section 5 to enable staff members to carry out normal staff functions. I would imagine that section 5 deals only with the powers that are specifically dealt with under this act and to which the commission has been given responsibility.

Appreciating that this is quite a thick bill with a lot of sections in it, I was trying to go through to see what responsibilities and powers are the responsibility of the chairman of the commission separate from the powers, responsibilities and duties of the commission. Could you just cover what those powers are?

[ Page 3459 ]

Hon. E. Cull: Let me give an example. The act gives the commission the power to enrol a beneficiary. We don't want the nine individuals doing that; they need to be able to delegate those administrative tasks to staff. The act empowers the commission to use public education as a means of living within the budget. I just gave an example of that. That might be delegated to some other body.

The act empowers the commission to establish guidelines and protocols that would govern what benefits would be covered under the act. Again, the nine members may not want to do that directly themselves. They may want to delegate that to a subcommittee or to the College of Physicians and Surgeons. There are many possibilities there. This section of the act makes it clear that the commission has the ability to delegate administrative matters and other matters to bodies that they see fit to carry this out. We're giving them the authority and the power to do it, but also the flexibility to carry out the job. Then we are limiting their power to delegate in a number of cases that we think are important enough to be retained at the nine-person commission level.

F. Gingell: I'm terribly sorry, Madam Minister, you misunderstood my question. In fact, I had listened when you gave the answer to that question before.

Section 5 deals with the powers and duties of the commission and the powers and duties of the chair. When I was looking through the act -- I'm not terribly familiar with all the sections; it's a complex piece of legislation -- I didn't find where there were powers and duties of the chair. I only found powers and duties of the commission, and that the chair has the ability, as we had discussed earlier in debate, to fulfil the powers, duties and responsibilities of the commission in the commission's absence. But are there any powers and responsibilities of the chairman of the commission designated in the act that are separate and distinct from the powers of the commission? That was my question.

[1:15]

Hon. E. Cull: Yes, there are, and we'll be coming to them. Section 17 is one such example.

Section 5 approved.

On section 6.

Hon. E. Cull: Mr. Chair, I move the amendment to section 6 standing in my name on the order paper. [See appendix.]

Section 6 establishes that a resident of the province is to be enrolled as a beneficiary under the plan upon application to the commission. Persons who are already insured under the present act will continue to be beneficiaries under the new act, and no additional application will be required.

Section 6(7) enables the commission to cancel the enrolment of a beneficiary if the commission considers that the beneficiary is no longer a resident. We are changing the wording here to go from "considers" to "determines" at the request of the BCMA. They suggested that the word "considers" was inappropriate; it should be "determines."

We will also be making amendments in later sections dealing with the hearing and appeal procedures available in the same manner to a beneficiary who has been subject to a determination under section 6(7).

Amendment approved.

On section 6 as amended.

L. Reid: I appreciate the clarification of the word "determines," because in my view, that suggests that somehow you must approve without doubt that the person is or is not a resident. "Considers" was very broadly based and in our view was certainly open to some abuse. So I compliment the minister on that particular comment.

Again, our question about residency requirements. We believe that what has transpired in this act still allows the government to disfranchise students or workers who are out of province. I would appreciate at this time the minister's assurances that there is some process that would allow exceptions to be considered fairly under this new system.

Hon. E. Cull: We spent some time on this yesterday. The definition of "resident" is in section 1 of the act. It requires that somebody be resident in the province for six months of the year to be determined to be a resident, unless they are a student. We have regulations that give a student up to five years out of the province to take studies that fit the requirements of our regulations. So there is provision for students.

There is provision for people who are out of the province for part of the year. But interestingly enough, in discussing with staff, we do have people who are not resident in British Columbia -- they may not even be resident in Canada -- who maintain a postal box here. From time to time we find these people and discover they're living in Hawaii or California or some other part of the world and trying to maintain their coverage under the Medical Services Plan. Clearly that's not what this is intended to do. It's not in the best interests of taxpayers in this province, so when we do discover these individuals, we do need the power to make sure the commission can cancel their enrolment until such time as they've moved back to British Columbia.

K. Jones: When you're in a position of cancelling due to residency, could you explain what sort of appeal process there is for those who feel they're unjustifiably barred from the plan?

Hon. E. Cull: Those sections are coming up under section 10 and also the appeal board, which is 36. We will be going through those. There is appeal should beneficiaries find that their enrolment has been cancelled.

D. Jarvis: I can appreciate the six-month aspect, and also the consideration of the member for Richmond East wanting to look after the student aspect. Can 

[ Page 3460 ]

something not be put in there relating directly to students alone?

Hon. E. Cull: The definition of "resident" is in the interpretation section of the act, section 1, and that's where we would do that. We dealt with that section yesterday; it's passed. Defining "resident" or trying to redefine it now would be very awkward, because it is used throughout this act, and you really need to deal with it in the interpretation section.

F. Gingell: Subsection (2) requires the commission to enrol a beneficiary effective at a date not more than three months after the receipt of the application. I don't understand why there is a time-limit there. Is that time that's required to ensure that the application is genuine and proper?

Hon. E. Cull: It's a three-month waiting-period for people who are newly into the province. It's a reciprocal arrangement we have elsewhere. I myself recall, when I moved here from Ontario many years ago, having that three-month coverage from Ontario before the B.C. coverage kicked in. If you happen to be a resident here in the province and for some reason have not become enrolled -- that would perhaps occur in the case of a person who's gone over the age of 19, left the family home and failed to enrol somehow as a separate beneficiary from their family coverage -- there isn't a three-month waiting-period.

F. Gingell: So there is an ability to make the application effective in less than three months if they've already served a portion of the waiting-period. Is subsection (4) for someone who has failed to apply to be enrolled more than three months after they have become a resident?

Hon. E. Cull: Yes, that is the intention, and it particularly applies to children. It's to provide some flexibility with respect to this. We don't want to deny people benefits, but there has to be some kind of process that people go through, particularly when they're coming here from out-of-province. My experience in dealing with constituents who find themselves in the awkward situation of not being covered is that the plan has been extremely flexible in trying to backdate benefits where that's possible. This does give that kind of flexibility.

F. Gingell: Do I understand you to say, Madam Minister, that this is a change from the present practice, and allows an inequity that existed in the past to be corrected?

Hon. E. Cull: You'll understand, I guess from some of the comments I've made in the House about this act, that not only is Bill 71 designed to deal with the current situation we've been having with the medical profession in this province, but some of it is extremely old and of a housekeeping nature. Under the current legislation, many things the commission does are not covered either by regulation or by legislation; they're only covered by policy. We're trying to strengthen the legislative framework, if you like, around some of the practices of the commission that have been in place for so long that everybody assumes that they're law, even though they may have no basis in law.

Section 6 as amended approved.

On section 7.

L. Reid: This section deals specifically with premiums. Certainly this gives rise to a number of questions and refers to election promises, where this government was somehow going to remove the viability of premiums, in terms of not asking taxpayers to pay health premiums. It's my understanding, from looking at this section, that in fact this further entrenches the payment of premiums by British Columbians.

I'm also asking the minister for clarification, because I believe that the Canada Health Act states that the failure to pay a premium cannot somehow impede someone's ability to receive health care. I wonder how we align those conflicting principles under this section. The government was in favour of removing the payment of premiums. How has that earlier position been changed by this particular section?

Hon. E. Cull: Again, this is a case of carrying forward into law existing legislation and existing practice. The issue of premiums in British Columbia has been discussed, I understand, with the federal government many times over the years, and has not been objected to by the federal government under the Canada Health Act.

The member raises the point of what we're going to do with premiums. I'll point out that in our first six months in office we're certainly not going to implement every one of the policies we stated during the election campaign. It would be rather boring thereafter if we did it all in six months; but the intent does remain to deal with the premiums. It's a $733 million proposition per year. The premiums that are charged are, if not the most regressive tax we have on the books in B.C., pretty close to it. So clearly there is an intent to move on it. This year, it was felt that the taxes that had been imposed under the budget had reached a limit that was such that British Columbians would not comfortably accept more. We have maintained the structure for premiums and, more importantly, for premium assistance, which is part and parcel of this section until such time as we're able to make some changes in the tax situation in British Columbia and move from premiums to something that is more progressive.

L. Reid: Yesterday I was speaking to the comments the minister just made, because I do believe that the premiums as they stand are a somewhat regressive tax. I would support a further amendment to this bill, either today or in the future, that looks at an income-based insurance premium scheme -- something that is going to be taken off annually or semi-annually as opposed to something that needs to be collected monthly. I believe this creates tremendous paperwork and is certainly not 

[ Page 3461 ]

a tremendous gain in the eyes of the government. For the record, under the Canada Health Act the collection of premiums cannot be a financial impediment to receiving care. Premiums are fine as long as failure to pay does not impede care. I think that's critical to this section, and I look forward to the minister coming forward at some point with some clarification of this section and hopefully a move to something that is a slightly more sophisticated measure.

Sections 7 to 9 inclusive approved.

On section 10.

Hon. E. Cull: Hon. Chair, I move the amendment to section 10 standing in my name on the order paper. [See appendix.]

This section is one of several in the act which provides for commission hearings to deal with the participation of persons in the Medical Services Plan in circumstances where there has been abuse or misuse of the plan. Section 10 enables the commission for cause, and after providing the beneficiary the opportunity for a hearing, to make an order restricting the number of practitioners, or the type of benefits, for which a beneficiary would be paid. The commission may make such an order in certain circumstances, defined as cause, for the purposes of this section.

I will deal for a moment with the meaning of "cause" for the purposes of this section. Under subsection 10(1)(a), cause includes a beneficiary who "knowingly requested services that are not medically required."

Subsection 10(1)(b) addresses the situation where a beneficiary has submitted a claim where no benefit was provided, or that misrepresents the benefit.

Subsection 10(1)(c) deals with the contravention of section 10, which is essentially the misuse of an identity number other than one's own, or other misuse.

It is important that the commission's administration of the plan not be thwarted by the deliberate refusal of persons misusing the plan to respond to communications that may be essential to hearings under this section. Therefore section 10(1)(d) deals with failure to reply in good faith to a communication from the commission. The effective order under this section is to make the beneficiary responsible for the cost of services provided in contravention of the order. The decision of the commission may be appealed to the Medical and Health Care Services Appeal Board under part 7.

I will now outline the proposed amendments. The amendment to subsection 10(3) simply removes a drafting ambiguity. The notion of cause is irrelevant in the context of making an interim 30-day order where the beneficiary is absent from the province. The amendment to subsection (4) ensures that a person whom the commission has found to be no longer a resident, and hence not a beneficiary under section 6(7), will be entitled to the same notice and hearing as other beneficiaries are given under section 10.

[1:30]

[M. Farnworth in the chair.]

Amendment approved.

On section 10 as amended.

L. Reid: I too would propose some discussion of this section and an amendment, and I would refer specifically to section 10(1). In this section we would like to see the deletion of the words "includes, but is not limited to," to be replaced by "refers to." We believe the clause "includes, but is not limited to," to be expansive -- if you will, to be permissive. We wish to see this section more specific, and we wish to see any powers such as this referred to specifically in the act. I place that before you for your consideration.

Amendment negatived.

