1998/99 Legislative Session: 3rd Session, 36th Parliament
HANSARD

The following electronic version is for informational purposes only.
The printed version remains the official version.

Official Report of

DEBATES OF THE LEGISLATIVE ASSEMBLY

(Hansard)

MONDAY, JUNE 28, 1999

Volume 16, Number 13

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The House met at 2:06 p.m.

Prayers.

Hon. H. Lali: I have two sets of introductions to make today. First of all, in the gallery are three roadbuilding contractors from the Salmon Arm-Sicamous area. I'll be meeting later today with Gerry Hoefsloot, Wayne Mounce and Vicky Bischoff. Would the House please make them welcome.

For my second set of introductions, I have the pleasure to introduce three special guests. Ritu Mahil resides in Victoria and is working on a combined law and public administration degree at the University of Victoria. Ritu is accompanied by her aunt and uncle, Jaswant and Rajwant Chouhan, who are on a six-week visit to British Columbia from Punjab. They both have an interest in politics and are in the Legislature for the first time today. Would the House please give them a warm welcome.

G. Abbott: For the first time, I think, the Minister of Transportation and Highways beat me to the punch on an introduction. I want to join him in welcoming three guests from the contracting community in the Shuswap: Gerry Hoefsloot, Vicky Bischoff and Wayne Mounce. I know they're here to discuss their serious concerns about HCL with the Minister of Transportation and Highways, and I wish them well in those discussions. I'd like the House to make them welcome.

Hon. P. Priddy: I actually have two sets of introductions to do. The first are people who are here to help celebrate the twenty-fifth anniversary of the British Columbia Ambulance Service. I would like to introduce to the House Jim Patterson, who is the president of CUPE Local 873, the Ambulance Paramedics of B.C; and David Babiuk, who is the executive director of the BCAS. Barrie Carlow, the regional support coordinator, has 25 years of service, so he has an anniversary as well; and Paul Gotto, director of provincial operations, again has 25 years of service. Sarah Moffat, paramedic unit chief from Chemainus, has 18 years of service; Gerry Parrott, regional director for Vancouver Island has 25 years of service; Ed Pfeifle, paramedic unit chief in Victoria, has 25 years of service; and Keith Price, paramedic unit chief in Duncan, has 25 years of service. Please welcome them to the Legislature today.

[1410]

J. Doyle: Today I'm pleased to introduce a constituent from Columbia River-Revelstoke. He's just completed grade 9 at Golden Secondary School. He is a good student and a young man I am very proud of. He has a summer job and a weekend job, but he's taken a couple of days off to be in Victoria. I'd like the House to join with me in welcoming my son Adam to Victoria.

E. Walsh: I am both proud and delighted to stand today and join the Minister of Health in welcoming my union brothers and sisters from CUPE Local 873, the Ambulance Paramedics of B.C., and also the B.C. Ambulance Service management staff here today. I would ask the House to join with me in welcoming them once again here to the Legislature.

T. Stevenson: In the precinct today are a fair number of people from the Rainbow community.

Interjection.

T. Stevenson: Well, there's one, anyway!

This community is made up of gays, lesbians, transgendered and bisexual people. Today out in front of the Legislature, "Queen Victoria" declared Pride Week. "Queen Victoria," and her consort are here. After talking with her, I understand that she did not have an annus horribilis but rather an "annus terrificus" this year. She's pleased to be here, as well, to participate in a reception at 6 o'clock in the Ned DeBeck lounge with all the Members of the Legislature. I hope the House will make them welcome.

The Speaker: Hon. members, it's not often that I have family here. Would the House join me in welcoming my daughter Jennifer Brewin, who is artistic director at Caravan Farm Theatre, and her partner Arthur Milner, who is a playwright from Ottawa. Would the House please make them welcome.

While I'm at it, I would just like to point out to the members the folder that's on their desks, which has to do with some new literature. Leaflets have been prepared for the Legislative Assembly to describe various aspects of the work that happens here. Some 200 copies are available for each of you for use in your constituency offices.

LAND TITLE AMENDMENT ACT, 1999

[1415]

Motion approved.

Hon. U. Dosanjh: This bill contains measures that will make British Columbia's Torrens system the most efficient title registration program in North America. It will enable a completely paperless filing and registration system through the use and application of technologies, policies and procedures necessary to support electronic documents and digital signatures. To achieve this, the bill has two principal objectives. The first is to give legal efficacy to specialized conveyancing instruments, such as deeds and mortgages, that are in electronic form. To do this, the bill resolves questions such as how to sign a paperless document and what constitutes proof of a paperless document.

The second is to provide legal efficacy to digital signatures. Traditionally, a signature is written on the paper docu-

[ Page 13992 ]

Let me assure you that the bill achieves its objective without detracting from our long-established Torrens principles of title registration. Nor will it change the existing laws and legal policies and practices relating to land transfer instruments. The bill enables electronic filing without detracting from the current paper-based system.

Finally, I point out that the electronic filing system contemplated by the bill will assist commerce, lower conveyancing costs for the homeowner, help the environment by eliminating the wasteful use of paper and improve levels of service for all those who use and rely on our land title program. I move that the bill be placed on orders of the day for second reading at the next sitting of the House after today.

Bill 93 introduced, read a first time and ordered to be placed on orders of the day for second reading at the next sitting of the House after today.

Oral Questions

PHYSICIAN SUPPLY IN PRINCE GEORGE

Hon. P. Priddy: As it relates to Prince George -- as the member well knows -- the Northern Interior regional health board is in contact with a number of physicians who are seriously looking at moving to the Prince George area in order to provide support for families in that area. Certainly there is emergency, which is by no means the best way of providing family service, but in the Prince George-Valemount area we have been able, over the last several months, to have six physicians placed there by the provincial recruiting board. I know they're working hard to get physicians into that community.

The Speaker: First supplementary, the member for Prince George-Omineca.

P. Nettleton: It's simply not good enough. The last time the doctors' shortage was on the front page, we had the Premier promising that there would be a long-term guarantee of services for people in the north. Here we are. . . .

Interjections.

P. Nettleton: Listen up. Here we are a year later, and the situation is getting worse. No one is stepping in to take the places of the departing doctors, as we speak. Will the Health minister tell the people of Prince George why they should believe any of her promises, when all they see are services and physicians disappearing?

Interjections.

The Speaker: Members, come to order.

Hon. P. Priddy: For the people of Prince George. . . . They have seen promises fulfilled around a budget increase -- the largest in the province, by the way -- to their regional health board: a promise made, a promise kept, and the largest increase to any regional health board in this province, hon. Speaker. They've seen the commitment to the renovation and extension of their hospital. They've seen that money released; that's a promise made and a promise kept.

So when the government and the health board and the recruiting agency say. . .

Interjections.

The Speaker: Members, members.

Hon. P. Priddy: . . .that they are doing everything they can to get doctors into Prince George, I would hope that the member from Prince George, as well, is talking about it as a community where it is important to work and valuable to work, and that this work will be valued.

COST OF GOVERNMENT ADVERTISING
RE PENSION LEGISLATION

[1420]

Interjections.

The Speaker: Come to order, members.

Hon. D. Lovick: What we are doing is responding to the deliberate misrepresentation campaign that was carried out by the opposition. The amount of money that we are spending. . . .

Interjections.

The Speaker: Members, come to order.

Hon. D. Lovick: You know, at first I thought they were just boorish, but now I realize that it's a limited attention span.

The Speaker: Minister, there's no need. . . . There's no need.

[ Page 13993 ]

Interjections.

The Speaker: Members, come to order.

Hon. D. Lovick: I rest my case.

The Speaker: Minister, watch the language, please.

Interjections.

Hon. D. Lovick: How are we doing for time, guys?

The Speaker: I'm sure the members realize that they're using up their own time. If that's the way it wants to be spent, that's the way it can be spent.

Hon. D. Lovick: To answer the member's question, the sum of money involved is some $20,000.

The Speaker: For a first supplementary, the member for Kamloops-North Thompson.

K. Krueger: It's $20,000, while this minister has failed to alert pensioners to the fact that they were being ripped off by pension suspension, and even as the carpentry workers' pension plan proclaimed these suspensions on the minister's own Internet site. Will the minister explain to the workers and pensioners of B.C. why his focus continues to be on self-serving advertising at taxpayers' expense instead of on protecting pensioners?

Hon. D. Lovick: Gosh, we're not even at July yet, but already they've run out of questions. This is what we spent about a dozen hours on during the debate on the bill. All of these questions have been answered; they have been answered at great length. Let me just. . . .

Interjections.

The Speaker: Members, come to order. No one can speak over all these interruptions.

Hon. D. Lovick: I would just remind members opposite, Madam Speaker. . . . To the questioner. . . .

Interjections.

The Speaker: Member for Kamloops-North Thompson, the question has been asked. We need the answer; let's hear the answer.

Hon. D. Lovick: We had no intention, in introducing the legislation, to spend any money whatsoever on an advertising campaign. However, when the official opposition consciously, deliberately and intentionally sets out to mislead people and scare pensioners, we have no choice.

GOVERNMENT POLICY ON
GAMING EXPANSION ON ABORIGINAL LANDS

Hon. M. Farnworth: Gaming expansion in this province is over; that is it. Gaming in this province, as in every other province in this country, can only take place under the Criminal Code of Canada. As such, the province is charged by the Criminal Code of Canada with conducting and managing gaming in this province.

[1425]

The Speaker: Members. . . . Minister, finish your remarks, please.

Hon. M. Farnworth: Aboriginal gaming can only take place if it is sanctioned by the province. As I said at our announcement earlier on, gaming expansion. . . . There will be no new licences issued in the province of British Columbia.

The Speaker: First supplementary, the member for Okanagan West.

Interjections.

The Speaker: Members, come to order.

S. Hawkins: According to a memorandum of agreement on gaming policy signed by the UBCM and the NDP government, local governments now have the ability to "make decisions as to whether new facilities or relocated facilities will be permitted within their boundaries." Assuming that this policy applies equally to B.C.'s aboriginal communities, can the gambling minister, then, confirm that in the face of the government's supposed halt to gambling expansion, we could see more casinos in this province?

Hon. M. Farnworth: The only casinos that are currently in this province are those which are currently existing or those which may get a licence at the end of the AIP process, and there are about seven of those. Those are the only licences that are in the province or that could end up in the province. Of course, casinos may move from community to community. That has been acknowledged all along. That's why I'll be announcing the name of an independent person to set up a process by which those relocations can take place. Key in that is a requirement that any casino relocation has to have community support in whichever community it may be relocated to.

INVESTIGATION INTO ALLEGATIONS
BY VICTORIA AUTO DEALER

[ Page 13994 ]

Hon. D. Miller: No.

The Speaker: First supplementary, the member for Richmond-Steveston.

G. Plant: I think these are important allegations. As I say, if what Mr. Alexander has to say is true, then the power of the Premier's Office is being misused and abused in ways that cause all British Columbians to be afraid.

This is not rocket science, hon. Speaker. This is not the NCHS all over again. This is a simple question. Is Mr. Alexander telling the truth, or does Mr. McIver have an explanation for his conduct? It's long past time for an answer to that question. I repeat my question to the Deputy Premier: does he have a status report? Does Mr. McIver still hold his job? Or are the business people in Victoria and the lower mainland all sitting at their desks waiting for a visit from somebody else from the Premier's Office?

Hon. D. Miller: Two things, hon. Speaker. The member never learned in law school how to listen, and I'm sure the behaviour he just exhibited wouldn't be allowed in a court of law.

Interjections.

The Speaker: Members. . . .

TEAM B.C. TRAVEL COSTS FOR
WESTERN CANADA SUMMER GAMES

[1430]

Interjections.

The Speaker: Members. . . .

Hon. M. Farnworth: There are rules and regulations governing how organizations can access money for travel to send teams to events whether they're in British Columbia or in neighbouring provinces. As is the rule, teams are eligible for travel grants that cover costs of travel within British Columbia. However, there are occasions when we have national representation or teams representing the province overseas, and I have asked the Lottery Corporation to review its policies around Team B.C. for games such as these. We will be exploring those options. At the same time, the money has been found and is available for them -- plus there are other programs which they may be able to access through grants through the Gaming Commission, which they are quite eligible to apply for.

The Speaker: The bell ends question period.

Ministerial Statement

PARAMEDIC APPRECIATION WEEK

It's particularly important this week and this year, because July 1 is the twenty-fifth anniversary of the B.C. Ambulance Service. Today the British Columbia Ambulance Service is the only provincially operated service in Canada. It has 3,300 full- and part-time employees -- women and men -- who respond to almost 400,000 emergency calls per year for ground and air service. Our fleet of 450 ambulances provides services in 167 communities across British Columbia, making BCAS one of the largest ambulance services in North America.

Our government believes that a strong, provincially based ambulance service is a cornerstone of our system of health care delivery. That's why we've invested almost $14 million in new ambulances and enhanced paramedic training for part-time staff in smaller communities and rural areas to ensure that BCAS employees have the knowledge and the medical skills they need to provide effective, emergency medical care to the B.C. public.

Ambulance stations in many B.C. communities are holding open houses and staging displays at locations across the province during Paramedic Appreciation Week. I encourage all of you to take the time to visit an open house, if there's one in your community.

I was pleased to attend an ambulance station open house in Delta yesterday and tour an ambulance station to mark the twenty-fifth anniversary. In honour of Paramedic Appreciation Week, I am pleased to see all of my colleagues, as I say, wearing the twenty-fifth anniversary commemorative pin. Actually, I would like to acknowledge one of our own sitting members, Erda Walsh, MLA for Kootenay, who's been a paramedic for BCAS for the past 17 years and was a regional. . . .

The Speaker: The hon. member will know that we don't name names of our MLAs.

Hon. P. Priddy: Sorry, hon. Speaker.

The member for Kootenay, who has been a paramedic for the last 17 years, was regional vice-president for the Ambulance Paramedics of B.C. Please join me in a round of applause in recognition of these very important front-line providers of health care for British Columbians.

[ Page 13995 ]

C. Hansen: On behalf of the official opposition, we'd certainly like to join the minister in saluting the work of these dedicated professionals from all around the province. Certainly Paramedic Appreciation Week should be going on 52 weeks a year, because I think we all have been in situations where we have had to rely on their services for ourselves or our family members. We join the minister in saluting their hard work and their efforts on behalf of British Columbians.

[1435]

Petitions

Hon. A. Petter: I ask leave to make an introduction, hon. Speaker.

Leave granted.

Hon. A. Petter: Joining us in the gallery are some members of the grade 5 class of Marigold Elementary School in my constituency. They're here with parents and with their teacher, I believe, Ms. Pommelet. I would like the House to join me in making them very welcome.

E. Gillespie: I ask leave to make an introduction.

Leave granted.

E. Gillespie: I understand that Karen Sanford has joined us in the gallery today. Karen Sanford was the MLA for the Comox Valley and North Island area between 1972 and 1986. She has been visiting with her family this weekend in Victoria to attend her daughter's wedding between ball games in the weekend tournament. Could the House join me in welcoming Karen Sanford.

Tabling Documents

Motions without Notice

Be it resolved that the Resolution of this House dated April 15, 1998, dealing with Sections A and B of Committee of Supply, be amended by adding to the said Resolution Section 9.1 as follows:

I move that motion.

Motion approved.

Hon. D. Lovick: By leave, I move that the following bills at committee stage be considered in section A of the Committee of the Whole, namely: Bill 56, Forest Land Reserve Amendment Act, 1999; Bill 71, Finance and Corporate Relations Statutes Amendment Act, 1999; Bill 72, Water Amendment Act, 1999; Bill 73, Private Post-Secondary Education Amendment Act, 1999; Bill 76, Health Statutes Amendment Act, 1999; Bill 79, Land Reserve Commission Act; Bill 81, Regulatory Impact Statement Act; and Bill 86, Park Amendment Act, 1999.

I move that motion.

Motion approved.

Hon. D. Lovick: By leave, I move that Ms. Erda Walsh, MLA, be substituted for the Hon. Moe Sihota, MLA, and that Mr. Gary Farrell-Collins, MLA, be substituted for Mr. Fred Gingell, MLA, as members of the Select Standing Committee on Public Accounts.

Motion approved.

[1440]

Orders of the Day

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

ESTIMATES: MINISTRY OF HEALTH AND
MINISTRY RESPONSIBLE FOR SENIORS

Hon. P. Priddy: I would like to make some introductory comments. Just as we begin, I thank the opposition critic for his cooperation in working out what would best manage the process so that everybody gets to ask the questions they need to ask and so that we can do it in a way that allows our staff to be here.

I'm pleased to present the 1999-2000 budget estimates of the Ministry of Health and the Ministry Responsible for Seniors. While I'm sure that there will be many staff in and out of the Legislature over the course of the estimates, I would like to introduce the three people who are currently here. To my right

[ Page 13996 ]

Our government has made improving health care for British Columbians a number one priority. We've done that for a very important reason. We believe that good-quality, affordable and accessible health care is a right for all people in this province and that as a government we have a responsibility to protect that right. In fact, we see health care as the most important service any government can provide its people. That's why we have consistently spent more per capita on health care than any other province in Canada. While other provinces have cut back in health spending, we have increased our health care budget every year for the past eight years, in spite of federal government cuts. Since 1991-92 our health budget has grown by $2.5 billion. This year again we're increasing our health care operating budget by $478 million and our capital budget by $137 million, for a total increase of $615 million this year. This 6.6 percent increase more than doubles last year's increase and brings total government spending on health care to $8 billion for 1999-2000.

[1445]

It's about being creative and innovative. We have to dare to change. We have to be creative and we have to take risks if we're going to continue this system -- one that, quite frankly, is the envy of the world. We have to act, because pressures on the system are profound, and fiscally we will be incredibly challenged if we do not find new ways to deal with those pressures. Our population is growing and aging. Baby-boomers are about to join the seniors' ranks in a few years -- that's many of us here in the House. That will mean additional pressures that will further challenge the health care system. Expensive new technologies and treatments are coming on the scene. There are escalating drug costs with an aging and growing population, and there are both old and newer diseases to contend with.

Life is changing in health care. When I look back over the last ten or 20 or 30 or 40 years, there were some traditional hierarchies. There were traditional roles for physicians and nurses, traditional treatments and traditional hospital stays. But some of these traditions are changing, and we have to change if we're going to save a system that is truly worth our being able to support. We're in transition, and these are indeed challenging times. After years of cumulative federal funding cuts, I think we have been able to stop federal money from leaving the system and have been able to start to move forward.

We've chosen to respond to the challenges facing our health care system by, first, taking actions to fill some of the gaps created by all those years of federal cuts and addressing the immediate health care priorities of the people of this province, which include adding more beds and more nurses and reducing waiting times, and second, by steering our health care system in a bold new direction, towards a new vision for health care in the future. In the health care system that I and many others envision for B.C., there will be a kaleidoscope of both traditional and non-traditional treatment choices, an array of community-oriented health service agencies integrated closely with local hospitals, and housing alternatives that enable seniors to stay at home, because of home support programs.

We will move somewhat further away from only an acute care system to one which offers a more flexible approach and enables health care professionals of all kinds to work together as a team. It will be a system where highly trained nurses and other professionals take on increasing responsibilities for the health and well-being of people, responsibilities that reflect their tremendous skills and expertise. It will be a system that places a greater focus on prevention and health promotion, to be able to curtail more costly treatment interventions down the road. People will have the tools and information to make healthy choices about their well-being. It will be a system where people might, for instance, have access to health and treatment advice at the touch of a telephone, night or day. They may be able to talk to a nurse by phone, to provide some reassurance to a distraught parent who is concerned at 2 o'clock in the morning when their child has a temperature of 102 and who doesn't know whether to take them into emergency or not.

Seniors will be able to live at home as long as possible with the kinds of support, such as seniors' centres and community centres, that offer a hub of activity and a range of exercise, nutrition and prevention programs. At least for some people, there will be a caring ear to listen and to help break some of the loneliness and isolation that many seniors live in.

It will be a system where hospitals will be available to treat acute care patients because patients who are chronically ill are being looked after in an innovative community housing program. Hospitals will find more ways to find more ways to expand their roles and their reach into communities, especially in the area of follow-up care. It will be a more integrated and flexible health care system that puts people first, embraces a community approach and encourages innovation. Is this idealistic dreaming? I don't think so. Here in B.C. we are on our way to shaping this vision of the future.

Let me outline some of the major steps we're taking to move our province closer to that vision. I must admit, hon. Chair, that normally in estimates I don't actually do much in the way of introductory comments. But I think that this will be an important discussion this year, so I did want to set some context for that.

Reducing wait times and relieving pressure on hospitals is certainly one of those major steps. One of our immediate priorities right now is to restore British Columbians' confidence in our health care system by continuing to take action to reduce wait times for surgery and for other procedures and to relieve pressure on our hospitals. We know that despite the best efforts of our care providers and administrators, there are B.C. children and adults who are facing unacceptable delays in getting the hospital treatment that they need. You know, any of us who've had to wait for needed treatment or surgery or -- and I think this is sometimes harder; it was for my family -- who have had to stand by while a friend or a relative waits for surgery knows that the stress of waiting can be agonizing, particularly when the length of the wait is uncertain.

[ Page 13997 ]

[1450]

Almost $15 million of the funding has been allocated to provide 5,000 more chemotherapy treatments and 5,000 more radiotherapy treatments for cancer patients in high-growth areas of the province. This year more than 17,000 British Columbians -- someone that you and I know -- will be diagnosed with cancer. This new funding will help to ensure that each of those patients has access to the treatment they need to fight this disease as hard as they can and enhance every opportunity that they may win.

Approximately $10 million will be used to fund more cardiac surgeries and procedures. Recent statistics from the Heart and Stroke Foundation of B.C. and Yukon show that British Columbia has the best survival outcomes for heart disease in Canada. Now, we believe we can make those outcomes even better by reducing wait times for crucial cardiac treatments. The new funding will pay for 700 more cardiac surgeries, angioplasties, pacemakers and electrophysiology services for British Columbians with heart disease.

There will be another $6 million spent to reduce the waiting times for people needing hip and knee replacement surgeries. These extra funds mean that 1,000 more British Columbians will have access to the orthopedic surgery they need to regain mobility and resume active lives.

We've also put an additional $1.337 million into the budget of the B.C. Cancer Agency's screening mammography program to pay for 38,000 more mammography screenings, so important in the early detection and treatment of breast cancer in British Columbia women. We're adding $2.75 million annually to our health budget to increase the capacity of B.C.'s seven public MRIs, or magnetic resonance imaging scan machines, by more than 50 percent. This funding will pay for 10,000 more MRI scans across B.C. and ensure that thousands more British Columbians are able to benefit from the best and the most timely diagnostic care.

On top of paying for thousands of more surgeries and procedures, our budget includes an additional $21 million to cover the operating costs of almost 500 more long term care beds. The addition of these new long term care beds will free up acute-care beds in our hospitals and help to relieve waiting times. As well, it provides $273.7 million in funding for capital projects to improve and expand B.C.'s acute- and long term care facilities.

Obviously these increased procedures and additional beds will mean an increased demand for skilled and dedicated nurses. That's why our budget also includes new funds to hire 400 more registered nurses this year in hospitals, long term care facilities and communities around the province. This is the first step in our commitment to bring 1,000 more nurses into our health system over the next three years, at a total cost of $50 million. It includes an additional $5 million to increase the number of licensed practical nurses and care aides this year. More dollars to fund more procedures, more beds, more nurses -- that's an important part of our strategy to relieve the pressures on our hospitals and reduce the amount of time that people have to wait for the treatment they need.

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We've taken action, too, to ensure that British Columbians will continue to have access to the medication and to the medical and ambulance services they need without disruption when the clock ticks forward to one minute after midnight on January 1 of the year 2000. My ministry has invested more than $40 million of its existing operating budget to make the ministry Y2K-ready. We've also given regional health authorities $100 million to prepare hospital computers, equipment, etc., for Y2K. Criteria for the Y2K funding were based on standards developed by the Year 2000 health authority working committee, which included engineers, biomedical experts, regional health authorities and Ministry of Health staff.

The next major step forward is ensuring that we're getting the best value for every health care dollar. These various steps are important and necessary ones. They're helping us to address the most immediate and urgent health care priorities of people and communities across the province. But as I said earlier, we know that we must go further if we're to guarantee a positive future for our health care system and the health of British Columbians. We must make sure that the system is accessible, affordable and accountable for generations to come. That means working with health authorities, health care professionals and our other partners to ensure that we're putting our available resources where they're going to make the biggest difference to people and that British Columbians are getting the very best value for every health care dollar spent in this province.

It is essential that our health care be accountable in two important ways. First of all, we must make sure that the money taxpayers are providing is well used and is spent in accordance with standard accounting procedures. But at the same time, we want to ensure that people have confidence in the quality of the health care they are receiving. It's important that British Columbians know that the care and treatment they are receiving meets accepted standards and has been proven to work. I'm absolutely committed to making sure we have accountability in both of those senses.

My ministry has long had processes in place for reporting to the people of B.C. on developments in and outcomes of

[ Page 13998 ]

In May our ministry completed a strategic plan called "Strategic Directions for British Columbia's Health Services System" -- not for the ministry but for the system -- and sent that out for feedback from the health authorities and other constituent groups. This document sets out parameters and steps to guide my ministry, health authorities, professional groups and our other health care partners in our planning processes over the next three years; it is a three-year plan. It's designed to help us enhance those principles I spoke of earlier: accessibility, accountability, affordability and quality.

One of the most important features of this plan is that it sets out a strategic direction for B.C.'s health care system as a whole, not just for the Health ministry. So some of the strategies identified in the plan will be undertaken by the Ministry of Health, and other activities will involve partnerships and collaborations with health authorities and our other partners. The strategic plan emphasizes accountability and the creation of standards with respect to quality of care and access to care, including what is an appropriate time a patient should have to wait for surgeries and procedures, and what is appropriate in terms of geographic access to a particular service. We'll be working with care providers to establish good measures of quality and to report those to the public.

We've now finished receiving feedback and comments on the strategic plan from health authorities and others in the field. That feedback has been both very positive and very constructive, and we will be releasing a final version of the plan in the coming weeks. In addition, as part of our larger accountability framework, we've asked health authorities to produce three-year service plans that map out how they will deliver care locally in ways that better meet the needs of the patients they serve. These plans are to include proposals for major changes to local health systems that are consistent with the principles of health reform. Regional health boards began submitting their plans this month.

The community health councils and community health services societies are expected to work together to develop single plans for their areas. Since this is a more complex task, their plans are not expected for about another 12 months -- in June of 2000. Following the submission of their first health service plans, health authorities will be expected to keep their plans up to date and to submit annual reports on their progress in implementing any proposed changes.

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As these various planning procedures I've described demonstrate, accountability in health isn't simply measuring and reporting on numbers. Accountability is talking about what good health outcomes are and how we can strive for improvement. That includes encouraging physicians and other health care practitioners to strive to find new and better ways of treating illnesses and health problems, and encouraging health care administrators to strive to find new and better ways of delivering services.

