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)
TUESDAY, MAY 11, 1993
Morning Sitting
Volume 9, Number 22
[ Page 6083 ]
The House met at 10:03 a.m.
Clerk of the House: Pursuant to standing orders, the House is advised of the unavoidable absence of the Speaker.
[E. Barnes in the chair.]
Prayers.
C. Serwa: I'm not sure if this is the right time, hon. Speaker, but on the basis of a statement made last night by the chairman of the Vancouver School Board, I move that an emergency debate now take place pursuant to standing order 35.
Deputy Speaker: Would the hon. member state the reasons for his motion?
C. Serwa: Hon. Speaker, the reason for the motion is that 54,000 Vancouver students and a thousand more around our province are now at home as a result of full-scale and rotating strikes by their teachers. Other districts at the present time are threatened. On the basis of the comments last night by the chairman of the Vancouver School Board, it appears that a short-lived strike is not going to be possible. It appears incumbent that the members of this Legislature have the opportunity to engage in emergency debate to encourage the government to take decisive action now.
Hon. M. Sihota: Hon. Speaker, of course, as you're well aware, urgency in these kinds of matters has been consistently interpreted as urgency of debate and not urgency of the subject matter. I think all members are concerned about what's happening in Vancouver, and I can assure the hon. member that this government is as well. But there is ample opportunity in this House to raise concerns with regard to statements made yesterday by the chair of the Vancouver School Board and by others involved in this dispute. In fact, as the hon. member knows, this issue was raised and canvassed yesterday in question period, and it is being canvassed by government. I would submit that the requirements for urgency as laid out under the rules have not been met in this request by the Third Party House Leader.
Interjections.
Deputy Speaker: Order, please. The Chair appreciates the member's motion and the submission by the Government House Leader. I will take the matter under consideration and bring back a decision at a later time.
Hon. M. Sihota: Before I call Committee of Supply, let me advise all hon. members that Committee A will be meeting this morning to debate the estimates of the Ministry of Tourism and the Ministry Responsible for Culture. I do appreciate the courtesy that was extended by all members to the minister yesterday, given the problem with the minister's back. I'm sure she's working on trying to solve that problem. But it is much appreciated that members did deal with the issue in a way that accommodated the minister.
With that said, hon. Speaker, I call Committee of Supply.
The House in Committee of Supply B; M. Lord 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'd like to begin this morning with a piece of correspondence from the Health Sciences Association of British Columbia, addressed to the Hon. Minister of Tourism, with regard to a proposal to merge University Hospital, UBC site, with Vancouver General Hospital. It says:
"Please be advised that the executive council of the Health Sciences Association has passed the following motion on this issue:
"That HSA write a letter to the provincial government expressing the following concerns about the potential merger of two stand-alone facilities such as UBC and VGH: that any consideration of any such merger include a process for full public consultation; that the unions involved be provided with adequate information and input into the decision-making process; that the merger is identified as a necessary part of the health care reform process; that the merger would result in the least possible displacement of services for the public and the least disruption for health care workers in all facilities; and furthermore, that HSA vigorously opposes any merger of our certification at UBC with any other existing HSA facility certification.
"We submit this for your consideration."
It is written by Maureen Whelan, executive director, Health Sciences Association of British Columbia.
It comes to debate today because it expresses the necessity for public consultation in this province, particularly regarding the delivery of health care to all British Columbians. This issue is hovering on the horizon, and it requires some assurance from this minister that public consultation will go forward. I believe this is the first of many letters that will come in regarding pressing issues and issues of urgent necessity in debate. These letters are written by individuals who do not believe that adequate public consultation has been sought or that it will be listened to.
I await the minister's comments, particularly as they pertain to the UBC site being merged with the Vancouver General Hospital.
Hon. E. Cull: There is an extensive consultation process underway with respect to the future of University Hospital, UBC site, and whether it will remain as an independent institution or be merged with Vancouver General. That consultation is ongoing.
[ Page 6084 ]
L. Reid: What would the benefit be of merging these two facilities? Why is this a consideration at this time?
Hon. E. Cull: Two options are being looked at: one is to allow the University Hospital, UBC site, to remain as an independent institution; the other is to merge it with Vancouver General. There are opinions on both sides of the issue. I've had the chance to speak to the president of the university, the dean of the medical school, many of the heads of the faculties involved in health profession education, some of the staff members, teaching and practicing physicians at University Hospital, in addition to those in the greater Vancouver community and at Vancouver General. In addition, there has been extensive consultation done by the Shaughnessy transition coordinator.
There are pros and cons to each option and they are being explored through the consultation that's currently underway.
L. Reid: If this process is underway, what are the financial considerations? Is this a cost-saving measure, or is this an opportunity to restructure health care? Or are both currently in place?
Hon. E. Cull: There are cost implications to both options. They are part of the considerations, but not the only considerations that we're looking at with respect to the options.
L. Reid: Has a cost-benefit analysis of both of these entities been done in terms of what the savings will be if indeed they are merged?
Hon. E. Cull: Yes, it's estimated that the cost savings of a merger would be approximately $5 million annually. But as I said, that is not the only consideration or even the most important consideration in this matter.
L. Reid: With respect to a merger, are we indeed looking at savings in the areas of administration? Are we looking at savings in terms of how other programs are delivered on that site?
Hon. E. Cull: Administrative savings.
L. Reid: In terms of our discussion yesterday which looked at evaluating the move to community care, the shift to regionalization in this province, my colleague questioned the presence of a cost-benefit analysis. From your comments yesterday we understand there is no such study currently in existence. Will the New Directions in health care receive an independent audit by this government?
Hon. E. Cull: For the record, I'll correct the statement that was made. I never said there was no such analysis. I said there was no analysis done for the cost of implementing the entire royal commission report, which includes 379 individual recommendations, some of which we will not be recommending or implementing. We do have cost estimates on any of the items that we are implementing this year.
L. Reid: With reference to Shaughnessy Hospital and to a particular correspondence, this individual believes there will be an expansion of existing clinic programs at Shaughnessy Hospital which will indeed have costs for the system. He certainly speaks of the trend across the country and of many of the issues we discussed yesterday. Is there currently a plan in place to expand the ambulatory clinics at Shaughnessy Hospital on site; or indeed when the programs are moved, will they be maintained in their existing size?
[10:15]
Hon. E. Cull: The task force report which is looking at the relocation of all the services at Shaughnessy Hospital and those that may remain on the Oak Street site is still not completed. When it is completed, we will have a better idea as to which programs can be enhanced, either in their current location or in a new one. One of the things we are looking at, particularly at University Hospital, UBC site, and Vancouver General Hospital, but also at the other Vancouver hospitals in general, is what can be done on an ambulatory day clinic basis and, where possible, how those options can be strengthened and expanded for the community.
L. Reid: Perhaps the minister would give us one or two examples of an expanded ambulatory clinic. The writer suggests that there are currently a large number of out-patient clinics with plans for expansion. Perhaps you have one or two examples for the purpose of debate.
Hon. E. Cull: I'm not fully up to date on where the transition team is with respect to those ambulatory clinics being considered for expansion and those which are absolutely adequate for needs being met now. Perhaps the member would care to pick one, and we can use that.
L. Reid: The New Directions, the regionalization of health care.... In terms of background there are a number of areas that we touched on yesterday, but I still have some questions and concerns about the bureaucratic overlay, and certainly local health areas. It's my understanding that there are 80 local health areas, which generally coincide with school district boundaries. They are for statistical and data collection.
In terms of regional health units, there are 21 regional health units responsible for the delivery of services to regions ranging in population size from approximately 50,000 in the Peace River to 450,000 in Vancouver. At the minimum, each health unit must provide the services of a medical health officer, a public health nurse, an environmental health officer and a community care licensing officer.
In terms of our discussion yesterday, and in terms of this being the existing framework, we in the opposition and certainly British Columbians have an interest in knowing how that new program fits. I have the sense from yesterday's discussion that we're talking about an increase in administration and bureaucratic overlay, as
[ Page 6085 ]
opposed to a consolidation of any of these existing structures.
I'd be very interested in your comments. I think this is the crux of the issue for people who are trying to get a handle on regionalization. They do not see it as a condensing of service delivery. They don't even see it as a streamlining of service delivery. They see it as an opportunity to add more spokes to the wheel, which is perhaps not in the best interest of patients.
Hon. E. Cull: I see this as a significant opportunity to eliminate bureaucracy and to coordinate those bodies that now make decisions independent from one another, often at great public expense because of the lack of coordination. The 71 local health areas that the member refers to, and the 21 regional health units, are administrative jurisdictions of the Ministry of Health, and they exist for our statistical and organizational purposes. But if you take an LHA such as the one in which Dawson Creek is situated, within that local health unit there will be: a hospital board; at least one long term care facility with its own board; the union board of health, which oversees public health services; and the regional hospital district making decisions about capital planning. This is not even getting into the number of non-profit community boards and other agencies that might exist with their own governing structure.
A community health council and a regional health board would replace all of those major boards in that instance as they're brought into place. A community health council would assume the responsibilities of a hospital board, a long term care facility board and the union board of health. The regional health board would assume, among others, the responsibilities that are now taken by the regional hospital district. Even with that very limited accounting we are talking about a 100 percent reduction in the number of boards and probably very close to that in the cost of administration.
We would not be totally able to eliminate all of the administration that is there in the duplicate boards, but at the end of the day we will certainly have fewer boards, fewer administrative people and less administrative overhead. What's more, it's not just an exercise to try and come up with a smaller administrative overhead -- as worthy as that may be on its own. We will end up with a system that is integrated so that decisions can be made in the best interests of the health of the community without having to stay within the artificial confines of a particular institution or a particular set of community services.
L. Reid: In terms of access of communities to other services -- and I speak particularly of the community nutritionists, speech therapists, speech and language clinicians and dental hygienists -- right now it's my understanding that those individuals have their allocations and budgets resourced through the regional health officer. Is that going to change in the short term? With reference to your immediate comment about the end of the day -- again, if you could tie a time line to that -- how long is it going to be before there are fewer boards and fewer administrative entities?
Hon. E. Cull: Decisions regarding the services the member mentions are made by the Ministry of Health, not by the medical health officer, with the exception that those services have been delegated to the five metropolitan boards of health -- for example, to the Capital Regional District and the Vancouver Board of Health. Those services are decided by the ministry and the budget allocations are made by the ministry centrally. We're trying to change that because we believe it would be better to have some of those decisions made at the local level. The intent is that when the boards are fully in place after 1996, global budgets will be available to regional health boards for allocation to community health councils, and decisions will be made as to whether that extra FTE should go to speech pathology or nutrition services or for another public health inspector.
In the time period between now and 1996, when we expect to have elections for some of the members on those boards, some community health councils will be formed voluntarily by the boards of the merging institutions agreeing to come together. That has already started to happen in cases where hospital boards and long term care facility boards have merged. As we go through the pilot phase, we will proceed with more of those amalgamations of boards so that we have not only the example in the community but also a model and a pilot for other communities to learn from.
L. Reid: Perhaps for clarification, my understanding is that it's currently the medical health officer for the region, in consultation with the relevant union board of health, who determines the resource allocation. When you say the Ministry of Health centrally makes those decisions, are you referring to the same bodies?
Hon. E. Cull: No, I'm not, but the decision about budget allocation is made by the ministry. While regional health units are certainly able to make some decisions, the vast majority of those decisions are programming decisions within the Ministry of Health. Not all of the services delivered locally by Ministry of Health employees come under the purview of the medical health officer. There's a whole variety of services in the continuing care area which do not come under the purview of either the union board or the medical health officer. Those decisions are made as any ministry would make a decision on a program basis. We want to change that. We believe that those decisions with appropriate budgets and appropriate guidelines about standards of service that are expected for those budgets can be made just as well, if not better, at the local level. Indeed, last year and this year we started to put in place a process that would approximate that by using the union boards of health and locally based staff to start to set some of the priorities and make some of the decisions under the overall direction of the ministry but without the detailed type of direction that might have been there in the past.
L. Reid: Again, from my understanding, it's currently ambulance services which are the single common denominator of the health unit suboffices, that
[ Page 6086 ]
they take some responsibility for that. For my clarification, is there a difference in service delivery? Are we anticipating that ambulance services will be looked at differently under your new framework?
