[ Page 1875 ]

The House met at 10:06 a.m.

Prayers.

In Committee A, I call Committee of Supply. For the information of members, we will be debating the estimates of the Ministry of Health and Ministry Responsible for Seniors. In this House, I call Committee of Supply. For the information of the House, we will be debating the estimates of the office of the Premier and Ministry Responsible for Youth.

The House in Committee of Supply B; G. Brewin in the chair.

The Chair: The procedure at this point is that if the Premier would like to begin with some remarks, that is part of the process; otherwise, the floor is open for discussion.

G. Campbell: I had actually hoped to hear from the Premier today, because we have seen so little vision over the last few weeks. It would have been nice to hear some comments on it, because the Premier himself has said that one of the important things for British Columbia is to have a sense of vision and direction. I must admit that for me, at least, it's been difficult to discern that over the last few weeks and months.

I'd like to raise a number of issues with the Premier throughout these estimates, as I'm sure a number of my colleagues would. The first one I'd like to talk about a bit is the whole issue of trust and accountability. It's something that I know has been important to the Premier in the past. He has talked about trust specifically in his public life, and I think the re-establishment, reinforcement and restoration of public trust are going to be critical to all of us in British Columbia and in the Legislature if we are going to move forward and take full advantage of the opportunities that British Columbia presents. As the Premier knows, there are a number of areas in terms of building the public trust, which is important.

I go back to one of his quotes. I've actually gotten used to some of the Premier's quotes now. I think he's decided not to make a presentation because he knew we'd be able to quote it later, and it would come back to haunt him. The Premier said: "If I don't deliver, I will resign. I will guarantee that. People deserve to be able to take the word of all the people who run for office. I will guarantee it, and if I don't, I'll resign." That sounds good.

I would just like to get from the Premier, who is the leader of the government, a sense of the standards and the code of conduct that he has set not just for himself and for his cabinet but for his MLAs and for his government officials. The Premier has said in the past that if he betrayed the public trust, he would resign. I'd like to get a sense of what the Premier means by betraying the public trust. What kind of circumstances would we run into where the Premier would feel that would happen, how would we know whether that had taken place, and how would his ministers know whether that had taken place?

Hon. G. Clark: Obviously these are subjective questions. I stand by the commitments I made. I'm not sure which quotes the member is referring to, but they sound very good to me indeed. They are consistent with my position.

As I said, during the election campaign we went through this notion where the opposition went and signed a pledge everywhere -- this kind of American-style gimmick of signing a pledge -- and notwithstanding that people thought it was a gimmick and it wasn't working, they did it everywhere. On the campaign I guess you are always looking for things to do, so in every stop they signed their little pledge. And in every stop the press asked me if I was going to sign a pledge, and I said: "You don't earn people's trust by signing a pledge. That is some kind of American-style gimmick. The opposition can do that. They can campaign on it. That's not my style."

Obviously I don't have to belabour the point that you people are on that side of the House, and we are on this side of the House. The people aren't as easily sucked in by this kind of gimmickry and these kinds of notions. They pass judgment on individual members...

An Hon. Member: Do what you say you'll do.

Hon. G. Clark:...on what we say we do and on what we do. They pass judgment on it. They actually passed judgment and agreed with the members on this side of the House, and they voted in a majority for us.

Interjections.

Hon. G. Clark: I know it is difficult for members of the opposition. I know it is difficult for them. I know the member for Kamloops-North Thompson is bellowing out their concern here every day. I know how twisted they are that they lost. I know it's difficult, hon. members. But they did, because people look at what it means to be in politics. They look at what people stand for; they look at the positions they take. And they pass judgment.

I feel extremely privileged to have been elected to represent my constituency of Vancouver-Kingsway for the last almost ten years, extremely privileged to be elected leader of my party and to be elected Premier of the province. As we move forward over the next four or five years of this term and a few terms after that, I'm hopeful, people will pass judgment on the basis of whether or not we betrayed public trust. I take that very seriously, and I intend to try to do the best I can to govern in a manner which is in keeping with the highest standards of this office and for the government. I trust the wisdom of the voters always in passing judgment on the activities of this government.

G. Campbell: One of the most frightening things for me over the last few months has been that I'm actually starting to laugh at a lot of these comments. It's kind of enjoyable to sit here and hear them rolling along again. I've got to take my hat.... I should actually have started.... But the Premier didn't mention earlier on in his presentation that he appreciated the opportunity to represent Vancouver-Kingsway. I congratulate the Premier on his electoral success, and although 

[ Page 1876 ]

there may be many things in terms of government that I don't agree with, there is no questioning his political acumen and the fact that he won.

I want to be very clear we understand that that side of the House became government. We don't particularly like the result, but we do understand that. I also want to be very clear that, rather than be gimmicky, what we tried to do on this side of the House was to lay out a detailed program which protected health care and public education, which set some goals and some objectives, and which said that we would be committed to our word and to the things that we did. I must say, and I'm sure the Premier understands this, from his comments over the last few weeks, that many people feel they did not get the straight goods from the government, the Premier and his party during the election.

I think what would be beneficial, as we go through these estimates, as we talk with the leader of the government, the Premier of the province of British Columbia, would be to get a sense from the Premier of what goals and objectives the Premier has set for his government. We didn't really get them in the election, and he kind of knows that, and I can tell that from his thoughtful presentation earlier on. We didn't really get the details; we didn't get the standards that he was trying to set or any results that he was looking for.

[10:15]

In fact, as we look at the results even in the short period of time since the election, we seem to see an erosion of the standards that have been there for British Columbia in the past. The Premier has said in the past -- and again, I concur with this -- that for budgets to be effective, they must be honest. The credibility of the government's budget is crucial, not only for government planning but also for prudent decision-making in the private sector. That's why deception in budgeting is so destructive.

We're going to move away from the immediate political sort of discussion about the disaster of this last budget cycle, and I'd like to get some comments from the Premier on how we develop a sense of confidence, on both sides of the House, that with all people who run for public office we are getting the straight goods and the information we need. Again, the Premier was so good in the past. It's amazing how good you are in opposition -- not you personally. It's amazing how good one is in opposition, compared to.... Although you were better in opposition, now that I think of it.

The comment was made that it's dishonest to try to portray the books differently, and it's fundamental in our democracy that the taxpayers who elect us have the right to know what the bottom line is. They have the right to know what the true financial position of the government of the day is, so that people can be held accountable. I want to go back to the word "accountable." The Legislature of British Columbia has had a Public Accounts Committee, which has done considerable non-partisan work in trying to establish a new means of establishing accountability in government for all government activities.

I'd like to start -- and I'll just do this briefly, because I'm hoping that before he goes to another appointment my colleague from Delta South will be able to pursue some of this with the Premier -- by asking the Premier if, in terms of the changes that we can make and of the institution we all serve, he has had an opportunity to review the recommendations of the Public Accounts Committee. If he has done so, are there any recommendations which he intends to bring forward in the coming months so that we can establish a sense of goals, standards and objectives -- and, to use the jargon, a new group of benchmarks -- that will help us judge the performance of government, as opposed to the political performance which may take place amongst the politicians?

Hon. G. Clark: First of all, let me note decorum for a second, at least. Let me also congratulate the members of the opposition and the Leader of the Opposition. I mean that seriously, not in any backhanded way, in terms of work that we all do. I've said this before, and I'll say it again now. I remember that when I first got elected, one of the senior members from government, from the opposition side, said to me: "Just remember that every single person who gets elected here has something to offer. They wouldn't be here if they didn't, regardless of which political party they're from." Sometimes you can't help but wonder how that person got here, and this is true of all sides. It's good advice to constantly remind yourself that people have worked hard to represent their constituencies, win a nomination -- many hotly contested -- serve their constituents and have the public interest at heart. I certainly feel that way about members of the opposition as well as members of the government. It is a privilege for us to be here in opposition or in government.

It is true that in some ways you get better in opposition. It's easier to be in opposition, and I wish the members a long time in opposition to practise and perfect their role. We had many years in opposition in the NDP, and in fact you do get better at that job. But it is a job indeed. I can already see the Leader of the Opposition, having not been here as long as some of us, more comfortable in the role. I'm slipping back and forth from being backhanded and having a little fun to being serious, but being serious for a second, I think that it does us all good as a democracy.

To get to the question, first of all let me say that I hope we're not.... The Leader of the Opposition knows that we've had some discussions privately. I don't intend to report on them here, but the member will know that I am serious about trying to make some reforms in the chamber and to the way we do business. There will be some debate, and I'm hopeful I will have the fortitude to carry on with some reforms, even if they at face value don't appear to be in the government's interest but are in the public interest. I hope I will recognize that those are the same thing. Sometimes that's hard when you are in government.

We are making, I think, modest progress, including some legislative committees sitting, and others. There's also progress -- and the member for Delta South knows this -- in some of the work of the Public Accounts Committee and of the auditor general, in particular the accountability project that we've undertaken with the auditor general and with deputy ministers at a senior level. I'm very supportive of that work.

To answer specifically, the kinds of benchmarks and performance measurements for government programs are a very useful exercise and one which potentially we will be leading the country in. So that work has my full support. My deputy minister, Doug McArthur -- whom I haven't introduced; I apologize -- has been engaged with other senior deputies and the auditor general in a reasonably elaborate process which looks at these questions. As I said, I'm very supportive of that work, and I anticipate significant reforms coming out of that.

G. Campbell: I want to say that I have had some discussions with the Premier with regard to how we can improve the Legislature. I want to refer, though, specifically to the recommendations of the Public Accounts Committee 

[ Page 1877 ]

in their report dated January 31, 1996. There were a number of recommendations that came forward as a result of that. I compliment the deputy ministers, the government, the Public Accounts Committee and the auditor general for the work they're doing on trying to establish a more accountable, more effective system of governing our various services and providing our various services across the province. But I'd like the Premier to focus for a minute, if he wouldn't mind, on the recommendations which were contained in that report. Are we going to be proceeding, or are we always going to be waiting on this?

I think there are a number of specifics made with regard to recommendations which we can put into place. I recognize that in the previous Legislature, the Public Accounts Committee was allowed to sit outside of the Legislature. I think that a similar situation should occur for this Legislature for the Public Accounts Committee and the Crown Corporations Committee, if we're going to have one that's effective.

I'd like to know if any of the specific recommendations will be moved forward. Or are we going to have to wait until everything is together? My sense is that often when we wait for everything, we get nothing. When are we going to start seeing some real steps taken towards establishing more accountability in this broad kind of perspective that has been outlined both by the deputy ministers and by the Public Accounts Committee?

Hon. G. Clark: I think it's a good question. I have been hoping that we could negotiate, if you will, or discuss a package of reforms which might be mutually agreeable. But I take the member's point. This is not a criticism of the opposition or, I think, of my side or me, but sometimes that's hard to do. So perhaps a smarter strategy would be to have some incremental reforms while we continue working on some broader, more comprehensive ones. Beyond that general comment, I haven't formulated any particular thoughts on which ones we might proceed with sort of unilaterally.

We're getting a little bit confused, and I'm part of that, I guess. There are two broad initiatives, it seems to me. One is the bureaucracy's accountability -- benchmarking, etc. -- project, working with the auditor general. The other is parliamentary reform and how we can make this place work.

The benchmarking is happening and carrying on, and I hope to report back. There will be no slowdown on it. I'm supportive of it, Public Accounts is aware of it, and I think there's some good work being done there. A big, big challenge with government is that there's no market test. In many cases we have demand-driven programs, and it's hard to establish the kind of objectification of the criteria you might use to evaluate government programs, but that's the kind of work they're doing.

With respect to the Legislature itself, we have made some modest progress. I've indicated, as the Leader of the Opposition knows, that I anticipate three committees meeting off-session, which will certainly be a record in British Columbia. One is the Aboriginal Affairs Committee, which is, I think, significant work -- I hope it is significant work. The second is the committee not just to appoint a new conflict-of-interest commissioner but to review the legislation surrounding that and ways which we can move -- and I think that's important work. A third, I've suggested to the Leader of the Opposition -- I apologize, because we were having this discussion privately -- should sit, and we have several options for that: one is Public Accounts, one is the Crown Corporations Committee and one is the Gove recommendations committee. So that would have three committees sitting all year, if you will. I appreciate that there are all kinds of issues -- in fact, many that I'd like to see go to committees. This is a kind of interim step, because I really do think that we might want to look at more committees sitting off-session.

The challenge, just to put it in very practical terms, is that if we have seven government members sitting on committees, and we have three committees sitting in September; that's 21 government members, which means that every member of the government will be fully engaged. So you cannot have other committees meet very easily, given their MLAs' duties and the importance of the work that MLAs from all parties do when this House is not sitting -- in the fall, in particular. So it's hard practically to have more than three sit.

I think -- and the Leader of the Opposition, just to recognize, has suggested -- that perhaps we should look at shrinking the size of the committees. Maybe that might make sense in any event, just to be more manageable and to do more things. I'm quite amenable to that idea. But this fall, to have three committees sitting on significant topics when the House is not in session is certainly at least two more than at any other time in the ten years I've been here, and probably ever. I hope people will recognize that's significant progress. I accept the criticism that it's not enough progress, and in keeping with the Leader of the Opposition's comments, these will be an interim step while we look at more fundamental reforms of the chamber.

G. Campbell: Actually, I didn't think I was being critical with that last question; I was simply trying to get at some information. I don't look at the report of the Public Accounts Committee and the recommendations they've done on accountability as dealing with the same issues of parliamentary reform that I think we were.... There was a minor recommendation, but in terms of the overall approach that we take, yes, there are some things that we have to do with regard to parliamentary reform. We can get into the debate about which committee should meet and how they should meet, and I know the Premier and the House Leader for the government will participate in that discussion.

What I really am trying to get from the Premier, though, early in these discussions, is a sense of the accountability measures that the Premier will bring to programs in government. One of the things that I think all of us can feel frustrated by is that it is difficult on many occasions to develop the kinds of standards we might want to have -- to use the Premier's term, to define "objective criteria" that we can use. They are not always going to be objective, but I think that a critical part of the exercise is to try to establish some standards.

One of the goals that I have, and I think we all have -- from going through some of the Premier's comments earlier, I think that the Premier used to have this; actually, I believe he still has this -- is that we have to be able to move away from the kind of political editorializing that goes on and have some measures we can use, so that people who are not involved in this House when it sits or not involved in political life can actually look at what we've done, see what we've decided to do or what the government has decided to do with their resources, the money that they take from their paycheques, and see whether it is working or not.

