[ Page 3685 ]

The House met at 2:05 p.m.

L. Reid: Hon. Speaker, I have an announcement and an introduction. I'd like to commend the B.C. Liberal opposition on their very fine performance this morning on the Big Bike Ride. The Heart and Stroke Foundation indicated that we indeed are leaders in fundraising, and I would like to tell them that we have done a very fine job.

I'd also like to take a moment to introduce two dear friends of mine in the public gallery. Dorothy Hamilton and Kathie Hamilton are visiting from the riding of Delta South, and I'd ask the House to please make them welcome.

G. Bowbrick: Joining us in the gallery today are a group of 20 grade 11 students from the Sigma program at New Westminster Secondary School and their teacher Ms. Martens. I ask that the House join me in making them welcome.

M. Coell: In the gallery today is a grade 8 student from Bayside Middle School in my riding, Steven Fissel. He has been here all day; he was here listening to the Health estimates this morning and says he very much enjoyed them.

Hon. J. Pullinger: Today I have the pleasure of introducing to the House a friend, an individual who has been active in the Cowichan Valley for a long, long time. He's a provincial emergency planning volunteer still, was a municipal politician for years, had a huge amount to do with developing recreation centres around British Columbia and is a longtime New Democrat who provided hours and hours of volunteer time to people like Tommy Douglas, Bob Strachan, Barbara Wallace and, happily, me. Would the House please help me welcome John Cannon.

R. Thorpe: It's with pleasure that I rise to pass congratulations on behalf of myself, the member for Delta South and our caucus to Alan J. Barnard, comptroller general, who has served our province for some 15 years. He's given very generously of his time and talents to the Financial Management Institute, the Institute of Chartered Accountants and the Society of Management Accountants. He is recognized across Canada as a mentor in the financial management community. He was recognized yesterday in Victoria and won the Financial Management Institute award for 1997. I ask the House to join in passing congratulations to Alan.

C. Hansen: The community of Quilchena is not in my riding of Vancouver-Quilchena. Quilchena golf course is not in my riding. But Quilchena Elementary School is, and today we have 25 grade 5 students from Quilchena Elementary School and their teacher, Patti Baldwin, and five parents. Would the House please make them welcome.

G. Plant: Today in the gallery is my sister Marnie Plant from Vancouver and her very good friend Kim Bartlett from Montreal. I ask the House to please make them welcome.

Hon. J. Cashore: It's with some sadness that I point out that the Minister of Education would rather be somewhere else today, given that it's his thirtieth wedding anniversary.

Interjections.

The Speaker: I hope you'll notice I'm giving everybody an opportunity to vent preparatory to question period.

Oral Questions

USE OF CONSTITUENCY OFFICE
FOR FEDERAL ELECTION CAMPAIGN

Interjections.

The Speaker: Order, members. Minister of Health, on what matter?

Hon. J. MacPhail: Responding, as House Leader, to the question being out of order.

The Speaker: Minister, if this is a point of order, I would ask you to take your seat for a moment, if I might.

We don't normally entertain points of order during question period. The standard practice, of course, is that ministers do indeed only answer questions falling within their area of ministerial responsibility. Yesterday, however, we saw the minister's willingness to answer. If the minister is still willing to answer, then the question is acceptable.

Interjections.

The Speaker: Excuse me, members. Members, please! West Vancouver-Garibaldi, please!

The assumption I am making is that the rules of the House belong to members, and if the opposition is prepared to overlook the rules to ask a question and the government side is willing to respond, then I will entertain the question. I am therefore deferring to the minister, should she wish to answer.

Hon. J. Pullinger: I indulged the opposition yesterday by answering a completely out-of-order question. I'm not about to allow them to continue asking completely out-of-order questions that I'm not prepared to answer.

G. Campbell: It's difficult for me to understand why the minister would answer the question one day and plead the Fifth the next. However, the Speaker's rulings on these matters have been unequivocal in the past. On September 28, 1995, the Speaker ruled that "under no circumstances is the constituency office to be used for political or election campaign purposes." My question to the minister is: did the minister consult with or lobby the current Speaker to find out that the previous Speaker's rulings had been ruled out of order?

R. Thorpe: We already know that the federal NDP candidate has moved into the minister's constituency office in Ladysmith. This office, if it's paid for by the taxpayers, is filled 

[ Page 3686 ]

with equipment and furniture paid for by the taxpayers. Can the minister tell us today: was the taxpayers' equipment moved out of the office before the federal NDP member moved in?

Hon. J. MacPhail: Just for the advice of the House, as Government House Leader, there is an avenue where this is properly explored. We do have a conflict-of-interest commissioner in place, and allegations such as this have been made before to the conflict-of-interest commissioner, can be made today and can be made tomorrow. Clearly this is not the time, in question period. There are good issues, I assume, that the opposition can bring forward.

[2:15]

Interjection.

R. Thorpe: Perhaps you should listen.

Mr. Speaker, the former conflict-of-interest commissioner Ted Hughes was clear in his constituency office review. Mr. Hughes said every attempt must be made to make everyone feel comfortable in entering and doing business in the constituency office, without the semblance of political partisanship. Can the minister tell us how the people can enter this office in Ladysmith without the semblance of political partisanship when it bounces back and forth between her and the NDP like a yo-yo?

USE OF CONSTITUENCY NEWSLETTER
FOR FEDERAL ELECTION CAMPAIGN

The Speaker: Government House Leader.

Hon. J. MacPhail: Again, on behalf of all the members in this House, there are. . .

Interjections.

The Speaker: Order, members, please. I must hear what's being said. Sorry, Government House Leader.

Hon. J. MacPhail: . . .avenues in which these matters can be addressed. If allegations are being made, there's an appropriate way to make those allegations. I would suggest to the opposition -- all opposition members -- that they make the allegation in the proper format, and it will be reviewed.

The Speaker: Peace River South, with the caution that clearly we are wildly out of order at this point. I would ask him to conduct. . . .

J. Weisgerber: Well, a supplemental to the Deputy Premier. We know the NDP are desperate to elect some members in British Columbia. We also know that that desperation shouldn't be funded by B.C. taxpayers.

Mr. Speaker, the member for Malahat-Juan de Fuca did the minister one better with his newsletter. He managed to get a candidate on each page of the mailer sent out by B.C. tax dollars.

The Speaker: Could we have a question?

J. Weisgerber: Will the Deputy Premier instruct the federal New Democrats to pay for the cost of these bogus mailers sent out by his member in the middle of a federal election campaign?

Hon. D. Miller: I'll tell you, if there's one party that's desperate in this federal election, it's the Reform Party, which would risk dividing this country. . . .

Interjections.

Hon. D. Miller: There is a principle. If any member in this House feels that there has been improper action on the part of another member, there is a process to follow. It's in the interests of all members of the House that they follow that process. These questions are clearly out of order.

USE OF MINISTERIAL STAFF
FOR FEDERAL ELECTION CAMPAIGN

Interjections.

The Speaker: Order, members, please.

G. Farrell-Collins: The principle is that you don't use taxpayers' money to get yourself or your friends elected.

I'm shocked that the minister won't get up today and answer questions. Not only did she close her two constituency offices, but she has closed her mouth in the Legislature.

Interjections.

The Speaker: Order, members. I'm sure we're all anxious to hear the question.

G. Farrell-Collins: I'm sure, hon. Speaker, you'll remember well that in 1983 they were heady days for the NDP in Nanaimo and Ladysmith. Dave Barrett was still leader, Dave Stupich was in the Legislature and the Nanaimo Commonwealth Holding Society had not yet gone belly up.

Interjection.

G. Farrell-Collins: There's a question, hon. Speaker. At a September 29, 1983, meeting at the Ladysmith Legion, the Sam Guthrie Club discussed forming a commonwealth holding society in Ladysmith.

The Speaker: Member, can I caution you? We've allowed considerable latitude here today.

[ Page 3687 ]

Interjections.

The Speaker: Order, members, please. The question seems to be wildly out of order, so I'm going to caution the member to please try and redirect it.

G. Farrell-Collins: I'll ask a very simple question of the minister, and it relates to her office. As a minister, she knows well that she has an executive assistant who spends time in her constituency. Can the minister tell us whether that person is currently on holidays or on a leave of absence?

Hon. J. Pullinger: Clearly the opposition has no real questions, because these are wildly out of order.

G. Farrell-Collins: There was an edict delivered to this House by the previous Speaker, someone we all had a great deal of respect for, Mr. Emery Barnes. It was clear in his edict that at no time should staff be working on campaigns unless they were on a leave of absence. Can the minister tell us whether her executive assistant in her riding is on holidays or whether he or she is on a leave of absence?

Interjections.

The Speaker: The member for Chilliwack.

B. Penner: Thank you, Mr. Speaker.

Interjections.

The Speaker: Order, members. Members, I can't hear the question, because people on the questioner's side are making too much noise.

USE OF CONSTITUENCY OFFICE
FOR FEDERAL ELECTION CAMPAIGN

Can the minister tell us why she is putting the interests of the federal NDP ahead of the interests of her Ladysmith constituents by closing her office during an election and during a legislative session?

Hon. J. Pullinger: The members opposite are abusing this House. These questions are all out of order. They should have respect for the rules.

Interjections.

The Speaker: Chilliwack, I hope this question is in order, because the last three or four simply have not been.

Interjections.

The Speaker: Order, members. Let's find out.

B. Penner: I hope that all ministers will conduct themselves in an orderly fashion during this election campaign. We certainly haven't seen that.

This morning the minister was quoted in the Nanaimo Daily News: "When they phoned me and said, 'Can we have our space back?' I agreed." Can the minister tell us exactly who in the federal NDP called the minister's office and asked for their office back, and whether or not she discussed this arrangement with the legislative comptroller's office before agreeing to this arrangement?

The Speaker: Is this a point of order, Government House Leader?

Hon. J. MacPhail: Hon. Speaker, this is just to note that a question, oral or written, must not inquire whether statements made in a newspaper are true. Just in case they didn't know. . . .

The Speaker: Excuse me, minister. . . .

Interjections.

The Speaker: Order! Members, we seem to be in a rambunctious mood this afternoon.

USE OF MINISTERIAL STAFF
FOR FEDERAL ELECTION CAMPAIGN

Interjections.

The Speaker: Let's hear it.

R. Coleman: The question is very simple: are those staff on holidays or are they on a leave of absence during the election campaign? I think it's a fair question; it should be answered by the minister.

Interjections.

The Speaker: Alas, the bell ends question period.

Interjections.

The Speaker: Members, please. Don't you think that we could as least extend courtesy to the Clerk and hear him?

Orders of the Day

[ Page 3688 ]

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

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

K. Krueger: We didn't seem to be getting anywhere just before lunchtime. The minister made some comments, and she and I spoke in the hall afterwards. It's evident that there was a kind of breakdown in communication between us, because my sincere intent. . . . I know from various conversations with her over the past year, and certainly during estimates last year, that her intent, too, is to help the victims of addiction in the province, whatever form that addiction takes. Certainly this is the ministry with the largest budget; it spends the greatest amount of financial resources. It employs huge expertise, and it would want to draw on the expertise available through British Columbia universities.

[2:30]

I'll just read a quick quote from the UBC study, which is also a UBC proposal to establish a centre for addiction studies here in B.C., a state-of-the-art centre of excellence for British Columbia, one that I think we'd all be proud of. They say:

"In order to target the problem of addictive gambling, proceeds from gaming could be dedicated toward a new centre for addiction studies. Such a centre could be built on the existing expertise in addictions and treatment in the University of British Columbia's psychology department. A university-based centre of excellence in addictions would integrate research and interventions that have proven effective across addictive behaviours. With respect to pathological gamblers, the new centre, in conjunction with the existing full-time psychology clinic, would provide integrated services for the high proportion of addicted gamblers who present with dual diagnoses. Moreover, the centre for addiction studies could provide additional much-needed services across the range of addictive behaviours. For example, B.C. is the only province that does not mandate assessment and treatment of individuals arrested for driving under the influence. Currently, it is estimated that 60 percent of drunk drivers in B.C. reoffend.

"The existing UBC psychology clinic is capable of delivering a broad range of addiction services in an extremely cost-effective manner. Outreach programs undertaken in collaboration with colleagues at other universities in B.C. -- i.e., UVic, Okanagan College, UNBC" -- they left out UCC, but I'm sure they didn't mean to, because we've got experts there as well -- "would ensure that trained specialists are available throughout the province."

"Available facility expansion and additional resources would be required to give the new centre its inception."

I know the Health minister is concerned; I genuinely mean that. I know this whole House is concerned. My colleague from Richmond-Steveston introduced a private member's bill recently, which I trust we'll have the opportunity to debate in this House, dealing with this issue of repeat offenders -- thinking particularly there, I think, of alcohol problems on the roads. For many years I investigated motor vehicle collisions. We didn't even call them accidents anymore, because they're predictable. When people drink and then go out and drive, these things happen, and there are grievous results. We've all known of, if we don't know directly, families who are terribly impacted by this awful antisocial behaviour of drinking and driving.

Drug addiction leads to the same situations, and gambling addiction, as it brings families to ruin and brings on other problems -- substance abuse and so on -- also brings on that type of problem.

My question is a direct one to the minister: Madam Minister, you have the business case; you have the business proposal. I don't think you dispute that UBC is a centre of excellence and has experts available. What have you done about this proposal? Are you willing to fund a centre of excellence, a centre for addiction studies, at the University of B.C.?

Hon. J. MacPhail: Hon. Chair, I understand the approach the hon. member is taking. Nobody's motives are in question here whatsoever. I appreciate the member's concern; I appreciate his recognition of concern by everybody in this House. But addiction programs, alcohol and drug programs, once again, have moved to the Ministry for Children and Families.

The Chair: I recognize the member for Vancouver-Mount Pleasant.

J. Kwan: I seek leave to make an introduction.

Leave granted.

J. Kwan: Visiting the gallery today -- actually, they have just arrived -- are 46 members of the Renfrew Park Community Centre, seniors and adults. They are constituents of the Premier, from Vancouver-Kingsway, and they are accompanied by Ms. Leung. I would like to ask the House to please make them feel very welcome.

K. Krueger: Perhaps I could just get a point of clarification from the minister, then. If the responsibility for addictions has been entirely assigned to the Ministry for Children and Families, does that include single males, men without families, who are addicted? Are they under the care of the Ministry for Children and Families?

Hon. J. MacPhail: Yes.

K. Krueger: Clearly, I will be putting these questions to the Ministry for Children and Families. Certainly the B.C. Liberals advocated incorporation of all of Mr. Justice Gove's recommendations. We were delighted to see the establishment of the Ministry for Children and Families. We believed that that ministry would then take over responsibility for children from the five different ministries that were involved and thereby eliminate the problem with lack of communication and the kind of silo effect between organizations -- all in the interest of protection of children.

The negative effect, if there is one, of moving in that direction and creating a kind of superministry might be a 

[ Page 3689 ]

breakdown in communications between ministries on important issues that affect other people. So, for the record, I'm really concerned about the men who develop gambling addictions and other addictions, and whether or not they will, by necessity -- with funding limitations, staffing limitations and so on in the Ministry for Children and Families -- be more or less left to fend for themselves, because of course that's disastrous and there will be disastrous consequences for children, families and all of us, and certainly for those men themselves. So just a word of caution there.

I'll more or less wrap up my discussion of this study. If I could just include a brief summary in the record:

"The costs of addiction, including pathological gambling, are staggering, resulting in more deaths, illnesses and disabilities than any other preventable condition."

"Significant progress can be made to prevent and treat addictive behaviours, utilizing an array of treatments in conjunction with broad expertise in mental health. By committing a fraction of the proceeds of gaming to the assessment and treatment of problem gambling, the government would help to ensure that potential costs of this disorder are minimized. In addition, by committing gaming revenues to a new centre for addiction studies, vital services would be made available to a wide range of British Columbians and would effectively apply the expertise and resources of an existing centre of excellence toward the needs of the general public."

So, if I'm not out of line in asking for it, I'd appreciate the minister's commitment to urge the Minister of Employment and Investment to channel some of the funds from gambling revenues into the creation of this centre for addiction studies at the University of British Columbia, in the interest of her own ministry. I wonder if I might have that commitment.

Hon. J. MacPhail: I was part of the executive council that formed our policy on gambling. I fully support that policy and all of the investment that we'll be making in that.

K. Krueger: Well, the policy that the minister has just raised is still a bit of a mystery to me. I've been waiting breathlessly. A certain amount of funding was mentioned.

The fact that it was assigned to the Ministry for Children and Families was certainly mentioned. I've asked for a briefing from the Minister for Children and Families; it hasn't been forthcoming. I believe the reason is that things aren't in place. I cannot fault the Ministry for Children and Families for not having something in place, because I believe they are overwrought and overworked. They have the urgent and pressing issue of the deaths and abuse of little children around this province to deal with. They're throwing their resources into that battle, and rightfully so.

Interjection.

The Chair: Member, sit down, please. Hon. Minister of Education.

Hon. P. Ramsey: Thank you, hon. Chair. I've been listening to the debate this afternoon with some interest. It seems to me that we're compounding the sin we began in question period. This has little relevance to the estimates of this ministry. I'd ask the Chair to call the member to order and ask him to address questions to this minister on the responsibilities of her portfolio.

The Chair: Thank you, hon. member. I'm sure the member will take that into account.

K. Krueger: Before I respond, hon. Chair, there's a member who'd like to make an introduction.

J. Sawicki: I ask leave to make an introduction.

Leave granted.

J. Sawicki: Thank you to the hon. member who had the floor for giving way. I would like to welcome students from Douglas Road Elementary School in my constituency, a class of grade 4 and 5 students, with their teachers, David Barry and Connie Bradley, and several parents. This school is particularly relevant, because it's the school that I attended when I was their age. So I'm pleased to welcome them. Finally, along with welcoming the class, I'd like to welcome my legislative assistant, Anne Paxton, who while I'm here in the chamber has entertained this class during their visit this afternoon. Would the House please make them all welcome.

The Chair: I recognize the member for Kamloops-North Thompson, with the caution about relevancy.

K. Krueger: Hon. Chair, I'm astounded that the Minister of Education would pipe up and interfere in a matter that, really, I don't think he knows much about and has no business intervening in. The Health minister can certainly speak for herself, is very capable of that and has expressed a personal interest in these issues on the record and a personal commitment to me to deal with them.

This is how people die in British Columbia, Mr. Education Minister. People die because of addictions. People pump China White into their veins on Welfare Wednesday, and they die. People die because of gambling addiction. Women are going to commit suicide because their husbands become problem gamblers and pathological gamblers. That's happened in every other jurisdiction in North America where this kind of stupid program has been introduced. It's ignorant and repulsive and regrettable that a minister would stand up and intrude on a debate when it's none of his business, frankly, except that he ought to be as concerned about it as any other British Columbian.

This is a problem for the Health ministry. The Health ministry has one-third of the funding of the B.C. provincial budget. People are going to be sick because of gambling expansion. People are already sick because of gambling addiction, alcoholic addiction, drug addiction, tobacco addiction.

The Health minister has told us in the throne speech that she intends to bring on litigation against the tobacco industry for its dangerous and addictive product. We know that gambling expansion is going to create those same problems. We know that gambling is addictive and that people suffer terrible consequences in their lives because of it. This Health minister, who is suing the tobacco industry -- or said she's going to -- is one day going to have to take the defence stand, 

[ Page 3690 ]

speak for this government and this ridiculous mistake made in 1997, whereby British Columbians become gambling addicts, and face those consequences and those very words that apparently are going to be in the. . . .

[2:45]

K. Krueger: When the province of British Columbia is ultimately sued by the victims of gambling addiction, and in the statement of claim the plaintiffs say this minister used those words with regard to tobacco addiction and the effects on her ministry of this dangerous and addictive product, and throw that precedent forward -- her very own words -- in bringing a claim against this province, what will her answer be?

S. Hawkins: If I may, I'd just like to go back to some of the issues that were raised this morning, which I had some questions on, and just clean them up a little bit. One was an issue with respect to the role of the provincial health officer and the medical health officer. This was pertaining to a water issue in a member's constituency. Certainly that's an issue in my riding right now. I'm sure it's an issue in some ridings, some communities across the province, as the spring runoff is high.

We had some problems last year with Cryptosporidium, and I heard a member saying this morning that in their community, water was tested for giardiasis and for Cryptosporidium. Is this something that the medical health officers in their own public health branch monitor on an ongoing basis? Or is this something that they're directed to do? Can I get some guidance on that?

Hon. J. MacPhail: From time to time in the summers, outbreaks of water-borne disease occur across Canada and in B.C. These are usually caused by animal feces in the reservoirs and can be prevented by ensuring that drinking water is adequately disinfected. There have been problems with water quality in certain areas of the province. The medical health officers are working to resolve the problems as they arise.

Medical health officers have been working toward the objective of chlorination of drinking water. However, there has been some resistance to chlorination in some areas. The medical health officers are attempting, and see this as a priority in their duties, to solve the recurring issue by educating people about chlorination and by taking non-legal actions to ensure compliance. However, if in their professional opinion they feel that the water quality is suffering because of non-compliance by a water purveyor, they can certainly take the next step, which is legal enforcement. They do so at their discretion.

We know that there may be a problem in very small communities, those that are under 200, in obtaining funding for infrastructure improvements. But we are working with the Ministry of Environment, Lands and Parks to ensure that these options are put in place.

Then, of course, we do have -- as I think is the case that was brought to my attention by the hon. member for Okanagan West -- the issue of enforcement of safe water regulations on reserve land that's federally regulated as well. We are working with the federal medical health officers to ensure that they are working toward compliance and assisting there, as well.

A risk assessment model for community water systems is being developed. That is so they can assist the regional staff to assess the public health risk associated with the wide variety of variables affecting public water supplies. Some of those variables are source water characteristics and water treatment options. This capability will assist health units to prioritize the actions on a regional scale as well as on the individual waterworks basis.

S. Hawkins: I thank the minister for that. The provincial health officer, then, has local medical health officers underneath his or her office's purview. This medical health officer works with the public health department in their local community. Who do they report to if there's concern of an outbreak? What are the lines of communication? Who gets the message if there is a problem with the water or if they're monitoring the water?

Hon. J. MacPhail: The medical health officer is required by legislation to enforce the safe water regulations. As we have discussed before, he is administratively accountable to the regional health authority, but in his technical and clinical competencies, he is responsible to the provincial health officer.

S. Hawkins: Is there some funding for the water testing? Does that come out of the Health ministry, out of the provincial health officer's budget or out of the Ministry of Environment?

Hon. J. MacPhail: As stated this morning, the purveyor must do the testing. The purveyor is the one responsible for the water, so they pay for the testing. But the auditing of the safe water is done by the medical health officer, and that is provided for in the health authority's budget.

S. Hawkins: I think I'm getting a clearer picture here. The member for Kamloops-North Thompson was talking this morning about this issue in his riding, and there seems to be some confusion on when the testing started and who was actually paying for it. It stopped -- it wasn't being done -- and then the city was asked to pick up the bill. There seems to be some confusion. The city didn't even know that the water was being monitored, and the tests were $350 weekly. That's why I'm trying to get a sense of who is responsible. If it's a public health issue, is that something that perhaps the office should have made the city aware of that they were doing? Or is this something that the health unit has a budget for, and when they run out, they make the city aware of it?

There seems to be some confusion in this case. I know I'm just bringing it to the minister's attention for the first time, but can the minister give me some guidance? Did something fall between the cracks here, and the city should have been aware of it? Should the health officer have made the city aware and perhaps the funding for the tests should have been cleared up before it ever stopped?

Hon. J. MacPhail: We haven't been made aware at all of the situation the member for Kamloops-North Thompson describes, so we'll look into it. It is the purveyor's responsibility to collect the sample. All samples are tested for free. The laboratory test is free through the B.C. Centre for Disease Control, so there's no cost there. I can only assume it's around 

[ Page 3691 ]

the issue of collection of the sample. It is the purveyor's responsibility, and we do the auditing. If there has been some miscommunication around that, we'll certainly look into it. It hasn't been brought to our attention until now, and we will do so.

S. Hawkins: I'll let the minister know that it was the south central health unit and the city of Kamloops. So that's something I'm sure will get some attention. Can we be made aware of any other areas, if the ministry is aware of tests presently being conducted or concerns around drinking water because of Cryptosporidium or giardiasis?

