Hansard -- Volume 5, Number 6 -- Wednesday, April 3, 2002

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

Official Report of

DEBATES OF THE LEGISLATIVE ASSEMBLY



CONTENTS

	Routine Proceedings
		Page

Introductions by Members		2399

Tributes		2399
	Kenn Borek B. Lekstrom

Statements (Standing Order 25B)		2399
	Cruise ship industry in Nanaimo M. Hunter Fish habitat protection on Vancouver's North Shore R. Sultan U.S. duty on tomatoes V. Roddick

Oral Questions		2400
	Severance payments for civil service employees J. MacPhail Hon. S. Santori Hon. C. Hansen Severance payments for health authority administrators J. Kwan Hon. C. Hansen Referendum on treaty negotiations B. Lekstrom Hon. G. Plant Maternity and midwifery services J. Wilson Hon. S. Hawkins Hon. S. Bond Report on core review of Workers Compensation Board P. Wong Hon. G. Bruce

Tabling Documents		2403
	Auditor general report No. 6, 2001-2002, Information Use by the Ministry of Health in Resource Allocation Decisions for the Regional Health Care System

Petitions		2403
	J. Kwan

Committee of Supply		2403
	Estimates: Ministry of Health Services (continued) P. Bell Hon. C. Hansen P. Wong S. Brice J. MacPhail B. Kerr S. Orr R. Lee R. Harris I. Chong Hon. K. Whittred

	Proceedings in the Douglas Fir Room

Committee of Supply		2441
	Estimates: Ministry of Human Resources (continued) Hon. M. Coell J. Kwan V. Anderson Estimates: Ministry of Attorney General and Ministry Responsible for Treaty Negotiations (continued) J. Kwan Hon. G. Plant B. Penner B. Belsey R. Lee

Hon. G. Abbott: I'm happy today to join with the Ministers of Health in making some introductions. As you may know, Mr. Speaker, the World Health Organization has designated Sunday, April 7, 2002, as World Health Day. This year's World Health Day is going to emphasize the importance of sport and physical activity in a healthy lifestyle. Certainly, that's a priority for our government, and we share that priority with many non-profit service organizations in the health, sport and recreation communities.

There are several representatives of these groups today in the gallery. I would like the House to join in welcoming Sandra Stevenson, who is the CEO and president of Sport B.C.; Gary Young, who represents the B.C. Recreation and Parks Association; Allan Courbold, manager of the Vancouver Island region of the Canadian Cancer Society, B.C. and Yukon Division; Patty McGowan, area manager for the Heart and Stroke Foundation for B.C. and the Yukon; and Arthur Burgess and Dorothy Burgess from the Canadian Diabetes Association.

These individuals work closely with the College of Family Physicians of Canada — B.C. Chapter, the Premier's sports award program and the Vancouver Whistler 2010 Bid Corp. to raise awareness about World Health Day. I ask all members of the House to join me in welcoming them to the Legislature today.

B. Belsey: Mr. Speaker, as you know, there are few times that I have the advantage to stand up in the House and introduce guests from the north coast. Few people want to leave the north coast — the clean water, clean air and clean living — but I have a couple of guests that have come down, plus my wife. I'd like to introduce Judy Fraser, who worked hard on my campaign as a scheduler and coordinator — she worked very hard; her husband, Paul; and my wife, Lonie. Please join in making them welcome.

R. Visser: It's not often that I, like the member for North Coast, get to rise and introduce some guests in the House. Everybody says that their guests come from the most beautiful part of the province. I have to say today's guests are from Kyuquot, which is, without question, one of the nicest spots on this planet. It's on the west coast of Vancouver Island, in the riding of North Island. I asked them today at lunch how they'd like to be introduced. They said: "In Spanish, hopping on one foot." I said I didn't think I could do that.

In the gallery today are Tania Jack, Henry Jack, Josh Gillette, Devon Hansen, Irene Hanson and Arlene Smith, students in grades 11 and 12 in Kyuquot; their teacher Brenda Gilman; elder and teacher Ann Cox and a third teacher, Dirk Zand. They're all here from Kyuquot. Would the House please make them welcome.

V. Roddick: In the House today — from beautiful, green, sunny Delta — is the president of the Delta Chamber of Commerce, Gerry Beltgens. He also, along with the chamber's support, is project coordinator of the Delta portal project, a strategic plan for post-secondary education in Delta. Will the House please make him welcome.

B. Lekstrom: I rise today with a note of sadness to report on the untimely death of one of our pioneers in the north, Mr. Kenn Borek, who was killed on Easter Sunday in a tragic car accident along with his daughter, Carleen. Kenn contributed to the development of the north in many ways, beginning his business in 1955. He was involved in construction in the oil field industry, the agricultural industry, the real estate industry and the aviation industry. Kenn contributed to the north as a pioneer and to opening it up and accessing the resources that help benefit all of us as British Columbians.

Kenn is a friend I've known all my life. I've grown up with his family, and I can tell you he was a man of honour and integrity. He went about his business and worked every day of his life. Up until his untimely death, both he and his wife, Rosella, were out at work every day in Dawson Creek, running a worldwide business from what we consider the true beauty of the north. He maintained his lifestyle and his home there with his family. I would ask the House to join me in passing our deepest condolences to the Borek family, in our thoughts and prayers.

M. Hunter: Today I'm going to borrow a phrase from the Minister of Energy and Mines. I want to tell the House about more good news from Nanaimo. As we all know, as surely as the swallows return to Capistrano, cruise ships start returning to British Columbia in the spring. Well, today the first cruise ship to ply B.C. waters in the 2002 season arrived in the port of Nanaimo. The Spirit of Columbia, owned by Cruise West in Seattle, with 80 passengers from all over the U.S.A. aboard, docked in Nanaimo for the first of a number of pocket cruise ship visits through 2002. Pocket cruises are a major growth sector within the cruise ship industry. The 143-foot Spirit of Columbia will operate out of Nanaimo on local cruises in southern B.C. for the

I want to praise all the people in Nanaimo who have worked so hard to attract the pocket cruise industry to my home port. Tourism Nanaimo, in particular, and the Nanaimo Port Authority really deserve the bright sunshine that greeted the vessel and its passengers this morning. Many other organizations and local businesses were involved in helping to sell Nanaimo to Cruise West as a destination during the spring and fall shoulder seasons. This commitment to the development of the tourism industry and its potential in Nanaimo and the mid-Island is just one more sign of a growing confidence in British Columbia.

We have a magnificent product to sell in this province, and in Nanaimo, as today's event shows, we have the motivated people to sell our local product. I'm delighted that Tourism Nanaimo, in cooperation with all its business partners, is leading the way in the British Columbia tourism sector with an aggressive approach that is creating new opportunities and helping to build new businesses. I am confident that those who are visiting Nanaimo for the first time today on the inaugural visit of the Spirit of Columbia will have been impressed by the warmth of their welcome to Nanaimo, the harbour city and the gateway to Vancouver Island.

R. Sultan: I rise to commend the 250 eager youngsters who recently descended upon Edgemont Village in North Vancouver to adopt a fish. I was one of them. The idea was to register at a booth opposite Delany's, get a diploma from the North Shore Coho Society, then hike down to McKay Creek where volunteers from the North Shore Fish and Game Club helped each youngster transfer a salmon fry into the creek, all the while receiving a lesson in fish habitat protection.

Brilliant educational strategy. In three hours about 400 chum fingerlings were sent on their way to the Pacific Ocean. North Shore creeks are home to Dolly Varden, all species of salmon, cutthroat and rainbow trout, and steelhead. Their enemies are people who dump chlorinated hot tub water onto the front lawn where it ends up God knows where, old paint and crankcase oil into storm drains, and the thoughtless encroachment of buildings, driveways and parking lots and loss of streamside vegetation.

Those things don't help very much, but on the North Shore we're demonstrating that development and fish can coexist and prosper. Some would have us believe this is impossible: "Either kill the fish and let development prosper, or kill the development and let the fish prosper." You don't have to kill one to save the other. For example, encouraging negotiations are underway with Seaspan to relocate the mouth of McKay Creek away from the ditch cutting through their marine basin. If these negotiations are successful, an estimated four to six of our adopted fish, and maybe even one of mine, will return home in four years to a restored natural estuary on Burrard Inlet.

Did you know that virtually every North Shore creek has a resident fish population? Otter know. They regularly clamber up McKay Creek catching fingerlings and crayfish right alongside the Sears parking lot. The hills are alive, and on the North Shore we intend to keep it that way.

V. Roddick: I am very pleased that the United States International Trade Commission has determined that anti-dumping duties imposed on the B.C. greenhouse tomatoes shipped to the United States were not warranted. Duties on British Columbia and other Canadian greenhouse tomatoes will cease within ten days, and liquidation of previous bonds and the return of all duties will be completed within 30 days. This is an excellent news story for my constituency, for British Columbia and for Canada. I wish to extend my appreciation to all those in the greenhouse industry who worked tirelessly on this case for their victory.

Tomatoes are the central product of the B.C. greenhouse industry, an industry which employs 5,000 British Columbians directly and indirectly. A North American tomato trade working group has been formed to help resolve trade negotiation problems and misunderstandings by consultation and negotiation.

This commonsense approach was first advocated by our Minister of Agriculture, John van Dongen, at the Canada–United States–Mexico tri-national agricultural accord meeting in Mexico last September 2001. Basic common sense prevailed throughout these discussions. A wonderful example was set by a member of the commission. She walked into the hearings one day with two tomatoes, plunked them down and said to everyone present: "All right, which is greenhouse, and which is field?" No one could tell. Her comment: "Then why are we here?" May further dealings with our North American trade partner use this as an example.

J. MacPhail: Last week the Minister of Finance told me to ask this question of the Minister of Management Services.

Can the Minister of Management Services confirm that in B.C. the law stipulates that public sector employees will not receive severance if they leave their jobs voluntarily?

Hon. S. Santori: If the public service employee leaves voluntarily, I believe that the severance pay is

J. MacPhail: That's not the part of the law that I'm talking about, but I will make the law in B.C. very clear. The Public Sector Employers Act regulations say that employees who retire or resign voluntarily are not eligible for severance.

Can the Minister of Management Services, who is responsible for enforcing this act, explain why the chief operating officer of the Central Island portion of the Vancouver Island health authority, Grant Roberge, received a 16-month, $300,000 severance package following his decision to quit?

Hon. C. Hansen: The health authorities, as the member knows very well, fall under the responsibilities of the Ministry of Health Services.

The severance provisions that were put in place for Mr. Roberge flowed directly from the contract that was put in place while the previous government was in office. We are obligated to abide by those contractual obligations.

J. MacPhail: In fact, the previous government put in the law that I am talking about.

Maybe the minister needs a few more facts. Following a management review, Mr. Roberge decided that he didn't like his new job, and he quit. Under the law, he should have been given a going-away party. Instead, he was handed a $300,000 severance cheque.

Given that Mr. Roberge's severance package is in violation of the law, will the Minister of Management Services — who the Finance minister says is responsible for administering the law — step in and investigate? And if it contravenes the law, will he see to it that Mr. Roberge's severance payment goes to patient care?

Hon. C. Hansen: There was a significant change in Mr. Roberge's responsibilities. It was considered to be constructive dismissal, and therefore the provisions that were in his contract had to be implemented and were actioned.

J. Kwan: Health authorities around the province are refusing to answer questions around severance payments. However, we do know that many health administrators are being handed some very hefty severance payments and pay raises as well — a pay increase of $45,000 per year for the CEO of the Vancouver coastal health authority. And last week the Minister of Finance, with no notice or any details, rushed through a bill paying almost $100 million in severance costs.

Would the Minister of Management Services, in what is fast becoming the most expensive and secretive government in Canada, like to tell British Columbians how many more health administrators are getting…

Mr. Speaker: Order. Hon. members, we cannot hear the question. Would the member please repeat her question.

J. Kwan: Would the Minister of Management Services, in what is fast becoming the most secretive government in Canada, like to tell British Columbians how many other health administrators are getting backroom deals, payouts that contravene the law?

Hon. C. Hansen: Those contracts are being put in place by the respective health authorities under the direction of the chairs of the health authorities. We have made a commitment that we're going to ensure that our top administrators are remunerated in a way that's comparable to other jurisdictions and industries. The instructions to the health authorities are that those contracts have to be consistent with the guidelines set down by government.

