1993 Legislative Session: 2nd Session, 35th Parliament HANSARD
The following electronic version is for informational purposes only. The printed version remains the official version.
(Hansard)
FRIDAY, APRIL 30, 1993
Morning Sitting
Volume 9, Number 13
[ Page 5705 ]
The House met at 10:02 a.m.
Prayers.
J. MacPhail: I am very delighted to have with us in the gallery today 24 mainly grade 10 students, accompanied by their teacher, Mr. Kuniss, and some of their parents and neighbours from the Templeton Mini School. That's a very special high school within my riding that contributes a great deal to our community, and I'm delighted that they're here with us this morning. Would the House please make them welcome.
PARTNERSHIPS IN PROVIDING HOUSING IN SALMON ARM
S. O'Neill: This Sunday I shall be at a groundbreaking ceremony in Salmon Arm at SILA's new social housing development. SILA stands for Shuswap Independent Living Association. When it is complete next fall, there will be 38 homes on a two-acre site, 16 for seniors and 22 for families. Three units are modified for wheelchair access. Salmon Arm's need is great. Virtually zero-vacancy rates in recent years and steadily increasing population have combined to produce some of the fastest-growing rents in the interior. According to Canada Mortgage and Housing, there have been no new market rental units created in Salmon Arm in the last five years. But historically, Salmon Arm has not been high enough on the priority list to attract much public housing. SILA's new development will increase the social housing stock in Salmon Arm by 16 percent, and I take this opportunity to publicly express thanks on behalf of the community to all those who are making it possible.
For Sherry Newbold and the members of SILA, this is their second housing endeavour. This group grew out of the Canadian Mental Health Association, and their first project, opened in 1985, was a four-bedroom home for people with psychiatric disorders. Over the last five years various studies have shown a broader need. SILA responded to that by broadening their focus to people with low income. To add 38 more homes for families and seniors is a major commitment by this very dedicated group.
Salmon Arm is fortunate to have people like Sherry Newbold in SILA. What is even more remarkable is that this group is just 13 strong. They are a graphic example of what individuals can do to make a big difference to the quality of life in our communities. Every member here will, I am sure, know of similar groups in their own constituencies. These groups work with very little fanfare or recognition, and it's not overstating it to say that both senior levels of government have come to rely on their commitment.
Another major partner is the province of British Columbia, represented by the hon. Minister of Municipal Affairs, Recreation and Housing and the B.C. Housing Management Commission. The province bought the site for SILA and has leased it back to the society for 60 years. Further, the province is financing the first mortgage, through B.C Housing Management Commission, in the amount of just under $3.5 million. On completion, the mortgage will be transferred to a commercial lending institution after a competitive bidding process.
Finally, the province will be contributing one-third of the operating subsidy so that residents will not pay more than 30 percent of their income for housing. In the current market conditions, this subsidy is essential.
I'm very pleased with the cooperation shown by the ministry and B.C. Housing in working together with SILA. This brings me to the federal government. It's not fashionable these days to thank the federal government for their contribution to our well-being. However, I'd be remiss if I did not acknowledge their major contribution to SILA and their role in providing social housing in British Columbia. The federal government has agreed to contribute two-thirds of SILA's operating subsidy -- just over $170,000.
In Sherry Newbold's words: "This partnership of the federal and provincial governments makes our job a whole lot easier. This funding is essential if we are to make a better place for people in our communities." I would like to put it a little stronger than that. I would say that the service rendered by groups like SILA is remarkable, and senior governments ought not to put them in the position of being their own bankers and fundraisers, too.
All British Columbians should know that we owe most of the credit for such social housing to the federal government. The reason is that with the exception of the mid-seventies, the federal government has done the lion's share of the financing for the best part of 40 years. This province alone among the provinces has been a very junior partner indeed. Other provinces have maintained pretty substantial programs of their own.
In some aboriginal cultures, the correct way to thank someone is to ask that they continue to make their contribution. It is my wish that the federal government would do the same. But that's not what they are doing. Since 1991, the federal government has cut by two-thirds the funding for social housing. This week in the federal budget social housing expenditures were frozen at new low levels. What this means for British Columbia is that we should be building about 1,800 fewer homes by the end of 1993. The population in our province is growing, and so too is our need for housing. Housing prices and rents are going steadily upwards. Vulnerable people in this province, including seniors and families with small children, will be most hurt by this.
The latest federal proposal -- just the other week -- was to reallocate national housing funds away from provinces like B.C. to the smaller provinces. I'm glad the Minister of Municipal Affairs said no to that proposal, and I'm grateful that despite budget problems the cabinet has sustained our portion of the housing program at the 1991 levels.
But I would like to suggest that much more needs to be done. Average rents in major areas in the interior
[ Page 5706 ]
such as Prince George, Vernon, Kelowna, Kamloops and Castlegar already exceed the GAIN shelter allowance. One strategic option would be to increase the housing supplies in these areas. According to the latest BCHMC call for expressions of interest, under present circumstances the non-profit sector in the interior will be lucky to be assigned 73 homes to build this year. That's 73 homes for the entire interior. That may be all we can afford to do this year, but in areas like Kelowna, which grew by 25 percent between the 1986 census and the 1991 census, it will scarcely make a dent. What will such low allocations do for groups like SILA? These groups will tend to atrophy if, as partners, we are unable to provide them with a reasonable level of funding for new projects. If that happens, our communities will be much poorer for it.
For their time and talent, we owe Sherry Newbold and SILA and all the other non-profits a hearty vote of thanks. We owe it to British Columbians to make sure that we do our part so that they can go on making their contribution.
V. Anderson: I very much appreciate the comments of the member in her statement on housing. We join with her in commending the local community group that undertakes the basic responsibility for planning and initiating, because without the volunteers in local communities who take on these projects and who push, if you like, both the provincial and federal governments, very few of these community undertakings would happen. It highlights the need for more community planning and initiative, because it's only with that kind of planning and initiative that governments, at whatever level -- municipal, provincial or federal -- can be challenged to look at the overall plan we need within the province.
I'm very much aware that part of what is happening at the moment is that seniors and others are moving from the city. They're selling their properties and moving out into the smaller communities, because it's more affordable to live there. But the upshot of that is they then raise the prices and take the available housing in those communities with the profits they made because of their move.
The people who live in those communities are the ones who suffer, because they don't have the opportunity to upgrade in their own communities. Many, even in smaller rural communities, are forced into untenable conditions or are forced to move away from their homes. This should not be, for seniors or families. In the history of Saskatchewan, I'm aware of the number of affordable homes, particularly for seniors, that have been available in communities throughout the province, so that they could afford to stay in their own community and offer a very important contribution.
[10:15]
It seems to me that as a province we need far more study to support this kind of undertaking and to support the volunteer sector in the programs and planning, and we need to help create a means of cooperative funding with them in order that they can undertake these projects. We also need to be more creative. As the member has already said, there has been some creativeness, where families and seniors, with a variety of needs, have been able to share the same accommodation. That's an important item. It's important that people of different backgrounds and ages come together and share, as they do in a normal community, because they have social contributions to make to each other. It's important that children live near seniors so they can share with them. They could be adopted grandparents, if you like. It's also important for those adopted grandparents to have children they can take some responsibility for and care for.
One of the side issues that comes up very often in some of these government-sponsored homes is whether or not you should have pets, such as dogs and cats. This is a very fundamental question, because it provides a social opportunity for those families to care for each other when those pets are allowed to be there. It's a caring opportunity for the seniors to have those pets, not only within their own homes but within the complex of which they are a part. It's interesting, when we're even taking dogs and cats into hospitals and long term care homes because of their contribution to the well-being of people, that at the same time we're beginning to exclude them from affordable facilities in the community. So there are some dimensions of social life that need to be taken into consideration besides just providing a house for people to live in.
So in the planning of these homes and opportunities throughout the province, I would hope there would be some guidelines that emphasize not only the physical necessities but also the social necessities: that there is access to transportation, to shopping and to community facilities for social and recreational activities. It wasn't too long ago that many of these new opportunities were put in out-of-the-way places, on the edge of the community rather than in the centre of the community. These things need to be taken into account. I was interested that two of the suites were made handicap-accessible. There are some projects now that build this into every suite, with adjustment possibilities.
S. O'Neill: I'd like to thank the member for Vancouver-Langara. I couldn't agree more with him.
I think one of the most interesting things about this project is the fact that it is integrated. Salmon Arm is a fairly small community, and we have a wide variety of needs. Unfortunately, very often we don't have the numbers to justify separate accommodation. Probably we have gained by this because we've been forced into integration, which is very important. The integration between the different ages is extremely important to everyone, young and old alike. Also, being a dog lover and dog owner, I can appreciate the benefits that come from having pets, and I would agree on that as well.
I'm really please that the Minister of Municipal Affairs, Recreation and Housing has moved on housing. The Provincial Commission on Housing Options toured the province last year and made a report with over 50 recommendations, and some of these have already been implemented. There certainly seems to be a consensus that something needs to be done -- but just what is still in the throes of debate.
[ Page 5707 ]
YOUTH SUICIDE
D. Symons: I rise today to share my thoughts and observations about a very serious and important issue which is getting progressively more serious as each year goes by. It is an issue that's long been hushed, and for far too long addressed to a lesser degree than other issues before us in this House. I am referring, of course, to the issue of youth suicide.
I have done a considerable amount of reading on this subject. As a former teacher and in my extended family, I have experienced the pain and helplessness that goes with the territory. Death is not easy to accept under any circumstances. But the sudden death of a confused child or an adolescent who has been crying out for help -- perhaps in a quiet way, perhaps not so quietly -- is particularly hard to take. I've recently learned that the suicide rate for youth has tripled in the last three decades. We are indeed facing a tragedy of serious proportions.
I find myself asking: what can I do to help a suicidal person? What can I do to prevent a youth from following through? What resources are available to me, and what resources are available to the troubled youth? How can a suicidal youth be identified? Mental health tests at an early age would be helpful, but do we subject every child to such tests? A study of trends in suicide could provide indicators -- that is, warning signs detected but often ignored in previous cases. For example, child victims of verbal, physical, emotional and sexual abuse, depression, loneliness, low self-esteem -- and I think that's the nub of all of these others that lead to low self-esteem -- broken homes, extreme poverty and handicaps may all well be in a high-risk category and therefore need to be identified and helped. Once the youths with suicidal tendencies are identified, what can we as citizens and as politicians do to help them? How can we give youth a renewed sense of usefulness, appreciation and importance? How can we raise a low self-esteem? A lot of it is the responsibility of the family, but in today's society the family is often neglected due to societal pressures, socioeconomic factors, lack of cohesiveness, competition, violence, illness and materialism. We cannot, therefore, leave this problem exclusively in the hands of the family.
Abusive relationships are easy to spot in books or on television. You may even see them in the homes of your neighbours or relatives, but the hardest situation to see clearly is your own. Often people make excuses without thinking or explain things away and begin to think their homes lives are fine. Many families cannot deal with problems. Many are too proud to ask for help.
Most youths spend the better part of their day in school, and it is in this environment that he or she can be best observed, not only as a student but in their friendships or lack of friendships, as a participant in extracurricular activities and as a human being. It seems to me that a school environment is all-encompassing, and therefore the best available locale for detection of the key indicators I mentioned earlier. I'm not advocating that yet another social responsibility be added to the already intensive workload of teachers. Having been a teacher for many years, I realize that would not work. Every school in this province -- elementary, middle, and high school; private and public -- should have qualified and certified counsellors and psychologists readily available. I'm all too aware that many districts in this province hire counsellors or psychologists, but their workload is overwhelming in that they service many schools. Therefore many students needing these services are neglected.
This concerns me a great deal. Our youth deserve better. Utilizing the services of mental health officials, specialized counsellors or psychologists, survivors of attempted suicide and family members of youths who have succeeded in ending their lives would be a positive step toward curtailing a growing problem which we must not ignore. Suicide is an issue which requires professional guidance for everyone involved. We all know that talking and listening are the keys to problem-solving. At-risk teens need a safe place to go to express themselves. They do not need to be living in fear of repercussion, judgment or criticism. The problems need to be broken down into manageable parts in a clean, comfortable, uninhibiting environment with the assistance of trained professionals. A designated room in a school or even some less formal setting for this type of service should be high on the priority list.
It is encouraging to note that the B.C. Council for the Family has produced and distributed a suicide awareness and intervention program for British Columbia schools. This program has taken the subject of suicide out of the closet and brought it right into the hands of the most vulnerable. I commend the council for taking that leadership role, and I am hopeful that it will not become yet another kit sitting on the shelves of many school classrooms and collecting dust. The community can also be very effective in helping to divert youth from that feeling of uselessness and alienation that many experience. The community can help to build or to rebuild self-esteem.
Hon. Speaker, I'll stop at that point and give another member an opportunity to respond.
