[ Page 3419 ]

The House met at 10:05 a.m.

Prayers.

Orders of the Day

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

ESTIMATES: MINISTRY OF HEALTH AND
MINISTRY RESPONSIBLE FOR SENIORS
(continued)

S. Hawkins: I was going to let the member from Richmond go first, but that's okay. I'll start, and he can butt in when he wants to.

I'm going back to some of the issues around the CHCs and the RHBs. I understand that regional community plans were being worked on in the last year or so and that some of the RHBs and the CHCs didn't have those plans in place. I'm wondering which ones do and which ones don't.

Hon. J. MacPhail: They all do now.

S. Hawkins: What do these plans include?

Hon. J. MacPhail: The health plans that began under New Directions were to develop an integrated approach to health within the community, but certainly moved the direction of health care away from the acute care model into a broader health and wellness public and community health model.

Since that time, the plans have also included the management organizational structures for the actual CHCs and regional health boards. Then the work that will be done now will be to make sure that the health plans that did involve a community structure that was different under New Directions than it is now under Better Teamwork, Better Care will work toward blending the community health model for health care delivery into either a smaller geographic area or a larger geographic area, depending on the restructuring.

S. Hawkins: What was the process involved in getting to this plan?

Hon. J. MacPhail: Let me give you examples of two models. One is an urban model and one is non-urban -- rural. I'm very sensitive to calling it rural.

For instance, in the Vancouver region a lot of consultation was done amongst communities. They set up individual neighbourhood councils and had focus groups amongst those councils. They then met together as a group and actually had subcommittees of specialized areas of health care delivery or specialized communities -- a multicultural community, etc. -- hold special meetings. Then, over the course of making the final touches to the plan, representatives from all the various task groups, for lack of a better term, came together to put together a broad plan.

In smaller areas, such as the Robson Valley, individual communities met, in a very broad-based manner and with lots of community input, and worked with the health care professionals in the area to develop a plan to meet the needs of their community. There was no one set way of developing a health plan. It was based on community need.

S. Hawkins: The minister has answered some of my questions, but I guess I'm looking for some more specifics around the process. Was there a structure around the process of developing these plans? What assistance did the communities get, perhaps from the ministry, in developing these plans?

Hon. J. MacPhail: I'm going to take this with a two-pronged approach. One was retrospective: what happened in the past? And what do we expect now?

Under the New Directions model, there was actually a formatted guideline provided to communities by which they would go through a process, with their own community touches, to develop a health plan. They also received assistance from the staff of New Directions offices throughout the province. That was the support given from the ministry.

[10:15]

S. Hawkins: Where are the plans now? Are they public documents?

Hon. J. MacPhail: Well, they rest both within the community. . . . We have all the old plans that were developed up until the restructuring of the boards. I would expect that as the health plans are integrated, they. . . . Yes, they are public documents.

S. Hawkins: Where would one find the plan? People have asked me. Certainly my constituents have asked me, because I think my regional health board was one of the last ones to file a plan. In fact, it is my understanding that they had filed several plans that weren't approved, for whatever reason. Now people are wondering what the process was and who had input. Where are these plans, where do you find them if you want to review them, how do you access them, and how do you see what priorities were set for the community? It is a large region that our regional health board covers. So if the general public in the region -- which is health care providers and consumers of health care -- wants to access these plans, how do they do that? How often will these plans be reviewed?

Hon. J. MacPhail: By us, annually.

[ Page 3420 ]

S. Hawkins: What process will the community have for inputting into these plans?

Hon. J. MacPhail: Again, there won't be a cookie-cutter approach to community input, but community input is expected. Regional health boards and community health councils will determine that community input is expected and mandated, but the way community input is received will be designed by the various regional health boards and/or community health councils. Already some examples are in place, such as town hall meetings, travelling board meetings, focus groups -- and I don't mean focus groups as in public opinion survey kinds of focus groups. Those community input models are already being put in place.

S. Hawkins: When these plans were being developed, what kinds of considerations were being taken? Was there a needs assessment done? What kinds of things were done to help develop these plans?

Hon. J. MacPhail: We're talking under the old model again here. It's been done over the course of the last three years, but it is an interesting discussion.

The needs assessments were done on a community or regional basis. There was support for doing the needs assessment in an evidence-based way. Inventories were done of what was in the communities. Then there were population surveys done, probably more extensively. . . . In fact, we know these were done more extensively than has ever been done before on the health care system in British Columbia. Out of those, the communities put a plan in place to meet the current and future health care needs of the communities.

S. Hawkins: Thank you. I was going to ask if an inventory of services in the regions and communities was done. Where would we find that inventory?

Hon. J. MacPhail: With the boards and councils.

S. Hawkins: I'm to understand that every board and council has a plan in place now, so that would be 11 regional health boards and 34 community health councils. Do the CHSSs have a plan, as well?

Hon. J. MacPhail: Let me just again distinguish between retrospective and prospective. Every single one of the 82 councils and regional health boards -- previous to Better Teamwork, Better Care -- had a health plan. As I said just a few minutes ago, it is now the responsibility of the newly vamped regional health boards and community health councils to bring those plans together under what is now their new responsibility, integrate them and move forward on a plan that meets the needs of the newly designed health councils and regional health boards. So that is the work that is being done right now to integrate the old work and move forward with the new work.

S. Hawkins: Do the CHSSs have to develop a plan as well?

Hon. J. MacPhail: They're new entities, so they haven't got old plans to work from, but they are expected to and will be developing management plans.

S. Hawkins: How much funding is going into helping these entities develop these plans?

Hon. J. MacPhail: The planning for health plans was an item that determined the global budgeting, the base budgeting for regional health boards.

S. Hawkins: This gets a little complicated, but every community health council and regional health board has to have a plan. They have apparently identified an inventory of the services that are in the communities right now. Did they also identify services that were lacking?

Hon. J. MacPhail: The health plans have an inventory, and it lists what the current situation is. Then the health plan identifies. . . . How can I say it? I don't necessarily want to say "gaps." Someone would then identify the gaps in the health care delivery. The way I would probably suggest it is that they would identify the optimal goals for proper health care delivery -- and with the best health outcomes. The health plans would identify where the health system has to move in their community, but they would probably also identify in many cases a time frame for reaching that in terms of the fiscal allocation of resources.

S. Hawkins: The minister is answering some of my questions as she moves through her answers here. I think it is important to identify the services that are available, and then if we're supposed to be working toward this totally integrated system from prevention to treatment, to identify the services that are lacking in the areas. . . . I don't mean every health region or council has to have a Cadillac service for everything, but I think we do have to find out where the gaps are, help the entities and work toward making them fill in those gaps.

There was a question put to me by a constituent about the planning toward where we've come right now. I understand there were transition resource teams that were used. Can the minister please tell me what resources and what support they provided to the health care entities?

Hon. J. MacPhail: The resources, and again we're talking about a period since 1992. . . . The ministry did provide resources to communities to assist them in developing this plan. However, the system has now matured, so it is now the responsibility of the regional health boards and community health councils to move forward. They have been provided the funding for this in their global budgeting, and it's for them to move forward and do this.

I think the sophistication is there, generally. Among the community health councils, certainly, the transfer of authority will occur when the confirmation of the sophistication and skills is in place to do this kind of work. Our ministry is virtually out of the business of assisting regional health boards and community health councils in terms of laying the groundwork for regionalization.

There are regional directors in place in the ministry who are responsible in particular regions for acute and continuing care. They are there as a resource. In the South Okanagan, for instance, the expertise is contained in the community through the regional health board to move forward on their own.

S. Hawkins: I seek leave from this scintillating debate to make an introduction, which I failed to do earlier.

Leave granted.

S. Hawkins: In the precinct today -- and unfortunately, I missed them when they were in the chamber -- is the grades 8 

[ Page 3421 ]

and 9 band from Dr. Knox Middle School in my constituency of Okanagan West. They are here with their band instructor, Mr. Fernando Mastromonaco, and their principal, Donna Connolly. I ask the House to make them welcome.

The transition resource teams, I understand, functioned for a period of time. What I understand is that now that their role is over, they are disbanded. How long did they function for?

Hon. J. MacPhail: Throughout part of '94, '95 and '96 -- for a period of about two years.

S. Hawkins: It was my understanding that these were support teams appointed by the ministry. Who made up these teams? Were they teams that travelled around the province, or were they teams specific to each of the regions or councils? How did they operate?

Hon. J. MacPhail: I'm relying heavily on corporate memory here, because, of course, I wasn't the minister at the time and this is dealing with a period of time that was about two or three years ago. So bear with me on that. The teams were region-specific. They were ministry employees but in regional teams for support. The regional teams were able to and did often draw on the resources of the Ministry of Health in specialty areas.

S. Hawkins: Did the members on the team actually come from the community, or did they travel from the ministry?

Hon. J. MacPhail: There was a mix. Some came from the communities, and some didn't.

S. Hawkins: My understanding is that some of the members of the team were seconded from positions in facilities within the regions. I'm wondering if there was another cost to the system because of that. There were apparently positions on the transition team helping the regional health board, which had set up its own little administrative bureaucracy, and at the same time, the facilities and functions of different health care institutions were running on their own. How much money was put toward these teams and the regions to bring about transition?

[10:30]

S. Hawkins: I look forward to that. I'm also wondering if the 82 plans. . . . I'm going back to the community plans, which we were talking about before, that were in place. If the minister would commit to getting a copy of those to us. . . .

Hon. J. MacPhail: Maybe what I could do is give the hon. member access to our archives, because they're massive. But certainly they're public documents. What I'll do is assist in giving access, sure, because. . . . Literally, I wonder if that would be okay.

S. Hawkins: If that's the commitment, that's what I'll accept, because I think it's important to see what the communities are doing with respect to planning for health care in the different areas.

Moving now to the structure that's in place, each region or community health council has their only little administrative structure. Does each region or community health council get to decide that? Or is it mandated from the ministry what they need as far as CEO, administrative support, vice-presidents. . .that kind of stuff? Can we get the organization structure?

Hon. J. MacPhail: The regional health boards and community health councils develop their management plans; they do that as a board or a council. But they have to do it in the context of the performance measures and accountability measures that we've discussed earlier. They have to meet those tests.

S. Hawkins: Let's just take, for example, one regional health board. We can use the capital region board here. Can the minister tell us what their organizational structure is?

Hon. J. MacPhail: The capital health region has announced their executive structure publicly. We can certainly. . . . Staff are listening, and they can get that for the member. There are further announcements to come, I understand, within the capital health region in the coming weeks. But we'll get that for you.

S. Hawkins: Do they also publicly announce -- because the taxpayer pays those salaries -- the salaries of each of those members?

Hon. J. MacPhail: It is public information; public salaries are public information. Whether that was part of the announcement, I don't know. Certainly all of the appointments were made within the Health Employers Association of B.C. compensation range, but I don't know whether they announced what point within that range at the time. But that too is public information.