L. Reid: I would again refer directly to section 10(1)(d). It reads: "refusing to reply in good faith to a communication from the commission." The intent of our amendment is to delete that line. We believe this to be potentially an abusive situation. Indeed, we have made no consideration here for interpretation, for the individual to receive communication in a language they might undertand. So in fact we've left this wide open for someone to receive a letter that they are not able to act upon and possibly, for no reasons of their own, to be refused service from the commission. It's unacceptable, in our view, and certainly very restrictive. We would appreciate the minister's comment.

On the amendment.

Hon. E. Cull: Mr. Chair, the section is there so that we have some way of dealing with those individuals who just refuse to communicate at all with the plan. That goes back to the one I just mentioned, the post box, where the mail is being stacked up but no one is really there. They're living somewhere else. There is going to be an appeal provided to this section, so that anyone in the circumstance that the member brings up, who for some reason was unable to reply to the commission through double-registered letters and the other means generally used in this case, will have the opportunity to appeal. In the case of language or other disability, there would have to be some safeguard for those individuals, and I believe it is there through the appeal.

L. Reid: This section continues to give me tremendous concern. You are suggesting that if they were unable to reply in good faith to a communication -- and perhaps it was in a language they did not understand -- an appeal process conducted in a language they do not understand is somehow a remedy to that. I have significant difficulties with that. If you wish to continue with this particular section, certainly there must be some consideration given in the act to appropriate language, language that can be understood, interpretation services. As it stands, we are disfranchising people and then saying that an appeal process will somehow put them back in the ballpark. This certainly does not reassure me that beneficiaries under this plan are going to be treated fairly.

[ Page 3462 ]

Hon. E. Cull: In other parts of the act, where we provide the safeguards that the member is looking for, we do make it clear that communications have to be made in a manner that the beneficiary can understand. They would deal with people who have language problems, who may be illiterate or who may have a disability that precludes them from using traditional communication. We need to have the ability to deal with those individuals receiving benefits from the plan in a fraudulent manner but refusing to communicate with the commission. We need to have some means of establishing their eligibility to be covered under the plan. We have found, through practice, that this is a very effective means of getting somebody's attention.

Amendment negatived.

L. Fox: The only concerns I have -- and they are very similar -- are with clauses (5) and (6). It appears that clause (5) actually disallows the practitioner from receiving payment for benefits rendered to the beneficiary in contravention of an order against the beneficiary. This appears to me to put a lot of onus on the practitioner rather than on the beneficiary. Could the minister perhaps explain that to me?

Hon. E. Cull: I believe that the protections the member is looking for are further on in this section, under (7) and (8).

L. Fox: Just so I clarify that, I had read that, but given that there may be an opportunity for a time lapse between when the practitioner is notified and when the action takes place and the service is delivered, clauses (5) and (6) appear to put the onus on the individual delivering the service rather than on the recipient of the service.

Hon. E. Cull: If the practitioner hasn't received the notice -- and it's given electronically as well as through more conventional means -- then the practitioner wouldn't be liable for providing that service; the commission would be. But the electronic means that we have of communicating with practitioners helps speed up this process tremendously.

L. Reid: I would speak directly to 10(2)(b), which says: "the liability of the commission for payment for specified benefits rendered to that beneficiary." What I need to hear from the minister is that this section in no way allows the commission to specify which practitioner a patient must see. Does the section still allow patients to make reasonable choices?

Hon. E. Cull: Section 10(2)(a) deals with that concern. It allows us to limit the number of practitioners for beneficiaries, and they can be named.

L. Reid: I will read subsection (2): "(a) the number of practitioners who will be paid for benefits rendered to that beneficiary, or (b)" -- and I believe that there is a tremendous potential for abuse in (b) -- "the liability of the commission for payment for specified benefits rendered to that beneficiary." Again, hon. minister, I need to hear that this commission will not adopt powers that suggest which specific physician a patient may see within the province -- i.e., if they choose not to see that specific physician, that physician will not be paid.

Hon. E. Cull: I'm still having difficulty with the member's arguments. Perhaps if we deal with them both together: subsection (2)(a) and (b) allow the commission, for cause and after having given the beneficiary an opportunity to be heard, to limit the number of practitioners, who can be named, and also to limit the types of benefits. Perhaps a way of looking at it would be the number of services that would be provided to them -- the number of tests that that individual could have of a certain nature over a certain period. Again, this is designed to get at those unfortunate individuals, who we were talking about a few minutes ago, who abuse the medical plan for reasons other than health reasons. We could get into the details of that, but I think the member knows full well what kinds of situations I'm referring to here.

L. Reid: I appreciate the comments. However, my concern refers specifically to the words "specified benefits." I am not comfortable if "specified benefits" could be translated to mean a specific physician.

Hon. E. Cull: Subsection (a) means specific physician; subsection (b) means type of procedure.

L. Reid: I want assurance that this government, this commission, will not be able to suggest to a particular patient that they must see a particular physician by name. That is my concern. I need your comments on that.

Hon. E. Cull: The commission can, for cause and after giving a hearing, limit the number of practitioners that a beneficiary can see, and those practitioners can be given by name.

L. Reid: My concern over this particular section has come forward from a number of consumers of the program. They see these kinds of sections as being very permissive to the minister and to the commission. In fact, at some point it may evolve into the system currently in place in Great Britain, where you are told that if you live in region X, you will see physician X. That is not a power we would wish to see explored in any more detail under this act. Hon. minister, your comments have not reassured me that that would not be an eventual outcome. Please know that the Liberal opposition is not happy with that eventual outcome, and certainly constituents -- consumers of the system -- are not happy with it. Please reassure us that that is not a direction this particular section would allow you to proceed in.

K. Jones: I also have a great deal of concern about this particular piece of legislation and this section, which could restrict the number of practitioners a 

[ Page 3463 ]

person may go to. I happen to be a member of a self-help group for an injury that is hard to identify. It's one which the medical profession doesn't seem to have a lot of knowledge about, nor do many other semi-professional representatives or organizations in health care or social care areas. It is often the case that these people go from one practitioner to another still having the problem but not being treated. It's not their fault. It's the fault of the system. It's the fault of practitioners not having enough knowledge about this particular injury. They are giving advice that indicates that there's nothing wrong, but the people know that there's something wrong. It happens to be ringing in the ears, head noises. It's called tinnitus. Those people are going to be mistreated by this legislation. How does the minister propose to deal fairly with these people with this legislation?

Hon. E. Cull: This section is not intended in any way to prevent patients from seeking out an appropriate health care practitioner or physician. It recognizes, and I think the commission will recognize full well, that sometimes people do have to get second opinions, sometimes third opinions. Sometimes they have to do some shopping around to find the appropriate health care personnel to assist them. Sometimes people have to try many different kinds of treatment.

What is intended in this section is to prevent individuals from abusing the system for whatever reason, because of needs that are not related to their health requirements. The example I give is of the individual who may go to ten different physicians to get numerous prescriptions, not for the purpose of dealing with an illness but for abusing those prescription drugs. An individual may go to doctors on a regular basis as something to do on an afternoon when they're feeling particularly lonely or depressed. A very small number of people fall into that category.

Those people do have health concerns that need to be addressed. In the first case it may be substance abuse, and in the second case it may be a mental health issue. We are not going to assist those people by allowing them to go from doctor to doctor. We will assist them by restricting them to a particular doctor or perhaps others in her practice who can assist that person, who know that person's background and who can continue to work with them on that basis. That is what this section is intended to deal with.

[1:45]

K. Jones: As the minister stated, our concern is that there is such a small number of people who would be involved in this. It is a rather unfair type of legislation to be bringing in. The people who have a problem in this area usually have a health care problem that needs to be treated, as the minister said. Therefore why would the minister preclude their getting treatment by law? This type of legislation is meant for those who are not persons with health care problems. Very few cases of that occur, by the minister's own statement. This type of bill is harmful to the intent of providing universal health care service specifically to those persons with a special difficulty. You're treating those persons with, say, a mental disability like they're guilty of something. Why are you treating them that way?

Hon. E. Cull: Someone in the situation the member has just described is not going to be assisted by allowing them to go to 50 doctors in a year, a different one every week. No one is ever going to address their problem and be able to start to deal with them. If we're really concerned about that individual, we'd probably do far better to deal with them. Approximately 100 individuals every year are captured in this manner under our current act, regulations and policy. Unfortunately, under the law we have right now, the only choice the commission has is to totally de-enrol them as a beneficiary; you're either in or out. This at least allows that individual to continue to have access to health care practitioners, but in a more controlled manner.

This is a problem that the practitioners have identified; particularly, doctors say they are not solely responsible for utilization. Again, this is a good example of patient-driven utilization. Doctors need some support, they need to be backed up, so that patients cannot drive up utilization this way. They may be few in number, but this can be very expensive in terms of the overall cost to the system. I think it's a reasonable approach to limit access to the health care system by those individuals who, for whatever reason, abuse it, whether it's something they're doing deliberately or as a result of another illness.

L. Fox: It's my understanding that, should a potential abuser be identified.... I guess they're classified as a potential abuser; then they have the option to appeal; after the appeal process, this commission has the opportunity to direct them to a doctor or a group of doctors. That's my understanding of the section. With respect to that, I bring two questions forward: (1)whether or not there would be any help for that individual to build their case through the appeal process; and (2) whether or not that appeal process would be in their community, so they have access to it.

Hon. E. Cull: The process the member outlines is essentially correct. There is a hearing and then an appeal, so there are really two opportunities. The individual has the opportunity through the hearing to explain what the circumstances are and then, once the decision is rendered, to appeal that to a third body. I think that the commission, in establishing the appeal procedure, would be wise to do so in such a way that made that appeal panel accessible to people in their community. Certainly that would be the intent that I would want to see in such a case. It's usually the case in other circumstances where appeals have been brought in through legislation. There's a recognition that you can hardly have a real appeal process if you're told you have to fly 500 miles to Vancouver and attend an appeal there. You really have to take the appeal board to the appellant, if you like.

L. Fox: Just one follow-up, perhaps by way of information to the minister. I would suggest that the WCB appeal process does exactly that: it limits access. If 

[ Page 3464 ]

this appeal process were similar to that, I would have some real concerns with it.

K. Jones: Rather than restricting the person who is having difficulties with this from receiving services, and taking away their right to receive the services of the plan, would it not be more effective to use a diversion process that would give this person who is causing an extra cost to the system some special attention, so that their problem could be addressed, rather than take away their benefits altogether? You're restricting them from many other benefits besides the one that they may be dealing with in the doctor's treatment.

Hon. E. Cull: It's not restricting their benefits. It's directing and limiting them to some extent. I think the member is suggesting that we can take an individual who -- we'll use the example of mental illness -- is abusing the system and going to a different doctor every week and force them to have some treatment. The answer is no, we can't. You can encourage that individual to seek treatment. You can provide opportunities for treatment. If somebody's going to a different doctor every week, we're going to be hard-pressed even to identify the problem, except for having a look at the billings over a period of time on a patient basis. We would then try to redirect that person back to appropriate treatment. That's what's intended in this.

Perhaps the way the member is reading it precludes that, but I don't think that it does preclude that kind of direction and encouragement. We are in a difficult position in insisting that somebody who has a mental illness is treated for it. We have no way of doing that. I don't think that the member would actually want to suggest that we would be insisting on treatment for people.