There's a whole series of layers of accountability that I believe we need to establish. One of them -- if I can move just for a minute -- is the whole question of the Auditor General Act. I know the Auditor General Act has been before the government for the last five years approximately. It 

[ Page 1878 ]

provides an opportunity for the auditor general to review all Crown agencies, all operations of government. It is an area, I believe, where we could see some improvement that would be non-political. It would be something that I believe most people in this House could agree to. It would be something that we could bring forward and set a timetable for and a time frame for ourselves.

We can all sit and talk about what we'd like to do and how the world will unfold over five years or ten years, but it seems to me we would be better off if we could say that we're going to set an agenda for ourselves that we can act on. I encourage the Premier to look to us and to his own colleagues to try to develop that agenda with regard to establishing a new level and new codes of accountability for all of us here.

[10:30]

In terms of the Public Accounts Committee, I believe they've made a number of excellent recommendations -- ten recommendations, in fact -- coming out of that January '96 report, all of which deserve consideration and most of which I believe deserve implementation. The question I ask the Premier is: would we have any timetable for looking at those? Would the government have any timetable for looking at those recommendations, which are really to do with accountability measures, including the House in examining programs of government, etc.? Would we have time to look for those, so that we could maybe come up with some recommendations by 1997? Pick a date. Is there a date we could look at so we can say yes, that will be going ahead, or that won't be going ahead? Or does this just become another report that gets put on the shelf?

The fact is, all parties in this House have been represented in Public Accounts. They have been interested in pursuing this on a non-partisan basis. To have some sense from the Premier that we can go through those ten recommendations, examine them, have a process, have a deadline that we will be able to say we are accepting or rejecting, would be worthwhile information for the House to have. I just wonder if the Premier has any thoughts on that today.

Hon. G. Clark: Well, first of all, the auditor general has for some time suggested a new act, and I'm quite sympathetic to that. There has been some debate about what that could construe and how it fits on the legislative calendar, etc. I haven't got any particular timetable, but we are working on a new Auditor General Act, and I know there are some recommendations coming out of the Public Accounts Committee that have some promise. We have a new Public Accounts Committee, so it's appropriate that they continue to do some work on that.

One of the things where there's a bit of a debate -- not to risk debate breaking out -- or where I have a little debate in my own mind is on the question of value-for-money auditing and how that would work. One of the aspects of the deputy ministers' accountability work is looking at standardizing ways in which you can pursue the measurement of some of these difficult-to-measure areas for benchmarking and accountability. We want to make sure the Auditor General Act -- the new Auditor General Act, if there is one -- dovetails with the work being done by the deputy ministers' committee on benchmarking, etc., so that we don't have overlap and duplication, but we do have standardization of the way in which we evaluate government programs. There's no particular time frame, except that work is continuing, and we're going to carry on.

F. Gingell: I thought I would take this opportunity to get into this debate, because I must admit that I have some concerns. The first concern is that, without question, the project that the deputy ministers and the auditor general's office are moving ahead on is not really relevant to the Public Accounts Committee. It is relevant in that we look at it and we have an opportunity for input, but it's moving ahead now. Already many, many ministers in government are beginning to publish goals. They're starting the measurement process. They won't get it right the first time. We all have to have a great deal of patience and support. It is not going to happen quickly.

Where my concern lies with respect to this is that I don't think this Legislature is properly formed or organized to deal in the most effective and efficient manner with the information that will come out of those reports. I think we need to relook at the way in which this Legislature reviews and comments on information that comes to it.

That is what caused the committee to make a series of recommendations that deal with what I might call parliamentary reform. Clearly it is not the role of the Public Accounts Committee to do anything more than make recommendations about how they see this all tying in. Clearly it is the responsibility of the Parliamentary Reform Committee to consider the recommendations and to look at what happens in other jurisdictions where they have made changes in recent years to respond to these movements.

I don't want us to get behind. It is really important that we get the process of parliamentary reform moving along, so that this Legislature is prepared and ready and knows which direction it's going to go in its program focus, with its stated goals and with its outcome measures, by the time this information starts coming from the ministers in its new form. This will also probably have an effect on the Financial Administration Act. There may well be consequences to the FAA that need to be taken into account. This is becoming a big project; this is becoming a very big project.

I would hate to see us get behind and not be able to move this project forward in a manageable way -- so that all the pieces of the jigsaw come together at the same time -- because of some issue like the fact that this time around, you are a little short of backbenchers, which you weren't last time, and you want to have a seven-four.... Maybe we should change the makeup of the committees. I'd like to suggest to you honestly that in my experience over the last five years on the Public Accounts Committee, it wouldn't make any difference whether they were NDP members, Liberal members, Reform members or PDA members.

I hate to give the Premier this information, but you will find we actually don't all line up on either side of the bench. You will find members of both parties.... Actually, you will find members of the NDP on the left-hand side, but I have to get some of our members to go and sit on the other side, because I think it creates the right atmosphere. We must not get behind because we are worried about numbers, about who sits on it.

In the committees that you mention, I'd like to suggest to you that the conflict-of-interest commissioner issue, which is one I'm interested in, is a minute task. All they are being required to do is make a recommendation on how you shall appoint -- that's all. I would like to see the act opened up for us to have a good look at the whole conflict-of-interest commission. I've actually written to the....

Hon. G. Clark: We've already done that.

F. Gingell: Oh, good. I have made a submission to the chairman of that committee. We shouldn't hold this process up.

[ Page 1879 ]

My next problem is that because this session is so short, the committee has met only four times. We meet Tuesday mornings at 8 o'clock. There has been a whole series of reports tabled by the auditor general. If the House doesn't meet again until next February or March, which I presume will be the agenda, two or three or four more reports will be out, and we'll be so far behind, we'll never get caught up unless we meet every morning at 8 o'clock. I'm sure that will be most difficult for me to organize. But clearly, if we don't meet in the intersession, the workload is going to be unmanageable. I make a plea for the committee that I chair; I appreciate that the Chairs of other committees can make the same plea for their committees. It seems to me that the Select Standing Committee on Forests has to meet. They have to deal with the business plan that is legislated. Perhaps before this House adjourns, we should really look at the numbers -- not to solve our problems, because our members sit on only two committees, and six of them sit on only one. Your members sit on something like five, so we do need to deal with that.

With respect to the Auditor General Act, the Public Accounts Committee met this morning and discussed the issue. It's of great interest to members on both sides of the House to have a good discussion about what the role of the auditor general is, where the issue of public policy is versus how it is being administered and how that fine line is definable. The Public Accounts Committee would welcome the opportunity to look at the Auditor General Act in some depth before decisions are made about amendments to it or about a new act.

I thank the Chair for this opportunity to say these things. They are things I was going to say when I tabled the report of the Public Accounts Committee. That's going to be a bit of a rush because we just finalized it this morning. The Public Accounts Committee has a big workload in front of it, because, purely and simply, this is a short session. We have also focused virtually all of our time on a review of the first report of the joint committee and on the second report, which had come out in the intervening period between the end of the thirty-fifth parliament and the start of the thirty-sixth.

We in British Columbia are doing this differently from Alberta, Nova Scotia and Manitoba and from most of the United States, in that the catalyst for it to happen has come from within the bureaucracy. This isn't a bunch of politicians telling the public service what they are to do and laying it on them. This is the bureaucracy coming to the politicians and saying: "We believe there are better ways of measuring. We believe there are better ways of evaluating whether or not we are accomplishing the goals in policy that government sets out and defines, and we would like the opportunity to change the way we do things so that can happen." We should encourage them; we should give them patience and understanding. It is not an easy project. I compliment them very strongly for pushing this. I would be disappointed if the Legislature didn't do the things they needed to do, like sit in the intersession so that we can assure that we do our best to make this project a success, because success will have great benefits to all the people of the province.

Hon. G. Clark: I didn't hear a question there, but let me first commend the member for Delta South and speak genuinely. This is an important project. It's an interesting question, and I am increasingly of the view that individuals make a bigger difference sometimes than the rules that you set. I think that is generally true in politics and in the system as well. So I commend the member, because it's the member's leadership that has helped move this committee along. I guess the challenge, though, is to make sure that we design new and different ways of doing things that, as much as possible, work regardless of the membership of the committee. That's a bit more of a debate, I guess.

First of all, I'll make a couple of comments. I also want to commend the senior public service in British Columbia, notwithstanding attacks from some quarters on some of them. The member is correct that they've generated a lot of the ideas around how we can better measure ourselves.

[10:45]

I also want to say unequivocally that having been here for almost ten years and in some respects, one could argue, being part of the problem, it's not hard to step back and say that surely we can do things better in terms of how we manage ourselves. Estimates is a good example of that, but not this particular exchange. Obviously I'm not being critical of the session and how people perform. But really, it's a pretty high-priced and expensive way of doing business for not a lot of accountability. Essentially, we engage in a political debate, and every once in a while a political debate breaks out in estimates. The newspapers don't cover what goes on in the chamber. They won't cover this discussion, as important as it is, frankly. Seriously, in terms of how we govern ourselves and accountability questions, very few people watch this at home. A surprising number of people watch it at home, actually, but it isn't that large.

Surely, in modernizing the way we do business, we can come up with a way that doesn't compromise the opposition's ability to oppose the government aggressively -- and, in some ways, theatrically, because debate is part of the business of politics -- and doesn't compromise the government's ability to govern as it sees fit, which it is elected to do, but that at the same time minimizes literally hours and hours of estimates debate, which has become the basic business of the House and which in fact isn't particularly productive.

I'll just use one example, if I could indulge for a second. Five years ago we tried to make some reforms. David Mitchell was the House Leader of the Liberal Party for a brief period of time, and there was another House Leader of the Liberal Party for a brief period of time -- long enough, I'm sure, for both of them. I was the House Leader for the new government at that time, and I made the same speech then about being concerned about how we could do things differently. So we split the Committee of Supply into two. We now have Committee A and Committee B doing estimates, and all that has happened is that we have literally doubled the amount of time spent on estimates. It didn't save any time in the House, and it certainly didn't enhance the effectiveness. In fact, you could very easily argue that it has diminished the effectiveness of our ability here, and it's a lot of work for members -- particularly opposition members, having been there myself for five years. So it hasn't been a great experiment. But having done it now, getting rid of Committee A would be horrific, because if we were to then spend all that time in here, that would be ridiculous.

If I can be critical for just a second -- and I appreciate that individual members are elected to do their job and that no one tells them how to govern themselves here, nor should they, because they're elected by their constituents -- it's ridiculous to go into detailed, technical questions ad nauseam in this chamber on television or in that committee room. You know, write me a letter, and I'll have staff brief you on the details. It doesn't have any effectiveness; it doesn't help you get elected; it doesn't shed much light on things. Again, not to commend the member too much, but when I was Minister of Finance 

[ Page 1880 ]

and the member was the critic, we probably had the shortest estimates of anybody in the House, and nobody said that the member wasn't holding the government accountable, etc.

Sometimes people equate time with effectiveness, and that's a challenge for all of us. Again, I'm not trying to criticize individual members or otherwise, because I know the game. But for the opposition to agree to a time limit on estimates strikes me as a reasonable and civilized thing to do. If we had time allocations for estimates and a legislative calendar, which limited the amount of time in the House, and if the rules of the game were set in such a fashion, then it would not compromise the ability of the opposition to oppose, and it would not lead to any greater favour for the government. It wouldn't have any impact on the election four or five years from now, or whenever it is. It wouldn't do any of that, yet I suspect that if the time were limited, people would be forced to be more focused. Again, it takes two to discuss these, and I appreciate that we're not going to solve these problems here.

I say unequivocally that I am prepared to make significant parliamentary reforms on the part of government to help make this place more effective. If at the end of the day we don't come to some agreement -- and I understand that, because these are all political questions that we have to answer -- then maybe we can still make incremental changes. That's what I've been trying to do, even with the modest progress of the committee, which is sitting out of session.

I don't want to sound defensive on that specific question, but it is a short session -- one of the shortest in many, many years. It is August, and we've just gone through an election campaign, so we are making some progress for committees sitting out of session this year. Again, I commit to members of the House that we will make more progress next year. That might require reducing the size of committees. It might require agreement with certain committees to, for example, sit only on a certain number of days or have a certain number of meetings, etc., so that we can all make greater progress.

I say simply that we've made some progress. It's not enough; I accept that criticism. I commit to all members of the House that there will be -- I give you this commitment -- more progress on parliamentary reform next session and after.

Some of the questions around Crown corporations, which I feel strongly about, are ones -- this is partly a government decision or policy decision -- we refer.... One option would be to refer the annual reports of all the Crowns to the Crown Corporations Committee. The other would be to take specific issues that arise or ask members to give specific issues that arise to particular committees to pursue. For example, we could take the no-fault insurance question to the member who is familiar with ICBC and send that to a committee rather than simply send the annual reports of all the Crowns to that committee. We could take a very difficult and controversial topic, one that would benefit from debate among all members, and put that over. These are questions that in a sense are really the government's decision to send, in terms of these policy questions. But I'm interested in input. Or it may be that we should simply routinize this question, send all the annual reports and have them meet -- even off-session. Those are decisions which, to be quite candid with you -- in August and after the election campaign -- I haven't fully worked out. I'm open to suggestions from the opposition, and I commit that there will be greater progress by the next session.

G. Campbell: We are talking briefly here about legislative reform, and I should say to the Premier that we welcome that invitation. What we have is three separate streams of activity taking place here. We have the Public Accounts Committee. We also have a stream with the deputy ministers and the auditor general, who I thought was also in touch with the Public Accounts Committee, and then we have a stream of activity with the auditor general saying: "My act is outdated and outmoded." I'll come back to the auditor general.

Suffice it to say, with regard to legislative reform -- so that I can be on the record with the Premier as well -- there are lots of things where we can all play... We can all have our political disagreements and arguments and get on with that. There are people who say that nothing in this world is not political; that can be true when you push it. However, I heard -- and I'm sure the Premier has heard from the back bench -- that we never get to say anything. We never get to participate. We never get to do this; we never get to do that. For me, it's probably....

Hon. G. Clark: Come and talk to us about it.

G. Campbell: I told them to. They said they're afraid of you; I don't understand that, hon. Chair.

What is important is that all 75 people in this House come from different walks of life and different parts of the province, have different perspectives and different talents to contribute to public policy, and our goal would be to make sure that we can move forward. So I look forward to working with the Premier with regard to parliamentary reform. I know that the House Leaders have done that, and I think parliamentary reform has to take into consideration.... Believe it or not, I don't come into the House every day thinking to myself, boy, I hope I can oppose something.

Obviously the government gives us lots to oppose, but there are times when we have things in common -- mutual concerns and mutual commitments to the province of British Columbia. We've just done that with the Premier with regard to softwood lumber and what's taking place in Ottawa. No one in British Columbia would say that's not a critical issue. There's no one in British Columbia who doesn't want Ottawa to understand that while we can have our little tiffs over here about whatever we're doing, there are some important things, which everyone should know about, that we in British Columbia all share and come together on.