Another major step is finding innovative ways to meet changing health care needs. In fact, we recognize that finding better, more innovative ways to meet British Columbians' changing health care needs is key if we are to guarantee a positive future for our health care system and the health of British Columbians. We've put that realization into action.

The innovation began in a major way with the regionalization of health care decision-making and service delivery. The new regional structure is now in place, and together with people in regions and in communities around the province, we've created a coordinated network of community and regional health authorities. I think the benefits of this regional structure are clear; they are certainly clear in many of the regions that I've visited.

Responsibility for health care decision-making has now been moved closer to the people being served, so their needs can be better addressed. At the same time, my ministry has retained responsibility for standards and policies so that we can continue to make sure that the quality of services available to British Columbians remains consistently high throughout the province.

Now, with regionalization mostly complete, we can step back and take a longer view. We can look at the way health care services are being delivered in this province and concentrate on finding answers to an all-important question: is there a better way? I believe that in many cases the answer is yes, and I don't believe that I'm alone in giving that answer.

There are a great number of examples out there of innovation and action, where health authorities, health practitioners and communities are taking the lead to develop new solutions or adapt existing ones to meet today's challenges. Some of the most innovative are modelling better approaches to the delivery of primary health care, the first point of contact for people entering the system. Strengthening our primary care system is a vital building block in renewing medicare and a powerful way to help individual British Columbians and their families stay healthy.

Let me mention a particularly innovative primary care project that's already underway in the province. This is called the Partnerships for Better Health project. It's a collaborative effort between the Medical Services Plan of B.C. and the capital health region. Under this -- this is wonderful; this is fun -- two-year pilot project, 12,000 households in the Victoria region receive self-care handbooks providing information about more than 180 common health problems. Project participants were given access to a confidential telephone support line staffed by specially trained registered nurses. The nurses who work out of Saanich Peninsula General Hospital can and do talk to callers about anything from a child's sore throat to: "I have chest pain. Should I go into emergency and seek a physician's support?"

Drawing on a comprehensive database of health care information, the nurse can identify symptoms and talk through self-treatment options with a caller, encourage the caller to get appropriate medical care if the problem is urgent or recommend that the person call 911.

The first-year results of the pilot project are greatly encouraging. More than 75 percent of the participants sur-

[ Page 13999 ]

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We're encouraging health authorities, health professionals and health care organizations to come up with other innovative ways of delivering primary health care through our primary care demonstration project. As part of this federally funded initiative, my ministry will be providing support for up to ten primary care demonstration projects across the province. The demonstration projects selected will use a community-based, integrated, multidisciplinary approach for delivering primary care. Each primary health care organization will be staffed by a team of physicians and other health care professionals, such as nurses, social workers and nutritionists. These professionals will work together to provide a variety of coordinated health care services, including information on health promotion and illness prevention. Patients will benefit because they will have better access to a wide range of integrated services in one location as well as information on how to keep their families healthy -- that's prevention and health promotion. Health care professionals will benefit because they will have an opportunity to practise as part of a coordinated multidisciplinary team.

An important focus for me as B.C.'s Minister Responsible for Seniors is to encourage innovative programs and projects aimed at improving the way that we respond to the health care needs of older British Columbians. As you know, 1999 is the International Year of Older Persons -- IYOP, as it's called. I applaud the efforts of the many community groups and service organizations that have chosen to celebrate IYOP with projects and initiatives that address the needs of seniors or recognize the contributions of seniors in their communities.

One of my ministry's major goals is to help seniors maintain their independence -- as we would all want to do, I believe -- and enjoy good health and an excellent quality of life. Let me mention just briefly two innovative joint federal-provincial demonstration projects currently going on that are helping to further that goal.

One project is testing new approaches to help patients, physicians and pharmacists improve patients' use of prescription drugs. The project is focusing on two health conditions that are often inappropriately treated with medications: asthma, and sleep and anxiety disorders. The results of this project will be important for the long term health of British Columbians. Research has shown that when asthma patients are taught how to use inhaled steroids, or anti-inflammatory drugs for the lungs, and take preventive actions to reduce allergens in the home, their health can be improved and their risk of hospitalization reduced. As a recent report in this province found, elderly people are prone to excessive or inappropriate use of benzodiazepines, or tranquillizers frequently prescribed for sleep difficulties. The long-term use of this medication has been associated with falls and confusion.

We're also testing standardized guidelines for congestive heart failure patients as they move from being cared for in hospitals to being able to be in their own homes. Congestive heart failure is the most common reason for the hospitalization of North Americans over the age of 65. By focusing on the important transition period after a patient leaves the hospital, researchers hope to develop guidelines that will both decrease hospital readmissions and improve the patient's quality of life at home.

Those are all ways of ensuring that our system works better for the patients it is designed to serve, but we recognize that it must also work better for the dedicated physicians, nurses, physiotherapists, audiologists, technicians, support staff and all the other professionals who are truly the heart of the health care system. We have to find better ways to attract them, and more importantly almost, we have to find better ways to keep them here if we're going to ensure a healthy system in the future. Here in B.C. we are working to do that as well. We have established an active recruitment agency through the Health Employers Association of B.C., called HealthMatch B.C., which is recruiting physicians to remote and rural parts of the province. We plan to expand its services to include other rural health care professionals.

Of course, recruiting physicians to rural and remote areas is only half the solution. That's why we have a number of programs that need to support rural physicians, including financial incentives to compensate for medical and social isolation, locum relief for vacations and education leave, and enhanced payment for continuing medical education.

We're also working with local health authorities and municipal governments to find ways of supporting their health care professionals. In fact, some communities have been particularly inventive in providing incentives to health care professionals, such as offices, housing, transportation to larger centres, regular weekends away -- things that will make it an incentive to stay in a community. That's being done by some municipalities and communities themselves.

[1510]

Hiring nurses is part of the answer, and as I said earlier, we're doing that. But it's also essential that we make sure that people continue to consider nursing as a career choice. The reality is that the number of new nurses in the province is declining, and there's a real shortage of nurses in some key areas -- not so much geographic but specialty areas. As well, we must provide better support to nurses who are currently caring for B.C. patients. That includes making sure that nurses have the skills they need to keep pace with the changes going on around them.

[ Page 14000 ]

In conclusion, the challenges facing our health care system are very real. To overcome these challenges and to make the changes that must be made if our health care system is to continue to provide the quality of health care that British Columbians deserve is going to take some time. It's going to take commitment and partnership from everybody -- from government, from health authorities, from health care providers and from communities. We need to continue to work together at the community level, in the corporate boardroom, in our schools and in our hospitals to transform the way that health care is delivered.

The encouraging news is that here in British Columbia we are making progress. We are taking actions to address the immediate urgent health care priorities of people and communities across this province, to strengthen our acute care system and to reduce waiting times for surgeries and other procedures. We are making sure that British Columbians get the very best value and the best-quality care from every health care dollar spent, by taking steps to improve our planning processes and to make our health care system more accountable. We're working with our health care partners to find new, innovative and more flexible ways to deliver health care services to meet the changing health care needs of British Columbians and to bring the services closer to people they are designed to serve.

The key now is to keep that progress going, to maintain our momentum, to build on our successes and to continue to tap into new ideas and dare to be creative. We plan to do exactly that over the 1999-2000 fiscal year. We'll continue to move forward to protect and uphold the principles of medicare and to build an affordable, accountable, quality health care system that will meet the real needs of all British Columbians on into the next century.

C. Hansen: I thank the minister for her opening remarks.

I want to start by explaining how we hope to approach Health estimates this year. I've had some discussions with her senior officials and her staff to basically outline the approach that we're going to take, in the hopes that we can ensure that there is a proper review of the work of the ministry and, at the same time, make the most effective use of staff time and resources that have to be available to the minister in the buildings.

First of all, let me say that in past years we've gone a lot more into programs right at the start and then started to look at some of the constituency-by-constituency issues towards the end of the process. We want to reverse that this year, partly to give some of my colleagues an opportunity to raise the issues they hear from their constituencies and to put on the table the real, human face of some of the problems we're facing in health care today.

So for the first part of our estimates this year, we're going to be looking at it on a region-by-region basis. I'll apologize in advance to the minister that we may be jumping around a bit, not because of design but mostly just because of the availability of members who have other responsibilities in the small House and also in committee meetings that are ongoing as we're going through this process.

Before we do that, I want to comment, just very briefly, on the minister's opening comments. Certainly when she talks about the bold new direction for health care and the emerging strategic vision, those words are fine words. I think that somebody who was perhaps not familiar with some of the challenges of B.C. health care today might take reassurance from those words. But I think as we go through these Health estimates we will be trying to point out areas where we feel that the vision is not there, where the accountability is not there and where there is a lack of enunciation of that bold new direction the minister was referring to.

[1515]

That's regrettable in a couple of contexts. First of all, this should be the key document in terms of reporting on the work of the ministry. I appreciate the minister's comments that she made in her introductory remarks about the various accountability documents that are there. But the annual report of the ministry should be the key one, and it should be the one that anybody that wants to review the work of the ministry should go to first. Now we have a document. . . . The most recent one that's available is for the year that was basically started three years ago, and I don't think that's acceptable. Quite frankly, when you start tabling annual reports that are three years old, you might as well send them straight to the archives rather than putting them forward as a legitimate accountability document.

The other thing that's important about the annual report is the number of recommendations that are coming through. I can think of some very specific ones from the auditor general, where he recommends that the annual report be the vehicle through which accountability is upheld and reports are made to the public. I believe that the annual report is something that has to be far more topical. When we get into that section of the workings of the ministry -- when we get down to communications and issues management -- certainly I will be looking for some commitments from the minister that that particular document will be forthcoming in a much more timely fashion.

The second document that I feel should have been available to us by now, because I think it's a very important issue facing British Columbians and should become the focus of at least a portion of our discussions in Health estimates, is the continuing-care review. The original target deadline for the report of the continuing-care review committee was the end of October last year. That was extended until the end of March of this year for, I think, the right reasons, in that the draft documents that were circulated were not seen to reflect input from caregivers and those who were on the front lines of delivering continuing care. Hon. Chair, I understand that that report is

[ Page 14001 ]

The third one that I find it unfortunate that we don't have access to is the report card on Better Teamwork, Better Care. Last year in Health estimates, the issue was raised about the requirement for an annual report card on the performance of health authorities. As we go into this first section, which is really going to centre around the work of health authorities, this particular document would obviously have been very valuable to us.

I just want to quote back to the minister her words from July 16 last year, when we were in Health estimates. She said: "I believe the commitment given to Public Accounts" -- being the Public Accounts Committee -- "was that there would be a report card by the end of this calendar year." That is a document that the minister had promised to us by the end of December last year. Perhaps, to turn a phrase that the minister used during question period today, this was a case of a promise made and a promise not kept. Perhaps that's as good a place for us to start as any -- if the minister could tell the House why that particular accountability document was not prepared and released by the end of December.

[1520]

C. Hansen: As we proceed through this, I see us starting with regional programs. Later on we will be getting into the issues of continuing care, and even later on in the process we'll be getting into communications programs, which include the annual report. Certainly I will have some very specific questions about the continuing-care review, and I'll have some very specific questions about the annual report when we get to that stage. But given that we're going to embark on regional programs, perhaps we can deal with this one, on the annual report card.

Hon. P. Priddy: I did hear the member read from. . . . I don't know if it was from Hansard or from comments around the Public Accounts Committee. We had made a commitment, I think, to begin to report out, in a report card kind of way, on regional health authorities. We are not at that stage yet. We are working with health authorities. We can report out, hon. member, on wait times in different regions. We can report out on their budgets. We can report out on their progress in a variety of areas. But we cannot in a complete way -- until we finish the strategic plan -- identify very specifically the kinds of things that need to be reported on.

In my meeting with health authority chairs a few weeks ago, actually, we talked about what kinds of things you could actually measure. Could you measure the number of days in hospital after gall bladder surgery? Could you measure the number of people who picked up some kind of infection in hospital? Could you measure the number of rehospitalizations? So we're actually talking with the health authorities about those much smaller things that can be measured.

But in terms of report-carding on the regions, there is the annual report from each region, which is available. There is the wait-time report, which is available. There are the financial reports, which are available -- the financial data, which is available -- and there's the statistical data. All of this information is reported out by the health authorities.

We're not at a report card stage yet, and I don't know, having spent a year in the ministry, whether report card is the right kind of word to use. Nevertheless, we're working with the health authorities on all the things we can measure in -- I always use my own example -- the South Fraser health region and the things we could legitimately measure and report out to the public on, and then how we can add to those this year. The health services plans are coming in; that's another way of measurement. As I say, we have a variety of statistical data, including workload, personnel data, surgical waiting time data and so on, which is all available in print from the regions.

C. Hansen: This particular report card is a very specific document that. . . . As I understand it, a commitment was made to it at the time when the Better Teamwork, Better Care was first announced. So we're going back two years. Just to read to the minister the exchange that took place last year, my colleague from Okanagan West stated: "In the Better Teamwork, Better Care announcement there was a provision for an annual report card on the performance of the health authorities. We haven't received one yet, and I'm wondering when we can expect that minister's report card." The minister then replies, and I'll quote the minister's own words back to her: "I believe the commitment given to Public Accounts was that there would be a report card by the end of this calendar year." There are other references made to it in the Hansard from last year.

Talking about the various reports that are being done doesn't put it in the context of the ability of the public to assess the work that is being done by health authorities and whether or not the whole regionalization process is working. Certainly it's been going through a lot of turmoil. That whole process of accountability back to the public should be done in a way that allows the public, on a consistent basis across the province, to see whether or not regionalization is working for them in their region.

Perhaps I can ask the minister: in terms of the development of this kind of accountability document, who's putting it together? She mentioned that there were discussions with health authorities. But I must say that I have talked to a lot of health authorities around the province about this very specific document, and basically they are not aware of any initiatives or moves. No one has been asked for input on what might go into this kind of an accountability document. Perhaps the minister can explain: when she indicates that health authorities are working on this kind of accountability, who is it that's working on it?

[1525]

I will say, though, that the commitment made by the previous minister around a report card is not in that shape. Is

[ Page 14002 ]

I'm not saying, by the way, that the public does not have access to regional data. They do. But they don't have a piece of paper that says: "In your region, this is what's happening." Although they do have it. . . . For instance, my region is having its annual meeting tomorrow night. They have all of the information laid out for the public around hospital days, hospital stays and seniors, that they've seen. That's all laid out in the annual report that will be presented to the public tomorrow night. But it's not in a consistent way throughout the province. It should be. That's the work that the ministry is doing with staff and that I've been doing with health authorities. Should it have been done earlier? It probably should have been, but it wasn't. We are trying to make it as easy to read and to measure as we can.

C. Hansen: Could the minister tell us when we should expect this to be completed? This time last year we were told to expect it by the end of the calendar year.

Hon. P. Priddy: We were just having a discussion about what would be both reasonable and achievable, since some of our dates have not been achievable. I'm trying to make sure that I give you an answer that is something actually achievable. My deputy assures me that that information will be available in the 1998-99 annual report.

C. Hansen: That's not very much assurance, considering that we never know when to expect annual reports.

I'm going to come back to this issue. But I do want to move on to some of the constituency issues, so that we can perhaps put a real human face on some of the discussions and problems that British Columbians are experiencing. So I will turn it over to my colleague from Okanagan-Boundary for now.

B. Barisoff: My first question to the minister is: the long term care situation in the Okanagan-Similkameen is actually in a crisis situation. It's gone beyond the realm of being something that we can deal with any longer. According to our figures, we're 365 residential beds short in the South Okanagan. I know that the minister has initiated 60 long term care beds to start, but I'm just wondering what the minister's planning to do with the fact that this would still leave us short 300 long term care beds in Okanagan-Similkameen.

[1530]

B. Barisoff: Well, I think one of my concerns is that right now, in the present state, acute-care beds are being used -- not only in the South Okanagan, and I'm sure my colleague from Okanagan-Penticton will refer to the situation that's taking place in Penticton -- by long term care people. I'm just wondering. . . . The minister talks about dollars and cents. If you compare what it costs for them to utilize a long term care bed versus an acute-care bed. . . . Can you justify it or tell me what. . . ? There's got to be some answer to that.

Hon. P. Priddy: I wish there was an easy one. There are people in acute-care beds, although we did provide, not all that long ago, $10 million throughout the province to provide some alleviation for that -- for hospitals or health authorities to be able to purchase long term care beds. There are places where long term care beds are being purchased by the health region in order to move people from acutecare beds who don't need to be there -- and don't want to be there, I'm sure -- into more appropriate environments. But I also go back to the whole idea of what we can do to support seniors in their homes or what we can do to provide some supported housing that isn't nearly at the level of long term care but does provide enough support for seniors to be able to maybe live in a congregate setting, if that's their wish. We have to be able to look more at that as well. But it makes no sense -- and the member is correct -- to have acute-care beds filled with people who don't need acute care.

B. Barisoff: The Okanagan-Similkameen has probably one of the highest per-capita rates of 65-year-old-plus people in the province. And if you compare the funding throughout the province, we probably have one of the lowest per-capita fundings. I'm wondering whether the minister has looked at this inequity that has taken place, probably not only in Okanagan-Similkameen but in the entire Okanagan, and whether there's a move afoot to balance that up with the rest of the province.

Hon. P. Priddy: Yes, there is. In point of fact, that began this year with an attempt around residential beds, if you will -- to provide more dollars to high-growth areas of the province, which the Okanagan-Similkameen is, at least in terms of high growth for seniors. So yes, we have begun that.

B. Barisoff: It's my understanding that the recent announcement of funding for the 60 long term care beds in Okanagan-Similkameen is operational dollars only. As we're still 300 beds short, will any of the remaining beds be funded as new capital projects?

[1535]

B. Barisoff: This is a question that I asked last year, but I'm obligated, I think, to put it back on the record again for this year. The Society of Obstetricians and Gynecologists of

[ Page 14003 ]

Hon. P. Priddy: We have been working with the provincial perinatal group -- which meets or operates out of Vancouver but is made up of folks from around the province -- to ensure that there is support provided for perinatal services in smaller communities.

B. Barisoff: Home support services in rural areas, due to geography and travel time costs, are presently inadequate, particularly in the Grand Forks area. What is the minister doing to remedy this?

Hon. P. Priddy: I'm sorry, member -- I can't speak to Grand Forks specifically, but there was over a 3 percent increase to home support services across the province this year.

B. Barisoff: There's a lack of trained home support workers who can provide home care services, particularly in the west Boundary area. There's a desperate need for trained workers. Courses run alternately between Grand Forks and Castlegar. I think it should be in Grand Forks this year, but for some reason, they're putting it in Castlegar. I guess my question to the minister is: if there's such a need in the west Boundary, particularly in Grand Forks, why would they shift it to Castlegar and not leave it in Grand Forks?

Hon. P. Priddy: When the West Kootenay-Boundary plan comes in -- although I must admit that because it's a CHSS-CHC, it will be longer coming in -- we will look at the reason they have made that decision. That's a decision that's made locally. I do know, from my own teaching of home support workers, that there are lots of ways to offer that, either by distance education. . . . It doesn't always have to be on site. We'll review those plans when they come in, to see if there's a specific reason or rationale behind why it's being offered in one place and not the other -- or indeed whether there's an educational way to be able to provide it in both places.

B. Barisoff: I think that my concern, of course, is that if it was alternating and then all of a sudden, for whatever reason, they chose to go into Grand Forks. . . . I am concerned about it. The long term care situation in Grand Forks, of course, is another one. There are 35 to 40 people on the list in the Grand Forks area, and I'm just wondering whether the minister has looked into that situation to see if there's anything that can be done.

[1540]

B. Barisoff: One of the issues that I think I've brought up since the day I got here is the Keremeos multilevel-care facility. I know that they're getting closer and closer. I'm sure there's some real concern that if they don't go to working drawings so that they can go to tender early in the fall, they probably won't get it in the ground until next year. Could the minister give me the status of where the Keremeos multilevel-care facility is at?

Hon. P. Priddy: I've checked with staff. They don't have that one with them, but we can have it for you after dinner.

B. Barisoff: I would really appreciate that, because it's been an ongoing thing for the last ten years.

One of the other real concerns that I have, coming from a rural area, is the sustained funding for the rural hospitals, in particular Oliver and Grand Forks. Another one that's been brought to my attention is the one in Princeton. They are all about equal in size. I'm just wondering whether the minister has made any commitment to these small rural hospitals that the acute care beds and the funding will be sustained in the coming years.

Hon. P. Priddy: Yes, funding will be sustained to the smaller hospitals.

B. Barisoff: Maybe the minister could elaborate a little further to assure me and the constituents of Okanagan-Boundary and the Princeton area that the acute-care facilities of these small hospitals will not be depleted and downgraded lower and lower all the time. It seems like every time they turn around, there are a few more beds being taken away from them. I just want to get more of an assurance from the minister than simply that they'll be funded.

Hon. P. Priddy: The funding will be sustained, hon. member. The decision about how that funding is used within that hospital is a decision of the local health authorities, not the ministry. But our commitment is to sustain the funding.

B. Barisoff: I just have to also put on the record that the number of calls that I get about the surgical waiting lists seems to growing almost on a daily basis.

[1545]

The drug has been available for at least a year. It's not been the be-all and end-all for Alzheimer's. The side effects

[ Page 14004 ]

Now, hon. minister, this lady called me, and from what she's saying, I believe that she feels very strongly that the $156 a month is certainly not going to break her but that a lot of people would end up institutionalizing their loved ones rather than looking after them at home. I'm just wondering whether the minister has looked into this, so that she could, in her case, keep her husband at home for in excess of another year. If you look at the costs of being in acute care or in long term care -- between $500 and $800 per day -- it seems not an awful lot to have these people at home. It seems almost like a false economy that we wouldn't be looking at cases like this where we'd keep these people at home. It would be a lot better for all concerned and actually be quite a cost saving for the Ministry of Health.

Hon. P. Priddy: Yes, as a matter of fact, I have. At the request of a number of people. . . . People have written in at the request of some of your members, actually. The member for Richmond East has a particular interest in this as well. There are not many provinces -- although you're correct that Ontario does -- that cover it as a first-line drug. Just currently, actually, the therapeutics initiative committee is reviewing Aricept yet again. They have reviewed it twice. They reviewed it last, I think, in November of 1998 and still did not recommend it for use -- not because it was unsafe, but because they did not believe that there were enough therapeutic and economic benefits to it. However, because of the concerns that people have raised, they are currently reviewing it again at my request.

B. Barisoff: Could the minister give me an indication of when that review would be done and when an answer forthcoming to anybody can. . . ? Is it a week away, a month away, a year away? Do we have any thought of how long it might take?

Hon. P. Priddy: No, I don't. I'm sorry -- I don't know the length of time that those reviews take, but I'll get that information to the member during these estimates.

If I might go back to a question that you asked earlier, member, around Keremeos, I think it's a $7 million project. It's a major replacement and expansion. Expected completion is October '99, I believe. That's planning -- sorry -- for October '99. So it's going ahead.

B. Barisoff: I'd like to say that I've heard that it's in planning. I've got that answer a number of times. I think the people of Keremeos would like to know exactly when they're actually going to be able to go to tender and when they could actually believe that commencement of construction would start. Is the minister saying that construction will be starting in October of 1999?

Hon. P. Priddy: No, I'm not. What I'm saying is that -- as the member knows, it's an approved project -- the planning, the drawings and so on will be completed in October of '99. Then I expect it would go to tender in the following fiscal.

[1550]

The next issue that I want to bring forward is an issue that was called in this morning. It's an urgent situation. I'm not going to use the name, but I will give the minister the letter when I'm done. It has to do with a response written to a lady -- who was very desperate this morning -- and her mother. It was a request for funding for transmyocardial laser revasculation in Seattle, Washington. This is a letter from the minister's office. It says: "I can appreciate that this will be a disappointment to you and your patient. If you can provide the documentation that it is no longer an experimental investigational treatment, the plan would be pleased to reconsider the request."

The reason I'm bringing this forward, hon. minister, is the fact that according to the doctor this morning, it is a desperate situation. She probably cannot go through another open-heart surgery type of situation. Rather than using the name, I would ask the minister, if I was to pass this letter on to her, whether she would give me the assurance -- and I know that she's going to be tied up in estimates -- that her staff would immediately look at this, sometime today.

Hon. P. Priddy: I'm just trying to think of who I have and what they can do in the next couple of hours. I will give the member assurance that we will look at the letter immediately. But I would say that we do have a policy that if it is still experimental treatment or surgery, we do not normally fund out of province. But I will have someone look at it immediately.

B. Barisoff: I guess when you get a specialist from anywhere -- from Vancouver, as it happens to be -- who is that concerned about this patient. . . . I appreciate the fact that the minister will look at it immediately.

Summing up some of the things that are taking place in Okanagan-Similkameen. . . . To remind the minister, we do live in rural communities. A big portion of this province is rural. People in those small hospitals in the South Okanagan, as the minister has indicated particularly and like I mentioned before -- the hospitals in Oliver and Grand Forks, and including the one in Princeton. . . . To make sure that we don't forget that these rural communities are important and that we look at most of these things that are happening that. . . . It's easy to say that they can travel to Kelowna or to Vancouver or to wherever it might be to get some of these services. But I think that ultimately we have to make sure that we look after the rural people of B.C. and particularly some of the issues that I've brought forward. I appreciate the fact that the minister will be looking at these. I'll pass this letter on to her immediately, and I thank the minister for her comments.

Hon. P. Priddy: If the member wants to pass the letter across the floor or has an additional copy -- if you wish to keep a copy -- we can get someone to start on that work immediately.

I appreciate your comments, by the way, about small rural hospitals. I know that sometimes it seems like most of us are city folks and may not have the kind of appreciation. . . . The first hospital I worked in was in northern Ontario; it was

[ Page 14005 ]

P. Nettleton: I have a couple of questions for the minister with reference to issues of a regional nature. My questions should be viewed in the context of the withdrawal of services by the northern and rural physicians, which commenced in excess of a year ago and concluded roughly a year ago.

[1555]

In terms of the most recent crisis -- if I may use the word crisis, because I think it is that -- residents of Prince George in particular, in this instance, are faced again with a problem which is tied in very much to the whole question of the ability not only to recruit physicians to northern and rural communities but to retain physicians in those communities. Bear in mind that Prince George is a vibrant, thriving northern community that has in excess of 80,000 people, so it's not exactly a small community in that sense. But in any event, it is still faced with many of the problems of the smaller northern communities. Currently an estimated 5,000 to 10,000 Prince George patients could be without a family physician this summer, because as many as five doctors may be leaving the city in the next few months.

Dr. Peter Gorman, head of the department of general practice at Prince George Regional Hospital, is quoted as saying: "This is totally unprecedented; there has never been a situation like this here before. We have always been able to fill family practice physicians."

