2000 Legislative Session: 4th Session, 36th Parliament
HANSARD
The following electronic version is for informational purposes
only.
The printed version remains the official version.
(Hansard)
THURSDAY, DECEMBER 7, 2000
Morning Sitting
Volume 21, Number 1
[ Page 17241 ]
The House met at 10:07 a.m.
Prayers.
The Speaker: Are there introductions by members?
R. Kasper: Hon. Speaker, visiting us in the gallery are members of the Save the Mill Bay-Brentwood Bay Ferry Coalition. I notice that Anne Bomford, who is the area director of the Cowichan Valley regional district, is here, and I'd like the House to make them feel welcome.
The Speaker: Members, it is with regret that I inform the House today about the passing of former MLA Bernard Webber. Mr. Webber died in Victoria on Tuesday, December 5. He was elected to the Legislative Assembly in 1941 as a member of the Cooperative Commonwealth Federation, CCF, and represented the constituency of Similkameen. We were fortunate to have Mr. Webber visit the precinct on November 22 as a member of the Association of Former MLAs of British Columbia. Some of you, I'm sure, had the pleasure of meeting him at that time. On behalf of all members, I will send our condolences to his family.
DEBATE ON SUPPLEMENTARY
BUDGET ESTIMATES
Hon. P. Ramsey presented a message from His Honour the Administrator: supplementary estimates No. 2 for the fiscal year ending March 31, 2001, recommending the same to the Legislative Assembly.
Hon. P. Ramsey moved that the said message and supplementary estimates No. 2 accompanying the same be referred to Committee of Supply.
Motion approved.
Petitions
G. Campbell: I have a petition to present on behalf of 3,300 residents of Terrace, British Columbia, asking that the government restore health care to Mills Memorial Hospital in their community.
[1010]
J. Weisbeck: I have a petition here on behalf of the Friends of the South Slopes Society. They're asking to reject the mining claim in the area of Angel Springs and also to include Angel Springs in the Myra-Bellevue provincial park.
R. Kasper: I have 14,607 names on a petition urging the government to keep the Brentwood Bay-Mill Bay ferry in operation. That brings it to a grand total of 19,501 signatures that have been tabled in the House.
P. Nettleton: I would like to present a petition on behalf of 37 woodlot owners of the Stewart-Nechako Woodlot Association, who are concerned about high stumpage rates and unreasonable operating costs.
Tabling Documents
The Speaker: I have the pleasure to table the following reports: the ombudsman annual report, 1999; the financial statement of the office of the auditor general of British Columbia for the year ending March 31, 2000; report of the chief electoral officer relating to the statement of votes of the Delta South by-election held on December 7, 1999, pursuant to section 13 of the Election Act; report of the chief electoral officer on the 1999 provincial enumeration, pursuant to section 42 of the Election Act; and the auditor general 2000-01 report on the implementation of the recommendations of the budget process review panel, September 2000.
Hon. G. Janssen: I move, seconded by the member for Malahat-Juan de Fuca electoral district, that Erda Walsh, member for Kootenay electoral district, be appointed Deputy Chair of the Committee of the Whole for this session of the Legislative Assembly.
Motion approved.
Hon. G. Janssen: I move, seconded by the member for Malahat-Juan de Fuca electoral district, that Dennis Streifel, member for Mission-Kent electoral district, be appointed Deputy Speaker for this session of the Legislative Assembly.
[1015]
Motion approved on the following division:
| YEAS -- 37 | ||
| Conroy | Zirnhelt | Doyle |
| Gillespie | Kwan | Waddell |
| Hammell | McGregor | Lali |
| Farnworth | Lovick | Petter |
| Mann Brewin | Pullinger | Randall |
| Sawicki | Priddy | Cashore |
| Orcherton | Stevenson | Robertson |
| MacPhail | Dosanjh | Bowbrick |
| Janssen | Evans | Ramsey |
| Smallwood | G. Wilson | Streifel |
| Miller | Sihota | Calendino |
| Walsh | Boone | Kasper |
| Goodacre | ||
| NAYS -- 34 | ||
| Whittred | Hansen | C. Clark |
| Campbell | Farrell-Collins | de Jong |
| Plant | Abbott | L. Reid |
| Neufeld | Coell | Chong |
| Jarvis | Anderson | Nettleton |
| Penner | Weisgerber | Dalton |
| McKinnon | Masi | Roddick |
| J. Wilson | Barisoff | van Dongen |
| Symons | Thorpe | Krueger |
| J. Reid | Stephens | Coleman |
| Hawkins | Hogg | Nebbeling |
| Weisbeck |
Orders of the Day
Hon. G. Janssen: I call Committee of Supply.
[1020]
[ Page 17242 ]
The House in Committee of Supply B; D. Streifel in the chair.
The committee met at 10:21 a.m.
SUPPLEMENTARY ESTIMATES: MINISTRY OF
HEALTH AND MINISTRY RESPONSIBLE
FOR SENIORS
The Chair: I call the committee to order.
On vote 36(S2): ministry operations, $212,000,000.
Hon. C. Evans: Two days ago our government outlined an ambitious and comprehensive health action plan for British Columbia. It's a plan that recognizes that we need to take strong action now to minimize the immediate and the long-term challenges that threaten our public health care system. It's a plan that puts investing in health care for all people ahead of tax cuts for the few.
Most importantly, hon. Chair, it's a plan that responds to the most pressing needs identified by health care workers and professionals all over the province. Those people working day after day in our health care system were very clear about what their needs were. They said to us: "Get us some more help, so we don't burn out." They said: "Get us some state-of-the-art equipment, so we don't get hurt on the job and we can provide the care that we were trained to provide." And they said to us: "Our hospitals can't do it all. Do things now to improve care in our communities, so the people who do not want to be, or do not need to be, in our hospitals don't have to be in our hospitals." And that's exactly what we're here today to do. We're here today to approve the funding needed to move ahead with dozens of initiatives contained in the health action plan.
As far as media critics have said
It can take over a hundred different technical professions to provide the comprehensive care to just one hospital patient from the time they come in the door to the time they finish and go home and do rehabilitation. The demand for those technical skills alone will continue to grow here and all over the world. We need to act now to make sure that we have the appropriate workforce trained and in place to meet those demands. We also need to make sure that they have the physical resources and the equipment they need to provide that comprehensive care.
