[ Page 3457 ]

The House met at 2:05 p.m.

Prayers.

I. Waddell: Mr. Speaker, the Young Ambassadors program was launched in 1994 by the Chinese Canadian Association of Public Affairs -- that's a non-profit organization -- to promote mutual respect and understanding amongst Canadians of all ethnic origins and to increase the political awareness of the Chinese Canadian community. I'm very pleased to have the House welcome 18 young ambassadors, who normally would go to Ottawa, but we're fortunate that they came here this year. Would the House please welcome Catherine Yeung, 18 students and two adults from the Young Ambassadors program.

G. Campbell: I am pleased that in the legislative precincts today is a councillor from Terrace, Linda Hawes. She is here to meet with us on the Northwest Communities Coalition. I'd ask the Legislature to make her welcome.

Hon. J. Cashore: In the gallery today is Margaret Makawaza. She's a guest of the United Church of Canada and Pilgrim United Church. She's here from Harare, Zimbabwe. Together, Margaret and the congregation are exploring what it means to be global partners. Margaret works with the Zimbabwe ecumenical church loan fund, which funds projects that give opportunities to the economically disadvantaged. Accompanying her is Gaye Sharpe, formerly the special assistant in my office. Would the House please make them both welcome.

R. Masi: It's my pleasure today to introduce two visitors from North Delta: Leslie and Brent Schaeffer. Would the House please make them welcome.

Hon. A. Petter: In the gallery today are a number of volunteers from the Royal Museum Shop at the Royal British Columbia Museum. They include June Yelland, Susan Cumar, Margaret Bragg, Eileen Goossen and, along with them, my mother, who's also a volunteer, Lisl Petter. I'd ask the House to make them all very, very welcome.

F. Gingell: It's my honour today to introduce another visitor who's very close to our caucus. I ask you all to welcome Mr. Sindi Hawkins, otherwise known as Ralph.

H. Giesbrecht: Visiting us today from my riding are six members of the Northwest Communities Coalition. One of them has already been introduced, but also here are Mario Feldhoff; Trafford Hall, who's the municipal manager of the district of Kitimat; Linda Gammel; and also Linda Hawes, a councillor for the city of Terrace. Unfortunately, I didn't get two names this morning when I made the call to determine who was going to be here, but there are six of them. Would the House please join me in making them welcome.

I. Chong: I notice in the precincts today one of my constituents and a B.C. Young Liberal. Would the House please welcome Mr. Bryan Matthews.

G. Bowbrick: I'm very pleased today to be able to introduce to the House my father John Bowbrick, as well as my wife Anna Santos and my 18-month-old son Colin. I know all of us in this House appreciate how important it is to have the support of family in this business, and I am indeed very fortunate. Would all members of the House please join me in making them welcome.

G. Abbott: I have two special guests in the gallery today from the Shuswap: my wife Lesley and my son Wade. I would ask the House to make them welcome.

E. Gillespie: Hon. Speaker, I have the honour today to make two sets of introductions. I'm pleased to welcome Molly Bain and Yvonne Bain, visiting here from Powell River-Sunshine Coast. I ask the House to please join me in making them welcome here today.

I would like to also make welcome a constituent of mine, Orville Reimer, who was here visiting over lunch today with the Minister of Forests and who is an advocate, in particular, of small-scale forestry on the north Island.

J. Dalton: One of the people accompanying the young ambassadors that the member for Vancouver-Fraserview introduced earlier is a friend and a constituent, Mr. Chris Lee. I first met Chris when he was the Premier of the North Shore Youth Parliament a few years ago. Would everyone please make him welcome.

Hon. S. Hammell: There are 45 great grade 11 students and their teachers, Mr. Murdoch and Mr. Shiu, from L.A. Matheson Junior Secondary in Surrey -- one of the many schools in all of Surrey that was built during this government's period of time. Would the House please make them welcome.

S. Hawkins: In the gallery, sitting here today, is the person who first got me involved in politics 15 years ago and who signed me up with the Liberal Party, which I've been working for in the last 15 years. And to set the record right, his name is Ralph Hawkins, not Mr. Sindi Hawkins. Would the House please help me make him welcome.

I. Waddell: I rise again. Normally we're reluctant to welcome people who live east of the Rockies, especially journalists, but I do see an old friend of mine whose brother I used to represent in Parliament. He's the national affairs reporter for the Globe and Mail, Jeffrey Simpson. I noticed him here. I think . . .

An Hon. Member: He's hiding.

I. Waddell: . . . he's hiding. So just for maximum embarrassment, I'd like the House to welcome him to the premises.

Introduction of Bills

CHILD, FAMILY AND COMMUNITY
SERVICE AMENDMENT ACT, 1997

[ Page 3458 ]

Hon. P. Priddy: I move the bill be introduced and read a first time now.

This amendment act will result in four more recommendations made by Judge Gove about existing children's legislation being addressed. This raises the total to 18 legislative changes.

Additionally, we are introducing four important amendments recommended by the Children's Commission. The amendments largely revolve around the recommendation which advocates the ability of the director of child protection to apply to court by summons for an order supervising a parent's care of a child, without first removing the child from the family. On a policy, legal and practice basis, a child protection worker should be removing a child if that child should be in the custody of the director, not applying for the lesser option of a supervision order.

[2:15]

Therefore a significant part of this bill is extremely technical. However, to put it in words that I and others who are not lawyers will understand, the summons procedure will allow the director of child protection to apply to court for an order supervising a child's care in the home, instead of removing the child from the family. This would only be done in cases where removal is not necessary and would be too extreme an action. This change will add to the spectrum of tools available to help families care for their children.

The other amendments are: a discretionary offer of a family conference instead of a mandatory one, when mediation might be inappropriate; requiring the director of child protection to make reasonable efforts to inform community members of the results of child protection investigations when this is necessary for the child's safety; the ability to apply for continuing custody up to 60 days before the expiry of a temporary custody order, instead of 30 days; changes to the service delivery principles to enforce the principles of integration and prevention; and, the last one, whistle-blowing protection for people who ask the director to review a decision made in the course of providing services.

Bill 24 introduced, read a first time and ordered to be placed on orders of the day for second reading at the next sitting of the House after today.

CHILDREN'S COMMISSION ACT

Hon. U. Dosanjh: This bill demonstrates government's commitment to creating a new system solely focused on the needs of children for a nurturing and safe environment. This legislation gives the Children's Commission many powers:

1. To monitor the development and implementation of internal review processes across ministries and agencies of government to ensure they are respectful, timely, effective and child-centred. We will start with the Ministry for Children and Families.

2. For the first time in Canada, to provide a comprehensive avenue for external complaints for children. This will eventually cover all services provided by the Ministry for Children and Families -- corrections, healthcare and child protection. This comprehensive complaint process will ensure timeliness, accessibility and accountability.

3. To ensure all children in care have a plan that meets their needs.

4. To investigate critical injuries that occur when children are receiving designated services.

5. To review all child fatalities and investigate any that are suspicious and unusual, through an investigation and multidisciplinary process.

The Children's Commission has the most comprehensive fatality review process in Canada, ensuring that we learn from mistakes to prevent further child deaths. This legislation also provides the Children's Commission the power to report on the progress made by the child-serving system in implementing change as recommended in any or all parts of the Children's Commission's mandate to better protect children. Public reporting, of course, will ensure ongoing accountability and government responsiveness. I move that the bill be placed on orders of the day for second reading at the next sitting of the House after today.

Bill 23 introduced, read a first time and ordered to be placed on orders of the day for second reading at the next sitting of the House after today.

Oral Questions

B.C.'S CREDIT RATING
AND FINANCIAL MANAGEMENT

The people of B.C. deserve some hope for a reversal in the decline in their standard of living. My question to the Minister of Finance is: will the minister take the first step toward establishing that hope, and resign?

Hon. A. Petter: I'm constantly amazed at the ability of the opposition to quote selectively from whatever reports suit their purpose. The fact is that British Columbia, as the rating agencies have all noted, continues to enjoy one of the lowest debt-to-GDP ratios not only in this country but throughout the world. We pay less than any other province in terms of taxpayer dollars going to service debt. We remain strong economically, and that's why all the rating agencies have continued a rating in British Columbia that is second to none in this country and is tied, in some cases, with Alberta.

G. Campbell: You know, the problem with this minister is that his economic policies are having a huge negative 

[ Page 3459 ]

impact on people's lives in this province. There is no question that the standard of living in this province for the people who live here, for the families who live here, has been going down for the last five years. The minister's own discredited budget says: ". . . economic growth . . . must be a component of any complete fiscal plan." But, in the last year, we have watched a decline in agriculture, a decline in logging, a decline in fishing, a decline in manufacturing and a decline in construction. There was a 13.2 percent decline in business investment in non-residential construction.

Can the minister tell us how he expects economic growth to improve while private sector investment in British Columbia is going down and he is driving the jobs of British Columbians out of this province?

Hon. A. Petter: There is no doubt that due to a decline in pulp and newsprint prices, principally, there has been a slowdown in economic growth in this province in the last two years. That's certainly the bad news.

The good news is that this province is enjoying considerable strength in other sectors, and because it's a more diversified economy, the overall effect on the economy is not nearly as great as it was, say, ten or 20 years ago. The member declines to refer to the fact that we've seen considerable growth in the high-tech sector and considerable growth in service sectors, and that consumer spending has continued to be strong. In terms of employment, employment is a major success story. Notwithstanding the slowdown in economic growth in the last year and in some measure, I would say, because of the commitment of this government to employment, employment last year went up by some 39,000 employees over the previous year -- an incredible success record in this province, notwithstanding some economic problems this government is working hard to overcome.

F. Gingell: Within the space of a week, B.C.'s credit rating has been downgraded by two bond-rating agencies. The agency stated: ". . . the provincial debt burden will continue to climb in the current fiscal year. This is contrary to Standard and Poor's prior expectations." While every other province is getting their act together, B.C. is going in the opposite direction with more debt. Will the Finance minister admit that the budget fiasco and this government's litany of broken promises are making life tougher for British Columbians?

Hon. A. Petter: I don't know. . . . I can't fathom that the members opposite think the people of British Columbia can't see through the duplicity of their position on this and all other matters. This is the same opposition that on Mondays, Wednesdays and Fridays cries that more should be spent on schools and hospitals, and on Tuesdays -- I guess today is a Tuesday -- complains about the level of debt.

Yes, we said to the finance agencies that we were going to continue to invest in schools and hospitals, that we were going to continue to invest in education. We recognize that by doing that, we might not please them and their bottom line. But we are determined as a government to maintain fiscal prudence -- which has been recognized by all these agencies -- with a commitment to continue to invest in those things that matter to British Columbians. It's the priorities of British Columbians that are important to this government, not the priorities of a few bond-rating agencies . . .

The Speaker: Thank you, minister.

Hon. A. Petter: . . . and not the schizophrenic position of the members opposite.

F. Gingell: The one thing that we complain about on Monday, Tuesday, Wednesday, Thursday and Friday, as all British Columbians do, is the incompetence of this government. When the cost of borrowing money goes up and the government insists on adding more to the province's debt burden, there is less to spend on health and education. We now spend more money on servicing taxpayer-supported debt than the total of all provincial government expenditures in 1973. Will the Finance minister tell us how many more credit downgrades it will take before this government puts a stop to the growth in British Columbia's debt?

Hon. A. Petter: Again, the member quotes selectively. The fact is that in this year's budget the debt burden is going down by about $100 million, not up year over year.

Interjections.

The Speaker: Members. . . .

Hon. A. Petter: As much as they try to cry out of one side of their face and scream out of the other, the members cannot have it both ways. If you invest in schools and hospitals, yes, that will increase debt. If you invest in programs for kids, if you invest in programs for health care, that will affect the bottom line. The members don't seem to care about that or understand that; we in this government do. The good news that's come out of these recent reviews is that this economy is performing relatively well compared to other economies -- notwithstanding some serious slowdown in the pulp and newsprint sectors. We are able to maintain our commitments to health care and education not just because we have the political will but. . . . Woe betide this province if that group ever comes to office . . .

The Speaker: Thank you, minister.

Hon. A. Petter: . . . because they don't have the political will.

BRE-X STOCK LOSS
BY TEACHERS' PENSION FUND

Hon. A. Petter: The member's facts seem a little askew. As part of a general investment portfolio undertaken on behalf of pension funds, there is a general policy of investing a small component of the overall investment strategy in the top 100 and top 300 companies that list on the Toronto Stock Exchange. That was undertaken in this case, and Bre-X was one of those companies. As a result, a very small component of the overall investment portfolio was allocated to Bre-X -- so small that it will have virtually no impact whatsoever on the overall investments. I can get the member the numbers, and I can give them to him in percentage terms if he wishes, but it is such a small component that it really doesn't show up as a blip in the overall investment scheme.

[ Page 3460 ]

[2:30]

If he's saying that an $80 million loss by the teachers' pension fund is insignificant, I would say to him: why then, if he's prepared to accept those kinds of losses, doesn't the province take responsibility for the investment policies of the teachers' fund and other liabilities that are accepted by the province? In other words, if we're on the hook, why don't we make the investments ourselves rather than leaving them to the people who would risk pension money on $80 million worth of Bre-X stocks?

Hon. A. Petter: Well, I'd be happy to provide the member with a detailed briefing on this matter, but again, I believe his assumptions are in error. In fact, I think the number he's quoting, the $80 million, is the number that reflects the total loss across all investments of all pension plans, not the prorated amount that affects the teachers' plan.

My information is that the impact overall and within individual plans is small indeed -- large in the individual numbers but small relative to the total exposure and amount of capital in those plans. But I'd be more than happy to provide him with the detailed information.

B.C. TRANSIT CHAIR COMPENSATION

Hon. J. MacPhail: Before agreeing to any settlement when the chair and I mutually agreed he would not carry on, I needed to receive assurance in two areas: (1) that there was a case for severance to be paid out; and (2) that when that severance was paid out, it was paid out within the context of the legislation introduced by this government the week before last. I received those assurances, and it was on the basis of those two assurances that severance was paid in the amount of $56,000 to Mr. Corrigan. The hon. member's research is wrong.

D. Symons: There are thousands of unemployed and poor people in this province who will see this payment to yet another NDP patronage appointee as a betrayal. Corrigan was appointed by an order-in-council which stated that he would be paid $4,000 per year and $500 per day spent working on transit. Yet the minister has seen fit to line Derek Corrigan's pockets with -- she corrects the figure to be -- $56,000 of taxpayers' money for a job supposedly worth $4,000 per year. Considering Mr. Corrigan's been paid this $4,000 per year, how can the minister justify giving him a severance payment worth 16 times his contract?

Interjections.

The Speaker: Order, members, please.

Hon. J. MacPhail: Hon. member, when the chair was appointed in 1994, our government took a very aggressive approach in the subsequent years to the implementation of public transit. In fact, I have not heard this member, who has been the critic for transit during that whole period of time, actually ask any question about public transit whatsoever. Clearly the opposition has no plans for public transit in this province.

We undertook a ten-year plan for implementation of a transit plan in the context of the lower mainland. We put in place "Going Places," which was to bring about better transit in the lower mainland. We brought about commuter rail, and we announced light rapid transit. We also managed to do something which has not been done by a government previously, and that's enter into negotiations with the greater Vancouver regional district on matters of funding and governance. I announced those negotiations last month. That brought to a conclusion the full-time tasks of the chair of the Crown corporation. The job is now part-time, and hence the change in duties.

The Speaker: The bell terminates question period.

Petitions

"We the undersigned, being citizens concerned about the condition of the Alaska Highway from Mile 30 to Mile 54 -- and in particular the stretch of highway known locally as the south Taylor hill -- hereby petition the Ministry of Transportation and Highways for an upgrade and reconstruction of approximately 24 miles of highway from two lanes to four lanes as per standard ministry specifications."

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)

D. Symons: Just before I get into Health, I would like to remind the minister that if she goes back into Hansard, she will find that many times I have raised issues to do with transit. She seemed to have missed some of them, I gather, by her answer in question period.

To deal with a Health issue, we have a group in Richmond called RADAT, the Richmond Alcohol and Drug Action Team, and they've expressed some concerns to me over regionalization. One of those concerns involves a move for Vancouver, which now -- the minister may remember -- is part of the Vancouver-Richmond regional health district. There was a lot of concern, I must say, on the part of the health care givers in Richmond about that amalgamation -- or should I say absorption? -- into Vancouver, sort of the mouse-and-elephant attitude, I think, on the part of people in Rich-

[ Page 3461 ]

mond. We do thank the minister for increasing the membership of Richmond's representation on that board. I would remind the minister: at the rate that Richmond is growing, we will no doubt be needing further representation to be proportional to the populations of the two centres.

My first question, I guess, will be: as Richmond's population grows relative to Vancouver's, will you be increasing the proportion for Richmond? And will that be by adding another member, or will we replace one of the Vancouver members when that time comes? In other words, is 18 going to remain fixed, or as the growth comes, will the total number on the board increase?

Hon. J. MacPhail: Actually, I've been very pleased with the way that the Vancouver-Richmond health board is getting up and running and with the model of consensus they've reached, not only amongst the board members but amongst the communities. I met with the mayor of Richmond to resolve some of the differences, and certainly the representations I've had from the community are that they too are pleased with the amalgamation -- not an absorption but an amalgamation.

As we have discussed many times here, the representation on boards is a combination of a group of skills to be able to plan across the board for health care delivery, not on a community-by-community basis. There is a taking into account of the size of the community and the representation that community should have on a board. It's one factor to be considered. So certainly as population shifts in our province generally and as population demographics shift, we will watch carefully that the makeup of our boards represents those shifts. But that is a general comment and not specific to Vancouver-Richmond.

D. Symons: I thank the minister for that answer.

I did mention RADAT earlier. The concern that they expressed to me. . . . Before Richmond and Vancouver amalgamated, Richmond had worked out a pretty good program, a model for delivery among all the health care givers within Richmond -- and RADAT was one of those groups. But they find now in Vancouver that there's a move toward what I think they call neighbourhood health centres. There are to be six of them in Vancouver, I believe.

RADAT, among a few other caregivers -- and mental health would be one of them also; it's coming up in a moment, so I might be covering that topic as well. . . . They have some concerns that if that is the model that's going to be used for some health care delivery -- where all the doctors, dentists, mental health and so forth are all in one centre so you can have a one-stop shop, shall we say, for health care delivery -- there could be some problems there. Because people, particularly those recovering from alcohol and drug abuse problems and those with mental health problems, might care to be a little bit more discreet than being in a public location.

RADAT works out of a quiet, back alley sort of location where the people who come there for help aren't sort of stigmatized in the community by the problems that they are dealing with. This concern has been expressed by RADAT. Can the minister give some assurances that there will be opportunities in the various health care facilities that are going to be developed so that people with those concerns won't be put in an area where they may not access the facility, simply because of the fact that it's going to be too public for the problems that they're dealing with?

Hon. J. MacPhail: Yes, and we had a very good discussion on this last week, as well. Certainly all of those factors have to be taken into account to meet the needs of the patient first, as we move toward establishing some pilot projects for community health centres.

G. Abbott: I have just a few questions for the minister to kind of sum up the various questions that I asked a few days ago with respect to regional health boards and regionalization. I guess the principal questions I have are with respect to the role that local committees might have in relation to regional health boards as a means or as a mechanism for communities to have a way, a voice or an opportunity to meet with regional health boards and so on.

[2:45]

Hon. J. MacPhail: The issue of a multilevel-care facility for Chase is unaffected by regionalization. It is part of the capital review, of course, though it is. . . . I mean, it's part of a capital plan. But certainly there is a recognition that in Kamloops and the surrounding area, which includes Chase, there is a growing need for long term care beds and that there is already a demand there. They have a lower number of beds than their population demands, even currently.

G. Abbott: I believe I also asked this question last year. It is sort of a curious-sounding question but I think one that has to be asked -- that is, does the existence of this proposed facility on the five-year plan indicate that it will be constructed within five years? And given that a year has passed since the last time it was confirmed as being on that list, is it now anticipated that it that might be built within four years? Or is the horizon for this particular facility rather closer than that?

Hon. J. MacPhail: Actually, I haven't made the capital announcements for health care yet. Those announcements will be coming very shortly.

G. Abbott: So the minister is saying that at some point in the foreseeable future we can expect some confirmation or some announcement with respect to where facilities such as the proposed intermediate and long term care facility for Chase might be provided with that planning or construction designation?

Hon. J. MacPhail: What I'll be announcing in the near future is the rollout of the capital plan for '97-98.

G. Abbott: I'll leave that one for now. I do hope that, as the minister has suggested, this facility will be given full consideration by the ministry. Certainly the Shuswap is a rapidly growing area. Seniors, in particular, find it an attractive place to retire. I suspect as a consequence of that that there is more than average pressure on our existing facilities in that 

[ Page 3462 ]

region of the province. I do hope the minster will give full consideration to the requests that have been made with respect to that facility.

I'll turn now to the issue of local committees and how they might be a part of health care governance in the future in British Columbia. I'll preface my question by saying that the very widespread interest that exists within communities about their health care systems frequently surprises me. Certainly when the first phase -- if we can call it that -- of New Directions was moving forward, there was a lot of interest in all the communities in the Shuswap in the new form of health care governance. A lot of people wanted to be involved, in some measure, in the decision-making in that area. With the more recent change -- the appointed boards and so on -- I think there is considerable concern within communities about whether they will have a voice in the future and in what way their input, if we can call it that, into health care governance might be realized.

The question here is. . . . In Revelstoke -- which is not in my riding; it's in Columbia River, obviously -- I understand they have created a health advisory committee which they hope will provide an opportunity for that community to meet with the regional health board and express concerns, ideas, etc., with respect to that community. Would the minister consider that to be possibly a prototype of community involvement with the regional health board?

Hon. J. MacPhail: Yes, that would be good if that occurred.

The Chair: I might just take a minute to remind all members that we are dealing with the estimates for this year. So questions should be related to and within the parameters of the budget for this year. Your question wasn't out of order because of the way you raised it, hon. member, but your introduction to it might have suggested a different kind of question than you actually asked. You may carry on now.

G. Abbott: Thank you for that clarification. I frequently do go off in tangential directions, and I appreciate your guidance with respect to these kinds of issues.

One area in my constituency of Shuswap where. . . . Again, this question has been put to me directly from. . . . I believe they call themselves the Sorrento Wellness Council. Essentially, it's a group in Sorrento that's very concerned about health care delivery -- all the various aspects of health care delivery in their unincorporated area.

Sorrento is an area of somewhere around 4,000 to 5,000 people. They don't have a representative on the North Okanagan regional health board, at least at this point. They would like very much to have an opportunity to have a voice or to have an opportunity, at least, to meet at some point with the regional health board, as well. Does that seem a reasonable kind of format, for a community to organize itself in that way and have a voice at the board that way?

Hon. J. MacPhail: The same general principles that we discussed all last week apply -- that is, the regional health boards are to get community input in the way that best meets the needs of the communities that they're responsible for. Regional health boards have been asked to do that and are beginning to do that.

It sounds like there's a great deal of interest in your area in ensuring that the community gets together with the regional health board. I look forward to them doing that in a fashion that makes the most sense for the community.

G. Abbott: I appreciate the minister's response.

To conclude, I just have a few relatively straightforward questions. These are questions arising from the news release from the Ministry of Health on March 28, 1997. The first line of the news release reads: "At the request of three regional health boards, [the Health minister] took action yesterday to ensure a full transfer of authority for health care decision-making into their hands on April 1, 1997." Could the minister advise what three regional health boards requested that intervention?

Hon. J. MacPhail: Sorry -- what was the date of the release?

G. Abbott: March 28, 1997.

Hon. J. MacPhail: I hate to engage in an exercise here, but are the hospitals not specified in the news release -- the hospitals that are affected?

G. Abbott: Not that I see.

Hon. J. MacPhail: Okay. If the member wants to send across the news release, we'll get that information on the three health boards.

G. Abbott: The news release also notes that the changes surrounding regionalization were preceded by extensive planning and consultation. Could the minister advise whether there was any consultation engaged in beyond that provided by the RAT team?

Hon. J. MacPhail: Yes, throughout the whole period of New Directions there was consultation. I consulted with some people and the regional assessment team consulted with some people. There was an election fought in between, as well.

G. Abbott: The concern about the lack of consultation has been forcibly put forward, particularly by the community of Revelstoke. Revelstoke has been included as one of the members of the North Okanagan regional health board. They were very much concerned with the amalgamation and very much concerned with the lack of prior consultation. Could the minister advise what there was in the way of consultation for the community of Revelstoke?

Hon. J. MacPhail: The consultation from the regional assessment team did cover Revelstoke through their visits in the Kootenays. There is an indication that one area was caught with a flat tire and didn't make it to the meetings. Consultation did occur afterward, but not in the formal meetings. I'm not sure whether that was Revelstoke or not, but I want give that. . . . There was consultation through that factor and then through the other methods I just previously mentioned.