Hon. J. MacPhail: Testing is done throughout the province on indicator organisms -- the bacteria -- but the testing for Cryptosporidium and giardiasis is very expensive. We in British Columbia actually lead on it because of the nature of our terrain. Those tests are done by consensus in the profession when there is an indication of an outbreak. The other tests are done routinely and uniformly throughout the province.

S. Hawkins: The issue does come very close to me, since I contracted one of those bugs last year. I know we have had a boil advisory in our community already. It has been taken off, and we just hope that there is continued testing, because it is the seniors and people who are ill who are most susceptible.

Yesterday we talked about the AIDS strategy. The minister did give me a document, and I'm wondering if it's the right one. The header is: "Community Recommendations for Action through 1999 to 2000." It says: "Towards a Provincial AIDS Strategy." This doesn't seem to be the AIDS strategy. Is it still being worked on? This document seems to be a compilation. Apparently, there were communities and groups that were brought together to come up with recommendations, and there seem to be numerous recommendations. I'm wondering if there's a strategy to look at these to see which ones will be implemented on a provincial level.

Hon. J. MacPhail: It certainly is a living document, just as the whole provincial AIDS strategy has evolved over the course of the last five or six years. As we discussed yesterday, this is a discussion document to update the next steps. It is all the strategic elements brought together by all the stakeholders. Moffatt Clarke has been hired to discuss with the community the order in which we implement, understanding fiscal constraints but also understanding the health priority in this area.

S. Hawkins: My understanding is that it's still being developed and that Mr. Clarke -- who is the expert consultant who has been hired by the ministry -- is working with groups to implement these recommendations. Could I just ask, if he's on contract, when he will have this completed by?

Hon. J. MacPhail: Moffatt Clarke is on an exchange from the federal. . . . He is a federal employee, but he's on secondment to us. He is well into his work. The initial exchange is for one year, but it can be extended. What is happening is, of course, as this. . . . I mean, it truly is a living document. Things get changed. Well, priorities change as certain aspects of the document are already implemented. A plan of what the remainder of the strategy is till the turn of the millennium will be announced within the next month or so. But certainly it's my view that any strategy has to be flexible enough to meet the changing nature of the disease, as the information -- always anecdotally believed to be true by our B.C. experts, but now confirmed -- is that the intravenous drug user population is at greatest risk. We have to keep our plan flexible enough to make the changes to target the highest-risk population, as necessary.

[3:00]

Leave granted.

L. Stephens: In the gallery today are grade 7 students from Simonds Elementary School in Langley, together with their vice principal Mr. Bennett, and 17 parents. Would the House please make them welcome.

S. Hawkins: I appreciate the minister's comments, and I do realize that priorities change. This is an issue that has been getting a lot of attention from public health-oriented groups. We look forward to the announcement in a month, and we look forward to seeing the combination of Mr. Clarke's work in the way of a more focused strategy.

I have another question pertaining to the tobacco strategy that the minister has put in place. Can we get an idea of what has happened around tobacco reduction programs in the last year and what we're doing for children in this province?

Hon. J. MacPhail: If I could just get some clarification. . . . We did go into detail on this. Was the member absent for that? I'll just quickly review it, but it is on the record.

It's no secret that we're working on a strategy around tobacco issues that will be announced very soon. Currently our program is almost $2 million. The focus of our strategy is around reducing tobacco use by young adults, particularly young women and girls. It's done through the schools, but mainly through health organizations such as the B.C. Cancer Society and the Heart and Stroke Foundation.

In terms of the children, I'll just go over that. There are also programs targeted specifically to adult women, but for children there's Supporting a Smoke-Free Generation. These are initiatives encouraging communities to identify local concerns regarding tobacco use by children and to work with young people themselves to identify strategies for change. The "KidZone" series on Knowledge Network looks at tobacco use in youth and the strategies to help them say no to smoking, and there are school and community-based smoking prevention programs for children and youth.

S. Hawkins: I've been running between the two Houses, and I apologize if the minister had to repeat herself.

I'm encouraged to hear that. That's an issue for young people that's close to my heart.

Perhaps I missed this too. I hope I didn't, but I know the ministry has launched a hepatitis C program to find the people that may have been affected and infected by blood transfusions. I wonder how successful that program is so far, and if we can get an update on that. I also wonder if the minister could give us an idea of what was budgeted for that program to track the people that were affected.

Hon. J. MacPhail: Let me start to do this from memory. The budget is around $5.5 million. That's what we're estimating for it, but, of course, it does literally depend on the uptake as a result of the notification program, because there are 

[ Page 3692 ]

physicians' fees and laboratory costs that arise from people taking the notification and having the tests done. We started the program on April 14, 1997. There are two major components. One is the notification of the more than 50,000 people that we can actually identify through hospital blood bank records who have received a transfusion prior to June of 1990. We know that hospital records go back to approximately 1985, so those letters of notification went out. One of the benefits in what is a very serious health issue is that we've got a database that is across hospitals now. It's really the first of its kind -- a database of blood transfusion recipients that is now the model for other jurisdictions that may move forward on the hepatitis C notification program.

The other part of the program is an education program where it's not only advertising posters and print materials but also notifying physicians about the issue, as well -- a mini-education program for physicians. It is interesting that we had unprecedented cooperation from the hospital blood banks to provide the patient data. And for the member's information, our campaign is going to be repeated now, because the uptake from the notification is certainly not as intense as we would like. So we're going to start the public notification campaign again in the coming days.

S. Hawkins: I appreciate those comments as well. In the blood advisory report that the minister received earlier -- I guess it was last spring -- there was also a recommendation about the slow virus, which was the Creutzfeldt-Jakob virus. I remember the news stories around that and the effects on patients who may have had transfusions. Is there something in the plans for education or awareness that the ministry has funded for that as well?

Hon. J. MacPhail: The advisory committee recommended that there be no public notification on the matter of Creutzfeldt-Jakob disease, because there was no evidence that it was transmitted through blood transfusion. However, they did say. . . . And we did put in place an information hotline around CJD. The hotline gives information on Creutzfeldt-Jakob disease, and it also instructs callers to write to the blood recipient notification project if they require more information on CJD.

We also requested hospitals to develop lists of persons who received blood or blood products identified by the Canadian Red Cross Society as having been donated by persons suspected or known to have developed Creutzfeldt-Jakob disease.

S. Hawkins: At this time, could we raise some questions on the Medical Services Commission, if the staff is here? I received a draft breakdown from the ministry staff, and I have a document in front of me that I believe is. . . . It's dated May 9, 1997. It gives a detailed account of estimates for this budget year. I wonder if the staff is familiar with the document that I received and if they can confirm that the numbers for the MSP are the same or if they have changed. It was a document dated May 14 that was brought to my attention.

Hon. J. MacPhail: Yes, I too have the document, and yes, it is essentially the same.

S. Hawkins: The MSP contributions, then, for all the different areas that it services, are on there, and there is an increase for BCMA fee-for-service. Is that an increase over last year, or is that including the money that was. . . ? Well, I wouldn't think it was the money that was put in last year. Is there, then, a deal being done with the physicians? And does that include the amount, or will it be topped up again at the end of the year?

Hon. J. MacPhail: There are two factors in the 4.9 percent lift. One is the announcement that we made, I think in April, of a 2.4 percent increase in fee-for-service payments to physicians. And then also, the inclusion of the special warrant around medical. . . . If the member remembers, we had a special warrant that resulted because negotiations for fee-for-service. . . . Negotiations between the BCMA and the government had not yet been completed at the time of the budget for '96-97, so what was in the blue book was an estimate of the negotiations. We then completed negotiations, which were literally higher than had been estimated in the estimates prior to the completion of negotiations. The combination of this is a restated amount for '96-97 that includes the special warrant, plus the 2.4 percent lift for '97-98.

S. Hawkins: The agreement made with the physicians -- is that on a yearly basis?

Hon. J. MacPhail: Like any other contract, there is a time limit or there's an expiry date on the contract that varies. The one currently in effect expires March 31, 1998.

S. Hawkins: There is also a physician benefits fund. I wonder if the minister can explain what that is.

Hon. J. MacPhail: The fund includes benefits for physicians: their pension plan; continuing medical education, CME; the physician disability insurance; and then the Canadian Medical Protective Association insurance -- liability insurance.

[3:15]

Hon. J. MacPhail: Certainly the Medical Services Plan payments to physicians are being retained by the ministry. Frankly, there are no plans at this time to regionalize the payments, but I know that neither side -- neither the ministry nor the B.C. Medical Association -- in any way precludes those kinds of discussions. We haven't reached an agreement to say, "Pinky swear, we'll never do it nor will we ever request it," but there are no plans at this time.

S. Hawkins: Pinky swear -- I'll hold you to that.

Last year in estimates we also canvassed a little about deinsurance of services. At that time I believe there were skin moles, warts and that type of thing being deinsured. Can the minister tell us what's been removed from the schedule this year as far as deinsured items?

Hon. J. MacPhail: Nothing.

[ Page 3693 ]

S. Hawkins: I understand there is a committee that looks at how deinsurance is going to occur. I believe it's a committee. . . . I believe it's the MSC in consultation with other groups. Perhaps the minister can just explain how that works.

Hon. J. MacPhail: There is a joint protocol steering committee comprised of the B.C. Medical Association and the Ministry of Health. That committee examines issues of utilization, appropriate utilization or changes in utilization, across all medical services funded under the Medical Services Plan. That committee would be the one that would examine any proposals for deinsurance. The ministry is not putting forward any proposals for deinsurance, and to date I'm not aware of any that the BCMA has either. But that would be the appropriate body.

S. Hawkins: There was a projected savings, I believe, of $7 million last year -- that was the estimate -- from removing warts, moles and skin lesions from MSP. Did anyone track the exact amount, or can we get a figure of what the savings were?

Hon. J. MacPhail: The savings are $7.1 million in terms of what we had been paying and are no longer paying for with that deinsurance initiative, which is. . . . Anyway, you know what it is.

S. Hawkins: That was from last year, I would assume.

Hon. J. MacPhail: It was put in place October 1, 1996, but those savings are annualized as a result of our experience from October until now.

S. Hawkins: I have a bit of a concern about how the deinsurance process works, because right now it is made with the Medical Services Commission and a group that bills for it. The public -- meaning those at large who use the service -- really are not involved, unless there is a process where they can become involved or if the ministry has a process where they can become involved. If services are going to be deinsured, is there a way that it's vetted before the decision is made?

Hon. J. MacPhail: Actually, the Medical Services Commission has three publicly appointed members representing the public interest. I met with the Medical Services Commission in the spring and certainly was very heartened by the advocacy on behalf of the public that the three and, really, the whole commission bring to it. There is no question that there are vested interests in six of the nine appointments. But the three publicly appointed members are highly qualified and certainly see their role as in the public interest -- just as we do in this Legislature, in maintaining. . . . I certainly see myself as representing the public interest, as I know the member opposite does as well.

S. Hawkins: As a consumer of health care in this province and as someone that represents people, I think people have to realize that they have to be more responsible with their own health and with the services they utilize. It's important that, if we can, at least some responsibility be placed on the consumer.

It would be important to somehow involve them in the process that does involve deinsuring a service, if it does exist. You know, perhaps the public could be involved in discussions -- in letting us know whether they're services that perhaps they feel we shouldn't or should be paying for. It just seems that sometimes these decisions are made without input from the people who actually use or overutilize the service. So it's just a suggestion I'm throwing out. If there was a way to involve people, it might be useful.

Something that I'm very keen on is making the health consumer aware of the services that are utilized and the expenditures that go into it. Get their input on whether they actually think it's important for our health care system -- taxpayer-funded -- to be paying or not paying for certain services. I don't know if the minister has a comment on that.

Hon. J. MacPhail: I think it's a point well taken. We are moving forward in that direction. It's interesting how regionalization is lending itself to some pilot projects in this area. For instance, there is one exactly as the member describes. It's called the self-care project. It was initiated this fiscal year; it's between the Medical Services Commission and the capital health region. They're testing a demand management strategy, really, through self-care education aimed at reducing unnecessary use of medical services. It's directly aimed at the consumer, with consumer participation.

Then there's another pilot that's called the high school curricula pilot project. It's a joint initiative between the Ministry of Health and the Ministry of Education. We're developing a curriculum module for high school students about the health care system, basic self-care, appropriate points of access and use of medical services. Then, as a result of this pilot, we're testing the value of this long-term strategy, really, for influencing the future culture of health care consumerism in British Columbia.

The last pilot project is around emergency room use, which is testing the effectiveness of educating the public about appropriate use of hospital emergency rooms and after-hours medical care. It will be used to evaluate its success in a particular region and then see its application elsewhere in the acute care sector.

Those projects are funded out of this year's budget. I too look forward to seeing the results of them. This probably will form the annual reporting through the regionalization process.

S. Hawkins: Interesting study -- I look forward to the results of that one, too.

Another initiative that the ministry undertook last year, I believe -- it was in concert with the BCMA or the physicians' group -- was: how many visits to a doctor would be paid for? Over and above a certain number of patients a physician would see, they would get a reduced rate, or they would not get paid for many visits. I believe the policy was more for -- I want to say McDoctor clinics -- the walk-in clinics that sort of mill patients through. I'm wondering if the ministry has tracked this, and what kind of a success they feel this policy was.

Hon. J. MacPhail: Yes, we are tracking this. This will be part of the discussions with the B.C. Medical Association, in negotiations with them. The actual claim restriction was implemented October 1. The services that exceed $47 per day are paid at a discounted rate of 50 percent, and then claims exceeding $65 per day are not paid. We are tracking this. We share the information with BCMA, but we can also make it available -- the success of it -- on an annual basis as well.

S. Hawkins: There was also a policy that went into place -- that I know we're going to have discussions on in the 

[ Page 3694 ]

Legislature at a later date as well -- with respect to designating areas of the province where physicians could practise and receive full benefits or half benefits or 75 percent benefits. This gets back to the northern issues. I understand that the recruitment and retention rate for physicians in the north is very, very low; they have trouble getting them. Now, is this policy working? Have we tracked that? Have we encouraged more? Has MSC actually tracked this to find out if we're encouraging people as a result of this policy?

Hon. J. MacPhail: Yes, and we will have a good chance to discuss this in legislation -- Bill 21, Medicare Protection Amendment Act, 1997. Anyway, it has been in place since October 1, '96, but the interim physician supply was introduced in 1994, as well.

[E. Walsh in the chair.]

Just a couple of statistics. There are physician supply measures numbers. The numbers given to physicians that are part of the physician supply program are called physician supply billing numbers. There has been a steady increase from 258 in 1994-95 to 354 in 1996 -- as the interim measures were in place -- and in '96-97, 386. Of the 998 new physicians enrolled with Medical Services Plan since the measures were introduced in 1994, 266 entered practice in overserved areas and were issued 50 percent or 75 percent billing numbers. Most of those physicians are supplying locum services in urban centres.

[3:30]

S. Hawkins: I wonder if the ministry also keeps track of whether these positions are going to the poorly serviced areas. Are they B.C.-trained doctors? Are they Canadian-trained doctors, or are they out-of-country doctors? Does the MSC keep track of that?

Hon. J. MacPhail: The numbers that I gave you include B.C.-trained doctors as well. Just for the record, now and through the next four years, all B.C. medical graduates get 100 percent billings; their fees are not reduced. That's part of the physician supply program. The numbers that I gave you in terms of location in the NIA communities include B.C. graduates, as well.

S. Hawkins: The reason I ask is that I know there was a policy that was going to be put into place, effective this June, not to allow out-of-country physicians to have medical licences. I wonder if the ministry was aware of that. The Royal College, actually, was advocating that, and they were going to review it. I know that northern communities depend on physicians from other countries to come and service some parts of the province that I suppose other doctors are not going to. Is the ministry involved in advocating for these communities, to allow for those physicians to come as the need is required?

Hon. J. MacPhail: Actually, that was a federally initiated policy. We actually took immediate action to urge the federal body to stop moving toward that initiative, and in fact they did. The policy is now stopped, for all intents and purposes. The former Minster of Health wrote to them, and I did as well, saying: "Please don't do this. It will unalterably affect communities such as Fort St. John, just to name one." So they stopped. Our policy actually is very generous in terms of allowing out-of-country physicians to stay in a community and give that community some stability in its medical services.

S. Hawkins: I was up north, as well. There's certainly a good quality of life there, if a physician and his family get to enjoy it. A lot of times, the community tells me, they can entice them up there and show them the beautiful country. But as far as giving them time off, the help isn't always there. Was there something in the ministry's initiatives that dealt with that problem? Does the ministry have a locum service or other initiatives that they use to help doctors get some relief up north, or in rural communities?

Hon. J. MacPhail: Yes, the B.C. locum program covers that very important issue for physicians. The B.C. locum program provides for the ministry to fund a locum in a community that has three physicians or less, up to a per diem of $600, for a physician to go in and give relief to the physicians in the community. We pay for that program, and it is meeting with a great deal of success.

S. Hawkins: When was that program implemented? If you have them available, can I just get some stats on how many times it was accessed and was successful?

Hon. J. MacPhail: The program was initiated in June of '96, so it's relatively new. There are currently six locum physicians participating in the program. The program has been operating at this status for ten months. Respite locum services have been provided to 19 physicians living and practising in 13 small rural communities. There have been a couple of requests for locum assistance that haven't yet been met by the program, but in order to address the shortfall of a couple of requests, we're actually recruiting more locum doctors for the locums, as well.

S. Hawkins: Is the locum program restricted to only certain parts of the province that get that benefit? Can I just get an idea of which parts specifically get that benefit?

Hon. J. MacPhail: It's called the northern and rural locum program. It's for northern and rural communities with three or fewer full-time physicians and is eligible for northern and isolation allowance.

Did the member ask to what communities does it apply?

S. Hawkins: No, that's fine. My understanding is that it is a very. . . . I don't want to say narrow. It's a very good program, but it doesn't always hit the communities that are crying for help. Maybe the physicians need to work out their call schedules a little better amongst themselves, too, I suppose -- work out their needs. In some communities where there are more than three and one falls ill or whatever, sometimes that program doesn't always kick in as fast as they and their patients would like. But it's encouraging to see that a program like that is in place and is being accessed.

Just for interest's sake, down on one of the line items is a reserve account. Can the minister explain what that is and what the money is used for?

[ Page 3695 ]

Hon. J. MacPhail: The reserve account was the result of negotiations in the last couple of years. There was money in the Medical Services Plan that was guaranteed, that would stay there and be used. Even when we put the hard cap in place on the Medical Services Plan payments, the money that was in the Medical Services Plan became a reserve account. It was agreed upon that that reserve account would be drawn down before physicians had to go to proration. That account has been drawn down to the extent that the agreement requires that there be a remaining $4 million left in it. There is still that $4 million left in it, but it can be used again until its expiry, until it's empty, before proration of Medical Services Plan fees starts.

J. Weisbeck: The member for Langley asked a few questions a couple of days ago on midwifery, and I'd like to ask a few more if I could, please. I've been sort of kidded by my colleagues, who are asking: why would I be interested in midwifery? Having been a practising dentist for 25 years, I very often had my female patients say that they'd rather have a baby than have a root canal, so I feel somewhat connected to this.

Actually, my interest probably lies more in the efficiency part of it. Especially with our limited health care dollars -- and I'm pleased to see here the former minister who was responsible for bringing in this program -- why would we get started on this whole thing? What was the demand out there? What's the motivation behind developing a college of midwifery, other than to give an option?

Hon. J. MacPhail: Really, in western medicine we're one of the. . . . Well, even within the context of western medicine, the North American jurisdiction is one of the last to legalize midwifery. It's an extremely important medical service, but it has also been a medical service where highly trained health care professionals other than physicians can provide certain aspects of pregnancy, labour, delivery and postpartum care. There are certainly quality-of-care issues, where the intensity of service that can be given by a midwife in a very cost-effective way meets the needs -- a holistic approach to the health care of not only the mom-to-be but the child as well in a very cost-effective way. It can be the least intrusive method in the birth experience, and it's also very safe, healthy and certainly in demand by a great number of families.

The bylaws of the College of Midwives were approved on April 2, 1997, as I said earlier in the estimates. We are publicly funding discussions with the Midwives Association of British Columbia. The College of Midwives of British Columbia regulates the practice of midwifery, they're defining the scope of practice for midwifery, and they designate a reserved title for the practitioners.

J. Weisbeck: I am told that probably approximately 5 percent of women would prefer to have their babies with a midwife. If this is actually the case, would you in time be assigning patients to midwives to fill up their schedules? Do we take away that choice?

Hon. J. MacPhail: No. It would be by family choice entirely.

J. Weisbeck: I also would like to know whether or not there is a rural or an urban sort of designation area. Are you trying to promote midwifery among rural areas, or are you going be confining them to the larger centres?

[3:45]

The college will be responsible for regulating the practice of midwifery and ensuring that safe health care facilities and the registered midwives are in place, and they will do that no matter where the midwife is going to practise. But certainly there is no restriction. Once the regulations, the safe practices and the scope of practice have been met according to the College of Midwives, midwives will be able to practise throughout British Columbia.

J. Weisbeck: Regarding the College of Midwives, you said they are regulatory. Are they also disciplinary?

Hon. J. MacPhail: Yes.

J. Weisbeck: I'm assuming that, obviously, midwives have to be trained somewhere. What schools will we recognize? Do you see in the future that we will have universities, for example, offering a course in midwifery?

Hon. J. MacPhail: The college establishes the training program for midwives.

J. Weisbeck: I'm interested in a comment made that the B.C. system will probably follow the Ontario model. So I'm interested in the employee benefits. What are their salaries? The comment was made that they'd be making between $60,000 and $70,000 per year. What would their benefits be? What would their hours of work be?

Hon. J. MacPhail: We're currently in funding discussions with the Midwives Association of British Columbia around compensation and benefits.

J. Weisbeck: So you can't give me any idea what sort of costs are involved? You're telling me that this is a cost-efficient service. How do we know that?

Hon. J. MacPhail: In just the same way that we engage in funding matters with every other health care profession in this province, except dentists. . . . We are in negotiations on that funding right now. We have allocated a budget -- I discussed this earlier in estimates -- and we're now in the process of allocating those funds.

J. Weisbeck: But you made a comment that it's more efficient, cost-efficient. How can I know that unless I'm given some sort of number as to what it's going to cost per birth?

Hon. J. MacPhail: I said cost-effective, and certainly we will be making. . . . As the funding agreement has been negotiated, we'll certainly make that public.

J. Weisbeck: I'm told that the cost under our current system is about $800 per birth. This includes all pre-, intra- and postnatal care. I'm also told that the midwives will be responsible for -- if they're following the Ontario model -- 40 births a year and will have to assist in another 40. So basically, they're in charge of 40 births a year at a cost of, for salaries alone, $60,000 to $70,000, plus their benefits. So I'm trying to get these numbers in my head here, that this is supposed to be more cost-effective than our current system. To me, they don't 

[ Page 3696 ]

add up. I mean, it looks like by using midwives it is triple the cost of bringing a baby into this world as compared to our current system.

Hon. J. MacPhail: As I have explored this before in estimates, the funding discussions are ongoing. I certainly will make them public at the time the agreement is reached, just in the same way that the BCMA funding is a public document.

J. Weisbeck: There's been a real emphasis on home deliveries. Obviously there's a risk factor involved, and I would like to know what sort of coordination or integration they have with the ambulance services when it comes to handling any emergency that might occur.

Hon. J. MacPhail: We have a home birth demonstration project, as required by the midwives' regulation, to determine and implement effective administrative arrangements for midwife-assisted home births. Major components of this project will be the development of protocols with the B.C. Ambulance Service for emergency transfer of women to hospitals and the monitoring of all planned, registered, midwife-assisted home births for a period of two years.

J. Weisbeck: In some jurisdictions they have some sort of a helicopter service where they can bring patients who have an emergency to the hospitals. Do you see that sort of thing happening, and what would be the cost of such a service?

Hon. J. MacPhail: Well, we have a Medivac program and certainly under the B.C. Ambulance Service, we can discuss that. If the member wants to engage in the estimates around the B.C. Ambulance Service, we can do that. That's available throughout the province on the basis of medical need.

J. Weisbeck: There seems to be a move in some areas that the midwives would replace the RNs. Is this going to be happening in British Columbia?

