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The House met at 10:07 a.m.

Prayers.

Hon. M. Farnworth: Today, in the members' gallery, we have a number of special guests from China. We have in the gallery Mr. Zhang Fenglai, the vice-principal from the Shanghai Administration Institute. He is accompanied by six senior officials from the institute. The visitors are participating in a newly introduced program at Douglas College in my constituency, where they are attending lectures on public administration and public policy. They're over here in Victoria meeting with various officials. Would the House please make them welcome.

Tabling Documents

Orders of the Day

Private Members' Statements

WHO'S READING TO THE CHILDREN?

Who told the stories your children heard? Who is telling the stories children are hearing now? These are significant questions, and it's an issue which is worthy of thought and consideration if we are concerned about a literate society. Most children in my day grew up in a home where at least one parent told the stories or read the stories. Today, as we all know, adults are busy, and television tells most of the stories to most of the children most of the time. It's not that the Barney character is not an interesting program for children, as my niece and nephew, Rosie and Trevor, will certainly attest.

There are nuances and subtleties of language that are, frankly, missing from television programming. The significant adult in the lives of many children has ceased to be the primary storyteller, has ceased offering children verbal accounts of personal observations or life experiences. The power of that lost experience has been transferred to a medium, the electronic storyteller, that does not know the child personally, will not likely enrich his or her inner life in the same way as a human reader sitting close by and will likely have a disjointed influence on the child's imagination. These electronic stories are portraying people immersed in personal ambition, consumer goods, glamour or violence and sensationalize these principles of life surrealistically, creating an unhealthy perception of life and the world around us.

Electronic storytellers, be they television programs, videos or recordings, are shaping our children, their values and their judgments, and making the family wane as an institution and distancing children from direct, quality, silent reading time and a reading time with significant others. In the words of Hillary Clinton: "It takes a village to [educate] a child." It's about memories; it's about family influence; it's certainly about family histories and sharing the things that are important to people. And when it's all said and done, what we are left with is memories of significant events in our lives. Those, carried forward generation to generation, are valid and certainly are part of how we create ourselves as human beings.

This kind of television imagination is assisting in the creation of a life of limited imagination, inactive mental processing, uninteresting conversation, a lack of interest in conversation. Consequently, reading education is, frankly, either shelved or shunned, which speaks to me as an educator. As a teacher, it's important that children have skills of literacy, and reading is a fundamental part of that package. This is not good, yet it has been happening for many years, and it continues to happen as we speak. Children are developing a limited interest in simple dialogue and subtle humour. They want action and jolts. Anything else turns them off. This is a sad statement, a sad reality -- a sad statement and a sad reality which should give each and every one of us and each responsible adult a jolt and result in some immediate action.

One of the major challenges of parenting is finding the time to read to our children. The challenge can best be met if we understand the value of the deed. Studies have shown that reading to our children not only enhances bonding but instils within a child a closeness to the beauty of language and of the written word. Reading and listening to a reader is an interactive and constructive process involving the enhancement of prior knowledge, the encouragement of new knowledge and sensitivity to language structure, patterns and cues -- all of which enhance the meaning of the text and nurture the memory process, as well as strengthen written and oral language fluency. These are, after all, fundamental skills. For beyond-average survival in the world out there, these are skills which must be instilled in the minds of our young people.

Developments in pedagogical research with respect to reading have fuelled a new interest in the link between reading, learning and thinking. Reading has become a challenge worthy of pursuit, as it enhances our abilities to meet the many challenges of life in our ever-changing society. Maximizing each child's and adult's reading potential is fundamental and a worthwhile educational and personal goal. It is a concept worthy of promotion and support.

Through reading aloud one experiences tone, intonation and gesture -- qualities from which one learns communications skills and qualities that contribute to deciphering meaning from a text. These same qualities are not derived from electronic media. The more exposure the child has to listening to a reader early in life, the better that child will accelerate in the learning environment, be it in school or in the community, and that child will be better equipped to face the many challenges later in life.

Reading is a fundamental skill, and being read to consistently from a very early age creates citizens who are not only well-read, good listeners and good readers but able to tackle the challenges of the future with confidence, competence and pride, quickly and efficiently, for the betterment of our community, our province and our country. Reading proficiency and reading comprehension are skills that should not go by the wayside, but rather should be at the forefront of the planning process behind every child's upbringing and should remain an active aspect of everyone's life.

I'm obviously advocating the promotion of reading this morning. It is, as I hope we can all agree, an essential skill and

[ Page 10452 ]

[10:15]

Just from my own personal experience, a good friend of mine had given me a book for my son. My son will be five in September. I think what was unique about this book was that his name was included throughout the book. When I showed him the book, his eyes lit up, because it was about one of his superheroes. More importantly, it enhanced his involvement, because he felt even more included in the reading process. I know that it is important for all families who have young children to make sure that there is an involvement. I think all of us are too guilty of reliance on electronic media, and it doesn't matter whether it's radio or television. There is an approach where we have to go back a few steps. We have to go back to our roots, to when there wasn't that reliance on that type of media.

From the government's perspective, there has been and still is a recognition of the importance of literacy. Over the past year, some $700,000 has been made available to some 71 literacy programs throughout British Columbia. Take, for example, the K-to-3 initiative, which will reduce our class sizes so that our young people in kindergarten-to-grade-3 will be able to achieve greater opportunities in learning to read and write. That initiative will accommodate and make available some 400 additional teachers, 300 additional teaching aides and also a number of librarians.

Even though the number of librarians may be relatively small in that initiative compared to the number of teaching positions and teaching aides, I think it's an important step. It's a recognition and a commitment by government that these dollars should be spent in those areas so that our young people, in those formative years, can have and achieve those learning skills and writing skills, because their future will depend on that.

I know that with the complications of our society, all too often parents do not have the ability, because of time constraints, to take those opportunities to sit down with their children. I encourage them to do it. I think I'm probably guilty of not being there all the time when my child wants to sit down and read a book. But my own personal experience in working with him -- sitting down and going through the words and, you know, pointing a finger so that he can follow as the words are read. . . . That will help him in his future. The more involvement that government -- and, I think, we as legislators and, more importantly, as parents -- can commit to our young people, the more it is going to enhance their lives. I look forward to hearing the conclusion from the hon. member.

L. Reid: I would like to thank the member for Malahat-Juan de Fuca. Certainly the story about his son is evidence that children are geared into fine material. If there are triggers or signals in that material that cause them to think it's personalized to them, all the better. Those things work extremely well. Educators continue to do their absolute best to personalize material so that children have an ongoing interest in the material that's shared with them.

I want very much to summarize this morning, hon. Speaker, by talking about valuing the deed. The deed is reading. Are we prepared to spend some time with our grandchildren, our nieces, our nephews and our own offspring in terms of continuing to enhance their desire to become more proficient readers? As they become more proficient, I think they have a better understanding of the world around them.

All of this, for me, is about the educated citizenry that I trust that we as a society will continue to produce. Indeed, when I talk about the value of the deed, the value of the deed is in finding the time as educators and as parents to be part of a process that is all about producing a fine citizen at the end of the day. Certainly if I've done anything this morning in terms of having people understand the necessity, I'm grateful for that.

I'm not convinced that we truly understand the need today, because the illiteracy rates in this country are growing -- astounding statistics. The statistics are a warning to each and every one of us. They bring forward a challenge, I believe. Are we facing the challenge, or are we leaving that up to others? Are we acknowledging the impact, or are we covering it up? Do we care, or are we indifferent?

I believe the message is clear. The problem has to be faced; the problem has to be addressed; the problem has to be solved. That is indeed about ensuring that each and every one of us commits at least an hour today and, hopefully, every day to be involved in some kind of literacy activity with someone in our community. It is about building community and building neighbourhoods. Having people who are better able to make prudent decisions is typically a result of their education status. We want people to be better thinkers, and having them be better readers is certainly part of that initiative. It is my hope that each and every one of us will do all we can to promote reading in each of our constituencies. Read to the children, and have them read to you. Make it a habit; make it a quality, one-on-one activity; make it a priority. I certainly believe in that.

I don't believe we can entrust that level of care to anyone but ourselves. I think that when the hon. member spoke about the school system and about librarians. . . . They are valid members of the team, but the ratio for teachers in our schools today is enormous: one teacher to 400, 500, 600 or 700 students in a library setting. So each of us has a responsibility to ensure that we do that one-on-one activity with children in our lives. I know that each of us has somehow been touched by a child in our lives. It's time we made some commitments in terms of giving something back to those children. I am today prepared to make it a priority, as I have done through my career as a teacher and will continue to do. I invite each and every one of us present today to take up the challenge.

GUN CONTROL IN RURAL B.C.

I believe that Skeena constituents reflect the views of most other rural ridings across B.C., and I believe that Bill C-68 does not have the majority support in Skeena. The government of Canada has had the right to regulate firearms since 1892. Permits to buy handguns have been required since 1913, and the registration has been required since 1934. All rifles and shotguns had to be registered during World War II. In 1979 Canada required the recording of all retail sales of fire-

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Why, then, Bill C-68, and why would it raise such objections, particularly in rural B.C.? Let me offer an opinion based on comments from Skeena constituents. The federal government wanted to be seen as doing something to address crime rates in cases of violence. They needed to take some visible action which the majority of Canadians would see as significant. Criminals often commit crimes and acts of violence with guns, and since you can't control when firearms owned by people might be used for criminal activity, you can put more restrictions and regulations on access for law-abiding gun owners. Criminals won't register their firearms, won't get FACs and won't take a course in firearms safety. Law-abiding citizens will inevitably comply with the law. Public sentiments around some very high-profile cases of violence -- that probably would not have occurred, had current rules been rigidly applied -- have blurred the distinction between criminals illegally using guns and people who should never have had them. Enforcement of existing gun laws and perhaps even some minor amendments would have been enough.

Firearm homicides represent less than 2 percent of all unnatural deaths in Canada, and only 1 percent involve legally registered firearms. Alcohol and drugs are evident in about half of all homicides. Alcohol has been determined to be a factor in about half of all homicides in this country. It would make sense to put more resources into preventing alcohol abuse, but it would be difficult to get the resources from anyone other than the general taxpayer. The perception of the feds acting to solve a crime and violence problem would probably not be there then.

There is no statistical evidence to support more control. I emphasize "more." I have not found any constituent who is unhappy about the current controls -- one, perhaps, but that's a unique case, and we won't go into that today. Most rural British Columbians simply don't believe that Bill C-68 will do what the federal government says it will. In rural B.C. firearms are more accepted and, in many cases, are part of recreation or of making a living. In some cases they are a necessity.

Bill C-68 will not have the desired effect. The irony is that any future assessment of its effectiveness will be sufficiently clouded by the effects of other social programs that we will never really be able to find evidence to prove that it actually has had an effect, and we will never be able to convince future federal governments that it should be repealed.