Spokesperson Renee Foot of the Northern Interior regional health board, when questioned as to when the board would develop a strategy to recruit doctors, made the comment: "We're not at a point to discuss what strategies we're going to use." This is a spokesperson for the Northern Interior regional health board. Stephanie Slater, communications official with the Ministry of Health, has meanwhile indicated that the ministry does not have a specific plan in place to address the situation.

My only comment -- not only in light of the response of the two spokespersons for the different agencies but in light of our experience in the north in terms of the government's seeming inability or unwillingness to recruit and retain physicians -- is that it's time that the minister directed her staff to develop and implement a strategy to recruit and retain doctors in northern communities such as the communities that I represent. It is not enough to say that the regional board will address this most recent crisis in health care delivery in the Prince George region. It's not enough to say that doctors themselves are responsible for recruitment. The minister and her ministry must provide leadership, and in coordination with the regional board -- yes -- physicians and other health care providers must move to address the underlying problems which have led to this crisis in health care delivery.

My question, then, to the minister is this: when will the minister act to provide the leadership necessary to provide a strategy to ensure health care delivery for residents of northern British Columbia?

Hon. P. Priddy: I cannot comment on the person from the Northern Interior health board's comments. They puzzle me a bit.

[1600]

Now, you're talking about a larger city, which may have a different set of reasons. These are smaller communities, which is what Dobbin addressed and what people were concerned about. I'm not sure about the uniqueness of what we're currently seeing in Prince George. We can't stop people from. . . . The example used earlier in question period was the one of people going to the United States. I think that's a difficult one. We're not in a position to compete with the United States, because we actually have universal health care here. Can the United States pay more, have people work less and have 40 million people not covered by health care? Sure they can. If that's where people choose to work, that's up to them. We can't do that kind of dollar-for-dollar competition with the United States.

In terms of the uniqueness -- if indeed that is correct, and I have no reason to doubt the member's statement -- of having family physicians leaving Prince George in that number, then. . . . When I asked about the question when I first heard about it, what I understood was that there were actually at least two physicians interested in going to that community. I don't know if that's concurrent with something that the member is aware of as well. Although these things happen, and you have what I think is somewhat unusual -- five physicians leaving -- the overall physician-to-population ratio in rural and remote parts of British Columbia has actually increased -- not very much, by the way -- a little bit between 1994 and 1998 and is a bit better than it was before.

I have asked the ministry to look at the Prince George situation. I did understand that there were two physicians. As I say, HealthMatch B.C. is a really important strategy and has placed physicians in all of those communities -- both GPs and specialists.

P. Nettleton: I would say that it's small consolation to the residents of Prince George who are faced. . . . Somewhere in the range, as I say, of 5,000 to 10,000 patients are estimated to be likely to be without a physician over the course of the summer. It's some small consolation, I suppose, to know that in fact a number of physicians have moved outside of the cities to the smaller and rural communities.

Again, in light of our most recent experience with the withdrawal of services by physicians -- who pointed again to the problems with reference to recruitment, certainly, and also the retention of physicians -- it seems to me that it's time

[ Page 14006 ]

The minister pointed to her experience in rural Saskatchewan. It is my hope that that experience is not so far behind the minister that she has forgotten what it's like to live in a small town in rural Saskatchewan. Perhaps it would even be helpful if the minister were to travel again to the north and reacquaint herself with some of the people who are directly involved in health care delivery and listen to some of the experiences and frustrations of not only physicians but of others involved in health care delivery, to gain some sense of what is needed to develop, as I say, this overall strategy for a long-term solution. I should also say that the man who's currently Premier of this province made a commitment about a year ago, during the course of this dispute, that there would in fact be long-term solutions put in place to ensure that northerners did have access -- the kind of access to physicians, and health care generally, to which they have a right and to which folks in the lower mainland have grown accustomed.

[1605]

What you've indicated is a very different kind of problem -- in a city of, I think, 80,000 people. So what can people from Prince George expect? They can expect HealthMatch B.C. to be working with Prince George. I know that there are two physicians who've been contacted who are interested in going there. I know that people are working on that. I know that the Northern Interior regional health board was given $250,000 in their base a couple of years ago for recruitment and retention purposes. I also know that, aside from Vancouver and Victoria, Prince George has the next-highest ratio of family physicians to patients in the province. So it's not as if people started out with a very low ratio of patients to family physicians. Only Vancouver and Victoria have a somewhat higher ratio than that.

Do those people need to be replaced? Of course they do. Will we work as hard as we can to do that? Yes, and if there are different recruitment and retention strategies required in a city of 80,000 people, then we'll need to look at that. As you know, the focus in the past has been those smaller rural and remote communities. We'll continue to work with the Northern Interior regional health board to do this.

P. Nettleton: The minister did bring up the issue, and I will make reference, as well, to the specialist who recently left town -- who is, as I understand it, on his way to the United States -- Dr. Roy Hobbs. He had practised plastic and reconstructive surgery in Prince George for some 11 years. He stated that his reason for leaving is because health care is rationed so badly here that patients can't get surgery and surgeons can't work. At the time he gave notice, Dr. Hobbs had a waiting list of 453 patients. At only seven hours of operating time each week, he was the third such specialist to announce an intention to leave the province in a three-week period during May. My question to the minister is: is the minister listening to what specialists like Dr. Hobbs are saying? What are you doing to address the concerns of specialists like Dr. Hobbs, who are looking southward to other jurisdictions?

Hon. P. Priddy: When I talked earlier about the people who'd been recruited through HealthMatch, of those communities I mentioned, two of those are specialists. We are indeed recruiting specialists as well. The fact that there are 58,000 more surgeries and procedures this year means that there is more OR time and that there are more dollars for those kinds of services. So we are working very hard to address the needs of physicians who indicate that they don't have enough OR time to be able to be able to provide the service to their patients. As I say, a 13 percent increase in surgeries and procedures makes quite a difference, and should to any specialist who's looking for that.

P. Nettleton: Briefly, if I may, I'd like to share an experience with the minister -- a Prince George experience -- and ask for some comment:

"A WCB patient came to the hospital shortly after lunch with a traumatic amputation of his left middle finger requiring further revision amputation. He was booked in the OR, and by the time I came in to see him at 5 p.m., he had already been waiting two to three hours on the OR waiting list, which was totally out of sight. It was unlikely that it would get done that night. The anaesthesiologist was out in the ICU putting in lines and had been out of the OR room for at least an hour before looking after more urgent cases.

"I asked one of the three nurses to come out and help me in the emergency room to do this revision amputation. Not one of the three nurses would come out because they were too busy, they said, doing other work. I asked the emergency room nurses to help me to at least set up the room to do this revision amputation, and none of them could even do that, let alone help me with the case. So I ended up spending a total of almost two hours doing a very short case without any nursing help whatsoever from either the operating room or the emergency room. I ended up doing it in the out-patient department by myself. This is Third World medicine at its best."

[1610]

P. Nettleton: I would be happy to share this letter -- and a stack of letters very similar in terms of the experiences of doctors and physicians in Prince George -- with the minister. I will certainly do that.

One other issue, if I may: a gentle reminder and a request for an update, with reference to replacement for the Omineca

[ Page 14007 ]

Hon. P. Priddy: I must admit to the member that I have told lots of people this story. It's actually quite unique, you know: you get flowers ahead of time to remind you that there's a capital proposal coming in for the region. I must admit it's strategically very interesting. I know that the regional health board, whose capital budget we got for next year, listed that as a top capital priority, so that will go into the mix with the other requests for capital for next year. I know how strongly people there are feeling about it.

Gosh, if that's for Omineca, my staff just reminded me, the $43 million hospital in Prince George should have got -- gee, I don't know what -- a garden, a truckload or something. But I do appreciate the strategy. I do know they've submitted it as their top priority, and we'll be looking at that when we look at the mix.

R. Thorpe: I would like to pursue some questions with respect to the south Okanagan and, in particular, the riding that I represent: Okanagan-Penticton. The first subject I'd like to talk about is joint replacements. I would like to know, to start with: has the ministry established regional goals for waiting lists for joint replacements?

Hon. P. Priddy: We don't have that by region, and I'm not sure that that's what we'll actually see. The orthopedic committee, which is currently working -- and just beginning the work -- on the standards, would expect to see standards like a provincial standard, not a standard for a joint replacement in Penticton versus a standard for a joint replacement in Kaslo or somewhere else. It would be a provincial standard that they would come up with.

R. Thorpe: I can appreciate why we would have a provincial benchmark. Surely, to build a provincial benchmark, we're going to need regional benchmarks. We don't have the same demographics of our populations spread equally throughout British Columbia. How can we measure ourselves against one standard for the province -- unless we want people just not to have comfort, or expect them to be able to tell us that demographically it's different in each region of British Columbia?

Hon. P. Priddy: I think that while the demographics may differ in terms of the need of a particular region. . . . There may be more people in a region that has a large number of seniors who require a joint replacement. That's one thing; that's demographics. But I don't think we would have a standard that says that because you have more seniors in your area they should expect to wait longer -- or, of course, if you have fewer seniors in your area they should expect to wait a shorter period of time. We do need to know the numbers of people and the demographics from that perspective, but I'm not sure it would make sense to me that there should be a different length of time people ought to wait, depending on where they live.

[1615]

R. Thorpe: Can the minister advise, then: are we going to fund differently for each region of the province because we're going to now measure ourselves against the provincial benchmark?

Hon. P. Priddy: Two things. As a sort of background comment, if I might, the provincial orthopedic panel is developing standards for both access and urgency -- not only how long you wait but what kind of orthopedics may be more urgent, if you will, than another one.

It is quite possible that you would fund differently. If you have a higher degree of need in one part of the province and if you have orthopedic money available, then more of that money will probably go to where the need is greater. That's not the same as having a different waiting time or benchmark, but it does mean that if you have more people -- we've seen that in other areas -- there would be more dollars directed to that region. That makes sense.

R. Thorpe: I do understand that if you have a benchmark for the province in which you say everyone should be treated fairly -- which I agree with -- but then you have demographic disparity from one region to another. . . . I thought I heard you say that you were going to fund to that. I don't believe you're funding that way at the present time. When is this new method of funding going to take place?

Hon. P. Priddy: We may be talking about two different things, so let me give you two answers and hope one of those will meet your needs -- or not.

If you're looking at trying to do a benchmark for orthopedic surgery and you know you have additional wait times, then if we found additional dedicated dollars for that -- as we have for cardiac surgery or for MRIs -- then it's quite possible that an area that has a greater need would get a greater amount of the dollars. That's very targeted, though, member. That's very specific -- in this case, about orthopedic surgery.

If you're talking about generalized funding by demographics -- or by population and demographics, because it's really about growth and demographics -- then what we are currently doing. . . . I'm open to ways to do it differently, but I haven't found any yet, except ones that take money away from people. Any new money we put into the regions is based on population and demographics, but that doesn't go back and adjust the base that has been there for the last however many years -- ten years or 20 years or whatever. But for the last five years, any new dollars that were added to the regions were based on population and demographics.

R. Thorpe: What are the acceptable benchmarks for wait-lists for joint replacements in British Columbia today?

Hon. P. Priddy: There are no acceptable or recognized benchmarks anywhere in the country. That's why we've asked our orthopedic panel to do exactly what they did for cardiac, which is to establish benchmarks. There are none here, and there are none in Canada. That's the work of the panel.

R. Thorpe: When will that work be finished?

Hon. P. Priddy: I'm told by staff that we'll probably have our first standards by spring.

[ Page 14008 ]

[1620]

How do you establish, in your funding allocations to the various regions, how much money is going to be spent on joint replacements?

Hon. P. Priddy: At least for the area of hips and knees, if you will, in terms of joint replacement, that is money that goes into the base for the health authorities. It's done in consultation with the health authorities, around what their need is and what their capacity is. Can we always meet the need? No, we can't. But we ask what the current need is and what the capacity is to be able to do that. Then that money goes into the base. But at least in tertiary care that money is circled, and that isn't money that can be moved from one place to the other.

R. Thorpe: I believe that the information that you have published on your web site, dated June 23, says that the median wait for hip replacement is 18 weeks and that for knee replacements it's 20.9 weeks. Both of those are increases from a report of May 10. Let me, if I could, now try to paint a picture of what is actually happening in the South Okanagan, particularly with reference to the Penticton Regional Hospital. If I could, let me just read this letter from a Mrs. Dorene King of Summerland, British Columbia, into the record. This letter is dated June 16.

"Dear Mr. Thorpe:

"My name is Dorene King, aged 75 years. I have been waiting over a year for a knee replacement. I am on a 'waiting list' with the orthopedic surgeon Dr. Tatabe. He put me forward on the list as a priority. However, he says it may still be another six months before I can have my operation. I understand the government promised more money for joint replacement surgery, but it seems this money was given to the overall health requirements instead of joint surgery. I am in constant pain with my knee and find it hard to sleep at night. Is there any way you could help this old age pensioner? I need a new knee to enjoy what few years I have left on this earth.

"Thank you kindly for your consideration."

"Yours truly,

Dorene E. King"

[1625]

I guess my question is because the minister or the government has made several announcements on reducing wait-lists. The reality in the communities -- and in my community -- is that the seniors are not having their surgeries done. They're not having them done in 20.9 weeks; they're not having them done in 18.0 weeks. It's over a year for many of them. How is this government addressing this issue?

Hon. P. Priddy: The first thing that we've worked to do is to try and establish some accurate data in terms of how the information is collected -- how different hospitals and physicians collect their data. But I would not suggest that it's nearly as easy as that, nor would I be disrespectful enough to do that. The other way that we're doing it is by funding 1,000 more orthopedic surgeries this year. I don't know the information that your constituent has been given, but it has not gone into general revenue; it has not gone into the general health base. It's orthopedic money; it's circled as that, and there are 1,000 new surgeries being done this year. I think that that is a very good first step towards addressing people's needs.

R. Thorpe: How many of those 1,000 surgeries are targeted at the South Okanagan?

Hon. P. Priddy: I don't know that at this current time, but we can have that for you this evening.

R. Thorpe: Thank you. I look forward to getting that this evening.

Is there an action plan to address this severe problem in British Columbia and, in particular, in the area I represent? Is there an action plan to deal with this in your ministry's business plan and in the estimates we're here debating? Is there an action plan to address this issue this year -- how we're going to handle it -- and how we're going to handle it in the future? Is that addressed in your business plan?

Hon. P. Priddy: I guess there are two pieces to this. One of them is through the planning of the South Okanagan board, which submits to us the information about what they intend to do with the dollars, what the unmet needs are, and how they, within their budget, intend to meet those needs. Secondly, as a provincial strategy, we're doing 20 percent more surgeries in this area -- in the orthopedic area -- this year than we did last year. That's an extraordinary number more. That's a very significant increase that I don't think you would actually see anyplace else. We'll get the information for you after dinner about how many of those are actually in the region that you represent, but I would suggest that the action plan currently is the 20 percent increase in orthopedic surgeries. Part of the long term plan is the work of the orthopedic panel, and part of the long term plan is the plan from your health region -- right? -- which informs the business plans of the ministry in terms of increased surgeries.

But I would also suggest that -- perhaps I digress; I'm always sorry when I do that -- some of the things. . . . Moving away just a little bit, if I can, from the joint replacement surgery, there's a lot more that we as a health community -- both the ministry and local health services, etc. -- can do around the areas of prevention: preventing falls and preventing some of those needs for orthopedic surgery that we see. So there are some prevention and health promotion things that we should be doing as well.

[1630]

[ Page 14009 ]

I want to ask this question again, because I'm not getting comfort from the answer. In your strategic business plan this year, have you identified that there is a crisis in certain parts of British Columbia, based on the demographics, for hip and joint replacements? Have you identified that there is a problem? Are you going to address that problem with results this year? Or is it just going to be more gobbledegook and "we're going to deal with it in the year 2001"?

Hon. P. Priddy: A 20 percent increase in orthopedic surgeries this year, I would suggest, is a plan to address the crisis that you talk about.

Secondly, with the greatest of respect, I realize that the people you're talking about are seniors, and while you may not be able to do as much prevention with seniors, much of what happens with falls either comes as a result of medication that seniors are taking inappropriately -- not intentionally, of course -- or comes because of geography, or comes because if we could do far more balancing activities with seniors, we'd lessen the occasion of falls. So I wouldn't want to suggest that. . . . At least, I would hope nobody would suggest about me that if I get to be a senior, that's over, and there's no point in doing any prevention and health promotion -- that you can only do that with younger people. I don't think that's accurate either. But a 20 percent increase in orthopedic surgeries this year is indeed a first step in a good plan.

R. Thorpe: Twenty percent of 181 is 36 -- that's what it is. I've probably listed that many people that have been waiting a year already. What I'm trying to suggest is that there is a crisis in this part of British Columbia. It is my responsibility as the MLA for this area to bring that forward to this House. Is the minister then saying that 20 percent is all her government is prepared to do and that there is no other planning or action taking place in the business plan for this year to address waits that are over a year? "It's 20 percent. Those over that, too bad; you wait till we decide to do something else." Is that what's in the action plan?

Hon. P. Priddy: I believe that the member just said that 20 percent would be 36. Is that what you said?

Interjection.

Hon. P. Priddy: The number of additional orthopedic cases in your area is 100, which I would suggest is significantly more than the 20 percent that you've asked about.

R. Thorpe: Perhaps I should advise the minister that I only represent part of the health region that she's referring to. In Penticton it's 181, if you care to check the record. Now, 20 percent of 181 is 36. I don't need a lesson from the minister on how to do math. The lesson I want from the minister here is: what is her ministry going to do to help these seniors that are having to wait over a year to have the surgery done? That's the answer I want. If you're going to do nothing, stand up in this House and tell them that you're going to do nothing.

[1635]

R. Thorpe: How much in this year's Health ministry budget is being spent on advertising telling people what wait-lists are all about?

Hon. P. Priddy: We've sort of organized our staff, because you wanted to talk about regions, not about advertising budgets or whatever. So if you want to move into different areas, if you could notify me, I'll bring other staff in.

C. Hansen: I think the understanding that I had tried to convey to the ministry was that as questions came up on a regional basis, if perhaps staff weren't available to answer that precise question at the time, we could park that question and come back to it. Certainly, when we deal with communications and issues management later on during this process, we can perhaps deal with the answer on that specific issue.

R. Thorpe: My point was that perhaps we should spend less money on advertising and direct more of the money to the people that need the care now. Instead of giving them the spin on what may or may not happen to them, perhaps we could actually spend the funds on them and get them on to living a productive life.

Let me just say that no one. . . . If the minister can remember, at the very beginning I asked what was an acceptable benchmark. That was where I started. Of course, we don't have an answer for that. People expect to wait. People expect to wait a reasonable time. But when no one knows what it is, and they're promised tomorrow, the next day, next month. . . .

Let me ask the minister this, then, and I'll move on to the next subject: is it an acceptable wait-list to have a senior, 75 years old, have to wait over a year for joint replacement in British Columbia? Is that acceptable?

Hon. P. Priddy: If there are no other circumstances of which. . . . It's very difficult to be aware with the example the member uses. . . . But given that this is someone who is healthy, or at least healthy enough to undergo surgery, and given that it's someone whose doctor has said it is a priority -- you know, given some context around that -- then I consider that too long.

Interjection.

Hon. P. Priddy: I consider that too long.

R. Thorpe: My last question in this area: will the minister and the minister's staff commit to. . . ? I believe there's a crisis

[ Page 14010 ]

Hon. P. Priddy: Yes, and maybe we can wait till estimates are over and then start the work.

R. Thorpe: I look forward to the meeting sometime in August, then.

With respect, moving along to the next item on my agenda, can the minister advise: has she had the opportunity yet to meet with Mrs. Leslie Gibbenhuck with respect to hepatitis C?

[1640]

R. Thorpe: No, I'm not going on to hepatitis C. The Premier, when he was in Penticton on April 30, undertook to instruct the Health minister to meet with Mrs. Leslie Gibbenhuck with respect to hepatitis C. That was on April 30 in Penticton. In fact, I have put a written question on the order paper asking the Premier if he has instructed the Minister of Health. Apparently the Premier has not instructed the Minister of Health to meet with Mrs. Gibbenhuck, as he said he would do in Penticton on April 30 of this year.

Hon. P. Priddy: I'm not personally aware of that. But what I will undertake to do is check with my office staff at the dinner break to see if the Premier's Office has spoken with them.

R. Thorpe: I appreciate that undertaking and look forward to the answer.

The last issue that I'd like to canvass with respect to my riding is long-term care. As my colleague from Okanagan-Boundary said, in the entire South Okanagan we have a crisis. In the Peachland, Summerland, Penticton and Naramata areas, it's estimated that we're some 200 beds short. The minister talked in her opening comments about commitment, creativity and partnerships. My question is: what particular initiatives do you have in this year's strategic plan to address the long term care crisis in the South Okanagan?

Hon. P. Priddy: I can't relate it to his constituency in particular, but I can speak about the South Okanagan, which I think is what you referenced. The part of the $10 million that was put out, I believe, last fall has gone into the health authority's base so that they can continue to purchase long term care beds, particularly for people who may be in acutecare facilities and don't need to be there and would be far better served somewhere else. So in the South Okanagan, that money has gone into their base for them to continue to be able to use this year.

There is the facility in Keremeos that your colleague asked about, which I realize has been underway for 12 years or whatever it is. But in terms of the status in the ministry, it is on track, and I would expect to see that moving along fairly quickly. There are the long term care beds in Kelowna, which is the South Okanagan, that people have mentioned. So there are initiatives underway.

The member raised earlier the fact that. . . . You're right. You have a large and quickly aging population, partly because many people love it there and are choosing to move there. We can't quite build as fast as people move in. But there are at least those initiatives currently underway.

R. Thorpe: I was more interested in the minister expanding upon. . . . It was the minister's words about partnership, commitment and creativity. I'd like the minister to take a few minutes to tell us: what does that mean in your business plan? What kind of new, creative and committed partnerships have you incorporated into this year's business plan to address such issues?

[1645]

We continue to look for what people call P3 partners or public-private partnerships. We will continue to do that because we will need to. We don't have enough capital money to build all the beds that may be required in the province. We've also begun to look far more at the non-profit part of who the private or public partner can be, if you will. There are union funds that are interested in doing the building. We're looking at building and leasing back, which is one of the projects that's being looked at currently and hasn't been done before. So those are new ways of being able to provide capital dollars, which we don't have to nearly that extent, and then being able to purchase beds from them. Those are not things that have been done in the past.

R. Thorpe: Perhaps I'm asking for too much information in my questions. So therefore I'd ask if the minister could give me a commitment when staff can look at the Okanagan, if they can they look at their business plan and let me know in the next week or so. What specific new, creative, committed-type partnerships are you pursuing? When are you pursuing them? When are they going to be done? It's because we have a crisis today. The mayor of Penticton told me last week that 35 percent of our population is of senior age. If we have a crisis today, and we don't start addressing the problem today, it's going to be a disaster five years down the road. So I'd like that detailed information.

I'd also like some details on what is available for communities, if anything. What is available for communities that want to go out and help solve the problem and work in partnership? The reason I say that is that the greater Penticton area has a history of solving problems. People in Penticton and the South Okanagan like to look after each other. The Penticton retirement centre is an example; the Andy Moog

[ Page 14011 ]

Hon. P. Priddy: We can give you the business plan, but the business plan for the South Okanagan is based on the South Okanagan's health plan. We don't do a plan and say to the South Okanagan: "Here's your plan." So the South Okanagan, when they submit their plan to us -- which is either in or just about to be in -- will be where that plan is identified. There's no point in the South Okanagan developing a health plan for that region and then us turning around and saying: "Oh, we're going to develop the health plan for your region."

Yes, there are some ways to help municipalities. I know that municipalities have good ideas. I would use Kelowna as an example. They have done a number of innovative housing projects, particularly for seniors in Kelowna. They've always been very active in that area and active in doing things a bit differently to be able to establish housing. So I will get that information to you. But I do need to say that the South Okanagan health plan is designed by the South Okanagan health board.

R. Thorpe: Yes, the day-to-day operational health plan is developed. But you and I know, hon. Chair, that there are all kinds of dialogues and pushes and shoves and gives and takes before it gets down here. The people I talk to -- it doesn't matter who they are -- are getting frustrated because they're not getting any creative new approaches coming out.

What is the best jurisdiction in North America for providing care, in a new sense and the most modern sense, for seniors? Where would that be? Do we know that?

[1650]

R. Thorpe: I know this particular government doesn't like the A word -- Alberta. Let me suggest to the minister that I've had the opportunity to talk to some people there, and they had a crisis in the Edmonton area not that long ago. They report to me that they are making measurable progress through two programs. One is called Laurier House, which I would suggest someone investigate and check into to see if there's something we can learn and bring back here and help solve our problems.

The other one's called a Choice program, which they copied off somewhere in the United States. They tell me that that's giving people the opportunity to stay in their homes as much as they can; at the same time, it's providing centralized services for them. I want to pass that along to the minister, because people do want to solve the problem. This does not have to be a partisan issue.

In the interest of time, I'm going to move along and let some of my other colleagues have some questions. I do want a commitment that senior ministry staff from the Okanagan-Similkameen health region, no matter what's in the business plan, are going to be prepared to meet with me, to agree and identify that there is a problem, and that we commit some resources -- even if it's just human resources -- to try to find a solution to this problem. The problem is only going to get bigger if we don't address it soon.

Hon. P. Priddy: Just in conclusion, because I realize that you want to offer your colleagues additional opportunities, I'm not familiar with Laurier House, so we will take that one on. I know that the Choice program, in point of fact, may have been partially based on the United States one, but it was also partially based on the capital health region's early intervention program for seniors. We also do have things like Abbeyfield Housing, the WISHS program for women. There are a number of innovative seniors housing projects here in B.C. as well. We're happy to look at that, and we're happy to do that with you.

I've never suggested it's partisan. We have another member of your caucus working on another committee with us around something different. So we're happy to do that.

R. Thorpe: Just on the last part of my question -- I know it was a long question; most of it was a statement -- did I have the commitment from the minister that senior staff will work with me on trying to find a creative solution and offer some resources with the regional health board to try to get a handle on it and get some solutions together, perhaps, with our community? I know the community's prepared to do that in the very near future.

Hon. P. Priddy: Yes, I think that's what I said when I said we're already working with another one of your caucus members on a different kind of issue, and we're happy to do that. We would also, of course, want to make sure that the region is part of that, because that is where the main responsibility lies. Not to make too fine a point on this, but yes, we will do that. At this stage, I'm not prepared or not able to say additional resources. We'll see what that brings.

S. Hawkins: I sense the frustration in my colleague's comments. I think -- and this minister's quite aware -- that although the government likes to paint a rosy picture about health care in this province, the minister is aware that it isn't that rosy. Frankly, for the last few years when we've travelled and talked to patients and health care workers and administrators and health chairs and volunteers in the province. . . . We know that people are frustrated. No matter which way the government wants to advertise and say that things are great out there, people are writing to the minister. They're writing to their members on this side of the House, and they're saying things are not good. The minister should know, if she doesn't know, that the perception out there is that things aren't as good as they should be.