So I look forward to dealing with that, and I hope we can move towards the next session of the House with at least some steps. I'm glad to see that the Premier has taken some steps. I've got some other suggestions with regard to the Legislature, and I would like to get some idea from the Premier on how he feels about them, because I don't believe we have even discussed these in any of our conversations to date.

The first one has to do with.... I put it under the terms of parliamentary reform, because I think that's how we include members of the Legislature. We have a number of officers of the Legislature who really don't have a direct means of presenting their reports to members of the Legislature. The ombudsman has said at different times that she does not feel that she can make a direct report to the Legislature. So something is not done and just.... As so often happens, we get these piles of material that sit on an out basket or an in basket or on some shelf somewhere. People spend a lot of time. The ombudsman and that act were brought forward to try to help us in this House understand the way our institutions are working and the impacts our institutions are having on people's lives.

The auditor general is another example, and I'll come back to that later. The child, youth and family advocate is an 

[ Page 1881 ]

officer of the Legislature who clearly would have some goals and objectives. She asks: "Can I speak to your caucus, this caucus or that caucus?" It seems to me that when they're officers of the Legislature, they should be in a position where they do present to the Legislature and give everyone an opportunity to see their non-partisan positions, policy recommendations or whatever. Then we can have our political discussion about whether we agree or disagree with them.

My question to the Premier is really if we can look, as part of our parliamentary reform package, at ways we can include officers of the Legislature in coming forward and directly presenting to the Legislature, either in committee or in some other way, so they feel that their work is noticed, recognized and legitimized. Instead of simply using it as a political tool, we could use it as a tool to build public policy and -- I think, broader than public policy -- a general public understanding that there are things we work on, try to commit to and try to move forward together beyond our political differences. Many times members from the government as well as members from this side of the House have worked together on projects with mutual commitment, and I think that establishing a direct channel for officers of the Legislature to be able to meet at a time when all of us are in this House, where we are all in a position to focus on their recommendations in their annual reports, would be worthwhile.

I would look forward to improving the situation in terms of legislative reforms as we move towards the next session, which I am sure will be some time in October or maybe November -- I don't know. I would like the Premier's comments as to whether we could include in our agenda the opportunity to find new ways for officers of the Legislature to respond and communicate directly and personally with the Legislature about their reports and concerns, and about the information they have gleaned over the year.

Hon. G. Clark: Certainly I have no hesitation in saying that we should look at different ways in which we report. There may be too many officers of the Legislature, but that's another question. But some way in which the officers can report, maybe to a committee rather than as we do, having perfunctory debate on estimates.... I think that at the very end, on vote 1 usually, there are a few questions on the ombudsman or the auditor general.

The auditor general has a committee that in a way keeps him accountable; he reports to it. As for the other officers, we could certainly look at that, and I would be pleased to take that under advisement.

J. Weisgerber: It's a welcome opportunity to talk about parliamentary reform. I'm not aware of a Premier's estimates that I've sat in where this topic was actually raised. First of all, I want to say that I'm pleased to have an opportunity to talk about something that I think is critically important. It's something we're very much in need of.

It is, in fact, probably worth reflecting that there is no member of this assembly who sat while the Select Standing Committee on Parliamentary Reform considered the standing orders of this House. We've gone well beyond a decade since, through any formal process, we've sat down and evaluated how the business of this House is done. Quite honestly, as the Premier thinks about his plans for next year, I genuinely believe that one committee that should be charged with the responsibility is the select standing committee that deals with parliamentary reform and standing orders. It's time we looked in a fundamental way, as we did probably in the mid-eighties, at the way this Legislature functions.

[11:00]

There are a number of areas that need to be addressed, obviously. At the top of the list -- and the Premier mentioned it -- is a parliamentary calendar. I think it's high time, like other legislatures around this country and other parliaments that use the British system, that British Columbia get into the notion of adopting a calendar. That takes a bit of courage on behalf of the government. It's the government that benefits from the lack of regimen in our parliamentary year.

I would encourage the Premier, first of all, to strike a committee to think about, as one of the things, establishing a calendar, and from that there should be a whole host of areas that we look at. It's no secret to members of this House that I believe we should embrace the notion of free votes. It's not a new idea; it's not a revolutionary new concept. The British Parliament has been practising free votes for a long time. The Leader of the Opposition and the Premier appear to agree on the need, particularly, to involve backbenchers on the government side in what happens in this House. One way to do that is to have a process for free votes and to allow some genuine debate to take place in this Legislature, rather than the set pieces that we see: the government bringing in legislation; the opposition taking whatever position they will; the government speaking in favour; and surprise, surprise, one side votes one way and the other.... But there is no real debate; there's no real attempt to change opinions.

I think it leads to a whole host of things. If you had a parliamentary calendar, you could, in fact, do away with special warrants and that kind of spending, because you would have a calendar that would bring some discipline into the budgetary process. We could talk about fixed election dates. There seems to be rather broad support within the public for the notion of moving to the predictability of, most often, four-year elections.

Given the rather positive words we have heard from the Premier so far, how far is he prepared to go? I agree with him in respect to his comments on estimates debate. I think we should consider putting some discipline on ourselves with respect to debating estimates. Maybe I could hear from the Premier before I go on too much longer.

Hon. G. Clark: The member and I will both have been elected for ten years in October, I think, so we're the veterans around the chamber. I give serious consideration to the idea of the committee on parliamentary reform. The member is obviously correct that the major reform of standing orders took place prior to both of us being elected -- I think just prior. The Clerk is nodding his head, and he, of course, wrote the changes, so I'm sure he's correct. I think that makes sense. Actually, one of the challenges, we have.... Again, I sound like a grizzled old veteran who has been around a long time.

In the election before this past one, so many new members came into the chamber that the rules actually changed quite dramatically and have now changed significantly without any change in the standing orders. For example, almost half of the questions asked in question period are out of order and would have been ruled out of order when I was in opposition. I guess one could answer: "So what, really?"

Interjection.

Hon. G. Clark: Well, you know, it's question period, not answer period.

Hon. Chair, I don't say this in any particularly critical way, except that with all the new members that session and 

[ Page 1882 ]

very few people who had been here before, you'd be shocked, I think, to see the change in the way in which this place is governed. Another example would be that the tedious and repetitious rule was invoked repeatedly when I was in opposition, usually at about 11 o'clock at night. Usually it shut the place down, and we were out of here. It's never been invoked in literally five years of operation. Again, I don't say this in any pejorative way or in any way that's critical of any member or the Chair or the Speaker, of course; I simply say that the place evolves in its own kind of direction, based on the people who are participants in the chamber and the way in which it's developed.

The odd thing -- it may be very healthy, frankly -- is that up until five years ago, it really was the same parties, the same government, the same opposition and rules, and the place was governed with everybody knowing the rules exactly. It worked, actually, much more efficiently than it does today. Today the rules, by the changing nature of the chamber and the people who occupy it, are really quite different from the first five years and are, I think, not as effective. I say that not just as a government member but for the intelligent management of the House business. There were members on all sides in the last five years who, I think, frankly took the time -- took hours and hours of expensive time -- pursuing issues that would have been ruled out of order at any other time in the history of British Columbia. I'm not saying that in any judgmental way.

It may be appropriate to review the rules again around how this place is governed, and not be bound by what went on in the past -- or by people like me, who fondly look back on those rules now, having been here for ten years -- and to look at different ways in which we can manage the business of the chamber. I think the question of time allocations and a calendar is in a sense enforcing the discipline we used to have with the rules -- and actually still have with the rules, but they've never been enforced. This requires everybody, then, to enforce the rules themselves, because you have a time limit. That's something I'm obviously interested in, notwithstanding that I agree with the member that a government gives up some important leverages in terms of how it governs itself.

With respect to free votes, I think the challenge we have in a chamber like this, and the advantage of a place like Westminster, is that the gap between backbenchers and cabinet is too large. That's really been the thrust of some of this discussion about parliamentary reform: the pay, the responsibilities, the ability to influence public policy. And where members have more power and have more responsibility individually, free votes are easier to do. Where all of the power rests in cabinet, then it's harder to genuinely have a free vote, because if you're on the government side, you in all likelihood want to try to get into cabinet -- I hope all members want to get into cabinet -- but if you're on the opposition side, there's an imbalance. I think what has happened in other parliamentary democracies like Britain is that over time the status, the pay and the responsibilities of individual members is sufficient that all members are liberated from particularly toeing the government's line all the time.

The other thing, of course, is that they're bigger Houses, so you have more dynamics. In a small House with a small majority on the part of the government, I can stand here and say that I'm in favour of free votes, but there won't really be any, because that's the nature of the way in which this place has developed. I think that's something which.... As I say, again, I'm sympathetic to the notion, and I think we could evolve in that direction. Practically and realistically speaking, at the moment it's not a particularly viable option for the government. I'm being quite candid.

It seems to me that essentially, aside from the comments we made earlier, if the member's interjection was to say that we should actually have a parliamentary committee review the standing orders, I certainly take that very seriously and will give it great consideration.

J. Weisgerber: I guess one might argue that given the rather slim majority that the Premier now enjoys, it might be a great time to introduce free votes, because, in fact, it would take away from the impact of losing a vote on a bill. As the dynamic of the Legislature changes, sometimes I think that the attitude and willingness to consider changes should come along with it. The Premier's arguments with respect to Westminster would perhaps have some application when compared with this House. When you look at the fact that Ottawa has never changed, I suspect that it's the Canadian approach, where we've simply not been willing to embrace that kind of change in our parliamentary system, to the detriment of the country. It's not a problem only for British Columbia; I think it's a bigger problem in Ottawa, but that's something for someone else to debate and rationalize. Anyway, I think it's something very much worth considering.

Obviously, the parliamentary calendar has to bring some discipline to the government with respect to introducing its budget, adjourning for the summer and probably reconvening in the fall. I think those have some real benefits for British Columbians, as well as for the members of this House.

While we're being kind of philosophical about the way this House has evolved, I would suggest that in addition to there being a different way that this Legislature operates, one of the upsides is that we don't see -- and we haven't seen over the last five years -- the acrimony that was in this House in the period of time prior to the election of the last government. While the rules have changed and perhaps the times have become longer, debate has become more repetitious in estimates; I agree with that. I agree also that both the questions and answers in this House during question period are incredibly long, and probably would never have been permitted on either side by the Speaker. The Premier himself is a master at looking at the clock and judging just how long he has to spin out the last answer in order to avoid the next question. But these are the rules that the members make themselves, and the upside of that is that it seems to me there's a lot less acrimony in the House as a result of that.

I certainly look to getting into more debates with the Premier, but I do want to raise the issue of the select standing committee on the conflict-of-interest commissioner. Again, I commend the Premier. I'm glad we have the committee struck, but I have asked the Chair of the committee to talk to the government about amending the terms of reference for that committee, and we're quickly running out of time to do that. The committee has been charged with the responsibility of recommending changes to the legislation, but the committee has not been given any instructions with respect to the possible selection of a conflict-of-interest commissioner. I would argue that that probably needs to be done today. The fact of the matter is that the committee has only been charged with recommending changes to the legislation. That can't possibly happen until the next sitting of the Legislature. I've asked the committee to pursue a change to its terms of reference, so that it can recommend to the Premier the appointment of a commissioner in an acting position.

It's an issue that needs to be dealt with; it's not a partisan issue. I'll say here, publicly, as I have in the committee, that as a member of that committee I'm not going to be involved in attempting to identify a successor to our current commis-

[ Page 1883 ]

sioner without some authority from this House to do so. I believe also that it's unfair to the commissioner to continue in a temporary position beyond an acting position -- which I think has to happen, unless the Premier is prepared to act unilaterally and appoint, or to make that reference to the committee.

[11:15]

Hon. G. Clark: First of all, I apologize to the member, because I'm not aware of it. The two House Leaders from the opposition and the government are dealing with it. But clearly, my intention is not to.... The principal purpose of the committee is to select a successor and, in addition to that, to review the legislation and any changes that might arise as a result of the practicalities of the act, because it's been in existence now for five years or so. If that's not the case, then I'll talk to the Government House Leader about how we can effect that. But I'm sure that in practice the purpose is to do that, so I hope the member's not totally hung up with a technical question on that. Because clearly, we want the committee to work.

This was brought to my attention, that the last free vote.... "July 10: United Kingdom MPs defied the three main party leaders to vote for a 26 percent parliamentary pay increase. While the Conservative, Labour and Liberal Democratic leaders called for a 3 percent increase, members voted, by a majority of 125, to implement a 26 percent parliamentary pay increase. Free votes in the United Kingdom...."

Interjection.

Hon. G. Clark: Probably the same thing would happen here.

Anyway, on the serious question the member raised, I'll have it looked into. You're right: there are only a few days left in the session, so hopefully we can make sure that in practice it.... Now, my understanding is that the committee is.... As the legislation stands right now, it's the Premier's prerogative to appoint a replacement. So until the act is changed, it seems to me that the committee can only recommend an appropriate person to the Premier. I, of course, would take the committee's advice -- having made a decision earlier which didn't meet with the favour of all members of the House.

J. Weisgerber: Just to finish up on this thing, there were some real contradictions in the press release issued by the Premier, which said the committee in fact was charged with the responsibility of identifying a new conflict-of-interest commissioner, I believe. The terms of reference are quite different from that. Again, let me say that I believe there is time to amend the terms of reference for the committee. I encourage the Premier, the Government House Leader and the Opposition House Leader to move expeditiously to deal with that while this House continues to sit, because I believe it is an oversight.

G. Farrell-Collins: The debate this morning is good; it's nice to have the opportunity to do this. I wouldn't want this debate today to fall into a debate examining all the negotiations back and forth that typically take place outside of the chamber with regard to the progress of business of the House. I just sort of throw that out as something for members to consider as the debate goes on, because it's difficult enough making those negotiations happen without them coming here.

But with regard to the comment by the member for Peace River South, if I can just clear it up, his comment is indeed correct. Indeed, the motion that appeared on the order paper and that was passed talked about the committee making reference to the process of selection of a commissioner. But there's no reference made in the motion to actually selecting a commissioner. It becomes sort of a chicken-and-egg thing, whether we design a process first and then appoint using that process, or whether we try and work through a process at the same time as we somehow come up with an interim appointment until such time as this new selection process can come to the House and be ratified in the next session, and then engage in a formal search. It's a difficult question.

It did come up at the committee and was discussed. My understanding was that the Chair of the committee was going to take that issue back to the government and address the concerns that were raised by all members of the committee at that time. I note that the committee intends to meet tomorrow morning, so I assume that we'll have a report from the Chair at that time with regard to how this is being dealt with. With that, perhaps, unless the Premier has some comment, we can move off that and leave those negotiations probably where they should be, given that they're not on the theory but on the actual application.