Since Bill C-68 was introduced by the then minister, Allan Rock, the B.C. government has been trying to get changes. B.C. took the initial position that any legislation or gun registration should not be onerous, expensive or bureaucratic. Many of my constituents wanted B.C. to join Alberta in taking the federal government to court. The legal opinion was that there was little chance of success.

B.C. did not opt out, and some improvements have been achieved. They are, of course, that licensing and registration were separated, meaning that legitimate owners in non-compliance will no longer face the threat of criminal prosecution; the federal government will bear the entire cost of implementation; the act will be phased in with staggered dates; spousal notification is included in the act; and firearm owners will no longer have to go to the police for a licence. This makes it easier and faster for owners and frees up the police for front-line duty, rather than for administration.

But provinces have a constitutional obligation to enforce provisions of the Criminal Code, and the effort has been to make a bad law less onerous, less expensive and less bureaucratic. I don't think it will be enough to satisfy Skeena constituents. Opinions range all the way from those who, like Allan Rock, say that firearms should only be for the armed forces and the police, to those who, like the National Rifle Association in the U.S., believe that citizens have some inalienable right to bear arms and that there should be no regulation. The prevailing opinion is something in between and more moderate. I suspect that there is quite a variation on both sides of this House, but I also expect that it is within the moderate range between those two extremes. There is a difference, depending upon whether you live in rural B.C. or in the city. In this case as in others, it is important to base the imposition of more gun regulation on the facts rather than on emotions and perceptions.

I think Skeena constituents would agree with the education and safety requirements of firearm use. What many object to are further regulations and restrictions required for law-abiding gun owners, with no guarantee that they will do anything to address the rates of crime and violence. Rural MLAs represent a greater portion of those who use firearms for recreation, of farmers who occasionally need them and of trappers. We also have constituents who are gun collectors, or those who have kept the firearm used by a grandfather or a great-grandfather. Bill C-68 was not supported when it was introduced, and it is important to understand the rural perspective as the debate heats up during the implementation of C-68 in the months ahead.

I expect that most citizens will abide by the law when the time comes. That won't prove that C-68 is accepted as good legislation. It will simply mean that even rural British Columbians are. . .

The Speaker: Hon. member, please pay attention to the time.

H. Giesbrecht: . . .law-abiding, even when it comes to bad laws.

R. Neufeld: It's my pleasure to respond to the member for Skeena with regard to gun control. Many of the points that the member brought forward, of course, are shared by my constituents in the northeast -- or, shall I say, by any part of rural B.C. Once you get out of the golden triangle of Vancouver and Victoria, many people feel that the imposition of gun control is just another way the federal government has of infringing on the rights of law-abiding citizens.

[10:30]

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I think it's such a backward way of going about trying to do something that probably has a greater meaning than even what we're talking about today. In Fort St. John, I live outside of town. I live on an acreage where many acreages are, close to a golf course. It's not isolated, and there are lots of people around, but we regularly see bears on our property. Oftentimes we'll even see a wolf. Those who think that some of those animals are nice kissy, cuddly little things have not had much to do with the wild.

I'm telling you, hon. Speaker, that when a female bear wants to take after you, she's going to. We had an example of that at Liard Hot Springs very recently -- just a year ago -- where a lady from the U.S. was actually killed. Her son tried to wrestle the bear off his mother. A resident of Fort Nelson went in and tried to wrestle that bear off the mother and gave his life. He was a resident of the north his whole life. He knew that he was not going to win against a black bear that was angry. He went in there knowing he was going to give his life. Luckily, some tourist passing through had a firearm in their vehicle and ran back and got it and shot the bear.

Now, if we want to put all these controls on firearms. . . . I have firearms; I take them with me when I camp. I don't know the last time I've shot them, but I take them with me. I have a .30-.30, and it's packed in my vehicle at all times just in case, because I do go in the wilderness. There are lots of folks like me.

I would encourage this government to quit just talking in this House about gun control and get serious about it. Join Alberta, Saskatchewan, Manitoba and the Yukon and get after the federal government in court, because the member for Skeena and myself from Peace River North just standing in the House aren't going to make one whit of difference in Ottawa. But if you get your Attorney General committed to actually fighting this ridiculous law that's going to cost you and me and all Canadians a huge amount of money and isn't going to accomplish what it's intended to do at the end of the day. . . . I think it's something you should take to your Attorney General in a more serious way than just through a private member's statement on a Friday.

H. Giesbrecht: I'll resist the temptation to be partisan.

Polling shows that the majority of Canadians support Bill C-68. Polling also shows that the majority of Canadians are not aware of the existing gun control provisions. The majority of Canadians also live in urban communities, and the majority of members of this House represent urban communities. So I would suspect that opinions on both sides of this House are somewhat split. I would also suspect that one would probably not get a very clear, definitive kind of position from the opposite side of the House, as they would from the government. So there is that dilemma.

The fact of the matter, of course, is that the government didn't join the Alberta action because legal opinion suggested they had no chance of winning. It was more a case of perception than anything else, the very kind of thing that the federal government is engaged in. There are a variety of opinions in terms of what this legislation will do; that's the reality. Given the polling results, it is extremely difficult not to at least concede that the majority of Canadians who live in urban centres think this is going to have some effect.

Interjection.

H. Giesbrecht: What I'm saying quite clearly is that I don't happen to share that and the hon. member doesn't happen to share that. That's the reality. We are from the north and from rural B.C., and in this House are a relative minority. That is one of the things we will probably be challenged with in the years to come.

I was simply going to say that he's quite right in saying that there are all kinds of other initiatives that the federal government could have undertaken. For example, if they were concerned about smuggling, why did they disband the federal port authority, the agency that was in charge of security at the ports? There are all kinds of things that could have been done, other than going after law-abiding citizens that happen to own guns and use them for recreational or other purposes.

STOPPING THE CARNAGE ON OUR STREETS

One of the strategies he has advocated is the introduction of an ignition-interlock device. That device attaches to a driver's ignition and stops a driver from being able to start their car until they have provided a breath sample. If they fail the breath sample, the car will not start. This strategy has been introduced in 28 jurisdictions in the United States, and it has been used in Alberta since 1990. They started it with a pilot program in 1990, and it has been built in as part of their system since 1994. It has reduced conviction for reoffences for hard-core drinking drivers by 65 percent. That's an astonishing number.

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We know too, from Mothers Against Drunk Drivers, that 12 percent of drinking drivers are considered to be hard-core drinking drivers. Those are people who reoffend. Of all the fatalities on the road, 82 percent are caused by that 12 percent of drivers. That ignition-interlock device is aimed at those drivers. A driver who blows and cannot start their car will not have a way to get home. The beautiful thing about this technology is that it forces a driver to reconsider their behaviour; it forces them to find new strategies for when they go out in the evenings. Instead of just repossessing their car, which is something that we don't do, we make it impossible for them to operate their car if they have had anything to drink. It means they have to find new strategies, new ways, to behave.

That's ultimately the only way that we'll stop hard-core drinking drivers from drinking and driving. We have to get them to separate their drinking from their driving. That's a hard change to ask someone to make, and it's a big behavioral change that we're asking them to make.

Can the system be defeated? Yes, it can be defeated. The newest technology makes it much more difficult to beat it, but of course it can be beaten. A driver can get a friend to blow. But think about it: hard-core drinking drivers aren't out there in the evenings with friends who aren't drinking. If they're out there with friends who aren't drinking, their friends are going to drive the car. So the chances of that happening -- I suppose it could happen -- aren't that great. The technology is also fitted so that it makes it very difficult to tamper with. Yes, it can be tampered with, but the technology is getting better and better every year, making it more and more difficult to tamper with. The system also has a monitoring aspect built into it, so that every 30 or 60 days, the data that is stored in the device will be checked by the company that is contracted to manage it. They'll be able to tell if a driver has tried to tamper with it. Of course, drivers who have been able to tamper with it will be kicked off the program altogether.

The program's success in Alberta has shown a 65 to 70 percent reduction in the number of people who have reoffended after they've been on this program. That's an enormous reduction, and that's something that we should all be working for. It's worked in Alberta; it's something that we in British Columbia should consider. We know that we've done as much as we can within the current framework that we've got legislatively. We need to look at new ways to get some of those drinking drivers off the road, new ways to try and reduce the number of people who are out there and new ways to reduce the number of fatalities from drinking drivers every year. I'd like to propose this to the House, and I hope that all members will support me in our drive to introduce an alcohol-interlock program in British Columbia.

M. Sihota: Hon. Speaker, I certainly have no difficulty with the suggestion that's made in terms of, if I can put it this way, a technological answer to some of the problems that the hon. member alludes to. I also see some downsides, which I'll get to in a minute. It is true that if this device keeps people off the road, then it serves as a necessary preventive measure and provides a necessary preventive measure in society. I think that's good. But I do want to say, as well, that technological fixes, of course, often don't go to the root of the problem. Let's take, for example, the situation of violence on television. They're now proposing these V-chip solutions to violence on television as a way of sort of blocking out the opportunity for young people to watch violence and to be impacted by it. It doesn't really go to the core of the problem. But it does serve a purpose, and I agree that the solution the hon. member outlines does serve a purpose.

[10:45]

I mentioned television a few minutes ago. I have to tell you -- and I guess some would argue that I'm a little puritanical on this issue -- that I take great umbrage at advertising that occurs on television that promotes alcohol, particularly at the way that it's aimed and targeted at younger audiences. I am one who does not believe that advertising of alcohol on television ought to be the case, largely because of the way in which it encourages the improper utilization of alcohol in society. That's a little puritanical. I'm not too sure if it would stop people from drinking, but I do think that we don't need it "in the face" of young people.

I also think that if we were to propose technological solutions along the lines that the hon. member suggests, the issue of payment would be a matter of debate. Clearly -- to use the old environmental principle -- the polluter ought to pay. Clearly, if one were to move to this technology, the alcohol industry, the liquor industry in British Columbia, ought to bear fully the costs of providing it. It ought to be a cost of doing business -- or if I could put it another way, an element of, or in the nature of, their social responsibility.

I think we also have to recognize that beyond these technological solutions, all too often -- and I've certainly seen this in my experiences over the years -- these problems as they relate to alcohol are rooted in poverty. There is a strong connectivity between the conditions that people find themselves living in, particularly as they relate to poverty, and the presence of and dependency upon alcohol. I don't intend to get into a wide-ranging debate about either the programs that government has introduced in that regard or the initiatives that we need to take as a society, largely because time is limited in terms of that aspect of the debate. But on that point, I do think that we ought to take note of our deficiencies as a society in terms of the programs we offer in that regard.

Interjection.

M. Sihota: Let me say this. The hon. member asks if I support it or not. I thought I'd made it very clear at the

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The Speaker: The hon. member will notice that his time is up.