J. Kwan: The law is clear. Severance must not be paid if an employee leaves his or her job voluntarily. We have evidence that the law is not being followed. Money should go to patients; instead, it is going to severance. The minister refuses to answer the questions, he refuses to step in, and he refuses to investigate. I'll give him one more chance: will the Minister of Management Services, who is responsible for the public…

J. Kwan: …service severance, order a full investigation into these secret backroom severance payouts so that British Columbians can have confidence that the law is being followed?

Hon. C. Hansen: As I reminded this member's colleague, the health authority operations are a responsibility of the Ministry of Health Services. The instructions we have given to the health authorities are that their contracts have to be consistent with the guidelines that have been set down by government. We made a commitment to British Columbians that we're going to

reduce the amount of administration in health care so that dollars can be focused on patient care.

As we go through that readjustment process, there are people whose positions are going to become redundant. The commitment we've made is that we will treat them fairly, that they will be paid severance where that's appropriate and is required, and that we will make sure those dollars, in the future, get redirected into patient care, because that's the bottom line for us as a government.

B. Lekstrom: My question is to the Minister Responsible for Treaty Negotiations. A number of my constituents have been phoning my office to seek clarification on some of the questions in the treaty referendum. For instance, the referendum asks whether fair compensation for unavoidable disruption of commercial interests should be ensured. Can the Minister Responsible for Treaty Negotiations explain or provide an example of what is considered unavoidable disruption of commercial interests?

Hon. G. Plant: Traditionally, government pays compensation for expropriation of privately held land, but there are many people and businesses in British Columbia who hold licences or leases of Crown land. That may be an agriculture lease, a forest licence or sometimes a permit to occupy some waterfront for the construction of a wharf.

We, as government, are putting forward in this second principle the proposition that we will work hard to ensure that the terms and conditions of those leases and licences are respected. But if it becomes necessary to make a treaty provision that has the result of making it impossible for someone to exercise their rights under a lease or a licence, then we're saying that government should compensate for that interruption.

B. Lekstrom: As well, some British Columbians may be unaware of the tax exemptions that are currently available to aboriginal people in this province. Can the Minister Responsible for Treaty Negotiations outline the existing tax exemptions available to aboriginal people and which of those exemptions he feels should be phased out?

Hon. G. Plant: Well, under the Indian Act of Canada and also as a part of our constitutional structure, there are some exemptions for taxes afforded to aboriginal people. For example, aboriginal people who earn income on a reserve don't have to pay income tax on that income. There are also exemptions for sales tax for the purchase of goods in some circumstances. We think — and the province has been consistently at the table for a number of years arguing this — that all Canadians should move forward towards tax equality.

This question, which is the eighth principle in the referendum, asks British Columbians to confirm that their negotiators should be at the table working with the federal and first nations negotiators to achieve a phase-out over time, in a fair and measured way, of these tax exemptions to facilitate the integration of aboriginal people into the larger economy of British Columbia.

J. Wilson: My question is to the Minister of Health Planning. In the New Era document the government committed to providing all British Columbians, regardless of where they live, with reliable, high-quality health care. Like so many of its other health care policies, the previous government failed to address the needs of new and expecting mothers.

Can the Minister of Health Planning tell us what she is doing to ensure that maternity care services are available to the women of this province when and where they need them?

Hon. S. Hawkins: We recognize the need for health care providers across the province, and certainly in communities that are underserved and need maternity care.

We announced a nursing strategy last year. In that, we had grants for training specialty care nurses, including nurses in labour and delivery. Those grants were given to health authorities. We sent a team of recruiters offshore, and we received about 46 specialty care nurses, including labour and delivery, out of that recruitment effort. The Minister of Advanced Education has announced a satellite medical school program at UNBC. Starting in 2004 we will be entering 24 medical students into that program to train in rural medicine. Today we're announcing a new midwifery degree program at UBC, and we will be offering, hopefully in conjunction with UBC, a rural component so people will get the care they need where they need it.

J. Wilson: My supplementary is to the Minister of Advanced Education. Rural and northern regions of B.C. have experienced a series of challenges in being able to retain health care professionals, including midwives.

Could the Minister of Advanced Education tell my constituents what this government is doing to encourage midwives to practise in northern and rural British Columbia?

Mr. Speaker: I must remind all hon. members that a supplementary question must be a supplementary to the original question. However, the Minister of Advanced Education may answer if she pleases.

Hon. S. Bond: In the work that the Minister of Health Planning is doing, certainly there is a focus on looking at what the specific needs of those in rural and remote communities are. Our announcement about the medical program was the first one of those components. What we're going to do is work with the University of British Columbia with this particular degree program to look and make sure there is a rural training component.

More importantly, the incentives that we're using. In August of last year we created a forgivable loan program in this province for health care professionals who agree to serve in underserved communities in the province. We are going to extend that forgivable loan program to include midwives who complete this particular degree to encourage them to serve in rural and remote parts of this province.

P. Wong: My question is to the Minister of Skills, Development and Labour. Last year the minister announced that as part of the core services review process, the operation of the Workers Compensation Board would also be reviewed. The minister also indicated that he expected to receive this report in January.

Can the Minister of Skills, Development and Labour update us on the status of this report?

Hon. G. Bruce: The reports — there are two of them, one by Allan Winter and one by Allan Hunt — have been deposited with my staff. One of the two reports deals with the issue of service delivery, as you are well aware, and the other is in respect to governance and benefits. We're taking the recommendations from that now.

In conjunction, as well, we're reviewing with the royal commission so that we can bring forward changes to the House that will improve WCB both for the employees that find themselves having to utilize WCB and for the employer community that funds it.

Mr. Speaker: The member for Vancouver-Kensington has a supplementary question.

P. Wong: The minister has also indicated in the past that he expected this review will provide ideas for improving the WCB system. Many of my constituents are interested in the findings of the review and what the government intends to do with it. Can the Minister of Skills Development and Labour tell us when he expects to make this report public?

Hon. G. Bruce: The changes will be significant. There's probably not a person in British Columbia that knows there isn't a need for significant change in operation of the WCB so that it can better represent the people it is supposed to look after. Those reports will be made available probably within the next month and a half.

Mr. Speaker: I have the honour to present report No. 6 of the auditor general, 2001-2002, Information Use by the Ministry of Health in Resource Allocation Decisions for the Regional Health Care System.

J. Kwan: I table 180 letters from parents who are appalled by the government's move to reduce the number of years a single parent can stay at home with their children. They point out that the inevitable result of this policy change will be "burnt-out single parents and emotional breakdown and damage to the parent-child relationships."

Hon. G. Collins: For the information of members, in Committee A I call Committee of Supply. We'll be debating the estimates of the Ministry of Human Resources, followed by the Ministry of Attorney General. In this House I call Committee of Supply for the estimates of the Ministry of Health Services.

P. Bell: The recently announced medical training program that will be a co-op venture between UBC and UNBC will likely have some impact on rural and remote health care, particularly that at Prince George Regional Hospital. I wonder if the minister could tell us

what some of the implications of that doctor training program might be on the north, specifically as it relates to Prince George Regional Hospital.

Hon. C. Hansen: This is very exciting news for Prince George and, indeed, for the northern half of the province generally. This allows Prince George to develop itself as an academic centre for training doctors. That, in turn, has all kinds of ramifications.

First of all, it will allow students from the north to be able to study medicine closer to home. What we have found in research that's been done around the world is that medical students who train in rural, remote and northern parts of, in this case, the country have a higher propensity to stay and work in those areas. I think it's good news when it comes to recruiting new doctors for the future needs of the northern part of the province. There is a strong emphasis on rural medicine that will be there for the training done at UNBC.

The other side of it, from which I think residents of Prince George will see a more immediate benefit, is that many of the best doctors in the world seek out positions that have an education component to them. Doctors who are not only among the best in their particular fields are also some of the best instructors. That's an additional dimension that will help the northern health authority to recruit some of the top doctors to come to Prince George to provide medical service and a teaching component as well.

P. Bell: I'm wondering, specifically from a layperson's perspective: if one were to visit PGRH four or five years from now, would one see student physicians in the hospital actually practising and performing various functions? What would one see from a layperson's perspective?

Hon. C. Hansen: Because this particular program at UNBC is going to have a family practice and a rural practice focus to it, many of these medical students will be working in family physician offices throughout the north — not necessarily just in Prince George. There are also opportunities in other communities. They will also be doing, particularly in their third and fourth years, a significant amount of work in the hospital. Obviously, they would be there under the guidance of a doctor who would be responsible for the work they're doing while they are in hospitals. It will certainly be an added benefit to the residents of Prince George in those years to come.

The other thing that's very important is that there will be an increased number of students graduating from this program who will choose to stay in the north and in Prince George, which is certainly a benefit to meeting our future needs.

P. Wong: In many cases the minister has said he wants to put the patients first. It's also the ministry's mandate to allow more choices in the health system. Since acupuncture and Chinese traditional medicine have been recognized by the previous provincial government and are self-regulated like any other medical profession, I would like to ask the minister whether, in fairness, there is any possibility that this category of medical treatment be included in the ten-times visit covered by the MSP similar to the podiatrists, massage therapists and natural therapists.

Hon. C. Hansen: We are not at this time looking at expanding coverage. We clearly have some budget constraints that we're trying to deal with. That was part of why the coverage for supplemental benefits was changed last December.

We are working closely with the Tzu Chi Institute in Vancouver. We provide some funding to that organization. We are working with them to determine the best ways that some of the traditional Chinese therapies and procedures could be integrated into western medicine. There's some wonderful work that's being done. Hopefully, over time that work will lead to a better integration of traditional Chinese practices with western medicine.

P. Wong: Can the minister tell me the progress of recruiting foreign nurses and medical professionals? Has the ministry made use of the provincial immigration program to recruit more health professionals to meet the increasing needs of the aging population?

Hon. C. Hansen: We are using the B.C. provincial nominee program to assist in recruiting nurses to come to Canada to work in British Columbia. There was a recruitment drive that was launched last fall to a variety of countries, which was quite successful. Many of those new recruits are now making arrangements to take up positions in British Columbia, so that has been a success.

We are also working with HRDC and Health Canada to find ways that we can further facilitate new Canadians coming to British Columbia to take up positions where there are shortages in various health professions.

P. Wong: Does the ministry have any arrangement with foreign overseas hospitals to have some kind of training programs before these people are training nurses coming to Canada?

Hon. C. Hansen: The ministry itself does not have any direct responsibilities in this area, but obviously there are several areas that we work closely with. One is HEABC, which has a program called Health Match B.C. where they try to recruit professionals, whether it's doctors or nurses, to come to British Columbia. We certainly have relationships with organizations in other countries that can assist us in recruiting nurses to come to British Columbia.

There is not currently training being done, but there is some testing that gets done in their home countries or countries of origin so that some of the credentialing work, particularly around nursing with the RNABC, can be done as soon as possible.

S. Brice: I'm following on my colleague from Prince George North's discussion about UNBC and the great news about the training of doctors, particularly for remote, rural B.C. and Vancouver Island. As we travelled with the select standing committee, we became even more aware that the doctor forms an important part of a team. Undoubtedly, in preparation for those newly minted physicians that will be clamouring to teach in remote and rural B.C. — which is of course what we're all hoping for — can you give us some idea of what is in the works? We heard they have trouble even with home care support. Obviously, a nurse is an important part of that team, as is anybody on the health care team that is going to be able to pull off a really good, solid program for the folks who live in the north.

Hon. C. Hansen: There are a bunch of initiatives that are underway. I've pulled out four that are just examples of the kind of things we're trying to do to ensure that we have an adequate number of health professionals going to rural communities.

The first one that we brought in just last fall was the student loan forgiveness program so that health professionals who agreed to practise in underserviced parts of the province can have their student loans forgiven over a period of five years.

The second one, which I mentioned earlier, is the expansion of the medical school. It's a benefit not just to Prince George, but it's a benefit to northern communities because many of those students will wind up doing some of their training in family practices throughout the north.

The third one, as an example, is called the northern isolation travel assistance program. That's for locums who are willing to go into some of the smaller communities to provide relief for doctors in these communities. Typically, there's not enough doctors in a small community to cover each other off. It's an important program to allow for locums to come in from outside the region, to fill in for them during that period of time.

The final example is all around the telemedicine project, which I think is really quite exciting for rural health. Using those video links, it gives the doctors in those communities better support from the top specialists in the province. When they have to make those judgment calls, they know they've got that backup of very high-level support.