S. Hawkins: Does the ministry monitor, then? If they get to decide on their own how many VPs they need, how much administrative staff, how much they're going to spend on perks and benefits. . . . I know that's been a problem in the past, and I know there's a bill before the House that hopes to deal with that. But these are being done. That bill hasn't been passed. What advice does the ministry give to the regional health boards and community health councils on their management structure and guidelines for payment?

Hon. J. MacPhail: Several factors. . . . One is that there are administrative cost savings that have to be met by the regional health boards and community health councils. We've already discussed that in the chamber. Also an incentive is that every dollar saved goes into health care services. They get to keep the dollar saved and put it back into patient services. Then thirdly, the Health Employers Association of B.C. has guidelines in place for all compensation matters, and the regional health boards and community health councils are required to abide by those guidelines. Of course, as of May 1 those are no longer guidelines; they're legislated.

S. Hawkins: What repercussions are there, then, for boards that don't meet the guidelines or legislated provisions that the ministry has set?

Hon. J. MacPhail: Because we are speaking hypothetically here, let me just try to reassure the hon. member that there is the commitment on behalf. . . . Let's use the capital regional health board as an example. Certainly there's a com-

[ Page 3422 ]

mitment to make major cost savings in the area of administration. The chairperson of the board is, of course, the CEO of Centra Gas, a very astute business person; the CEO has 30 years of senior executive experience. We have the former federal Deputy Minister of Finance on the board. We have a former Liberal cabinet minister on the board. These people are committed to, and have said so publicly, their goal to reduce administrative costs and put that right into patient care.

Will we monitor it? Yes, of course. We monitor it through our budgeting process. Of course, as of May 1, we monitor it through the ability to impose penalties and recoup costs if matters are exceeded. But I actually am pleased, to date, with the foreshadowing of announcements that are going to be made, particularly in the area -- because we're using the example of the capital health region -- of what administrative savings will be made and plowed back into health costs.

I don't know whether this is indeed being suggested, but if the member is suggesting that maybe we need to actually impose penalties in some way through the budgeting process, I would rather. . . . I worry about that, because at the end of the day it may be possible to affect patient services. The approach we've taken is to allow for incentives for positive results.

S. Hawkins: The point I'm trying to make here, I guess, is that the money to fund these boards and these positions is coming from health care -- from the health care budget. I think the first responsibility absolutely should be looking for administrative savings.

But let's use the capital health region as an example. Back in February, we saw that board make an appointment of a former NDP cabinet minister for a contract. We saw that contract of $1,000 a day for a part-time job, over six months. And we saw a lot of outrage over that. We saw letters to the papers; we saw editorials; we saw people. . . . Yesterday, I believe, the minister was answering questions about whether foundations were threatened by fear of people not donating to hospitals and societies and what have you. I saw letters to the paper suggesting that people weren't going to donate anymore if that's the way the capital health board is going to operate, giving thousand-dollar-a-day contracts. And for what? That amount of money, $70,000 -- I understand that this contract is almost completed -- pays for a lot of health care services.

You would think there would be services in the ministry that could provide that kind of service this contract provided for. You would think there would be people already, somewhere in the capital health region, that could have been seconded -- could have taken leave of absence two days a week or something -- to help with that kind of service. . .and not pass contracts out to Elizabeth Cull and Associates for $1,000 a day. The contract itself calls for severance pay -- well, hopefully, we will get the legislation that remedies that -- for a six-month part-time contract. It was absolutely -- well, here -- disgusting: "Disgust Over Deal With Cull."

We're talking about accountability here. And this side of the House feels that accountability is very important, especially when we're talking about precious health care dollars. In this day and age, when we know the dollars are tight and we know that there's not a lot to spread around. . . . We know that patients are waiting on lists; we know that patients are waiting for cancer care in this health district. We have a cancer clinic that's waiting to be built. We have patients that have been going down to Bellingham. We now have patients that are going over to Vancouver; apparently there are extended hours going on at this clinic. Patients are not happy with things like this.

At the time this contract was announced, I heard the minister say that this was "inappropriate" or "ridiculous," and I heard the Premier say the same thing. My understanding is that the money from these boards comes from the ministry. The minister has talked about accountability, and she says that the boards are accountable to the Ministry of Health. So why was this contract allowed to continue? What message do you send to this board about accountability when you have people in the capital region outraged over this -- people who are waiting for health care services -- and who say: "This kind of thing won't be tolerated. These kinds of contracts won't be tolerated"? What kind of measures did the minister take to tell this board that this was wrong? She publicly said it was inappropriate, and the Premier publicly said it was ridiculous, or not to be tolerated. What message was sent to this board?

Hon. J. MacPhail: The contract is not renewed -- that's the message.

But let me just say a couple of things. I too agree with the hon. member that every dollar that possibly can should go into health care. I don't think there's any disagreement in this House whatsoever. And, of course, the members opposite will use examples to their political advantage. I have an example on my side, Ron Mulchey, who was under the previous system, which I suspect is. . . . I don't know what system of health care the members opposite actually support. They have certainly defended the status quo of the past, so let's take an example that's the status quo. Where we had 122 hospitals doing their own thing under the previous system, Ron Mulchey got $500,000 in severance. That was outrageous. Paying a person $1,000 a day, in my book. . . . I'm stunned that anybody makes $1,000 a day, although perhaps the legal profession does. I don't know. In fact, I do know, but it's still an incredible amount of money. So yes, I found that unbelievable.

So we can talk about the amount of compensation. But I think what was useful in this, and what the capital health board learned from this, was that the demand by the public that we connect with the community. . . . To make sure that we design and change the way we deliver our health care services is essential. The former Minister of Health came with credentials that were recognized as beyond reproach to have the ability to do community consultation. There will be an announcement about the success of those consultations. I will express my dismay -- and have done so by tabling legislation -- about compensation levels that seem to be in excess. But let's not forget that the member for Chilliwack stood up yesterday and took a different point of view on this matter.

So what we have to do is make sure that we move forward, and I actually look forward to the support from the opposition members around the legislation tabled. We have to move forward, bring the industry into the twenty-first century, bring the industry into the times -- what the public demands here -- and agree: fair compensation, and every dollar that possibly can goes into health care.

[10:45]

[ Page 3423 ]

The minister mentioned the member for Chilliwack. I think the point he was making is: how were these changes made? Where was the plan? This government was engaged in this New Directions exercise -- this little fiddling with bureaucracy -- for the last three or four years. Where was the planning around this that the month or two before. . . ? All of this was supposed to go into place April 1. We now have decisions like hospitals not knowing what to do with CEOs and negotiating severances.

Hon. J. MacPhail: They did know.

S. Hawkins: The minister says they did know. I'll tell you when they knew. They got a letter in February -- which was directed to our attention, too -- saying that there would be repercussions if they tried to do this. Where was the direction for them before that? There was none.

There were three or four years of planning around New Directions -- actually, lack of planning, because no one seemed to know what was happening. CEOs didn't know if they were hired, didn't know if they were fired. There were apparently some that were hired twice, some that got severance packages, some that didn't, one that actually. . . . When I did my tour, I went up to one of the northern communities. There was a CEO of a long term care facility up there who was apparently expecting to get severed a year ago. He moved his family to Salmon Arm. Then he found out he still has a job, because the government wasn't ready to move ahead with New Directions last year. So now he's got a wife and children in Salmon Arm, and he's still working up north. I said: "What are you doing after this?" "Well, I don't know." CEO, to folks out there today, is "career-ending opportunity." That's what they're calling it.

Where was the planning around this? That was the point the member for Chilliwack was trying to make -- not that severances should be rich. That lady that worked at the Chilliwack General Hospital had put in 18 years or more of service, and she got less than $200,000. Ron Mulchey worked six or seven years, and he got half a million dollars. Marc Eliesen worked for less than two years; he gets $1.2 million. All of this money could be going toward more efficient ways of delivering health care, but it goes to all these other wasteful things.

There were years and years of planning that should have eliminated some of the problems we've seen in the last few months around regionalization and implementing New Directions. That's the point I think the member for Chilliwack was trying to make: not that the severance and the firing of CEOs and all that was warranted, but rather that we should have looked at people in the system and treated them fairly.

I think he was also trying to make the point about some of the societies that were fired. How did this government treat people that had worked for years and years? Some of these societies were 90 years old or older. They'd been entrenched in those communities; they had good people that had built up facilities, built up resources, built up volunteers and built up support systems for health care facilities and organizations in their communities. And in one fell swoop they were gone. They were gone.

I'll tell you, I have letters and phone calls to my office. . .absolutely disgusted with the way people were treated in communities. That's what's wrong.

And what did we say? We said, all along, that pooling of resources in areas, sharing services and trying to find administrative savings was the right way to go. It was the absolute right way to go. And we said programs should be piloted. If something works well in one area, make sure that there are positive outcomes, make sure it's evidence-based before we move it into another area. That's what we called piloting regionalization and pilot projects. And that's what we support.

The minister also mentioned that Elizabeth Cull, who was the failed NDP candidate, came to the capital health region with this wealth of experience and great credentials. Well, wasn't she the minister that started New Directions -- the New Directions fiasco? And wasn't she the minister responsible for the failure of that first model? Wasn't she the minister responsible for the waste in the system -- the $30 million, $40 million, $50 million or whatever? Who knows how much was wasted in the planning around New Directions. She was the one responsible. I put to the minister that the only reason she got that contract at the capital health region was because she had an NDP card. That's why people were very, very upset and not very happy over the deal that she got: $1,000 a day. The minister herself said that that's a lot of money, and the minister can't imagine anyone who makes a $1,000 a day. This is $1,000 a day for a part-time job. What could $70,000 buy in health care services? We saw a hospital in Prince George cancel surgery for a packet of sutures. Well, how many sutures could $70,000 buy?

I'm just looking at the news stories, because there was quite a bit around this. The minister still defends the contract that Elizabeth Cull got with the capital region. It's absolutely unbelievable. I'm going to read some of these into the record, because I think it's important. Perhaps she hasn't seen them or hasn't read them. This is a letter of January 22, 1997, that was in the Times Colonist:

"Pay 'Obscene.' Just read about Elizabeth Cull getting $1,000 per day for her community relations job with the capital health region. Give me a bloody break! There are things in this world that can be classed as obscene, and this certainly falls into that class.

"We have a health care system in disarray, and now we're being told [capital health region] head Ken Fyke and his high-paid cronies need more help to regionalize health care. What does Cull know about anything, especially health care? Just because she was a very inept Health minister does not give her the expertise for this position.

"If she really cared about our health care system, she would offer her services for free. The money saved could then be put to good use within the health system and maybe a few people wouldn't have to wait forever for their surgery or a CAT scan."

When we talked about accountability in the last few days, I don't think we got into any in-depth discussions. When we talk about accountability, we should talk about how the boards will be accountable to the community, because the community was outraged. They expressed their concern and outrage through letters to the paper and through phone calls to the hospitals. They said that they didn't want to donate to the hospitals or facilities, because if that's where their money 

[ Page 3424 ]

was going, they weren't going to give any. And nothing was done. When I ask who these boards are accountable to, the minister says: "They're accountable to me; the buck stops here."