C. Clark: I'd be happy to maybe clarify for the member some other aspects of the program, which might make him feel a little more comfortable with it -- although I understand that he says he supports it. The first is the issue of who pays. In Alberta it's user-pay. It's $125 for your first installation and removal of it, then I think it's $90 a month rental for the unit. It's the user, the offender, who bears that cost. So there wouldn't be any additional cost to the system.

The second question the member quite rightly raised is: does it replace other methods? No, it doesn't. It supplements them; it's another tool in the toolbox for the court system. It doesn't replace driving suspensions, revoking people's licences, jail time or all those other things. But it is another tool in the system, and it has apparently worked. What they do in Alberta is require that before you are eligible to get into the system, you must not be under any other alcohol-related suspension, you must have completed your court-ordered driving prohibition, and you must have taken a required impaired-driving course. There are a number of other requirements there.

I ask the House to just consider the real benefits of this program. It will reduce the number of people who drive uninsured on the road, so it will protect all of us. It will make sure that the driver is still able to drive to work rather than go on welfare if they require their car for employment. Most importantly, it will teach the driver to separate drinking and driving habits. Hopefully, it will prevent people from making the same mistake again. I'd ask the House to look seriously at this program. I think it's a good tool for judges and the court system to be able to use. The proof is in the pudding. In Alberta it has worked enormously well. I think it's certainly time that we in British Columbia consider similar measures.

COMMUNITY SUSTAINABILITY

My first exposure to the Comox Valley was in 1985, when I travelled there and had an opportunity to look around a little bit. At that time, I saw a community that had all of the elements of being able to take care of itself. It has a strong agricultural base, a service-based industry, a public service-based economy. There are many people who have been employed in resource extraction. It has also attracted many people who have a strong ethic of self-sustainability, people who have made choices in their lives in order to be able to produce just enough to get by, people who perhaps have small farms or who engage in trades in order to be able to sustain themselves and their families.

Many small Vancouver Island communities have developed around resource extraction, be it mining, forestry or fisheries. People have been attracted to these communities both for the opportunity to work and certainly for the lifestyle opportunities as well. But what we're seeing right now in these small communities on Vancouver Island and across this country is a massive shift. There's no longer that strength in the resource extraction industries, and we have to be looking to ways of diversifying our economy and our communities. It's no longer a given that an individual is going to be employed for life in any particular occupation or industry. So we have these communities on Vancouver Island, many of which I'm quite familiar with, communities where we are seeing a loss of employment but where people still wish to live. People have very strong emotional ties to their communities and have grown to love and appreciate the lifestyle that is available to them there. So communities have to -- and are -- looking for ways to address these changes and to survive and prosper in the future.

In the Comox Valley, I have mentioned the sustainability project, and I look back to some of the planning projects that I've been involved in over the years I've been there. We've had Valley Vision; we've had the Comox Valley Round Table. We've looked at a variety of official community plans, and we've also looked at a liquid waste management plan. We bring all kinds of people together to discuss and make decisions, and the greatest difficulty around all of these planning processes is that in the end we always find that there is no consensus. That's a great source of conflict in the community: if there is no consensus on how we can move ahead together, then there will continue to be nothing but conflict.

The sustainability project is committed to empowering individuals and community groups, through education, through neighbourhood conversations and through bringing citizens together. I met with members of the sustainability project the other day, and they shared with me some of the information that they're using as a base for developing the project for the Comox Valley. The idea of sustainability is not new; it has been with us for a long time. But it's time for us to bring together all of the ideas into some concrete format.

I'd like to share with members here some work that was done in Kimberley. Kimberley has both suffered and benefited from being a single-industry community and has been working for a number of years now to move beyond that. In 1993 Kimberley went through a planning process and developed a vision of what they consider to be a sustainable future. Kimberley will continue as a friendly, cheerful, caring, vibrant and essentially small rural community. People's desires and needs are respected and enhanced, while their active participation in a healthy lifestyle is encouraged. The employment-aged population is engaged in meaningful and financially secure local employment. The community's commitment to preserving and respecting its beauty and wilderness is apparent in its public policies, the behaviour of its citizens and the appearance of the city. Mutually beneficial relationships with the natural environment are supported through recreational, sporting, cultural and artistic endeavour and a wide variety of leisure pursuits.

The Kimberley of the future will be supported by solid yet diverse industrial and commercial enterprises which complement and maintain the community's commitment to a clean, healthy, natural environment, by imposing a low -- or no -- negative environmental impact. Kimberley's beauty, opportunities, well-rounded lifestyle and attractions will draw a wide variety of visitors and tourists to participate with local people in their way of life. Through active, informed citizen involvement in local government and in industrial and commercial ventures, and through strong, supportive interconnec-

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The project went on to bring together some definitions of sustainability, which I think are very useful. A sustainable community is a community which continues to re-create itself indefinitely, by its own means and resources. Community refers to the sum total of social and economic interactions occurring between people within a definable physical area, such as this group. . .identifies itself as unique and recognized as a separate community to outsiders. Hon. Speaker, resources may include physical resources such as trees, minerals, water -- the total natural environment -- human resources. . . .

The Speaker: Hon. member, your time for this portion of your statement is concluded.

L. Reid: I rise today certainly to contribute some remarks to the remarks made by the member for Comox Valley. When we talk about community sustainability, it's inextricably linked to economic viability. There are no differences in communities across this province when it comes to people having dollars in their pockets to spend. The same anguish is in place if people cannot afford to pay their mortgages, to buy the things for their children that they would like to buy. So we cannot have this discussion this morning independent of that item, that notion. They are inextricably linked. The economic viability of a community, whether it be based on tourism on initiatives that are underway in the Comox Valley, is not separate from the health and well-being of this entire province.

We do not have communities that are independent. Each community in this province is interdependent with other communities in this province. That's a notion we have to keep, I believe, foremost in our minds when we talk about diversity. We can diversify various communities in the province. Nelson and Chemainus, where they have indeed looked at community sustainability, have focused and have emphasized the tourism initiatives underway.

Other parts of the province are absolutely dependent upon resource extraction. We may indeed be able to emphasize resource extraction with the application of some science and technology that'll make that process of resource extraction more viable, more environmentally sound, more economical. But the bottom line is that to meet the budgetary requirements of this province, this province needs industry. We have enormous benefit to offer our constituents, the residents of this province.

[11:00]

The challenge is whether or not they receive assistance from this government. In many cases, I believe they have not. Indeed, I believe that this is about ensuring that communities continue to go forward, because we believe in a sense of neighbourhood -- each of us does in our community. We want to build families, build communities, build neighbourhoods. Those neighbourhoods are found within municipalities and regional districts across this province. But this government has often not made it easier. Frankly, in the last two budgets, they've made it much more difficult to deliver sustainability, to assist in the delivery of sustainability. That's an enormous issue.

The member mentioned gardening -- whether or not people could go forward and, you know, continue to provide foodstuffs for their family through their own initiatives. We support that. Frankly, it's an important initiative. But the bottom line is that it's a far cry from a vibrant economy. It's on the continuum, but we need to move ourselves along in terms of ensuring that people in communities today have dollars in their pockets to purchase the things they desire. All the best intention in the world, all the best discussion in the world. . . . The philosophical underpinnings are valid, but they're not tangible. People today are looking for the tangible aspects of a decent, health community.

In the B.C. Liberal Party we talk about community empowerment. We believe we've delivered it within the B.C. Liberal community charter. We do believe that people in the regions of this province are best suited to make decisions in their best interests; we fundamentally believe that. This is about a discussion of individual rights and freedoms, because those individuals know best how to build communities in their region. Frankly I support that.

I had the absolute privilege a few weeks back to visit the community of Skidegate on the Queen Charlotte Islands. People were coming together to build something that's rare and unique, and to diversify in the midst of tremendous fragility as a community. They will achieve that. They have the determination, the spirit, the heart, to do that. They know full well that they have not been assisted by this government. They know full well that the economic viability that troubles this province troubles them, because they are inextricably linked to how this province presents itself to the world, whether or not it has a competitive edge, whether or not any of the things this government does here in Victoria has a positive impact on them. They will tell you today: "Not very much."

I'm sure that if we made a list of the communities across this province, their answers would not always be positive. The goal for this Legislature should be to deliver the finest possible product in terms of governance. It's not incredible bureaucratic overlay; it's not overmanagement; it's not any of the issues that this government has taken to be their priority. It's about allowing communities to do what they believe in. That's what it is for British Columbia Liberals, hon. Speaker, and I look forward to the member's response.

E. Gillespie: My only regret is that the time is short for these private members' statements. There is a lot more that I would like to say about community sustainability, and I'm sure that at some point I will have the opportunity to debate with this member some world economic factors as well.

There's something that I've always held kind of central to my view of the world. It's something that the provincial medical health officer also holds very important. That is that the greatest, the most important, measure in establishing individual and community health is employment. I make no argument at all with the member opposite with respect to that. What I was speaking about with respect to community sus-

[ Page 10458 ]

I just want to mention a few of the groups who have come together to form the Comox Valley Sustainability Project. It includes municipal councils, environmental groups, the community health council, Community Futures and the Farmers Institute, to name just a few. So we're looking at all of those kinds of groups -- economic, environmental, local governance -- coming together to form this initiative.

I also want to speak about the role of the province in all of this. Almost every ministry in this government has some program or role to play with respect to community sustainability. Through FRBC we have community development initiatives. Through the Ministry of Environment we have initiatives around improving the health of our watersheds. Through the ministry of economic development we have support for local economic initiatives. B.C. Hydro is funding four students who are working on the sustainability project this summer alone. The role of the provincial government is to support those local initiatives, and I expect to work with this government and ensure that the Comox Valley Sustainability Project goes further ahead and into the millennium, taking us into the year 2000 with a much stronger economic, environmental and human organization than we have had to this point.

The Speaker: Thank you, member. And I thank all members who participated in today's private members' statements.

Hon. P. Priddy: I call Committee of Supply for the estimates of the Ministry of Health.

The House in Committee of Supply; E. Walsh in the chair.

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

The Chair: I recognize the member for Chilliwack.

B. Penner: Thank you, hon. Chair. I guess it's a little hard to see this far down to this end of this chamber. I know that the member for Powell River-Sunshine Coast often remarks to me that we seem to be in a different time zone at this end of the chamber.

An Hon. Member: He is.

B. Penner: Perhaps he is; you're right.

I'm going to take an opportunity to enter this debate regarding the Ministry of Health budget estimates and to raise a number of issues of concern in the Chilliwack area. To begin with, I would like to address the minister on a matter involving the Grosvenor House care home. In the past few months, there has been some media coverage on the television news involving a seniors care facility in Port Coquitlam and, to a lesser extent, in Chilliwack, both of which are known as Grosvenor House care home. It's a privately run seniors care home facility that encountered financial difficulty and is now, I believe, in receivership.