It's also a valuable tool for continuing medical education. Those video links will be used so that physicians can actually get additional training in their communities. They don't have to leave their communities and patients to come to Vancouver or some other centre to get education that they may require to meet the needs of their communities.

J. MacPhail: Just to confirm with the minister in terms of the opposition's approach to these questions. Although the rest are very useful, I'll be continuing with appointments, then performance contracts and the accountability framework. That will complete the health authorities portion of our discussion.

On appointments, I note from an examination of the appointments made that two out of about 57 appointments are for first nations. There used to be in place the Aboriginal Health Council of B.C. that worked very closely with health authorities on a provincial strategy around aboriginal health issues. The Aboriginal Health Council of B.C., as the minister is aware, no longer exists. With just two health appointees who are first nations, what is the minister's plan to ensure the health goal of improving aboriginal health?

Hon. C. Hansen: I guess the question is built around the appointments to the health authorities. Certainly, I have met one of the two individuals the member refers to, who I think will be a very solid and very beneficial contributor to the work of the health authorities in question.

In terms of our approach to aboriginal health generally, which is where I think the member may be going on this, it is true that we chose not to continue with the council. The program dollars that were in place are being regionalized so that they will be administered through the health authorities. Too often we've seen aboriginal health issues wind up being sort of disconnected from the rest of health services. When we start looking at some of the outcomes in aboriginal communities, clearly we're not doing a very good job of meeting the health needs of aboriginal communities. We want to make sure that those are integrated into the work of the health authorities at the regional level so that they don't get lost, and those programs don't fall between the cracks.

By September of this year each of the five regional health authorities has to submit to us a plan for how they are going to ensure better aboriginal health programs and, ultimately, better health outcomes. We have built into the ministry service plan specific targets around aboriginal health. It will be expected that health authorities will meet those targets.

I think the final thing I can say in this area is that we also had a very excellent and constructive meeting with the First Nations Summit, with the entire cabinet. Health issues were certainly part of that discussion. That has subsequently led to a couple of meetings between the ministry and the chiefs council on health. That falls under the First Nations Summit. There's been some excellent dialogue, and we're certainly looking forward to moving forward in a way that will produce better outcomes in the future. As I think we all know, we've got a long way to go before aboriginal health outcomes will be anything near what they are for the rest of the province.

J. MacPhail: I do know that we will be discussing matters further under the aboriginal health programs. I am specifically asking about this matter under the appointments to health authorities. Not only in the past was there a designated first nations, aboriginal ap-

pointee on each health council and regional health board — that's now gone — but the Aboriginal Health Council was also supposed to take a broad provincial perspective to the delivery of on-the-ground health services. Now that's gone.

Let me say that I wish the minister well in the new health authorities. I do. I hope that the appointees prove effective. All we can do is give them a chance. That's exactly my starting point. The two first nations appointees out of the 57 are excellent appointments as well.

But the Aboriginal Health Council was the glue that held together a strategy of health programs for aboriginal, first nations people across British Columbia. Now that's gone, and the money they were responsible for is gone as well. Aboriginal dollars are being put into the health authorities, and those health authorities, save for two positions out of 57, have no experience in first nations health delivery.

Yes, I do know that the minister and the cabinet met with the First Nations Summit and discussed with political leaders on-the-ground delivery of health programs. I'm not going to ask about health programs right now; we can talk about that in a bit.

The Aboriginal Health Council also reports to the First Nations Summit, the UBCIC and the UNN. They are the people who actually have the experience — the clinical, technical and community experience — for delivering the programs. The First Nations Summit political leadership isn't a replacement for that. It would be like the cabinet micromanaging health programs. That's what the First Nations Summit is. It's the political body. They do their jobs extremely well, but they don't deliver health services, nor have they ever said they could or would.

We now have done in the area of aboriginal health delivery exactly what the minister says he's getting out of the business of doing himself — stopping the micromanagement of health care delivery through politics.

Hon. C. Hansen: I would be the first one to agree with the member in terms of the importance of government not trying to micromanage health care delivery. We had that discussion in a couple of other contexts yesterday. The discussions we've had with some of the aboriginal leaders were around how we ensure that the needs of the aboriginal populations get met and that we start to see better health outcomes.

Currently, the Ministry of Health Planning is working with aboriginal health stakeholders to develop what will be known as the provincial aboriginal health services strategy. The steering committee that is in place developing this strategy includes representatives of the First Nations Summit, the Union of B.C. Indian Chiefs, the Métis Provincial Council, the Aboriginal Peoples Council and provincial health organizations such as the Community Health Associates of British Columbia, as well as provincial advocacy organizations such as the B.C. Aboriginal Network on Disability, the Council of Aboriginal Women and the Red Road HIV/AIDS Network. That is a strategy that's coming together.

The fundamental shift taking place in health care delivery is that we are giving that responsibility to the health authorities. It is vitally important that we not try to micromanage that from Victoria or from the minister's office, but instead that we ensure aboriginal programs are integrated in a real way with the program delivery of the health authorities so that aboriginal people from around the province can get equal access and equal benefit and we can start to see changes in the dismal record we have when it comes to health outcomes in this area.

J. MacPhail: I know it's hard to get an answer and also listen to the question.

My assertion was about the fact that the minister's suggestion that the First Nations Summit could deliver health care programs and that that's the place to negotiate the delivery is the same as having the cabinet deliver health care programs. I'm urging the minister that it isn't the appropriate body to do that.

I wish him well in his aboriginal health strategy. However, a couple of points to note: funding ended for the aboriginal programs on March 31. There's been a stay of execution, I believe, till June sometime. After that there's no guarantee for any funding. In fact, when I met with aboriginal health organizations, they suggested to me that they were…. Oh no, it wasn't even that the funding was continued; it was that they'd get an answer in June about the continuation of their funding. They have two choices: either to end the program or to go into their own resources to sustain the program until June. Now we hear that the strategy won't even be in place until September, and that causes me a great deal of concern. It will be one that I will be monitoring very closely.

My last point for the minister to observe is this: the very people who have been dismissed from the Aboriginal Health Council are now being asked by the Ministry of Children and Family Development to replicate the structure, on a regional basis, that the Ministry of Health Services has just ended. Literally the same people who have been done out of the job by the Ministry of Health Services are being asked to set up exactly the same structure for the Ministry of Children and Family Development. Again, they are confused about what real role this government wants first nations, aboriginal people to play in the delivery of social services.

Hon. C. Hansen: I just wanted to correct a point that the member had made. There has been no curtailment of money for these aboriginal health programs that we've been discussing. What has happened is that the dollars have been transferred to the health authorities, and the contract obligations that were there before have been transferred to the health authorities. As we move forward, those health authorities will determine what services they wish to contract for and through whom, in order to make sure that aboriginal British

Columbians get the services they need. There is no intention of curtailing anything as of March 31. It is simply a transfer of who's responsible for the administration of those provisions.

I also wanted to add that I met with the Aboriginal Health Council prior to the election in my capacity as opposition critic. Every individual that's part of that council, in my view, is dedicated to the province and dedicated to ensuring that the needs of aboriginal communities get met. They're fine individuals who I think have provided a very good service. The fact that we're changing the way these programs are administered is in no way a reflection on the quality of the individuals involved. I have no doubt that even if the contracts in the future are set up in a way that — perhaps in health care — doesn't include the skills that these individuals have, they will continue to be involved in their communities. If it's through contracts with Children and Family Development, then I applaud that, because clearly they have a tremendous contribution to make.

J. MacPhail: As a final note in this area of aboriginal appointments, the minister may want to make that clear to the organizations I met with just several days ago, who assume that their funding is kaput March 31 and that there's no guarantee of funding in the future — no guarantee. If that's not the minister's intent, all he has to do is call them up and tell them that.

I've done a quick analysis of the health authorities, and I note there is a wide range of communities that have no representation as appointments at all. The Premier made it very clear that the appointments to health authorities were not going to be based on communities. There would not be a community factor for representation. Fair enough, but I note that communities such as Hope, Williams Lake, Courtenay, Port Hardy — no representation on any board. Burns Lake, Powell River, Kitimat, Chilliwack — no representation on any health authority. Trail — no community representation on their health authority. Golden, Kimberley, Mission, Squamish. These are just a few communities that have no representation on any health authority. Oh, I'm sorry. Trail does have a representative on the provincial health authority but not on the interior health authority.

These are fairly substantial communities. I know that the communities may feel they have health needs that need to be addressed. How will the health authorities represent those communities without any human appointment to the health authority? Will there be travelling meetings? Will there be subcommittees? There's a lot of people whose communities are not represented.

Hon. C. Hansen: If you take the six health authorities and there are nine appointees to each of those health authorities, although that's not a number that's etched in stone, that makes a grand total of 56 appointments for the health authorities. Clearly, it's not possible to have an individual from every single community. Nor would I think it desirable, because part of the intention of appointing people to these health authorities is to find people who aren't going to take a specific, narrow view of how health care should be delivered.

We want individuals on these boards who are going to look at the region as a whole, so in trying to select individuals, we made an effort to get a balance of individuals from different health service delivery areas within the regions. We also made sure every single one of the five regionally based health authorities had somebody from that region serving on the provincial health services authority, so we did try to find that balance.

We have also said to the health authorities, to the CEOs, that they need to ensure they develop a comprehensive program of consultation with the communities that fall within their jurisdiction. It's important that the health authorities have regular contact with community leaders and with mayors and council, for example, throughout the region to ensure there is a good liaison. We will be holding the health authorities accountable for having good consultation mechanisms so all those voices can be heard.

J. MacPhail: My final question on health authority appointments: is the minister in discussions with physicians about the fact that there is not one physician appointed to any health authority?

Hon. C. Hansen: We also made a decision that in appointing someone to the boards, we wanted to avoid having somebody who had a financial, contractual…or received remuneration from the health authority. As a result, it was felt that physicians who were active and practising in that health authority — say, had hospital privileges in that authority — would be avoided so that there would not be a sense that there may be a conflict — or open the board up to a perception of a conflict of interest. There is not a policy that says physicians cannot serve on these boards. In fact, we have some doctors, although they are not actively practising within that particular health authority.

J. MacPhail: Well, I didn't notice any medical physician, MD, on any board. I noticed some PhDs, which is good. I had a discussion with the Premier and then the Minister of Health Planning about the fact that there was a letter received from physicians — I think it was the medical society — about their dismay at being barred from appointment.

My question was: is the minister in discussion with physicians about representation on the health authorities, or have the physicians abandoned that issue?

Hon. C. Hansen: I am aware of the letter that came in and the view that was expressed. I've certainly had lots of discussions with physicians over the last number of weeks on other subjects. This one hasn't been pursued in those particular face-to-face discussions,

but I am aware of the concern. I think there was initially a concern that somehow we were just saying that no doctors could serve on boards. That's not the case. What we were trying to do was avoid appointing anyone that would have a contractual…or receive remuneration from the health authority for which they were serving on those boards.

J. MacPhail: I'm going to move to the issue of performance contracts and accountability framework. Of course, my colleagues in this chamber have already asked questions about that, so I don't plan on repeating those questions. What I'm not clear on, even after the debate of yesterday, is how the accountability framework relates to performance contracts. Does the accountability framework get set first, and then performance contracts are developed in the context of an accountability framework?

Hon. C. Hansen: The accountability framework is not a document per se. It is, in fact, a series of initiatives. It is a framework in the sense that it's the accountability process upon which we will build a whole bunch of initiatives, some of which have already come forward. They are specific plans and policies around the area of mental health, for example, where the seniors initiative is out. We're also working on a youth and transition strategy in the area of home and community care. There are new assessment tools being implemented to ensure there's consistency throughout the province. In the area of acute care we are developing access standards to ensure that British Columbians, regardless of where they live in the province, get access to necessary health care services in a consistent way throughout the province. There are also guidelines that will be established for the health authorities regarding the provision of care throughout their regions.

The performance contracts will flow from those. As you may know, in our service plan we have set out specific targets for a variety of areas throughout health care that the ministry itself will be held accountable for.

The ministry, in turn, will be developing the performance contracts with those specific targets so that when you see the performance contracts for the health authorities, they will reflect that. If you add up the targets of the six health authorities, they will, in total, be driven towards meeting the targets we have set for ourselves as a ministry in our service plan. From our accountability framework flows our service plan, which is on our website. From the service plan flow the performance contracts for each of the health authorities, and as soon as those are finalized, those will also be posted on our website.

