[ Page 3663 ]

The House met at 10:05 a.m.

Prayers.

Orders of the Day

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

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

L. Stephens: When we left the Health estimates yesterday, we were talking about the B.C. reproductive care program, and I'd like to continue in that line of questioning this morning.

The program is a provincial program, and it's mandated for optimizing maternal and newborn health care around the province. The proponents of the program are concerned that under regionalization, the program will come under the mandate of the Vancouver-Richmond health board, and that under the pressures of funding, the direction for a truly provincial program will be lost -- or the potential will be lost -- to deliver and to have the focus and the discipline around rural health care, rural obstetrics, and newborn and maternal care. I wonder if the minister would talk a little bit about the role or her view of the reproductive care program, particularly bearing in mind the needs of the rural communities around the province.

Hon. J. MacPhail: This program, just as any provincial program, while delivered via a particular regional health board, is a provincial program with provincial performance standards. The funding is protected. So the administration relationship may change, but absolutely nothing else will change. Of course, the mandate for the program remains the same, which we talked about yesterday.

L. Stephens: The funding will be protected by that. I presume that the amount of money that is presently going to the program will continue and will be targeted, as opposed to just going into the pot for the Vancouver-Richmond regional health board. Is that correct? Will there be a targeted funding for this particular program?

Hon. J. MacPhail: No. In fact, the funding won't be the same. It's almost a percent higher than in 1996-97, and it is protected. It can't be spent on anything else.

L. Stephens: The special needs of rural communities to provide high-quality perinatal care, and the realities and the expectations of rural maternity care, including those standards of care, educational competencies and credentials, and the retention and recruitment of professionals, are issues that came around the conference that was held a couple of weeks ago -- the Critical Issues in Rural Obstetrics conference in Victoria. I wonder if the minister could perhaps first talk a little bit about the quality of perinatal services. That was one of the issues that was front and centre, and that dealt primarily with the ability of the facilities to have the proper equipment in place.

As the minister knows, babies are going to be born, and women have to go to hospital facilities in order for that to happen. So while we can designate and provide specialized services in parts of the province, the fact still remains that there are going to be babies born in hospitals that perhaps don't have as much equipment as there should be. So I wonder if the minister could talk about that in particular -- the equipment and services in these sometimes remote and certainly smaller communities around the province.

Hon. J. MacPhail: The reason why our ministry helped sponsor and fully fund the forum was to receive advice on exactly these matters, and I am awaiting the final report from the conference.

L. Stephens: I'm sure that none of the issues that came forward or that will be coming forward from the conference are new. I think they are probably concerns that have been expressed on a number of occasions and in a number of different ways to the minister, or to the ministry certainly. The message that came through loud and clear for me at that particular convention was that there is a crisis in obstetric care in rural British Columbia, for a variety of reasons. One of them is that a lot of the doctors -- the obstetricians and the gynecologists, the specialists -- are aging and retiring, and with the physician supply plan in place and a number of other factors, there don't seem to be doctors coming forward to replace these specialists.

A lot of the family doctors have decided to withdraw from the practice of delivering babies, for a variety of reasons again. Some of it is insurance costs; some of it is the fact that it needs specialized training; and another issue is that because a lot of the hospitals don't have the facilities in them, the family practitioners don't feel comfortable delivering around the province.

So I wonder if the minister could talk a little bit about physician supply, the doctors, the retention of obstetric and gynecology specialists, particularly again in the rural parts of the province, and what the government may be doing to help retain these professionals in British Columbia.

Hon. J. MacPhail: I have two comments. One is that the reproductive care program board members are multidisciplinary and from all around the province, and will advise us on. . . . So I very much look forward to their recommendations as a result of the conference. Then we can certainly get into the matter of physician supply in great detail when we discuss Bill 28 in the Legislature.

L. Stephens: Let's talk about nursing staff, then, and nursing support and the maternity care in general. Many of the nurses and doctors feel that there needs to be more support for maternity and perinatal care and that there perhaps needs to be some additional training for nurses in this regard. Is there a training program? Is there a focus on perhaps upgrading nursing skills to assume some of the responsibilities that the doctors are now responsible for around perinatal care in the hospitals?

[ Page 3664 ]

[10:15]

L. Stephens: Could the minister talk about what is in place at the moment? What kind of best practices are required by nurses in rural communities in the province at this time?

Hon. J. MacPhail: A professional practice issue is an issue between the professions and the various hospitals. But the program does have an outreach education program that ensures that physicians and nurses in each of the eight perinatal regions have the opportunity to participate in comprehensive, low-cost perinatal education on an annual basis.

L. Stephens: Would the minister care to make a comment about the doctors at this point in time in the province -- some of the difficulties around retaining doctors in the province and, more specifically, the training of doctors in the province and whether or not they are. . . .? Again, in obstetrics and gynecology, have they been increasing, or has the number of those particular individuals been falling?

Hon. J. MacPhail: Again, I can make general comments, but this is a matter of future legislation that will be debated under Bill 28 -- physician supply measures. We do have a provincewide plan for recruitment and retention of physicians. It's regionally based, and certainly the physicians themselves agree that gynecology and obstetrics is not one of the areas in short supply, by any means. But this is a matter for legislation that's been introduced in the House.

L. Stephens: Could I ask the minister, then, on detailed protocols and guidelines for use in development of specific issues to the rural setting. . . ? Are these protocols that are developed by the ministry, or are they developed by the individual hospitals? What kind of provincial standards are in place, if any, for maternity and newborn care?

Hon. J. MacPhail: Certainly I don't want to short-circuit the discussion, but I also have the consensus document from the conference, where there is a brief document outlining the consensus of the participants. The conference organizers have written to me and said that they will be forwarding to me the final recommendations and the reports. I await their final report. The issue around guidelines will be included in that.

L. Stephens: I presume that the minister, when she receives the final report and recommendations, will be acting on those recommendations. One of the issues that will likely be coming forward is the risk management strategy. That was one of the issues that was talked about. What is the current state of the risk management strategy for hospitals and for maternity and newborn care? Is there an issue that. . . ? In rural obstetrics in British Columbia, what are the specific risk management protocols?

Hon. J. MacPhail: The physicians have a risk management protocol that's developed with the BCMA, the College of Physicians and Surgeons and the hospitals, in association with the Ministry of Health. Then there is a risk management society, as well, that funds the doctors and determines liability, and also the strategy in place to implement the risk management.

L. Stephens: I would just like to make a further comment around this, and that's about nurse practitioners. The federal government has a number of nurse practitioners around the province, particularly in the northern isolated parts of the province. Is there any recognition that perhaps RNs and those with their degrees could be retrained, or certainly have their training furthered, to give them a nurse practitioner status in order to provide some of these services in the outlying parts of the province where perhaps doctors are in short supply -- and make sure that that kind of health care is available to people in rural areas and in the more isolated parts of the province by using nurse practitioners as opposed to medical doctors?

Hon. J. MacPhail: There is a desire on the part of our ministry to ensure that the people who are best able to deliver services do. This is a professional issue that the RNABC is examining right now, in terms of what levels of education are needed to deliver what services and who is best able to deliver those services. So those discussions and an examination of the issues, which would incorporate the hon. member's point, are going on right now.

L. Stephens: Perhaps we'll move on to another issue, and that's teen pregnancies. They are an issue not just in the lower mainland but in the north as well. That was one of the areas that they reiterated time and time again. Some of the populations have a very high teen pregnancy rate. In this year's budget, is there a particular program or policy that is moving forward to try to deal with teen pregnancies in the province?

Hon. J. MacPhail: Yes, there is funding in place. But again, this is the responsibility of the Ministry for Children and Families. I'll make sure that this minister knows that this question is coming.

L. Stephens: Just to get this straight. . . . Because we've got a new Ministry for Children and Families now, it's difficult to know where the programs start and end for this particular ministry and also for the Ministry for Children and Families. I want to talk about fetal alcohol syndrome and FAEs. I wonder if the minister could indicate whether that falls under her ministerial responsibilities or perhaps under Children and Families.

Hon. J. MacPhail: What we really have tried to do as a government. . . . If the program deals with children under the age of 19, we have tried very hard to make sure that the program is under the Ministry for Children and Families. I think we're almost completely successful. I use that just as a guideline for the hon. member. For instance, the programs for fetal alcohol, FAE and FAS, are under the Ministry for Children and Families.

L. Stephens: When we get to that particular ministry's estimates, that's one of the issues that we will want to talk about with that particular minister.

About two years ago, there was some talk about testing the labelling of liquor bottles. I wonder if the minister could fill us in on what is happening. Is this program still going forward? What has happened to it?

Hon. J. MacPhail: I know that my predecessor -- and I think even I did this in my initial days as minister -- wrote a letter to the federal government urging them to proceed with this policy. Labelling, because of the nature of the industry, 

[ Page 3665 ]

requires federal action, and our government has urged the federal government to proceed with the warning/advisory labelling on alcoholic products.

In the meantime, though, we also have a provincial policy, where we advise residents directly about the harmful effects of alcohol consumption during pregnancy.

L. Stephens: I believe the federal Parliament does have a bill on the table at the moment -- or it did. I would suspect it's coming back, and I believe it was in committee stage. That is exactly what they're talking about.

My understanding is that in 1993, I think, there was an amount of $65,000 in the provincial Health budget to develop a pilot project around liquor labelling, to serve as sort of a national pilot project for when the federal legislation is enacted. That particular line amount disappeared from the '94 budget figures. Is there an appetite for the government, for the Ministry of Health, beyond what the minister has said around some educational information that's available on the effects of drinking and pregnancy. . . ? Is there going to be a more focused, more highly developed education campaign -- perhaps in the schools, perhaps in the newspapers or whatever -- around the dangers of this particular illness and disease? It is preventable. Again, this is another one of those 100 preventable diseases, and they cause huge costs not just to our health care system but to our educational system and to our justice system. So I think this is one of the issues that perhaps the minister should really focus on, because it is 100 percent preventable.

Hon. J. MacPhail: Again, across government there are initiatives that the liquor distribution branch funds. That works very closely with, and will continue to work with, our health authorities. The municipalities have their own system, which I have seen as very active across the province in terms of warnings. Again, we will pursue the initiative federally, as well.

L. Stephens: I wonder if the minister has any idea of what the costs are to the health care system of fetal alcohol syndrome and fetal alcohol effect, and the treatment of these illnesses.

Hon. J. MacPhail: Again, these are questions that are appropriate for the Minister for Children and Families. Certainly we do have programs in place, such as at Sunny Hill Hospital, specifically for fetal alcohol effect and fetal alcohol syndrome. But there are societal costs that are much beyond the health care system. The costs for education end up to be much more in the corrections system, the day care system and the special needs system.

L. Stephens: This is a subject that we can talk about for quite some time, but I understand, and I hear the minister saying, that it's an issue for and a responsibility of Children and Families. However, Health is still a huge part of this particular problem, and the costs do come into the health care system, particularly around newborns and the further effects of alcohol consumption on mothers and babies. I just want to say that this is an issue that I think the Ministry of Health has to come to grips with, as well, and not just the Ministry for Children and Families.

Having said that, I want to talk a little bit about some of the issues in my constituency. The minister has heard these comments before. The first one that I want to reiterate is that the South Fraser Valley region is, per capita, underfunded. I know the minister has said that there's going to be some relooking at the funding formula that is happening there. Again, it's a very fast-growing region, as the minister knows. We have some multicultural issues that need to be addressed, and there are a lot of different issues in our region that make it in need of adequate funding and certainly equitable funding. That's really all we're asking for -- that our particular region receive the same per capita funding as the other regions.

We have some capital projects that we've been waiting for: the Maple detox centre that has been slated to move into the hospital for some time now. I wonder if the minister could give an update on the Maple detox centre -- what is happening there and when we can expect to have something happening on that particular issue.

[10:30]

L. Stephens: For these questions, I will wait until we move into the capital projects, then.

I have just one final question, and it's back to fetal alcohol syndrome for one moment. Does the ministry know how many babies are born in their hospitals with fetal alcohol syndrome and fetal alcohol effects? And does the ministry know how much it costs per day to treat children with fetal alcohol syndrome or fetal alcohol effects?

Hon. J. MacPhail: If the baby is diagnosed at birth with FAS, yes, we will be able to get that statistic. If not. . . . The diagnosis often occurs substantially after birth time. We can get that stat for you, but it would be a diagnosis at birth that we would have.