Well, the community did say they were unhappy with this contract, and the minister says the boards are accountable to her. So why wasn't a message sent that this was inappropriate? The community didn't like it. They wanted that money better spent on health care in their region, because they knew there was a cancer clinic to build, they knew there was a pediatric intensive care unit to build and support, they knew there were people on waiting lists, and they knew there was a cardiac surgery program in their community to support with waiting lists around that. They know there is technology that needs to be funded, and they see this money going there. It just boggles the mind that this government can still support something like this. On one hand, they say they're absolutely outraged, it's inappropriate, it's ridiculous. Well, what message do you send that board? And will this happen again?

Hon. J. MacPhail: Clearly the hon. member didn't have time to prepare for substantive questions over the course of the evening, so she's relying on some outrage that has absolutely nothing to do with what we're talking about here today. We can throw back information about wise expenditure of tax dollars; we can talk about a million-dollar mailout that the Liberal caucus did that wasted our money -- a million bucks. We can talk about wasted tax dollars. Let's talk about that, compared to $70,000 of invested health care money.

I am pleased that this hon. member mentioned the funding of the cancer clinic which we announced in February. I am pleased that she mentioned the pediatric unit that we opened last month. I am pleased that she mentioned the wait-list that our government has funded to an unprecedented level. I am pleased that she mentioned the technology that our government has funded to an unprecedented level. I am sad that she has never once in this House mentioned mental health, except for a passing reference. In fact, I don't even know whether there has been a passing reference. I am sad that this member has never mentioned public health. Instead, this member has taken it upon herself to defend only the interests of specialist doctors.

But I am pleased that we may get to some substantive questions around the real issues facing us in other areas of health care. We can attack the boards all we like and defend the status quo. When this member stands up and says she defends patient care, that is so easy. It is so trite to say, "I'm an advocate for patients," without any substance behind it whatsoever, except to say: "Give more money to doctors." To give more money to surgeons to perform surgery is all this hon. member has ever said in this House.

It is easy for a member in this House to stand up and attack the chairperson of Centra Gas, who is donating his time. It's easy for this member to stand up and attack the CEO of the regional health board, who has 30 years of experience. It is easy for her to stand up and attack the former Deputy Minister of Finance, who is donating his time. It's easy for her to stand up and attack a retired person like Judd Buchanan, who is donating his time as well.

You know what? I think that the system that has taken three years to develop, where we've learned from our errors and improved on our successes, makes a lot more sense than having 122 hospitals out there with extra continuing care institutions working in isolation from each other, not working with the mental health community and not working with the public health community. I think it makes a lot more sense to have high-profile, good, solid community citizens working together to improve our health care system.

We have put in place a model that's open to public debate, that's completely inclusive and that has dollars attached to it. We are here today to talk about the dollars attached to the health care system. If the hon. member wants to stand up and in some way say, "Every single person who is contributing their time now is bad, is rotten and doesn't know what they're doing," she is free to do so, and she will have to be subject to the views of the community coming back on her.

[11:00]

S. Hawkins: That was a very nice, positive response from the minister. I can see that she totally understands the system of accountability, and it's comforting to know that she's going to carry on supporting a board that makes the kinds of decisions that outrage a community.

When she says that she's put into place a system of community volunteers, she's absolutely right. But you know what? They are all people she has appointed. They didn't come from the community. They didn't exactly just fall into the minister's lap; she picked and chose them. They didn't come from elected positions in the community. They didn't come from community input.

She talks about community input. Well, let's see what kind of community input went into New Directions. In the last three or four years a lot of community input apparently went into New Directions, because the community was actually involved until this minister came into place. Then we had what we called a pause; regionalization went on hold. Then we went into not New Directions, but two directions. It was their way or the highway, and boards and people who didn't comply with the new mandate, "Do as we say, or we'll fire you" -- guess what -- got fired. That was the kind of community input that they offered the public. That's the kind of community input and. . . .

An Hon. Member: Consultation.

S. Hawkins: Some hon. member here mentions consultation. We've talked about community plans before. Where were these meetings? Where were these consultations? Where were they? They weren't there. I've got people asking me now what the boards were doing, what process of consultation they were engaged in. . . .

Hon. J. MacPhail: Where were you?

S. Hawkins: Well, I was standing up for people in my community, and I was going to board meetings and trying to find out what was going on. It was very difficult, because the ministry kept things very close at hand. Right now I again hear from regional health boards, I hear from the community 

[ Page 3425 ]

health councils that this minister has actually appointed, and they tell me they have very little control because all of the instructions and all of the mandates come from the ministry.

And we'll get into that; we'll talk about how much authority and governing power these bodies really have. They don't even have control of the money right now, because for this year it's in a transitional account which the ministry will control. So this business about moving health care closer to home, this business about empowering communities and this business about more consultation is a bunch of bunk. It hasn't happened. We will wait and see; we'll watch.

When the minister accuses me of not being a patient advocate, that's absolutely laughable. I spent 12 years on the front line as a nurse. It may be very hard for you to believe, but I looked after the sick, I looked after the dying, I looked after people who were ill, and they come to me now because they don't get any help from over there. They get absolutely no help from over there. It's absolutely very, very sad, the way this ministry communicates with actual patients and actual people in the community.

Again, I mentioned headlines. This is how people express their outrage, and it takes a lot for people to write letters. People read the paper and usually put it aside, but when something really hits them, they will write a letter. This contract that I mentioned with Elizabeth Cull generated a lot of letters. Again, I hear the minister saying: "There's nothing wrong with that. She'll just let the boards do what they want."

Then she said I was accusing the capital health region chair of not doing a good job. Well, when they do stuff like this, someone's got to hold them accountable. The community was not happy with this. He may be very, very skilled, but people do make mistakes. If this was a mistake, then it should have been pointed out to him. I heard the minister say it was ridiculous, and I heard the Premier say it was inappropriate, but it was allowed to carry on. If the minister says that the accountability rests with the ministry, that's what I'm trying to get here: how do you tell these people, especially with the community's concern -- the community's upset -- that this is not appropriate, that this is not right, that this is a concern?

It's obviously a concern to the community, which is waiting for all these projects that this government announces every few months for a photo op. Let's talk about the Vancouver Island cancer clinic. I was going to save it for another day, but yes, we can get into that. How many times was that announcement made? Every year it's a new photo op. We'll wait and see if that building ever gets off the ground, and every year we're pouring money into that for planning. If you actually got your books right, budgeted properly and managed properly, that clinic might have been started to be built last year.

The cancer clinic in Kelowna. . . . Yes, we're opening a cancer clinic in Kelowna. I'm helping to fundraise for that. I was a cancer nurse for years; I know how important it is to treat these patients. The announcement for the cancer clinic in Kelowna. . . . This government took over, and do you know what they did? There was no MLA that was an NDP member in Kelowna, so we engaged in another series of consultations to see whether the clinic should actually be in Kamloops -- because you know what? -- Kamloops had an NDP MLA. We always look after our own, don't we? This government always looks after its own.

We went into a year of consultations, and there were studies redone, and guess what the studies came up with. The cancer clinic should be built in Kelowna. So we delayed cancer patients another year. That clinic won't be open until next year, and those cancer patients in the interior are denied another year of good service. It's money wasted. It's absolutely ridiculous. That's the kind of decision-making -- or lack of decision-making -- that this government does. It's absolutely inappropriate. It's a waste of tax dollars, a waste of precious, precious health care dollars.

They go on this rant about how they protect health and education. Well, let's see where dollars that they say they protect health care with. . . . We saw the Ministry of Transportation and Highways engage in a photo radar exercise.

The Chair: Hon. member, be relevant to Health estimates, please.

S. Hawkins: We saw $60 million wasted that could have been put to health care, and it wasn't. Thirty-three million dollars over; it's unbelievable.

The minister says she's shocked at the lack of accountability in the health care system under hospital society boards, but at least they were responsible with their budgets; they had to do what was within their means. Now the minister seems to think that stacking the health boards with NDP appointments gives the health care system the accountability that it was missing. About 600 or 700 appointments in this province, all made by the minister. . . .

She says they're accountable to her, yet we see a $1,000-a-day contract from the capital health board to Elizabeth Cull, and she can't do anything about it. She can express that it's inappropriate; the Premier can say that. Well, where is the accountability? There's absolutely no accountability, then. There's nothing in the system that makes it accountable if she cannot tell that board that that was inappropriate. What we're trying to get at and what people who expressed outrage and concern are concerned about is: what message do you send boards that engage in that kind of activity? What measures have you put into place to make sure that those kinds of things don't happen again?

R. Coleman: I ask leave of the House to make an introduction.

Leave granted.

R. Coleman: Visiting us in the gallery today are 30 students from Strasbourg, France, who are being hosted by the Walnut Grove Secondary School, and their teacher, Mrs. Bourque. They are here to basically concentrate on government and local history, and I'd like the House to please make them welcome.

Hon. J. MacPhail: The hon. member can read Hansard for the answer to that question.

The Chair: I'd like to caution all of us that we're on the estimates of the Ministry of Health and to avoid repetition.

S. Hawkins: I will read Hansard. And this may very well come up again. I'll consider the minister's answers. Like I said, people are outraged. I'm sure they'll be reading the minister's answers to that, as well. I'm sure she'll be getting some feedback on that.

The member from Vernon mentioned the other day a patient who was on dialysis in her region and now would like 

[ Page 3426 ]

to travel to another area of the province for dialysis care. This patient has been told that the area that she wants to travel to, which is Sechelt, will not provide her with that care. Under regionalization -- that's what they seem to give as a reason -- this patient isn't able to transfer from area to area. She needs life-saving dialysis three times a day, in Vernon, and she wants to travel to Sechelt to see her sister. Now, is she going to be stuck in that area, or will she be able to transfer to another region? How does she go about doing that?

Hon. J. MacPhail: I provided the answer to this yesterday.

S. Hawkins: We had a question around how patients were going to be able to travel from region to region if there's only funding provided -- and you can correct me if I'm wrong -- per patient under the regionalization of the renal dialysis program. Does that funding then move with the patient to another region?

Hon. J. MacPhail: The funding is on the basis of the need in the region. If that need increases we adjust it, as we did in the example that was given yesterday. Overall, there's been an 11 percent increase in renal dialysis funding.

S. Hawkins: I understand that there's been an increase in funding, and I understand that there were inequities between regions in the past. I'll get into those in a more specific way when I talk about the renal program. But I guess what I'm wondering is, since this patient has funding provided for her in one area, and now she wants to travel to another, how easy is it for her to do that?

[11:15]

S. Hawkins: What does a patient have to do to travel from one area to another, to get that service that they need -- a service like dialysis?

Hon. J. MacPhail: The patient should work with her or his nephrologist and plan for the travel. The nephrologist is to contact the area to which the patient is travelling and plan for the services, which is what happened in the case that was brought to our attention earlier.