G. Campbell: I would like to go back quickly to the Auditor General Act. As the Premier has noted, the Auditor General Act has been in for review now for five years, I think. I think the first submission of new legislation was in 1991. It seems to me that one of the critical things the public wants us to do is to ask which information we can count on. This is not to cast any aspersions on the government at this point, but I don't think any government's information is generally held in particularly high regard by the public, so they're looking for independent ways of getting that information out, of measuring results, etc.

The auditor general has submitted that legislation. I think it would be a strong and positive step to take to bring that legislation forward. I would just like to ask the Premier if he has any intention at this point of bringing forward the auditor general's recommended legislation, or an amended new Auditor General Act, in time for the next session.

Hon. G. Clark: No. There are some recommendations around it that we've been working on, and as the member for Delta South indicated, the Public Accounts Committee will be reviewing it again with some great care. Depending on their deliberations, we'll consider it for the next session.

G. Campbell: The first answer I got was no, and then I got: "Depending on the recommendations, we may bring it forward." Can I just be clear on what the answer was?

Hon. G. Clark: Both of those are correct. You asked if we have any plans to bring it in in the next session; the answer is no. If the committee is going to be reviewing this in some detail, they may make some recommendations which then we'll consider, and then perhaps we'll bring it in next session.

G. Campbell: I'd like to move to one of the areas of specific concern. I know it's been an area of specific concern to the Premier in the past; it has been an area of specific concern to the auditor general. That is the whole issue of special warrants. I really don't have much interest in redebating whether special warrants should have been used or should not have been used in the past, through the election period, or whatever. We can have a shouting match about that, I suppose, if we want to. It seems to me, though, that there is no 

[ Page 1884 ]

need for special warrants in 1996. There is no condition I can think of that we cannot meet in terms of the legislative rules that currently exist, and I believe we would all be better served if we just eliminated the potential use of special warrants. We can always bring the House back for emergency reasons, and I think that's something that we could look at.

I concur with some of the comments that the Premier made earlier, that our system is founded on some very basic principles, the most basic of which is that the government has to justify its spending and taxing decisions to the representatives of the people. Special warrants really undercut that. They've been undercutting it more and more, and it seems to me we would be better off to simply say that we will eliminate the use of special warrants. It's a very small change to make. I would ask the Premier if he has given any consideration to eliminating the use of special warrants in the future and bringing forward legislation with regard to that.

Hon. G. Clark: I'm not unsympathetic to that notion. The member for Delta South indicated the Financial Administration Act's potential for modernization, which is another project for the Public Accounts Committee and for the government. That's an area where the special warrant power is grounded, so that's appropriate for review at that time.

If I could just make a comment, though, the challenge we have in government -- and I'll say this again.... I don't mean this in any pejorative way, but it's not like running a sort of city hall.

Interjection.

Hon. G. Clark: I'm trying to think of another example, but that's the only one that comes to mind.

In that sense, we have certain entitlements in the province which are rights. In this country you have a right to send your kid to school for free when he or she turns six years old -- or in this province to kindergarten when he or she is five years old. We don't know how many children are going to go to school in September until September, because it's a statutory obligation on the part of the provincial Crown to provide a free education. It's one of the few countries in the world where we have that. We also have a right to health services and to welfare. We have three demand-driven programs.

If you look at the use of special warrants, they are almost exclusively related to demand-driven programs for which budgeting and forecasting -- I hesitate to open that topic -- are imprecise by their nature. And school boards will tell you that. You do not know how many kids are going to go to school. So we make an estimate, we bring it into the House, we debate it, we pass it, and then it's incorrect. It is incorrect, by definition, because you won't know until September how many kids are in school.

If you look at the use of special warrants, they are almost always welfare, health care, education and the Attorney General. The Attorney General is linked largely to prison populations and other demand-driven questions in the Attorney General ministry. The way the Attorney General gets around it, somewhat, is with something called a statutory appropriation. In other words, if the government gets sued and loses $10 million in court, we don't have to come to the Legislature and approve it; it is paid. By statute, there's an obligation to pay.

If we were to eliminate special warrants to deal with demand-driven programs, the alternative is one of two things. One is that you call the House back to deal with the unexpected demand for a program, and that's a challenge. First of all, it's expensive to bring the House back; and secondly, you're still estimating, because they're demand programs. You don't know -- the welfare caseload could suddenly drop the next month, and you're in the House debating what you think is the forecast. The second option is to bring in statutory appropriation, which says that it is a right to receive welfare, it is a right to have education and it is a right to get health care; therefore it's driven by population demand. If you do that, potentially you could at least argue that you might have less accountability than you have today.

These are the kinds of issues we'd have to deal with if we were to eliminate special warrants. I've said repeatedly, and I stick to the belief very strongly, that special warrants should not be utilized if at all possible. They won't be as long as I'm the Premier, with the occasional exception which I'll explain to the public at the time and which will likely be linked to demand for programs exceeding the estimates that we passed in the House -- or at least pending further review. That's my view.

The only time we used special warrants was because of the election call in the interim -- and that's a debate, I guess, we could have. I think that it's appropriate for the government to call an election whenever they want and not to be held captive by the chamber, if the Premier of the day decides to call an election. There may be other tools we could use that are less offensive than special warrants. I'd be quite happy to pursue them, but that's the purpose behind them.

In general, I think that special warrants should be reviewed and that we should minimize their use. We should look at alternative mechanisms. But I'll just explain that the reason why governments at the provincial level face special warrants usually at the end of the year is almost exclusively related not to a government announcing new spending initiatives for which they have no legislative authority but to the fact that demand exceeds what was estimated by the Ministry of Finance at the time, based on the fact that these are statutory rights or entitlements in legislation.

G. Campbell: I'd like to start by saying that I don't think that the challenges of bringing people back to the House are particularly significant, particularly when what we're fundamentally talking about is the government deciding to take money out of people's pockets and spend it without any accountability. What we're talking about here is some level of accountability, and I think that's something the public is looking for more and more. I think sometimes we forget that more than half of people's paycheques are going to pay for government services of one sort or another -- not just provincial but other services, by the government as well. It seems to me that we have to find ways to put constraints around the unfettered acquisition by the government of people's dollars out of their pockets. In terms of accountability, it's critical. It may be a little bit expensive, but I can tell you that whenever people feel that they're not accountable, it's far more expensive than when they do feel that they're accountable. I can tell you that when people are spending other people's money, it's far easier to spend than when it's their own money.

It seems to me that what we should be saying about special warrants is that we will eliminate them. I believe that you can call the House back on a regular basis without any difficulty whatsoever in terms of the public. It's one of the fundamental things that we're elected to do. As the Premier himself has said, it's fundamental to our democracy. It's an area that the auditor general has said he is very concerned about. I don't believe he's making that comment from a politi-

[ Page 1885 ]

cal soapbox; he's making the comment from the perspective of the taxpayers of British Columbia, who would like to see those things change.

In terms of the Auditor General Act, I can tell the Premier that I believe it's an important act for us to bring forward. I understand that the deputy ministers are working through all of the benchmarking in their accountability sessions, and that's a worthwhile endeavour. I've got many more questions on accountability that go beyond the general government situation. I think it's worthwhile for them to do that. I agree that the Public Accounts Committee is taking a very broad-based look at how government works. If we always wait for everybody to get everything together, though, I am concerned that we'll get to the session in 1997 and we won't have done anything; we'll get to the session in 1998 and there will be more left to do.

[11:30]

Now, I agree -- I believe, at least -- that the deputy ministers have been trying to push this project forward. There is a mutual and laudatory commitment from them that they would like to move that forward -- probably, from their own perspective, so they can see when they're doing well, just as much as for us to be able to judge what the results are. I would like to see more effort put into bringing forward a revised, modern and updated Auditor General Act, not because it will help us in the House but because it will help the public to see what's taking place. They would see someone that they recognize as independent measuring results, and they could come forward and say: "Yes, we can now make our own judgments." Too often we say that we'll keep our information in the House, in the committees, within our small group of acquaintances that we have here, without giving that information out to the public. That's a role that the auditor general can play. People can pass their own judgments.

That requires us to change the act so that the Crown corporations are reviewed, so that the agencies are reviewed, so that all governing activities are reviewed in a straightforward manner. It requires us to change the act, to be sure that the auditor general is unfettered by political interference from anyone in the House. I think we can meet those challenges, those goals, and I would hope that we could bring that forward in the next session of the Legislature or certainly in the one immediately after that.

One of the things I would like to get a sense of coming out of these estimates today is a timetable: when we can expect things and what we can hope to accomplish together. Then, if we can get a sort of map or timetable that we're marching towards together, we can accomplish some things. If we don't, I think that what happens is.... I don't, frankly, think that some of the time it's because the government is trying to stop it; you end up feeling like there's an effort to stop it. I'd like to see something brought forward in the renewed auditor general's legislation to give the public, as well as all members of the House, a sense of confidence that we are going to move forward on that and not stick with the oldest act in the country.

Hon. G. Clark: I've sort of answered the question on the Auditor General Act, so I won't belabour it. I do think that the questions of accountability are important ones for all of us. There's the old book -- it's five years old now, I guess -- called Reinventing Government; I know the opposition has talked about this, as well. I think that where possible, the challenge of modern government is, obviously, doing more with less; it's the size and the unaccountability of the bureaucracy, and the inability of the bureaucracy to deliver on certain things. It's not a criticism of the people who work in the bureaucracy. One of the reasons why the senior public servants are, in fact, involved in accountability is exactly so that we can measure and benchmark.

There are other jurisdictions in Canada doing interesting things with respect to the civil service. One is next door in Alberta, with Ralph Klein, just to give you one example. The members might want to consider; maybe they'll raise this next year with me. The special warrant issue is.... They changed the rules there so that you can allow overspending in some areas; you just have to move it from another vote. So the notion is that the House votes to approve a total budget, and you can move within the variations of that budget. We, of course, in this House have the notion that with each voted question, if you exceed the vote on some very minor issue, you must pass a special warrant to deal with it. In Alberta they have said: "No, you can be over on welfare spending as long as the total budget isn't overrun." That puts incredible discipline on the system, because they then have to go in and slash forestry or health care or something in order to pay for overruns in the welfare ministry.

That's an interesting model which is brand-new in the country and which, in some ways, limits the requirements for special warrants, because you've passed it in the House, and you can move money between votes. There are interesting models other than just that. I guess that my only pitch, then.... With respect to the Auditor General Act, I would say: "Yes, we're working on it. Yes, we can review it." But there are all kinds of models we should be looking at to reinvent government, bring more accountability, force the system to adapt, to make do, to do more with less, and to provide flexibility and accountability to this House and to the taxpayers. I'm interested in pursuing all of those.

K. Krueger: As one of the newest members in this chamber, I listen with interest to everything that the Premier says -- and always have, as a matter of fact.

Hon. G. Clark: You'll do well here.

K. Krueger: Yes, I hope to do well.

One of the things that I heard on the street a lot throughout the election campaign, and indeed for years before I decided to become a candidate, was the growing cynicism of the public and the conviction that people have that no matter what politicians say, when they get here they'll do what they want or what their party wants them to do -- and it often won't be what makes sense to the public. I came here because I genuinely wanted to have a part in bringing about positive change and serving the people who sent me here.

I listen with empathy to the Premier's frustrations about the estimates process, but, of course, from a totally different perspective, being on the opposition benches. I found that the estimates process was the least frustrating part of what we've done in this chamber for the last number of weeks.

It seems to me that as the opposition we have a very limited scope for holding the government accountable for its performance. The annual reports are filed, but many of them are really quite dated when they're filed. In fact, we've seen annual reports for various ministries or Crown corporations for two consecutive years filed on the same day since I've been here in this chamber. Many times they're not in the level of detail that a cabinet minister can give us in the estimates process, and they just aren't as useful as a person would like them to be, in trying to represent his constituents.

[ Page 1886 ]

The operation of the standing committees is another part of the framework for holding government accountable, but some of the committees don't even meet. Again, I listen with empathy to the Premier's explanation of why it's hard to have more than three standing committees meet out of session, although it seems to me that they don't meet continuously. Many of them would only meet one day of the week; perhaps it wouldn't be that hard to have all of them meeting, providing that they were synchronized in a way that didn't create undue hardship for the government's MLAs. Certainly the MLAs from this side of the House are willing to meet and work in committees, and they're really hoping that the Premier will be able to deliver in a very demonstrable way on his commitment to have working select standing committees of this Legislature.

The estimates process was the one area where we actually got to talk with the ministers face to face about the concerns that our constituents have. It's not something that I'd like to see changed in any way that detracts from that opportunity.

Of all the things we're dealing with and have on our plate right now, it seems to me that the one that would really give us the opportunity to demonstrate that we're walking the talk as a legislative assembly is a new Auditor General Act. I've audited all the meetings of the Public Accounts Committee, and I was appointed to the Committee on Crown Corporations. We met jointly at first, and I stayed on and listened to all the meetings. I didn't hear anyone on the Public Accounts Committee indicate that a new Auditor General Act needs to await the results of our current deliberations or of the very important process that the ministries are all working through. This process is only going to bring the government of British Columbia closer in sync with what a lot of the business world has already done in terms of accountability, setting benchmarks or standards and measuring performance on the basis of results. So the government's playing catch-up in that area. The Premier has mentioned many times -- and when referring to this process -- that he wants British Columbia to be the leader in Canada in various areas. I think that's what we all want to see, as well, and we're entirely capable of delivering on that. So it's a shame for British Columbia that we have an Auditor General Act that is 20 years old, the oldest unamended act of its type in Canada.

We know that the auditor general's office has been working for at least ten years to bring about an updating of the act, and there's general consensus, I think. There probably isn't a Member of the Legislative Assembly who wouldn't agree that the current Auditor General Act is outdated and needs replacing. There's general agreement with respect to the provisions that people think should be included in a new Auditor General Act. Indeed, if further changes were necessary as a result of the process that the Public Accounts Committee is overseeing, amendments are not difficult. There has been a lot of change over the 20 years since the current act was made law, which renders the conditions under which the auditor general has to work very difficult in 1996 and approaching the next millennium.

In 1992, as I understand it, about this time of year or maybe earlier, the then Minister of Finance -- who is, of course, now the Premier -- and his deputy met with the auditor general to discuss the proposal for this new Auditor General Act and to establish a process to bring it before the House. They did set up a process, and that went on for some time. There are all sorts of issues that arise to delay something like that, and they have arisen, but year after year the matter was brought forward. The Finance minister in 1994, Elizabeth Cull, made a commitment to try and bring the legislation forward, but again, for various reasons, that didn't happen in 1995.