J. Beattie: I'm glad to rise to respond to the statement on teen suicide. I think it's a very important discussion that we're having today and one that we should continue. The personal tragedy that's attached to some member of a family going from us at such an inopportune time and in such a dramatic way not only causes tragedy for the family but really also for the community. It has the extraordinary effect of under-mining the confidence of children and the whole community in what exactly is transpiring. So it's something that we have to deal with.
I think it's become quite obvious in recent years, as there's been much more examination of the issue, that there are a number of causes. But really important, I think, is the deteriorating group integration that takes place in our communities, where people feel an overpowering sense of personal responsibility for the things that are happening in the world yet feel unable to deal with them. We're talking about the incredible problems that exist with world peace and with the environment. We're talking about jobs, about how we're
[ Page 5708 ]
going to support ourselves as we get older, and young people have an incredible burden to bear in that sense.
The other very important aspect that has been discovered is that traumatic experiences, things like sexual abuse or alcoholism in the family, are the hidden, taboo parts of people's lives that they are often unable to express in a public forum or in a responsible, managed way. These things fester and grow and become insurmountable problems in the end. It's the personal trauma there.
I think we have to recognize that we're dealing with structural problems in our community in both these areas. We're dealing with problems that have to be dealt with in a larger sense; it's not something that individuals can take on by themselves. Because of the attempts of the hon. member to bring this forward and our response, we're trying to say that it is an issue for government to deal with and for the larger institutions to really to get a handle on.
I think the statistics about who in the youth group is committing suicide are quite interesting. Although more men do, in the end, kill themselves, the number of attempts by women is three times higher. The statistics show that the number of failed suicides by women is three times the number of failed suicides by men. The point is that perhaps men have developed a more aggressive way of dealing with that phenomenon, because they use guns and have more ways to take their lives. The problem crosses both genders, and that's very important to recognize. I also want to comment that native suicide, although it's a specific concern, is ten times higher than suicide in the non-native population. So the problem there is exacerbated even more.
Another important thing that differentiates our culture from American culture is that the Canadian rate of suicide is 57 percent higher than the American rate of suicide. There are some very important sociological aspects that we as politicians have to examine there, and I don't think we have to look upon it in a negative sense. In the United States there's a history of dealing more aggressively with exploiting the land and the resources. The development of their imperialistic history is reflected in the fact that they have a higher murder rate. They tend to take their aggression out on other people, whereas Canadians take it on as a personal responsibility and turn it inward. I think it's an example of a more reflective society. It's not that there's a qualitative difference, but it's something we have to deal with.
The hon. member talked about ways we can get into prevention by recognizing the symptoms and dealing with the issues. I think age-specific testing is very important and can be done in the schools. I want to commend the Greater Vancouver Mental Health Service for their 14-year program in which they've tracked ways of evaluating and educating people. Through moves to regionalization and more money for mental health, drug and alcohol programs and lunch programs, the government has attempted to raise the esteem of individuals and give them a better chance to survive in this world.
[10:30]
D. Symons: Hon. Speaker, I've listened attentively to the words of my colleague for Okanagan-Penticton, and I appreciate them very much. The comment he made that nowadays people have the feeling of a lack of future was driven home to me quite a few years ago. I conducted a survey of 300 students in the high school I was teaching at, and I included a question about their thoughts on the future. I had read a survey in a California school which indicated that a number of students felt there was no future for them. They felt they would end up dying in a nuclear war in the future. This was when the threat of nuclear war was higher than it is today, but nevertheless, I was appalled at the high number of students who were concerned about that. I found that the same thing was reflected in the Vancouver school I taught at. For a good number of students, if it wasn't nuclear war, it was simply the lack of a job or a vision of the future. That would certainly have an effect upon their self-esteem, if they can't see where they fit into society.
As I was just emerging from my teens, I had to be a pallbearer for a neighbour's boy who committed suicide. Not too long after that, two members of my extended family committed suicide. As well, I knew a man with a young wife and two young children. He had lost his job, and I guess his self-esteem was gone. He felt he couldn't perform for his family. He found the way out through suicide. So I have known a great number of people affected by suicide. Of course, people immediately around them think: "What could I have done? Could I have seen this happening? Could I have prevented it?" I think there's a lot of self-blaming that goes on, which really shouldn't be done, but it seems to be human nature to take some of that upon yourself. It's something that we also have to learn to deal with.
We should look at some of the warning signs that need to be highlighted and shared, and I would like to draw the House's attention to a few of these. Some signs are obvious and some are not. We should look for any talk or written notes regarding suicide or statements of the person wanting to die: "I wish I wasn't alive" or "I wish I wasn't born" -- things of that sort. Self-mutilation, razor-blade cuts, rope marks and things of this sort are danger signs. Sudden changes in behaviour and mood or changes in sleeping order or eating habits could be indications that people have suicide on their mind. A continuation of depression, excessive crying, feelings of hopelessness -- and I guess we all experience this at one time or another -- are certainly things for concern. We should also be looking for signs of low self-esteem.
MOTORCYCLE AWARENESS MONTH
G. Janssen: It's with great pleasure and honour that I rise -- for the fifth year in a row -- to speak about motorcycle awareness in British Columbia. Of the some 195,000 classic licence holders in this province who ride motorcycles, some 62,000 range in age from the very young -- as young as four and five years -- to well into their eighties. They ride for both sport and pleasure, as well as for a means of reliable transportation and an efficient alternative to the automobile.
[ Page 5709 ]
The automobile, as we know, takes up a lot of space. We spend a lot of dollars building roads and parking lots. You can park four motorcycles in the space of one automobile. Many motorcycles get as much as 200 miles to a gallon of gasoline, and the ease of handling and manoeuvrability in traffic makes them an efficient and attractive alternative to the automobile. In fact, as we all know, in Europe and Asia, motorcycles outnumber cars as a preferred transportation.
In British Columbia, May has been proclaimed a motorcycle safety month. We have been striving for many years -- through the B.C. Safety Council and the motor vehicle branch -- for better training, not just for motorcyclists themselves, but also for the driver examiners who give those tests. This year the aim is to have all driver examiners hold a class 6 motorcycle licence. We also aim to enforce proper riding apparel for those who ride motorcycles.
Technology in the production of motorcycles is far in advance of that of automobiles. It is possible today to buy a 500-pound motorcycle that produces 160 horsepower and can go from zero to 100 miles an hour and back to a complete stop in less than eight seconds. We allow young people, at 16 years of age, to purchase these with virtually no training and then allow them to ride around in nothing more than a bathing suit. This year will see the Insurance Corporation of British Columbia, the government and the B.C. Coalition of Motorcyclists, under their president, Peter Jack, inject over $100,000 into motorcycle awareness programs in British Columbia. Through advertising at bus stops, on B.C. Ferries, on radio and television and in newspapers, we will attempt to make car drivers more aware of motorcycles and their vulnerability in traffic.
In addition, the aim of the Association of Injured Motorcyclists is to assist motorcyclists who, in many cases, have very severe injuries because of traffic accidents. Their chairperson, Ted Allen, is working very hard with committees in almost every community throughout this province to assist those injured motorcyclists with not only their physical injuries but also the trauma they experience because of being injured.
Last year we had the motorcycle ride. When we started some five years ago, 17 motorcycles took part in the ride. Last year we had over 300. Of course, the ride is meant for MLAs, admittedly to get some publicity to make the public more aware of the safety concerns of motorcyclists. During that ride, the Member for Richmond East was struck by a car and taken to hospital. I don't think I need to say more about the effectiveness of this ride.
Last year, on a Ride for Sight, motorcyclists raised over $1 million for retinitis pigmentosa. That money funds research in British Columbia and two doctors at the university. Additionally, over $2 million was raised in British Columbia last year by show-and-shines, motorcycle events, motorcycle shops, poker runs and, of course, the famous toy run. In fact, last year over 6,000 motorcycles took part in the Vancouver toy run. Besides raising hundreds of thousands of dollars, they collected 17 milk delivery vans full of food for needy families. The money was distributed to home-support organizations, women's centres, hospitals, the Salvation Army and disability groups.
I'll wait for the response.
L. Fox: It's a pleasure to rise and respond to this private member's statement. Having not spent a lot of time on a motorcycle myself, I'm sure that I don't have the same appreciation for them as those who have spent a lot of time on them. Therefore I probably don't have the same understanding of the issues as the member who spoke. But I do know that motorcyclists have contributed substantially to very worthwhile causes in the northern part of the province, as they have, as the member pointed out, in the southern part of the province.
The awareness created throughout the school system by their visits and driving programs is of extreme importance to our young people who are looking at motorcycles -- because of the economy and the thrill, and perhaps because it's just a bit of fad -- as a means of transportation.
Recently I've had calls in my constituency from individuals who have motorcycles and are finding them increasingly difficult to afford. In one particular case, the ICBC rates went from $3,000 to $4,000 last year, before the 40 percent discount was taken off. I know that the member who made the presentation has been lobbying for some consideration for bikers with respect to insurance costs. As well, I'm well aware of the lobby by the motorbike association that the motorcyclist is not the individual who causes most of these accidents. It's more a result, perhaps, of a misjudgment by an automobile driver, such as the accident the member for Richmond East was in a year ago, during the ride.
If this industry is going to continue to be viable and this recreation affordable, then this government must look very closely at how it can maintain: (a) an insurance cost which is affordable; and (b) an educational cost which limits the liabilities for that insurance. I am concerned, hon. Speaker, that we will see motorcycles being phased out as an alternative mode of travel because of the associated costs. If we look at our taxing policies just this year, by this government, you can no longer trade a motorbike in and get the credit for that without paying tax on the full price of the new vehicle, have one repaired without paying tax on the labour or have the oil changed without paying tax on that. There are many things facing the motorcyclist today, and I look forward to the presenter lobbying his government to limit those obstacles which stand in the road of recreation on a motorcycle.
G. Janssen: I'm pleased that the member brought up the issue of insurance costs, which we at ICBC -- and I as a director -- have been pushing forward to see some action on. I'm sure that if the member cares to partake in the ride on Monday, he may be surprised at some of the results of that lobbying effort and the fine work that the motorcycle community has done in conjunction with the Insurance Corporation to see a resolution to that problem.
[10:45]
[ Page 5710 ]
The economic aspects the member alluded to are real. Thousands of young people partake in motorcycle and dirt bike races in British Columbia. It keeps them off the streets; it teaches them safety; it teaches them to safely take care of their machines. This is done mostly through volunteer efforts in British Columbia and by many British Columbians who donate their time, weekend after weekend. Some machines can run up to $30,000: a tremendous amount of money for people to invest in something that they feel is a sport and a worthwhile activity for themselves and for their families.
I hope that all members partake in the ride on May 3, this coming Monday. It will be at noon in front of the buildings. We are hoping that the former Speaker, Stephen Rogers, will be there, along with Jack Munro and other dignitaries. It will be the fifth year. We expect over 300 members to be there. The ride will take approximately 15 minutes. I hope the members listen to the concerns of the motorcycle community and follow the practice of inviting the motorcyclist you will be riding with to lunch after the ride.
FINANCES
C. Tanner: Private members' statements on Friday mornings are particularly important, because it gives members the opportunity to express a very personal point of view. I want to emphasize to the members in the House, and to Madam Speaker particularly, that this is a very personal point of view. It is my own; not of the members of my caucus or the opposition, but of the member for Saanich North and the Islands only. Madam Speaker, I not only make that preference, but I'm going to refer to it throughout the speech.
After a year and a half in this House, I have noticed a great penchant on the part of everybody associated with the Legislature, and in fact all areas of the government, to spend money. I have been urged to spend funds prior to the fiscal year-end simply to use up my budget. In mid-March, government employees hastily spent their budget allotments to clear out any surplus funds before the budget came in for the new fiscal year. When I suggested cost savings to conserve government funds, I was told: "We do not do it like that. This is not the same as business." Well, Madam Speaker, perhaps it's time for this small business man to tell the members of this House what he thinks about how we spend money in this government -- and I speak only for myself.
Let's examine some of the costs of government and be prepared to cut funding over a five-year period. I have separated government departments and some programs into five different groups for action by review and by attrition.
First, at the very least, administrative costs must be reduced and program dollars made more effective in the following departments: Education, Health and senior services, Social Services, Aboriginal Affairs, Government Services, the Legislature -- and I'll refer to that again in a minute to illustrate my point -- the Attorney General, Finance and Labour.
Second, we should examine the costs of, and be prepared to invest more money in, programs to promote a return on the taxpayers' investment in the following departments: Forests; Energy, Mines and Petroleum Resources; Transportation and Highways; Agriculture, Fisheries and Food; and Advanced Education, research, apprenticeship, industrial partnerships and training.
Third, the government should be prepared to review the continuance of these programs -- and let me emphasize these are only suggestions; there are alternatives to what I'm suggesting: the ombudsman's office; sports and cultural funding; multiculturalism; Environment, Lands and Parks; Consumer Services; Crown corporations like ICBC and B.C. Ferries; liquor distribution sales; and legal aid.