I've made inquiries in the past through correspondence with the minister's office and with staff in her ministry regarding provincial government regulation of privately run seniors care homes. Notwithstanding assurances that the Ministry of Health did monitor what was happening at these privately run care homes, it appears that -- to put it mildly -- financial irregularities took place and seniors are now at a tremendous disadvantage.

I'll be more specific. At the Grosvenor House care home in Chilliwack, which I know the most about, there are 53 beds available. Last fall -- I think it was in October 1997 -- the owners of Grosvenor House offered seniors an opportunity to forgo paying a monthly fee. The fee varies between $2,000 and $3,000 per month, and in return for that they receive food, lodging and a certain degree of attention from qualified medical staff. A lump-sum payment option was offered to seniors that involved payments of $36,000 to $40,000 per person, and in return, seniors wouldn't have to pay the monthly fee anymore and presumably would receive accommodation indefinitely.

A total of 25 senior residents took advantage of this option. Now Grosvenor House is in receivership. These seniors have been told that the money they paid is gone and that they will have to start paying the monthly fee if they want to remain at Grosvenor House. In other words, they're going to have to pay twice. They've paid up to $40,000 each for what was supposed to be an indefinite package of care to look after them for the rest of their lives. But now, if they want to stay there, they're going to have to pay between $2,000 and $2,500 a month to remain at Grosvenor House.

I'm wondering if there's any way the provincial government can regulate privately run care homes in future to make sure that this kind of ripoff doesn't happen to our seniors again. I've been in contact with people who have their parents at the Grosvenor facility, and to put it mildly, they're very concerned. In some cases, the children of the seniors at Grosvenor House have not told the seniors what has happened to their money, for fear of causing them unnecessary stress. I think we can all imagine just how much trauma losing $40,000 can cause someone, particularly seniors with limited financial resources.

I invite the minister to make some remarks about what the provincial government might do in future to prevent this from happening and, more specifically, what can be done today to help these seniors who have apparently been ripped off due to poor financial management at Grosvenor House.

Hon. P. Priddy: I want to ask a question of clarification. The only facility that I'm aware of where this has happened is Grosvenor House in Port Coquitlam. I want to know if the member is telling me that Grosvenor House in Chilliwack is in the position of closing and is telling people that their money is gone.

B. Penner: Yes, my information is that Grosvenor House in Chilliwack is in similar financial straits, and there is a receiver in place. In fact, I've been speaking with a number of individuals who are on staff there, and one person is an acting administrator working for the receiver-manager. Reading between the lines, that tells me that Grosvenor House in Chilliwack is also in receivership. This person tells me that she's working for the receiver-manager. I was last at Grosvenor House on Canada Day. Traditionally, they have an outdoor barbecue, and it's a very good event. I was there, and a number of children of seniors who are at that facility pulled me aside to tell me about their concerns. I followed up, and

[ Page 10459 ]

[11:15]

A second option -- and it might be less effective, but it has also been suggested -- is that a body like the Securities Commission be established to monitor and oversee the marketing of prepaid care and shelter contracts, ensuring that sufficient moneys are held in trust to maintain the financial viability of the facility and are not diverted to other investments or to the owner.

The people who are looking after their parents and the seniors who paid these lump-sum amounts on their own thought the money was being held in trust. I'm not sure if they were explicitly told that, but that was the implication: that the money would be protected. It would be in a trust account, and it would be earning interest to pay for their ongoing care and shelter at these facilities. Obviously that wasn't the case. The money was not in a trust fund, as lawyers would think of it as being, and the seniors are now on the hook and being asked to pay it again -- now paying $2,000 to $2,500 per month.

Hon. P. Priddy: Actually, I appreciate the suggestions that the member has put forward. I know that we have had some discussions with the consumer protection branch. From the Ministry of Health perspective, this is a private, unfunded facility -- we don't fund this facility; it is a private enterprise, as you said -- although we do license it for health and safety issues. This certainly leaves seniors in those kinds of facilities in a less-supported position. There's no question about that.

We're looking at this within the context of our continuing-care review around the province, which is also looking at the issues of not just private but private, unfunded facilities and what responsibility either the Ministry of Health or the government has for those.

So we're talking about the consumer protection branch, because if it was any other kind of service where that had happened to people, that's where that would be. . . . But I think the two suggestions that the member has put forward are both good ones. I would appreciate it, for the sake of the continuing-care review, if he could actually forward those in writing to me. I would be grateful.

B. Penner: I'll quite gladly do that.

I could go into more detail, explaining some of the hardships and some of the adverse consequences of a lump-sum payment. For example, the point has been made to me that it creates a perverse incentive, really, for owners. The longer the senior remains in the care home, the less profit they'll make per senior, because the lump-sum payment is to look after the cost of care for an indefinite period of time -- for the amount of time the senior remains at the care home. The shorter the period of time a senior remains, the more money the care-home owner would retain. I think that is an improper incentive, if I could put it that way.

To move onto a different topic -- but also of a local nature -- in January of this year women in Chilliwack were told that they would no longer be able to receive mammography screening at Chilliwack General Hospital. They were told that they would instead have to go to Abbotsford for mammography screenings. In fact, it was not only women in Chilliwack who were told that they would have to drive to Abbotsford for mammography screenings. Women from as far away as Boston Bar in the Fraser Canyon would have to travel to Abbotsford for the service.

This raises a number of interesting and fairly serious concerns. I have obtained a protocol agreement signed by the Medical Services Plan and the screening mammography program of British Columbia. It sets out certain guidelines which I think were violated as a result of the decision to cancel mammography-screening services in Chilliwack. Those guidelines stipulate that women should not have to drive for more than one hour in order to reach a mammography-screening centre and that women shouldn't have to wait more than eight weeks on a waiting list before receiving a mammogram.

Well, as a result of the decision to move everybody in the upper Fraser Valley, including parts of the Fraser Canyon, to Abbotsford for mammography screenings, the wait-list in Abbotsford ballooned from five weeks to eight weeks in a very short period of time. I am told that it is teetering on the brink of going beyond that threshold of eight weeks. Also, driving from Boston Bar to Abbotsford takes longer than the one-hour guideline established in this protocol agreement between the Medical Services Plan and the screening mammography program of B.C..

I made some inquiries earlier this year about why this had happened. I was told that a review of the equipment used at Chilliwack General Hospital was being conducted to see if it was appropriate for mammography screening. That seemed a little strange, since they have been doing mammograms with that equipment for a number of years with no apparent difficulties. Furthermore, it seemed strange that there would be anything wrong with the equipment, considering that they had decided, even this year, to continue doing diagnostic mammograms with that very same equipment. So if the equipment was good enough for diagnostic purposes, which is a more intense type of mammogram, why wouldn't it be good enough for doing mammography screenings? I was told not to panic, and that a review was being undertaken and no final decision had been made.

Well, a number of months went by, and more and more women were being told that they had to go to Abbotsford. I can tell you that at my constituency office I was hearing from more and more women who were not at all happy. There is a further guideline contained in the protocol agreement between MSP and the screening mammography program, which I should mention. It states an objective of having close to 70 percent of women in a certain age group receive mammograms every year. In the Fraser Valley, we have one of the lowest mammogram-screening rates in the province. I think it is around 23 percent, far short of the 70 percent target for that

[ Page 10460 ]

I was told in late May that, unfortunately, there was bad news, and the screening would not be returned to Chilliwack, at least not in this fiscal year. A similar message was conveyed to the Fraser Valley regional health board. I attended a meeting in early June when this issue was discussed at some length. I can tell you that all members of the Fraser Valley health board, including card-carrying NDP members, were not at all happy with this provincial government for the effect that their decision had on women in the upper Fraser Valley. Within a few days, though, of being told that there would be no mammography screening in Chilliwack this year, we received a letter saying, "Oops, another review has been done, and we will restore mammography screening at the Chilliwack General Hospital," with a goal of about 2,000 such procedures per year -- at least initially. Now I've received another letter saying that they still haven't started screening in Chilliwack. So we were told in June that within a month or two, service would be back in place. In the last couple of days, I received a further letter -- because I inquired as to the status of re-establishing that service -- telling me that they're still doing more reviews of the equipment, and no firm date is in place for when mammography screening will start in Chilliwack.

This was a fairly lengthy preamble expressing some of the frustration that people in Chilliwack have felt in the last few months. We have been given one answer and then given a completely different answer within a few days, and people really don't know what to expect. There is a feeling in the upper Fraser Valley that we've been treated as second-class citizens by this government. I don't think that's acceptable, particularly when it comes to health care -- and women's health care especially.

I'd ask the minister to provide some clarification on what exactly happened. We've been told numerous different stories, and nobody is quite satisfied with what has happened in the Fraser Valley. We're hoping that screening will resume soon, but we haven't been given a specific date. Women and medical doctors in my constituency keep asking for a specific date.

Hon. P. Priddy: The member makes a very good point about his own community. I think there were 11,000 women from around the Chilliwack area. . . . That sounds high, but that may be the number who actually had to go to Abbotsford last year for screenings. There are two pieces to this. The information that I have is that at least some of the mammography that was done. . . . The purpose it served was screening mammography, and it was actually being billed as diagnostic mammography, which is considerably more expensive. There was some question, I think, about whether what women need was diagnostic mammography or screening mammography. Just in terms of the protocols being used, there were some questions being asked about that.

I don't think there's any question about the member's point about the women in Chilliwack needing closer access to mammographies. We know the difference it has made. We've actually just celebrated the millionth mammography screening in British Columbia, which is quite wonderful. The additional increase for mammography screens in the province is currently being reviewed by me, and I would expect that there will be an announcement very shortly.

B. Penner: To clarify then, the minister doesn't yet have a firm date to offer people in the upper Fraser Valley as to when mammography screening will resume. I point out that it's not just the women in Chilliwack who were being screened in Chilliwack. People all the way up through Agassiz, Harrison, Hope and Boston Bar, in the Fraser Canyon, relied on the service at the Chilliwack General Hospital. I offer that as a point of clarification.

Hon. P. Priddy: No, I don't have a specific date. It seems to me that I've made a significant number of announcements in estimates in the last couple of days, and I probably won't be doing a lot more. I would think that we would have a date for the member, were that to happen, probably in the next week.

B. Penner: I'll just mention, before leaving this topic, that I have received a petition that was circulated by a number of women in Chilliwack -- and also through my office -- who collected more than 2,000 signatures in a very short period of time, from men and women who are upset at the decision to take mammography screening away from Chilliwack. As I said to many people -- and other people commented to me -- this isn't just a women's issue. We all have sisters, mothers, wives, daughters and nieces who need this medical service. It really did strike a nerve in Chilliwack, and people responded. It wasn't seen as just a women's issue. It was seen as a fundamental human health care issue in our community. I was very encouraged by the amount of support that this program received from everyone in Chilliwack, not just women.