We have an opportunity -- not just a symbolic opportunity but a very practical one -- to demonstrate this willingness and desire to modernize government, to demonstrate to all of the officers of the Legislature that we have the utmost good faith in wanting to allow them to do their jobs, and do them well. As a new Member of the Legislative Assembly speaking to a Premier who has shown us all a lot of ability over the years, and certainly in winning the last election, I'd just like to humbly ask that you reconsider the decision not to table this legislation and that you proceed with it this week.

The Chair: Hon. members, just before the Premier speaks, I wonder if I might remind all members about some of the standing orders that the Premier has already referred to all of us using and not using. Reference to legislation is not generally part of the discussion in estimates -- it's there on page 107, for further reference. We have obviously allowed a lot of latitude on all sides; I just remind all members, though, that that's part of the tradition we used to use here.

Hon. G. Clark: We're not going to bring it in this session. But as I said, Public Accounts.... I gather from the member's comments that he is on that committee. We'll take under advisement recommendations coming out of that, and hopefully, we'll have a new Auditor General Act someday.

K. Krueger: As an alternative, in that event, I wonder if the proposed new Auditor General Act might be tabled as an exposure bill so that it could at least receive the sort of public consideration that would benefit it by advancing its cause through the process and, indeed, make it front and centre in the other forum that we've been discussing.

Hon. G. Clark: Generally, I don't support exposure bills. If there is an auditor general's bill, it's in draft form. The member, as a member of the committee, has it, I'm sure, and he's free to expose it to anybody who's interested.

K. Krueger: That's the sort of glib response that detracts from the respect the Premier's performance earns him in other areas. It's a real disappointment to me, and I'm sure it will be to the auditor general and to many people -- that this key opportunity to demonstrate a willingness to be more accountable in what we do here is going to pass us by.

That said, like with many things that happen here, there obviously isn't a whole lot the opposition can do except work to unseat the government and bring about an opportunity ourselves. With that, I'll pass the debate to my colleagues.

[11:45]

G. Campbell: I'd like to move now beyond some of the general topics that we've talked about and get to some specifics in terms of how the Premier looks at running his government and his cabinet in the future. One of the issues we've all been dealing with in terms of accountability is the accountability of ministers for their portfolios -- how they are held to account and if, in fact, they are held to account -- and how we hold Crown corporations to account for the performance they have undertaken. There are a number of areas I would like to touch on.

First, could the Premier outline for us if he has in fact laid out for his ministers a program of activity for the next 

[ Page 1887 ]

12 months, and if there are specifics that he has laid out for them in terms of his plan? I should say that I still didn't hear what the plan is from the Premier, in spite of his goal to establish a four-year plan with a new focus on specific issues. I am having trouble hearing how he intends to do this. So I'd like to deal with how we.... Who is accountable, in terms of the House, for performance, and what performance criteria have been set by the Premier for his ministers and for the other arms of government?

Hon. G. Clark: The measurement of cabinet ministers' performance is made exclusively by the Premier. The decision the Premier makes with respect to evaluating performance is not an empirical one; it's a subjective one, based on a variety of considerations about how they're handling their portfolio -- how they're explaining to the public the positions the government is taking; how they work to reduce costs within government; how they manage within budgetary performance guidelines; how they work as a team in the cabinet; how they interact with the public in the community and with the client groups or interest groups that interface with that ministry. There is no document, no grading system. There are totally subjective criteria the Premier has to exercise from time to time, should he or she be satisfied or unsatisfied with the performance of various ministers.

G. Campbell: Again, to get back to this whole issue of accountability.... I appreciate the Premier outlining how he generally evaluates the performance of his cabinet ministers.

From our perspective -- from the public perspective, on this side of the House -- the question I'm really getting to is that we often hear an announcement that such-and-such is taking place, and such-and-such a minister is announcing that this has taken place; and here are the goals that we've set for ourselves, etc. The problem is that if there are no criteria that say, "This is the performance I'm expecting," whether it's the public servant who's acting on behalf of the minister, executing the policy that's been put in place; whether it's the minister acting on behalf of the Premier, executing the policy the Premier puts in place.... If there are no specific and explicitly detailed performance criteria, it's very difficult for us to tell, number one, whether things have worked out the way they should have and -- more importantly than us -- for someone from the public to say, "My dollars, which have been taken from my pocket, have been put to the best use," whether it's for health care or public education or transportation improvements or whatever. What I'm getting at is: are there any criteria established by the Premier in terms of his review of the performance by ministers and the ministers' review of public service performance that he can share with us today?

Hon. G. Clark: No.

G. Campbell: That's what I was afraid of. Is that because the Premier doesn't want to share any performance criteria or because he doesn't have any?

The Chair: I'm sure that's in order, but.... Mr. Premier.

Hon. G. Clark: I'm not prepared to elucidate detailed criteria by which I evaluate cabinet ministers.

G. Campbell: Let me deal with some specific projects. We have an announcement that says: "Here's a business plan. We are going to invest the public's money in this business plan." Is there any requirement for due diligence on the part of cabinet ministers that that business plan has, in fact, been put together properly? If the business plan is not successful, what happens then? Do we just say, "Oh, that was too bad," and those dollars are down the drain, or: "We don't care"? Hon. Chair, it seems to me that that's a legitimate question for people to ask, and it's a legitimate question for the Premier to be on top of in terms of how the whole government is working.

Hon. G. Clark: There is a whole series of checks and balances in government, not the least of which is Treasury Board and the due diligence that they apply to various projects that get approval, and also, of course, the due diligence of the opposition in terms of holding the government to account.

G. Campbell: The opposition could be much more diligent if the information were more easily flowing. Let me use a couple of examples. Treasury Board has been referred to by the Premier, so I'll just slip to that. Can the Premier give us some idea of how Treasury Board and the Premier's Office interact? Does the Premier get representations directly? Does the deputy minister get representations? How, in fact, does Treasury Board, in its evaluation and due diligence, get provided with that information to provide to the Premier and the Premier's Office?

Hon. G. Clark: Treasury Board is a committee of cabinet, so all Treasury Board decisions come before cabinet for approval or for amendment.

G. Campbell: So when projects have been approved by cabinet, or when a minister goes out and makes a public announcement with regard to a project and what is going to happen and the criteria that have been established, has that been through the cabinet and to the Premier's Office? Is the Premier's Office generally apprised of that? Does the Premier generally know, and even specifically know, what is being announced on behalf of the government?

Hon. G. Clark: The cabinet makes a decision on a public policy issue, and often with that is the due diligence involved in the policy as well as any communications that may flow from that. At that time the Premier's Office is advised to ensure that it fits with the corporate agenda and with the corporate policy of government. Then the minister is free to proceed to make certain announcements. There are press releases issued by ministers every day in terms of the size and scope of government, and while they are reviewed by the Premier's Office, if you will, or people associated with the Premier's Office, they are not reviewed by me personally, other than the policy decision made at some time and at some previous date.

G. Campbell: So when we establish a goal or an objective or a program, is there any review? Is there an annualized review that judges whether or not we are performing? If performance falls short, are there any consequences of that? Is there any accountability for that, and how does that accountability flow in terms of the people of British Columbia and the Legislature of British Columbia?

Hon. G. Clark: Essentially, ministers have independence from the Premier, as well, and that's how I think all Premiers operate -- certainly I do. You cannot micromanage the entire size and scope of government. So you appoint people who are elected to serve, and you give them the autonomy to manage their departments with their senior staff.

[ Page 1888 ]

If it's a major policy initiative or one that is usually associated with the spending of tax money, every year they are reviewed with incredible scrutiny and debate during the budgetary process. At that time, failures or flaws in policy or errors made are held to account. If it's a problem of staffing in the bureaucracy, people are dealt with. If it's a problem with the minister, then it's up to the Premier to make a decision about whether to move the minister or to remove the minister entirely.

G. Campbell: I have a number of items that I would like to go through, but in view of the hour, I move that the committee rise, report progress and ask leave to sit again.

Motion approved.

The House resumed; the Speaker in the chair.

Committee of Supply B, having reported progress, was granted leave to sit again.

Committee of Supply A, having reported progress, was granted leave to sit again.

Hon. J. MacPhail moved adjournment of the House.

Motion approved.

The House adjourned at 11:55 a.m.

The committee met at 10:13 a.m.

Hon. J. MacPhail: I'd like to make a couple of opening remarks, if I may. I'll be very brief. It's a great honour, actually, to be the Minister of Health, and while I'm relatively new at it, I am very much looking forward to the debate among my colleagues in the Legislature. I expect to be able to impart knowledge, but I also expect to learn. I look forward to the coming days.

Our publicly funded health care system, as many in this room know, has been praised as one of the best in the world, and not only by us here in British Columbia. It has also been held up as a model in the rest of the world. But it is under constant pressure. There's constant pressure from the federal government; from other provinces, in the form of in-migration to British Columbia; and also from others who see a different model, a different vision, for health care than the one that currently exists in British Columbia. We face many challenges, and we have to work together.

I think health care is one of the areas where we as legislators have to work together to ensure the delivery of high-quality health care that continues to meet the needs of not only our children but also our children's children. Our government is totally committed to defending the medicare system, the health care system. It's the reason why we've made it one of our highest priorities.

[10:15]

But it takes more than just words to protect medicare for the future. It takes a vision, and it takes action. Over the last five years, certainly in our first term and continuing into this term, I think we have demonstrated a clear vision, and we've done a great deal. I would hazard to say that our record here in British Columbia in protecting health care is unmatched across Canada. There will be differences -- no question about that -- among those of us who sit in the Legislature. But I don't think those differences have to become a barrier to us moving forward in ensuring that the medicare system, the health system, is here to protect all of us not only in the 1990s but also in the next century. We can have a vision of optimism. I share an optimistic point of view for health care, and I also have a vision of resolve. We believe, as a government, that medicare has been a success and is certainly worth preserving.

I don't want to say in any way, though, that there aren't those amongst us here in British Columbia who believe other systems in the world are a better model -- particularly the American-style health care system. I just want to make it clear from the beginning that we disagree. Now, more than ever, is the time to not allow, in any way, the American health care system to impinge upon our system. That's why our vision starts, first and foremost, with maintaining and improving funding for health care. It's an interesting perspective for me, coming from the Ministry of Social Services to the Ministry of Health and seeing the different demands from the public about funding the two ministries.

There is no greater test for a government than to meet its commitment to provide adequate funding for health care services. I think our record stands up to the test; our record certainly stands up to what has happened elsewhere in Canada. Over the last five years, we've increased health care funding by $1.5 billion; that's a 27.8 percent increase. In this year's budget, funding for health care will increase by over $200 million. We've targeted that extra funding to areas of greatest need. For instance -- and we've talked about this in other areas -- we've invested over $25 million to reduce wait-lists for cardiac surgery, cancer treatment, hip surgery and knee surgery. We've also targeted additional funding for community-based care. We've expanded the community health care services budget by $410 million over the past four years. Those extra dollars go for things like the two-dose measles immunization program, new beds for continuing-care residential facilities, and tobacco reduction and prevention initiatives, to name a few. We've also, I think, done a good job of showing that we can maintain and increase funding for health care while not sacrificing other services across government and while certainly getting our financial house in order.

There's another aspect of the vision for our health care that I want to talk about very briefly -- and we can get into this in estimates -- and that's the new kinds of technology that are now being explored, such as teleradiology and telecare. This will greatly improve access to care in areas where access has traditionally been limited. I look forward to our members from the north discussing this, because it's of particular concern to northern and rural areas of British Columbia. Better regional training, improved staff deployment and enhanced regional dispatch centres for paramedics and ambulance crews are also increasing access to services in the 

[ Page 1889 ]

northern and remote areas. That's because we believe that, no matter where people live, British Columbians should have access to high-quality services.

We're also implementing new ways to curb abuse and reduce waste in the health care system that do not impact on patient services. For example, we've implemented reference-based pricing, and this is at a time when the costs of prescription drugs are rising at record rates. This new policy will save up to $30 million. We have also developed PharmaNet, B.C.'s new and confidential computer pharmacy network, to prevent harmful drug interactions, and that will save taxpayers millions of dollars in reduction of fraud. We are also bringing about efficiencies in other areas. New measures such as clinical practice guidelines and the provincial wait-list strategy are encouraging better management of our health system, and that is being done in partnership with health care providers. It's all part of our program to spend smarter.

Ensuring that our system is as efficient and streamlined as possible was the key factor in the decision to review the regionalization process as well. From the beginning, we made it clear that regionalization was meant to reduce bureaucracy, but British Columbians, including many who sit on the other side of the House, have said that they are concerned about the process resulting in increased bureaucracy. To ensure that regionalization meets the recommendations set out by the Seaton Royal Commission on Health Care and Costs, I ordered a temporary pause in the process. Right now, as we speak, a special assessment team is reviewing regionalization to make sure that the original commitment arising from the Seaton commission remains on track.

I want to make it clear here that it is not the whys of regionalization that are up for debate; it's the hows of that process that we need to explore. It is worth repeating that when it comes to improving our health care system, the government's main concern is to protect and enhance our high-quality health services, and we simply do not want increased bureaucracy.

It's that same concern that led us to take action in other areas. In many other areas, we decided that to ensure that health dollars went to patients and not bureaucracy, we had to reduce administration at our headquarters here in Victoria. Last winter our government announced a reduction of over 100 administrative positions, which will lead to a savings of $5 million annually. The recently concluded labour accord is another example of our managed approach to downsizing B.C.'s health care sector. I know there is some disagreement on support for that labour accord. I'm sure we'll have some discussion about that with my colleagues from the opposition. If we as a group manage to examine the details of the health accord carefully and we look beyond self-interest, I think we will come to the conclusion that the labour accord has improved our health care system.

The system has been reduced by 2,200 full-time workers, and many, many hundreds of others have been shifted to serve areas that are underserved, such as the rural areas of the province, whereas they were in the urban areas before. It's a good deal for patients; it's a good deal for hospitals; it's a good deal for health care workers. And it's also a very good deal for taxpayers, in that underserviced areas of the province now get well-trained, well-qualified health care workers.

It's not just the unionized workforce that are to make sacrifices; we also worked out a very important agreement earlier this spring with B.C. doctors, which ensures that health services are protected. The agreement between the B.C. Medical Association and the province resulted in a total of $28 million being saved by capping the '96-97 base budget for doctors. The agreement also reaffirms the commitment of the BCMA and the government to improve efficiencies in our health care system through measures such as clinical practice guidelines and improved physician supply. In meeting with the BCMA over the course of the last weeks, it is very encouraging to see the cooperation both from the government and the BCMA in ensuring that those efficiencies are in place. The sacrifices made by B.C.'s doctors through this agreement and by B.C.'s health care workers through the accord are to be acknowledged, and at this point, I congratulate the health care providers for their commitment to ensuring efficiencies.