K. Jones: Could the minister tell us what process they have for redirecting them?

Hon. E. Cull: The commission would have considerable scope in dealing with a problem like this. They would be able to call the beneficiary and discuss the circumstances; they could make suggestions about dealing with their family doctor; they could have someone do a review of the circumstances, if we were dealing with somebody who is mentally ill, and make some appropriate suggestions. That's why the powers that we talked about earlier of delegating some of the responsibilities to others to have a look at it.... They could call in other people to have a look at the situation, to provide an appropriate response.

Right now with the Medical Services Commission we do have medical consultants who review individual circumstances from time to time, make recommendations, and work with family, practitioners and specialists. There is something called a lay-subscriber demand subcommittee that reviews certain circumstances, as we have been discussing. There are a variety of mechanisms that can be used by the commission. They can continue with the practice. It's not that none of this has been happening before; it's just that the way it has happened has been far more arbitrary, as you're cutting them off or leaving them in a situation where they're creating problems for the practitioners as well as the plan. There are processes we can continue with in the commission, because we've given them the power to make the decision. They can develop their own processes to do this.

L. Reid: I would speak directly to section 10(4)(c), which reads: "...the beneficiary has the right to a hearing, to be requested by the beneficiary within 21 days from the date that the notice was delivered, and to appear in person or with legal counsel at the hearing...." It continues into the next section. My concern, and I must share this with the minister, is that the rights of the beneficiary are not clearly understood under this. It is a very permissive section. I believe it requires some discussion.

Ideally, hon. minister, I would hope that one of the first tasks of the tripartite commission will be to identify the obstacles impeding a clear understanding on behalf of the taxpayers of what their rights are. Certainly the writing of this bill is not sufficiently clear as to suggest that it can avoid confusion, or indeed sufficiently clear to alleviate the concerns I have, let alone the individuals coming before the commission to bring forward where they believe the commission or the plan has let them down. I believe this section needs a tremendous amount of work, and I would trust that either regulations or a continuing discussion will improve this section as we go forward.

K. Jones: Further to what the member for Richmond East has mentioned, is the minister planning any advocacy support role? Is there provision for an advocacy support role for this person who is appearing, perhaps in some cases not able to have the pleasure of legal counsel, since they may not have the ability to either understand it or to afford it?

Hon. G. Clark: I'm advised that they can certainly bring someone else with them. The normal course of natural justice would allow that.

K. Jones: Would the ministry be paying for this advocacy person to provide that support? If a person can't afford a lawyer, they surely won't be able to pay for another person supporting them adequately, particularly when dealing with the bureaucracy, which is what has been described as what this person will be having to address through a hearing process and an appeal process, or even some of the alternatives that were being suggested. There seems to be a great deal of bureaucracy that this person is going to be confronted with. I'm talking about a person with a disability, perhaps, that prevents them from making the best judgments about their way of life, through whatever circumstances. It may be a matter of mental disability or physical disability that leads to more confusion, depression or other factors.

Hon. G. Clark: The answer is, briefly, no. No costs will be provided by the commission or the government. If it moves to an appeal stage, then the appeal board has 

[ Page 3465 ]

the power to award costs should it so desire. I want to remind members that this is not a bureaucracy. This is a tripartite body to administer the law. There's some very heavy onus on that commission, including the onus to communicate: "The commission must notify the beneficiary in a manner the beneficiary can understand." It even has plain language in it, so obviously this is not a bureaucracy, as you suggest. This is something significantly different than that.

[2:00]

K. Jones: Further on that, when you state that there will be sufficient understanding, does that include translation services? Would that be paid by the ministry?

Hon. G. Clark: Yes.

K. Jones: Could the minister explain why, then, translation services would be provided, and yet advocacy services, which is the same type of making it possible for the person to state or present their case -- and certainly a lot less expensive than the lawyer would be -- would not be covered in support of this person?

Hon. G. Clark: I'll remind members that it is currently a bureaucracy. There is no appeal, there is no right to appeal, there's no right to communicate in a language the beneficiary understands. This is a significant improvement, and I'm not sure that taxpayers should be paying for advocates when that's not the intent. If it gets to an appeal stage, then the appeal board has the power to order costs to allow for a lawyer. But at this stage, I think this is a significant improvement over what exists currently.

Section 10 as amended approved.

Section 11 approved.

On section 12.

Hon. G. Clark: I move the amendment standing in the name of the Minister of Health on the order paper. [See appendix.]

Amendment approved.

Section 12 as amended approved.

On section 13.

Hon. G. Clark: I move the amendment standing in the name of the Minister of Health on the order paper. [See appendix.]

Amendment approved.

Section 13 as amended approved. On section 14.

K. Jones: I move the amendment standing in the name of the member for Richmond East on the order paper. [See appendix.]

Amendment negatived.

Sections 14 to 16 inclusive approved.

On section 17.

Hon. G. Clark: I apologize. It's section 16.

On section 16.

L. Reid: Point of order. If we are past section 16, the advice that was given to this side of the House was that we could not return. I am asking for a consistent ruling from the Chair.

The Chair: The Chair has shown considerable latitude after having ordered sections passed; members of the opposition have asked to speak, and the Chair has recognized them on numerous occasions. While we are working through this, sometimes the Chair sees a "see" where there's supposed to be an amendment, not a "see." I am going to recognize the minister.

Hon. G. Clark: I move an amendment on the proposed subsection 16(1)(b) by deleting "regulations" and substituting "regulations or by the commission." It's a housekeeping amendment, a technical amendment, and has no significance. We could live without it, but we're trying to clean up these things as we move through.

Amendment approved.

On section 16 as amended.

L. Fox: Point of order. I actually got confused earlier on section 12. There was an amendment for 11, and then you asked for section 12 as amended. You jumped. However, I let that go, thinking that I'd missed it. But now, since you have given the minister the opportunity to go back, I just want to go back to 13 and make one observation.

The Chair: Hon. member, we moved off that section a considerable time ago. It was a quick move from this section to section 17. We're on section 16 as amended.

R. Neufeld: Point of order. I think the member has a good point. He did leave it, and it is section 12 or 13 that he wanted to discuss. We went to 16 before he brought it up again, but that's because it wasn't until 16 that the government wished to go back to a section. He obviously just thought it had gone that far. He's not letting the bill go a long way and then wanting to go back. I think it's a fair request.

[ Page 3466 ]

The Chair: Hon. member, the Chair, as I said, has shown considerable latitude to members of the opposition when we have just moved off a section. We had just moved off section 16; the minister meant to make the amendment. The Chair's ruling stands.

Section 16 as amended approved.

On section 17.

Hon. G. Clark: I move the amendment standing in the name of the Minister of Health on the order paper. [See appendix.]

Amendment approved.

Section 17 as amended approved.

On section 18.

L. Reid: I have significant concerns regarding this section: "Interpretation. 'Available amount' means, for a category, the available amount set under section 20(1) for that category for a fiscal year...." I'm going to require extensive explanation as to why this is found in the bill as it lies before us today. Would the minister refer directly to experience, to demographics, i.e., are we looking at the possible...?

Interjection.

L. Reid: Yes, 18(1).

Are we looking at some point to set a budget specifically for a region of this province, to a group of this province? Where are we headed with this? I am not prepared to leave this section, because I believe this section is wide-open for abuse.

I would welcome your comments.

Hon. G. Clark: We can deal with this on section 18, but if you would just refer to, say, section 20, that actually is where the meat of the description of "available amount" is. I think that might be the more appropriate place for debate. This is an interpretation section. I don't mind doing it -- we could do it either way -- but it seems to me that the debate, if the real question you're asking is "available amount".... Perhaps you could give us just a little more of your question.

L. Reid: The specific word I am referring to is "category." I need to know what we're looking for in 18(1). My concern is that that particular term is wide-open for abuse. It does not preclude, in my view, categories of experience, categories of region, categories of demographics of this province. That is a concern for me, and I'm not prepared to pass section 18 unless that is clarified for this House and for taxpayers and certainly for physicians in this province. If we go forward from this section, we do not have the opportunity to come back and decide whether or not that is even appropriate to be included in this bill.

Hon. G. Clark: Would it not be more appropriate to have that debate on section 21, where "category" is defined? Section 18 would be sufficient for you if section 21 were amended in the way you're suggesting. In other words, the interpretation of section 18 has these sort of tautological descriptions; in other words, a category is defined as a category established under section 21. So the debate on what is a category is really the debate around section 21. That's where the full gamut of what category means can be discussed by the House. Honestly, I don't have any problem. We can do it here, but it seems to me the appropriate place for the discussion about what category means is in section 21.

L. Reid: My feeling is that the minister is not well versed in the discussion that needs to happen at this section. I would suggest, and submit for his indulgence, that the House recess for ten minutes until the Minister of Health can return.

The Chair: Hon. member, the only motion that could be moved would be that the committee rise and report progress.

L. Reid: I would move that the committee rise, report progress and ask leave to sit again 15 minutes from now.

Motion negatived.

L. Reid: In my view, if we're not recessing the House, the minister has no other recourse but to answer the question. Explain to me the parameters of category.

Hon. G. Clark: I'm sorry, and I don't mean to.... I have no problem doing it in this section. It just seemed to me more appropriate. So with the House's indulgence, I'm going to refer to section 21, where the definition of category really exists. Section 21 enables the commission to establish categories of practitioners and payment schedules for those categories. This section enables the commission to establish categories of practitioners. The act is very specific as to the basis on which these categories may be established. They are past service levels, estimated future service levels, pattern of practice, type of practice or specialty. So the commission must establish payment schedules setting out the amounts payable for practitioners rendering benefits under the plan under each category. Payment schedules may differ among categories, distinguish between professional and other aspects of services, include extra payments for special circumstances, and differ among geographic areas. The commission is empowered to retroactively include or increase payments under a payment schedule or established benefits. The commission may also continue to establish a medical educational program. This is more into section 21, but on the categories itself -- which is the question -- it's past service levels, estimated future service levels, pattern of practice, type of practice or specialty.

L. Reid: In that the minister was referring to section 21, I would ask that section 18 be stood down until the 

[ Page 3467 ]

minister returns, and we will continue with the discussion of 19.

The Chair: Is that agreeable to the committee: to stand section 18 down until the minister returns?

Hon. G. Clark: No.

The Chair: Then we continue on section 18.

L. Reid: I too can read section 21. I am looking for an explanation for the creation of categories, not to have section 21 read to me, with all due respect.

[2:15]

Hon. G. Clark: It seems to me straightforward to establish different groups for different payments of services and to recognize the possibility of the past service levels in terms of how we apply those to differentiate between specialties. Establishing categories allows us to differentiate by specialty and by type of practice. It allows the commission to establish different rates for different services. It seems to me quite straightforward. That's the reason for the requirement to have different categories.

L. Reid: Let me suggest to the minister that this is not straightforward. This is not housekeeping. This is a dramatic departure from the way physicians are currently paid within the province. We have a fee for service that pays the exact same amount for the service performed, whether it be performed in the lower mainland, in the north or on Vancouver Island. What you are suggesting in this section, and what I would suggest, hon. minister, that you are ill-advised to respond to, dramatically changes the direction of health care funding in this province. I am not in support of anything that suggests categorization of payment, other than to specific fee for service.

It is seemingly not well understood on your side of the House, but this is a very significant section. The interpretation of how you define a category within the fee-for-service schedule is a huge departure from what we currently do. I need the minister to at least understand that section before we proceed.