Hon. J. MacPhail: No.

J. Weisbeck: I think they are currently talking, as well, about the medical doctor seeing these patients for the first trimester. Is that correct?

Hon. J. MacPhail: Sorry, I didn't get that.

J. Weisbeck: The medical doctor will be seeing the patient, or the future mother, for the first trimester. Is that correct, or does the midwife have that patient for the whole term?

Hon. J. MacPhail: The College of Physicians and Surgeons was involved and has agreed upon the regulations for the practice of midwifery, so the whole nature of care surrounding the moms and babies has been well attended to, in terms of the integrated health care professional approach. But to answer the specific question, the midwife can give care throughout the entire pregnancy, unless there is a clinical decision that a physician is required or through the choice of the family.

J. Weisbeck: I understand that B.C. Women's Hospital has the only hospital-based midwifery program. The five part-time midwives delivered 144 babies last year. What was the cost of that?

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

L. Reid: Previous Ministers of Health and Elizabeth Cull, when she was minister. . . . She and I had many discussions regarding the aboriginal program and whether that would extend to midwives in the province. The discussion we had at that juncture was about prenatal and postnatal health for aboriginal women. Both she and I agreed that that was a significant issue, and a number of the discussions we had surrounding midwives in British Columbia looked at having a significant specialized component of the midwifery program to extend to the aboriginal population.

I'm not clear if this minister has covered, perhaps in a status report, where that program is today. I know that there was such a commitment for it -- probably three and a half years ago -- and if the commitment is valid, the program should have some results that would be worth reporting on. Would the minister kindly comment?

Hon. J. MacPhail: Yes, there's a committee on aboriginal midwifery that is set up within the college to deal with the registration requirements and the standards of practice for both traditional and non-traditional aboriginal midwives. The committee consists of aboriginal people appointed by the board in consultation with the aboriginal community. The home birth demonstration project includes an aboriginal midwifery component. Of course, now that the College of Midwives has been set up, they're responsible for aboriginal midwifery initiatives.

L. Reid: I appreciate the minister's comment. However, what I'm looking for is a specific status report. I appreciate that the committee has been set up, but if indeed this project is getting close to four years of age, I would assume that's probably been the case since we had the initial discussions. How has the aboriginal population been assisted by access to aboriginal midwifery? How many aboriginal births have been assisted by midwives? Has the committee had a productive influence on that process? Those would be my questions.

Hon. J. MacPhail: If there's a specific request about the performance of midwifery services on reserve. . . . Is that the question? I can just report that the Nuu-chah-nulth community hosted a consultation with aboriginal communities in January 1997 to discuss the further development of aboriginal midwifery. That's the basis. We're moving forward at a pace that fully involves the aboriginal community. The report from that was submitted to the College of Midwives in March 1997 and transfers the responsibility of this whole thing to the committee on aboriginal midwifery. So that's the status report.

K. Whittred: I ask leave to make an introduction.

Leave granted.

K. Whittred: Seated in the gallery this afternoon are students visiting Victoria and the Legislature from Sutherland Secondary School in North Vancouver. There are nearly 100 students here today to observe the workings of the Legislature. They are accompanied by their teacher Mr. MacKenzie and their principal, Mr. Green. Would the House join me in making them welcome.

L. Reid: Just prior to the introduction, the minister suggested that the Nuu-chah-nulth nation hosted a consultation. My rendering of that would be that they held a meeting. I'm 

[ Page 3697 ]

interested to know if anything else has transpired between the initial discussion of an aboriginal committee on midwifery and today. My rendering of this discussion is that it has probably been three and a half or four years since the initial discussion.

I'm trusting that we are well beyond having hosted a consultation, which I see as yet another meeting on the process. Indeed, I'm looking for some kind of accountability benchmarking discussion on whether the introduction of midwifery into the aboriginal community has had a positive impact -- not whether they held another meeting. How is this ministry going to evaluate it, first off, from a cost-benefit analysis perspective, and second, from a performance perspective? Is this indeed improving the pre- and postnatal health of aboriginal moms and babies?

Hon. J. MacPhail: Well, midwifery services on reserve are subject to the same regulations as anywhere else, but there was a traditional. . . . As has been previously discussed, aboriginal midwifery practices have existed with or without our approval. These included the use of traditional herbs and medicines, and the management of home births on reserve by aboriginal midwives who practised prior to regulation. That status hasn't changed.

What has changed is as the member outlines. There is a traditional midwife from a first nation who is on the College of Midwives board, and indeed, the aboriginal community itself has met in a formal way -- as I outlined in January '97 -- and made recommendations. So that is what has progressed.

I might say that this is not the movement forward around getting midwifery regulated, registered and up and running. That has not moved with lightning speed. There have been roadblocks in the way that have been substantial, and some of the queries in the House today have highlighted those roadblocks. Nevertheless, we are well on our way, and what now formalizes the process around aboriginal midwifery practices is that there is a committee of the college dealing specifically with aboriginal midwifery.

[4:00]

One of the original discussions we had was around low birthweight infants, that having decent prenatal care would assist in that. Is the minister standing today and saying that that hasn't changed, that there has been no dramatic improvement? That concerns me, because this process has been ongoing for quite some time. If the minister is prepared -- and I trust that this is valid -- to stand and say that the program is a good thing, that it is improving the outcomes for these babies, that fewer infants are dying at birth or dying before they reach one year of age. . . .

We've always had the discussion in this Legislature about poverty being a significant determinant of health. One of the reasons that we believed mightily in the midwifery program was because it would provide that level of support and intervention to pregnant moms so that they would be doing some decent things in terms of caring for their pregnancy from the outset. So it doesn't warm my heart that the minister is saying the status hasn't changed. I want the minister to be able to stand up at some juncture in this Legislature and say that the medical outcomes, the health outcomes, for those babies has dramatically improved as a result of this intervention.

I truly appreciate the minister saying that in the past aboriginal midwifery was practised without regulation. No question. That was the case in many parts of the world. But if we're going to commit to regulating the exercise, are we also committing to evaluating the outcomes?

The minister is well aware that I have a real concern around accountability, not just for this program but for all programs that government delivers. Is there some mechanism in place? Can the minister perhaps provide a time line when indeed performance will be evaluated? Are we getting X number of infants born on reserve who are of a dramatically increased birthweight this year over last? That's the kind of information I'm looking for, and I would be pleased to receive it at any time.

Hon. J. MacPhail: When I say that the status hasn't changed. . . . The formal regulation of midwifery on reserve is taking place at the same pace, and they are subject to the same rules and regulations of the college now -- on reserve and off reserve.

But what has changed is that the community itself is now part of the college. There is a formal aboriginal midwifery committee of the college. They have identified the issues for the college subcommittee to address. I can certainly make those issues and that report available to the member. That's the report dated March of 1997. Certainly aboriginal midwifery issues rest with the College of Midwives now. There's not a separate health care system for people who live on reserve. That was what I meant by the status. But I certainly can get that report for the member.

Also, the provincial health officer's report of last year -- the conclusion of the last calendar year -- is being released very shortly. As always, the provincial health officer spends a great deal of time on aboriginal health issues and will be addressing this matter as well.

L. Reid: I thank the minister for the clarification. I appreciate that there is a similar, if not identical, set of regulations in place, whether you're born on reserve or off reserve, that will regulate midwives in the province. Perhaps the information is in the material that the minister has just promised, but at some future point I would like the information that talks about how many midwife-assisted births there are in the province: how many on reserve, how many off reserve and whether or not that has resulted in an improved outcome for any child in this province. Are we seeing improved health status as a result of this program? That has to be the question, no matter what the health program.

That kind of information hasn't been received today, hasn't been debated in this House. The answers don't appear to be available today. I accept that, but at some point, in terms of the number of births and the number of improved outcomes as a result. . . . That was the original discussion. That was certainly the discussion when the home birthing demonstration project was discussed. What are we doing? How could we do it differently? Will it result in improved outcomes? I don't think the answer is available. If it is, I welcome it. If it's not, just give me some indication of when we might expect that.

I know the home birthing project discussion has been ongoing again, probably for about four years. At some point I trust there will information published that says: "These are the 

[ Page 3698 ]

number of births we assisted with, this is the outcome we wished, and this is the outcome we achieved." The member for Delta South talks repeatedly about benchmarking and talks about accountability questions. He talks about reporting back to the taxpayer how best to achieve some kind of outcome that's understandable to the public. Would the minister kindly comment?

Hon. J. MacPhail: The point is well taken. Those evaluation benchmarks will be put in place, and we will provide you with that information. The member asks when. On April 2 the regulations became official. We are going to provide annual reports, and I would expect that we will be able to provide that kind of evaluation for part of this year at the end of this fiscal year.

L. Reid: I thank the minister for that. As well, I would ask if the information on the home birthing demonstration project could be included, because I think the questions are equally valid.

I have many, many questions on accountability and benchmarking and the like, and I will return to this debate at a later date. I thank the hon. minister.

[G. Brewin in the chair.]

A. Sanders: I rise to continue the questioning on midwifery in British Columbia. I've listened intently to the debate of the members here in the House -- and specifically of the member for Okanagan East, who I felt asked some very important questions about midwifery and did not get the answers that he required. Therefore I will take up some of those issues again in order to clarify them for the record.

When we look at midwifery, the minister has mentioned that North America is one of the last bastions to not have midwifery. In terms of midwifery being recognized, this is in fact the case. For the minister's information most of the RN staff we have in a lot of the smaller locations in British Columbia are British-trained nurses -- as we do have many British- or European-trained physicians -- and many of these people are trained midwives who practise in British Columbia as registered nurses. Having been one of those individuals who worked in a more northern location than most of us are used to, I can tell the minister that the majority of the nurses I worked with on the maternity floor -- in the hospital in Quesnel, for example -- were midwives, and they were excellent.

I have nothing but good things to say about midwives. They provide an excellent service; they provide alternative care; they provide a choice for our patients; they provide the possibility for home births. All of these things provide options for us. But those options must not be confused with cost-effectiveness.

We're in a circumstance at this point where cost-effectiveness has become the buzzword for every ministry. In the area where I'm spending more of my time, which is Education at this point, cost-effectiveness and accountability are the terms that keep coming up over and over again. In terms of health care in the last two decades -- especially the last decade -- cost-effectiveness has been the mantra for everyone, from the minister all the way down to the patient. Although some people have been forced into the role more than others, it certainly has been a motivation and a vector for changing the direction of how we even do health care in B.C.

So if we're looking at midwives, it's really important for the public to recognize that we're not talking about cost-effectiveness. In fact, there is probably more information to suggest that the introduction of midwives will increase the cost of medical services in British Columbia. There are a lot of questions the public wants answered around that above and beyond what studies are being done. What the public wants to know with our health care -- which everyone claims to see as spiralling out of control, taking up approximately 26 percent of our GNP -- is if we are actually in a situation where we're going to be paying more for midwives, and if we are, should we know that? Those questions need to be answered by the minister, and they need to be put on the line for people to be able to formulate further questions more effectively.

In my view, midwives are on the agenda. They have come on the agenda under an NDP government. I don't think there's any coincidence about that. I think they've come on the agenda because of lobbying groups -- and I have no problem with that at all. I think they've come out because women are looking for more choices. Often having been themselves born in and then treated by what was a traditionally paternalistic model, they are wanting more control over things like reproduction. It's about women wanting options and recognizing that women can develop options, can lobby for those options and can get them through the appropriate methods within government.

Our responsibility here, hon. Chair, is not what we think as individuals, women, patients, doctors, taxpayers and government politicians. I think our option is reality. I think our option in this House has to be to look at the actual facts, not to tarnish those facts with any opinion from my point of view or from the minister's.

The thing that has to be asked and has to be answered about the issue of midwifery, when we are introducing a new program into a system that is straining under the costs, is: does the minister actually feel in her heart of hearts that midwifery will decrease the cost of reproductive care for women in B.C.?

Hon. J. MacPhail: I maintain that midwifery will be a cost-effective service. It is done on evidence-based medicine. Certainly, the stringent questioning applied to midwifery services should be and will be applied across all health care services now, with our performance measures. The health outcomes will be measured, as the member for Richmond East recommended as well. But just the same way that evidence-based medicine has to be balanced with what is affordable in the system and what is required in the system -- just as physician practices have to and just as the range of health care provider services has to -- the same will apply to midwifery as well.

Certainly, I'm heartened by the comments from the member for Okanagan-Vernon about why the demand for midwifery has perhaps come about. But let's be clear. The practice of midwifery in this province is coming about at a snail's pace because of the concerns raised by other health care professions around the issues that the member herself raises. We're moving at a snail's pace so that we make sure all those issues are addressed. We worked very closely -- and it took quite a long time -- with the College of Physicians and Surgeons to get agreement on the bylaws of the College of Midwives of British Columbia.

Members opposite and I had this exact conversation last August, at which time I thought it was imminent that the College of Midwives would be set up -- and here we are. It wasn't until April 1997 that the College of Midwives was set up, because of the concerns, some important and some 

[ Page 3699 ]

unfounded, of other colleges -- particularly the College of Physicians and Surgeons. We have reached agreement on moving forward with the College of Midwives.

We are currently engaged in funding discussions with the Midwives Association of B.C. As with all health care professions, utilization is important. There is no health care profession in recent years that has ever said to us: "We're unconcerned with the cost-effective methods of our health care." We, too, know that that has to be a factor. It's one factor, though.

[4:15]

I remember talking, in a different role, to a minister of a former government of British Columbia. He was cross because he found that the number of people who were in dialysis at St. Paul's in fact went up, not down, with increased renal transplants. The fact was we were improving people's quality of life by giving them dialysis earlier so that they were able to work, able to function, able to live relatively normal lives at an earlier stage of renal failure, as opposed to the fact that if we operated and transplanted a bunch of kidneys, these people would all automatically go away.

If we introduce a new program in British Columbia, be it midwifery or anything else, we are going to increase our costs in the health care system. That needs to be the framework in the nineties around which we look at every program; that is, any new medical service, any new health care service of any kind.

Some of the things that I'd like to bring up with the minister in terms of the actual costs of midwifery need to be looked at. I propose that midwifery will cause a cost increase in the system, thereby making prenatal, antenatal and postnatal care more expensive. I also propose that this is not a project that will result in cost savings. Thirdly, I'd like to look at some of the areas in terms of where some of these costs that I have not heard mentioned from the minister are important.

The first one is malpractice insurance. In British Columbia right now, if you are practising the care of women in pregnancy and labour, you pay a fee called malpractice insurance. For the average family doctor in British Columbia, the amount of malpractice insurance comes out to roughly ten deliveries. What that means is that for doctors doing maternity care, they must do ten deliveries and be paid for those ten deliveries by MSP prior to starting to make any income doing maternity care.

As we all know, if anyone follows Ontario, malpractice fees are rising substantially, to the point that many practising obstetricians in some of the eastern provinces are no longer taking patients in labour. They are simply doing gynecology, cancer care, etc., because of the exorbitant malpractice fees surrounding birth and labour.

My estimate for malpractice insurance is that for those people who continue to deliver babies in the nineties and into the year 2000, malpractice insurance premiums will rise. I believe, based on settlements that are being made, that they will rise substantially. This is a whole area that no one I have heard, in government or otherwise, has talked about in terms of who is going to insure the midwives, who I feel are putting themselves in a very dangerous situation -- especially in home births, for example. Who is going to pay the midwife malpractice insurance? Will it be -- as is the case with our present practitioners who deliver babies -- that they pay it out of their MSP billings? Or will it be that the government pays the malpractice insurance in addition to the block salary that the midwife would get?

Hon. J. MacPhail: The College of Midwives has identified an insurer who will provide malpractice insurance. It's the same insurer that provides it to midwives in Ontario. The compensation, if any, for malpractice insurance is part of the funding discussions that are going on right now with the Midwives Association of British Columbia.

A. Sanders: Could that be clarified a little bit more? Does that mean that out of the block salary that the government would pay a midwife, they will procure their own malpractice insurance from this association? Or does it mean that you and I as taxpayers will provide that amount of malpractice insurance as part of their package in terms of benefits?

Hon. J. MacPhail: Well, this is an item that's part of the negotiations on funding arrangements that we're in with the Midwives Association of British Columbia. It's not unlike compensation for any other health care provider. This is our position: we will provide a level of compensation to a midwife for her to perform her duties. Both parties recognize that there are certain factors that affect the provision of duties, one of which is malpractice insurance. What is discussed is not that we'll agree to a level of funding and then malpractice insurance being considered separate and apart from that; it will be part of the package of compensation. What is still up for discussion, though, is the size of the amount being given to a midwife on an annual basis. But both parties agree that part of the compensation has to address the issue of malpractice insurance.

A. Sanders: This is an incredibly important point, because what we have now is a system where family practitioners pay their own malpractice insurance -- and, as I said, to the tune of about ten deliveries prior to starting to break even. We have the introduction of a new College of Midwives, which I believe -- and I may be incorrect here -- would be somewhere along the line of nurses, where they are employed by the government and work in governmental facilities. This is an additional ancillary cost that would be above and beyond the hospital insurance.

If this is the case and this is part of the package deal, there will be people in British Columbia who will want to know exactly how much we're paying for what we're getting. I think this is one of those cases of looking at the insurance policy and not reading the small print. You find out that not only are you paying a salary of $70,000 to bring in a new service, but you bring that in with a 30 to 35 percent benefit package, which is pretty common for a unionized worker in the health care system, and that has already got your net over $100,000. And then you're going to bring in a potential for another $5,000, $10,000. . . ? Who knows how malpractice will go now that it's partly under the legal system. Will this come in to be a considerable expense for the delivery of a baby that we were already delivering?

I think that this particular aspect of the circumstance is very, very important. If you then combine that with the fact 

[ Page 3700 ]

that unionized employees within the health care unions now work 36 hours a week. . . . I can tell you that the average family physician or obstetrician working in a northern community, which is exactly where we would need midwives, is not working 36 hours a week. Therefore, for a $70,000 salary for a 36-hour week, we are going to have some problems in terms of increased cost. In fact, we would probably require two individuals to replace the one family practitioner to give midwifery services on a 24-hour basis. I wonder if that particular aspect of hours of work has been discussed between the college and the government in terms of midwifery.

Hon. J. MacPhail: I was fascinated by the description of negotiations. I know that you're just speculating and that it's imaginary in the way you describe it. . . . It's hypothetical, I should say, not imaginary. Certainly what I have said is that the compensation for midwives will be total package compensation and will be announced publicly. These matters are under discussion right now. All of the factors in delivery of a service are under discussion.

Just a half hour ago we were discussing the special benefits fund of the Medical Services Plan. I know that the hon. member is very concerned that the public be aware of the costs of our midwifery, but I think it would come as a surprise to the public that over and above the $1.5 billion we pay to physicians, there is an additional $55 million in benefits, $16 million of which goes to malpractice insurance for physicians.

So rest assured that we will make sure that the compensation to midwives is made public, in just the same way that I think it should be our responsibility to let the public know the compensation for other health care providers that are not. . . . When I go to a doctor, that fee-for-service that the doctor receives does not reflect the full value of the money that he or she is being compensated for. There are pension benefits, continuing medical education benefits and malpractice insurance benefits that are outside the fee-for-service.

We know what we're doing when we negotiate compensation packages. Rest assured that we will make sure that the public is fully informed of the costs of midwifery.

A. Sanders: I'm pleased to discuss the special benefits fund for the B.C. physicians at this time. I'll just do this briefly, because it's not my target of interest at this point.

This special fund was set up by the government in negotiations with the B.C. Medical Association in lieu of payment raises that they were owed. It is a circumstance where there is additional funding that goes beyond MSP, and the government does pay part of the insurance premium. The part that I was referring to from family doctors, in terms of medical malpractice insurance, was the part that was not paid by the government.

The part that is not paid by the government is the equivalent of the ten normal deliveries that would be instituted and carried through. It is not the part covered by the government; it is the part above and beyond that, which comes out of the practitioner's pocket. I am happy to compare that in any form to that of the midwives, inasmuch as we need to know what we're buying. We need to know what we're getting.

Quite frankly, I don't care who does the delivery. There will be many, many physicians in British Columbia who will welcome the midwives and welcome staying in their beds at night as opposed to doing acute deliveries. That's not the point here. The point is not personal between my interests in health care as a physician and the option of midwifery.

What I'm trying to get to are the facts. What I'm interested in is a cost comparison between those facts -- not between groups and not to drive wedges between people. What are we really getting for our money? We are bringing in a new service at a time when we're telling people that they can't go to a lab in their medical building half a foot down the hallway, because we need to have cost containment. And yet we're setting up multimillion-dollar new programs without the raising of an eyebrow.

I think there's some problem here, and that's the issue that I'm addressing. We need to talk about these issues as people who are responsible to our constituencies not just in terms of their choices -- because I truly believe they should have choices; all of us should -- but in terms of what they're going to pay for their choices. If they don't know what they're going to pay for their choices and don't know the full picture, then they don't know what they're getting into, and the answers they give to our questions cannot be termed in terms of their reality because we haven't given them the facts. That, to me, is the responsibility of being in the official opposition or in government: to let people know prior. . . .

[4:30]

In terms of midwifery, there are some things that I'm interested in as an individual in the community who welcomes and anticipates the midwives moving into my community. In terms of low-risk deliveries, my understanding is that the midwives will be working in hospital doing low-risk deliveries, and home deliveries will be done on a pilot-project basis. I'd just like to briefly ask the minister if my understanding, from what I heard in the previous discussion, is in fact the case.

Hon. J. MacPhail: Yes, we just discussed this earlier. All of this is established by the midwives regulations, part of which includes a home-birth demonstration project. We just finished discussing that.

A. Sanders: Would the minister tell me where that project will be?

Hon. J. MacPhail: That's currently being decided. I'll let you know as soon as it is decided.

A. Sanders: Will this be one location, or will it be several satellite locations?

Hon. J. MacPhail: That is one of the things that's being decided.

A. Sanders: What are the criteria on which that location will be ascertained?

Hon. J. MacPhail: I guess this will be the second time, if not the third time, we've discussed midwifery. The staff is not present, but I'll get that information for you.

[ Page 3701 ]

A. Sanders: I looked through Hansard before coming here, and I know that this question has not been asked, so I will be quite. . . .

Interjection.

A. Sanders: The question about where the facility will be has not been discussed or answered. I'd be interested to know that, because there are some important implications of that.

If you go to European countries, for example, where there are home deliveries, the reality that many people may or may not recognize is that in many European countries first babies are always born in hospital. It is only subsequent babies that are born at home. First babies are always considered high risk; they are never considered low risk. That is because of factors such as pelvic disproportion that have not been tried.

Nevertheless, assuming that this pilot project will be second deliveries that will be done at home, there are a number of things that the typical European maternity hospital would have in order to be put on top of the list for the site or the location -- for clearance. A similar example would be when we as a country apply for Commonwealth or Olympic Games. They will evaluate our facilities and decide, after the politics is over and the dust has cleared, whether we have the ability in that location to in fact put on that event with the appropriate number of buildings and transportation systems and so on. Nevertheless, if you look at the European model, most of the hospitals that do home births are equipped with a chopper pad near the maternity floor. There is an ancillary neonatal intensive care unit or staff that can provide neonatal intensive care, and there is an adult trauma specialist or area.

One of the things that hasn't been clearly discussed, for my benefit, is the fact that delivery not only involves a baby and the baby's well-being, but it also involves a mother. Many of the underlying conditions that people get in trouble with with their babies haven't got much to do with the baby at all, but have to do with problems that arise from the delivery itself and the post-partum period.

My question to the minister is in terms of the negotiations for the pilot facility. What are the criteria on which those will be outlaid? Have those types of criteria that I have just mentioned been previously brought to the minister's attention?

Hon. J. MacPhail: As I said, the staff are not present. I'll make sure they're aware of all of your questions and your concerns in this area. I'll get answers for you on it and perhaps provide the advice that you're offering as they move forward on establishing the policy around this. It's very useful. But let's be clear: we're moving forward at a snail's pace. Nothing's in place yet, so your input is appreciated and can be listened to.

A. Sanders: Out of a very particular interest, what opportunity for consultation does the public have in terms of the implementation of services at this point?