[1655]

[ Page 14012 ]

I want the minister to know that although the purse has opened up because the federal government did put some money back into the system, the perception out there is that it was like having a noose around your neck. It was tightened and tightened and tightened, and the resources weren't forthcoming. Now we've got a little bit in. The noose is loosened a little so that it feels a little better, but there are still a lot of challenges and a lot of work to do.

I know the presentation that went before the minister from these three chairs did deal with the issue of equitable funding. The minister got quite a good overview of the common issues that the three regions are facing. The three regions, including the ones that my colleagues in the Okanagan represent, certainly are facing issues around acute care, around seniors and seniors housing, around mental health services and around public health services. Frankly, the minister heard from these chairs that the money that had come forward in the last few years. . . . I know the minister likes to brag about how much money the government was adding to the budget every year. But the additional funds mainly addressed the increase in wages in tertiary provincial programs, new programs and other provincial commitments, and that didn't leave a lot for addressing the inequity in services. I hope she got that message loud and clear from the chairs.

In the three regions that the minister heard from, certainly she knows that population growth is a huge issue, and that certainly impacts on services in our valley. In my community we have a huge seniors' population. I would say that about 20 percent, if not more, of the population is seniors, and it's growing. It's a wonderful retirement community, and it's expected to grow quite a bit in the next few years.

I think the minister heard that as far as acute care services, we have lower utilization days than other regions in the province and that our cost per weighted cases is the lowest in the province. I understand that the term "weighted case" refers to a formula that balances the costs of less expensive hospital stays against costlier procedures -- maybe routine childbirths against heart surgery. If we average those out, we find that the Okanagan-Similkameen has the lowest cost per weighted case in the province, at $2,348 a case. We'll just compare that to, say, the capital region, which is $3,228 funded, and Vancouver-Richmond, which is $3,632. I know they deal with some provincial programs, but there still is a perception of inequity in funding around the province.

I mentioned continuing care. Again, that is a huge issue, and I think that the biggest shortfall in our area -- and certainly the member from Penticton brings it up every year -- is the need for long-term care and long-term planning. Finally, I think we are starting to see the ministry address this in some very real ways, but we're still very, very short. We're about 650 beds short, I understand, in our region, and that's just to bring it up to the provincial standard and not planning for the future. I believe the need is going to be doubled in the next five to ten years, which is just staggering.

I want to ask the minister, first of all, what the outcome of this meeting was, what she got from this meeting and what, if any, commitments she made to the chairs as far as looking at this issue. I understand that there is a desire on the part of the ministry to move towards equitable funding, but when are we going to see a formula change so that we do have different regions of the province treated more equitably?

[1700]

They did, I think, focus on a couple of things. One of them was an issue that has been raised by your other colleagues and is raised regularly -- and fair enough -- and that is the issue of distributing the dollars totally by population and demographics. As I said earlier, all new moneys are distributed in that way, but to go back to the. . . . You have two choices: you either add hundreds of millions of dollars to the budget, or you redistribute and take from some and give to others. Those are the only two ways to equal out the funding, and I'm not sure that taking from some to give to others is one that very many members of the Legislature would support.

[H. Giesbrecht in the chair.]

It's very interesting. When people come to see me, everybody says: "If you only funded by population demographics, our health board would have more money." Every health board says that, so every health board clearly would not have more money if you did the funding in that way. We're moving towards that as much as we can. But it literally would be hundreds of millions of dollars to be able to, if you will, level everybody up as opposed to take away from, and we're not close to doing that at this stage. What we are doing is that all new money, all targeted money, is based on the demographics.

The continuing-care needs that the member raises are quite accurate, and as I say, the whole Okanagan area has those. Six hundred beds is about $65 million, which is what it would cost to build only in. . . . I think you said Kelowna, but I'm not sure if it was the Okanagan or Kelowna. It would be about $65 million to build and then so much more -- I'm not sure how much -- to operate. It's about $32.5 million to operate. And that's just for that area. So we don't have a way to catch up that quickly, but I think, looking at the more innovative. . . . You know, Abbeyfield housing, WISHS -- these kinds of public-private partnerships -- the May Bennett Home, and so on, at least give us more leverage to be able to provide those beds more quickly.

S. Hawkins: I did understand that new money was being distributed more equitably. That's good. I appreciate what the minister is trying to say about everybody asking for more money. I guess what my constituents like to see is the government prioritizing.

The member from Penticton was asking about advertising. It drives my constituents absolutely crazy when they see government ads on TV. It's not just Ministry of Health; it's other ministries that are advertising. We're in the estimates of the Ministry of Health, but certainly the Minister of Finance is

[ Page 14013 ]

[1705]

Anyway, I bring that up because when the minister says that it's going to cost $65 million. . . . Certainly just in fast ferries alone, say, we saw the cost of the fast ferry go over budget to. . . . I think it was $240 million over budget. It's that kind of stuff, I think, that drives my constituents absolutely crazy, because they try to keep their books the way the government wants to keep them. But certainly we don't see the government doing that with their spending. So there are priorities. My constituents certainly feel that health is a priority, and that's where they would like the money targeted.

I want to talk a little bit about acute care, because last year I did raise the issue about the ICU. Last year the minister told me that the ICU improvement would be done by last February -- that everything would be on target -- and it wasn't. The money just came through, I understand, and it'll probably be done next February. I think the contract's been let. I believe that Westside, the Westbank company, now has the contract. Can the minister give me an update on that?

Hon. P. Priddy: A couple of things I might mention. One of them is that while there probably has been advertising -- and we'll talk about that when we get to. . . . I know that, because I raised this with the critic, so I can't sort of go into it now. But I do want to comment that I don't think I've ever said: "The health system is perfect out there; everything is rosy; there are no problems and no challenges." Of course there are. There are also good initiatives, and so I do talk about those. But are there challenges? Of course there are, and I talk about those as well.

As it relates to my learning as a Health minister, I've learned not to listen to dates. I guess that's one of the things I've learned. But the certificate of approval for the ICU, I know, has been released by the Ministry of Finance. That's in the hands of the region.

S. Hawkins: I understand that it probably will be done sometime next year. I understand it's quite a few years late. The government promised it, I think, two or three years ago, and it'll finally get done about four years later. It's that kind of stuff that drives the health care workers and the patients absolutely up the wall -- when things are promised and then put off and put off and put off. Thank goodness, this one has finally come through. It was a priority, and it's been a priority on the Kelowna General Hospital list for years.

The minister knows that we don't have a coronary care unit, and I know that she and the health region have been talking about a cardiac care surgery plan, so I wonder if she can tell me about that. Perhaps with the new ICU, we will probably have the proper telemetry, monitoring and equipment to finally look after our acute cardiac patients, but I keep hearing this trial balloon floated about a cardiac surgery program for our hospital. So maybe the minister can tell me if she's had recent discussions or where they are along the way with introducing a program like that in the province, when we're not even able to provide -- I would say -- those services properly in the four centres that we currently have in the province.

[1710]

S. Hawkins: The reason I bring that up is because I found an old memo from ten years ago -- it might even be 12 years ago now, because it was probably a couple of years ago that I found it -- where they were spinning the idea of a cardiac surgery program in Kelowna. That seems to come up when it's popular or when the waiting lists tend to go out of control. There is no way that that hospital is going to be able to support that program, given the facilities that we have right now. That will take a lot of planning, and I would think that's at least five to ten years down the road.

A few moments ago the minister mentioned that the board chair from my region came to see her, with the other board chairs, prior to the region getting their funding. I understand the regions didn't get their funding until late May. As the minister says, there were some pleasant surprises, but the story after they got their funding was that they were still $40 million short. There is still a lot of cause for concern about how. . . .

According to equitable funding and the needs and impact of the senior population. . . . I understand that the way the board separates it out, they are about $5 million to $15 million short on acute care services, about $1.2 million short in the public health area and almost $34 million short in long term care funding if we are going to provide the provincial standards of care for each of those. That is what they reported, actually, to the media after they got their funding and after the meeting with the minister.

I understand that last week the board got funding for mental health services. Last year the minister unrolled this provincial mental health strategy and promised that $10 million was going to be released. That $10 million, which was going to be released last year, just got released last week, I believe. Can the minister tell me: how is it going to be spent in my region? Has the board liaised with her? How much money did they get, and how much are they going to spend in the region and on what services?

[ Page 14014 ]

[1715]

There was money released last year to Okanagan-Similkameen for mental health. That was almost $400,000, which was an annualized amount. I think what you're referring to are the mental health binders that went out on May 17 or something -- the middle of May -- with the mental health dollars for this year, with the $400,000 annualized.

S. Hawkins: How is that money spent? Is there a strategy for the province? Or is the minister asking the regions to prioritize their programs and then approving what they will spend that on or giving them money for what they'll spend that on? Can the minister just outline for me what they're spending it on?

Hon. P. Priddy: What we did last year, when the dollars went out. . . . Yes, there is a plan. What we said to everybody in the province last year, in concert with what the mental health plan established as priorities. . . . The priorities for last year -- and continuing priorities -- were taking the pressure off of Riverview Hospital, dealing with people or working with people who were mentally disordered offenders and taking pressure off acute care hospitals. Other than the fact that people talk about people with long term care needs in acute care, we know that people with mental health needs are also a pressure on the hospitals. What we said to the regions was: "These are the priorities. Can you give us a plan about how you would deal with those priorities in your area?" In many parts of the province people have picked up those priorities. The programs they've organized around them are somewhat different, but they've used the dollars to meet that plan.

In the health region that you are from, the funding has focused on hiring four outreach workers, increasing after-hours outreach services and peer support services to link people with mental illness to the necessary community supports. A mental health court liaison worker is being hired to coordinate existing and new services for treating people with mental illness in conflict with the law and to minimize inappropriate involvement with the criminal justice system. That's how your region has indicated it would use the dollars. It is consistent with the mental health plan and the priorities, but for the Okanagan-Similkameen, that was the best way that they felt they could use that.

S. Hawkins: I also want to ask the minister about homemaker services, because I'm starting to get letters. I just had a couple on my desk. There was a lot of concern in the last few months -- and I'm not the only one getting the letters; I'm sure the minister is getting them as well -- that homemaker services have been cut. I wonder if the minister is aware of it and what she's telling these people who are writing to her about these services that aren't being funded anymore.

Hon. P. Priddy: Just while staff is looking for more region-specific statistics. . . . Yes, I am getting letters from all over the province. You're quite right. I think that what's happening in health regions is that they're trying to organize home support services to meet the needs of people who need them the most. So we could get into discussion, if you will, about that. If you continue to provide only housekeeping support, that will keep people in their homes longer.

[1720]

Sorry -- I'm just looking at the Okanagan-Similkameen, member, for a moment, if you will. There was a review of home support by your health region, and I'm sure that you're aware of that. It has caused some reduction primarily, I guess, in homemaker services. Most of the letters I've received -- and if people have received different ones, then I will be very concerned, and I do want to hear. . . . I mean, I'm concerned anyway. But if people are receiving cutbacks in personal care, then I would really want to know about that, because if you're cut back in personal care, then I think the chances of your being in a facility as opposed to at home are quite a bit greater.

My understanding is that in the Okanagan-Similkameen, the reductions for whatever reason affected some areas more than others, particularly the Oliver and Osoyoos area and Princeton, which had very high -- actually, extraordinarily high -- utilization of home support services in the '97-98 year. But we did provide the same amount to the Okanagan-Similkameen, plus an additional adjustment of half a million dollars late last year to assist with the increase of pressure on service demands. I would think that that half a million dollars will make quite a difference or at least some difference in meeting some of the service pressures, particularly for elderly clients.

This isn't an easy one. So again, it's not one of the ones where I'm saying: "Gosh, isn't everything good out there?" There have been cutbacks. I guess the preference would be that you would just fund everything that people needed. The health regions are trying to manage their home support budgets in the ways that work best within their budget and meet the needs of people. It's being handled differently in different parts of the province. But yes, I am concerned. I do realize that the longer we keep people at home, it's also. . . . Other than the good moral reasons, which is the real reason you want to do it, there are economic savings. But this one is a real challenge.

S. Hawkins: I know that the minister understands the dilemma. Personal care homemaker services are great, but if we don't complement them with some of those other basic services like home cleaning or laundry, that person can't look after themselves. They probably can't do the other. What happens is that they get moved from home to hospital, they plug up that hospital bed, and then we get back into that vicious circle. I am probably hearing it in my area more, because again a huge portion of our population is seniors, and they're seeing these services cut back.

Are you still waiting for staff? Or was that the answer that you were happy with, for the last question?

Hon. P. Priddy: The staffer from mental health has come and then gone. So if you'd like her back, it's fine, because she can do public health if you want. She's only across the hall.

[ Page 14015 ]

Hon. P. Priddy: Okay.

S. Hawkins: I also want to raise just quickly the issue of morale, because I understand from staff at the hospital, administrators, caregivers and physicians that morale at our hospital is probably the lowest they've ever seen it. There's probably a lot of reasons for it. I want to know if the minister's aware of it if she's had discussions with the board about it.

[1725]

But are there some efforts on the part of the ministry to try and investigate why morale is not so good across the province and in my area, where we're finding that people are tired? They're finding that the hospital priorities are not being met. They just don't think that the regional health board is giving them the support they need to raise the priorities and get things done for patients in their region.

Hon. P. Priddy: One thing that I think has been raised specifically with me by the chair in Kelowna and then other things that I think are much more general across the province. . . . Let me do the provincial part first. I would agree that morale is low in health care, no matter where you go across this country. I guess I can't speak for the United States in the same way, but I can certainly see what's happening across the country. I've talked to my counterparts, and I've talked to nurses across the country and other health care professionals as well. I talked to some physicians from Nova Scotia the other day, and I think that is a very common situation across the country. That doesn't make it okay, by the way, but I think part of it. . . . There are several pieces to it, I think. Some of it is the amount of change we've seen not just in British Columbia but in other provinces, as well, going from Closer to Home to Better Teamwork, Better Care. It's a lot of change in the health system, and that's hard. Lots of it was bumpy; some of it's turned out very well. But I think that's had a big impact, at least on certain groups of health care professionals.

I think the kinds of budget challenges -- probably less so here, but here as well -- that people are trying to deal with. . . . They're wanting to do a quality job, which is what they went into their profession -- whichever it is -- to do, and they're perhaps not feeling that they have the time to do it. It's part of what adds to that. When I talked to the RNABC recently, they said to me that they think the additional nurses will make some difference in terms of morale because of being able to not work that amount of overtime. When I talked with health care professionals about the new committee on occupational health and safety. . . . A lot of people are off on injuries; we know that. It depends on where you are in the province, but the injury rate is high, and people are off longer, which adds to the issue of morale. There's no question of that either for the people who are off or for the people who are covering for the people who are off. I think, again, that there's some commonality across the province with that.

I think all of those things have added to the pressures. What people have told me would help is less overtime -- certainly around nurses -- and more support in hospitals around prevention of injuries like from lifting. And, you know, there are dollars through the occupational health and safety group for lifts, and so on, that hospitals may not have. People are therefore doing two- or three-person lifts and still perhaps injuring themselves. Being able to have some education as professionals would make a difference, and in some places there isn't time to do that. That would help.

The only thing that's been raised specifically around your particular hospital, member, is the issue of physicians resigning from committees. The other two chairs did not raise that with me, but the chair of your health board did say to me that in your hospital, that was a particular problem.

S. Hawkins: Our hospital, before regionalization actually, was probably one of the most efficient, well-run, not-in-a-deficit-situation hospitals. I think that in the last couple of years, certainly the added pressure from the cancer clinic. . . . Having to look at the region as a whole and redistribute funding has probably put it in a precarious situation.

[1730]

These were not really problems a few years ago. So there is a huge concern around funding for acute care, around looking after patients adequately. We're seeing ambulance waits at our hospital, ambulances piling up around our hospital emergency. I thought that this was just a phenomenon in the lower mainland, but we're seeing it in our hospital. So we know; we're using the cast room for overflow. Around Christmastime we were seeing some very concerning situations.

The staff -- the care staff, the physicians, the administrators -- are frustrated. That is tough. I'm interested -- and I will be looking forward to the debate around the hiring of new nurses, because I want to know where the minister's going to find all these nurses. I understand that Ontario is looking for 10,000, Saskatchewan has promised another 1,000, I believe Alberta has promised 3,000, and the government here has promised us 1,000 or 800 new nurses. I don't think we're going to pull them out of a hat, so I'm wondering where we're going to find them. We haven't increased the positions at the nursing schools, and I still see a lot of graduating nurses looking abroad rather than at home. That'll be an interesting situation when the debate comes up in the House here.

There are a lot of concerns around acute care at our hospital, Kelowna General, and I am watching the situation carefully. The wait-lists are getting longer. Things, I would like to think, are getting better every year, but I find that patients and caregivers are actually bringing more problems to the forefront, rather than telling me that things are getting better.

Can the minister tell me quickly about the cancer services for our region? I know that in the first six months after the cancer centre opened last year, it was functioning beyond capacity. I know there was some new money put in recently. Can she just tell me if she's met with the cancer services administration and if they are meeting the needs of that cancer

[ Page 14016 ]

Hon. P. Priddy: The note that I have says that the Kelowna clinic expects to reach its full operating capacity in July of 1999 -- this week -- and expects to reach its full operating capacity. I have someone checking on the amounts for Kelowna, particularly. You're right; there were additional dollars.

I haven't met with Bill Nelems in particular, but I have met with the Cancer Agency to look at all of the centres around the province. And if you'll be patient for one minute, I'll tell you the amounts for the clinic up there -- which has had wonderful reviews. I need to say that. Maybe if the member has the next question, then. . . . Staff is checking, and we'll give it to you in a minute.

L. Stephens: I'm very pleased to join in the Health estimates debates today. I want to follow up a little bit on what the member for Okanagan West was talking about, which is that health care services -- certainly in my region, which is South Fraser -- are not getting any better. As a matter of fact, we have a number of issues that I'm sure the minister is well aware of, because she represents one of the constituencies in the South Fraser region. I know that the health board and various other organizations have had long meetings with her, talking about some of the issues that need to be address in the South Fraser region.

[1735]

The other area that people felt very strongly about was an aging population bulge that will seriously overload the capabilities of the present health care system. I think we've heard that from a number of members who have talked today about their particular regions. The serious lack of long term care beds; shortages of both doctors and nurses; the high cost of technology; the cost implications of wage contracts with employee groups; the fragmentation of home care, home support; a serious lack of treatment services for drug and alcohol addictions; and no framework of support for people with recurring disabling illnesses -- those were the areas that people identified at this public health forum and that needed to be addressed.

I just want to put that on the record for the minister to have a look at. I'm sure these are not issues that she's unfamiliar with. I'm sure she's hearing these over and over again all through the province, but I would like to simply encourage her to try and have some more answers for the regions.

For the South Fraser region, I know that the minister knows it's one of the fastest-growing health regions in the province. Due to this population increase and demographic changes, it's estimated that in our region the demand for services will increase from 30 percent to 60 percent in all areas of health care services over the next ten years. Our region expects an increase of 15,000 people in just the next year and about 147,000 over the next ten years. So there are some significant decisions that will have to be made in our region.

I know that the minister is also aware of the chronic underfunding of the South Fraser region. As of March 31, 1999, $50 million more was identified by an independent consultant -- I understand the ministry agreed with the calculations that this particular individual used to come up with his formula and his suggestions. . . . In order to address this underfunding, we needed to have that $50 million. Well, I understand that $6 million was in fact forwarded, with a shortfall of $42 million. The region is looking for a further $42 million.

The systemic underfunding of our region is well known. I heard the minister talk earlier about the inequities that occur around the province. She suggested that perhaps it wouldn't be appropriate to take funding from regions that were overfunded and redistribute it to regions that were underfunded. Coming from a socialist cabinet minister, that was quite astounding, because I think that the ideology of the NDP government has always been to take from the rich and give to the poor. It's a little difficult to understand why the minister would not be agreeable to looking at regions that were overfunded and perhaps redistributing the wealth of the ministry -- the wealth of the taxpayers of the province -- which she so very much likes to do.

[1740]

Hon. P. Priddy: I don't think I suggested that there are rich health boards. What I'm saying is that if you were to decide on a formula and redistribute on that basis, you would have to take away from certain health authorities who are already spending that money on programs for people in their areas. That might be challenging. I'm not suggesting that there are rich boards, just that if you were to use a formula, it would distribute differently than it currently does.

Let's talk a little bit, then, about the South Fraser. I take the member's point, although less so about the South Fraser. Let me first comment generally about vision and then about the South Fraser. I think, in terms of all of the challenges that the health system has gone through, it has been hard for people to say: "And this is the vision, not about where the government's going but about where health care is going in the province -- where the health system is going in the province." That's why I believe that the strategic document that has been prepared, the plans from the regions and the workplans will actually begin to bring those pieces together. I would certainly take the member's point that it's been very hard to do that and that there are people who've commented that that could be done and done better.

[ Page 14017 ]

I understand that the work has been excellent enough that they have been asked to present next year at the national health conference that just took place a couple of weeks ago in Quebec City, because people are so impressed with the kind of vision and planning that the South Fraser regional health board has done. Am I biased? I suppose I am. I live there, so I think they do good work. They have been asked to present because of the kind of planning work that they have done in the South Fraser.

Around the population growth, I think there's a couple of pieces. One clearly is around long term care. As you know. . . . I don't think it was your riding; it was the riding of the hon. member for Langley, where a brand-new long term care facility just got the soil turned a couple of weeks ago. So I know that there is building and preparation going on. I'm not sure about Langley in particular, but I am about the region. A lot of the growth is also youth; there are elders, but there are also people whose children are getting to be, you know, at the end of elementary school and into high school. We do have a really good opportunity to do health promotion and prevention work.

I keep saying that if we could get every girl at the age of 12 to exercise regularly, in 60 years we'd have so much less osteoporosis. I know that, for our society, it's really hard to look 60 days down the road, never mind 60 years. But it is an opportunity, given the diversity of our community, to do some of that really good work that could be done around health promotion and health prevention.

I would say -- because I'm prepared to look at the flaws, as well, around children and the work that needs to be done in the South Fraser -- that our immunization rate is not what it should be, and that bothers me. We need to be doing far more aggressive work around making sure that infants and children are immunized. It actually may not be Langley -- it may be Surrey -- but the South Fraser rate has dropped, and that disturbs me.

[1745]

We do still have a challenge around some of the long term care issues. We provided dollars, as you know -- $10 million last November; I can't remember -- for people with long term care needs to move out of the hospital and into a long term care bed to free those beds up. I know that some of those beds have filled up again. We still have all kinds of challenges. The option that you saw for the new facility in Langley is a good one, but not everybody will be able to afford that, so we've also got to find ways for more affordable housing for long term care. By the way, the one out there looks quite wonderful. It's like Chelsea Gardens in Surrey.

Those are some of the issues you've raised. My understanding from the board is that they will submit a balanced budget and they will be fine.

L. Stephens: Our region has a management group that I think is exceptional. Our CEO and the people who run the hospitals and the different health services in the region are very good. Certainly those in Langley that I know are. I'm sure that those in Surrey, White Rock and Delta are as well. Overall, the people try very hard. They're very talented, and they do the very best they can with the dollars they are allocated. It's been very difficult to do the best they can with what they have. Unfortunately, with all of their best efforts, there are serious problems in the South Fraser region. And it's systemic -- the inequity of the funding.

Yes, the ministry has in fact given some dollars over the last couple of years -- and particularly this year -- that will help alleviate that. The fact still remains that this is going to be an ongoing problem for the region. Whether or not the ministry thinks that the board and the CEO are very happy with what they have. . . . I'm sure they're happy with whatever they receive, but they would still like to see the per-population equitable funding issue resolved once and for all so that they can move forward with their next phase and implement the very important priorities that they've identified.

One question that I want to ask the minister is about the mental health plan. She did say, I believe, that our region. . . . No, she didn't say that. How much money did our region receive as their share of the $10 million for mental health that was announced last year?

Hon. P. Priddy: I want to make two comments, if I could, and then I'll try to close. One of them is that people aren't usually happy with whatever they get. This is the very first year since I've been elected that the South Fraser health board has said that they are happy with what they got. I do consider that to be progress. I think the difference is because the money went into the base. That doesn't mean that they don't have all kinds of other needs and challenges, member, that we have to address. Of course they do. This is actually the first year -- as someone who talks to these folks a lot, I'm sure you know -- that they've said: "This is making a difference."

In terms of the mental health plan, I have someone checking for me here. What I can tell you is that it was the largest amount for any health region in the province. After saying that, let me check. It was population based. The mental health allocation for the South Fraser was $605,870. Would you like to know how that was spent? No.

[1750]

[ Page 14018 ]

Motion approved.

The House resumed; the Speaker in the chair.

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

Committee of the Whole (Section A), having reported Bill 72 complete with amendment, Bill 86 complete without amendment and Bill 79 complete without amendment, was granted leave to sit again.

The Speaker: When shall Bill 72 be considered as reported?

Hon. M. Farnworth: Next sitting, hon. Speaker.

Bill 72, Water Amendment Act, 1999, reported complete with amendment, to be considered at the next sitting of the House after today.

Bill 86, Park Amendment Act, 1999, read a third time and passed.

Bill 79, Land Reserve Commission Act, read a third time and passed.

Hon. M. Farnworth: I move that the House at its rising do stand adjourned until. . . .

The Speaker: No, "recessed" is the word, I think.

Hon. M. Farnworth: I move that at its rising, the House stand recessed until 6:35 p.m.

The Speaker: Members have heard the motion -- and, I believe, "thereafter until adjournment."

Hon. M. Farnworth: And thereafter until adjournment.

Motion approved.

The House recessed from 5:53 p.m. to 6:39 p.m.

[The Speaker in the chair.]

Hon. A. Petter: I call the estimates of the Ministry of Health.

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

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

L. Stephens: Before we broke for dinner, we were talking a little about the mental health funding in the South Fraser. Would the minister perhaps just tell us what the funding allocation was for the South Fraser region for mental health for the 1998-99 year and for the 1999-2000 year. She did offer to tell us what they were going to be using those funds for. I've changed my mind; I would like to know what they're going to be doing with it.

[1840]

The South Fraser received an annualized amount of $605,870 into the Fraser health region from last year. That's annualized money into the base this year. This is around the mental health plan, of course, not all of the mental health dollars that had been there previously. Again, around the three priorities that I talked about earlier, the South Fraser region has chosen to fund five case management workers -- who are called intensive case management workers -- and to increase psychiatric services, to be able to improve its response to emergencies and reduce pressures on the hospitals. It has allocated $106,000 to the expansion of its clubhouse program. I don't know if that's a term everybody's familiar with. Clubhouse programs are centres funded by the health authority, with certain kinds of programs that are actually defined by the consumers themselves. There's $14,000 to family support, and they've added 15 spaces to the therapeutic volunteer program. As well, because we have the Surrey Pretrial Centre there, the region will work closely with forensic psychiatric services, community corrections and the Surrey Pretrial Centre to meet the needs of people with mental illness who are in conflict with the law. As you'll recall, that was one of the priorities. There was a bit of an issue, I gather, with psychiatrists leaving Surrey Memorial, but that has been resolved. They are staffed up, if you will.