Hon. G. Clark: This is a substantial difference in the way in which it's structured. It need not mean there's any difference at all, of course, but it does give the commission the power to vary, by category, fee for service. The commission could decide that it is required to give a higher fee as a result of different regional considerations, or a lower fee as a result of regional considerations. It allows us to disaggregate by specialty, region, or pattern of practice in order to differentiate the fees. I agree with you completely. It is a significant change from the current across-the-board fee structure as negotiated. It gives more fiscal control, but it also allows the commission to enhance funding in certain categories where it is so desired. I agree with you that it could lead to a significant departure and change in the way fees are established.

L. Reid: I would respond to the minister's remarks. I have some difficulty accepting that this is somehow plausible because it's being put forward under this act. Again -- and to be very clear on this section -- to move to a differentiated payment schedule, depending on where you may practice in this province, departs entirely from the fee-for-service schedule which is in place and has been agreed to in this province for at least the last 25 years. What we are anticipating under section 18 is seeing this province move to salaried physicians. Right now, we do not tie income to a salary for physicians. We tie it to the fee for service. A certain number of dollars go to each service performed. That should not change where you decide to perform that particular procedure or process.

The hon. minister made mention of a reward. I'm not looking for government to be any more a Big Brother or any more intrusive. I don't want this government somehow suggesting that we'll reward physicians -- who may have the same level of experience and training and who are performing the exact same procedure -- differently if they perform it in Prince George as opposed to Vancouver. That gives me serious concern, hon. minister. I need to be reassured that this intention is clearly understood by your government, because I'm not clear that, in fact, a shift away from universal.... This is where we're headed with this. If you move away from fee for service, you are somehow suggesting that at the end of the day, if you take this to its natural conclusion, we're going to look at physicians on salary who are going to be working nine to five. The rest of this opportunity or obligation we place upon our medical profession has gone by the wayside. Frankly, I cannot imagine the NDP government would wish to be saddled with that. This is an integral section which is pivotal to the understanding of this entire bill and demands further explanation.

Hon. G. Clark: You're wrong in a couple of instances. First of all, this has nothing to do with moving to salaries; this is still fee for service. It allows varied fees for services rendered. Secondly, I don't know if the member is aware that there is an isolation allowance now. It varies from 6 to 20 percent, so not every physician doing exactly the same service gets paid exactly the same today. We already have varying fees for the same service provided in different regions to recognize isolation or northern regions of the province. So the principle which you say we're breaking has long ago been broken in order to deal with some of the problems attendant to regions of the province. This section establishes a category which allows the commission to vary the fee based on the specialty, the type of practice, the pattern of practice, or northern or regional considerations. That may be an extension of that practice which I've talked about it, but it's not a radical departure in that respect. We currently do vary the fees charged, even for the same service, by region.

L. Reid: I am aware of the northern allowance that currently exists, but that in no way interferes with the fee-for-service schedule we have in this province. That is in addition to the fee-for-service schedule. It does not 

[ Page 3468 ]

suggest that a procedure performed for $400 in the lower mainland is performed for any higher cost in the north. The northern allowance is an additional allowance for living in that part of the province. It does not impact on the fee for service. Again, hon. minister, I would submit that you have misled the House, because in fact these are two distinct issues.

The Chair: Order, please, hon. member. I would ask you to withdraw the statement impugning the minister's integrity.

L. Reid: I have not, in my view, impugned the minister's integrity. I have suggested that his understanding of this section somehow leaves much to be desired. If I might continue....

The Chair: Hon. member, order, please. You cannot either intentionally or unintentionally suggest that someone has misled the House. That's why I ask you to withdraw.

A. Warnke: On a point of order, there is a difference between saying "misled the House" and "misleading" or "deliberately misleading." "Deliberately misleading" is unparliamentary, but to say "misled" or "misleading" is parliamentary and has been established by Beauchesne.

The Chair: Hon. member, misleading is misleading, whether deliberately or not. Therefore I would say that it is unparliamentary and that your point of order does not stand. I would ask the member for Richmond East to withdraw the comment.

L. Reid: If indeed this minister or the Chair believes that I at any time impugned his integrity, absolutely I withdraw that remark.

However, we are not leaving this section until we receive some justification for the dramatic departure it will allow the Medical Services Commission and this government to proceed with. If that somehow hurts the feelings of the hon. minister, my oh my, I apologize! However, I need an answer.

Hon. G. Clark: I'm not sure what the member is getting at. I want to clarify the current northern allowance. The northern allowance is in fact a markup on the fee for service. There is a differential fee paid based on region, so you're absolutely incorrect. This is a continuation of that; it's a broadening of that. It allows the Medical Services Commission to vary the fees paid based on certain categories. I appreciate that that is a departure. The category I've been referring to is a regional category, and it's exactly the same principle we have today. I'm at a loss to understand what the member opposite is talking about.

Rather than a fee for service that is absolutely equal for every doctor, perhaps she should be considering equal services to people. That requires the commission to vary the fee paid in order to ensure that people have equal access to medical services. That is what lies behind this bill, rather than some prescribed notion the member opposite has that the fees should be exactly the same for every person in British Columbia regardless of where they practice or any other category they may fall in. We reject that. The bill is a significant departure from that; I agree.

L. Reid: Again, I would refer my comments directly to the minister. I cannot accept his comment that somehow the northern allowance was an add-on. From where we stand today, we have a fee-for-service arrangement with the physicians in the province. If we're going to somehow look at different categories for services that are delivered, we are not necessarily going to rule out the experience quotient being attached to physicians. We have never paid physicians based on years of experience, similar to trade unions and other professions in this province. I need some reassurance from this minister that we are not looking to have years of experience as one of the possible categories under this section. I have not been reassured at all by the remarks of the Minister of Finance. I would suggest that if seniority or years of experience become an issue under one of these categories, we will have moved from a fee-for-service arrangement to a salaried position. I'm not clear that that is the direction we wish to go in. I'm certainly not comfortable going in that direction.

The Minister of Finance made the comment that it's time we treated all patients fairly. I have no difficulty with that. But let me tell you, this is not about treating patients fairly. If the minister accepts that universal medical care is in place in this province, we are now treating patients fairly. So I have some difficulty with his previous remarks. I would ask the minister to clarify section 18(1). When we speak to "a category," would that ever include years of experience of a physician?

Hon. E. Cull: If the member cares to let us move on to section 21, she will see that there is an amendment standing in my name on the order paper that will deal with the concerns that she is raising around the number of years of practice. It will make sure that no one can be discriminated against based on their number of years in practice, their age or their gender.

L. Reid: I appreciate your remarks. I did note your amendment standing on the order paper. We began with the Minister of Finance looking at "a category" in terms of a region of the province. I'm unclear as to why that would be a direction we would wish to go in, because my understanding was that the fee for service, whether it be the relative value fee guide or the current one we have in place, does handle how we reimburse physicians in British Columbia. Could you expand on this particular direction?

Hon. E. Cull: The reason for regional categories is that we may want to have a differential fee that would pay higher fees to people in more isolated parts of the province to encourage physicians and specialists to move there. We can provide incentives for physicians to move to those undersupplied areas.

[ Page 3469 ]

L. Reid: My understanding was that the purpose of the northern allowance was to encourage other people and to offset the costs of living in various regions in this province. If you are now suggesting that a differential fee schedule will encourage people to live in other parts of the province, what is the future of the northern allowance?

Hon. E. Cull: The northern allowance simply recognizes that there are additional costs involved in practising in isolated communities. That is different from wanting to have a differential fee guide to attract a practitioner to practise in a particular area.

Interjection.

Hon. E. Cull: The member is saying that it's the same thing. You might have additional costs in the north, and conceivably -- although it certainly doesn't exist right now -- an over-supply of physicians in that area. Therefore you might want to attract them to work in another part of the province. It's a question of allowing the commission to use incentives through a regional category. It's something that is done in a number of different provinces across the country.

L. Reid: For the record, I would submit that I see section 18(1), referring to the establishment of categories, as being wide open for abuse. I truly see this section as moving us from a fee-for-service schedule to salaried physicians. I believe that would be the natural outcome. Frankly, hon. minister, I think that what we enjoy today as universal access to medicare will be directly impacted by this section and by the following sections if indeed we are not able to come to grips with this being a dramatic departure. For the record, I leave it with you today. However, please know that your comments and the comments of the Minister of Finance have not reassured anyone as to whether or not patients in different parts of the province will be treated fairly.

[2:30]

Section 18 approved.

On section 19.

Hon. E. Cull: I move the amendment to section 19 standing in my name on the order paper. [See appendix.]

On the amendment.

Hon. E. Cull: Section 19(1) requires the commission to take all reasonable and practical measures to ensure that payments remain within the funding appropriated for the fiscal year. The proposed amendment to this section clarifies that the commission may also take proactive measures in the management of payments such as public and professional education, establishment of guidelines, as well as the establishment or limitation of benefits and payment reductions.

Under section 19(2) the commission may adjust payments to practitioners in a category so as to ensure that payments remain within the available amount set for that category. The categories are established by the commission under section 21, and the commission may under section 20 set the available amount for each category. Under section 19(3) the commission may exempt or limit the application of a reduction where the special circumstances of the patients of a practitioner so require.

Amendment approved.

On section 19 as amended.

L. Reid: I too would move an amendment to this section. I would suggest that section 19(2) be deleted and the following substituted: "19(2) The commission shall through negotiations with the appropriate representatives of practitioner groups set the budget for fee-for-service payments to practitioners."

On the amendment.

L. Reid: Hon. minister, that is the current practice in British Columbia. That is the practice that the people whom we charge with the delivery of these services are comfortable with. Why this ministry would believe that somehow a departure from this is required at this time makes no sense. This particular process -- and again I stress process -- has been followed successfully by both parties, i.e. the Medical Services Commission and the physicians in British Columbia. I would ask that this amendment be carried forward so that this particular practice can continue.

Hon. E. Cull: I'm opposing the amendment. This amendment goes to the heart of the issue that we have with the medical profession in British Columbia. The Liberals are suggesting through this amendment that the prerogative and the responsibility of the Legislature to set budgets for health care and for physicians is to be delegated to another group through negotiations.

We believe that the Legislature has been entrusted to set the budgets, and that is not something we can negotiate or delegate away, in any respect. So this particular amendment is repugnant to the entire direction of the bill.

L. Reid: For the record, I believe I just heard the minister say that she cannot negotiate. That is fundamental to where we are going in this province in terms of the delivery of appropriate medical care. That has been the concern of the Liberal opposition in this province since the day this government was elected: their inability to negotiate, to sit down and renegotiate and discuss and to have some sense of process.

For you to suggest, hon. minister, that somehow negotiation is not required and not possible is absolutely primitive, in my view. We need to ensure that as civilized people we are still talking through difficult issues, and that we are not legislating to get through difficult issues. It is a huge dilemma for me that you would suggest that negotiation is not an appropriate exercise. I would ask for your comment.

[ Page 3470 ]

Hon. E. Cull: Mr. Chair, Bill 71 provides for negotiations with the B.C. Medical Association with respect to their fees and benefits. It does not provide for the doctors or anyone else to negotiate directly with the Legislature with respect to the budgets or the appropriations that are set for particular parts of the health care budget.