Fourth, government should give consideration immediately to closing down, over the next five years, two departments altogether -- Economic Development, Small Business and Trade; and Tourism -- because industry can do it better, and government should confine itself to the regulation of these industries.
Fifth, and finally, in an attempt to reduce taxation, reduce government and reduce duplication, the government should sell off some assets, such as Crown lands, government buildings, B.C. Hydro, B.C. Rail and the Insurance Corporation of British Columbia, and use the income to reduce the deficit.
Interjection.
C. Tanner: I thought you'd like it. The government, of course, has complete regulatory authority over all these assets. It has complete regulatory authority over all the areas in which I think it should reduce its competence, and it can bring regulatory power to bear on those industries that are affected.
It is all very well for me to suggest this � la Erik Nielsen, federal government, 1984-85, but now I'll give you some more specifics on how it affects the members of this House. I'll take it one step further as an example of how the Legislature and the members of this House should proceed.
Here are my cost-saving recommendations for the Legislature: (1) cut the number of members to 50; (2) change the $16,000 expense allowance to a taxable salary; (3) allow only a 60-days-a-year sitting allowance; (4) cut off MLAs' severance pay; (5) make pensions optional on a 50-50 MLA-government basis, with no topping up; (6) reduce travel allowances in the province and completely cut outside-province travel, except in exceptional cases; (7) reduce the budget for the Speaker, the Clerk and legislative staff; (8) don't pay capital allowances to any MLAs within an hour's drive of this House; (9) cut all salaries by 5 percent -- in my plan they're now $50,000, not $32,000; and (10) increase the pension eligibility to ten years.
In all my suggestions there is an urgent need to give more responsibility and more accountability to public servants at all layers of the bureaucracy, and to always try to push the responsibility lower and lower towards the client, the recipient -- the people who receive the service.
[ Page 5711 ]
In suggesting that culture and recreation should not be funded, I'll offer you an alternative. Of the $200 million raised by lotteries each year, $100 million of the funds are presently spent -- or should I use the word "dropped"? -- in the Health budget. This government suggested, then made the change. That's like throwing a bucket of water into Elk Lake. And $100 million of the lottery funds goes into general revenue.
Lottery funds should be used exclusively to fund sports and culture, and every dollar that's given should be matched by another dollar. I learned after ten years with the United Way, the fundraising organization, that there is only one way to go, and that's by example. If you are going to ask for money in the United Way, you've got to give money yourself. If you ask somebody to donate a dollar, you've got to give a dollar. If we want the public service to make changes, if we want people to decrease their expectations, if we want the public to ask for less, then we, the members of this chamber, have got to get off our self-serving programs first.
The Speaker: Thank you, hon. member. Your time has expired.
D. Lovick: I certainly listened with interest and enjoyed the comments from my friend across the way. I noticed that he emphasized many times that this was a private member's statement and that he spoke for nobody else. I have two responses, two observations: (1) thank goodness; and (2) I noticed that his colleagues in the Liberal opposition benches were all suddenly smiling and breathing a sigh of relief.
It's worth noting that the member's title for his remarks today was "Finances." When I looked at that, I must confess that I thought, oh, isn't this wonderful. I'm truly hopeful; I'm looking forward to the fact that perhaps he's going to say, "Here is a way that we have found to give you approximately $1.5 billion" -- namely, the amount of the projected deficit. It would solve all our problems, and life would be wonderful. Sadly, we didn't get that. Sadly, what we got is a very old theme. The very old theme, of course, is that all you have to do to solve your problem is get rid of government.
It always strikes me as passing strange that members who run for office, who ostensibly want to be part of government to accomplish things, can stand up and in the same breath say: "I don't want us to have government. I want to reduce government." I wonder, then, if we might all be better served if members who feel that way wouldn't run in the first place. That's a passing thought.
Let's be very clear. We all of us in this chamber -- indeed, I suspect, everybody listening to and watching what goes on in this chamber -- agree that government must be answerable to the people. Government must be accountable. We need to spend smarter, and we should do whatever we can to achieve greater efficiencies and greater economies. We should ensure that we get value for dollars spent. Nobody debates any of that stuff. But let's not fall into that simplistic and clich�d response to complex problems by saying we will be leaner and meaner. Leaner maybe -- but meaner isn't what we need. Indeed we need the opposite: we need probably greater sensitivity and greater awareness of the complexity of problems.
What is government? What does it do? According to the member opposite it has one function. I'm pleased to note that the member is indeed familiar with eighteenth-century philosophy, because that's the philosophy of government he alluded to; namely, the police officer on the street corner and government's only function being to regulate -- nothing else. In other words, let people solve their own problems, let them do what they do, and government's only function is to regulate.
Unfortunately, there's a problem with that particular hypothesis, that particular theory of government. What's wrong with it is proven by the last 200 years of history. Every modern society has developed big government, not because of any desire for big government, but simply to respond to the complexities of modern society. That's the reality. Government, as the late Tommy Douglas pointed out very eloquently many years ago, is simply the community writ large. Government does for us collectively what we as individuals cannot do. That's what government's role is. It's our government; it's something we control.
This morning two members of the opposition caucus stood up during private members statements, one to make a statement and the other to respond to a statement. One had to do with housing. To his credit, the member from the opposition said that he agreed with my colleague's comments on housing. As government, he said, we need to do things that the private sector isn't doing, and he praised the federal government, provincial governments and local societies for doing what they did.
The other member, making a statement about the terrible tragedy of youth suicide, pointed out prima facie that one of the problems with our society, when left to its own devices, is that we can't produce enough jobs. We do not provide a warm, comforting, stable environment for young people -- and thus the tragedy of youth suicide. In other words, two members from his own caucus today did very well what I perhaps am not doing very well; namely, they demonstrated the facile quality -- with all due deference to my friend -- of the notion that our solution is to be found in simply reducing the size of government.
Government is complex and difficult. An example to support the proposition that we are probably not going to need less government, but more, is environment.
I see my time has expired. I thank hon. members for their attention and look forward to seeing if the hon. member will reconsider or carry on.
[11:00]
C. Tanner: I've got to tell you that I am disappointed in the member for Nanaimo. Yesterday in committee he asked me whether I could give him some indication of what my speech was going to be. I thought this would really get him going, so I gave him four basic points -- without giving the details, of course -- of what the speech was going to be, and the best he can come up with is that government's got to be big to solve
[ Page 5712 ]
the problems in today's world. I have not said anywhere that government doesn't have to be big. What I have said is that maybe we should be looking at it a little differently. I'm not surprised at all by the reaction I got from that side of the House. I anticipated it, and I've got some answers for you.
D. Lovick: You said you were going to give me the whole speech.
C. Tanner: I changed my mind, because I knew that if I did, he would need three hours to reply and he's only got three minutes.
Now that I've got your attention and the attention of the hon. members, when I say that perhaps we should think about the ombudsman, things have changed since we established that department. We're about to have a fully fledged -- the best in Canada, I agree -- Freedom of Information Act. Maybe we should be putting a bit more money into our constituencies so that the 75 of us -- or in my new book, the 50 of us -- can act as ombudsman or have staff to do that job in the constituency.
When I say that we should think about the funding of sports and culture, I specifically think we should be funding it as a special area out of lotteries, a fund which, in my view, is found money. As found money it seems like a reasonable place to put it.
When I say that we should be talking about multiculturalism, there is a huge federal bureaucracy, and we've got one within one of our departments. There are some duplications and we should be looking at that.
When I say that we should be looking at Environment, Lands and Parks, we have a regulatory authority, an enormous federal environment department that's growing by leaps and bounds. Is there duplication? If there is, we should forget our federal and provincial jurisdictions. We're all Canadians living in one country. If one layer of government can do it, another one shouldn't be involved.
When I talk about consumer affairs, I wonder: in today's world, how effective is the consumer affairs department? How responsive is it to the public? Let's see what they've accomplished. All I'm suggesting is that over the next five years we should look at these things.
On the Crown corporations. We do not have enough control in this House over Crown corporations. In many respects, we could do it better in industry, and we should be looking at that. Why does this government, and the previous government, insist on selling liquor, Madam Speaker? Why do we have to do that?
If I may wrap up, Madam Speaker, all I've said is that if we want the public service to make changes and we want to change people's expectations and expect less, the members of this chamber have got to lead the way. We've got to get off our self-serving programs. We must set the example. We cannot turn our economy around, reduce our deficit and stop increasing deficits without sacrifice. We should proudly lead the way in this House.
The Speaker: Thank you to all hon. members for their private members' statements and responses this morning.
J. Dalton: May I have leave to make an introduction, hon. Speaker?
Leave granted.
J. Dalton: Hon. Speaker, on behalf of the member for Richmond East and myself, I would like the House to welcome a longtime friend and colleague from Langara, our good friend Mary Kruger. Would the House please make her welcome.
B. Copping: May I have leave to make an introduction, hon. Speaker?
Leave granted.
B. Copping: In the House today we have several grade 7 students from Hillcrest Elementary School in Coquitlam, accompanied by their teacher Mr. Silver. Would the House please make them welcome.
The Speaker: I'm assuming that members are rising on the same matter, and perhaps we could grant collective leave for introductions at this time.
Leave granted.
D. Symons: It's my pleasure to introduce Mr. Don King and his wife, Mrs. Rose King, to the House. Don is president of the Richmond Auto Mall, and he is in Victoria today out of concern for the employees and jobs in that industry in Richmond. Would the House please make him welcome.
The House in Committee of Supply B; E. Barnes in the chair.
ESTIMATES: MINISTRY OF HEALTH AND MINISTRY RESPONSIBLE FOR SENIORS
(continued)
On vote 47: minister's office, $419,400 (continued).
L. Reid: I'm pleased to enter into debate in the estimates process, in terms of how it relates to health care in the province, on an ongoing issue from Monday's debate on health. We will be discussing Shaughnessy Hospital for some time this morning. I would ask the minister to please refer to the University Hospital report of June 1992: "The Shaughnessy site will be the centre of quick-response clinics and short-stay units offering 'one-stop shopping' to patients near and far. The Shaughnessy site will continue to provide specialty services to support the Oak Street site partners." This report was sent to the Minister of Health for some acknowledgement. It encapsulates many meetings and months of process on behalf of the
[ Page 5713 ]
strategic committee at Shaughnessy Hospital to create a plan. They have brought forward a compromise position in terms of how they could complement the direction the minister wishes to go in and maintain the integrity of the provincial referral programs.
The transition team report of April 26, under the direction of Mr. Bert Boyd of the transition team of Shaughnessy Hospital, has in fact looked at maintaining some of those programs on-site. So there seems to be some similarity in terms of maintaining provincial referral programs.
I would ask the minister this morning if she can comment on whether or not a compromise can be reached. I do believe there must be some acknowledgement of the Shaughnessy Hospital strategic team, who did plan, who did put a process in place, who did evolve a very fine strategic plan of where they would like to see the hospital go. And I believe they are in sync with some of the wishes of this minister. Rather than continuing conflict in this area, perhaps we can reach a compromise. I would ask the minister to please comment.
Hon. E. Cull: Well, I think the answer to this question that's been posed to me is in fact in the words of the member. There was a strategic plan that was prepared by the hospital; it was shared with the ministry's staff; it was given to me after it had been completed. Since that plan was prepared by Shaughnessy Hospital, events have moved on. The government has made a decision to close the old building and to reallocate some of the services. But as the interim report that was released by the transition coordinator, Mr. Bert Boyd, on April 26 shows, some services will be remaining on the site. Indeed I made that statement myself when I announced the closure and the reallocation of services on February 15 this year.
The Women's Health Centre will stay there, as will potentially a number of ambulatory clinics and other services that are necessary to support Children's and Grace Hospitals. The report that has just been released by the transition coordinator is out with the medical community and the larger health care community and indeed the public at large for final comment before any decisions are made. So certainly some of the work that has been done in that 1992 strategic plan has been part of the decision-making that is now underway.
L. Reid: A direct question to the minister. Did this Minister of Health acknowledge the receipt of the strategic plan prepared by the individuals at Shaughnessy Hospital?
Hon. E. Cull: I met with the former CEO of the hospital and the chair of the board and discussed the plan with them at that point, yes.
L. Reid: It seems to me we must acknowledge today the planning process that went in place in terms of the preparation of that particular report. And it seems to me that this planning process was in place for some 15 or 18 months. They consolidated the plans, they coordinated with many groups that reported in the hospital and they created a strategic vision. Based on the minister's comments, I'm not convinced that strategic vision is so different than the direction the minister wishes to head in. I do not accept the notion that the buildings at Shaughnessy Hospital are old; in fact, the buildings are a lot younger than the majority of the members of this House. Certainly we have had discussions in this House over time where we have looked at the quality of care, and medicine being a people business and having some respect for the process to far exceed the bricks-and-mortar question. That is the process I believe we are missing today.