L. Stephens: I don't have much time. We don't have a lot of time, so I'm just going to move on to community programs. I just want to talk a little bit about continuing care. This is something that's in a critical state, I think, in all parts of the province.

We talked a little bit earlier about the new facility that is going into Walnut Grove, which is up in north Langley -- the new, very nice residential private care program that's going up there. As the minister said, not everyone can afford those kinds of facilities. In our region, we've got the third-worst rate per 1,000 population of patients in acute-care beds waiting placement in a long term care facility.

The minister announced that there would be 2,000 more long-term beds in British Columbia in the next two years. Perhaps she could bring us up to date on what is happening in the South Fraser region. What portion of those 2,000 beds are we getting? How many are we getting in the years '99-2000 and 2000-2001?

[1845]

In terms of ministry involvement facilities -- because there are other ones going on as well -- there's Zion Park Manor, there's the psychiatric and geriatric assessment unit at

[ Page 14019 ]

L. Stephens: I think, as the minister knows, that the occupancy and utilization rates in all four of the acute-care hospitals in our region are overutilized. In fact, I think the minister knows that a number of the beds they've been using have not been funded beds. A study was done that. . . . We'll need 100 new long term care beds in our region per year just to keep up with the population and the aging and so on. So the minister is talking about $1.6 million for '99-2000 that will purchase those beds, those operating costs. What I'd like to know is: of those 2,000 long term care beds facilities that the minister talked about, what is going into the South Fraser region?

Hon. P. Priddy: I want to go back to the 2,000 beds for a moment, because I used that number quite a while ago from a note that I had, and everybody now looks puzzled when I look around, you see. I think that number was ones under construction as well as ones coming.

Interjection.

Hon. P. Priddy: Yes, I know; it's Barb McLintock's article. I remember. But I will tell you that the $1.6 million will actually buy 30 new beds. There are 70 multilevel-care beds coming on stream from Zion Park Manor, and then there are other. . . . You probably, I'm sure, may have read about the Elim Housing Society -- which isn't government money, by the way, but it's still long term care housing -- which passed Surrey council. It's a fairly large aging-in-place project which will offer low-cost housing to a number of seniors as well.

L. Stephens: Speaking of long term care beds, does the minister have a strategic plan to provide those beds, whether they're 2,000 or 1,500 or 2,500? Does the ministry have a strategy and a plan in place to provide those beds around the province?

Hon. P. Priddy: That, in part, has been the goal of the continuing-care review, but the continuing-care review is not going to be able to say that there should be 42 beds here and 67 beds there. It's not going to be able to do specific numbers in that kind of way.

[1850]

L. Stephens: I want to talk a little bit about home care. I know other members have raised it. This is certainly a huge problem in my area, as it is in the whole of the South Fraser region. What I'm hearing -- and what people are telling me in Langley -- is that people are not getting funded for home support; they're only being funded for medical care. Anyone who's living at home and who needs medical home care will be getting it, but that's all they're getting. There isn't anyone that is coming to bathe, to do any of the personal care or to do any of the house care. The only service that you will get in Langley is if you have a dressing that needs to be changed or an IV or some kind of a medical service that must be provided -- that's the only kind of home care. It's been cut back significantly, and this has been going on for a year. The funding just isn't there.

It's extremely frustrating, certainly for the health care providers in Langley, because what is happening is that. . . . Trying to keep people in their homes longer is a laudable goal, but so many of these people are being released from hospital sooner, and they're ending up having to be readmitted. They're living at home with some very serious health problems, and usually the caregiver is elderly and very concerned about being able to provide that level of care. Not having that home support is extremely debilitating and frustrating not just for the patient but also for the caregiver. So perhaps the minister could talk about home care, because I know it is a huge issue around the province, not just in Langley.

Hon. P. Priddy: I think I said this earlier when somebody raised this. If there are circumstances where people have had personal care cutbacks, then I need to know about that. I know there are circumstances where people have had housekeeping. . . . And I don't mean to minimize that. But vacuuming, you know, house maintenance cutbacks -- I do know that's happening. That doesn't mean that I'm not concerned about it, but my understanding is and our guidance has been that the personal care and medical care. . . . So I consider personal care -- you know, bathing, lifts, hair-washing, etc. Then I need. . . . I'm not suggesting that what the member is saying is inaccurate. What I'm saying is that I need to know about that, or the ministry needs to know about that, because if people cannot get that kind of support, then they will very, very quickly not be in their home, and I understand that. So what I need is for that information to be reported to the ministry.

Those decisions may be made locally. Maybe people are not being assessed properly -- I'm not sure. But certainly our understanding and our intent has not ever been that that should happen. Because you might be interested, in the South Fraser, for community care in this coming year's budget there's actually an 11.5 percent increase.

L. Stephens: For the minister's information, people in Langley aren't getting the personal care. They were; they were getting the personal care. Like I said, the cutbacks have been incremental. At first, they were cutting back the housekeeping. Now they've cut back on the personal care. So the only people that are getting service are those that require the medical care. What I'm told is it's because they simply don't have the funds to employ the people to go out and actually do that kind of work. So it's become very, very difficult -- extremely difficult.

I would just like to ask the minister: is there a standard of home care? Does the ministry have best practices or a standard of care that these home support organizations must follow?

[ Page 14020 ]

[1855]

L. Stephens: I would be very interested to know what the ministry's reaction is to what is happening out there as far as home care is concerned, because I think it's very. . . . It's certainly of great concern to a significant number of people in Langley and certainly to those families that are having to deal with these cutbacks.

I want to move to the health capital plan and ask a few questions around the health capital plan and the minor projects and the major projects. There were five '98-99 Treasury Board minors for the region that were approved. Are these all going to be moving forward? They are the pharmacy, phase 2 at Surrey Memorial; psychiatry emergency project at Surrey Memorial; psychiatry upgrade project at Peace Arch; Maple Hill extended-care unit reroofing at Langley Memorial; and the nurse call upgrade at Delta Hospital. Are those projects all moving forward?

Hon. P. Priddy: I have staff checking. Some of them I know the answers to without checking, but then, of course, if I give them, I could be wrong. I'm quite sure the pharmacy one is. I'm quite sure the emergency one is. The roofing at. . . . Is it Maple Lawn? I'm sorry, that one I don't know, and I have staff checking, so maybe if you move on to your next question. . . . They're in different categories in the book, so it's just taking a minute to sort them out, but if you give us a minute, we can get that for you.

L. Stephens: This one is the health capital plan for '99-2000: the replacement of Kensington Building at Surrey Memorial, renovations to the emergency department at Delta Hospital, and priorizing the upgrades to some of the older buildings -- that is, the Langley Memorial Hospital towers and the Peace Arch District Hospital. How are those major funding proposals moving along?

Hon. P. Priddy: I think it will take us a few minutes, because they're in different places. If you have another question that isn't about capital. . . .

Interjection.

Hon. P. Priddy: Oh, okay. We can do one of a couple of things. We can get it for you in a few minutes, but it will take five or ten minutes just to put it together and find it. I'll take your guidance.

L. Stephens: We'll move on. But I have just one more for the capital health plan, and that's the planning dollars. Are the planning dollars secured for the next phase -- phase 3 -- at Langley Memorial Hospital? Have the planning dollars been approved?

[1900]

L. Stephens: I'll just go on, and when they're ready, perhaps we can just. . . .

Interjection.

L. Stephens: No, it isn't capital; it's surgical wait-lists. We're all going to be talking about wait-lists at some time or another.

Cancer surgery at Surrey Memorial has increased from an average of ten days in '97-98 to 41 days in '98-99. The wait-list increased over 40 percent from February '98 to February '99. At Langley Memorial there's been an increase of 22 percent from April '98 to February '99. At Delta the average wait for surgery is now ten to 12 weeks, and the wait for cancer surgery is two to three weeks. At Peace Arch the wait-list in orthopedics is 18 months. So we have some significant problems around the wait-lists in our region.

The board has flagged the wait-list initiatives as one of the priorities that they're trying to deal with. They're putting $2.5 million into trying to deal with that. The wait-list initiatives here really don't talk about much in the way of alleviating some of these particular operations.

At Langley Memorial it's eight to nine months for a gall bladder, and it's eight to nine months for hips and joints. This is an area that needs to have some significant work, and I wonder if the minister would comment on those kinds of numbers in the South Fraser region. The one that is particularly difficult, I think, is Surrey Memorial Hospital, where the surgery wait-list has increased by 40 percent from February '98 to February '99. That's a huge, significant increase. What is being done to alleviate that wait-list?

Hon. P. Priddy: A question of clarification, if I might, to the member: are you talking about all surgical wait times or cancer surgical wait times?

L. Stephens: All.

Hon. P. Priddy: All surgical wait times. That's something we will have to check and get back to you on. That's not consistent with any numbers we have, and we're not aware of any wait times that have gone up in that length of time by that percentage. I'm not suggesting that your information is not accurate; I'm just saying it's different than what we have. I'd appreciate an opportunity for my staff to check that out, because that's different from what we have.

L. Stephens: I'd be happy to make a copy of this and get it to the minister. It's the South Fraser health region's operating budget presentation for 1999-2000. It gives a number of statistics here and supporting documentation for their budget deliberations. I'd be happy to get a copy to the minister. There's a lot of interesting information in here. I'm not able to get to all of it tonight, but it's something that I think the minister needs to see.

Hon. P. Priddy: If that's where it comes from, then clearly we have it. And you know, having put those particular num-

[ Page 14021 ]

G. Hogg: I've found the discussion to date to be most interesting. Dealing with it in the context of the full South Fraser region is causing me to reminisce on my wonderful two years on the regional health board.

Interjection.

G. Hogg: Well, thank you. The critic made reference to wanting us to tie it more specifically, to put some faces and names to some of the issues with respect to the types of services that are going on. I'd like to do that by, first, referencing Hilda Trehearne, a 77-year-old who's on the wait-list for a hip replacement and has been since August 18, 1998. It's difficult for her to move around, even with a walker, and she's in constant pain and is deteriorating rapidly. The current wait-list is over a year. There's one full-time orthopedic surgeon in South Surrey-White Rock. He is given one surgery time per week at Peace Arch Hospital, which means that he can do one hip surgery or knee surgery per week. As of today, if there are no further postponements, Hilda's surgery will be somewhere in October of this year.

[1905]

I'm wondering whether or not the ministry has had an opportunity to look at some of these issues or to hear any comments from the South Fraser regional board -- the health authorities board -- with respect to these issues, and whether or not we can look at any types of improvements in these wait-lists for the Peace Arch Hospital.

Hon. P. Priddy: Thank you, hon. Chair, to the member, who did just fine work as a regional health board member. You know, Surrey people support each other.

I can't speak specifically for Peace Arch, but given the wait times you have and given the 58,000 new surgeries, then some number of those will allow them to open. . . . Clearly it's about opening the OR. It's not about the OR not being there; it's about having enough OR time for the surgeons to do the surgery. So both for orthopedic surgery, which I think is one that you named, and for other surgeries, there will be additional dollars for Peace Arch to be able to provide additional OR time.

If I might, while I'm on my feet, I have an almost total answer for the member for Langley. Is that all right? Delta Hospital -- fire and life safety is, I guess, the category; it's a half a million dollars, and its completion is 2000-2001. Maple Hill Centre, I guess, in Langley has, for the roofing, $171,000 with completion in September of 1999 -- this September. Surrey Memorial Hospital phase 3, which is $75 million, is March 2001. That's the tower, so there's a lot of construction there. The pharmacy, phase 1, at Surrey Memorial is half a million dollars and is currently under construction. For the psychiatric emergency services at Surrey Memorial, construction will be finished by March 1 next year -- March 1, 2000 -- and that's $286,500. Zion Park Manor will be finished August 1, 1999 -- that's $10 million -- and psychiatric and geriatric assessment at Peace Arch by March 1, 2000, at $900,000. Those are the ones we've got for you so far.

G. Hogg: Thank you to the minister. The critic on this side has told me that I am not allowed to believe the fact that you were saying that I was a wonderful contributor to the South Fraser regional health board.

C. Hansen: I said: "Don't let it go to your head."

G. Hogg: It's really true.

I'm sure the minister is aware of the issues with respect to population in South Surrey-White Rock. I want to make reference to contextualize some of the issues that we've talked about with respect to the surgery waiting lists -- in particular, the orthopedic surgery, which is such a prevalent issue with seniors. I have recent figures that actually break down 27 metropolitan areas across Canada, and they show that age 65-plus in White Rock, at 18.2 percent, is the highest of any jurisdiction that they have referenced in Canada. I know the ministry's figures, and the figures show that age 75 years and over is growing at about 44.4 percent in the South Fraser region, whereas the provincial rate is at about 36.3 percent.

On any given day, Peace Arch Hospital has 35 beds that are occupied by people in need of long term care who are obviously taking up acute-care beds. We need to be able to compensate for that so that we can have the appropriate usage of the beds and services that accrue to that, as well as the savings that accrue to the system, thereby allowing us to create more long-term beds.

[1910]

I'm wondering if the minister could provide us with the planning that is going into responding to those types of needs in South Surrey-White Rock and the South Fraser region, with respect to those long-term care beds. There has been some specific reference to it in the previous discussions, but if we could be specific about those types of services as they may relate to taking the workload off of the Peace Arch Hospital and providing services to the needs of the people in the South Surrey-White Rock area.

Hon. P. Priddy: I must admit that I have to ask myself the question about Zion Park. . . . It may be Surrey-Cloverdale. Given the relationship to South Surrey and Cloverdale, I would suggest that we can actually look at Surrey -- or at least at Surrey below Highway 10 or below 64th or whatever. Zion Park Manor, which I think has 75 beds, is due to open fairly soon; that will take some of the pressure off.

When the CEO. . . . I'm not challenging her numbers at all, because as the member for Langley said earlier, it is a

[ Page 14022 ]

At this stage there are the 75 coming on at Zion Park. There'll be some expansion of home support. There's the Elim housing unit in the Fleetwood area, which will be coming on stream. So there are beds coming on stream, but there are probably not 1,000 in the next four years. Again, that's why we have to find public. . . . Even if we can provide the operating dollars, we still have to find the partners to provide the capital dollars for us. That's work on everybody's part, not just ours.

A number of these -- the Elim one and some of the others -- have actually come from the community, come from the city or come from the municipality, as opposed to the Ministry of Health. There isn't a plan for 1,000 at this stage, but those are the ones that are coming on stream now.

G. Hogg: The Zion Park is in Cloverdale, and part of its catchment may fall within the bounds of Peace Arch District Hospital, but probably the majority of it would not. Therefore, with the type of needs that we're talking about with respect to Peace Arch District Hospital, is the minister saying that there are currently no long-term bed plans at this stage -- any form of planning -- that would be able to respond to the types of needs that we have when we have as many as 35 long-term beds, on average, being used in the acute hospital? So is it fair to say that with the exception of the 75 beds in Cloverdale, there is nothing planned at this point?

[1915]

G. Hogg: I know from sitting on the regional health board that we're patently aware of the fact that people place their names on different waiting lists for long-term care, because Peace Arch District Hospital's long term care waiting list for the two pavilions that are there is very lengthy, with names from all over the province. This exacerbates the problem and causes extra consternation for the people of Surrey-White Rock, who obviously want to stay very close to their homes when they have to go into such a facility. It seems that many people from other parts of the province also want to come to take advantage of the services of Surrey-White Rock and the hospital therein.

There were some questions asked previously with respect to the capital health plan. I'm wondering whether or not your staff was able to find those. I believe they were asked with respect to the major facilities as opposed to the minor ones. The Kensington Building at Surrey Memorial Hospital was one specific of the capital programs -- and then the planning dollars as they were to apply to Langley Memorial Hospital and Peace Arch District Hospital. Have staff been able to find answers with respect to those three questions?

Hon. P. Priddy: The Kensington Building is currently being considered for emergency funding. And the two planning funding answers we don't yet have, but we will soon. The other ones I think I already answered.

G. Hogg: Well, just to add on to the top of that, then, I assume you're including the major capital funding requests for South Fraser in that. Just to reiterate what the major capital funding requests have been for South Fraser and whether or not they had been approved. . . . Is that easily accessible information?

Hon. P. Priddy: Well, the 1999-2000 capital request from the regions was due in about two days ago. So without going back. . . . Even if I could tell you what was on it, I couldn't tell you what was approved. If you have questions from last year, we could answer those. But the capital plans from the regions have just come in, so there would no approval at this stage.

G. Hogg: Could we know how long it will take for those approvals with respect to that capital plan, which has presumably been received? How soon the health authorities will know with respect to those approvals?

[1920]

For instance, the Surrey Memorial tower, which is. . . . It won't be completed until March 2001, but that's a large project. It's well under way. You can drive by and watch it grow. The capital project at Zion Manor, the capital project of the psychiatric emergency service at Surrey Memorial, the pharmacy service at Surrey Memorial are all capital projects that are underway this year in the South Fraser, as well as the psychiatric and geriatric assessment at Peace Arch Hospital -- your local hospital. It's $1 million. It will be finished next March. And there is one in Delta and one in Langley, which I mentioned earlier to the other member. Those are the capital projects currently under construction, if you will.

G. Hogg: Those on the report that I have from the chief executive officer's report to the board are all referenced as Treasury Board minor projects. What I was looking at was trying to go to the capital plan for '99-2000, which makes reference to what, I guess. . . . If those were minor, these would be major capital projects. Those are the ones that, again, make reference to some of the questions I asked earlier with respect to the Kensington Building, with respect to the planning dollars for Langley Memorial, as well as for Peace Arch.

[ Page 14023 ]

Actually, there are several I gave you that were not: Zion Park, the tower at Surrey Memorial. There are a number that aren't, actually, minors at all. But we still have someone checking the planning dollars. I'm sorry we don't have that for you; we should.

G. Hogg: Then I'll just leave you with, specifically, the Kensington Building at Surrey Memorial Hospital and the planning dollars for Langley Memorial and Peace Arch District Hospital, as the three that are referenced in the capital health plan for '99-2000. If I could also add to that any information you might have with respect to the fifth and sixth floors at Peace Arch hospital, which are as yet unfinished. . . . They've been sitting with a frame that might well be utilized in one fashion or another.

I will then, while waiting for the responses to those issues, move to a couple of other specific examples of people who have been into our office and talked about issues or concerns. These may, in some ways, be about medical health practices and policy.

One is an 11-year-old boy named Dillon Ezerins, who was diagnosed with diabetes when he was five. Through a blood test, Dillon was diagnosed with celiac disease in February of this year at the Children's Hospital juvenile diabetes department. They did some testing on about 600 children, and 11 out of 150 children tested in Dillon's group tested positive. They need a very restricted diet. Apparently this disease, untreated, has life-threatening implications for a diabetic, yet apparently there are no available services for a person such as Dillon.

I'm just wondering what policy framework that falls in -- or should that be a specific item that should be referred to the ministry? They have had contacts with the ministry in an effort to try and resolve this. I know it's difficult to speak to any specific case in the estimates process. But it seems to me that this is a sad case of a boy who has life-threatening diseases for which, apparently, there is no funding available to deal with any of the nutritional needs he has or any of the diet training and any of the specific needs that might be focused around such a problem. I just wonder whether or not the minister has any response to that.

[1925]

There are certainly programs at the Children's Hospital both for children with diabetes. . . . I don't know how common or uncommon diabetes and celiac disease are together. The question you may be asking -- and we will check on that, but I expect that you may be correct -- is whether we would cover special foods that a child with celiac disease might need. I shouldn't put words in your mouth, so maybe if you can. . . . There are certainly programs at the Children's; there's treatment at the Children's; there's parent education; there's nutrition counselling. There are all those kinds of things, so I want to be sure I'm understanding what isn't in place so that I can properly check.

G. Hogg: The information I received from the family was that there was no diet training or nutritional information that was offered or available to any of the 11 out of the 150 who were diagnosed, and that was part of their concern. Well, I'll just leave that with the minister for clarification.

Hon. P. Priddy: If the member will provide us with that information, we'd be happy to check on it. I certainly know children with celiac disease whose parents have received, as has the child, nutritional counselling, etc. I guess we'd have to check on those circumstances, and we'd be very pleased to do that. It may be the combination of diabetes and celiac together or whatever, but we'd be happy to do that -- especially since the child is in the Vancouver area and has access to the Children's quite easily.

G. Hogg: I will provide that information to the minister.

Ross Riches, another constituent, was told by the doctor that he had a fungal infection under his toenails, and it was very painful and very uncomfortable for him. The doctor took a culture to be sent for analysis and prescribed Lamisil to begin fighting the infection. This drug was only available under special authority, which could not be granted until the culture tests are received and come back as positive. The catch-22 is that it takes four to eight weeks for the culture testing, and therefore Mr. Riches would only be covered if the culture tested positive, which it did. Mr. Riches started the medication immediately and has paid out $282.75 for the Lamisil, and Pharmacare will not reimburse Mr. Riches, as Pharmacare obviously does not pay retroactively at this point.

So the 48-hour turnaround, which seems a reasonable one when you're asking for special authorities, doesn't seem to be as reasonable a process in this type of example for approval of a medication which requires special authority. I'm wondering whether or not there has been any consideration or whether there is somebody who has special authority to look at these unique circumstances and determine whether or not there is some type of approval process under Pharmacare which would fall into examples such as Mr. Riches' case.

[1930]

And if I might answer the capital question while I'm on my feet, we realize why we're having trouble finding it, it's because it hasn't been submitted yet. The Kensington and the Langley planning and the Peace Arch planning -- the fifth and sixth floors -- are ones that we would expect to see in the capital plan that they are just now submitting or may have submitted 24 or 48 hours ago, which is why we don't have it yet.

[ Page 14024 ]

A number of pharmacists in my constituency of Surrey-White Rock have contacted me regarding the pharmacy participation agreement. It is on hold, I understand, for review and consultation. Could the minister just provide a bit of information with respect to what that review and consultation involves and when we could expect an outcome for the pharmacy participation agreement issue?

Hon. P. Priddy: I'm a lot more careful about dates this year than last year; I'm trying to be cautiously optimistic. I would think that over the next several months. . . . The consultations will be ongoing over the next several months. One of the issues that has been raised and has not been resolved is: is the B.C. Pharmacy Association a bargaining agent, if you will, for pharmacists? Some people think they should be, and some people think they shouldn't be. That's one of the things that has to be resolved, as well as some of the issues around, particularly, superstores and the kinds of loss-leaders, or whatever, that they use and whether you have to discount that. I expect those consultations to be going on certainly over the next several months.

G. Hogg: I think that concludes the areas of concern that I had with respect to South Fraser, particularly Surrey-White Rock. I will provide in written form the two other items that the minister has sought clarification on, and I thank the minister and her staff for assistance and support through this.

J. van Dongen: I just have three issues to ask the minister a few questions about. The first one is, I think, a perennial question, which is the status of the MSA General Hospital. This project has been under discussion for probably over ten years now, and certainly there's a serious need in our community. Just this past week we had a front-page article on the morgue in the hospital -- the fact we've outgrown the size of it and the fact that there's a risk for the doctors working in that facility. I wonder if the minister could tell us the current status of the hospital in terms of the capital priorities.

Hon. P. Priddy: Actually, I had this discussion with the chair of the health board up there. It is not approved in this year's capital budget. It's $150 million, so it would be the only capital project that would be approved in any year. We will look at that again next year, but it's not in this year's capital plan.

[1935]

Hon. P. Priddy: The ministry does acknowledge it as a priority. I said that as well to the chair, and people know that it is. But again, given the size of the project, you would only be able to do one or two in a year. But the ministry does identify it, actually, as one of the top priorities.

J. van Dongen: The second issue I wanted to briefly raise is the issue of general operating budgets. Certainly in our region, the Fraser Valley region, as in other high-population-growth regions such as central Vancouver Island and Okanagan-Similkameen, there have been some serious funding pressures that have developed over the last ten years. We were talking electoral boundaries recently, for example. You look at population growth from 1986 to 1996, and in some of the figures that I was looking at, we were talking about an over 50 percent increase in population. The funding hasn't really kept up.

I know that recently there was some additional federal money, and the minister did make some effort to try and start to address these funding disparities. I'd ask the minister to confirm that, but the main thrust to my question is: has the ministry made a policy decision now to try and redress these funding disparities on a long-term basis? In other words, are we going to be moving, and has there been a decision made to move, to a population-based funding formula?

Hon. P. Priddy: The only decision the ministry has currently made -- I've had this discussion with your other colleagues, and I know it's important in your community, because it is a growing community, and I had the discussion as well with your chair -- is that any additional money over the last five years has indeed been based on population-based and demographic-based funding.

But there has not been a decision to take the entire health budget and do the whole thing on population-based funding. As we had in an earlier discussion, that would mean that unless you added literally hundreds of millions of dollars to the overall budget, you would be taking away from some health boards and giving to others. On the surface that may sound fine -- and I've probably made that argument as a Surrey MLA before -- but nevertheless, every health region that's ever talked to me says that if we only use population-based funding, we'd have more.

Every single health region thinks that, and therefore it can't quite work like that. It is difficult to go to a health region and say: "We're going to use a different formula, therefore you can't have any of these programs anymore, because we're taking back the money." The only decision so far is that every time we put out new dollars, that is based on population-based funding. When I met with your chair, as well as with the chairs from the Okanagan and Nanaimo -- who all have the same issues that you had identified, which are around growth -- your chair did say that he was pleased that there had been what he saw as a really legitimate effort to address that this year by putting money in the base.

What often happens when there's growth is that historically -- and, by the way, it's happened since the seventies -- boards run deficits. Then at the end of the year the ministry -- not just this one but across the country and, actually, across North America -- picks up the deficit, but it's one-time funding. By the next year, people are in exactly the same position. So what we did this year is actually put money into the base so that people are indeed further ahead. It's not like having a deficit and you put it in and it only takes care of it once. It's in the base, and therefore people will be able to manage in a different way. Your board chair did indicate to me that it didn't meet all his needs, by any means, but that he was pleased with what he saw as a first effort to improve the base this year.

[ Page 14025 ]

[1940]

Hon. P. Priddy: I don't think that was the case in all regions. My understanding is that that was the case in Fraser Valley because there were ongoing negotiations around the home support part. It wasn't that, sort of, all fiscal budgets didn't get settled until the end of the year. There was some ongoing negotiation about the home support part of your budget that did not get settled until late.