G. Robertson: Hon. Chair, I ask leave to make an introduction.

Leave granted.

G. Robertson: In the gallery this morning are a number of grade 7 students from the Fort Rupert Elementary School in Port Hardy -- a great place in northern Vancouver Island. There are a number of adults accompanying this group, as well as their teacher Mr. D'Arcangelo. I would ask the House to please make them welcome.

L. Stephens: I would like the minister to commit that in fact we will be able to receive the information on the number of children in the hospital and the amount of funding that is required for the care of children with fetal alcohol syndrome and fetal alcohol effects.

Hon. J. MacPhail: This matter will be addressed in the provincial health officer's report. But let me give you a preview of what it is, and I think it's what the hon. members are aware of. There are difficulties in diagnosing FAS, and it is not easy to obtain an accurate measure of the number of FAS births. In fact, the provincial health officer reaches the conclusion that an objective or target with respect to FAS is therefore not advisable to be included in a report. But what information I can get, I will make sure that the Minister for Children and Families provides it to members.

[ Page 3666 ]

V. Anderson: Last year in August we were talking about healthy families in the report and in estimates. Just to review the minister's comments at that time would be my beginning comments. In an answer on August 15, 1996, the Hon. J. MacPhail said:

"The point the hon. member makes is a legitimate one, where he is actually distinguishing, I think, between healthy people and health care. That makes sense. Healthy people require a greater input than just the health care system. . . . Our lives over the past few years would certainly indicate where we have come together in the area of social services, and it is absolutely the case that a much broader system than just the health care system is necessary to maintain the health of the population.

"Let me just try to give the hon. member reassurance, though, that the contemplated transfer of spending authority from Healthy Communities to the regional health boards will in no way affect Healthy Communities programs. The future of Healthy Communities, the community basis of those programs and the broader community input beyond just the health care professions will in no way be affected by the potential transfer of authority. But let me also reassure the member that the importance of community programs that go beyond health care delivery is also being assessed by the regional assessment team. Your comments will be added for their consideration."

Hon. J. MacPhail: In all community health programs, the funding was increased by 5 percent. So our commitment is to increasing funding for community health programs. The Healthy Communities programs have been transferred to the regions. It is the regions' responsibility, just the same way that it is in every other program we've discussed here -- that there be performance audits and standards set and that those standards be met. We've had those evaluation discussions over and over. The Healthy Communities projects are transferred to the regions, and I'm totally confident that the regional health boards and the health authorities are going to be using their best judgment in evaluating the programs within their boundaries. I also know that some health authorities are already pursuing joint partnerships with other groups around the issue of Healthy Communities programs.

V. Anderson: As the minister is aware, the World Health Organization has encouraged the development of this Healthy Communities program. Also, the Canadian strategies and Healthy Communities have likewise been part of this program. So it's a national and international network of healthy communities activities, which has been very important.

Would the minister indicate how she feels that we will continue to be a part of the national and international networks of healthy communities, as kind of an overall process? I think it's important that we maintain our links with these national and international programs, as well as with our local programs.

Hon. J. MacPhail: As I'm sure the hon. member is aware, the Healthy Communities project, which was introduced in 1990, was to ensure that the World Health Organization initiatives were given seed money here to help communities set up these programs through the municipalities. And now that responsibility for the continuation of the network and the good work done is not only the responsibility of the municipalities but of the health authorities as well. I have certainly not had any fear or alarm raised by anyone that somehow our western world status in this area will change at all.

V. Anderson: I'm wondering how the minister can explain to us in working with the UBCM, for instance, on. . . . The municipal areas are very much involved in the Healthy Communities project. Has there been any discussion with the UBCM regarding the Healthy Communities concept as a process that the government is willing to encourage as a network across the province? Part of what I'm trying to get at is: what is the overall provincial interaction process when it's devolved down to just regional districts and regional areas?

Hon. J. MacPhail: Well, there is a health subcommittee of the UBCM that we work very closely with. Indeed, these discussions are ongoing in our relationship with the Ministry of Municipal Affairs in working with B.C. communities to support all sorts of projects that improve the quality of life of British Columbia through Healthy Communities programs. That's an established working relationship that continues.

V. Anderson: I understand the minister saying that that's an established working relationship, and I'm aware of that. Could the minister indicate, though. . . ? I'm still trying to get a feeling of what the minister's commitment is to the Healthy Communities process. Part of the strength of that process is that there was an overall very limited provincial coordinating body and committee, with a great many volunteers involved, that helped the individual regional programs or municipal programs to coordinate and tie in with each other, and to develop the process and the educational and philosophical programming skills that are available. What I'm trying to understand is how that overall coordinating, assisting, consulting body will be available for the regional activities.

Hon. J. MacPhail: Well, in fact one could argue that we're making our whole health care system a Healthy Communities program by transferring the responsibilities to the local and regional level. I have encouraged the health authorities to form a provincial health association to decide how provincial networks will be in place to deal with local community-funded programs. But the comments that I made in 1996 are the same as they are now: Healthy Communities will be the responsibility of the regionalized health authorities. Our government has made a strong commitment to moving our resources from acute care into community care, and the regional health boards have been given that directive. I see nothing but a positive uptake by the regional health boards and community health councils in this area.

V. Anderson: I'm still trying to get the place of. . . . I understand that in some areas, in tertiary care and other areas of concern across the province, the ministry will still be taking a leadership role where the Closer to Home. . .the local health units will be dealing with community programs. But with those programs that go right across the province in tertiary care, which may be administered in part by certain local areas. . . The ministry will still be taking direction and giving guidance in those overall programs over the local community ones. It's in that context that I'm trying to clarify where this kind of program would exist.

[10:15]

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delivered by the Healthy Communities program will now be part of the overall mandate of the regional health boards and the community health councils. I've already explained to you how I've asked those groups to come together in an organized way across the province.

I assume the member isn't wanting me to go through the tertiary care programs again, which we spent almost a week on. I assume the answer that he's asking for is just around Healthy Communities. The responsibility for these types of programs and the evaluation and continuation of these programs are the responsibility of regional health boards and community health councils. We also have a B.C. Public Health Association that takes an overall provincial approach to the delivery of public health programs and that will work closely with the health authorities.

V. Anderson: I understand the minister's comment. Part of the evaluation that was done on behalf of SPARC -- Social Planning and Research Council -- about the Healthy Communities policy across Canada. . . . I will quote, just briefly: "The national evaluation of the strengthening community health program strongly endorses the potential of an intermediate structure in the form of a provincial healthy Community steering committee." All the way along, evaluations seem to have been done in Quebec and other places that have indicated that in order to strengthen the Healthy Communities program, there needs to be a central, provincial, supportive steering committee. I am asking about that kind of provincial focus, as well as, and not as a substitute for, what the minister is talking about within the regional areas.

Hon. J. MacPhail: I think my previous comments stand on how I described this program moving forward.

V. Anderson: May I ask: has the minister -- I presume they're giving some guidelines, emphases of importance and direction to regional boards -- given any guidelines to regional health councils as to the place and possibility of their being able to use Healthy Communities? Has the minister given any support and direction to help how this movement may become a part of the program that regional committees are undertaking?

Hon. J. MacPhail: Again, I have discussed at length our emphasis of moving from acute care funding into community health funding. Certainly, as the hon. member knows, the Healthy Communities program was a very small portion of the overall community health program that our government has in place. I also indicated that over the course of the last five years we've put a half a billion dollars more into community health funding.

The direction that the ministry and I have given to health authorities is: community health is the way to go, and if there's going to be any shift in resources, it will be from acute care into community health funding. The health authorities will do that in the overall context of all community health programs, including the Healthy Communities initiative. That was really a program that was very much one of providing municipalities with seed money to look after their own local health determinants. In fact, we've gone much beyond that by regionalizing and putting in place, on a community level, the whole health care system.

V. Anderson: With that, I would move to the area of multicultural. . . .

S. Hawkins: Val, I've got some questions. I have some questions on the Healthy Communities initiative, as well. I understand that this initiative was already regionalized. Is that correct?

Hon. J. MacPhail: I'm not clear on the question. The proposals came from communities via the Healthy Communities program. They're community-initiated.

S. Hawkins: Yes, I understand that they came from municipalities, but the municipalities were arranged in a region, so there was a southwest region and the Thompson-Okanagan region -- whatever. I understand that the grants came to the regions via. . . . The grants flowed through different societies that managed the money for the Healthy Communities program. Is that the way it ran?

Hon. J. MacPhail: Again, this is a matter for Public Accounts, but I certainly don't mind going over it very briefly. The contracts were managed through the population health resource branch of the ministry. Some were dealt with through societies, and some went through public health units. There was a variety of mechanisms by which they were held.

S. Hawkins: It's encouraging to hear that this initiative will be continued. I know the minister is looking at ways that that money will be used effectively. One concern that was raised with me was that in one of the regions -- and I'll use the specific example of the southwest region -- the money flowed through the B.C. Public Health Association. The public health association, from my understanding, basically just collected the money and then wrote the cheques with which the initiatives were to be implemented.

They took an administration fee of 10 percent or more. So if there was a $250,000 grant, they took 10 percent of that in administration fees. I believe there was discussion between this region and the ministry, through the population health resource branch, addressing this question -- and not to their satisfaction. When the communities want that money for their initiative and they feel that the money is just flowing through an account with basically very little administrative service given to it, they wonder why it needs to go through that. Is that going to change when it goes to the regions, or is it still going to flow through an account like that and have an administration charge tacked onto it that really doesn't benefit it and takes away from the Healthy Communities initiative?

Hon. J. MacPhail: Again, I'll just reiterate that all funding for Healthy Communities is the responsibility of the health authorities now. The health authorities will decide what their priorities are. We're out of the business of it at the Victoria level; in fact, the population health resource branch doesn't exist anymore. We've rationalized our own services because we've regionalized these programs. So if a health authority continues a program, they will do so without an administrative charge to the provincial ministry.

S. Hawkins: Then let me get it clear in my mind. The money now goes straight to the regional health board; it doesn't flow through an account -- through something like the B.C. Public Health Association. The regional health board will get that pocket of money and dole it out through applications for Healthy Communities.

Hon. J. MacPhail: I've answered this question three times. The health authorities will be responsible for determining 

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in their best judgment what programs continue. If the programs continue, they will fund them. It's now been regionalized. It's the responsibility of the health authorities.

S. Hawkins: What I'm trying to bring to the minister's attention is complaints about waste in the system. If the money is going to flow through these accounts, it's not going to the initiative that the community wants to fund. There have been complaints to the ministry that there have been excessive administration charges -- $21,000 or $28,000 for an agency that's just cutting cheques. People have been trying to find out what they do for that money, and they haven't been able to find out. That's what I'm bringing to the ministry's attention. We're getting concerned people asking us to help them to find out what they do for that money. If that money is now going to regional health boards and they're going to continue on with the process the way it is now, then that's what I'm bringing to the ministry's attention. Would the minister please find out how that's being administered and perhaps give direction to the regional health boards that maybe there needs to be a streamlined process? They can manage that money and not run it through an account for someone to charge $21,000 or $28,000. That's all I'm asking. If the minister can commit to doing that, then I will assure these people that the ministry is aware of the problem, that they will advise the regional health boards. Hopefully, they'll get their grants in the full amount rather than having excess taken off for an administrative charge which. . .they don't know where it's going.

V. Anderson: Just for the record, if I remember correctly, it was the previous Social Credit government that initiated the Healthy Communities program in British Columbia. So it wasn't initiated just from the municipalities. It was part of a World Health Organization initiative, and it was part of an initiative which was Canada-wide, under the special health committee programs across Canada. It was the Socred government that initiated it, and municipalities were able to cooperate with that program. I find it interesting now that this government, the NDP government, does not have the same kind of commitment and initiative on the international and worldwide scale that the previous government had. I just find that strange, so I have to make that comment.

At the same time, I hear the minister making the comment that it's now up to the regions, and she was very emphatic about that. Subsequent to that comment, I'm asking if the minister is now saying that the provincial government no longer cares or has responsibility for what goes on in the regions, that whatever they do is fine with it -- if they all do different things, that's fine -- and that there are no standards, directions or guidelines coming from the provincial government. What I'm trying to get is the difference between everybody being on their own, on one hand, and on the other hand, the government directing and telling everybody what to do, which was the case for many years in the province. What's the difference, and what kind of a system are we in now? What kind of interactive process is taking place?