If you were to travel in Europe, hospitals 200 and 300 years of age continue to provide world-class service, and no one with a sensible approach to health care suggests that the service cannot be provided because of the bricks and mortar. That simply is not a position that can be supported by the official opposition. It was certainly not a position that was supported by Vancouver City Council on Tuesday evening, when the member for Vancouver-Langara and I attended the extraordinary meeting of council. No one was accepting the notion that the buildings were old, and certainly the work that we have done suggests that those buildings are built to code and have passed safety standards. If the minister's going to take the position that the seismic issue has not been well understood, I would submit that this building, as many schools, as many public buildings in this province, may not be in line with the most current seismic standard. But that does not render the building useless or counterproductive to the enterprise it's currently involved in.
The issue -- and let's just take the spinal cord unit as one example -- Tuesday evening at the Vancouver City Council meeting, and the issue today, is whether or not something as significant and fragile as the spinal cord program is going to be transferred twice. If it is the intent to put that program into the tower at Vancouver General Hospital, that tower is not ready for occupancy. So if the minister could comment on where it's going first, where it's going next and what the costs of those two moves would be, that would be most appreciated.
Hon. E. Cull: I'm sorry, hon. member. I was just having some material passed to me and missed your question. I was listening to all of your debate and was prepared to comment on some of it, but I missed the question at the end. If you'd be so kind as to repeat it.
L. Reid: Certainly. I'm happy to do that. And I would take the opportunity to welcome the staff to the chamber. It's very nice to see you all back.
In terms of the question, I'm looking specifically to a cost accounting for the shift of the spinal cord program, in that the tower will probably not be ready for occupancy for some time. What is the cost of shifting into the first location -- and where would that be -- and what is the cost of shifting for the second time, if indeed the program moves into the tower?
Hon. E. Cull: The cost accounting cannot be determined until the location of the spinal cord unit has been determined. That has not been finalized, nor have
[ Page 5714 ]
the enhancements to that service -- which have been requested by the people involved in the program and the task force looking at the program. So it's not possible to provide a cost accounting until some of the decisions around location and service have been finalized.
I was listening to the comments of the member with respect to the old building, and I want to remind the members of this House that the age of the building was only one of a number of things taken into consideration when we reviewed how best to reallocate services in the greater Vancouver area. The reasons behind the decision to close the Shaughnessy Hospital building, besides the age of that building and the need to replace it -- which has been well documented over a number of years -- include the fact that there is a surplus of 500 beds in the city of Vancouver, 300 beds in Vancouver that are closed due to lack of operating funds and a shortage of over 800 beds in the Fraser Valley -- all of these statistics coming from the Greater Vancouver Regional Hospital District.
The advice of the B.C. Health Association was that if there were to be significant difficult decisions to be made around the hospital budget this year -- in other words, if the hospital budget was to have only a small percentage increase, as it did with a 3 percent increase this year -- we not spread the cuts over the entire system, but have a look at where the services are, where the surplus beds are and where the inequities are. We do have parts of the province with as few as less than two beds per thousand population, once you've age-adjusted it and looked at referral patterns; and we have other communities that have over seven beds per thousand. There are significant inequities in the system, and they have asked us to try to address those rather than ask everyone to take an equal share of the pain.
In addition to that, the issue of Children's Hospital was still before us, no matter what decision we made. The city of Vancouver has made it clear that the density on the Oak Street site could not be any higher than it is right now. Children's Hospital needs to have an expansion, and the choice had to be whether Children's would be allowed to expand or whether we'd have to relocate some of their services.
[11:15]
L. Reid: I appreciate the minister's comments. But what I'm hearing is that the barriers to maintaining Shaughnessy Hospital are indeed arbitrary. The funding for the hospital beds, the process and the formula, were arrived at. I think the minister has said that over time we may indeed never reach that particular funding formula in all communities in this province. That's been my experience in education. Arriving at a formula, which may or may not be applicable in the current day, is perhaps not all that valuable.
The zoning barrier, if you will, is also arbitrary. Certainly committees can render different decisions and can come down with a different perspective on this issue. So today the official opposition is still standing firmly behind the position that we need to reconsider the decision. It's not appropriate, I believe, to somehow suggest that the decision is taken out of your hands; that in fact there are zoning barriers, and there is a formula we must address, and zeroing in on a provincial referral hospital. I don't dispute shifting community care beds. You and I have had that discussion many times. My question is: why community care beds from a provincial referral hospital? You stated just moments ago in your own remarks that there are empty hospital beds in the city of Vancouver, that there are community care beds that could be shifted easily into the valley. Why a provincial referral hospital as opposed to another hospital that does not reflect provincial referral programs?
Hon. E. Cull: As the report of April 26 points out quite clearly, some of the services that are being provided at Shaughnessy Hospital are provincial-level programs, and that's why a significant number of those resources are being reallocated to other teaching hospitals and other tertiary-level facilities. However, a number of the services provided at Shaughnessy Hospital are of a general medical nature. They're the kinds of services that we would have provided at regional and, in some cases, community hospitals around the province. Indeed it's those beds and the resources to support those programs which need to be reallocated to the fast-growing parts of the lower mainland, the suburbs and the Fraser Valley.
While all of us in B.C. accept that we will always have to travel to Vancouver or Victoria to go to a tertiary-level facility in order to receive those very specialized services that are not available in every community throughout the province, most of us expect that if we have more basic or lower-level-specialty needs that require us to go into a hospital, we should be able to get a bed at our own community or regional hospital. Unfortunately, in the areas that have had rapid population growth in the last number of years, we simply haven't been able to keep up with the demand for basic hospital services in those communities. We cannot ever hope to provide the appropriate level of service -- not a precisely described number for every community, not a formula, as the member puts it, but a target, a benchmark, something that we're aiming at -- we can't even hope to approach that in the current situation, with a 4 percent overall budget increase in the Ministry of Health, unless we start to reallocate some surplus resources that are now in the system.
Indeed, that was the message of the royal commission, which reported in November 1991. They told us that a third of the provincial budget, which is what we have been spending on health for many years now, give or take 1 or 2 percent, is an adequate amount of money to spend on health care services. It's enough -- and we believe and accept that. But they also told us that while that money being spent overall for health care is enough, the money isn't always in the right places. We have shortages in some areas, surpluses in others. We don't always have our priorities right. If we are to do a better job of providing more service with the same amount of money, which I think everybody would like, and if we can be more efficient and more productive, which is certainly a goal all members in this
[ Page 5715 ]
House strive for, we have to make some decisions to reallocate those resources. That's what we have done with Shaughnessy.
L. Reid: The question I posed was in terms of understanding where you're coming from with the discussion: why Shaughnessy? Why not other empty community care beds in the city, which you have just said do exist? That was the question.
Hon. E. Cull: A very good question, and a question that is being asked in other provinces right now. I've seen some of the analysis going on in other provinces where they too are contemplating closing hospitals.
Quite simply, if you want to take -- let's pick a number -- 300 beds out of the acute care hospital system in a particular geographic area, you have a number of choices: you can either take one institution that has 300 beds and close it entirely, or you can take beds here, there and everywhere throughout the system that add up to 300. The advantage in taking out one institution -- if it is acceptable and reasonable, all other things considered -- is that not only do you take out the beds and operating costs required to support them but you eliminate all the administrative overhead that a hospital naturally requires.
In looking at the cost implications of relocating the Shaughnessy services, it became apparent to us that the receiving hospitals had within their administrative capacity additional capacity that would allow them to absorb responsibility for the Shaughnessy programs without having to expand their administrative overhead. We saved money from administrative overhead, and that money saved means it goes back into direct patient care. I think everybody would rather see more money into direct care to patients and the smallest amount possible into overhead and administration.
L. Reid: When this decision was first aired to the public, it was based on moving community care beds outside of Vancouver. By your own admission, the closure of Shaughnessy Hospital is only going to result in the movement of 83 beds outside of Vancouver. We need some justification, hon. minister, because 83 beds could be found in the city of Vancouver, if indeed the premise was to shift that number of beds.
With respect to your comments on administrative accommodation, there's no reason in the world why administration services between Shaughnessy, Children's and Grace could not have been aligned more efficiently, and certainly that is contained in this strategic New Directions policy statement of June 1992. Again, hon. minister, I would direct your comments to the number of beds leaving as a result of the Shaughnessy closure. I know you have stated publicly that 83 will be leaving. That seems scant justification for the closure of a hospital that contains provincial referral programs.
Hon. E. Cull: Since there have been a lot of numbers thrown around -- and at some point I may have said 83 when we were talking about this -- let's just put the numbers on the record so we can all use the same numbers. The transition team is proposing to redistribute direct care resources for 135 acute care beds to teaching hospitals and the resources for 90 beds to community-based hospitals. The balance of 81 beds -- which now brings us up to a total of 306 for Shaughnessy -- will be removed from the system. So there will be the resources for 90 hospital beds going to the community-based hospitals.
There is also a saving realized from not keeping those other 81 beds open anywhere. The money that is saved is being redistributed to hospitals, because it's not always a bed that a hospital needs to provide better service in its own community. In many cases it's resources for ambulatory clinics or to improve services in another area of the hospital. There are 90 beds going to the community, but additional resources are going to those suburban and Fraser Valley hospitals. The decisions about additional resources -- because I'm sure you will want to pose that question at some point in this discussion -- has not yet been resolved.
The hospitals have been asked to submit proposals for programs that they want to have funded with the reallocated resources, and we're now in the process of sorting through those. Undoubtedly they add up to more than the amount of money that's available to distribute. But we're now trying to prioritize them, and to work with the hospitals to determine what we can do to enhance their services -- not just simply open up another bed, but enhance their services in other parts of their hospital activities.
L. Reid: I need to return to the numbers question, hon. minister, because when the decision was aired publicly that you were closing Shaughnessy Hospital, it wasn't based on closing beds; it was based on moving beds. That was the position you took publicly, and which you continue to take to this day. However, there's little justification for that when 135 of those beds -- again by your own admission just moments ago -- are going to be retained within the city of Vancouver. That is where these specialty teaching hospitals are. We're simply shifting them from Vancouver quadrant X to Vancouver quadrant Y. That is not a shift to the community. You say 90 beds to the community; I certainly anticipated 83. It is interesting to me that there are 90, but 81 are going to be closed. Ninety beds to the community is not a dramatically different number from 83, and is scant justification for closing a hospital.
I would refer you again to the report of this strategic committee of June 1992. They anticipated this direction, and they came back with what I believe to be a glorious compromise.
"[The move to] decrease the number of acute care beds in Vancouver offers University Hospital's Shaughnessy site an unprecedented opportunity to become the provincial leader in diagnosis and treatment through ambulatory services, day care and short-stay care. Seizing this opportunity would make University Hospital's Shaughnessy site a leader in the development of non-traditional methods of hospital-based health care delivery. It would also acknowledge the province's support for providing health care closer to home by strengthening the hospital's relationships
[ Page 5716 ]
with community agencies as both acute care and long term care patients are returned home."
It seems to me that in June of 1992, the strategic committee from Shaughnessy Hospital anticipated and complemented the direction you wished to move in and understood the need to reduce acute care beds. By your own admission today, we're only moving 90 beds outside of Vancouver. How does that justify the first-ever closure of a university teaching hospital in Canada?
Hon. E. Cull: We're picking apart different parts of the decision and trying to examine them in isolation, which is just not appropriate. The pieces of this decision have to be seen in their context and in the whole. The decision around Shaughnessy doesn't just relate to what could stay at Shaughnessy, the condition of the building and what needs to be done there. It's part of the overall process of trying to make better sense out of our acute care services.
Closing Shaughnessy does frees up $40 million to be reinvested into other parts of the hospital system. Another aspect of keeping Shaughnessy open involves the capital costs, which we haven't discussed, of either maintaining that building or doing what the hospital suggested: rebuilding at a smaller size, which was estimated at $80 million. That's another aspect that has to be considered.
But besides the reallocation of direct beds and programs from Shaughnessy Hospital into teaching hospitals and to the suburbs in the valley, there are other parts of our overall strategy in the $2 billion-point-whatever dollars of our hospital budget this year which come together to make up the whole of the decision. In addition to the 90 beds that are being reallocated out of Shaughnessy and the funded programs that will be coming up in these communities as a result of the money not being spent at the Shaughnessy site, we have a variety of other initiatives that are increasing beds in the Fraser Valley in the suburbs. While it's one thing to build those beds, you also have to have the operating dollars to run them. That's where the savings from Shaughnessy become very critical, so that there is the money in our budget to not only open up new beds, but also to run them.