That's why this funding includes new high-tech equipment and new hospital beds, critical care beds for the acutely ill, transition and flex beds for emergency rooms that have to deal with seasonal peaks and multilevel-care beds for residential facilities. And that's why it includes a fully functional provincial bed management system, so that people who should be spending most of their time looking after patients aren't spending most of their time on the phone looking for the right kind of bed.
This is not a very hard concept to grasp. A harder one
[1025]
Interjections.
The Chair: Order, hon. members.
Hon. C. Evans: A harder one for some people may be that the best way to improve hospital care is actually to improve community care.
The Chair: Minister, order.
Interjections.
The Chair: Would the committee come to order. Minister, I know spirits are high today.
Interjections.
The Chair: Members, order. Now, spirits are high today, but if we're going to get through the day, I think a little decorum would be required from all benches.
Hon. C. Evans: Hon. Chair, a harder concept, perhaps, is that one of the best ways to improve hospital care is to improve community care. All too often hospitalization is the only choice and not the best choice. That's why this funding includes significant expansion of continuing care and home support programs and innovative new programs to help prevent people from getting ill or getting hurt in the first place. That's why it includes funding for new community health centres where people can receive the whole range of services under one roof.
And that's why it includes funding for a new palliative care benefits program, so people don't have to die in hospital just because they can't afford to pay for their own medication and supplies, if they wish to die with more dignity at home. And that's why it includes funding for the most ambitious health information and advice program in the country, providing every B.C. household with their own health guide handbook and a 24-hour telephone access line to registered nurses, who can help them address their health concerns inside their own homes.
Finally, this funding includes $35 million to help meet current demand
pressures to cover things like B.C. Ambulance Service, volume increases
and medical services covered by the Medical Services Plan. As I said
earlier
Interjections.
The Chair: Could we bring the committee to order, hon. members.
Interjection.
The Chair: Matsqui, come to order.
Interjections.
[ Page 17243 ]
The Chair: Hon. members, bring the committee to order.
Hon. C. Evans: As I said earlier, this funding will allow us to
create a ripple across the entire health system. As I told health
Interjections.
Hon. C. Evans: I can outshout them, if you want.
As I told health stakeholders two days ago, we expect the effect of that ripple to be measured. We expect to have a public commentary and debate on how we're improving health services and how effective we are at implementing these new programs. And we expect to see results, measured results.
Some of the initiatives in the B.C. health action plan -- and there are plenty more than the ones I've just outlined here -- will take some time to show results. But there's an old saying: "The best time to plant a tree is 20 years ago, and the second-best time to plant one is right now."
C. Hansen: This is now December of the year 2000. It's the twelfth month of this year. This is the third Health minister we have had in this province this year alone. We have had three different visions for health care, and none of them have been very visionary. The minister talks about 20 years ago as the best time to plant a tree. I would say that the best time for this government to start dealing with the health care system in British Columbia would have been nine years ago.
The announcement the minister and the Premier made two days ago and the opening remarks this minister has made today are an admission of failure of this NDP government for nine years of mismanagement of British Columbia's health care system.
[1030]
It was less than three months ago that this House was called into session to pass $290 million of supplemental estimates for health care. We were told at that time the dollars that were being approved in September were going to go toward the training of more critical care and operating room nurses and improved access to operating rooms and reduced wait times for surgeries. That was September. What we found out during that debate in September was that this was not true, that the dollars were not in fact going to new initiatives. The dollars the approval was asked for in September were going to cover the existing and forecasted debts of the health authorities throughout the province.
Exactly what is before us today is yet another new initiative and yet another attempt to fool the public into believing that this government is actually doing something to improve health care in this province. And after nine years of mismanagement, nothing this government has done this week is going to fool the public again into thinking they actually have the competence to deal with health care in this province.
As part of that mismanagement, we have seen that the 52 health authorities around this province did not even know what their operating budgets would be for this fiscal year until more than six months into that fiscal year. We've had lots of discussion in British Columbia about the need for stability in health care, the need for long-term assurances that the dollars are going to be there. Instead, we don't even see oneyear budgets, never mind three-year budgets that are essential if we're going to bring that stability. And nothing in this announcement is going to bring that kind of stability.
So I would like to start by asking the minister to take himself back
five years to this same stage, right prior to the last provincial
election. In the months and weeks leading up to the 1996 election, this
political party made dozens and dozens of promises about what would happen
in health care. There were dozens of commitments made for new capital
facilities around British Columbia that were not designed to improve
health care; they were designed to buy votes and nothing more. What we
found
Hon. Chair, my question to the minister is: is there a plan with this
announcement that if by some miracle this political party got re-elected,
if by some miracle
[J. Cashore in the chair.]
Interjections.
Hon. C. Evans: Hon. Chair, the hon. member asks me to take myself back to 1996. Everybody, cast your minds back to 1996. There was a nattering nabob of negativism over there who said we'd never come back. We came back, and that's why there's a health care system in British Columbia today.
[1035]
Interjections.
The Chair: Order, order.
G. Campbell: You know, hon. Chair, it's interesting to hear the tone from the government, because I can tell you that in British Columbia they don't think it's funny what this government has done to their health care system. They don't think it's funny when your son is a patient that's trying to get access to a hospital in Terrace, and he's turned away for a night, and he goes to Smithers, and he's turned away again. And three days after he's broken his arm, finally he gets the care he needs in British Columbia. That is the result of the NDP.
This is not a strategic plan. This is a cosmetic attempt to cover up nine years of NDP malpractice; that is all it is. Nine years ago this government, members on that side of the House, were elected, and they said this: "A New Democrat government will staff our hospitals properly to eliminate waiting lists and make sure that quality health care is available to all who need it."
Some Hon. Members: What happened?
G. Campbell: What's happened since then is a deterioration of health care in this province, so that people in the province of British Columbia are frightened, so the profes-
[ Page 17244 ]
sional health care providers in the province of British Columbia are not getting the support they need after a nine-year war on their credibility and their professionalism by this government, by the NDP.
Today we have the spectacle of the sixth Minister of Health in the last four and a half years standing up and telling us that he's figured out a plan. Well, let's use the words of this Minister of Health to see how credible the New Democratic Party is in dealing with any issues in British Columbia and this government. These are this Minister of Health's words: "We made announcements about things we weren't even going to do." This Minister of Health said that his government made announcements about things they weren't even going to do. That is exactly what we're seeing from this government once again today.