[11:30]

The doctor, the treating physician -- let me refer to my notes here -- Dr. Martin Gleave, requested approval from the Medical Services Plan on August 19, 1997, to perform a certain procedure. On November 6, the day the procedure was to be performed, Dr. Gleave had still not received a reply from the Medical Services Plan, so he telephoned the office in Victoria. He was advised by telephone that the procedure was covered by MSP and that he did not need permission to perform the surgery. "Thanks for asking, but it wasn't necessary" is what he was told. Dr. Gleave subsequently received a letter from MSP, dated the day after the surgery, advising that the procedure was considered experimental and was therefore not a benefit approved for payment under the plan.

On behalf of this family and Mr. Jansen, I'm seeking some clarification for why there would be this kind of miscommunication. Recently, on July 14, I did get a letter back, signed by William Mercer, director of operations for the Medical Services Plan, indicating that they will now refund about $500 to either the doctor or the individual who had the procedure. That was $303.27 for the surgery and $227.61 for the anaesthesia. Again, Mr. Jansen makes the point that it's a fairly modest amount of money to have been haggling over in the first place, but it did cause some grief for his relative, who is a

[ Page 10461 ]

Hon. P. Priddy: It's not possible for me to comment on that particular one. It sounds to me like there has been an error in communication. When that was drawn to the ministry's attention, they moved to rectify that. Should somebody be told one thing one day and another the next? Of course not. If we weren't going to cover it, then we should have been really clear about that up front. There are procedures, of course, where we might cover the MSP part, but we might not cover the anaesthesiology part. But in this case, that person should have been told that immediately, not given two different answers. Clearly there was an error, and it seems to me that we've moved to rectify that.

B. Penner: I have one last question. That's just to inquire as to the status of a recommended $1.5 million refit of the Chilliwack General Hospital. I've seen some documentation indicating that this improvement is on the books. It's gone a certain way in terms of getting approval, but to date, the improvements have not been made to the Chilliwack General Hospital as contemplated by that plan. I wonder if the minister could tell me what the status is of that proposed renovation.

Hon. P. Priddy: If it's the same one that's in here, I am aware that the request is in. I'm aware that the ministry put it in as a priority, and we will be announcing those capital decisions quite soon.

R. Thorpe: Hon. Chair, I see the minister waving at me. She's obviously very pleased that I'm here to ask her some questions, because I know the minister is very concerned about the citizens in the riding of Okanagan-Penticton.

I have just two quick areas. The first area I want to spend a few minutes on is the wait-list for orthopedics in my particular riding. I believe it's been on the record, but I'll just confirm it. In my particular community, 19 percent of our population are 65 years and older, and 8.3 percent are age 75 and over. That compares to 13 percent for the province and 5.5 for the province for those respective age groups. In our community, that is causing some severe difficulties with respect to the seniors who have built our province. I want to use two examples, and then I want to ask the minister a couple of questions.

The first pertains to Mr. Buck Pacholzuk, who wrote to the minister on July 8, indicating that he believes he has an 18-month delay for his surgery. One of the great things in dealing with seniors is that they certainly do have a lot of worldly experiences, and they often have solutions that perhaps escape many of us. His observation is that surely there is something we can do to avoid these extremely long and building wait-lists when we take into account all of the other costs that are incurred by the health system while they're waiting, whether it's extra medication, extra visits to the doctor, etc. My first question is on behalf of Mr. Pacholzuk: how does the Ministry of Health factor in these other cost factors vis-à-vis addressing the increasing wait-lists?

Hon. P. Priddy: In some cases, with individuals, we can do that. In some cases, there is not a cost. There is not an offsetting cost factor for certain kinds of surgeries that people are waiting for, so I don't think you can do that in each set of circumstances. Are there accompanying costs? Yes, there are. As the member raises, for this one in particular, I think we have recognized, around orthopedic surgery in particular, that the wait-lists are unacceptably long.

We have done with orthopedic surgery the same thing that we did with cardiac surgery wait-times. With cardiac wait-times, you may recall, we established a committee of cardiac surgeons and others, primarily cardiac surgeons or cardiologists, who reviewed the issues in the province and looked at what it might take to reduce those wait-times to any kind of acceptable level, if there is any such thing as an acceptable level -- but to bring those down. As a result of that, there is $8.5 million in new dollars that went into cardiac wait-times.

That's exactly what we're doing with orthopedic surgery. We've established a task force of orthopedic surgeons in the province to review that and make recommendations to the government about what resources it would take to reduce the wait-times. One of the other things that I think we also need to do as a Health ministry. . . . Physicians need to be able to help their patients, too. It may not be as applicable in a smaller community such as yours, but when you look at wait-times among specialists in different hospitals, you'll often have. . . . I mean, I'm more familiar with ophthalmological surgery. But you'll find wait-times from one specialist that go two weeks to six weeks; at another specialist it'll go 12 to 18 months. So we also, I think, have a responsibility to ensure that patients know they have a choice and that there may be surgeons who have shorter wait-times than the person they're currently consulting. That is somewhat more difficult to do in a small community, where you may have only one or two surgeons. We have the orthopedic task force, and they will be making recommendations to government about how we can reduce those wait-times and on the resources it will take.

R. Thorpe: I suppose our community is small, relative to Vancouver, but we consider ourselves a significant community. We have four orthopedic surgeons in Penticton. The minister would be happy to know, as would her staff, I'm sure, that our orthopedic surgeons work together to try to serve all the patients.

Just one other example, and it pertains to an 84-year-old gentleman by the name of Clarence Gordon, who was born in the province in 1915. His hip has deteriorated to the point of replacement. The minister's report said that the average wait was 9.4 weeks; his wait is now determined to be nine months. I am reading from a letter from his daughter, Gloria Muir: "Your government reports, and I quote: 'Our government remains committed to a health system that's there when you need it and accountable to the taxpayer.' " Ms. Muir's immediate response to these statements is: "Balderdash." She talks about her father, as she feels very frustrated and very concerned as the pain increases and she watches his quality of life decrease dramatically. She fears that he'll become a burden on his family and on our medical system. Mr. Gordon needs the system's help now.

Those are but two examples. Just so the minister knows, I have a grave concern about this, to the point that I've gone to the hospital, spent time watching the surgeries and trying to understand the problems -- which takes me to what the minister said. She has announced a new orthopedic panel. Now, I guess I have just a couple of questions. Is that panel just looking at the province and trying to address one-size-fits

[ Page 10462 ]

Hon. P. Priddy: We are dealing with it on a regional basis. We have orthopedic surgeons from different areas in the province that are on the committee. I mean, you couldn't simply look at a provincial perspective and say there are X number of people on wait-times. You'd have to look at whether it's far more in the Okanagan and not nearly as much in the Kootenays, or whatever. It absolutely has to have a regional perspective, because when you come to allocating any new resources, you're not just going to sort of divvy them out evenly around the province. They're going to go to the areas that need the most assistance.

R. Thorpe: Does this new orthopedic panel involve just physicians, or does it actually involve people from our communities who understand the problems in the various parts of the communities?

Hon. P. Priddy: It is orthopedic surgeons at this stage, until we have at least a first cut at it, if you will. Then it will involve people from communities, including consumers.

R. Thorpe: What is the time line on this panel looking at the problem and coming up with action plans? When can we expect action?

Hon. P. Priddy: The work has just begun, but I would expect -- well, I would hope -- that work to be complete certainly by late fall, in order to be able to inform the budget. That's when budget plans begin.

R. Thorpe: Would it be possible to get a copy of the plan and see how that plan in particular relates to the Okanagan? I'm particularly concerned about this.

[11:45]

Hon. P. Priddy: Two things. I'm wondering if what the member is asking for is the current terms of reference for that committee -- because the plan, of course, won't be ready until the fall. Are you asking if you can have the plan? I don't know why I ask these questions, because the answer is always: "Both." Do you want the current terms of reference and the people on it? Or are you asking for the plan when it's completed? The answer, of course, is both -- right?

R. Thorpe: Yes.

Hon. P. Priddy: We'll get you the terms of reference.

At this stage, until at least there has been a first cut at this, there isn't an estimate of budget resources; there isn't a plan to look at a pilot project. But I will take the member's comments under consideration.

R. Thorpe: I do appreciate the minister's comments and her commitment. But I'm troubled. Why is it going to be the fall before we have a plan? We have a crisis on our hands. Why can't we say and agree together -- it doesn't have to be a partisan subject -- that it's not acceptable? Men who are 84 years old and who have built this province are in pain and hurting. People are crippled and they're hurting. Why do we have to wait until the fall? Why can't we say to people: "Address this problem like it was your mother and father who are in pain and on these waiting lists"? Minister, I plead with you today to let us accelerate these programs to make sure that we're putting the patient first. Surely the plan cannot take until the fall to get done when we're at July 24 today. Minister, I know that you don't think that's acceptable, and I'd appreciate your comments.

Hon. P. Priddy: No, of course not; I don't consider it acceptable. But there's a couple of things, I guess. One of them is that I don't think you can do. . . . If you're going to do a provincial plan and really look at that, with the greatest of respect, I think that they do need some time to be able to do that in the way the cardiac review was done, which is in a comprehensive way, and then bring forward recommendations. So I don't think the amount of time they've asked for is unreasonable.

One of the challenges we have, of course, is that if we decided, for instance, to reallocate dollars to orthopedic surgeons within the MSP budget, we're not allowed under the agreement with the BCMA to reallocate between specialties. We couldn't take from one kind of area and reallocate it for orthopedic surgeons. What we have to be able to do in the next budget is add additional resources to do so.

S. Hawkins: I just want to thank the member for bringing up this issue. It's not a new issue. In the last two years, and this is the third session. . . . We're standing up and asking for a provincial plan. I think the first year we stood up -- since I've been elected, anyway -- 1996 we asked the then minister, who is now the Minister of Finance, for a plan. This is the third session that we're standing up and asking for a provincial plan. I can understand the frustration of this member, with his concerns about why it's going to take until the fall. I guess my concern is: why has it taken over two years to finally strike a committee and get a plan underway? We will look forward to that plan and to seeing the terms of reference. Certainly we will be pursuing these issues next week when we talk in more detail about the waiting lists around the province. Just to let this minister know, we will be watching to see what she's going to do. We will be waiting for and watching with great interest the plan that they come up with. The provincial plan that this minister is talking about is something that we've been talking about -- and I know the critic before me has been talking about it -- in this House for years. It's nice to see the government recognize that there is a need for a provincial plan.

R. Thorpe: I just want to say a last couple of words. I know the minister visits hospitals -- as do I and many members here. I do have a community that has a disproportionate number of seniors, with a disproportionate number of people requiring surgery. I ask that the minister please put this project on a fast track with her staff, so that we can truly say that the elected people of British Columbia are working for their constituents and that the health care system is truly there, as we've told them it would be, when the 84-year-old builders of this province need the care.