G. Abbott: Just one last observation. One of the last points made in the news release of March 28 suggests that amalgamation will not diminish public input in health care. I hope that in fact that is going to be the case.

I'm pleased that the minister appears to be very receptive to community involvement in regional health board decisions. I think that will have to happen for the process to work effectively. I presume we'll see some evolution of community participation in regional health board discussions over time, but I'm pleased that the minister is at least initially open to that and hope that amalgamation will not in the end diminish public health input in health care.

[ Page 3463 ]

A. Sanders: I'd like to canvass a couple of areas that I had originally asked about on Vernon, and then I'd like to talk about mental health -- if that's appropriate -- in terms of staffing, just to let the minister know that.

The first area that I'd like to revisit from last week, hon. Chair, is that of renal dialysis. I'd like to let the House know that the minister and her staff have in fact sorted out the dialysis problem for the patient in my riding, for which I am appreciative.

The second question, which I did not ask and would like to at this point, is: would the minister be able to provide me with a breakdown of the members of CHCs and RHBs in terms of occupation or, if retired, in terms of previous occupation, as well as political affiliation?

[3:00]

A. Sanders: I would appreciate any information that we can have so that I can look at this in terms of the analysis of groupings -- which groups are represented in bulk and which are perhaps not.

The third issue having to do with Vernon that I wanted to recanvass was what seems to be a confusing circumstance between MSC -- Medical Services Commission or Medical Services Plan -- and a private laboratory in Vernon. I want to read the minister a letter from a constituent in Vernon, a Mr. Kevin Kienlein. This is a gentleman who has something called tricuspid atresia, which means that the valve on the right side of the heart is poorly formed. In addition, he has a hole in his heart; he suffers considerably from failure of the heart and requires bloodletting in order to prevent congestive failure. These individuals are often very, very unwell. Often they are on disability pension.

Mr. Kienlein writes to the attention of Lorne Verhulst, senior medical consultant at Medical Services Plan:

"Dear Sir:

"On Tuesday, May 13, I went to the Valley Medical lab located at the medical clinic here in Vernon for my biweekly blood test which I have had done there for the past 30-plus years. When I arrived, I was told they would not be able to do my bloodwork, as the doctor who looks after my case has had his eligibility status cancelled, so that his patients cannot be served by the lab. I was then told that I had to go to the outpatient lab down the street, which is run by the same company, to have my bloodwork done. I then had to go back to the doctor's office for the rest of my checkup. I then had to wait three days to find out the results of my test, which usually are done the same day within 10 to 20 minutes while I'm waiting for my appointment.

"Today I received a call from the doctor's office and was told that I required a phlebotomy."

"I proceeded to the lab at the clinic, where I was told that they could not provide this service either, which I have had done there for the last 20 years. I was told I had to go to the hospital across town to have this procedure done. I arrived at the hospital, where I had to fill out forms, wasting some more of my day. I finally had the phlebotomy done two and a half hours after I had originally arrived at the Valley Medical lab for a procedure that would have been done in 20 minutes.

"My time is just as valuable as yours, sir, and if you feel you are making our medical system more efficient and cost-effective, you are very wrong. Whatever bureaucratic wrangling you are having with this lab is not serving British Columbians at all. If my case would have been a serious one, I would be holding you personally responsible for any serious problems that might have arisen from the instatement of this" -- he uses an expletive that can be abbreviated to b.s. -- "[b.s.] politics that seems to be going on. I hope next time you go to the doctor you are made to wait and waste your time as I was.

"Sincerely,
"Kevin Kienlein"

I had explained to the minister in a brief way that there was a problem with the medical lab and that this was basically a lab where, in 1985, eight or ten doctors used to work. The lab expanded; there are now 19 physicians there, and Medical Services Plan has decided that only the original eight can have their patients go there. So we have a two-tiered circumstance within the clinic, where one doctor's patients can go to the lab and the other patients' doctors cannot send their patients to the lab. As a result, a list was passed out of physicians approved to use the lab directly in the building, and a list of the people who could not use the lab was passed out.

There has been some back and forth conversation between the physicians and the Ministry of Health. The ministry has specifically said that no new laboratories or any significant expansion of present laboratories will be approved until there is reasonable utilization of existing approved labs. In other words, they would like the patients to go to the hospital rather than use the lab that's right in the building.

I think that Mr. Kienlein's letter is a very good demonstration of what the problem is in this case. I would like to provide the minister with the information, in terms of correspondence, so that she can look at this and perhaps suggest a more equitable solution to what wasn't a problem but what has been created through one aspect of the regionalization process. I would just like some feedback from the minister on that.

Hon. J. MacPhail: I too was interested when you brought forward this issue last week, so I actually looked into it. I'm sure the member is well aware of how complex these matters are in terms of bleeding stations and licenses, etc. This is particularly representative of a complex situation where the policy around funding of labs and who could refer, and what used to be called the vested-interest lab. . . . The policy changes around that -- which, the member is quite right, took place throughout the mid-eighties and into the early nineties -- are complex.

So I am interested in your bringing this particular example to my attention, because I certainly have been approached by many people who say we need lab reform. We need to reform the way that we carry on our business in laboratories. Of course, the previous decisions around laboratories -- and this one, too -- is a Medical Services Commission decision. Because labs exist on fees for service, the method by which labs are funded or receive their funding is a Medical Services Commission decision. But there is no question that lab reform is needed. We're not issuing any bleeding station licences until the matter of utilization is addressed. It's a very important issue for physicians in this province, and it certainly is an important issue for the Medical Services Commission as well, since the fee-for-service budget for laboratories really is expanding quite substantially.

I know that in the situation you refer to -- I have information, but it's only written information; I've never been there -- the hospital had set up a collection station within about two 

[ Page 3464 ]

blocks of the Okanagan Pathology Group's office, so the referral didn't have to be to the hospital. There was a collection station only two blocks away, and I guess that information wasn't available to the patient.

But let me just say that I hope to work over the course of the next year with our physicians and laboratories, as well -- both the publicly owned and the privately owned laboratories -- on a new way of delivering our laboratory services. And there has been reform that has taken place in other parts of the country, which. . . . There are some successes to be learned from and there are some failures or a lack of success in other areas of the country, too. I think this is an area that can only get better through the use of regionalization, in that the use of laboratory services would probably be better determined on a regional basis and by what the community truly needs rather than by edicts from Victoria.

The Chair: Hon. members, I have an introduction to make. In the gallery there's a group of 35 grade 7 students, parents and their teacher, Mr. Struckmeyer. They are from the Annie Wright School in Tacoma, Washington. Would the House please make them all welcome. We caught them just in time, just as they were leaving.

A. Sanders: The importance of this issue is severalfold. Number one, it isn't creating a new laboratory; it's creating a use that was already established. In other words, this lab has been there as long as the clinic, although the ownership has changed. The ownership originally changed -- I'll find the letter -- because of the 1985 ruling in the medical-clinical partnership document from the College of Physicians and Surgeons. Basically, the clinic got out of the business of running a lab because it was felt to be a conflict of interest for physicians to do that. I have the documentation of that in a letter to Dr. David Bolton from Dr. John Mann, March 19, 1986, which I'd be happy to share with the minister. Specifically -- although I feel, too, that laboratory services need to be critically analyzed -- we are talking about a lab that used to exist, so we're not increasing utilization by having patients go there. So number one is the point of no increase in utilization.

Number two is that in this particular area, with which I'm familiar, two blocks can be quite a considerable way, because a number of the individuals who go to this clinic are elderly. Many of the older physicians were originally located there, and these elderly people are probably skewed more towards the medical clinic. Incidentally, I don't work there and have no vested interest in whether these people have a lab or not. But I do know that this two blocks, if you're in wheelchair in Vernon in the winter, when we do not clean our sidewalks, has brought me a few patients in emergency with fractures that they didn't leave with. So it's not as easy as one may think, even though two blocks does not sound like a long way.

Thirdly, the purpose of rules in any system is to make the system work, to streamline it and to have people obey the law. I think this can create an underground laboratory experience for patients. In other words, if I am a patient of Dr. Stacey Butters and need a laboratory test done, and she is not on the list of physicians who can utilize the clinic literally next door to where the patient has been examined, but Dr. Arnold is on the list, then I can become a patient of Dr. Arnold's -- or use Dr. Arnold's laboratory forms -- in order to still go to the lab instead of going two blocks away.

What we're doing here is that we're creating a circumstance of inequity for the patient. The doctors can probably still get around this if they want to put their nose to the ground and really keep their back up above it. But I don't think that's the purpose. I think that if we're going to create rules, we want to be creating them so that people follow them and not look for ways to get around them.

So this problem needs to be looked at and to be solved for these individuals. I think we need to figure out an equitable way, within the parameters of how the ministry is working, to allow patients to go to the lab they've been going to for 25 years and to allow the increase in physicians who are at that lab and have been using the lab since day one to continue doing on Tuesday what they were doing on Monday, basically the day before.

What I would do at this point is just leave this documentation with the minister and, hopefully, have some further discussion once there's an opportunity for her to go through this, because I truly feel she can solve this problem with no blood loss and no additional phlebotomy.

Hon. J. MacPhail: When I receive the documentation, I'd be happy to refer it to the Medical Services Commission for further advice to both of us.

A. Sanders: I'd like to shift gears a little and move from the regional aspects of health care in Vernon -- which, of course, is of interest to me, and I'm charged with the responsibility of seeing that my constituency is well addressed -- and turn to an area that is of larger concern for me and certainly of significant importance for a number of people in British Columbia. That is the area of schizophrenia. There are a couple of points that the minister has made over the period of time in the House that were documented in, I believe, her opening remarks on Health. I'd like to read those into the record, because I feel they are important. I do feel they are what the minister feels is the template for what we should be working on in mental health.

[3:15]

". . . our commitment for the most vulnerable in society is to care for them through the provision of high-quality health care services. This is our measure of our humanity and a testament to all of those who have paved the way for a system that would never turn its back on a person in need, regardless of their ability to pay."

Specifically for the benefit of those who may not be familiar with schizophrenia, it's not an uncommon condition in B.C. About one in 100 individuals will suffer from schizophrenia. The suffering of schizophrenia is not something that we understand totally. It's a biochemical problem. We have more information that there is in fact a genetic relationship, but there are many other factors beyond the genetics in terms of why the biochemical change occurs.

The profound problem of schizophrenia is that young children who are in a family and not in their teen years are normal children with no obvious sequelae going to happen to them in terms of their family life or their schooling. The usual clinical presentation is that you'll have a normal, happy individual who at 17 -- somewhere between 17 and 29 -- will start to develop some very strong and often very bizarre symptomatology. Specifically, they'll come to their physician, their counsellor at school, their friends, their minister, often 

[ Page 3465 ]

with hallucinations. These hallucinations are in the form of voices they hear. Sometimes these voices will be command hallucinations, and these commands will tell the individual to do certain things. They will come with ideas that are called delusions, meaning that they will interpret a set of circumstances as being something totally different. Often, again, these are delusions of paranoia, where people are plotting against them. They often have signs that are similar to depressive symptomatology. They may be very flat, unable to exhibit any behaviour. When they have behaviours, they may be very bizarre. For example, they may have posturing and go into positions that they will maintain for very long periods of time.

The things that families see once they've. . . . Often families confuse these first symptoms with drug abuse, which, especially between the ages 17 to 29, can become quite a problem. But the other things that are so profound and worrisome for families are the decrease in personal hygiene -- this is a global benchmark for deterioration in terms of schizophrenia -- and also, even more important, the decrease in premorbid functioning. So you will have people who were gainfully employed, who were doing well at school, who were participating with groups -- maybe in a drama club -- who have absolutely no ability to function socially -- tremendous social withdrawal in addition to the very marked symptomatology.

When these people present themselves, wherever they come into the system, they have the opportunity for treatment. When you have a son or a daughter who's been completely fine and then has marked deterioration so that they are no longer able to do any of the things they were able to do formerly, you find parents and families and communities in severe distress. When you look at individuals who have a clear diagnosis of schizophrenia, the most important thing for those individuals is treatment.

One thing that often people don't know, if they have not been in contact with or had family members who are schizophrenic, is that the first interaction with that individual as a patient may be the only chance that individual gets. So, very commonly, if an individual comes in with a first break, a first psychosis, and you treat them appropriately with something that doesn't make them worse, you may find that you can actually help them. The help is something that goes on forever, because this is not a curable condition. So if we're looking at treating someone with schizophrenia and treating them well, that first contact and what we do to that patient may be everything; there may not be anything more. If they have a good result -- a good interaction with whoever is looking after them -- that may indicate whether they come back in a year or two or three down the road.

These are the most vulnerable members of our society. I feel more than anyone that these people cannot be here to stand up for themselves, because of the correlations of the disease with poverty, with the lack of ability to support oneself, with the lack of job opportunities and the lack of relationship opportunities. We therefore must stand up for them.

One of the things that government needs to understand when looking at the medications we use to treat schizophrenia is that if you look at the population that's being treated, about 50 percent of people who are treated will discontinue their medications because of side effects. It's one of the highest percentages for any medications we use for any condition. If 50 percent stop the medications, we are going to be in a position where we have not done our job. So we have people who can't stand up for themselves, who are the most vulnerable, who get into problems with incarceration -- police involvement, forensic psychiatry -- and who have terrible side effects from their medication. We see them once, and maybe that's our only chance to treat them. We're looking at a circumstance where this is a highly volatile and vulnerable group.

Why is this important now? The reason is that we're looking at a situation in British Columbia where we have the opportunity to do something right by looking at the medications we treat schizophrenia with and providing the best solution for that problem. What we have right now are two new medications which we've been using in British Columbia for about five years. One is called risperidone, and the other is called olanzapine. These are drugs for schizophrenia. What we haven't done in B.C. is put those drugs on the front line for use by people with schizophrenia.

Because of cost-containment measures, if an individual comes in with a first break or with schizophrenia, that means they must first be treated in British Columbia with medications that belong to a family of which one representative drug is something called Haldol. There is a good reason why Haldol is used, and that's because it's cheap. But in this case, we have to decide whether cheap is best. If we look at Haldol and compare the difference in the results, what will happen if you have people who are treated with Haldol is that 23 percent of them will not take the medication and another 30 percent will have to stop the drug in the first five weeks due to side effects. So here we have almost 60 percent of individuals who go on Haldol -- albeit it's cheap -- who cannot take the medication because of side effects.

With the other medications, which are more expensive, we find that they do not deteriorate cognitively, meaning that their thinking is not impaired as much on the medication. It's also the best tolerated of the medications, along with olanzapine. A very prominent psychiatrist and researcher into schizophrenia in British Columbia has written the following:

"It is essential that these factors of better tolerance and less cognitive decline be considered when prescribing decisions are being made for patients with first-episode schizophrenia. If this is not done, they will be denied the opportunity for the best possible outcome."

The most important group, as I hope I've demonstrated to some degree, that this totally knocks out of the ballpark is the group with first psychotic break. These are the people we need the risperidone for; these are the people we need the olanzapine for. And we must use those medications first. If they work for the individual -- and sometimes they don't -- we have to use those medications first, and then if the patient is stable and has some feeling of success about their treatment and has some rapport with the individual looking after them, perhaps we can be in a situation where we could change them to the cheaper drug. But to do it the other way, where we do not allow individuals who are this vulnerable a medication that could potentially cause them to be well for extended periods of time, is completely unconscionable for us as government.

[ Page 3466 ]

I want to read the minister some of the side effects of the traditional medications we use. If you see a patient who comes in with first psychotic break into emergency, you put them on medication. They will often manifest a number of disorders. First of all, the more common ones are that they'll have dry mouth and. . . .

Interjection.

A. Sanders: Basically, hon. Chair, what I want to do at this point is ask the minister if this issue has been brought to her attention previously.

Hon. J. MacPhail: I would just like to say to the member for Okanagan-Vernon that I very much appreciate her presentation and the compassion with which she articulates the issue, as well.

Yes, I am well aware of this issue, and I appreciate the fact that we can have a discussion across the floor about it and work toward a resolution on this very important matter. I don't share the experience from a family point of view but certainly from a neighbour's point of view. Many of the people who are affected by schizophrenia end up living in my community by virtue of the untreated symptoms that the member so compassionately describes. So it is an issue for me on behalf of my neighbours, as well.

Just a couple of points. I would like to tell the member what we are doing in this area to address the concerns that she has raised. But I hope we can discuss this in a context that is truly about the facts. This has nothing to do with reference-based pricing; this is not a drug controlled by reference-based pricing at all. It is about the practice of special authorities. That's true -- the hon. member does describe that accurately -- but special authorities have been part of our Pharmacare program almost since its inception. The member is correct in saying that olanzapine and risperidone are on special authority.

A couple of things. I've met with many people to discuss this issue, and I think it is time -- even after we've got our pharmaco-economics initiative, our therapeutics initiative and even our BCMA chapter of psychiatrists to address this issue -- that we also have to talk to the community about it. We have to talk to the Schizophrenia Society, the parents and the patients themselves.

The good news -- and it is good news -- is that olanzapine and risperidone are covered by our Pharmacare program. But the member is quite right that they're not used as a first-line therapy but as a second-line therapy. We did investigate thoroughly the effects, the advantages, of olanzapine and risperidone in the context of our pharmaco-economics initiative. The member is correct that other first-line drugs are cheaper, but really, we know that we have to look at the investment in our treatment plan in the context of the overall cost and not just of the cheap cost of the drug. If there is a more cost-effective way of treating a patient that requires a higher input into a drug upfront, we'll certainly do that.

[3:30]

It is controversial. There's no question about that. It is controversial among those who are most vulnerable in our society, and I very much appreciate the comments that the member made about us having. . . . It's almost the one illness where you have one chance to get it right, and then you have to work really hard to get a second chance. I know that from talking to family members of people with schizophrenia.

[E. Walsh in the chair.]

So it is under review. Let me reassure the member that our policy of special authority for risperidone and olanzapine is currently under review. We're working hard right now with the BCMA psychiatry section and with the PI and TI initiatives but also with the Canadian Mental Health Association and the Schizophrenia Society in the review of our Pharmacare policy around this matter.

A. Sanders: The minister said one thing that's very important in this whole discussion -- that there is a large group of people who have been grandfathered -- but new patients are the ones who require this special authority. Those are the most important of the entire group. If they have already been on the medication and are grandfathered, that's great, but it's with those first-break psychotic individuals, who are young people coming into whatever facility they are first seen in, that special authority. . . . Waiting two or three days to get the paperwork done in order that they can actually have medication cannot be the way that these individuals are treated.

From a humanitarian point of view, if this government wanted to make political hay in terms of doing the right thing, they would huck out their review of whether or not this is an economically viable solution. What you're not comparing in that economic viability, when you look at the cost of Haldol at 15 cents a day versus risperidone at $6 a day, is that you are not looking at those people who cannot take the medication. That is up to 50 percent of the individuals, from the studies I can cite for you, and those individuals are unable to take the medication because of the horrible side effects. Some of these side effects are permanent. You have permanent movement disorder. You cannot get away from a jerking or a flinching, and abnormal, bizarre behaviour that is with you forever because of medications like Haldol.

What we need to remember is that if schizophrenics are not treated and are in the community, we are not paying for the medication but we're paying for the mental health worker, the nursing people who are in the emergency department, the physicians, the crisis line and the support team. We're paying for the Attorney General ministry's costs of policing and incarceration, and for forensic psychiatry. If they are on Haldol, we're now paying not just the 15 cents for the Haldol, but most people who are on this kind of medication also require one or two additional drugs to stop side effects.

When you're looking at the cost of the drug and comparing the two, you actually have to look at that. If the person is on Haldol, they're also on an anti-Parkinson's drug to stop all the jittering and jumping movement that the Haldol causes. You have to take the two drugs almost in conjunction with each other. There's a cocktail for all these people who are on anti-psychotics such as Haldol, the ones that we pay for as government. They're not just on one drug, and if we're looking at cost versus cost, we have to look at what the combined cost of all of the medications is in terms of treating these individuals.

Hon. Chair, I'd just like to ask the minister a question, and I am very interested in hearing the answer, because I can tell 

[ Page 3467 ]

her that there are very many people in British Columbia who also will be awaiting the answer. If we are having a pharmacy review, what is the time line for some information or direction coming from that pharmacy review with respect to the newer anti-psychotics?

Hon. J. MacPhail: I just want to reassure the member that while the review is underway, the drugs are, of course, available on special authority. But the first-break aspect of this is under review now and will probably be completed within the next few weeks. The people most affected by it are, of course, involved in the review, so they'll be well aware of the time lines of the review.

I hope the member heard my comments when I did agree with her that one has to look at the overall health care costs to the system and examine what's the most cost-effective way of. . . . When one puts a cost-benefit analysis in place, I totally agree with her that you have to look at the overall costs and benefits. But I also know that in my discussions with members of the mental health community, there is also a recognition that there are many thousands of people who are functioning in society on drugs such as Haldol and many of the other typical anti-psychotic drugs. It's important for us to make sure that their confidence is not undermined at the same time. In the context of the atypical drugs such as risperidone and olanzapine, the review will be completed within the next few weeks.

A. Sanders: I'm pleased to hear that it will be that short a time line. In terms of the minister's concern about those who are already on Haldol and who may feel discriminated against, what the drug review should in fact do is say that, instead of special authority, patients will be placed on whatever medication works and then moved to cheaper drugs if possible. That way, you would catch all those individuals with a first psychotic break.

If other drugs such as Haldol were helpful or useful, these could be used in the future. Then you're not barring the way for those medications to be used at a future time for the patient who has that first episode of psychosis, but you're still treating that first break with the most user-friendly medication that can give people quality of life and not render them susceptible to side effects.

Those range from being purple. . . . Those of you who have visited Riverview will know that is in fact the case. Often the patients are blue, purple or grey-coloured because of the medication, which also inflicts them with permanent movement disorders that would isolate them from society forevermore should they venture out into the real world with controlled schizophrenia. When we're talking about one in 100 individuals and the potential to treat them properly, when they are not able to stand in the House and fend for themselves, these are things that we must do. I appreciate that it will be two or three weeks, and I will be looking forward to the minister making the right choice on this particular issue.

The second issue I wanted to canvass, other than the use of these two medications. . . . I offer the minister a letter from Dr. Liddle, who is our made-in-B.C. expert on schizophrenia. If she does not have that letter, I offer that. He is a very well-known psychiatrist and also a good researcher, and he has written a very effective letter as to why government should be in the business of providing this as a first-line drug without special authority, so I will provide that for the minister.

I'd like to look at the mental health initiatives. The auditor general indicated in his report that the Legislative Assembly needs to be better informed about our mental health services. He recommended an annual status report on implementation of the mental health initiative and how this initiative will show the community what facilities will be available in British Columbia as Riverview is downsized and mental health services are improved.

The auditor general made a number of recommendations; I would like to focus specifically on three. The first is that the ministry apply principles and practices of program management to replace Riverview. My question to the minister is: have we in fact followed the auditor general's recommendation? Are project management practices and principles being formulated for the replacement of the Riverview facility?

Hon. J. MacPhail: This report may have been published prior to the member becoming a member, so I can make it available to you. The ministry published a 1995 report in response to the auditor general's report; it's called "See Mental Health in a New Light." The short answer to your question is yes, those principles are being followed, but perhaps the member would like a copy of the entire report, as well.

A. Sanders: I have seen the report. Is this a report that will be done annually now, as a response to the auditor general's recommendation?

Hon. J. MacPhail: I made some very brief comments last week when we started to talk about mental health. I indicated that the original mental health plan for the province was done ten years ago, and we are now reviewing the plan again in the context of what has been achieved in that ten-year period. There have been several reports: the ombuds report, the auditor general's report. There has been, I think, a large amount of public debate around the direction that mental health should go in this province: should Riverview Hospital play a bigger role than had been planned in terms of deinstitutionalization, or is there another approach to take in that area?

So the whole mental health plan is under review now. Again, I reported that we're working with the stakeholders in the industry. That plan will be completed probably by the end of September, at which time we will then publish another annual report.

A. Sanders: So I should anticipate seeing the '95-96 report at the end of September.

Hon. J. MacPhail: No, it will probably be published in 1998, because the changes, if any -- I suspect there will be changes; I certainly hope there will be -- will be put in place over the course of later this year and into the spring. Then a report will be published.

A. Sanders: One of the acute strategies with replacement of Riverview was the shift from what are called tertiary beds, meaning the third level up -- in other words, you're not in your town or in your district, but in a centrally organized place, which is Riverview -- to secondary beds. Theoretically, these secondary beds would be at the regional level. As part of the replacement of Riverview, 170 acute psychiatric beds in general hospitals were to be created. My question to the minister is: has this been done as of May 1997?