The Premier of this government, the Premier who says that health care is a concern of his, goes to the editorial board of the Vancouver Sun and tells them on December 6, yesterday: "I didn't know the enormity of the problem." Someone who has been in the cabinet for more than five years didn't know the enormity of the problem. Someone who sat in cabinet and had a responsibility for providing care to British Columbians and watched as five northern communities did not have hospital services for five months in 1998, and he didn't know the enormity of the problem.
Someone who sits as the Premier of the province and has attacked doctors and gone after health care professionals, and he says: "I didn't know the enormity of the problem." Someone who sat in cabinet as they deliberately cut back equipment expenditures for health care in the province of British Columbia over the last five years, and he says: "I didn't know the enormity of the problem." Someone who didn't have the courage to charge the Health committee in the province of British Columbia's Legislature, with all parties, to go around this province to talk to people, to hear from people, to hear about their concerns, and he says: "I didn't know the enormity of the problem."
The enormity of the problem is when the Premier doesn't listen to the
cries of patients, when the Premier doesn't listen to the voices of
regional leaders across this province, when the Premier doesn't listen to
health care professionals in this province, when he says, "There is
no crisis" -- until December 6, when he says: "I didn't know the
enormity of the problem." A Premier who sat in cabinet and watched as
this government deliberately, through their own decisions, decided they
were going to cut back on the number of training spaces for nurses in
British Columbia
[1040]
A government that decided it was better to have fewer nurses in B.C, so
today, in the year 2000, they are training 272 fewer nurses than they were
in 1993
So instead of 40 nurses coming for northern communities and rural communities in British Columbia, this government decided it was better to graduate seven nurses out of UNBC this year. Of those seven nurses, two will stay in the north. This is a government that has created a health care crisis in the province of British Columbia because of a relentless scheme of incompetence and dishonesty that left patients out, and this is a government that has to be stopped.
We heard yesterday from the newest Minister of Health
Just think: if you would actually have thought of talking to people in
the health care professions; if you'd thought of talking to health care
workers; if you'd thought of talking -- if the government had thought of
talking -- to patients and asking them about the care that they're
receiving; if they'd thought of talking to people in the Peace River or in
Fort Nelson or in the Kootenays or in Trail or in Cranbrook or even in
Nelson to find out what the government's policies have wrought throughout
the system
This government does not have a plan to address the nursing and physician shortage. They have a stopgap, one-time-only suggestion that they hope will get them off the electoral hook. But there is not one patient who will have better care next week or next month, and that's because of this government's decade of negligence and incompetence that has always put the patient at the bottom of the list.
When the BCMA pointed out to the government that there were serious problems, the Minister of Health said: "The BCMA would have us believe that the system is falling apart. It's not true." The BCMA has been calling out time and time again to tell people that there is a serious, serious problem in health care. We know that this government has not listened to the people of British Columbia or to the care providers in British Columbia. This is not a plan to reduce surgical waiting lists. There is no plan to reduce the decade of neglect in hospital equipment. It doesn't come close to covering up the neglect and negligence that this government has seen.
So let me ask the Minister of Health simply this. He has announced that there will be some dollars for equipment expenditures. Can the minister tell us today what the capital costs will be? How will those costs be allocated? What regional facilities will be receiving equipment? How are the operating costs for that equipment going to be funded? What is the full cost of the operations for that equipment? Is the minister sure that the technicians are available to be sure that that equipment is going to be fully funded and fully operational, so patients in British Columbia can get the kind of quality care that they get in every other part of this country but that they have been declined by the NDP in the past?
[ Page 17245 ]
[1045]
Hon. C. Evans: Hon. Chair, I will speak quietly and briefly,
because I think most of what we just heard was rhetorical. For the benefit
of everybody here on both sides of the House and everybody at home, the
stage is now set for what's really going to happen here over the course of
the next day or few days or however long it takes. The hon. member who
just stood up is the same person who said, on the eve of the last
election, that $6 billion was enough. Now the question is, $6 billion
Interjections.
Hon. C. Evans: I said I'd say this gently.
So now we're going to have a debate, and the hon. member's question about where the money is going to go is absolutely apropos for the course of the rest of the day. That's the kind of thing we're going to debate. But folks at home, what's really going on is a real choice between the rhetoric of the other side and the action of this government in the health action plan and our plans for the future.
Hon. J. MacPhail: Hon. Chair, through you to the Minister of
Health, I'm actually delighted to be able to rise and join in this debate
on behalf of my constituents. The constituents of Vancouver-Hastings are
familiar to the Premier and to the Minister of Health, and I've been
spending a lot of time
Interjections.
Hon. J. MacPhail: Is the Liberal opposition objecting to
I've been spending a lot of time talking to my constituents about the issues that they see facing them.
Interjections.
The Chair: Order, hon. members.
Hon. J. MacPhail: My constituents really do represent today's families. They're ordinary working people that have to face the challenges of paying their bills, have to face the challenges of child care, have to face the challenges of getting their kids to school and getting a good education. And I've been talking to them throughout the last months about what their highest priorities are.
They know that they're being faced with clear choices. They know that on the one hand, they can have a government that puts health care as its highest priority, or on the other hand, they can choose to have a government that would purport to represent only the most powerful and the privileged and tax cuts that won't affect them at all. And they've made their choice, hon. Chair. They have said to us over and over and over again that health care is our highest priority.
Many of the people in my constituency are health care workers themselves. They are health care workers that, day in and day out, go into the system and try their hardest to deliver proper health care. And when they wake up in the morning in Vancouver-Hastings and hear a member from the opposition say, "What is the value of a toilet-cleaner in the system? Why would we possibly pay decent wages to a toilet-cleaner in the hospital?" they are sickened by that Liberal opposition, because they are the heart and soul of the health care system. They say: "What kind of respect, what kind of value, does that Liberal opposition put on a health care system when they have members out there calling them the lowest of the low?"
That is what this Liberal opposition thinks about the people in the health care system. When the Liberal opposition leader stands up and says, "We should be out there listening to the health care workers in the system," as the Premier and the Minister of Health have done, and a Liberal opposition member gets up and denigrates those health care workers, as did the member for Kamloops-North Thompson, those health care workers know who speaks for them. And it isn't the Liberal opposition.