J. van Dongen: On the general operating funds, then, I certainly want to encourage the minister and the ministry to move in that direction. I know that the minister's predecessor felt quite strongly that population base is a fairer approach. Certainly over time we should be able to roll in that direction to provide equity across the province -- or what a lot of people, including the previous minister, felt was more equitable.

The last issue I want to raise is the general issue of home care cuts. I want to speak specifically to one case in my constituency, and this is the case of Cindy Milligan. I think the minister has some familiarity with. . . . This lady, who just had her thirtieth birthday, is pretty much confined to a wheelchair. I think that, over the years, she has very aggressively and very actively -- to her credit -- developed a very independent life. She has some very serious issues. She's a paraplegic. She has spina bifida, scoliosis and hydrocephalus. She even has a rod implanted in her spine to provide some stability to her back.

I visited with her for two hours yesterday, and it's amazing to me what she is able to do. I note that she's maintaining an independent living -- her own apartment, her own car -- on $771 a month, and has gradually actually reduced the amount of home care that she was getting to the point where she's now. . . . She was getting, up until January, two hours of housekeeping every two weeks -- vacuuming and this kind of thing. My concern for her is that because she's worked very hard to be independent, I think we may underestimate her fragile health. I think that's one thing. Secondly, I think that she is going to try and maintain her independence, and my concern is -- and it's also the concern, I think, that's shared by G.F. Strong in a letter they've written to our region -- that her risk of having further health problems is quite serious. She's already hurt her back a couple of times trying to do things. As I said, to her credit, she's pushing the edge all the time of what she can do. But it seems to me that two hours every two weeks is a pretty small price to pay to reduce health risks for her, and she has certainly had some problems, as detailed in the G.F. Strong letter. So I wonder if the minister could comment on what the guidelines say about risk to health in a case like this, which could have significant increased health costs.

[1945]

J. van Dongen: I could confirm with the minister that she's had two visits in the last, I'd say, month and a half. I don't think the decision has changed, if I understand it correctly.

I wonder, though, if the minister. . . . I'm not trying to get the minister to render a decision in this case, but would it be reasonable to expect the region to apply the principle that they should be assessing the increased health risk of her trying to do some of these functions herself, which I think is going to happen?

Hon. P. Priddy: It would be reasonable to believe that that would be one of the criteria that they would look at, along with a whole variety of other criteria.

J. van Dongen: One of the things that's being put in place in our region, as I understand it, is an appeal process. Does the ministry have any guidelines for the regions on the design of an appeal process -- who should be on the appeal panel, that kind of thing? Are there any precedents for that within the health care system?

Hon. P. Priddy: It is a requirement that each region does have an appeal process. We do not tell them what it must look like, but it is a requirement that they have one and that they make it public.

J. van Dongen: One other issue I was going to raise, I think, ties back to our discussion about funding. One of the articles that was written about Cindy Milligan -- and I'm referring to the June 23 Province newspaper. . . . An article written by Wendy McLellan made reference to comments by a spokesman for the Vancouver-Richmond health region, saying that they had no intention of cutting home care to residents who only need help with housekeeping or meal preparation. I wonder if the minister can comment on that funding disparity in this particular case. I think it's unfortunate that some regions and not others appear to be able to afford to continue a housekeeping program.

Hon. P. Priddy: Just out of interest, was that a direct quote from somebody from the Vancouver-Richmond health board?

J. van Dongen: I can read you the quote out of the newspaper. I don't think it is a direct quote, no. I'll read you the quote out of the article, if you like. It says: "A spokesman for the Vancouver-Richmond health board said the region has no intention of cutting home care to residents who only need help with housekeeping or meal preparation." That's out of the article.

Hon. P. Priddy: I can't comment, certainly, on behalf of Vancouver-Richmond. Each health authority will make those

[ Page 14026 ]

[1950]

Hon. P. Priddy: I guess this is where you go: "And what the communications person meant to say was. . . ." I'm kidding; that's not true. When home care began with housekeeping and so on, it wasn't actually intended to be a health service. It was intended to be a service that supported seniors who needed some assistance to be able to maintain their homes. Part of the assessment process that people go through should look at whether indeed, for some people, having that additional support actually does. . . . I think this is the question you, or someone, asked earlier: does that impact on their health? I think it was your question, hon. member.

Sometimes, I guess, we're talking a bit about apples and oranges. We sometimes talk about home care and people talk about personal care and may mean a variety of different kinds of things. Some people use home care to mean everything. They mean housekeeping; they mean bathing; they mean somebody helping you with your IV therapy at home. So sometimes it's the terminology that's used. But if you're talking about housekeeping services in particular, that should be part of the assessment that's used to see if that has an impact on people's health.

A. Sanders: I'd like to address a few of the issues that are pertinent for Okanagan-Vernon. This area now, under regionalization, is responsible for care all the way from Nakusp through Enderby, Armstrong and Salmon Arm and into the Vernon area. There are a number of things that are very concerning there. I think that what I'd like to do is use a patient history as a kind of a signpost for some of the problems that are going on. A lot of them have to do with rationing of services. This is basically what we're doing under regionalization: we're rationing services to patients to keep within a capped budget.

One of the people who comes to mind the most is a fellow named Ian Widdows. He works at a local mill; he's a registered professional forester. He's about my age; he has children who are about my children's age. The only thing we don't share in common is that Ian has cancer. What we've found through the rationing of health care services for Mr. Widdows is that after seven years he has, every step of the way, had a problem gaining access to medical facilities, diagnostic services and hospital wards. This has impacted critically on his present well-being.

He's been wait-listed for major surgeries, radiation and chemotherapy. His family life has been compromised by physical, emotional and financial stress. He asked me a number of months ago to bring his story forward. In 1991 Ian was first put on a surgical wait-list, because he had a lump in his neck. The lump grew quite rapidly. After seven months, he still hadn't got to surgery, and his family physician intervened and insisted that he be put on an immediate surgical list. When he was operated on, it was found that he had a nasopharyngeal carcinoma, which is a very serious kind of tumour that grows in the sinus and nasal area. He found that the lump in his neck wasn't the primary; it was in fact a metastasis.

Three years later, nasal swelling signalled where the actual tumour came in. At that time, a CT scan showed malignancy in the sinuses, brain and behind his left eye. The cancer was inoperable, and he was offered chemotherapy. This shrunk the tumour beyond detection.

One year later, the cancer returned to the frontal lobes of the brain. A repeat chemotherapy proved to be ineffective. He was told that brain surgery was not an option, and he was denied consultation by a neurosurgeon. Two months later, he was doing better than people thought, so the decision was reversed, and neurosurgery was offered. It was felt that he needed immediate surgery. Immediate surgery for him, at that time, turned out to be a week and a half later; it was a week and a half before a bed was available in the hospital. He was told that if a bed did not become available in VJH, his surgery would be cancelled.

[1955]

Really, what you have to look at with this gentleman is whether all that needed to be done and how much wait-lists interfered with his potential well-being after a period of time. This is a man who has spent seven years navigating a health system that's been blocked every step of the way for him by the rationing of services and the denial of access at every level through wait-listing. It's been complicated by hospital downsizing and regionalization and decreased direct access to services. Regional bureaucracy has increased. These have all been very much of a problem, and the transition in the system, several times over, has been a problem as well.

If you ask Mr. Widdows about the original New Directions, he will tell you that it was a nightmare for him with respect to how his health outcomes have been. He brings forward a number of questions. He wants to know why services are rationed and people are denied care when they're sick -- very sick. Why do we have unacceptable waiting lists for surgical procedures, diagnostic equipment and hospital beds? Why does expensive diagnostic testing equipment sit idle because of lack of funding? Why are surgeons denied access to operating facilities when there are people like Mr. Widdows, a man who in his thirties and forties has serious, possibly operable and possibly now inoperable cancer?

Everybody's got a horror story, but the thing that's concerning me now is that I see these horror stories all the time. I

[ Page 14027 ]

Another constituent of mine, Mr. Mike Stogrin, initially had a diagnosis of colon cancer, but he had to wait 90 days on a waiting list to see what the actual diagnosis was. Because the surgeon felt that there was probably adenocarcinoma, he was offered chemotherapy and radiation before he actually had a final diagnosis. He had a biopsy that did confirm cancer, but the wait-lists for the CT scan and the other diagnostic services in Vernon put Mr. Stogrin in position where the doctors felt that the best medical guess was to start radiation and chemotherapy before the diagnosis came in. Mr. Stogrin's comment was: "What if I don't need it?" You can see that there'd be a tremendous amount of fear for any individual who's found to have cancer and is given treatment prior to diagnosis because we can't afford to wait for the outcome.

Let's look at the other side of the coin; let's look at what the surgeons have to say. I have a letter from Dr. Kenneth M. Scott. He is the ear, nose and throat doctor in Vernon Jubilee Hospital. This young man has his speciality training, but he also has two years at the University of California doing subspecialty training in ear, nose and throat. He's a very valuable kind of surgeon to have and certainly the only one of his kind in the North Okanagan.

He recently sent out a letter to his colleagues:

"Dear Referring Colleague:

"I'm writing to you to ask your advice and perhaps your assistance as well. My current wait for a tonsillectomy is estimated to be greater than six months if booked on a semi-urgent basis and more than a year if booked electively. My current policy is to book semi-urgent cases only when the upper airway obstruction is occurring and is a concern."

[2000]

"My overall wait-list in the past ten months has grown from 40 patients to greater than 220, and every week I book more patients than I have time to operate on. I spent much time discussing it with the administrators of the hospital. It's obvious that the waiting list is completely due to lack of OR resources, as I would happily make time in my schedule for more OR accessibility.

"My impression from what has happened so far is that the powers that be are not committed to providing timely ear, nose and throat care for patients in Vernon Jubilee, and I believe that timeliness of care is a component of excellence. I find it personally very disappointing when my patients are not experiencing good care."

We recently lost our back surgeon, Dr. Ian Fyfe. He, again, is a specialist in back surgery and arthroscopic surgery, something you don't find very often. He has left purely out of frustration at the wait-lists and the inability to look after people. He is moving to a job in the United States. The job isn't particularly more in terms of the remuneration that he will get, but he knows the satisfaction will be quite significantly increased, because he will actually be able to operate on people who are sick and not have them wait one and sometimes two years.

What we've experienced in Vernon is wait-list after wait-list. We now have approximately 1,600 patients on the wait-list, and that's an increase of over 40 percent or 50 percent from November 1997. We have increased waits for surgical specialities, orthopedics, opthalmology and neurology, and these are quite significantly above the provincial average as well. So if you live in the North Okanagan, not only will you wait, you'll wait longer than people in the rest of British Columbia -- or in many comparative areas of British Columbia.

I'm seeing things, from a medical point of view, that I've never seen before. When I was in training, if I had suggested to an examining surgeon that you would treat bone pain, osteoarthritic pain, hips that need to be fixed and knees that need to be fixed with daily morphine, I would probably have failed my exams. But I can tell you that very commonly now in British Columbia, we treat people who need hip replacements, who need knee replacements or who need any kind of orthopedic procedure with MS-Contin, a slow release morphine tablet. When you're waiting for a year for surgery for your hip and you're 40 or 50 or maybe older, and you go through a year on morphine, you've got another problem when you finally get your hip fixed. That problem is compounded by the other things that can occur, such as depression, loss of job, loss of family, loss of self-esteem.

There isn't an MLA in this House -- on either side of the House -- who doesn't have a drawer full of these kinds of letters from patients. Whether they're from Mr. Whitfield of Lumby or Mrs. Florence Olson from Vernon, from Mr. and Mrs. Birnie, from Mrs. Agnes O'Connell, from Chris Dirk in Lavington, from the Correale family, from the Copland family -- it goes on. There is a systemic problem here. Injecting into the circumstance a whole bunch of federal dollars that we have on a one-time basis may temporarily fix the circumstance, but it's not going to cure it. What I'm looking for from the minister is maybe an overview of what her plan is. I haven't really heard a plan here today. I've heard members asking for strategic plans. I'm not looking for a band-aid solution.

[2005]

We have problems in the ICU. We have, in the radiology department, a potential for capital expenditure that is huge. We've got the oldest nuclear medicine camera in the province. We've got a seven-year-old ultrasound machine. The nuclear medicine camera is probably on its last legs. We have a number of significant costs and a significant wait-list for many of these services.

I know the government would like to say that since 1991 -- when the NDP came in and brought in their idea of what regionalization should be -- health care has not deteriorated. But I can tell you, from having worked in many parts of the province -- and I've certainly visited more -- that there has been a serious decline in the quality of health care that we provide.

In some areas we are doing better. We have new services like home IV therapy -- a wonderful service. It saves time, saves money and saves hospital beds. But when you've got a hospital with 20 and 30 percent of their beds blocked by

[ Page 14028 ]

I guess what I'm looking for is some commitment from this minister and this government to stop saying everything's fine and to start looking at how we can solve problems, because the problems are out there. They are real, and they are very concerning for the people who are sick. I'd just like a response from the minister.

Hon. P. Priddy: I have heard the comment before. I won't speak for the entire government, but I don't think that this minister goes around saying everything's fine in the health care system. If everything was fine in the health care system, we wouldn't need to continue to put more resources into MRIs and into orthopedic surgery and hear the kind of comments that we do about home support and long-term care. I don't for one minute suggest that everything is fine in the system.

I think that certainly the power. . . . The individual letters that people read -- including the circumstances that the member for Okanagan-Vernon has spoken of -- are difficult to respond to without knowing the circumstances, but as you hear them, it sounds like the system, at least in one of those circumstances, simply has not worked for people. Why? I don't know. I don't know without knowing all the pieces to that.

But I do know that I have certainly not had people call and say that they need surgery for cancer and that they're put on a wait-list of -- I'm not sure what the member said -- nine months or whatever that was. It seems to me quite unconscionable for that to happen -- and to wait for diagnostic testing. I mean, I've not heard about rationed cancer care. Yes, I've heard that people are waiting too long for MRIs, which is why we put so much more money into reducing wait times for MRIs by 50 percent -- which is, of course, one of the important diagnostic tools for quickly diagnosing a variety of kinds of carcinoma.

While we do hear the accurate and often tragic stories people talk about in the Legislature, I would say that we also keep stacks of letters. We have letters from people talking about the really good care that they got in the system or the fast care that they got in the system or how quickly they got in for radiation or for chemotherapy or for treatment of cancer. So the stories that people bring, I'm sure, are accurate, but we also do have people writing to us -- and they're a significant number -- talking about how the system has worked for them. But because the system's worked for them doesn't make it acceptable that the system hasn't worked for other people. So yes, of course we need to make it work better.

[2010]

In terms of the fact that wait-lists are longer in the Vernon area. . . . That I didn't check, but that may very well be the case; I have no reason to doubt that. That is the reason we are providing additional surgeries, and I don't consider that to be only a band-aid solution. It is one of the steps towards reducing wait times. It's one of the steps towards being able to move from only focusing on acute care to being able to do the kind of community care, long-term care, home support and health prevention and promotion in the community that we really want to do. This system will not survive unless we are able to change that focus.

R. Neufeld: I have a few brief questions for the minister. I don't expect that she'll possibly have all the answers for these questions, but I would appreciate a response at some point in time when it's convenient for her.

I want to start off with the $10 million Fort St. John General Hospital upgrade and ask the minister why, as I understand it, funding increased this year only by about $300,000. But I may not have the right figures. Maybe the minister could tell me when she envisions that the Fort St. John hospital will actually be brought up to a standard that many other hospitals in the province of British Columbia enjoy.

Hon. P. Priddy: I'm just reviewing the list. I think that when the proposal was first submitted to the ministry, hon. member, it was a $12 million project. What the ministry did was break that down into more manageable pieces, and the ones that are currently approved and underway are the infrastructure and safety systems, which is certainly what people talked about with me fairly regularly. Those infrastructure and safety systems are underway. The upgrade of the elevator is underway, and if we actually got the papers signed -- and I think we did -- the replacement of the ambulance station. So those are the ones that are currently underway, and we will move forward with more of those. I can't give you a completion date on when the entire $12 million will be finished.

R. Neufeld: I appreciate that the elevators are being repaired, because they both quit working. So obviously that's an emergency that had to be taken care of.

I think there are a whole bunch of other issues that are desperately needed in the Fort St. John hospital, and I know there are in every hospital. I understand that process, but elevators and the ambulance garage which was promised by the previous Minister of Health on June 10, 1997. . . . After seven years of study, I think it's something that we should have had quite a while ago, before we moved the ambulances out of the fire hall. But obviously it didn't happen. I guess by this fall maybe they'll have the station built; I appreciate that. But there are some other issues around the Fort St. John hospital that desperately need some funding. So I appreciate that from the minister.

[2015]

[ Page 14029 ]

This gentleman has been refused many times by the Ministry of Health and in fact has been told that it would take an OIC -- an order-in-council -- to be able to subdivide this piece of property. I think, because it's no fault of this gentleman's that this piece of land was actually isolated and because there is precedent close around there where there are small parcels under the five-acre recommended size, that we should look seriously at how we can actually accommodate this person so that they can subdivide that piece of land off and sell it.

I just wonder if that's what the ministry understands has to take place -- that there's an order-in-council that has to go through -- before we can actually subdivide a one-acre parcel. It seems to me to be just a bit of a stretch. Unless the minister has some responses to that, I'll send a package to her and we can look at it, okay?

Hon. P. Priddy: We would appreciate further information on it. On the surface of it, it doesn't sound like it needs an OIC, and folks behind me don't think that's the case. But on the other hand, I'm sure we can always find out something different when we look, so. . . . But on the surface, it looks a bit silly. So if you could give us the information, I'll have someone get back to you by next week.

R. Neufeld: And I will. I have the file number and everything in here for the Ministry of Health, so it'll be fairly easy to get that to the minister.

The other question I have is on mammography services for people along the Alaska Highway, and specifically in Fort Nelson. My office has been in discussion with your office on how we can resolve this issue -- instead of asking some 175 women from Fort Nelson to travel by bus, or whatever means they can get, to Fort St. John or Dawson Creek to access this kind of service. I understand from the Fort St. John health authority that about $100,000 would put the equipment in place which would not just service Fort Nelson, but. . . . There is quite a distance between Fort St. John and Fort Nelson -- 250 miles -- and then there are an awful lot of other women that live along the Alaska Highway all the way to the Yukon border. So it services a huge part of the province of British Columbia, not just Fort Nelson.

I just wonder if the minister has made any headway on how we can resolve this, I think, very serious issue.

Hon. P. Priddy: Yes. I think there are several alternatives being explored. As the member knows, one of the problems was that the contract was let to someone and then their equipment was not able to fulfil all the purposes for which it was intended. Yes, we're looking at a variety of options, and I can guarantee the member that it will be fixed to his satisfaction in the next. . . . Give me two weeks, okay?

[2020]

The other issue I'd like to bring forward is the utilization of the CAT scan. Dawson Creek is the regional facility for that kind of service. I wasn't aware of that until early this year. I had a gentleman in Fort St. John who had an appointment made. Actually, he was in the hospital on December 17, 1998, and needed a CAT scan, and January 6 was the earliest that it could be done in Dawson Creek. As I understand, the CAT scan facility is not used very many hours in a day. This gentleman unfortunately worsened and had to come into the hospital on December 30. He was air ambulanced to Edmonton, because he could not get a CAT scan. In fact, he had a blood clot which could have killed him quite easily. Luckily, the doctor he visited during the middle of that night knew what was happening to this gentleman, and they air-ambulanced him at 6:30 in the morning.

[P. Calendino in the chair.]

Maybe the minister can just explain to me the type of rationale that's used in providing the CAT scan services and how that takes place.

Hon. P. Priddy: I have some general comments, and then I want to go back and check whether Dawson Creek has identified this within the health plan for the area -- if that's okay with you. They've just come in a little while ago. On the surface of what you say, flying someone from Fort St. John to Edmonton. . . . If you could have someone go into Dawson Creek to have a CAT scan done, even on an emergency basis or at 3 o'clock in the morning. . . . It does sound like, on the surface, that would be more sensible.

The only general comment I would make -- and I consider myself no expert on this at all -- is that sometimes it depends on the kind of CAT scan machine that people have and what people need. One machine may not do every kind of scan that someone needs. I don't know if that would've been the circumstance or not. I want to go back and see if Dawson Creek has identified that, because from what you describe. . . . It seems that even on an emergency basis, if you

[ Page 14030 ]

R. Neufeld: I'll also provide the minister with the letter that I received from the gentleman in Fort St. John. I'm not an expert by any means on CAT scans, so. . . . I would think, though, that if the gentleman was scheduled to use the CAT scan in Dawson Creek on January 6, that wouldn't change to any degree. You would think that you could use the same CAT scan on December 30 as you could on January 6. It just seemed to be something to do with scheduling or having the people available to operate the CAT scan or whatever was there. I can understand the minister wanting to get back to Dawson Creek to find out how they allocate these issues.

[2025]

I want to talk a little bit to the minister about travel points. It's something I come to the House with once a year since I've been elected, trying to get the ministry onside in the use of travel points as they relate to government-funded travel. I think that I and the ministry themselves have done some work. There's no doubt about it. But I have done an awful lot of work trying to get this process into place.

I would like to see us, at some point in time, finally get there so that MLAs that are presently in this House. . . . If they have points -- or if they don't have points, they can start collecting them, at least; let's start somewhere -- they can donate them to the Mission Air Transportation Network or Ronald McDonald House or Children's Wish Foundation. If we are in a position where we can't have all government employees do it, then let's start with a pilot project. Let's at least start with the MLAs requesting that they collect them and that they donate those points.

I don't know whether the minister is aware or not, but Mission Air actually flew about 355 patients this last year in British Columbia, without any commitment from British Columbia for donating its points to Mission Air -- and in fact even cutting off the funding that we used to give to Mission Air. I would certainly like to see a process started. I have in the last six months given up on the fact that we can actually have our own made-in-British Columbia program, and I was saving my points so that I could donate those to that process. I have since donated 150,000 points to Mission Air, which I've collected while on government business travelling back and forth to my constituency.

If you take into consideration all of the MLAs that are in this House -- although they may not all fly the miles that I do, but a lot of them do -- it would be a tremendous help to that organization. It's a good organization. It serves British Columbia without us even requesting it to serve British Columbia. I just wonder if I can have some kind of assurance from the minister that we will look really seriously at this and not just give lip service to it, as we have through the past number of years, but actually get very serious about putting in place a program where we can donate our travel points.

I would also like to ask the minister a second question: if we could -- and I've asked the ministry before over the last number of years -- begin donating to Mission Air the $5,000 per year, which is not a lot of money and was donated to Mission Air up until 1994 on a consistent basis. That was the recognition that British Columbia gave to Mission Air, and I believe it was 1994 when that $5,000 yearly grant was cut off. I wonder if we could get back to giving them the $5,000 and start the process of gathering points.

[2030]

The second one around the travel points. . . . As I think the member knows, we've picked this one up again. We've set up a committee that the member has agreed to sit on with us and with Ed Conroy. I'm not supposed to say that -- the member for. . .

An Hon. Member: Rossland-Trail.

Hon. P. Priddy: . . .Rossland-Trail has a particular interest and some experience with this as well. I haven't done this in order to create a make-work projects for somebody; I want to see us find a resolution for it. I have since discovered that, you know, you're not the only one who's doing that, which was a bit of a surprise for me. I'm hoping that that committee will actually bring some resolution, in spite of the article from the airlines saying that they refuse to transfer points to individuals. I'm hoping that that committee will meet soon and will be able to work out some resolution to this. In terms of Mission Air, we will restore the $5,000 funding.

R. Neufeld: I just wonder if my colleague from Peace River South would have some questions if. . . . Did I hear the minister right? You're going to restore the $5,000 donation every year to Mission Air?

Hon. P. Priddy: That's correct.

R. Neufeld: I'm happy that's the case, because as I understand, the transportation assistance program we have in British Columbia that was struck by your government is actually referring people to Mission Air as we speak to fly them in British Columbia. I'm quite thankful that the ministry is going to restore the $5,000 a year to that worthwhile program.

I thank the minister for her time. I think I've probably taken up a little more time than I should have. I just want to say one thing. In our health care system, we often hear all the negative things and all the things that don't happen. In just the last number of months my sister-in-law had a heart attack and was taken care of at St. Paul's Hospital. She's called a

[ Page 14031 ]

K. Krueger: In every health care estimates debate since I was elected in 1996, I have brought to the attention of the government its promise eight months before the last election -- long before any of the classic vote-buying type of promises were made by anyone. As a result of sound business decision-making processes, this government committed to build a multilevel health care facility in Clearwater. I'd like the minister to give us the status of that project, if she would, please.

Hon. P. Priddy: It will go to tender in November.

K. Krueger: Could the minister account for the lengthy time span that's gone by? It's going on four years since the facility was promised, and there are deep needs in Clearwater. There are people from Clearwater who are sent to the Fraser Canyon Hospital for long term care beds. They're four hours away from friends and loved ones. Their condition tends to deteriorate rapidly as a result of those absences. It's heart-wrenching to hear from the families of these patients who are moved back and forth. Certainly I'd like to be able to give them an explanation of why the project is so long in coming.

[2035]

K. Krueger: My thanks to the minister. It's good to have a firm date, and I understand that to be a firm date. The other major project in my area is the psychiatric tertiary care unit at Royal Inland Hospital. There again, there have been many announcements, but there hasn't been a spade in the ground yet. I wonder if the minister could give us the status of that initiative.

Hon. P. Priddy: I want to be respectful around the answer. My intention would be -- this is sort of one of those "God willing and the creek don't rise" things -- that sod would be turned this summer. I made the announcement with the MLA last summer. I understand that there is now an issue with city council and the parking garage. I don't want to see this facility held up because people can't agree on where to build a parkade and whether two trees should come down or not.

As much as I love trees and as much as I appreciate keeping historic trees -- or however historic those trees happen to be -- there are a whole lot of people in that area in the Okanagan, in the Thompson, who need that psychiatric facility. To hold it back because people in city council can't agree on a parkade, and whether you take down two trees, is not acceptable to me. So my intention would be that we're able to turn that sod this summer. I guess folks are going to have to worry about where they park afterwards.

K. Krueger: I certainly agree with the approach that the minister just enunciated. There is no reason that the parkade location should tie up the psychiatric unit construction, in my mind or in the minds of most people. That sounded to local people like a dodge from a bureaucrat -- perhaps a way of strong-arming the location that a bureaucrat has decided upon. There was an offer from St. Ann's Academy, adjacent to the hospital, to provide a parking arrangement. That was bureaucratically rejected quite out of hand -- and quite rudely, it seemed to me.

I understand the minister to have just said that the unit will go ahead regardless of the status of the argument over parkade location, which is music to my ears. I just would like her to confirm that that's what she said: the psychiatric unit construction will proceed, regardless of the outcome of this argument on the parkade location.

Hon. P. Priddy: I just want to go back to a comment about wherever bureaucrats said the parkade would be, so I can be clear that it's not any of the fine bureaucrats in the Ministry of Health. It's obviously somewhere else. And yes, I intend that it go ahead.