S. Hawkins: I see your support is here for that issue, so maybe I'll just ask how much the funding is per patient on dialysis in this province.

Hon. J. MacPhail: There's a document that's headed "Management and Funding of Renal Services." It went out to all health authorities and has what I would view as a very complex model. It's a public document. I'd be more than happy to make it available.

S. Hawkins: That's fine; I'd be happy to have the document. But is there a base funding per patient for dialysis in this province?

Hon. J. MacPhail: This information is of course based on a per-patient-year, because that's how the model calculates it. There's a very complex formula for what goes into calculating a per-patient-year, because there are different demands. I'm sure the hon. member is well aware of this -- that there are different levels of dialysis per patient. There are 1,200 patients receiving renal dialysis in this province. We contribute $40 million to the provision of that service, so the average per-patient-year cost -- it's not on a per-patient basis -- ranges, per institution, from $35,000 through to almost $50,000 per patient-year. That's the range. It's on an institutional basis.

S. Hawkins: That will be the three-times-a-day dialysis, or whatever, done in hospital care? I understand there are community dialysis units, as well. Is the cost per patient less in those units?

Hon. J. MacPhail: It's less than community dialysis.

S. Hawkins: How many community dialysis stations do we have in the province?

Hon. J. MacPhail: Again, this is all contained in the document that I offered the hon. member. There are 13. There's also the Rutland community dialysis, which is part of the Kelowna General Hospital.

S. Hawkins: I understand that the minister has offered me this stuff. I'll just note for the record that that stuff was offered to me last year, I think I got it five minutes before Health estimates this year. There was a commitment made to me on Monday for some stuff that was going to come to me for Tuesday; I still haven't received that. I hope the minister doesn't mind if I ask some specific questions, because I never know when I'm actually getting that stuff. It would be appreciated if it would come to me; it would help me out a little bit. If it comes to me, great; if not, I'll just pursue the line of questioning I'm at here.

It's cheaper to do community dialysis than hospital dialysis. I brought this up last year in my region. In the Okanagan Valley we do have two community dialysis stations. We have one in Vernon, and we have one in Rutland, which recently opened. We have dialysis that's provided, on a chronic basis, at the hospital in Penticton, and we have a unit at Kelowna General Hospital.

What I understand the patients from Vernon and the medical staff telling me is that the community dialysis service in Vernon has actually decreased in the last five years. The staffing levels and the hours put in have actually decreased over the last few years. The minister can tell me if that's right or not. That's what I'm told. And if it's cheaper to do these people in the community rather than in the hospital, and if it's a higher cost to the system in the hospital, why aren't we encouraging more hours for these community dialysis stations? Why aren't we encouraging that so patients get dialyzed closer to home?

Hon. J. MacPhail: The benefit of Better Teamwork, Better Care is that the programs will be managed locally now. The South Okanagan regional health board will be in charge of the Vernon community program as well as the hospital programs and will no longer be subject to the sometimes bureaucratic rules of Victoria. So that's the good news.

S. Hawkins: That is good news. And it is good news that there was an 11 percent lift given to the dialysis program. Can 

[ Page 3427 ]

we get some information on why 11 percent? Was that a population increase? Was that an aging problem? Was that more patients? Maybe we can just get an understanding of why.

Hon. J. MacPhail: That was the percentage increase recommended by the Renal Council, which took into consideration inflation costs, population changes and the increased incidence of end-stage renal failure.

S. Hawkins: When I was in Prince George, I was talking to the medical director of dialysis, and there was a concern that they had been underfunded for dialysis patients in the last few years. I understand that there has been some movement towards getting them to a stage where they're able to provide the services they can for the patients they have up there. Is that correct?

Hon. J. MacPhail: This year Prince George received a base adjustment of $388,000 -- that's additional dollars in the base -- and then they get the increase for inflation and population growth on top of that.

S. Hawkins: How, then, will dialysis services work under a regional health board? The Okanagan, which has functioned as a region including Vernon, is now separated into two regions: the community dialysis in Vernon, and then the Rutland dialysis, the Penticton dialysis and the Kelowna General dialysis. Will the North Okanagan board and the South Okanagan-Similkameen board now have control over a part of a unit and three-quarters of a unit, or will one board be looking. . . ? Who's going to decide in that region who's going to be in charge of the dialysis?

Hon. J. MacPhail: I'll read from the document:

"On the recommendation of the British Columbia Renal Council, the Ministry of Health agreed on the transfer of the KDS community clinics to health authorities currently operating an in-centre renal program. Following the transfer, each of these health authorities will be responsible for providing service to a larger geographical area extending across health authority boundaries."

For instance, the example given was the Okanagan-Similkameen area. The organization of that, how that will unfold, is actually specified in this document. But it's a buddy. It's an in-centre unit taking responsibility for the buddy community programs.

S. Hawkins: There was also a question around capital funding. The machines are very, very expensive, and apparently the funding formula. . . . There was a problem with it only accounting for operating costs and possibly not taking capital costs into consideration. We know that the capital is very expensive around this kind of disease. Machines are changing and technology is changing. How is that going to be addressed? How are the regional health boards going to manage that problem?

Hon. J. MacPhail: This, I'm sure, will come up again under the capital equipment budget. We've tripled the capital equipment budget this year. Machines will be paid for out of that capital equipment budget. We're working with the Renal Council now to discuss allocation and the potential for group purchase, as well.

S. Hawkins: Renal service, in my mind, is a core program. It goes hand in hand with the transplant service. Who's going to monitor this on a provincial level? If each regional health board is responsible for services within their area, who's monitoring the whole provincial picture?

[11:30]

S. Hawkins: Certainly standards in the units and the performance of the staff that care for these patients is a concern as well. Who is going to monitor that on a provincial basis? Who looks after providing that the quality of care and the standard is met on a provincial level?

Hon. J. MacPhail: The Renal Council made a recommendation that a provincial renal agency be established. We're doing that. That agency will be responsible for standards, and the agency will be located at St. Paul's Hospital.

S. Hawkins: Just for information's sake -- and it is probably in the document that you hold -- are there community dialysis stations in the urban areas? I know there is one in Rutland. How many are in Vancouver?

Hon. J. MacPhail: In the large urban areas, there is one in Surrey, one in Victoria and one in Vancouver. Nanaimo is a large urban area, and there's one there. Abbotsford is a growing area, and there's one there.

S. Hawkins: The minister can appreciate that for the urban areas -- and I come from an urban-rural area in Kelowna. . . . We have a unit in Rutland as well as in the hospital, and we have a unit in Vernon. But when I travelled up north I saw a disparity. We have an acute dialysis unit in Prince George, and I believe there's a self-care unit -- a community dialysis unit -- in Fort St. John and perhaps in some of the outlying areas. When I was up there I was told that patients often get very ill and cannot be managed in the self-care unit anymore, so they have to move to Prince George, away from family and away from their support systems.

In the urban areas it's very easy. There's transportation, it's easier to get to family, it's easier to get to the acute dialysis. I found it to be a very difficult and significant problem that these families are facing in the north. There are travel costs associated with having to travel to Prince George from Fort St. John or wherever to see their loved ones. And there is a problem with patients starting dialysis in one centre, being moved to another and then back again. Certainly it becomes expensive in transferring them by ambulance -- and all kinds of issues around that.

I'm just wondering what kind of planning is being done to provide more equitable service in the northern areas.

Hon. J. MacPhail: Just to make it clear, we funded the renal dialysis program at the level requested by the Renal Council, so the funds are in the system. I'm wondering whether the proposal being offered is that there be more money in it -- because we certainly did fund it. It's an excellent news story for British Columbians that we did fund it at the level that was recommended.

[ Page 3428 ]

In terms of the management of patients such as the hon. member describes, the hospital, which is the in-centre unit responsible for the community dialysis buddy clinics, will be able to plan to best meet the needs of the patients in that geographic satellite. It will be much more community-oriented, and I expect it will go a long way to resolving family concerns.

S. Hawkins: I understand that more money was put into that, but I understand they were also underfunded for many years. That was one concern that was raised. I heard the minister say a little while ago that the funding was adjusted.

What I understood. . . . I went and had a look at the unit up in Prince George, and it wasn't a pleasant sight. It was very crowded. They've got a new unit now that they're a little happier with. But there were old machines. Capital funding has always been a concern around this service. They've finally been adjusted to a level where it is manageable to give the kind of care they hope to give these patients in these northern areas.

Is there a provision for home hemodialysis because of the length of travel, driving conditions in the north and the need for families to be more supportive and closer to these patients? Is that something that's being considered up there? How much of that goes on for those patients up there?

Hon. J. MacPhail: The region has been funded for all modalities of health care delivery.

D. Symons: I ask leave to make an introduction.

Leave granted.

D. Symons: It was my pleasure just a few moments ago to welcome 40 grades 10 and 11 ESL students from Richmond Secondary School. They're accompanied by their teacher, Ms. Schuck, and several adults. I wish the assembly would make them welcome.

S. Hawkins: I understand that the program is going to be regionalized into regions and that another agency will follow this program, provincewide.

I think home hemodialysis is an issue, because I've heard that perhaps KDS, the monitoring agency that looked after this before regionalization, wasn't moving toward the modality of home hemodialysis. I understand from northerners that that is something they are very much for, and they hope it will be considered.

I'm wondering how much of that is going on in the north right now -- for patients in Prince George who have to be moved back into their communities for a better quality of life. Is there a home hemodialysis program going on in the north, and how many patients are on it right now?

Hon. J. MacPhail: The program is funded on the basis of per-patient-year funding for the needs of the area. It is then up to the nephrologist to determine the best method of treatment and to provide for that. So it would be up to the nephrologist in Prince George to determine treatment.

S. Hawkins: You're absolutely right; it is up to the physician who is managing the patient caseload. But, unfortunately, they only have the resources they have to work with. This is life-saving treatment that we're talking about, and patients in that condition aren't always in the best frame of mind to be thinking about what they're doing. I know, from working in health care, that oftentimes patients get so destitute because they're away from family at a time when they're critically ill and need a machine to sustain their life. Some of them will go home, and miss a couple of dialysis treatments because they just want to be closer to home. They want to be home with family, with friends.

They're not intentionally making a decision to end their life, but sometimes they get so frustrated being so far away from home, because that's the only place the service is offered, and they get tired of travelling. I know patients that come from Revelstoke three times a week to dialyze in Kelowna. It's a significant commitment on their part to travel back and forth in road and weather conditions the way they do.

There are different modalities of dialysis and treatment offered, and that is one that I know has been suggested several times by physicians in the north. I understand that funding has gone up there, and I'm wondering if the new agency or the KDS has some kind of mandate -- that they're looking at home hemodialysis. It may very well be that it's even more cost-effective. Have they looked at that model and at how they might be able to make it work for patients in the north?