[1050]
We have just been through a federal election, and this Liberal
opposition couldn't decide who to support. Some of them wanted to get up
there and prance around in their wetsuits with Stockwell Day. I think the
member for Peace River North couldn't actually get into a wetsuit, so
that's why he couldn't come out in defence of Stockwell Day. And then
others
Interjections.
The Chair: Order. Order, hon. members.
Hon. J. MacPhail: And then others wanted to support the federal
Liberals, as did the Leader of the Opposition, when the federal Liberals
Interjections.
The Chair: Order, hon. members. Hon. members, I would ask you to refrain from personal comments. Thank you.
Hon. J. MacPhail: And then others wanted to support, as did the Leader of the Opposition, the deep cuts that the federal Liberals made to our health care system over the last decade. And even in the face of those deep cuts, this government, for nine years, not only made up those cuts but added more resources to the patients of British Columbia, in spite of the Liberal opposition leader saying: "Cut deeper."
So there they were -- confused, conflicted. Should they support the Canadian Alliance, which wanted the most massive tax cuts for the powerful and the privileged? Or should they support the federal Liberals and make even greater cuts to the health care system? Well, I'm here to say that they're delivering on both their conflicts. They want greater tax cuts for the most powerful and the rich, and they want to make sure that the health care system is privatized, as would Stockwell Day. They manage to manifest, even in their conflict, both representations at the expense of the public in British Columbia.
What did our Premier do? What did the Premier of British Columbia do? The Premier of British Columbia went to Ottawa and said: "We have a plan that's practical and doable, and, federal Liberals, you have to join us." He went quietly
[ Page 17246 ]
and argued amongst all the Premiers of the provinces. He took a leadership position and got the federal government to agree, finally, to restore transfer payments for health care. And that is as a direct result of the Premier of British Columbia.
What was the Liberal opposition doing during that time? They were saying: "Cut deeper." Our Premier was in Ottawa saying: "We need to have the federal government come on board for health care." He got that money for British Columbians in spite of the Liberal opposition's protest to that.
What have we done since that time? The federal government has finally agreed, under the leadership of the Premier of British Columbia, to restore proper health care funding, and we have guaranteed that every single one of those dollars will go into the health care system. And not only have we guaranteed that every single one of those dollars will go into the health care system, we are now in the Legislature today, in the most open and transparent way across Canada, debating how those dollars will be spent. It's unprecedented in openness and the transparency.
What I would like to put to the Liberal opposition is: are they once again going to speak against it? Are they going to speak against it and confuse the public, because they have no plan? Are they going to speak against it and then stand up and vote for it? Are they going to be that hypocritical once again -- to speak against it hour after hour after hour and then stand up to show that they have no plan and join with us and vote for it? I say: "Put their money where their mouth is." If they think this is not the plan, then have the guts to stand up and vote against it.
[1055]
You know, hon. Chair, the leader of the opposition says that they've been out there talking to people. I know for a fact that they toured the province and that they refused to listen to people about health care. They had closed-door meetings where you had to attend by invitation. How's that for openness and accountability? People were knocking on their door, saying: "We have some ways of resolving the health care plan." And what did the Liberal opposition say? "We didn't invite you. We don't want to hear from you." That's openness and accountability with the Liberal opposition. I say shame on them.
Then when they kept the doors locked tight against public input, while
we were out there quietly talking to the people in the health care system
But even though the Liberal opposition leader had a nice, comfy
discussion with all of those to whom he had said: "Listen. I'll let
you into my discussions as long as you say the right things. And, oh,
those of you that say the wrong things are not going to be included in my
consultation. Come in behind these closed doors, and let's have a nice,
private chat
Let me just quote what the Liberal opposition said: "This requires
a strategic
Interjections.
The Chair: Order, members. Order.
Interjections.
The Chair: Order, members.
Interjections.
The Chair: Order, members.
Hon. J. MacPhail: "This requires a strategic, long-term plan for the province of B.C., and we don't have one yet."
Interjections.
An Hon. Member: Who said that?
Hon. J. MacPhail: That was
Interjections.
The Chair: Order, members.
Hon. J. MacPhail:
But let me just say that my constituents have a very specific question that they really, really want me to ask today. My constituents are today's families that face great pressures in their day-to-day challenges, in managing the pressures of families, in managing the pressures of work, getting their kids to school, people who are elderly. They have their parents who are elderly that they have to look after.
You know, hon. Chair, they need access to primary care outside of the ordinary hours that would be offered through doctors' offices. They need community-based health care. They need access to health care professionals after work. They need access to health care professionals who are based in their community, who are outside the emergency rooms. They don't want to take their family to emergency rooms after hours. They want to have community clinics with doctors that understand their community.
I have a perfect example that I share in my riding with the member for Vancouver-Mount Pleasant. It's a clinic called Reach Clinic. It's salaried; doctors are on salary. The health care professionals already work together in a cohesive way. But that's one clinic. That's one clinic in my community. They need more community clinics like that, which are staffed by health care professionals, where they can take their kids after school, in the early evening or on weekends. I want to know what plans you have to do more of that.
[1100]
Hon. C. Evans: The province of British Columbia at present has eight primary care clinics, as the hon. member was describing. We had only one for 25 years. Last year we added
[ Page 17247 ]
seven more, including the clinic that the hon. member refers to, and in the health action plan we said we will add five more immediately and five more per year for each of the next four years.
So without regard to the partisanship, I would like to encourage all members on both sides to go home to their communities and say that if they desire to have a community care clinic on the model that the hon. member was talking about, submit proposals to myself, because we'll be naming more clinics in the very near future.
Interjections.
The Chair: Hon. members, the Chair is having difficulty hearing everything that's being said. So I'd ask all hon. members to respect that.
G. Campbell: I want to go back to my question, which of course we didn't get an answer to. The minister has announced that there are some additional dollars for equipment. Can the minister tell us where that equipment is going to be distributed? What will the costs be of operating that equipment? Is the staff available today to make sure that equipment is put into full use? What will the patient standards be that we expect to have? We know that in British Columbia, we lag far behind the rest of the country in the use of modern medical equipment.
I can recall talking to the urologist in Quesnel, who pointed out that he was expected to practise year 2000 medicine using 1975 equipment. This is a government that has, over the last number of years, consistently underfunded equipment purchases in the province of British Columbia.