[3:45]

[ Page 3468 ]

where the member is getting that from, as well. Since that time there has been a great deal of consultation, up to and including the '87 mental health plan. The community standards by which we develop mental health plans shift. Since that time the community has said to us: "Don't institutionalize. Set up community beds, as opposed to acute care beds." So the beds have been in place, but they're community beds, not acute care, institutional beds.

A. Sanders: In terms of the demographic changes in British Columbia, I'm wondering whether it is the ministry's understanding that we are in fact holding our own with the establishment of in-the-community placements of any kind for our mentally impaired patients.

Hon. J. MacPhail: Generally, in terms of where we stand in relation to other provinces, we take the lead in most areas of supported living, whether that be beds in a hospital or independent living. That's mainly because we've been developing our solutions through the provision of housing. Other provinces have gotten out of the business of providing social housing, so I think that's where the difference comes.

Let me provide you with some numbers, and you can check the interprovincial comparisons. First of all, in terms of the acute side of psychiatric and crisis residential beds, there are 705 psychiatric beds in acute care hospitals and 83 crisis residential beds. In the area of supported housing, there are 1,780 residential care beds in the community; there are 190 family care home beds. In supported independent living, there are 731 beds. Under BCHMC, which has a policy for priority to people with mental illness, there are 255 beds. We've just expanded that policy with BCHMC to give priority now in terms of placement for people with mental illness. There's a rent subsidy for people with mental illness: another 817 beds. And there are other miscellaneous supported housing initiatives with another 354 beds. So in community residential care there are now 4,127 beds.

A. Sanders: I hope the minister will be able to provide me with a copy of that information sheet.

I would like to canvass a little bit about what many emergency room nurses and emergency room physicians, especially, call "mainland gridlock," for want of any better name. Specifically, this is acute care space in the emergency room that is occupied by sometimes five or six individuals who have mental illness. Often with the emergency care for psychotic patients in hospitals outside the very lower mainland -- Vancouver General, for example -- there are no restraining areas for patients. Quite commonly, because there aren't any beds in the hospital, the patients have to be restrained in the holding tanks of the emergency room, the outpatient department. The restraint is either physical, meaning that they have to be bound down, or chemical, meaning that they're given a cocktail that will knock them flat, so they aren't walking about disturbing everyone. This comes down to an issue of humanity and justice and whether this is the right thing for us to be doing in a health care system. I'm interested if the minister has ever been alerted to this situation.

Hon. J. MacPhail: Yes, I have, partly from my own constituents and also from the emergency room review that we did earlier this year. The hospital of use for my constituents who suffer from mental illness is St. Paul's Hospital. The community support groups inform me -- this is all anecdotal, but clearly it supports what the hon. member is saying -- that the emergency room at certain periods of time becomes the social centre. . . . I don't mean that in a pejorative way. It becomes the referral centre for people with mental illness who may need just some other support in the community but the services aren't there late in the night or on weekends. Statistically, in January, the emergency room review team came to the same conclusion that the member states, which is that often the backup in emergency rooms is as a result of people with mental illness being both improperly held and improperly referred.

Just a couple of solutions that we're putting in place now. . . . One, of course, is to put services into the community that meet the needs of people with mental illness on a much more regular basis, so that the services are there when the patients need them and not at the convenience of the hours of operation of the service. So we are looking at putting more support services in the community. We also know that supported housing is the way to go in many cases, so when a person gets in crisis and needs some support, that can be given in the context of her living situation and she need not go, or be forced to go, to an emergency room. We're now, this year, building 200 supported-housing units in the lower mainland, and more are planned throughout the province.

The final issue, of course, is that we have found that the occupancy rate of Riverview is below what it should be, in that hospital emergency rooms have not been able to refer patients to Riverview. We investigated that because, of course, Riverview is funded at a level where the beds are available, and the occupancy should be maximized for patients who need institutionalization at Riverview. So we have given direction that Riverview must make 50 additional beds available for admission immediately -- we did that last month, actually. There's no sense of keeping an occupancy rate at 90 percent if you're funded for 100 percent and the beds are needed. So that direction has been given to Riverview.

Also, we're now planning to permit the regions to admit directly to specific Riverview beds, so that their critical needs are met. I don't want to use the term "designated beds," but they don't have to go through a circuitous route. . . .

A. Sanders: I'm pleased to hear there will be more beds available at Riverview. The minister did mention that to me last week. I can tell you, it has been very difficult to get individuals into Riverview. As recently as the Christmas holidays there were two patients that I specifically am aware of who were not committed under the Mental Health Act, despite the fact they should have been, because there was nowhere to hospitalize them. So they were not committed. I've also been aware of one patient in my own facility who was denied hospital care until they committed a crime and was therefore sent to the forensic psychiatry location. I've also been aware through letters of parents who have resorted to laying charges against their own psychotic children in order to get that particular individual into the hospital, into the facility and eventually into Riverview. That does result in a criminal record for the individual. And we've come to a sorry state when we're creating criminal records for people in order to get them health care.

I'm interested in the Riverview expansion of 50 beds, because I understand there is some differential in how these beds are named. I wonder if the minister could explain to me the differences between the beds: for example, designated bed, occupied bed and this other terminology -- just so I can understand that there aren't beds being counted twice and, in fact, that there are 50 more beds.

[ Page 3469 ]

Hon. J. MacPhail: Regardless of what designation the beds have, there will be up to 50 more people in Riverview than there are now, assuming that there is the demand for up to 50 more people. But if there's a demand for commitment of 50 more people, there will be the beds available -- extra beds, new beds.

A. Sanders: What will be the final bed count with the addition of 50 new beds?

Hon. J. MacPhail: Seven hundred and twenty-five -- that includes the new 50.

A. Sanders: Could I have the dollar figure from the minister for funding a Riverview bed, please?

Hon. J. MacPhail: The funding for Riverview Hospital is $92 million.

A. Sanders: I'd just be interested if the minister has any figures that can break that down into. . . . For example, in our hospital we have a per-bed figure. If we open a new bed, we know the dollar figure. Is there such a figure for Riverview?

Hon. J. MacPhail: Riverview is funded on a global budget; there's not a per-bed breakdown such as there is in the acute care institutions.

[4:00]

Again with emergency services -- which seem to always be the tip of the iceberg for communities -- my concern now turns to the broader spectrum of suicidal patients. My question to the minister is: is the minister aware, or does she feel the communities have presented to her, that there is a paucity of acute beds for suicidal patients?

Hon. J. MacPhail: I haven't had anyone make that specific point to me.

A. Sanders: This is an area that I would be interested in the ministry staff looking into. In a way, we are forming protocols for just about everything, from how to administer medications to how to brush your teeth. This an area where I think there's a lot of work to be done.

One such example where there is an inquest. . . . And it's not the only reason. I receive many letters from the community about individuals who have taken their suicidal children to hospital, and found that they've been discharged from emergency. The family is not understanding whether that is the appropriate way for their individual family member to be treated. This is common.

[G. Brewin in the chair.]

This young woman, Brenda Barrass from Castlegar, exemplifies the problem. Specifically, this is a woman who. . . . The actions of Vancouver Hospital officials were questioned because she slit her throat -- committed suicide. She had tried to kill herself four times in three weeks prior to her death on December 9. She was treated at three Vancouver hospitals, forcibly held once for involuntary treatment, and each time discharged. She was admitted on December 7 to Vancouver Hospital -- fourth suicidal attempt -- and released within three hours.

There is an inquest into this, and I do understand that it is before the courts. My interest is not specifically related only to Brenda Barrass, but more to the fact that I get -- and many MLAs do -- very, very many letters where family members do not understand why they took their suicidal family member to the hospital, and they were discharged an hour later.

I think that the ministry needs to do some education, that we are moving towards more of an out-patient-oriented service, and that those services such as crisis-line therapy counselling that we can bring into the hospital through our mental health quick-response teams are the answer, and not that the system is failing. I would appreciate the minister looking into that particular circumstance, and doing some more educative stuff for the public so they are not viewing the system as failing them in terms of their families.

Hon. J. MacPhail: Some excellent points were made there. Just a couple of responses. I talked at length with Mr. Barrass, Brenda's father, shortly after her death, and it truly is tragic. We hope that the coroner's inquest that's going on now will make some strong. . . . We do anticipate them making some strong recommendations. Of course, all of the health care facilities are cooperating fully with the coroner's inquest.

A couple of points on education. You are absolutely right. We are working right now, as the member suggests, to strengthen the link between those who learn and those who educate us -- for instance, the chief coroner's office, the UBC suicide prevention program and the adult mental health division -- so that we can have a coordinated approach and then make the community aware of the coordinated approach that is available.

We are now printing the guide to the Mental Health Act, which is a plain-language, family-friendly, consumer-friendly guide to the act and what your rights are as a patient, what your rights are as a family member and what responsibilities there are for health care institutions. That should be on the shelves very shortly. It's being printed as we speak.

A. Sanders: I turn in a little bit of a different direction to specifically focus on psychogeriatrics. For those who may not be aware, psychogeriatrics is the psychiatric care of the elderly. Again, from a demographic point of view, that's involving more of us than it maybe used to, and from the bulge in population, will involve a very large number of British Columbians.

Looking at psychogeriatrics, you have to look not only at acute medical conditions but also at continuing medical conditions and the mental aspects. You are looking at quite a few different areas in geriatric medicine, and psychogeriatrics is a part of that spectrum.

The individuals we're talking about specifically are those. . . . Commonly people understand Alzheimer's being in that category, but there are many other individuals with organic brain dysfunction from incomplete suicides, chemical exposures, etc., who fall into this category, as well as a large percentage of the elderly population who experience delirium, either acutely or on an ongoing basis. As we have an increase in the percentage of the population that's elderly, we are most definitely going to need more of a focus on psychogeriatrics.

[ Page 3470 ]

My question to the minister is: in the four planning regions, is there specific psychogeriatric care that will be incorporated into those areas?

Hon. J. MacPhail: The review that we're doing now specifically addresses psychogeriatric needs in the population. Addressing that concern will be part of the new plan. And yes, it's based on a provincewide solution.

A. Sanders: I'd like to focus specifically on the psychogeriatric unit at St. Paul's. This was a 20-bed ward -- 15 geriatric medicine beds and five geriatric psychiatry beds. This has been cut down to 11 geriatric medicine beds and four geri-psych beds. I'm wondering what the longstanding vision for this service was, and having it truncated within a couple of years of its creation.

Hon. J. MacPhail: This was a decision that St. Paul's Hospital took last year. The hospital has reassured me that it was based on the utilization of the beds, in which they changed and amalgamated their services. But, since that time, I've also followed up with St. Paul's Hospital, and the changed nature of the provision of services is meeting the demands of the population.

A. Sanders: I think we have to look at this issue critically, and again, it would be helpful to talk to those who work in the facility as well as to management, because there is some definite misunderstanding between those levels of bureaucracy. There is also concern, specifically with hospital amalgamations, that these beds will be cut further at St. Paul's and perhaps distributed to other areas -- a turf war kind of circumstance.

In terms of expertise and in terms of functioning, so that we can learn from these facilities, I think there does need to be a critical size, below which you don't learn much. If you only have four geri-psych beds, you need to maintain that funding and have the hospitals work together. So I would encourage the minister to follow that and to make sure that she is getting all the information and not just what comes from the managerial level.

I'd like to ask a brief question on another area in the mental health realm that has become topical, it seems -- at least, to the media. This is on the ethics of mental health, specifically when we're looking at the ethics of what we do either in the large spectrum of health care or in the smaller spectrum of mental health. I'm interested in knowing what kind of ethics committees we have set up to deal with the issues in health care.

Hon. J. MacPhail: There is a minister's advisory committee on ethical issues that reports directly to me. They examine and investigate and then publish opinions and advice to the minister on matters of ethical concern. I've met with them a couple of times -- three times, I guess. It's a very interesting group. I can certainly make those reports available to the member, including the makeup of the committee as well.

A. Sanders: I would be specifically interested in several things. Number one, who is on the committee? Number two, how are they picked? In other words, how do they get to that position? And, number three, what is the committee's position on ethics? Specifically, we're looking at one issue right now that I think is very important, both for mental health and for other health conditions. What is the position of the committee on the ethics of when it is ethically defensible to assist patient suicide? So, specifically looking at whether they have a stand on that, and especially with the media. . . . In another province a physician was recently arrested for the assisted suicide of a terminal patient. Where are we in that circumstance?

Hon. J. MacPhail: The advisory committee on ethical issues has been in place since 1987. The 12 members are selected for their background and expertise, and they don't represent a particular organization. The current committee have backgrounds in philosophy, medical ethics, religion, human rights, law, education, medicine and nursing. I will provide the names of the members to the member opposite, as well. They have published a report on euthanasia and physician-assisted suicides. I will make that report available.

A. Sanders: That will be interesting bedtime reading, I'm sure.

Another area I would like to canvass is that of eating disorders. This is a very, very common problem in British Columbia, within the care of many physicians. In some family practices the condition may be as common as two of every five patients. Specifically, I'd like the minister to describe for me the provincial strategy that we have for eating disorders in British Columbia at this time.

Hon. J. MacPhail: Let me just go through a couple of points here. But I also want to offer the member this: many of the services for eating disorders have been transferred to the Ministry for Children and Families, and particularly those that affect children and young adults.

Overall, our comprehensive program is that we spend more than $6.5 million on direct eating disorder programs: $2.7 million of that is in acute care and mental health services; $330,000 is for a high-level out-patient program at St. Paul's; then there is the day program for children and youth at Children's Hospital. That figure doesn't take into account the billings that are made to MSP services -- that's separate and apart from that -- or the costs of the acute care beds.

[4:15]

There are three initiatives being developed as we speak. One is the provincial database, which is a database of what services are offered where, to whom and with what outcomes. There is a prevention framework that really involves school prevention initiatives. The Ministry of Education is heavily involved with that, but the coordination is now done through the Ministry for Children and Families.

My understanding, although I don't have personal experience -- actually, I do, sort of -- is that there is a lot of prevention work already being done in the schools. But the committee will be setting the standard for schools in terms of the prevention work.

Then there's a needs assessment, where the committee looks at where the greatest needs are, both for patients and their families. The committee also has the responsibility for developing therapeutic standards for the residential programs that wish to be considered for public funding. There are private programs that have no public funding, but the committee sets the therapeutic standards for the publicly funded programs.

[ Page 3471 ]

A. Sanders: There was a term that I would like the minister to clarify, because I'm not sure it's the same group that she has just described. Is the Provincial Advisory Committee on Eating Disorders the group that the minister was talking about?

Hon. J. MacPhail: I'm talking about the provincial eating disorders steering committee, which is the group that's giving the direction and advice on all of this. That's what we call it.

A. Sanders: One thing I have some concern about with respect to this issue being transferred to the Ministry for Children and Families is that I would probably say that in practice, although a very large percentage of anorexia patients are children under 20, a very large percentage of obese or bulimic patients are over 20. In fact, often those disorders actually become masked in secondary disorders. In other words, the crossover for drug addiction, alcohol abuse and other such issues is so large that we -- the Ministry of Health -- need to be careful that we are not decreasing services that have been available to individuals who are over 20 by transferring the money to a ministry that will, hopefully, focus on children.

I saw an article in the paper in Vernon this weekend that I was interested in, and I would appreciate the minister's comments. This was also concomitant with information I have about a private eating disorders clinic in Victoria, I believe, although I have not had any information about or interaction with that individual place. A 100-bed holistic treatment facility is planned for Westside Road in Vernon. It will be the first of its kind in the world. Dr. Bryan Lask of Great Ormond Street Hospital in London, England, who is a world expert on eating disorders, came to Vernon to tour the site. He is specifically interested in setting up such a private facility for eating disorders. Because there is an interest in my community, there is a group of parents, many of whom have experience with this condition, that is spearheading the development of a state-of-the-art treatment facility.

Could the minister please explain to me how, within the legislation we have in British Columbia, we can have private facilities for this type of circumstance, when we have actually done away with private facilities that had to do with ophthalmological surgery and orthopedic surgery, etc?

Hon. J. MacPhail: It's an interesting question. There are no private clinics that receive public funds in British Columbia. There is a private clinic in existence in British Columbia -- in fact, in this vicinity -- but they haven't asked for, nor do they receive, any public funds from government. The provincial eating disorders steering committee is responsible for setting standards for establishing the program requirements of eating disorder services. That's who we work with and provide public funds to, but not to private clinics. There is a method which anyone wishing to establish a publicly funded clinic in this province would have to go through, meeting the standards and developing the same user-payer relationship that other health services have with us as well. So there may be private clinics, but they're not in any way funded out of public dollars.

A. Sanders: I'm interested, in terms of the individuals who are planning this. . . . And I think it's an admirable thing on their part to move forward with something they had as a problem in their family and develop a service for all of us to use. Would it be my understanding, then, that the staff, including physicians, etc., who are working with this population would not procure any tax dollars from British Columbians?

Hon. J. MacPhail: I would prefer to provide an answer that's not in the context of this particular situation, because I can't address the specifics of this situation. But if anyone wishes to open up a health service that provides physicians' services or hospital services, they have to meet the test of our legislation. We'd be more than willing to talk to anyone who wishes to offer a medical service about how they can do that, but publicly funded health care institutions have to meet the test of the legislation.

A. Sanders: I understand that. I understand it in the context, for example, of private orthopedic services in Vancouver, where British Columbians cannot access those services because parallel services are offered within medicare. What I don't understand here is: would this then be a clinic that could only treat individuals from outside British Columbia? Using that model suggests to me that if you have an orthopedic problem in B.C., you have to go to a publicly funded B.C. hospital and not a private facility. If you have an eating disorder, you would have to go to Vernon Jubilee Hospital; you could not go to Dr. Bryan Lask's service. So I'm just interested in a clarification of that parallel.

Hon. J. MacPhail: Again, let me offer this: the group expressing an interest in setting up a clinic should contact our ministry. There is a very complex set of criteria to be applied. That's what should happen here. We'd be more than willing to engage in those discussions.

A. Sanders: I will offer this to the minister for her to view, and I will try and contact someone so they don't go and build a 100-bed facility that they cannot treat British Columbians in.

A question along the line of eating disorders, under the context of mental health estimates, which I wish to turn to now, is that of steroid abuse. Although it may not appear obvious why I've moved from eating disorders to steroid abuse, I will offer exactly why that is the case from a women's magazine that I read at the hairdresser's on the weekend. This particular magazine is talking about disorders and how the disorders of anorexia and bulimia, which occur most commonly in women, are paralleled and mirrored by steroid abuse in men. The psychometric equivalent -- if you're looking at a personality profile of those individuals who have eating disorders and are, in general, female -- will often be similar to that of males who are on steroids.

This is an area that I know is not dealt with at all by the ministry, and it's an area that is definitely growing within the context of young people. This magazine reads:

"The AIDS crisis -- which made thinness synonymous with illness -- helped popularize Hercules chic, but the look can be traced back at least as far as Michelangelo's David. Many of my gay friends take the dangerous but quick route to the de rigueur physique: steroids. In fact, steroid addiction -- the self-confidence provided by instant bulk is absolutely addictive -- is the gay equivalent of eating disorders in women. And gay men who do not fit the rigidly defined physical parameters don't just feel alienated; they are spurned, derided and essentially invisible."

[ Page 3472 ]

[4:30]

My question to the minister is: is this something that the minister has ever heard of or been apprised of?

Hon. J. MacPhail: Not as Health minister, but I thank the member for bringing it to my attention, and I will look into it.

A. Sanders: I'd like to see the ministry look into this issue. The statistics are there, and there are many individuals within the Council on Health Promotion who can give you an idea of this -- and, most definitely, those of us who deal with a lot of sports athletes and the gay population.

My next question to the minister revolves around an issue that is familiar to many of us through the work of Dr. Christine Loock at Children's Hospital. I have received a letter from Templeton Secondary School -- May 8:

"Dear Mrs. Saunders:" -- I think it's supposed to be me and that's Sanders, but anyway -- "We are a group of family management students at Templeton Secondary School in Vancouver, and we are writing with regard to children with fetal alcohol syndrome.

"After hearing a guest speaker discuss FAS in our class, we became more aware of the serious consequences of drinking during pregnancy and realized that teenagers, as well as adults, lack knowledge of FAS. We strongly believe that there is a need for more education for expectant parents, communities, schools and multicultural groups.

"We are particularly concerned about funding cutbacks to educational facilities for children with FAS. These resources are too important to lose, because many students with FAS need specialized learning environments. Without special attention children with FAS are at risk of being neglected in the educational system. We believe that there is a need for government support for public awareness campaigns and involvement, media coverage, billboards, television commercials, volunteers in schools, speakers and tutors.

"As new voters in the next election, we would like you to know that your consideration of our concerns with regard to FAS may influence our voting decisions. We would appreciate a response to our concerns and your position, including that of your party, on the matter. We look forward to your reply."

Hon. J. MacPhail: Is that Templeton Secondary School in Vancouver?

Interjection.

Hon. J. MacPhail: Oh, that's in my riding.

I'm most familiar with our government's response to the community in working with the community around fetal alcohol syndrome from my time as Minister of Social Services. There are two aspects that the member has noted. One is prevention, in terms of us notifying the public and making them aware of how this 100 percent preventable syndrome can disappear. The second is how we work with our children who have fetal alcohol effect or fetal alcohol syndrome.

For the detailed response, what I will do is to let the Minister for Children and Families know to expect this in her estimates, because she is responsible for the programs, even those that were previously delivered by the Ministry of Health. There is a wealth of services offered now, and Dr. Loock is truly a world-renowned leader, I think, in the area of the treatment of FAS and the proposal for community support.

I do know that the Minister for Children and Families has a coordination of programs that involve Sunny Hill Hospital for diagnosis of FAS children, coordination through children's mental health, the education system. . . . The member is quite correct; these are special needs children as they go through our day care and educational systems. Of course, youth corrections is also involved, because so many of the children end up in a criminal atmosphere simply because of the lack of proper treatment of their syndrome.

I could go on at length with this because it was so important when I was Minister of Social Services, but I would really be answering for the Minister for Children and Families. I will let her know to expect this and to have a good discussion about the range of services in the community.

A. Sanders: I'd like to pass that letter with these signatures on to the minister, and if she would be so kind as to give those individuals the appropriate answer from the appropriate minister. . . .

My next area of canvassing is that of accountability within mental health. Accountability within mental health is a very complex circumstance. The reason it's complex is because we are talking. . . . What are we talking about when we talk about accountability here? Are we talking about dollars spent? Are we talking about hospitalization decreases? Are we talking about the quality of life of the individual? Because there are so many different ways of looking at accountability, looking at it in terms of mental well-being is a very, very difficult circumstance.

There is a technical paper, which the minister probably has, from the Canadian Mental Health Association describing and discussing the elements of accountability within mental health. For my first question. . . . I would be interested if the minister has previously seen this paper.

Hon. J. MacPhail: My staff have seen it.

A. Sanders: We know how good the staff are and that they will pass on all of the information to the minister. Hopefully, we can all use this as somewhat of a learning experience.

Specifically, when we're talking about mental health accountability, what I would like to know is: in terms of mental health, how will accountability be established in B.C.?

Hon. J. MacPhail: In the area of mental health care services, we're now focusing on, in terms of accountability. . . . For the fiscal year '97-98, the regional health boards and the community health service societies will be provided with a separate funding envelope for mental health programs from the adult mental health division. The funding envelope will be provided to health authorities along with the funding envelopes for acute and public health programs. The 

[ Page 3473 ]

funding letters to the health authorities outline explicitly the terms of reallocation of program funding and the expectations regarding maintenance or improvement of existing levels and quality of mental health services. The funding letters note that changes to the range or volume of mental health regional and/or tertiary services must be identified in the budget and approved by the Ministry of Health prior to implementation.

It further states that the quality of mental health service delivery will be maintained and existing mental health clinical programs and services will be preserved with no reductions in the levels of service except as related to the positive changes in utilization patterns. And that's a nice way of saying that we're going to protect the funding for mental health even though we expect health authorities to integrate their services and get efficiencies from that integration. We also expect them to allocate no less than the money that we currently spend -- along with the increase that we gave this year -- on mental health.

We did that this year to reassure the mental health community, and also the patients, advocates and families, that we are committed not only to the preservation of our mental health services, even as we move towards regionalization, but also to the enhancement of those services. There's external monitoring of provincial and regional services. There's a Provincial Mental Health Advisory Council; they monitor the performance of B.C.'s mental health services system, and they provide recommendations to me on system requirements. Then there are regional mental health advisory committees that have been developed to monitor regional systems issues and to provide advice to the health authorities where it's requested.