[11:30]
There are 75 multi-level-care beds going into Eagle Ridge, 35 into Coquitlam, 75 into Hawthorne Lodge, 25 extended care beds into Maple Ridge, 100 multi-level-care beds at Buchanan Lodge in New Westminster, another 100 into Chilliwack General Hospital and 100 into Langley Memorial. There's the new Surrey cancer clinic to enhance those services and bring them closer to home to people who live in the suburbs, and a new acute care hospital planned for Abbotsford MSA. There are 37 new acute care beds at Surrey and 20 more extended care beds and another 100 at Fair Haven in the southern part of Vancouver. Peace Arch is getting another 150 extended care beds; Richmond General, 50 acute care beds and 150 multi-level-care beds, and St. Vincent's 25 extended care beds. Children's Hospital is having a major expansion and revision, Grace Hospital is having an expansion and G. F. Strong is getting 12 rehab beds.
This is part of an overall planning process to increase the level of hospital and long term care services in the Fraser Valley, keeping in mind very clearly what the royal commission told us: 25 percent of our acute care hospital beds over the province are filled up with people who shouldn't be there. They are mostly people who need to be in long term care facilities. The only way we can get them out of those acute care beds is to have more long-term care facilities, and the only way we can do that is to reallocate resources.
We're back to the name of the game: we've got $6.2 billion to spend on health care this year. We can move it around however we like. But if we're going to start to deal with people who shouldn't be in hospitals but need to be in long-term care where they will get more appropriate and better care for their needs, if we're going to start to deal with the high-growth areas of the province which don't have anywhere near the level of acute care services that they should expect, and if we're going to deal with the fact that we really need more community-based services and fewer acute care services in many communities in this province, we're going to have to make some decisions to reallocate resources. Sometimes those decisions are going to be very difficult, and they will require the closure of a building like the Shaughnessy Hospital.
L. Reid: The minister began her remarks by saying that an analysis of this decision was somehow not appropriate. I take issue with that. The job we are here to do is to analyze these decisions and decide if the numbers we're being presented with are indeed factual.
I believe that the general public has to come to some understanding of this decision. That understanding does not currently exist. The general public believes they have been misled. This is not about closing a hospital in order to shift beds to the Fraser Valley; it is about eliminating beds from the system. Again, by your own admission, that was not what was originally touted as the reason for this hospital closure.
There is tremendous apprehension out there. I believe there is a tremendous misunderstanding, because what they were originally told was the same as the discussion you and I are having today. I think it comes back to the issue of respect for the people who provide those programs. I don't find that this decision is particularly respectful of the individuals who work in those programs, who believe in those programs and who have spent their life creating those programs. Your response is simply that they will relocate, and life will continue. Yes, I'm sure some of those things will happen. But I believe that British Columbians will lose a tremendous amount due to that cavalier attitude about somebody's life work. As British Columbians, we need to have some respect for those programs.
If we're not going to shift sufficient numbers of beds to the Fraser Valley, and if we're not going to follow through on the original intent of this decision, I believe it is time to reconsider the decision. We are simply going to maintain those programs.... I think there is evidence out there that we need those programs. I've
[ Page 5717 ]
heard nothing to suggest that the corneal transplant and diabetes clinics and the spinal cord unit are no longer valuable to the process; they certainly are.
I guess what I'm asking is for you to somehow convince British Columbians that this was a good decision. As it stands today, they're not buying it. I cannot support it as a good decision. I can accept your comment that sometimes it's necessary to make difficult decisions. I'm looking for good decisions. I'm looking for a sense of how this is going to somehow benefit health care delivery for the primary recipient, which is the patient. The patients do not believe they're going to benefit from this situation. Certainly earlier discussions suggested that this was about saving money. Shaughnessy Hospital was not losing money, hon. minister; it was working just fine. In terms of justifying the closure by robbing Peter to pay Paul so that the closure of Shaughnessy Hospital will fund the cancer clinic, for me, that's not legitimate health care reform. That's not accepting the process in terms of where people need to give input on where they need to see it go.
The majority of the British Columbians I speak to on this question feel there's a lack of process. There's a lack of understanding about where you are going, and they don't believe that they've received all of the facts on this question. That's the issue for today, and I think that issue is going to colour any health care reform, certainly over this term of office and well into the next decade. A respect for process is missing from this decision.
People cannot accept the reasons you have provided, because frankly, they don't believe them. If there's any way you can flesh those out, in terms of why Shaughnessy Hospital.... That's where we started an hour ago. I can appreciate the explanation about extended care beds and multi-level-care beds, but I can't appreciate dismantling something that's working extremely well. It's a world leader. When we have something of that significance in British Columbia, we should be applauding it. To go back to the report of June 1992: "The current climate of change and the willing attitude of staff provides University Hospital, Shaughnessy site, with the opportunity to become the provincial centre for health care...."
Out comes research, evaluation, clinical epidemiology and clinical guidelines -- important things that you have said you stand for in terms of the Seaton commission's report, Closer to Home. Analysis, outcome, people understanding how the process comes together.... They were prepared to be the provincial leaders in this, and in fact I believe they are world leaders in a lot of the programs they currently have in place. There is also an opportunity to offer teaching programs focused on the future needs of family physicians and specialists stressing quick and efficient care. They are doing already many, many of the items that you say you will put in place as a result of the Closer to Home document.
If we have excellence -- and I believe we do have excellence in British Columbia today at Shaughnessy Hospital -- why is the decision being taken to reduce the access of British Columbians to a centre of excellence? It may indeed be possible to create another centre of excellence, but it won't happen tomorrow; it won't happen this decade, hon. minister. It will take ten to 20 years to rebuild, because that's what it took to create these original programs. This is a long, long, process. We've achieved excellence, and I think it's time to applaud excellence. I think it's time to look at the report as an integral part of the decision process. They have suggested a lot of the things that you wish to do.
I still need to come back to the original point. Perhaps it is possible to compromise on this question. I'd appreciate your comments.
Hon. E. Cull: As I said in answer the first time you asked the question, yes, the transition team is aware of the document. The people who prepared that document are having input; they're serving on the transition task forces. And the work that is underway right now, when it is completed, will show us what services are going to go where and how they can best be integrated into the system. What you're asking, hon. member, is that we keep everything going in the system that we're going to have after we've reallocated these services, but that we pay $40 million more a year to do so. I think that if we can continue to provide high-quality health care services to people not only in Vancouver but in the growing areas of the province and save $40 million that we can then put back into other health care services in this province, that is a far better decision than going with your suggestion, which is to say: "Don't touch it. We can afford to waste $40 million right now to keep everything just as it is."
L. Reid: The comment was, hon. minister: "Maintain the integrity of the provincial referral programs." There are cost savings that could be achieved at Shaughnessy Hospital and I would ask the minister to tell me the cost of removing those 81 beds. What would be the cost saving to the system?
Hon. E. Cull: I don't have the breakdown for those 81 beds right now, but I'd be happy to get that from the transition coordinator. I can tell you, though, that on an annualized basis the decisions that we're making will save $40 million.
L. Reid: Again, hon. minister, I have heard you refer to $40 million many times, but what I'm looking for is a breakdown of that $40 million and how the 81 beds figure into that. If I will be provided with that at a later date, I don't take any issue with that. But I'm interested in the remaining portion of that $40 million. What direct cost benefits will those accrue from?
Hon. E. Cull: Sorry, I don't understand the question.
L. Reid: In terms of $40 million which is the cost saving you believe will accrue from the closure of Shaughnessy Hospital, I'm interested in knowing how that breaks down. Eighty-one bed closures will result in X dollars -- which I will be provided with. Those remaining dollars, where does that cost saving flow from?
[ Page 5718 ]
Hon. E. Cull: I will get that information for the member and we can perhaps discuss it a bit later in the estimates.
L. Reid: I will move to consideration of the health labour relations accord at the present time, pending future information coming forward from Shaughnessy Hospital. I will tie my remarks to the debate of April 27 between the minister and myself. The minister is using the defence that labour costs to the hospital will be reduced under the accord. That is true. But it ignores the substantial direct labour cost, which would increase, in providing job security for 4,800 positions. So what we have, in our view, is the NDP device of running two sets of books. If you look at the accord purely in terms of incremental costs to the hospital, you get one set of figures, but that does not include the incremental costs of moving thousands of employees to the community care sector. Would the minister please comment.
Hon. E. Cull: The whole accord is based on the elimination of 4,800 FTEs from the system. When you're looking at the cost of the accord, you have to look at what the wage bill would be under the current collective agreements and the likelihood of what collective agreements would be in the second and third years of this accord, and you have to compare it to what the accord will cost with a reduced workforce. Over the term of the agreement the total package for wages and benefits is estimated to cost approximately $57 million. In almost all cases, that's going to be a better deal for the hospitals than the current situation would lead to. The HLRA's own analysis shows that.
L. Fox: I've been listening to the debate around the Shaughnessy issue with some interest. I apologize to the minister for coming back to it, recognizing that the opposition critic for health care has moved away from it onto another subject. But I find it rather odd that one of the main priorities of the new direction in health care is to involve the public in the process of developing health care, and in health care decisions in the province. Yet the closure of Shaughnessy did just the opposite to that. It didn't involve any of the public, any of the stakeholders or any of the union workers.
I'm also a bit disappointed when I hear the minister say she doesn't have the rationale behind the $40 million she's going to save. I would think -- given the significance of this decision and the kind of concern it's raised in the Vancouver regions -- that you would have at your fingertips a substantial amount of information about the $40 million.
I recognize that health care is a very wide and varied spectrum, but Madam Minister, I'd like to ask: why the lack of public process? Why the lack of consultation and discussing efficiencies in the system, if they are to be there, and how might they be shifted elsewhere? I've heard some of the rationale over the speaker, but I certainly am not satisfied with those answers. If you could just expand on that for a moment, then I would carry on.
Hon. E. Cull: Let me just comment on the $40 million. I know you would like me to have it at my fingertips -- unfortunately it's probably on my desk. I have seen the figures. We've extensively gone over the cost implications, and as soon as I have an opportunity to have some staff pull that document for me, we'll be able to talk about it.
[11:45]
With respect to the consultation, I think many people are aware that the future of Shaughnessy Hospital had been under discussion for many years. Some suggest that as long as ten years ago there were discussions about what was going to happen to that building -- whether it would be closed, renovated, expanded or whatever. Over the time that I've been the Minister of Health, there has been a lot of looking at the issue, but no public consultation about what was going to happen with the hospital.
There were discussions with other hospitals in the Vancouver area about their roles versus Shaughnessy's role. There were discussions with Shaughnessy when they presented their strategic plan to the ministry, and also in a brief meeting with me. The issue had been looked at by a number of people over a period of time. We got to the point where we were looking at a 3 percent budget increase for hospitals this year -- which is a very challenging budget for the hospitals in this province that have had double-digit increases in the last number of years: ten, 11, 12 percent increases. The analysis done by the hospitals and the ministry staff showed that if we were to continue to fund all of the services that exist right now and not change the way we provide those services in the hospital sector in any way, we would again need that kind of double-digit increase. Your side of the House, both the third party and the official opposition, have been very critical of the increase in spending that we have brought forward, small as it is, in terms of a 4 percent increase for the Ministry of Health this year. We have tried our best to make decisions that make some real sense in terms of the efficiency of the hospitals.
When we got to the point of looking at our budget for acute care and recognizing that there was no way that any agreement could be reached between the three hospitals on the Oak Street site about their needs for expansion and about who was going to be what size and what was going to go on there, we did the analysis and came to the conclusion that the only thing that made sense was the decision we made.
There were two other alternatives. One was to do nothing and leave the hospital operating as it was, which would have required us to continue to invest capital funds in that building to keep it running. As you are fully aware, $13 million has been invested in that building over the last decade, and there's no reason to think that that requirement for capital improvements would not continue over the next decade. So we could have left it where it was and continued to pour money into a building which, by any modern hospital standards, is not adequate. We still would not have solved the Children's Hospital issue, and we would not have addressed the bed distribution question in the Vancouver area.
[ Page 5719 ]
The second option, other than the one we've chosen, was the proposal put forward by the hospital, which was to rebuild Shaughnessy in a smaller size at a cost of $80 million. Unfortunately, that still didn't deal with the Children's Hospital issue or the bed distribution question. So by the time we got to the point of looking at this year's budget for hospitals and those options, it became clear that there really was only one option available.
We had a choice at that point to take the three options out to the public. I've spent all of my professional life working in public consultation as a community planner, and certainly I've staked a lot of my political reputation on consultation around issues. I think there is nothing more deadly to consultation and the public's respect for that consultation than to enter into a phony consultation process where you lead people to believe that there really are three options, when indeed everything is driving the system toward the decision that we made.
We made a decision at that point to not enter into a phony consultation process, to make a decision -- which government has an obligation to do sometimes -- to break deadlocks that could not be negotiated in any other way and to then have consultation around how the decision will be implemented. You can hold me accountable if you like for not having gone through that consultation process in advance of making the decision, and I will tell you that I considered it and rejected it as being nothing but a sham if we went into the process of consultation at that point -- when the budget decisions and the decisions around the other hospitals on that site were driving us to the decision that had to be made.