The question that I have for the minister is: has the government now decided that their previous policy of underfunding equipment, in fact, did exactly what we suggested it would do, which was undermine patient care? Does he know where that equipment will be given and distributed? Does he have the staff? Does he know that's available? Are the operating costs available? Are the capital costs available to house the equipment? What are they? And will the minister please tell us which facilities will receive this equipment and on what timetable?
Hon. C. Evans: There is $24 million allocated to high-tech
equipment in the short run, with an annual operating cost
MRIs for Thompson, north interior, capital regional district, Vancouver-Richmond, B.C. Cancer Agency, and again, Vancouver-Richmond at Vancouver General; CT scanners at St. Joseph's in Comox Valley, Campbell River, South Peace in Dawson Creek, South Fraser in Langley, capital RHB at the Saanich Peninsula hospital, and the Simon Fraser RHB at Ridge Meadows; angiographic suites at the capital regional health board at Victoria General Hospital and also at Vancouver-Richmond RHB at B.C.'s Children's Hospital; renal dialysis machines at various sites, as per the plan of the renal dialysis agency.
G. Campbell: Could the minister please inform us what the operating costs are in terms of staff -- whether the full complements of technicians and nursing staff are available to operate this equipment, and what those costs will be? Has he allocated to the various regional boards the resources necessary to make sure that this equipment is operated on a 24-hour-a-day basis until patient needs are met? That will be additional costs; I'm sure the minister recognizes it. Can he identify what those costs are and whether or not those costs have been allocated to the regional boards?
Hon. C. Evans: We announced a good deal of equipment in the
fall. As you can understand, hon. Chair, you order these machines
[1105]
G. Campbell: One of the things that I heard in our open public meetings as we went around the province -- which perhaps the minister didn't hear in his meetings -- was that there was a lot of capital that sat idle for a long time. Equipment was sitting idle for a long time because there was not the staff support, there were not the resources necessary in the various regional health board budget allocations to make sure that that equipment was used. There are operating rooms, in fact, that have never been used in this province, that have been there for 15 years.
So the question to the minister is
Hon. C. Evans: The regional health boards who create this list also create the staffing cost figures, which they negotiate with the ministry. And the $6 million figure is our estimate of the total. I don't know if the hon. member wants it broken down per machine.
As for his comment that there is equipment that is not used or operating theatres that are not used because of lack of staff, that's quite true, hon. Chair. And we should admit to failures in the system when they occur, which is really the raison d'être for everybody being here today. It's not -- I don't think, hon. Chair -- a secret to anybody in the province who reads newspapers or watches TV that we have had occasions where staffing was the issue. Equipment was there, and we were unable to deliver sometimes up to the 30 technical people it requires to use the appropriate equipment on the appropriate day. That's why the importance of the training component that is built into the health action plan.
G. Campbell: Well, I understand that when there's a windfall profit the government wants to spend it to get equip-
[ Page 17248 ]
ment. That's fine. And we need the equipment in British Columbia. The issue for me is: there is equipment, there is staffing for that equipment to be operated fully, and for the staffing to be fully operational, there needs to be ongoing funding. What is the annualized cost of these equipment changes, and is the minister planning for that in health budgets in the future?
Hon. C. Evans: Yes, it's a really good question. The only logical way to buy capital equipment is if you can then afford to operate it and the staff to run it. The cost, as I've said, is estimated to be $6 million for the list of equipment that I just read. And yes, it is planned for in next and future years' budgets.
The Chair: Attorney General.
An Hon. member: Hon. Chair, could we
The Chair: Hon. members, the Chair has recognized the Attorney General. The Attorney General has the floor.
Hon. G. Bowbrick: Thank you, hon. Chair. Last week we had the
release of the second quarterly report of this province. What was
projected at that time was a substantial surplus. Now.
Interjections.
The Chair: Order, hon. members.
Hon. G. Bowbrick: Hon. Chair, when the member for Vancouver-Kensington became Premier back in February, he committed to two very important things. One was to get this province's fiscal house in order, and the second was to respond to the priorities of today's families.
What's emerging in this debate already, since the second quarterly report, is a clear difference between the government and the opposition. There's no disagreement about the need to get the province's fiscal house in order, and it is. That's why we're projecting a surplus this year.
[D. Streifel in the chair.]
[1110]
The question is: what are the appropriate priorities of the people of this province to respond to? The Premier has made it very clear. The first priority is health care. Now, the opposition and the Leader of the Opposition in particular believe that the top priority of British Columbians is dramatic tax cuts for the wealthy, who need them the least.
So what we're talking about in this debate is part of a plan for health
care in this province. The problem that we're seeing emerging thus far and
that I think the people are seeing increasingly is that this opposition
and this opposition leader have no plan for health care. The opposition
leader has been asking questions which don't
Interjections.
The Chair: Will the committee come to order, please.
Interjections.
The Chair: Vancouver-Little Mountain, come to order. Order, hon. members.
Interjections.
The Chair: Vancouver-Little Mountain, Esquimalt-Metchosin, come
to order. Vancouver-Little Mountain
Interjections.
The Chair: Attorney General, minister, would you take your seat please.
Vancouver-Little Mountain, come to order. I recognize that the debate
is going to be difficult today. If both sides of this House
Interjections.
The Chair: Come to order, members. Vancouver-Little Mountain,
come to order. The debate is going to be difficult today. If both sides of
this
Interjections.
The Chair: West Vancouver-Garibaldi, come to order. If both sides of this House insist on carrying on in this matter, the debate is going to drag. I call both sides of this House to order.
Attorney General, would you take your seat for a moment, please.
I call both sides of this House to order. Esquimalt-Metchosin, Vancouver-Little Mountain and West Vancouver-Garibaldi, we need to continue this debate with some decorum and a little less attitude, if we're going to get through this today. And this is what I call order.
Attorney General.
Hon. G. Bowbrick: Thank you, hon. Chair.
Interjection.
Hon. G. Bowbrick: Of course, in this debate I do have a question for the minister, and I'm getting to that question.
But the point I was making is this: we have an opposition leader participating in this debate who is the man with no plan for health care in this province. He has been opposition leader for seven years, and he still can't present a plan to the people of this province.
There is a one-point plan being offered by the other side, and that is dramatic tax cuts for the wealthiest people in this province who need them the least. Now, the problem is that those tax cuts will cost billions in revenue. This opposition wants the people of this province to believe that you can take billions of dollars out of revenue in this province and you can still pay for health care. But you can't. You can't give away billions in tax breaks, particularly to higher-income people, and say that you will not hurt the health care system and that we will not move down the road towards privatization. This is what will happen, and the people of this province should have no question in their minds about that.