Then, of course, there's the detailed status report to the Legislature and to the public around Riverview Hospital. We've already discussed that and when to expect the next report in that area. I've also indicated that the PMHAC -- which is not what you think of as PMAC, but is the Provincial Mental Health Advisory Council -- and other stakeholders are working with us now as we develop the updated mental health plan for consideration this fall. Also, at my direction, ministry officials are now working closely with Riverview Hospital management to improve the utilization of its current funded capacity -- we've already talked about that -- and to minimize the time required for admissions from referring general hospitals. Adjustments to the membership of the B.C. Mental Health Society board are also being explored to further improve the linkage between the new regional health authorities and the Mental Health Society board.

A. Sanders: Accountability is one of the things that the auditor general and the public are demanding of us more, as budgets get tighter and tighter. And one method, in addition to those that the minister has outlined as appropriate ways to establish accountability, is the potential for accreditation. I'm interested if the idea of accreditation within the mental health framework has been floated within the ministry staff as a possibility.

Hon. J. MacPhail: Yes indeed, we have piloted accreditation in mental health services. We initiated the pilot project last June, 11 months ago, and that was to test the applicability of standards and survey processes of the two major accreditation organizations: the Canadian Council on Health Facilities Accreditation, out of Ottawa, and the Commission for Accreditation of Rehabilitation Facilities, out of Tucson, Arizona.

Twelve sites volunteered to participate, and ten have been surveyed. The above ten sites have been accredited for periods ranging from six months to three years. The results were uniformly very positive, with all sites reporting that there was increased teamwork among the staff, greater accountability, and a stronger focus on quality management and performance indicators. We have determined that this pilot project has been very successful and that we're going to continue the strong encouragement of accreditation in the area of mental health programs as a result of this pilot project.

A. Sanders: I'm interested in the concept of a mental health advocate, and would like to have the minister discuss that with me now.

Hon. J. MacPhail: That was a recommendation made by the ombuds about a year and a half ago. Certainly, the establishment of a mental health advocate is part of the review that we're doing now because, of course, certain changes have taken place, not only in the area of mental health but also in the area of advocacy, with some of the mental health services now moving over to Children and Families and there being the child and youth advocate. So certainly, how we bring about the recommended mental health advocate is part of the review and will be part of the mental health plan. I certainly see myself, and have said to the community that I see myself, as an advocate for mental health. They think that's fine, but they say: "Yeah, yeah, but we want someone who can do it on a full-time basis and can get in there and advocate within the system, as well."

[4:45]

Their conclusion reads as follows:

"This fact sheet has looked at the issue of accountability at the system level and discussed measures of quality, such as balance, as well as ways of achieving quality. It has looked at accountability at the program level and talked about ways of ensuring that interventions achieve the goals or outcomes set for themselves. It discussed the technique of program evaluation as a way of measuring this type of success. It also looked at a specific kind of evaluation: cost-effectiveness studies. Research shows that there are existing program models . . . which are effective in meeting outcome goals, and have potential to reduce costs, at the program and wider system levels.

"Implicit throughout this paper and throughout the entirety of the fact sheet series is the understanding" -- and this is the important part -- "that for the concept of accountability to have meaning it must begin and end with the consumer."

"Planning and evaluation at the system level must include the consumer and his or her support network. At the program level, outcome goals should reflect the consumer's wishes about how treatment and support should be arranged. The most fundamental issue, though, is that system, program or individual supports should improve the consumer's quality of life, as defined by him or her. This is the touchstone of any real notion of accountability.

"Once again, the importance of removing medications from special formulary or special authority that are so impor-

[ Page 3474 ]

tant to preventing side effects for those individuals who have diseases that result in marked social, personal and relationship deterioration such as schizophrenia. . . ."

I'd like to ask a bit of a potpourri here -- some short questions. Short question No. 1: I'm interested in the concept of the short-stay unit. I'm interested to know if the minister has been apprised of this concept by the ministry staff.

Hon. J. MacPhail: We're consulting here. Is it also known as the crisis stabilization unit? Yes, we are aware, and we are providing beds in that area.

A. Sanders: This is a concept that is working very well. I think we need to have ministry staff concentrate in this area in terms of looking at this as a bridging unit between acute care and the community. There are beds being planned in my own riding. I would be very interested to show the minister the use of those beds in the future, why they are much better than hospital beds, and why, for acutely sick patients, they are better than putting them in the community when that is not the appropriate place. That is something I would like her to take some interest in over the next couple of years as we move towards that concept more.

Another question that I was asked and have been asked to relay to the minister concerned the lands at Riverview Hospital. Specifically, I was asked if the communities were having input into the use of those lands as Riverview is being downsized.

Hon. J. MacPhail: Yes, there is a community consultation process that has been ongoing for awhile.

It's interesting. The whole premise of future use of Riverview lands is based on a change in the use of Riverview Hospital. So what we have done is say: "Whoa, just a minute on planning for change there until we figure out, with our renewed mental health plan, what exactly is the future of Riverview Hospital." So the community actually has agreed -- along with the MLA of the area, my seat colleague, the Minister of Aboriginal Affairs -- to put the community process on hold while two things occur: we determine under the renewed provincial mental health plan the future of Riverview Hospital itself; and the community works on costing various models of future use, as well.

A. Sanders: My understanding is that in that community -- where your colleague is in fact MLA -- the community had hoped to use that land for a future hospital site. I wonder if the minister has any comments on that.

Hon. J. MacPhail: Actually, there is a range of proposals. This land is known for its unbelievable number of unique species trees that were planted by Riverview Hospital over the course of the last decades. It's a unique arboretum, I'm told.

There's also a request from the community, strongly held by family members of people with schizophrenia, that there be a future use, a residential use, on the site for people who suffer from schizophrenia. There's also a request that there be some continuation of psychiatric hospital services as well as out-patient services. Then there's the ever-present demand for commercial development as well. These are the interests that are being explored in the community model.

A. Sanders: Thank you for the information.

One final area that I'd like to canvass at this point, before turning it over to my colleague, has to do with what's called the review panel. Specifically, the review panel, in my estimation, is not working.

The review panel is what we have under the Mental Health Act that allows individuals who are unable to be protected from harm to be placed, against their will, within psychiatric facilities, be they at the hospital level or at the Riverview level. Specifically, with the review panel, if a patient is committed against their will with the signature of two attending physicians, and the individual then decides that they feel this is an unjust treatment, they can call in a review panel. The review panel comes in, composed of a number of individuals. Those individuals review the case independent of the treating individuals and come to a decision as to whether the committal was appropriate. If you look at the statistics for the review panel, 30 percent of the cases of individuals committed are reversed by the review panel. I guess my first question to the minister is: is the minister aware of that fact?

Hon. J. MacPhail: Yes.

A. Sanders: Because the minister is aware of the fact, I would be interested in whether there will be any motion afoot to look seriously at whether this is appropriate.

Hon. J. MacPhail: I'm hopeful that the guide to the Mental Health Act that we talked about earlier today may give some comfort to those. . . . In using the guide to prevent the 30 percent that you talk about, we could actually prevent that from happening.

But really, at the heart of this -- and I wonder whether the hon. member would agree -- is the Mental Health Act as it exists now. The fact is that it hasn't been reviewed for years and years. I would say there is no agreement on how change should occur under the Mental Health Act, because there are divergent opinions around the strengths and weaknesses of the act.

I think the most prevalent advice I've received, though, is to not change the Mental Health Act but make our systems work better within the context of the Mental Health Act: don't go overboard in penalizing or committing people with mental illnesses on the basis of technicalities. By the same token, don't force families to do what the member has described earlier, which is to charge their own children with a criminal act in order for them to get assistance. So I'm hopeful that the guide to the Mental Health Act will help in these circumstances to change that statistic. When you see the guide, it will be interesting to have your opinion on that, as well.

A. Sanders: I think it's important for the minister to know that this review panel is not working. We are finding a decision made by two treating individuals who have looked after this patient, and now having a panel -- very commonly made up of lawyers who don't know much about medicine, and I have nothing against lawyers -- coming in and advising patients of rights. This is a medical issue, not a legal issue.

I think that when the implication of an incorrect discharge is suicide -- and the statistics are very high for pot-

[ Page 3475 ]

ential suicides among this group -- we are not doing anyone a favour by allowing a review panel, which hasn't been overhauled. . . . Succinctly, I look to some expeditious improvements in this system, whether it be overhauling the legislation or looking at the review panel.

Those are all of the questions that I care to canvass at this point. I have some other ones that I would like to revisit, but at this point I'd like to turn over the questioning to my colleague. I thank the minister for her time.

[5:00]

I have thought of following the money, as you're advised to do in the crime dramas. That, however, is extremely difficult, given the information that this side of the House is given. Unhappily, the line-by-line breakdown that was assured us by the ministry has not been forthcoming.

I have thought of another way, and we'll see whether or not it works in a few minutes. In making some of my points, I'm going to be quoting from a report -- which is one of the more recent I have come across -- on the impact of the mentally ill elderly with severe behavioral problems. This is done by the greater Vancouver regional district, and it's dated, I think, August 1996. It certainly isn't the only report, but it is one of the most recent.

Just to begin, I will give one short quote. This is just to get our minds set. This is under the heading of "Considerations for Long-Range Health Services Planning": "Of particular significance to the planning of mental health and continuing-care services is the prevalence of dementia syndromes among the elderly in Canada, which is predicted to triple by the year 2031. . . ."

In another section of the report, it makes the point that the incidence of dementia is increasing at about 8 percent for every five years. Now, I'm not sure whether the staff of the ministry agree with these numbers or not, but these are the numbers from this particular report. To put it in another context, by the year 2006 -- which is not very far off -- there will be an increase of 18.6 additional bed spaces needed for behaviorally impaired individuals who are also elderly.

The first question I would like to ask of the minister is: can the ministry staff tell me how many psychogeriatric clients were served in, say, 1995 as compared to the most recent figures you have? What I'm trying to do here is get a sense of whether or not there is, as there should be, an increase in the number of clients served.

Hon. J. MacPhail: I take the point that the member is trying to make. I'll try to find those statistics for you; they'll be continuing-care statistics. I'll also ensure that the member has a copy of the line-by-line budget as well.

An Hon. Member: Sure.

Hon. J. MacPhail: It is ready.

K. Whittred: Well, let's try a little different approach, then. I'm working now from Public Accounts, and if I can just find my place here. . . . I've taken one example just at random. I just opened the regional allocations pamphlet at random, and I opened Public Accounts to the same spot. I came across psychogeriatric services, Kimberley Special Care Home. Looking in Public Accounts, I see that Kimberley Special Care Home received $1,732,480.

The Chair: Excuse me, hon. member. I would like to draw to your attention that this is not the Public Accounts Committee; this is estimates. I would appreciate it if you could tie it to the estimates or a different line.

K. Whittred: Well, I am tying it to the estimates. What I would like to know is: has that amount in the most recent budget increased?

Hon. J. MacPhail: The continuing-care budgets have not been announced yet. But if the information is available, I'll get it for you tomorrow. You can make that comparison then.

K. Whittred: I hope the minister does understand where I'm trying to go with this. What I'm trying to do is get a sense of whether or not there has been a movement to the community, as is the whole intent of the program.

All right, let's go back to another question, then. Again referencing this particular report, there is a chart here that has to do with staffing levels and client-staff ratios. According to this, there is an average ratio of 8.1 clients per staff; this is throughout the GVRD. But for mental health teams, that increases to 38 clients. Now, I am not a professional in the field. My question is: are those reasonable ratios? Thirty-eight clients seem like a lot to me, but I would like to know the opinion of the people in the ministry.

Hon. J. MacPhail: I'm advised that a client capacity or client caseload of between 35 and 38 is -- I don't want to use the word "norm" -- the range or average for community services in this area, yes.

K. Whittred: Also referring to this report, it states that the going rate is 2.5 beds per thousand for psychogeriatric care. I'm wondering whether the minister can tell me how many psychogeriatric beds there are and whether or not it is anywhere near that particular formula.

Hon. J. MacPhail: It's interesting. We're trying to figure out the basis of that stat, because, of course, it wouldn't make any sense to have the beds listed in the general population when you're talking about geriatrics. It's our view that that number seems very low compared to our number, but I think it's based on how we calculate our number of beds. We probably calculate our beds on the number of people in the general population who have access to the beds -- i.e., geriatrics -- as opposed to the general population.

K. Whittred: I'm sorry that I was unspecific on that. The rate is for continuing-care beds, for long-term facilities. We're dealing with just a specific grouping. So what the figure means is that 2.5 beds per thousand in long term care facilities would be designated as psychogeriatric beds. If that. . . .

Hon. J. MacPhail: We think that's a low figure for designation, and ours exceeds that.

K. Whittred: One of the particular problems in the area of psychogeriatrics that I have discovered as I have gone from 

[ Page 3476 ]

facility to facility throughout the province is that there appears to be a lack of differentiation in diagnosis. In other words, in many care facilities there are special units specifically for those suffering from dementia, but also included in those units are people who have specific psychiatric diseases.

What I am told by the people who work in these facilities is that that mix is often very unfortunate. What it means is that the particular mode of the unit, if you like, that is set to be of use to people with dementia is not suitable for those with mental illness. What often happens is that those with mental illness end up being untreated when they possibly would benefit from specific treatments. This is also made note of in this particular report. I wonder if the minister could comment on that particular issue.

Hon. J. MacPhail: In continuing care, beds are funded on the basis of the care that's needed and provided. There are standards, one imposed by the ministry from a funding point of view, and then enforcement of those standards is expected, as well. The type of care is taken into account in the funding formula.

What I think the member is saying is that in a particular institution there may be something amiss in terms of how the funding formula is applied and what that means in terms of the delivery of care. Those mismatches should be corrected in the annual funding arrangements. If that's not the case, I would be happy to look into the specific situation in the institution that is being mentioned by the member.

K. Whittred: In this instance, there is no particular institution. It is a fairly widespread problem, and as I mentioned, it is mentioned in this particular report. I will quote:

"Another major consideration for health services planning is the need to differentiate between different types of problematic individuals. For caregivers in continuing care facilities, the profile is that of the resident with dementia who may also have a related psychiatric disorder."

[5:15]

Well, let me just say that a general statement like that from the GVRD report is hard to. . . . I mean, there is certainly broad-brushing of potential concern, but unless it's institution-specific, it's hard to understand how we would correct the problem. The management of institutions and the proper allocation of resources are the responsibility of the regional health board. Let's try to take another crack at it to see if we can. . . .

K. Whittred: I feel like I must have been a very unclear teacher for all those years. I'll take one more stab at it. I first encountered this problem in Penticton. In the intermediate care facility, there is a special care unit. That unit is primarily designed, as are most special care units, for patients with Alzheimer's. Patients with Alzheimer's, I believe, suffer cognitive impairment. That is the term that is most often used.

The complaint is that patients with other diseases. . . . They may not even have Alzheimer's. They may have some mental illness that presents itself with some similar characteristics, and in terms of the continuing-care criteria, they fall into the same category. As I was told, it's a little bit like treating apples and oranges in the same place. I don't know how I can make it any clearer. It's having an Alzheimer's patient and someone who may be severely depressed, and the way that they are treated is quite different.

Hon. J. MacPhail: We understand the point being made. We're trying to find out whether the member is proposing a solution. Let me take another crack at it to see, firstly, if this is determined to be inappropriate, but secondly, if it is determined to be inappropriate, whether there is a better solution.

A person needs to be treated appropriately for the illness that's affecting her, regardless of where she is institutionalized, and a person shouldn't be institutionalized on the basis of what people assume their illness is without really finding out what the illness is and treating it appropriately. If a geriatric is suffering from depression, she should be treated for depression, and it should not just be assumed that she's suffering from Alzheimer's.

That is the standard of care that's supposed to be in place, and if it's not, then there's an inappropriate standard of care being delivered and our continuing care division needs to deal with that. Again, it has to be dealt with on an institution-by-institution basis. If that is the problem of the past -- that where there's been no integration between mental health and continuing care or, for that matter, even acute care -- I'm hopeful that the regionalization of health will bring about many more solutions. It is now the one authority responsible for the patient, regardless of where that patient needs the service and what kind of service the patient needs. Continuing care now has to work with mental health and with public health to deliver the best possible service in terms of what the patient needs. I don't know what to offer beyond that except an offer that if there are examples brought to our attention such as the Penticton one, we can go and look at it to make sure that the standard of care is appropriate.

K. Whittred: I would like to focus now for just a moment on a couple of the recommendations out of this report. I certainly won't go through all of them, but I think two or three have more universal appeal.

The first one is recommendation No. 4, which makes a recommendation that residential care develop a range of housing that ensures the suitability and eligibility of all mentally ill elderly with behavioral problems. It goes on to say: "A number of existing special care units should be redesigned into small pods, and approximately 193 beds should be added, of which at least 25 should be located in enhanced psychogeriatric units or residences such as those recommended below."

I think what that recommendation is saying is that this particular report, in any case, would recommend a movement away from the large institutional centres to smaller residential centres. It might even address the problem I was just mentioning. I'm wondering whether the ministry has any plans in this regard or any programs in place to support such a movement.

Hon. J. MacPhail: You are still referring to the GVRD report, which is not a ministry report, but you're asking us 

[ Page 3477 ]

whether we're taking it into account. The regional health board for Vancouver-Richmond is developing a mental health plan that includes psychogeriatric mental health. It's the board itself that's doing that, and it is exactly that kind of report that the board will be relying on as it develops its plan. It's working on that right now.

K. Whittred: There is one other recommendation I want to make note of, because I think it has universal appeal. It says:

"Collaborative initiatives between acute care, continuing care, and mental health agencies are increasing in response to the complexity of the needs of the psychogeriatric population. Formalized collaborative agreements such as the amalgamation of geriatric programs from continuing care and mental health at the Burnaby Psychiatric Services should become the norm."

Hon. J. MacPhail: That is exactly what regionalization is about. How are we going to achieve that through funding mechanisms? First of all, there will be administrative efficiencies that are met, and the success of the example that the member gives is largely that there have been administrative efficiencies that can then be plowed right back into the program delivery aspect. But secondly, if there's any change in the way we deliver our services, the health boards have been advised that the money should flow from acute care into community and continuing care. That's the direction that money should flow in. There's a prohibition on money flowing in the opposite direction.

K. Whittred: I thank the minister for that explanation. I do think I understand what is supposed to happen. I'm a little bit concerned, though, about the budgets, maybe because a few moments ago the minister stated that the budget for continuing care is not yet out. I think the other budgets are, so I'm still puzzled. In this process how do these parts of the puzzle fit together?

Hon. J. MacPhail: It's actually standard that this is the month in which budgets are released. We released the hospital budgets last week; continuing-care budgets will be out by the end of this month. What happens is that you have to wait for the allocation of funding -- the global allocation directed by cabinet -- to continuing care or acute care, and then the individual budgets flow from that, with a funding methodology and a committee in place. So the continuing-care institution budgets will be out by the end of this month.

K. Whittred: I think that concludes the questions I had on psychogeriatric care. I do have some others, but I will leave those until I do continuing care, because they relate more to community services. I think they will fit better in that particular category.

I do have a question, though, about drugs and the elderly. I am referring here. . . . And the report is not really that important, I don't think. This is a report that was done by Dr. Nancy Hall. It was a falls-prevention project. Basically, what it concluded is that elderly women are, for the most part, overdrugged, which has a serious and significant effect not only on their mental health but frequently on their physical health. They are prone to falls and so on. I'm sure the ministry probably has this report. If it doesn't, I'm happy to provide you with a copy.

What I want to ask the minister is: do you have a sense or do you have any statistical sorts of information that will give us a clue as to how well programs like SMILE are doing?

Hon. J. MacPhail: The SMILE line is. . . . We keep track of the numbers of calls statistically. Certainly I receive thanks -- but this is anecdotal only -- from people who have received good information from the SMILE line. We can get you the number of calls made year over year.

After the report to which the member refers was published, the therapeutics initiative, which is a group of independent pharmacists, pharmacologists and physicians funded by UBC, issued a letter to physicians advising them of the overprescription of sedatives -- including the ones that the member referred to -- with advice on how to properly manage patient care in this area. That went out to all physicians. We also have the North Shore drug management project. It's the provision of what is called academic detailing around the prescription of drugs rather than commercial detailing. Commercial detailing is where a pharmaceutical company comes in and gives information to a physician about how to use a drug and then gives them the drugs as well. Academic detailing is where a group of pharmacists, physicians and pharmacologists meet with doctors and give them independent, academically based advice.

There is a project on the North Shore, now in its third or fourth year, that saves Pharmacare hundreds of thousands of dollars each year and much improves the prescribing patterns of doctors as well. There are a couple of hundred doctors involved in that.

So those are a couple of the initiatives to deal with this situation that the member describes. We also brought in the 30-day rule, which is where the maximum length that a prescription can be filled at any one time is 30 days unless it's a life-support maintenance drug, in which case there is no limit on it.

Just for the member's information, the most calls I got from people concerned about the switch from what used to be a 100-day prescription limit to 30 days were from women -- largely elderly women; at least it sounded like that on the phone -- who'd been on prescription sedatives and this category of drugs for ten or 15 years. Now they were by law being limited to a 30-day prescription. So there may be some side benefits to us, limiting the number of days one can get for one prescription.

[5:30]

In the North Shore study, which I am vaguely aware of, is there any follow-up to the outcomes? I'm afraid that unlike my colleague, I don't know all the medical terms. If the study that showed that elder seniors who took too many sedatives were prone to falls. . . . Is the study that is ongoing, surrounding the doctors and the use of pharmacy that the minister has described, monitoring the effects on seniors in terms of their health outcomes?

Hon. J. MacPhail: Yes, there is research in this field. It's academic research, and we certainly avail ourselves of that research. But there are also clinical practice guidelines in place 

[ Page 3478 ]

that have been agreed upon by the medical profession about how to prescribe and when to change the prescribing and what the consequences of long-term use of sedatives are, especially among the elderly.

There is certainly a recognition of a large potential for addiction to such drugs, and we then have programs in place for reduction of use and withdrawal from the drugs as well. At the end of the day, though, we work with. . . . It's best physician practice in order to deal with these matters.

K. Whittred: I wonder if I could inquire of the minister what mechanisms. . . . What is the protocol, now that we have PharmaNet, for people who may in fact doctor-shop for a variety of prescriptions? What happens when they go into the pharmacist with their sixth prescription of the day?

Hon. J. MacPhail: Yes, this is an interesting question, because I met with the College of Physicians and Surgeons about two weeks ago, and we were discussing this very issue. There are a couple of programs in place. What PharmaNet allows us to do for the first time ever is ensure that a prescription is only filled once. Once that prescription has been filled, there is no way of using that same document in any way to get it filled again.

There is also a program in place that keeps track of the number of doctors that a patient has used. Then advice can be given by the College of Physicians and Surgeons about how a particular patient of his or hers could be using an inordinate amount of services from different doctors. That's not necessarily in any way to say that the patient isn't necessarily doing it under fraudulent circumstances or whatever. But it does allow the doctor to receive advice and to then discuss with the patient why they're needing the services of so many doctors.

Then, of course, there's our triplicate prescription program that deals with the use of narcotic drugs, where the College of Physicians and Surgeons has a contract with us to ensure that controlled, narcotic drugs are being used in the way that they're meant to be used. They control the use of those drugs through a triplicate prescription program and deal with any abuse in that area.

K. Whittred: So do I understand the minister correctly that in spite of all the research and the modern systems of communication that we have. . . ? Somehow I imagined that, in this day, if someone had this vast array -- we read the research about the overdrugging that many seniors indulge in -- when they're taking 12 different pills, alarm bells should ring. What is the responsibility of the pharmacist -- let me put it that way -- in that instance?

Hon. J. MacPhail: Yes, PharmaNet does address many of these concerns raised by the member. One is that if there is a prescription brought to a pharmacist, and the pharmacist sees that the patient is on another type of drug where there would be a contraindication for use of the prescription being filled, the pharmacist should not fill that prescription and should contact the doctor to discuss what further action, if any, is necessary.

The other issue is that pharmacists can and, I think, do refuse to fill a prescription if it would be, in his or her view, inappropriate practice of pharmacy.

Then, of course, PharmaNet does keep track of all the prescriptions of a patient and does allow the pharmacists to either advise the doctor that the patient should receive greater counselling in the mix and use of drugs or should work on what is the best method of dealing with the future use of the drugs taken by the patient. That is occurring now with PharmaNet, especially amongst seniors.

K. Whittred: Just one more question in this vein. The reason I'm pursuing this is that one of the things I've discovered in my travels is that appropriate medication, or the appropriate taking of medication, is one of the basic parameters of seniors' well-being, and, of course, is one of the things that is most often neglected or misused.

The final question in this vein that I have for the minister is: what is the pharmacist's responsibility if the patient or the client is obviously inappropriately taking the medication? For example, the client has a prescription, and the instructions are that that prescription should be taken three times a day -- and the pharmacist knows the number of pills. The patient comes back in three days and they're all gone or, alternatively, comes back in six months and they're not all gone, both of which are inappropriate. What would be the appropriate action for the pharmacist to take?