Hon. E. Cull: Ambulance services are not under the purview of the local medical health officer; they're centrally administered.
L. Reid: Is there any anticipated change in the current service-delivery model for ambulances?
Hon. E. Cull: No.
L. Reid: In terms of where we're headed in community care decision-making and aligning what happens in the field more closely with what happens within the ministry, you mentioned yesterday that there was a reorganization in place. Are we talking about the entire Ministry of Health? Or are we talking, perhaps, about isolating certain segments, i.e. whether it's community care or emergency health services? Can you perhaps give some more background on that for the purpose of debate?
Hon. E. Cull: The member may recall that until November 1991, alcohol and drug programs were part of the Ministry of Labour. They've now been put back under the Ministry of Health. One of the things that we are looking at is the appropriate integration of those services, not only at the headquarters level but at the regional level. It obviously makes sense to have a number of programs integrated with those on alcohol and drugs -- mental health programs, for example. We're also looking at where continuing care fits in with respect to some of the community-based programs: should continuing care be allied with the institutional sector or allied with the community sector in terms of the ministry? So that is another area that's being looked at.
We have recently reallocated six senior managers to provide support to regions on a temporary basis -- they're not permanent positions -- and to assist those regions to get up and running with community health councils. In addition, we have elevated the responsibility of our policy and legislation unit to a full assistant deputy minister position, which, I think, puts it in line with other ministries. We are now looking at the overall structure -- particularly of the community and family health area, which is extremely large -- along with these other items I mentioned with respect to continuing care and where it fits into the institutional sector. And when our new deputy minister arrives at the end of this month, we'll be making further decisions.
L. Reid: I appreciate the comments. In terms of realigning some of these areas in the province, will there be a significant boundary change? Are we going to have the same or similar boundaries in terms of how the province is now dissected?
Hon. E. Cull: The major change I think we'll see is in respecting the new regional health board boundaries that will be created over the next couple of years. We're starting, as the member knows very well, with the existing 21 regional health units, but I've already had good representation from some parts of the province saying that the boundary of the health unit should be moved, it should be in a different place, it should be split into two. So we are taking a very close look at what makes sense on the ground, but just starting with the existing 21 units we have as a point of departure.
L. Reid: I have no issue with the starting point. In terms of criteria, will we be looking at population as a significant factor, or will it be perhaps more in touch with what the communities wish, which tends to be geography for the most part?
Hon. E. Cull: We'll be looking at both, because obviously a certain critical mass of population makes sense in terms of administrative efficiencies and ability to provide sufficient services. But there are parts of the province where geography becomes quite compelling: Haida Gwaii is one example, the Nisga'a Valley is another, as well as the north part of the Peace River. Then there are other areas, as brought up by the member from Sunshine Coast with respect to coastal areas that on a map may look contiguous, but when you try to travel from point A to point B, they may not be.
[10:30]
L. Reid: Certainly I can support the minister in that comment because I know our member from Powell River-Sunshine Coast has those issues of being divided, and I'm sure the members for some of the regions of the north have difficulties travelling.
In terms of a pilot for regionalization, I understand that currently selected regions of the province will be on an accelerated program to institute these changes. Would the minister comment on what those changes are and again what the time line would be?
Hon. E. Cull: Originally we thought that we would select about a half-dozen communities to start. We have been overwhelmed with communities interested in becoming involved. Everyone wants to be one of the fast-start communities. We don't want to offend anyone, so we're struggling with this. At last count we had at least 26 communities that either had started to form a health council or were anxious to do so. In fact, the vast majority of them had actually started. Some of them started well before I made my announcement on February 2, because they were quite familiar with the direction we were likely to go in when I made the announcements.
We are in the process of working with all of those communities. We're still identifying more as our staff get out and meet with the communities and discover that they're interested in doing this. In the next number of weeks we will be addressing a number of them -- I'm not sure it will be as small as six anymore -- as the pilot projects that other communities can look to. I think it's important that we establish those communities,
[ Page 6087 ]
monitor and evaluate them and provide the results to other communities so that they can then move forward with a proven product.
L. Reid: One of the concerns shared by members of the opposition was that the program had not been piloted in a northern community. We were looking to see whether or not it would be possible to put in place the same type of stop-gap agencies currently in place in Victoria. I know there has been tremendous discussion about the success of the Victoria Health Project and the Greater Victoria Hospital Society.
With reference to the Victoria Health Project, I would be very interested in the results of the evaluation done by Simon Fraser University. I hope the minister will comment on that report in debate today.
Hon. E. Cull: With respect to the evaluation of the Victoria Health Project that the member is referring to, for a number of reasons that analysis was never completed and therefore is not conclusive in terms of what they were setting out to look at in the first place. There are a number of reasons around that which have been explored with the researchers, the B.C. Health Research Foundation, the Victoria Health Project as it existed at the time and Simon Fraser University.
With respect to communities besides the CRD looking for smaller rural or northern communities, I'll just read you a partial list. It's partial because the document that I have is dated April 6, and we're five weeks on from that. The partial list we were working from at that time includes New Westminster, Port Alberni, Mount Waddington, Victoria, White Rock, Abbotsford, Chilliwack, Langley, Delta, Hope, Maple Ridge, Mission, Keremeos, Armstrong, Enderby, the entire West Kootenays -- every community in their region wants to start a health council and a health board for the West Kootenay area simultaneously, because they've been doing extensive regional planning there over the last while -- and the Peace River health unit, again as a regional health board.
L. Reid: I'll make two comments to the minister. I myself have heard you say that the Victoria Health Project has been tremendously successful. If the evaluation project never went through, what were the criteria for evaluating that project, and what was the basis for saying it was tremendously successfully?
Hon. E. Cull: The research project that the member refers to was an evaluation project looking at a number of different parts of the Victoria Health Project from an academic, evaluative, research point of view. Unfortunately, for reasons that were not entirely within the ministry's control -- they were certainly not within my control -- that project failed to come to a conclusion. Despite the fact that the particular research project did not conclude, the individual programs were all adopted into the health care system by other parts of the health care system. For example, the Greater Victoria Hospital Society was able to evaluate the impact of the quick response team that was in its facility, working out of the Victoria hospital to determine that it was having an impact on admissions and on seniors being able to regain their independence in the community. Other programs, such as the elderly outreach service, were evaluated by the mental health centre, the mental health community and the consumers involved and were found to be very effective. They were taken over by the mental health centre as a project. There is an adult day care centre on the Saanich Peninsula which I think went into Saanich Peninsula General Hospital.
What I'm saying is that the proof of the value of individual projects was demonstrated by the eagerness of other health care providers to continue funding those projects after the four-year pilot funding ran out. Had they not been of value to the hospitals, to the mental health centre, to the Capital Regional District or to others, they would not have spent their scarce dollars to fund those projects. So while the overall evaluation failed, certainly the individual evaluation that took place by the receiving institutions and agencies proved that they were effective and proved that they were of value. If you want to look at it, they paid for it; they bought those services. They felt that they were very valuable to their overall program.
L. Reid: I have some serious concerns about the comments you've just entered into debate. If the criterion was simply whether or not they were eager to institute them into their program, that's a non-starter, hon. minister. At the end of the day, the majority of those institutions and agencies receive their funding from the government. If they had chosen not to implement a particular program, fine, but they would only receive funding to implement programs that fell in line. My concern still rests with the fact that the program was not evaluated. Certainly eagerness is one aspect of the entire enterprise. I'm looking for some objective analysis of those programs: fiscal accountability, a cost-benefit analysis, some kind of measure other than one that is very subjective of whether or not those programs were successful. Perhaps you have some statistics at your disposal. Perhaps there is some measure, some vehicle that was put in place to evaluate whether or not those programs indeed had any benefit or savings to the system or were a more humane way to deliver health care. I'd appreciate your comments.
Hon. E. Cull: I should point out to the member that no additional funding was provided to those agencies to take on those services. I can tell you that an organization like the Greater Victoria Hospital Society is highly fiscally responsibility. They have limited resources and great demands and would not willingly spend those scarce resources on a program that they found was not useful for their overall aims and objectives. The programs were absorbed by the agencies but the pilot project funding ended with the pilot project, for the most part.
L. Reid: What was the cost of the Victoria Health Project?
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Hon. E. Cull: I'm sorry, we're having a bit of a disagreement about how much the project was, because it concluded prior to the change in government. I'll have to look back into the records for you on that.
L. Reid: For my own clarification, in terms of the regionalization discussion and in terms of the Seaton royal commission, it seems to me that where we are today there is tremendous carryover. Certainly your government has carried over the discussion as an offshoot, as a reflection of how valuable the Victoria Health Project had been to members of this community. I would be really interested to know how I can access the study, however incomplete it may have been. If there was absolutely no way to evaluate that program, we are somehow generalizing based on what may indeed have been a very limited success.
We are now engaged in an entire restructuring of the health care system entitled regionalization. It seems to me there is a definite connection. It seems to me that there are still cost discussions missing from the exercise today. I would trust that because we are in Health estimates, some discussion will occur surrounding the evaluation tool. I understand that the minister has said that there are a number of reasons that this study did not conclude. I would be interested to know what a number of them were, because at the end of the day, taxpayers have funded something that may or may not have been valuable.
Hon. E. Cull: Unfortunately I can't even provide the member with unfinished reports, because the project didn't proceed beyond data collection. There was never any analysis. The money that was spent taking the project to that point was of great concern, not only to the ministry -- which was a partial payer of research dollars -- but to the B.C. Health Research Foundation, which reviewed the project partway through and decided not to continue with funding it because of the lack of progress at that point for the money that had been spent. Unfortunately there is not even a draft report, and I regret that too. There is a lot of controversy over the data that has been collected. But it was not analyzed, so it is not in any useful format for any of us.
Other analyses have been done on particular subprojects in the Victoria Health Project. If you would like any of those individual subproject reports, I'm sure I can arrange for the institutions which did some of the evaluation prior to taking over those subprojects to make them available to you.
L. Reid: Both you and I have engaged in academic exercises over time, so the fact that the data may be old does not necessarily reflect on the interpretation of that data. Yes, I'd be very much interested in receiving those reports.
In terms of my earlier comment regarding the need for a pilot project, the only northern community I heard you mention that would allow us to make some decisions based on the effectiveness of regionalization was Peace River. Could you tell me what programs are in place and where that community currently is in terms of its organization or its reorganization to regionalization?
Hon. E. Cull: I believe both Dawson Creek and Fort St. John have held a number of meetings exploring the concepts of community health councils, but I don't have an up-to-date report beyond those initial meetings. I do know that they have been coming together, they are very excited about it and are continuing to work with our staff up there.
L. Reid: In terms of the decentralization discussion -- for my clarification -- apparently the province has been divided into five subregions: Vancouver, Fraser Valley, Vancouver Island-Coast, Okanagan-Kootenays and the north. If that's the case, the other entities you mentioned would somehow fall into those groupings. Will these five regions be involved in any kind of overall evaluation, as opposed to community-by-community evaluation?
Hon. E. Cull: Those five geographic areas are simply an administrative tool for us in organizing our staff. As I indicated, we have six executive directors working with communities throughout the province, and we had to allocate those six individuals in some rational way. The easiest way to do it is to give them each a part of the province geographically and say: "You work with the communities on Vancouver Island, you work with the communities in the north, and you work with the communities in the Kootenays." So those regions exist only for the simplicity of assigning our staff to individual communities. We could have assigned our staff in other ways. We could have had them all having different parts of the province within their jurisdiction. For travel purposes it doesn't make a lot of sense. Some of these people actually live outside of Victoria, so it makes sense to have people who live in those communities being responsible for facilitating the process in those communities.
[10:45]
L. Reid: When we talk about the devolution of health care, I understand you to say that there are six new regional directors in place. Would each of those regional director positions be responsible for each of those five geographic regions of the province? I understand there will be additional staff required for Vancouver and metro. I believe there is an individual in Burnaby and there will be one in Richmond as well. Do those six positions cover those five geographic regions?
Hon. E. Cull: Yes, they do. Those six positions are positions that have been reassigned from other duties within the ministry to facilitate on an initial basis, the communities to get up and running with the community health councils. As the health councils get organized and up and running, the need for us to facilitate will become less and less. They will start to take on more responsibility for themselves. Those people will then be reassigned back to other positions in the ministry -- perhaps back into their old positions, but certainly back into other positions.