Hon. J. MacPhail: The College of Midwives is establishing all of this. I'm unaware of public consultation with any colleges for any health care provision. If the member would like to make a recommendation in this specific case, that would be interesting. But I'm unaware of it in other areas.

A. Sanders: Where would an individual receive an interim document on the status of the circumstances for midwifery at this time?

Hon. J. MacPhail: I'll make available all the documentation that we have.

A. Sanders: I would appreciate that documentation from the minister. I would be very interested to have the opportunity to look at this in a constructive way, as I feel it's an important program. It is also something that I look forward to in terms of service for my patients. But I also look forward to understanding the reality and the actuality of the incorporation of this new service into the larger picture of health care.

At this point I'd like to close the discussion on midwifery, from my point of view, as I feel that the questions I have asked have either been answered or are pending.

I would be interested in just canvassing a couple of areas from my own riding, in terms of the issue of MSP funds. I believe that the member for Okanagan West had questioned the minister on this earlier. I've had a number of letters from patients who had concerns over going to the hospital and having to pay tray fees for the removal of benign lesions. I wonder if the ministry has placed any thoughts in developing an overall letter that hospitals around the province could give to patients. Those could be read by the patients and understood, rather than having a lack of communication between staff and the hospital and the patient. Has that particular thing been thought of or brought to the minister's attention?

Hon. J. MacPhail: I can certainly put that suggestion to the BCHA for their consideration. If they wish to adopt a cross-hospital policy, I'll certainly put that forward to them.

A. Sanders: I think there's some need for direction from government on that. We are responsible through a tripartite commission, which is the B.C. Medical Association, the government and the public. We are responsible, as a group of three groups coming together, to convey that information to patients. As an MLA, I have found -- very, very commonly -- that patients coming into MLAs' offices in the area where I live are very concerned and confused about these kinds of issues. If there were some cross-province incentive, where the government centrally gave a prototype for the hospital nurses, ward clerks or whoever it is in that out-patient facility to provide this information as to why it is, then we would probably save a lot of people a lot of time and do a lot to undermine the confusion, and sometimes the anger, that develops and finally makes it to the MLA's office, which I do not feel is the appropriate place for these things to occur.

In terms of other areas of deinsurance, I listened with some interest to the conversation earlier on deinsurance. This minister was talking about incentives for deinsurance coming from clinical practice. . . . I think there is some confusion there. I hope to offer the suggestion that deinsurance, which means that there are services we paid for last year that we're not paying for this year, in terms of -- at this point -- benign warts and things like this. . . . If you have to have your wart removed, in 1995 you could have had it taken off; now you pay for it if you're over 16. This has come through cost containment within the service.

Again, I think this goes back to what we were talking about in terms of buzzwords for health. We have to decide what we're going to pay for in British Columbia. And with the collective wisdom of government, those providing primary care and the public, we have decided that these skin things are no longer covered. It is not that they are clinically less significant than they were previously; it's that we can no longer afford under the system to do everything for everybody.

[ Page 3702 ]

When we're looking at deinsurance, it's very important to not leave the impression with the public that these things have somehow been devalued. It is that the money is not there and that in order for us to pay for all of the important services that we have, we move on and do that, and not sacrifice the services that are very, very important for us to have.

My question to the minister is: in terms of deinsurance for the year '97-98, through the tripartite commission and through the collective wisdom of that commission, what other ancillary items do we anticipate will be deinsured? What is the total dollar value of that deinsurance anticipated to be?

[4:45]

I would like to again give my point on the benign lesions. The clinical advice we received. . . . We had discussions about this last year in estimates, in anticipation of the deinsurance, and now we actually have eight months of experience in deinsurance.

The BCMA gave us full assurance that the delisting involved no medically necessary service. They continue to say that, and the proof is in the pudding of eight months of experience. Where a medically necessary removal is required, it is paid for -- and in fact, the charges are being made.

S. Hawkins: I just want to canvass a few more issues under MSP. Last year we spoke about patients who go out of province. Again, I've received a lot of letters over the last year from patients who either can't acquire treatment in the province and have to go out of province or are sick elsewhere and want to collect. One thing I hear from a lot of seniors is that when they go out of province, MSP pays $75 a day for medical care.

I wonder if the minister has been approached about increasing this rate and what the province's position is on out-of-province care for people who travel out of province -- out of country, I believe it is. Sorry.

Hon. J. MacPhail: Yes, just to. . . . I'm sure this was just a slip. When one goes out of province, the plans are covered. But when one goes out of country. . . . I have met with the Snowbird Association, who are suing us over this issue. Certainly I have communicated to them that we are spending our health care dollars in British Columbia, in Canada, and there are no plans to change that.

S. Hawkins: There was an issue, as well -- I've received several letters from around the province -- of patients who have acoustic neuromas, which is a tumour on the hearing nerve. The minister may or may not be aware of this. These patients can get a very specialized surgery in the United States. It's called a gamma knife; it's a radiation beam. The alternative, the procedure here, is through another radiation machine called a linear accelerator. The benefits of the gamma knife are that it's more precise and it preserves the hearing. I know the ministry has, through different advocates approaching the ministry, been able to fund some patients out-of-country for this gamma knife surgery. It is costly, but a lot of these people are young. They have work that they want to pursue, and they certainly want to preserve their hearing. I'm wondering if the ministry has a policy on this and if the ministry is funding patients for this procedure.

The Chair: While the minister is working out a response, I recognize the member for Chilliwack, who is rising to make an introduction.

B. Penner: Yes, hon. Chair. You show remarkable mental telepathy. I am rising to seek leave to make an introduction.

Leave granted.

B. Penner: It's my pleasure to introduce a group of grade 10 students, numbering close to 25, from Sutherland Secondary in North Vancouver-Lonsdale. I met with them a few moments ago, out on the front steps of the Legislature. They are here today with their principal Mr. Doug Green, as well as a grade 10 teacher, Glen MacKenzie. Would the House please make them welcome.

Hon. J. MacPhail: Thank you for the question. It is interesting that this issue has been examined by the B.C. Cancer Agency, which advises us on such treatments. There is a consensus statement developed, in which open microsurgical excision is considered the treatment of choice. However, in the context of that, the Medical Services Commission has recently put in place a policy where, when the treatment is recommended as the medically necessary treatment, we will fund the treatment in Seattle at the U.S. rates. That has been a recent decision of the Medical Services Commission. In fact, four out-of-country treatments have been paid for very recently. So that's the new policy in place.

S. Hawkins: That's heartening to hear. Can the minister tell me who exactly makes the decision whether it's medically necessary and whether the patient will have the gamma knife or the linear accelerator? Who recommends that to the ministry?

Hon. J. MacPhail: The B.C. Cancer Agency neuro-oncology team, which is a team of specialists in neurosurgery and central nervous system radiotherapy, makes the decision about provision of this treatment.

S. Hawkins: So if it was suggested to a patient that they have this procedure, would they have to access this team, then? Because sometimes the decision is made in a specialist's office. Is this a team that would review the case and make the presentation?

Hon. J. MacPhail: The attending physician acts on behalf of the patient, and the attending physician contacts the team of specialists through the B.C. Cancer Agency.

S. Hawkins: What other kinds of treatment are being funded for out-of-country procedures? What other out-of-country treatments are we paying for?

Hon. J. MacPhail: The general policy is that medically necessary services that are not available in British Columbia or elsewhere in Canada are funded at the U.S. rate.

S. Hawkins: I wonder if the minister can tell us what we spent last year on out-of-country treatments.

Hon. J. MacPhail: There was $14 million spent interprovincially and $3 million spent out-of-country, and that's been consistent over the last couple of years.

S. Hawkins: When we fund patients out-of-province, are we paying our provincial rate or are we paying the provincial rate for the province where they get treated?

Hon. J. MacPhail: I want to make sure I get this answer right, not to have an influence on the federal election. We have 

[ Page 3703 ]

a reciprocal agreement with every province except Quebec. We have no reciprocal agreement with Quebec. So the hospital bills us, then we pay at the B.C. rate. But with other provinces it's a reciprocity arrangement where we pay their rates.

S. Hawkins: When a patient brings back a claim, what's the process that the patient has to go through to get reimbursement?

Hon. J. MacPhail: In the vast majority of cases there is no patient involvement. The physician providing the service bills directly to the Medical Services Plan. That is part of the reciprocal agreement. But in the odd case the patient may deal directly with MSP, in which case the bill is submitted, and then MSP checks and verifies the claim and pays.

S. Hawkins: Constituents of mine and other people around the province write and tell me that they have travelled and incurred costs and submitted them. I'm just wondering what they have to prove to get the reimbursement, because they have their doctor's bill and they have what they've incurred as an expense. Oftentimes they are writing to us, and, of course, I forward this stuff to the ministry. What exactly do they have to prove to get their reimbursement?

Hon. J. MacPhail: The Medical Services Plan gives the person in receipt of the services a form that lists all of the documentation, and the form lists the requirements. It's really one-stop shopping. Again, I emphasize that it has to be an insured service that's covered. They then submit the form with the receipts, and MSP takes over after that.

S. Hawkins: Last year we talked a little bit about premiums. I think the minister informed me that we were one of two provinces in Canada that pay premiums. Of course, in a strange way the premiums are conforming to the Canada Health Act, because it falls under the publicly administered format of that principle. I know that. . . . Well, I don't know. How much do we collect in premiums each year in this province?

Hon. J. MacPhail: It's approximately $860 million.

S. Hawkins: I know there's a shortfall. There's some that doesn't get collected. What's the shortfall that we bill but don't collect?

Hon. J. MacPhail: We want to get you an exact number. We're ballparking it now, but we can do that in the course of today.

S. Hawkins: I was just asking my colleague how we decide how much everybody pays, so I'll ask the question. Some people who can afford don't pay. Is there a graduated premium system according to means? How is that determined?

Hon. J. MacPhail: Yes, there is. It's called the premium assistance. Below a certain income level. . . . Based on $19,000 plus how many dependents you have, you pay no premiums. There are over half a million people in the province that pay no premiums at all, and beyond that it's whether you are paying a single, couple or family rate.

S. Hawkins: Other provinces that don't have the premium system do it through taxation. Is that something that this government has ever considered? I'm sure we'll get into the debate once we debate the bill that's before the House, but it just seems to be a system where, with premiums, some people will fall through the cracks. If they don't pay, the government still has to pick up the cost, because under the Canada Health Act you are guaranteed universality, accessibility and all those good things. It just seems a little strange that under the premium system, those that do pay will get the benefit; those that don't pay will get the benefit. Are there other options the government has considered, and why isn't our health care system based on a taxation system rather than a premium system?

[5:00]

Conversion to another system of collection is complex. It's certainly one that is the topic of discussion amongst many governments. For instance, the Ontario government actually moved to a payroll tax. Was it Ontario that moved to payroll tax? No, others have a payroll tax system. We have been advised by our business groups that we should not consider doing that. Other governments have actually introduced a high-income surtax -- Ontario being the recent one -- to pay for medical costs. So the debate does. . . . I mean, we are always cognizant of how to make our tax system fair, and this is one area that is examined. But really, there's no change anticipated currently.

S. Hawkins: Again, there's a bill before the House that will be debated. But there's a sense that fairness is not in the system, the way it is right now. I think the minister can appreciate that. Anyway, we'll cross that bridge, I guess, when the bill comes forward.

I think my colleague from Okanagan-Vernon has some more issues she'd like to canvass. I'll defer to her at this time.

A. Sanders: It's nice to stand up and still be awake. I'd like to mention a couple of letters from my constituency to the minister, just for comment. The first one is signed by 45 individuals. It isn't an original, and I will ask the writers to send me the original for the minister. Basically, it says the following:

"I have written letters to Vernon Hospital's chief executive officer and to the Ministry of Health about this subject before. The subject is mixing men and women in the same room at the hospital. I received a letter from Leah Hollins of the Ministry of Health, stating:

"'As you are now aware, the hospital's policy is to segregate males and females. However, on rare occasions, when all hospital beds are occupied and someone is admitted late at night, the decision has been made to have the patient overnight in the first available bed. The hospital promptly moves the patient the following day, if required, to ensure gender segregation.'

"This sounds great on paper but is not what is happening in real life. Several people in my circle of friends have been put in the hospital in the last few months, and they have been left in non-segregated rooms even after requesting to be transferred to rooms without members of the opposite sex. This has not been on the night they were admitted, but the next day or the day after that. One lady went home earlier than she should have, 

[ Page 3704 ]

because she refused to stay in the situation, and the hospital staff would not move her. This is not an isolated case anymore, this is common practice and what we feared would happen when the policy of mixing rooms was begun.

"As I have stated before, this type of behaviour is unacceptable to a large group of people who have to use our B.C. hospitals. We therefore respectfully ask that this practice be ended or that more money be given to hospitals so they can open more beds and have this practice be used only when a real emergency arises, not on an everyday basis.

"These friends of mine have asked to be allowed to sign their names to the bottom of this letter to show their agreement to my statements.

"Sincerely,

Kay Przybille"

Hon. J. MacPhail: Well, I assume that the letter from the assistant deputy minister of continuing and acute care clarifies the policy, which is segregation, but I'll be happy to look into this woman's situation.

A. Sanders: I think, too, with respect to Mrs. Przybille, who really. . . . I was going to say has her knickers in a knot, but I don't think that was the phrase I really want to use. Mrs. Przybille has been very unhappy about this. This does affect our elderly patients quite a bit more in that they have frequent hospitalizations. They very often do find, because of the lack of beds in acute facilities, that they are in a four-bed room with one woman and three gentlemen, or some combination thereof. This is very, very upsetting for individuals from many different parts of the country, and certainly in Vernon. So my hope for Mrs. Przybille is that the minister will answer her question and give her an answer that she can feel is appropriate.

The second letter was sent to me on May 20. "Dear Mrs. Sanders" -- I think that's me:

"I would like to bring to your attention something that really shocked me this weekend. Our son, age 40, has just been diagnosed as a severe diabetic and is on insulin twice a day. He is the father of three children, worked for 171/2 years as an inventory clerk, and as soon as he was told he was diabetic, they fired him. He and his wife have bought a franchise on the Island and are hoping to make a living at it.

"They, of course, now have to pay over $70 per month for their medical to the government. He informed us on the weekend that the needles he has to use twice a day are not covered. Why is it that we give drug addicts free needles, and he has to pay for his? His are to stay alive. Theirs are for a lifestyle that they chose. This, to me, does not seem fair.

"We really thought we had a wonderful medicare system in Canada, but now I'm not so sure. I wish you could find a way to bring this up with the minister. Thank you for reading my letter. I hope something can be done about this.

"Sincerely,

Mary. . . ."

Hon. J. MacPhail: The needles, testing strips and syringes are covered under Pharmacare, so the level of coverage one receives is dependent on the coverage one has under Pharmacare. Of course, there are several different plans. I took from the letter that the parents get a different level of coverage than the son. Is that. . . ? Yeah. It could be that they're eligible for different levels of coverage under Pharmacare.

But did I also hear in the letter that the man was fired from his job? Yeah. Well, there are other avenues that I would urge him to pursue in that -- Employments Standards as well. If there's no effect on. . . . Anyway, I would just -- from another life -- urge him to do that.

S. Hawkins: Another issue. I get a lot of letters -- I'm sure the minister does as well -- from people who want different treatments covered under MSP. One that we've been getting a lot of letters for is chelation treatment. I wonder if the ministry has a position on that.

Hon. J. MacPhail: Yes, I too get a lot of information from meetings around the issue of chelation therapy, and I very much respect the people who lobby me on this. So my comments that I'm about to give to the House are really based on what health care professionals advise me of, because I, of course, would not make a decision around this or even offer any advice that wasn't evidence-based.

The therapeutic agent ethylene diamine tetracetic acid, EDTA, is not an approved drug for use in Canada or in the United States, and that's what is used in chelation therapy. But there is also a very active worldwide lobby group to have this treatment paid for by health care systems. In British Columbia we have asked the College of Physicians and Surgeons to deal with this issue.

So really, until such time as EDTA is accepted by Health and Welfare Canada as a proven and safe form of treatment for coronary atherosclerosis, we're not going to be funding any programs or covering the cost of this through the Medical Services Plan or Pharmacare. As I said, the College of Physicians and Surgeons is dealing with this issue as well.

S. Hawkins: I appreciate the candid remarks by the minister. The minister is probably aware that in, I believe, Saskatchewan and Alberta, there's legislation on chelation, and, I believe -- and I could be wrong -- it is covered under MSP. These are the kinds of inquiries that come to me: if it's covered there, why isn't it covered here? If there are concerns about a drug that perhaps isn't approved for a certain amount of therapy. . . . I know it is being used in the province. I believe there is a chelationist that works in the Okanagan. I know of patients that go to him and then write to me and ask: "Why aren't the treatments covered?"

Is the ministry perhaps looking at this as a safety issue, then, for patients? If it is already out there and there's treatment being done, is there something the ministry is monitoring or following to make sure that patients are getting safe care? Or are we just channelling them off to the College of Physicians and Surgeons to handle?

[5:15]

We're continuing to follow the development around this treatment. The College of Physicians and Surgeons is responsible for the professional conduct and practice standards of physicians in British Columbia. So the safe practice of medicine is their responsibility. During a recent meeting with them, 

[ Page 3705 ]

they assured me that they were very much concerned and on top of this issue, but once again advised me that they would not recommend any change around the provision of chelation therapy.

S. Hawkins: I have concerns about the safety of this treatment modality with regard to children, because I do get letters from parents, saying that their child is undergoing treatment for heavy metal or whatever. I try and refer them to the college, and I certainly refer them to the ministry. What does the ministry advise these people that write to the ministry?

Hon. J. MacPhail: Actually, chelation therapy is approved for heavy-metal poisoning, and it is an insured service. It's chelation therapy for atherosclerosis that's not approved. So the proper recourse is for patients to go to the College of Physicians and Surgeons on that matter, and that's what we advise.

S. Hawkins: Thanks for that clarification. I'll deal with that later. I have a few other questions, but perhaps I can clear those up with a little research of my own.

One of the last remaining issues around this is the area of supplementary benefits. Who are the providers under supplementary benefits?

Hon. J. MacPhail: Physical therapy, chiropractic, naturopathy, massage therapy, optometry, some dental surgery and podiatry.

S. Hawkins: On the estimate sheet that I have, it appears that the benefits actually decreased in that budget. Am I reading that correctly?

Hon. J. MacPhail: The difference is that the balance will be made up by. . . . Two factors will occur. We anticipate that there will be a decreased utilization as a result of the increased user charge. In some of these services the patient-visit charge went from $7.50 per visit to $10. So we do anticipate that there may be some decreased utilization. Also, what is accounted for here is that the difference is made up by the increased patient-per-visit charge.

S. Hawkins: The patient-visit charge. Can I get some background information on that? I know it went into place about ten years ago. My understanding is that it's by legislation. There is a fee that the practitioner is reimbursed, and there is a fee that the patient is charged. Is that correct? Is it done by regulation?

Hon. J. MacPhail: The patient-visit charge is by regulation. These services are not covered by the Canada Health Act. They are paid for 100 percent out of B.C. tax dollars.

As a result of negotiations with supplementary health care practitioners, a patient-visit charge was put in place on July 1, 1987. That patient-visit charge was increased in 1994. The first patient-visit charge was $5 per visit. Some of the supplementary benefits don't have a patient-visit charge, but for those that do, it was $5. In 1994 it was increased to $7.50 per patient-visit charge, and on April 1 of this year it was increased to $10 per patient-visit charge.

S. Hawkins: Where does the patient-visit charge go? Who keeps that?

Hon. J. MacPhail: It's revenue to the health care practitioners; they keep it.

S. Hawkins: Perhaps you've clarified something for me, because my understanding was that the patient-visit charge wasn't going to the practitioner. There was an increase that was done this Easter, and my understanding is that $2.50 -- from $7.50 to $10 -- was going straight back to government. Am I misled on that?

Hon. J. MacPhail: No, they get it. There's no interference between. . . . The patient pays it directly to the health care practitioner.

S. Hawkins: How much benefit does the practitioner get from MSP, compared to the patient-visit charge? How much is provided for both?

Hon. J. MacPhail: There is a fee schedule. I could make that available to the member if she wishes to cross all of the disciplines. The total amount paid for supplementary benefits to the practitioners remains the same, but there is a shift that more of that is now received from the patient-visit charge. But in terms of that proportion on. . . . It depends on what service is received, and I can get the fee schedule for the member.

S. Hawkins: I'd appreciate it if I could get that information.

A few moments ago the minister mentioned that the fee increases. . . . The fees were introduced in 1987 and then increased in 1994, and it was done as a result of negotiations. My understanding is that there was very little consultation or negotiation on this fee increase. Is that correct?

Hon. J. MacPhail: No, actually it isn't. I personally had discussions with the various interest groups representing health care professionals. They personally made two recommendations -- well, some of them made three recommendations -- one of which was to increase the patient-visit charge. Another recommendation for me to consider was an overall Medical Services Plan premium increase across the whole system. A third recommendation, but certainly one that was not supported widely by them, was to reduce the number of visits eligible for coverage. So no, there was consultation.

Certainly what I heard through the media. . . . I had numerous meetings with various supplementary benefit health care providers, and I think that of the three options they discussed with us and presented to us, they would have preferred the Medical Services premium option. It wasn't like they didn't suggest the other option to us. However, the Medical Services premium would have exacerbated what I consider an already regressive system of payment. But there was also the issue that less than one-third of the population actually uses the supplementary benefits portion, and they were asking that the Medical Services premium be increased across the entire population.

S. Hawkins: I guess I'm hearing different sides of the story now. My understanding was that there were meetings and proposals put forward, but that the fee increase actually came as quite a surprise to the groups that were affected.

In front of me right now I have a press release from the Physiotherapy Association of B.C. The header is: "PABC Shocked by User Fee Increase." It's dated April 1 of this year. If I may, I'll just quote from it here. It starts off:

[ Page 3706 ]

"Provincial physiotherapists are reeling after last week's surprise announcement by government of an increase in the patient visit charge. 'We are very disappointed with the patient visit fee increase and frankly feel very exacerbated,' says Lenore English, president of the Physiotherapy Association of B.C. 'We're in regular contact with government and had no warning whatsoever of an increase in the patient visit charge being considered. Government's lack of consultation on this issue is shocking.' "

One of the other concerns I had when I read this press release was that the group seemed very open to having meetings with government and working with government, and it just found that an increase without consultation was unacceptable. They were quite disappointed, I guess, at the way that it was announced. I wonder if the minister wants to comment.

[5:30]

There is a balance to be had on how our Medical Services Plan payments are made, and we have paid very close attention to it. We value the services of the supplementary benefit plan providers to the extent that we didn't deinsure anything. We also know that there are areas where we have to manage the budgets. We listened carefully to all the options and chose the one that met the needs of patient care first, in a way that also permitted that in the context of B.C. tax dollars that are available to pay.

S. Hawkins: There was another issue around this, besides the lack of consultation that the group perceived there to be. There were groups that said they had a reserve -- somewhat, I understand, like the reserve the physicians had. Maybe there are discussions right now. Was that applied or will it be applied toward this? Can the minister comment on that?

Hon. J. MacPhail: Some of the supplementary plan health care provider associations have reserves. The agreements have expired, and we're in negotiations again. Those reserves are part of the negotiations. They're available to the health care providers.

S. Hawkins: I understand also. . . . It's reassuring to hear that the minister is not thinking of delisting the service, because I think it is an important service in the limited, I guess, quantity of visits that a patient can access through MSP. I wonder: is there a move now to look at this group of providers and reorganize it in a different fashion? Is it going to continue with MSP? Are there discussions in the ministry on how this group of providers is going to be handled?

Hon. J. MacPhail: Yes, all of the items listed by the member are available for discussion and can be part of the negotiations with the individual associations.

S. Hawkins: Is there a group of patients that don't have to pay the patient-visit charge?

Hon. J. MacPhail: Yes, those who are on the Medical Services Plan premium assistance that we talked about earlier don't pay the patient-visit charge. That's about 20 percent of the population.

S. Hawkins: Are there any special cases made for patients who are in need and who, perhaps, don't have the income base to pay that patient-visit charge? I'm just thinking back to a few years ago, when hospitals had out-patient physio departments, and they could pick up the slack on some patients who maybe fell through the cracks and were not on premium assistance but couldn't pay the for visit. Now those out-patient units are less and less funded every day, because hospitals are, of course, tightening their belts and deciding where their priorities are and whether they can offer that service or not.