Hon. J. MacPhail: PharmaNet does catch this if there is an improper dose prescribed. Then the best that would be done is that the pharmacist would counsel the patient to that effect and then either advise the patient to return to her doctor or call the doctor directly to offer that advice or to clarify the prescription and correct it.

K. Whittred: I'm sorry, I thought of one more question. In the movement to integrated health delivery and regionalization, it occurs to me that perhaps in instances like this, the most appropriate person that the pharmacist might call would be, for example, the home care worker. I'm wondering if the ministry has any plans in terms of involving the pharmacist as part of the community team that is dishing out this integration of service.

Hon. J. MacPhail: That is actually a very interesting concept. Of course, the first line of care is with the physician, so that's who the pharmacist would contact initially to correct the problem. But it's highly likely that the physician would then involve the home care nursing team to ensure proper taking of the medicine. Actually, it sounds like a good integrated team as you describe it, and I'm sure that is on the agenda for when services are integrated.

K. Whittred: I will just, if I might, disagree with the minister a little bit about. . . . The continuing-care system, as I'm sure the minister is aware, is a little different from the acute care system in that the continuing-care case manager is the gatekeeper of the system. Therefore it is entirely possible -- I think, and I would just ask if the minister would agree with me -- that although the doctor must write the prescription, in many cases, after that is done the whole care of that client is largely in the hands of the continuing-care case manager and whatever home support or community support services that have been recommended. Could the minister comment on that?

Hon. J. MacPhail: Your point is very well taken. I don't know whether we need to discuss it any further in that I'll pass the advice along. I do know that pharmacists themselves are looking at home care visits as well. They, of course, want to be compensated for it, but those are discussions that are ongoing. Your point is well taken.

K. Whittred: I'm sure that we will canvass some of these issues in perhaps a little bit more detail when we talk about home support and home professional services.

[ Page 3479 ]

I will just conclude, if I may, with a comment about one of the issues that my colleague raised earlier: the plight of mentally ill people in the community. This is meant more as a comment, simply for the minister.

In my role as a MLA I have certainly found mental health to be the single most serious, overriding issue that I have to deal with in my office. There appear to be many, many people in the community suffering from varying degrees of mental illness who have, for whatever reasons, fallen through the cracks of the system, even though there appear to be any number of programs in place.

[5:45]

I offer that simply as a comment, and I really don't expect any response. As I said, we'll be canvassing many of these issues surrounding community care and continuing care in a few days' time. I think my colleague is just itching to get in here before we adjourn.

R. Thorpe: Could the minister advise if Riverview accepts patients seven days a week?

Hon. J. MacPhail: Yes. It would depend on the admissions. . . . It's a hospital; I don't see why it shouldn't accept seven days a week. If there's some evidence that they're not, then I want to know about that.

R. Thorpe: It's been reported to me that in certain situations in the riding of Okanagan-Penticton, patients have not been able to be admitted on weekends -- on Saturdays and Sundays -- especially patients who have required air ambulance transportation. Air ambulances have been there to pick up other patients, have flown to Vancouver -- not full -- and then, because Riverview is open Monday, have come back on Monday and picked up patients. In these times of precious dollars for health care, I think that might be something that you'd want to look into.

Hon. J. MacPhail: We will, especially if it somehow involves that we also. . . . There are acute care services involved, as well, and how that works. So certainly we will look into that.

R. Thorpe: Braemore Lodge in Penticton is a community-based adult psychiatric care facility. I have received a note from many of the workers there. They are saying they are being left with little choice but to move closer and closer to a strike that no one wants. I wonder if the minister could comment on what is going on with respect to that facility and why some patients are perhaps not being treated and cared for in their community.

Hon. J. MacPhail: That facility would be part of the community bargaining that's going on right now. Certainly there are issues that are creating tension on both sides in the area of community bargaining. It's a huge table of bargaining with dozens of employers and thousands of workers, some of whom are at this institution. The issues are complex, but they're also very costly to resolve. The issue is how you value continuing care in the context of what has been established in acute care in terms of wage rates and comparisons, etc. I'm well aware of the situation, and the Minister of Finance is well aware of it. We're trying very hard to reach a resolution that doesn't involve any effect whatsoever on patient care.

R. Thorpe: We would all agree that the patient should be the number one priority, and I do wish the minister well in reaching a resolution. Of course, if there's anything we can do to help reach resolution so that both the patients and their families feel comfortable in difficult situations. . . . Also, I must say that we must. . . . If promises have been made to employees, then. . . . I don't know. I'm not on the negotiating side, so I don't know what promises may have been implied or whatever, but we should work together to try to resolve those, especially in the communities.

My last question pertains to an individual constituent of mine who has written me a letter that has to do with schizophrenia. You may have addressed part of this earlier, but I was out. I think it's very important when constituents take the time to write about personal situations. "Schizophrenia is a biological disease of the brain, it strikes youth, mainly from the ages of 15 to 30, and is known as youth's greatest disabler." I don't know whether the minister had the opportunity to see a clip on "60 Minutes" last night about this very disease. If you didn't get a chance to see it, it would be really worthwhile if. . . . Actually, it was shocking, quite frankly.

This pertains to a constituent's son, who has had schizophrenia for 28 years. Over the past year, he has been taking -- I'll probably say it wrong here -- risperidone. He has greatly lessened side effects, his quality of life has much improved and he has not needed acute care in the hospital. They have apparently received a notice from Pharmacare, advising them that funding for this drug will now be cut off. They're going to be forced to take a generic drug. This particular constituent ends her letter to me: "I urge you to address this problem in the Legislature, as average wage earners like ourselves do not have the resources . . ." to pay for these drugs that have shown improvement for their son. I'm just wondering if the minister could comment on that, please.

Hon. J. MacPhail: I'd be more than happy to look into this particular example, because it is not correct that if a person has been on risperidone, they are cut off. They are grandfathered for the coverage. I would be more than happy to correct that particular situation.

We did have a very good discussion. The member for Okanagan-Vernon articulated some points very well. The short of it is that we are reviewing our process now about how we fund risperidone under medicare. We hope that review will be completed in the next few weeks.

R. Thorpe: I just want to make sure I understand the minister that a review is going to take place. People have some concerns, but you did say that if we can get you the particulars of this, there can be some grandfathering provisions made to ensure that the patient does in fact get the drugs they need. If that is the case, I will get the information and bring it to your office tomorrow so that we can address it.

Hon. J. MacPhail: Yes, in fact the grandparenting provision is in place now, so we can easily take care of that.

I just want to read for the record that the member for Shuswap asked about the regional health boards affected by 

[ Page 3480 ]

the March 28 news release. It's the South Okanagan, North Okanagan and Thompson regional health boards that were affected.

R. Thorpe: I move that we rise, report progress and seek leave to sit again.

Motion approved.

The House resumed; the Speaker in the chair.

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

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

The Speaker: Before we move adjournment, I would like to respond to the privilege motion that was presented. Hon. members, on May 6, 1997, the hon. member for Richmond-Steveston reserved his right to raise a point of privilege and on May 15, 1997, stated his matter of privilege after having given the Chair notice in accordance with the standing orders.

The Chair has heard representation from the Minister Responsible for Intergovernmental Relations on the matter, and the Chair has considered the statements and all the material filed in support of this matter. I also note that the hon. member has quite correctly submitted a copy of the motion that the member would intend to move should the Chair find that a prima facie case has been established.

The heart of the member's complaint is contained in words attributed to the Minister Responsible for Intergovernmental Relations, when the minister stated that it was his understanding -- and here I paraphrase -- that the members of the official opposition did or did not do certain things and stated his conclusions as to why members of the opposition did or did not do the acts attributed to them. The hon. member in his argument then contends that the minister's statement as quoted was false, and he produced various exhibits which he alleges support his conclusion.

In coming to my conclusion that the matter before me amounts to a disagreement between members, I was particularly persuaded by the similarity between the matter raised by the member and two earlier matters raised in the House and recorded in the Journals of the House on April 13, 1982, at pages 41 and 42, and on June 8, 1982, at page 132.

After careful consideration of the arguments advanced and the material filed in this case, it is the Chair's view that this matter falls squarely within that category of cases which are categorized as a dispute as to facts. The hon. member may have a serious disagreement with the minister, but neither the statement made in the House nor the material filed in support thereof establishes a prima facie case of privilege as defined by our own precedents and the relevant parliamentary authorities.

Hon. J. MacPhail: Before we adjourn, I'd like to inform the House that we will be sitting tomorrow, and I now move that the House do adjourn.

Hon. J. MacPhail moved adjournment of the House.

Motion approved.

The House adjourned at 5:58 p.m.

PROCEEDINGS IN THE DOUGLAS FIR ROOM

The House in Committee of Supply A; W. Hartley in the chair.

The committee met at 2:43 p.m.

ESTIMATES: MINISTRY OF ABORIGINAL AFFAIRS
(continued)

R. Thorpe: I trust everyone had a good weekend.

Could the minister please advise in the broadest sense. . . ? And when I ask this question in the broadest sense, obviously I'll be focusing on the Penticton area just for the record. But in the broadest of senses, does your ministry approach dealing with bands on a reactive basis or a proactive basis?

Hon. J. Cashore: Ideally, proactive. Circumstances being what they are, there are times when it's reactive. There are times, also, when those situations arise, that the lead ministry is not the Ministry of Aboriginal Affairs.

[2:45]

Hon. J. Cashore: On the receivership issue, the lead role is the Ministry of Employment and Investment. The Ministry of Aboriginal Affairs, to my knowledge, doesn't have a primary mandate relationship with any of the issue-oriented aspects of circumstances around Penticton and Apex and the Penticton Indian band, other than that it is our mandate to seek to build new relationships with first nations. We have not been very successful in that regard.

R. Thorpe: When the minister states that they have not been very successful in building those new relationships, is he talking in generalities or with direct reference to the Penticton Indian band?

Hon. J. Cashore: I appreciate that clarification question, actually. It's primarily in relation to the Penticton band. As I've referenced previously in these estimates, we have joint policy tables with the Union of B.C. Indian Chiefs, the First Nations Summit, the Métis and the urban aboriginal people. Where it's difficult to find a forum where you can get a handle on promoting negotiated or consultative solutions, obviously that is not a strong measure of success. Recognizing that it takes more than one party to craft success, it's still something that I don't feel very good about.

R. Thorpe: I think most of us would conclude that if we can get economic development going with respect to bands, that would relieve many of the pressures and difficulties they have. I think all of us agree that gainful employment adds to the community, adds to the life of the children, and reduces 

[ Page 3481 ]

health care and other substantial social problems. Could the minister give me a view on if they've been able, in the past year, to establish any links with the Penticton Indian band with respect to overall economic development or providing some kinds of services -- educational services, etc. -- to foster that development?

Hon. J. Cashore: I'm aware of certain potential developments with the Upper and Lower Similkameen bands and their potential joint partnership with regard to the ski hill. I'm also aware of the relationship between the residents of Apex and the Penticton band in trying to take a position, as I understand it, opposing the garnet mine. I think there are a variety of relationships that have been formed. When we had a protocol agreement under which negotiations were taking place, I think there was great potential, and in that my ministry had a key role. At the present time, where it comes to actual economic initiatives, that would come under either the Ministry of Small Business or the Ministry of Employment and Investment.

R. Thorpe: When you make reference to the protocol agreement, I'm assuming that the minister is referring to the agreement that was part of the discussions in the Penticton area. Assuming that is the case and assuming that not too much has happened, has the ministry taken any new initiatives in the past six months to try and get something going? If we don't keep trying, nothing will happen.

Hon. J. Cashore: I understand that there have been some initiatives undertaken with some success between the Ministry of Transportation and Highways and the Penticton Indian band relating to, I believe, the road along the airport lands. I think there have been some discussions in that area involving that ministry, as well.

Again, the Ministry of Aboriginal Affairs has not been undertaking direct relationship-building with the Penticton Indian band in the recent time, other than to be a party to discussions with other ministries as they were following through on their issues. There could have been times when we would have been consulted if there were issues, which don't readily come to mind, that had to do with fiduciary obligation.

R. Thorpe: All of us may recall that there was the protocol agreement, that negotiations and discussions were going on with respect to environmental studies and that a baseline audit was presented by the Ministry of Environment. The conclusion of that has driven parties apart. Again, with respect to the environmental issues, has the ministry done any work to ensure that any gaps that were identified in the environmental studies are being fulfilled? And has the ministry had any discussions with the Penticton Indian band or the Lower and Upper Similkameen bands with respect to moving that process forward?

Hon. J. Cashore: I have within the last eight weeks had a conversation with Jon O'Riordan, ADM in Environment, who handles those files. Again, I am aware that the terms and conditions that have been agreed to with regard to the environmental studies are being carried out by the Ministry of Environment. But again, that is the primary ministry involved in that.

R. Thorpe: For a relatively small community, we have quite a list here. The next issue I'd like to talk about just briefly is the Penticton airport. Can the minister give us the province's position with respect to ownership of the Penticton airport?

Hon. J. Cashore: I am advised that the city of Penticton is aware that at this point that is a federal issue, with regard to the federal government having the lead role and having been the subject of the question of the transfer of those lands in the early 1940s. To my knowledge, that is an issue between Penticton and the federal government at this point in time.

R. Thorpe: I don't want to assume too much of what the minister is saying. Am I to hear out of that that the province of British Columbia has no position on the ownership of the airport in Penticton?

Hon. J. Cashore: This ministry has not been directly involved in those discussions, so I don't think that is an issue that involves this ministry at this time.

B. Barisoff: Just a few things, considering that Apex Mountain is actually in my riding -- and a lot of the people come from the hon. member from Penticton's riding. . . . I would like to know. . . .

Hon. J. Cashore: You've got the mountain and he's got the motors.

B. Barisoff: That's right. I've got the assets.

Considering that the hill is in bankruptcy right now, I was just wondering whether the minister had ever considered some joint involvement with the Ministry of Employment and Investment to make sure that the Penticton Indian band and the Upper and Lower Similkameen bands are jointly involved in what's taking place right now.

Hon. J. Cashore: I do take an active role in those discussions. It is the lead within the Ministry of Employment and Investment. It's something that I've followed closely over a number of years now for obvious reasons, and I'm very pleased to see the potential. As I understand, at the current time the Upper and Lower Similkameen may be entering into that joint venture. From what I've read, I understand they've left room for the Penticton band to come in at some future date, if that were to bear fruit.

But in my role -- not having the lead role -- I do play a role of encouraging attention on this issue and also encouraging any such partnership opportunity. Earlier in these debates we have, on both sides, cited that perhaps even more important than the treaty-making process is the partnership-building process that leads to job creation and is perhaps a most proactive way to manifest cultural development.

B. Barisoff: As I remember, at one point last week I think the hon. minister mentioned the garnet mine up there, and I think the Apex Property Owners became a marriage of convenience to create that relationship to get environmental studies of whatever else was there. Being the critic for Transportation and Highways, I was wondering whether the minister has had any talks with the Minister of Transportation and Highways about looking at the proposal for an alternative highway going into Apex from Highway 3A, now that the Upper Similkameen and Lower Similkameen bands seem to be more congenially involved with what's taking place.

Hon. J. Cashore: I haven't had any recent discussions on that topic, but I have discussed it thoroughly over the last 

[ Page 3482 ]

three or four years. Without having maps and other documents in front of us, it would be difficult for me to remember, with accurate recall, some of the various factors with regard to alternative routes. But from the point of view of aboriginal relations and the relationship that our province has with people of first nations throughout the province, once you start entering into somewhat large or even megaprojects to get around some of these unresolved problems, the domino effect could be formidable.

So I think that the first approach -- and again I think this could be canvassed in other estimates. . . . But even though some of these seem to be without solution, I think the first approach needs to be to avoid that kind of solution, because the ramifications could be immense, and it could send signals elsewhere that we don't want to send.

B. Barisoff: I know what you're saying, but as the years tick by and time ticks on, I think that some of the alternatives should be and will have to be looked at. I will be bringing that up in the estimates of Transportation and Highways -- for some actual cost figures that go through the Upper and Lower Similkameen bands. But my consideration was mainly due to having an alternative route sometimes, as one solution solves both problems -- just to put that on the record. But I think there is some means of doing things.

While I'm standing, one of the items that I've got in my riding. . . . Apex is still in my riding, even though the hon. member from Penticton likes to scoop it away at times. I was just wondering about the Sinixt band, which has laid claim to quite a bit of the area in the Boundary country. They were supposedly extinct. We met with them in Cranbrook, and they've actually laid claim. . . . I think they're actually camping or have created some claims up in the Christina Lake area. I wonder if there are any comments on that.

[3:00]

This has happened from time to time. This is not new and it's not unique. The only instrument through which I can see it being addressed is the B.C. Treaty Commission. During the time that the B.C. Treaty Commission opened its doors on December 15, 1993, and then first nations started filing statements of claim, there was a period of time in which the commission had to go through a process of deciding whether indeed these statements of claim could be accepted by the commission. Some were rejected, and my memory is that one of those was rejected because they could not identify any particular connection to land within the province. So my understanding is that it was rejected on that basis.

In order to get an answer on this, one step might be that that self-proclaimed band may decide to seek to file a statement of intent to negotiate a claim with the B.C. Treaty Commission. Of course, they might come under the philosophy, which is more the philosophy of the Union of B.C. Indian Chiefs, that does not see the province as a player in those negotiations, and therefore they don't accept the B.C. Treaty Commission as an entity. I guess part of that remains to be seen.

B. Barisoff: I think you're right in the fact that sometimes in our travels throughout the province we've found that a lot of the bands were looking to go nation-to-nation and weren't considering B.C. a nation.

But I think that at one point there was a letter -- Mr. Ebbels would probably know -- from that band that was filed in court maybe a month or so ago, saying that they actually filed a claim to some of the land. I was just wondering whether the minister had looked at that. Considering that the bulk of that is in my riding, I would like to know the status and what's taking place there.

Hon. J. Cashore: I think a lot of what I said in my previous answer would also apply here, but I would add that it was. . . . It's my understanding that it was the federal government that declared this band to be extinct. So again, where it comes to their status under the Indian Act, that would clearly be a federal relationship. I've often said that I want to get rid of the Department of Indian Affairs, but until we do that, they still exist as a legal entity. That is the way in which such matters are dealt with at this time in Canada. That is where that connection would first be dealt with.

B. Barisoff: To clarify that, could I get some paper on the fact that this is part of a federal negotiation -- I think they had filed it with the B.C. Supreme Court when I looked at the last document -- just to know which way it's going, so we can alleviate some of the fears in the Boundary country? It has created a little bit of tension there in the fact that we're probably one of the few areas in the province that hasn't been touched with a lot of this. Now that it's appearing there, of course, there's a little bit of tension. The last thing we want to see is for anything to get out of hand. If we could get some facts and figures together that we could present to the media, we could then clarify a lot of things that are happening.

Hon. J. Cashore: We will undertake to do that.

R. Thorpe: Both the member for Okanagan-Boundary and myself appreciate the minister's compliment about us being a formidable team. We would like to offer that asset to him when the House breaks for the summer, perhaps, in the interest of building partnerships.

M. de Jong: It's not likely to happen, the way we're going.

R. Thorpe: It's the minister I'm looking for the reaction from, Mike, not you.

Interjections.

R. Thorpe: Sorry, hon. Chair.

Very seriously, uncertainty for people in communities -- the aboriginal people, the people of Penticton, Summerland and parts of Okanagan-Boundary. . . . We need certainty so we can build together. What I would really like to offer to the minister and to his staff is that we want to work together, in partnership, to bring people together. I very strongly believe that if people are not talking, then we have no opportunity to solve problems and to build a better tomorrow.

I would like the undertaking of the minister that this will be put forward on their agenda as an important issue. We would look forward to working with them, if they agree to come up and work with us.

Hon. J. Cashore: The first step towards that would be that we would ask our deputy minister to arrange a meeting here and begin steps to do that shortly after we get back, following the time the House rises.

I just want to say to the hon. members that this is a very difficult issue. I believe that all parties in the House have not 

[ Page 3483 ]

tried to play politics with it but have been trying to say: "What are some ways that we can work on solutions?" It's very vexing. We all have a sense of respect for the historical circumstances that have resulted in high frustration for the Penticton Indian band and indeed for the large numbers of young people that we quite often see involved. Yet we all share the belief that the way to a resolution -- again, to use the hon. member's words -- is proactive and solution-oriented. We simply cannot resolve issues that we had no control over years ago, but we can try to come up with just and appropriate solutions.

J. Weisbeck: I'd like speak again about Gallagher's Canyon, because last session I. . . . I'm still not clear on a couple of things. One of them is: what level of discussions are we currently at? Particularly, what is the province's role as far as any further discussions, or do they feel as though these negotiations have been completed?

Hon. J. Cashore: Again, this is Canada's responsibility. Reserve issues fall under the federal Indian Act, so it is an issue of responsibility for the federal government. The province expects the federal government to follow through with its responsibilities and the process for transfer in a manner that satisfies local community concerns and provides jurisdictional certainty. The province understands that the Westbank first nation has resolved a number of issues with municipal and regional bodies and has continued to negotiate with a regional district regarding coordinated development in the Kelowna area.

Further to that, when MLAs have raised these issues with me, on many occasions I've taken it upon myself to write to the federal Minister of Indian Affairs and state that this is interfering with the ability of the people in British Columbia to carry out their lives in a reasonable manner. I also raised issues like this when I met personally with the minister.

Again, I would be more than happy to set up some kind of discussion between the member and our staff. This would be arranged through our deputy minister, to try to find ways that we could be supportive -- as I believe we have tried to be in the past, and we will continue to be so. A hopeful part of that is that the Westbank Indian band and the community of Westbank both have a very positive track record in seeking to work things out. I hope that we can build on any goodwill that is there.

J. Weisbeck: We spoke last time -- and the member for Okanagan-Penticton talked about it, as well -- about the uncertainty of these negotiations. I guess something had happened fairly recently with some maps that were sent around, which showed huge tracts of land associated with Gallagher's Canyon. The biggest concern right now is that it seems to have connected this land issue with a treaty issue, which, from my understanding, is absolutely separate. Who authorized the issuance of these maps, and why do they exist in the first place?

Hon. J. Cashore: I don't know specifically what maps are being referred to, but let me make an assumption -- and I want to say that very clearly, because I may be making the wrong assumption. There are maps filed at the time a first nation files a statement of claim to negotiate a treaty. Basically, what they are called on to do when they file those maps is put, as part of their package going before the Treaty Commission, a map that is, in their opinion, what constitutes their traditional territory.

These maps have caused a lot of consternation among British Columbians, because people would look at such a map and see that their private property is situated within a claim. We have, in a number of ways, done everything we possibly can to make it very, very clear that the province will not negotiate private property. Private property is not on the table. Indeed, we have filed a factum with regard to the Delgamuukw cross-appeal, which is causing a great deal of criticism from the First Nations Summit -- and others -- because of the position we take with regard to that factum and its indication to the court of the necessity to protect those private property rights.

So it is understandable that if somebody who doesn't know very much about the process sees their property situated within a map that somebody else is claiming, then yeah, they're going to want to find out about it. They're going to be concerned, and those concerns have to be taken very seriously.

The fact is that Canada and British Columbia are not in there to negotiate private property; hence, you have other approaches. Treaty-making is not putting toothpaste back into a tube; we can't create what existed before. What we have to do is be prospective and try to come up with just and honourable settlements that recognize there are some things that have been changed for all time. That's a reality.

So when you refer to a map, it may be that people are concerned about seeing this broad map having been drawn, stating that that's traditional territory. That could be overlaid with the map of these Gallagher's Canyon lands, which, from their point of view, they would presumably use to reinforce what they consider to be their position.

J. Weisbeck: As I mentioned, part of the confusion is that they've connected these two things: the treaties and the lands. My understanding is that the Gallagher lands, being private lands at this point in time, until they're stated reserve lands. . . . When they do become reserve lands, adjacent lands obviously can be taken up as part of the negotiation. I think that's the biggest concern of the public out there. The public is very, very concerned about not only including the Gallagher lands but including surrounding lands, as well.

I'd like to know whose responsibility. . . . We could potentially see some increased costs to the municipality. Yes, some of the DCCs have been discussed. I understand that the Westbank first nation has agreed on road DCCs, but they haven't agreed on some of the other ones. Whose responsibility is that, then, if the Westbank Indian band gets their reserve status, and then the municipality all of sudden gets strapped with extra costs?

Hon. J. Cashore: In a pre-treaty context that would be a subject for negotiations between the municipality and the band. I believe the relevant legislation being administered there would be under the Municipal Act. That legislation is the responsibility of the Minister of Municipal Affairs.