L. Fox: I find the statements rather alarming, especially with respect to consultation. Does this mean, in fact, that the consultation happening throughout this government is really a sham? Many decisions are made, the decision goes out then for public consultation, and you're suggesting through your statements that those kinds of processes are a sham. That really concerns me.
I would suggest that in fact the so-called health care accord that was signed by the Finance minister and the three unions would not have been nearly as important had you gone through a consultative process with the stakeholders involved in that decision. You're telling me -- and it's really disappointing me -- that your ministry staff have made a decision in isolation from all those people that are going to be impacted by that decision, and then you as a minister have applied that without giving any consideration at all to those people affected -- either the patient, the worker or the management. That really disappoints me -- that disappoints me extremely.
The other thing that I'm hearing constantly is that you really do not have a handle on what the impacts of this closure are going to be from a financial point of view or from a service point of view. Mr. Boyd is supposed to be developing that particular kind of information now -- after the fact, rather than before the decision was made. With any decision of this magnitude, I would have thought you would have known exactly the financial impacts and service levels and known exactly how those patients and displaced workers were going to be dealt with. I'm extremely disappointed that those answers are not readily available and yet the decision has already been made.
Hon. E. Cull: Let's get very clear here on who made the decision. The decision was not made by ministry staff; the decision was made by the cabinet, as is appropriate in this matter.
In terms of the financial figures, we do have the information. I apologize, I don't have it here on my desk at this point. We will get it at some point later in this debate, and we will then be able to go over those figures together. I don't carry all of that stuff in my head at all times.
L. Fox: I'm going to have to leave shortly in order to get my plane, but I look forward to coming back to this issue. Hopefully, in the next go-round we will have that information available, plus we'll have advance notice of when the estimates are going to happen. I'm sure the minister appreciates that a person like myself, who works on three different sets of estimates, would especially appreciate some advance notice as to when these estimates are going to sit.
L. Reid: I take tremendous support from my colleague, because what he says is exactly the basis for this decision -- that there wasn't appropriate process and there wasn't respect built into it. Ken Georgetti himself stated in a letter written a few days ago, April 27, that consultation ends with a decision; it doesn't begin with one. He finds fault with the process around this decision. I concur also with my colleague, the previous speaker, when he says he's alarmed by the direction of this decision.
It is alarming when you come to this chamber and suggest that you didn't consult because you'd already made up your mind and knew what the outcome was going to be. That only suggests you have limited understanding of what consultation really is. It's not throwing a decision out there and asking for the same decision to be returned. It's hoping for new insights and perspectives that reflect on that decision and hopefully massage it into something that the committee, the community, the larger view truly wishes to see. That wasn't done. And I can only assume it wasn't done, hon. minister, because you didn't believe they would return the same decision you had already anticipated.
That's not good government. I believe the role of government is to facilitate good decisions, not to decide what is best for people without any appeal process in place. The majority of Vancouverites and the majority of British Columbians do not support the decision to close Shaughnessy Hospital. For me, there is a tremendous amount of explaining that still needs to happen before they will even understand your rationale, because I frankly think the rationale is weak at best. Again, I ask for your comments on that.
V. Anderson: I'd like to follow up on some of the issues that have been raised regarding Shaughnessy Hospital and its implications in the wider context.
[ Page 5720 ]
Perhaps I'll go through them one by one for clarification for myself and others.
One of the reasons, among others, that the minister has already indicated for closing the Shaughnessy site was that it was an old building and no longer suitable. But as the discussion goes on, the minister has indicated that a number of facilities on the Shaughnessy site will continue to operate there. That seems to be a contradiction if the building is not suitable for what is there, yet only part of what is there is being taken out and the rest is remaining at the Shaughnessy site. How is it that the building is not suitable for some things but is suitable for others? I'm not sure of the explanation for those two approaches.
Hon. E. Cull: The hospital building isn't suitable for acute care hospital beds, which are being reallocated. If you look at a modern hospital wing right now, you'll immediately see the difference in the kind of architectural and design thinking that goes into hospitals being built now and the kind that went into those that were built 50 years. They're much more efficient and effective to work in now.
V. Anderson: As one who has visited a great deal in Shaughnessy in my capacity as a United Church minister, I understand part of what the minister is saying about acute care beds there. Unfortunately the whole discussion seems to centre around acute care beds, when the actual acute care beds are only one part of what goes on in Shaughnessy Hospital. In fact, most of the activities in Shaughnessy Hospital have to do with anything but the acute care beds. They deal with many other areas. I'll come back to some of that in few moments.
One of the concerns there is that the hospital board itself, in conjunction with the other hospitals in Vancouver, had been developing a plan over the last two or three years for a rationalization of programs somewhat along the same lines the minister is suggesting. They had come up with an integrated plan that would service not only Vancouver but the whole province with the special services that are located there.
There's a concern being raised not only from the Vancouver area but from other areas as well that this indicates that when hospital boards do planning, their planning is not accepted or responded to in a consultative way by the minister. If their planning is being neglected or not taken into consideration, does this indicate a pattern whereby hospital planning throughout the province takes second place to the minister's planning?
Hon. E. Cull: I've been looking at the New Directions document. The current plan is to establish regional health boards that will take on the job of doing this planning and allocating funding at the regional level. That's the direction we're moving in. We're establishing those as we speak.
[12:00]
V. Anderson: Following up on that answer on the establishment of the regional health boards -- and I appreciate it -- I realize that this was part of the suggestions that were made in the Closer to Home document. Would the minister explain to us how many communities in the province have requested these regional health boards? I'm trying to understand whether the process of developing regional health boards is coming from community requests. Are there community groups -- such as current health boards and other groups -- that have banded together and passed resolutions requesting regional health boards? Are the regional health boards coming from local requests or are they coming from the top down?
Hon. E. Cull: They're all coming from local requests. In fact, we're not even interested in talking to communities about establishing health councils and regional health boards at this point, unless they are interested in the subject. We have no intention of going into communities and telling them they need a health council or a health board. We're dealing entirely with requests that are coming from communities. I don't have an exact listing of all the communities that are now coming forward and asking for this.
We have six regional directors who are working throughout the province with each community, and they haven't finished talking to every community in the province, but I'm aware of at least 20, and probably 25, communities from my own tour of the province that said they wanted to form a health council or regional health board. We have lots of examples of councils and boards that are already underway. There is a regional health board established in Victoria. There are councils in the process of being established in Port Alberni, Keremeos, New Westminster, Penticton and Dawson Creek -- just to name the ones that I'm personally aware of from having had something to do with the committees that are setting it together.
I can tell you that without exception every community I went into when I toured the province for seven weeks talking about the New Directions document said: "We are interested in starting to form a health council." The reason they said this is that as part of my remarks around the New Directions document, I indicated the ministry was prepared to support six fast-start communities. Everyone wanted to be one of those six fast-start communities. Since we released the document and found out that the interest is far higher than we had originally anticipated, we are moving to a larger number of fast-start communities -- meaning those that would get off and running, with support from the ministry to establish them as pilots for other communities that may want to sit back, look for a while and figure out what exactly is going on.
V. Anderson: In starting those regional health councils -- which is no doubt an excellent experiment; I'm not downgrading that at all -- is there an indication at this point that each of them, because of different geographical and historical circumstances, will be quite different from others? Or is there, on the other hand, a set of guidelines and directions coming to them from the ministry that gives some standardization and
[ Page 5721 ]
continuity? I think the direction could come up with two different results.
Hon. E. Cull: It's a mixed approach because we recognized the need for there to be, as you said, some continuity and consistency between the various health councils that will be established around the province. But we also recognize their need to reflect the realities of their community. While we're in this initial stage, in the early months of establishing health councils, we are giving the communities a fair amount of leeway to establish a council that reflects their needs so that they can pilot the idea for other communities. We expect, as we move further into this, that this will narrow down to a number of models that we will be able to then illustrate and demonstrate to other communities that are still in the very early stages of establishing their council.
So there is a need for balance. One of the things that we've done is prepare a workbook for communities, which gives them some guidelines about who should be at the table, how they get things started and what things they should be looking at. We will be preparing legislation to come forward later in the session that will allow these councils and boards to become established.
We have six people designated to focus on working with the communities. Those people meet on a regular basis to make sure that what's happening in, say, the Peace River area is consistent with what's going on in the Kootenays and on Vancouver Island. So there's some flexibility, but some recognition that there has to be consistency, and that that will narrow as we move through this process.
V. Anderson: Taking that discussion and relating it back into the total Vancouver community -- and Shaughnessy Hospital is only one of the many parts of the health community within Vancouver -- I realize that up in the Prince George area, when some decisions were made about hospital changes in that and neighbouring communities, there was a demand from the community people for consultation. I understand that the consultation took place, and out of it came a new plan that they were part of and were wanting to be part of. It seems to me that what is being asked in the Shaughnessy discussion is not simply about Shaughnessy itself. The discussion is about all of the health care programs in Vancouver -- the university site, St. Paul's, St. Vincent's, Vancouver General -- and the people of Vancouver wanting to have public consultation about the whole of Vancouver health programming. When they're asking about consultation about Shaughnessy, it's not simply about the Shaughnessy building but about the whole of Shaughnessy. Part of their anger at the Vancouver council is that the council wasn't involved in that planning of the whole of the Vancouver community. They're asking -- demanding, actually -- that there be public consultation about not only Shaughnessy but also all of the other health care institutions in Vancouver. Even if the Shaughnessy one goes ahead, there's going to be so much anger and frustration that there will be disruption in every hospital and medical facility in the city, unless we back up and do an overall consultation. That's very much what the minister has recommended and is talking about: community consultation involving the people. Not only the ones in the medical facilities, but the actual citizens, will want to be part of this consultation. I'd be interested in the minister's response to a community consultation, which is desperately needed for the whole of the Vancouver community.
Hon. E. Cull: The Vancouver area hospitals have formed a council to look at health care planning for the Vancouver area, and it has involved the medical health officer bringing in the public health and the community health aspects of that. I know that they have been meeting and continuing to put together their ideas about what a Vancouver-area council would look like. Of course, one of their responsibilities will be to prepare the plan to make sense out of the services that are in the Vancouver area.
As I understand it, in the past -- because we have to go back over five or ten years -- with respect to the roles of individual hospitals, it's been very much the hospital making the decision on its own or working it through with ministry staff. There hasn't been community discussion. In fact, there hasn't even been discussion with adjacent hospitals as to whether it makes sense in the total scheme of things in their larger community. If you're a hospital that's in a region and the next closest hospital is 100 miles away, you can have that kind of autonomy without creating a lot of difficulty. But if you're in an area.... You were referring to Prince George. I think you meant the northwest, Prince Rupert, Terrace and Kitimat were making decisions around their budget allocations that had the community concerned, and the ministry came in and said: "We'll put in a team to have a look at the decisions the hospitals are making and see whether they have looked at all the alternatives." If you're dealing with situations like that, then it's really important that the hospitals do talk to one another and make sure they're not duplicating or competing for services, as they were in the northwest.
The Vancouver hospitals are starting this. They're in the early stages. One of the most important things will be not only to look at it from the hospital perspective but also to bring in the community health perspective, because a lot of things that are now done in hospitals could be done more effectively and at less cost in the community.
D. Streifel: I seek leave of the House to make an introduction.
Leave granted.
D. Streifel: Hon. Chair and hon. members, it's my pleasure today to introduce to the House a group from Gig Harbor Christian School near Tacoma, Washington. There are 16 students and 12 adults visiting our House today, and they are led by a very dear friend of mine, Miriam Hoiem. Miriam and I have known each other for...it's decades now, actually. It's frightening to admit
[ Page 5722 ]
it, but that's how long it is. I bid the House to make them very welcome to British Columbia and Canada.
V. Anderson: Following up on the discussion, I would ask the minister to comment, because it seems relevant. If we're going to go ahead in Vancouver with any sense of cooperation with the thousands of people who have been turning up over the one issue of Shaughnessy and the thousands of others who are going to turn up over the other issues, does the minister think it's wise at this point to cooperate and have community consultation with the citizens involved. As Alderman Rankin pointed out the other night, the minister has found that when she's dealing with lawyers and they're trying to make decisions, the citizens don't trust the lawyers in the legal decisions. And the citizens don't necessarily trust the medical people in medical decisions. What's being asked at this point is not that medical people just get together, which is important and significant, but that the citizens have the opportunity to say to the medical people, government and governing boards of the hospitals that they want their wishes known. A community consultation of citizens is being demanded before any decisions are taken, because they want to be in on the decisions and to make sure they've been heard.
Will the minister facilitate community consultation before we move further ahead, so the citizens can really believe in and support what is happening instead of being antagonistic to it? This isn't a political question. This is a question of good health. I know it has political ramifications, but it's more a question of good health and one of enabling the citizens of the community. If the minister would be prepared to enable that citizens' consultation -- not a medical consultation, although they're the resource people for it -- this would be fundamentally important in our community at this stage.