Hon. J. MacPhail: That is exactly why we have a Renal Council, and we'll be establishing a provincial renal agency upon the recommendation of the Renal Council, to examine issues such as that.

S. Hawkins: The new renal agency, then, will be looking at standards or quality of care around the whole province. What structure will the regional boards have in place to look after dialysis in their own regions -- and what reporting mechanism to the new agency?

Hon. J. MacPhail: These questions are answered in this document. I understand, actually, that this document has been provided to your community, but I'll certainly make this copy available to you at the conclusion of estimates, when we break for lunch.

S. Hawkins: I look forward to getting that document, because I think it probably will answer a few other questions I have around the nephrology issue.

While your support is here, I will perhaps talk about the transplant program a little bit. As I mentioned a couple of weeks ago in the House, the renal transplant program gets more organs by donations from family members or unrelated donors than it does from donors from accidents and what have you. I'm wondering how many patients are waiting on the transplant list as of today or as of the most recent documents.

[11:45]

S. Hawkins: I understand that the minister did give a lift to the dialysis program. Is there also a lift to be given to the transplant program over the next fiscal year?

Hon. J. MacPhail: Could the member repeat the last part of the question?

[ Page 3429 ]

S. Hawkins: I understand that there was more money put into the dialysis program. Was that inclusive of the transplant program, then? And how much did money for the transplant program go up?

Hon. J. MacPhail: The 11 percent increase is just for the renal dialysis program; it's not for the transplant program. The transplant program budget went up by just under 0.9 percent, but that's only for a budget line item.

If organs are available, we do it and compensate elsewhere. It's cyclical, and we certainly expect and are very hopeful that there will be more organs available. Therefore, if the organs are available, we provide the money.

S. Hawkins: I will have more questions for the renal program. I note the other committee Chair is here, and if it's agreeable, 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 11:49 a.m.

PROCEEDINGS IN THE DOUGLAS FIR ROOM

The committee met at 10:12 a.m.

ESTIMATES: MINISTRY OF
ABORIGINAL AFFAIRS
(continued)

M. de Jong: In a few moments, my colleague from Prince George-Omineca is going to investigate with the minister some of the issues around economic development that are relevant, particularly to aboriginal peoples, first nations, in B.C.

I would like to briefly explore along those lines an issue that I think arises out of the Nisga'a AIP. I promised myself I wouldn't put evidence that the select standing committee got to the minister, but I want to put this evidence to him. I don't think it's necessarily argumentative, but I think it raises a very good point.

When we began our hearings and travelled to Nooaitch, we heard, as the minister might expect, from many of the Nisga'a themselves and some of the people in the surrounding area. But there was one witness who made something of a lasting impression on me. She appears -- Miss Wright -- in the Hansard for October 1. I just want to read to the minister her brief comments.

The situation she was describing was her frustration as an aboriginal person with securing the kind of loans and investment capital that many of us non-aboriginals would take for granted. The page reference, just for the record, is 106 on October 1, 1996. She said:

"The one thing about that is that being an Indian, I can't build anything secure to this ground. For the last couple of years I have been an entrepreneur, trying to get things started, and I run into the same rock wall all the time. It doesn't matter how much credit I build up; it doesn't matter how much money I am saving; it doesn't matter how many assets I may have. The fact is that I'm building on a reserve, and it's always the same wall. It's harder for me to get anything, because I live under the Indian Act, and the bank can't secure my loan. That is sad, because it keeps a lot of us from really getting anywhere."

"I had a secure job and assets, and so did my partner. But our assets are on the reserve. We wanted to take out a $15,000 mortgage. Yeah, right! It was a bit of a joke. Honestly, it was a joke. We couldn't get that from the banks because we were Indian. It just makes no sense to us."

But a few days later we were in Prince Rupert, and we had representatives from the B.C. Central Credit Union there. The young lady's testimony, as I said, had left something of an impression on me. I can't think of anything that would upset or frustrate me more than to be told that I couldn't get a $15,000 loan for a home. To have to go cap in hand, bank to bank to bank, and be refused in spite of having a secure job and a spouse having a secure job, struck me as just being incredible. But, of course, the difficulty related to taking the security was the ultimate problem.

So when the lending institution representatives were there, I put the scenario to them. I said -- and I should say to the minister by way of summary -- that these representatives, Mr. Tarr in particular, were very supportive, or purported to be very supportive, of the treaty process and in fact of the Nisga'a AIP. To briefly summarize their testimony, they had a very positive outlook on the Nisga'a AIP, and I think that accurately reflects the general nature of their testimony.

I put the question to them that I wanted them to be a little bit more specific. I said to them: "This is only a meaningful exercise if at the end of the day this young lady can get that loan that she now can't get. You've talked to me in a very general way, and you've talked to the committee in a very 

[ Page 3430 ]

general way about all that you see as positive about the treaty negotiating process. But at the end of the process, is this agreement-in-principle as it now stands going to lead to a treaty that will give you the confidence, the mechanisms and the abilities that you need to extend right across British Columbia the kind of loans, the kind of investment capital that the rest of us take for granted?"

His response -- and I'll read it -- is on page 168:

"The point is that as long as the financial institutions cannot register title free and clear on property on the reserve or on the nation's land, then there will be reluctance on the part of financial institutions, in terms of prudence, to lend money. I mean, that's a reality."

I guess what I'm ultimately asking is for the minister to describe to this committee of the House why he is confident that the model that is contemplated by the Nisga'a agreement-in-principle is going to satisfy. Why does he have that confidence, when others apparently do not, that some of these impediments are going to be removed -- that people like Miss Wright are going to be able to get on with finding their place in society, as I'm sure we all want them to do?

Hon. J. Cashore: I just want to put a brief comment on the record; then I want to consult with the deputy on further comment.

I would be interested to know if this individual who was speaking on behalf of the credit union had had the opportunity to reflect on the actual documentation in the AIP that relates to the changes that would take place with regard to land and the fact that that land would be under lien by provincial Crown title -- albeit recognizing that it would be land that would be transferred to the tribal council in a manner similar to fee simple land -- and if he was fully cognizant of the actual Nisga'a agreement-in-principle when he made those comments.

Also, I'd be interested in knowing if he has had an opportunity to sit down with persons on our negotiating team -- who wouldn't be there, of course, to try to convince him but to answer questions he may have with regard to the way in which the actual anticipated status of the land would be dealt with.

It would be helpful for me to know that, because I think that there are two things in terms of where we need to go with this. One is to try to identify if this is an absolute concern based on the direction that the AIP is going, or if it is a concern based on what he may be assuming about where it's going -- and in that assumption, where he would be saying, "Well, really, it comes right down to: there just isn't the ability in this to register a title free and clear," as he said in that statement. I just would be interested in knowing that, but I also want to consult with the deputy minister.

M. de Jong: I will just provide this by way of background. The short answer is that I can't be certain what information Mr. Tarr had or how familiar he was. He appeared as the chief executive officer for Northern Savings Credit Union and also as a member of the board of directors for the B.C. Central Credit Union, and there was a fairly detailed submission made by both of those bodies. I must assume that on that basis he had some background in the agreement itself -- to what extent, I don't know. But it certainly raised for me a very important point.

Hon. J. Cashore: I'm advised that, first of all, the Indian Act precludes security being taken over assets on-reserve, and therein lies the problem. As a result of the treaty, the Indian Act will no longer apply. The Nisga'a final treaty will provide for the registration of Nisga'a land in the land title system and thus for security to be registered against it.

One of the responses which I would anticipate to that answer is that there is, I think, some feeling and expectation that we have been using the phrase in a manner similar to fee simple land, in that it would be a transfer to the tribal council. Mr. Ebbels advises me that in the drafting of the final document, it will make it very clear that the tribal council would be in a position to register that title free and clear, with regard to an individual homeowner in this instance.

M. de Jong: A couple of things arise out of that. I guess my first reaction is that. . . . My concern arises out of the apparent lingering concern in financial circles. Now, I don't want to mislead the minister. We didn't get other submissions from other banks on this point, but the one lending institution that did speak to us addressed it directly. If there is doubt and concern in their minds, then ultimately that is going to operate in a negative way insofar as first nations people are concerned.

I think the other thing that needs to be said is that from an individual's point of view. . . . And I have heard Mr. Ebbels speak on this point, in fact. I don't think there's a lot of doubt that in terms of financing for residential homes, there are means by which the band or the central government can guarantee ways that will satisfy banks. It is something different than what you or I would be expected to do. I suppose I have a little bit of concern about that just insofar as one's individual rights are concerned, but I suppose the logical response is that that is something first nations people will have to concern themselves with.

The other component to this, though, is larger-scale investment. Although I think we can cite examples where lenders, investors and first nations people have managed to get around some of the difficulties that exist, I would like to think that at the end of this tortuous process, as many of those obstacles as possible will have been removed. What I am given to understand by speaking with the likes of Mr. Tarr and others in the financial world is that all of those obstacles aren't going to be removed.

In fairness, I should say this as well. When I speak with first nations people, this is a double-edged sword. When you want to attract investment capital, there's a downside to it -- that is, if it doesn't work, you can always lose your security that you pledged. I think, in fairness, that a lot of first nations people have difficulty with that notion, as well. It can't be a one-way street. But I think in previous discussions in the estimates last year, we spent some time talking about the exigibility of assets on Nisga'a lands, since that's the model we're talking about. I think there is some lingering doubt about the ability of a creditor to realize against certain types of security. So I still have these concerns, and the reason I have the concerns is the way I think they might operate to limit the opportunities of first nations people.

Hon. J. Cashore: I think, with the explanation I gave a few moments ago, that the lingering doubt would be a lingering doubt that is not caused by the final draft. I think it's a lingering doubt that would be caused by a lack of awareness of what's in the final draft.

[ Page 3431 ]

[10:30]

I think it's a matter of stating clearly that the agreement will provide for that free and clear title, and there is a responsibility on the provincial government to ensure that there is close consultation with the financial community. I believe that a lot of that consultation has been present -- or maybe I shouldn't say consultation. A lot of that knowledge has been present in the kind of work that Mr. Hugh Gordon has done as part of our team. We should also recognize that the lending institutions -- credit unions and, I would also point out, some major banks -- have vice-presidents in charge of aboriginal relations. I would just cite Matt Vickers at the Royal Bank. Also, if you go to a meeting -- I think this is significant -- of the Nisga'a tribal council, you will be surprised at the number of major banks that show up at those meetings, handing out cards and wanting to talk to the Nisga'a with regard to various types of investment opportunity, various types of economic opportunity that they foresee in the post-treaty circumstances.

I think it's a very valid concern to raise here, and I'm impressed with the quality of the comment that was made to the select standing committee. But I do believe that it's not a matter of this being an ongoing problem, because the problem is inherent within the treaty. I think it's an ongoing problem where there is a need for communication and clarification, and we need to do everything we possibly can to satisfy that need.

M. de Jong: I guess the fact that we're dealing with an agency that is ultimately destined to be the recipient of $190 million probably explains the presence of many of the investment-type individuals that the minister referred to.