Hon. J. MacPhail: When the hon. member has read the last two weeks of Hansard, I'd be more than pleased to answer any subsequent questions that arise out of that. We've discussed that exact issue for the last two weeks.

V. Anderson: I have listened, and I have gone over Hansard. I understand the minister is saying that she refuses to answer any more questions in that regard, so I will move on to another topic.

Perhaps the minister will indicate whether she has discussed in full detail the multicultural policy of her ministry and her report at this time.

Hon. J. MacPhail: I'd welcome questions on it.

V. Anderson: The last report we have is the multiculturalism annual report, which was '94-95, because the other reports haven't been made available to us since that time -- if they are available. . . . But in that report there was an indication that they were exploring an interministerial. . . . This is a report from the Ministry of Health, in the Report on Multiculturalism. It says that in looking at goals and objectives, they were exploring ". . . an internal Ministry of Health committee on multiculturalism, which might, amongst other duties, assist with the promotion and implementation of multicultural initiatives within the Ministry of Health that respond to the ministry's multicultural health policy framework." Could the minister indicate to me what has happened in the development of that Ministry of Health committee on multiculturalism and what it is that they might be doing or what might be done by others in their stead?

[11:00]

The objectives that are being put in place by these agencies are to. . . . They have established multicultural change committees. They've developed a mission statement that will reflect a commitment to meet multicultural health needs. They've developed organizational needs assessment tools that include patient, staff and community profiles. They've developed educational modules pertaining to multicultural health. They've trained designated individuals from each participating agency who will ensure the provision of educational sessions targeted to all levels of their organization. They've developed a comprehensive plan for initiating and maintaining multicultural initiatives. They've established an interpreter service, incorporating the standards established through the B.C. Health Research Foundation interpreter project. They've developed an inventory of multicultural resources, and they've developed a resource manual on multicultural institutional change.

Our Seniors Advisory Council has also identified ethnic seniors as a priority population, and they have struck a task force on seniors and ethnicity. The task force showed that the top three concerns of ethnic seniors were lack of culturally sensitive care facilities, cultural isolation due to a lack of ethnic and social recreational centres, and a lack of information, communication and education about community services and programs for ethnic seniors. The council is on the verge of releasing a position paper that will include its findings regarding seniors from diverse cultural and ethnic communities.

As a result of that, the office for seniors has published a guide to programs and benefits for British Columbia, and the guide will now be expanded to include a section to assist native elders in accessing information. The guide is also being translated into Punjabi, Hindi and Chinese.

V. Anderson: I appreciate that. The minister indicated, in giving that report, that this was a two-year project -- I understand that -- and those two years are up now. Will the minister indicate whether this will be ongoing and what will 

[ Page 3669 ]

follow from the project on multicultural health? That was ongoing and has now ceased to be a project. Has the minister taken any new initiatives to follow up from the very effective and very important work that was done during that project? I have attended some of those sessions, and I was part of their windup session not too long ago. So it would be interesting to know what the future directions are in carrying on from the lessons that were learned during that project.

Hon. J. MacPhail: Again, I'll make sure I get this information of. . . . If the question is the evaluation of the project, Multiculturalism B.C. would be the evaluator of that. Our government specifically set up Multiculturalism B.C. so that we have a cross-government initiative on multicultural issues.

Again, this was a project where the work and the protocols would be entrenched in our health care delivery system. That is what has happened. There is an interministerial committee, on which Health sits, that reports to Multiculturalism B.C. But the report on the evaluation of the project would come from that agency.

I just know, from personal experience, that while there's much more work to be done, hospitals that I have visited where there's a highly diverse multicultural population are making huge strides in this area.

V. Anderson: Yes, I think it's fair to say to the minister and to appreciate that there's probably more awareness, understanding and appreciation of multicultural needs in the health care system -- and the need to respond to them -- than in almost any other sector of the community. They have worked very hard at that, and I appreciate that work.

I am still trying to find out, though, and maybe the minister has answered the question indirectly. . . . In the objectives for 1995-96, they were exploring the need for an internal committee on multiculturalism within the Ministry of Health. Was such a committee set up? Who takes responsibility within the Health ministry for the focus on multiculturalism and activities? Who carries the responsibility for interministerial committee activities?

Hon. J. MacPhail: The committee that reports to our ministry participates on the committee that reports to the AG. We also have a committee that advises the reporting-out to Multiculturalism B.C. in our own ministry. I can make the terms of reference available for the internal ministry committee on multiculturalism that then reports out via Multiculturalism B.C.; I can make the terms of reference of that internal committee available to the member. But we also fund a substantial number of programs that are ethnically based. The list of those programs and funding for those programs are available, as well.

V. Anderson: I'd appreciate getting the terms of reference, and the persons who are on the committee would be helpful, as I would get an overview of all of the different ministries and see the totality of what's happening. Often the individual reports don't really give you that total picture.

I understand the reporting form will be different for Multiculturalism this year than it has been in the past. It was almost a standard report for every ministry, and it didn't give you the individual things, although the ministry did say some very interesting things.

I'm wondering about one particular. . . . Could the minister comment? They report in their report: "BCCDC's systems division is making provisions within WordPerfect and Labs systems to communicate in different languages, as well as in different scripts, such as Greek, Cyrillic and Hebrew." Can the minister indicate if she has knowledge of what was reported and if she knows if that has developed or what has happened as a result of that?

Hon. J. MacPhail: You're talking about the B.C. Centre for Disease Control and their information systems being culturally sensitive -- is that it?

V. Anderson: I was just going by the report of the ministry: "BCCDC's systems division is making provisions within WordPerfect and Labs systems to communicate in different languages, as well as in different scripts, such as Greek, Cyrillic and Hebrew." This was in the report for 1994-95. I was asking for future information about the nature of that and what has developed as a result of it. I'm just going from the Health report itself.

Hon. J. MacPhail: I'll get that information.

V. Anderson: Thank you, and I'll appreciate getting that information and the programs that have been sponsored.

The minister is, I'm sure, aware of the multifaith calendar, which highlights. . . . I would like to offer her a copy of it and make sure she can share it with her ministry and perhaps encourage others in her ministry in the multicultural programs to make use of the multifaith calendar. I'd be happy to make that available to the minister.

Hon. J. MacPhail: Thank you, but I'm not going to share it; I'm going to use it myself. I'll let them look at it, but I love that calendar.

V. Anderson: Changing topics for a moment, hon. Chair, I want to just comment briefly about the inaugural health plan of the Richmond health board. I noticed the minister showing this yesterday in the House -- at least one with a cover similar to this. The comment that I want to make is just a general comment at this point. We'll perhaps come back to it in more detail at another time. The inaugural health plan summary particularly focuses on the reports that have come in from the community about the health system in Vancouver. In reading the summary, more so than when you read the whole plan, the conclusion that you draw is that we have a sick system. When I was discussing that with members of the health council as I attended their meeting last Saturday, they reflected that when they asked the community at large what the gaps were and what the needs were, this is what they put forward, and properly so. So what we have in the summary are all of the things that need to be done and very little -- in fact, nothing at all -- of what is being done that is positive. So instead of saying that it's a sick system, it's a system in which there are many illnesses to be corrected. I just wanted to make a general comment on that.

I was also interested in discussing with them that in putting the plan forward, what they struggled with was to be able to maintain the style and framework and wording of the people of the community, rather than putting it in a more organized, bureaucratic kind of fashion. I want to commend them for doing this and being able to maintain the actual feelings and hurts and undertakings of the people in the community itself. I want to say that in that attempt, I would encourage them to continue in that vein and hope they're able to continue to do so in the future. As to the other questions and comments, we'll probably come back at another time.

[ Page 3670 ]

B. Penner: I'm going to be raising a matter today that I believe is of some considerable urgency, which I think needs to be addressed by the Minister of Health and her staff. Last week we were discussing issues pertaining to mental health, and I realize that there was some extensive discussion about that. Since that time, however, I've been contacted by a constituent of mine who is facing an imminent crisis in the family, because one of their family members is mentally ill.

Specifically, I was contacted by a woman whose brother is 37 years of age, has been mentally ill for some time and occasionally has violent episodes. He has epilepsy and requires daily medication. Without medication he has grand mal seizures, which, as the minister will know, can cause further brain damage. Over the past number of years he has been in the care of various homes sponsored by the Ministry of Health and has gone from one home to the other. In recent times there has been an increasing number of problems, and he has been thrown, essentially, from one facility to another. It now appears as though he is coming to the end of his rope. Accordingly, so is his family, who is very concerned about him. He needs to be in the care of a facility that gives enough attention to make sure he takes his medication. I'm told that he takes his medication willingly but is not able to look after himself sufficiently to administer the medication himself. He needs someone to do that for him.

[11:15]

Prior to going to the CRESST home, because there was no other facility that would take him, he was staying at the Lookout home in Vancouver, which as I understand it is primarily a shelter for the homeless. They are not specifically equipped or trained to deal with the mentally ill. When he was at the Lookout home, he got into more problems because he was not receiving his medication on a regular basis, and he was arrested by the police under the Mental Health Act for his own safety.

Psychiatrists have recommended a number of things to try and deal with the situation. Specifically, I'm told that they recommended a six-week program called the behaviour program, which used to be run out of Riverview Hospital. I'll certainly take a correction from the minister if I'm wrong on this, but I'm told that this program is no longer available to anyone anymore, presumably due to budget cutbacks. The alternative. . . . The people who deal with this gentleman have suggested a facility known as Terrace house in Vancouver. However, they are also apparently unable to deal with this troubled gentleman due to a lack of funding at that facility.

Last week when I raised some issues generally pertaining to mental health, I expressed my observations or my suspicions that perhaps the pendulum has gone too far in terms of reducing the number of beds available to those who need intensive treatment while mentally ill in favour of integrating people into the community.

I go back to the matter of urgency. The family feels that they are at their wits' end. On Monday morning at 1:40 a.m., they received a phone call from, I believe, the New Westminster police, who are once again having to deal with this gentleman. They phoned his next of kin, the family, who are his legal guardians and have power of attorney over his affairs. I've spoken to the family. They have given me their blessing or their permission to raise this matter in the Legislature and to provide whatever details are necessary to try and get some attention focussed on this matter. I look forward to hearing what solace, if any, the minister can offer to the family. Perhaps her staff will have some suggestions to this family about what they could do about someone who they obviously love very much but who they themselves are not able to deal with due to a lack of sufficient training.

[F. Randall in the chair.]

Hon. J. MacPhail: I would be more than happy to have the details communicated to my office, and I will assign the appropriate staff to look into this matter. I certainly empathize with the family's concerns as the hon. member has outlined them. I think there is a way that we can deal with the concerns raised by the family in an appropriate way that actually allows us to investigate and assist. I look forward to receiving the details in writing from the member.

M. Coell: I seek leave to make an introduction.

Leave granted.

M. Coell: I have a guest in the gallery this morning who is a student in grade 8 from Bayside Middle School in Brentwood in my riding. Steven Fissel is here with the idea of checking out a political career. He's going to be with me for the day and asked to come and see the House. Would the House please make him welcome.

K. Krueger: We have a severance issue in Kamloops around the former CEO of Royal Inland Hospital, and I'd like the minister's comments on the status of that matter, if she would, please.

Hon. J. MacPhail: I understand it's before the courts.

K. Krueger: I know it's before the courts now. The minister and I had some conversations wherein I was hoping to head off this expense for the system. I wonder if we could get a ballpark figure as to how much the ministry has set aside to pay severance packages as a result of the regionalization of health care.

Hon. J. MacPhail: I reported about two weeks ago, I guess, in my estimates that so far we've paid out around $95,000 in severance costs. And direction has been given across the system, with a concerted plan of action, to absolutely minimize severance payments.

K. Krueger: But my question was whether a reserve amount has been established to pay for the inevitable payments. A lot of these situations are in the courts. There are legal costs for that. There will ultimately be settlements, and I'd like to know what the ministry's prediction is.

Hon. J. MacPhail: No, there has been no reserve money. There's no money set aside.

K. Krueger: I'm informed that recently the Royal Inland Hospital took over laundry services completely, which had been 

[ Page 3671 ]

contracted out to private sector laundries up until a little while ago. I'm wondering if this is a direction from the ministry or just a local decision.