[ Page 17249 ]
Interjections.
The Chair: Minister. Attorney General.
West Vancouver-Garibaldi, would you come to order, please. Every member
of this House has an opportunity to rise and speak on the question and to
question the minister. So with that in mind
Hon. G. Bowbrick: As I was saying, hon. Chair, the big question -- and the question increasingly going to be asked -- is: where is that plan? Where is it? After seven years as opposition leader, this Leader of the Opposition can't offer a plan for health care to the people of this province.
[1115]
Speaking in September to the Prince Rupert Daily News
This Leader of the Opposition will hide until election day if he can. We do not intend, on this side of the House, to let him or the members of that opposition hide right through the next election. They have an obligation. He is the man with no plan until he presents a plan to the people of this province.
They have no answers on health care -- no answers. They have empty rhetoric; they have criticisms. They go around the province. They have "invitation only" meetings. They listen to their friends. They have no plan. How can they have no plan after this many years in opposition? They want to be the government of this province; they have no plan for health care.
They have a one-point plan: dramatic tax cuts for the wealthiest people in this province who will benefit them the most. That's the wrong priority, hon. Chair. It is the wrong priority.
It defies logic that you can cut billions, give away billions in tax cuts for those who least need them, and still fund a publicly funded health care system. That Leader of the Opposition will lead this province on the path towards privatization. Our public system will be undermined. He doesn't have a plan for health care.
He can participate in this estimates debate by getting up now and giving us just a hint of what his plans would be for this province, but he can't because he doesn't have a plan. He doesn't have a plan.
So I can't expect any answers. The people of New Westminster can't
expect any answers from this opposition or this opposition leader when it
comes to their plan for health care, so the only thing I can do now is
present our plan. My question for the Minister of Health is: since the
Leader of the Opposition can't offer any solutions at all because he has
no plan, the people of New Westminster want to know -- in the House, on
the record -- how this
Interjection.
The Chair: Fort Langley-Aldergrove, come to order.
Hon. G. Bowbrick:
The Chair: Before I recognize the minister, I'm going to refer to standing order 19. I'm going to read standing order 19, and I stress very strongly that this applies to every member of the House, both sides of the House:
I stress again, hon. members, that that applies to all members of the House during this debate. I recognize that it's going to be difficult, and I expect that we will conduct this House with some decorum. I would act, with regret, on standing order 19."The Speaker or the Chairperson of the Committee of the Whole shall order a Member whose conduct is grossly disorderly to withdraw immediately from the House or Committee of the Whole for the remainder of that day, and the Sergeant-at-Arms shall act on such orders as may be received from the Chair in pursuance of this Order."
[1120]
Hon. C. Evans: The hon. member's question is specific to New Westminster, and I would like to start by giving an expression of thanks to the people who work at Royal Columbian Hospital. The Premier and I were there for two-thirds of a day. We met with HEU workers; we met with nurses; we met with the physician staff at the hospital; we met with the health board and with the regional MLAs. All of those individual groups chose amongst themselves which physicians would like to address the Premier and myself, which HEU workers. And they brought an extensive list of concerns and ideas.
I was especially pleased in New Westminster that physicians came from up the Fraser Valley to make the point to the Premier and to me that the sort of urban/rural split that we sometimes think about in health care is really a continuum and not a split at all. Physicians came from up the valley to say: "We need the facilities at Royal Columbian to work in order that we can refer our patients to that facility with some faith." Amongst the ideas they put forward was the idea of a unified bed allocation system, so that if they're up the Fraser Valley as far as Hope, they can find the bed at New Westminster.
The health board made the point that they had a good number of people at Royal Columbian who they didn't really want in the hospitals. They wanted them in continuing care facilities, and they had plans for those continuing care facilities. So they are also part of the authors, in the health plan, of the need for the operational funding for 2,000 beds outside the hospital.
Staff advised me that the specifics for the Simon Fraser district are that they will receive $9.87 million in equipment and seasonal beds, home care and mental health diversion services. I think that a special use in that particular area, because they raised it so clearly, is 258 long term care beds.
G. Campbell: I'd like to go back to the questions that I was asking the minister before, to make sure that we have the answers. The minister says the operating costs of the equipment that he has announced he will be taking forward is $6 million. Is that $6 million operating cost till the end of March, or is it annualized operating costs from April 1 to March 1 of the year 2001-02?
Hon. C. Evans: It's an annualized
Interjections.
[ Page 17250 ]
The Chair: Order. Member for North Coast will come to order.
Hon. C. Evans: It's an annual cost. Most of the equipment that I read off the list to the hon. member will now be ordered and will not arrive by this March. So it's an annual figure.
G. Campbell: So in next year's Health budget there will be an additional $6 million that you believe is enough to cover the costs of staffing and operating that equipment on a full-time basis for patients across the province. Is that correct?
Hon. C. Evans: It would be wrong to figure that the operating costs of those machines is a specific figure, because according to what facility they go to, there may be people working there already who can run that machine. So that's not an additional cost. The $6 million figure that I gave is the estimate of the additional costs for new operational costs of having that equipment.
G. Campbell: Has the minister or the minister's staff done an estimate of the service plan for those machines -- meaning, how will those machines be used? How often will they be used? How regularly will they be made available? And to what extent do we expect an upgrade of patient services in the province and the resources that will be required to maximize and optimize the use of that equipment?
Hon. C. Evans: On the high-tech -- the CT scanners and the MRIs
-- the answer is yes. And if the hon. member wishes to ask a specific
question about it, I'll attempt to find the information for him. On the
general question of: do we order these machines based on an estimate of
their usage in the system
[1125]
G. Campbell: In making these allocations, these equipment
acquisitions -- at least, for the short term -- and in the allocation of
resources, can the minister tell us what the
Hon. C. Evans: I'm not quite sure from the hon. member's question if he wants it broken down by region, but I would like to say that the estimate is that the MRI usage provincewide of the new equipment will be 2,000 usages per year, and the CT scanners will be 5,000 usages per year.
C. Hansen: I want to ask the minister about the cost of the health action plan. There have certainly been very differing numbers floating around, and I'm wondering if the minister could tell us how much the elements of the health action plan will cost in total. How much will it cost this fiscal year that we are currently in? How much will it cost in the next fiscal year?