Hon. J. Cashore: Well, that and other factors.

M. de Jong: Undoubtedly.

The Chair: Through the Chair, please, members.

M. de Jong: Thank you, hon. Chair.

Can I ask the minister this? Because it is something that we heard both from aboriginal peoples -- individuals, I should say -- and non-aboriginal peoples. The comment tends to make more of an impression upon me when it comes from an aboriginal person, for reasons that I think will become apparent in a moment.

This notion that an individual, let us use the Nisga'a as an example, will have to convince a level of government -- their own government, as it were; central government -- that they are worthy of receiving the support of that central government in pledging some form of security. . . . And I should say to the minister, the impression we were left with was that under no circumstances would Nisga'a central government abide by any process that could ultimately result in the loss of land. The minister knows, obviously, the strength of the tie to the land, so we are not talking about traditional forms of security as he and I might know them or utilize them in our lives. I think we have to be careful about the terminology we use. The Nisga'a clearly contemplate a different form of security, and I think we have to keep that uppermost in our minds.

Is the minister troubled at all, as I am at times -- and other witnesses, aboriginal individuals -- that their individual ability to gain access to investment capital, to loans, is hampered somewhat by the form of agreement and the leading role played by central government as the custodian of the land base?

Hon. J. Cashore: No, I'm not troubled by that. I think we have to recognize, as a fundamental, that there is a democratic process in the Nisga'a people electing their tribal council, and the tribal council then, for their part, negotiating on their behalf on the basis of a balance of interests that need to be covered. One of those interests, I think, is related to their reflection on the experience of the Alaska claims, where virtually major, if not all, lands that were settled were mortgaged away in some instances. The Nisga'a, through that democratic process, through their elected tribal council, have opted for a Nisga'a central government having a role in setting rules under what circumstances land could be conveyed as a means of trying to ensure to the greatest extent possible that they don't see that same situation repeating itself.

That still means, in the final analysis, that when it comes to their interests in enabling investment to take place, one of the factors in that enabling is the investment community. One of the factors for the investment community is to be able to have security -- security according to their criteria. Therefore the Nisga'a have decided in their wisdom, that they want their central government to be able to work to find measures to ensure that the way in which they go about this does not lend itself to the loss of huge tracts of land, while at the same time recognizing that they can never completely avoid that risk. I admire their desire as a people to seek to go carefully and cautiously, as a means of ensuring that the lands that they do receive are a legacy into future generations.

M. de Jong: As the minister was replying, I recalled some information that had been passed on to me, and parenthetically, I wonder if I could ask the minister: is he aware of an action that has been commenced pursuant to societal statutes, the Society Act, and what the status of that is? I don't know the answer, but I'm curious to know whether such an action has been commenced and what the status is.

Hon. J. Cashore: I'd like to advise the committee that I am aware of two recent actions that I know very little about. I expect to know more about them by noontime. My understanding of one is that there are two individuals in Kincolith -- which is the most westerly of the four villages and is the one village that is not connected to the other villages by road, although there is a road being built -- who have filed a suit that I think addresses issues around mandate and that sort of thing, with regard to the Nisga'a tribal council and the way they have carried forward their mandate work at the treaty table. We're going to find out more about that. The second issue I heard about late last evening was that there may also be some decision made by the Kincolith village council. And we're going to try find out more about that, too.

M. de Jong: For what it's worth, I think the scanty information I have relates to the latter action, and I have been

[ Page 3432 ]

advised that several hundred members of the Nisga'a nation are expressing their dissatisfaction with the manner in which their representatives have proceeded. I know the minister always proceeds very carefully on these points, bearing in mind that these are largely internal matters that need to be resolved by the members of that agency or organization. Nonetheless, when it impacts upon the treaty process and what may flow from it, I think it becomes a legitimate issue for discussion here. Recognizing that the minister, his deputy and I don't have a great deal of information about either of these actions, maybe I can just ask this question: how does the agreement-in-principle. . . ? There are the indemnification sections that are designed, I think, to protect against -- I was going to use the word renegade groups, but I don't want to use that term -- splinter groups, shall we say? How does the AIP operate to protect the government against this type of dissension within the ranks of the Nisga'a themselves?

Hon. J. Cashore: At this time, the AIP has no legal clout; therefore there would not be anything in the AIP that would mitigate against this kind of thing. I think it's helpful to look at the fact that this is a very unique negotiating circumstance -- the arena is very unique. I don't think I can think of any example that entirely compares to it. Even if you look at other treaty negotiations elsewhere in the world, I think this would still be described as unique because of a number of circumstances.

[10:45]

I don't think there's much more I can say about it. I mean, if you had asked me how I feel about it, I feel sad. I think this is obviously something we've been seeing good progress being made on, so it's potentially a setback. But this is the real world, and these things do happen in similar complex situations. Depending on what we find out over the next few days, we'll ascertain what, if any, the responsibility and response of the provincial government should be.

M. de Jong: I won't ask the minister a speculative question about what may take place in the future, as that would probably be unfair. I will ask him, though, two things. Is he in possession of any information now that leads him to question the government's ability to negotiate with the Nisga'a council in the manner they have for some years now as the legitimate representatives of the Nisga'a nation? I think I know the answer to the first question. The second question is: if he receives that information -- and that may well be by virtue of how the actions we have discussed here a moment ago proceed -- will he disclose that immediately to the Legislature?

Hon. J. Cashore: First of all, with regard to the facts that we have now, I don't think we have enough to be able to answer that now. And I think the hon. member was recognizing that. With regard to disclosing information to the Legislature, I will respond to questions, and I will also consider other approaches that would be prudent and timely with regard to keeping the Legislature up to date.

M. de Jong: Thank you. I'm going to ask my colleague from Prince George-Omineca to proceed with some questioning he has.

At this point, with the strongest emphasis I can, I want to say to the minister that one of the best reasons I can think of for engaging in this lengthy, costly and at times very emotional exercise is to ensure that at the end of the day individual first nations people in this province have all the opportunities that he and I and everyone in this room have. That means educational opportunities and health opportunities but also economic opportunities.

I would urge the minister to keep that uppermost in his mind. And if lending institutions, like the ones Mr. Tarr represents, are incorrect in expressing reservations about their ability to provide the kind of investment capital under the scheme envisaged by the Nisga'a AIP, then they need to receive information that will ensure they have the confidence to do that. If at the end of the day, Ms. Wright runs into the same difficulties for different reasons than she experiences now in seeking with her husband a $15,000 residential mortgage, then I don't think we've accomplished anything, and that will be indeed a tragedy.

Hon. J. Cashore: I just want to say that I'm asking the deputy minister to contact Mr. Tarr and arrange some way, which would be worked out in the discussion with either him individually or with some of his colleagues, to sit down and go over the AIP and to ascertain if there are indeed continuing concerns. Also, even if estimates are over, I'd be glad to follow up on that with the hon. member, because I think it is an important concern.

P. Nettleton: I too had some questions I wanted to explore in regard to the whole question of bands' and band members' ability or inability to arrange long-term financing. I think my colleague has explored that in some detail. It is, however, not clear to me at this point how that can be done in both the short term and the long term.

Reference was made by the hon. minister to the Alaskan experience and their mortgaging away vast tracts of land. My recollection of the Alaskan experience was that it involved a joint venture between Cominco and the first nations in the northwest portion of Alaska. Certainly that serves to underscore the difficulties or the risks associated with the ability to mortgage properties.

In my own constituency, Prince George-Omineca, the Yekooche first nation is presently embroiled in some fiscal difficulties. I believe that they're now negotiating with the federal government to attempt to resolve those. The Yekooche first nation chief is illiterate. He's a fine man and a very simple man. Yet, as I say, he's illiterate, and many of his council are illiterate.

There are longstanding systemic social problems in that first nation. Again, this is a first nation that is currently involved in the treaty process. I'm not certain at what stage they are presently, but I know they're moving forward quickly. It doesn't take a rocket scientist to anticipate that there may be some difficulties in terms of their management of fiscal affairs. Certainly this is a huge issue of tremendous concern to first nations peoples. There have been a number of first nations throughout the province that have had some difficulties in terms of mismanagement of their fiscal affairs, and this has impacted young people particularly.

I know the minister made a comment earlier in estimates which was of some interest to myself -- namely, that 55 percent of first nations are young people under the age of 25. I found that a very significant comment. I'm certain that the minister shares the concern for young people: their future, 

[ Page 3433 ]

their economic and social well-being. One would not want to see factions within the various first nations mortgage away the futures and mismanage the fiscal affairs of the various first nations. That's a very difficult issue, and I appreciate that it's a very complex issue. As my colleague has pointed out, in the short term it has been something of a difficulty in terms of people's ability to arrange long-term financing to provide adequate housing and things of that nature.

One of the things that has been cited is lack of infrastructure and a commitment to that end as being a great deterrent to a successful integration of aboriginal communities. For instance, if people do not have adequate hydro, sewer, gas and roads, and their general safety and health needs have not been met, then how can we expect them to fairly and competitively enter into the provincial or interprovincial business market in the context of aboriginal economic development and opportunities? Perhaps the minister could comment on that.

Hon. J. Cashore: I'm tempted to let those comments stand on their own, because I think they're very thoughtful comments. With regard to the question, what it comes down to is, first of all, recognizing that the history between the people of Canada and the people of British Columbia -- we're a part of Canada -- and first nations has not been a productive and respectful history, as it could have been. I think that part of it is looking back and owning our history, although it's sometimes quite convenient for people of my generation to look back 50, 100 years and blame something that was going on then without having a real understanding of the context. What we're left with is. . . . We must try to learn from the past about how to make those decisions and build those relationships that help create a future.

I was at a meeting last night with a number of first nations people where there was some discussion about my role being an advocacy role for aboriginal people. My position is that my role is to be in an advocacy position for British Columbians, including aboriginal people. I can never lose sight of that in order to fulfil my responsibility to the province. It is indeed our responsibility as legislators to advocate on behalf of all British Columbians. But we can't do that with blinkers on. We have to be very cognizant, as the hon. member points out, about such serious problems as the burgeoning youth population, the high incidence of teen suicide, the high incidence of infant mortality, the fact that there are still communities that don't have running water -- places like Middle River, where there's contaminated water supplies -- and it can go on and on and on.

We also have to look at the other side of the coin. We have to look at Calvin Helin, who I knew in Lax-Kw'alaams when he was four years old -- a little kid running around the village. He is now a very highly regarded lawyer with a law firm in Vancouver, and he leads trade delegations to Asia that are presenting aboriginal entrepreneurship on the Pacific Rim. That in itself isn't the solution, but I think it's a part of the direction that we need to be going in.

There is the First Nations Summit dialogue that the First Nations Summit leaders and Brian Smith and others are promoting. Again, it's taking a look at the ways in which partnerships can be formed.