Hon. J. MacPhail: I didn't give the direction, so I assume it's a local decision.

K. Krueger: Staff in one of the extended-care facilities in our region recently told me that their management had decided to try a new approach to make staffing stretch better, whereby they would change the order of residents' days and oblige some residents to wake up and begin their day later than they naturally did on their own or than people normally do. So you might start your day at ten in the morning or you might start it at noon. They would try to stagger the time that patients were awakened and dealt with throughout the day in order to make the staffing level constant rather than staff up for the times when people are normally awake. I wonder if that would be a local pilot project or just at that particular facility. Has there been any ministry direction to attempt that sort of experiment with people?

Hon. J. MacPhail: Why do I get a sense from the Liberal opposition that we're just stalling for time here, in terms of these issues being brought forward in estimates, where there are matters to be proceeded upon? Why do I get a sense that this opposition is sitting here stalling for time? That is a question that you can ask your local hospital. There is no ministerial directive, and I'm sure the hon. member knew that when he asked the question.

K. Krueger: Well, as I understand it, the opposition asks the questions, but I'll answer that one. I don't know why the minister gets that sense, but a lot of things that happen in British Columbia right now don't make sense locally -- don't make sense to local people. There has certainly been huge intervention on the part of the ministry. The whole system has been turned upside down. There's been huge expense as a result. Certainly the minister recognized that when she stopped the regionalization process as it was and then started over again, although she essentially reappointed the same people, of course, in our region.

We have legitimate cause to ask at what level these decisions are taken, hon. Chair, because we can't necessarily get answers locally. A lot of the people who are in the positions now haven't been in them very long. It's not terribly clear to us, necessarily, why they were appointed. Clearly they're getting some kind of direction. The whole process is still relatively new, and I certainly have no interest in stalling anybody or wasting anybody's time. But I have concerns from constituents, and some of the things I hear are disturbing. People are entitled to answers, and I think a good place to start is in the estimates debate. That's my answer. I don't know why the minister has that sense, but it's not a valid sense.

Next I want to ask about the issue of waiting lists. It seems impossible to me that anyone in this Legislature could think that it's appropriate for anybody to be on a waiting list when they need care for cancer or heart problems. I'd like to know if the ministry has any plan to eliminate waiting lists in those key areas over the next short while.

Hon. J. MacPhail: Hon. Chair, maybe I could seek direction. Are we now approaching the discussion of waiting lists? Are we doing that now? Should we bring in the appropriate staff? Is there direction from the opposition on that?

K. Krueger: Hon. Chair, I'm asking it. I'm concerned about it for my area. Whether everyone concerned is ready at this moment, I don't know. If the minister would like to wait and if specific staff are required, then it would make sense to wait, and I'll ask the question again later.

The same approach may apply on the next question, although I think the minister has a personal familiarity with these capital projects. There are several capital projects that are on hold in my constituency and the neighbouring one. The minister dealt with the Clearwater multilevel health care facility in estimates the other day because we were dealing with seniors issues, but I would like to know the status of the psychiatric unit planned for Kamloops.

Hon. J. MacPhail: Under Riverview I did discuss that the Riverview replacement centres were on stream as planned, and an announcement will be made shortly about the details of that. The psychiatric facility in Kamloops is part of the regionalized replacement facilities for Riverview.

K. Krueger: The second facility I'd like to ask about is the Royal Inland Hospital emergency ward upgrade. I toured this ward recently, as well as the radiology area, and it really is pathetic the way people have been shouldered aside by equipment. Equipment has taken the place of where beds used to be. Patients are actually lying in hallways with very little privacy and being dealt with on an emergency basis. That's no way to treat people in British Columbia in 1997. Again, I would like to know if the minister can give me any assurances as to when that project will proceed.

Hon. J. MacPhail: As the member is well aware, the overall capital plan has been under review, and announcements about details of projects proceeding will be made shortly.

K. Krueger: The people in Barri�re who worked hard on the community health council that was appointed there and then were abruptly fired tell me they've never really had an invitation from any of their replacements or the ministry itself to sit down and talk about the results of all the hard work they put in. They're tremendously offended. They didn't end up with even one appointee on the regional health board. Although I think I know what the minister's answer will be, I'd like to hear it: why would one community the size of Barri�re be excluded from a regional health board when a number of other communities clearly were carefully included?

Hon. J. MacPhail: Yes, the hon. member's quite right that we have discussed this issue at length. But I'll certainly bring to the attention of your own regional health board, if the hon. member doesn't feel comfortable doing it, the feeling of exclusion by the community and ensure that the community's views are sought.

K. Krueger: I made the valiant effort to have the regional health board reconsider its costly decision with regard to the CEO of Royal Inland Hospital, so I have no confidence that the regional health board is paying much attention presently to what local MLAs have to tell them. That may be part of the settling-in process.

[11:30]

[ Page 3672 ]

organisms. Of course, cryptosporidium and beaver fever, or giardia, are issues in the interior right now, things that people are concerned about. This is really a two-part question. What is the minister's position on whether or not the health units pay this cost of water testing for municipalities? Secondly, what provision is there to ensure that this sort of decision isn't taken in isolation so that water goes untested when people are relying on it?

Hon. J. MacPhail: The safe drinking water regulation requires water purveyors -- in this case, the city -- to provide safe drinking water, and the water quality must meet legislated bacteriological standards. So the job of the Ministry of Health is to do an audit of those standards. It has always been the responsibility of the city to ensure safe drinking water. I'm unaware of the issue of notice that the hon. member brings up, but perhaps he could provide more details. If there was a lack of communication, I'll be happy to look into it.

K. Krueger: I have a few questions around the issue of gambling expansion. The minister and I canvassed the issue, particularly of gambling addiction, in the estimates last year. Some commitments were made and some meetings took place between the minister and me, and her staff and me. I'd like to know if the Health ministry has specifically included any budget in its plans for the additional -- I'm not talking about the cost of assessing and treating addicts -- actual cost to the health care system of increased health problems in British Columbia as a result of gambling expansion. Has any specific money been set aside to anticipate that?

Hon. J. MacPhail: Our Health budget, which has increased by $300 million this year, is on the basis of need, community by community.

K. Krueger: I understand that, but my point is that every academic and scientific study that I read indicates that we will incur health problems directly as a result of gambling expansion; that there will be more people who hurt themselves, who attempt suicide, who have a whole range of stress-related illnesses. There will eventually be an increase in the number of people drawing upon the health care system -- probably throughout British Columbia, certainly in the areas where gambling is expanded.

As the Minister of Employment and Investment has projected $270 million per year increased revenues, which is 18 times -- an 1,800 percent increase -- the revenue that the province has received from that type of gambling in the past, certainly I think the Health ministry would be wise to expect an increase in costs, particularly for the types of illnesses that have been documented to us. I received a comprehensive study from the University of British Columbia's department of psychology. I've provided it to the minister's office. It lays out specifics of what we should expect. Do I understand the minister to say that no additional funding is budgeted for as a result of gambling expansion?

I take it the answer is yes, since the minister did not rise. Did the Health ministry commission any studies of its own to predict what cost there would be to the health care system in British Columbia as a result of gambling expansion?

Hon. J. MacPhail: Not that I am aware of.

K. Krueger: Well, why not?

The minister apparently has no answer. I would like her to tell me what she did as a result of last year's commitments to me that she would work to help develop assessment and treatment programs for gambling addicts.

Hon. J. MacPhail: The hon. member is well aware of our overall government policy on treatment of gambling addictions, and he is well aware that that's the responsibility of the Ministry for Children and Families.

K. Krueger: With respect, hon. Chair, I'm well aware of what the announcement was. We have an Employment and Investment minister who announced on the very day he got the gambling portfolio last fall that he was in favour of casinos, in spite of the fact that the NDP have been saying for years that the public is opposed to the expansion of gambling in British Columbia, and casinos, and who then pressed on at breakneck pace to go ahead and implement his wishes and foist casinos and gambling expansion on an unwilling public.

There are predictable costs and consequences to this activity, and this minister made me a commitment -- made a commitment to the people of British Columbia -- in estimates last summer that she would help work to bring on programs to assess and treat gambling addicts.

I didn't see anything get done, so I went to UBC and talked to experts there. We have experts there, homegrown and home-developed experts, and they are wonderful people. They have plans, and they are perfectly willing to go ahead with them. They have apparently never heard from the government, and I don't understand that. We pay for that university; the taxpayer pays for it. These are severe problems that the taxpayer is facing. The Minister of Employment and Investment is going to exacerbate those problems greatly. That's been documented to this minister.

So I am asking for the courtesy of a report on what she actually did. I know what the Ministry for Children and Families has been charged to do, and I don't understand why anyone would dump that in their laps when they already have such a struggle trying to protect children in this province and when they don't appear to have enough staff. Their staff say they don't have enough staff, and they are overworked, according to the staff, with the caseloads they have. How they are supposed to deliver a program for gambling addiction is beyond me, but obviously they have got to do it.

The Minister of Employment and Investment has said that, yes, some money will finally be channelled in that direction. This government has had a responsibility for a long time to do that and hasn't done it. So I am asking for this minister's advice about what she has done. If it is nothing, I'd like her to say so, and at least I'll know that the only thing being accomplished is whatever the Ministry for Children and Families is doing right now.

Hon. J. MacPhail: This is well outside the debate of the Ministry of Health estimates. I've answered the question. Our government has taken an overall approach to dealing with the issues of addiction associated with gambling. As a member of the executive council, I participated in that decision. I am well aware of the various initiatives this hon. member has made to various ministers, including myself. He received a very honoured position in receiving the information, in discussing the information, and that information was dealt with and explored as we put forward our government policy.

The hon. member is well aware of all of the activities that have taken place. He may disagree with them, but he is well 

[ Page 3673 ]

aware of all of the activities. And I would also suggest that these matters are absolutely appropriate for discussing in the estimates of the Ministry for Children and Families.

B. McKinnon: Hon. Chair, I ask leave to make an introduction.

Leave granted.

B. McKinnon: I would like to introduce 25 adult students who are learning about government and history. They are from the Cloverdale Learning Centre, along with their teacher Mr. Terry Teather, and will be attending the House any time now, if they are not already here. I would ask the House to make them welcome -- and if you see them in the halls, to also welcome them then.

K. Krueger: Although I hear very clearly what the minister said about another ministry being responsible for gambling expansion, there are health issues, and I am going to continue to canvass a few of those. I am going to refer specifically to a report from the University of British Columbia which I previously provided to the minister. It is authored by Dr. Julian Somers, who is in the department of psychology, and it was commissioned by Dr. Tony Phillips, who is in charge of the department of psychology.

I'll quote a few remarks from this report, starting with this one:

"The diagnostic criteria for pathological gambling have been formalized by the World Health Organization" -- this is why I think it is a health issue -- "and the American Psychiatric Association. The essential feature of this disorder is 'persistent and maladaptive gambling behaviour that disrupts personal, family or vocational pursuits.' Pathological gambling is associated with increased rates of substance use disorders, mood disorders and personality disorders. One in five pathological gamblers attempts suicide, a rate that is higher than that of any other addictive behaviour.

"A thorough scientific estimation of the costs of pathological gambling to society has not been undertaken. However, some indication of the financial and social costs of gambling can be derived from recent investigations. Among a large number of individuals in treatment for gambling disorders -- over 900 patients [in this particular study] -- 33 percent had undergone substance use treatment and 47 percent had received other mental health services. Ten percent of the sample had been arrested for a gambling-related offence in the past six months, and 58 percent reported recent absenteeism from work due to gambling.

"The effects of gambling are not limited to the individual who places a wager. A number of studies estimate that each problem gambler adversely affects numerous individuals, including family members, friends, employers, co-workers and others. The spouses of severe problem gamblers experience very high rates of stress-related illness, including hypertension, headache, gastrointestinal disturbance and backache, which are eight times more common than in the general population. Pathological gamblers provoke a reactive form of violence in their spouses, 37 percent of whom have physically abused their children. Compared with females in the general population, spouses of male pathological gamblers are three times more likely to attempt suicide."