Hon. C. Evans: I think I can answer the hon. member's question. The one-time allocation cost of the plan is $197.22 million. The amount of that funding already committed in our base budget is $17.07 million, for a supplementary estimates requirement at this time of $180.15 million.
The second half of the hon. member's question was the annual cost of the plan in future years. I take that to mean the operational costs of the health action plan minus the one-time-only expenditures. The annual cost is $146.57 million.
C. Hansen: Perhaps the minister could explain to us. In the supplementary estimates that have been presented to us today, the minister is asking for spending authority of $212 million. Can the minister tell us what the additional amount is for?
Hon. C. Evans: Yes, I think I can help the hon. member understand. The difference between the figures that I just expressed in his previous question and the total that we're asking for today is increased costs of $31.6 million, which we will require by the end of the year but that are not brought forward as part of the health action plan.
C. Hansen: Can the minister tell us how many dollars are flowing from the federal government into consolidated revenue this year as a result of the CHST, which were not anticipated at the time that the budget for this year was drafted?
[1130]
Hon. C. Evans: In a more rancorous environment, I would defer
this question to the Minister of Finance's estimates, because I think it's
actually his. But it is my belief, and trying to be
The Chair: The hon. member for North Coast.
A Voice: The member's continuing.
T. Nebbeling: You can't do that. He stood first.
Interjections.
The Chair: Members, committee -- please. I'll recognize
D. Miller: Mr. Chairman, having been recognized, I'm happy if
the opposition Health critic
The Chair: North Coast, would you just hang on. Give me a little patience here, North Coast. I wasn't aware that Vancouver-Quilchena was up first. I'll take this question from Vancouver-Quilchena.
C. Hansen: I would like to point out to the minister that the $133 million he referred to was just that that followed from the latest allocations of dollars from the first ministers' conference that was held in September. There were also additional moneys that are flowing into the budget this year from the federal government, from the CHST, which had been previously announced but had not been allocated to this year's budget. I'm wondering if the minister has those numbers available for us today, because I think they are pretty relevant to the supplementary estimates that we're being asked to approve today.
Hon. C. Evans: Hon. Chair, I think that's a question more correctly directed at the Minister of Finance at the appropriate time.
[ Page 17251 ]
C. Hansen: I would also like to ask the minister: how much is going to flow from the CHST in the next fiscal year? How many additional dollars, as a result of the first ministers' meeting in September, will flow to British Columbia in the next fiscal year?
Hon. C. Evans: Again, in the spirit of helpfulness, I'm going to attempt to get an answer over the course of the day, and I will rise if I get one for you.
D. Miller: I think the debate we're having is perhaps one of the
more
G. Abbott: Point of order.
The Chair: There's a point of order, hon. member; I'll recognize the point of order.
Point of Order
G. Abbott: You've noted on numerous occasions today your concerns around decorum. It seems to me that the frustration here is obvious. We have members continuing with questions, and despite the fact that they're on their feet before the minister sits down, they're being denied the opportunity to continue with their questions.
The Chair: I would invite submissions on the point of order. Or would the Committee of the Whole prefer the Chair read standing order 37?
North Coast, is this on the point of order?
D. Miller: I thought you recognized me, Mr. Chair.
The Chair: There's a point of order, and we'll deal with the point of order first, North Coast.
Members, standing order 37 -- maybe this will help the debate in the House: "When two or more members rise to speak, the Speaker calls upon the member who rose first in his or her place; but a motion may be made that any member who has risen 'be now heard' or 'do now speak' which motion shall be forthwith put without debate."
The concern around the debate today, if I could interject a little bit as the Chair, is that all members have an opportunity to enter into this debate. It's recognized, I believe, by both sides of the House that we are in probably a very serious debate around the issues. The Chair is going to attempt to give the opportunity for all members of the House to address this debate. I think that's within the standing orders.
If the member for Shuswap would like to point out a standing order that's in violation today, we could perhaps address that. As it is, I've recognized the member for North Coast as an opportunity to take his debate in the House on these issues.
[1135]
D. Miller: I certainly appreciate that I do have the opportunity and the right to stand in this House, along with all other members, to ask questions of the minister on what I think is one of the more important debates we may have.
I'm also very pleased that unlike the opposition, when we ask questions over here -- whether it's in the House or when we go out and talk to British Columbians -- we take that information, we compile it, we analyze it, and we actually put it into a plan. We present it to the people of British Columbia because we not only ask questions, we actually translate that into action.
I am very concerned that we have a Liberal opposition that is being somewhat disingenuous with respect to their position. I think it's important to put the issues in the broader context. The fact is that the B.C. economy is performing much better than even we anticipated. If you listen to the opposition, they don't think that's happening. But the fact that we're here with additional revenue, additional spending for health care, is a direct result of the improved performance of the British Columbia economy.
We think they have some ideas over there about the economy. They keep changing those ideas; they keep denying those ideas. We think they've got some ideas over there, but the fact is that the economy is performing much better than expected. This government, after consulting widely with British Columbians, has made a decision that I think is quite in keeping with public sentiment: to allocate more of that additional revenue to improve the health care system. That, in my view, is quite an appropriate and laudable goal.
Now, no one should think that problems in health care exist only in
British Columbia. It's clear, if you cast your mind a little bit wider --
and the opposition has failed to do this
If you would listen just to the opposition in this province, they would
suggest that the problems are very narrow, that they're simply confined to
B.C. and that all the blame has to rest with the provincial government.
What I find disturbing, what I find very, very disturbing
Now, when I listen to the member for Okanagan-Penticton, and when I
listen to the Liberal House Leader
[1140]
Interjections.
D. Miller: Mr. Speaker, tell the member for Shuswap not to take anything personally; he'll have his time perhaps.
But when I do listen to the member for Okanagan-Penticton, and when I
listen to the Liberal House Leader, and when I ask them: what is your plan
Do you know what they say, Mr. Chairman? They say: "We're not going to tell you." Do you know what they say?
[ Page 17252 ]
Do you know what the member for Okanagan-Penticton said when I asked what their plan was? He said: "Call an election and I'll tell you."
Now, that's very revealing -- very, very revealing. What that member is saying is: "We have a plan and we're hiding it. We are not prepared to tell British Columbians." They are saying -- the Liberal opposition is saying -- that they are not prepared to tell British Columbians what it is specifically that they would do.