J. MacPhail: Well, it's a complex route. I wonder whether the minister or his staff had any time to reflect on the legislation that would…. Well, let me ask this question. The minister said, in answer to some questions from his colleagues yesterday, that it's the health authorities — i.e., the boards — that would be held accountable and that the performance contracts would be with the health authorities. I assume he means the boards of directors. I'm sorry; are they called directors? Has the minister had a chance to reflect on whether any legislation change would be needed to hold the health authorities accountable?

Hon. C. Hansen: There is not a change in legislation that's required to put the performance contracts in place. The performance contracts will be signed by the chair of the health authority, by the CEO of the health authority, by myself as Minister of Health Services and by the Deputy Minister of Health Services.

J. MacPhail: Let me tell the minister where I'm going on this. The health authorities have a budget of — we agreed yesterday — about $5.946 billion. If the health authorities improperly spend or overspend, who's responsible for that? If there's no legislative responsibility for overspending transferred to the health authorities, does that mean the Minister of Health Services is responsible for that and that, for instance, his pay would be affected by that?

Hon. C. Hansen: The answer is yes. The authority that is being exercised by the chairs of the board and by the boards themselves is in fact delegated authority. I as the Minister of Health Services am ultimately responsible and accountable. In terms of the pay, as we will be building into the performance contracts, one of the things we're looking at is a hold-back of the CEO's pay so that if they don't meet the standards they have committed to — and that's not just the financial outcomes but also the health outcomes they have to deliver on — they will see a reduction in their paycheque as a result of that. They will not get what's being held back.

In turn, if the Ministry of Health Services in this year does not meet its targets in terms of living within its budget, then I as the minister will not receive the portion of my pay that is being held back for this current fiscal year. So there are ramifications, and I think it's more than the financial side of not receiving a paycheque. I know, for me, if I wasn't to receive the portion that is being held back from my pay now, the embarrassment of it would be much greater than the financial implications, although it might mean there's a couple of bills at the end of the year I wouldn't be able to pay as quickly as I might like to.

Clearly, these are ramifications that, while they are real, are also powerful in the sense that it sends a message that we expect accountability, and we expect people to deliver on their targets.

J. MacPhail: Well, that's reassuring, because it would be unfortunate if the public had as an answer: "Well, the overspending or inappropriate spending that arose is the responsibility of the health authority, and there's nothing that the government can do about it or be held accountable for." I'm reassured by the minister's comments.

Because almost all targeted funding is gone for health authorities…. I was looking at the budget letter that the newly remunerated Phil Hassen received June 19, 2001. It's a very, very specific targeted funding budget, and that's gone. Fair enough. The minister said that the new way of doing it is to make a lump sum payment to the health authority and then, as I understand it, ensure delivery of services through the performance contract.

I don't know the answer to this, so it's not a trick question: what if the health authority doesn't spend according to the performance contracts, the CEO gets his salary reduced and the minister gets his salary reduced? What does that do for the services?

Hon. C. Hansen: The other tool we have to deal with a situation like that is to remove the board or chair. We put in place some very competent individuals as chairs and to serve on these boards. I am very confident that under their leadership, we will see that kind of accountability. We will see targets being met. These individuals will ensure that the senior management and executive staff in their particular health authority are going to be delivering on the patient care that is expected of them. But ultimately, if for any reason that was not to happen, we certainly would have the opportunity at the end of the day to replace board members or chairs. Given the quality of the people there, I don't anticipate that's ever going to be required.

J. MacPhail: Just for the Minister of Health Services' information, I'll be exploring that matter very thoroughly with the Minister of State for Mental Health in terms of how that works. Unfortunately, we've already received information where money that is the current spending on mental health is being deleted in substantial numbers from health authority budgets. We'll put that to the test with the Minister of State for Mental Health.

Again, we will watch this very carefully over the coming year where there's an accountability or a performance framework through a contract. I say this with cynicism: there are certain contracts the government feels the necessity to honour regardless of their lawfulness. There are other contracts that this government decides to break regardless of their lawfulness — one way or the other. It's a very mixed perception that British Columbians have about how this government views contracts. I will be monitoring that very carefully.

I know that the minister has given this information, but I can't remember it right now: when will the performance contracts be made public?

Hon. C. Hansen: At this point there is not a specific date that is proposed for the release of them. They're still being worked on. Certainly, it's my expectation at this point that those documents would be made public within six to eight weeks, as long as there are no unforeseen delays that come along in that process. That's the expectation.

J. MacPhail: Will health authorities be holding public meetings on a regular basis?

Hon. C. Hansen: There is a requirement in the act for them to hold public meetings. Through the leadership council, there have been discussions around how those should take place. We certainly have advised the health authorities that we expect them to live up the requirements of the act, which is for public meetings to be held.

J. MacPhail: Mr. Chair, I'll be moving on. As we agreed, we'll leave community care and adult mental health policy for the Minister of State for Intermediate, Long Term and Home Care. The next one is public health. I'm working from the general responsibilities list now. There's public health, and I think the other one that's the direct responsibility of the Minister of Health Services is adult addiction policy.

In public health, I have one area I want to explore, and that's the controversy around the immunization program for children. It's a prevention program that includes vaccinations for diseases like meningitis and chicken pox. There has been some confusion about whether or not the government is proceeding with this. Could the minister update us on what the status of that program is?

Hon. C. Hansen: Certainly, there are three new vaccines that have been approved. They were approved last fall, so they have been reviewed by the committees within the report to the provincial health officer. They certainly have felt there's merit in these vaccines. They certainly have proven they could be effective.

We are working now to determine how we can implement a vaccination program. Partly, we're looking at where we can find the appropriate budget for it, because it is a very expensive program. We're also looking at how that program should best be phased in. There's some work being done on it now as a result of the recommendations that have come forward, but there are no specific decisions that have been made regarding the timing or the manner in which this would be phased in.

J. MacPhail: I understand that the headline saying the program is killed is incorrect, because the program didn't exist. I'm not in any way suggesting that the media has this story correct from either the front end or the back end. I would just like exactly what is happening. What are the three new vaccines that have been approved — and that is approved by whom? Is it just that they're able to be sold?

Hon. C. Hansen: The vaccines were approved by Health Canada, so they were licensed for use in Canada last fall. Of the three vaccines we're talking about, one is for varicella, or chicken pox. Another is conjugated pneumococcal vaccine, and the third is a conju-

gated meningococcal vaccine group C. These have been reviewed by the advisory committee to the provincial health officer. Their recommendations are that these have merit, so we're trying to look at how we can move forward.

J. MacPhail: Let me just ask: what parts of the reports are accurate? It's very interesting. As an MLA I have received quite a few calls in my office from concerned parents on this. I don't think that the parents were actually concerned before the stories, so it's one of the areas where a little bit of information causes alarm. We need to straighten this out.

The three have been approved by Health Canada. The B.C. Centre for Disease Control reported that the vaccine program had been frozen for three years, and that freezing meant that the plans to move forward to provide these three vaccines was gone because in a frozen budget one can't increase vaccination. What's wrong with that report?

Hon. C. Hansen: The budget that is in place for the Centre for Disease Control currently reflects the programs that have been approved. If we were able to move forward on this, then clearly we've got to find the financial resources to make it happen. In the health budget over the next couple of years, it's going to be a zero-sum game. It's all about priorities. If it is determined that this is a higher priority than other programs, then clearly we would have to be shifting the dollars so that the Centre for Disease Control had the financial resources necessary to deliver on this program.

J. MacPhail: Does the minister have a ballpark budget of what the program would cost to implement fully?

Hon. C. Hansen: The ballpark is about $25 million in the first year, and then it would decrease over a number of years because it is a one-time vaccination program. Once an individual has it once…. It would be decreasing over time, but it's $25 million in year one.

J. MacPhail: Just to be clear. What's back on track is the consideration of this vaccination program in the context of, if the vaccination program goes ahead, the health authorities have to find either efficiencies or savings or cuts elsewhere to pay for it.

Hon. C. Hansen: First of all, this program has never been off track. The advice that came from the advisory committee was a short while ago, and the ministry has been actively considering how we could move forward on their recommendations. When it comes to the dollars, if we are able to move ahead on this program, then we would have to find the dollars from within the entire $10.2 billion health budget. It's not saying that the provincial health service authority would have to find it, although if that's where we found something of lesser priority, then that would certainly be an option. But that's not the only option when it comes to finding the dollars necessary.

J. MacPhail: What is the time frame for the minister's search for the funds?

Hon. C. Hansen: The work is being actively pursued. Certainly, the value of the immunization program is recognized. It's all about priorities. It's a big challenge for the ministry to try to find something of lesser priority because it does mean shifting dollars. We're moving as quickly as possible. Whether it's a case of weeks or months, I don't have an answer for that yet. We are certainly trying to come to a conclusion as quickly as possible so that we can move forward on it.

J. MacPhail: My other area on public health that I'd like to ask the minister about is public drinking water. I was told that in one set of estimates, all of which blend together in moments of great excitement, the Minister of Health Services was ultimately responsible for ensuring the safety of our drinking water. There's been a report out with substantial recommendations on drinking water in the province. One of the recommendations was to not only start to enforce the Drinking Water Protection Act but also to strengthen the act. What's the status of protection of public drinking water in this province today?

Hon. C. Hansen: I noticed how the member was very careful not to get into legislation. I compliment her on her choice of words to achieve that goal.

We certainly are looking at the recommendations of the task force that was charged with that responsibility. I think drinking water is something that is becoming top of mind for every Canadian as a result of the issues coming out of Walkerton. We're anxious to move forward on the recommendations. It's one that while the legislation itself is the responsibility of the Minister of Health Services, it also clearly affects other ministries. There's been a series of meetings to try to move forward on the recommendations, and we hope to be able to do that very shortly because we certainly see it as a priority for British Columbians. We're anxious to have a response to the report out as quickly as we can.

J. MacPhail: Does the minister anticipate some action in the coming weeks or the coming months?

Hon. C. Hansen: Certainly, there is action that has already taken place. I think we have a very solid network of oversight when it comes to the quality of our drinking water. I think we have one of the best systems in Canada in terms of our multi-barrier approach. We don't just rely on any one program to ensure safe drinking water.

We are looking at ensuring that we have good source water. We're also ensuring that there are proper

chlorination programs in place, that there's proper monitoring in place and that the alarm bells will go off at a variety of levels if there is any way that we find the quality of drinking water has been compromised in this province. We're anxious to strengthen that. Some of the recommendations coming out of the task force will allow us to do that. In some cases, we're going to be able to move forward within a matter of weeks. Others, particularly around legislative amendments, will certainly be put in place as quickly as we can get them onto the agenda.

J. MacPhail: I'd like to move now to adult addiction policy, which I understand includes smoking as well. What is the status of the stop-smoking programs in the government? Also, what is the status of the court case against the tobacco companies?

Hon. C. Hansen: There has been no reduction in the tobacco reduction programs that were in place from the previous administration. In fact, we've certainly tried to move forward on a couple of initiatives. One that the member may be familiar with is a curriculum program around B.C. tobacco facts. I had the privilege of speaking to the school principals association when they met in Victoria and of announcing that the last part in that program for grades 8 to 12 is soon to be released. That will be available to schools very soon.

One of the things that has changed is that we are working very closely with the federal government. As the member will know, the federal government has put forward some communications initiatives, on which we're working closely with them. We have an official from the ministry who sits on the federal minister's advisory committee in this area. We're certainly anxious to continue to encourage British Columbians to stop smoking.

The other question the member had was around the tobacco litigation. Not only is that continuing, but we are actively pursuing partnerships with other provinces across Canada to join us in that litigation. The federal government has certainly expressed interest and is cooperating to try to help us in any way to move that litigation forward. Ultimately, we hope that will bring some justice to British Columbians who have suffered the effects of tobacco on their health.

J. MacPhail: Can the minister point out in either the Estimates or the Supplement to the Estimates where I can be reassured that there has been no cut to the tobacco reduction strategy dollars?

Hon. C. Hansen: There is not a specific line item in the Estimates, just as there was not a specific line item in the Health budget for any of the years gone by. That is partly within the wellness and prevention division of what is now within the Ministry of Health Planning. There are also programs within the individual health authorities that they are administering.

The member, if she has been through the service plan of the ministry, will note that we've also set a very specific target for the ministry when it comes to the future reduction of tobacco use in the province.