I know I have patients writing to me, and certainly other members in the House have patients writing to them, saying: "I need the service, but when I phone the ministry, they tell me to go on welfare, and that's how I'm going to get the service." Is that right, or is there some special needs way that their needs can be met?

Hon. J. MacPhail: Our government handled this issue by substantially expanding the premium assistance program from about '92 through to '95. Whereas just a couple of percent of the population were eligible for premium assistance, it's now fully 20 percent of the population. If you're eligible for premium assistance, you don't pay any patient-visit charge. So in terms of ability to pay, that's how our government has managed this issue. It's a substantial. . . . It's still a lower-middle income level that gets the premium assistance, so anybody above premium assistance has a middle income available to them. The other issue is, of course, that many of the patient-visit charges are covered by extended health care benefits. As a last resort, some health units do provide in-patient services for physical therapy.

S. Hawkins: Something that just came to mind was that other provinces regulate one or the other -- the patient-visit charge or the MSP premium. This province does both. Is it on the table to take the regulations off one or the other?

Hon. J. MacPhail: Actually, we did. It's like a patient of the government provides a patient-visit subsidy, and then the practitioner charges over and above that. We did consider that option and rejected it as being, of the choices, a more limiting choice for patients who have lower incomes.

S. Hawkins: I suppose that the practitioners then have the alternative to either stay in the program or opt out. And if they opt out, they can charge whatever they want. Am I correct? Is that their option? I see the minister nodding.

Hon. J. MacPhail: Yes, that's available to them, because they're not an insured service.

[ Page 3707 ]

S. Hawkins: A few minutes ago I asked the minister what happens to that $10 fee, and she said the practitioner keeps it all. But as I read the press release to the minister, the physiotherapy group, anyways, is saying that the government takes it all. Are they wrong?

Hon. J. MacPhail: Let me again explain that the amount of money that is available to the practitioner remains the same from last year to this year, but the portion of money that they will receive from the patient-visit charge increases. So the global funding now, it's. . . . Like, who pays into the pot for the global funding? What percentage comes from the patient, and what percentage comes from the government? There's still the global funding. In other words, the practitioners aren't having their compensation reduced, but the amount of money that comes from the patient has increased, rather than from the government. That's the best way that I can explain it.

S. Hawkins: I think I understand. I'm trying to do the math in my head. If it were $10 from the government and $10 from the patient, what you've done is reduced the government's amount to $7.50 and added an extra $2.50 onto the patient's amount that they're pulling out of pocket. Is that correct?

Hon. J. MacPhail: You're just outlining a theoretical concept?

Interjection.

Hon. J. MacPhail: Yeah, the concept is correct.

S. Hawkins: Are the groups right in saying that they're collecting this money, then, and that it goes back into the government pot? No?

Hon. J. MacPhail: No. I don't want to in any way suggest that they're playing games. What they're saying is: "No, we don't recover any money from the health care practitioner." Their global budget stays the same, but the amount that they receive directly from their patients is a greater portion of the fee-for-service now than previously. Compensation remains the same, but they get more directly from the patient. And we pay them less, a corollary amount less.

S. Hawkins: I'm sure I'll continue to get information on that as soon as some of these groups have read Hansard. I'm sure it'll be raised again.

If I can, I'll just take a few minutes here and address an issue that I've been following for about half a year or longer. It's with respect to home ventilation and with respect to a patient who injured himself and wants to live at home. He doesn't want to be a burden in the hospital and has a caregiver who is at home. The minister might actually be quite familiar with the case. His name is Scott Yarrow, and he lives with his girlfriend Suzanne Rundquist. She cares for this person. I'm just using their case as an example, because I know there are other cases like it. I have ALS patients and families that come to me with the same kind of scenario, where they want to be at home, they want the life support at home, because that's what home ventilation is. If they were in the hospital, they'd be paying the daily hospital rate and the nursing care and whatever around that. I'm wondering what policies the ministry has for helping to fund caregivers for patients like this -- family caregivers who stay at home and look after their families, yet feel that they have somehow fallen through the cracks, because the only way they can get any kind of respite or relief is to admit the person to hospital to be cared for there.

Hon. J. MacPhail: A point of clarification so we can give a proper answer. You're not talking about oxygenation; you're talking about home ventilation. Okay. You're not asking us to look into this specific case but are just making a general comment.

Most of the home ventilation is done through the B.C. Rehabilitation Society, so we're going to have to get the information directly from them. But we will do that, because it is an important point.

S. Hawkins: I appreciate the willingness to look into that. You may or may not have the stats or anything, but how does a person apply for that? Are you saying they go through home rehab? Or does the ministry have another way to access this service?

Hon. J. MacPhail: It is through the B.C. Rehabilitation Society, in the majority. I apologize for not having this directly. There may be some special applications for the home care program, but I will get that information for you.

S. Hawkins: I'm not familiar with the service. I'm confused, because I had hoped this person had written to the minister, too, and would have gotten that information. Obviously they didn't and have written me multiple letters. Is the home rehab service available all through B.C.?

Hon. J. MacPhail: The nature of the ability to provide this life-support system -- and without it there is no life -- is a physician's call. But it would also be contingent upon whether the services to continue the life support are available in the community. The ability to have the service throughout British Columbia is there.

[5:45]

I just want to clarify. When we spoke about the doctors' fees. . . . I just got a little bit more information in front of me. There was an agreement announced in September last year that there would be as much as $80 million over the billed amount of the doctors' fees, and they would be prorated. Are physicians prorated at this time?

Hon. J. MacPhail: Just to answer in reverse order, there is no proration now. But the figure of $80 million that was announced back in September was a speculative figure by the BCMA. It actually never came to fruition. The Medical Services Commission prorated it in October of '96, and it ended up that there was a proration value of about $18 million. Again, that managed the MSP budgets through the last fiscal year, and there is not currently any proration.

S. Hawkins: Is this being tracked? Is this being monitored?

Hon. J. MacPhail: Yes. The commission tracks it on a monthly basis and monitors the need, to examine whether there should be any proration.

[ Page 3708 ]

S. Hawkins: How is the decision then made for proration? Is that made jointly between the MSC and the physician group? What's the process?

Hon. J. MacPhail: The working agreement provides for proration. The working agreement is between the B.C. Medical Association and the government of B.C. The Medical Services Commission is charged with the administration of that agreement. So the rules are in place as a result of the working agreement. The Medical Services Commission monitors it to see when and if the rules have to be applied.

S. Hawkins: The reason I ask is that I know there were some sticky times last fall, when doctors were talking about office closures -- and that's the last thing we want to see. We want to make sure there is continuous patient care. We've already got problems with patients not getting treatment. The last thing we want to see is a group bucking and saying: "We're not being listened to." For whatever reason, they want to take measures that may not be quite in the best interests of patients.

It would be nice to know that we're working together with that group and making some kind of progress with keeping the budgets within the limits that were promised or contracted for, and making sure that patients still get the care they need from their physician.

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

Motion approved.

The House resumed; the Speaker in the chair.

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

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

The Speaker: Hon. members, following question period today, I returned to my office and reviewed the Blues for today's question period, as well as those for yesterday.

An examination of the questions directed to the Minister of Small Business, Tourism and Culture discloses that, for the most part, the questions failed to deal with the actions of the minister for which she is responsible to parliament, in the ministerial sense. Accordingly, they were out of order.

It is true that there may be circumstances in which a minister wishes to provide an answer to an otherwise disorderly question, and as a matter of practice in this House, that has been left to the discretion of the Chair. It must be noted, however, that the willingness of a minister to answer a disorderly question does not thereby make that question orderly. It must also be noted that the discretion to rule the question out of order and to not permit an answer thereto always remains with the Chair. Here I would refer members to page 109 of the third edition of Parliamentary Practice in British Columbia.

Members, it seems to me that we and I ignore our rules at our peril. In that spirit, let me remind members that the pivotal requirement for questions to ministers is that such questions must deal with an action of a minister for which that minister is responsible to parliament. Stated another way, the question must deal with the administrative responsibility of the minister. Here I would refer hon. members to the twentieth edition of Erskine May's Parliamentary Practice, at page 341, and to the sixth edition of Beauchesne, at page 125. I would ask all hon. members to read and be guided by the authorities I have quoted.

Hon. J. MacPhail moved adjournment of the House.

Motion approved.

The House adjourned at 5:54 p.m.

PROCEEDINGS IN THE DOUGLAS FIR ROOM

The committee met at 2:32 p.m.

ESTIMATES: MINISTRY OF
MUNICIPAL AFFAIRS AND HOUSING
(continued)

I. Waddell: I'd like to just take a couple of minutes to put some matters on the record, and if the minister wishes to comment, he can, or he can take note of the matter for his department.

Raymond and Betty MacDonald of Vivian Street in Vancouver are constituents of mine in Vancouver-Fraserview. On December 23, 1995, their son Trevor, a young man, was tragically killed in a ski-lift accident at Whistler mountain, when the high-speed Quicksilver Express crashed and four chairs fell three storeys to the ground. Trevor MacDonald died, a second person was paralyzed, and a third person died later of complications. I have met with the MacDonalds. I met with the MacDonalds' lawyer, and I talked today -- just this morning -- to the coroner. The coroner is Peter Gordon of Squamish. He issued a report on this matter. I believe the ministry has a copy of the report. The report is dated October 24, 1996, and it is a very thorough report.

The parents, my constituents, are concerned that. . . . They want to make the point that some use be served by their loss. Their son can't be brought back, but at least we should learn from his tragic death. So far we haven't learned, and that's what causes me to rise today. An article appeared in the weekend Vancouver Sun of April 19, 1997, saying that Whistler was closing down two lifts for the rest of the season: the Redline and the Greenline chairlifts. There was an additional problem in the year after the accident that caused further lifts to be shut down. This was not to happen again; it could have happened again, and that's the real tragedy.

I'd like to just give a bit of background from what I've been able to glean about what happened. I specifically refer to the coroner's report -- I'll call it the Gordon report. The Gordon report made 23 recommendations. I think page 3 of the report deals with some of the difficulties and the nut of the question. The problem is this: that the government and the ski 

[ Page 3709 ]

operators have this kind of relationship. What happens is that a third party, an engineer, is to do the inspections. So the government imposes standards, regulations, and the operator tries to meet the standards. But the operator in this system engages a third party, an engineering firm, to do this. The problem is that the checks and balances are just simply not there in the system. Remember that there's a potential conflict here, because the third-party engineering firm wants the work, it's a short season and there's incredible pressure. I see the former mayor of Whistler here, the member for West Vancouver-Garibaldi, who would probably corroborate what I'm saying: the fact that the pressure is on to get moving, you know, to get the ski season going. The way the system of checks and balances works, I think there's a fundamental flaw here, and the coroner deals with that on page 3 of his report.

On page 8 of his report, he identifies previous accidents which should have rung alarm bells. I will just quote from the bottom of page 8 of his report, where he says: "The underlying cause of the accident was systemic in nature. The problems, weaknesses and causes noted in this report were all items that could have and should have been found and attended to before they culminated in the fatal accident on December 23, 1995."

Twelve of the 23 recommendations relate to some form of government engineering inspections and the way those inspections operate. The coroner's report outlines how they should be changed and how some regulations should be made clearer, and there's a blueprint for these systemic problems.

I want to say a little bit about the difficulties of what happened here, a little bit of background. There are three manufacturers of these lifts. There's Doppelmeyr, Poma and a third one called Yan. This Yan was an engineer who was with the other companies in Nevada. He broke away and set up his own company. He used new types of engineering and was able to reduce the cost, but the result was lots of problems.

Doppelmeyr and Poma are really solid European manufacturers that go to great lengths to construct properly, and they have higher prices. This guy broke away, formed his own company, lowered the cost and put certain things at risk -- and he's used the term "at risk" in newspaper interviews -- by doing new engineering.

All ski locations in North America took the chair and grip detachable elements away -- that was the Yan engineering method -- except at Whistler. What Whistler did after the accident was they re-engineered and hired an engineer from Yan. This was a hurried effort. It was done to get the opening of the season going, and it almost happened again. In fact, problems emerged in December of 1996 with respect to cracks in bearings and the shivs seized again. Luckily, they found that on inspection.

I talked to the coroner this morning, and I just want to put on the record some of the things that caused me some concern. There was another matter, too, that was brought forward by the lawyer and the coroner -- that is, there is a problem with people who work for Intrawest whistle-blowing, if you like, phoning the government and telling it that there are some problems. The problem is that they won't get a job anywhere else in a ski area in North America, because Intrawest is increasingly becoming a monopoly. So it's another thing one has to watch.

The coroner said to me this morning that the Yan system failed. They tried to revamp this system after the accident, and they had replaced parts of the system in the summer of 1996. Six months later it was failing again. There was fatigue cracking already at Christmas of 1996.

The rest of the ski areas were fed up with Yan, and they went to Doppelmeyr and the others. They didn't care about the cost; they replaced the rest of the lifts in North America. But Whistler was still not getting it, I'm informed, even though there were rumours that there were some difficult situations.

The coroner came and met with the deputy minister and the assistant deputy minister to try and deal with this kind of inspection system and so on. Let me just state what he told me the problem was. Here's the problem -- and members have faced the problem of government regulation. You've got government regulations; you want to get moving on things -- you know, the ski season has gotta get on, so you've gotta do these repairs in the summer and get it moving. So there's a pressure to do it, and there's a pressure on the government to approve -- don't be bureaucratic, approve. The government's under that pressure to approve, and that's what happened again in the summer of 1995. Remember that there had been a ski accident, and then the next year there were further problems with the system. And we were back to the old situation again.

The coroner says this: we should recognize that the accident can be a result of a failure of the system. The system must be structured so that if one part fails, the next part picks it up. He says the present system of inspection, the cooperation between the government inspectors and the lift companies, is too cosy. Well, we need cooperation, of course. But on the other hand, with these kinds of new systems, it makes it difficult.

What he means by "new system" is the following. In the old way of doing things, there were the old types of lifts. Now there's this new type. They're fast, they're computerized. They have a lot more loads on them, and it becomes a whole new kind of system out there. The coroner said to me this morning that you must have a system where you say: "You must have X in place before you get your okay to go ahead, and before you get our signature to approve your operation." This is just not happening. The coroner said he predicted that there would be further problems. He thought it would come in a couple of years. It came within six months. There was a problem with the shivs -- this is after the accident. I don't think many British Columbians realize this, that they were in danger up at Whistler in that ski season. I've skied that lift. I bet you some members here have skied that lift. Have you skied the red chair and the green chair at Whistler?

So an engineer was consulted. It would cost $100,000 and they'd have to shut it down. They said no, they weren't going to shut it down in December. And they went to April. At that point they started replacing the system.

I guess the moral is this. We've got to follow the coroner's report, and we've got to look at this systemic problem that the inspection is farmed out to a third-party engineering firm. We've got to look at that. Secondly, we've got to look at this Yan engineering, and whether this company really should be operating in British Columbia at all, given their safety record.

[2:45]

[ Page 3710 ]

regulatory system, and that's the responsibility of the Ministry of Municipal Affairs. So now they're officially on notice that they've got to improve this system, and Whistler is on notice that they've got to make sure that skiers in British Columbia are safe.

Hon. M. Farnworth: I thank the hon. member for his comments. This was a very tragic accident, and one which the ministry responded to upon receipt of the coroner's report. And we accepted the coroner's recommendations. It was a very thorough report, a very thorough investigation. The ministry responded very quickly. I have a letter here from the chief coroner of the province of British Columbia, which I'd just like to read into the record. It's in response to correspondence previous to my becoming the minister back in December, and it says:

"Thank you for your letter of December 12, 1996, in which you address the recommendations flowing from the above deaths. I have taken the liberty of passing a copy of your correspondence on to the coroner with jurisdiction, Peter Gordon. It is evident from your response that due consideration has been given to the coroner's recommendations, and I write here to express our appreciation for the steps your ministry have taken and to assure you of our continued cooperation. Clearly, our goals are mutual in striving to prevent recurrences of death or serious injury. Thank you again for your response.

"Yours truly,

Larry W. Campbell,

Chief Coroner, Province of British Columbia."

I. Waddell: I thank the minister, particularly, for his interest in that and for his commitment there.

I wanted to add that. . . . He mentioned reports. There was a report prepared for the ministry. I have it here in my hand. It is by Douglas MacKay. The coroner's view was that it went halfway there; it dealt with some problems, but other problems it didn't deal with. Also, the view of the lawyer in the case was that there should be some processes put in place that were done after the Save-On-Foods cave-in. Apparently they put in a system to identify the line of responsibility so that it would never happen again. That's what we want.

R. Coleman: If the minister wants to get the people for Housing ready, I can proceed.

I'd like to welcome the people from the B.C. Housing Management Commission. I just want to let the minister know how I'm going to proceed this afternoon. There are a number of issues to do with housing that affect the commission. I'm going to deal with the commission portion of the housing side first and then the ones that just affect the ministry. Then we wouldn't need the people from the commission to be here for that, because it deals more with things like regulations for mobile homes and those sorts of things that are also affected by the ministry.

I'd like to just start out by trying to put the discussion this afternoon into perspective. I think the best way I can put it into perspective is to relate a story. In 1990, as a volunteer to do with social housing, I interviewed a lady for tenancy in a social housing project. She was a single mother with five children. She was pleasant; she was motivated; she was dedicated to her children. However, her personal life was in complete turmoil. She was on income assistance. She was facing impossible costs to house five children -- as you can well imagine -- to shelter her family. Her crossroads were between abuse and quality of life. I had the great opportunity to provide that individual with housing in a four-bedroom townhouse in a B.C. Housing Management Commission project, in cooperation with a non-profit society. It is said that we need three basic needs as human beings: food, shelter and clothing. When the burden of housing was lifted from this individual, she prospered. A remarkable thing took place over the next six years. The children have all settled down and have done well in school. She returned to college. She retrained. She now has a full-time job, and she has a small computer accounting business.

To me, this is what social housing is supposed to accomplish. It's supposed to accomplish the ability, for the least and the best dollar, to take the burden off people so they can improve their lives and get on with them. It is to provide an affordable environment for families, seniors and special needs residents and should also provide occupancy in a most cost-effective manner. That's the objective of why we're here today to discuss housing.

I want to deal with a project or a particular area which I know the commission is very, very familiar with. It is a file that we call high-maintenance -- if I could be kind -- basically because the project and the information and the calls and the letters have been going on for about ten or 12 years. It's with regard to a housing project in Squamish. It's a seniors group that's had a piece of property that's Crown land that they've been trying to get done for some time. I've spent a lot of time on this particular site. I've also had the fortune -- or the misfortune -- of seeing the size of the file at the B.C. Housing Management Commission. So first of all, I want to know if you're prepared to discuss this one at the moment. If we are, then we could proceed; I'd like to walk through this project.

Hon. M. Farnworth: Yes, I don't see a problem in discussing this particular issue. The only caveat I would give is that if there's some very technical detail that I have to get, I will commit to getting that information back for the member.

R. Coleman: I don't think that on the technical side you're going to have to get anything to me; I think I have all of the technical things on this one. I think it's more a question of setting the record straight and making it possible for the commission to get on with life in regard to this particular site.

I'd just like to give a description, first of all, of the site. The site is a piece of Crown land that sits in an area called the Cheekye. The Cheekye flat is an area in Squamish that is affected by a certain floodplain, and the floodplain also has some other issues to deal with.

Now, the organization wants to put on the property a series of mobile homes for seniors housing. They basically want to build a seniors housing park for the community -- some of them to be subsidized and some of them to go to market. The difficulty with the land is that it is sitting in a fairly sensitive area. I want to walk the ministry through the sensitivity of the area this afternoon, because I think it goes 

[ Page 3711 ]

toward the solution to our problems in dealing with this organization, who -- as I say again -- are somewhat high-maintenance.

There have been a number of engineering reports done on the particular property. When you walk the site itself you look at it and say: "This is an absolutely gorgeous site; it's a great location to put in some form of housing with some sort of affordability, and maybe even come into some pretty good and successful private-public partnerships."

The difficulty, of course, is with the property itself. I think we should understand the hazards -- and we should put them in the record so that people know what the hazards are so that we can deal with this one. The hazard assessment deals first of all with Mount Garibaldi, which is a dormant volcano whose latest period of activity was completed several thousand years ago. There is presently no indication of renewed activity, but a response time of many thousand years is possible. That's the good news.

However, up on Mount Garibaldi there is a substantial amount of debris. This debris is very loose debris which could move and could come down the river into Squamish and across this particular flat. The Ministry of Environment has done a study of the flat and basically identified the serious areas where this earthen flow could affect this particular area of the community. It could literally wipe out a large portion of the area. The property that we're dealing with is on the outside edge of that flow. So it isn't directly affected by the flow, except that if this occurrence ever took place, a little bit of it may come down and end up on this particular piece of property and cause some minor difficulty.

The difficulty, though, of course, is that with this particular situation plus the normal flood patterns that take place in the area, there's a second hazard. The second hazard is the redirection of the Cheekye River, which would then cross this floodplain and could flood out this entire area. Depending on the earthen flows and what have you, these are the two difficulties we have with this particular site.

I've had some discussions with the general manager at B.C. Housing. We both have had the misfortune of dealing with environmentally sensitive sites in our past, so we're somewhat sensitive to these issues. The situation, simply put, is that in order for the land to be developed -- and for the balance of the community that's actually affected by this possible eventuality -- there has to be a very large dike built. The dike has to come completely across the plain, right down to the river, to protect the entire area. But the Crown land is only a portion of the land that's involved. The balance of the land is municipal land, and it's also land that's affected by existing housing.

So my conclusion has been -- and I guess we'll see whether the general manager agrees with me or you agree with me -- that effectively this land cannot be developed until such time as whoever may be developing the property makes a substantial investment in a dike that's fully engineered and approved by the Ministry of Environment and by the Ministry of Housing, or whatever the case, to make sure that we mitigate the liability in the future.

Hon. M. Farnworth: That sounds perfectly logical to me. I want to say that I concur with your assessment in terms of Mount Garibaldi, having had a geological background before I got into politics. When they say that it might or might not erupt, that's true. It's highly unlikely; I think Mount Baker has a much better chance of doing that.

In terms of mitigating any liability if the project's built, it sounds to me like a fully engineered dike is required. It seems to me that a dike would have a benefit not only to this housing project, were it able to go ahead after that, but also to the municipality as well. So the answer would be yes.

R. Coleman: I just want to clarify one part of the minister's statement, because I can tell you that these Hansards will no doubt be scrutinized by some people involved with this society. It's got nothing to do with an eruption of a volcano. It's got to do with. . . . Let's call it a mud flood.

Hon. M. Farnworth: Yep, okay.

R. Coleman: Having said that, if we look at the property and look at the balance of the property in the area, my suggestion would be that there has to be strong community consultation with regards to all the land base that's affected by this. I think that the community of Squamish could, in the long run, probably benefit from the dike if it was ever built, but obviously we are not in the business of providing dikes so that a development can go ahead for profit.

Maybe the suggestion back to the society should be that it's a community process, that the community has to buy into it, that the municipality has to buy into it, that there has to be some form of latecomer's arrangement or agreement, and that the society should be instructed to seek a private-public partnership outside of the Ministry of Housing.

Hon. M. Farnworth: Yes, I fully agree with what you just said. At first glance you may look at it and say: "Can we do it without a dike?" People say, "Oh, it could happen, maybe in a hundred years, or what have you," but it could just as easily happen tomorrow. I think we only have to look at this spring's events in Manitoba to realize that a flood of devastating proportions can happen very quickly and very unexpectedly with drastic, dire and tragic consequences. Clearly, were the province to proceed with a housing project of this nature, knowing that there is a potential for a flood, a mud flow or some debris flow coming down that would impact on it, there would be serious liabilities which in all good conscience we cannot be prepared to take on.

I would agree that a dike is necessary, and I think, given the philosophy that we are moving to in terms of wanting to see more public-private partnerships, that this sounds to me like an excellent opportunity for a public-private partnership. I would say that studies should be done in that regard. I would encourage people concerned about this particular area to look at that as an option.

[3:00]

Interjection.