So if we already have 4 percent of the population of British Columbia with problem and pathological gambling disorders and we're going to have more, and if the spouses of the male pathological gamblers are going to be three times as likely to attempt suicide as the general female population and eight times as likely to experience those health problems that I outlined, then doesn't the minister think it would be a good idea to at least project increased cost to her ministry as a direct result of gambling expansion? To look for some allocation of funds for that in order that the general system doesn't have to absorb those costs and make wait-lists longer for heart care, cancer care and everything else that people presently look to the health care system for? What specifically is she going to do to try to safeguard British Columbia from these many predictable negative effects of gambling expansion?

[11:45]

Hon. J. MacPhail: I've answered the question previously. I thank the hon. member for once again bringing this to the attention of British Columbians. He has done it on several different occasions. He's well aware that the way he puts the case forward is sometimes in dispute, but I thank him for bringing it forward. Certainly he uses different facts in different forms, etc.

I'm aware that he's said on the record that some level of addiction is okay. Nevertheless, I fully appreciate his commitment to the issue. He can certainly take credit for ensuring over the course of the last 11 months that our government has put in place a good program for dealing with the addictions around gambling. I'm sure the Minister for Children and Families looks forward to once again hearing the member's position on this.

The funding methodology committee for determining budgets and allocations of funds in British Columbia follows widely accepted principles for determining appropriate levels of funding in the health care system.

K. Krueger: That was a bizarre statement from the minister, and I am going to correct the record. I have never said that some level of addiction is okay. I have been asked about the official opposition's position with regard to existing levels of gaming and gambling in British Columbia. I have said that it is very difficult to roll back the clock and that certainly the experience in all jurisdictions is that once a certain level of gambling is permitted and the doors have been opened a certain width of crack, it's very hard to ever close those doors again.

With that, as I enunciated earlier, the government has already surveyed the public twice -- once in '93, once in '96 -- and has seen a perceptible growth in pathological gambling percentages of the population, even though expansion was pretty much frozen between those dates.

I have been asked by reporters what our position is about those people. Our position clearly is. . . . I worked on it all last summer in estimates, trying to get this government doing something for those people. It's unacceptable that we have that level of addiction and the consequences that flow from it in British Columbia. It's really unacceptable that this government has never done anything for them, in spite of the fact that it has been pocketing $300 million a year in gambling revenue, in income, and has caused $1.5 billion of economic activity per year around gambling in British Columbia. It's completely unacceptable.

We have never said that a level of addiction is okay. We have said that addiction is a severe and terrible problem with terrible consequences, and that it needs to be dealt with.

[ Page 3674 ]

Referring again to the UBC study, U.S. surveys conducted since 1991 report the lifetime prevalence of problem and probably pathological gambling is between 2.8 percent and 6.3 percent of the population, with higher rates in regions where greater opportunities to gamble exist. British Columbia is obviously about to become one of those. These prevalence rates are higher than those recorded in the same regions prior to 1990.

Surveys in Canadian provinces report a range of problem or pathological gambling from 2.7 percent to 8.6 percent of the population. So Canada is already showing higher degrees of problems than U.S. jurisdictions.

In Ontario, the prevalence of pathological gambling was measured at 1 percent in 1993. However, following the introduction of several new casinos and expanded bingo and offtrack betting sites, the Canadian Foundation on Compulsive Gambling -- Ontario projects that the prevalence of pathological gambling will increase to 10 percent within 15 to 25 years. So these people who specialize in this area are predicting a 1,000 percent increase in the problem in Ontario over ten to 25 years.

Will the minister, at least in future budgets, attempt to have included additional funding -- because of the problems that this government is creating with gambling expansion -- specifically to deal with the cost of the consequences that are going to flow?

The Chair: Hon. member, we're dealing with today's budget, this year's budget, not future budgets.

K. Krueger: This year's budget is going to be underbudgeted as a result of the gambling that is already going on in this province and the expansion of gambling that has already started. A projected $50 million is the government's increased revenue from gambling expansion this year. How much of that is allocated to Health?

The minister is shrugging and shaking her head, so I'll have to take that as my answer.

The Saskatchewan experience was that the initial amount set aside to deal with problems that flow from gambling expansion had to be tripled. If this province experiences the same phenomenon, is there an emergency provision whereby the minister can access additional funds rather than see other areas of the health care system shortchanged?

The Chair: Shall vote 40 pass? The hon. member continues.

K. Krueger: Apparently the minister is declining to answer.

I'll read in a little more that I think she should know:

"Individuals who require treatment for their gambling disorder present a particularly challenging set of needs. Approximately half of problem gamblers in treatment will have a co-existing psychiatric disorder, such as alcohol dependence, mood disorder or personality disorder. In British Columbia, as elsewhere, there are very few treatment professionals who are capable of providing integrated services to such patients. Research suggests that gambling disorders frequently pass undiagnosed by health professionals, resulting in further health and personal costs. To address this, programs have been developed to train health professionals in the early diagnosis and treatment of gambling disorders.

"A number of effective treatments for problem gambling have been devised. However, the dissemination of these programs and services lags well behind the level of need" -- and obviously in British Columbia way behind, because there haven't been any. "A recent review conducted in the U.S. reported that there are approximately 13,000 treatment centres for alcohol and drug addiction and less than 100 treatment programs for addicted gamblers. Appropriate treatments are available to only a small minority of British Columbians. Psychologists and psychiatrists with expertise in gambling addiction and related psychopathology are difficult to access because of demand. In addition, pathological gamblers are typically in debt and lack extended health insurance that would enable them to receive treatment from registered psychologists. Research in the field of addictions confirms that patients stand the best chance of success if they are individually matched to an appropriate form of treatment. Optimally, an adequate range of treatment services would be available to each patient. When appropriate services are provided, the benefit-to-cost ratio of treatment has been estimated as in excess of 20:1."

Hon. J. MacPhail: I would remind the member that this is appropriate for the Ministry for Children and Families, whose responsibility covers addiction programs. All alcohol and drug addiction programs are transferred to the Ministry for Children and Families. I think I've said that three times now.

The Chair: Would the member consider moving on to a different line of questioning?

K. Krueger: Yes, I am doing that, actually, hon. Chair.

"As British Columbians consider the possible expansion of legalized gambling" -- this report was written in April; obviously that's happened -- "it is strongly recommended that adequate resources are committed to minimizing social costs. Following the recommendation of the National Council on Problem Gambling, treatment and research on problem gambling should be included in provincial health care plans. In light of the complex treatment needs of addicted gamblers and the shortage of other addiction services in British Columbia, it may be timely to consider the institution of an integrated research and treatment facility for addiction studies."

K. Krueger: I'm moving on, hon. Chair, to a question about. . . .

The Chair: Would you do so, please?

K. Krueger: I am.

"In order to target the problem of addictive gambling, proceeds from gaming could be dedicated toward a new centre for addiction studies." This report goes on to outline in detail the tremendous resources that the University of British Columbia already has to provide a centre for addiction studies. This centre could easily be funded out of gaming revenues that this province already enjoys, let alone the expanded gaming revenues that the Minister of Employment and Investment projects. It would also have benefit for the victims of all kinds of other forms of addiction, and I'd like the Health minister to put on the record her position with regard to developing a centre of excellence for addiction studies in British Columbia.

[ Page 3675 ]

The Chair: Shall vote 40 pass?

K. Krueger: It was clear that the minister wasn't paying any attention to what I was saying, and now she has refused to stand up and provide an answer.

Hon. J. MacPhail: Point of order. I am listening carefully to every word the hon. member is saying that is no part of the Ministry of Health estimates. It's clear that he is stalling for time, as is the entire Liberal opposition bench, and I'm fine to assist them in stalling for time.

K. Krueger: In this province there are many people with drug addictions, and their problem is a responsibility of the Ministry of Health. There are many people with alcohol addiction; their problem is a responsibility of the Ministry of Health. There are many people with tobacco addiction. The health problems that flow from that are responsibilities of the Ministry of Health. It's true that I am saying that a centre for addiction studies -- a centre of excellence, B.C.-based -- would help with the gambling addiction problem, but it would also help with all of those other problems. So from the point of view of a Health minister concerned at least about the other addiction issues that I've just outlined, if not about gambling addiction, could I please have this minister's position on a centre for addiction studies at the University of British Columbia as proposed in the report that I have provided to her?

Hon. J. MacPhail: I was part of the executive council who made a decision on our gambling policy, and I support it 100 percent.

K. Krueger: I don't know why the minister has this bee in her bonnet about us allegedly stalling for time when she is not providing adequate answers at all. But since she doesn't want to -- maybe she's crabby, maybe she's having a bad day -- I move the committee 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 granted leave to sit again.

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

Hon. J. MacPhail moved adjournment of the House.

Motion approved.

The House adjourned at 11:57 a.m.

PROCEEDINGS IN THE DOUGLAS FIR ROOM

The committee met at 10:13 a.m.

ESTIMATES: MINISTRY OF
MUNICIPAL AFFAIRS AND HOUSING
(continued)

G. Abbott: I'd like to begin by tying up just a few loose ends from the topics we've been canvassing to date. When we left yesterday, we were talking about local government organization or local governance forms in British Columbia.

I have just a couple of questions, to begin with, on library boards. One of the recurrent concerns that I hear and that I know some of my colleagues hear -- and I'm sure the ministry hears them, given that these things are almost inevitably presented to you, as well. . . . In fact, we usually get them second hand, after talking to you. One of the concerns surrounding library boards is that, depending on where people physically live, they may be closer to a library in another library jurisdiction. In order to access that library, they have to pay a user fee of some sort -- frequently quite a substantial user fee -- and consequently are upset by that. We'll get to that point.

Let me begin by asking an even more basic question. I don't know the answer to it, but I'm sure the minister does. That is, on what basis are the existing library boards in British Columbia structured? Are they based around regional district boundaries, municipal boundaries or what?

Hon. M. Farnworth: Actually, that's a really interesting question. Primarily it's municipal boundaries, not regional district boundaries. A lot of the boards were set up 50 or 60 years ago on a geographic basis that made sense at the time. Over the years some areas have left and some areas have joined, so you have some interesting geographical configurations. The Fraser Valley regional library board is one that I'm familiar with, having sat on it. Surrey is not a member, but Delta is. So there's a little bit of a patchwork.

Basically, it's a historical accident, in many ways, formed along municipal boundaries. They've changed over the years as some have left and pursued their own libraries.

[10:15]

This leads into my next question: is there, in the Library Act, the Municipal Act or any other provincial statute, any regulation, guidance, limitation with respect to a constant or occasional reconfiguring of library board boundaries?

Hon. M. Farnworth: None that particularly cries out, that says that every ten years there must be a rationalization. I certainly think, though, that the recent events in Delta, where 

[ Page 3676 ]

there has been a vote to look at leaving to set up their own library, is an example of what you've just stated. That was turned down.

Any review of the Municipal Act should probably encompass how it impacts on other acts, such as the Library Act, or on the configuration of library boards. It's primarily been a decision that has been left up to local communities.

My own sense is that by and large most people don't give a great deal of thought to the structure of a library board or of a regional library, as to which community it serves and which community it doesn't.

G. Abbott: I agree with the minister. I think that while many people value their libraries enormously and take great exception to, for example, a reduction in library hours or a reduction in holdings or even not expanding holdings that they'd like to see. . . . While they're very emotional on those issues, I don't think, in terms of the governance structure that provides the libraries, that they probably give it an enormous amount of thought. As we both know, the way in which the governance structures are composed can very quickly affect the quality of service that people will get at their libraries.

To summarize where we have come so far, at this point there is no provincial regulation with respect to any configuration or reconfiguration of library board boundaries. At this point is there a level of provincial funding or provincial interest on library boards? Is there provincial representation, or is it all left to the local level at this point in time?

Hon. M. Farnworth: There is no provincial representation or provincial component in terms of representation, but there is a per capita funding commitment, which the province contributes.

G. Abbott: Could the minister advise what that per capita funding contribution is at this point and how it compares to the previous year?

Hon. M. Farnworth: The provincial contribution is $8.2 million, and that's equally distributed on a per capita basis. It hasn't been decreased.

G. Abbott: So it's $8.2 million across the province, and that has remained relatively static for at least a year or two.

The issue that we need to address. . . . My colleague from Oak Bay is one who has received concerns about the configuration of a particular library board boundary and the consequences of user fees, and so on, in terms of a family's ability to access that. The question I'll want to get to is whether there is or can be a mechanism developed to provide for interlibrary or interlibrary-board user agreements, that kind of thing.