Hon. C. Hansen: There has not been any additional regionalization of the dollars with regard to tobacco or smoking-cessation programs. The health authorities, through their ongoing public health programming at the community level, certainly put funding into this area, and they continue to do that. The contracts that we have are administered centrally by the ministry, as well as the curriculum development program that we have in place and some of the other central programs that we have there. There has not been any additional regionalization of the smoking-cessation dollars.

J. MacPhail: The reason I'm asking is because I note the absence of any mention of tobacco reduction in the description under the subvote for regional health sector funding. It's on page 144 of the estimates. There's a footnote description of what regional health sector funding includes in that subvote, and it very clearly says that the regional health services are responsible for alcohol, drug and gambling addiction services but not tobacco. Why?

Hon. C. Hansen: Tobacco is not specified in the description that comes with it, but it certainly is expected that the health authorities will continue with the programs that they have had in the past. It's not a shift in policy at all. I would also like to point out that we have set a specific target within our service plan, and there will be specific targets within the performance contracts for each of the health authorities to achieve with regard to smoking cessation. There is that obligation that they are taking on, and they can't achieve those targets if they were not to continue with the programs that they've had up till now.

J. MacPhail: Would the minister mind pointing out to me in the service plan what the target is for tobacco reduction?

Hon. C. Hansen: In the service plan it actually falls under goal 2, which is to improve health and wellness for British Columbians, and item No. 5, which is smoking rates.

The target for '02-03 is to reduce smoking prevalence by 1 percent per year from a year-2000 baseline to 19 percent for a population aged 15 and older and to 17 percent for youth aged 15 to 19. The target for the '04-05 year is a smoking rate for age 15 and older of 17 percent and for age 15 to 19, 15 percent. The overall target in addition to that is to reduce smoking rates in the highest-rate regions toward the mid-range. There

are certainly some regions of the province where smoking rates are higher, and we are asking them to give special attention to that challenge.

J. MacPhail: Thank you for the reference. I've found it as well. I read where the smoking rate for adults is 18 percent, the lowest in Canada and the second-lowest in North America, for which we should all take credit. It's wonderful.

Hon. C. Hansen: I am informed that for the age group 15 to 19, in 1999 it was 20 percent, and in the year 2000 it was 18 percent. Apparently, the number for the year 2001 has just been released since our service plan was finalized and made public. That rate is now at 17 percent.

J. MacPhail: We've reached the target, which is good news. The minister was giving me the information for the ages 15 to 19, I assume.

J. MacPhail: Yes, so we've reached the target for '02-03. That's good news, because we're supposed to be at 17 percent in '02-03.

I would urge the minister. I don't know whether the minister knows this, but my only plea for change, which I made in a concerted way to the Premier, was this government's address of smoking…. I made the plea. I said that if I could ask the Premier to change one thing…. The minister knows full well that I've been on full flights of requests in all sorts of areas. If I had one wish to make, it would be that this government put every possible effort they could into reducing the harm through tobacco use. That was my closing comment to the Premier.

Here's where I'm going: the reversal of the WCB ban on smoking was an incredibly sad day for health in this province — incredibly sad. I fail to understand how anyone can justify that reversal of the WCB smoking ban as good for the economy.

The number one health care cost — 100 percent preventable — is the use of tobacco. The diseases and deaths that arise out of the use of tobacco…. It's the number one cause of health care costs in this province. On a $10 billion budget, it sure would be good for the economy if we could reduce the use of tobacco to a point where there were tens of millions, if not hundreds of millions, more dollars available to go into the economy through reduced taxes.

I just didn't understand for one second the argument that the reversal of the smoking ban that the WCB had imposed was good for the economy. Then, when members stood up and said, "Oh well, it's good for the economy in certain parts of the province," again, I didn't understand that. Maybe the minister could help me.

Hon. C. Hansen: I want to be a little bit careful not to tread into the area of estimates of another minister. Clearly, I share the member's interest and concern about smoking-cessation programs. I certainly accept her challenge that we should be doing everything — and we are doing everything — that we can to try to reduce tobacco use in the province.

As I said when the issue was quite topical, my goal as Minister of Health Services is to try to eliminate tobacco use in the province. That may not be an attainable goal, given the severe addictions some people have with regard to tobacco use, but we certainly have to keep striving for that objective.

In terms of the WCB issues — and the member may want to canvass them directly with the Minister of Skills Development and Labour — I think it's important that as we bring in programs, they have to be enforceable. There is much more to be achieved in terms of tobacco use reduction in this province by ensuring that programs are attainable. I'm very proud of the fact that the regulations brought in by my colleague make British Columbia a leader in Canada when it comes to those types of restrictions, the focus on secondhand smoke and the damage it does.

We're certainly in agreement when it comes to what the objective of this government is — to do everything possible to reduce tobacco use — but we also have to make sure we do it in a way that will ensure measures are enforceable and will have the desired results, and not just a rebellion against laws and regulations that people think are inappropriate. There is that balance, and we've tried to achieve it. We're certainly determined to move the anti-smoking agenda forward in this province.

J. MacPhail: I am limiting my remarks only to what's good for the healthiness of people and how healthier people make a greater contribution to the economy through reduced costs. That's the link right here.

Smoking puts huge pressure on our economy through increased health care costs — gigantic health care costs. That's the link. I'm not intruding on any other area here.

We're not a leader. We could have been a leader in terms of our no-smoking policy by just allowing the WCB to do their job. The WCB's decision to have a smoking ban in public places in British Columbia was well researched, well documented and scientifically based.

In fact, there's a smoking ban in every public place except in hotels, restaurants and bars. The economic argument doesn't work even there. The lobbying argument works. Hotels and restaurants lobbied, but other places would have just as much right to make the argument that: "Gee, smoking would be good for our economy if only people could smoke indoors." Nobody was silly enough to ever make that argument, because they would be laughed out of the province.

Smoking is bad. I happen to know…. Well, actually I don't know factually, but I suspect the Minister of Health Services understands fully and supports every single initiative that goes toward the full elimination of

the harm of tobacco use. However, his government chose a path that doesn't advocate that.

I have been trying to get information about what input the Minister of Health Services had in terms of the period of time between the government's decision to reverse or put on hold the WCB decision on the smoking ban, which I think was around September. Then there was a caucus committee appointed to look at this issue, and then a final decision to reverse the smoking ban by the WCB was made in December or January. During that time, what input did the Minister of Health Services have to the caucus committee on the economic costs to the province of the use of tobacco?

Hon. C. Hansen: As much as I'd love to, I'm not going to discuss what discussions took place in caucus or in cabinet. I'm not at liberty to do that, as the member knows, but I am a strong advocate for smoking-cessation programs. I think that, certainly, British Columbia is a leader in this area, and I expect that we'll continue to be. I have carried that message to federal-provincial conferences. I have also ensured that other jurisdictions know some of the programs we're implementing in British Columbia, because we think they should be replicated in other provinces as well. I will continue to be an advocate for smoking-cessation programs to ensure that, first of all, our kids don't start smoking and, secondly, that adults who have been smoking have more and better opportunities to quit the habit.

Just for the minister's information, the caucus committee wasn't a secret caucus committee. It was a caucus committee that was supposed to investigate the value of continuing the WCB smoking ban in British Columbia. It was headed up by the member for Vancouver-Burrard.

Just so the minister knows, I've asked for the information about who had what input into that caucus committee on an incredibly serious matter where the government, for the very first time ever in the history of British Columbia, reversed a WCB decision.

I got an answer back. I can't believe that it's right; I actually can't believe that it's right. That's why I'm asking the minister this question: what input did he have on this health issue? I got an answer back that there was one submission to the caucus committee, and on the basis of a submission which we don't even know the content of, the government reversed a WCB smoking ban. Surely, that can't be right, but I can't find out. Nobody will tell me it's wrong.

Did the minister have any input? Did the member for Vancouver-Burrard approach the minister on what the health costs to the economy were on reversing the smoking ban?

Hon. C. Hansen: The caucus committee is exactly that. It was a committee of caucus, and if the member has questions, she may want to direct a letter to perhaps the chair of caucus. I, as a member of government and executive council, have responsibility for the workings of the Health ministry. I don't have responsibility for the workings of a caucus committee, so I certainly can't respond to the questions that she's putting forward. There clearly are opportunities for her to direct those questions to the appropriate individuals.

J. MacPhail: Well, that's not a good enough answer, because of course it was an executive council decision that relied on the caucus committee work of the member for Vancouver-Burrard to reverse the smoking ban, so there's a link. It's direct; it's A to B.

I sure as heck hope — and there are other areas that I can explore this in; I prefer to explore it here — it isn't correct that this government reversed the WCB smoking ban on the basis of one submission. If that is the case, British Columbians will be absolutely outraged.

Just for the minister's information, I have been trying to get somebody to tell me that's not the case. The information was received through an FOI request, and I didn't believe it. I didn't believe that it could be just one submission — where the government takes an unprecedented action.

So anybody on the caucus committee, run in here and tell me I'm wrong. I'd be happy to be proven wrong on this issue. The Minister of Health is not comforting me at all on this issue, because I assume that cabinet fully deliberated on the work of the member for Vancouver-Burrard before they reversed the smoking ban by the WCB.

Anyway, that question is out there for anyone who will come in. I know there are lots of people who listen to every word I say and run here and tell me when I'm wrong and stupid and off the track or out of order, so have at me.

I will move to other areas of addiction services, and those are the areas of drug and alcohol use and gambling. Can the minister please give me what his government's approach is to these three addictions?

Hon. C. Hansen: First of all, to deal with the alcohol and drug programs. As the member will know, this had been transferred over to the Ministry for Children and Families. I think there are lots of examples that came forward as to why that was problematic. We transferred the alcohol and drug programs back to the Ministry of Health, specifically the Ministry of Health Services.

In turn, we have given that responsibility to the regions throughout the province. Many of the staff that had worked with Children and Families and were transferred over to the Ministry of Health Services have now been assigned to the health authorities. We believe quite strongly that the alcohol and drug programs should be an integral part of the delivery of health programs generally at the community level. We believe that is the right place, although the policy and the

standards development will certainly continue to be administered centrally by the ministry itself.

With regard to gambling addiction, I know this is an area where there is more that needs to be done. I can remember estimates from years gone by, actually, when I believe the member was a minister and the member for Kamloops–North Thompson was the gaming critic, talking about the need for more dollars to be allocated to deal with gambling addictions.

At our constituency offices, certainly we've received letters, some real horror stories, of people whose lives have been destroyed by gambling addictions. There are increased dollars going to be focused on those programs. The Lottery Corporation is going to take an active role in ensuring that programs around gambling addiction are enhanced and adequately funded into the future.

J. MacPhail: That's good news. Could the minister expand a little bit on what expanded role the Lottery Corporation is taking on funding gambling addiction programs, and where are those gambling addiction programs? How are they being delivered?

Hon. C. Hansen: I apologize for the delay. What I'm trying to do is get as precise information as possible for the member, although we may not have that right at our fingertips.

The number I'd like to give her is how much the Lottery Corporation is allocating for the gambling program. I will undertake to get that information to her. One of the examples of a program that is being funded is a toll-free call line for assistance for either individuals who feel that they are suffering from gambling addiction or their family members. One of the things the casinos in the province have been very cooperative on is ensuring that information is posted, giving people this toll-free line and where they can go to get the help they may require. That program, as I understand it, has had some initial success, and we're hoping we can build on that.

I will undertake to get the member more specifics around the amount of money that's being allocated and what other programs may be funded out of those dollars.

J. MacPhail: One of the things the minister may be prepared for is that during the committee stage of the bill — I think it's Bill 6, the gaming bill — I will be asking questions about the contribution of the province to gambling addiction programs, given the expansion of gambling. Either the minister can provide the Solicitor General with that information, or the minister can participate in the debate. My concern is that there is no legislated requirement to provide gambling addiction services under that legislation.

In the area of drug and alcohol abuse, we did a lot of work in the years 2000 and 2001. The ministry staff were extremely competent in moving the issues around drug and alcohol addiction forward and worked very hard to put in place a community-based discussion document with recommendations on how to change the delivery of drug and alcohol services. There was, of course, yes, a recommendation to regionalize the services, but there was also a recommendation that the model for that delivery be community-based. Are the regional health services being directed to establish a community-based model? I'm sorry; my apologies — I can't remember the report. I'm sure Mr. Hazlewood can remember it.

J. MacPhail: Weaving Threads Together. Right. My apologies. It's a senior's moment.

What is the status of the recommendations of the report, Weaving Threads Together?