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L. Reid: Are there additional hirings anticipated to implement the program at the regional level? If that is the case, will those positions be reflective of the Victoria bureaucracy, or will those be individuals in the field?
Hon. E. Cull: There may be the need for additional staff in some areas. We do have some funding available to support the communities that are getting up and running with their community health councils. Some of that will be made available directly to the emerging councils. Some of it may be used to reallocate staff or to second staff from other parts of the ministry or other agencies to provide that support. Again we're looking at short-term positions here. These are not ongoing positions. As a result, we're looking at secondments, transfers and other arrangements which facilitate this kind of easy movement.
L. Reid: There's tremendous speculation out there that the province is going to end up with approximately 100 community health centres. In terms of there currently being approximately 150 municipalities, how are we going to rejig that organization? I understand that we're in the transition and implementation phase, but are we going to stand at 100 community health centres to reflect the 150 municipalities, or how will that come to pass?
Hon. E. Cull: First of all, it's not the idea that every community needs a community health centre. It's an opportunity for communities to take advantage of circumstances that occur within their community. I can best illustrate this by giving you some examples. For example, in Kitimat there is an old hospital that needs replacing. We've agreed to replace it. They need additional multilevel care beds and a new public health office space for the public health staff. Traditionally what would have happened is that there would have been a planning unit in our care services division to plan the hospital, there would have been another planning unit to plan the multilevel care facility, and then there would have been BCBC looking at the office space for our health unit staff.
We are suggesting to communities that there are opportunities to partner with others in the community that have similar space needs, so instead of solving these space problems individually and independently, we can come together and create something that's larger than the sum of the parts. In Kitimat they have decided to proceed with all three services -- public health services, long term care and acute care -- in one planned facility. It might be more than one building, but it is certainly one planned facility.
In other communities we're looking at expanding, say, a diagnostic and treatment centre to provide additional space for others that provide health services in the community. They may be private practitioners, Ministry of Health employees, public health employees, non-profit agencies that need space or other ministry employees. Social Services is often an agency that you will find sharing space in some of the smaller diagnostic and treatment centres around the province, because it just makes sense to have them all together.
The possibilities are really endless. What we're telling communities is that no longer is the old style thinking of "I have a space problem, and I will solve it independently" the way to go. Have a look around your community. Look at what space might be available. Perhaps the hospital has a vacant wing as a result of a new addition or some changes in their approach. Public health, rather than continuing to look at itself as an isolated organization, could go into that wing as they are doing in Quesnel. There are lots of opportunities.
We're not planning to go out and tell each community in the province that they need a community health centre. Communities will tell us where they have those opportunities, and we will try to facilitate them through our capital planning.
L. Reid: For my clarification, we currently have approximately 71 entities out there. From your comments -- we'll end up with approximately the same number of community health councils of decision-making bodies -- I didn't anticipate major shifts. Again, you know, I would certainly welcome your comments in debate. My take on this is that we're going to end up with roughly the same number of agencies responsible for rendering some kind of decision. For the purpose of committing this to the record, it's my understanding that one-third of these individuals will be elected directly by the community, one-third appointed by the minister and one-third appointed by an elected board of municipal authority. Is that the situation -- if we were to compare the community health councils to the regional health boards -- and will that reflect equally on community health councils and the regional health boards?
Hon. E. Cull: I said 71 earlier, but I've been corrected. The correct number of LHAs -- local health areas -- is 79. So I guess we can both get our numbers right here.
LHAs don't have any governing body. There isn't anything that is a local health area authority. It's a line on a map that carves up the geography so you can collect statistics, compare them year after year and provide services according to that.
So when you say there are 79 entities out there, there aren't really any. There are 21 union boards of health -- is that correct? -- so they certainly exist out there. There are 150 hospitals, give or take, so there are certainly all those boards out there. I don't know how many long term care facilities there are, but it would be fair to guess there would be at least as many as there are hospitals. There are all kinds of other agencies and boards. So I think it's fair to say that right now we have an awful lot of different boards that are governing different parts of the health care system. Some of them are elected from society; some of them are appointed. Most people in your average community probably couldn't tell you who was on them; so they are kind of unknown governing bodies that aren't very visible to the public.
At the end of the day, we are proposing there would be roughly 21 regional health boards. There may be a few more if areas that I mentioned earlier decide that
[ Page 6090 ]
they are their own region and are separate. But give or take a few, that should be the area we're in. The community health councils will represent those communities within those health boards -- it's difficult to say. If you look at the Victoria area where, I believe, we've got something like 11 different municipalities, I don't anticipate 11 different community health councils, but I do anticipate more than one. The Capital Health Council, which is an unfortunate name right now because that name got picked before we released this paper, is really a regional health board. So there will have to be some health councils established, and they are starting to look at how to do that. It's a little difficult to be predictive at this point as to what the total number will be at the end. But there will be fewer boards and councils than there are boards and agencies now administering the system. We will have fewer at the end of it all.
Yes, the proposal for the community health councils is: one-third direct elected, one-third indirectly elected -- which is how union boards of health are composed right now -- and one-third appointed. The regional health boards will be composed of individuals from the community health councils who go to those boards to form the regional bodies for regional planning purposes.
L. Reid: What are the criteria for appointment of the one-third to those boards on behalf of the Ministry of Health?
Hon. E. Cull: That criterion is under development right now. We are in the process of putting together what I call a reference committee -- that will involve people from all of the major stakeholder organizations -- to act as an advisory body to the ministry as we develop policy with respect to appointed positions. For example, what would be the criteria for standards, and what should the funding formula be? We want to have, beside some very focused working groups that will be dealing with these individual problems, one body that would act as a reflective body we could keep going back to, as we did with the minister's advisory committee on the royal commission, which didn't look at every nut and bolt in the package but certainly did provide good, general, overall guidance. I would think that the members to be appointed by government to the local councils would be selected in a way similar to the minister's advisory committee. We worked very hard to find a balance of people not only geographically and with representation from different groups in our province, but also people who were really knowledgeable in their own right about health care or their communities.
I think the individuals that we had on the minister's advisory committee -- the late Dr. Lionel McLeod; John Blatherwick; John Anderson, formerly the head of the BCMA; people like Sally Mackenzie of the Women's Centre in Nelson, Kathy Sanderson from the small business community -- are the kind of people that most folks will look at and say, yes, they are a credible voice for a part of our society, and therefore they have some real credibility when they speak out on those issues. I don't think you can have an effective organization unless you make sure your criteria for appointing people to it reflect that. Otherwise, your body can't get on with the work it has to do.
L. Reid: Would it be safe to say that those appointments will at least reflect health care professionals in the field?
Hon. E. Cull: That's an interesting question, and it's one that I think is still open to considerable debate. I have not reached a conclusion on it, and there are arguments on both sides of the issue. I guess the question that we have to answer is whether the body that will be put in place to represent the community on health issues should try to reflect the makeup of providers in the community as well as consumers, or whether it should be more like a municipal council and therefore representative of community interests but not necessarily representative of the people who might ultimately be employed or have their financial decisions made by that particular body.
If you assume that the health council will be managing the hospital and making decisions about long term care facilities and community health services, you would have real difficulty having any of those employees on that council who are not in a conflict of interest as they decide priorities which might affect their own employment or income. So I think naturally there would be people excluded just because of the fact of their source of income or employment. Then if you've excluded part of the health care provider community for those reasons, do you include the rest? How do you handle that whole situation?
Here in Victoria the Capital Health Council has worked its way through that particular set of issues. We turned the problem over to them and said: "You think about it. You work with your community. You advise us on it." They have come to the conclusion that community representation is the way to go; in fact, that's the recommendation they've made to me with respect to the current vacancies. That board is a hybrid right now. There are people from the Greater Victoria Hospital Society and the Capital Regional District, which are both providers and employers. But the vacancies are in those two agencies, and the advice that I've had back from the Capital Health Council is to replace those vacancies with community people, who are the vast majority of the board. It's not a closed decision, and I'm sure there will be many people who will want input into that particular decision before we draft legislation to finalize it.
L. Fox: Just to follow up a bit on that line of questioning. As I understood the minister, she was stating that in fact the community health council was going to replace all the local boards with respect to long term care, hospitals and so on. Did I understand that correctly?
Hon. E. Cull: Not all of them.
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L. Fox: Well, perhaps she could give me some clarification.
[11:00]
Hon. E. Cull: The intent is that the major boards in a community will come under the community health council. I don't expect every non-profit agency or every community agency that exists in any of our communities around the province to amalgamate under the community health council. Some of those agencies may determine that it's in their best interests and the best interests of their communities for them to maintain a separate organization. That may change over time as the community health councils become established and make decisions.
At the other end of the scale, we have to work our way through the problems, particularly in Vancouver -- to a lesser extent in Victoria -- where there are many hospitals. If you go back to my Dawson Creek example, we're dealing with one institution; if you get into Vancouver, we're dealing with many institutions. Whether it would be feasible for one health council to administer all of those institutions is unlikely. The Vancouver model, which is now being developed with input from both the community sector and the hospital sector in Vancouver, will have to develop a model that fits Vancouver. It's not going to be as simple there, and it's like many of the integration and regionalization issues that come up around the province. The urban areas often require a different approach and a different model.
L. Fox: We could end up with virtually a different model for every community, which I think is going to be a bit of an administrative nightmare -- from a provincial perspective -- if each community health care council has a different flow chart. In fact, you are looking at some communities where if societies are not prepared to give up the autonomy they have built up over the years on a particular complex -- most of which I assume would be intermediate care or long-term facilities -- you could end up then with a.... I'm trying to envision the flow chart in my mind as to how the structure is going to work, and beyond that, how the ministry is going to do any kind of evaluation as to whether it's getting the best bang for the buck in meeting the needs of the community.
I'll use Vanderhoof as an example to see if I understand how this works. In that community we have two facilities: one described as an intermediate care facility; the other one receives very little money through the Ministry of Health. I think it's through other agencies, but it is also a senior citizens' facility -- more of a self-care kind of facility. We also have the hospital which is, hopefully at some point in the near future, going to achieve a long-term care or extended care facility. If the Omineca Lodge -- which was built primarily by the Legion and through time has been funded jointly with the province, and is financed by the province in terms of its operating costs -- wishes to maintain its management structure, which is an elected board of the society, then is the minister suggesting that that option is open to them, or not?
Hon. E. Cull: First of all, with respect to the comments about there being a different model in every community: no, that is not going to be the way that it will unfold.
Will there be one model for every community in B.C.? No, I don't think it is reasonable to expect a model that works in Vanderhoof will also work in Vancouver. So there will be some differences in the models that are put in place around the province. I expect that we will have a small number of different models, and we are going to do some piloting over the next year so that we can see what works in different sized communities. I think we will see two or three, and maybe even four, different models in place that would reflect the complexity and makeup of different communities. I don't think that that is administratively unmanageable. If you really think about it, our municipalities work that way right now. They look very similar, but I daresay that the administrative structure of Vancouver is somewhat different from the administrative structure in Vanderhoof. So I believe we can live with the differences.
Before I give the answer on the specifics in Vanderhoof, I just want to clarify one point. Is Omineca Lodge the personal care facility or is it the intermediate care facility? You indicated that one facility is an intermediate care facility that we fund, but the other one you couldn't think of the correct name, and you called it self care. So is Omineca Lodge the self care?
L. Fox: No, it's a combination. Sorry.
Hon. E. Cull: It's the other one. Okay. But there is another one that the ministry doesn't provide much funding to.
Sorry, hon. Chair, I realize I'm supposed to be going through you and not directly to the member, but it's simpler than getting up and down and clarifying all of these.
The system right now is to work with communities to get them to voluntarily come together and amalgamate. They have been doing this already in many parts of the province. But the boards that we expect to amalgamate and that will ultimately be required to come together will be those for which we provide the lion's share of funding. They will include intermediate care facilities, hospitals, extended care, the union board of health services and other services directly provided by the Ministry of Health.
I don't know what a self-care senior centre is. I'm not sure we're using the same definition here, but certainly there are residences for seniors which have a care component but are outside the Ministry of Health system. We don't fund them, because of the level of care that they provide. They probably will stay outside. There has been a lot of discussion in the consultative phase about amalgamating more than just Ministry of Health functions. The concern has been raised that there is a direct linkage between Health and Social Services. While I understand that, my immediate problem is to get the Ministry of Health services better coordinated and integrated. Should we come to the point where that's nicely sorted out, we can move on to
[ Page 6092 ]
bigger and better things. I know I have my hands full now, however, just dealing with the fragmentation in the health care system. Reducing that fragmentation would be a major accomplishment.