Just as school boards negotiate with teachers around their wages and benefits, but not with teachers around the Education budget, this bill has the same impact on doctors. There are other provisions in the act that allow for negotiations of fees and benefits, conciliation, dispute resolution and binding decisions around fees and benefits on the government. But what this amendment would do is bind the government on the budget for health care, and negotiation in that respect is something we're not prepared to do. Indeed, it's in agreement with the other Health ministers across this country who are not prepared to do so either.

G. Wilson: I wonder if the minister might explain, if they are prepared to put in place this particular section in this bill, whether that should apply as a cap or as a wage limit for all public sector employees, everybody who this government negotiates with and provides fees for -- i.e., the BCGEU, the HEU and all the other groups. Should there be the same kind of provision put in place as is put in place with this bill right now?

Hon. E. Cull: The provisions that are put in place for all other public sector employees allow them to negotiate their wages and benefits; in the case of doctors, their fees and benefits.

The BCGEU does not negotiate with the government as to what the overall provincial budget will be, which is essentially what is, in large part, used to pay their wages. It's easier if you look at it from the Education point of view, where 80 percent of the Education budget goes to teachers, administrators and other employees in the system. They don't negotiate the Education budget; they negotiate their fees and benefits. If they negotiate fees and benefits -- or wages and benefits -- that are too high, given the Education budget that is established by this chamber, then some teachers will be laid off, as has happened this year. There is no provision to lay off doctors. We can't do that under the arrangements of the fee-for-service system. What we can do is say that only so much money will be spent on fee-for-service doctors in a year. That is the responsibility of the government.

The member for Surrey-Cloverdale asks: "Isn't that layoff?" Indeed it is. It is the counterpart to layoff. So if doctors negotiate fees and benefits that are too high for the taxpayers of this province to afford, they may have to expect that there will be some limitation in services that will be provided. This act has set out a way of doing that which maintains medically necessary services, but gets at some of the parts of the system where there is room for efficiency, where there is abuse and where there is waste.

G. Wilson: With respect to that, let me say that we heard from the Minister of Finance today that the reason this government, after only one quarter, is some $200 million over its budget, is that HEU salaries were too high, because the settlement was too great. Does that constitute something similar...?

The Chair: Hon. member, order, please. I would advise you that we are talking to section 19 in committee, and I would ask you to keep your remarks within the context of that section.

G. Wilson: Mr. Chair, I am, in fact, speaking to section 19(1). I'm saying that if you're suggesting that there is no way to fire or lay off doctors, which is what the minister said.... What I'm trying to do is understand the rationale of this particular bill. We had the Minister of Finance say today that part of the reason for a $200 million overrun on his budget was that the HEU settlements were too high. Is that the same kind of proposition? Should we not have, then, a position where we can cap all public sector salaries when we see that there's a fiscally difficult situation for the government to run into? Or is it only doctors in British Columbia who should be singled out in this manner with respect to the provision being put in this bill?

Hon. E. Cull: I would encourage the member to go and talk to some of the hospital boards around this province. If he doesn't think that layoffs are occurring in some hospitals as they strive to live within their budgets, then I don't know where he's been in terms of health care issues recently.

G. Wilson: We're fully aware of what the policies of this government have done to the hospital system and the health care system in British Columbia, and we understand that many of them cannot live within the budgetary measures and have to lay off workers. We know also about the long waiting-lists and the problems people have as a result of this government's health care policy.

The question I am coming to now is specifically on 19(2), the commission and payments. Can the minister tell us why, when we already have existing legislation under the Medical Services Plan Act -- I'm referring specifically to the section which allows for the minister to set fees from time to time -- that is not a successful way to resolve this question, particularly in light of the fact that doctors were prepared to get into a negotiation on a reduction of the tariff that is demanded in order to overcome what is clearly a difficult financial situation?

Hon. E. Cull: The section to which the member refers would only allow payments to be adjusted once in a fiscal year and would force everyone to be affected equally. There is no flexibility; it's a very blunt instrument. We could not deal with people who are directly responsible for driving up the utilization. While that section is there, it is simply not good enough.

The member suggests that the BCMA was willing to negotiate such an agreement with us. I have to say that we worked very hard to come to some agreement on that over the weekend, when we negotiated for two 

[ Page 3471 ]

consecutive days on this, and I have to tell the member that they were not willing to do that at that time.

G. Wilson: I wonder if the minister can be just a bit more specific when she talks about the requirement of a sharp instrument to get after those who are directly responsible for driving up the cost. Exactly who is she referring to, and how is this bill -- in this manner, with this language -- going to effectively provide that sharp instrument? Could the minister give us some specifics as to who is going to be severed or lacerated by this sharp instrument that's going to cut down these costs?

Hon. E. Cull: We'll be looking at categories of practitioners where their personal services per patient are far in excess of the norm for their peers.

G. Wilson: That comes to the root of our concerns about 19(2), which is an assessment of how this government is going to essentially determine what is far in excess of the norms. What is the measure by which we're going to start to look at that? Who is going to look at those measures and make that decision? Is that going to be done by those people who are involved in medical practice, as is currently the case? Or is this a part of the additional portions of this bill that essentially determines a squad of inspectors is to do the surgery that we're hearing is going to be administered by this sharp instrument?

Hon. E. Cull: It's done by the Medical Services Commission, which is a tripartite body representing all the interests. One of the means that it may be done is through patterns-of-practice committees.

G. Wilson: I wonder if the minister might explain the last portion of her statement. Could she explain one more time how that body is going to administer it under this act?

Hon. E. Cull: The Medical Services Commission has the responsibility. In an earlier section we talked about advisory committees, including the patterns-of-practice committees, that could look at things like this. There are a number of ways we can do this. It's really up to the Medical Services Commission, not the government, to direct the Medical Services Commission.

W. Hurd: I wonder if the minister could provide the members of the committee with some advice as to what advice they might be able to render the doctors in their ridings, particularly doctors who may find themselves during the course of the year in an overextended position in terms of the levels of service they're able to provide. I'm particularly concerned about patient visits.

In my own riding there's a high percentage of senior citizens who, during the course of a year, may want to have greater access to their physician. Under this particular section, perhaps the minister could advise us what decision the doctors will have to make if they find themselves in a situation where, because of the number of visits they've had, they might have to start turning people away. Is that what's being asked of individual physicians under this particular section of the act?

[2:45]

Hon. E. Cull: No, it isn't.

L. Fox: I would like a clarification. Are we discussing the amendment or are we discussing the whole section?

The Chair: We are on the amendment, hon member. I think that is an excellent point that you raise. I would ask members to bear that in mind.

C. Tanner: We have two amendments, as I understand. Don't we have one from the minister and one from the Liberals?

The Chair: Hon. member, the one from the minister has already been dealt with. We are on the second amendment.

Amendment negatived on division.

On section 19 as amended.

L. Reid: I would draw your attention to section 19(3): "If the commission considers that the special circumstances of a practitioner's patients so warrant, the commission may order that a reduction calculated under subsection (2) does not apply, or applies to a limited extent, to payments to the practitioner." The amendment I would move is that subsection 19(3) be deleted.

We see that particular section having tremendous potential for abuse. We believe it is discretionary, permissive and it is not, in any way, suggesting that this Medical Services Commission needs to sit down and negotiate with physician practitioners in this province who provide service. We need that to be changed.

C. Serwa: Point of order. It's my understanding of the rules of procedure in the debate that amendments have to be written, signed and submitted to the Chair to be read out. This has not been done, and yet the Chair continues to accept them. This is clearly not the procedure of the House.

The Chair: Hon. member, this amendment is on the order paper; therefore the Chair will accept the motion.

Hon. E. Cull: I oppose this amendment, and I hope that every member in this Legislature who represents a rural, northern or isolated community will also oppose it. This is the exact section that allows us to zero in on the special circumstances of somebody like an internist working in a small community -- the only doctor in that community, who may have to work seven days a week and see an extraordinary number of patients -- who, on the surface, would seem to have a pattern of practice far outside the norm. But that individual is having to practise in that fashion to meet the needs of the community. We have to have some 

[ Page 3472 ]

flexibility in this act to exempt those particular practitioners from any kind of treatment under this section which would not be in the best interests of their patients.

L. Reid: Again, you're only asking for an exemption under this section because the entire section which it refers to is abundantly unfair. We on this side of the House do not support the creation of categories that allow physicians to be treated differently in this province. I fail to see how, under a fee-for-service agreement, the minister can justify something that is discriminatory at best. This is not decent legislation, hon. minister.

Amendment negatived.

On section 19 as amended.

L. Fox: I want to ask a couple of questions on section 19(1). There's not much sense in me debating the capping issue, because we did that at some length in second reading, and the direction that the government is moving in is clear. But I have some concerns with respect to subsection (1). This section requires that all reasonable measures be taken to ensure that the plan does not exceed the available amount set by the commission. The first question is: what are reasonable grounds? Secondly, what happens if the total exceeds the amount available? Thirdly, what happens if we have influenza epidemics? Are they expected to be handled by the ministry through a special allotment because of that emergency situation, or what actions will be taken?

Hon. E. Cull: Mr. Chair, he asked what the reasonable and practical measures are. They are the tools given to the Medical Services Commission to ensure that the billings don't exceed the budget. They are detailed in the amendment. We have pulled them all together here in the amendment that's on the order paper, because there was some concern that while they were in the act, they were scattered throughout it. I think that the BCMA, particularly, wanted to see them in one place. It is quite clear that we're looking at what we have called a toolbox all the way along that has all these things in it -- including education, protocols and guidelines, ensuring that appropriate billings are with the government body that should be paying for them and reviewing medical benefits and dealing with payments. So those are the reasonable and practical measures that can be taken by the commission.

The question of what happens in the case of epidemics or earthquakes or other disasters is the same as would happen in many ministries should a disaster or a totally unforeseen circumstance occur. There would be an additional appropriation, a special warrant or money found to deal with that. We're talking about extreme circumstances. In other words, if there's an earthquake, we're all going to have to be looking at our budgets and recognizing that they will not be sufficient to meet those emergency needs, whether it's health or highway construction or education or whatever. Problems would have to be addressed. It's very clear that it would be our intention to do that.

I'll mention another part of this now. I'm not sure that it's specifically tied into this, but it's tied into your question. How is a reasonable appropriation made? We have suggested that the Medical Services Commission will prepare a budget proposal for what it thinks will be required for the following year, taking into consideration negotiated fees and benefits with the BCMA that are applicable for that fiscal year. They will recommend that amount publicly to the Minister of Health, who will carry that forward in the Treasury Board submission for the entire Ministry of Health budget. That is a very strong step. A tripartite commission can make a public recommendation on the appropriation. It will be known to all in terms of how it was put together.

Treasury Board will continue to make the kinds of decisions that Treasury Board needs to make, taking into consideration all of the factors that are made. That particular aspect of section 19(1) is a very strong one and shouldn't be overlooked.

L. Fox: With respect to the emergency situation, oftentimes we'll find that influenza, for instance, will be a regional concern. It could affect different regions each year and obviously would have a direct impact on the billings of doctors in that region. At what point do we recognize this as an exceptional situation, something outside of the controls expected to be handled by the capping issue?

Hon. E. Cull: That really is a question that the Medical Services Commission will have to address. An interesting piece of information that I learned in looking at this this year is that the meningitis outbreak in the Kamloops area had no measurable impact on utilization. I would have thought that it would have sent a lot of nervous parents to the doctor with their small children at the first sign of a sniffle or a fever, but it didn't have a measurable impact on utilization.