We have chosen to work cooperatively with the health care providers in making sure that we improve medicare. Other areas of the country are taking a different approach than the cooperative approach. Many of us have been faced with the effects of that through our families, if we have families in other parts of Canada, which are facing the restraint in other health care systems. I would also suggest that governments that have tried the broadaxe approach to health care are now having to reverse their approaches. I look forward, in September when I meet with my colleagues from across the country -- the other ministers of health -- to getting a view from them, behind closed doors, of areas of change that have occurred in provinces such as Alberta, as they restore their funding for health care.

The principle of universal accessibility to health care services for British Columbians is threatened. There's no mistake about that. There are forces out there that would like nothing more than for our government to join other provinces in reducing funding and open the door to alternative health care systems. We are simply not going to do that; that is not part of our vision. Our top health care priority is to ensure access to medically necessary health care services and that that access remains a right of all British Columbians.

We believe that access to health care should be based on a person's medical need and not on the size of her wallet. That's why last year we passed the Medicare Protection Act, the first provincial legislation ever to entrench the five founding principles of medicare: universality, comprehensiveness, accessibility, portability and public administration. All of these are key to our government's vision for health care.

I'm sure that members in this House will become tired of me talking about the federal off-loading, and therefore I won't do it. But it is a factor that we must keep in mind as we debate these estimates. The federal government has, in reality, cut tens of millions -- up to hundreds of millions -- of dollars in health care transfers to British Columbia. However, we are doing all we can to ensure that those cuts in payments to health care do not in any way jeopardize the universality of the health care system in British Columbia.

It's important, I think, when we talk about the preservation of our health care system, to understand that we all -- I would hope -- see it as our role to advocate for the defence of the health care system. It's the one area where silence is not a virtue; it's a failing. If we fail to speak out in defence of our health care system and our medicare system, we'll actually be failing the people of B.C.

I want to assure the hon. members that our vision for health care and for the well-being of this province includes the protection of quality of life for seniors and for the well-being of the quality of life that lifted seniors out of the poverty that so many of them rested in in the forties, fifties and sixties, and we want to continue that growth in the well-being of the quality of life of seniors.

[ Page 1890 ]

Our vision focuses on maintaining funding for health care for seniors, on improving the delivery of services and on resisting the development of a parallel private health care system. Most importantly, our vision is one that puts the well-being and the health care needs of British Columbians first.

S. Hawkins: I listened with interest to the minister's comments, and I think she'll find that we probably agree more than disagree with some of the things she said. I also have some opening statements.

I'm very pleased to have the opportunity to rise today to begin the debate on the estimates of the Ministry of Health. Before I begin, I would like to share some thoughts on the health care system and talk about how it evolved and where we feel it should be going. The NDP frequently and, I would say, rather fiercely proclaim that they are the party that brought medicare to Canada, and to a degree that is correct at least in one sense. I'm from Saskatchewan, so I'm going to talk a little bit about Saskatchewan, Tommy Douglas and the CCF, who brought in a form of socialized medicine to Saskatchewan's Swift Current health region in 1946. That system provided for fee-for-service medicine to be available to residents of that area at no charge to the patient.

What was different about the way that Mr. Douglas introduced health care changes in Saskatchewan compared with the way that it is evolving now in British Columbia is that Mr. Douglas introduced the changes in a well-defined, geographical region and on an experimental basis -- I guess what we would call today a pilot project. Unlike the NDP government in our province today, Mr. Douglas valued primary health care providers and allowed them to be well represented on the executive of the administrative body or boards.

[10:30]

Fifteen years passed between the creation of the experimental Swift Current health region in 1946 and the provincewide implementation of the medicare plan in 1961. He did allow ample time for assessment and adjustment of his sweeping health care reform. Mr. Douglas was evidently intelligent and patient and not impulsive and hasty. Mr. Douglas knew that review and consultation with key stakeholders were not just important; they were crucial to the success of medicare implementation. Mr. Douglas had a plan, and he stuck to it. But he was also prepared to be flexible and adapt the plan to suit the wishes of the public. Medicare in Saskatchewan wasn't just an idea implemented by order-in-council; it was implemented by listening to people and being responsible and responsive to their wishes. Mr. Douglas understood how to introduce sweeping change into society, unlike what is happening and what has happened in the past here in British Columbia.

In the 1950s, it took another populist politician from Saskatchewan, the Rt. Hon. John Diefenbaker, to introduce a hospitals act which provided for prepaid financial coverage for hospital care. In the early 1960s, Mr. Diefenbaker commissioned a federal royal commission on health services chaired by yet another visionary resident of Saskatchewan, the late Justice Emmett Hall. So we have the NDP and the Conservatives now involved in medicare. The Hall commission report in 1964 laid the foundation for what has grown to be the universal health care system, which Canadians now call medicare.

It would appear that all the groundbreaking innovations in medicare originated in the minds of people from Saskatchewan, and I feel particularly honoured to follow in the tradition of these former Saskatchewan-raised public servants. I will make every effort in this House to remain true to the intention of providing comprehensive medical services to the people of this province regardless of their ability to pay. In essence, that's what we on this side of the House call and know as putting patients first.

The commitment to quality health care that's both accessible and affordable crosses party lines and is a desire that is shared by all Canadians. I would argue that this commitment does not fall and has not historically fallen under the sole domain of the NDP. The 1964 Hall commission report was implemented by the Liberals, by Mr. Diefenbaker's immediate successor, the Rt. Hon. Lester Pearson. In successive years of Liberal tenure came the evolution of federal-provincial cost-sharing to support health care and the adoption of the Canada Health Act in 1984, which remains the single most important piece of federal legislation defining the cardinal principles of medicare.

It should become clear, then, that the parenthood of medicare in Canada does not solely belong to the NDP, but rather is an example of a truly Canadian creation conceived by the CCF in Saskatchewan in the forties, expanded and studied by the Conservatives in the fifties and sixties, and implemented by the Liberals in the seventies.

I cannot accept and I do not accept the outrageous criticisms that are thrown about by the members opposite that the B.C. Liberal Party somehow intends to, or ever intended to, destroy Canada's medicare system. Let me go on record again today with our party's position on medicare. We have repeatedly said that protecting universal health care is the fundamental goal of the B.C. Liberals. We believe in putting the patient first. We went on record during the recent election campaign and outlined firmly what we believed: protecting health care from reductions in federal transfers by finding savings elsewhere in government. We believe in stopping the NDP's failed New Directions experiment, which has increased bureaucracy at the expense of patient care. We believe in setting up pilot projects in test regions so we can build on successes. We believe in stopping reductions in hospital services until community health services are in place, and we believe in reducing the time it takes to build hospitals by tying construction dollars to operating costs. That's what we said then. We meant it then, and we mean it now.

Hon. Chair, the members opposite and the Minister of Health have no need for confusion from now on. It's on the record here, and they can read it in case they have a certain lapse of memory. B.C. Liberals have always supported universal health care as a fundamental goal -- period.

There's no question that health care is expensive; in fact, it's the most expensive item on our provincial budget. But it shouldn't be any surprise that expensive as it is, the cost of medicare was precisely predicted, through to 1991, by the original Hall commission report in 1964. The projected '96-97 cost of our health care system is in the neighbourhood of $7 billion, and it is the largest single budgetary expenditure each year.

In the more than 30 years since the Hall royal commission, the growth of medicare has been steady and predictable, at approximately 4 percent per year in real dollar terms. The fact that it's become such a large proportion of the budget was expected back in 1964. Mr. Justice Hall's only mistake was that he trusted that successive governments would be competent to manage the growth better than they did. In the words of the Hall commission report: "Nor is the cost of the best possible health care overwhelming. Canada has the resources and the competence to implement a comprehensive health services program for all her people."

[ Page 1891 ]

Well, history is witness to the fact that Mr. Justice Hall's hopes for competence in managing the resources of Canada by successive governments were not, unfortunately, fulfilled. Not only has our economy softened, but successive governments have increased government debt, requiring larger and larger proportions of the budget to be dedicated to interest payments and debt reduction, rather than to public services like health care. We're paying the price of that today: a generation of deficit financing -- the type of fiscal mismanagement that this government still hasn't learned to recognize and control. This is evidenced by the fact that this government has been responsible for the fastest growth in debt in this province's history: more than $11 billion during its last term and well on the way to $1 billion more already in this new budget.

I would remind the government members that Tommy Douglas never ran a deficit in Saskatchewan. He saved the money to pay for his medicare experiment in advance, before implementing it. Mr. Douglas was prepared to tell people in advance what he planned to do, and then he kept his word. He put fiscal responsibility ahead of sweeping social changes, and he accomplished both.

For its part, the federal government has responded to budgetary pressures by unilaterally reducing its share of transfer payments to provinces. This essentially abdicates the responsibility for the financial support of social programs such as medicare, which was intended in the 1977 Federal-Provincial Fiscal Arrangements and Established Programs Financing Act.

What many find astounding about the issue of health care costs is that we've maintained things as well as we have, given the province's spendthrift approach to fiscal affairs coupled with the federal head-in-the-sand disregard for impending crises in social program funding. With the passage of time, we have seen successive governments, both federal and provincial, adopt measures intended to assist with the cost containment of medicare, with a model of protecting health care for the public. What many of these measures really achieve is to just disenfranchise Canadians from the type of comprehensive medical coverage that was intended by Chief Justice Hall and enshrined in law in the Canada Health Act.

It's my view, and the view of the members on this side of the House, that recent government measures fail to put the patient first. We have seen this government enter into an agreement to deinsure excisions of skin lesions from medicare coverage for short-term fiscal reasons. How does this put the patient first?

We have seen government introduce changes to the provincial Pharmacare plan which restrict patients from having access to certain types of medications as a Pharmacare benefit, even though they would have received a prescription for those medications. How does this put the patient first?

We have seen this government grant extraordinary funding, as was announced by the Premier in April, to alleviate waiting lists and other shortfalls, but we are now witnessing that this special funding is not being allocated to provide equitable benefit and opportunity for treatment for all British Columbians. How does rationing emergency patient care in the interior put our patients first?

After four years of regionalization discussions, we have seen this government create a parallel bureaucracy of regional boards and community health councils, essentially pitting community against community, regional boards against hospitals. How does this put the patient first?

We have seen this government enact a health labour accord which shortens the work week for hospital labour and provides regular salary increments. But the cost of this accord is being borne by hospitals whose budgets are not being increased to keep pace with increasing wage and benefits costs. This has resulted in an increase in wages and benefits, essentially draining the patient care portion of the budget. How is this putting the patient first?

We have seen many hospitals put into place a system of EDOs -- extra days off -- where the hospitals operate at skeleton staff levels for ten days of the year in order to comply with the health labour accord terms. These are days which ordinarily, in past years, would have been regular working days, not statutory holidays or weekends. How does this strangling of acute care hospitals put the patient first?

We have seen this government freeze capital projects, such as the pediatric unit at the Victoria General Hospital and the replacement of a burned-down health care unit in Hudson's Hope up north. How can this government action possibly put those patients first?

Our health care system has been thrown into a state of flux and confusion by a government that has failed to manage responsibly and to outline priorities for the health of British Columbians. We have seen acute care beds and services reduced. Patients are waiting an inordinate amount of time to be treated. Services for patients are not being provided in the community as they are being removed or reduced in acute care settings. How does this possibly put the patient first?

Hon. Chair, I look forward to raising these and many other issues with the minister in these estimates. I hope that together we can learn where the problems lie, and hopefully, we can work together to develop solutions, keeping in mind a commitment to providing comprehensive and universal access to quality health care that will truly put the patient first.

I'd like to start very broadly. I was reading the provincial health officer's report, and I understand that he says that a process is underway to develop provincial health goals, measurable objectives and targets. After consultation with the province's 20 health regions, the goals will be submitted for cabinet's consideration in the spring of 1996. I'm wondering if the minister can tell me where we are with that process to get provincial health goals and measurable objectives and targets in place.

Hon. J. MacPhail: Well, even though it's future policy, I don't mind answering at all, because it's an important question. The provincial health officer is still on his final draft, and we're anticipating the matter coming before cabinet in the fall.

S. Hawkins: This report was supposed to have gone to cabinet in spring, so it hasn't been received or completed.

I would also like to ask the minister what the top five priorities for the Ministry of Health are over the next year.

Hon. J. MacPhail: My apologies for not introducing my staff who are with me. Bob Cronin is the assistant deputy minister responsible for corporate programs. On my right is John Herbert, who is the executive director of finance and management services. There will be other staff joining us as we proceed, and I'll introduce them as we go along.

The vision for our government is one of healthy citizens and healthy communities. We have five parts to that vision, which we will endeavour to deliver on, to contribute to the health of British Columbians. The five parts of that vision are: 

[ Page 1892 ]

(1) that the availability of health services be equitable -- that all British Columbians be entitled to the health care services they require; (2) that the health services be effective -- that the health services will lead to better health outcomes; (3) that the health services be efficient -- that they be managed and delivered as efficiently as possible; (4) that they be integrated -- individual services will be integrated within the service sector; and (5) that the health services be appropriate -- the right service at the right time, in the right place.

S. Hawkins: I guess what I wanted to ask was: are there any programs that the Health ministry has set as priorities for the next year that they want to focus on? Is there some kind of plan to achieve anything specific in the next year?

Hon. J. MacPhail: Well, indeed I thought I had addressed some of those in my opening comments, but I will reiterate. Certainly making sure that the hows of regionalization meet our vision, in terms of the five parts of the vision I outlined with you, is a priority. The second priority is to ensure that, even in the face of reduced transfer payments from the government, we maintain and enhance a strong and healthy health care system; and third, that we do so in a way that reduces administrative costs in the health care system and puts the delivery of health care services first and foremost.

S. Hawkins: I wonder if I can ask the minister if, when she does get the provincial health officer's report, she would share it with us.

[10:45]

Hon. J. MacPhail: The provincial health officer has made the document widely available now among health care providers, in terms of the consultation. When the matter comes before cabinet, I anticipate that the provincial health officer's report will then become a public document. If the hon. member is asking that she see it in the interim, I'll look into that, but at this stage it is future policy.

S. Hawkins: It was interesting that the minister referred to the Ministry of Health as an unwieldy bureaucracy, and I am wondering if the minister can give us some information. I know that the number of employees is given in FTEs, but can the minister tell us how many employees actually exist in the Ministry of Health?

Hon. J. MacPhail: There are close to 10,000 employees -- between 9,000 and 10,000 -- funded by tax dollars in the health care system, and that takes into account the part-time employees. There are hundreds and hundreds of ambulance employees, for instance, who are part-time. The number of people actually working in the system is closer to 10,000.