I just want to point out, in reference to a point that the hon. member made a moment ago, that if land becomes reserve land in the modern context, it isn't necessarily so that adjacent lands would then be subject to becoming reserve lands. I'm not sure if that's what is being said. But remember that in a post-treaty context it is the goal of the provincial government to get rid of reserve lands. We don't want reserves in the province. That's our position. If you look at the Nisga'a's agreement-in-principle, there would not be reserve lands left as such.

[3:15]

[ Page 3484 ]

The other thing is that post-treaty it behooves the negotiators to negotiate into that a respect for the interests of surrounding neighbours concerning questions about how you address those issues of zoning, of consultation in order to bring them together and avoid, for instance, the kinds of confrontation we've seen in the Tsawwassen area. In other words, post-treaty it needs to build in mechanisms so those issues can be resolved. Right now we don't have those mechanisms. It's all in the federal government's hands. The federal government simply upholds the fact that there are certain powers that exist because of the Indian Act, and we think there has to be a better way to do that.

J. Weisbeck: I guess my final question would be: are you prepared, on behalf of the province, to relay to the federal government that they place these negotiations on that private land transfer on hold until such time as treaty negotiations have been completed?

Hon. J. Cashore: As I say, that falls outside our jurisdiction. That is, according to existing law, a relationship between the federal government and the band. The federal government knows that our position is that we don't want to see more reserves in British Columbia. We want to see that come to an end in the interest of working out non-paternalistic relationships.

I'm not going to give the hon. member a definitive answer on that at this time, because I would have to do a little research on it. But generally, we are doing everything we can, through negotiation, to try to bring about the day when there are no more reserves.

D. Jarvis: You may have given me the answer before I asked my question. I want to get some clarity about the Gaming Commission review back in early May, which put forward a list of management companies. Several of those management companies were aboriginal groups on the North Shore, in my area of North Vancouver-Seymour in the district of North Vancouver. It ostensibly said that new gaming facilities would only proceed through certain criteria, one of the criteria being that they must have demonstrated local government support. The local government, being the district of North Vancouver -- the municipal government, as far as we're concerned over there, is the closest government, the first government -- has said that they are not in favour of any gambling or expansion or destination gambling and all the rest of it.

I was wondering if you could sort of clarify which takes precedence in this instance. If the Burrard band or the Squamish band decided that they wanted to put a gambling casino on their reserve, which would take precedence: the district of North Vancouver saying no, or do they have to abide by what the municipal government says?

Hon. J. Cashore: I have shown a great deal of leeway, in the interests of this discussion, in responding to questions that are far outside my mandate, but I'm not going to do that in this case. These are getting into technical questions that should be answered by the minister responsible for gaming. His estimates haven't been up in the House yet, so there will be an opportunity for that.

D. Jarvis: I appreciate that when it comes down to specific gaming, that would be another ministry. But what I want to ask the Minister of Aboriginal Affairs is: which law takes precedence? Would it be the aboriginal group's on the reserve lands that are encompassed by the municipality, or would the municipality's laws take precedence?

Hon. J. Cashore: There is no aboriginal precedence over provincial law when it comes to gaming.

K. Krueger: Last Thursday morning we commenced a brief discussion about the effect of gambling expansion plans on aboriginal communities. The minister adjourned the discussions for lunch, recommending, I think, his answer over lunch. I had lunch with about 100 accountants, and between all of us I don't think anyone could count the social costs of gambling expansion to British Columbia or to the aboriginal communities in British Columbia.

One of the things the minister said in those remarks was that he did not get everything he wanted in preparation for gambling expansion with regard to concerns he was obviously raising about aboriginal communities and the effects on them. I would appreciate some more detail on those things that the minister wanted and hasn't yet achieved with regard to safeguarding aboriginal people's interests with regard to gambling expansion.

Hon. J. Cashore: I've made several statements in public that have been reported in public. Members of the opposition have repeated those statements, so I know they're fully aware of them. I will not be commenting further during these estimates on an issue that has been decided by our government and which is now the responsibility of another minister.

I stand by what I said the other week. Did I have a role in creating our policy? Yes. Did I get my own way 100 percent? No. Is this the most restrictive gaming policy in Canada? Yes, it is. I'm prepared to repeat that.

I would just also refer to an exchange that took place during the discussion the hon. member was referring to, where I stated that his question in question period implied that I somehow had the authority to speak on behalf of aboriginal people. I was pointing out then that no, I don't have that authority. I think the hon. member stated in his subsequent comments that that really wasn't what he had said, but I just want to mention that it states in the transcript: ". . . and the Aboriginal Affairs minister isn't allowed to speak for aboriginals." I say that it's not a question of not being allowed; I just simply wouldn't do that.

K. Krueger: Perhaps, then, I'll go back to the mandate document that I considered in preparing for these estimates and ask the minister if this is still his mandate. The preamble is:

"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 . . ." -- and the last item is -- "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."

[ Page 3485 ]

thing is an initiative, and it certainly relates to aboriginal people. There's a great deal of research throughout North America about the effects on aboriginal people, and a great deal of concern on the part of aboriginal people in British Columbia, which I'm hearing about.

Therefore I do have some more questions for this minister with regard to the fulfilling of this mandate for aboriginal people and examining the whole question of gambling expansion. I would hate to have to just read a lot of questions into the record. I have appreciated the candour of this minister's responses up until now. Initially, I would ask if that is still the mandate of the Ministry of Aboriginal Affairs?

Hon. J. Cashore: The mandate of the Ministry of Aboriginal Affairs is very clear. We've been canvassing that mandate very thoroughly during these estimates.

K. Krueger: Then I'll carry on along the same line, accepting that that is still the mandate of this ministry and this minister.

When the questions were put to the Aboriginal Affairs minister in question period a couple of weeks preceding the question he has just referred to, one of his responses was that there has been an important debate ongoing concerning gambling expansion in B.C. My question to the minister is: where has that debate been ongoing, and what part has he played in it to fulfil his mandate with regard to aboriginal people?

Hon. J. Cashore: Again, we've covered that. We covered that the other day, and a few moments ago I stated that I have stated my positions publicly. I also stated that we have joint policy tables with four first nations entities within the province. Where topics for discussion are identified by either party, those are discussed. I also enter into discussions on a wide variety of topics, including gaming, among many others, as I go about doing my work. I have those discussions with first nations people and also with non-first nations people.

The Chair: Just before I recognize the member, the Chair needs to caution members in regard to irrelevance or tedious repetition -- standing order 43.

K. Krueger: During the question period I just referred to, the opposition questioned this minister about a 1995 study on the effect of gambling expansion on aboriginal people in Alberta. This study is available in our library. It was done by Nechi Training, Research and Health Promotions Institute for the Alberta government. The minister indicated at the time that he hadn't yet read this study. Has he had time to read it in the intervening period?

Hon. J. Cashore: Yes, I have. I have two studies here, including that study. I've also had staff do some work on some of the studies referenced in the bibliography. These studies do not provide any information that surprises me. I would say -- given the study that I've done of the subject throughout my careers -- that there is nothing here that surprises me. So that's that.

K. Krueger: I'm pleased to hear that the minister has taken the time to do that. But one of the findings reported in this study is that the rate of gambling among the students studied, aboriginal students, was triple the rate of problem gambling for the non-aboriginal youths. Therefore, knowing the minister's concerns with the issue in general and with his ministry in particular, I wonder what safeguards might be underway as far as ensuring that this sad history isn't repeated in British Columbia through gambling expansion.

Hon. J. Cashore: Again, I will continue to provide my wise counsel and advice in the various forums where I have that opportunity within government, but primarily this is a question for the minister responsible. I will continue to take with me my values and priorities, and that will be part of the mix. That's how this democratic process works.

K. Krueger: As a part of that process, is it this minister's obligation, in his mind, to acquaint aboriginal communities with this type of research -- the findings from other jurisdictions of the effects of gambling expansion, particularly when they seem to be unique to aboriginal populations? Is it part of this minister's duty, in his mind, to forewarn aboriginal communities who are considering hosting gambling venues about these findings?

Hon. J. Cashore: In the context of working with first nations -- identifying their priorities and discussing how to address those priorities -- that could well be the type of thing that could be considered. I've asked my staff to develop a bibliography for me of material that relates to the issue of gaming where first nations have been involved. As the member knows, there is a mountainous body of research. We will certainly be proceeding with that project and informing first nations that if they seek that information, it will be available.

Again, I think there's a very important fine line not to cross, and that's where one does not seize upon the temptation to take over moral authority for a group of people whose real salvation is through their own self-determination.

K. Krueger: I'm just going to quote a brief paragraph from the same study, from the background section: "A recent study of gambling among native Americans in North Dakota (Volberg, 1993) found that their lifetime prevalence rate of problem and compulsive gambling was 14.5 percent. Thus the rate among North Dakota native Americans is almost four times that of the general population." It goes on to say that the findings for the aboriginal Albertans that were included in this survey indicated that there was a higher prevalence rate than that, even.

[3:30]

Hon. J. Cashore: I don't think there could be anything more concrete than what I've just told the hon. member -- the development of a bibliography that will be made available to those who request it, and the availability will be made known to them. Beyond that, I won't go.

I read an article in the Christian Century about a year and a half ago. I don't remember it absolutely clearly, but at the end of this article there was a line saying that there may be an irony in this, given the impact of gambling on non-aboriginal people who come to use those facilities in the United States. The reference in the article was something like: this is, ironically, perhaps one form of revenge.

K. Krueger: A sort of quid pro quo for the havoc that's been wreaked in aboriginal populations by things that Euro-

[ Page 3486 ]

pean civilization introduced to North America, I take it. Can the minister tell me how many proposals for gambling expansion venues are forthcoming from aboriginal communities in British Columbia right now?

Hon. J. Cashore: No.

K. Krueger: I'll go on to quote a couple more statistics from this report. One of them has to do with the effect on the lives of young people who have become problem gamblers. This is on page 19 of the report.

Incidentally, the report makes it clear that students who were identified as problem gamblers tended to have participated in significantly more different types of gaming on their way to becoming problem gamblers than those who weren't problem gamblers. In other words, the finding is similar to that of many other studies around North America: the more gambling options a person has, the more likely they seem disposed to become problem gamblers.

This study also mentioned: "It is of particular concern that problem gamblers begin gambling significantly earlier than non-problem gamblers." But then the study went on to talk about some of the effects on these young people's lives. It mentions that 39 percent of the problem-gambling group had borrowed money or stolen something, and 31 percent had borrowed money and not paid it back.

This is a discussion of the consequences of problem gambling developing in the lives of individuals, communities and in particular aboriginal groups.

So once again -- and the minister may feel that he's covered that in his earlier answers -- is this something that aboriginal communities will be formally warned of, rather than just being referred to a bibliography or the references that are available? Because, frankly, in months of pounding through this material. . . . As the minister said, I just continue to see further mountains of material to read, and all of it is alarming.

Hon. J. Cashore: Hon. Chair, this debate is so far off the order of the Ministry of Aboriginal Affairs, it's incredible. But I'll just say that I have canvassed the questions that the hon. member is now starting to ask in different ways. I have answered them where I could, and where I wasn't able to do that, I've said so. I'm not sure that this is really a useful track that the hon. member is on right now.

With regard to the most recent question, it goes back to the dialogue the member and I had in question period. Again, given those forums in which I am involved in discussions with the leadership of first nations, if there are ways that I can be of assistance to them by providing services, by making use of the services that I can glean from the Legislative Library or by making information available, then that will be done.

I have to make it very clear, though, that I am not going to make a project of this. This is not my mandate. If this were to be a mandate, it would appropriately be a mandate coming through the leadership, through the self-determinative process, of first nations people. Were they to come to me and say they would like me to work on that with them, even though our staff is stretched, I would still try to find ways to do that. But I want to say very clearly to the member that I will not take the initiative to introduce that project. The primary reason for not doing that is that I don't believe that would reflect the relationship I have with aboriginal people.

K. Krueger: It is no intention of mine to annoy the minister with this line of questioning, so perhaps I'll take a step back -- before I cover a couple more points raised in these studies -- to something the minister said earlier. It's something I've spent a lot of time considering. He referred to fiduciary duty.

Having established a Ministry of Aboriginal Affairs in British Columbia, having spelled out a mandate in the words that I quoted earlier, having taken the responsibility -- this is the province of British Columbia, of course -- to appoint a Minister of Aboriginal Affairs, I think it's foreseeable that people will argue that a fiduciary duty was assumed, even though some people would argue that it didn't exist earlier. Does this minister feel that there is a fiduciary duty for aboriginal communities in British Columbia?

Hon. J. Cashore: Hon. Chair, you can argue that fiduciary-duty point both ways. You could say it's a fiduciary duty to warn people of their potential downfall. You could say it's your fiduciary duty to try to make sure that first nations have fair access to economic opportunities such as casinos.

As I've said many, many times, hon. member, even though I have some fairly strong personal views, I'm not going to impose those views on people who are struggling with the need to achieve self-determination because of a legacy of those who, in the past, had taken it upon themselves to decide what was best for them.

K. Krueger: For the record, there's no conflict in my mind at all between the two points the minister made. If he considers it a fiduciary duty to make the options available, that's not a conflicting position with also having a fiduciary duty to make sure that the downsides of those options are understood.

This report goes on to talk, as the minister may be aware, about the extenuating circumstance within aboriginal communities of having such a large extended-family heritage. The existence of these large extended families, and so many individuals having a direct effect on a young person's life, seems to exacerbate the development of gambling addiction problems. For example, this paragraph:

"Students who gambled were more likely to have a father who gambled -- 42 to 49 percent -- and a mother who gambled -- 48 to 57 percent -- than those who did not: father, 23 percent and mother, 31 percent. Among gamblers, those classified as problem were somewhat more likely to have a father who gambled -- 49 percent -- than those classified as no problem. . . ."

Another paragraph says that, in general, students whose mothers gambled were more likely to have experienced various kinds of violence or abuse and to smoke or drink more than young people whose mothers did not gamble.

The same trend occurred for fathers gambling, but not to the same extent.

I'll move to another study. This was done by a group of MLAs in Alberta, and it's called the "Native Gaming" report. It's dated April 1996. I'll ask the minister if he's familiar with this report.

Hon. J. Cashore: Yes, that's the report that contains the words: "With a successful history of credibility, respectability and accountability, the made-in-B.C. casino-gaming model places public acceptability and community benefit above the pursuit of commercial profit maximization."

[ Page 3487 ]

The Chair: Members, the Chair is having a little bit of a problem in regard to relevancy to the minister's estimates. We seem to be into a discussion that properly belongs in the Ministry of Employment and Investment.

K. Krueger: With respect, hon. Chair, I think I've outlined very clearly how these questions fall within the mandate of the ministry and the minister. There aren't a whole lot more of them, frankly, and I'd appreciate your indulgence, because the minister is willing to discuss. . . .

The Chair: Member, could you take your chair, please. It has nothing to do with indulgence. The Chair is confined to the standing orders, and I would appreciate it if all members would adhere to them.

K. Krueger: Well, I'll try, hon. Chair.

This report by the MLAs says it has been suggested that, on average, Albertan aboriginals could be spending up to $6,000 per year on gambling, where the average for Albertans in general is $1,427 per year. So once again, I think this report begins to make it clear why there are some unique considerations, particularly if there is a fiduciary duty on the part of this minister and the provincial government to very explicitly warn aboriginal communities about these findings.

There is a quote from the RCMP in this report on page 13, which says:

"Organized crime will attempt to gain a foothold in Canadian gaming through first nation gaming venues if the opportunity is provided. The general populace of the first nations and the integrity of the activity itself must be protected through appropriate regulation, security measures and follow-up enforcement."

Hon. J. Cashore: I have ventured into an area that is not my responsibility. With respect, I have answered forthrightly with regard to some of the areas that the opposition wanted to get me on record on, which was my own sense of my own moral responsibility in my stewardship of this ministry. I've not tried to hide that or duck that; I've answered those questions.

But in my opinion, the questions are becoming tedious and repetitious. So I do want to acknowledge the point that the hon. Chair has made, and say I will not be answering more questions on gaming. Perhaps the hon. member, to the extent that he's within the rules, just wants to get his points on the record. But I believe that I have done more than a fair job of seeking to answer some issues that the opposition wanted to get me on the record on. I believe that I've strayed outside the normal rules of debate in doing that.

[3:45]

In other jurisdictions, when an aboriginal community has been given approval to open a casino or have some gambling expansion venue, a number of jurisdictions have provided for a fund for first nations people, where a percentage of the profit from those venues is paid into a common account and shared between aboriginal people throughout the jurisdiction. Is that in the plans for British Columbia?

Hon. J. Cashore: Hon. Chair, it's a question for the appropriate minister.

The Chair: Perhaps the member could pursue another line of questioning.

K. Krueger: I'm rapidly running out of lines of questioning.

There was a forum held in Kamloops very recently by the chamber of commerce. Interested parties from anywhere in the community were invited to come forward and ask their questions of Peter Clark and the other people who were presented as a panel of experts to deal with the issue. There was a speaker from the aboriginal community in Kamloops who said that aboriginal people feel pushed toward gambling expansion by the provincial government. This woman asked specifically what protection the provincial government was offering to aboriginal communities along with the push that she and others in her community felt was occurring. What shall I tell that person?

Hearing no answer. . . . This government in its throne speech and budget made the point that it intends to pursue the tobacco industry for its dangerous and addictive product and the effect that it has had on the health care system in British Columbia. Given this precedent, does this minister foresee a lawsuit by aboriginal peoples for having failed to forewarn them of the social consequences which they may well face as a result of gambling expansion -- having, from their point of view, pushed them toward it and certainly having opened the floodgates without any apparent preparation in British Columbia? Does the minister see a connection there at all?

Seeing that the minister has no intention to respond, I will wrap up. I believe that this government has presented itself to aboriginal people as an authority on their affairs and that its mandate does spell out a duty to at least safeguard aboriginal people's interests when other ministries consider moves such as gambling expansion, which may well have a tremendously negative effect on aboriginal people. I think it's a terrible shame when a minister of the quality of this man stuffs his courage in one pocket and his mandate in the other and fails to take those measures in dealing with his responsibilities.

M. de Jong: I've seen this debate degenerate into a monologue. It's very disturbing. Before I move on to an entirely different area, let me offer these observations only. The minister may or may not care to respond. It's easy to deal with this issue of gaming and aboriginal people. I know that the minister is always careful not to leave any impression that he purports to be paternalistic or to single out a particular community in British Columbia for different or specialized treatment. That is the impression he wishes to leave, particularly with respect to aboriginal peoples and communities.

I'll say this for the record. Insofar as the Nisga'a agreement-in-principle purports to incorporate a model of self-government under which aboriginal peoples will be assuming a tremendous amount of jurisdiction over their own 

[ Page 3488 ]

lives, jurisdiction formerly exercised by other levels of government, I think these are legitimate questions insofar as they explore the nature of the relationship that will exist. It is a particular policy issue, a particular area. But just as we can discuss the interplay between the Ministry of Attorney General and Nisga'a central government on an issue like criminal justice and the administration of criminal justice, I suggest to the minister that it's equally applicable on an individual issue like gaming.

The minister obviously feels the issue is of sufficient import to make himself familiar with some of the studies that the member for Kamloops-North Thompson has questioned him on today. To that extent at least, he has devoted a portion of the resources of his ministry to the issue. I say only that insofar as we are embarking upon a whole new regime of aboriginal self-government, it is relevant in that respect. If the minister indicates that he wishes to respond, I'm happy to let him do so.

Hon. J. Cashore: Any fair reading of the record of the two days in estimates that we've canvassed this subject. . . . I am absolutely confident that any objective person reading that will recognize that I've entered into this discussion to quite a considerable extent on the terms that the opposition wanted to enter into it on. Except for where the questions became kind of repetitious, I believe that we have had a useful discussion on this. Therefore I only urge that if copies of this debate are being distributed, it be the entire debate.

M. de Jong: I wonder if I can move to an issue. . . . I must confess that I stepped out briefly to consult with the Chairman of the select standing committee, and a portion of this may have been canvassed earlier. But it relates to the issue of no-fault insurance and the representations that I believe the minister and his government have received from both the First Nations Summit and individual aboriginal bands and first nations, expressing their opposition to rumours of a policy shift by the government in that area, particularly ICBC.

I guess the first question I need to ask is along the lines of the mandate for the ministry to deal with and provide representations to various line ministries about social policy that may affect first nations. Is this an issue that has been addressed in his ministry, either in a formal way or on an ad hoc basis, with respect to responding to the submissions that the ministry has received?

Hon. J. Cashore: No.

M. de Jong: Can the minister indicate whether he believes it falls within his ministry's general mandate to advise the Finance minister, the Attorney General or the Transportation minister when those elements of society for which he has direct responsibility are urging upon his government that a certain course be either adopted or abandoned?

Hon. J. Cashore: Not in the context of active files; not in the context of the legislation that this ministry administers. But in the context of the discussions that take place and the various forums that develop and deliver policy, yes. And that does take place.

M. de Jong: I'm not sure I understand the distinction. Is the minister suggesting that a shift in policy along the lines that the government confirms is being contemplated within the realm of ICBC and our automobile insurance scheme would not have a direct and dramatic impact on first nations people?

Hon. J. Cashore: In response to the question, I'm indicating that that is how my views are, related to those parties that have direct responsibility and to the decision-making process. So what I'm saying is that the views that I have, the knowledge that I have and the interest that I have, in the context of my work, are how that is made available.

M. de Jong: I'm referring to a copy of a letter that I think went to this minister from the First Nations Summit. It was originally addressed to the Douglas Allen review team; it's dated February 7. The authors, Chiefs Joe Mathias and Robert Louie and Grand Chief Edward John point out a series of circumstances or distinguishing characteristics that they believe differentiate aboriginal peoples from other groups in society insofar as quantifying damages for automobile accidents is concerned. According to these gentlemen, because of unique cultural differences -- and they cite the example of a chief of the Gitxsan nation who was injured, and the obligations that flow to a chief historically and culturally as a result of sustaining that injury -- there are other factors that a court can legitimately take into account in quantifying a loss. As I read their letter, that ability to take those kinds of factors into account would be lost in any kind of an amended or no-fault scheme along the lines of what is being considered.

I suppose the question they have is: will this ministry and this minister in the months to come -- before we are back here engaged in this process again next year -- be devoting any ministerial resources to considering the concerns that these and other first nations people have? If that's not the case, perhaps the minister should say so now, and they'll save some ink and write to whoever will be considering these issues, insofar as how they uniquely affect first nations people.

Hon. J. Cashore: That's future policy. But if any such resources were to be applied, they would not be applied through this ministry. So the short answer is no.

M. de Jong: Thank you. Last question on this point. These individuals can take it, then, that there will be no studies undertaken by this minister and this ministry to consider the effects of a no-fault insurance scheme on first nations people.

Hon. J. Cashore: Yes.

M. de Jong: I want to explore a couple of other areas. But I know that the critic for the Health ministry is here and has some time constraints, given what has taken place in the big House, as we affectionately call it, so perhaps I will. . . .

S. Hawkins: There is a flooding problem in my constituency, and I believe that the minister has received some correspondence with respect to this. The flooding started over a month ago in Westview village. It's affecting about 300 people; a lot of them are seniors. The flooding is happening on first nations land.

Unfortunately, we have canvassed through several ministries -- Health, Attorney General, the PEP program, this ministry, Environment, Highways -- and it seems that every time there is a situation where something like this happens on first nations land, no one seems to take responsibility for the problem. We get diverted to another ministry, to another program, 

[ Page 3489 ]

to somewhere else, and I wonder if the minister is aware of this problem. We've also contacted the federal Department of Health and the Department of Indian Affairs. I wonder if the minister can direct me to somewhere -- some place -- that will take responsibility for these people's problem.

It is going to be a major health concern, because there's flooding over septic fields and there's pumping going on. A lot of these are seniors. Some of them are doing without power, electricity and water, and I'm asking for the minister's help. Will somebody take responsibility and let us know where we can direct this problem so that somebody can help these people?

Hon. J. Cashore: We are not aware of the municipality contacting our ministry about this issue. I stand to be corrected, but we're not aware of that. We've just made a few inquiries. I don't think. . . . The litany that the hon. member went through -- they've talked to this agency, that agency, and everybody says it's not their responsibility. . . . Having said that, hon. member, it's not our responsibility. It is a federal issue. The deputy minister is going to be meeting with the regional director general tomorrow. If the hon. member would like to put a situational analysis of the situation on the record or else give him some notes, he will take it up at his meeting with John Watson tomorrow.

Secondly, if the hon. member will write me a letter and outline the circumstances of the issue, while it is not our responsibility, we will try to see if there is anything within our power to facilitate those who should be addressing it. I do acknowledge that it is frustrating. So while it's not our responsibility, we'll try to see if there's anything we can do to help.

[4:00]

M. de Jong: The member for Peace River South is here, and I know he has an issue. I'm going to offer some general comments and then let the member for that particular area -- this is on the McLeod Lake issue -- deal with it in further detail.