If we're dealing with regional budgets, that will have to be considered. We're probably a considerable way from regional budgets at this point. The Medical Services Commission will have to address that should they make that move.

K. Jones: With specific interest in 19(1), this requirement to maintain a global budget is creating the commission as a buffer, a scapegoat, for the Ministry of Health to use, similar to what was done in the early seventies by a similar NDP government with the human resources board. This is not the accountability form that most governments intend to be in but is a means of putting off the responsibility for accountability in health care services to another quasi-governmental agency. The whole act is intended along that line.

We really need to have accountability for the budget not to a group of quasi-legislative people but to the legislative people themselves. The minister and the government are to be accountable. This type of situation is not what most British Columbians want. Can you tell us the difference between this form and the former 

[ Page 3473 ]

human resources boards that were used as a buffer in the 1970s in the former NDP government?

Hon. E. Cull: I'm sorry, I don't know enough about the former resources boards. I wasn't a resident of British Columbia in those days, so I can't....

An Hon. Member: Shame!

Hon. E. Cull: Well, at least I showed that I knew how to pick the right province after having the misfortune of being born elsewhere.

All I can say is that my understanding is that those were locally elected bodies. I could be wrong on this because, as I said, I wasn't here then. The idea of this commission is that this is a decision-making tripartite body structured by the government to make decisions with respect to a fairly significant amount of government spending. The intent is to expand the decision-making power from being one bureaucrat of government into one that is co-managing the system with the other groups, which really have a great stake in what happens with respect to the Medical Services Commission, particularly the public and the doctors.

K. Jones: Where is the accountability through this process?

Hon. E. Cull: It's through the minister.

K. Jones: How does the accountability get through this commission to the minister?

Hon. E. Cull: The commission reports to the minister.

Section 19 as amended approved.

On section 20.

L. Reid: Section 20(1) reads: "The commission may set the available amount for a category that may be paid under all payment schedules to practitioners in the category for rendering benefits under this act in the fiscal year specified by the commission." If we might consider section 20(2): "The total amount that may be paid by the commission to all practitioners in a category for rendering benefits under this act in a fiscal year must not exceed the available amount for the fiscal year."

I would move that section 20(1) and section 20(2) be deleted because this particular piece of legislation would negate any possibility of negotiation and would not require negotiation on behalf of caregivers in this province. That is a fundamental issue for the Liberal opposition. We believe that you sit down and negotiate; then you sit down and renegotiate until you arrive at some kind of mediated solution. You do not take the heavy-handed approach in terms of legislating something because you were unable to see the wisdom of a negotiated settlement or are unable to reach a negotiated settlement.

I would submit for your consideration, hon. Chair, that we have not, I hope, moved to such a primitive approach to resolving our differences in the province of British Columbia. Again I would move that both of those sections be deleted as they appear on the paper.

Amendment negatived.

Interjections.

The Chair: The Chair heard both yeas and nays, and the Chair rules the nays have it on division.

Section 20 approved.

On section 21.

Hon. E. Cull: Hon. Chair, I move the amendment to section 21 standing in my name on the order paper. [See appendix.]

There are essentially two parts to it. One is in the proposed subsection (6) by deleting the word "medical" and substituting "practitioner." This is at the....

F. Randall: On a point of order, hon. Chair. I find the voting confusing. I wonder if the Chair could say "all those in favour" and then say "those opposed," because we're all saying it at the same time; it's very confusing. I think it helps if you say "All those in favour," and they can say "Aye." Then say "those opposed say nay," and they say "Nay." If you could say the yeas and nays so they're not together, I think it would be a lot better.

The Chair: Thank you, hon. member. Your points are taken under notice.

[3:00]

Hon. E. Cull: We're proposing an amendment to subsection (6) by deleting "medical" and substituting "practitioner." That will make it clear that educational programs can be established for any category of practitioner, not just medical practitioners. Then there are two subsections being added to the bill, subsections (8) and (9). These subsections are at the request of the Professional Association of Residents and Interns. They make it quite clear that there is no ability in this bill to discriminate on the basis of age, gender or the number of years of practice as a member of the appropriate licensing body.

Amendment approved.

On section 21 as amended.

L. Reid: I move the amendment to section 21(1) standing in my name on the order paper. [See appendix.]

Amendment negatived.

[ Page 3474 ]

L. Reid: I move the amendment to section 21(2) standing in my name on the order paper. [See appendix.]

Amendment negatived.

L. Reid: I move the amendment to section 21(3) standing in my name on the order paper. [See appendix.]

Amendment negatived.

L. Reid: I move the amendment to section 21(3)(a) standing in my name on the order paper. [See appendix.]

Amendment negatived.

L. Reid: I move the amendment to section 21(4) standing in my name on the order paper. [See appendix.]

Amendment negatived.

C. Tanner: It's a little difficult to know where we can get in here when we want to speak on something that's not being amended. On section 21(3), as it's now amended, does it say that the commission can act without any consultation whatsoever with the authorities that it's making schedule changes for?

Hon. E. Cull: The commission represents all three parties. Yes, it can.

L. Fox: My question is on section 21(2). It mentions here that there will be consideration given to different geographical areas. Could the minister perhaps enlighten me as to how that might be different than the present formula now offered under the billing process for those geographical areas?

Hon. E. Cull: The current procedure I think you're talking about is the northern isolation allowance. Is that what you're referring to? There isn't a differential regional payment right now.

Interjection.

Hon. E. Cull: Not for physicians. You're confusing different parts of the health care system here.

L. Fox: There is still a northern allowance, as I understand it. Perhaps you might be able to tell me how this will improve the inequities and the opportunities to attract medical doctors to rural geographical locations.

Hon. E. Cull: The northern allowance recognizes additional costs involved in practising in isolated areas. The section that you're referring to pertains more to the recommendations of the Royal Commission on Health Care and Costs, which suggests that there could be regional budgets established that would have an incentive value of attracting physicians into particular areas, and so that could be based on specialty, for example. You could have a category of specialists that you wanted to attract into an area and have a differential payment for that area. It wouldn't apply equally across the north unless there was an equal problem across the north, which in fact there may be. It's more of a fine-tuning, as opposed to just recognizing an overhead cost.

L. Fox: That was one of my concerns, that the commission will then be able to decide through this capping process whether or not a certain type of specialist will be recognized differently in the Prince George region than a Vancouver region. The commission will have the power to do that? Okay.

C. Tanner: Could the minister tell us why we need section 21(6), when all the conditions in 21(6) are taken care of in 31?

Hon. E. Cull: I don't understand what the member is referring to. Section 31 is the audit and inspection provision, and section (6) is allowing the commission to continue or establish an education program, disability insurance program or a practitioner benefit program for practitioners. Those exist right now with the BCMA. They do have a $25 million benefit program through the Medical Services Plan, and that will be continued.

C. Tanner: I'm talking about 21(6), which says the practitioner must keep records for examination.

Interjections.

C. Tanner: That's the one I've got.

The Chair: Hon. members, we are on Bill 71, section 21.

Section 21 as amended approved.

On section 22.

Hon. E. Cull: I move the amendment to section 22 standing in my name on the order paper. [See appendix.]

On the amendment.

Hon. E. Cull: This proposed amendment relates to (6). This subsection requires a practitioner to provide the commission with records to substantiate the claim including any medical record. It is worthwhile noting that medical records, here and in other sections, may only be requested or reviewed by a medical practitioner. However, at the request of the British Columbia College of Chiropractors, we propose to add the term "clinical records" to clearly refer to the records of health care practitioners.

[E. Barnes in the chair.]

Amendment approved.

[ Page 3475 ]

Section 22 as amended approved.

Sections 23 to 25 inclusive approved.

On section 26.

L. Reid: I propose an amendment to section 26, which is that the words "considers to be immediately life-threatening" are deleted and replaced with "in consultation with the appropriate licensing body, considers was an emergent situation where the practitioner was ethically required to provide care."

Speaking to the amendment, we have a situation where a physician, a medical care giver of some description, could provide what they believed to be immediately necessary care, and retroactively the commission can come back and suggest that they're not prepared to pay for it because in the opinion of the Medical Services Commission -- which may or may not be the opinion of a physician registered to practise medicine in British Columbia -- that person could somehow make a determination based on whether or not the decision reached by the physician was indeed valid. I would move immediate adoption of this amendment.

On the amendment.

Hon. E. Cull: Unfortunately, this amendment would require the practitioner, before rendering the care, to consult with the licensing body, which is even worse than the situation the member appears to be objecting to.

L. Reid: As a clarification to the minister, no, this does not request consultation in advance. What it looks at and allows for is that if a procedure is medically allowed, based on that description, that explanation on behalf of that appropriate licensing body, the commission cannot come back at a later date and decide that it was not valid. This is not adding an extra layer. This is simply suggesting that once a decision has been reached in good faith, it be honoured by the Medical Services Commission.

Amendment negatived on division.

Sections 26 to 30 inclusive approved.

On section 31.

L. Reid: In my view, this is an offensive section. It allows -- in fact, requires -- government to be intrusive in British Columbia. We are not comfortable with the section. Constituents are not comfortable with this section. I have heard many explanations for why this section is necessary. I can assure you that no constituent in the province is comfortable with the inspection practice as outlined in part 6, section 31, of this bill.

We have situations now where if you have medical records and you are involved with the Insurance Corporation of British Columbia, you must sign a release for your medical records to be viewed by anyone other than you and your physician. That is a practice that is acceptable because the patient is aware that someone else will be checking into their files and they have been given permission. This section in its entirety allows for that practice to continue within this province without even the knowledge of the patient. In my view, this seriously contaminates the relationship that a patient may enjoy with their physician, and in some cases absolutely eliminates patient-doctor confidentiality. I am not comfortable with this section, and I would honestly hope that we can reach some agreement, because this entire section would allow for a police state of some magnitude to go forward in the province. I have heard this minister suggest: "No, this is already going on, so we shouldn't be concerned about it." That is an unacceptable explanation, hon. Chair. We are not on a drive to mediocrity in this province. To consider somehow justifying something because it's happened in the past is not acceptable to the Liberal opposition.

This is not a good section; this is not something that is plausible or palatable for members of constituencies around this province. They find it absolutely intolerable that we would even consider allowing this to rest on the order paper without significant opposition. This is a critical section for patients.

I have a number of amendments, hon. Chair, and I would move all the amendments at this time pertaining to section 31. [See appendix.]

[3:15]

On the amendment.

Hon. E. Cull: Mr. Chair, the proposed amendments remove all references to "inspector" and appear to be confusing the patterns-of-practice committee -- which looks, if you like, at aberrations in practice -- with the audit provisions. This allows us to deal with cases where billings may be being put forward for services that were not rendered, and other such cases where there is abuse.

The inspectors of the medical records will have to be medical practitioners. They are bound by their own professional oath. They would be subject to discipline by the College of Physicians and Surgeons if there was any unethical disclosure of confidential information.

We will be coming to section 40 and 43 of the act, which have put a strict duty of confidentiality on any inspectors, the breach of which would be an offence under the act and subject to fairly severe punishment. We need this provision. We will be the eighth province in Canada to have such provisions, and it is something that is needed for prudent management of the Medical Services Plan.