K. Krueger: I will clarify that. It's a regional health board bureaucrat that made those remarks. I'm very pleased to hear that the ministry intends those spades to be in the ground this summer.

On a number of occasions in recent months, Royal Inland Hospital has had no available acute-care beds or intensive care, critical-care beds. There have been instances when the hospital had to divert elsewhere -- to other cities -- patients who were transferred to the facility, in spite of the fact that this is a regional health care centre. I'm told that this problem is becoming fairly common.

[2040]

We have an extended-care facility called Overlander in Kamloops which has a wing that is shelled-in and has never been finished or furnished. We also have closed ward 3-West on Royal Inland Hospital's premises. One of the problems is that there are usually two or three dozen patients in acute-care beds in Royal Inland Hospital who really ought to be in long term care, extended-care or intermediate care facilities. What's obviously needed is to complete that shelled-in wing at Overlander and, I would think, to get the wing operational at Royal Inland.

These are not isolated instances. These things are in the news constantly, and it certainly erodes the public's confidence in the availability of acute-care health care facilities in Kamloops. I'd appreciate the minister's comments on this problem.

Hon. P. Priddy: I think there's probably one unique circumstance about the circumstances you describe in Kamloops. Certainly that is generally an issue around the province, and many of your colleagues have spoken to that. But we will check back. I'm not aware -- but I will check -- whether the

[ Page 14032 ]

I think the other piece that's somewhat unique around this is that last fall -- or last whatever it was, November -- when I announced $10 million for people to be able to move people with long-term care needs out of acute-care beds in regions, the Kamloops hospital chose to open another OR instead of using it to move people into long term care facilities. So they chose to use that money that others used for long-term care much differently, and I think that may have compounded the problem.

K. Krueger: It's kind of a being-between-the-devil-and-the-deep-blue-sea choice for people who have to make those sorts of decisions. It's very important to have the operating rooms functioning, of course. There are operating facilities that have been mothballed in Kamloops for some time, while people who are in pain are obliged to wait on the wait-lists. At the same time, it seems to me that it only makes sense that people ought to be in extended-care beds actually in those locations, rather than tying up the much more expensive acute-care beds in Royal Inland.

The minister has, I think, received a letter from a general surgeon in Kamloops. It's dated June 2, and I have a copy of it. I happen to know the individual because he did a little cutting on me last year. At the time he was still fairly new from Alberta. He's a young and very talented surgeon, and he was very frustrated, when I met him two years ago, with the fact that he could get so little operating room time, when he had come to Kamloops to be a surgeon. That's what he's good at, and he has long wait-lists of people with really pressing needs. He made the point with me back when I first met him that he doesn't create the need -- and he never would, of course, if he could -- but these people are sick, and they need surgery. And until they get it done, they won't get better.

In his letter he mentions to the minister: "I've only been here two and a half years, but in that time, I've seen a continual deterioration in the level of service due to inadequate health care funding." He talks about having to divert an acute upper GI bleed from within our region to Kelowna in the recent past. And he says: "For the last six months our hospital has been running at full capacity or beyond, almost at all times. There have been several episodes where all of the available holding units were full, and the hospital had to divert transfers at various times." And he talks about elective surgery having to be cancelled, about the critical shortage of nurses and the fact that the nurses that are working at our hospitals have been working flat out and are approaching burnout in many cases. We have inadequate numbers of beds and of nurses.

[2045]

I appreciate what the minister just said -- that she has tried to come up with blocks of money from time to time and distribute them between the regions -- but some of the things that are happening are so penny wise, pound foolish. My understanding is that the daily cost of an acute-care bed is at least triple that of extended-care beds. It seems to me that the money has to be made available to change this situation, so that those beds are available to the elderly, the people who need to be in them, the extended-care and intermediate care patients, and so that surgeons can get caught up on these pressing cases once and for all and stay caught up -- rather than the occasional infusion of cash to try and catch up the wait-list somewhat. I wonder if the minister would comment on that.

Hon. P. Priddy: This is, in part, in answer to a previous question and in part, I think, to what you raise now, particularly when you talk about the cost of an acute-care bed versus the cost of an extended-care or intermediate care bed.

The health authority in Kamloops, I'm told, has been at least discussing -- and I guess that's all I can say about it at this stage -- the Overlander facility with the Ministry of Health staff in the regional programs. So that has been raised, and people are beginning some discussions about that. I think that is, in part, a response to your question earlier about whether Overlander can be used in a different way or whether they can complete the shell, as you described it.

I think that one of the other things that will make some difference is the completion -- I think it's August 1 this year that it's due to be completed -- of the fourth floor of the west wing. It will accommodate an expansion of day surgery -- which makes a really big difference, if you have an ability to do more day surgery and you don't have to be using in-patient beds to do that -- post-anaesthetic recovery and OR areas, and it will provide better space for a neurointensive care unit and respiratory therapy services. So I think that by being able to finish that floor, as well, it will free up or release, if you will, other space in the hospital. By providing more ways to do day surgery, you free up some of the in-patient beds as well. The discussions with Overlander and the work that's currently going on at the hospital will bring, I think, at least some relief to that.

The question of underfunding, I mean. . . . I guess every health area and every health region would say they're underfunded. I'm sure that there are all kinds of things that regions, including my own, can do with additional funding, but we do have to find other ways as well -- and other creative ways that don't involve additional funding. It may involve reallocating funding. It may be that there are places where there's waste going on, and we have to be able to find those better. I'll acknowledge all of those kinds of things. Given the level of funding per capita, I'm not sure that we can say that every region is underfunded, but I think we can look at some ways to service people better.

K. Krueger: I certainly agree that we can.

Dr. Keith Donaldson is our principal cancer specialist in Kamloops, and Dr. Donaldson wrote recently on two issues which I want to quickly canvass. I believe the minister may have dealt with one of them already, and that was the need for a bone densitometry X-ray device for Kamloops, dealing with the problem of osteoporosis -- particularly in post

[ Page 14033 ]

[2050]

K. Krueger: Thank you; that's great. Just for clarification, my understanding is that a private donor wished to pay for the machine, but the problem was whether or not the ministry would provide funding for its operation in Kamloops.

I don't think the second issue has been resolved, and that has to do with what Dr. Donaldson refers to as tumour markers. He says that chemicals are released from cancers and prove a useful marker with which to follow the disease. Examples are the PSA for prostate cancer, CA15-3 for breast cancer, CEA for colon cancer, and so on. Many of the tumour markers are being done at the Kelowna General Hospital, and permission has not been given for them to be done in Kamloops, although the laboratory is certainly well equipped to do them at Royal Inland Hospital. There is no financial benefit or cost benefit to doing them in one hospital over the other.

The problem, from Dr. Donaldson's point of view, is that since the blood has to be sent to Kelowna and the results obtained later, there is a significant delay in obtaining this information, which is often very important in making decisions with regard to treatment. He therefore seeks approval for an arrangement for this testing for CEA, CA19-9 and CA125 to be done at Royal Inland Hospital, as well as the CA15-3 and PSA which are currently done. Could the minister help us with that?

Hon. P. Priddy: I will actually now go back and answer your bone-density testing one, if you'll let me take this one until morning. It sounded fairly complicated, and I do want to have somebody check that out.

But in terms of the bone density or the actual machines for testing, the Medical Services Commission did have a cap in place -- or a moratorium, if you will -- on the approval of new facilities, pending the development of a protocol for when bone-density testing would be used. The protocol has been developed. It's been approved, and the moratorium on the approval of new machines has been lifted. There have been some applications for facility approvals that have been processed, and approvals have been granted. The first approvals went to Nanaimo, New Westminster, Kamloops, Nelson and the South Fraser health region. So while the equipment hasn't actually been purchased and delivered yet, Kamloops has an approval for that.

It was part of your question, and then I'll probably try and close, if I might. There are many times when people want to donate the capital cost of a machine, and it doesn't seem reasonable to people that they wouldn't be able to do that. But it does commit the ministry to an ongoing operating cost, and that may not be the part of the province that most needs to have operating money put into a particular kind of machine. We have this situation in one other part of the province as well. So that's usually the reason why we say no to those kinds of very kind donations.

Do you have other questions? Otherwise, I'll close.

K. Krueger: Perhaps I will just mention two other issues I'd like to deal with in the morning, in case the minister needs to get some resources in place overnight. One is the status of the emergency ward makeover that's going to happen at Royal Inland Hospital -- a tremendously busy emergency ward of up to 224 people in a day sometimes. I know that something's in the works -- something major there -- and I'd like an update on that.

[2055]

Hon. P. Priddy: We will try and have that information for you in the morning. Seeing the time, I would move that the committee rise, report progress and ask leave to sit again.

Motion approved.

The House resumed; the Speaker in the chair.

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

Hon. P. Priddy moved adjournment of the House.

Motion approved.

The House adjourned at 8:58 p.m.

PROCEEDINGS IN THE DOUGLAS FIR ROOM

WATER AMENDMENT ACT, 1999

On section 1.

M. Coell: Firstly, I'd like to thank the minister's staff for the briefings they held with regard to the Water Amendment Act. I wonder whether, in dealing with it, we could just deal with general questions throughout all of the sections -- there are ten sections -- and then deal with the sections one at a time.

Interjection.

M. Coell: Thank you.

Is it the minister's intention that this bill will speed up the process for all water licence applications by shortening the queue for these quick licences?

[ Page 14034 ]

[1450]

Hon. C. McGregor: There will be a review after a period of one year.

M. Coell: Then I suspect we won't have that information in time for estimates 2000, but I would flag it as something that I would be interested in pursuing in estimates of 2000.

Will there be any changes in application fees stemming from these changes?

Hon. C. McGregor: No.

M. Coell: The appeal mechanism typically accorded to applicants under section 40 of the Water Act does not apply. I wonder if the minister could give the reasoning for that.

Hon. C. McGregor: The idea of the quick licensing provisions makes clear that we identify it as small volumes of water in a stream where there's clearly enough adequacy of flow to allow the licence to go forward. It is the view of staff that to permit an appeal would be frivolous in nature, because the applicant itself was non-contentious. So there would be no need for appeal.

M. Coell: I thank the minister for that response. I guess it would also be interesting at the end of the year to see whether you did have any requests for appeals and if any were turned down. It does appear that there would be very few, if any, turned down during this process. Will this process alter the compliance monitoring processes that are in place at this point?

Hon. C. McGregor: The beneficial use declaration is really a substitute for staff monitoring. It's a requirement for self-monitoring and reporting on a regular basis to the ministry. So there will be that change in the monitoring of those licences.

M. Coell: When we spoke at second reading, I mentioned time frames for approval. In briefings, your staff suggested that the approval process could be almost immediate in most cases. I wonder if the minister could outline her views on that. I had originally said that I was interested in seeing an amendment that outlined a time of either ten days or 30 days. That may not be necessary if the minister can explain her expectations for time frames.

Hon. C. McGregor: Often the delay in being able to approve licences is a result of having inadequate information from the applicant. As long as all the information that's clearly spelled out as necessary. . . . As long as all those conditions are met, as well as meeting the criteria for quick licensing, it's our goal to have those applications reviewed and approved within a two- to four-week time frame. We have no expectation that it would take longer than that. These are really considered to be perfunctory. If they've gone through all of those steps and stages, the approval itself should be fairly automatic. We will make sure that there are internal processes at play to meet that two- to four-week time line.

[1455]

Hon. C. McGregor: I believe I just answered that question -- or I tried to, anyway. I'll say it again. It's certainly our view that once an application has been put into the quick licence category and all the information that's required has been provided to us, it will take no longer than two to four weeks to approve such a licence. We will put in place processes within the ministry to ensure we meet that time line.

J. van Dongen: That may well be the intention. I would think that if the ministry is certain that it can process an application in that kind of time frame once the full package of information is received, the minister may be willing to put that into, say, the legislation or a regulation. I think the problem I have with the Water Act generally is that the legislation is absolutely permissive in terms of the responsibilities of the staff in the ministry. There is no onus of responsibility on the staff to really do anything. I've been thinking about trying to find a mechanism to ensure that there's some accountability for performance, not just on the applicant but also on the staff.

It seems to me that one of the reasons for this legislation is to foster a better economic use of the resource and to foster economic development and activity. The way the whole act is designed, there is no accountability, no responsibility, no expectations in the legislation and no onus of responsibility on the ministry's side of the ledger. I'm wondering if the minister could comment further on that.

Hon. C. McGregor: I think I have to disagree with the member. There is clearly a lot of responsibility on the side of the water staff to assess an application to see if it meets criteria that can then permit it to go through a quick licensing system. In second reading I said that the intention of the bill is not to permit a quick licensing scheme to overrule any legitimate issues that might surround a water licence. That is our job to assess, because that is, of course, the statutory responsibility of the employees.

In terms of how quickly licences can be approved, I certainly agree with the member that there's an opportunity for us to consider regulation at some point in time if we find we cannot approve these licences within a two- to four-week time period. I'd certainly be prepared, if after a one-year review the staff have been unable to meet those kind of time lines, to consider putting a regulation in place that would require that. I mean, the purpose of having a quick licensing scheme is indeed to make it quick; and if our intentions are not being dealt with through this mechanism, then we can find other tools to do that.

[ Page 14035 ]

[1500]

In terms of the member's questions related to how staff manage issues, I have great confidence in the staff's ability to know how much time. . .and how to manage their time in such a way that they can make decisions on both complex and less complex applications. We do not prescribe the methodology through which staff apply themselves to applications, but it's been my experience that most water licence applications are extremely complex. When people come to you with a complaint that it's taken a very long time to do so, it's largely because of many complications: first nations issues, adjacent landowner issues, lack of water for fish and other similar concerns. The time that's necessary, through hydrological work, to assess the adequacy of flows, the seasonal nature of flows -- all of this information has to be in hand before a licensing decision can be taken. If we were not to go through all of those steps and procedures, then we might give licences that would endanger previously held licence holders -- which, as I'm sure the member will be aware, is of significant concern, particularly to the agricultural community, which largely has the longest-standing licences and, as the member knows, has the greatest right to water on the basis of the age of their application.

We take all that work most seriously. We're not implying -- and I hope my remarks haven't implied in any way -- that because we're putting in a quick licensing provision, suddenly all the quick licences will be approved and no time will be spent on longstanding applications. Of course, those will receive the attention that they must and should have. As I indicated to the member for Saanich North and the Islands, it's my view that it will free up staff to be able to actually spend more time on those more complex applications and to have those reviews considered in a more timely way as well.

J. van Dongen: I just want to say that I appreciate the minister's answers and that I agree with her. There are many cases that are very complex and many applications where there are lots of issues that need to be considered. But I want to say for the record that it's my understanding, having dealt with a number of offices, that there are lots of cases sitting on desks or in files that are incomplete and unfinished but also not being worked on.

I want to ask the minister to maybe do a management review of the process of the paperwork flowing through offices. I think that's part of the explanation for the long waiting list of 5,200 -- or whatever it was in the press release -- either unfinished applications or amendments to applications that we have. Just to pass that view on to the minister and hope that there are other efforts being made to deal with files that are simply sitting there unfinished but also not being worked on. . . .

Hon. C. McGregor: It's my expectation that throughout the implementation period of bringing this new legislation into force, there'll be many opportunities to look at the way in which we're managing our work and to review how many licences remain outstanding. This is a tool to try and deal with the backlog of applications. This didn't come out of the sky. This came out of the real experience of people in the field who believe that this will be a way in which they can speed up their work and meet all of the conditions under this provision of the act and under other provisions of the act as well.

[1505]

The Chair: Member, is your question on section 1 or section 2?

J. Wilson: On section 2.

The Chair: We'll have to go back, then.

Section 1 approved.

On section 2.

Hon. C. McGregor: I move an amendment to section 2 standing in my name in Orders of the Day:

[SECTION 2, in the proposed section 12.1 (1) of the Water Act, in paragraph (b) (i) (A) of the definition of "maximum eligible quantity" by deleting "500 gallons per day," and substituting "2 500 gallons per day."]

On section 2 as amended.

J. Wilson: Under "an application for a licence," section 1 (a)(i)(C), could the minister outline the other uses that would fall under the quick application process?

Hon. C. McGregor: As I'm sure the member is aware from reading the details of the bill, it will only apply to domestic and agricultural operations to begin with. This section is enabling if there is a ministerial order to add other provisions. Some of those others would include something like a kennel. For instance, a horse kennel would be considered an agricultural purpose, but a dog kennel might not. So

[ Page 14036 ]

J. van Dongen: Just a question on the issue of excluded streams: can the minister tell us whether the designation of sensitive streams under the Fish Protection Act is -- whether that work is -- essentially complete? Or is it still being worked on?

Hon. C. McGregor: It's nearing completion.

[1510]

Hon. C. McGregor: As I understand the way this section is meant to work, it will allow the designation of streams beyond those covered off by the Fish Protection Act. Other streams could be designated because of shortage of water, for instance, or because there's concern over volumes of water required for fish. Those would be categories of streams, then, that could be excluded from the quick licensing provision on the basis of those issues.

The consultation itself is designed to begin with agencies, so with Ministry of Fisheries, Ministry of Agriculture, DFO, Aboriginal Affairs line agencies that would be involved in the management of water. If concerns arise through that process, then it would be referred to a broader public consultation.

J. van Dongen: Does the minister have a time frame as to when the design phase of this will be completed and we'll actually be implementing and able to use the tool that's being set out here?

Hon. C. McGregor: The staff workplan is to have it completed by the end of October.

J. Wilson: Under "excluded streams," I understand that any streams that will get that designation will be in place by the end of October. Is that what I hear?

Hon. C. McGregor: Yes.

J. Wilson: Then does the minister have any idea at this point how many streams are going to be classified as excluded, and their locations? How much work. . . ? I mean, the end of October is not a very long time to do a lot of work here. I'm wondering at what point we sit, as of today, in relation to the final outcome.

[1515]

J. Wilson: If it's a doable task, can we expect all of these applications to be put on hold until the category of excluded streams is in place?

Hon. C. McGregor: I believe I understood the member's question to be: will you stop doing licensing while you're doing the stream designation? The answer to that is no.

J. Wilson: In that case, should I get an application approved and suddenly find out that there is an excluded stream, will that affect my licence?

Hon. C. McGregor: No, it will not. Once your licence is issued, it is your licence.

J. Wilson: I had a couple of questions in relation to the maximum eligible quantity of water that can be used under this process. It says "500 gallons per day," which is domestic. However, if another quantity is established, can the established amount exceed the 500 gallons a day?

Hon. C. McGregor: No. As it stands now, the legislation makes it clear that there is a 500-gallon-per-day limit for domestic -- that's the upper limit for which a licence can be approved under these provisions -- and 2,500 gallons per day for agricultural purposes. That's the upper limit. That's not to say that we couldn't, at a subsequent time, perhaps raise that limit somewhat as a result of reviews, but at this time it is not our intention to do so.

J. Wilson: When the minister says for agricultural use, is this use that would be for irrigation? Or is it use that would be for, say, stock watering -- something like that?

Hon. C. McGregor: The definition is meant to include crop suppression, flood harvesting, frost protection, greenhouses, nurseries, stock watering and irrigation.

J. Wilson: If we drop down to (B), it refers to "1 acre foot per year." Now, is that one acre we're referring to, or is it one foot per acre? How did the ministry come up with this?

[1520]

J. Wilson: So then the total irrigation that one could expect would be one acre-foot, which is one foot deep times whatever -- 42,000 square feet. My calculation is slightly more than 2,500 gallons. I guess if that's where it stands, that's what it is -- one acre-foot.

Hon. C. McGregor: I believe I've described what the technical meaning of one acre-foot is.

Section 2 as amended approved.

On section 3.

[ Page 14037 ]

Hon. C. McGregor: The beneficial use declaration will give us a tool through which we'll be able to better determine what use and what values are being represented by the water licence. There are some cases in the province where there clearly are shortages of water. If it's determined through the application of this provision that there is not a beneficial use being made of that water, then it's incumbent upon us to have that information and use the provisions under the act to either modify that licence to reflect what portion is being used beneficially or in fact to consider cancelling it at the end of the three-year period that is already a part of the act. But it gives us a tool through which we can assess that the water is truly being used for a beneficial purpose.

J. van Dongen: I don't have any problem with the ministry developing this tool or passing this legislation to have an additional tool, but I think it's going to be important for the ministry to be clear in terms of policies, because there are a lot of licences not being used and people continue to pay the fees.

[1525]

My second question is: does that property right have any kind of value? I think that's again a policy issue for which, in the briefing that we had, we didn't get a very clear answer. I think it's an issue that the ministry needs to have a clear sense of direction on. So I raise those two questions for the minister.

Hon. C. McGregor: Well, I don't pretend to be a lawyer, so my answers may not be as technical as some people would give. As I understand it, the water right is attached to the land, but it is not a form of property right in that sense. Whether or not it has a value. . . . I think that water does have a value. But if the member is asking whether I think it's a compensable value, then I'd say no. That's attached to the beneficial use provision, because we view water as a provincial resource, not the right of an individual. It has to have that beneficial use attached to it.

J. van Dongen: That's a useful answer. I think it is an important policy issue, because I have heard -- I don't have concrete evidence of this -- that there were situations where a farmer who held a water licence and was going to release it back to the Crown made a deal with another farmer or another property owner, and there was a small exchange of dollars from farmer B to farmer A -- subject to the obvious approval of the ministry. Certainly my understanding is that this has happened. I think it's important for the Crown to have a clear policy on that -- whether or not those sorts of things are considered to be allowable under the intent of the legislation.

Hon. C. McGregor: A private transaction like that would have no standing with the ministry. People can enter into them if they choose to, but it would have no standing from our perspective. They would have to meet all of the same criteria for the transfer of that water licence as any other applicant would. I mean, that's not to say that people wouldn't engage in those discussions. But from our point of view, it has no standing.

J. van Dongen: One final comment on this section is that it's my understanding that under the Water Act, where there are new applicants for water on a stream or watercourse, there are provisions in the act for the ministry to go back and revisit the uses or all the other licences on that stream. And that power exists today.

Certainly my understanding is that there are people seeking water on streams where there is not a beneficial use being made by others who are currently holding licences. I would hope that this provision and other efforts that the ministry could make would be done to get some of these licences more current and to get a better use of the water resource for the Crown and for the economy around these water sources.

Hon. C. McGregor: I agree with the member's comments. I think it does provide us with that opportunity.

[1530]

Hon. C. McGregor: There would be no reason to believe that anybody who had a good explanation for why there would be that interruption in the use of the water for a period of two or three years. . . . That would be acceptable to the staff in the ministry. But obviously, if there wasn't a reasonable explanation other than that they simply weren't using it, then we have to consider the other applicants who might want to put that water to a beneficial use on that same stream.

J. Wilson: I take it that this beneficial use declaration is only going to apply for these quick use permits.

Hon. C. McGregor: No, it will apply to all water licence holders, but it will be implemented over time.

J. Wilson: The value of a water licence to agriculture can't be overemphasized. I think the minister probably realizes that, because -- considering the riding she represents, where we have a lot of agriculture along the Thompson River -- if it wasn't for the water rights on that river, that industry wouldn't exist there.

Periodically we run into stretches of weather where we don't need additional water. We may not even have to turn our irrigation system on -- like this year, which may be a good example of that. It's been raining every day. There's no need for that water. That could happen three years in a row very easily.

We have other uses out there that are permitted. We are going to see applications coming in, maybe not for irrigation

[ Page 14038 ]

Hon. C. McGregor: As the member well knows, as do all of us in this room, we would acknowledge that agricultural use is a beneficial use. That's one of the key purposes of a beneficial use: to provide that benefit not only to the person who's engaged in the agricultural operation but to the broader public to whom that agricultural product will be sold. Of course, I'm sure the member is aware that this really is not a new provision. We've been able to assess these licences in the past on the basis of non-use for a period of three years. But the member makes a good case in the seasonal nature of weather and so on. If an individual were not able to or it was not necessary to access their water licence in storage because of the way the weather had proceeded, then that would be a very good, reasonable explanation, and that would in no way impact on their water licence.

J. Wilson: Should someone have need of a water licence that can be issued in a relatively short time period for domestic or whatever use, is the ministry going to entertain an application process or something that will allow people the use of water on any river or stream where a water licence exists and is not being used? The argument that the ministry will be presented with is: "We need this water. It's important to us; it's essential. We have a volume in a licence here that is not being utilized. It hasn't been utilized for two years, and it may not be utilized this year. We need this water urgently next month or in two weeks' time, for whatever use." When the ministry knows that the licence that exists is not being used for what may be a good reason, is that new licence application going to be looked at and issued on, say, a short-term basis?

[1535]

J. van Dongen: There's just one issue that I want to raise quickly under this section. Certainly, with this bill going through, there will be a fair bit of review of the whole management of water licences. One point that I think is important is that there are many situations, in my experience, where we can get multiple uses out of water -- for example, using water for fish and also dovetailing that with the requirements of water for agriculture. I just want to ask the question in that context: does the Crown currently hold water licences exclusively for fish? Is that happening today? If not, is there any intent of going in that direction? That would be a concern from an agricultural point of view, and I would hope that we could continue to dovetail the two needs.

Hon. C. McGregor: There are some licences held by the Crown or by DFO, and they are for hatchery purposes. But there are provisions under the Fish Protection Act where stewardship agencies could apply; and if it were approved by cabinet, they could hold licences themselves for fish as well.

Sections 3 to 9 inclusive approved.

Title approved.

Hon. C. McGregor: I move that upon rising the committee report Bill 72 complete with amendment.

Motion approved.

The Chair: This committee will move on to Bill 86.

[1540]

PARK AMENDMENT ACT, 1999

On section 1.

M. Coell: Again I thank your Parks staff for their briefing and the illustrations they gave us. I wonder if we could do the same thing: have a few general questions and then go through the sections.

One of the outstanding questions is ensuring that the parks as presented have not been altered relative to the LRMP process and the recommendations for the areas. I know your staff answered this question for me this morning, but I'd like to have it on the record.

Hon. C. McGregor: We have done our very best to make sure we are implementing exactly what the LRMP tables have told us are their recommendations as they relate to designation for protected areas.

M. Coell: I would presume that that is the size of the parks and the boundaries as well.

Hon. C. McGregor: Yes, that is correct.

M. Coell: In determining why the two parks were converted into heritage sites, the explanation for that -- and the minister can confirm -- was that they were transferred to the Ministry of Tourism a number of years ago and that Parks hasn't done anything with them and is now transferring the authority to where they belong. Will the two heritage sites still be included in the 12 percent dedication to parks, or are they taken out of the dedication to parks?

Hon. C. McGregor: They are not actually included in the 12 percent, but the sites are very small and in fact would likely not have much affect on the overall 12 percent issue, in any event.

M. Coell: My understanding is that there are, I guess, three separate issues on parks in the bill. Areas that were identified through the LRMP process have now been made a classification of parks. Some parks that were of one classification have been upgraded, and the two parks were taken out. That, to me, is simply what you're doing here, and most of the announcements were known to all members of the Legislature.