R. Coleman: I don't think that that really exists.

The difficulty here is that the society has no funds, of course, so they have no ability to go out and do the engineering and to do the studies to actually prove that this is right or wrong. Even in meetings with the ministry, the society has a tendency to say: "Well, I know somebody who has a front-end loader and somebody else who has a truck, and we can go in there, move the dirt, build the dike and solve the problem for a lot less money than anybody else is doing."

[ Page 3712 ]

I think it's important that these societies understand that we're not going to proceed on property -- on any property, but particularly on Crown land -- in any manner that is going to be done without the proper engineering or the environmental studies in place, and that we're going to live with the recommendations of the people we deal with. I think that probably solves. . . . We will certainly have the Hansards delivered to these societies so that they're aware of our discussions this afternoon, and hopefully it will put some of this to bed.

I want to move on just for a few minutes before I go into some more detail on housing. I want to thank the commission on a couple of projects, because I think that, obviously, there have been a couple in the past year that were tougher and that they did particularly yeoman service on.

One of them that I'd like to bring to the attention of the minister is the Ishtar Transition House in Langley. The Ishtar Transition House may have been the first transition house in North America. We're not sure, but we think it's very close. It is very old; it has been there a long time. It was governed by a number of programs: CMHC was involved; B.C. Housing was involved; the Ministry of Women's Equality was involved. They basically needed a new house and some way to make a land transaction take place with the old house, under a different variety of programs, in order to make the project go in a different direction and to be able to come up with a new house. When I approached the commission with the problem, and I gave them my information and CMHC's information, they were very good. They reacted quickly, and I am now told that the fundraising for Ishtar is somewhere around $200,000 in the community. Their goal is $350,000. So they're making a community contribution to the house as well. I just want to compliment the commission on that particular project.

Hon. M. Farnworth: One of the nice things is when. . . . We're often very quick to criticize a project for not doing this and meeting that. It's nice when the housing commission and staff are complimented for work well done, so thank you.

R. Coleman: I want to go on to another one -- again, it's a compliment. This one I think we're going to be dealing with in more detail later when I get into the possibility of CMHC downloading a substantial amount of product to the province. There are a number of funny little agreements out there on properties, with caveats and covenants and what have you.

I just got a call today from the people from Ebenezer Home. I understand that their issue is on the agenda for cabinet for June 5. It's a cabinet order to deal with the land and this allowable transference to allow these people to develop more care facilities. Again, I think the commission has handled it quickly and efficiently -- and reacted. I'm just wondering what the status is with cabinet and then outward from there.

Hon. M. Farnworth: It should be an OIC that's required, and that should be in the next couple of weeks.

R. Coleman: My next issue is not to do with the commission itself per se. It's to do with residential tenancy, and I realize that the Attorney General ministry are the people who do residential tenancy. I canvassed that particular issue in great detail with the minister. I would be remiss if I didn't take this opportunity to put forward my case to the Minister of Housing with regards to a couple of issues. When I did estimates with the Attorney General, we dealt with a couple of fairly serious issues that deal in the marketplace of mobile homes and mobile home parks and retroactivity in rent. At the time the minister said that if he could, he would try and bring something forward in this session to fix the problem.

My understanding now, from a briefing session this week with members from the ministry, is that those changes are now drafted. They're now in the minister's office, and it's up to the cabinet colleagues to agree to deal with this particular issue to do with residential tenancy and bring it forward on the agenda. So I'm going to ask the minister: would you bring that up with the Attorney General to see if we can push it forward a little bit further?

Hon. M. Farnworth: I am more than willing to.

R. Coleman: That's two out of 13 votes; I think we're getting there.

I'd like to move now on to B.C. Housing's annual report, just to canvass a few questions I have with regards to the annual report and the operation of the commission. First of all, there's some interesting statistics that we should be aware of, and I don't think they've changed. Basically, in the budgeted revenues for B.C. Housing in 1997-98, my understanding would be that the provincial subsidies cover 44 percent; the federal subsidies cover 37 percent; you have a small sundry revenue of about 1 percent and rent revenue of 15 percent; and then you have 4 percent that comes from sponsoring ministries.

Hon. M. Farnworth: That is correct.

R. Coleman: I'd like to deal, then, first of all, with the area from the sponsoring ministries. I wonder if the minister could tell me how many various ministries the commission is actually involved with as far as delivering housing services.

Hon. M. Farnworth: Five ministries, hon. member: Health, Human Resources, Children and Families, Women's Equality and Attorney General.

R. Coleman: I'd like to just deal with them as a block, because, hopefully, you have them standardized as to how they operate with each one.

The first question I would have, then, is. . . . When I was canvassing the Minister of Health during Health estimates last week, I was asking about the selection and delivery of various health types of facilities, under mental health and disabilities and what have you. The ministry was able to answer my question with regards to the fact that, yes, they did have a lease in place, but they had no idea how the selection process took place -- how their land was selected. They seemed to think they were just a funding agency and didn't have any input. I'm just wondering if that's correct. Is the commission responsible for the entire design and delivery of these various group homes and what have you with regards to Health, or is there some involvement from the Ministry of Health in design and delivery?

Hon. M. Farnworth: The answer is yes to both questions. B.C. Housing is the agent that does the design and delivery, but the site selection also takes place in consultation with the regional health authorities and input from the ministry.

R. Coleman: Are these done through a proposal call?

Hon. M. Farnworth: No, they're not done through a proposal call. B.C. Housing goes out and selects the sites and then works with the ministry.

[ Page 3713 ]

R. Coleman: And this holds true for all five ministries that we're dealing with?

Hon. M. Farnworth: Yes.

R. Coleman: I prefer longer answers.

The next thing is: are all of these properties held title-wise with the Provincial Rental Housing Corporation, or are they held with the individual ministries?

Hon. M. Farnworth: There are 603 group homes within the province. The ministry holds title to 258 of them, and societies hold title to 345 of them.

R. Coleman: The societies that hold title, then. . . . Are these relatively old projects? It seemed to me that the process always used to be to put them into long-term leases and hold the title with the provincial government. I wonder if you could explain the differentiation there, please.

Hon. M. Farnworth: In terms of new construction, hon. member, you are correct. That title is vested within the province, as a rule. With existing ones that were done through CMHC years ago -- generally much older projects -- the title is vested with the society.

R. Coleman: And those CMHC ones are under the funding and management of the commission, or are they still held over with CMHC?

Hon. M. Farnworth: In terms of the older ones, they're cost-shared one-third -- two-thirds, with the province putting in one-third of the money and CMHC putting in two-thirds of the money. The newer ones are provincially funded.

R. Coleman: I think you misunderstood my question. I understand the funding formula. I'm not going to get into that this year, but. . . . Oh, I can, if you wish.

My question is: who has responsibility for them now? We know that there's a large inventory that sits with CMHC, and I'm just wondering if they're holding responsibility for those or whether the commission is actually running those units now.

Hon. M. Farnworth: We do the property management on 258 of them, and the balance is done by the societies.

R. Coleman: Are the ones that are managed by societies in an operating agreement with the commission or with CMHC?

Hon. M. Farnworth: They're in an operating agreement with the commission.

R. Coleman: My next couple of questions have to deal with the housing registry. I would just like to know the status of the registry. I know that we closed down a registry this year. When the commission shut this down. . . . I'm going to canvass some of the problems with that a little later.

I know that during estimates last year we discussed the fact that there were registries actually being handled by the commission in a variety of offices. I think it was Penticton, and then Burnaby was the main one. There was also a new computer system that was being anticipated at that time. I'm just wondering what the status of that particular registry and the computer system are.

[3:15]

R. Coleman: Tracking was another question last year when we were dealing with estimates. One of the main issues in social housing, as the people at the commission would know and as the people who have been involved in the societies know, is the inability to track tenants.

I'll give you just a quick example of somebody in the Legion project on Lobb Avenue, which is in your constituency and which you voted for when you were on council back a number of years ago. One tenant will trash a suite in a society-owned project -- it's $5,000 or $10,000 -- and then leave behind, usually, a very small damage deposit. Then they'll show up and be approved into another housing project that's managed by this commission, because they still meet the snipped core need income threshold. They still have the need and the desire for housing, but nobody knows where they came from. They actually owe us money, effectively. We canvassed this last year in estimates, and I'm wondering what progress has been made on that particular area in the past year.

Hon. M. Farnworth: The problem still exists. Has there been satisfactory progress made to date? I'd have to say no. The fact of the matter and what it basically comes down to is that the non-profits are operating independently, and you've got the province basically operating independently. There still needs to be that integration. There needs to be considerably more work done on it, but I think it's something we do need to do.

R. Coleman: I think it should be a priority, simply because there are 12,000 people sitting on a waiting list for social housing. Most of them, I suspect, would be good tenants and good residents of social housing or assisted housing or whatever you want to call it. And we have people out there abusing it because we can't track them.

There should be a message sent to the non-profit societies that in cooperation with B.C. Housing, they should get on this through the different tenants' organizations. I know that the tenants' associations, even those in B.C. Housing's own projects, encourage the growth of the tenants' organization -- even the provincial body now in social housing -- which I think is admirable. Now we have to get down to where we are going to do something about it.

The next area with regard to housing. . . . I sort of get nervous about contingent liabilities, especially when you deal with the Condominium Act, which I also have the misfortune of dealing with. I'll have to deal with that with the Minister of Finance. There are some substantially old products out there, under the management of the commission. I know that we have a modernization and improvement program coming into place, and it's moving along at some speed. The question, basically, is: does the commission know what they think their future liabilities are? I know that some projects have good capital reserves for some repairs and what have you, but some 

[ Page 3714 ]

modernization and improvements in projects is anticipated. I'm just wondering: to what level, and how many projects are we dealing with?

Hon. M. Farnworth: There are basically two groups of stock. There's the directly managed stock, and there's the non-directly managed stock -- by the societies, if you like. In terms of directly managed stock, there are no reserves in place. Instead, we do a three-year capital plan and operate on that basis. We're doing internal reviews with the others over a three-year period, as well, in terms of identifying what problems there are. If extra money is required over and above normal repairs, then we make that available.

R. Coleman: The commission also involves the tenant association in this process, as I understand it. One comment in the annual report that sort of struck my eye with regards to this process was that there are certain management activities that are funded by the program, which is the modernization improvement program. There's input into this. I guess my question would be: if the tenant association is involved in the improvements, who is giving them advice on the building upgrades with regards to what they're requesting when they're dealing with the program?

Hon. M. Farnworth: Basically, we get input from two sources. Some is from tenant associations, but probably more detailed input is from the people who are actually managing the project -- from the head of the project management team, if you like, right down to the caretaker. That's where we get a great deal of information in terms of state of capital and that sort of thing.

R. Coleman: I guess my next question, then, is: as this progresses, does the B.C. Housing Management Commission have the appropriate staffing levels to handle these three-year capital programs in a manner that's efficient enough, and the ability to basically produce -- if I may be so bold. . . ? My experience with the commission is that the field staff are actually somewhat constrained in the amount of time they have to even give to non-profit projects or to their own projects as far as donating their management advice. I'm just wondering if the commission is actually positioned to be able to handle this type of thing.

Hon. M. Farnworth: At the current time I would say that yes, it is adequate. I think what you're finding is that in terms of directly managed maintenance, the amount of time required on that has been declining and will continue to decline for some time. It's allowing us to shift resources within B.C. Housing to sort of spend more time on the non-profit housing stock, and I think that's going to continue for the next few years. However, I would say that if that starts to change, or if you're seeing an increasing number of problems with the non-profit, or vice versa, then clearly you're going to have to do a reassessment of where you're putting your resources at that time.

R. Coleman: I know we will be discussing what kind of resources will be required when we look at 55,000 additional units being popped down in the province in a little while. I think that's probably going to be of some concern.

Basically, I want to go back to the housing registry for a minute, just to understand what we're doing with the BCHMC tenant stock -- let's call it that, for lack of a better description. With the networking, are we now just downloading information so that in Burnaby we're maintaining the one list for the entire province, and basically they're inputting from a remote location? Is that what we're doing?

Hon. M. Farnworth: Each regional office -- let's say Penticton, Prince George or Prince Rupert, for example -- keeps and manages its own lists in its own areas. And it's all linked now so that if they've got a tenant here in the lower mainland, they're able to access the stock up in Prince Rupert, and someone in Prince Rupert is able to access the stock down here.

R. Coleman: Within that system, are we now tracking, at least, the B.C. Housing Management Commission tenants as far as damages and what they may owe us, and what have you?

Hon. M. Farnworth: Absolutely. And quite frankly, I'd be extremely ticked off if we weren't.

R. Coleman: We wouldn't want to see that, would we?

Hon. M. Farnworth: I don't think so.

R. Coleman: Just a quick question: I wonder if you could tell me how many people are now on the wheelchair registry and how that's functioning for you.

Hon. M. Farnworth: There are 174 currently on the wheelchair registry, the vast majority of them being here on the lower mainland and in the Victoria area.

R. Coleman: Until we build the fixed link, this won't be the lower mainland. That's a discussion for another day.

My next question with regard to the wheelchair registry. . . . You know, considering the. . . . I know that there are certain varieties of stock out there. There are some three-bedroom-disabled, some two-bedroom-disabled and what have you within society- and government-owned projects. Is that registry also tracking available stock in the public sector or in any other sector in the marketplace with regard to availability of wheelchair-accessible units to people, outside of what we're managing in housing stock?

Hon. M. Farnworth: No, we don't currently track what's available in the private sector. However, private sector landlords can enter into our housing registry, if they wish, so they can make their unit available. That's what I can tell you there.

R. Coleman: Are the different organizations like the Canadian Paraplegic Association or the Kinsmen Rehabilitation Foundation made aware of the fact that they can register a product that they're aware of in this registry so that we start to build some sort of standardized level of stock and what have you?

Hon. M. Farnworth: Yes, we do. They are aware of it, and we do have a very good relationship with those organizations. If they have stock that they're aware of, we encourage them to get it into the registry.

R. Coleman: That's excellent. I want to move on just briefly, then, to what I refer to as second-stage housing: what I think you refer to as priority-placement type policies with regard to housing. Knowing the situation with transition 

[ Page 3715 ]

houses and the strain that's put on them and the need to basically move the families from transition into housing stock within 30 days, I'd like to know how successful we are in being able to do that, as far as the turnover in transition housing vacancies and being able to place these people goes, and whether we're able to place them or if we still have a difficulty at the other end, with no place for families to go after 30 days in transition housing.

[3:30]

R. Coleman: I would be interested in statistics, though; I would be interested in how many people are in transition houses and how full they are, the burdens with regard to them. I know that the 25 percent turnover into housing -- and I think it's very critical that we continue to push societies to do that. . . . I'd be interested to know how many people are leaving transition houses with no place to go, and whether we have to up that 25 percent to 30 percent or whatever the case may be.

Hon. M. Farnworth: In terms of the actual figures, the question is probably more appropriately asked of the Ministry of Women's Equality. Basically they keep track of all that, and we act on the requests. So in terms of how many are in transition houses and what the numbers are, it's going to be Women's Equality that's going to be able to supply them.

R. Coleman: Nice slide! They do it on the other side, though. Women's Equality slides it over to the commission, and the commission slides it back over to Women's Equality. All I'm trying to get at here is: could these two ministries maybe get together and come up with the numbers so that we can determine that we're completely meeting the needs of the rollover out of transition houses? That's basically what I'm after.

Hon. M. Farnworth: Not wanting to be accused of sliding, I will make a commitment to the member to get him the numbers he has asked for.

R. Coleman: As part of my review of the annual report, I'd like to ask some operating questions with regard to the commission. These are basically questions relative to review of the financial position of the commission -- the financial reporting side of it and how you do it. I'm basically looking for whether certain things are done quarterly, annually or biannually with regard to the operation of the commission.

The first one would be on the financial side with regard to operating results: the review of total revenue, net income, any corporate overheads and increased revenues in any forms -- so basically, a revenue review. How often would that be conducted?

Hon. M. Farnworth: In terms of internal revenue, the reviews are done monthly. External revenues are done annually.

R. Coleman: With regard to assets and liabilities and productivity, which are two areas that are somewhat identified with regard to the strategic plan which we're going to deal with in a little while, basically the review of your assets versus your liabilities and whether things like holding costs, outstanding development costs, outstanding architectural costs, dollars put out to societies, how often that review takes place and how often you do a productivity or management review on your employees. . . .

Hon. M. Farnworth: The answer to the first part of your question is: monthly.

The second part of your question: we do an annual performance review on employees.

R. Coleman: Whenever you're in a business, but in rental housing particularly. . . . Of course, this is a bit different than straight-up rental housing, obviously, because there are subsidies involved. But how often do you do a review of the cost delivery versus the expense side project-by-project? I know that they are audited annually, but do you do performance reviews on how your product is performing with regard to revenues, accommodation costs, utilities, maintenance costs and what have you?

Hon. M. Farnworth: In terms of the directly managed stock, it's monthly; everything is done on a monthly basis. On the non-profits, it's done annually, in terms of all financial things, and then a thorough internal and external review is done every three years.

R. Coleman: Just on that note, before I move on to the next question, is CMHC still doing spot audits on some of their product with regard to the stuff they had the two-thirds dollar value involved in?

Hon. M. Farnworth: The effective answer is no. They're still doing the odd one, but not in terms of anything that you can bank on.

R. Coleman: So basically what you're telling me is that it's another download to you.

On the customer service side -- and I know we're dealing with social housing -- how often do you actually conduct reviews, surveys or whatever with your tenants to see whether they're being serviced well, and whether they're happy with their accommodation and with regard to the quality of delivery and what have you?

Hon. M. Farnworth: Currently there is no systematic satisfaction determination process in place. That is one of the areas that is addressed in the strategic plan for the coming year. There needs to be more of that done.

R. Coleman: I'd like to take sort of a market vacancy rate around the province just so that we have an idea of how we're performing in various regions. I've toured housing in most areas of the province. I'd like to start out with the area around Prince Rupert.

You seem to have two sets of product up there. You seem to have native-managed housing, to some degree. My first question on that is: why isn't the federal ministry taking care of that particular portion of your portfolio, if they're not? The second part is that when I was in that area I got the impression that you're dealing with a very high vacancy rate and turnover on the performance of your product, and I'm just wondering about the status of that.

[ Page 3716 ]

Hon. M. Farnworth: In terms of projects that were specifically geared to an aboriginal market, if that's the best way of describing it, they're still managed by CMHC. There are a number of projects up there that were built and funded by B.C. Housing. They were not specifically aboriginal in nature initially, but over the years they have evolved into a primarily aboriginal tenant base. So that accounts for a segment up there.

In terms of the turnover, there is a very high turnover rate -- not a particularly high vacancy rate, just a high turnover rate. In part, I think that is related to a number of factors. One is demographics. The fact that it's a very young community up there and there is high seasonality in the work leads to a high turnover factor.

R. Coleman: Could you tell me what your vacancy rate is on an annualized basis in that particular marketplace?

Hon. M. Farnworth: In Prince Rupert it would be less than 2 percent. Nominally, throughout the province as a whole, it's zero, in part because we have a waiting list.

R. Coleman: I find that kind of surprising, because I got the impression that it was much higher than that in the Rupert area. In Prince Rupert you have a number of other problems, and I don't know how the commission is dealing with them or going to deal with them. Your product in Prince Rupert is old; it was built in about 1970, looking at the vintage of its construction. You have two difficulties with it. One is erosion, which seems to be endemic to the way they were constructed in the beginning. Basically, you have patios that are suspended with six, eight or ten inches of dirt missing from underneath them. I know you've moved some product out into the marketplace, too, at one point in time. But I'm just wondering how you're dealing with this soil condition. And what do you think your projected long-term liability is with regard to those?

Hon. M. Farnworth: We're not projecting any long-term liabilities at the current time. We've addressed most of the outstanding issues in regard to soil stability problems over the last number of years.

R. Coleman: The other observation I had about this particular area of the province is with regard to the roofs of the buildings. Interestingly enough, a number of your houses, a number of units, seem to have been built on a flyway of seagulls. I know we're laughing at this, but it's actually creating a problem in Rupert because they seem to make rather large deposits on the roofs of the building and this seems to deteriorate your roofing. Your roofs are actually deteriorating at a more rapid level than normal. It looks to me as though you have replaced some roofs, and you're going to have to be looking to replace some more. Looking at the marketplace and looking at the product, I'm wondering whether you've thought of going to a metal roof in that particular jurisdiction versus the asphalt, which seems to deteriorate more rapidly.

Hon. M. Farnworth: I guess most of the roofs have been upgraded in the last five years, so currently there is an expectation that the province will get full value from their life expectancy. The hon. member has raised a good suggestion, and I'd certainly say we'd be more than willing to look into metal roofs if there is a problem. The only caveat I'm thinking of is that a tin roof in Rupert, with the rain and the seagulls, could be a little noisy.

[3:45]

I'd like to move on, then, to a couple of other quick things with regard to the management of the housing. The Rupert area is probably a good example to use for these questions because I don't think they have any duplication there, whereas you do have in some areas. I got the impression that most of the product in that particular area of the province -- it's called the northwest sector of the province -- is managed by the commission and not managed by societies.

Hon. M. Farnworth: That's absolutely correct. In fact, there's only one cooperative in the area.

R. Coleman: The next question I have, then, is with regard to. . . . Last year we discussed some review of duplication within the system in estimates, sort of like an evaluation. We canvassed it from a standpoint of looking at. . . . The fact I brought up was that there were two non-profit society-operated facilities in a community within half a block or a block of a facility directly managed by the commission. I know that there was supposed to be some time spent on that and some discussion. I'm just wondering where we're at in those particular areas as far as looking at the duplication of services for landscaping, maintenance and that sort of thing.

Hon. M. Farnworth: I guess I can make a couple of observations. In terms of the amalgamation of some of our stock, whose employees tend to be covered by collective agreements, and non-profits, whose employees aren't covered by collective agreements, I'd say the situation is pretty much the same as it was last year. What we have been doing, though, is encouraging groups within the non-profit sector to come together and eliminate some duplication and become more efficient in that respect. One of the other factors that needs to be considered at the present time is that a lot of our stock is family-oriented, as opposed to the non-profits, which are for seniors. There's some difficulty in trying to get the two to work together -- seniors and families.

R. Coleman: I'd like to just canvass, then, for a few minutes with the minister. . . . Last year we had some discussion about rent supplement. I dealt with it in some discussions with the minister at the time from the standpoint that I thought this was a reasonable delivery of service without the capital cost delivery -- the cost to deliver. It basically creates an opportunity within Housing to create more stock by subsidizing in place, by using up some of the stock in the rental marketplace and probably by eventually creating the rejuvenation, to some degree, or the building of new rental stock in the province, other than that subsidized by government. I don't know if the minister is familiar with rent supplement, but I'll just give you a brief summary.

A good example is the community where I come from. I know that a three-bedroom in a non-profit-managed project is costing us $1,350 a month with all-in costs -- which are basically our costs of delivery, costs of financing and all the rest of it for the project -- whereas in the same community we can rent a three-bedroom for about $725 a month, and those are readily available. So we have this difference of about $600 a month that it's costing us to produce the same housing.

We can't go back in time and take the capital cost delivery philosophy out of the system. But rent supplement was a program that was in place until about 1991. I know we discussed 

[ Page 3717 ]

it last year, and there was some indication that we might be moving forward with the idea of using some more rent supplement in the future. I'm just wondering what the status of rent supplement is.

Hon. M. Farnworth: The hon. member has raised a really good and interesting point. Currently there is some rent supplement taking place in terms of the Ministry of Health, but the area that he's outlined is one that certainly needs more exploration. There's a report just being done. The first phase is complete; I think it's been completed in the last few days. It was funded by CMHC. We're funding the second phase of the report, which is going to look at more options in terms of delivering that rent supplement. I look forward to getting that report and then, hopefully, moving forward on it. Given the way the member has outlined it, and my understanding of it, I think it would be a very valid form of providing accommodation in certain market segments, in certain locations.

R. Coleman: In the annual report, you refer to 1,811 units that were provided with subsidies and rent supplement last year. Are those 1,811 units. . . ? When you referred to those 1,811 units as supplemented. . . . Are these in other ministries, then? Or are some of them actually still in the marketplace, with regards to 15-year leases or whatever the case may be?

Hon. M. Farnworth: The 1,800 are in non-profits, but then there are also approximately 322 in private homes and another 244 in private homes for the disabled. So there is some rent supplement currently taking place.