G. Wilson: Mr. Chairman, on this section alone, the Liberal opposition could not support this bill. That's why I speak in favour of the amendments. At least what they attempt to do, given that we have a government that is prepared to listen to reasoned amendments and to make some reasoned amendments.... I think it's important for the public to be aware that this section alone is going to provide for inspection of patient 

[ Page 3476 ]

records at any reasonable time for any reasonable purpose. What is a reasonable time, and what is a reasonable purpose?

It would also allow the commission to seek a warrant to enter a private dwelling if they believe records are being kept there. What kind of inspection service is it that this squad of MDs is going to have to be able to go in and seize records of doctors, where there is a potential confidentiality -- not potential, a real and a desired confidentiality -- between doctors and their patients? To allow a commission of MDs who are given inspectors' status to seek a warrant and enter private dwellings to seize records is something that is offensive in British Columbia. It takes us on a new and, I think, an unacceptable direction.

In speaking to these amendments, let me say that there is no other profession in this province with this kind of inspection that is being put forward on the administration of government. It outlines two things. One is the government's fundamental distrust of doctors, because they don't believe that doctors are, in the vast majority, honest. Therefore they're putting in place a group of medical doctors who are going to become the squad of inspectors to go in and seize records when they desire to do so. Secondly, it demonstrates that, once again on the matter of medical practitioners, they're going to be singled out and given treatment that is not provided any other professional sector in British Columbia.

On this section alone, British Columbians should stand and reject this government's direction toward medical services and provision of medical services, because it introduces a new and most onerous requirement of doctors and those medical practitioners who will be recruited to essentially become the police squad. Let me say on this section that, without those amendments, we could not support any of this bill -- not one part of this bill -- because this section alone is enough to make us say that is an undesirable, onerous and unreasonable bill for the people of British Columbia.

Amendment defeated.

L. Fox: I know it's in the interest of time for me not to speak at any great length. It's fairly evident that this government is not looking to amend this particular section. I have an observation to make with respect to section 31 of Bill 71.

Recently a court of law determined that it was the patient's right to protect their files from other individuals. It was their property. That says something to me. This government even goes beyond the law in this legislation. They are taking a fundamental right away from the people of British Columbia. Unlike the leader of the official opposition, I had not intended to support this bill anyway, so this particular section doesn't mean anything more to me than the rest of the bill. However, I'm extremely concerned about the fundamental rights of British Columbians that are being removed by this particular section of this bill.

Hon. E. Cull: The member is referring to a court case which deals with a patient's right to have access to their records, which is something that I think all patients should have. They have not been able to have that. I think that was clarified by that judgment. This piece of legislation will make it clear that there can be some reasonable access to checking records for the purposes of confirming billings. To do otherwise would be to turn over $1.3 billion without any ability of the government to scrutinize that it has spent wisely and for the matter intended.

Sections 31 to 33 inclusive approved.

On section 34.

L. Reid: I would move the amendment to section 34(1) as listed on the order paper and ask for its consideration now. [See appendix.]

Amendment negatived.

Sections 34 and 35 approved.

On section 36.

Hon. E. Cull: I move the amendments to section 36 standing in my name on the order paper. [See appendix.]

This section provides for an appeal by a beneficiary to the Medical and Health Care Services Appeal Board from an order under the commission under subsection 10(2). The proposed amendment would also provide an appeal from a determination of the commission under subsection 6(7) that a person is no longer a resident. This change was requested by the BCMA, and we're pleased to accept their recommendation.

Amendment approved.

Section 36 as amended approved.

Sections 37 to 42 inclusive approved.

On section 43.

Hon. E. Cull: I move the amendment to section 43 standing in my name on the order paper. [See appendix.]

This section imposes a strict duty of confidentiality on persons acting under the authority of the commission and this act. Breach of this section is an offence. The proposed amendment simply corrects a minor drafting problem. You can see that the words "in a" are deleted and substituted by "to a," so I think it's very minor.

Amendment approved.

Section 43 as amended approved.

Section 44 approved.

[ Page 3477 ]

On section 45.

Hon. E. Cull: I move the amendment to section 45 standing in my name on the order paper. [See appendix.]

This section deletes proposed subsections 2(f) and (j) and also 2(p). These are categories that were going to be established under the regulations. We don't believe that it's necessary, given the other parts of the act. The Professional Association of Residents and Interns and the BCMA had some difficulties with these sections, so we are agreeing with their suggested amendment that we remove them.

Amendment approved.

Section 45 as amended approved.

Sections 46 to 51 inclusive approved.

On section 52.

G. Wilson: I rise on section 52, on the commencement of this act, which will provide force for this act for the Lieutenant-Governor-in-Council.... I wish to say that in my view and the judgment of the Liberal opposition in this province, this is indeed a dark day because of this bill and what this bill has done to the Medical Service Act and to doctors and the provision of health care in the province.

As the Liberal opposition in this province we have attempted to put forward amendment after amendment at both second reading and in the final third reading. We have put forward reasoned and sensible amendments to make an offensive bill at least a little less offensive for the people of British Columbia. At every stage the amendments we have put forward are of substantive nature; they have been denied and rejected by this government in a manner similar to the way this government has denied and rejected the reasonable position that has been put forward with respect to the practising of physicians in British Columbia.

We cannot support section 52 of this act; we cannot support Bill 71. I believe that the people of British Columbia should know now and learn more about the kind of government they elected on October 17 of last year. That's exactly what the opposition in this province intends to do over the coming months.

Section 52 approved.

Title approved.

Hon. E. Cull: Mr. Chair, I move that the committee rise and report the bill complete with amendments.

Motion approved on division.

Bill 71, Medical and Health Care Services Act, reported complete with amendments.

The Speaker: When shall the bill be considered as reported?

Hon. G. Clark: With leave of the House now, hon. Speaker.

Leave granted.

[3:30]

Bill 71, Medical and Health Care Services Act, read a third time and passed on the following division:

Hon. G. Clark: I call second reading of Bill 82.

LEGISLATIVE ASSEMBLY
MANAGEMENT COMMITTEE ACT

Hon. G. Clark: I'm pleased to move second reading of the Legislative Assembly Management Committee Act. The purpose of this bill is to establish the Legislative Assembly Management Committee to replace the Board of Internal Economy.

It's an important piece of legislation that continues the tradition of the separation of the powers of the Legislative Assembly from those of the executive arm of government. It's also part of an ongoing commitment to good government, which I'm sure is shared by all members of the House.

The bill reflects the authority of the elected representatives in this Legislature to manage the administration of their assembly and the provision of services to its members. Key among the provisions of the bill are recognition of the third party and the ability of its members to participate in the management of the assembly; a requirement that decisions of the committee be made known not only to members, which was not required before, but also to the public -- the public has a right to know this; we in this House are conducting public business when we make these decisions -- and, of course, a clearer specification of the powers of the committee and how they relate to those of the Speaker.

Matters relating to salaries, indemnities, allowances, pensions and severance have been referred to an independent body and are not the subject of this bill. This bill does not have the sweeping power to override 

[ Page 3478 ]

other legislation that the previous Board of Internal Economy did.

Hon. Speaker, this bill has been discussed with your office, the official opposition and the third party. Such discussions are, of course, entirely appropriate with this kind of legislation, which so directly affects the rights of members of this assembly. If I could, I want to pay tribute to both the House Leaders for the official opposition and the leader of the third party for extensive consultation.

I think it's a good piece of legislation that we can be proud of. It replaces a piece of legislation that had some deficiencies and allows us to move forward after this session with a joint committee, so that rules of the House and other irritants that members have can be addressed by an all-party committee. Of course, decisions in these kinds of matters generally are made by consensus, and that's as it should be.

Hon. Speaker, I commend this to the House for speedy second reading and committee stage later today.

D. Mitchell: Hon. Speaker, I am pleased to rise on this bill and to speak in favour of the motion that has been moved by the hon. government House Leader for second reading of this bill. I would like to make a few brief remarks.

The Legislative Assembly Management Committee Act might be known also as the Legislative Assembly Board of Internal Economy Act, Part 2. In fact, this bill could be brought in as an amendment to the existing act. Instead, the act which established the Board of Internal Economy has been repealed, and this new bill has come in seeking to create a new committee.

One has to wonder why that would be the case, because there's a principle here that's important, hon. Speaker, and I know it's one that you care about as the Speaker. As chair of the committee or of the board, as it used to be called, your role is an important one: to preserve the independence of this House.

This bill is largely a rewrite of the Legislative Assembly Board of Internal Economy Act with the one exception, as the hon. government House Leader said, of taking away the powers of remuneration for members, pensions and severance payments from the body. Essentially it's the same forum, the same body and the same institution. It's still the Board of Internal Economy, but we're going to call it something else now.

We support this, and I'd like to note that members of the government, when they were in opposition, supported the original establishment of the Board of Internal Economy. It's important to note that. Members of the government, when the Board of Internal Economy was first established in British Columbia.... I might note that this Legislature was one of the last in Canada -- in fact, one of the last in the Commonwealth -- to establish an independent Board of Internal Economy to manage the affairs of the House so that we could truly be masters in our own House.

When that bill came forward in 1987, the Leader of the Opposition, who is now the Premier, spoke in favour of the concept of a Board of Internal Economy. I think his words are worth quoting into the record:

"...the Board of Internal Economy was a very significant and positive change of the Legislature. We look forward to the initiatives that the bureau will bring forward for the sole purpose of improving our ability to serve the people of British Columbia better. I think the agenda items that they have before them now will allow our respective caucuses and this Legislature to serve our constituents better, and allow there to be more open government."

That was the Leader of the Opposition, who is now the Premier, speaking in favour of the Board of Internal Economy. I'm not sure what happened. Something must have happened to create a situation where we had to repeal the board and bring in this new committee.

It's good that we are going to have a forum for all members of this House to share concerns that affect us in the administration of the House itself. Whether we call it a board or a committee isn't germane.

We note with interest that the government did want to distance themselves from the previous board, for whatever reasons, and we can only speculate as to what they might be. In the interest of being constructive today, I'm not going to openly speculate as to what they might be. I'll leave that for others to do.

All parties want to ensure that there is independence from government and the executive in this Legislature. That's important. That's why we need to have a separate committee to manage the affairs of this House. We can't have everything going through Treasury Board. We need a separate vehicle for the affairs of the House, chaired by the Speaker. I think that's very important. For the last little while we've laboured in a situation where we haven't had such a forum. Members of this House haven't had a vehicle to express concerns directly. I know that's been frustrating for all members and for the Speaker. With this bill being passed into an act, we are going to have that forum re-established. It's not going to be called the board; it's going to be called something else.

As the hon. government House Leader said, the one significant difference is that matters of remuneration aren't going to be referred to this committee any longer. That's good, because it takes away a potential conflict of interest, where members are setting their own salaries. That's wrong.

Earlier today we had a motion from the Minister of Government Services with respect to the appointment of Chuck Connaghan to take a look at issues relating to members' remuneration and pension and severance matters. I think that's important. We wish Mr. Connaghan well in his significant challenge to come back with some recommendations as to how MLAs should be paid. Of course, ultimately the choice is still a political one. He can come back with recommendations, but the choice is still a political one, one that the government of the day is going to have to approve.