Even though we know that there are some real strains in relationships between aboriginal and non-aboriginal people in Burns Lake, the fact is that in Burns Lake there's a very successful aboriginal business partnership with a couple of long-term corporations. The Burns Lake people, having achieved some cutting rights, have gone from a very modest development a few years ago to being perhaps the main payroll source in that community. I forget the number of jobs. I understand that the majority of those jobs are non-aboriginal jobs, but aboriginal people and non-aboriginal people are working side by side in a very productive, job-oriented enterprise.

[11:00]

The last thing I want to say in response is that there are some remarkable people out there who have achieved leadership positions in the aboriginal community. That's because they entered what for them was a struggle a number of years ago, and they've tried to equip themselves with the wherewithal to be able to enter that struggle.

There was a real push on about 25 years ago to graduate more aboriginal lawyers, and it was very successful. A lot of those people are now involved in the land claims process and in other processes where they're entering into legal things.

I understand that there's some move afoot now to be graduating more health care people in all levels of health care. There's a real concern over the lack of first nations people entering the medical profession. Again, there are some very significant examples, one recent one being a young woman graduating from the UBC school of medicine. But that's another area. We have to recognize the importance of health care, healthy communities. If it's going to be a really practical approach, then together we can concentrate on trying to see more people trained who can work in that field.

P. Nettleton: Hon. Chair, as the hon. minister has suggested, there has indeed been some progress. In fact, there is progress in terms of addressing some of these concerns.

The hon. minister mentioned Middle River. Middle River is a village that's fairly close to my heart -- that is, the residents of Middle River. I travelled there initially when I was a lawyer at a native community law office in Fort St. James. It's a fairly remote village, as I'm sure the minister is aware, but it is in an idyllic setting in terms of where it's located geographically -- on the edge of a lake, with fish and beaver and so on available to the residents of that village. The people are very warm and friendly. They have a small schoolhouse there, where I was able to give a couple of workshops dealing with legal issues which impacted youth. I enjoyed my visits there and my close associations with the residents of that community.

Just as a matter of interest, they now have a water purification system in place, as well. And in terms of addressing their problems associated with housing, I believe a number of houses have also gone up over the past few months. There certainly has been some progress in Middle River in terms of addressing those kinds of problems. So the minister is quite right that these problems are being addressed in some villages, and one cannot minimize that.

I believe my colleague at this point has some questions along the same lines, so I will defer to him.

[ Page 3434 ]

B. Barisoff: Being a member of the select standing committee, I want to clarify with the minister. . . . I happened to be at the same hearings at New Aiyansh, and I listened to the lady who was unable to get a loan when she went to the bank. Listening to the minister, my concern is whether her individual rights as a person from the Nisga'a nation will still be intact when the Nisga'a agreement is finally done, so that she can go individually to get that loan. Because when I listened to the minister talk, I got the impression initially that she would be able to go out and get a loan on her land. But as we progressed through the conversation, I got the impression that we were back to the state where nothing would happen unless the Nisga'a government would cosign the loan and that it would be up to them to decide whether they would actually get a mortgage on the particular piece of property.

Hon. J. Cashore: Just to be very clear, the Nisga'a central government will receive the Nisga'a land. The Nisga'a central government will then be developing a procedure for ensuring that individuals are able to gain land with title. I think that is entirely appropriate, given that. . . . I do recognize the standard and the value around individual rights. But whether it's Nisga'a or Canada or B.C. or any community, I think there is always a creative juxtaposition, a creative tension, a creative balance between collective rights and individual rights. That's how our communities work.

Through their democratic process, I think the Nisga'a have said. . . . In other words, these individuals who want to be able to own their homes and use them as collateral, they have elected that tribal council through a democratic process to negotiate this issue. I can only assume that they respect the value that's inherent in the desire of the tribal council to try to administer that, under their own self-determination, in a way that enables them to provide those individual rights, while at the same time seeking to come up with an approach and a plan that also recognize their relationship to land and the importance of them not seeing their land drain away. So they have every intention of enabling their people to have that clear title. But through this democratic process, they have sought to negotiate it in a way that enables them to have what, in their view, is a more prudent approach than the approach they saw followed in Alaska.

B. Barisoff: So would the suggestion that the minister is making be that if, in future, members of the Nisga'a tribal council decide that they can turn the fee simple land over to members of the Nisga'a nation, they could actually turn it over in such a way that they could mortgage or do whatever? Is the particular agreement that's in place now, because ultimately the abolishment of the Indian Act. . . ? Is the minister suggesting, then, that if a new tribal council happened to be elected in a year's time, this set of circumstances could actually change? If new members of the Nisga'a nation got elected, could they make sure that ultimately members from that particular nation had fee simple title to their land and could do with it as they wished?

Hon. J. Cashore: In the lands and resources section of the agreement-in-principle, it says: "The final agreement will include provisions to allow for Nisga'a lands and parcels thereof to be incorporated into the provincial land registry system." So I think that answers the question. As a tribal council the Nisga'a will have responsibility for that land, and they will enable individual Nisga'a to have free title to their land.

B. Barisoff: Being a member of the select standing committee, I'm still puzzled by the line we're going down here. Because if I interpret what you just said again, it seems to me, then, that we're going back to the initial statement when you told my colleague from Matsqui that they would or could have that right, but later on you indicated that this right is only given through the tribal council themselves. For some reason. . . . I just want complete clarification, because when we went through the testimony at the hearings with the Nisga'a people, I think a lot of the members were very concerned that this would be a very important factor in what takes place.

Hon. J. Cashore: Hon. Chair, I'll only answer this question once more. The land will be conveyed to the Nisga'a tribal council. The Nisga'a tribal council will then work out its own system through the democratic process, given that they've been elected by the people there to ensure that individuals are able to have land and use that land as collateral. The hon. member has seen the agreement-in-principle, and I think it makes clear that those are the steps. I think the hon. member is trying to make out that, from his point of view, we should be negotiating this around the value that raises the individual rights above the collective, and there the position of the province is that it is not for us to take over the self-determination with regard to how a people wish to carry out their affairs.

B. Barisoff: I wasn't trying to direct the government on the direction it wants to negotiate it. I think I was just trying to clarify what would take place with the individual rights of some of the Nisga'a people. Now I understand the direction that the government has taken on what would take place with collective rights and what could happen in future years.

P. Nettleton: A few more questions for the hon. minister. Correct me if I'm wrong, please, but it's my understanding that there's been a cut in funding for business ventures available for first nations peoples, from $75,000 to $50,000. Is that the case or not the case?

Hon. J. Cashore: I can't confirm that figure at this time; it is possible. I'll find out and bring that back this afternoon.

But I am almost entirely certain that this question is related to the First Citizens Fund and the Native Economic Development Advisory Board. It's an advisory board made up of aboriginal people from regions throughout the province; they advise on the disposition. If there was a change, that change would have been based on the advice being received from NEDAB.

P. Nettleton: Thank you, hon. minister.

In terms of business opportunities and entrepreneurial ventures, it has been suggested by some that one area in which a commitment to first nations entrepreneurial ventures could be made would be to invest in the roughly 10,000 to 15,000 artisans who have a wealth of talent and a lack of accessibility to materials, as I understand it, because of their personal financial restrictions. For instance, a totem pole carver may pay in excess of $20,000 for a piece of carving material, which certainly is something of an obstacle for many first nations artists. It has been said before, and I think it's worthwhile saying again, that perhaps areas of wilderness could be set aside specifically for native artisans.

I think we have that art in our hands; we could promote it. Our foreign and domestic trade offices are great places to start promoting the values and the work of native peoples. Does the minister have any comment on that?

[ Page 3435 ]

[11:15]

With regard to the artisans, I think that's a good point. Again, I am sure that through the First Citizens Fund a number of these business development loans have been for exactly that purpose. As I said the other day, I think it's the most successful loan program in British Columbia because of the high incidence of loans being recovered. Having said that, right now the standard is that 50 percent is paid back, and the rest is forgiven. The board is actually looking at possibly increasing the payback portion to 60 percent. But from the province's point of view, I think that's probably one of the most frequent ways in which that type of process is supported. We should also acknowledge that this is one of the ways in which there's a growing small business reality in the aboriginal community, and a lot of aboriginal people are becoming pretty good business people. Mind you, they always were. If we look back to the days of contact, I would think that there were some contracts that helped get Alexander Mackenzie down to the mouth of the Bella Coola River.

P. Nettleton: I'm sure the hon. minister is quite right. Perhaps I won't explore this any further at this point, but that's certainly something I would like to explore with the minister or with his staff at some point, in terms of the provincial government's involvement in the promotion of first nations artisans.

I've got a couple of questions here that I'd like the hon. minister to respond to. Is the hon. minister aware of any provincial government program involving the hiring of students through the Crown corporation of B.C. Hydro? Is there anything presently in the works whereby B.C. Hydro is actively soliciting primarily first nations students, presumably for summer employment?

Hon. J. Cashore: We'll endeavour to find out the answer to that over noon. I do know that B.C. Hydro does have staff at the executive level who are aboriginal people. They advise B.C. Hydro on various projects, so I think that could very well be. We will try to find out. It's possible the hon. member has more information that might help us follow that up.

P. Nettleton: In terms of economic development generally, I'm certain the hon. minister has looked at other models in other jurisdictions, particularly here in Canada, in the territories and in the Yukon area, in terms of the provincial government's involvement in economic development among first nations. Are there any models that are of particular interest to the minister in terms of his government's involvement in economic development here in British Columbia?

Hon. J. Cashore: Now, economic development. . . . In part of our discussion the other day, I was pointing out that it's my strategy to not allow this ministry to become an institution. We have an interest in this, but we think that it's best if these programs -- where there are to be programs -- are delivered by other ministries. I also stated a value earlier in the debate that I think it's better where a program is inclusive of first nations and non-first nations peoples rather than the other way around, but I realize that's not always the best model. Another value is models where there is a proven local body of research that has been done with regard to a particular kind of project.

Therefore when the Native Economic Development Board advises on loans, they are looking to see if this is a project that has a good chance to succeed, and that is a model. I have had some discussions recently with the Minister of Small Business, Tourism and Culture with regard to the growing cutting-edge entrepreneurial activities around first nations and tourism. I know that she's very interested in that and is looking at it.

I don't know about models elsewhere that necessarily should be incorporated here. I think that maybe we have models in British Columbia that I referred to earlier, and some of the approaches that people like Calvin Helin have been taking, which I think are made in B.C. and are showing some remarkable progress. . . . Another -- if we can call it a model -- is an association of aboriginal women in business. I think they are a very impressive group, given that they recognize the need for mutual support. They are, again, a group of a growing number of businesses that are finding quite a degree of success.

Other economic development, I think, would relate to the Minister of Employment and Investment. For instance, that ministry recognizes a role, where mining is concerned, to try to address issues where sometimes we end up with a difficult situation because of aboriginal perception of aboriginal rights, which potentially impacts the speed with which projects are able to get up and running. With the Tahltan, just to give an example, there's a recognition that here is what people would characterize as a development-oriented first nation. Therefore we know that there is a way of working with the Tahltan, where an issue arises, to try to help work it out in a way that is mutually acceptable. Sometimes that results in some kinds of partnerships being formed, and that sort of thing; sometimes it doesn't work. We've seen that the Cheslatta, I believe, have been undertaking court action with regard to the Huckleberry mine and that sort of thing.