R. Coleman: Let's just clarify the first part of that answer. Are the 1,811 units in non-profits, or are they in the marketplace? Rent supplement is usually a marketplace-driven subsidy. Otherwise, you wouldn't be supplementing somebody in a social housing project.

Hon. M. Farnworth: These are old non-profits that were done before 1986, when there was a turnover to the province.

R. Coleman: I need a bit more clarification on that.

Hon. M. Farnworth: Prior to 1986, these 1,800 units were administered by CMHC. In 1986 there was a cost-sharing agreement, and they were turned over to the province. As part of that cost-sharing agreement, the province is providing the supplement to those particular units. So that's my understanding of how it works.

R. Coleman: Who owns the inventory?

Hon. M. Farnworth: The non-profits.

R. Coleman: So this is operating under a different non-profit operating agreement. Are these entire projects, then, that you're referring to as a rent supplement. . . ? Like, there's an entire project of 15 units that some society owns that they were doing a rent supplement program on. My understanding of the rent supplement program that was in place in '86 and beyond was that it was a revolving five-year agreement or lease with an owner of a building. Let's say it was an apartment building out here, and I was building an apartment building. You would come to me and say, "We would like to have five units in your building, and we'll give you three five-year leases, revolving, turning over to guarantee your stability, if you'll produce rental housing in that particular building," which is still the asset of the owner. These 1,800 units are with the societies. Now, I know that some of those other rent supplement agreements were in place, so where are they if these 1,800 are with non-profit societies? What's the breakout here?

Hon. M. Farnworth: We direct the rent supplement to the society. The society can then direct the rent supplement to a private building.

R. Coleman: So the inventory is not owned by the society?

Interjection.

R. Coleman: Okay. So if it's not owned by the society, who has the lease agreement with the owner of the building? Is it the society or the B.C. Housing Management Commission who would have the lease arrangement with the builder? And are there any guarantees on it if it's with the society? Is the commission guaranteeing those lease agreements with the owners of the building?

Hon. M. Farnworth: The society enters into an agreement with the private operator or the private building owner, and then we guarantee the subsidy to the society.

R. Coleman: It says no guarantees by the commission on the agreement from the society to the owner of the building.

Hon. M. Farnworth: No.

R. Coleman: Just one final clarification on this section, then. The 1,811 units are all society. . . . None of them are into agreements with the commission directly with an owner of a building. And the commission doesn't send the tenants; the society sends the tenants. Is that correct?

Hon. M. Farnworth: The society totally selects the tenants. We don't have a role in that.

R. Coleman: I'd just like to know what type of agreement the tenants in these rent supplement units are governed by. Are they governed by the CNIT, or are they governed by a formula from a previous program for the calculation of rent?

Hon. M. Farnworth: They're selected in the same way that any other tenant is in the system. So there's no difference between how they're selected by the society for placement into a private rent supplement situation; it's as if they were going into one of our own.

[4:00]

Hon. M. Farnworth: In terms of how often we monitor them, I'll get you the answer for that. I don't have that here for you today. I'm allowed one once in awhile.

[ Page 3718 ]

So that's what's happening there. With the rest, they are selected in the same way that everybody else is.

R. Coleman: I'd be interested in seeing the first draft of the report that you referred to which the CMHC is releasing, and I'd also be interested in the follow-up report. I think we have some fairly interesting crises taking place in housing in our province right now because of the influx of offshore involvement in our housing market, and there are some artificial markets being created. At the same time, perhaps because of the residential tenancy side -- where we have to get into the plain language acts so that we can handle it better -- my experience to this point is that we're losing rental housing stock. And if we lose rental housing stock, it's going to make it more and more of a crisis for the commission. They're facing 12,000 out there now that are on the core need side, but you also have people scrambling to find housing that are not on the need side, that just can't find rental accommodation.

The creation of a rent supplement program, one that would supplement and also create interest back into the marketplace for the people to develop rental housing, would, in my opinion, have a positive impact. I think you'll find from the reports that that works, and it has worked in a number of jurisdictions. And I think we'll find that it is also quite possible in our jurisdiction. I'd like to know what the minister thinks. I know he made one comment with regards to it, but I don't know what he thinks the mandate of the commission is. But when it's Municipal Affairs and Housing, and housing is governed by about seven different ministries in the province and is not consolidated. . . . It's very difficult to understand the marketplace if your own commission has an effect on it. I wonder if there's any thought to expanding the mandate of the commission to deal with the direction of the provision of housing in the province as a whole, particularly in the rental marketplace.

Hon. M. Farnworth: I guess the answer to your question, particularly the first part, is yes, I clearly think there is a role for rent supplements. It's something we need. In fact, there is going to be considerably more work done on it within the commission. In particular markets in particular areas of the province, as I said earlier on, it seems to me to make sense. We've got the first stage of a report being done and the second stage being financed by the commission, so I think that's a good basis to start on. Clearly, it seems to be an extremely cost-effective way. So it's one area that I think we need to explore further.

In terms of us getting further involved with the rental housing market, certainly I think there are opportunities there. The question is: how far do you go? In terms of looking at coordination within different ministries, I think we should be looking at better ways of coordinating responses and policies because of the fact that there are so many ministries involved. But in terms of getting involved with the private sector or recognizing the impact that B.C. Housing has on the private market, I think I would want to err on the side of caution.

R. Coleman: I would like to move on, then, and thank you for your comments on that. I think you'll find that if one creates a positive impact on a marketplace, the marketplace will respond, and then we'll solve some of the housing dilemmas that we're facing.

The reason I bring this up is because in discussions on the Condominium Act and on some other areas, I'll be bringing up the fact that there's a number of new forms of housing and different hybrids that keep reappearing. What they effectively do is do strata title projects without having to go through due process, a similar process, which takes rental products out of the marketplace. It's being done because, you know, it can be. As a result of that, we're going to see the pressure become very immense on this particular group of people.

I'd like to deal briefly and know the status of. . . . We went through a review last year in estimates of the non-profit operating agreement. We went through this. The non-profit operating agreement is up for review and up for a rewrite. I believe that the annual report basically makes mention of the Homes B.C. operating agreement. I'm just wondering what the status of that particular operating agreement is and what has been implemented. If it hasn't been, what is the time frame for its implementation?

Hon. M. Farnworth: We're into full implementation and work is proceeding rapidly. As every project comes on, it's being implemented.

R. Coleman: The operating agreement that we're using -- is this just for new product, new projects, new societies, new privately managed housing or whatever the case or description may be? Is that what the implementation is for?

Hon. M. Farnworth: Yes.

R. Coleman: Okay. Then I'd like to go back just briefly. Were there any changes or adjustments made to the operating agreement that is governing the balance of the product, which we canvassed last year -- the operating agreement that is presently in place?

Hon. M. Farnworth: No, and we don't, in fact, have the authority to change those operating agreements at this point.

R. Coleman: Would you, would it be. . . ? Actually, I'll deal with that question when we get into the CMHC side of things, because it's more balancing than anything else. It's just that I found it humorous last year when a non-profit operating agreement referred to the fact that the society had to operate with a profit, and if they didn't, they were in breach of their agreement. We brought that up, and I just wondered if anybody had done anything with that.

The next area I'd like to briefly deal with is some reporting and some measurements with regards to the non-profit societies themselves. I don't know what process the commission is using with regards to this. I just wonder where you deal with a number of areas. I'll just deal with a couple of quick ones. This is with regards to the societies themselves.

Obviously, the boards of directors have to, on an annual basis, be elected through a process that takes place at an annual general meeting, and a form 11 has to be filed under the Society Act. In addition to that, a financial statement has to be posted. I'm wondering: how do you monitor the standing of your societies as far as the filing of the form 11 and their being in good standing under the Society Act?

Hon. M. Farnworth: We ask the external auditor that is doing the audit of each of the societies to report on whether or not they are in fact a society in good standing with the Society Act.

R. Coleman: My experience with non-profit societies with regards to social housing is that they basically have to have a constitution and bylaws that fit with the National 

[ Page 3719 ]

Housing Act. What type of constitution and bylaws do organizations have that operate transition houses or that operate care homes -- for instance, under mental health -- or that operate different types of facilities under various ministries that the commission has responsibility for? What type of constitution and bylaws are they governed by? And who has to review them, according to what particular act?

Hon. M. Farnworth: The responsibility for that, in fact, actually lies with the particular ministry whose building it's associated with. So if it's a health building, the Ministry of Health is responsible; if it's social services, Social Services is responsible; if it's children and families, Children and Families is responsible; if it's women's equality, Women's Equality is responsible.

R. Coleman: They don't seem to know that. This brings me to my next question. I assume that all of the societies you deal with are governed by the National Housing Act. I assume they have constitutions and bylaws they have to mention, unless it's a special needs situation. And if it's not a special needs situation. . . . For ones that wouldn't be governed under that type of formula, which was the formula that was being used, does the commission review the constitution and bylaws and mission statements of these societies that we're funding into the group home side -- outside of these other ministries that are, evidently, supposed to take responsibility for them? Incidentally, when I've asked the question, they always put it back to the commission -- that the commission is responsible for this. That's why I. . . .

Hon. M. Farnworth: The agreement is between the society and the ministry. So if it's the society doing housing for the Ministry of Health, the agreement is between that society and the ministry. So they are the ones that have. . . . You know, it's their responsibility. We manage the property; we can own the land. But basically, that's the extent of our involvement.

R. Coleman: Maybe we should just sort of step back for a second. Maybe you could tell me what group homes the commission has direct responsibility and management for, taking aside the Ministry of Women's Equality and the Ministry for Children and Families and all these different ministries that have housing. There's a series of housing that obviously the ministry has responsibility for. Obviously they wouldn't all be covered under the same type of constitution and bylaws, because I got the impression there, a minute ago, that they wouldn't be. So how many units would not be governed by that type of an agreement that the commission has direct responsibility for?

[4:15]

[S. Orcherton in the chair.]

R. Coleman: I want to canvass this a little further. Since 1990, if we developed 600 units a year under Homes B.C. or whatever the case may be, those constitutions and bylaws -- if there was a society involved -- would be this ministry's responsibility. Okay.

When this ministry makes a decision on the operation of that particular form of housing with a particular group, this group is. . . . You know, under a proposal call they always had to list their board of directors, the bank, the background of the board of directors. They have to list what they've done historically in housing, their qualifications and what have you. And they usually have to provide you with the constitution and bylaws that will operate that housing, which you provide for the society.

The sponsoring society is usually a different organization that also has a constitution, bylaws, a mission statement and what have you -- for argument's sake, let's say a Kinsmen group or a Legion group or what have you. They have another constitution and set of bylaws, which cannot be in conflict with the operation of the housing. That's why the independent societies are set up.

I'm just wondering, having dealt with that standard, on the other organizations that are providing housing. . . . If you speak to the ministries of Health, Human Resources, Women's Equality and -- there's one other -- Attorney General or the other ministries that deliver housing, their position on all of that -- the proposal call, the vetting of the constitution, the mission statement and all that -- is that the commission does that. They are strictly the funding agency.

I'm wondering: if that's the case, first of all, in the selection of the society, the construction of the building, the overseeing. . . . Then the funding is ongoing, you know, from the individual ministry to that particular form of housing, whether it be a group home or whatever the case may be. What I'm getting at is that the ministries are saying you're setting the guidelines, the rules; you're doing the review; you know what the constitutions say, what the society's background is, what their mission statements are. Then it gets built and operated. And they're just the funding agency. I'm wondering what the status is on that particular thing.

Let's just take, for instance, one transition house that's going to go out for some kind of a proposal call -- or approval, because you do it a bit differently, I know. But you do have a society. They do have a constitution; they do have an operating agreement. I'm wondering who vets that and makes that decision as to who's going to run that particular facility.

Hon. M. Farnworth: In my comments, hopefully, you may also be able to clarify a couple of remarks, because it does have a bearing in terms of the response. In terms of anything that flows through Homes B.C., that's correct. We do everything. Okay? We approve the bylaws; we do all that stuff -- all the background, boards of directors and the whole works. Anything that flows through the ministry, we don't. That's outside Homes B.C. That's done through the ministry and the sponsoring society.

Clearly, though, I think you've raised some good points. Certainly there needs to be better coordination if there's a problem with other ministries understanding their relationship in terms of approving boards of directors or doing backgrounds on the constitution and the bylaws to see if they meet with what the appropriate standards are supposed to be. But in terms of anything to do with Homes B.C., everything that comes through Homes B.C. comes through us.

R. Coleman: So let's go to Homes B.C., then. What flows through Homes B.C.? What projects go through Homes B.C.? 

[ Page 3720 ]

We can clarify that first of all. Maybe we can just sort of do it this way: do any group homes or transition houses flow through Homes B.C.? Maybe it's easier to answer the question in general. What flows through Homes B.C.?

Hon. M. Farnworth: Self-contained units and second-stage housing is primarily what flows through Homes B.C. We have done one transition house on behalf of Women's Equality, but only one.

R. Coleman: You're running those ones through a standard constitution and bylaws. You're doing a review of their boards of directors. You know their mission statements. When I asked some similar questions in some of the other estimates, I was also told that you did that for the other ministries, which evidently you don't.

I have some concerns. Fortunately, one of the ministries is still doing estimates, so I can go back and recanvass that issue. Actually, Women's Equality is coming back up, so I can recanvass that issue. The only one that might get away from me is the Attorney General, but he didn't have that much product anyway, so it isn't quite as important to me.

The concern I have, and the reason I bring this up, is that when the commission is involved, the commission has a certain set standard of management. I've read some of the agreements in some of the other ministries, and by comparison, they're lacking in some of their depth. But the commission sets down some fairly straightforward standards as far as tendering processes over certain dollar values. They actually provide documents to a society that they can use for tendering if they're going to tender services or what have you, so the operating organization can handle their paperwork, their tendering and their flow very well, because the management structure is there.

Because of the fact that they have to follow some act -- in the case of pre-1990, it is the National Housing Act -- and that they have to meet some standard for constitutions from to 1990 forward, there shouldn't be any slippage in the mission statement of the direction of the society. That can happen if that is not monitored on a regular basis by the ministry involved. You could have somebody delivering a particular form of housing who slides away from their mission statement, their direction. Then the management can go sideways and we end up with a difficulty.

I think it's important that a review take place on an annual basis similar to what happens with the commission, with regards to the audit procedures of some very specific things. Those would be: who the board of directors are; whether their form 11 is in place -- the financial statement, which is audited when it comes to the commission -- if that society is in good standing; what this society's objectives are and if they have changed in the past year. It's obviously very important that if you have somebody bucking the system with B.C. Housing and allowing second-stage housing, B.C. Housing has the option in its agreement to come in and say: "This is what you will you do." The mission statement, the services or goods they're providing, how they're servicing their clients and how that's being measured by the particular ministry. . . . I would assume that we're measuring those societies that we're doing business with with regards to the delivery of their services, any tendering procedures they're using, their outline of qualifications and their breakdown of expenditures.

When you start to canvass housing in other ministries and you keep getting sent back to the commission, and then you come to the commission, and they say, "No, we don't lay out the qualifications, designs and what have you for these things to happen," I think there's a concern that has to be dealt with, either at the cabinet table or some place, so that people know that their ministries are responsible for these types of guidelines in their housing. The commission isn't actually running it. The impression the Minister of Health had in estimates was that they're just a funding agency.

Hon. M. Farnworth: I think the hon. member has raised some extremely valid points, and I want to assure him that he's got my commitment that they are going to be addressed. I think what is required is my ministry getting together with Housing, taking the lead in the sense of getting together with the other ministries and addressing some of those problems that he's outlined. He's got my commitment that that will be done.

R. Coleman: That's good. It may just be a case where -- especially in the Ministry of Health, where you have a $7 billion ministry -- I don't know that you can expect the minister to know all of the answers. I think it's important.

The B.C. Non-Profit Housing Association received a grant from B.C. Housing. It was a one-time grant of $85,000. The grant was to develop an educational program and for general support, including tenant development. I'm just wondering how that is flowing, how we're doing with that and what the status of the report is.

Hon. M. Farnworth: The association is up and running and is representing about half the societies in the province right now. We're currently looking at funding them for probably another seven months until they become self-funding, which is their goal.

R. Coleman: And the educational program? What's the status of that?

Hon. M. Farnworth: They've done a considerable amount to date in the area of workshops and related functions. I think, though, in terms of a long-term program that's in place, it's going to take some time for that to evolve into the form that they, and the rest of the societies that they represent, envision could work.

R. Coleman: The $55,000 to develop the educational program -- has that been spent? Has that program developed, or is it evolving and the money hasn't been spent yet?

Hon. M. Farnworth: In terms of all the money and whether it has all been spent, no, I think there's still some left. A chunk of the money has gone to pay the salary of an educational coordinator, so that accounts for some of the money. There's still some left over. I think that over the long term, though, it will pay off. The fact is that you're going to have a much more sophisticated group of societies, which can only benefit them as a group individually and as a group organizationally. That, in the long term, will pay off for B.C. Housing.

[4:30]

Hon. M. Farnworth: Yes, there was.

[ Page 3721 ]

R. Coleman: Has there been a review, then, of the performance of the funding -- relative back to how the agreement was structured -- as to whether they have performed according to the agreement and produced the tools that they said they would for the agreement?

Hon. M. Farnworth: Yes. In fact, there was a performance agreement in place. A performance review did take place, and that's forming part of the basis for negotiations for the continuation of funding for the next seven months.

R. Coleman: That's refreshing to hear -- very refreshing.

I just want to basically touch on the tenant association grants, or what you refer to as TAGs. Just a couple of quick questions with regards to them. I'd like to know: how many of them have been applied for, and what's the utilization? There are some broad statements made with regards to TAG funding. It says here: ". . .eligible to apply for TAG funding to support a variety of projects from skills development and program planning to recreation activities for children." It goes on to say that this funding goes to community service programs, such as hot meal programs, day care support and what have you. I'd like to know what types of programs these people are developing for these funds and how many organizations have taken advantage of the funding.

Hon. M. Farnworth: There have been 54 TAGs approved. They cover a wide range of activities and are cost-shared with the federal government, so there's a federal component coming in. They cover a range of activities, from support for tenants and such things as a hot meal program and a food bank at one end, to seniors day care at the other. Typically, they apply for more money than is approved, so there is a thorough review done of each application. So that, I hope, is an answer.

R. Coleman: Could the minister tell me, then, just two things? How much was spent on this program last year, and how much do we anticipate spending in 1997-98? In addition to that, I'd also like to know what the two most successful uses of these funds are. What two things are you finding the most successful?

Hon. M. Farnworth: Approximately $160,000 was spent last year, and the anticipation is to spend probably about the same this year. I guess the best examples of the two most successful programs are probably one that's in the annual report, which is the Orchard Park food pantry program, and the other is a hot meals program for seniors provided at the Doug Drummond Home in Burnaby.

R. Coleman: That's great, and then I know the numbers. Just previously you mentioned that one of the programs that some of this funding went towards was for a seniors day care. Now I pose a question back, because I had to canvass seniors day care in another ministry. When you talk about a seniors day care, I'm just wondering what it is we've developed here, because I think they're funded through the Ministry of Health. How did you fund your residents who would have had to pay for the day care? Did they receive an allocation from somewhere, and what was the. . . ?

Hon. M. Farnworth: I think it's a question around terminology. It's a question of providing a program for seniors within a particular building, and they can come down and take advantage of a day program. So I guess that's where the term "day care. . . ."

R. Coleman: We're not going to go down the seniors road right now, because I have a colleague who really wants to spend some time on that. So she will deal with most of it.

As you probably have figured out, I'm going through the annual report at this point in time as part of leading in to my next section, which will deal with the strategic plan. But in the annual report, we talk about a tenants' handbook and how we've developed a tenants' handbook. There's just one disturbing comment I read in the annual report with regards to the tenants' handbook. Frankly, I think it's a positive step anytime you create good language documentation for people to understand what their rights are, how they should be taking care of their own property and what their responsibilities are back to a landlord -- or whatever the case may be in whatever type of operation.

The comment in the annual report, however, says that it was done and distributed to tenants of B.C. Housing units, right? I get the impression that it hasn't been distributed to the tenants of the society units, which are all operated the same way. I'm wondering if they are being distributed, because I think if it's working in our self-managed units and it's a positive step, then it should be a positive step in the non-self-managed units, which are the society ones. Frankly, those tenants need educating, as well, and they need to know their rights. I'm just wondering if they've done it or if they're planning to do it, or whether after this question they're now planning to do it.

Hon. M. Farnworth: I guess that question almost relates back to a question we had in Municipal Affairs around equity and equality: if it's good enough for one municipality, it's good enough for others. Clearly, if it's good enough for a B.C. Housing project, it's good enough for a society project. So if they're not there, they will be.

R. Coleman: I guess we just gave the general manager another job to do when he gets back to Vancouver.

There are some other things. . . . Back when I was involved with societies and social housing, we were all getting big into the idea that personal development was very important to the residents of social housing and that certain programs should be put in place for them to be able to either expand their educational opportunities or expand their opportunities into certain areas of the community. There are a number of things that happened in the last three or four years within the commission and within the operation of Housing that are quite positive in that regard. One of them was in February 1994 when you came in with the bursary program. I always thought the bursary program was an excellent idea. There are a couple of questions I have around it, because I am of the distinct impression that we haven't tapped this very well. I think what we're doing -- if I don't miss my guess -- is funding the bursary program through the commission. That would be my first question: is that how we're funding it?

Hon. M. Farnworth: Yes, that is in fact how it's being funded.

R. Coleman: I had the opportunity a few years ago to end up working on a foundation that tapped into a database of people, and I saw a foundation that became successful as far as being able to fund opportunities for one particular user group. Out there right now, I think we have. . . . I'm not going to try and pick the number of units, because I'd have to go down to this project list-by-list. But we have these massive numbers of societies out there that are, frankly, very well 

[ Page 3722 ]

funded outside of Housing. They do other fundraising activities in the communities. For instance, I know that one service club I belong to has an annual budget of about $80,000, and it looks for the opportunity to do bursaries for people within the community. I'm just wondering: has there been any thought of expanding this bursary program into a program where the participants and the beneficiaries of housing -- whether it be the society or the people who go through Housing and then move on to other forms of housing -- have the opportunity, through some sort of bursary foundation, to contribute back into a larger fund so that we can help more people with bursaries and provide more educational opportunity.

Hon. M. Farnworth: We spend about $20,000 a year, and any suggestion of being able to expand that is very welcome. There are some good opportunities out there, and there are, as you say, a number of service clubs that are extremely well funded. I know some service clubs provide bursaries in other areas, but in terms of getting people who've benefited from social housing, in terms of trying to tap the service club market, there are some opportunities. That is an area we should be looking at.

R. Coleman: I would encourage the commission to do that. I know it's not the mandate of the commission to set up some sort of a foundation or what have you, but when you look at who benefits from housing all across the board -- whether it be the person who develops and builds it, the person who lives in it, the society that's reaching a certain goal. . . . I think oftentimes the societies would be glad to donate to a bursary fund.

The beauty of something like that is that if you're only spending $20,000 a year, it doesn't take long, with the number of groups we're dealing with here, to build up a fund where we'd just be rolling it over every year and providing a legacy to one more portion of a social benefit that we're providing for the community. It could eventually get to the point where there are no tax dollars provided at all, but the benefit is created. Oftentimes the vehicle is the key -- the vehicle being provided by somebody who obviously has a reputation, has the ability to control it and make sure the funds are well-spent and have some charitable direction.

I would encourage the commission to take a look at that, because I think there are some benefits in there -- short-term and long-term -- and I certainly know a number of people who would be more than happy to work with the commission to try to support that type of initiative.

I wonder if I could get a quick update on the STEP program, basically as to what it's costing and how it's working.

Hon. M. Farnworth: The STEP program is up and running this year. It's going to cost about $95,000; it's cost-shared with the federal government. It's about the fourth year of operation, and projects will be in Richmond, Campbell River and East Vancouver.

R. Coleman: I just want to go to some other more mundane portions of the annual report now, if I could. We've been into philosophical stuff, but now I have some other questions.