Hon. C. Hansen: We are very definitely putting expectations on the health authorities that these programs be community-based. I share the member's enthusiasm for the Weaving Threads Together document. I think it's an excellent piece of work, and there are a lot of individuals around this province that have dedicated many, many years to alcohol and drug programs and clearly had a lot of valuable input into that document. In addition to implementing the regionalization of these programs, we are also looking at how we can move forward on the other range of recommendations that are in Weaving Threads Together, so it is very much a living document for us and is guiding us in our policy development work.

J. MacPhail: What's the status of the centre for excellence around addictions, with a board to operate the centre for excellence? What's the status of that?

Hon. C. Hansen: As the member will know, there is a foundation that was established by the previous government with funding of $10 million. That was set up at arm's length from government, so we don't have any direct control over that board or the money that was allocated. The individuals who are serving on that board have met recently and are moving forward with ensuring that the $10 million, or at least interest revenue from the $10 million, will be utilized to provide the initial work around what hopefully will become the centre of excellence the member is referring to.

J. MacPhail: Have there been any changes in the appointments to the board operating the centre for excellence?

Hon. C. Hansen: We don't have the power to do that. The way the previous government set it up was that it was totally at arm's length, so there have been no changes that I'm aware of. It would have to be the board itself, which serves as the board of what was constituted as a society, that would make that determination, but I'm not aware of any changes.

J. MacPhail: In the area of the regionalization of adult addiction services, does the minister anticipate any change in who delivers those services? Here's my question: does the moving of addiction services to regional health authorities from the Ministry of Children and Family Development entail the transfer of the employees, drug and alcohol counsellors, as well?

Hon. C. Hansen: What is underway is a transfer of those staff. First of all, they were transferred from Children and Families to the Ministry of Health Services. While they are now physically working with the health authorities, there is still some transition work that's being done around the shifting of those FTEs from the Ministry of Health Services to the various health authorities, but we expect that to be completed in the near future.

J. MacPhail: The minister may note that under general responsibilities, I'm moving beyond resource allocation because I'm not sure what that means in terms of something different than discussing the budget. What does resource allocation mean in terms of his general responsibilities?

Hon. C. Hansen: Perhaps the member just might explain…. She's obviously referring to a document that refers to resource allocation. I'm not clear on what the reference is.

J. MacPhail: Oh, sorry. It's a document that my staff pulled off from the website. It's a list of the Ministry of Health Services responsibilities. It's got general responsibilities, programs and services, and major boards and commissions. It's the document that I've been working from, but it could have been updated.

Hon. C. Hansen: The reference is just with regard to the fact that the minister is responsible for the distribution of the total budget. We've got a $10.2 billion budget within Health Services, and I have responsibility to ensure that is allocated across the various programs.

J. MacPhail: I'm moving now — and I don't mind giving the minister a copy of this list, because it's the order in which I'm discussing matters — to Medical Services Plan operations and policy.

I'd like an update on the discussions with the physicians. We had quite a little breakthrough last week in terms of physician negotiations. Perhaps the minister could give us a time line on potential resolution. What are the outstanding issues? I understand that there's a May 1 deadline for resolution before physicians may consider job action.

Hon. C. Hansen: It's certainly everybody's intent that we move forward on these discussions as quickly as possible. It is the intention of the BCMA and the intention of government to try to resolve these issues as quickly as can be done.

The range of issues on the table is really quite lengthy. I could list them, but it was included in the press release and the memorandum of understanding that was released a week ago Tuesday.

The discussions with the BCMA have begun this week. It's our intention to push them forward as fast as we can. There is not a specific deadline that we're working towards other than that we're going to try to get these issues resolved as quickly as possible because we recognize the anxiety that's out there on the part of doctors throughout the province.

J. MacPhail: Yes, I read the news release and the memorandum of understanding as well. I'm just wondering what progress has been made in terms of whether all those issues are still on the table. Who's at the table?

Hon. C. Hansen: The full range of issues that were set out in the memorandum of understanding are on the table and are being discussed. At the table is, I assume, the bargaining committee of the B.C. Medical Association, although I'm not 100 percent certain on that. On the government side these negotiations are being led by the Health Employers Association of B.C.

I'm just wondering. As I recall, there have been a few people who have had experience from the government side in these negotiations, such as Ron McEachern, etc. Just who's at the table? Have we got some new people? Are they starting from square one in terms of their experience — on our side? Who's bargaining for the taxpayer?

Hon. C. Hansen: The HEABC has a range of individuals that they use to assist them with negotiations. I don't have specific names that I could give the member at this point, other than to say that the HEABC is leading these negotiations. They, in turn, will be drawing on the expertise of staff in the Ministry of Health Services as well as the Ministry of Finance, potentially PSERC — whoever would be the appropriate organizations that can assist them with inputs. But we will be relying on HEABC to ensure that they have competent negotiators putting the government's position forward and moving it on. I apologize. I don't have specific names for her at this time.

J. MacPhail: The budget under the '02-03 supplement to the estimates is $2,517,611,000 for the Medical Services Plan. How much did we add by supplemental

estimates? What is the total budget we're working with in '02-03 now, for the Medical Services Plan?

Hon. C. Hansen: The total budget for the Medical Services Plan for this coming year, this year that we've just started, is $2,517,611,000, which the member indicated.

J. MacPhail: I'm sorry. That was a supplemental estimate for expenditure in '01-02. But part of the Premier's announcement was that the funding for doctors would be ongoing, year after year — the $392 million. That's not reflected.

Hon. C. Hansen: If you go back to the blue book number from a year ago — and we can get this exact number — it was approximately $1.9 billion for the Medical Services Plan. This number, the amount for physicians' services, was about $1.9 billion. The $392 million that we increased the MSP budget by is reflected in this number of $2.5 billion.

If I can anticipate where the member might go next with this, she will recall that the physicians' arbitration came down on a Friday afternoon, as I recall. The budget had to be finalized the following week. In the interim, between the physicians' arbitration and the budget numbers being locked in by the Minister of Finance, he increased this line item by the $392 million.

The announcement that was made last week was confirming that the $392 million is not only built into the budget for this coming year but is, in fact, built in for the years after as well. This number of $2.5 billion reflects that increased amount. If the member wants more detail, I'll certainly provide it.

J. MacPhail: I mean no disrespect to the physicians, but they could have figured that out by reading the supplementary estimates then. Is that the view of the minister? Instead of worrying, fretting or threatening patient care, they could have opened up the book and said, "Yes, it's ongoing funding" — which I find interesting.

Is the minister sure the full amount is there? Maybe it's because there are other things in the Medical Services Plan, other than physician payments. Is it the minister's view that physician payments out of the Medical Services Plan have been increased over '01-02 by $392 million?

Hon. C. Hansen: Yes. If you look at the restated budget from last year, it was $2.244 billion. The increase to the $2.5 billion number that she was talking about is an increase of approximately $273 million. Also in this budget are the reductions in terms of the supplementary benefits program. There are some program reductions outside of physician remuneration that bring that number down, but the full $392 million is built into the budget for the coming year and the years after.

J. MacPhail: Great, I understand it now, but in no way do I endorse the fact that massage therapists, podiatrists, physiotherapists and optometrists have to pay for the increase for the physicians. However, I do understand it.

I must express disappointment in the B.C. Medical Association for not understanding that. They could have understood that and not put patient care at risk, by accepting the documents that were tabled. It's unfortunate that they chose not to.

There are some physicians in the province who have said that unless there is resolution to their issues by May 1, job action may start again. Is the minister familiar with that time line?

Hon. C. Hansen: I certainly read the news reports of that, but I think we're driving this to try to get the issues resolved as quickly as possible. We will certainly do that.

We have already taken action on delivering on some of the commitments. The retroactive component of the fee-for-service increase for the period from April 1 to September 31 has already been transferred to doctors, as of last week. We're certainly anxious to move on addressing these issues as quickly as we can. If it's possible to get all of these issues resolved within the month, I think that would certainly be good news for patient care — to bring that kind of stability. We are working as quickly as we can.

J. MacPhail: Are there any issues on the table around alternate payments to physicians?

Hon. C. Hansen: The answer is yes, and I was just trying to refresh my memory on the breakdown. Of the $392 million, there is $185 million on fee-for-service increases for the coming year. There is $80 million to provide for on-call payments. The balance of $127 million is for a variety of things including population demographic changes and enhancements to the rural agreement. There is a significant portion in there for alternative payments to ensure that those doctors who have chosen alternative payments get the same relative increase as doctors who are on fee-for-service. We want to make sure that balance is maintained or, if possible, enhanced, because fee-for-service is certainly an option that is being chosen by more and more doctors throughout the province and indeed across Canada.

J. MacPhail: I have one more question under the Medical Services Plan, operations and policy, which will conclude my discussions of the Medical Services Plan. The operation question is…. I am getting a lot of calls into my office about the fact that people have to pay long-distance charges for MSP inquiries. The staff has been cut in MSP. I don't even know whether those staff cuts are actually implemented yet. If they're not, we're in big trouble. I am getting a lot of calls mainly from poor, dear seniors who are now having to pay long-distance charges.

First of all, can the minister give us a status update of the cut to the MSP staff? Is there any chance of re-

view of this policy? How much is the government saving from this policy of charging long-distance to inquire about MSP changes?

Hon. C. Hansen: The staff changes in MSP with regard to responding to public inquiries have now been implemented. They have in fact happened.

We are trying to enhance a variety of services in terms of access to information, including Web-based. There is 1-800 access to an automated voice information system. In addition to that, individuals from throughout British Columbia have the option of going through Enquiry B.C., which is an opportunity to get access free of charge to information about any government programs. This one is no exception in that regard.

J. MacPhail: Oh, gosh, I'd hoped the minister wasn't going to go there, because I'm now getting complaints. I don't know whether this is accurate or not. I would love to be able to go back to the couple of seniors who have already called my office.

Let me just read this out, if I may. It's a case that's come into my office. This is from my constituency assistant:

That's through Enquiry B.C. That's the first one. Since then, we've had four other calls like this.

Is the minister aware of Enquiry B.C.'s policy around this matter, or is this an error that we can get straightened out? I just want to tell the minister that if he won't reverse the smoking ban policy, this would be another one that he could reverse.

Hon. C. Hansen: Maybe the member is not aware that this is an ongoing problem in terms of trying to access the MSP line. I know; I've received similar letters over the last six years from constituents with regard to the time it takes to get through.

That's part of the reason why we're trying to find new ways of ensuring that information is available. I know that not everybody has access to Web-based information. The member mentioned that these were inquiries from seniors in particular. For many people that do have access to our website, it's got comprehensive information. If we can free up those people from the telephone inquiries, then it makes sure that those lines are available for those for whom it is the only vehicle through which they can get information.

Yes, there's room for improvement. We're certainly trying to use technology in ways that will allow information to be accessed more easily in the future. I'm not saying that's the panacea to the problem, because clearly it's a challenge.

J. MacPhail: Yes, this has been an ongoing problem; there's no question about it. Since the new government has been in place, there have been substantial cuts to MSP staff, and there are long-distance charges. Those two changes certainly don't assist people with greater access.

The other issue, as I'm sure the minister is aware, is that confidential information is very hard to access via the Web. General information about changes in fees and all that is accessible, but it's very hard, if not impossible, through the Web. There are no privacy or security codes in place — nor am I saying there should be, but there aren't any to access individual information.

I have one request, usually, for each set of estimates that seemed to be so easy. I asked for the audio book policy cancellation to be reversed. I asked the Premier to reverse the denial of the WCB smoking ban. I'm asking the Minister of Health Services: out of his $10.2 billion budget, this would be a good one to reverse. He would be well regarded.

I am with the minister until 5 p.m.; then I'm going to yield the floor to other members until the supper break. I have no questions on Pharmacare processing, but I do have questions on the Pharmacare program, which we'll do after supper. That's the income testing.

Now I'm going to go to the ambulance service. For the minister's information, my questions are the ones that were referred to him by the Minister of Health Planning, of which I gave the minister a copy. I can certainly go through those.

I do note that the budget for emergency services — B.C. Ambulance Service — has been reduced by over $4 million. The questions to the Minister of Health Planning were based on the Minister of Health Services briefing document. Maybe I should just read the questions I had into the record.

I'm referring to the minister's briefing book document, the so-called leaked document. It says that there were cost pressures over three years on the budget for emergency health services of $55 million. The Minister of Health Planning and I then proceeded to discuss the strategies listed there to reduce that cost by $59.3 million. In other words, the management strategies over the period to offset the cost pressures would be full; then there would be $4 million in savings. That's how I read it. Indeed, the budget has been reduced by $4 million.