It's important to note that issues relating to constituency allowances and members' benefits are still going to be the purview of this new committee. That's important, because there is a concern about how constituency allowances in particular are used. In fact, that's a matter that's also being reviewed. There seem to be endless reviews right now. It's being reviewed by Mr. Ted Hughes, an officer of this House, who is looking

[ Page 3479 ]

 into the Nanaimo Commonwealth Holding Society affair. It's important that this committee is going to be able to look at matters of constituency allowances. When Mr. Hughes comes back with his recommendations, my hope would be that this legislative management committee, which is being established by this bill, would review those recommendations.

Here in British Columbia we run what is regarded as the leanest Legislature in the land. On a per capita basis we spend less than any other legislature or parliament in Canada. That is something that we can be proud of. While we might not enjoy all the perquisites that other elected representatives in other parliaments enjoy, we can be proud of running our Legislature in a very lean way. We do a good job. British Columbians probably do get some value for their money on a comparative basis with other jurisdictions.

[3:45]

There is a concern that I have with the bill that I am going to be raising in committee, with respect to the officers of the Legislature: the office of the ombudsman, the office of the auditor general, the conflict-of-interest commissioner and now the new privacy commissioner. Their budgets are not included under this bill, which is going to become an act of this Legislature today. They're not included for review under this committee.

I would point out that in other progressive legislatures where there is such a body, officers of the legislature have their budgets approved by the committee of members, rather than going through the Treasury Board process. It's an important distinction to separate the executive from the legislative branches, and to not have officers of the legislature have their budgets set and approved by the executive through treasury board. They should go through an independent process, like a board of internal economy or this legislative management committee. I think that's one change that would improve this bill significantly, and we will propose that amendment in committee stage.

That's something that the government supported when they were in opposition. They supported that in principle, and in fact many members spoke in favour of it. I'll just put one quote on the record that the Minister of Tourism, who is in the House, might remember. She made this statement less than two years ago in this House in 1989. She was speaking at the time on the estimates of the auditor general that came before the Committee of Supply. She stated: "I put forward a thought that both the auditor general and the ombudsman would benefit greatly and so would public accountability be better served if the vehicles and the processes through which both these offices receive their funding is accomplished through a body other than Treasury Board." I agree with the statement made by the Minister of Tourism back when she was a member of the opposition. The sentiments are correct. We support that notion. I think it's an element that would improve this bill. I would ask the government House Leader to comment on that, perhaps when he concludes debate on second reading. Certainly we're going to be proposing that amendment in committee stage.

Interjections.

D. Mitchell: I note that the member for Okanagan West is waving a white flag. He wants to get out of here. I know that all hon. members want to get out of here. Surely this is an appropriate note on which to end this portion of the first legislative session of this parliament -- this bill, which reasserts the independence of the Legislature from the executive. It's something that members of the government will remember, because when they were in opposition not too long ago, they fought the battles of the Legislature, the battles that in the opposition trenches you must fight to keep the Legislature alive, independent, vital, dynamic and free from domination by the executive. I think that's what this bill does.

If the new committee being established under this bill can work in a non-partisan manner to preserve the rights and independence of the Legislature, then I think it will be testimony to the kind of political renovation that voters voted for last October. So with those few words -- and they are very few, because I could speak on this bill ad nauseam -- I will conclude.

I would like to second the motion from the hon. government House Leader in favour of second reading of this bill, and I'll address the concern I raised in committee.

J. Weisgerber: I will rise simply to unconditionally support the legislation as it is brought forward. The creation of this new committee corrects a number of situations in the old Board of Internal Economy -- a number of instances that demonstrated a need for change. I think it was important to separate from the actions of the members of this House questions surrounding members' benefits and salaries, and I applaud the government for establishing a separate commission in that regard.

I also think that an important part of this bill is that it continues to function through an election and into the next parliament, and that was certainly a flaw in the Board of Internal Economy, in that it had no process to continue to be active through an election and into another parliament. All of us saw the shortcomings of the bill following the election.

I also want to recognize that the Minister of Finance has agreed to a couple of minor amendments that were put forward, and I want to thank him for doing that. I think we've made another important step forward as we evolve ways to regulate and administer this Legislature which is important to all members. I'm sure that this particular committee and this act doesn't answer all of the questions, but it goes another important step forward. I want to thank all members of the House for their support on this legislation, and would move second reading as well.

Motion approved.

Bill 82, Legislative Assembly Management Committee Act, read a second time and referred to a Committee of the Whole House for consideration forthwith.

[ Page 3480 ]

LEGISLATIVE ASSEMBLY
MANAGEMENT COMMITTEE ACT

The House in committee on Bill 82; E. Barnes in the chair.

Section 1 approved.

On section 2.

Hon. G. Clark: I'd like to move an amendment in response to the leader of the third party. Section 2, by adding the following subsection 2.1: "The first meeting of the committee must be held within 14 days of the appointment of the members referred to in subsections (1)(g) and (h)."

On the amendment.

Hon. G. Clark: What that does is address a legitimate concern raised by the third party that after an election there is a hiatus between the time in which the new Legislative Assembly committee could be struck, and this requires the appointment some 14 days after the election day. One of the problems we've encountered with this transition was space allocation and the difficulty in doing that. So this is a positive amendment that the third party has requested and we agree with.

Amendment approved.

Hon. G. Clark: I move a further amendment in section 2 in the proposed subsection (2) by deleting "45 days from the day named as the return day in the writ for the general election" and substituting "45 days from the polling day for the general election."

On the amendment.

Hon. G. Clark: Again, this is a companion resolution so that there are 45 days from the election day that members have to be appointed.

Amendment approved.

Section 2 as amended approved.

On section 3.

D. Mitchell: I propose a brief amendment. I believe the table has a copy, and I think the minister may have a copy.

We've had some good consultation on this bill. The government has accepted most of the recommendations of the official opposition. We stumbled in one area. This is on whether or not the budgets of the ombudsman, auditor general, all the officers of the House, should go through the new Legislative Management Committee. We think it's an important principle. Members of the government supported it when they were in opposition. Most legislatures in Canada have this provision. Would the minister be willing at this time to accept this amendment to the bill?

Hon. G. Clark: We're not willing at this time, but I want to say to the House that we've had discussion on this, and I'll certainly consider it. Let's get the bill through this year. In all sincerity, we'll review it over the coming months to see whether we can bring in an appropriate amendment at that time. To be candid, we've had some difficulties in trying to deal with the situation. I like the status quo at the moment; this bill currently is the status quo. If we're going to make a change from that, I'd like to have more consultation and more discussion on it.

D. Mitchell: A further comment would be desirable from the government House Leader. He indicates that he's not ready to go at this time. I'm not sure what the difficulties are. There is an important principle here. We talked about the principle of the bill, and he and I have certainly discussed this at length. The principle of the bill here is dealing with the independence of this Legislature from government. The officers of the Legislature surely should also be independent and should not have to go through the Treasury Board process, which the hon. government House Leader chairs as Minister of Finance. They should go through an independent process to ensure that there's never any suggestion of political interference in setting their budgets, so that they can do their work in an independent fashion.

This is something we've discussed at length with other ministers as well, including the hon. Attorney General with respect to the privacy commissioner, the ombudsman's office and the auditor general's office. Our Finance critic, the member for Delta South, has raised this as well with respect to the auditor general and the fact that most jurisdictions in Canada have this feature. What would the specific reason be why we could not achieve this now, Mr. Chairman?

Hon. G. Clark: The specific reason is that the Board of Internal Economy in the past did not -- or the Legislative Assembly Management Committee does not -- raise taxes to pay for these questions. There has not been any political interference to date under the previous administration or under our administration. But there have been requests for significant enhancements of the budget to do new things, etc. I guess my reluctance at the moment is because I would like to see how the Legislative Assembly Management Committee works, and then we can have some discussion about budgets. I do sit on both boards at the moment. We can review this. I'm quite prepared, in all sincerity, to review it over time, but I prefer to leave the status quo at the moment.

Amendment negatived on division.

Sections 3 to 14 inclusive approved.

Title approved.

Hon. G. Clark: I move the committee rise and report the bill complete with amendment.

[ Page 3481 ]

Motion approved.

The House resumed; the Speaker in the chair.

Bill 82, Legislative Assembly Management Committee Act, reported complete with amendment.

The Speaker: When shall the bill be considered as reported?

Hon. G. Clark: By leave, now.

Leave granted.

Bill 82, Legislative Assembly Management Committee Act, read a third time and passed.

Hon. G. Clark: I ask leave to table a report.

Leave granted.

Hon. G. Clark: I have the honour to present the report of the guarantees and indemnities for the fiscal year ending March 31, 1992, in accordance with section 56 of the Financial Administration Act.

Hon. G. Clark: I ask leave to answer questions on the order paper.

The Speaker: Please proceed, minister.

Hon. G. Clark: I'm tabling today, on behalf of all ministers, responses to written questions 1 through 18 on the order paper. Time did not permit individual confirmation for 100 percent of these contracts, but to the best of my knowledge, all were awarded in compliance with chapter 6 of the government's General Management Operating Policy.

I'm also tabling this policy on contract management for the information of all members. The most recent major revision to the policy was five years ago, in August, 1987. Members will be aware of significant issues related to government contracting identified by the independent financial review and will also be aware of the work being done in this area through the Korbin commission and other processes. It remains the government's commitment to ensure that public services are delivered in a means that provides both value for money and fairness to provincial employees. We also intend to bring the contracting system to the level of openness and accountability that the public expects. I look forward to the comments of all members with respect to these endeavours.

The Speaker: Hon. members, I am advised that the Lieutenant-Governor is in the precincts and will be here shortly.

His Honour the Lieutenant-Governor entered the chamber and took his place in the chair.

[4:00]

Law Clerk:

Professional Retirement Savings Plan Agreement Extinguishment Act

British Columbia Transit Amendment Act, 1992

Assessment and Property Tax Reform Act, 1992

Medical and Health Care Services Act

Tobacco Product Amendment Act, 1992

Legal Profession Amendment Act, 1992

Election Amendment Act, 1992

Municipal Amendment Act (No. 2), 1992

Forest Amendment Act (No. 2), 1992

Miscellaneous Statutes Amendment Act, 1992

Legislative Assembly Management Committee Act

Miscellaneous Statutes Amendment Act, (No. 2), 1992

Clerk of the House: In Her Majesty's name, His Honour the Lieutenant-Governor doth assent to these bills.

His Honour the Lieutenant-Governor retired from the chamber.

[The Speaker in the chair.]

Hon. G. Clark: I move that the House, at its rising, do stand adjourned until it appears to the satisfaction of the Speaker, after consultation with the government, that the public interest requires that the House shall meet or until the Speaker may be advised by the government that it is desired to prorogue the first session of the thirty-fifth parliament of the province of British Columbia. The Speaker may give notice that she is so satisfied or has been so advised, and thereupon the House shall meet at the time stated in such notice and, as the case may be, may transact its business as if it had been duly adjourned to that time and date. And that in the event of the Speaker being unable to act owing to illness or other cause, the Deputy Speaker shall act in her stead for the purpose of this order.

Motion approved.

Hon. G. Clark: On behalf of all members of the House, I wish everyone a welcome respite this summer until we reconvene sometime in the near future.

Hon. G. Clark moved adjournment of the House.

Motion approved.

The House adjourned at 4:05 p.m.

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