Hon. M. Farnworth: Yes, libraries can get into those types of agreements. There's an extensive one, for example, in the GVRD InterLink.

The key point in terms of any provincial encouragement or provincial involvement in determining whether an agreement should be mandatory or if there should be a reconfiguration of boundaries is that apart from the $8.2 million contribution the province gives to libraries, the rest of the money is locally raised. It comes from the local municipality, so it's very much a service that is provided at that local level. Those decisions are going to have to made at that local level, even though it may, at first glance, look like: "This community is here and this community is there, so why don't we just have some sort of common market, if you like, in library services?" It's primarily within the purview of the local government involved.

G. Abbott: I don't want to stray too much from where we're going in estimates, but I'm going to ask you in a moment about the InterLink -- what regional districts or municipalities are involved in that and how it works. Perhaps it's a model for addressing this problem.

First I'd like to ask my colleague from Oak Bay to outline the specific concern that's been provided to her.

I. Chong: I'm sorry to come in while this discussion is in progress.

The question that was posed to me -- I wouldn't say a constituent but someone just outside my constituency -- was essentially this issue. They were on the other side of the street. Their child could not access the greater Victoria public library system because they were part of the regional library district. I'm not sure which one -- Saanich Peninsula. I guess it's the Vancouver Island regional board. In order to be able to access the greater Victoria public library system, she was required to pay a hundred-dollar user fee for her child. She called me up, saying: "Does this seem right? Education is important for all our children." The fact is that she would car-pool the neighbour kids and her kids to the library; yet her child was denied the right to use that. I understood that the system was such that there were these different library boards, but I didn't realize there was the imposition of these user fees and that they could be to that extent.

My question to the minister, as my colleague originally posed the question, is: has the ministry had any opportunity to look at those kinds of things to ensure that public libraries -- because they are, as we say, public libraries -- can be made accessible to everyone and be uniform in terms of the fee imposed, as opposed to being dictated to by regional boards?

Hon. M. Farnworth: I understand the problem. It makes perfect sense. It can apply to other municipal services. I guess the key part of the problem is that the primary funding source is the local municipality, so they're the ones who basically set the rules. I mean, there is a provincial component. We do encourage municipalities to work cooperatively together in the provision of library services. There are mechanisms through InterLink, but there is no policy or mechanism by which the province can say: "On this side of the street, the library is over there, and you get to use it for nothing."

It's one of those things. Local government authority is just that: it's local government authority. Even though you may think it doesn't make sense, at the end of the day that's where the decision has got to be made, because they are the ones who are paying for it.

I. Chong: Given that the response I heard earlier by the minister was that there was provincial funding of $8.2 million, can I ask the minister, just for the record -- and if I missed it, would he repeat it: is it per capita?

Interjection.

I. Chong: Oh, so it is per capita funding.

Would there then be an opportunity to. . . ? If local governments were to come to the ministry and request a grant for 

[ Page 3677 ]

perhaps a restructuring of the library districts, would the ministry be able to provide some funding to see if there are in fact cost-effective measures that can result in terms of better use of that per capita dollar spending by some sort of -- I hate to use the A word -- amalgamation of those services?

Hon. M. Farnworth: We would certainly be willing to look at a proposal brought forward by some municipalities or to look in terms of services. In terms of a strict financial component, I don't know how much would be available. Certainly any technical advice, any staff resources -- that would be a possibility.

One of the things that is starting to happen or in fact should happen is that. . . . Maybe people in their local community need to say, "Okay, maybe we should look at integration or a more cooperative effort between two communities in the provision of library services in the way that many municipalities are looking at providing recreational services," and come up with agreements where people in this area can use a facility because they are close to it. The emphasis has to be placed on the local community. If there is something the province can do, I wouldn't see that standing in the way.

Again, it comes back to the local taxpayer funding the bill for local service despite the fact that there's a provincial contribution. That's where the decision has to be made. If people are unhappy with the level of service or the way the service is provided, maybe they need to push at the local council level to get some things changed.

I. Chong: I thank the minister for that, and I will relay that message to the particular constituent who has raised this concern.

The other question I have is in respect to the funding, the $8.2 million. Perhaps the minister can enlighten me on whether or not, when a board is originally formed, there is a base or core amount provided exclusive of the $8.2 million. If a new district were available. . . . I see some head-shaking. Also, can the minister advise, then. . . . Even though this is a per capita, surely in some areas there must be a minimum that is provided. I just want to be clear whether the $8.2 million is strictly per capita. I know that with municipalities a base amount will always be provided, and I'm just wondering if this is the same case.

Hon. M. Farnworth: No, there isn't; it is strictly the per capita funding. It's not like a municipality, where there is a core base grant.

[10:30]

The minister mentioned InterLink at one point. Could he briefly outline the jurisdictions that are involved in that and how it works, so that we can suggest to people with these kinds of concerns that this might be a model that they'll want to take forward to their local library board?

Hon. M. Farnworth: A couple of things. First off, right now there are 12 lower mainland library boards and the Fraser Valley regional library board all participating. Basically, you have complete access to any material they stock, from one library to another. In a sense there is a financial bonus in helping to maintain the system, because it is encouraging cooperation and the ability to access materials from other library boards. There are 12 lower mainland library boards and the Fraser Valley regional library.

G. Abbott: Within the greater Vancouver regional district, there is not one library function; there are 12 separate library boards. Is that correct?

Hon. M. Farnworth: That is correct, from Bowen Island to Boston Bar. That's when we go back to our earlier questions about the boundaries of library boards: Fraser Valley regional library and then Vancouver, Coquitlam, Port Moody. . . . There's a whole slew of them.

G. Abbott: Fascinating. I don't know whether I should ask this question or not, after asking yesterday about how many improvement districts there were in the province. I was quite astonished at the number. Does the minister have any idea how many library boards there are in the province?

Hon. M. Farnworth: I don't have the exact number, but it's in the high seventies.

G. Abbott: Is the entire province of British Columbia covered by some library board function or another? Or are there areas of the province that don't have this service, period?

Hon. M. Farnworth: No. There are some areas that aren't covered by library services. Some just have small reading centres.

G. Abbott: So would those areas that did not have formal, supplementary letters patent, I guess it would be called, for the library function -- where they just had informal reading centres or whatever -- not be benefiting from a small contribution from the $8.2 million from the province? Or is there some mechanism to involve them, as well?

Hon. M. Farnworth: There is, within the $8.2 million per capita, a small component that goes to some of these small communities -- Atlin, for example -- to maintain reading centres.

G. Abbott: A final question, I think, in this area, unless my colleagues have additional ones. In what way is the question of aboriginal band involvement determined? Are aboriginal bands included in library board areas? Are they part of the per capita grant and so on?

Hon. M. Farnworth: That is actually an important issue in areas, for example, where there are no libraries on reserves and the band has to use the library off reserve. Sometimes they run into problems in terms of being charged user fees. It's been the policy of the ministry to try and negotiate to encourage an agreement whereby the band members are able to access the library. That's what's happening at the current time.

G. Abbott: I'm struggling with concepts here and how lands reserved for Indians, being a federal responsibility under the constitution, would not be paying for library services 

[ Page 3678 ]

through property taxation. That's obvious. The question, then, is: is there any other mechanism, other than a user fee, to take that into account? The minister has indicated that this is a problem, and the ministry has tried to address it by encouraging local library boards to come to some agreement with bands without library services. Is there anything beyond that encouragement that the ministry can do? How can this particularly thorny problem be sorted out?

Hon. M. Farnworth: No, there is no sort of compulsory arrangement right now. It's strictly very much an encouragement. Some of the things that have worked. . . . There's the taxation issue, which, as the member has just pointed out, is one issue. I guess if an aboriginal child comes to the library, the community is well within its rights to say: "No, you're not funding it, so you can't use the facility." But that's a very difficult thing to do. So what has happened is that there has been a sense that the reserve either makes a gift or makes some sort of volunteer contribution. Those are generally the ways in which some of the agreements have been structured or worked out. So there's a sense of contribution, and, at the same time, people aren't denied access.

G. Abbott: I guess the provincial funding of $8.2 million would compute -- and math is not my strongest suit -- to approximately $2.25 per capita across the province. When, for example, the province makes its contribution to the Okanagan regional library board, would the per capita contribution be inclusive of the population of the numerous Indian bands located within that boundary, or is it exclusive of it?

Hon. M. Farnworth: The short answer is probably yes, but the long answer may in fact depend on whether or not the reserve is within the boundaries of the municipality. I can get that technical information for you.

G. Abbott: That's fair enough. I guess an Indian reserve, technically, is never within the boundaries of a municipality. They are always separate from it, and that's why it's an intriguing question to me. I'm not even sure if they're ever legally within the bounds of a regional district. I guess they probably would not be, because they are a special piece of land reserved for the use of aboriginal people and consequently are never legally -- at least as I understand it -- a part of those boundaries. So the question would be whether they would in fact be included for library purposes for that reason. We'll move along from that, unless there's anything further you can add with respect to that.

Hon. M. Farnworth: I guess this is an intriguing question. But there are some examples of where in fact they can be: Burns Lake, for an example. And it probably applies more to a smaller community than, let's say, to a larger community like Kelowna or Kamloops. But it is an intriguing question.

G. Abbott: Well, I'm an intriguing kind of guy, people say, so I guess it's fair that I ask these kinds of questions of the intriguing kind of minister here. We'll move on from there before I get too goofy.

An Hon. Member: Before you get too intriguing.

G. Abbott: Too intriguing, yes -- far too intriguing.

Aboriginal municipal issues, given that we have a sort of natural bridge at this point. The other day in estimates I think we briefly canvassed the position of the aboriginal liaison officer. And I think the minister mentioned that that position was still in place, that they were working on a number of obviously aboriginal municipal kinds of issues that were still unaddressed -- or uncompleted, I guess -- in the province. The one area I want to look at a little bit further is the local service agreements between either municipalities and first nations bands or regional districts and first nations bands. It seems that the bands were given the authority to tax their own lands or the non-aboriginal tenants on their own lands. When that authority was given to the bands, there were no local service agreements in place prior to that, and, with some difficulty in some cases, regional districts and municipalities have been attempting to negotiate those.

When I was on the Columbia-Shuswap regional district board, I had the good fortune to be involved in a couple of negotiations, and it was very interesting. In fact, the Columbia-Shuswap regional district has been quite successful in concluding their agreements with their bands for solid waste management and so on. The district of Salmon Arm, however, has had some very considerable difficulties in resolving their differences with the Adams Lake Indian band on the quite substantial native holdings west of Salmon Arm.

First of all, could the minister advise what the experience has been over the past year in terms of successes in developing and successfully concluding more local service agreements? Secondly, how many, like the Salmon Arm situation, remain outstanding and sources of friction in the province?

[10:45]

One of the keys to the success is that it's almost one at a time. As every community gets one, you reduce some of the suspicion and some of the animosity that's out there on the part of community and on the part of aboriginals. In the long run, I think it's working. But there are always going to be some of those outstanding ones, whether there's a historical grievance or whether there's a personality. . .or whether it's a particularly thorny issue. But they are working, so I think they are going to continue for the foreseeable future.

G. Abbott: Is the principal function of the aboriginal liaison officer of the Ministry of Municipal Affairs to provide advice and -- I'm not sure of this -- mediation in these kinds of issues?

Hon. M. Farnworth: Primarily, advice and facilitation. I don't know if I'd use the term "mediation," but certainly if there's a role for him to play, he's more than willing to play it.

G. Abbott: In the past year, I think the discussions surrounding the Nisga'a agreement-in-principle have really highlighted the issue of models of local self-government for aboriginal peoples in British Columbia.

[ Page 3679 ]

Could the minister advise whether, out of the discussions that have been held in conjunction with the UBCM or any other forum or work by the ministry, they have looked at models of self-government other than what we might term the Sechelt model and indeed whether there are any refinements to the Sechelt model being considered by other aboriginal communities?

Hon. M. Farnworth: No. We haven't been doing much developmental work. I guess the Sechelt one is the only one that I'm aware of, and I don't see any on the horizon right now, either.

G. Abbott: Over the past year, since the last estimates, have any aboriginal communities in British Columbia looked at or concluded that they should embrace the Sechelt model, or does Sechelt remain pretty much unique?