Are the management strategies that are outlined in the document — I don't have any other way of describing it than "the leaked document" — being put in place as we speak?

Hon. C. Hansen: With regard to the chart that's at the bottom of one of the pages of the document she's referring to, under the title of "Emergency Health Services" there are four tables. The table at the bottom, which is the one that totals up to $59.3 million of management strategies…. Those are being implemented to

J. MacPhail: Okay, so we are working on all of those strategies. That's a step forward in information.

What I was trying to explore with the Minister of Health Planning was that some of those strategies — for instance, the demand mitigation strategy that says to reduce demand for services by redirecting low-priority calls to other resources…. Some of these demand mitigation strategies are appropriate for urban settings but not rural settings. Is an urban health authority being treated exactly the same way as a health authority that covers mainly smaller communities and rural communities when it comes to emergency health services demand mitigation strategy?

Hon. C. Hansen: There are clearly different needs and different demands put on the Ambulance Service depending on where you are in the province, and different regions have different challenges. As I was talking about yesterday, the Ambulance Service itself is going to go through core review to look at how it should be structured in the future and what that relationship should be between the Ambulance Service and the health authorities. Already the health authorities are focusing in on what they need from the Ambulance Service in order to ensure a continuity of care from the time an individual is first involved in an accident or an injury or an event that would require ambulance service to deliver them to a hospital.

That work is being done now. We're not pretending there are one-size-fits-all solutions for the entire province, because clearly issues in the north and the interior are going to be markedly different than issues in downtown Vancouver.

J. MacPhail: Is the B.C. Ambulance Service up for consideration for privatization, contracting out or regionalization?

Hon. C. Hansen: If the member is aware of the process that goes before a core review, those basic questions get asked of everything that goes through core review. This won't be any exception. Clearly, I think that, as I mentioned yesterday, one of the big strengths of our Ambulance Service is that it is a comprehensive provincial program. On the other hand, I also think it's one of the big challenges of the Ambulance Service — that it is provincial, when all of the other aspects of health care delivery are regionalized. As a result of the core review process, we will be asking those critical questions and seeking good expert advice, including advice from those who are on the front lines of trying to make it work.

As to how we can structure the Ambulance Service in British Columbia to best meet the needs of patients, it may well be that at the end of it, it will be status quo. On the other hand, it may well be that some other form of administering the Ambulance Service will be arrived at. I wouldn't want to second-guess what would come out of that process.

J. MacPhail: These demand mitigation strategies — are they separate and apart from core review?

Hon. C. Hansen: Yes, that's right. We are working on trying to ensure that we meet our budget targets for this year, and these strategies are being developed as we speak. They're certainly not waiting for the core review process.

J. MacPhail: Then my concern about the difference between smaller and rural communities and large urban communities remains. A demand mitigation strategy such as "reduce demand for services by redirecting low-priority calls" has a very different application in a rural community than it does in an urban community. "Longer response times" has a very different application in a rural community versus an urban community. "Single ambulance response regardless of acuity of the situation" has a very different meaning urban versus rural. In terms of these demand mitigation strategies, which are really cuts — it's a fancy word for cuts to ambulance service — is the minister taking an approach that recognizes those substantial differences between rural and urban communities?

Hon. C. Hansen: Strategies are being developed for different regions of the province. As I mentioned earlier, we do not take a one-size-fits-all approach in this matter. These are not service cuts we are talking about. What we are trying to ensure is that there is the appropriate usage of the ambulance service we have available today. In no way will we want to see patient care compromised, but we do want to see the appropriate utilization of our equipment, of our staff and of the dollars allocated in this area.

J. MacPhail: What does a longer response time mean? The service may be delivered, but does it mean it's less? I mean, a longer response time may mean greater crisis for the patient.

Hon. C. Hansen: We're not planning towards longer response times. What we are planning for is the ability to properly prioritize calls, so those that are of the highest priority will actually get the rapid response they need and expect of our Ambulance Service.

I had the pleasure of spending about an eight-hour shift with the Ambulance Service in Vancouver. Part of that I spent at the dispatch office — it was probably about three hours — sitting with some of the dispatchers as they went through their job. They are well trained. They have the algorithms that actually allow them to walk through a situation to determine now, today, what the appropriate response is for a particular call.

We believe that by better managing this, we can ensure better utilization of the ambulances so you don't

have two and sometimes three vehicles showing up at one incident, and you have the right vehicle showing up at the incident. It's also in terms of the ability to respond in a priority way to the urgent needs first.

It may mean that if there are calls of lesser priority, which are really around inappropriate utilization of the Ambulance Service, we'll be able to assess that at the time the calls come in. They may, in fact, see a longer response time if there is no requirement for an urgent response. We have the capacity of doing that. Our staff have the training to do that, and that's part of what we hope to be implementing to achieve some of these goals.

J. MacPhail: I note this document suggests that the original budget strategy was to eliminate approximately 300 paramedics and associated administrative supports. The document then says: "This is not possible within the current collective agreement." When does the current collective agreement expire?

J. MacPhail: Is this then part of the core review approach? Will this issue be addressed as part of the core review?

Hon. C. Hansen: We do not anticipate that this would be part of the core review process. What that process will do is look at what is the appropriate governance of the Ambulance Service, how the Ambulance Service should best be structured to meet needs throughout the province. It's challenging some of the assumptions. As I mentioned earlier, it may well be that at the end of it, we wind up with a governance and administrative model that's what we have today. On the other hand, we may determine that there's a better way of meeting the needs of individual British Columbians with regard to their ambulance service.

J. MacPhail: My last series of questions in this area, before I yield the floor, is around the issue of paid training budget. I've given those questions to the minister. Let me just reiterate that the paid training budget has been cut by half from $8 million to $4 million. I then articulated how I understood prepaid training to work. This is a particularly rural issue, as I understand it. In rural areas paramedics only get paid when they're called out.

The answer I was given to that was yes. The reason why prepaid training is important for the rural areas and the reason why people agree to commit the time to sit, be on call and be paid only when they're called out is the opportunity to have training paid for by the employer, which then allows them to bid on jobs in larger areas where full-time employment is available. Is that correct?

Hon. C. Hansen: In fact, we are protecting the funding for training for rural paramedics in particular. While there is an overall reduction on the amount spent on training, it is being focused on rural training in particular. In the past we have provided training programs for about 350 paramedics a year. In this budget we are actually providing for training of 1,300 paramedics, and those are from all over the province. Our goal is to ensure that any paramedics that would like to access training can get access to the paramedic level 1 throughout the province. I think that's good news for smaller communities throughout the province. I think it will ensure that the paramedics in those communities have the opportunity to get to that paramedic level 1, which I think is important to them as paramedics. It's also important to the communities that rely on them.

J. MacPhail: That is very good news for rural communities, but it probably might be seen as robbing Peter to pay Paul for those paramedics who are not in the rural communities. What does that mean? How will the cuts be imposed to reduce the paid training budget by $4 million in urban areas only? How does that get achieved?

Hon. C. Hansen: The shift taking place is to open up the training system, so there is increased public access to the training programs. We expect there will be more individuals recruited into the ambulance service that will have already undertaken the training required for higher levels of training, which is totally consistent with other professional groups within our health care system that we rely on. The training programs that the B.C. Ambulance Service will not fund in this coming year are the advanced life support paramedic 3; advanced life support assistant, which is P2; the unit chief course; the duty unit chief course; and the B.C. Ambulance Service management training. Those are the programs we will not be funding, and that is resulting in the reductions.

We will still be able to meet the public need as a direct result of the increased access to the training programs by individuals who would seek that training before applying for positions with the Ambulance Service.

J. MacPhail: I heard a story today that if you want to become a police officer, you have to pay for the training yourself. Let me ask the minister this: who is affected? I gather that the payment for this training will have to come out of the pockets of the paramedics. Who is affected by this? People who are looking to move up the ladder? What type of person in the Ambulance Service now will have to pay for his or her training that was previously paid by the employer?

Hon. C. Hansen: What this will enable is that individuals who would either like to enter the Ambulance Service or are currently in it and would like to advance would have that opportunity of pursuing training, which they could fund themselves. That is consistent

with most other professions in health care. In the areas of nursing, for example, there is certainly lots of in-service training provided, but there are also a lot of individuals who go out and get the training they need so that they can apply for the positions as they come available.

We have made a commitment, and we'll continue to commit, to ensuring that an adequate number of the trained paramedics are available to the system, so if we have a need within the ambulance system that cannot be filled as a result of individuals that have accessed the training, then we will certainly be putting in place the training programs to make sure that the need gets met. We're not in any way going to put access to these services in jeopardy in the future. This whole process will be well managed to ensure that the human resource needs of the Ambulance Service are met into the future.

J. MacPhail: My two final questions are: one, have the ambulance paramedics themselves been consulted on this change, and what was their response? And lastly, when is the core review of the Ambulance Service expected to be completed?

Hon. C. Hansen: First of all, the union was advised of the changes that we are implementing. I also want to underscore the fact that we are enhancing training for many paramedics throughout the province that is being funded out of this budget, which includes the increase from the 350 to the 1,300 paramedics that will be given the opportunity to come up to the paramedic 1 level.

With regard to the time line on core review, it's not a hard and fast time line, but we anticipate that recommendations should be coming back to the deputy minister around the end of April, although that's a tentative target at this point.

J. MacPhail: I'm going to yield the floor to my colleagues who have questions for the minister. I will return after the supper recess, whenever I have a chance, and commence with the Pharmacare changes, just for information of the minister.

Hon. C. Hansen: Perhaps just to clarify where we would be going with that discussion tonight, I have on my list that we had discussed, when we started this process, Pharmacare, Ambulance Service and health information systems. I believe we've dealt with Ambulance Service, so if we go from Pharmacare to health information systems, she had then mentioned she had some issues around wait-lists; aboriginal health, which I think we've dealt with; women's health, which she may still have more questions on; and tobacco, which I think we've dealt with. I just want to get some clarification that we're going to deal with Pharmacare, health information systems, wait-lists and women's health issues. Is that appropriate?

J. MacPhail: Yes. Then, tomorrow, we can proceed to mental health and continuing care, and we should be done. That will complete my submission to this minister tonight. Yes, the order is correct.

B. Kerr: I haven't heard all of the debate, so some of the questions I have for you may have been answered. If they have and you don't want to be redundant or repeat yourself, please just advise me to read Hansard. I'll do that.

Some of the questions I have concern my riding specifically. My riding is sort of a hybrid, and it creates a bit of a problem. Within the CRD, my riding goes up to Sooke, Port Renfrew and Jordan River. It's funny, because people look at my area as if it's urban, but it really isn't. It's actually a rural area. Take the area of Sooke, for instance, which is grossly underserviced — at least, we may determine that it's grossly underserviced. My concern is: what is being done for an area such as that to ensure it will get the service that it needs? Right now it doesn't even have a clinic.

Hon. C. Hansen: I've certainly had the pleasure of visiting some of the points in the member's riding, in terms of Port Renfrew and other areas out past Sooke. I also know that the Minister of Energy and Mines may have a different definition as to what's rural and remote when you come to the very remote parts of the North Peace region.

Sooke, for example, is considered a rural community, and it does get additional support because of that. We have put in place standards that will ensure all British Columbians get access to care, regardless of where they live, within time frames that are considered medically appropriate. We are putting expectations on all of the health authorities, and certainly the Vancouver Island health authority is expected to ensure that it can deliver adequate and timely health care services to residents of all the remote parts of Vancouver Island, including the parts in the member's riding.

B. Kerr: I guess the member from the North Peace country recognizes the rural. The problem with Sooke is that people think it's urban when it really isn't. So I appreciate that.

What are the specific time frames that you set up for, let's say, ambulance service to take a person that has to have some treatment done — heart attack, something of that nature? What time frames have you set up to deliver them to a place where they can receive care?

Hon. C. Hansen: Basically, we are structuring the health care system — and specifically the ambulance service — in a way that allows us to get an individual into the emergency care they need within the appropriate time frame. We often talk about the golden hour of care. We are structuring the system in a way that if somebody had a serious heart attack or a major car accident involving trauma, we would by and large be able to deliver on that level of care.

It's not to say that in every case, for 100 percent of British Columbians living in extremely isolated and remote areas, we're able to meet all of those needs. But the standard we have set for ourselves is that for all but the exceptional cases, we're able to meet those targets in terms of getting people into the care they need.