L. Fox: The minister talked briefly with the opposition Health critic about the makeup of the community health council and how it's going to be elected. Could she tell us what the makeup of the regional health boards is going to be? Are they going to be formulated in the same way as that discussed for the community health councils? Are they going to be one-third appointed by government?
Hon. E. Cull: Each community health council will send representation to the regional health board.
L. Fox: So each community, irrespective of its size, will have one representative on the regional health board?
Hon. E. Cull: That particular issue about whether there should be weighted representation on the board is being hotly debated by those people now working with us on what the final structure should be. It's one of those issues in the consultation process. There are very convincing arguments on both sides of the issue. The union boards of health have expressed their position on this to me very clearly. We have to hear from other organizations in this amalgamation before we're able to make a final decision on that. Earlier in these debates we were talking about legislation. There will be enabling legislation coming forward in this session, and permanent legislation in the next session after we've had a year of the transition period. Those questions will have to be answered in the legislation.
L. Fox: Is it envisioned that both the regional health board and the community health council would have paid positions, or at least partially paid positions or part-time paid positions, along with an expense allowance?
Hon. E. Cull: It is expected that the positions will be exactly as they are now: voluntary positions with reasonable expenses covered in terms of meeting costs, etc. The volunteers that form hospital boards right now have no pay for their position. The union boards of health -- the councillors and the school trustees -- do not, to my knowledge anyway.... Certainly when I was a school trustee we didn't get extra pay for serving that function. We just got to go to a lot more committee meetings. The government appointees will continue as government appointees do right now, again unpaid.
L. Fox: My experience has been just the opposite: that in fact it varied from municipality to municipality, school district to school district, regional district to regional district. In some cases they are remunerated. It would be refreshing, I suppose, to have consistency throughout the province rather than the kind of ad hoc or local decisions that are presently made with respect to that issue.
While we're on the subject of community health boards, certainly the delivery of services.... In the dying minutes of last evening the minister mentioned that she had been comparing the cost of having a long-term patient in an acute care bed versus in an extended care bed, and there was a savings of almost 50 percent, which allowed the ministry to treat two patients instead of one. She used the number of $400 per bed per day as a low cost in an acute care and $200 in an extended care facility. Given the increase in the housing portion of intermediate and extended care beds that is paid by the individual who can pay.... As I understand it, the housing portion of that care went from $31 a day up to $46 a day. I hope I've got that correct.
Interjection.
L. Fox: From $21 to $34? Okay. If an individual has the ability to pay, that substantially increases what they pay. Given that involved in this new concept is the cost of an extended care bed at $200 a day, is there going to be the opportunity to consider, for instance, a patient wanting to stay home? Given that it's now going to cost $34 a day to stay in one of these facilities, will that individual have the option to stay in the family home and have a nurse provided for, say, four or five hours a day in order to do the necessary treatment and to care for that individual? It seems to me there would be substantially more saving if that option were there for families to have a nurse brought in for four or five hours a day versus having to go to an extended care facility.
Hon. E. Cull: Just for the record, I want to try to clarify the terms that we're using. It took me quite a while to sort out the difference between extended care, intermediate care, personal care, long-term care and all the rest of it.
Extended care is the very highest level of care for chronic care patients, and if you need extended care you need to be in an institution. You could not provide that level of care at home. Intermediate care does have different steps. You used to rate people as to whether they were intermediate care 1, 2 or 3, and each level, going from one to three, required a higher level of care. There used to be a category for personal care, which was very light care. We no longer fund that. That's almost all provided now through home care and support to individuals in their homes. It is confusing. Sometimes I find that I use the terms interchangeably. It's important to focus on what it is we really can provide.
[11:15]
With intermediate care, we are now looking at the lower levels of care and providing people with more assistance to stay at home. It's quite a simple calculation done using two factors. Can we provide the care to the person in their own home? Are we able to provide the level of service they need to maintain their health and to be safe, to have those kinds of considerations taken into place? And is it no more costly than having them in an institution? Obviously we're not going to pay more to maintain somebody at home than it would cost to have them in a bed. That doesn't make good sense in terms of
[ Page 6093 ]
our limited health dollars. We do have a look at it; we provide services up to a certain level, at which point it does make more sense for the patient to move into a facility.
But as a first consideration we also have to ask the question: can we look after that person in a home environment? It will depend on the person's condition and needs and what kind of services they would require -- the potential for them to suddenly develop a emergency situation and their distance from hospital should that occur. As you can imagine, it's an evaluation that has to be done by people who really do understand how to provide for people who need chronic care.
I think that's probably answered your question. I'm not sure where your logic was going with respect to the increase in the long term care user fees. The user fees apply only to the housing portion, not to the health care portion, and while the $200 per day was simply a number I was using for illustration yesterday, I don't have the average costs here in front of me. Clearly the lion's share of the costs in an intermediate care facility are for the health care, not for the accommodation, so we're dealing with a very small portion of the costs in the user fees. They apply only to housing, not to health care.
It's the same costs that a senior would pay whether they were in a seniors' centre such as the one you were describing which might have self-care, or whether they were living at home. They would still have to pay rent or their utilities or their costs of day-to-day living. If you're in an institution, of course, you're getting not only your accommodation but your meals and other services provided to you at no cost or at a limited cost -- the maximum, depending on income, is $34 a day.
L. Fox: Thank you, and I appreciate the minister giving me a bit of an educational lecture. But let me just tell the minister that I'm well aware of the different classifications. My mother is in an extended care facility and my wife works in an intermediate care facility, so I have some understanding. I also have some understanding that there are many extended care patients who may be looking at other opportunities, given that you've increased the housing costs to something that's now going to run that particular individual beyond $12,000 a year in terms of actual costs. Families are going to start to look at other opportunities if they're going to pay that much just for the housing portion for their parents or their loved ones. Then perhaps, with some kinds of initiatives that would give them the opportunities to provide some of that care at home, they could put that $12,000 to use within their homes rather than paying it out, and there would be a saving to the ministry.
I was pleased, actually, to hear the minister talk about the fact that it's not possible in many cases for extended care patients to live at home, and I recognize that as being so. I have been part of a thrust for five years in trying to convince the ministry that that was so, to get an extended care facility in Vanderhoof. We've not yet been able to convince the ministry that it's needed.
Let me go on to talk just a little bit about.... I had some questions following up yesterday's comments when we ran out of time. The minister also talked about evaluating and doing some cost-benefit analysis, and during the course of that we discussed the hepatitis B problem. She identified that there were 830 cases which had a cost factor to the province of $5.6 million in 1990 and that she expected that to increase. In the process of evaluation, have we evaluated what's causing the increase, so that we're not just reacting to the symptoms but actually trying to deal with the problem?
Hon. E. Cull: Yes, we have. The Centre for Disease Control has a very good idea of what is leading to the disease. The vaccination program is a preventive measure; it isn't treating the symptoms. We're ensuring that people who may come in contact with the disease at some point in their life do not develop it. It is being been given to children so that they will be immune to what is often a fatal disease.
Hepatitis B is spread very simply through contact with body fluids, so it has to do with lifestyle: IV drug use and unprotected sexual activity. I guess that virtually limits it. There's a possibility of it being transferred to infants through the birth process. It's very limited, but it is spreading because of some of the lifestyle considerations. As the disease gets a hold here in British Columbia, more and more people have the opportunity to become exposed to it, unfortunately. As a result, more and more people have the misfortune to contract it.
L. Fox: Are there any statistics in that evaluation which show that the poor economy, less opportunity for job creation and other stresses on the family because of the lack of jobs are contributors to some of the issues that you just spoke about with respect to what's causing this?
Hon. E. Cull: No doubt there is an impact of some extent. I couldn't quantify it for you. As I have said on many occasions, you can look at any activity that you can become engaged in that would negatively impact your health. Some people have gone to great lengths to calculate how many years of life you will lose if you do certain things: drive your car too fast, skydive, inject IV drugs or eat fatty foods -- you name it. You can come up with a long list of things that, we all know, reduce our life expectancy.
The thing that has the greatest impact on life expectancy, bar none, is poverty. Poor economic conditions are more likely to cause poor health than anything else you can imagine, if you look at the overall population and ask what is going to impact it. In fact, if you look at the vital statistics report, which has all the wonderful coloured maps showing the health status for different local health areas around the province; look at certain illness indicators, where there's a very high incidence of particular illnesses; and think about the relative economic circumstances of the communities in those areas, you will see there is a very direct
[ Page 6094 ]
correlation between poverty and much of the poor health that is experienced.
L. Fox: I have one further question on that just so I can understand it. Within our capabilities and within the stats known on the 830 patients, do we know -- and I'm sure we must -- whether or not any particular cultures are more affected than others; whether or not there is an increase in hepatitis B among, let's say, our aboriginal people or another aspect of our population?
Hon. E. Cull: We're just doing a quick consultation here of whether there is any cultural pattern there. I'm not sure about hepatitis B. We do know, for example, that AIDS, which is spread in a similar fashion, has a growth rate in the aboriginal community that is quite alarming. The numbers are very small, but the growth is of great concern. If we look at things like substance abuse, we know that that is more prevalent in the aboriginal communities, at least in some parts of the province. There is certainly some concern there around diseases that are often spread in conjunction with substance abuse. As to anything more definitive, I'm sorry, but I don't have that information. Perhaps you could ask the Centre for Disease Control if they have done such an analysis and could provide it to you.
L. Fox: I guess my next question was going to be: if there was, what kind of dialogue was taking place between this Minister of Health and the Minister of Aboriginal Affairs with respect to how we might approach that on behalf of the aboriginal people? Given that the information isn't readily available, I'll leave that, and perhaps the minister can respond at a later time.
I'll get back to my line of questioning of last evening, and the process of evaluation and doing a cost analysis. I know that it's very easy to sit down and assess the cost of a long term bed versus an acute care bed, and to make those kinds of evaluations and decisions, but it's extremely difficult, in my view, to do the same kind of determination over a shift from acute care into this new Closer to Home process and initiative. I wonder if there has been any kind of cost-benefit analysis done as to what it would cost to treat an individual in rural British Columbia who has been released two days or three days after their surgery, but who requires dressings and so on, versus the cost of having that individual stay in an acute care facility.
I'm pleased to see that the Minister of Forests is going to respond to this question.
Hon. D. Miller: Hon. Chair, I certainly don't know the answer to that question. It's a good question, however. I'm certain that the officials are taking note of the questions being posed by members and that minister will, upon her return, attempt to provide that answer. I could give you my own guess, but that may or may not be helpful. So I would certainly urge members to continue to raise issues of concern and pose those kinds of questions.
L. Reid: I would like to enter into the record today, on the discussion initiated by my hon. colleague, part of a correspondence written by Dr. John Blatherwick of the Vancouver health department regarding hepatitis B:
"The province of British Columbia began a grade 6 hepatitis B immunization program in September 1992. These youth will then be fully protected in June 1993, when they will have received the three doses.
"Parents are asking what about their children in grades 7 to 12. The answer is," -- no -- "they will not be immunized.
"For approximately $6 million per year for three years, $3.2 million for vaccine and $2.8 million for staffing, a program could be carried out for grades 9 and 12. The grade 9 program will catch the youth who may drop out after that grade, and the grade 12 program will protect the 72 percent of youth who would shortly become sexually active. The program is only needed for three years, because all grades would then be protected, and after that only the grade 6 program, plus the catch-up, would be required.
"Why should we do it? Hepatitis B numbers are high and growing in B.C. There is a safe, effective vaccine. It's a long-term prevention program. If we, the adults, have put these young people into long-term debt in order to provide services for us, the least we can do is to protect them against this disease....do we believe in prevention, Closer to Home, or just the words? This program would be action, not words."
[11:30]
This Minister of Health has commented on Dr. Blatherwick's expertise in a number of areas. It seems to me that this is the issue that we must address. In the words of my hon. colleague, we saw a $5.6 million loss in wages from the 830 individual cases who had contracted hepatitis B. If the cost of lost wages is equal to the immunization program, it certainly seems relevant that we engage in some kind of proactive stance on this issue today. At the end of the day, we're not assisting anyone who happens to contract this disease and we're certainly not ensuring that people have adequate protection from this disease. The question posed in the letter that I repeat today is that since we know the costs and we know the benefits of the program, why indeed has this government decided not to institute the program?