Hon. M. Farnworth: No, we haven't had any applications or even expressions of interest.

G. Abbott: Is it the minister's understanding that the model of self-government in the Nisga'a agreement-in-principle is similar or identical to the Sechelt model?

Hon. M. Farnworth: No, it's quite different from the Sechelt model. It's much broader, it's much more developmental and it's consistent with the principles that are enclosed within this report -- not in terms of a one-size-fits-all approach, but dealing with issues that are unique to that particular area or to that particular band. I think there's still a lot more work that needs to be done on it, but in terms of it being similar to the Sechelt, no, it is quite different.

G. Abbott: Models of government always fascinate me. I'm curious how, from a technical perspective in terms of authority conferred by the Municipal Act or any other act, the model of Nisga'a self-government would vary from the Sechelt model of government. Functionally, what are the additional areas of authority that a Nisga'a community or region would enjoy as opposed to what Sechelt, as a traditional municipal model, would enjoy?

Hon. M. Farnworth: I guess one of the primary differences is the fact that the Nisga'a are more interested in terms of resource development and resource control, and that's not the case with the Sechelt model. The Sechelt model required a special act of the federal government and of the provincial Legislature to come into force, so it came about through a different route. So while they are both levels of local government in a sense, they have arisen through different mechanisms, and their requirements or perceived requirements within each community are quite different. The focus on the Nisga'a has been very much towards resources.

G. Abbott: Again, I don't want to stray into probably what is more properly the territory of Aboriginal Affairs, but there is certainly a powerful Municipal Affairs aspect to this question.

Of course, one of the areas of broad public concern with respect to the Nisga'a AIP is the model of self-government included in that model, and it would seem that in terms of comparing the two models, the Nisga'a is more like either a regional district with enhanced authority over resource issues or something approximating a small province or territory. Does the minister have any comment with respect to that comparison?

Hon. M. Farnworth: The hon. member raises some good points. This is new ground. There are differences evolving. We do have the Sechelt model, and we now have the Nisga'a AIP. We have staff within the ministry because we're quite interested in. . . . This is going to be one, and there are going to be others, and I think one of the keys has been not the one-size-fits-all approach. Local government has been very much concerned, and they have been involved and are aware of the developments, and we have technical people involved in determining what's taking place and how it's going to work.

But at the end of the day, I don't think you're going to get a real. . . . It's going to be some time yet before everything falls into place. One of the things about the Sechelt model is that it is relatively easy to understand because it is so similar to existing structures. So in a sense it's quite familiar to most people and it's one they understand, whereas I think one of the difficulties in terms of understanding the Nisga'a AIP and how it relates to local government is the fact that there is some different focus taking place in areas that are outside of, say, where the Sechelt agreement was, by their interest in focusing on resources.

So that is going to entail, I think quite rightly, some different technical developments and some different developments in terms of how structures form. But at the end of the day, it's not something that's going to happen outside the purview of local government, in that local government is very much an observer and getting, I think, a better understanding of where it's going.

G. Abbott: The only other comment I'd have with respect to the issue of the comparative models of native self-government is that it's rather like federal-provincial constitutional negotiations. It's typical that if one province demands or wins a broader sphere of authority from the federal government, whether it's in immigration or indeed in any other area, other provinces will say: "We would like that authority as well."

I'm wondering whether this ministry is concerned with the creation of two models, one of which has, shall we say, an enhanced sphere of authority -- particularly over resources but perhaps other areas as well -- and whether that will create a kind of instability in the other model, where they will be demanding the same. Is that an issue that concerns the minister?

[11:00]

On the coast, in terms of resource development, fishing is extremely important. So there may be a resource component within a local government authority -- that may be a possibility -- whereas the same requirement is not needed, let's say, in the Peace country. So I think you have to be prepared to be flexible, but it doesn't necessarily mean that just because one area has the ability to do something, it's going to apply elsewhere. In that sense, it probably is similar to federal-provincial relations. Just because one province gets the power or gets the ability to do something, it doesn't necessarily mean that another wants it or in fact may even need it. But the fact 

[ Page 3680 ]

that you are extending it to someone else is an indication that you're prepared to look at dealing with local issues or problems by extending an authority to deal with those.

G. Abbott: I'll leave that issue aside. I think if I pursued it much further, we would properly be getting into the area of Aboriginal Affairs and the very complex discussions that the Aboriginal Affairs Committee is seized with.

Hon. M. Farnworth: That's why they have a minister and a critic.

G. Abbott: Yes, exactly. That's why they have a minister and a critic, who I'm sure can deal with these kinds of issues very, very effectively. I'm delighted to let them do that.

One of the issues which occasionally emerges in terms of the right to vote and that kind of thing is with tenants who lease or rent or, in any event, find themselves located on aboriginal lands. They typically. . . . You can tell me whether in the Sechelt case they do have the right to vote; I understand that they do not have an opportunity to vote in the Sechelt aboriginal elections. They wouldn't have an opportunity to vote there. Do they have an opportunity to vote, then, in the non-aboriginal jurisdiction outside that? How does that all work?

Hon. M. Farnworth: With regard to the Sechelt municipality, there is an observers committee that non-aboriginals have a right to vote for, but not in terms of voting for the council. If you are a tenant on a reserve. . . . It gets into that intriguing question we were talking about before, about being located within the boundaries of a municipality -- let's say Kelowna, for example. You would vote for the council in Kelowna but not for the band council on the reserve.

G. Abbott: I appreciate the minister clarifying that, even though, technically speaking, they may not be located within the legal boundaries per se of the city of Kelowna. Even if they are tenants in a trailer park on aboriginal land, they would be able to vote either in the adjacent municipal election, if the reserve is within the bounds of the city of Kelowna, or in the regional district election, were it within the Central Okanagan regional district. Is that correct?

Hon. M. Farnworth: Yes, that's my understanding.

G. Abbott: I appreciate that clarification.

One of the concerns that I hear from time to time within my own constituency is that these same tenants on aboriginal land are frustrated that they wouldn't have an opportunity to vote in a referendum, for example. But I guess that unless there was some special arrangement made with the band, they wouldn't in any event, be paying for a function that was created by referendum would they?

Hon. M. Farnworth: That's exactly right.

G. Abbott: Well, I'm on a roll here. I ask the questions and answer them at the same time, and the minister merely confirms them. This is very good.

The transfers from the province to the Sechelt Indian band local government is where I want to go next, briefly. Sechelt is the only example of this kind of model in British Columbia. Could the minister advise how, or if, transfer arrangements work with the Sechelt Indian band in relation to, say, the neighbouring municipality of Sechelt?

Hon. M. Farnworth: The Sechelt municipal local government would get a small community protection grant. They get the homeowner grant in the same way that other municipalities do.

G. Abbott: I suspect that begs a question, but I haven't formulated in my mind yet as to what that implies. I presume the band contributes to provincial coffers in the same way that other taxpayers in the province would, and therefore merits being treated in the same way with grants. Or is there a special arrangement in place?

Hon. M. Farnworth: I guess one of the keys to understanding the Sechelt arrangement is to recognize that it is a double jurisdictional arrangement, in that there is the band council, and they will be doing their traditional band council functions, and then there's also the municipal function. And depending on whether they're wearing their band council hat or their municipal function hat is how things are administered. So when they're wearing their municipal council hat and dealing with things on a strictly municipal basis, it's on that basis that they get the municipal grants that are available to them -- when they're acting as the municipality as opposed to just the band.

G. Abbott: How is it determined what percentage of the time they're wearing one set of hats and what percentage of the time another set of hats? Are the planning grants, the homeowner grants, the small community protection grants provided on the same, I guess, per capita basis, or whatever, as any other community?

Hon. M. Farnworth: The same formula applies to the Sechelt band as it does to any other community in terms of the administration of these particular grants.

G. Abbott: When we were having our extensive Bill 2 discussion about grants, transfers from the province to municipalities, the argument I put forward was that the transfers to municipalities really weren't grants in the sense of being a gift. They were grants because there was a legal, almost business arrangement, with the corporation -- that is the municipality -- providing a range of services which would otherwise be the responsibility of the provincial government. Probably the biggest and most expensive example would be the local maintenance of roads within municipalities. Does the Sechelt band effectively provide the same range of services to the province in return for those grants as would be found in other municipalities?

Hon. M. Farnworth: Yes, they do provide the same services.

G. Abbott: Before we leave aboriginal and municipal issues, unless others have questions on it. . . . Our gaming critic asked a number of questions in this area the other day and certainly satisfied my level of interest with respect to the gaming issue. But there is sort of one lingering area that I'm curious about, and that is the extent of provincial control with respect to gaming on aboriginal land. I'm curious because from my perhaps limited knowledge of constitutional issues, it's not obvious to me how the province gained its authority constitutionally over gaming on aboriginal lands. Could the minister advise me of the ministry's understanding with respect to that?

Hon. M. Farnworth: That particular question is probably best addressed to the Minister of Aboriginal Affairs and the Minister of Employment and Investment.

[ Page 3681 ]

G. Abbott: I don't know whether I'll let the minister get off that easily. Let me back up and put the question in the context of the assurances that have been made by this ministry and the province that before any extension of gaming into aboriginal lands will be provided, the province will ensure that there is a full consultation with neighbouring municipalities. Indeed, there was even some question as to whether, if the adjacent municipality was opposed to that extension, in fact the province might ensure that it didn't occur. I guess that's my real question. How is that going to be achieved without having that constitutional control?

Hon. M. Farnworth: What it comes down to is. . . . We've stated, and I'll state again, that the province will be issuing the licence. And if there's not community support, there isn't going to be a licence issued. I guess it comes back to. . . . I think there is a limited market. There is a limited capacity of around, let's say, five or six in terms of destination casinos or whatever. That's not a great number, and either there is support there or there isn't. I think that where you are seeing proposals that are being looked at, it's because there is. . . . In the case of the Kootenays, it seems there is local community expression of interest and a band's expression of interest, and the two seem to be working together. That is a model that's going to be successful, not one where one community says yes and there's no community support. So I think that's the mechanism that's going to be used.

G. Abbott: I think that concludes the questions I have with respect to aboriginal municipal issues. I just want to back up quickly and see if I can tie up a couple of the other loose ends I have.

[11:15]

Interjection.

G. Abbott: An eastern perspective. Well, you may get at least a central Canadian perspective from Mr. Marchi.

At any rate, this is quote from the federal Environment minister, saying: "The B.C. government is shortsighted when it's having a program with a top-down approach. It won't work as well." These are comments from a speech in Vernon.

This is a paraphrase. He said that communities that are familiar with their needs should decide how infrastructure money which is partially raised locally should be spent. And another direct quote: "There is the mind-set that the provincial Legislature knows best and wants to do just roads. It is a colossal mistake for the government to just do roads. Don't crowd out the rest of the projects when we are talking about green infrastructure [such as sewers]."

So it appears that the suggestion from the federal Minister of Environment is that in fact it was the province that was pushing particularly hard for the roads component in Infrastructure 2. In fact, if one were to make some deductions from the minister's comments, they were amenable to sewer and water projects being included in Infrastructure 2 but in fact had been pretty much obliged by the province to go with roads as one of the dominant components.

Hon. M. Farnworth: What's the date on that?

G. Abbott: That's May 14, 1997.

Hon. M. Farnworth: If I'm smiling, it's because part of me wants to sort of just go. . .bonk! -- and hit him out of the ballpark. I won't comment on the fact that there's a federal election and that he may be wanting to do things to assist the federal candidate and all that sort of stuff. And I don't want to comment that maybe if he'd gone back and lobbied harder with his own Treasury Board and didn't insist on putting in a 12-month deadline and taking a very top-down approach with the province in terms of being flexible. . . . I don't want to talk about the fact that maybe if there had been a bigger program with more money, which perhaps we would have liked or municipalities would have liked, we could have done more projects and extended it and done more sewers. I don't want to talk about any of that with a minister from Ontario who. . . . It's nice that he comes out to British Columbia at election time to tell British Columbians how we should do a program.

I don't want to say any of that. I think if Mr. Marchi spent more time back in Ontario looking after the environmental problems of Ontario and looking after his own constituency, he'd probably be a lot better off. Anyway, I think I've made my point. Sergio can get stuffed.

G. Abbott: The, I thought, rather neutral question that I asked seems to have struck quite a sensitive chord with the. . . .