Hon. E. Cull: A number of task forces right now are involved in implementing the decision around Shaughnessy Hospital. The community is welcome to participate in them. In many cases the community has been specifically invited to participate in those task forces so there can be community input. Sometimes it's through specific organizations, sometimes it's a more general approach. I would welcome community involvement.
If you're asking if we will stop and hold a consultation process around the decision, the answer continues to be no. There are many reasons for that, but one reason -- which makes it very difficult to reconsider the decision right now -- is that the $40 million savings on an annualized basis has already been redistributed to other hospitals in the province.
V. Anderson: That's a very significant statement and shows the real concern that people have. The people were of the understanding that in the implementation process and the review of her team there was still consideration of what should go or stay in Shaughnessy. This minister has now said that's already been decided in total, because the money to contain Shaughnessy has, in the most part, already been distributed.
So if it continues, it continues on its own funds. Perhaps the minister is suggesting to the community that if they want to do their own fundraising program and make it into a private hospital rather than a public hospital, this is the way they may have to go. I well think the community might be willing to take up that challenge at this point; that would be interesting if they were. Because what she has said today is that the $40 million which would underwrite the programs now related to Shaughnessy has been dispersed, even before the implementation teams and plans have been put in place.
[12:15]
When we met at the city council the other night, question after question was put to Mr. Boyd and to Mr. Blatherwick. They'd both had to say: "We don't know the answers. They haven't been decided yet. They're being studied." The minister has now said that the $40 million has been dispersed, so there is no turning back. Perhaps it's the time to comment to the minister what she said just yesterday, I believe, what I heard her saying on television last night when she was quoting to the hospital employers. As I heard and scribed it down, it was a quote from Shaw, if I'm not mistaken, that said: "Those who cannot change their minds cannot change anything." The minister is caught in her own saying: that those who cannot change their mind cannot change anything. She's going to be hearing that back, and I challenge her to look carefully in the mirror the next time she makes that statement.
The minister has put herself in a difficult position, having spent more than $40 million and reallocated it even before plans and decisions were in place. I understand why she's changing her mind and back-tracking. When the Minister of Finance had to backtrack, he at least hadn't already spent the money he was planning to get from that particular surcharge. This minister is in a difficult position.
Part of our community's concern is the specialized nature of Shaughnessy's programs and how they are related to other hospitals nearby. Before the minister moved ahead, had she undertaken a study and projection on how many of the medical, technical and engineering personnel are related to those programs? Has she undertaken a study of how many medical, nursing, specialized technical and engineering personnel now related to those programs will not be moving with those programs? Will they go into private practice or to programs in other parts of Canada, the United States or overseas? A significant number of the specially trained nurses, doctors and technical people -- who have the option of going anywhere in the world -- will be leaving. They do not have to stay here. Has she projected how many of those will go, and how they will be replaced?
Hon. E. Cull: Let me return to the $40 million. The reallocation of the programs from Shaughnessy Hospital to different hospitals, and the reallocation of money to hospitals in the Fraser Valley to enhance their programs, are net of the $40 million savings. We get that
[ Page 5723 ]
savings by not having to duplicate those services elsewhere in the hospital system. The annualized amount is $40 million -- less than that, because the hospital will not be closed until partway through the fiscal year. This is considered part of the base hospital budget distributed through the funding formula earlier this year.
With respect to staff moving with the programs: the planning going on right now does not move just machines or beds. It moves staff and the medical expertise to do those services. All indications are that the vast majority of staff are going to be moving with their jobs to new locations.
V. Anderson: I hope the minister is right about the staff moving. I'm afraid she will be proven wrong, which is a real concern, from the messages we're getting from many medical, technical, engineering and other staff. Would she reconsider and check that before it's too late and they have already left the province? One of the dangers is that specialized staff will leave because they're not willing to accept the conditions under which the move is taking place. Others of like qualifications will not be willing to come in, because they will follow the advice of those who leave and say: "This is not a pleasant or acceptable place to work under these conditions." That is an even graver concern than the actual leaving of those professional personnel.
Do I understand the minister to say that in the move that has taken place they have already guaranteed to Children's Hospital, Grace Hospital, University Hospital, other hospitals in Vancouver, other hospitals in the valley and Richmond and Surrey amounts of money which have increased their budgets in order to undertake these programs moving to their facilities? Are these amounts already stipulated and guaranteed to those hospitals so that they are clear what the cost is in the move for them?
Hon. E. Cull: No, those amounts are not in the hospitals' budgets at this point. The decisions about where the various programs are going and what resources will be needed to support them in their new location has not yet been finalized. That work is underway right now. The April 26 report -- if you care to have a look at it -- has a lot of the details in it. In some cases it indicates the funding that will have to accompany the program when it moves to a particular location. But until the final plan for the reallocation of the services is presented and approved, those amounts will not be given to the hospitals. The money will be transferred once the decision has been made.
V. Anderson: For clarification on that, is she indicating to those receiving hospitals that whatever the cost is to them, both in moving and in the continued operation of those new facilities, that these funds are guaranteed to them out of the general health budget?
Hon. E. Cull: We are talking to all of the receiving hospitals about what the additional costs will be of assuming a program that cannot be absorbed in their existing capacity. In some cases, they will have capacity to absorb some of the costs; in other cases, they won't. So that is being worked out with each of the potential receiving hospitals.
V. Anderson: I think I understand why the employers are hesitant about the present contract that is trying to be negotiated at this time. The minister indicates that it's a process of negotiation, but it also implies that these receiving hospitals may be left in the lurch -- getting only some of the funds they feel they need -- It's not their statement of need that will be recognized; it will be the minister's assessment of their statement of need that will be recognized. I think I'm right in that. Perhaps the minister could clarify that it's the minister's assessment of need, rather than their assessment of need, which will be the final decision.
Hon. E. Cull: It certainly won't be my personal assessment of the need of the hospital, but yes, ministry staff and the transition coordinator will be working with the staff of the receiving hospitals to determine what is needed. I don't think anybody would expect us just to go out and say, "Tell us what you need," and once we have the number, we write the cheque and hand it over. There will be some examination of what has been requested and an attempt to make sure that we come to an agreement about what is necessary.
V. Anderson: I understand the need for that safeguard, but in light of people already having made plans, and decisions that have been overridden by the ministry, the trust quotient is not very high at this moment. So people are going to be very cautious in moving in that direction.
Do I understand -- particularly with regard to Children's Hospital in their desire to expand, as the minister explained this morning, and I understand the same is true of Grace Hospital -- that in the minister's statement she has, at least implicitly, confirmed that the ministry has already given assurance to Children's Hospital, and to Grace Hospital, that they will be supported in their expansion on that site? That's been given as one of the reasons for closing the Shaughnessy site: to make room for that expansion. The ministry has already given affirmation to encourage them to go ahead with those expansions, and has guaranteed the funds.
Hon. E. Cull: We have indicated to both hospitals that we do support the expansion. The details of the expansion will be contained in future capital announcements.
V. Anderson: Thank you. I think this is a concern that until now has not been clearly brought out: that the other plans that the ministry has in mind which would affect Shaughnessy and the other hospitals within the Vancouver area are just behind the scenes and under the surface. We are beginning to realize that there is much more behind the scenes than we had first considered, which makes people even more anxious about the overall plan -- particularly the citizens of Vancouver who, as I mentioned before, are not getting
[ Page 5724 ]
an opportunity to participate. The more they hear about this, the more anxious and angry they are becoming.
I will move to another question this raises with regard to the teaching facilities, which are important for the whole province as well as for our local Vancouver area. It's my understanding that some 1,800 undergraduate, graduate and postgraduate students were going to the Shaughnessy site, at one time or another, for part of their internship training. Part of that was at the Shaughnessy site, in particular, because of the integration and interrelationship of facilities, which was a unique and important experience. It was also partly because they were able to have world-renowned teachers and experts in the medical field who were not available anywhere else. So how is that teaching function going to be replaced in facilities...?
I happen to know something about the teaching facilities at UBC and the General Hospital site, having worked with the clinical training students who were in training for the ministry, doing their pastoral education work. I know that the facilities and programs at UBC, Vancouver General and St. Paul's are already overtaxed with respect to carrying out those teaching functions. Could the minister explain how she is going to compensate for the removal of teaching facilities in a key teaching hospital when they are going to be placed in facilities that are already overtaxed in every way?
Hon. E. Cull: I'll refer the member to the April 26 report, which deals with the relocation of the family practice program. There are two options being considered, depending on the future governance of the University Hospital, UBC site. Both options call for the retention of the family practice ambulatory care teaching unit at the Oak Street site. In the first option, the family practice in-patient training unit would be relocated to St. Paul's or VGH, depending on discussions that are currently underway, with the transfer of incremental resources to recognize the impact of the family practice in-patient teaching unit. In the second option, the family practice in-patient teaching unit would be relocated to the UBC site, again with the transfer of incremental resources to recognize the impact.
[12:30]
Last week I met with a number of people from the university and from the UBC site of the hospital, and they indicated their strong desire for the option to have the family practice unit relocated to the UBC hospital. We're quite excited about the potential of doing some creative things to support the new directions in health care as a result of being able to have that family practice unit at the UBC site.
V. Anderson: Just today, I believe, I read there was some discussion that some of the teaching would be transferred to Vancouver General. I know some of it has gone there. I was interested that the minister didn't mention Vancouver General as a teaching hospital; she mentioned the other sites. I have some concern there, and I think other people have a concern about this as well, because within the last few months we have heard grave concerns from those who have been in family practice about the lack of internship opportunities for them and about the real threat to their program as it exists now. We need to look at that very increased opportunity.
In looking at the expansion of these tertiary care facilities that have the opportunity to serve all of the province -- thinking not so much of the beds and location at the moment -- what is happening in the overall plan? It will not be possible, physically or financially, to provide the kind of specialists which are unique to Vancouver and Victoria to many other places throughout the province. For one thing, there just aren't that many bodies available who have that kind of specialty.
What kind of planning has already been projected prior to changes taking place for technological satellite connections for communication? What kind of transport connections are being arranged so that specialists can be flown, within an hour, to almost any place in B.C. where they are needed? What larger networking is in place to undertake these, or is that something that's still in the dream stage rather than in the reality stage?
Hon. E. Cull: Back on the teaching unit, I did say that one of the options was to relocate to St. Paul's Hospital or Vancouver General, VGH -- you may not have heard the VGH; it is, of course, being considered.
We are asking all hospitals to have a look at their role and the services that they provide. I guess there are two somewhat contradictory forces here. If you'll bear with me, I'll describe them, because I think that while they may appear to be going in an opposite direction, they make sense.
We have situations where we have hospitals -- particularly outside of the Vancouver and the Victoria areas -- which over time have not had a service in their hospital to meet the needs of people in their community, because there wasn't enough need for that service, or maybe there weren't the right medical specialists there, or maybe the critical size of the hospital wasn't as big as it is today. So patients in communities such as Campbell River may be going to Victoria or Vancouver to receive services that now they may be able to receive in their own community hospital.
We're asking hospitals to look at some of those things, because circumstances change over time. The population may change: it may age; it may grow. There may be more of an ability to support that service closer to home. So we're asking hospitals to look at their roles with respect to repatriating services that are being provided elsewhere in the system that could be provided in their own hospital.
At the same time, we're also asking hospitals to have a hard look at some of those things that they are doing which perhaps they shouldn't be doing at their community hospital any longer, because, as you pointed out, there is a need for a critical mass of specialists around some areas to be there. You don't want to put yourself in the situation where there is only one doctor in the town that can do a certain kind of procedure, because that person is forever on call. With some specialties, you do need to have enough patients
[ Page 5725 ]
to be seen in a year and enough physicians that are dealing with those patients to be able to provide really good quality care. Indeed, sometimes patients make their own analysis of the quality of care they get in their community and decide to go to a larger centre to receive what they consider to be a higher quality of care. So we're asking hospitals to look at what services they are providing now that perhaps they are not doing as well as they should be doing. Perhaps they should consider no longer doing them and having another facility do it.
What that requires is that hospitals start talking to one another, and hospitals of a similar size in a region talk to one another and determine: "Are you going to specialize in one thing? We'll specialize in something else, and we'll try to concentrate our resources." They are going to have to talk to the hospitals up and down the system: the hospitals that are larger than them, the regional hospitals. We're talking about a community hospital, or a tertiary level hospital for the regional hospitals, or back down to community hospitals, depending on where you're sitting in the hospital hierarchy, and saying what needs to be done at this level, what can be done at this level, what has to be done at the tertiary level. We're asking all hospitals in the province to go through a planning process of re-evaluating their services. That is happening everywhere to look at what needs to be provided.
You've asked what we're doing in terms of more creative ways to provide these services to the outlying regions. We've had a travelling specialist program in place for a number of years. Funding is available for specialists to go on a regular basis to communities that would not normally have that service. We are also, as part of our New Directions strategy, preparing a northern and rural health strategy that will allow us to explore some of the ideas around telecommunications. A very interesting proposal has already come in, I believe from the northwest, with respect to using telecommunications in some of the diagnostic treatments. I don't have much more in the way of detail. I'm certainly not a specialist in this area. If you want to explore it further, I could get more information for you.