I think the best models are probably those that we learn about as we find where success can be achieved. But, you know, it's an interesting thing; the dynamics of all of this are absolutely fascinating. You take, for instance, the garnet mine up at Penticton which, in my view, is a very small and environmentally benign project. That minesite will probably be about a quarter of the size of the parking lot over at the village, and yet the people of the ski village have joined forces with the Penticton band to try to stop it. Go figure.

P. Nettleton: In my limited experience dealing with various ministries -- I'm thinking particularly of the Ministry of Forests -- there seems to be a policy, either some kind of an understanding or policy initiative, in which submissions for forest licences, community forest programs, what have you, if they involve first nations' support, involvement and so forth they are much more likely to succeed than if they do not. I'm just wondering if perhaps the minister could enlighten me. Is this in fact a policy that the minister and his ministry have been involved in in terms of developing and implementing this policy? Perhaps the minister could just shed some light on that whole question for my interest.

[ Page 3436 ]

Hon. J. Cashore: We did canvass this in the context of the Crown land activities policy a few days ago. Briefly, first of all, it's very important that the commerce of the province continue to function. There has to be a delicate balance here. For instance, you can't say: "Well, the commerce of the province can't function unless the proponents work out a deal with the aboriginal people." But you can encourage reasonable people to sit down and come up with reasonable solutions that serve their part of the world. The most desirable situation is where government can stay out of it and where those things do get worked out.

Our Crown land activities policy, as I pointed out, is informed by court decisions and by our fiduciary responsibility as government, which comes down to the requirement that there be consultation where there are Crown activities that may infringe on an aboriginal right. It's often in that area that things either result in a very creative way -- one that brings people together, and they say, "How can we work this out together?" -- or where sometimes it turns the other way and is not that creative. Of course, I think we're learning -- all of us in the broader society -- that the creative approach is the better approach.

P. Nettleton: Moving along to a final comment and question, the aboriginal procurement strategy came into effect April 1, 1996, as I'm sure the hon. minister is aware. The strategy is intended to support aboriginal economic development, providing aboriginal businesses with increased opportunities to supply goods and services, in this case, to the federal government.

The Department of Indian and Northern Affairs is working with the various federal departments to establish procurement targets and to develop policy changes. Among the goals that have been developed in the procurement strategy is the establishment of a comprehensive database of aboriginal suppliers. Aboriginal businesses are being informed about federal government purchasing procedures and marketing activities through orientation sessions.

Further, government procurement officials are being informed about potential aboriginal suppliers. Mandatory set-asides are being developed to ensure that aboriginal suppliers are used for federal procurements over $5,000 intended for populations that are at least 80 percent aboriginal. Voluntary set-asides are also being identified for federal procurements under $5,000.

Contracting policy changes are being developed to encourage joint ventures with and subcontracting by aboriginal businesses. It is currently the intent of the federal government, as I understand it, to ensure that 80 percent of all contracts to aboriginal communities are fulfilled by aboriginal enterprises and 20 percent of all federal contracts are fulfilled by aboriginal firms.

[11:30]

The minister had alluded to the position he finds himself in, in that he's not just an advocate for first nations. In fact, the hon. minister is quite right in that he represents all British Columbians in terms of his dealings with these very sensitive issues. In terms of negotiating, I think we would all hope that the hon. minister would conduct himself in a manner that involves an arm's-length approach, dealing fairly and honestly with all people in the province, including first nations.

In terms of this procurement policy of the federal government, some of the considerations are best value, competition, prudence and sound contracting management procedures. This new federal initiative borrows from the example set by a number of large businesses or corporations, which use mentoring, joint-venturing and their own contracting needs in a purposeful way to build a healthier aboriginal community, which I believe is the objective of all on both sides of the House. One component of the policy, of course, is the powerful new tool -- rather the set-aside, which I alluded to, both the mandatory set-aside of $5,000 and the voluntary set-aside -- which is competition by aboriginal suppliers alone.

My question to the minister -- and I guess what I'm looking for is a response or a comment as much as anything -- is: given the initiative of the federal government and the relative ease by which provincial governments, including our own government here in British Columbia, could enter into the same type of agreement, why is it that such a policy is not or could not be embraced here in Victoria?

Hon. J. Cashore: Well, I think there's real food for thought there. The brief answer is that the relationship between B.C. and the first nations and the relationship between Canada and the first nations are very different relationships. We have talked about, for instance, the whole issue of the potential for federal off-loading and the importance of the province not picking up, on behalf of B.C. taxpayers, that responsibility, which is a federal responsibility.

I think it is a commendable policy, but I would submit that the practical application of that policy has to do with the fact that with the administrative responsibility that the federal government has under the Indian Act -- as it states in the Indian Act, "Indians and lands reserved for Indians" -- there is a direct relationship where they can fulfil that procurement policy.

If it were to be the provincial government -- and I'm stepping into territory that's really not part of my estimates here -- we're dealing with programs of general application, and in many of those instances, the dollars for those programs actually come from the federal government. But, for instance, if it has to do with schools, it is dealing with a program, the standards for which and the delivery of which is based on the provincewide system. Therefore I don't think it conveniently lends itself to that kind of a procurement policy, because I don't think we have the traditional relationship and responsibility that the federal government has. So I think it is appropriate for the government to be doing that.

But when it comes down to the practicalities, what I'd be interested in is how the hon. member would actually see that apply or, if there are areas where we may look at pilot projects, what those areas would be. Because off the top of my head, none come readily to mind.

I think, however, when it comes to such things as the government of British Columbia looking at procurement policies, it needs to be done fairly. And if we saw that in a certain area the first nations community produced a certain type of 

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product and was seeking to enter that market and was never getting fair consideration, that would be wrong. It would be important that we seek to address that.

P. Nettleton: I appreciate the candid comments of the minister, and I will accept his challenge. In fact, I'll develop a memo, perhaps, over the course of the next little while and submit that to the hon. minister, with some creative suggestions, hopefully, as to how that might be done.

In any event, that concludes, for my part, my line of questioning. I believe some of my colleagues have further questions. But again, thank you very much for your response to some of my questions.

Hon. J. Cashore: I just want to say that I certainly value the hon. member's comments. We've had some private discussions around these issues, and I think it does enhance the fact that the vast majority of what we do around this issue is not large-P politics, but it's trying to help to come up with solutions. The hon. member started off addressing some of the endemic issues that we want to see changed. It's something that really does behoove all of us to put our thoughts on together.

K. Krueger: I would like to explore, just a little bit, how the gambling expansion plans in British Columbia fit into the minister's area of responsibility, with an emphasis partly on governance issues: how gambling expansion and the questions that revolve around it will relate to the concepts of self-government that are being explored by the ministry and by aboriginal people; the social implications of the plans, which the Minister of Employment and Investment has outlined to aboriginal communities; and how the ministry is pursuing the role of oversight for gambling expansion implementation as it relates to aboriginal communities. The implications, of course, could be very far-reaching -- and have been in some jurisdictions.

With that brief preamble, recognizing that nobody is taking or wishes to take any sort of paternalistic view in all of this but that nevertheless there are a lot of interrelated issues around gambling expansion, I wonder if I could just have the minister's comments in general on those issues.

Hon. J. Cashore: Certainly, hon. member. I appreciate the hon. member's saying that he doesn't want to take a paternalistic view on this issue; I appreciate that point. I would encourage him, however, to reread his comment in question period the other day where he went through a litany of. . . . I don't have it in front of me, so I can't quote it exactly, but basically it was that this ministry hasn't taken responsibility for these people, and finally, the Minister of Aboriginal Affairs hasn't taken responsibility for aboriginal people.

The answer is: rightly so. I don't; it's not my role. My role is to facilitate, out of respectful relationships, those circumstances that enable aboriginal people to set their own course, state their own values and follow their own visions in a way that is worthwhile. So I think, based on the premise of where that was coming from, I just have to say that in some ways we just fundamentally agree to disagree. I'm not responsible in my mandate for advising aboriginal people of what's in their best interests on this issue, and I don't intend to do that.

Part of the hon. member's comments had to do with the province's general position with regard to gaming. The obvious question is: "Well, what am I, as the Minister of Aboriginal Affairs, doing with regard to that, given the fact that I have publicly stated my own comments and opposition to gaming expansion?" Again, I think that's a fair question, although I don't expect to go too far in that line of questioning, because it's not my mandate. Again, the more I get into it, the more I appear to be taking over something that isn't my mandate. I want to make that clear.

It is a very difficult area; there's no question about that. One comment about the government's policy: it is the most restrictive in all of Canada. I think that needs to be recognized.

I do also want to say that even given my publicly stated views with regard to gambling, I took the position before that the government's position on gambling expansion was one which did envisage the potential for making similar types of casino enterprises available to first nations. Again, that was in the context of a restricted and limited approach, but I did support that, recognizing that politics is not a pure science. In doing that, I was placing a higher value on the value that I hold for aboriginal self-determination than on the values that I hold around gambling issues. So that's where I was coming from there.

K. Krueger: I don't have the record in front of me, either, but I'd just like to correct the minister's perception of my remarks in question period. What was said in question period was that the Minister of Employment and Investment tends to intervene when questions are asked around the gambling expansion issue. Whether it's this minister, the Minister of Women's Equality or the Attorney General, the Minister of Employment and Investment seems to want to provide the answers. It wasn't really a series of remarks about taking responsibility. It was rather a remark about who gets to answer questions in question period and why individual ministers, responsible for individual areas and with their own mandates, seem to be pre-empted by that minister.

If I could just review the mandate and why I'd like to pursue a line of questioning with regard to gaming expansion with this minister, the document I have, entitled "Ministry of Aboriginal Affairs Mandate," says:

"The Ministry of Aboriginal Affairs has primary responsibility for the government's strategic priority of fostering a new relationship with aboriginal people. This is accomplished through, first, the negotiation of treaties with first nations and Canada; second, by providing support and advice to line ministries as they develop and implement social, economic, land and resource policies and initiatives related to aboriginal people."

The Chair: Minister -- noting the hour.

Hon. J. Cashore: Hon. Chair, I think I should answer the question, so the hon. member can have the whole lunch hour to prepare for when he comes back. The answer is no, we haven't done that.

Do I give advice to the Minister of Employment and Investment? Yes, constantly I do. Have I had a role in crafting the policy that our provincial government has on gaming? The 

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answer is yes. Did I get 100 percent of what I wanted in that process in that cabinet chamber? No. Do I support what came out of that process? Yes.

[11:45]

Having stated that, I would like to move that the committee now rise, report progress and ask leave to sit again.

Motion approved.

The committee rose at 11:46 a.m.

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