In announcing the parks at the press conference the other day, the Premier mentioned that the 12 percent was a goal but that the process may be more than that. Is any work being

[ Page 14039 ]

[1545]

M. Coell: It's kind of a complicated question.

Hon. C. McGregor: . . .just like it was a complicated question. The Premier is correct in saying that 12 percent was the goal we set. It was based on the Bruntland commission, and that's where the 12 percent came from. It was really a doubling of park space in British Columbia. It was a laudable goal, and we're fast approaching it; I think we're now at 11.3 percent in protected areas. We do have a number of LRMP tables that are still to report, so those tables may take us a bit above the 12 percent. But it will be through that process that we'll determine whether or not we do exceed the 12 percent target. That was the reference, I think, that the Premier made. That's the process that we're using to identify protected areas, special management zones, intensive development areas and so on -- through that land use planning process.

But let the member have no illusions that that in fact means that we can pump this number way up. There are targets set for each LRMP table, on the basis of achieving the 12 percent target around the province. Clearly there are limitations placed on tables in terms of how much protected area they can set aside overall. That is also, in part, from the nature of the geography of the area -- pre-existing park areas, for instance, which may impact on that overall percentage of protected areas -- as well as the ecological significance of particular regions that might need to be captured. All of those are factors which influence how that number will shape and what the size of the overall total protected area will be in one LRMP versus another. We've had some fairly significant ranges, with some going well above 12 percent within their region and others going significantly below.

B. Penner: Attached to Bill 86 is schedule F, and mentioned in schedule F -- No. 30 on the list -- is a reference to the Nahatlatch valley and watershed. I wonder if the minister can confirm whether or not these changes would in any way impact any logging operations that are currently underway or affect people who currently hold rights to operate logging operations in that area.

Hon. C. McGregor: None that we're aware of.

B. Penner: It's my understanding that a number of different companies have logged in the general area of the Nahatlatch from time to time, including Cattermole Timber, which is based in Chilliwack, as well as J.S. Jones Timber, I believe, which is located in the Fraser Canyon at Boston Bar. They've had cutting rights in that area for some time. I've heard through the grapevine that perhaps there was an error initially in setting out park boundaries, which may have inadvertently left the logging companies in the position of logging in what was, in legal terms, park land. Is it the purpose of this amendment in schedule F to correct that problem?

Hon. C. McGregor: I'm unaware of there being any conflicts or issues around this protected area. It came out of the lower mainland protected area strategy. This is the first time it's been designated as a class A park under the act.

[1550]

Hon. C. McGregor: I'm sorry. It would appear that the boundary has been adjusted to reflect an existing cutting permit, so the boundary of the park has been written in such a way as to exclude that area. It's adjacent to the park and not included within it.

B. Penner: Thank you for that clarification. If I can just push the minister, though, to let us know: what was the category of this park before? You indicated that it has now been upgraded to class A. Was that area designated as a park previously?

Hon. C. McGregor: This land didn't have any previous designation. It came out of the lower mainland protected area strategy. It was recommended as an area to be protected. It was Crown land up until that point.

B. Penner: I'm aware of the time, but there's one other matter that I became aware of only last Friday. Otherwise I would have raised it during the minister's estimates debate. I'm told that this year there is reduced availability of brochures that promote B.C.'s parks. Hotel and restaurant operators in Hope tell me that they're upset that they don't have access to brochures promoting Manning Provincial Park.

When I made some inquiries this morning, I was told that the ministry has changed the way it handles the distribution of brochures. Previously the ministry would produce all the brochures for the various provincial parks in British Columbia centrally here in Victoria and distribute them to the various regions of the province. Now, I'm told, the various park districts are responsible, within their own budgets, for printing, producing and distributing the brochures that apply to the parks in their particular areas. This seems to have led to a somewhat uneven availability of brochures that promote our parks.

The reason I'm concerned about this is that I'm worried we may miss out on an opportunity to capitalize on the economic potential from tourism that our parks lend themselves to. I wonder if the minister can clarify the status of the individual brochures that typically would refer to a specific park -- or maybe one or two parks -- in a given area, listing the hiking trails, the camping facilities and the other recreational opportunities that present themselves in those particular parks.

Hon. C. McGregor: Well, there are a number of ways in which these kinds of publications can be continued. It is largely in partnership with other agencies or non-profit groups through advertising. The member will probably be

[ Page 14040 ]

It's self-funded, really, through the contributions of advertisers. So there's clearly an opportunity in the case of Hope, if they're interested in doing a brochure in a similar way -- or in a different way -- to engage in that kind of partnership with the district office for that parks region to ensure that that kind of publication can continue.

But it is true that this ministry's budget has been reduced, and one of the things that we've reduced some spending on directly is brochure development and printing. That's why we've gone to this new partnership methodology, which is just as successful, I might add, and gives the same kind of tools to really promote the values of the parks around the province.

[1555]

The Chair: Member, through the Chair, please.

J. Wilson: Were these parks that I see in schedule F at one point all set aside as protected areas -- and now they're going to receive park status?

Hon. C. McGregor: All of schedule F includes all of the new protected areas that have been announced through a variety of LRMPs, including the lower mainland and the Muskwa-Kechika, Fort Nelson and Fort St. John. But it also includes 15 parks that were previously declared under an OIC designation.

J. Wilson: Then will it be the intent of the ministry to designate all protected areas that are set aside as parks sometime in the future?

Hon. C. McGregor: Sometimes they're covered under the Park Act; sometimes they're covered under the Ecological Reserve Act. From time to time they're under the Environment and Land Use Act. Because there could be pre-existing uses, we are unable to designate them as a class A park, given the kind of restrictions that are placed on certain types of activities under the class A designation under the Park Act. But under one of those three mechanisms, yes, it is our intention to protect them.

J. Wilson: What I understand the minister to say here is that any acceptable use in a protected area will be protected and not infringed on by moving that protected area into, say, a class A park which may not permit the existing permitted uses that are there today.

Hon. C. McGregor: Existing permitted uses continue as part of the negotiation around the LRMP processes themselves. But there are cases from time to time where the table itself comes to an understanding that there may be a permitted use that's ongoing at this time that might end at some future time and that when that permitted use ends, it could then turn into a class A designation. These kinds of opportunities are afforded from time to time when that previous use ends, but these are matters that are directed by the LRMP tables themselves.

[B. Goodacre in the chair.]

[1600]

Sections 1 and 2 approved.

Sections 4 to 9 inclusive approved.

Schedule approved.

Title approved.

Hon. C. McGregor: Hon. Chair, I move that the committee report the bill complete without amendment.

Motion approved.

The Chair: Could we have consent to go back to Bill 72 to redo section. . . ?

Leave granted.

WATER AMENDMENT ACT, 1999
(continued)

Section 10 approved.

Interjections.

PARK AMENDMENT ACT, 1999
(continued)

The Chair: We've been informed that we missed section 3 of Bill 86. Shall section 3 pass?

Section 3 approved.

The Chair: We'll recess for a minute or two until we find some more legislation.

The committee recessed from 4:04 p.m. to 4:06 p.m.

The Chair: I call the committee to order on Bill 79.

[ Page 14041 ]

LAND RESERVE COMMISSION ACT

Section 1 approved.

On section 2.

B. Barisoff: Could the minister indicate to me what land is actually in the forest land reserve?

Hon. C. Evans: Does the hon. member mean how many hectares? Or is he talking about a generic description of what kind of land it is?

B. Barisoff: Actually, I'm looking for both. I'm looking for how much land is in there and, basically, exactly. . . . We've been trying to get the information and can't seem to get hold of what land is actually in the forest land reserve.

Hon. C. Evans: In the forest land reserve there are 15,320,000 hectares of Crown forest land. There are 716,000 hectares of managed private forest land under the managed category with the assessment branch, and there are 207,000 hectares of Crown licensed private land -- that would be private land which is held under a tree farm licence -- for a total of 923,000 hectares of private land and a grand total of 16,243,000 hectares of total forest land reserve.

J. Wilson: At 16 million hectares of forest land, how much of our Crown forest land, then, would be excluded from the forest land reserve?

Hon. C. Evans: The very vast majority. I'm not sure what percentage the forest land reserve represents, but it's a very small portion of the total.

J. Wilson: So the portion of Crown land that is included in the forest land reserve -- can the minister tell me where this Crown land is, say, by region? We've been led to believe that there is no map available or anything that can show us where that Crown land actually exists, except by reference maps, which are very small maps and small areas. They have never been put together into one map that would cover a region or a district or the province, as far as that goes.

[1610]

However, there are approximately 25 regional districts in the province. I could read off every one and the amount of forest land reserve in each one. Or the hon. member could ask me about the regional districts that he's interested in, or I could just share the paper with him.

J. Wilson: It's a little bit confusing to me. During the Forests estimates, the Minister of Forests made the unequivocal statement that all Crown land in the province that is forest land is in the forest land reserve. Now, either this ministry is not up on it or the Minister of Forests is not up to speed. Could the Minister of Agriculture try and clarify this situation?

Hon. C. Evans: Absolutely. I'll clarify it for you.

J. Wilson: Is all of the Crown land in the province included in the forest land reserve -- or is it not, as we've heard today?

Hon. C. Evans: My impression is that it is not. However, the Minister of Forests, of course, is much wiser on these matters than I am. It's also his purview. So I will clarify it rather than contradict him.

J. Wilson: Foiled again, hon. Chair.

The reason I ask the minister this is that if the Forest Land Commission is going to be the advocate for forestry and the Agricultural Land Commission is the advocate for agriculture, and the two commissions are combined and sit at a table to make decisions. . . . Then supposing -- and this is not just supposing -- that a lot of agricultural operations in this province are not within the agricultural land reserve but will be in the forest land reserve, will there be advocacy there for agriculture? Or will it be for forestry, because they are not located within the agricultural land reserve?

Hon. C. Evans: The Ministry of Agriculture will continue to be the advocate for agriculture. However, the Minister of Agriculture would like to move away from the two-solitudes way that we've historically looked at the two industries to a more unified point of view which allows the landowner or lessee to grow animals, vegetable products, grasses or trees, according to what they think is best for their pocketbook.

[1615]

J. Wilson: But by combining two commissions, are we still not dealing with two commissions that speak for two different industries? We're not combining them to deal with what that person would like to do to make a living or how they see fit. The commission's mandate is to speak for the resource. I don't see anything in here that will allow the combined commissions to modify the rules that they have to follow.

Hon. C. Evans: Well, yes, I think the hon. member is correct, but we're working here in sort of an evolutionary way.

[ Page 14042 ]

Section 2 approved.

On section 3.

B. Barisoff: Carrying along with my colleague, I think that, hon. minister, is probably one of the concerns that we have. In the Agricultural Land Commission Act, section 10(b) states: ". . .encourage the establishment and maintenance of farms, and the use of land in an agricultural land reserve compatible with agricultural purposes." However, section 3(c) of this act is very general, stating: ". . .encouragement of farming, forestry and agroforestry on agricultural reserve lands and forest reserve lands." I think our concern is: shouldn't a clearer distinction between a suitable use for each of the two reserves be set out in this bill and not just be left at the consultation of the two existing acts?

Hon. C. Evans: This section, section 3(c), tells the new commission what its purpose is. This is not the purpose of either of the reserves. The purpose of the commission is: "to assist the communities of interest referred to in paragraph (b) in the accommodation, support and encouragement of farming, forestry and agroforestry on agricultural reserve lands and forest reserve lands." That's what we want the commission to do: to assist people. And as the previous hon. member spoke, he used the words "advocate for." It could just as well say "advocate for the communities of interest." However, later on in the act there will be sections that refer to the purposes of the reserves, which remain agriculture and forestry. We're just trying to say to the commission: "Go out and assist the communities to do the work that they desire to do."

[1620]

Hon. C. Evans: Yes, the hon. member is correct. We felt it unnecessary to say in this bill what the purpose of the forest land reserve is and the agricultural land reserve is, because there are acts. There is the Forest Land Reserve Act, and there is the Agricultural Land Commission Act. What this act is about is creating a new commission which is supposed to be, I hope, thoughtful and sort of aggressive in helping people to do the kind of work they want to do. They have to work within those acts that set out the forest land reserve and the agricultural land reserve, but the commission itself should be the advocate for people who want to work there or make a living there. In fact, what I hope we're doing is saying to the commission: "Break down some of the barriers in your head and help people go do the work that they've always been doing."

J. Wilson: The Agricultural Land Commission basically deals with rezoning applications and this type of thing -- uses that people want to put agricultural land to that may not be compatible. They make decisions under the act.

The forest land reserve falls under an act very similar to the agricultural land reserve. Now, the point I'm trying to make to the minister is: should I have an agricultural operation that is outside of the agricultural land reserve, it is in the forest land reserve. There are a lot of them out there, especially in the interior and the north. I may be surrounded by huge areas of land that are suitable for either agriculture or forestry. Unless you're a proponent of the forest industry, most people will agree that agriculture is a higher use of land, and over the long run it creates more jobs -- more employment -- and contributes consistently to our local and provincial economies.

Should I find that my operation is somewhat hampered by its size and I need to expand, I'm going to have to apply for some land in the forest land reserve in order to expand my agricultural operation -- which, no doubt in the minds of most of us, would be better use for that land. However, I am not in the agricultural land reserve, where agriculture takes precedence. I'm in the forest land reserve, where the Forest Land Commission must be the advocate for forestry. So what will happen when an application. . . ? Now, maybe I'm one step ahead of myself, but I don't think so. Presently, should you make an application -- and this has been going on for a period of time -- you have to go through a reference process. The reference process goes to each ministry, and they pass judgment on your application -- whether or not they think it's suitable. In some cases, the application will go to the Ministry of Forests, and they will say: "No, this is in the forest land reserve. We don't want to see this land removed."

[1625]

Hon. C. Evans: The Forest Land Commission never did comment on or deliver ag leases. The hon. member is quite right that the ag lease issue needs to be addressed. However, the Forest Land Commission and the Agricultural Land Commission were not the people that were addressing them. There are other processes, and this bill doesn't affect the outcome of those processes. I'm sorry that we're unable to resolve that issue in this legislation, in part because. . . . We might have moved further had we decided to amalgamate the two

[ Page 14043 ]

J. Wilson: If someone makes an application to the forest land reserve, the way I see it -- and maybe I'm wrong here -- will that not be an avenue to appeal should an application be turned down within ministries? Is the Forest Land Commission not an avenue of appeal for forest land?

Hon. C. Evans: I've never heard of the Forest Land Commission or the Agricultural Land Commission acting as an appeal agent in terms of an application for a lease.

J. Wilson: Then, if the forest land reserve is being used as a tool to prevent applicants from acquiring land, what is their appeal route should they be turned down? What avenue do they have if it's not to the Forest Land Commission? What is the purpose of the Forest Land Commission if it isn't to hear applications or appeals for land use and land rezoning?

Hon. C. Evans: The purpose of the Forest Land Commission has been to hear applications for withdrawal or for other uses within a reserve by whoever holds a legal title or lease on the reserve. The government, through agencies of the government -- in this case, an agency called BCAL -- issues leases on Crown land. The Agricultural Land Commission or the Forest Land Commission do not act as appeals for someone who is denied a lease by BCAL.

J. Wilson: BCAL approves applications pending approval by ministries. They follow ministry guidelines to approve applications. They do not have the final say. It is up to the ministries. The ministries will use the forest land reserve, in some cases, as an excuse not to issue a lease. So what steps are available to people that need approval of these applications?

[1630]

I do not know if the farm groups on the committee would find that appropriate. However, they might. I know that the ranching industry, which is the foremost user of agricultural leases, is well represented on that committee and has been bringing forward issues like predators and the like. The ranching industry finds that committee to be a useful place to put forward issues related to cross-ministerial jurisdiction.

J. Wilson: The minister's answer is fine to a point, but at this point what I hear is that the Forest Land Commission will look at applications for withdrawal of land from forest land, but they have to be lands that are under title.

However, the question still remains, and we haven't received the answer yet. Is all Crown forest land included in the forest land reserve? If it is, then it has a very important bearing on my questions. So when I get that answer, things will fall into place a little more than at the moment.

J. van Dongen: I want to follow up on some of the earlier questions from the member for Okanagan-Boundary, particularly with reference to 3(c) in this bill versus 10(1)(b) in the existing act. In this bill, we're talking about the objects of the commission and the existing Agricultural Land Commission Act. We're talking about the objects and powers. If we look at objects and powers in the existing act as they intend it to be amended, when it's amended, 10(1) will read: "It is the object of the commission under this act to. . . ." Then it goes through the various (a), (b), (c). . . .

It still strikes me that there's a fairly direct conflict between the objects of the commission as proposed and what would be in the existing act as amended. In 3(c) here we're saying: ". . .assist the communities. . .in the accommodation, support and encouragement of farming, forestry and agroforestry on agricultural reserve lands and forest reserve lands." In the Agricultural Land Commission we just talk about agricultural purposes. That seems to me to be a direct conflict. I'm wondering, again, how the minister reconciles those two sections -- the direct conflict there.

[1635]

I don't happen to think that to assist the communities of interest in the accommodation, support and encouragement of farming, forestry and agroforestry is a contradiction at all. What did we used to call it when people grew nursery crops on agricultural land? Is that less close to perfection than growing food? What about people growing turf farms? Is that okay? What if you happen to grow flowers, and you don't eat the. . . ? We call that agriculture. What if you grow poplar trees? How is growing a poplar tree agriculture and a fir tree, forestry? I don't see the contradiction.

In fact, it seems to me that the hon. members would want to deregulate government and make it work for people. Let people decide what's a crop. We're trying to make it possible to make money, not fit people into boxes.

J. van Dongen: Well, I appreciate the minister's excited answer. Maybe I can respond to the minister this way, then. Under the current Agricultural Land Commission Act, is my understanding correct that if the Land Commission so chose on a policy basis that farmers could grow virtually any kind of tree as a crop. . . ? Is that not possible under the existing legislation?

Hon. C. Evans: All forms of forestry are permitted. In the ALR you can grow fir trees or cedar trees; you just can't call it the crop for tax purposes. The opposite is not true. In the FLR you can't grow corn, necessarily, on land. You can't clear land to grow corn without permission.

[ Page 14044 ]

Hon. C. Evans: It doesn't yet, but I hope that it will. As I say, we're not melding the reserves, changing the nature of the reserves; we're just melding the commission. I hope that the commission will make recommendations that make sense. I have had representation by some landowners whose land is in FLR right now who want it moved into the ALR because they find it more permissive. They find that the ALR rules give them more scope for making money. But we're not going to do that. We hope there will be recommendations in the future that move in that direction, but not at this stage.

J. van Dongen: I think I understand the minister's expansive and futuristic thinking here. But I think one of the concerns that we have -- and what's behind all of these questions -- is that given the significant pressures that land in the agricultural land reserve faces, is the minister not concerned that this direction within the legislation and possible future directions are going to water down or weaken the commitment to the agricultural land reserve? With this legislation, there will not be an Agricultural Land Commission. I think that's the issue that we're struggling with. Are we watering down that body that has a specific commitment to the preservation of agricultural land? I think that's fundamental to our interpretation of where we're going with this bill.

Hon. C. Evans: I appreciate that clarification. The hon. member is correct: there won't be an Agricultural Land Commission. That will be a change forever. But there will still be a Land Commission with an Agricultural Land Reserve Act. It matters less, I think, what you call this group of people. You could call them the library board. If their mandate is to deliver the Agricultural Land Reserve Act, that's what they'll do.

[1640]

J. van Dongen: Well, certainly the direction that we're going here does give the prospects of more flexibility down the road, and I'm certainly not one of those people who believe that we shouldn't grow a tree in the agricultural land reserve. On the other hand, there may be land that's currently in the forest land reserve that could be effective range land.

But I guess the concern and another dimension to our questioning of the minister is that, with the Agricultural Land Commission, we've seen a relatively tight and very defined boundary, whereas with the forest land reserve we don't seem to have that same sense of a tight, well-defined boundary. I think that's part of the questioning behind this: well, what is the forest land reserve? You seem to get different answers. I would be more comfortable, I think, if I understood the forest land reserve legislation better and if I knew that that was very, very clearly defined as all of the working forest land -- as, you know, I perceive the agricultural land reserve to be defined now.

So that's the other part of. . . . There's the commission itself having a broader base and possibly in the future the reserves having a broader base. That's where our questioning on the forest land reserve is coming from. Maybe I could just ask the minister: in 3(a), where the bill talks about the working forest land base. . . ? Maybe the question I could ask the minister is: is the term "working forest land base" the equivalent of the forest land reserve today?

The second part of that question is: does that include all of the land that's currently being worked as forest land? My understanding is that it does not. So then the question becomes: well, why doesn't it? Why isn't the concept kind of parallel? That is, as I said, the other aspect of our perception that this could weaken the resolve. It could weaken, maybe not in a legal sense, someone else's perception -- the public's perception -- of the commitment to the preservation of the land base. So that gives the minister lots of things to work with.

Hon. C. Evans: I appreciate the hon. member's comments, especially when he says "maybe not in a legal sense" but in people's perception. It does not weaken the intent or the borders of the agricultural land reserve or the forest land reserve in any legal sense.

Now, on the question of whether or not it does in any kind of a social or political sense, the hon. member knows that the agricultural land base, while it is defined by the agricultural land reserve. . . . The previous hon. member pointed out real well that there are lots of agricultural activities that take place off of the agricultural land reserve, and we still consider them part of the agricultural land base. I'm pretty sure that when people fly overhead in an airplane and look down, they can't tell the difference between that ranch that's in the ALR and the next ranch that's out. Similarly, to me, the working forest is almost a jargon term used in law here, which means the land that we've agreed that we're going to work on. But flying over in an airplane, you couldn't identify the difference between that piece of the working forest that's in the reserve and that piece that's out.

[1645]

Otherwise, you take something that's finite and known and mix it with something that is less finite and less known and perhaps water it down. That's not in this law; that's what we're not doing. That's why, I hope, the hon. members take some comfort that this is just the bringing together of two

[ Page 14045 ]

J. van Dongen: I realize that certainly we're projecting beyond the words on the paper in terms of where the minister appears to want to go with this. I guess one more question on this section. . . . I assume that the minister's lawyers have looked at this issue of potential conflict or allegations of conflict between the objects of the commission and the objects of the Land Commission over here. The minister has a clear legal opinion on that -- that this is all workable.

J. Wilson: I'd like to go back and pick up on something the minister said. He made the statement, I believe, that in the agricultural land reserve you can do pretty well whatever you want. You can grow trees. The only thing is that you can't, perhaps, get a tax break as an agricultural producer under your tax assessment. That would be the only difference I see. Yet within the forest land reserve you couldn't clear up a piece of ground and plant it to corn; that wouldn't be an acceptable use. Am I correct in what I hear?

I'll take that nod as a yes.

Now, if all the things we do on the agricultural land base, whether they're in forestry or agriculture, are acceptable uses: growing trees, whatever. We seem to have run into a bit of a hurdle here with what you do with what you produce or can produce out there. I'd like to go back and maybe point out that the Agricultural Land Commission may not allow certain types of activities to occur, even though they are dependent on the crops that are produced there. A good example would be log home building on agricultural land. It still is not a completely acceptable use, in my understanding.

B. Barisoff: Just one quick question. I didn't get the answer from the member for Abbotsford. I think the minister leaned over and was going to get an answer for that last question from the member for Abbotsford -- about the legal part of it.

Hon. C. Evans: Yes, I have that commitment from our own legal department and also from the Ministry of Attorney General.

Section 3 approved.

On section 4.

B. Barisoff: Just one quick question here. I'm just wondering, with the five members from the Agricultural Land Commission and the three from the Forest Land Commission, has the minister given any further thought to whether it's going to be only five, or are we looking at eight or nine or ten or. . . ? Is there any figure that you've given some thought to?

[1650]

B. Barisoff: The only reason I asked the question is that I did have a concern over the fact that we had eight and just the diversity of the province and taking the agriculture issues and the forest land reserve issues -- just that it was on the record, so that we knew that was going to happen.

Sections 4 to 6 inclusive approved.

On section 7.

B. Barisoff: Under section 7(2)(a), the commission must submit "a report of its operations during the preceding financial year" to the minister responsible for the administration of the Agricultural Land Reserve Act and to the minister responsible for the administration of the Forest Land Reserve Act. Will the format of this report be general in nature, or will it specifically lay out the commission's operations with respect to each area of agriculture, forestry and agroforestry? I'm just wondering: shouldn't the commission -- not necessarily under this section -- be required to complete an annual report that would break down the commission's activity in each of these areas, to allow for an examination on how well the commission represents the interests of agriculture, forestry or agroforestry? I think my concern is that we know what's happening in each one of these areas, rather than ending up with just a general statement of: "This is what's happened over the year."

Hon. C. Evans: I hope that the hon. member's objectives will be met in the reports. I kind of think so, because they have to report to two separate ministers. The Minister of Agriculture has an interest; the Minister of Forests has an interest. I hope that both of their reports will attempt to show that they are meeting the objectives of both ministries and client groups.

B. Barisoff: I'm just making sure that these will be broken down into the two areas. That's my biggest concern -- that we actually have a breakdown. Leading up with all the questions that we've giving the minister -- particularly coming from the Agriculture critic -- I guess you understand where we're coming from; we're concerned about what could happen on the agriculture side of it. We're really concerned that we don't water that section down in favour of the forest land reserve -- that kind of thing.

Hon. C. Evans: I very much appreciate the concerns of the hon. members. I agree that their questions are appropriate. I agree that the reports should ascertain, on a year-by-year basis, whether we're meeting the objectives or watering down the interests of either group. I hope that in future years these issues are resolved, so that we can get on to other stages of what I hope will be an integration of the two economies.

Sections 7 to 25 inclusive approved.

On section 26.

J. Wilson: Under section 26, does this mean that only those agricultural operations that are operating within the agricultural land reserve will receive the Farm Practices Protection (Right to Farm) Act?

[ Page 14046 ]

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Hon. C. Evans: I have staff on this side saying yes, that's correct, and I have staff on that side saying that if municipal zoning says it's agricultural land, it does have the power of protection of the Right to Farm Act. I do not have the act in front me. This act does not change that act, so I think the context of asking the question in this debate is incorrect. But I will supply the information as soon as we get a copy of the act.

J. Wilson: If the Municipal Act does apply, does the Municipal Act read the same as, say, the act that the regional districts will operate under? Or are they under a separate act? Do they apply to agricultural operations?

Hon. C. Evans: This act doesn't change the terms of the Right to Farm Act whatsoever. It just changes the name of the act.

Sections 26 to 45 inclusive approved.

Title approved.

Hon. C. Evans: By leave I move that upon rising, the committee report Bill 79 complete without amendment and ask leave to sit again.

Motion approved.

The committee rose at 5 p.m.

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