I will tell the minister that during the course of our travels as members of the select standing committee. . . . I talked earlier about moments and impressions and lasting impressions. The submissions we received in the McLeod Lake Legion during the height of winter. . . . It was cold outside, but the atmosphere was warm and productive inside. The impression one gained was that here was a community that had undertaken a very difficult process insofar as negotiating an adhesion to Treaty 8, that they had dealt with the question of land selection and that there were a whole range of factors at play. Included amongst that is the language that is part of Treaty 8 and the various formulas that have been applied historically. But the people in that community managed to bring themselves to the very edge of concluding a successful arrangement. We also heard from all quarters of the frustration of people who have come that far and then seen an obstacle erected in their path to achieving final settlement.

But the lasting impression that one was left with -- at least I was -- was that here were people in the community that had come to an agreement on that often divisive issue of land selection. We heard that from the chamber. We heard that from representatives of local government. We heard that from the McLeod Lake band representative, who commented that the only time he really gets a headache is when he speaks with Mr. Schuck, the band's lawyer. We heard that these people within this community had gone as close as you can really go to effecting a final settlement. Now we're left with the impression that the two levels of government, the province and the federal government, have yanked the rug out from under them. In particular, it was left very unclear in my mind what the difficulty was with respect to the final memorandum of understanding, which I understand was tabled and ultimately went to cabinet -- what the basis was for the rejection of that proposed settlement formula and arrangement.

I think the member for Peace River South will discuss a range of issues relating to the language of finality, the method by which land was selected, the quantum of land that was involved -- all of those being relevant issues. I think the point -- I'm going to sit down and let the minister respond and then listen to the debate that takes place -- he's going to make is that here is a negotiation that took place around language, which we are now told by the province and the federal government is antiquated and out of date and no longer applicable. Yet during the course of our deliberations, aside from the Nisga'a, it was one of the few examples we saw of a negotiation that showed some signs of ending fruitfully and in the near future.

Hon. J. Cashore: I think we've all had considerable discussions on the McLeod Lake issue. It goes back a long, long way. The fact is that we would all like to see it settled. I think it best that I make my comments in the context of the questions that will be coming forward, but I think it's a matter for the record that the facts of the situation have been reported to the select standing committee. The fact is that as a province we still believe it is possible to achieve a negotiated settlement. Legal counsel for the province have previously raised with the court the prospect of a settlement conference with the court or mediation by a judge or a court. So we certainly haven't given up on the possibility that this can be settled without having to go all the way through the court process. But at the same time we feel that the situation has got to the point where it is moving in that direction, and I guess we'll be getting into the details in the course of the questioning.

J. Weisgerber: Indeed, my experience not only with the committee but as MLA for the area, as someone who has been involved in land claims and negotiations and tentative agreements over the years. . . . I think the closest I've ever come to seeing unanimity in support of a settlement is at McLeod Lake. We heard from a number of people around the community, both in the process of our committee deliberations and in my various roles as MLA, and really there's almost no opposition to the McLeod Lake settlement. It's supported by the local Member of Parliament, who happens to be a Reform member. It is supported by all of the agencies that I'm aware of in the community, and that's encouraging. To me, it's incredibly encouraging, particularly given that the settlement -- I understand it to have been negotiated under the general terms of Treaty 8 -- was generous in terms of land allocation: 128 acres a person to a maximum of 640 acres per family, which is roughly twice the land allocation being considered by the Nisga'a. I understand the cash component to be in the area of $25,000 a person, somewhat smaller than the $39,000 with the Nisga'a. Nonetheless, putting the land and cash together and considering subsurface rights, etc., this is a very strong fiscal package in a settlement.

So I've asked myself, and I hope the minister has too: why, then, this broad base of community support? I've come to the conclusion that there are basically three factors. First of 

[ Page 3490 ]

all, there has been a very good public relations job done by the McLeod Lake band and I believe by the other parties to the negotiations, although the McLeod Lake band have been most active in their own region. Second, I believe there is clear language -- certainty language, extinguishment language, if you like -- which provides a very high level of certainty to the communities that are going to be affected. Third, the McLeod Lake agreement has no self-government component to it, because it is a Treaty 8 adhesion. I'd like to start the questioning by asking the minister whether he too agrees that this high level of community support is directly tied to those three factors: the public relations effort, combined with the certainty and the lack of complexity in terms of self-government.

Hon. J. Cashore: In addition to the reasons the hon. member has cited, I think it's related to the certainty of language, to the fact of certainty and to the economic benefit for the region. Having met with delegations from the area from a broad range of interests -- business and other -- I would certainly confirm that there is an interest in the community. Recognizing that the settlement of this can be economically beneficial in job creation and a number of other ways, I think that too relates to the certainty issue and is one of the reasons why it does have such broad support.

J. Weisgerber: Yes. Given that in the McLeod Lake agreement we see language not at all dissimilar to the language we discussed vis-�-vis the Yukon settlements, is it still the minister's opinion that it's unreasonable or unfair to ask aboriginal people to consider the language that was used in those two agreements but is conspicuously absent in the Nisga'a agreement?

Hon. J. Cashore: Hon. Chair, I think we're dealing with apples and oranges in this question. We're dealing with Treaty 8. It contains language which the First Nations Summit, in the modern context, seeks to have changed. So the fact that this language is there is because the negotiating parties recognize the nature of it as being an adhesion to an existing document.

J. Weisgerber: The McLeod Lake band had -- and still has -- the option of pursuing an adhesion to Treaty 8 or simply deciding to pursue a comprehensive land claims settlement. I would argue that if the extinguishment or surrender language in Treaty 8 is so distasteful, as the minister and others would have us believe, then that would be the factor that would decide. . . . The McLeod Lake band would simply say: "Adhesion to Treaty 8 is unacceptable because it has certainty language which we simply can't live with; therefore we're going to pursue our comprehensive land claim." They haven't done that.

The Yukon aboriginal community has decided -- and is still deciding -- that they're willing to sign agreements under the umbrella agreement that contained that kind of language.

I suspect this is an area where the minister and I may simply never agree. But again it's important for me to put in the context of activities today the fact that first nations people are accepting language which the minister and others would have us believe is totally unacceptable. If the minister wishes to comment on that further, I'd be happy to hear from him.

[4:15]

J. Weisgerber: One last point on this, and then I'll move on to cost-sharing. The negotiators at McLeod Lake have examined Treaty 8. Part of the component of the historic agreement was the provision of farm implements and livestock. It also contained a $5-a-year award cash component in the old agreement. The parties have looked at those parts of the treaty and decided that they're no longer relevant, no longer acceptable and no longer appropriate in the modern-day context, and they've changed them.

One would argue, then, that if it's possible to change the form of settlement, it would arguably be possible -- if the parties were insistent -- to change the language with respect to certainty. I would submit to you that this wasn't a big issue for McLeod Lake, or it would have indeed become a sticking point in the negotiations.

Hon. J. Cashore: I think the hon. member makes a very good point. If that point were understood and accepted and held up by one of our negotiating partners, then it's conceivable that we would not be having this issue around certainty language. I don't argue with the argument that he is making. It's just that there are those for whom we have respect, who do not accept that language as being language that they would be willing to negotiate within the modern treaty-making context. As I said the other day, to get off on that issue would be to simply divert the process that we need to get on with towards negotiating fair, honourable and lasting settlements. We believe it is possible to do that with language that is acceptable to all three parties and protect the interests of all Canadians and all British Columbians at the same time.

J. Weisgerber: To move onward -- because I think we've explored that -- my understanding is that the impasse reached, which ultimately resulted in the band deciding to withdraw from negotiations and seek redress in the courts, has basically been because of the inability of the province and the federal government to reach an agreement on cost-sharing. Could the minister tell me whether the approach to cost-sharing at McLeod Lake is one that mirrors the memorandum of understanding or the cost-sharing agreement that exists with Canada and British Columbia for the resolution of comprehensive land claims?

In other words, have the province and Ottawa said, simply, that we have an agreement on cost-sharing -- lacking definition, perhaps, in some areas -- and that it's the same understanding that we'll use to resolve an adhesion to Treaty 8? Or has the province embarked on an entirely different process with McLeod Lake or with the federal government on cost-sharing with respect to McLeod Lake?

Hon. J. Cashore: We thought we had an understanding with Canada with regard to how this would be done, but the fact is that it turned out we didn't.

J. Weisgerber: As I reflect on the longstanding debate over cost-sharing arrangements, the first significant announcement came from former Premier Harcourt, who 

[ Page 3491 ]

announced, rather proudly, that British Columbia would not accept any more than 17 percent -- I think that was the figure -- of the costs of settlement. We now hear talk about British Columbia's dissatisfaction with Ottawa's apparent reluctance to pay a full 50 percent. Somewhere along the way we lost ground rather significantly from where Premier Harcourt started.

Can the minister tell me this: is it the 17 percent number that British Columbia is pursuing with respect to McLeod Lake, is it the 50 percent number, or is it some other number that British Columbia believes is appropriate for its share of the costs with respect to the cash and land settlement at McLeod Lake?

Hon. J. Cashore: Since we are now involved in a litigation, what we're pursuing in the litigation is that it's entirely Canada's responsibility.

J. Weisgerber: I just want to make sure that I have it clear in my mind. British Columbia's position with McLeod Lake is that the federal government accept all of the responsibilities for cash, land and subsurface resources. In other words, in this particular instance British Columbia is simply saying, "Identify the land that's necessary to effect a settlement, and we will be happy to sell it to Canada," who will use it in the resolution of the adhesion to Treaty 8. Is that the position, then, of the province?

Hon. J. Cashore: The case now is revolving around other issues, so B.C. is arguing that this is entirely Canada's responsibility, given locale and other factors.

J. Weisgerber: It's incredible that the McLeod Lake band would be taken into a process. It's a small band; it's a band that had limited resources. It's a band that -- through statements coming from, if not this minister, the previous one -- believed that the province was prepared to sit down and negotiate an agreement.

If the position was -- and there are many who will support the position taken by the minister -- that this is entirely a federal responsibility, then that surely had to have been the position at the onset of negotiations. It's the minister who changed the position of the previous government, which said this is entirely the responsibility of the federal government. That was the historical position. It was this minister's government that said: "No, we're going to step back from this. We think that we have an obligation to help resolve this." And then to go through a period of years of negotiation and at the end of the day say, "Well, we're right back where the other guys were," is to cause an incredible amount of cynicism, particularly among aboriginal people with respect to land claims negotiation.

I want to be very clear in my own mind, and I want the record to reflect very clearly, that that's in fact what the minister is saying: the province doesn't accept any responsibility for any of the costs associated with the resolution of the McLeod Lake adhesion claim to Treaty 8.

Hon. J. Cashore: It's the difference between negotiation and litigation, and now that we're into litigation we're arguing points that have named the federal government as a third party. We believe that is the prudent and appropriate approach to be taking at this point in time.

J. Weisgerber: Is it, then, that the minister has taken the position that he's unwilling to share with us the position with respect to cost-sharing taken by the province prior to the break-off of negotiations with McLeod Lake band?

Hon. J. Cashore: With regard to the federal-provincial cost-sharing, the agreement that we had with the federal government on cost-sharing was based on the comprehensive claims through the B.C. treaty process. Then later McLeod Lake came along. When that characterization had been expressed -- with regard to the amount of the projected federal share and the amount of provincial-federal share and the fact that the province was responsible for most of the land, and the way that all those various factors worked in together -- at the time that those projections were made, they were not based on what might be the eventual outcome of the McLeod Lake. Obviously the position that the province was taking at McLeod Lake was one that would, to the greatest negotiated extent possible, ensure that the federal government was undertaking the major and appropriate share of the cost.

J. Weisgerber: Could the minister, then, tell me whether. . . ? Could he give me a sense of the quantum. . . ? First of all, perhaps he could tell me where the province is with respect to comprehensive land claims and the cost-sharing agreement there. Could he give me, in very simple terms, a percentage of the overall costs -- land resources, lost revenue opportunities, etc.? Where does the minister believe the province has agreed with the federal government? Is it 17 percent, 50 percent or somewhere in between?

Hon. J. Cashore: Hon. Chair, our projections are that the amount of cash the province would be providing would average out to 17 percent over the course of treaty settlements and that B.C. would be providing most of the land.

[4:30]

Is there some figure that the average British Columbian can understand: we're paying half the costs, we're paying three-quarters of the costs, we're paying whatever? We've played number games on this issue going back to the days of Premier Harcourt, and I think the real question people want to know is: what share of the total cost is the province prepared to accept? What has the province negotiated in terms of a cost-sharing agreement with Ottawa?

[S. Orcherton in the chair.]

Hon. J. Cashore: In January of '96 the province released the KPMG benefit-cost study. It estimated the total cost to the province -- that is, the cost of settlements, negotiating and implementing treaties, consultation, public information, the B.C. Treaty Commission funding and the purchase of third-party tenures -- at approximately $2 billion, or an average of $50 million annually over 40 years. That was one-quarter of 1 percent of the annual provincial budget, so I think that's getting into the area of amounts that people can understand.

J. Weisgerber: Well, it deals with a part of the equation. The other is obviously lost revenues and lost revenue oppor-

[ Page 3492 ]

tunities. And another factor that's important to know is the federal contribution. If the $2 billion represents all costs, all forgone revenues, then what does Ottawa contribute -- $2 billion, $4 billion, $6 billion, $10 billion? Because in order to be relative, we've got to know how much the party that we both appear to agree has the primary responsibility. . . . How much is the government of Canada contributing?

Hon. J. Cashore: That would have to be based on these projections, but the portion that we calculate would be Canada's cost portion is 17 percent of the total. The amount over and above that could be calculated.

J. Weisgerber: I understand again why I never pursued accountancy as a trade. The minister, on one hand, tells me 17 percent of the cash, then he comes back and says $2 billion, but now says that that represents 17 percent of something else. I really believe that these numbers simply take us round and round in circles.

But if the minister is telling me that $2 billion represents all of British Columbia's expenditures in fixed dollar amounts and that that represents 17 percent of the overall cost of settling the claims in British Columbia, I will be happy to accept that. I can assure the minister that I'll then monitor these settlements very closely to try and ensure that British Columbia stays within that 17 percent overall expenditure -- cash, land, resources, forgone revenues, etc.

Hon. J. Cashore: Yes, that's our intent.

J. Weisgerber: Then my final question on this issue is: is a copy -- the most current copy -- of the cost-sharing agreement between British Columbia and Canada public information? Is it available to me and to others who might want to sit down and, perhaps with just a hint of skepticism, do our own mathematics, our own calculations, on this cost-sharing agreement?

Hon. J. Cashore: Hon. Chair, I was just given permission by the deputy to use the vernacular, but I don't think I will.

Yes, the deputy advises me that seminars have been held throughout the province on the cost-sharing agreement. Basic documentation has been distributed at those meetings, and we'd be glad to make that documentation available to the hon. member.

I just want to hedge slightly on what I'm saying. There may be some documents that have not been released that the hon. member is referring to, but I don't believe that is the case.

J. Weisgerber: I certainly will look forward to considering the cost-sharing agreement in light of this commitment by the minister. Again, I just want to make very sure that I have this down pat. The position the minister is articulating is that the total overall contribution, when the claims are settled in British Columbia and factoring in land, cash, resources and forgone revenues over time, is roughly $2 billion and that that represents a total of 17 percent of all of the costs associated with the settlement of land claims. I want to be absolutely certain as I leave this portion of the estimates that I have that clear. I'm a little thick on these kinds of things, and I just want to make certain that I've not misunderstood.

Hon. J. Cashore: We just want to hedge a little bit on that so that we can review some documents. We don't have those documents here, but I believe that there may be discussions between constant dollars and net present value that show up with different dollar amounts, depending on whether you project those costs on the basis of future dollars. We're going from some cryptic notes that we have here, but we will get that for the hon. member.

J. Weisgerber: Well, hon. minister, I guess a little wiggle room is the prerogative of the government. Certainly I wouldn't want to deny you the same kind of wiggle room that the Finance minister and the Premier enjoy.

It's unfortunate. If the minister and his ministry have succeeded in working out that kind of an agreement, then it's a real tragedy for the people of McLeod Lake and the people of Mackenzie that this agreement has broken down. I'm not going to affix blame. It would be entirely unfair for me or anyone else to do so. But it's tragic that an agreement which appeared so close to resolution has broken down, apparently as a fundamental failure of the cost-sharing agreement between the two levels of government.

So with that, I'm going to move off this issue. If I have an opportunity in the next few minutes, I'll come back with some future items. But I'll leave the debate at this time.

M. de Jong: In terms of the issue that has just been addressed, the only message I can add is that which was left with me following the presentations in McLeod Lake, and that is the realization on the part of all parties located in Mackenzie that if this matter does require submission to the court and a decision is left to the court, all bets are off with respect to the land selection process that has been undertaken to this point -- the concern being that all of the parties recognize that those negotiations involved a lot of give-and-take. It would be a shame if those negotiations were lost, and a court-imposed settlement were required and led to the divisiveness that would likely result if the parties aren't able to come to a negotiated settlement.

The issue that I wanted to move on to now. . . . Some of these are issues that I guess you could characterize as themes. We started down this path a couple of days ago, through this estimates process. I told the minister at the outset that I wanted to explore with him some of the mechanisms or means that we might have available for expediting this process, for moving it ahead more quickly, and satisfying and relieving the frustration that I think he agrees exists out there in both aboriginal communities and non-aboriginal communities.

We started to talk about an issue like the fishery and the possibility of taking negotiations to a different level. I don't at this point want to get bogged down in agreement or disagreement with the model that exists in the Nisga'a AIP. I think the minister's comments are on the record in other debates and in other forums, and so are mine. There's no point rehashing them here.

But I think where we left off this part of the debate several days ago was in my submitting to the minister that, whether you agree with it or disagree with it, there is general acceptance in British Columbia of the proposition that the Nisga'a model is not one that lends itself to application elsewhere and that, increasingly, people are coming to the conclusion that if these negotiations are to result in any kind of a meaningful settlement which takes account of the fact that the fishery represents a finite resource, negotiations need to be taking place, at a minimum, on a watershed-level basis that takes account of the fact that we deal with a resource which is tied to a particular region or a watershed.

[ Page 3493 ]

I wonder to what extent the minister has been investigating that possibility with those bands within the Treaty Commission process -- and those that aren't -- and whether we can expect some progress. I suppose that depends in some measure upon the level of the minister's commitment to taking negotiations on that particular issue to a different level, so that they're not being negotiated around 44, 50 or 55 separate main treaty tables, but are taking place on a more central basis -- on a regional or, as I suggested, watershed basis.

Hon. J. Cashore: I think it comes down to a discussion of the uniqueness in each and every circumstance where a treaty is being negotiated. I think the hon. member is aware, given his pilgrimage in the last several months, that not many of the negotiations are getting even close to dealing in a really substantive way with the fish issues.

But be that as it may, I think it's obvious that the circumstances in most parts of the province dictate that the arrangements. . . . Given the numbers of first nations and the population density and the multi-use, for instance, of the Fraser River as compared to the relatively less complex multi-use of the Nass, it behooves that very different types of arrangements be negotiated in those differing circumstances.

M. de Jong: Whilst it may be true that other negotiations at other main tables are, sadly, some distance away from arriving at the point which we find ourselves at with the Nisga'a AIP, I guess that my submission to the minister on this point is that we can perhaps ensure that when they get there, one of the obstacles that has been removed is management and allocation of a resource which, as the minister indicates, is being claimed by a whole host of different groups and interests, particularly in the case of a river like the Fraser.

One of the submissions suggested that the ministry and the parties to negotiations might take advantage of other organizations as facilitators for these types of negotiations -- the Fraser basin commission, for example -- so that it becomes an issue that is removed from the main table, to the extent that it will allow the negotiators to get on with those issues that are unique to a particular band or first nation.

The time, I would suggest, for us to consider that, to advocate that and to take steps that will lead to that would be now. And I suppose my interest and my advocacy today is to urge upon the minister that he be proactive in taking those kinds of steps and encouraging his partners at the negotiating table to see to it that that occurs.

[4:45]

M. de Jong: Well, I will repeat something I said earlier: I hope that that is a recommendation. I anticipate that it may well be, but I wouldn't presume to put words in the mouths of my colleagues on the committee. I think the minister understands that.

When we talk about finding the means for moving this process along more quickly, more efficiently. . . . I often thought as we were listening to submissions that in order for that to happen, either there must be a benefit that accrues to the parties for moving ahead or there must be some threat of sanction. Usually it's a combination of the two that will lead parties and encourage them and cajole them into finding settlements which otherwise might not so readily appear. One of the issues that occurred to me as providing a means by which we can do that is this mechanism that we refer to as interim measures agreements, which really amounts to nothing more, in my view, than trying to maintain that balance between ensuring that a resource or an area isn't depleted by the time it transfers into the hands of a first nation, if indeed it ever does, and the desire we have as a province not to have development grind to a halt.

I know that the province has undergone a shift in policy as a result of some criticism that was levied by the B.C. Treaty Commission, and I know that there is still a struggle taking place in trying to find the appropriate balance. But in my submission to the minister, we haven't found it yet, insofar as in many areas of the province there is still a sense that development is being stifled. And you contrast that with the belief, oftentimes in the same areas of the province, from aboriginal peoples that their views, their concerns, aren't being taken account of.

Surely there is an opportunity here for the parties to these negotiations to set some ground rules that say we are going to bind ourselves to some deadlines, and if we don't achieve those deadlines, there are going to be some sanctions that operate against us. It's a balancing act, but without doing that. . . . In the Yukon, I understand that one of the mechanisms to encourage settlement was the notion of forgiving some of the debt or some of the interest on some of the debt incurred by first nations in the negotiating process. Now, it is the subject of some controversy today, as I understand it; nonetheless, it was imposed as a condition of negotiating, I presume to try and encourage quicker settlements.

Does the minister have some ideas that he is prepared to share for what he would like to see as part of this whole negotiating framework that will get this process moving? Because surely it isn't at the moment.

Hon. J. Cashore: I just want to clarify with the hon. member. . . . When he says "get this process moving," I'm assuming, but I want to make sure my assumption is right, that the hon. member is referring to getting on with a timely resolution of treaties so that these issues such as interim measures and Crown land activities, etc., cease to be a burden. I just want to make sure that that's the context in which the question is asked.

M. de Jong: Yes, I think so.

Hon. J. Cashore: There are sort of two sides to this coin. On the one hand we are dealing with what is an enormous amount of change in a very short period of time. That enormous amount of change in that short period of time goes back to the time when the former Minister of Native Affairs brought B.C. into the Nisga'a negotiations and, along with his federal counterpart in the First Nations Summit, commissioned the task force report which then became a fully accepted report, which our government accepted, with its recommendations to set up the process. So in some ways things have been happening so fast in that short period of time that you do need the time that it takes to be able to absorb that -- understand the ramifications, the potential impacts -- and then, in a timely way, be able to incorporate that into your thinking, your policy and your planning for where you go from there.

[ Page 3494 ]

On the other hand, the process is also restricted by at least a couple of factors, and one of those factors is its success. The task force report envisaged some 32 first nations coming into the treaty process. The actual fact is that we have well over 50 who have entered the process. The volume entering the process is such that it creates a problem in itself, because it wasn't anticipated.

Add to that the fact that the money the province is able to put into this for negotiations and for staff to support negotiations -- which really accounts for the major portion of the budget of the Ministry of Aboriginal Affairs -- plus for costs that are incurred by other ministries in order to be able to do their part in all these things is restrictive. If we had several times the amount of money we have, we could probably have a lot more negotiating teams, and we could be making more progress more quickly. But at the same time, if that were the case, we might have a problem with things continuing to go too fast. So there has to be a balance there somewhere.

We need to get these done in a timely way, to get the certainty and get on with it: no question about it. At the same time we need to be taking the necessary time to do it right. We need to work within the limited fiscal resources we have, to get the best value out of those negotiation and support resources, so that it is something that is managed and moving along, where steady progress is being made and where we can see that as we build on our success, it will happen even more quickly.

I can say to the hon. member -- at this point in time and subject to change -- that during this term of government we would project seeing the conclusion of the Nisga'a, possibly the conclusion of the Sechelt, possibly the conclusion of three or maybe four agreements-in-principle, and other negotiations having moved along in those areas as well.

Those are projections, not predictions; we have to work within that context. Once we have that kind of experience, it will represent a variety of situations throughout the province. As we get more of that variety represented, more of the kinds of issues that have a repetitive nature within them will be addressed more quickly in other subsequent negotiations. I remind hon. members that in our debate a few days ago we canvassed the issue of trying to find ways to keep things going by the economies of scale of regional tables on various kinds of issues.