S. Hawkins: How many of these employees actually work here in the ministry? I know there was a plan for some reduction in the so-called bureaucracy. How many are in the bureaucracy, and is there a plan for further reductions?

Hon. J. MacPhail: In terms of the people who work in the ministry, there are about 3,000 FTEs that are going to be regionalized and put into the field, and there are about 1,600 FTEs delivering services such as kidney dialysis, medical supplies, vital statistics, Pharmacare, etc. Less than 1,000 are in administration. Of all the total I told you about, 3,000 will be going out into the regions.

S. Hawkins: Can the minister tell us how many of these employees she mentioned have been newly hired, and does she anticipate that hiring is going to take place in the ministry?

Hon. J. MacPhail: Other than the normal turnover, which I understand is very small in this ministry, we have held the line in terms of new hires.

S. Hawkins: Can the minister tell me how many of these positions have already gone to the regions?

Hon. J. MacPhail: That is part of the reason we went for the assessment, because the transfers had not occurred other than in terms of informal secondments. The movement hasn't occurred yet.

S. Hawkins: Also, in the health officer's report there was discussion of the development of an information system to provide comprehensive input and output accountability for the Ministry of Health. I wonder what the ministry is doing to achieve this.

Hon. J. MacPhail: I will give two examples here, but there are others under development. One is PharmaNet and the other is HealthNet, which also connects educational materials and information for people throughout British Columbia. I would also suggest, in terms of information being readily accessible outside the urban areas, that it's one of the aspects that will be developed in the telecare program, as well, for access in the northern rural areas.

S. Hawkins: Is there a plan to put all the hospitals on line so they communicate together? Is there anything that comprehensive in the works?

Hon. J. MacPhail: That is HealthNet, but it's an incremental growth. So yes, that is the intent, and that is what it's called -- HealthNet.

S. Hawkins: The reason I'm asking is that different hospitals are on different systems, and one of the ways we could reduce waste and increase efficiency is to get them all on the same system. If there's a plan, that's great. I don't see that happening in the regions, and my region actually asked me to bring it up. I have a letter here from the Shuswap region, from a physician who's concerned about the lack of information-sharing and about duplication and waste. How far along are we moving this? Are we moving to a program where all hospitals will be on the same system, sharing the same software? I know New Brunswick has a card system now, where the patient just uses a type of credit card, and the hospitals have the information right up on screen. Is that the kind of system we're moving toward?

Hon. J. MacPhail: The assistant deputy minister chairs a council called the Health Information Standards Council, which is a committee of both government and the industry itself, moving toward an agreed-upon system of computerization. Not all health care institutions agree on an end point, which I found very interesting in terms of.... Even in my own region, for instance, the Vancouver region, there was not a sharing of technology, even though patients were within travelling distance from hospital to hospital. But the standards council is moving surely toward the goal that you talk about, where everybody literally buys into the system, and there will be savings. Of course, one of the positive aspects of regionalization is that within a region institutions will have a central point to make sure that this happens.

S. Hawkins: There was a study done by a graduate student that was interesting, and I have a computer printout 

[ Page 1893 ]

of it. She studied 107 hospitals and interviewed Ministry of Health officials as well. I wonder if the minister can comment on the type of experience with respect to health care that her ministry officials have, perhaps from the deputy minister level down.

Hon. J. MacPhail: Sorry, sometimes I laugh because I'm nervous. That's a big job, but I don't mind. Let me just tell you about the deputy minister, who will be joining us very shortly. He has a master's in public administration and is an economist, which probably works against him, but he has wide-ranging experience in Ontario, Saskatchewan, Alberta and now here in both social services and health care. The assistant deputy minister to my left has exactly the same experience in terms of health care delivery and social services. He's been around a long time.

I actually don't mind, but let me give you my general sense, if I may, and then we can ask specific questions as we go through the various programs. In the Ministry of Health, I am very pleased with the depth of experience within the context of the senior bureaucrats I have met. There is a corporate memory that is long and exceedingly accurate. As a person responsible for answering and having ministerial accountability for the bureaucracy, which sometimes can be very frustrating, I have found that the corporate memory in the ministry is long, detailed and accurate. As I travel around the province, which hasn't been enough lately, I also know that there is also a very great deal of in-depth experience at the regional level in terms of corporate memory.

S. Hawkins: The reason I ask is that, from this study that was done, about 80 percent of the Ministry of Health personnel who were interviewed held degrees in business, and only 10 percent possessed degrees in health care administration. Most of the degrees were in sociology, political science and that kind of stuff. Can the minister fill me in on how many people she knows of in her ministry who actually have experience or education directly related to health care?

Hon. J. MacPhail: Did you say a study of the British Columbia experience?

S. Hawkins: Yes.

Hon. J. MacPhail: I'd be very interested in seeing it. I'd appreciate seeing it. I do know that there's a wealth of medically trained physicians, for instance, throughout our system, and I also know that the nursing profession is well represented from an administrative point of view. I would be pleased, though, to look at the study and give a more detailed explanation in the context of the study.

The experience I have faced in dealing with my officials is that there is actually a huge amount of experience -- I don't want to mislead the member -- perhaps not at the actual bedside delivery, even though there is some of that experience, but certainly working within the front lines of the health care system. I would appreciate a copy of the study, and I'd like to look at it.

S. Hawkins: I'd be happy to share a copy of the study with you. I'm surprised that the ministry doesn't have a copy, because it was noted that everybody who participated would get a copy.

I have some specific questions that I've been asked to ask, questions to do with the minister's office. Can the minister tell me if Chris Chilton continues to act as a special adviser to the Minister of Health?

Hon. J. MacPhail: Yes.

S. Hawkins: Where in Victoria is he based?

Hon. J. MacPhail: He's in the Douglas Building, which is across the road just outside this building.

S. Hawkins: Is that the same office as the cabinet planning secretariat?

Hon. J. MacPhail: It's the same building but not the same office.

S. Hawkins: What are his specific duties?

Hon. J. MacPhail: Mr. Chilton is responsible for developing and implementing strategies needed to address the unprecedented cuts by Ottawa to B.C.'s health care funding. We have a very aggressive approach that we're taking with Ottawa on these transfer payment cuts. Mr. Chilton was also responsible for delivering, on behalf of the government, the medicare protection act -- B.C. being the first province to entrench that. Also, Mr. Chilton continues to act as a special adviser on the programs and initiatives that are in place in the ministry now.

S. Hawkins: What is his salary, and what is the amount of his travel budget?

Hon. J. MacPhail: His salary is $117,000, and travel is less than $10,000 -- about $8,000 or $9,000 is budgeted.

[11:00]

S. Hawkins: Could his duties not be done by someone else? We're just wondering why the minister needs a special assistant at a cost of almost $120,000 per year.

Hon. J. MacPhail: This area has been canvassed thoroughly with the previous government in question period, etc. Certainly all of those issues have been explored thoroughly by the members of the opposition. This is one-third of the budget of British Columbia, $7 billion. Health care has been made a priority by our government, and it continues to be made a priority. The experience of Mr. Chilton in ensuring not only that the system remains strong and secure in British Columbia but also that we get our fair share in Canada.... It requires that we have the services of Mr. Chilton.

Interjection.

Hon. J. MacPhail: Sorry, the anticipated travel budget for Mr. Chilton would be $12,500.

S. Hawkins: I wonder if the minister can tell me how many deputy ministers this Health ministry has been through in the last year.

Hon. J. MacPhail: We have a new deputy minister since June, so that makes this the second deputy minister.

[ Page 1894 ]

S. Hawkins: How many Ministers of Health has this ministry been through in the last year?

Hon. J. MacPhail: I'm the third.

S. Hawkins: I have in my hand a flow chart of the Ministry of Health and Ministry Responsible for Seniors, and I'm wondering if all the positions are filled. I think this is an old chart. I'm also wondering, because the minister has said that there is an unwieldy bureaucracy, if there's any plan to reduce any of this staff in her office.

Hon. J. MacPhail: You think it might be an old org chart. Do you want me to look at it?

S. Hawkins: Yes, absolutely.

Hon. J. MacPhail: There is a newer one, and I'll get it for you. Let me just make some general comments. Oh, I see that my name is just pencilled in there. Did the Premier do that? I want to know. We will make it available to you.

I have just a couple of short comments, again, on future policy. It was announced in the budget that we're doing a governmentwide program review with a goal of reducing administration costs across government, perhaps eliminating certain programs. Our ministry is out in front on that now. For instance, we are already working toward integrating, amalgamating and thereby reducing their financial services operation in our government.

Let me get you a newer chart than this.

S. Hawkins: Is it okay to come back to that later, then?

Hon. J. MacPhail: Sure.

S. Hawkins: Okay, fine.

I'd like to talk a little bit now about emergency health services. There has been a lot of talk about ambulance services in this province. Would the B.C. Ambulance Service, perhaps having their own building in Burnaby...? I am wondering if we have budgeted in this budget for this new building that the Ambulance Service sees themselves setting up in Burnaby.

Hon. J. MacPhail: For the information of the members, I've been joined by Mr. Val Pattee, who is the executive director of the B.C. Ambulance Service.

Yes, that is part of the budget.

S. Hawkins: How much is being budgeted for that?

Hon. J. MacPhail: Well, we are in the planning stage. I don't mind exploring further the whole issue around whether that indeed will go ahead or not, if the hon. member wishes to. We are in the planning and design stages right now, but it's anticipated that the cost will be about $4 million.

S. Hawkins: You said $4 million, and I heard $7 million. That's about a $3 million difference there, but that doesn't really matter.

Can the minister comment with respect to the issue of whether this building and this service will amalgamate with fire and police services under the Vancouver plan? That has been quite a concern to the public, to the Ambulance Service and to the fire and police services in Vancouver. What is happening, and what is the ministry doing in regard to this?

Hon. J. MacPhail: Yes, the hon. member is making reference to the emergency operations and communications centre that's being put forward in the city of Vancouver -- in my riding, actually. Initially, the EOCC, emergency operations and communications centre.... Initially, the concept was being designed as -- and I say this with the greatest of respect -- the Cadillac concept, bringing all of the emergency services together under the same roof and using sophisticated technology to coordinate emergency responses.

In the context of the initial cost for the BCAS to participate, it became clear that it would be more cost-effective in terms of tax dollars to have our separate Burnaby Mountain operation but to ensure that our technology -- it may be in separate locations -- achieved the reduction in the response time that could be achieved within the EOCC. Since that time, though, the city of Vancouver and particularly the firefighters, who are strong advocates of a building, have approached other potential shareholders in the EOCC and other municipalities, etc. They are now at a stage where they are able to enter discussions with us about a proposal that would reduce the cost for the BCAS to enter into the EOCC. The BCAS is awaiting a proposal from the city of Vancouver that would substantially reduce our participation costs, so we are actively pursuing that right now.

S. Hawkins: The minister is probably aware that the BCAS does not -- at least they made me aware of it -- want to participate in this Vancouver project. Is the minister aware of that?

Hon. J. MacPhail: Well, this is the BCAS. And I just asked him, Val Pattee, the executive director of the B.C. Ambulance Service. I don't want to mislead the hon. member in terms of the issues that exist out there. I am well aware of them as well. There have been issues around first response, around the Ambulance Service's provision of life support versus the firefighters' life-support provision. From my previous life as a labour activist, I'm well aware of those issues, and certainly they're issues that are important to us as well. But in the context of the participation of the BCAS within the EOCC, the guiding principle for us is cost-effectiveness.

S. Hawkins: I'm sorry, it wasn't the BCAS; it's the paramedics' union that I've been talking to. From their understanding, they think they're going to get a new building, and they're not really in total agreement that setting up with Vancouver in Vancouver is the best way to go. They think, from the discussions I've had with them, that they already provide regionalized and provincewide ambulance service. There's no problem with municipal borders in the way they provide their service right now. From what I understand, they feel that plans are already underway for this new building. Maybe I can ask if this building is under a capital freeze. Is it one of the projects that's been frozen?

Hon. J. MacPhail: Certainly the hon. member accurately reflects the views of the paramedics' union. Yes, this is part of the review process for the capital freeze.

S. Hawkins: As part of the review process, does that mean that you're looking at ways of making it cheaper? And if it's cheaper, will they then be forced to go into Vancouver?

[ Page 1895 ]

Hon. J. MacPhail: Those are two separate questions. The building itself is subject to the capital review process and all of the parameters that apply to that. It would be an interesting discussion to have, of the Legislature trying to resolve a jurisdictional dispute amongst union members. I've actually attempted for years to try and assist in a resolution of that, without success. So I don't in any way want to mix that issue with the issue of whether it be the Burnaby Mountain BCAS building or the EOCC. Let me just reassure the member that I am well aware of the jurisdictional issues and the work-related issues that exist between paramedics and firefighters, and I in no way wish to exacerbate those issues through participation or the lack thereof in the EOCC.

S. Hawkins: There has been a lot of talk about ambulance services outside the lower mainland and about emergency services being very, very stressed, perhaps to the point of being inadequate and maybe even to the point of being unsafe. I have the updated statistics for fiscal year 1994-95 from the BCAS in front of me. I got it off the Internet. I'm looking at it, and it says there are about 3,310 field paramedics in total. I wonder how many of those are outside the lower mainland.

Hon. J. MacPhail: About 2,400 are outside the lower mainland.

S. Hawkins: Total ambulance and support units are 422, and total ambulance stations, it says, are 198. Again, could you break that down? How many are outside the lower mainland?

Hon. J. MacPhail: Out of the 198, about 120 are outside the lower mainland.

S. Hawkins: And out of 422 ambulances and support units, how many of those are outside the lower mainland?

Hon. J. MacPhail: Of the number that you have there, there are a hundred or a few more in the lower mainland; the rest are outside the lower mainland -- 3-to-1 or 4-to-1.

S. Hawkins: I wonder if the minister can comment on the concerns of people outside the lower mainland and the paramedics outside the lower mainland that talk about reduction in services. Is the minister aware that there has been a reduction in services?

[11:15]

Hon. J. MacPhail: Well, actually there has not been any reduction in service, so we just need to make that clear. The issue of staffing goes back as long ago as 1974, when the government of the day took over responsibility for providing a provincial ambulance service. Just let me tell you what has happened over the past year. The paramedics' union, along with the BCAS -- and the paramedics' union is CUPE, Local 873; I'm sure the member knows that -- have discussed the need for development of criteria that will allow for a rational distribution of full-time staff throughout the province. So during the last set of negotiations, where they achieved a four-year agreement, an understanding was reached with the union that will have an agreed-upon approach to the introduction of an equitable staffing model. That is now the work of the joint labour-management committee. I really do wish them well, because it's an important issue.