B. Penner: There is one additional specific issue I wish to raise with the Minister of Health. I only received the authori-

[ Page 10463 ]

"I'm writing to you in an attempt to obtain your assistance for the above lady. Ms. Bjerke is my mother-in-law, who resides in Summerland. She has been riddled with arthritis for many years and has had several surgeries in order to replace various parts of her body that have been ravaged by this horrible disease. This spring she was scheduled to have her shoulder replaced in Penticton by Dr. Tatebe. However, X-rays revealed that the shoulder was so far gone that it would be too dangerous to operate in Penticton. Instead, her doctors have requested an appointment and, hopefully, surgery soon in Vancouver. After all the scans, X-rays, blood work, correspondence, she now has an appointment for" -- and I've got a copy of the appointment slip -- "March 10, 1999, at UBC Hospital in Vancouver. This date seems hopelessly so far down the road that I was compelled to write to you.

"This 70-year-old lady has worked so hard all of her life but is in constant, unbearable pain. Her face has been blackened by the drugs that she is on. She has to lift her arm with her other hand in order to pick up a fork to eat. Surely there has to be a remedy to such an incredibly long waiting list. Her quality of life is slipping daily, and at 70 years of age, I'm not so sure that she'll even make it until next spring without some relief from the pain of a shoulder that is complete mush from years of cortisone and every other drug that the poor woman has been tested on.

"If there is any solution to this problem, please advise myself and my husband. I would appreciate any assistance that you can offer me. Thanks for your concern in this matter."

We've heard of other examples about surgery waiting lists. Yet we're constantly bombarded with advertisements saying that this government has taken steps to reduce waiting lists for British Columbians. When we get these individual examples, they seem to tell a different story.

I'm taking the opportunity today to raise it directly with the minister because we happen to be doing Health budget estimates; otherwise, it would probably take a longer period of time to get the minister's attention on this matter. But on behalf of Ms. Bjerke, I am seizing this opportunity to bring her problem directly to the minister, and I ask for her help in assisting this woman.

Hon. P. Priddy: We've taken note of the member's information, and we will get back to the patient's family directly. I would note that while there certainly still are wait-times, and some are unacceptable, in the last two years there has been a 25 percent increase in dollars for orthopedic procedures. That is not insubstantial -- to raise the budget by 25 percent over a two-year period of time. I look forward to the work of the orthopedic panel, and we will get back to the family in question.

R. Thorpe: On that point, I just want to ask the minister: have those funds kept pace with the population and the demographics that have flowed through, therefore increasing the demand for orthopedic surgery in British Columbia?

Hon. P. Priddy: Certainly a 25 percent increase will keep pace with demographics. I don't think there's any question about that. Over a two-year period of time, we haven't had a 25 percent change in the demographics of people requiring orthopedic surgery, although I think we may see that over the next five years as that other large group of people becomes whatever we describe as older. The older we get, the more differently we describe it -- right?

But I think the other thing that impacts on this, which is also hard to keep up with, is changing technology. Changes in medicine and surgery and in our ability -- or physicians' and surgeons' ability -- to do these kinds of procedures are much more sophisticated now. So while it might have kept up with demographics, there's also the inability to keep up with the changing technology, as well, which is an increased-cost issue.

G. Abbott: I want to discuss with the minister the hot springs review which was undertaken by the Ministry of Health earlier this year. If there's any staff required, I'll frame the issue a little bit first, before posing some questions about it. The hot springs in question are Ainsworth Hot Springs and Nakusp Hot Springs, both of which contacted me earlier with concerns about this. I know they contacted some other members as well.

The issue is basically that for years those hot springs, which are composed entirely of therapeutic or hydrotherapy pools. . . . They're not hot springs with swimming pools as an adjunct; these are hot springs that are, in the usual sense, therapeutic. For years there was no question about lifeguards being required at those facilities. About two years ago, I guess it was, or a year and a half ago, the regional medical health officer -- for his reasons, I guess -- informed the facilities that they would have to have lifeguards on duty in the future. The matter had been discussed in the past, and I think some kind of exemption had been arranged. It seems that the owners and operators of these two facilities were taken aback that the policy appeared to change without any kind of discussion.

As you might expect, the decision by the medical health officer to require lifeguards at these facilities was not greeted favourably by the owner-operators. From their perspective, the addition of trained lifeguards would be a substantial cost burden to them. Indeed, from their view, this problem threatened the financial viability of the enterprises. Again, as one might expect, the hot springs sought continued exemptions from the requirement to provide lifeguards.

After some toing and froing with the Ministry of Health, the Ministry of Health concluded that it would be appropriate to appoint a hot springs review team to go in and look at the facilities at Ainsworth and Nakusp -- look at the clientele, the nature of the pools and so on -- and form some conclusions based on their observations. I believe the team was made up of the health officer, plus four others who were kind of third parties, or at arm's length from the ministry, in order to get that independent assessment of what should be done.

The team, I know, toured the facilities in early May. Can the minister advise whether the committee has, subsequent to that tour of the facilities, formed conclusions about whether a lifeguard should be required at those facilities?

[12:00]

G. Abbott: For my satisfaction, I wonder if the minister might advise what the conclusions of the panel were. I presume, if it has been resolved to their satisfaction, that either an

[ Page 10464 ]

Hon. P. Priddy: The decision was made to go back to the situation they have been under for the last 25 years or longer -- however long it has been -- which is where they were exempt because they were seen as therapeutic pools.

S. Hawkins: It's interesting that the minister earlier mentioned technology, because that is what I would like to talk about now: capital equipment and the budgets for capital equipment. First of all, can the minister tell us if the ministry knows what the budget is for capital equipment for medical imaging in the hospitals of B.C.?

Hon. P. Priddy: In equipment capital, which is what the member is referring to, there are no line items that say we're going to budget so much this year for medical imaging equipment and so much for radiological equipment and so on. We base that budget on the needs that are submitted by the regions or by the health authorities. The other part that I don't have, of course, is what they may have contributed, because sometimes communities will fundraise for particular kinds of equipment, including medical imaging, if they have an agreement that there will be operating dollars to support that.

When the final decisions are made around the requests from the health authorities about the kind of equipment, I would be able to give that information then. It would vary from year to year, because there may be years in which health authorities make no requests -- that would be highly unusual -- or smaller requests for medical imaging and more for another kind of equipment. When the final decisions are made for this year, I can certainly tell her how much the health authorities got in terms of the requests for medical imaging equipment.

S. Hawkins: One of the huge areas of concern is the amount of funding for hospital equipment and medical imaging and those kinds of resources. Unfortunately -- and this has been raised before -- because the ministry has not filed a report in the last few years, I can only go back to '94-95 for those figures on capital equipment funding. When I travel around the province and go to hospitals and facilities and the like, they tell me that the budget has been severely reduced, that they've had a very, very contracted budget for capital equipment. Again, the ministry's annual reports aren't that helpful either, because they don't really tell me if operating costs are tied to the capital equipment budgets as well.

When I look in the '91-92 annual report on page 32, at that time $47.441 million was reported as capital equipment funding; in '92-93, $47.442 million. It was reported in the Vancouver Sun as $31 million in a story under the headline "Prognosis Poor for Equipment Funds." It appears that the funding fell over $10 million -- well, gosh, $16 million between '92-93 and '93-94. When we contacted the ministry, the ministry's figures were $4 million or $5 million over what was reported in the Vancouver Sun in May 1995. The Vancouver Sun did a story a year later on '94-95, and we didn't find the reported figure in the ministry's annual report. But the Vancouver Sun reports that the capital funding was $3 million. That is a significant shortfall. That's why I'm asking the minister if they know how much they're going to spend in this budget year on capital equipment.

I travel around the province, and by and large, the hospitals tell me that their resources have been cut and that the wards are labour-intensive but not very capital-intensive. Certainly the medical imaging departments tell me that they are in dire straits, in dire need of upgrading their technology. Frankly, that's something I've noticed when I travel around the province. I've mentioned this to the minister. I go into hospitals around the province, and I see X-ray machines from the 1960s and 1970s. Because of those cumbersome machines, we have work-related injuries. So I know that there is a great need out there, and perhaps the minister can tell us what process is followed in the ministry now to determine what the needs are, what the priorities are and how they will be met.

Hon. P. Priddy: The development of the priority list for capital equipment funding. . . . I'm sorry, but earlier the member had asked about diagnostic imaging equipment, and I can't do the breakdown in quite that way. If the question is about capital equipment in general, it is actually the same as for other parts of the budget for other capital projects. The health authorities submit to us what they see as being what they would like to see in their community. It is submitted to the ministry, and that's prioritized within the budget available to us.

S. Hawkins: They get this every year. Does the ministry have a provincial needs list, then? The ministry has to approve that capital expenditure. Does the ministry have a list of priorities of all the needs on a provincial basis and a list of priorities?

Hon. P. Priddy: We do have -- or will have when the decisions are made -- a list of what the health authorities and then us within the ministry have considered to be priorities and what will be funded. That certainly can be available to the member as soon as those final decisions are made. I'm happy to give those to her.

The other thing we have historically is what people have said, every year, would be the things they would like to see in their communities. We have done some work around trying to bring the costs down. We've done that by doing some group purchasing of high-tech equipment to actually get a better deal for the health authorities and to be able to make our dollars go further. One of the things I notice about the requests that come in -- and part of this is about need and part of it is probably about how good people are at marketing new equipment -- is that we continue to see advances in equipment and more sophisticated equipment. Of course, every community wants the best and the latest for their community -- and I understand that -- which certainly tends to drive the request costs up.

S. Hawkins: Are the priority lists kept from year to year and then compared with what the regional authorities are asking for the next year? Does the minister have the list from last year, and does she match that list with what they actually funded?

Hon. P. Priddy: We would have that information. I don't have it with us here.

S. Hawkins: I wonder if I can get the list from last year.

Hon. P. Priddy: Yes.

S. Hawkins: When I go through my files, I find articles that were sent to me. Just as an example, on June 28 the Maple Ridge-Pitt Meadows News reported that the health board

[ Page 10465 ]

I know that the need is great. When I travel around the province, one of the things that strikes me the most is how far behind we have been in keeping up with technology. I have a document that was leaked to me. I know the minister has a copy. It's with respect to medical imaging services in the capital health region. It's interesting, because it talks about ultrasound resources in the capital regional district. The information that's in there is quite disturbing. It just demonstrates how far behind we are in funding technology. Certainly a region like this, which has grown and which also has a large population of elderly people, has basically received. . . . It says in the document:

"We've repeatedly submitted five-year plans that have met with hospital committee and widespread community rapport, but we have received very little government capital funding for ultrasound in the last ten years. As a consequence, serious problems with our equipment became apparent in 1992, which were partially solved by purchases in 1994 and in 1996. The funds for these purchases were cobbled together from hospital parking-lot fees and donations from the foundation, with minimal provincial funding. Given this lack of support, we are not surprised in 1998 to again face serious difficulties. Thirteen units are now in urgent need of replacement and four new ones are required to meet increasing demands. Furthermore, as long as there is no plan for basic maintenance, erosion of quality will be a constant fact of life in ultrasound.