Hon. D. Miller: As with the last question.... I see the minister returns, so I'll make just a general comment on those questions. It appears to me that one of the difficulties or one of the responsibilities of the exercise of government, whether provincial, federal, municipal or whatever, is the situation of balancing costs and benefits. One cost is clearly balanced against other costs that have to be incurred. There is a general debate taking place, has taken place and I suspect will continue to take place, wherein people advance what often appear to be contradictory notions. On the one hand, people say that government budgets need to be restrained, that budgets and the tax load need to be reduced; on the other side, in what often appear to be contradictory messages, individuals and organizations are continuing to appeal to government to spend money for worthy causes. Clearly there's an element of contradiction, and we need to balance those legitimate
[ Page 6095 ]
desires for expenditures in areas such as the member has outlined with the need to be careful in terms of the overall impact on budgeting.
Having said that, having leaped into an area that I'm not familiar with, I would ask the member to pursue her questions, obviously, with the minister.
L. Fox: I appreciate the minister's forced difficulty in answering a Ministry of Health question. But I note with interest that he didn't miss the opportunity to point out to the opposition that they shouldn't be asking on the one hand for more money and on the other to cut the budget. I don't think either I or that member was doing that. In fact, I think the whole process that I've enjoyed this morning has been one of trying to bring some accountability to whether or not we're spending money as wisely and effectively as we can.
I want to go back, though. Has the minister had a chance to be briefed on the question that I asked? Perhaps before I continue, I would allow her to answer that.
Hon. E. Cull: I understand that one of the questions you asked was with respect to a cost analysis for rural B.C. of acute care versus home care. Yes, there has been some analysis done. I believe the royal commission, in fact, did some background work on that. I know from talking to some of the people in our health units that there are some cost analyses that have been done in various areas. I don't have that here with me, but I would be most happy to put it together and send it to you.
L. Fox: I would appreciate receiving that. To be very frank, my major concern here is a process of evaluation as to whether or not this new direction is in fact going to meet the needs of British Columbians in all areas of the province, from the perspectives of both health and cost-effectiveness; and I would be really appreciative if the minister would make that information available to me.
I want to go back a bit. Earlier the minister talked about the concept of a one-stop shopping centre, and she used Kitimat as an example of where we're going to put public health, long-term care and acute care into a kind of one-stop-shopping health care facility. This is something I've been supportive of for a long time. One of the major difficulties in achieving it in the past was the fact that there was such a different funding formula for all of these different levels of care. The regional districts had a real problem in terms of how they were going to split local responsibilities from the provincial government's responsibility. Could the minister explain to me whether or not there has been some determination as to how this is going to work, given the new initiative in Kitimat?
Hon. E. Cull: There hasn't been any change to the cost-sharing arrangements currently in place. We can very simply apportion the costs out to each part using existing funding arrangements. It's quite straight-forward in identifying responsibility for the acute care portion of a community health centre in Kitimat and in having that funded according to the existing arrangements. Likewise, public health can be funded according to the existing arrangements. It's just a matter of putting them together as opposed to dealing with them in isolation.
L. Fox: I take it, then, that in terms of maintenance costs, janitorial costs and that kind of thing, there's going to be some kind of contract....
Hon. E. Cull: No, those are operating costs.
L. Fox: But in fact the operating costs are funded differently. With all due respect to the minister, the regional health boards -- and I hesitate to use that term because it confuses it with the new initiative of regional health boards -- pay a percentage, certainly in terms of small capital repairs. They pay percentages of roofing costs and those kinds of things. Each one is funded differently. But if you're all under one roof.... I was part of the Smithers initiative, where we were actually trying to address all of these issues in a finite way so that an agreement could be signed between all the agencies which reflected the costs as the formula suggested it would if there were individual buildings. It was an extremely complex and difficult process. Now I'm wondering: has that been simplified so that this kind of thing could be achieved, or is there some kind of mechanism to handle those expenses?
Hon. E. Cull: I guess it depends on what you include in the concept of maintenance. A certain amount of maintenance comes under operating costs and, of course, operating costs are all, for the most part, funded by the Ministry of Health -- same formula in all three circumstances.
But yes, there can be cost-sharing in terms of minor capital. The Kitimat project may not be all under one roof, but for argument's sake, let's suggest that it is all one building and assume that the hospital, the long term care and the public health unit each have a third of the space in there. That's not likely -- it will obviously be different -- but it makes it simpler for this debate. One-third of the minor capital costs of repairing a roof that would cover the entire facility can be allocated along the same basis that determined the original capital funding. I don't think it's highly complicated; it does require that you understand the formulas, and that you put them in place in the agreement in advance. Certainly we will continue to work with the Union of B.C. Municipalities and the Ministry of Finance to determine if we can simplify the cost-sharing arrangements that exist right now between the Ministry of Health and local communities in capital funding. But it's a matter of shifting taxation from one body to the next, and that's not always easy to do in the short run. So I think the easiest way is as we do it right now, where we have long term care facilities attached to acute care facilities, where we actually move public health space into acute care space. We will use the cost-funding
[ Page 6096 ]
formulas that we have and continue to try to improve them.
L. Fox: Thank you. I'll leave that at this point. I did want to just follow up a little bit on the initiative of '92, and get some kind of report as to what the status of that initiative was. There was an advertisement right across Canada looking for 800 new employees in the Health ministry. There were a couple of things I wanted to find out with respect to that. One, how many people were hired to fill those 800 positions? And what percentage of those came from British Columbia versus other provinces?
Hon. E. Cull: To the best of my knowledge, all of those positions have now been filled. With respect to the percentage of people from B.C., I haven't got the answer to that. I'm sure staff are making a note of it, and we can provide that information to you.
L. Fox: I understand that the minister has to leave a bit early.
Interjection.
L. Fox: As I understand it, you said all 800 positions have been filled -- but you don't have the information as to how many came from outside the province?
Interjection.
L. Fox: Okay. I will leave it at that. Will that information be available before the end of the estimates?
Hon. E. Cull: I'll try to get that information for you as soon as possible.
L. Fox: Seeing the time, I would move that the committee rise, report progress and ask leave to sit again.
Motion approved.
The House resumed; E. Barnes in the chair.
Committee of Supply B, having reported progress, was granted leave to sit again.
Committee of Supply A, having reported progress, was granted leave to sit again.
Deputy Speaker: Hon. members, earlier today the hon. member for Okanagan West, pursuant to standing order 35, sought to move adjournment of the House to discuss a definite matter of urgent public importance. The matter raised by the hon. member was the disruption of students' education as a result of strikes and job action. In support of his view of the public importance and urgency of the matter, the hon. member referred to a statement last evening made by the chair of the Vancouver School Board to the effect that the current strike by teachers would be ongoing for some time.
The Government House Leader made a submission to the Chair that, while the matter raised was an urgent one, the hon. member for Okanagan West had not established the urgency of debate as required by the rules relating to standing order 35 applications. As recently as April 26 last, the Chair made a ruling in relation to a standing order 35 application and referred in some detail to the authority of Sir Erskine May's Parliamentary Practice, as well as to previous rulings made in this House by other Speakers on the prerequisites for a successful application under standing order 35.
[11:45]
These essential prerequisites include the requirement that the matter must be of recent occurrence and be raised without delay. The authorities further note that the fact that new information has been received regarding a matter that has been continuing for some time does not in itself make the matter one of urgency within the meaning of standing order 35. It is common knowledge that a series of strikes by teachers has been ongoing for many weeks in different school districts within the province. Further, a number of references have been made in this House to the disruption in the education system by reason of disputes between teachers and school boards. Clearly the matter raised is not of recent occurrence, nor has the matter been raised under standing order 35 at the earliest opportunity and without delay.
Accordingly, in accordance with the rules relating to standing order 35 applications to which the Chair has referred, the hon. member's application must fail.
Hon. M. Sihota moved adjournment of the House.
Motion approved.
The House adjourned at 11:46 a.m.
The House in Committee of Supply A; D. Streifel in the chair.
The Committee met at 10:17 a.m.
ESTIMATES: MINISTRY OF TOURISM AND MINISTRY RESPONSIBLE FOR CULTURE
(continued)
On vote 56: minister's office, $330,000 (continued).
[ Page 6097 ]
C. Tanner: Good morning. Nice to see everybody here again. I'm able to stand up a little bit this time, so I'll do so when I can.
Yesterday the minister told us about the 1-800 phoning program and the marketing program. I think everybody was pleased to hear the announcement, and hopefully we will see it in operation fairly quickly. I have just one question following from that discussion yesterday. The success of that program will depend to some extent on the marketing of the number, on the exposure of it to the public. Could the minister tell us what the marketing program is that backs up the installation of that new program. As far as the financing of the marketing is concerned, would it come as much from the telephone company as from the government?
Hon. D. Marzari: The marketing program for the toll-free service around Discover B.C. will be as follows: B.C. Tel will cover $500,000 in domestic marketing expenditures in 1993. B.C. Tel has committed to contribute $2.16 million to domestic marketing over a five-year period, plus an investment of $1.5 million per year in operating costs over five years. B.C. Tel is basically in charge of the marketing of Discover B.C. We feel we have a very solid marketing program that builds upon the marketing program that the government has put through our contract with Canadian Facts Co., which now handles the 1-800 line. The new program incorporates the 1-800 line, adds to it, includes B.C. residents and will market itself accordingly.
C. Tanner: Then there is a little confusion in my mind -- perhaps only in mine and not in anybody else's. I understood the minister to say that her $500,000 would be matched by telephone companies other than the one resident in this province. Is that correct? Will it be used in adjacent jurisdictions?
Hon. D. Marzari: The contract for Discover B.C. is with B.C. Tel. It services B.C., but its purview and its reach will extend through the close-in market, through the west coast of the United States and through other provinces in Canada.
C. Tanner: Do the telephone companies in Washington State and Alberta participate in any way other than as a normal telephone company would in any long-distance calls? Or do they put money into the plan? I would suspect not.
Hon. D. Marzari: No, they do not.
C. Tanner: In that case there will be some charge to anybody phoning from outside the province, for the normal long-distance call, to facilitate their use of the program within British Columbia. Is that correct?
Hon. D. Marzari: This is a 1-800 service, and the 1-800 line is a line the customer uses at no charge to the customer. The line will survive now that the Discover B.C. program is wrapped around the accommodations reservation system, which will be an adjunct to the service we have provided in the province for some years. The 1-800 service exists now, but you can't phone it if you live in Vernon. You can phone it if you live in Spokane. This service with B.C. Tel expands the service (a) by including British Columbian residents, and (b) by providing a built-in accommodations reservation system as well.
C. Tanner: The last question in my series of questions regarding this new program is: is this a unique program to British Columbia, or has it been used anywhere else in North America?
Hon. D. Marzari: I believe that Nova Scotia has a rather sophisticated accommodations reservation line, obviously not run through B.C. Tel. It is B.C. Tel's first attempt to do this particular kind of program. They are working with B.C. now, and its success will be noted in two or three years when we can start seeing the program breaking even. B.C. Tel, I know, has the intention of marketing this service to other provinces.
C. Tanner: That's an interesting connection there because the minister might be aware of the fact that my party is going to be conducting a phone-in election this coming September, and in fact they're using Maritime Telephone Co. It could be that B.C. Tel and Tourism should be participating in that phone-in -- and consequently, the subsidization of our vote for a new leader -- since the two companies obviously have a relationship.
Yesterday the minister mentioned specific cases where they've used the 2 percent tax raised in Whistler, Vancouver and Victoria for specific purposes in the States. She mentioned the fact that the Alaska Highway reunion was promoted last year. She mentioned the fact that there is a special program for a wine tour through the Okanagan. In the same vein, what is the department doing to prepare for the Commonwealth Games in Victoria? How closely are they associated, and what are they doing to help Victoria promote that sports event?