What do we have on record? What do we have on the public record? We have the leader of the opposition saying that $6 billion is enough for health care. And on top of that, at the time he said that, he said that the cuts to health care imposed by the federal Liberals at that time weren't deep enough. That's what we know is on the public record.
Now, if they want to deny that, if they want to say, "We've
changed our mind" -- fair enough. But what follows? The obligation
they have politically and to the public they hope to represent is to
actually say specifically how much money is appropriate for health care.
Mr. Health Critic, stand in your place right now and tell the public what
your position is on what the global budget for health care ought to be.
Say it right now and here today, or the public will rightly conclude that
I'm right: you have a plan. It's a hidden plan; it's a hidden agenda. It's
reminiscent
Tell the public what your position is. Everybody can ask questions; it takes some courage to actually stand up and say what you are in favour of. I invite that kind of response, Mr. Chairman.
Interjections.
The Chair: Committee, come to order. Member for Vancouver-Quilchena
Hon. C. Evans: Thank you to the previous speaker for giving us the time to get the answer to the question before the last question. Hon. Chair, I believe that the hon. member's question was on the total of the federal transfer increase as a result of the Premier's negotiations in Ottawa. Next fiscal year I believe the number is $331 million, which should help considerably to operate the health care system.
C. Hansen: Hon. Chair, I will certainly come back to this -- the issue of the dollars that will be flowing in the years to come. But before I do that, I wanted to raise the issue of continuing care, because continuing care is certainly one of the big Achilles' heels in this documentation that has been put forward. It is noticeable by its absence until the year 2003, when it comes to new continuing-care beds. It is yet an urgent need in this province, which I know the minister has been told of, time and time again, in his consultations around the province. Yet we see it's an area that has been totally ignored.
[1145]
I wanted to remind the Health minister of a commitment that was made by his predecessor that directly affects the availability of continuing-care beds in this province. I'm speaking of the situation in the Comox Valley involving Glacier View Lodge, as a result of the actions of this government to authorize and to enable the expropriation of facilities owned by not-for-profit organizations such as the Glacier View Lodge -- the legislation that was changed three or four years ago, and I guess it would be four years ago now, to allow for the compulsory expropriation without compensation of those assets.
There was a court case that came down earlier this year, a court decision. In that court decision it pointed out that while the government had backed off on their initiative to expropriate that facility, the legislation was still in place. I think the judge's words were to describe the legislation as a snake -- that while it had been scotched, it had not been killed. Those are pretty powerful words.
The minister's predecessor made a commitment that in the fall sitting of this Legislature that legislation would be changed, that the legislation provisions in there for compulsory appropriation without compensation would be withdrawn.
I'd like to point out to the minister that there is a private member's bill on the order paper today that could be called, which would actually mean that we could fulfil just one promise that was made by the previous Health minister. I'm wondering if either the minister will stand up today and refute his predecessor and say he doesn't believe that it's the right initiative or he will support his predecessor and say yes, that wasn't just his predecessor's promise; that was a government promise to make sure that this legislation was changed. Will he seize this opportunity today, while the House is sitting, to call that legislation for debate?
I will guarantee him the cooperation of the opposition to ensure that it is passed quickly, so that at least as we end this year the government can point to one promise that it actually kept. Will the minister take that initiative today, as his predecessor had promised?
Hon. C. Evans: I'm pleased that the Glacier View situation is stable and that they operate today as an independent functioning organization.
There is not a legislative agenda scheduled. Just so the hon. member knows, he's not the only person who has asked to bring forward legislation. In my consultations as I went around the province, there were a great many people who would like laws passed, and we're just going to deal with the estimates today, hon. Chair.
C. Hansen: This was a promise made by the previous Health minister -- that in the fall sitting of the Legislature, legislation would be introduced to repeal those provisions. Is the minister now adding that to the very long list of promises that have been made by this government and then subsequently broken?
Hon. C. Evans: If you take the last two questions together
This is a calling of the House to discuss supplemental estimates; this is not a legislative session. I have told that to lots of people -- other members who wish to bring forward private members bills. We're here to deal with the health
[ Page 17253 ]
action plan, without comment on previous ministers' comments or the hon. member's comments. Surely the hon. member understands that if we were to begin to have a legislative agenda, the supplemental estimates would disappear from the public's attention and this organization's schedule, and it would alter everything. We're not here to do that.
[1150]
C. Hansen: This is directly relevant for two reasons. First of
all, the minister says that this isn't relevant. It is very relevant to
our ability to develop and put in place community care beds in this
province that the not-for-profit sector, which this government pays lip
service to and then does everything to undermine
Hon. C. Evans: Absolutely, they're taking it seriously. Everywhere I went in British Columbia, the non-profit sector was saying: "We desire to build continuing-care facilities." It's built into the health action plan -- the assumption that they will be a major player in the creation of new facilities, the expansion of existing facilities and the continued operating of the facilities that they're operating today. So, for sure.
We're planning a conference next year for the non-profit sector on precisely this issue: how to expand our continuing-care facilities. So absolutely, I think they take it seriously. Certainly the people I met did. And my guess is that the hon. member has also met people all over the province -- certainly in his own constituency -- who desire to be offering continuing care.
C. Hansen: And the message I have received in those consultations, which I'm sure he has also received, is that the not-for-profit sector feels threatened by the expropriation action that was taken against Glacier View Lodge. Will the minister make a commitment to bring in legislation that will repeal the provisions of the Health Authorities Act that allow for the compulsory expropriation of not-for-profit facilities around British Columbia?
An Hon. Member: Yes or no.
Hon. C. Evans: I believe that the not-for-profit sector is waiting anxiously for these continuing-care beds, and I believe that they will respond. I understand the need for the rhetorical flourish of the hon. member. Nothing in what I am bringing forward today should in any way change the commitment of the previous minister that he's talking about.
This is not a legislative session. This is an opportunity to discuss the estimates of the Ministry of Health. I want to carry forward the good work of the previous minister in every respect, including his legislative commitments, but this is not a legislative session.
Minding the time, hon. Chair, I move the committee rise, report progress and ask leave to sit again.
Motion approved.
The committee rose at 11:53 a.m.
The House resumed; the Speaker in the chair.
[1155]
Committee of Supply B, having reported progress, was granted leave to sit again.
Hon. G. Janssen moved adjournment of the House.
Motion approved.
The House adjourned at 11:56 a.m.
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