Hon. M. Farnworth: Well, when you ask for comments. . . .

The Chair: Order, members. Through the Chair, please.

G. Abbott: It seems to have struck quite a sensitive chord with the minister, and certainly I didn't particularly want to induce that kind of response. I was just, in my usual objective, non-partisan. . .

H. Lali: Being intriguing.

G. Abbott: . . .and intriguing fashion, pursuing issues which seem to be of current and recurrent interest in the province of British Columbia.

I do appreciate the minister not wanting to go into a whole range of areas which may not be particularly germane to the question -- because he's right, they're not. Really, I was just trying to ascertain whether in fact, as the minister had suggested, the province put particular emphasis in their negotiations with the federal government on roads and transit, as seems to be suggested here.

Hon. M. Farnworth: Before I answer the member's question, I would just like to welcome four members of our safety engineering services division from the ministry. This is the first time, I think, they've witnessed the scintillating and intriguing estimates debate that takes place. I'd just like to make everyone welcome.

[ Page 3682 ]

In terms of the negotiations that took place, you could always say, "Look, more emphasis should be placed on water and sewer, more emphasis should be placed on other types of infrastructure," and clearly roads and bridges have been a priority for the province. But it comes back to the fact that one of the limiting factors was the 12-month deadline. The fact is that that has a big impact on what projects are able to go ahead. Frankly, I would have liked to have seen a much larger program with more money spent, because I think there is a backlog of infrastructure in this province that could be addressed in all areas -- not just water and sewer, but in roads and bridges.

I think it comes back to the remarks that we talked about earlier on in terms of: will there be an Infrastructure 3? I sincerely hope that there will be. I think one of the things we can take, if there is an Infrastructure 3, is that we will have had Infrastructure 1 and Infrastructure 2, and will have a better sense of whether there's more opportunity for discussion in terms of where priority areas should be. That's something I hope that we can do in the future. Mr. Marchi will have his opinion, and I will have my opinion, and I'm sure that during the 28-day campaign they will be poles apart. But afterwards, you know, they have a habit of coming closer together, and it's much easier to resolve things. But certainly I think that water and sewer are going to continue to be a focus in the future in the same way that roads and transportation are, because there is a huge backlog in this province.

G. Abbott: I appreciate the minister's comments about election campaigns and the things that happen during them. Certainly when I had the honour of being in local government, we used to call the period of roughly six months prior to the municipal election the "silly season." While there was not the great fanfare of the federal and provincial election campaigns associated with local elections, nevertheless one began to see in the few months prior to local elections a certain occasional posturing or tailoring of positions in order to ensure that one's views were gratefully appreciated in the upcoming local election.

So I expect that perhaps some of that may be happening here; I don't know. I think it's really fortunate that neither the minister nor I are in any way emotionally charged with the kinds of issues which surround Infrastructure 2. We can deal with these things in a dispassionate fashion rather than, say, getting very partisan about it or that kind of thing.

Again, the whole purpose of my question here was whether in fact it was implicit, at least as it appeared to be here -- I think's it's probably explicitly here, in fact -- that the province had driven the agenda with respect to roads and transit, and that in fact the federal government were reluctant bridesmaids in going along with that. Again, summarizing the minister's remarks, it appears that he's denying that, that in fact the province hadn't drive the agenda with respect to roads and transit -- that a series of extenuating circumstances made that a reasonable way to go in this case, but that the province wasn't, as Mr. Marchi suggested, out in front pushing that. Is all that a fair summary of that discussion?

Hon. M. Farnworth: Let me put it this way: when was the last time the federal government ever acted as a reluctant bridesmaid or in fact ever let the province set the agenda on anything that might put them at a disadvantage, especially going into an election period?

G. Abbott: I appreciate the non-rhetorical nature of the minister's response. I suspect I'm not going to get too much closer to the inner negotiations between the federal and provincial governments on this. I'm sure the minister's comments will be of great value to those historians who will try, in the end -- long after this election is over -- to put the Infrastructure 2 negotiations into perspective.

The one sort of residual question out of this -- and I'm sure the minister will appreciate it has nothing to Mr. Marchi, the federal government or the current federal election campaign -- is that everyone agrees that there is a great residual of deserving water and sewer projects around the province that obviously are not going to be addressed by Infrastructure 2. Nevertheless, in some cases they cry out for resolution down the line. Given that Infrastructure 2 is not going to be addressing those sewer and water issues, is the ministry looking at enhancing conditional grants to municipalities and regional districts in 1997-98, or indeed 1998-99, to address the growing number of deserving projects around the province?

Hon. M. Farnworth: There is a component this year for water and sewer, and that's fully committed. The member is right: there is a great deal of water and sewer that still needs to be done, in the same way that there are roads and bridges that need to be done. I want to see the same level of commitment next year -- ideally, enhanced.

G. Abbott: We'll leave this aside until, more properly, the discussion of provincial transfers to local governments. But at that time I would like it to get some indication from the minister of where we have come from in terms of conditional grants -- in fact, I think I have those figures somewhere in my estimates package here -- and where the minister would like to go to in the years ahead in terms of those grants areas and conditional grants for sewer and water. Again, it's an ongoing problem, and it's never going to go away. It seems there are always more projects than can be funded, and given the growing population of British Columbia, I expect that there will be more and more demands on the conditional grants for sewer and water particularly. I look forward to hearing how the ministry will be proposing to enhance that in coming years.

We are getting so many things tidied up here today; we're just moving right along. When we report out today we will be able to genuinely report progress, as indeed we've been able to every day, but even more so today because we've put so many issues to rest, including some of these details around Infrastructure 2.

Electoral reform. We did start that the other day, and actually I think we had some very useful discussion with respect to that.

[11:30]

[ Page 3683 ]

Hon. M. Farnworth: In terms of when specific measures are used, they are spelled out in the Municipal Act under section 330 and a number of other sections as well.

In terms of what future changes are going to take place, I think those are something that we've indicated we want to see discussed through the joint council process. We've dealt with the issue in terms of. . . . I think an example is the need in terms of public-private partnership in Victoria. But clearly the time has come to look at these particular sections to look at the ways in which accountability is dealt with, because ultimately they are accountability issues. I think it goes back to that philosophy: you have a council that's elected to make decisions, so let them make them. But any changes are going to be done through the joint council process, and that is something that is currently being looked at.

G. Abbott: I appreciate that that is a very good way to go, in terms of dealing with these kinds of issues about mechanisms to determine the degree of public support for something.

I still have a question. In my role as Municipal Affairs critic I occasionally hear from people who say that the council or the regional district board exceeded what should be at least their proper authority in using their ability of director consent to move ahead on a project. They say: "It should have gone to referendum or there should have been some counterpetition process." Is it the minister's view that in fact when people make those kinds of expressions of concern about a council exceeding its authority that it's clear-cut enough in the Municipal Act and that there's no need to address that concern?

Hon. M. Farnworth: I think it's clear within the act. I also think the ministry itself does administer administrative guidelines. I guess it comes back to that issue of devolution of authority and accountability; that is, you have a locally elected body with the power to make decisions that is accountable, that does have staff, that does have expertise. The question is: do you let them do the job? Occasionally they're going to make mistakes. That's what elections every three years down the road are for. That has to be an underlying principle. At the end of the day do you recognize the ability of the local council to make a decision on behalf of its electorate and then the ability of that electorate to judge them three years down the road? As far as I'm concerned, that is a fundamental basis of the way things work. So I think the act is fine as it is right now.

G. Abbott: I've probably formed the same conclusions about that issue, as well. Really, what I was seeking was whether there was any incentive or initiative on the part of the ministry to look at that in a different way, and it appears there is not. That's fair enough.

One measure of public support that's relatively new in the province is the counterpetition process. I had only one experience with counterpetition, and that was with respect to the possible introduction of a 911 system in the Columbia-Shuswap regional district. The board chose counterpetition as a way in which the public could express their disapproval of proceeding with that project if they chose.

Counterpetition in that case -- and I think it's universally the case -- is that if 5 percent or more of the eligible electors in the Columbia-Shuswap regional district signed a counterpetition saying that they did not want the service, then the regional district's initiative on 911 would be deemed to be defeated. In that case, in fact, just over 5 percent of the eligible electors in the Columbia-Shuswap regional district signed a counterpetition, and the initiative did not proceed. Could the minister advise whether, in the ministry's view, counterpetition has been a useful mechanism in terms of dealing with these kinds of public policy issues, or is it just one in a range of things that may be used in the future?

Hon. M. Farnworth: The ministry hasn't done any surveys, and I was going to say that the member's experience with counterpetition is probably one more than I had when I was on a city council.

In terms of it being useful, I think it is an appropriate mechanism, in that it does give you an indication early on in terms of some sense of where the community is at and doesn't require the council to commit itself to a full-fledged referendum and the expense that that entails. It puts some onus on the local community. It allows them almost, if you like, a community initiative to demonstrate some support or lack of support.

G. Abbott: The counterpetition process in the case I mentioned in Columbia-Shuswap did raise some questions about how the number of eligible voters would be determined. It also raised some questions about petitions going out from the district offices into the community and possibly being misused, and that kind of thing. I can't remember when those issues were put to the ministry. I can't recall the response.

Has the experience with the counterpetition raised those kinds of questions about the legitimacy of the process? Or was the Columbia-Shuswap case sort of unique in that way?

Hon. M. Farnworth: Not that I'm aware of. It certainly hasn't either come through the ministry or through the UBCM that there is a concern about the way that it's being used or the fact that it may not be appropriate. But certainly if there is, I would see it as being something that we would address, again, through that joint council process, as something that we would be willing take a look at. But as of today, the answer would be no.

G. Abbott: I'm trying to propose this in a way that's not going to draw offence from the Chair. When we come around to discussing, I think, Bill 26. . . .

Interjection.

G. Abbott: Yes, the Municipal Affairs bill.

The one thing that struck me about the bill. . . . The minister characterized it as a fine bill, and my reading of it would suggest that it probably is too, although we'll obviously be looking much more closely at it in second reading. The one thing that surprised me about it was that there's a kind of duality in the bill about the designation of covenanted areas alongside streams, the riparian areas alongside streams. There is, on the one hand, the ability of a council or a regional board to determine that a riparian area could be covenanted and exempted from taxes for that purpose. But there is also in each of the sections a reference to counterpetition, where, I guess, at the instigation of 5 percent of the qualified electors, it could be undone. Is that a deliberate way that the ministry is moving on these kinds of questions, to put both in?

Again, we've talked a good deal about councils and regional boards being provided with the tools to make decisions. Maybe in some cases they might make the wrong decisions; where they do, the electors are going to express 

[ Page 3684 ]

their dissatisfaction with that in the upcoming election. Given that sort of general direction, I guess I found it curious that we would see that kind of alternative mechanism in place.

Hon. M. Farnworth: I guess it's a question. . . . I mean, it is sort of straying into second reading debate on Bill 26. But in terms of the general philosophy, it's sort of separating it out from that particular bill and looking at it as a whole. I think it's a question of. . . . Yes, you are moving to saying, "Give more accountability to communities; give more accountability to local government to make decisions," and recognize that there may in fact be mistakes.

But I also think there is a role here for citizens in a community to recognize that, as much as their local community is being given more authority, they're not being completely shut out. Their ability to hold the council accountable isn't just every three years -- which I think is extremely important. But if there's a sense that they're having something taken away. . . . If you empower a community to make a decision and, for example, the council says: "Look, we want to do X, and we're going to go ahead with the project. . . ." Under the old ways of doing things, you would be coming to Victoria for approvals and requiring referendums. There are people who feel that that accountability mechanism is being taken away.

So in providing for a counterpetition, or for the ability to do a counterpetition, you are still maintaining that element of local accountability and local control. It's a check and balance, in a sense, and I think it will work and be less cumbersomeand less costly than the current system. I think it's a very manageable one. Of course, time will tell, but I think that right now there's no reason it shouldn't work.

G. Abbott: I'll be pursuing that a bit later in estimates, but I believe the member for Vancouver-Fraserview has a few questions.

[11:45]

The Chair: Member, perhaps you could just move that we rise, report progress and ask leave to sit again, and then you can continue after the break.

I. Waddell: I move the committee rise, report progress and ask leave to sit again.

Motion approved.

The committee rose at 11:46 a.m.

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