Hon. D. Marzari: The Ministry of Tourism and Culture is very interested in the promotion and development of the Commonwealth Games for a number of reasons. One, it brings Victoria into a very high-profile situation in 1994, and already I have been told that we've got zero vacancy looking towards 1994 and the Games. It also provides Victoria and British Columbia with an opportunity to display and showcase their culture. There is a full-fledged aboriginal exchange now in process and being planned. There is a community arts program in conjunction with Saanich and three other municipalities, including Victoria. We are putting together a community arts program which will be a parallel and complementary program to the Games themselves.
The provincial government's contribution to the community component was put at $40,000 early last year. In addition, the Ministry of Tourism and Culture has forwarded a commitment to $180,000, not in cash, but in services rendered -- in staff time being allocated to the Games and in services that we can bring to the Games through our offices that wouldn't be easy to find
[ Page 6098 ]
otherwise. So there is a commitment by the Ministry of Tourism and Culture to these Games, as there is a commitment from virtually every ministry in the government, as well as from government itself with its initial $16 million outlay.
C. Tanner: The minister started her conversation about the Commonwealth Games by saying that it was her understanding that there is zero vacancy already for the coming year, which concerns me in that if it's been that successful this early, how are we going to accommodate those people? What plans have been made with the industry, which has apparently guaranteed that the rates won't go up any more than 15 percent? How is the minister going to accommodate the obviously greater influx of people? Has she made any plans? Has she talked to the industry about taking people into private homes, and that sort of thing?
Hon. D. Marzari: The Games themselves have done an excellent job, along with Tourism Victoria and other tourism agencies, to ensure that people's homes are available for billeting, and bed-and-breakfasts are certainly coming on stream, so that the accommodations will not be a problem. I should assure the member that in fact the agency of the Games and other tourism agencies, such as Tourism Victoria, have handled this situation very well.
C. Tanner: I'd like to get back to the line of questioning that I was pursuing yesterday concerning the financing of tourism in British Columbia. I think the minister is in possession of a letter from either COTA or the hotel association itself asking the minister and her ministry to pay more attention to the 2 percent. Other than Vancouver, Victoria and Whistler -- and I think Smithers -- are there are any plans within the ministry to raise that extra 2 percent with the cooperation of the municipalities in other areas in the province? Could she tell me how much is raised by the 2 percent in the three large municipalities and how it's spent -- not in detail, but in round figures -- by her department?
Hon. D. Marzari: The 2 percent is raised by municipalities on a voluntary basis when all accommodations and tourism facilities get together and tell their municipal councils basically that they would be prepared to pay an additional 2 percent on their hotel room tax in order to do some marketing or build civic infrastructure, which is related to tourism. The Ministry of Tourism endorses most of those requests. The only request that has come through since I have been in this office has been from Smithers, and it is basically that they are going to use their $25,000 for marketing. Oak Bay, Whistler, Vancouver, Victoria and two other municipalities access this 2 percent to use for marketing. I know that Whistler, for example, uses a certain portion of its dollars for building civic infrastructure -- a skating rink and a swimming pool, I believe -- and the remainder for marketing.
The Ministry of Tourism itself does not control those dollars. In fact, there has been a history of the Ministry of Tourism not being particularly coordinated with those programs. In the last year the ministry has taken an active interest in partnering, consulting and helping to coordinate the programs of the three majors, at least, so that we're getting the maximum impact for the marketing dollars spent.
As I said yesterday, Vancouver was in receipt of about $4.5 million last year for its marketing. Whistler was at about the $500,000 level, and Victoria comes in at $1 million to $1.5 million. That 2 percent really does drive a lot of marketing for the municipalities that consent, volunteer and apply for it.
[10:30]
C. Tanner: I understood basically what the minister has said. In fact, we had this discussion last time. She did mention on the way that Smithers had applied. Does the application come to the ministry, then go to the Ministry of Municipal Affairs and the municipality makes the decision? Where does the initial application come to?
Hon. D. Marzari: The initial application comes to the Ministry of Tourism, and then the ministry takes it through to Treasury Board.
C. Tanner: Is the ministry actively promoting that among municipalities throughout the province? I can see great benefit to the Okanagan area, for example. Should they apply to have it? Would the minister look upon that with agreement?
Hon. D. Marzari: I have raised the 2 percent option with a number of municipalities and a number of tourism associations as I've travelled through the province. Many municipalities, it must be remembered, have their own very viable, very strong tourism associations. Prince George, for example, assured me that on a voluntary basis they managed to work with the accommodations and restaurant sector there quite effectively and basically have no need at this point to approach government for an automatic or a guaranteed 2 percent on the hotel room tax.
When I have broached the subject with the Okanagan, similarly I believe that they have a reasonably good infrastructure there, growing annually with new accommodations coming on-stream. They do seem to have a reasonably strong infrastructure and financing capability that requests only access to the coordinative benefits that come through our funding of the association and the Partners in Tourism program, which the association actually administers.
C. Tanner: I wanted to get the 2 percent out of the way so that it was clear to everybody what we're talking about and so I could address the criticism by the hotel association particularly and by COTA as a whole of the 8 percent taxes raised in this province, which bring in revenue of approximately $500 million. It's the industry's contention that having raised that sort of money with the hotel tax, the ministry is not returning sufficient of that to the industry. Could the minister comment on that statement, please?
[ Page 6099 ]
Hon. D. Marzari: I applaud the industry voice for saying exactly that. Were I an industry, I would be saying the same thing. The industry knows full well that it has a ministry that's working on its behalf and advocating for it. And certainly it has a ministry that's prepared to pull together all the strands in this province and start encouraging the industry to speak with one voice, so that when it does speak with that one voice, it turns into a roar.
I believe that at this point in time the total hotel tax returns to this province are $63 million, and the industry is interested in pulling in 2 percent guaranteed marketing dollars from that. It is my contention that the ministry is putting $10 million into marketing, and by our effective partnering with the major municipalities, we are in fact making those dollars work in a way that $15 million worked three years ago, and in a way that those marketing dollars have never worked before.
The tourism industry is saying $4 million more would make a difference. Give us a formula that will guarantee us a $14 million to $15 million marketing budget every year. I'm saying to the industry that would be very pleasant to have, but in tough financial times, you're not going to get that. What we are going to do is: do our marketing smarter and better; we're going to consult with you as we do it; and we're going to put you, members of the industry, on the decision-making boards that determine how WEPA dollars are going to be spent and how the marketing dollars should be spent, and on the panel and the committee that determined which advertising agency would be used by the Ministry of Tourism. So our reaching out to the industry has pulled them into a full-scale partnership at the administrative, budgeting and marketing levels. I think it is this kind of partnership that is making up for the so-called missing marketing dollars at this point in time.
C. Tanner: I'm sorry. The minister's absolutely right. So that it's understood, I didn't misquote the hotel association. They say all taxes raised from all sources from tourism in their industry are about $500 million, including liquor taxes, sales taxes, and so on. They mention $57 million is raised directly from the hotel tax.
But the point they're making is that, other than the recent legislation withdrawn last year on the legal profession, where we raised exactly 6 percent -- I guess now 7 percent -- there aren't that many industries which specifically have a tax raised on them. The hotel industry is saying that since that is the circumstance in the hotel industry, it deserves consideration other than the fact that it's another revenue source for the government. I think they have a good point, Madam Minister: $63 million is not to be sneezed at, particularly when we've reduced the amount we're putting back into the industry. They see two things happening. They see a change in marketing, which we discussed yesterday -- and I have a few further questions on that this morning -- and they see a large piece of change coming into the government. Their contention is $500 million overall and $63 million specifically, and they feel that that $63 million should be spent -- not all of it, but some larger portion of it -- to promote their industry even more than is happening now. While I appreciate that the minister is spending smarter, as she keeps saying, they're saying that it's not quite smart enough and that consideration should be given to raising the amount spent.
Hon. D. Marzari: Let me clarify a couple of things here. The $63 million is the total number of dollars retrieved through the 8 percent hotel tax. That represents 8 percent of the total revenues accumulated through the hotel tax. The industry is basically looking for some marketing security. They're not asking for $63 million; they are asking for approximately $12.6 million, which would be the 2 percent that they are looking for. The industry is asking for 2 percent for the provincial marketing budget, just as Vancouver, Victoria, Whistler, Smithers and Prince Rupert access their voluntary 2 percent. The industry is suggesting that B.C. Tourism, almost as a Crown agency perhaps, work with a guaranteed budget of that 2 percent. For this year that would amount to $12.6 million.
I am not opposed to the idea or the concept. I think the security of putting a set amount into marketing is a good idea in the long run -- maybe even in the short run. I'm working with the industry to pull together all the literature that has been developed over the last number of years and all the correspondence that has gone on in the ministry over the last number of years around that 2 percent. I will continue to work with them until I think we've got a package that looks good enough to take to Treasury Board and say: "Yes, marketing should have its own agency." Perhaps this is the route to travel down the road. But in the meantime, this year we are putting in $10.1 million, which is $2 million less than they would receive under the model they've been discussing. We are actively saying in the ministry: "Let's ensure that those bucks are properly spent and properly partnered before thinking about spinning off into a separate Crown agency."
C. Tanner: I appreciate what the minister is saying, because it sounds to me like there has been some meeting of minds between the industry and her ministry. I think benefits will come to all parties in this. In fact, it could even see an extra $2 million spent, and raising it to 2 percent across the board could actually see a benefit in taxes increased because of more promotion.
A study done in New York a year or so ago said that for every 1 percent of tax you add -- my figures are only rough -- you can lose a potential of about 1.4 percent in room income. In fact, in B.C. now, with the 8 percent tax imposed by the government, the 2 percent imposed on themselves, if you like, and the 7 percent GST federal tax, at 17 percent we're getting two or three points higher than in the surrounding.... Is the minister cognizant of that fact, and has she given it any consideration?
Hon. D. Marzari: I'm very cognizant of that fact and of the fact that the GST, which slapped on an additional 7 percent last year, affected tourism
[ Page 6100 ]
revenues. Revenues that would have been considered as part of a 5 percent growth rate in B.C. ended up being sucked away by the GST, so we ended up with basically a wash in terms of revenue, although with an increase of visitors walking through the door. So of course it concerns me. Every time you look at an industry and start thinking about fees and licences or taxes, it's going to have an impact, and it's important to measure those impacts. That's certainly one of the things we're doing now with our interministerial look at fees and licences and the potential for adverse effect. So yes, I'm very aware.
C. Tanner: As far as the GST is concerned, apparently -- and I hear this from hotel operators around the province -- the aggravation that the GST causes, in that tourists can get it rebated when they go across the border, is creating annoyance on the part of the tourists, and resentment when they get home and say, "Oh my God, don't go to British Columbia," -- B.C. in our case, or Canada -- "They hit you for all sorts of things, and they make it very difficult for you to get the tax back." I appreciate it isn't the minister's responsibility, but I'm wondering what representations the minister has made to the federal government to see if they can find some easier way -- for example issuing a card at the border that says: "This exempts you from GST."
I have actually stood in the lobby of a hotel in Kamloops and heard people registering, and they were getting quite annoyed. When they've had a long trip and suddenly they're getting hit with this extra tax, and when they're told, "Well, you can get it back at the border," and they know they've got to fill in forms and so forth, they get very aggravated. The classic case was a hotel here in Victoria which -- would you believe, and I was surprised to find out -- rents rooms for $495 a night. The man's bill came to some several thousand dollars, and he had to pay $550-odd dollars in taxes. He didn't even turn a hair at the bill, but he was really aggravated at the taxes.
Has the minister made any representations to the federal government to find some simpler, more straightforward method of satisfying our tourists?
[10:45]
Hon. D. Marzari: Last spring I personally made a strong representation with members of the Victoria tourism association to the hon. Minister of National Revenue, Mr. Jelinek. The full tragedy of how GST is collected at the bottom of the hotel bill, as well as the 7 percent itself, was canvassed thoroughly. Mr. Jelinek spoke to us about having received similar complaints across the country and suggested that various models were being experimented with to deal with the situation. But as to this point nothing has happened, and another attempt to meet with Mr. Jelinek did not happen.
C. Tanner: I appreciate the minister's efforts on behalf of the tourists in this respect with the federal government, but I was thinking more on a departmental rather than a political level. Are members of her department talking to members of the federal department? I mean, this must be an ongoing problem in every province in Canada, more specifically ours because our percentage of tourism income is higher than many other provinces. But have there been departmental discussions with Canada Customs or with the federal tourism or taxation departments -- within the department, not at the ministerial level?