"I am unaware of any other centre where this is thought to be acceptable and do not understand why we should consider this reasonable in the capital health region."

[12:15]

"As equipment fails, we have to close rooms, with loss of service to patients, serious staffing problems and loss of revenue for the hospital. The purchases of ultrasound equipment in '94 and '96 were made with 100 percent local funding and no government support."

"We were excluded from a provincial bulk purchase of ultrasound equipment in 1998 because of our recent purchases." That was the purchases they made in '94 and '96. "In fact, given our inventory of $9 million in equipment, a standard seven-year replacement policy would entail annual expenditures of over $1 million, without adding any new capacity. We have not even come close to making these investments. As a result, our equipment is undergoing a constant erosion of quality."

"The facility," it says, "is the major outpatient ultrasound centre on Vancouver Island for obstetrical, musculoskeletal, vascular and abdominal imaging." The three units that they mentioned are not up to standard. "One machine apparently is the most problematic, with decaying probes and a nearly unusable monitor which can't be upgraded."

At Victoria General they need four new machine replacements and three new units for perinatology, musculoskeletal and breast ultrasound. It's interesting, as well, the information that's under here, because the Toshiba machine apparently. . . . One of them, they say, is used by a perinatologist.

"With no colour Doppler and outmoded imaging technology, it is inadequate for his role as a referral expert for complex pregnancy management for Vancouver Island. The service is also sufficiently busy to warrant a second ultrasound unit."

"Our MRI unit now has the longest wait in Canada. Some of this load could be reduced if we added a musculoskeletal ultrasound unit to assess shoulders, knees and ankles. Our department is more experienced in this form of ultrasound than any other centre in Canada. In general, ultrasound is much less costly than MRI."

So I mean, this is just from one region. I'm sure the minister is going to get letters like that from all the regions. But that one just underlines for me how serious the problem is in the different regions around the province and how far behind we have been in this province in keeping up with technology. Certainly in the last five to ten years we've seen the funding drop significantly. It will be interesting, if the minister ever files the annual reports of the ministry, to see the comparison from 1991 to 1998 and see where the capital funding has actually gone and how much has been spent on capital funding. Now my information is that the ministry is only spending $5 million on capital funding this year. I wonder if the minister can confirm that.

Hon. P. Priddy: Member, I just didn't hear the last part of the question. I heard the information leading up to it; I didn't hear the last statement.

S. Hawkins: Because the minister says she's waiting for all the budgets to come in. . .I know there's not an infinite amount of money. It's not a line item; I can't find it. But my understanding is that there's only $5 million this year to spend on capital funding for imaging. If the minister has any information around that, I'd appreciate it.

Hon. P. Priddy: There are a couple of things. One of them is that I think the earlier document the member was referring to -- however it came to the member -- was written by a radiologist to the CHR. There hasn't been any comment on that report at all yet from the capital health region.

Secondly, I just want to comment on the ultrasounds. Last year we bought 20 new ultrasounds for various places throughout the province that indicated that need. I don't know of a figure of $5 million this year for medical imaging equipment, but when the final decisions are made, I guess I

[ Page 10466 ]

S. Hawkins: I wonder if the minister can give me the comparison, then -- because she doesn't know this year's -- with the last couple of years. I've only been here a couple. . . . Let's just take from '96 to '97. I don't have the annual reports, and I don't have the information. Can she tell me what it was in '96 compared to '97 and compared to this year's budget?

Hon. P. Priddy: Just from the information we have with us, last year we spent close to $50 million on capital equipment. As yet, the total is not known for this year.

S. Hawkins: Does that $50 million include operating?

Hon. P. Priddy: No, it's a capital budget, so it does not include operating, nor does it include the contribution that the local health authority or regional health district would make.

S. Hawkins: Can the minister break that down, region by region or hospital by hospital? I would be interested to know where that $50 million went. I don't hear all the happy news around the province. I wonder if part of that commitment was for the radiology department at one hospital -- Vancouver General Hospital?

Hon. P. Priddy: We'll get that information for the member.

S. Hawkins: I'm also interested in. . . . The minister was talking about bulk purchasing, and I'm wondering if she can tell us what bulk purchasing is and how the ministry goes through that process.

Hon. P. Priddy: What we do in terms of group purchasing is identify equipment that is particularly high-cost equipment. For instance, the ones we identified last year were nuclear medicine gamma cameras, general radiology equipment and ultrasound units. We set up a steering committee for each of those equipment areas. That's made up of physicians and technologists with expertise in that area. They go out and do both a clinical and a financial assessment of the equipment. They actually do site visits. Last year they brought ultrasound equipment in to be tested. Based on that information, we make a decision about group purchase.

S. Hawkins: If I can just go back for a minute, the minister said $50 million was spent on capital equipment last year. Out of that $50 million, how much was on medical imaging?

Hon. P. Priddy: Two things: first, just in terms of a point that was raised by the member earlier. . . . I think the member asked whether that $50 million included the radiology equipment at VGH. No, that was not part of that $50 million.

Secondly, I know how much we spent on group purchasing for medical imaging. But in terms of the entire budget last year, I think I committed earlier that we would get back to the member on that. I think that we saved about $1.5 million last year by group purchasing.

S. Hawkins: Does the minister not have the figure, then, on what they spent on medical imaging last year out of the $50 million? Is that what she's saying?

Hon. P. Priddy: We don't have that information with us, but I will ensure that the member has it by Monday.

[12:30]

I understand that group or bulk purchasing is a good idea and that it can save money. It's interesting, because it can also penalize some hospitals, too, because some of them, through their foundations and other resources, have fundraised. Say, if the flavour of the year was ultrasound, and if one hospital, through their foundation or auxiliary, fundraised for that ultrasound and then the ministry said: "Well, now we're going to buy for everybody else, but we're not going to help you out because you already bought yours. . . ." That hospital obviously has another need, and perhaps it's not met that year. I wonder how the ministry applies that policy fairly to hospitals who need other equipment but. . . . The ministry decides. I don't know what the flavour this year is. I know that it's been CT. I know that it was angiography in '96, CT in '97 and ultrasound in '98. I don't know what it's going to be -- maybe nuclear med cameras -- in '99. How does the ministry apply that policy fairly, so that it's not a generic: "We're just doing CTs this year, and if you got your CT last year but need an ultrasound this year, we're not helping you out"? How do they make that fair across the board?

Hon. P. Priddy: If the hospital or health authority purchased a particular piece of equipment last year, and the ministry makes a determination in three or four different areas that that will be the area for this year for going ahead with the group purchasing, I'm not sure that that penalizes. . . . It does mean that people didn't get their ultrasound last year at a group rate, but if they have a different need. . . . The group purchasing is only part of the capital budget. If, for instance, they had a need for something last year that wasn't ultrasound, wasn't general radiology and wasn't nuclear medicine, that's looked at in the capital budget as well. This just happens to refer to. . . . It was about $14.5 million last year, so there were lots of additional dollars that went out to health authorities to purchase the particular piece of equipment they needed.

S. Hawkins: Let's just use the capital health region, because they had their ultrasound, and the ministry was buying ultrasounds. They didn't get it on the group purchase. I wonder if the minister can tell me if they did ask for more ultrasounds but, because they had purchased theirs, perhaps the ministry didn't include them in a group purchase to buy other replacement ultrasounds. From the documents I have, they need about 18 replaced.

Hon. P. Priddy: I don't think the region would be penalized because they bought an ultrasound the year before. Let's say they say: "You're bulk-purchasing ultrasounds this year. We need some more, so we want to be part of the bulk purchase, even though we got one last year through individual funding from you" -- or however they acquired it. They wouldn't be penalized. If they were still seen as really high need, in terms of the resources available to us, then they'd be eligible to be part of that bulk purchasing. It would be based on need. They certainly would not be penalized because they had already done that the year before, but it would have to be based on need.

S. Hawkins: My understanding is that they did have that need, and they did want to be part of that group purchase,

[ Page 10467 ]

Hon. P. Priddy: I don't know the particular details of that, but I would suggest that within the dollars available to the ministry and the priorities set by the ministry, it's possible that while. . . . People have a very long list every year of what they believe they need. As I think the member has said, there is equipment that comes along as a "flavour of the month." So they may have identified that as a need, but I would think that from the ministry's perspective, it must have been judged to not be within the priorities of the budget.

S. Hawkins: The flavour of the year was ultrasounds, and they were left out.

The minister says that the ministry prioritizes. I want to know how the ministry prioritizes. What is the process that the ministry goes through, and what is the fair process that's applied across the board?

Hon. P. Priddy: I was just checking with staff to see if there was a piece of this that I didn't understand. I think we canvassed this a little bit earlier. The health authorities submit their lists, meet with the regional teams from the Ministry of Health in their area and go through those lists, and within the budget of the Ministry of Health, there's a determination made. . . . If everybody wants an ultrasound, we're probably not going to be able to fund everybody -- just using that example -- and a determination is made on who might need that the most. It's based on age of equipment, on increased number of uses -- whatever. It's based on who might need that more than someone else.

S. Hawkins: The descriptions I read to the minister were "decrepit" and "ancient." There were a lot of adjectives like that applied to the equipment in just the one area, the ultrasound area, of the capital health region. Again, I'm having trouble understanding how exactly the decision is made. What criteria are applied? Is there a ranking? Is there a value system? It's fine to say that all the health authorities submit their stuff and have their priorities. The ministry prioritizes it somehow. Does the ministry cap it -- like: "We're only funding this many"? What needs assessment is applied to say who's going to get it and who's not going to get it?

Hon. P. Priddy: While I do appreciate that the adjectives used in the report that was submitted to the capital health region may be those -- although there has certainly been no response from them at this stage -- I want to assure the member that we are not using equipment in this. . . . Well, I guess we would all like the latest and best equipment for our local health authority. We are not using equipment that is unsafe in this province, and while people might wish to have it updated -- and we work at that as much as we can -- we're certainly not using equipment that is unsafe to anyone.

Secondly, the only cap that is put on equipment is a budget cap. We don't cap only X number of certain kinds of machines or say that this year we're only going to fund certain kinds of equipment. The cap is totally limited by budget, like most caps in government.