The first is on page 29, item 5, and this goes back to the old rent supply program and some financing that's outstanding there. It says: "During 1993 an advance of $3.45 million was made under the B.C. rental supply program. . .secured by a second mortgage on property bearing interest rate at 8 percent annually during the first five years. Over the last 15 years the effective rate is 9.58 percent." On that $3.45 million that's outstanding, obviously that's a pretty good return; we're not going to knock that. I don't know why they haven't gone and remortgaged and got rid of it, but maybe they can't. I'm wondering how many projects that actually covers off.

Hon. M. Farnworth: It is in fact one project, the Vancouver Land Corporation. The trend has been to remortgaging, so we are seeing a reduction in this type of thing.

R. Coleman: I'd like to go to item 6, which basically deals with project development advances. This is where, I take it, we advance to societies so they can scout out their proposal calls and what have you, and they're either repaid through the development of the project or they're written off. What is our level of write-off, and how many dollars annually? What is our level of success as far as the number of groups that are given dollars, the number that repay and the number that are written off?

Hon. M. Farnworth: There's a write-off rate of about 20 percent, a success rate of 80 percent, and the write-off is about $1 million.

R. Coleman: On the 20 percent write-off, knowing the number of units that we're trying to deliver into the marketplace -- and we'll get into the allocations here in a few minutes, as well -- are we actually overencouraging people to be involved in the Homes B.C. thing with these type of grants, as far as getting them to enter proposals and to assist them, knowing that we only have a limited number of units that we can actually deal with? I think 600 units is basically what we're trying to achieve on an annualized basis. I'd be curious to know: on that 80-20 split, how many proposals is that? Are we overencouraging the marketplace to think that there's something there that they can't get?

[4:45]

In terms of whether I think it's time to make changes, yes. We are, in fact, currently working on changes to the proposal call system, looking more at being able to cherry-pick projects and looking at tightening up, to see if we can't either reduce expectations or tighten it down so the number of projects that come through an initial screening is substantially reduced.

R. Coleman: I think as we go through this we're going to be looking at other ways to deliver housing and services simply because of the dollars that are there, but $1 million is obviously a lot of money. You could probably retire on it -- I don't know that I could, but we could probably try.

You did make mention that you are anticipating some changes to the proposal call. I'm just wondering what those changes would be and what you're anticipating looking at.

Hon. M. Farnworth: I can't commit to anything specific right now because it is still very much at the beginning stages. 

[ Page 3723 ]

But in terms of looking at proposal calls, one of the things that has come to my mind initially is looking at things not just based on a geographic allocation but on a need allocation. For example, should we be ensuring that every region in the province gets the same per capita number of units, so to speak? Or should we be looking at saying, "Okay, where are the greatest problems?" and addressing projects that meet specific identified core needs and incorporating that into the proposal call? I also think there needs to be some change in terms of financing, a much tighter control on how much financing, how realistic it is -- doing more groundwork there. In terms of absolute specifics, I think we're probably a few months away from having that developed, but the work is currently taking place and it is a priority.

R. Coleman: I thought you did that very well. Just while we're on the subject -- and I think you've made a couple of very valid points -- obviously, when you only have 600 units, you're not really going to make a large impact on a marketplace the size of ours. It all comes back again to how we're delivering the product, it comes back to the rent supplement discussion, and it comes back to some private-public partnerships -- which I have some details on for later -- and how we can actually deliver some of these things very innovatively. I think you hit the nail on the head when you deal with the geographic versus the other.

The other thing is, as you go through that process, I think it's very important for your staff to be aware of the fact that the cost of a proposal in the past has been very, very expensive. The specifications you request, the risk that you have to take, even down to prospectuses and some kind of drawings, dealing with the land, the optioning back and forth -- especially with the societies side of it. . . . They don't have Crown or municipal lands. All of these issues create a great deal of expense to your proposal call side of the operation, which either discourages some people not get involved or costs us money, because we're funding the society so that they can make the calls to meet our specifications -- and we're actually the ones imposing the costs on them.

I can remember the day when there were seven large binders with ten or 12 sections, and the need was there, and a list of the telephones and the names of the people who had applied had to be in there, and all of that. I think it's very important that, knowing what we know statistically. . . . Particularly when we know there are 12,000 people out there who need housing and we know where they are, we don't really need somebody to establish where our need is; we should be able to establish that ourselves. We should be able to do a lot of these things that we put on people in the past, at extra cost, to deliver the housing. I think it's very critical that as we go through that we're very much aware of that.

We have a group home replacement fund in our financials, and the reason I bring this one up is basically because I'd like to know what group homes it is for and what it's related to. Are these commission group homes, are they group homes that are actually for other ministries that we're holding funds for, or what is the case?

Hon. M. Farnworth: These are owned by the Housing Commission, but they are funded by the ministries. I can see where this is going.

R. Coleman: Well, that's really not the answer I was looking for, because it sends me down a whole other road. These are owned by the commission; the Provincial Rental Housing Corporation has the land and the body. The lease is back to a society, I would assume, or to the commission. These are group homes, so they're not back to the commission, because the commission doesn't run those societies. Is that right? Some other ministry is funding these. So why are you holding their replacement funds?

Hon. M. Farnworth: We hold the property; we do the property management and the maintenance. In turn, we bill the ministry on the basis of our projected long-term maintenance costs and short-term maintenance problems. We bill the sponsoring ministry, who then pays the PRHC. That's how the money ends up where it does.

[5:00]

From the previous discussion, what I understood was that we don't have any involvement in the commission and other ministries' operations. We don't run their housing. Their explanation, when I canvassed earlier, was that they are only the funding agency; you are responsible for the society, the management and all the rest of it. Now, with these funds sitting over here in the group home replacement fund, I'm just wondering if I missed something, or what ministries are involved. You just said you have the maintenance responsibilities. You have a number of responsibilities you outlined. I think we're getting into this cross-purposes discussion again with these ministries, so maybe you could just clarify that a little bit for me, and we won't have to. . . .

[W. Hartley in the chair.]

Hon. M. Farnworth: I hope this clarifies it. The ministries are operating these particular facilities, okay? We are acting as a property management company. So in billing these places, we bill them for short-term maintenance costs and projected long-term maintenance costs. We even take an administration fee. Basically, we act as a property management company, and that's all we do. The operation of the facility is the ministry's responsibility.

R. Coleman: So this is basically a profit centre, effectively. At least it should be a profit centre for the commission. I'm just wondering: if you're in the property management business for group homes, are you doing it in a manner to ensure that you're actually making a profit to offset some of the costs of the commission? That's similar to what BCBC did with its management procedures.

Hon. M. Farnworth: We cover our costs; we don't make a profit.

R. Coleman: So in order to cover your costs, do you have a separate department set aside that basically does the property management on group homes? You must have maintenance schedules. I don't know, but if you're in property management, that would mean you're involved in. . . . Are you treating it like a triple-net situation when you're managing a group home -- i.e., you're responsible for ensuring taxes, etc., to do with property management? Or are you strictly doing maintenance and some other form of management?

Hon. M. Farnworth: The answer to the first part of your question is that there is no separate division. What we do is annual inspections, capital upgrades and emergency repairs.

[ Page 3724 ]

R. Coleman: So you don't do any grounds maintenance or that sort of thing on any of these projects.

Hon. M. Farnworth: The group home operator does that.

R. Coleman: These group homes that are viewed in this fund are the some 200-odd you mentioned earlier that the commission has some involvement in. Is it the same number?

Hon. M. Farnworth: The same.

R. Coleman: But you have no involvement in the management of the balance of the products, which are the ones that the societies are operating. Is that correct?

Hon. M. Farnworth: That is correct.

R. Coleman: So who's responsible for replacement funds and maintenance funds for the some 300-odd other group homes that are managed by societies in the province? Given my understanding that the operating agreements are somewhat unclear -- there's one I can get -- that therefore leads me to the next step as to whether there's a replacement reserve being built like there would be in social housing. How are we monitoring that? Do we have some large unfunded liability out there for the replacement of these other group homes that are being funded directly to societies by ministries and that the commission has no involvement in?

Hon. M. Farnworth: There is a reserve put away on an annual basis. It's done because they're run by societies under a federal-provincial agreement, and it is part of the regular subsidy, but it's not broken out.

R. Coleman: The other ones are run under a federal-provincial agreement -- is that what you said? And where is the federal involvement relative to these particular other facilities?

Hon. M. Farnworth: The federal government provides us with a subsidy on the basis of a one-third-two-thirds share. So we get the 66 percent subsidy from the federal government, and it basically flows through.

R. Coleman: So the two-thirds subsidy is still in place from the federal government to group homes today?

Hon. M. Farnworth: Yes, it is.

R. Coleman: I guess my next question is relative to this package of inventory, let's call it. I mean, 300-and-some-odd is a tremendous asset. It's a big asset, and obviously there's property involved and there are buildings involved -- the physical plant and the internal assets are involved. The operating agreements are not monitored and managed by the commission; they're monitored and managed by somebody else. I guess the question is: who is monitoring the operating agreements on the balance of the group home stock in the province of British Columbia?

Hon. M. Farnworth: On behalf of the federal and provincial governments, B.C. Housing monitors them -- monitors them quite intensely.

R. Coleman: So the commission is monitoring the entire group-home stock of the province of B.C. Would that be a fair summation of what you just said?

Hon. M. Farnworth: On the ones that come under the federal-provincial cost-sharing arrangement, we monitor property and we monitor operations. On the ones that come through ministry operations, where the operations report to the ministry, they monitor operations. We just monitor property.

R. Coleman: So we have a mixed bag here. Originally, when we were talking about this, we were talking about commission-operated group homes. Now we have some ministry-operated group homes, with societies that we also monitor the management of. Then there are some others that are monitored by the ministries themselves. Okay?

Hon. M. Farnworth: Yes, that's correct.

R. Coleman: So how many group homes do we monitor as a commission? Those are the ones we have that basically are under our direct supervision. And how many societal group homes do we also have under the federal-provincial agreement that we're involved in the monitoring of?

Hon. M. Farnworth: There are 603 group homes: 258 where we manage the property; 345 where we manage property and operations.

R. Coleman: Let's go to the 345. The other ones you manage as property, which are obviously under the Provincial Rental Housing Corporation, because that's where all the titles are held. Of the 345, how many of those are societies and how many of those are ministries?

Hon. M. Farnworth: They're all societies.

R. Coleman: I see the general manager is going to get greyer -- if it's possible -- before. . . .

My next question to the minister, then, would be this. These 345 units have operating agreements. Who's responsible for those operating agreements? Who are they signed with? If they're signed with the ministry and you have some management responsibilities, are you responsible for the operation of those operating agreements and the monitoring of those operations? Or are you just responsible for what you referred to earlier as fixing some of the physical assets -- some minor management and the management of the land? What is your involvement in those 345?

Hon. M. Farnworth: We'll go over these numbers again: 345, we monitor everything; 258, we monitor property. The operating agreements are with the ministries.

R. Coleman: Let's define "everything." With the 345, when you say you monitor everything. . . . We have form, character, design, utilities, budgets. We have societies, and we have constitutions and bylaws. We have operations and the whole thing. Are we running those 345 units the same as we would under a non-profit housing society operating agreement? If the operating agreement is in place and we're monitoring them, are we as a commission responsible for those agreements and for their operations?

[5:15]

R. Coleman: In that case, then, basically there are goods and services being provided. I'll go back to the previous form 

[ Page 3725 ]

of questioning that I had. Goods and services are being provided, which the ministry is funding through the B.C. Housing Management Commission for these 345 group homes or units. Somebody is responsible for the society's objectives, their mission statement, their operation, their constitution, their tendering procedures, their services or goods provided, the outline of qualifications of their board and their staff, and what have you.

I would assume that the staffing side of a group home on mental health is not the responsibility of the commission; I would assume that the Ministry of Health is responsible for that. But the society that's operating it is responsible to the commission, because they're under your management. They have to operate under an audited financial statement and all the procedures that would be inherent in it.

My question is: what is the procedure that's going on to monitor these groups to make sure they're delivering the products and services they're being paid to deliver under an operating agreement that you're responsible for? Who's monitoring the delivery from the standpoint of the operating agreement and the service that's included in the operating agreement or the management of the premises?

Hon. M. Farnworth: If there's a service agreement with a particular ministry, the ministry is responsible for overseeing that service agreement. They vary between ministries; there's not a one-size-fits-all. If there's not a service agreement in place, then we are responsible and we do the monitoring and oversee everything. I think that one of the things we need to move to is a greater integration between ministries and B.C. Housing, and I think that's got to take place. But in terms of who's doing the overseeing, we are unless there is a service agreement with another ministry, in which case the ministry is responsible.

R. Coleman: I know you won't be able to give it to me now, but I would like from B.C. Housing Management Commission a list of the homes that are under each form of management with the commission. I think that's critical and that we're identifying a problem here.

My first concern would be the standard of management of the other 200-and-some-odd units: who is actually monitoring the physical plant? Who is actually seeing how the maintenance and the long-term reserves for those particular projects are being taken care of, and who is making sure that the housing stock that we own is being taken care of? If they're in a service agreement with a ministry that has no expertise in housing and property management, if they're not being managed by the commission and I know that they're not being managed by BCBC -- those are the two levels of government, in my opinion, that know about management of a physical resource -- and if they're off somewhere else, we have two or three other property management divisions in various ministries monitoring 50 group homes here and 25 over here and 50 over there, or whatever the case may be, and that doesn't really make a whole lot of sense to me.

I guess the question goes back to the commission. Are you sort of stuck in a corner here, where you have a service agreement on one side -- a society that has a constitution, bylaws for operations and an operating agreement which is the service agreement -- and is there a separate management agreement or the management of the physical asset? That means they're basically dealing with two masters: they have the master on the one side, which is the delivery of the service, and the master on the other side, which is the running of the asset -- which is the asset whatever group home that is. My concern would be: how are you basically standardizing the management of these properties that you have responsibility for, these 345 units? How do you standardize and monitor their management, and how much staff does it take to do just that? Forget the other 200-and-some-odd.

Hon. M. Farnworth: We will get that information for the hon. member.

R. Coleman: That's great -- more reading. I just think it's wonderful.

I want to close this off, because actually I was curious about the replacement funds when we walked into this little land mine a few minutes ago.

What I should say here is this: if we have that much housing stock in group homes in this province, they should be under some form of standardized management, and they should be under some form of standardized operating agreements as far as the management of the asset is concerned. Having said that, at the same time the ministries have to become more aware of the fact that they have more responsibilities than they think they do in some of the management of these particular properties. They're of the opinion that all they do is send money to the commission, and the commission manages all of these things. So there are 200-and-some units out there somewhere in projects of two, three and four units, and we have ministries who don't believe they have any management responsibilities for them, because they think that the commission is handling them all.

If that's the case, we probably need some communication through you to cabinet or through the commission to take a look at this inventory, bring it all together and say how we are operating it. We may have some very esoteric agreements out there as far as operating agreements are concerned, which are dysfunctional. We have no standard monitoring of the societies -- whether they're meeting their operating agreement, whether their boards of directors are qualified, whether they're actually holding their annual general meetings in a proper format or whether their mission statement meets with the goals of the particular product that we have there.

Then we have another bunch of inventory that I just want to deal with quickly. We also have inventory out there that is not being used for the purpose it was originally built for. Some of it would be in halfway houses or what have you. I know there's one in one of my communities that is basically a rented house now, because it didn't work out in the neighbourhood that it's in. I'd be interested to know how much inventory we have out there in the marketplace that's really not being used for group homes that we own and what we're doing with that product.

Hon. M. Farnworth: I can't give you an exact figure today, because it does change on a fairly regular basis, but I'll get you the latest numbers that we have. It's not an uncommon occurrence for there to be properties that are vacant in terms of the use that they were initially intended for. It's the policy of the ministry that when this happens -- when a society withdraws for whatever reason -- to hold the property, canvass other ministries to see whether they have a use for the particular property and then make a decision after that on whether to dispose of it or do something else with it.

R. Coleman: I wonder if the minister could explain to me the self-insurance funds that are mentioned in the annual report.

[ Page 3726 ]

Hon. M. Farnworth: It's a payment made monthly by the province and CMHC to cover basic insurance -- things like fire, disaster, earthquake. It's made on a unit-by-unit basis.

R. Coleman: This isn't mortgage insurance; this isn't insurance on the loan to the mortgagor.

Hon. M. Farnworth: That is correct. It's not mortgage insurance.

R. Coleman: The comptroller general had you change your accounting policies for recording purchases of fixed assets last year. I just want to deal with some questions on fixed assets and movable assets.

First of all, I'd like the determination from the ministry with regard to movable assets -- things like computers and desks and what have you. I'm always curious as to what level of inventory and control the movable assets of any corporation are subject to. How many times do you do inventory? What value do you set at the lowest common denominator of the inventory and move out into another form of inventory -- as far as how you book it? How often do you do it? What is your standard and form of practice based on with regard to your inventory management?

Hon. M. Farnworth: Everything over $1,000 is classified as a fixed asset. Each asset gets a tag and a number, and it is counted on an annual basis. The depreciation is over a five-year period -- a fixed depreciation rate. That covers everything except computers and computer software, which is depreciated over a three-year basis.

[5:30]

Hon. M. Farnworth: It's $2,864,000.

R. Coleman: The inventory is done annually, I take it, on those fixed assets. What are you finding is your level of shrinkage in your inventory as far as losses are concerned?

Hon. M. Farnworth: The losses are insignificant -- insignificant, insignificant. Everyone has a desk.

R. Coleman: Could the minister tell me what "insignificant" is, please, as far as. . . ? Do you not. . . ?

Hon. M. Farnworth: We have an extremely honest staff, and I guess by insignificance. . . . It's, like, none.

R. Coleman: I used to be in the security business, involved in shrinkage control, and "none" would be a phenomenal record in any industry at all. You should bottle that and take it out and sell it in the marketplace, because I'm sure that the entire retail market would like to know how you're doing that. So would most corporations, because there is a problem in that area and there always has been. One thing that is refreshing is to see that you're doing it. When I sat on the Public Accounts Committee last year, I was kind of shocked to find out how many agencies in the ministry did not do any inventory and that the standard of practice was to record inventory only on fixed assets of $5,000 and above. That obviously leaves a huge void within the marketplace as to the control of our assets. I'm pleased to see that the commission is monitoring its assets, because I think it's a very important thing that we do.

I wonder if we could just briefly deal with the advances received in advance of construction. I would take it that these are funds advanced by. . . . I'm going to use the term "soft costs." I don't know whether that's what it is or not, but usually an advance that's in advance of construction is relative to soft costs. I'm wondering if these were advances to the commission or if these were advances to organizations that were proceeding or moving toward construction.

Hon. M. Farnworth: It was a capital grant to get the homeless-at risk housing initiatives and some aspects of Homes B.C. work done, basically. We receive the grant and use the grant to write down the size of the mortgage.

R. Coleman: Could you just describe the first portion of Home B.C. that the grants were. . . ?

Hon. M. Farnworth: Homeless initiatives.

R. Coleman: Homeless initiatives. What is that, and what were the funds utilized for?

Hon. M. Farnworth: It was an initiative introduced in 1992 to specifically target people who are homeless or at risk of being homeless. There are a number of projects associated with doing that. That's where the money went.

R. Coleman: Would this be as a result of one of the initiatives that the. . . ? I think it's called PCHO or something. I can look at the report, and I am going to get to it in a while, but the housing options. . . . Is that a result of that particular report?

Hon. M. Farnworth: Yes.

R. Coleman: What was the second half of the funding you mentioned towards?

Hon. M. Farnworth: The second part was through B.C. 21 for Homes B.C., for the same purpose.

R. Coleman: And the purpose was to develop the program and materials. Is that what it was for? What is the amount of money that we're dealing with?

Hon. M. Farnworth: About $22.5 million.

R. Coleman: I just want to deal with one other area of this particular set of estimates; I see we're getting close to the hour. Basically, it's the construction-financing side of the annual report. I want to read the portion of the annual report that I'm dealing with, because that's where my questions are centred.

"In its capacity as a National Housing Act-approved lender" -- that's the commission -- "the commission funds construction draws for societies for building approved projects under social housing programs. These advances are repaid at substantial completion of each project from financing arranged with private lenders and CMHC. The provincial government provides block funding to the commission for this purpose. Societies are charged interest at the province's weighted average borrowing rate for short term funds, plus administration costs."

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Hon. M. Farnworth: All of them.

R. Coleman: Having said that, then the definition for social housing with regards to this section would be "all housing provided by government" -- with the exception, I would assume, of some forms of intermediate care and care facilities for which there's no involvement in the lending. Would that be correct? It then goes on to say that they're paid a substantial completion on these products from financing arranged with private lenders and CMHC. How much lending is CMHC doing these days? I was under the impression that they basically went back to becoming an insurance company and really weren't in the business of lending, and I'm just wondering.

Hon. M. Farnworth: They're doing basically nothing, and you can interpret that any way you want.

R. Coleman: They probably wouldn't like to hear that you think they do absolutely nothing, but they're not doing any lending.

Hon. M. Farnworth: No, absolutely.

R. Coleman: So the financing that's arranged with the private lenders is for the long-term finance -- the long-term loan, the mortgages. Basically, at that point in time, if it's a society, there's a guarantee in place with regard to social housing. That guarantee in the past was made, I think, under the National Housing Act using two agencies, which were CMHC and B.C. Housing, or whichever agency the government used for the guaranteeing of those mortgages. Now, I would assume that somebody is guaranteeing those loans. If it's now a provincial program without funding, two-thirds-one-third, from the feds, is it the commission that's taking that responsibility or PRHC that's taking that responsibility?

Hon. M. Farnworth: While there's no guarantee provided, we are in essence purchasing insurance from CMHC because the project has a better chance of getting financing if it does have CMHC insurance. And then, if the project does run into trouble, we in turn indemnify CMHC.

R. Coleman: So basically what we are doing is getting a CMHC-insured loan. That's what we're doing.

Hon. M. Farnworth: Yeah, without it being called that.

R. Coleman: What kinds of premiums are CMHC charging you on those loans? Obviously they should be getting some preference on the premiums, and I'm wondering what kinds of premiums they are charging you.

Hon. M. Farnworth: We're not charged a premium; we're charged an administration fee of about $75 a unit.

R. Coleman: The $75 a unit on a CMHC loan is on the approval of the loan. That's the fee; it's almost like a placement fee. But in addition to that, you're not taking out the insurance premium on the mortgages through CMHC on the long term.

Hon. M. Farnworth: CMHC insures the loan over the long term, but we are not paying the normal industry premium.

R. Coleman: I should hope not. But you are paying a premium to insure the loan on behalf of the society. So if it's not an insured loan, then at this point in time. . . .

The Chair: Through the Chair, please, member.

R. Coleman: Thank you, hon. Chair. The minister is jumping up in anticipation of answering this question, so I'm going to sit down and allow him to do so. But I'm sure there's another question that's probably going to follow immediately.

Hon. M. Farnworth: The loan's insured. We don't pay a premium; we're just paying a $75 administration fee.

R. Coleman: This is because you cross-indemnify back to CMHC. Would that be correct?

Hon. M. Farnworth: That's correct.

R. Coleman: Then it goes on to say, of course, in the same area, that societies are charged interest at the province's weighted-average borrowing rate for short-term funds, plus administration costs. So the first part is basically. . . . The borrowing rate for short-term funds, I take it, goes through Treasury Board.

But at the same time, you know, in the previous sentence we said we were dealing with private lenders. But then we have a borrowing cost. And we're the lender -- like, B.C. Housing is a lender. B.C. Housing is going to the marketplace to borrow from, let's say, the Royal Bank of Canada, which will carry the mortgage on a particular project. In the past, it was always bulk financing on the renewals. We still do that, but let's not get into that part.

The interest is the weighted-out. . . . The short-term funds are just the construction funds. Then we roll it over into a long-term mortgage, which we'd go into the normal lending market for. Then we charge an administration cost. What is the administration cost that we're charging on the funds that we're using?

Hon. M. Farnworth: It's $2,000, plus interest.

R. Coleman: So it doesn't matter if it's a $200,000 project or a $2 million project -- it's a $2,000 fee, plus interest.

Hon. M. Farnworth: Yeah, right.

R. Coleman: Okay, thank you.

I could start on another subject at this point in time. Or we could rise and report progress, I think. Hon. Chair, I move that we rise and report progress and seek leave to meet again.

Motion approved.

The committee rose at 5:45 p.m.

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