V. Anderson: An experiment was done by some doctors working out of church hospitals about ten or 15 years ago, so it's not that new. That kind of communication was taking place then. I'm sorry to see that it's not more advanced; it's at least 15 years that I'm aware of since the request was made and that was undertaken and promoted.
I'm still curious about the means of transportation. I've been where there's a one-doctor hospital and they couldn't do a operation because there weren't enough tractors to pull the doctors through the mud to the hospital. Those are critical situations. Knowing the geography of much of British Columbia, and knowing the weather of much of British Columbia for much of the year, if we're talking about what kind of transportation or helicopter system or processes are in place to go along with this new planning.... It seems to me that the planning cannot take place unless people are aware of the kind of resources that are otherwise going to be available. If you can be guaranteed that in half an hour or an hour you can have a specialist flown in by helicopter, in almost any kind of weather, to where you have need, then you can plan your facility one way. If you have no guarantee that those facilities are available to you, then you have to plan it a totally different way. It seems to me that as much as we're talking on one hand about local planning, there also has to be a larger context for what's available for resources in getting people from one place to another or getting the patients to the resources -- either way. That's important.
This was raised with regard to the discussion by Harry Rankin, who lives in Surrey. He said it would take him half an hour but he would much sooner go to a Vancouver hospital where all of the facilities were available than go to a Surrey hospital 15 minutes away where not all the resources he would have need of would ever be available. I was really trying to find out -- before the planning takes place -- what technological and travel resources will be available so that communities will know the context in which they are doing their local planning?
Hon. E. Cull: They vary widely all over the province in terms of what's available, but the hospitals are fully aware of what is currently available in terms of access to visiting specialists. They already have arrangements through the Emergency Health Services for people who may have to be transferred on very short notice to a facility that would have the ability to do something that that hospital wouldn't have. That is part of their planning right now. One of the things they have to do in terms of looking at the roles is look at what the existing situation is with respect to the distribution of specialists and the access to specialists.
When they do that and they match that up to their community needs and they have a look at what their community priorities are.... I think that's the most important part of this exercise -- not just looking at hospitals but looking at the bigger health questions in a community, going back to the health status indicators that we have about communities and finding out what the health problem in your community really is. Is it that you don't have an orthopedic specialist, for example, or is it that you have a lot of low-birth-weight babies in your community relative to the provincial average? Where you really need to be focusing your resources right now is on providing programs to moms who might be at high risk for having a low-birth-weight baby. If the community process really works well.... I believe it can work well. We've got examples of it working in other parts of the country. We've got examples of it working here in British Columbia. We should be able to get a sense of what the real priorities are for health care funding in a community. When those priorities are identified -- and they're not compartmentalized off into different institutions or different parts of the ministry, competing with one another for who gets their stuff up on the list, but there's community agreement as to where the resources need to be targeted -- then you can start to look at what you want to do. Do you want to try to recruit a
[ Page 5726 ]
specialist? Do you want to try to provide for maybe a telecommunications connection that would allow specialists to be consulted without actually having to be there? Do you want to look at something that might involve improvements to getting people in and out of your community -- which might deal with improving the airstrip or getting night lighting in some smaller places in the north? You have to start at what it is you need, what the priorities are, what the resources are that you have to bring to bear on the problem. The solutions flow from that.
V. Anderson: I'd like to come back again to the planning at the Shaughnessy site, because that's a particularly critical issue for the people of the community I serve. I bring to your attention again a report that you're already aware of: the external review report of August 28, 1992, done by Stuart Bailey and Conal Wilmot, external evaluators. Conal Wilmot is chairman of the department of rehabilitation medicine at Santa Clara Valley Medical Center, chief of the spinal cord injury service and project director of the Northern California regional spinal cord injury care system -- without going on to his other qualifications. Stuart Bailey, MD, is assistant professor of orthopedic surgery at the University of Western Ontario in London, Ontario, and chief of the orthopedic surgery division at Victoria Hospital in London. In the report that they did on Shaughnessy Hospital they had this to say:
"Shaughnessy houses one of the premiere spinal centres in Canada. It is the only location in North America where all aspects of spinal surgical care are provided at a single site and it provides the only fully integrated spinal cord trauma system -- including research, prevention, acute surgical and rehabilitative care -- in the country. These attributes combine to make it unique among North American centres offering spinal surgical fellowship training. It has an international reputation not only for orthopedic care but also for care in related areas."
The report goes on -- without reading it indefinitely -- to indicate the treatment, research and new techniques that have developed out of this centre. This was spoken to very clearly in the representations that have been made by spinal cord people who have been -- and still are -- part of that treatment both as in-patients and out-patients. They commented that when the spinal cord unit first opened, it was expected that people would be able to roll out of the unit. That expectation is now that people will be able to walk out of the unit. There has been that much advancement. They also commented on the out-patient services in sexuality approaches, and that many who had thought they would never be able to have a family now have the ongoing care and support from that service.
[12:45]
In the renovation of the spinal cord unit, they remodelled the hospital rooms to make them double-sized rooms and built in the latest technology. That was completed not that many years ago and is brand-new and up to date. Tearing out that system and moving it is a real concern that people have, particularly with regard to the spinal cord unit. It has proven itself not only in its in-patient service but particularly in its out-patient educational programs that it undertakes in the community at large with the many volunteers who are a part of that program. It's not just a question of the in-patient surgery, but it's a question of a medical facility that serves and educates the whole community in prevention as well as in cure.
When they talk about this move, are they talking about the prevention, education, outreach and research continuing with all of their facets? How are they going to fit that into the overcrowded facilities -- even with a new tower, which is at least ten years away -- in VGH? As we understood the other night from city council, the tower is to replace the Heather Pavilion and one of the other pavilions. So it's not a new facility; it's simply replacing two facilities. The city council has been advised that the tower would also be replacing the Centennial Pavilion. So the direction is that the tower, which looks empty and vacant at the moment, is in essence replacing the majority of the present Vancouver General Hospital system. If you move that in, then how do you work out this? And in that tower facility, how do you provide the ground-level facilities that are needed for the spinal unit? The spinal unit needs ground-level facilities in case of fire and emergency. When elevators are not available, you have to be able to get those people out, on beds, quickly and immediately. The tower does not have that many ground-level facilities, and much of what there is is going to have to be used by other programs -- the emergency, for instance, and other areas.
So there's a major concern about the spinal care area that has not been answered as far as the community is concerned, and particularly for those who have had need of it and are using it for their ongoing recovery and treatment.
Hon. E. Cull: The member has raised a lot of excellent points about the relocation of the spinal cord unit. As he knows, a decision has not yet been made about the final location of that program. Indeed, the task force that is looking at the spinal cord program is looking at enhancements to the existing program, and until the full program configuration is determined it's not going to be possible to move on to the location questions.
But the concerns that you've raised with respect to access and with respect to the high-quality services that have been provided there and the need to continue with them are part of the considerations that are now ongoing with respect to the options around relocation. When you ask about what will happen if it has to be moved -- how it will be crammed into an already overcrowded hospital and if it will go into the tower -- I can't answer those questions because the decision on the location has not yet been finalized. There's a process underway. That process has to conclude. It's coming close to conclusion, but we're not there yet, and we have to respect the work of the task force that is going on right now around the spinal cord unit relocation, and let them carry out their work and provide us their advice before making a final location decision.
[ Page 5727 ]
V. Anderson: One other question that I would raise with regard to Shaughnessy came out in the presentations the other evening at the rally held outside of the council chambers, which was organized by the medical union people primarily. The major theme and presentations of that rally were by the women of those medical facilities. They were very clear in stating, both in the Closer to Home document and in what has happened since -- and that's all on record, from what they said that evening -- that women's concerns had not been fairly treated. They were very definite in wanting to put forward that neither the Closer to Home document nor what has happened since has taken that concern into account in any way that satisfied them.
Particularly when they related to the Shaughnessy Hospital situation -- recognizing that the Women's Health Centre is apparently going to stay there -- they very strongly indicated that it cannot stay there in its present form and do its present work without the continuing presence of the other fundamental programs. Many other special programs for women are connected to the Shaughnessy site, particularly the women's counselling assault program, which is very much a part of the Women's Health Centre. They are integrated, one with the other. The whole team of physicians who works with the women's assault group also works with the Women's Health Centre, many of them as volunteers. I believe they said they had some 52 on their volunteer roster who are willing to come in, on call, 24 hours a day, every day of the year, and most of the calls come in at 3 or 4 a.m. Their clear perception was that if this transition takes place and the women's assault centre is not there in connection with the Women's Health Centre, then they have undercut the whole program. It's only because of the expertise of the staff at the Women's Health Centre that they're able to run the women's assault program. If they are separated, then neither program is effective.
Hon. E. Cull: The member raises good points, and all of these concerns have been taken into consideration in the ongoing planning. Dr. Penny Ballem, who is the head of the Women's Health Centre, is chairing the group which is looking at the services that have to remain on site with the Women's Health Centre to be able to support the services for women. I think at the end of this process we're going to come out with a strengthened Women's Health Centre that will not only provide services to the women in the west side of the city of Vancouver but will start to fulfil the mission that the health centre has had since it was opened. That mission is to do significant outreach into the province to provide women, wherever they may live, with the specialized services that they're just not going to get in their own community and to help them start to address some of their needs closer to home. I know that's a commitment of the Women's Health Centre, and they're eager to start to move in that direction. Part of the planning that's underway right now is to make sure those services are strengthened and enhanced at the existing site so that their mandate can really start to be fulfilled.
V. Anderson: The other part that they stressed is that the emergency services presently on the Shaughnessy site must continue to be there, particularly in relation to these particular programs. Those emergency services are provided by a team that specializes in dealing with women and their concerns as they come into emergency services and go to women's assault and the Women's Health Centre. There's a whole network there that can't be divided up.
They also pointed out very clearly that it is not feasible to take women who have emergency services, particularly as a result of assault, into another emergency service clinic where you have to wait in line, and where you have all the pressures and uncertainties of most emergency centres in the province. These women are in a state of psychological shock and concern, and they need calm, collected and welcoming people, who understand their condition, to be with them. They stated strongly that no other emergency service in the city can handle this because they do not have the time, the resources and the specialized trained staff that are available on an ongoing basis in the present emergency centre.
The emergency centre, the women's assault centre and the research on women's activities that is carried on in the hospital generally are all part of the package. If any one of them is separated out, it destroys the rest of the package. I hope the minister will hear what these women are saying so strongly and clearly: that a fundamental part of their concern is the women's services in the centre. In their own words, they have not had it demonstrated to them that these areas are being taken seriously.
The final question I would raise with the minister -- as well as a comment on those emergency services -- has to do with the frustration, anxiety and concern. It's a pressure-cooker situation because of the September deadline the minister has put on it. Will the minister acknowledge that you cannot move this kind of facility, with all the things that are involved in it, by that deadline? Will she extend the deadline so that there's some breathing room and so that people can feel that they have a fair opportunity to be heard, that their issues are being considered and that they will be responded to? They do not believe that this can be done in this short period of time. And as long as they don't believe it, it won't be done, because you won't get the cooperation that's needed. You will have all that anxiety, which will take years.... This is far worse than any strike situation; there's far more involved. If it's not done properly, with people's cooperation, the ill will which will be created will go on indefinitely.
Hon. E. Cull: I have the utmost confidence in Dr. Penny Ballem, the chair of the task force looking at women's health services. I know that no detail will escape her careful watch. She's a very talented and dedicated person, and I think that the plan she will be coming forward with will be excellent.
I agree that women who have been sexually assaulted need special services. But I don't accept the fact that they should only be provided at Shaughnessy Hospital, because some women who have been sexually assaulted will have to present at other emergency rooms. The goal we have to strive toward is to make
[ Page 5728 ]
sure that all emergency room staff are sensitive to the particular concerns of a woman who has been sexually assaulted and that there is training and support for those people there.
With respect to the timing, as I have said on a number of occasions, there is a task force. It is putting in place the final details of a plan, and that will shortly be coming forward to us for approval. The time lines will be established as a result of the decisions made in that plan. At this point, the transition task force has not given me any reason to believe that the time lines that have been set cannot be realistically met. As they go through their process, if they decide otherwise, I'm sure they'll let me know.
Mr. Chair, given the hour, I would like to move that the committee rise, report progress and ask leave to sit again.
Motion approved.
The House resumed; the Speaker in the chair.
Committee of Supply B, having reported progress, was granted leave to sit again.
Hon. A. Hagen: Hon. Speaker, we have really worked right through this week to the final second of our sitting, and I would wish everyone a very pleasant weekend. I move the House to now adjourn.
Motion approved.
The House adjourned at 1 p.m.
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