S. Hawkins: Back to the concerns, then, of people who live outside the lower mainland. They feel that they don't have adequate ambulance services, and times for calls or, perhaps, lack of service does affect patient care. Does the minister have any comments on that? Is there a plan in place to help top up areas that are concerned that they don't have the ambulance service they require?

Hon. J. MacPhail: Indeed, this is one area where we have protected service, and there have not been cuts; but the concern of the people outside the lower mainland is real. The combination of the agreed-upon staffing model and also increased training initiatives will go a long way, I hope, to ensuring that the concerns of people outside the lower mainland are dealt with. It is an area that we are monitoring closely.

S. Hawkins: I wonder if this is an appropriate time to discuss capital projects.

Hon. J. MacPhail: If I could just ask the hon. member, did you wish to...? Shall Mr. Pattee go to lunch?

S. Hawkins: Absolutely. I've canvassed that area for now.

I wonder if the minister can tell us how much is projected in capital spending, and on what projects, over the next year.

Hon. J. MacPhail: I'll introduce Colin Millard, who is the director of the design and construction division within the ministry. I actually have a document here that I can make available to the hon. member that lists the capital projects. The ones that are legally committed, of course, are the ones that are going ahead, and they are valued at $195 million. I certainly don't mind making this list available to the hon. member.

S. Hawkins: I would appreciate that document.

With respect to the committee that's reviewing the freezes, quite a few health projects are frozen. We're just wondering if the committee has met and when the committee will decide which capital projects will be released.

Hon. J. MacPhail: Yes, the committee is meeting as we speak. It's under the auspices of the Finance minister, and it was announced by the Finance minister in June that it would be a six-month review. I recall from cabinet discussions that we're looking at the end of November, which isn't quite six months.

But I also want -- and I hope this is the appropriate time -- to update the member. For instance, with the hospital at Hudson's Hope, we asked for an early review. It is proceeding, of course, and I let the community know as well. There will be further news today around the pediatric unit, for instance.

S. Hawkins: I appreciate that, because the Hudson's Hope hospital is of concern. It's not a replacement or an addition; it's a hospital that burned down. From what I understand, they're running a health care unit out of the basement of a municipal building. They're trying to recruit a doctor. Northern medical services are already stressed to the limit, and I'm sure they will appreciate a quick review of that project.

Another project of interest is in my constituency: a service project that's projected to be built at Kelowna General Hospital. Basically, it's work to include such things as a loading dock, a biomedical and engineering space renovation, garbage 

[ Page 1896 ]

disposal and those kinds of things that will service the new cancer clinic. Interestingly enough, when the capital project freeze came out, this contract -- I think it's only a $1.2 million project, or maybe it's $2 million -- wasn't on any list. The hospital is still waiting to hear if they can have the go-ahead to do this, because we will have the cancer clinic but no area to service it.

Hon. J. MacPhail: Yes. They're tied, and they will go ahead at the same time. It's tied to the construction, and it will proceed when ready for the cancer clinic.

S. Hawkins: There is another minor capital project that is a concern in my constituency, and that's the construction of the new integrated intensive care unit at Kelowna General Hospital. Kelowna has the second-busiest cardiac service in the province, outside of Vancouver Hospital's, and it's certainly the busiest cardiac service of any community where open-heart surgery is not offered. As well, there's no coronary care unit at the Kelowna General Hospital. In fact, close to 80 percent of patients with documented heart attacks are cared for in the cardiology ward rather than in a CCU setting, which in itself lends some concern. There is a documented need for an ICU that has cardiac, medical and trauma capabilities.

It was rumoured that the Premier was going to announce this construction project during the election campaign. Lots of work has gone into it, yet as recently as this weekend we had to open four beds on the cardiology ward for an overflow due to ICU shortages. We're just wondering what stage that minor capital project is at.

Hon. J. MacPhail: Well, I just say thank God the Premier didn't do that. That would have been blatant electioneering during the campaign.

S. Hawkins: He did everything else but.

Hon. J. MacPhail: And he was in Kelowna, too.

I'll just put on the record here the issues behind why there's a capital project freeze, because again, this was an issue that many of us talked about during the election -- the issue of debt and deficit, etc. But I also fully appreciate the needs within our own particular communities and that there are certain matters that just simply have to go ahead.

The purpose of the freeze was that.... Over the course of the last year, the voters expressed a concern about the level of debt. The purpose of the review in that context is to lead to a lower level of capital spending in response to that concern. The review, which will take place this year, will be concluded probably by the end of November. It will identify capital projects that can proceed in accordance with the lower capital debt level and those which need deferral, cancellation or a more cost-effective approach. It's in the context of that that we can discuss all capital projects.

I must also say that if we tallied up all the capital projects that we have discussed over the course of the last seven weeks here, there are very few, I think, that any member of the House on either side has said shouldn't proceed, so it is going to be a very time-consuming task to meet the need of a lower level of capital spending.

That's the overall context. But in the context of the project that the hon. member identifies, nothing has started yet. There is no legal commitment. The discussions proceed, but they will proceed after the capital review has been completed.

S. Hawkins: Again, it's interesting, because a lot of promises were made. In 28 days, ears were opened and came to a conclusion that perhaps it was time to buckle down and look after debt rather than look after patients in the province. It's very interesting. It will be interesting how decisions will be made to release some of these projects and have them go ahead. Some of these are needed on an emergency basis. The review was going to take six months, and six months will extend these projects into a year or two years. There are a lot of hospitals that are stressed to the limit and need these things. It would be really appreciated if some of these decisions could be made earlier.

I think my friend here has a question, so I'll let him get up on that.

G. Abbott: I'll let our Health critic catch her breath for a minute and just ask a couple of very straightforward questions, if I could. There's nothing unique about this, I am sure. The same kind of question arises across the province. This is a question that is posed to me by the Chase and District Health Society, and I just want to run it by the minister to get an inkling of how these folks should plan for the future.

The issue at hand is a multilevel-care facility in Chase. The former Minister of Health indicated in November of 1995 to the health society that their project had been identified as a priority in the ministry's five-year capital plan. Given the timing, should the health care society plan for provincial funding for this facility somewhere between now and the year 2000, or November of the year 2000, if it's currently in the five-year capital plan?

Hon. J. MacPhail: It is part of the review, there's no question about it. In the diagnostic and treatment centre there was a minor capital project that did go ahead or is going ahead in Chase -- expansion and renovations.

You are talking about the 25-bed multilevel-care facility. It remains a priority within the region, if that helps you in terms of the context of your question. It is part of the review.

G. Abbott: I wasn't raising it in terms of the capital freeze or the review, I was raising it in terms of its being on a five-year plan. How should the health care society proceed in terms of its planning for when the provincial funding might actually appear? Should they just regularly canvass the ministry with respect to funding? Is there any indication of when they should plan to be working to put this in place?

Hon. J. MacPhail: I understand that there is regular dialogue, but I want to make it clear that this remains a priority within the health region. It wasn't the highest priority this year, and that's why it didn't make it into this capital envelope. But there is constant dialogue between the ministry and the various regions, so that will continue.

[11:30]

S. Hawkins: Going over some of the line-by-line breakdowns, I have a couple of questions. Elections for regionalization are going to happen this fall. I remember meeting with the deputy minister, and he said that $3 million had been set aside for these elections. I'm wondering what's happening to that money now.

Hon. J. MacPhail: It won't be spent. It's part of keeping costs down in the ministry.

[ Page 1897 ]

S. Hawkins: I wonder if I could talk about funding for hospitals at this time. I understand a funding formula for hospital operations has been established. I wonder if the minister could explain this for me.

Hon. J. MacPhail: I'll make a general comment. The staff who are the hospital experts are coming down after lunch, so we can explore it further then.

Just to start off, it's a peer group committee of people from the industry. They meet and review the funding formula. It's not a test of physics, fortunately, but it is a formula based on population, regional factors and the nature of the service given by the facility, and the peer group reviews the allocations on a regular basis.

That can start the discussion, but I can offer the hon. members more detail after lunch. My apologies that I don't have the person responsible here.

S. Hawkins: I thought there were going to be more members asking about capital projects in their ridings as well. I understand they are coming after lunch to do that, so we'll probably be flip-flopping all over the place today.

I have some questions about the line-by-line breakdown. The deputy minister was kind enough to give me that when we met earlier. There are some changes between budgets in '95-96 -- changes up and changes down. I'm interested in the legislation.... Under strategic programs there is a 16 percent increase in legislation -- professional regulations -- and I'm wondering what accounts for that change.

Hon. J. MacPhail: That's mainly increased funding for the Health Professions Council for their increased responsibilities. There's one extra FTE in that particular branch, but the main increased funding goes to the work of the Health Professions Council, which, of course, has expanded greatly.

S. Hawkins: There's also a decrease in the aboriginal health policy of approximately 3 percent. I'm wondering why that has taken place.

Hon. J. MacPhail: In this portion of the budget there are discretionary grants and contributions we would make to various aboriginal community programs. There are two things. One is that some aboriginal health programs were discontinued generally because of the withdrawal of the federal government from the programs, so the community programs ended. But, two, this would probably then reflect our actual expenditure from the previous year. We just committed the actual expenditure from '95-96 to '96-97.

S. Hawkins: Also, under program standards and information management, there's almost a 10 percent decrease. I'm wondering what accounts for that, considering that we were planning to implement information systems.

Hon. J. MacPhail: This again would be an example of where the '96-97 budget reflects the actual expenditures that occurred in '95-96. We just carried it forward.

S. Hawkins: The kidney dialysis service shows almost a 60 percent increase. Can the minister account for that?

Hon. J. MacPhail: It's for increased community support for kidney dialysis.

S. Hawkins: Under frozen funds, regional health and provincial, it's a 20 percent decrease. Can the minister comment on that?

Hon. J. MacPhail: This line is to deal with the costs associated with staffing in the field. We had greater stability because of the renewed accord, etc., and the renewed health care providers' agreements, so we were able to predict more accurately the funds that would have to be frozen to meet the needs in '96-97. Indeed, that accurate prediction allowed us to allocate a smaller number than the previous year.

S. Hawkins: What kinds of funds were frozen?

Hon. J. MacPhail: Wages, generally. There was some money around funds for Closer to Home projects that had been committed but not allocated yet -- but mainly wages.

S. Hawkins: On New Directions, I know that the deputy minister talked to me about this before. There is almost $10 million allocated for New Directions. I'm wondering if the minister can tell me how much has been spent to date on the New Directions program that she's aware of. I suppose there would be a $3 million reduction in that figure, considering that the elections aren't going ahead. Could she clarify the costs around New Directions for me?

Hon. J. MacPhail: I'll give this in terms of the whole since the inception of New Directions, but I'll break it down for you. The royal commission was started in the '89-90 fiscal year, and that commission completed its work in '91-92, but there was some follow-up responsibility. The offices didn't actually shut down until fiscal year '92-93. There was a little over $6 million -- $6.4 million -- just on the royal commission, but if you then talk about the funding that started in the year 1993 for the New Directions program through to this previous fiscal year, the expenditure is about $26.5 million.

S. Hawkins: I wonder if anyone has done an analysis of what it costs. These, I would think, are the hard costs that you can actually put your finger on. Can anyone put the costs together on staff time, honorariums and everything? We hear figures in the $200 million range that New Directions is costing us to date.

Hon. J. MacPhail: That's the problem with the rumours that are out there; many of them are absolutely inaccurate. The calculations that we have.... Separate and apart from staff time within the ministry, where people who have other duties also contribute to New Directions, this is the cost of New Directions, all in.

S. Hawkins: How much of this money was spent on advertising? Can the minister break that down?

Hon. J. MacPhail: We did publications, but advertising.... There's certainly no communications budget around selling the thing, other than publications. There are very insubstantial costs, if any, for advertising. But publications, yes.

S. Hawkins: Does the minister have a figure she can put on that?

Hon. J. MacPhail: Yes. The communications and public affairs part of the ministry has not spent any money on New Directions. But I will get the costs of publications around New Directions, if that's what the hon. member wishes. I'll have to get it for you, though.

S. Hawkins: I think my colleague has a question.

[ Page 1898 ]

K. Whittred: As principal critic for Seniors, I will be asking a battery of questions later on. I must say I find it a bit confusing to know exactly where to put some of these in. However, I did think it might be appropriate at this time to ask this particular question, because it has to do with the various projects, and I want to make sure that we've got the right people here. Perhaps, if it will suit everybody's purposes, I will try to use my own judgment on where to jump in at what I think are appropriate times. Then we can look at the more holistic nature of seniors' care, also, at that appropriate time. Is that acceptable to everyone?

Hon. J. MacPhail: Absolutely.

K. Whittred: Okay. This is just a very brief question. On the project list, I have roughly added up the number of beds that are frozen -- those that are itemized -- and it comes to nearly a thousand beds. I doubt that it's possible to break these down into who actually would occupy these beds, but it is of great interest to me to try to get a handle on how many of those would be facilities for seniors specifically. Does the minister have any access to that particular information?

Hon. J. MacPhail: I can actually make the document available that I am going to make available to the hon. member for Okanagan West. I'll just make it available to all members. It actually specifies the "under review" category of the number of beds. If it says "multilevel care" beds, that is.... The vast majority of multilevel care institutions are dedicated to older people. There are some which are not, but pretty much all are. So I can make that available to you, and it actually specifies those institutions.

K. Whittred: That was my thinking, as well. Conventional wisdom tells me that the vast majority of these beds would be affecting seniors more than any other segment of our population.

[11:45]

Another conclusion that I draw from this document that is of major concern to me regarding seniors' issues is that in just going through the document and highlighting the key words, I keep highlighting things like "community," "native," "tertiary," "residential care" and so on. Just to serve notice here, one of the things that I really wish to explore in the Seniors portion is the holistic nature of the care. I sense -- and I have a very grave concern -- that a great many of the projects that are being frozen are of particular importance to seniors and are those issues that in fact provide the infrastructure for the kind of total and holistic care that we are looking for. I'll just leave it at that for the moment.

Hon. J. MacPhail: I think that's a very fair comment from the hon. member. I agree that it is part of an interesting discussion that I've been having with many health care professionals. I would actually appreciate your advice on it as well.

We are at a time where there was not planning for seniors in terms of multilevel care beyond acute care. Seniors got sick, and health care was delivered in acute care beds. We are at the cusp of planning right now, where there is a commitment to say that many, many more multilevel care facilities must be developed, be planned for and be built for our aging population.

So your point is well taken, and I actually think it is accurate as well. We're not going to get any disagreement. But it also means that I hope that there's great hope for them proceeding, as well, when the review is completed, because they're essential not only to the well-being of our seniors but to the efficient use of the rest of our health care system as well.

Noting the hour, I would move the committee rise, report progress and ask leave to sit again.

Motion approved.

The committee rose at 11:48 a.m.

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