Hon. D. Marzari: We certainly work locally with our customs people. We've done some research projects with customs, and Mr. Jelinek was certainly aware of those. I believe we've actually made an improvement at the border. At the federal level, we've worked closely with other ministers across the country and with the federal minister of tourism to bring some of these concerns, and many others, to his attention. There's a concerted effort going on, as you may well imagine, by the tourism ministers across the country. The federal minister of tourism himself, I believe, has been spending some time with his colleagues trying to make some of these points about the impact of GST.
C. Tanner: I omitted to tell the minister, Mr. Chairman, that it looks like we might be going on another day. I said today we'd be into the cultural side of her ministry, but primarily because of the success, I felt, of yesterday's discussion, I've got a bit more questioning this morning and early this afternoon. We'll get to the cultural side around 2:00 or 3:00, and then we might have to continue into tomorrow. I hope that's convenient.
Getting back to the specifics of her department, could the minister tell us -- I think it's in the estimates -- how many employees we have today, as compared to last year?
Hon. D. Marzari: Last year, the FTE count was 327 for the ministry, and this year it is 317.
C. Tanner: A drop of ten. Last year I think there was an increase of two people in Barkerville and another facility. Where has the drop come this year?
Hon. D. Marzari: The drop comes: two in administration, three in heritage, three in tourism services, and two from the policy area, which accounts for ten people -- ten FTEs. I won't say people, because people were not involved in this.
C. Tanner: I'm sorry, I didn't catch the last part of what the minister said.
Hon. D. Marzari: It's a little-known bureaucratic fact -- or a well-known bureaucratic fact, but it's difficult to translate into political language -- that FTEs don't necessarily correspond to people. The ten positions were there when the ministry was put together in late 1991. These positions were not filled, so they were therefore not truly vacant. There were no layoffs, in other words.
[ Page 6101 ]
C. Tanner: I'm sorry, I did hear that. The piece immediately before that, when she said the last two or three people had not been.... Those positions hadn't been filled?
Hon. D. Marzari: The positions were not filled.
C. Tanner: I've not only got problems with my back, I've got problems with my ears today. Could the minister repeat -- for my benefit if for nobody else's -- what the ten positions were, and where they went to? I missed the last two or three.
Hon. D. Marzari: Two positions existed in administration, three positions existed in heritage services, three positions in tourism services, and two positions in the policy field.
C. Tanner: Did I understand the minister to say that those ten positions, in actual fact, hadn't been filled the previous year? Is that reflected in a reduction in last year's budget?
Hon. D. Marzari: As you know, last year there was a reorganization and a restructuring inside the ministry, so that certainly had an impact on some of these vacancies. There was also a hiring freeze in place in 1992-93, so consequently the vacancies were never filled.
C. Tanner: But last year at this time, when we were discussing the budget, the minister had a projected budget which included ten more employees -- ten more FTEs -- which positions weren't filled. Wouldn't we see that reflected in a reduction in the budget of last year, including -- because you didn't spend the money on the salaries -- the reduction you see this year?
Hon. D. Marzari: Yes, there was a reduction in the budget last year. The final figures for '92-93 aren't here and aren't reflected in the blue book. There was a small surplus at the end of the year. What we're dealing with is the fact that throughout the course of '92-93, because of the fiscal restraint or the reality, money was taken back from all ministries. Consequently, there was a reduction in the budget through the course of the year.
C. Tanner: What in actual fact happened was that we didn't fill ten FTEs and money, which was anticipated could have been spent, went back to the consolidated revenue fund. Does the minister have discretion on those funds to move them from that part of her budget to another part of her budget? Could she have used the saved money, should she have wished to do so, in, for example, marketing?
Hon. D. Marzari: It is possible and it is legal to move money between allocations, but it is not possible to move money between votes. That is out of the question. Money can be shifted from one category to another, yes.
C. Tanner: Did the minister have that choice last time, and could she have made that decision rather than let the money go back to the consolidated revenue fund?
Hon. D. Marzari: I wish I had the numbers in front of me, but I don't believe they are available for any ministry. I am assured by the administrator it was an exceedingly small surplus.
C. Tanner: I won't pursue it any further. The point I'm trying to make is that if there were discretionary funding there, and the minister could have moved it, the industry and I would have liked to have seen it used in marketing, because the minister and I don't agree on her marketing plans. That brings me to a specific and, for me, one of the more difficult parts of this questioning: the decision to close two offices in the United States.
It is my strong contention, from my personal experience and what I understand now of my 18 months looking at the industry, and from what I've learned from the minister and from the last budget exercise, that you spend your money where the market is. If you've got a good market now, while it's nice to go and create other ones, you've got to spend money where it's working best for you and you get the best return.
The best market we have in Canada, in my view, is British Columbia. The second-best one is Alberta, and the other ones are in the United States. I understand from the industry that in the United States, California, not Oregon, surprisingly enough, is the next best one after Washington State. The minister's decision to close those offices has had strong repercussions, and I think the minister -- far be it from me to put words in her mouth -- can make a case that it was a gutsy decision. It was a tough decision she made, and she made it. On the other hand, just days ago, we had the Premier in Japan boasting that you've opened another office in Osaka. For a number of reasons, those two things don't equate. In a news release, which the ministry and the Premier's office sent out -- certainly the ministry, maybe the Premier's office too -- they were saying that one balances off the other. I disagree. I think you've got to address those markets where you know you're getting the dollars now, and not address the markets.... Eventually you've got to address the other markets, but that's not the prime concern. The prime concern is to continue to feed the market that we know well.
Many people in the industry, particularly in Victoria -- and I suspect it's true of Vancouver and Whistler, too -- tell me that their biggest market, or a large chunk of their market today comes specifically from California, and we've closed two offices in California. The minister has justified those in the press, and I know she came under criticism on radio and TV and in the newspaper. Will the minister once again, just briefly, give us the justification for closing the offices and the hotel industry in British Columbia, and Victoria particularly, why they're going to be better off with an office in Osaka as a compromise?
[ Page 6102 ]
Hon. D. Marzari: The total amount paid for rent in Seattle and Los Angeles was $230,000 a year. The Los Angeles office was located in a small industrial park in a place called Irvine, 60 miles south of Los Angeles, which took an hour to reach. It was a perfect location for an economic development office that was dealing with the Silicon Valley and other projects and pulling money and manufacturing possibilities from industries in and around that area into British Columbia. However, having a sales agent operating out of that office and paying rent for that office was not particularly useful either for visiting trade members, members of the industry or for the individual sales agent located there. Rent is not being paid now on that office. A sales agent is working for us in Los Angeles. In fact, it is the same sales agent who was working in Irvine.
In Seattle the office which was located on the ninth floor, I believe, of a downtown building, was not a friendly storefront office, which people are inclined to believe a tourism office should be. It was an office which handled mail and dealt with the occasional off-the-street visitor. But basically it was a coordinating office that pulled together trade shows, and enabled the industry here in B.C. to go to Washington trade shows to do their marketing and their advertising. This function is being more than adequately handled now by the coordination, involvement and partnering around those trade shows being done in Vancouver, and by our Vancouver staff travelling to Seattle to make the arrangements and do what needs to be done on behalf of and with the industry.
The cost saving was an important one, because it enabled us to go into our shoulder-season, highly targeted marketing campaign down the west coast, which I believe has been a tremendous success and has brought us tourism, tourism dollars and exposure that we wouldn't have received otherwise. The sales agent is functioning in Los Angeles on a full-time basis, and our Seattle presence is still very much there, and the industry is being very well served.
[11:00]
We now have an office in Tokyo with two full-time people in Tokyo, and we will be establishing a permanent presence there to coordinate and facilitate the trade shows and to work with the tour operators and the organizers. The Tokyo presence, we consider to be an important one, and that is where we will be putting our efforts in order to maximize our opportunities around the Pacific Rim.
Japan is our largest overseas market, and in '92 it showed a 6.5 percent increase in the number of people who came to B.C. That figure doesn't include the number of people who in fact flew to Ontario first and then came back through B.C. So we believe that the 6.5 percent increase is a very conservative number. Between '88 and '92, B.C.'s share of the Japanese market increased from 33 percent to 41 percent. So we're doing very well in that market, and I quite agree with the opposition member, Mr. Chair, that we have to feed the markets that are producing the greatest potential, and we believe that the potential for us is on the Pacific Rim and in Europe.
C. Tanner: I'd like to deal with this in two ways. First of all, I'd like to sort of round out what happened in San Francisco and then we'll deal with the Japanese market. I had an occasion quite recently to talk to a major hotel chain in town here who informed me that he's been going down to shows and promoting us in California for a number of years. One of the greatest assets he had when he went there -- either personally or his staff -- was having somebody on the ground who knows the market. There are two things obviously happening here. He wasn't aware that the ministry still had somebody situated down there, and he is one of the more successful marketeers from Victoria. I think it's necessary to advertise that fact throughout the industry, because obviously a number of them are not aware of it.
This operator says -- and I've heard it from others -- that while it's nice to look after the trade shows, there are other things that knowing the contacts does for them. The point was made that this is a people industry and that knowing the right people, talking to them and being steered in the right direction by those people on the ground is a very important part of the business. In actual fact, bookings are suffering as a consequence of closing the Los Angeles office in particular and, in some respects, the Seattle office.
Hon. D. Marzari: The numbers I quoted into the record yesterday from the success of the shoulder-season direct marketing campaign suggest that bookings aren't suffering at all. What has happened down there -- and the industry is fully aware of these changes -- is that Mr. John Bateman, who is our sales rep in Los Angeles, is available. He receives calls just as he used to receive calls, but people do not have to travel 60 miles south to the Irvine office to keep an appointment with him. Mr. Bateman is making full use of the Canadian consulate office in downtown Los Angeles and of the contacts in a people business with any of the visiting industry reps who happen to go to L.A. or San Francisco. Mr. Bateman also covers San Francisco, since the office there was closed two or three years ago.
I should say that we maintained our U.S. overnight entries in 1992, compared to a Canadian decline of 3.4 percent. So B.C. has done not too badly at all in terms of maintaining our share of the market.
C. Tanner: The hotel industry, of course, is working at the very minimum of eight months ahead and frequently a year or so ahead. So if there is a detrimental result in closing those offices, particularly the one in Los Angeles, it probably won't be apparent for a year or two. Last year's results don't really come to bear on what I hear the trade telling me the minister has done to them by closing that office.
I would reiterate that I think there is a dearth of information in the industry about Mr. Bateman. Maybe the ministry could serve itself well by promoting that again and letting the world know he's there. I'm sure that is not the impression some members of the industry have.
I take issue with the statement that you can serve Seattle out of this area. I'm concerned about the Los
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Angeles one. The minister took great delight in telling me last year that it was the other government that closed the San Francisco office, so she's following the trend. I think both governments were wrong. Seattle is a very specialized market. I'm going to get into the Victoria ferry thing in a little while, but in the meantime, the Seattle market is important to Victoria and, I suspect, to the whole of British Columbia. I think it does warrant a presence there. I don't think that by living in Victoria, in particular, or in Vancouver you can appreciate a market -- even one such a short distance away -- when it's in a different country with different customs and a different clientele that we've got to specialize in. We've got to specialize in them by being on the ground rather than by operating from Vancouver. I can't prove my point, but neither can the minister, because she's got no more results than I have. I suspect we're going to see the results within a year or so, and I think you can even go a step further in Seattle. I think you do need a showroom office in downtown Seattle -- not an office nine floors up. It's an investment that will pay off handsomely for British Columbia.
Hon. D. Marzari: I could only ask the member of the opposition, through you, Mr. Chair: if he had $107,000 rent money to spend, would he spend it on a direct marketing campaign that would bring visitors to Vancouver, Victoria, Whistler and the province immediately, or would he spend it on the rental of an office that would coordinate trade shows for the industry? I daresay that his keenness and energy -- and his complaints about the lack of money under marketing to this point in these estimate debates -- would suggest that if he had the choice in front of him and could see the benefits of a directly targeted marketing campaign and the cost benefits of maintaining a rental arrangement in downtown Seattle, he would probably go for the marketing campaign.
C. Tanner: We obviously don't agree. We disagreed yesterday on marketing strategy; now we're disagreeing on another strategy in marketing. Frankly, when I take that seat a couple of years from now, I'll probably change the policy to some extent.