With regard to the question about interim measures. . . . Yes, I understand that there can be incentives, whether it's in the Crown land policy or the interim measures policy. But we always have this tension between the extent on the continuum that you go with the five levels of interim measures, as referenced in the task force report. . . . It's constantly a very strong tension between the development community on the one hand and the first nations on the other hand. We hear their concerns loud and clear. The only thing is, those concerns being expressed are on opposite sides of a political spectrum.

Be that as it may, we are still making progress with interim measures. We are trying to work with the parties in a consultative way so that it is done in a way that people are fully aware of. I think we're doing better now than we were a couple of years ago, because we are finding better ways of making those kinds of contacts.

M. de Jong: When we talk about timeliness and costliness of negotiations and achieving best value. . . . We did talk about the potential for regional-based negotiations, and we have now talked about negotiations -- perhaps on a watershed basis, where that is appropriate to a fishery resource. These things don't just happen. One of the things we didn't talk about is whether or not the minister thought it appropriate to build into the negotiating process financial or other incentives that would encourage first nations to adopt that kind of approach.

For some first nations, quite frankly, "centralization" is a dirty word, and they don't have a whole lot of interest. But for others, if you could lay out a financial incentive for coming together and negotiating on a broader front, it may make a whole lot of sense -- and they may see the sense in it. That is something that needs to be explored, but it will only happen, I would suggest, if the minister is prepared to make it happen or encourage it to happen.

There is a difficulty in terms of prioritizing the negotiations. As I say, we've heard time and time again about the frustration associated with having negotiations every two months. Is the minister prepared to entertain an idea that a broader-based level of negotiation . . . or if more bands come together, that they'll move up in the priority list so that those negotiations can happen more quickly?

Hon. J. Cashore: I answered this question a few days ago. Just to repeat, we are discussing this with the summit through the context of the Treaty Commission, and B.C. has taken the position right from the start that we should be doing exactly that. We are getting more support from the other two negotiating parties now than we had when I first became the minister. The Treaty Commission is becoming much more active in addressing this whole topic.

I'm always interested in the hon. member's suggestions. Again, the one about incentive is one that I'm going to check to make sure is also being discussed in the context of the work the three parties are doing through the Treaty Commission, because I think it's a very valid issue. The suggestions and recommendations that will be coming through from the select standing committee will be taken seriously in this regard too, I expect, by all three parties.

[W. Hartley in the chair.]

M. de Jong: Maybe I could explore another issue that relates to treaty negotiations generally. The idea that arose within the context of self-government discussions of the need to vest in aboriginal peoples greater autonomy. . . . There is -- and has been and will continue to be -- a debate about the manner in which self-government can best be achieved within the context of the Canadian Confederation. But in terms of the tension -- the minister used that word a few moments ago -- there is a tension that exists within the realm of self-government negotiations and autonomy. If I can lay it out for the minister this way, there are those who would advocate for the greatest possible autonomy for first nations, who would defend vehemently their need, their right, to make decisions about issues that affect them on a day-to-day basis. They defend that right on the basis of their history, of aboriginal history, and of their unique culture.

[5:00]

[ Page 3495 ]

The dilemma seems to be this: there are those who will argue on behalf of this need to vest the greatest possible autonomy within the ranks of aboriginal self-government and the aboriginal peoples, but everyone's got a line. Everyone's got a line where they say at some point, "Oh yes, for cultural differences we're going to preserve the culture, we're going to preserve the history," and that autonomy is defendable on this basis until you get to a particular issue, and then they say: "Stop. We can't go any further than that." It seems to me that the whaling issue qualifies as one of those issues where people and groups who otherwise advocate very strongly for aboriginal autonomy suddenly take the position that it is necessary to apply a different standard.

Maybe I should ask the simple question first and ask the minister whether his government supports a resumption by the Nuu-chah-nulth of hunting of grey whales. But having asked that question, I've attached all sorts of baggage in the preamble which he may also wish to respond to.

Hon. J. Cashore: I have stated in the House that I am opposed to the resumption of the hunting of grey whales. Our government is on record as being opposed to the resumption of the hunting of grey whales. That was stated several months ago.

In negotiations, part of the context of respect is that any party can bring to the table that which they choose to bring to the table, and then it has to be dealt with in that context. Given that example, the self-government provisions, where they might address the issue of autonomy and that sort of thing -- as in the case of fish. . . . While some feel it's not restrictive enough, it's still restrictive. In other words, it's a tripartite negotiation that comes to a tripartite decision, which reflects tripartite input. And therefore, almost by definition, at the point of negotiation, it's something that very seldom gives complete autonomy -- which stands to reason, because most of us don't have that, anyway. Therefore in a modern treaty in today's reality it has to address those issues. It has to address the reality of some global stewardship and responsibility when we're looking at a resource such as that, as it does with fish.

In the present context, prior to treaties being resolved, the primary responsibility is with the federal government on that particular issue. But I realize the hon. member could come up with another example where that might not be the case.

M. de Jong: I guess my confusion relates to how the minister or how the government would distinguish this issue. I'm the first to admit that I don't have all the facts on the grey whale population of the world, and the minister may invoke conservation-related arguments. But my query is this. I may object strenuously to the hunting and shooting of moose, of grizzly bears, which is defended, as I take it, on the basis of a historical and culture-based entitlement and, in some cases, much further: a spiritual link with those particular species. How is this different? I may, for the record, object strenuously to the hunting of grey whales. But why is this different?

Or maybe I'm being unfair to the minister and, recognizing that at this point it is a federal government issue. . . . When he says that he is opposed to the hunting of grey whales, does that automatically mean that the government would, if it were within its power, take steps to prevent the hunting of grey whales? I suppose that's the million-dollar question. It's one thing for him to simply say he opposes it. But is this the line? Is this the line where the government, if it had the power to do so, would step in and invoke certain regulatory or legislative provisions and say: "Thou shalt not hunt grey whales, notwithstanding whatever arguments you may have about a cultural or historical entitlement."?

Hon. J. Cashore: I think I've said enough with regard to the position that the province has taken publicly on this. In the past I've always said that I want to avoid getting into a discussion that has me carrying out negotiations in a context and a forum in which that shouldn't be the case.

But to the question: what is the difference between hunting grey whales and, say, hunting grizzly bears? There is no difference. There is an element of subjectivity in that. There's an element of taking a look at a global issue and the importance that that issue has, given a broad variety of contexts and concerns and inputs and values. So it's a good comparison to make; it's a good hypothetical example. The fact is that at the present time there is the hunting of grizzly bears and black bears and all sorts of wildlife, and in British Columbia it is a managed situation.

There is the recognition within those contexts of an aboriginal right for which the province has a responsibility in terms of that resource. As it is now, it would not be a provincial responsibility with regard to that particular example. That's why I said I think probably there might be some other example the member could come up with, or has come up with, in talking about grizzly bears that is more of a provincial example.

So I don't know if that adequately answers the hon. member's questions. But in terms of defining a line that is future policy and prospective with regard to actual negotiating positions at tables, I'm a little leery of doing that -- although I'm quite happy to remind the hon. member about the positions that this government has taken publicly.

M. de Jong: I think the dilemma I face -- and probably more importantly the dilemma faced by first nations people -- is the impression that is left that the commitment to this notion of aboriginal self-determination, albeit within the Canadian constitutional framework, and aboriginal autonomy over certain issues hinges in large measure upon what the government's perception is of what the society's views of the day are on a particular issue. And my sense is -- to go back to the issue we were dealing with -- that governments feel relatively confident that there is a feeling across the broad spectrum of Canadian society that there should not be any whaling, and therefore it's a safe position to take to apply that insofar as aboriginal peoples are concerned, notwithstanding that they may present arguments for a cultural entitlement.

If I can take that argument and apply it, without belabouring the subject, to another context where I saw a very similar phenomenon develop -- and I have noticed it for some time. . . . When we talk to aboriginal government representatives, and then, particularly when we move into the urban areas and hear from off-reserve natives, particularly women, there are dramatically different ideas and notions about the responsiveness of aboriginal government to the needs of women and their sensitivities to what we would call feminist issues. And the phenomenon I saw develop again was, on the part of aboriginal governments, a defensiveness that said: "Hey, we will look after our own affairs, whether they relate to women or some other component of our society, and it's none of your business." And the contrary argument, often from those individuals who would, the day before, be the most ardent proponents of the need to enhance native autonomy, said: "Wait a minute. On this issue we need to build in some safeguards." For those individuals, that issue 

[ Page 3496 ]

went beyond any notion of aboriginal sovereignty or autonomy; there was an overriding concern. There seemed to be a lack of confidence on the part of people making those submissions that those concerns would be adequately addressed, and they therefore warranted special attention by the provincial and federal governments. So I saw the same phenomenon develop there.

[5:15]

Recognizing the very legitimate concern being expressed in that point, what gives me hope. . . . For instance, I look at the Ktunaxa-Kinbasket, where the chief negotiator on that team is a Ms. Tenise, and other negotiations are taking place where women are well represented within the process. I think we are seeing increasingly healing activities taking place in first nations communities. I have personally been invited to such events. At times, the powerful leadership of women in this new healing process that's taking place in first nations communities is quite overwhelming to observe.

I realize that there is a very legitimate concern. When treaties were finalized, if there were systemic situations that were bad situations for women or for children, that would mean that we would have to look back at that and say: "Why didn't we do a better job of addressing that issue?" I think we have to be cognizant of that. But in doing that, I'm just saying that there has to be a respect for the party that you're dealing with -- that you don't start to try to micromanage their context, their reality, their world. What gives me hope is the strength of the voices of children and women and men who perhaps didn't have that much of a voice in the past, where that is now happening. I think that what's going on at Alkali Lake right now. While it's probably going to be opening a bit of a Pandora's box of concerns and issues that need to be addressed, what is good is that it's happening and it's getting out there, and I think that's where the social transformation takes place.

At the end of the day, I guess one of the things we have to be very sure of is that treaties don't create an entity in which that social transformation is stymied, because that's where the real difference is going to be made -- not in a document, but in the ability of a people to express themselves and fully take part in building their own people's destiny.

M. de Jong: I guess the message I would bring to the minister is that my own observation is that on occasion, in certain cases, that autonomy that we seek to inject into the lives of aboriginal peoples via the mechanism of self-government -- and hopefully it will be the exception rather than the rule -- could result in circumstances that we as fellow British Columbians are not entirely comfortable with. The minister warned against micromanaging, and I think that's very important. There may be a downside, and I fear that there may be people in government who are prone to selectively micromanaging, depending on what their particular issue of paramountcy is. So I think that's an important component, and people need to be alive to that as we head into the process.

I know that the member for Peace River South has some time constraints. I wonder if I might allow him to proceed.

J. Weisgerber: One of the most useful exercises I've embarked on in the last little while is a rather careful consideration of the Yukon agreements. It seems to me that that sort of modern context of an agreement closely aligned geographically -- a lot of tribal overlaps, etc. -- is a useful document that British Columbians probably haven't spent as much time considering as we might. So I'd like to take a few minutes to review some of the commonalities and some of the contradictions between the Yukon agreement and the Nisga'a agreement particularly.

Earlier on in our discussions I expressed my concern over the amending formula contained in the Yukon agreement. At that time the minister indicated that he was very much opposed to any amending process that would have the ministers of the federal and provincial governments act unilaterally, without bringing some broader process into the amending formula. Could the minister tell me what process the province favours?

The minister indicated that these negotiations are going on in the context of the final Nisga'a agreement. What's the position of the province with respect to amendments? How does the minister believe amendments should be made after the final agreement?

Hon. J. Cashore: Discussions are now underway at the table with regard to the amending processes. I think the words that I used the other day were "major" and "minor." I guess that through the negotiations there would have to be some way of ascertaining where that clicks in, and I think in our discussion the other day we gave a couple of examples to try to define that. In the final wording, there are also going to be some situations where there would be, for obvious reasons, amending processes that would be facilitated by virtue of the wording that's in that agreement. But anything that would change the nature of any of the significant factors in the treaty would be subject to legislative treatment.

J. Weisgerber: I'm going to assume that the minister is saying that any substantive change in the agreement following the treaty would come back to the Legislature for approval before being implemented.

If that's the case -- time being a constraint for everyone, I expect -- with respect to roads, I thought it was rather significant that in the Yukon settlements, the federal government -- and, one would assume, the Yukon territorial government -- simply said that in the selection of lands you cannot select lands that cover other than, I believe in the words of the negotiator, "goat trails." Any major thoroughfare was simply not available for claim. That's quite a stark contrast to the process with the Nisga'a, whereby the province gets back some irrevocable easement or right-of-way, but the ownership is being transferred to the Nisga'a. Can the minister tell me again what gives him the sense that this is a better way of handling the issue, given the tremendous amount of difficulty that already exists in B.C. with respect to proper filing of road right-of-way ownerships, etc.?

Hon. J. Cashore: We get the same amount of security and protection as if we were the owner, and I think in many ways it parallels the relationship with municipalities.

J. Weisgerber: I'd be prepared to accept the argument if we had a history of parallel confrontations with municipalities around public access. The fact of the matter is that's not been the case. The fact of the matter is that the municipality is the creature of the provincial government by way of delegated 

[ Page 3497 ]

authority and that anytime the municipality goes too far in attempting to impose its jurisdiction, the province has a unilateral way of resolving that. That's not been the case; that's not been the historical situation in British Columbia. Road access and road blockades have been a key area of confrontation. My great fear is that we're setting ourselves up to perpetuate that activity in the way we're resolving land claims, rather than setting out to make sure that there is absolute certainty as to the ownership by the province of the lands on which our roads and highways lie.

Hon. J. Cashore: It comes down to having legally enforceable language in the treaty that ensures that we will be in precisely the same position that we were in with regard to that road prior to the treaty. Otherwise we wouldn't do it. So the language has to be language that absolutely ensures the province's interest and authority.

J. Weisgerber: The Yukon umbrella agreement covered a whole range of issues, and flowing from the Yukon umbrella agreement were individual agreements. The Yukon umbrella agreement dealt with repealing the Indian Act, section 87, taxation benefits -- this being consumptive taxes, PST and GST in the local context -- within three years of the umbrella agreement coming into force, regardless of where the 14 claimant groups were in their negotiations. In fact, the taxation provision is just in the process of kicking in, even though only four of 14 bands have signed final agreements. Can the minister rationalize for me the province's agreement to deal with the eight-year and 12-year implementation of taxation, given the experience in the Yukon?

Hon. J. Cashore: Again, hon. Chair, these are different negotiating circumstances wherein the federal government virtually bought the tax status from the Yukon first nations and made a cash arrangement within the treaty settlement to deal with that. Therefore they were able to have that click in earlier. As the hon. member knows, it was the province that put the tax exemption issue on the table. It was not put there by the federal government. When the province put it on the table, the federal government objected at first. Now the federal government is taking credit for the fact that it's there. I should add that the federal government have stated that they would never repeat what they did in the Yukon agreement, and it was the federal government that put that money into that. So one of the negotiating parties, Canada, has said that it would not entertain that approach.

J. Weisgerber: Well, it seems to me that when one looks at the elements of the Yukon agreements that are being signed currently and then one looks at the Nisga'a agreement, it's hard to identify this big cash buyout for taxation. Indeed, when one looks at per capita settlements or settlements by any measure, it's difficult to identify that big lump sum payment the federal government alleges it paid in order to get this accelerated taxation issue. I must say, I find it incredibly hard to believe that the federal government, on one hand, was willing, by the minister's own words, "to pay a premium to get this tax exemption under the Indian Act repealed in the Yukon," and then to come to British Columbia, where the magnitudes are tens of times greater, and come to the negotiations prepared to ignore taxation. It does, indeed, stretch credibility. It stretches one's imagination to believe that Canada would come to British Columbia, having negotiated this taxation deal in the Yukon, and not seek some similar tax treatment in British Columbia. I wonder if the minister is sure that that's in fact the position he stands behind.

Hon. J. Cashore: I think the hon. member can make any assumption he wants. But the fact is that the federal government, in my view, in so many words, have recognized that, from their point of view, they made a mistake. They have said they would never do it again. So the hon. member is raising a point about them coming into British Columbia and not being willing to do that again. The fact is that, for whatever their reasons, they have decided that that will never happen again. I think the hon. member might want to ask the federal government about that. I'm not being facetious, but they didn't even want us to raise the taxation issue, and we did. Finally, after about 18 months, we got them to be somewhat enthusiastic about it being their issue.

[5:30]

The minister has taken another initiative -- or at least what appears to be another initiative -- on behalf of British Columbia: that is, to limit the amount of land available for land claim settlements provincewide to 5 percent. Now, I'm still unsure whether that's 5 percent of the total geographic land base in British Columbia, whether that's 5 percent of public lands in British Columbia, or whether that 5 percent includes parklands, for example, and other set-asides. Perhaps the minister could clarify for me exactly where the province is with respect to that 5 percent cap on available lands.

Hon. J. Cashore: My understanding is that it's 5 percent of the province's land base, including reserve lands.

J. Weisgerber: I want to make sure whether it includes fee simple lands, 5 percent of parklands or an equivalent amount. Perhaps the minister could clarify for me how the 5 percent was established. The most recent figure I'm able to see is that according to the federal government's figures, about 2.6 percent of B.C.'s total population are status Indians registered under the Indian Act. I'm wondering if the idea is that aboriginal people would be entitled to twice the per capita amount of land that might be available to other British Columbians. I wonder if there is a correlation between the 2.6 percent of the population in B.C. and the fact that 5 percent of some geographic number is going to be available for land claim settlements.

Hon. J. Cashore: Well, as I've said in estimates for three years running now, it's a completely subjective, arbitrary position put out by our government in the context of a claimant. . . . When there were absolutely preposterous statements being made about 112 percent of the province being lost through treaty negotiations, we realized as a government that we had to put a figure out there which made it very, very clear that that was certainly not the case. That 5 percent figure was not based on a scientific survey, and it wasn't based on any sophisticated per capita analysis, although that was a factor that we were aware of -- the number of aboriginal people in the province. So we said: "At the end of the day, when treaties are settled, it will be less than 5 percent of the land base." So I'm being completely open on that. It was not based on any sophisticated kind of analysis at all. But we needed to get a message out there so that the public could understand the general parameters in which this new relationship was being established.

J. Weisgerber: So by some process, not particularly scientific, British Columbia has decided that roughly 2.5 percent or 

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2.6 percent of British Columbians -- being those that are status Indians registered under the Indian Act -- are entitled to 5 percent of some land base. We're not quite sure whether it's fee simple lands, or if it includes parklands or other set-aside lands.

The point that I made earlier with respect to the Yukon agreement, and the reason that I believe and continue to look more carefully at the Yukon agreement. . . . The Yukon agreement transferred 10,000 square miles of category A lands, which included subsurface rights. In addition, they provided another 6,000 square miles of category B lands with no subsurface rights. That means that about 5.7 percent of the Yukon Territory was made available for settlement of lands as category A lands. If one throws in category B, it comes up to 8.7 percent of the Yukon lands that are available either as category A or B lands. But the interesting different statistic is that in the Yukon Territory, 23 percent of the population is registered under the Indian Act as aboriginals.

So here we have in the Yukon an agreement that has been repeatedly criticized as being far too rich, far too generous, rammed through the federal parliament only because there wasn't a province standing up on behalf of the territory. Here we see 23 percent of the population get 8 percent of the land -- and the minister saying that 2.6 percent of the population in British Columbia should get no more than 5 percent of the land. Just by quick math, that says to me that if indeed the 5 percent is used to settle lands, it will be on a percentage basis six times more generous than the settlements made in the Yukon Territory. I wonder, given the relative value of land in British Columbia and then starting to calculate in terms of the dollar value of the land -- recognizing that B.C.'s land will represent six times on a per capita basis the settlement in the Yukon -- how the minister can square anywhere near 5 percent, based on the Yukon experience.

Hon. J. Cashore: I think that some of those calculations are interesting, but they bear scrutiny because the 2-point-whatever percent that the hon. member has referred to as the aboriginal population is not accurate. It's greater than that.

The situation is a bit confusing, because in the treaty process there are the negotiations around enrolment which do not subscribe to the Indian Act definitions of who is enrolled. So I think the characterization of those relationships and those figures is open to a great deal of question.

J. Weisgerber: Being as generous as I possibly can, if indeed the numbers were twice what the figures shown in the federal government's own statistics are, the agreement in British Columbia as capped by the minister would still be three times as generous in terms of a per capita percentage allocation -- and in terms of dollar value, many times that. I want to raise these points, because I think those people who read and consider the Hansard record of these debates, who are interested in this issue, may well want to go and look at these Yukon agreements and start to consider British Columbia in the context of a very recent, very current undertaking that's happening in a jurisdiction adjacent to British Columbia.

My final question, recognizing the time, is one around self-government representation. There I took a look at the Nunavut territory agreements. There, as in the Nisga'a lands, the vast majority of the people living on those lands are aboriginal and are indeed treaty. Yet the Nunavut territorial government structures are open to everyone who lives in the territory, regardless of race. I wonder what the minister's thoughts are and why he would think, again, we would negotiate an agreement differently in British Columbia, under circumstances that are at least similar, if not very similar, here in British Columbia.

Hon. J. Cashore: That's apples and oranges. The Nunavut is a territorial government, and it is in a different category altogether. On the question of the comparison between the Yukon and B.C., I would just make a comparison between the Yukon and the Nisga'a agreement-in-principle. In the Nisga'a agreement-in-principle, the amount of hectares per person is 35.4. In the Yukon, it is 639.7.

M. de Jong: I had a line of questioning for the minister relating to the issue of ratification, if and when we find ourselves in that happy position to be able to take a final product treaty, be it Nisga'a, Sechelt or some other treaty relating to other negotiations. I know that the AIP provides for a mechanism, and it is well understood that the Nisga'a themselves will take an agreement to their people. There is a formula which they must satisfy in terms of achieving support.

The province has undertaken to ensure -- and the minister can confirm this yet again -- that the treaty will be debated in the Legislature. As we entertain submissions from people across the province, a couple of themes emerged. I'll begin with one, and that is this notion that. . . . People believe that these treaties will affect their local areas in different ways, some positive, some negative. But one of the themes that emerged was the hope that their representative in the Legislature would have an opportunity to speak freely and unconstrained by the discipline of party on a matter that is of such fundamental importance and that will really chart the course for the shape our province will take into the next millennium. Is the minister prepared to consider that a vote on the first modern-day treaty in British Columbia should take place on a non-partisan, or what we would traditionally refer to as a free-vote basis, in the Legislature?

Hon. J. Cashore: I'm not going to answer that question.

M. de Jong: I'm not sure I understand the minister's reluctance to engage in a debate that would focus on the ratification process.

I could, I suppose, go to the next theme that emerged around this subject, and that was the submissions we heard from numerous people who advocated the province submitting its first treaty or proposed treaty to a referendum exercise. Unless something has changed, I understand that the province rejects and this minister rejects any notion of referendum on a treaty-by-treaty basis. Is that correct?

Hon. J. Cashore: I have indicated in the past that I don't think that's a practical solution to a ratification process. I do realize, as I've been following it closely, that there have been recommendations coming to the select standing committee, which I will be reviewing.

I want to make it very clear in not answering that question that I am not in a position to answer that question at this time. I want to be able to review the information that comes in through the select standing committee process and give it some thought, as I will to each and every recommendation that comes in there, but I'm not prepared or willing at this time to enter into taking a position on that.

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M. de Jong: I appreciate that the minister could have but did not adopt that position on just about any one of the numerous issues that we canvassed over the past number of days.

I think what concerns people most of all -- and by this I mean non-aboriginal people in the province -- is that they have the confidence of knowing that their representatives at the table are acting on a firm set of instructions that is not going to be influenced by changing political considerations -- that they know what it is their representatives are negotiating.

One of the mechanisms that may be available in terms of legitimizing a process. . . . I know the minister might react strongly against that word. I think the treaty negotiation process has acquired a great deal of legitimacy, but not enough. There are still people who harbour, in my view, great doubts and great fears about where the province and the government in particular intend to take this exercise. To deal with that uncertainty to the extent that it remains, it has occurred to many that some next step, some final and ultimate step of public involvement, is necessary.

The minister might say, and he might even get my agreement, that to inject a component of referendum ratification at the last minute would be unfair to the other parties at the table -- in particular native participants. But there is a sense that the public need to be connected at a level that says: "These are our negotiators. We approve of the principles they are taking into negotiation." A referendum or a reference to the public at that level may have some value. I don't think it's an issue that the minister has to be shy about confronting, notwithstanding that it is something that came before the select standing committee. I'll let the minister respond.

Hon. J. Cashore: I'm not shy at all about confronting that issue. It's an issue that I seek to review, based on the recommendations that do come in. So that's about all I have to say about that.

Having said that and noting the time, hon. Chair, I would like to move that the committee now rise, report progress and ask leave to sit again.

Motion approved.

The committee rose at 5:48 p.m.

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