S. Hawkins: Well, I'm going to disagree with the minister, because I know there is unsafe equipment being used around the province. I know that, because I've visited facilities. While she says it's unsafe to no one, it's unsafe to some of the workers. There is old, old X-ray equipment, and I'm told there are WCB claims around using that equipment, so I know it's unsafe to some of the folks. When I read reports that come to me and letters from concerned individuals that work in X-ray departments, I know they're working with old equipment, and they don't feel that it's safe all the time -- the determinations they're making with the equipment they have to use. Sometimes it's more costly -- and I would say a lot of times it's more costly -- to use old equipment, because you get a picture or a report that's not as accurate, and you have to send someone off for another test. Then you're paying twice or maybe three times.

Again, I am absolutely surprised at how far behind we are in technology across this province. It is disturbing. I don't know if there is a provincial plan. Again, we use that provincial plan. This planning, I think, is something that perhaps is done on the fly in the ministry. I know they're under a great deal of stress, and it is challenging, but I have to wonder if there is a plan to replace and upgrade technology across the province -- that it's not just done where it's politically expedient to do so. I have a lot of concerns around the replacing and upgrading of technology to make it safe for patients and not send them for two or three different tests because one isn't clear and we have to send for another one that will give us a better picture. There are a lot of those examples around the province.

While we're talking about the different CTs and MRIs and the like, I wonder if the minister can give me the waiting lists around the province on MRI, CT, ultrasound and nuclear medicine, if she has those kinds of numbers available to her. Every year we stand here and try and get them. I've had a commitment to get them for the last two years, and I've never received them. The only way I get them is when patients write to me and I get information that way or, again, when the GVHS goes public with their waiting lists. I wonder if the minister can advise us on the waiting list for MRI and get us those numbers. She doesn't have to go by hospital -- perhaps region to region.

Hon. P. Priddy: I wanted to go back, for a moment, to the member's comments that concern me, and I don't mean that her comments aren't legitimate. Every hospital in British Columbia is accredited. In order to be accredited, hospitals have to demonstrate to an accreditation team that their equipment and working conditions are safe. By the way, on top of that, the radiation protection branch inspects equipment in hospitals on a regular basis. If there are workers who consider themselves to be working with unsafe equipment or in unsafe working environments, then they have the right and they absolutely should. . . . I'm sure that their union carries out their responsibility vigorously, as they should, to bring those complaints forward to the WCB. That is what they're there for, and it is unacceptable to me that we would have workers working in unsafe conditions. Those situations brought forward to the WCB absolutely need to be resolved. I don't for a moment suggest that it's acceptable to have people in unsafe working conditions or working with unsafe equipment. While we do rely on hospital accreditation -- as we should and as we do across the country. . . . By the way, I will check with my colleague the Minister of Labour.

An Hon. Member: He's busy.

Hon. P. Priddy: Well, okay, when he's not. I'll check with him, as well, about the kinds of concerns coming forward about unsafe working conditions in those areas.

The second question is: do we have a list, region by region or whatever, for MRIs, CAT scans. . . ? I can't remem-

[ Page 10468 ]

S. Hawkins: Well, I'll go back a step, then. I'm not going to accuse the minister of being naïve, but I'll give her one example of an unsafe working condition, and that's the radiology department at Royal Inland Hospital. I was there last year, and I was there again, and I asked the minister yesterday about the upgrade for that department. Just walk through there and have a look, and see if that is a safe environment for patients or for people working there. It's hard to get a stretcher around the corner; they've got equipment in the hallways; they've got film-processing machines in the hallway. There's one big example. We can go through all kinds of hospitals, and I can show you that.

The minister knows as well as I do what the accreditation process entails. We prepare for months for it. We document for it very well and prepare our policy manuals for it. I've been through it a few times on the wards where I was a head nurse. We get through accreditation, and you know what? Those two days are perfect. They're absolutely perfect, and the rest of the year we struggle to get by. I'll tell you about accreditation, because I have personally been through it a few times. We want accreditation so we will get good funding and all the other kinds of stuff. So for the couple of days the reviewers are there, we each put on our best dress and our best face. I hope the minister will make that trip to Royal Inland and have a look at their radiology department.

[12:45]

I hope she talks to the Minister of Labour about it. If she wants, let's do a survey of hospitals around the province and ask the workers who are working there about their safe working conditions. In fact, I think I just saw a bill -- the Workers Compensation (Occupational Health and Safety) Amendment Act -- that this minister put in front of the House, a bill about safe working conditions in businesses. We already have the regulations and the committees in hospitals, but I was talking mostly about technology. I know that in radiology there are departments around the province where workers don't feel they are in safe situations with the equipment.

The other part of that was whether the tests being conducted were actually of good enough quality to give the doctors or the radiologists comfort that what they were reading about the patient was accurate. Oftentimes, as I was telling the minister, when they don't feel that way, they send the patient for another test to make sure they have an accurate picture. If the X-ray wasn't good enough, they'll send the patient for a CT. If we had the upgraded technology, maybe we wouldn't require that extra test. That's what I was asking the minister to consider.

With respect to waiting lists, we have seen a lot of attention around the Greater Victoria Hospital Society. Frankly, I have documents showing MRI wait-lists at Victoria General going way back -- from February '97, over a year ago, to the current date. It's remarkable, because back in February '97 -- and this is a report that was being sent monthly to the ministry. . . . On February 5, 1997, there were 707 patients on the waiting list. "The elective cases," it says, "will be booked in September." This is quite a few months' delay. It says: "This would make the elective waiting list approximately seven to eight months. We're finding, too, that the urgent cases seem to be increasing in number, and it's making the elective wait-list even longer. As you are aware, we are definitely capped in the number of cases we can do, at approximately 3,000."

These are the kinds of concerns I'm getting. On November 19, there were 932 patients on the wait-list. That's an increase of almost a couple of hundred, and it just goes on -- January, February. . . . In March of this year, it says they had an 11-month wait for elective MRI procedures. I know that the minister is aware of this. I know she's asked for a review of the situation, but I have to wonder why it takes so long.

The ministry has had this information for a year; they've started collecting that data. In the last couple of years, we've been standing here and asking the ministry to look at this issue. Unfortunately, the ministers keep changing, so the new minister has had to shoulder this and has had the weight to bear for the last couple of years, anyway, of me being here and asking the questions. I know it's difficult, but just for this region alone, I understand that the waiting list just for MRIs is now three to four times what it is in, say, greater Vancouver.

It's hard for patients; it's hard for providers. Patients want to know that they have the security of a diagnosis. In my own area, I think there's a considerable wait-list too. I think it's eight or nine months, I think, for elective MRI. When I talk to the radiologists there -- because I get letters; I get three or four letters and, unfortunately, the patients do go public, and they want answers -- the radiologists tell me that they're capped. The minister's staff write to the patient and say: "We don't control the wait-lists; the doctors do. If it's urgent, they will get you in." Yeah, the doctors will get you in, but if it's capped at a certain number, then you're not going to get in until you move -- until you're sick, until you're showing symptoms of emergency or are urgent. You're not going to get in until the next budget year comes in.

Again, I have a press release dated May 25, 1998. In it the physician says: "Orthopedic surgeons in Victoria are now cancelling knee MRIs and are instead regressing to invasive and far more expensive diagnostic arthroscopy." It says: "Dr. Koopmans added: 'Suspected MS patients are having to wait a year for scans, and patients having complex gynecological malignancies" -- which the minister knows is cancer -- "are often not getting the MRI scans they need for proper diagnosis and treatment.' " Now, that is frightening.

I want the minister to comment on why the ministry is sending letters to patients saying that they don't control the wait-lists, when we know the ministry caps the amount of funding. They decide how long the MRI scans are going to run and for how long. So patients are going to wait longer. The urgents -- the emergency ones -- just keep adding up and taking away from the funded amount of MRIs and keep pushing the patients further down the wait-list.

Hon. P. Priddy: I just want to cover off two or three issues that the member has raised. I want to go back to the

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Interjection.

Hon. P. Priddy: Sorry, hon. Chair, I think I hear the member saying that it wasn't a priority request for them, because they knew they wouldn't get it. I'm not absolutely certain that those dots join up very well. Surely you would put it as a priority and wait for a decision to be made, as opposed to saying: "We won't put it on our priority list, because we don't think we'll get funded for it." They got funded for four of their top five priority equipment requests, and ultrasound was not amongst them.

When we talk about wait-times for MRIs, yes, there are, and we realize the challenge within that. In the documentation I have and in the conversation that took place this week between my deputy minister and the capital health region, the capital health region assures us that the waiting time for emergency MRIs remains the same as it was in December '96, April '97, August '97 and March of '98, and continues to be, as of this week, zero days. Now, that's the information given not by us but by the capital health region. So when we talk about emergency wait-times for MRIs in the capital health region, it is zero.

In terms of urgent MRI patients, the wait-time is the same as it was, again, in December '96, April '97, August '97 and currently, which is two to three weeks for urgent or emergent -- not emergency -- cases.

We do have quite a difference going on in the capital health region. From December '96 to August '97, the wait-time for elective MRIs was four months. Somehow, in the space of about five months, it's gone from four months to 12 months. While undoubtedly the wait-times or the patients are there, to have it triple in a period of less than 12 months, about nine months, is quite extraordinary.

That is the reason I asked the ministry to work with the capital health region. I have met with the physicians from there concerned about MRI and that's the reason I've asked the ministry to come back with an action plan. To see it triple within a period of about nine months seems to speak to something else that might be more extraordinary. That's why I'm awaiting the action plan and the results from my ministry's investigation into this.

S. Hawkins: I think and hope that the minister can appreciate that if they know they're not going to get it, they're not going to put it in their top five priorities. My understanding is that they were told they weren't going to get ultrasound. So why would they put it in their priorities, if they were told they weren't going to get it? They might as well put on their priority list something that they might get. They were told they were not going to get ultrasound because they had purchased them already. I'd like to make that distinction.

With respect to MRIs, I would hope that the wait-list for emergency is zero. I'm glad to see that the wait-list is zero for emergency. I know that in other wait-lists -- and we'll get into them next week -- the wait-list is not zero days; it runs into weeks and sometimes is greater than that. I'm interested in knowing when this management plan or this review of MRI -- for the capital region anyway, the greater Victoria region -- is due. In the meantime, has there been anything put in place to help? Have there been extended hours? Is there any plan in place to deal with the wait-list as it stands now?

The Chair: Noting the time, minister.

Hon. P. Priddy: Thank you, hon. Chair. I was going to do it, really. I mean, there's four minutes of diligent work still to be done. I'll just respond very quickly.

In the ministry's review of this, that's obviously one of the considerations that they would be taking into effect.

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

Motion approved.

The House resumed; the Speaker in the chair.

The committee, having reported progress, was granted leave to sit again.

Hon. P. Priddy: I move that the House do now adjourn, and hope that everybody has a wonderful sunny weekend and rests up.

Hon. P. Priddy moved adjournment of the House.

Motion approved.

The House adjourned at 1 p.m.

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