Let's talk about the Japanese market for a moment. I don't think the minister mentioned Osaka, but I'm reasonably sure that I heard the Premier make an announcement that Osaka was also going to have a trade and tourism office with one or two staff persons. If you're going to go into the Japanese market, I think that makes sense. But when the minister says there's a 6.5 percent increase, we're talking about 3 percent of the total income in British Columbia, and it's a small percentage. Admittedly, those Japanese dollars are a lot richer than the Canadian dollars, or the Seattle dollars, or the Los Angeles dollars, but it's a small percentage of the total market that comes in here.
There's another problem, I think, with Japanese tourism. It's one that the minister and I hadn't discussed last year or this year: the circular Japanese dollar. The Japanese dollar doesn't always stay with us, not like the American dollar. The Japanese dollar sometimes goes in circles through Japanese investments in Canada -- which I don't have any problem with, because it employs Canadians and some of the money sticks. But some of it goes back to Japan in profits; it doesn't necessarily benefit Canada. Would the minister comment on that?
Hon. D. Marzari: I've heard this story a number of times: how the Japanese dollar goes back to Japan has almost become an apocryphal tale. Bill Clinton stayed in the Hyatt Regency Vancouver because it's an American-owned hotel. I have yet to see -- and I would like to see soon -- the numbers around foreign ownership of accommodations throughout British Columbia, most particularly in the large urban cores, so that we can actually get some good multipliers on what dollars actually remain. Right now I do know, just from the gross numbers around gross domestic product, that $2.7 billion remain in the British Columbia economy because of tourism. That number is a pretty good one for me. Until I actually see numbers that suggest that the Japanese multiplier is not as great -- does not have a great impact on our GDP -- I will not be convinced.
Similarly, the Japanese office in Osaka is primarily a trade office. It's sometimes useful to have trade and tourism together, and I am assuming that there will be good coordination, since I believe the previous office, the trade office, was in Tokyo. Consequently, I'm assuming there will be -- I'm planning on there being -- good consultation and cooperation. Tokyo seems to be the best location for tourism at this point, according to the trade itself and the industry itself.
I'm also looking forward to some spinoff through the rest of the Pacific Rim: to be able to take a close look at the potential developing market in Korea, the market through Hong Kong, and perhaps a developing market in Taiwan as well, which has been overlooked to this point but is a community of 26 million people who want to travel. So there are advantages to establishing ourselves as a presence in Tokyo: developing the potential, working with the trade office, and increasing our ability to pull tourists in from the Pacific Rim.
C. Tanner: The minister talks about the stories circulating within the industry. There are specific hotels owned by Japanese interests, both in the metropolitan area and upcountry. If you go there in the summer, they are full of Japanese tourists. I don't know about the bus line but there are certainly Japanese stores open in Vancouver for Japanese tourists. There are certain locations where Japanese tourists are kept together and favoured. The fare is paid in Japan.
My point is that the benefit to Canada from some of those tourists isn't as obvious as it is with other tourists. My opinion, and some tourist industry members' opinion, is that, while we want that money, those jobs, that capital investment, we don't benefit or reap the profit as greatly as we do from other investors -- because other investors are prepared to leave their money here, but they don't; they take theirs home. They are operating smart, from their point of view, but we're not necessarily the beneficiary of it.
Mr. Chairman, my fellow member has some questions.
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A. Cowie: I have just a few friendly questions, to get some clarification. The other day I had the pleasure of going through the airport on the way to Revelstoke, and I paid my first $5 tax. I wonder what the minister feels about having a separate tax paid by visitors to B.C. going through the airports.
[11:15]
The Chair: Hon. minister, recognizing that it is not within the administrative capacity of your office.
Hon. D. Marzari: No, it isn't.
A. Cowie: Hon. Chair, another clarification. I met with several B.C. residents in Revelstoke who said they were so mad about the tax, the $5, $10 and $15 tax, depending on where you are going, that they were going to leave from across the border from now on. My anger at the tax.... I must say I did go see the vice-president, and I understand why they have the tax. It is a direct tax on improvements for the new runway facility, and I have no objection to that. What I object to is that it wasn't going through the travel agents and the tickets so that when you buy your ticket, you pay for it there. It is just a real aggravation, and I think it does affect tourism and people travelling around the province too. The minister might want look at that and think about it. I won't see if I can get an opinion. I imagine she'd be just as mad if she went through the airport and didn't use government airlines or something like that.
Anyway, another question I have is: while travelling around the province, one stays in different bed-and-breakfasts and hotels, and they vary considerably. You have to get to know whether it's a good or bad bed-and-breakfast. I won't say that there are any bad ones, but some of them are better than others. What does the minister feel about having some kind of rating, some kind of system, so you know you're getting into one that is of a certain acceptable standard?
Hon. D. Marzari: The Ministry of Tourism does not at this time have a full-scale licensing or standardization of any accommodation. Accommodations are routinely visited by our tourism services, but they are not visited to fulfil any registration requirements. The visitations are to get into the accommodations guide itself, and our person from tourism services will occasionally recommend an upgrade. But the business of licensing and registering any accommodation in B.C. has not reached the point where.... They are moving in Nova Scotia, for example, to have a full-scale registration. We are investigating the possibility in British Columbia of moving the quality of service into the realm of the twenty-first century by looking toward a registration program which the industry can live with, agree with and buy into over the next decade. At this point we don't have a registration or a licensing requirement at the provincial level for any accommodation, let alone B-and-B accommodation.
A. Cowie: There used to be a system where there was a triple-A or a double-A, and if you got below that it was pretty bad. At the present time -- I won't mention specific bed-and-breakfasts -- in Port Hardy, where it's pretty difficult to get accommodation because of the ferries leaving at certain times, there are some good ones and some not-so-good ones. It's just that I do hear tourists saying, "I'll never go back to that bed-and-breakfast," and when I stayed there, I realized why. I also realize that you have to phone around now and get recommendations of which ones to go to. There's a delightful one up in Prince Rupert on the harbour. It's well worth staying in. I think we should be promoting those and giving them magic stars. Then, I suppose, it would be difficult to get into them. But at the same time, if you know that's a good one, you can recommend it to your friends. So at least we have that system.
I think we need some sort of system for tourists to ensure that there's a basic level. I don't think I'll stay on that any longer, because I think the minister knows what I'm talking about. I would like to talk about bed-and-breakfasts. When you go to the American side of the islands, there are some beautiful little places. You can go from one to the other, and they're reasonably priced at least at the edge of the season. We have some very nice ones in the Gulf Islands as well. And it's a good way to travel, especially if you're on bicycle. I wonder how the minister feels about bed-and-breakfasts and about promoting them a little more.
Hon. D. Marzari: At the present time there are 2,000 bed-and-breakfasts in British Columbia that are loosely affiliated under small groupings, which sometimes helps them to rent out their accommodations. But most of them operate as individual operators. In the last few months we've encouraged a local private publisher to pull together an actual registry that would not be our registry but would be a guide to bed-and-breakfast accommodations. That, I gather, will be happening before this season starts, so that travellers will have access to a detailed list of what's available in the bed-and-breakfast line.
Once again, the provincial government isn't taking -- nor should it at this juncture -- responsibility for accrediting or registering bed-and-breakfasts since, as I say, we don't standardize quality of service for any accommodations. It's something that we have to work toward. I agree with you that bed-and-breakfasts are a good way to travel. It's a unique way, especially in B.C., where there's such a variety and diversity of service in each community.
A. Cowie: I've always encouraged multiple use, especially in the downtown areas, and have always encouraged bed-and-breakfasts or small hotels being mixed in with single-family use. I was raised in Fredericton, New Brunswick, and some of the heritage buildings there are fixed up, just like in Victoria, as little hotels or bed-and-breakfasts. It's a good way of getting a nice community spirit, and I wish more communities would think about this sort of thing. It allows a more flexible, lively approach to one's community. Is the ministry doing anything to encourage cities like Vancouver, where you don't see many bed-and-breakfasts? Does the minister have any views? For
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instance, why couldn't we have a nice little bed-and-breakfast in Kitsilano or Kerrisdale or some place like that? Has the minister any feelings about that?
Hon. D. Marzari: I don't believe the ministry has had any direct contact with the City of Vancouver or municipalities to actually encourage zoning for bed-and-breakfast, although it is a tempting idea. I know that during Expo people ran bed-and-breakfasts out of many neighbourhoods throughout Vancouver, and it was quite a success. I would be very surprised if those arrangements weren't still ongoing. In fact, I'd be very surprised if we didn't have quite a number of bed-and-breakfasts throughout the lower mainland region that don't really want to speak their name because of the zoning requirements.
A. Cowie: It's a problem here in Victoria. I happened to look at one just down the street last year that's very nice.
C. Tanner: Are you going to buy it?
A. Cowie: No, I was thinking about getting a share in it, but....
The Chair: Through the Chair.
A. Cowie: Anyway, I fortunately decided not to. However, it was really nice accommodation.
One of the problems the bed-and-breakfasts were having was that there were a lot of illegal ones. I think the ministry might want to take this under some kind of leadership and encourage some kind of registration. It's just like legal and illegal suites. For goodness' sake, suites are great things; we should encourage them. But let's make them legal. I would just leave that as a little message. Maybe next year I can ask again what's been done about registering bed-and-breakfasts.
I have one other thing that had to do with the airport. We're trying to promote walking and bicycling, as I mentioned earlier. I wonder if the minister would consider lobbying the airport authority about getting a walkway or a bicycle path to and from the airport. There's nothing, absolutely nothing. I witnessed that because I was one of the few people who actually walked out of the airport. You might want to consider that.
Hon. D. Marzari: This is because you wouldn't pay your departure tax.
A. Cowie: I wanted to see what was going on with the expansion. I had to get my pants dry cleaned, and it took ages to dry out my shoes.
One of my favorite spots in B.C. is the Gulf Islands. I believe we badly need an overall plan for the Gulf Islands, to determine some future for it. I know there's the Islands Trust; it's a little out of the minister's line. But I personally believe the Gulf Islands are so unique they should be preserved, almost in their entirety, for people who visit there or people who have real cottages. We really should discourage people from living on the Gulf Islands. I know the member next to me might be a little sensitive about this, and I haven't mentioned it to him. But I believe it's so unique that we should have a long-term plan for it. Like the Greek islands, it's a great resource for tourism, different in its nature, but it's unique. I'm wondering if the minister has any feelings about the Gulf Islands?
Hon. D. Marzari: The Gulf Islands have a very viable and vibrant small tourism industry. It's very important that we maintain the support structures that we have for that industry, both in terms of access to ferries when they need them, especially for weekend travel, and to ensure that we are responsive to the needs of those small operations on the Gulf Islands. I know that a number of operations have been set up in the last three or four years, and they've been very successful. They're small quiet bed-and-breakfasts and small resorts. We haven't had any problems coming from the Gulf Islands, so I'm assuming that things are moving along there quite well.
A. Cowie: The Gulf Islands are unique, and there's a limit to their development. You can only build so much community there, and also have the tourists and the resort or recreation-type atmosphere. At some point there's going to be a huge clash. I'm just saying there should be some kind of plan for it, which I'm sure my colleague is working on very hard.
One other thing, I imagine the minister's been over to the Gulf Islands. A lot of residents try and hide the facts that there are -- every once in a while -- public rights-of-way to the beaches. It annoys me that they're very hard to find. Being a planner, I bring a little map, and I know where they are. Sometimes I have to beat my way through somebody's garden, or they've fenced it in. What does the minister feel about creating more access? Now these are legal rights-of-way. They should be made open and accessible to people visiting these islands.
Hon. D. Marzari: I have no comment on these items.
A. Cowie: Well, maybe next year.
The Chair: Part of the Chair's difficulty, hon. member, is that these questions do not fall under the administrative capacity of the minister's office.
A. Cowie: I'm not arguing with that, but it does make tourists very angry when they can't get to the beach, knowing darned well that the beach is public. I think it's a matter of these being public properties, and it's a matter of signing them and of making people welcome on the islands. I think with that very large question before us, I'll leave it for a while.
Hon. D. Marzari: Mr. Chair, seeing the hour and knowing that the House is rising at 11:45, I move that the committee rise, report progress and ask leave to sit again.
Motion approved.
The Committee rose at 11:29 a.m.
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