B. Kerr:. I meet with the docs in Sooke on a regular basis to see how we can service the area. They are receiving the rural allowance for, as they call it, retention and on-call services. They have a concern whether or not that will continue into the future, and I just wonder if you can respond to that.

Hon. C. Hansen: This is very much going to be part of the discussions we are having with the BCMA. As part of the increase in physician remuneration of $2 million, one of the issues that will be addressed is recruitment and retention for rural physicians. We certainly want to make sure that those programs are in place which will ensure there's stability in retention of physicians in rural communities throughout the province.

B. Kerr: Moving on to the negotiations, I guess we had the McEachern report. What part of the negotiations were included in that report, and what part of the negotiations are we taking on as an addition because of the actions we took? I mean, I know the McEachern report made certain aspects that we had to negotiate, so what is the difference?

Hon. C. Hansen: The negotiations we're undertaking with the BCMA are set out in the memorandum of understanding, so the scope of those negotiations is really quite specific. The intention is to capture the issues that were on the table throughout the mediation/arbitration process and to try to bring them to resolution. While the specific language and recommendations or rulings that were in the arbitration report have been set aside, we are trying to work with the BCMA to make sure the issues set out in the memorandum of understanding are addressed in a comprehensive way.

B. Kerr: I understand there was $392 million in additional health care funding that came about for the physicians. I'm just wondering if you can, for my benefit, tell me how it's broken down. For instance, how much of that is an increase in the fee schedule?

Hon. C. Hansen: There's $185 million allocated for an increase in the fee-for-service payments. There is $80 million allocated for on-call payments. The balance of $127 million is for a range of things including population demographic increases; alternative payments, which are essentially for salaried and sessional physicians; and also enhancements to the rural agreement.

B. Kerr: Will this ratio stay the same over the next three years, or is that part of the negotiation?

Hon. C. Hansen: Yes, the $392 million does carry forward. It's built into the base budget for the years to come, and that breakdown will remain throughout the years. That's the envelope on the table for negotiation with the BCMA.

B. Kerr: Essentially, if there's a percentage increase in the fee schedule, it will be a percentage on the $185 million, not a percentage on the $392 million. Is that correct?

Hon. C. Hansen: Yes, the increases to the fee schedule that will be implemented as a result of these discussions will come out of the $185 million. That is the envelope for that portion that'll be carried forward over the next three years.

B. Kerr: One of the things that concerned me when I looked at some of the numbers that were given out there in the public domain was the fact that in British Columbia, our per-capita physician costs are almost between 40 and 50 percent larger than the next jurisdiction. Maybe I have that wrong. Maybe you can answer that for me.

Hon. C. Hansen: The short answer is that we have more doctors per capita than any other province in Canada, or at least we rank in the top one, two or three, depending on which year you're looking at.

The amount of money that's built into our budget to provide for physician remuneration on a per-capita basis is 23 percent higher than the next closest province, and that would be Ontario.

B. Kerr: That's a bit more encouraging. What is the ratio of physicians per capita in British Columbia?

Hon. C. Hansen: I don't have those numbers at my fingertips right now, but there's a wonderful website that has that breakdown. It's the Canadian Institute for Health Information — CIHI, as we often refer to it. They have that data in terms of the numbers of physicians on a per-capita basis. That's actually broken down by specialists and by GPs.

When it comes to the number of GPs on a per-capita basis, we are number one in Canada. When it comes to the number of specialists, we rank further down the list vis-à-vis other provinces. Certainly, if the member would like, we can track down that specific data for him and get that over to his office.

B. Kerr: Thanks for just leading me in the right direction. I can look that up and pass that information on to anybody who wants it.

If we have the most doctors per capita, my next concern would be: how is it skewed? How is it weighted between urban and rural? Is it weighted

more in the urban areas and other areas or more in the rural areas of British Columbia?

Hon. C. Hansen: There is quite a discrepancy in the ratio of doctors per capita in urban British Columbia to rural British Columbia. I know there are some communities where there is one doctor for 3,000 people. The standard that is generally aimed for — the target — is one doctor per thousand. In parts of the province, in urban centres, we far exceed that. Certainly, there are some rural and remote parts of the province where there are very, very high ratios of the numbers of doctors to people living in those communities.

B. Kerr: Those are the questions that I had. I've spoken to the doctors, and I thank you for your candid answers, because we do create a dialogue. There was a problem created with the doctors. I think a lot of misunderstanding and rumours went out there as a result of the McEachern report.

I'm hoping there is some bridging mechanism being set up with the BCMA and with the doctors specifically, and that possibly that information could be given to us so that we could approach the doctors we deal with to help smooth the path. I know there is a desire on the part of the physicians to move forward and put patients first, which is the same desire we have.

S. Orr: My first question. I think we've been over this once before, actually. I did look it up in Hansard, and I don't think I said it the way that my constituent wanted me to say it, so I'm going to go over it again, if you don't mind. It has to do with routine eye exams.

The Ministry of Health media release in October stated — we all know this, but I will repeat it: "People 18 years of age and younger, and 65 and older will continue to be covered for routine eye examinations."

This is good news, especially for the most vulnerable. Yet I have constituents who fit this category calling to say they have been charged. In the past MSP was paying $44 for an eye exam, but lately optometrists are now what they refer to as "soft-opting," which means, I guess, that they can charge more than MSP is charging.

My question is: is there anything we can do about that? Is there any way that my constituent can be sure that when they're in the category that we cover, they're able to find an optometrist who is actually working within the guidelines of the MSP payments?

Hon. C. Hansen: Optometrists' services are not covered by the Canada Health Act, so it is an area where individual optometrists have the opportunity to opt out of the MSP program if they choose to do so. If they stay opted in, they are restricted in terms that the amount they can bill is what we'll cover. We do cover 100 percent of that agreed-to amount for those age groups that the member mentioned. If an optometrist decides to opt out of the Medical Services Plan, then they do have the ability to charge more, and there is nothing we can do to prevent that.

What this comes down to in the end is the need for individuals to shop around, to make inquiries of the optometrist's office to determine whether or not that individual has opted in or opted out. If in fact they are opted out, what additional charge would the optometrist be presenting to the patients when they come in? It's an area where we're certainly encouraging people to make those kinds of inquiries at the time they make their appointments.

S. Orr: Thank you for that answer. I sort of figured that was it, but I thought there might be some other thing that we didn't know about.

I'm now going to this absolutely wonderful document that we have, this three-year fiscal plan. It's very nice to see things laid out. I have to reiterate that it is a joy to have something with some future to it that you can actually work from.

I have a question. I'd like to read it to you, and then you give me the larger interpretation of this. It's on page 44. The first piece that I'd like you to just embellish a little on is bullet 2: "Increase opportunities for private sector involvement in health capital projects and non-medical health services and reduce the number of health capital projects." Then we have an estimated savings there.

Hon. C. Hansen: So you'd like me to embellish? Basically, I think this is one of the opportunities we have given to the health authorities: to find the most cost-effective way of ensuring that they get the support services they need. Our primary function in the Ministry of Health Services and the various health authorities is to deliver on health services. It's the direct care for patients and health programs for the general public.

I've often said we're not in the real estate business, and we're not necessarily in the laundry business or the food service business, because those aren't core to our operations. What's core to our operations is patient care, and everything else is there to support the delivery of patient care. We have given the challenge to the health authorities to look at the most cost-effective way, and it's our sense that there is an opportunity for some considerable savings in health care budgets in the years to come. Every dollar that's saved is a dollar that can be directed into direct patient care.

S. Orr: I have several doctors in my area who have set up…. I'm not sure if they're even called private clinics. They perform surgery for WCB and other different organizations. Could you explain to me how we could pursue that further within the Canada Health Act? I have quite a few doctors who seem to be quite interested in providing services on a fee-paying basis. How would they go about doing that?

Hon. C. Hansen: The point the member makes about staying within the Canada Health Act is very important to us. We want to make sure that all of the health services we deliver in this province are consis-

tent with the Canada Health Act, and we're certainly trying to be vigilant in that area.

Health authorities throughout the province have come to us with opportunities around how private clinics could be used to ensure that we deliver not only on effective patient care but on cost-effective patient care as well. The challenge we have put back to them is that they should be exploring those opportunities. They should be putting forward a business case for how patient care can be met using some of those opportunities.

Again, we are adamant that it must be consistent with the Canada Health Act. That means there cannot be any additional charges to the patient or facility fees over and above what would be paid for by the public system.

The other thing that's clear, which is misunderstood by a lot of people, is that what we're talking about is publicly funded surgical care being provided in these clinics. We're not talking about telling people that they won't be funded for medically necessary care and that they've got to go and pay for it themselves at these clinics. We're talking about publicly funded care for medically necessary procedures.

We've said to the health authorities that they have the ability to pursue those opportunities, but they have to be cost-effective. We're not going to drive this for some kind of philosophical motivation. It's based on how to get to best value for every dollar that's there in the health budgets.

S. Orr: I want to go again to page 44, which I assume you have open, and I'm going to go to bullet 4. It goes, "Shift costs for services not mandated under the Canada Health Act from government to consumers and/or private health insurers," with an estimated savings, which looks pretty substantial, of $70 million over three years. How do you see that looking? You're shifting the costs for services. Could you embellish that?

Hon. C. Hansen: What that's in reference to is the changes we made, which we announced in December, to coverage under supplemental programs: the areas of physiotherapy, chiropractic care, naturopathic care, non-surgical podiatry and massage therapy. That resulted in a reduction to the supplemental health budget of $68.8 million, which is your $70 million. Over the three year period it's a net reduction to the budget of approximately $70 million. That's how that reads.

S. Orr: I'd like to clarify something. This was said to me last week. When we removed those services, I'm assuming the money that we're talking about, which we saved…. Your budget has grown by another billion dollars. We actually took that money and put it into more direct services, which went directly to the patients. In other words, as somebody said to me last week, you took that money and gave even more to medical services — doctors, nurses and direct patient care. Is that right?

Hon. C. Hansen: I wouldn't want to imply in any way that the work done by physiotherapists, chiropractors or massage therapists, etc., is not direct patient care. I certainly am a user of those services. I think they make a very valuable contribution to our health care system, but because they were outside of the Canada Health Act and they were services that are covered by extended health programs for the majority of the public, we felt this was an appropriate place to look to save some dollars so that we could meet some of the other budget challenges that we had.

It's not a case of saying that a dollar saved in this area was transferred over to provide for a knee surgery or something like that. It's a case of saying that it became part of the budget planning exercise. The $70 million that we were able to save in this area helps us to meet the overall challenges that we have in other areas of health care delivery and I think, at the same time, protect services to the most vulnerable. That's why we ensured that those on premium assistance, which is almost 30 percent of the population, would still have access to ten visits a year. By and large, those who are not on premium assistance have access to extended health programs that will ensure they continue to get access to these very valuable services.

R. Lee: I have a few small questions. The first one is about registered nurses and practical nurses. We understand that B.C. still has a shortage of registered nurses, and in fact many jobs can be done by practical nurses. Are there any plans in the government to increase the number of practical nurses? The training will be shorter — only two years versus four years for registered nurses.

Hon. C. Hansen: This an area where there is some really good news. Since the nursing strategy was introduced by my colleague the Minister of Health Planning last August, and in working with the Ministry of Advanced Education, we have already managed to increase the number of training spots for nurses by 177 in the province. That includes 78 registered nursing spaces, 49 for licensed practical nurses and 50 for resident care aides. That is a good start, but clearly there's more that we have to do to meet those challenges.

It's important that these programs be throughout the province. I was in Terrace last week. Individuals in Terrace were quite excited about the restarting of a licensed practical nurse training program that will be based in Terrace, a program that had been curtailed a number of years earlier. That provides opportunities locally for residents in the northwest to get access to that training.

I think the point that the member makes is a very good one — that there are a lot of functions which have been done by registered nurses that in fact could be done by licensed practical nurses. In the past there was very little differentiation between the hourly wage of a licensed practical nurse and that of a registered nurse, so the incentive was built in for health authorities to

hire registered nurses instead of licensed practical nurses. It is now such that the health authorities have the incentive to ensure that licensed practical nurses are used to a greater degree. I think what's important is that we want to ensure that our professional staff are used to the extent of their scope of practice so that we can best utilize the individuals according to their training levels.

R. Lee: I understand that in some colleges they have a program for care aides. It's a ten-month program. For those students, if they're allowed to register in the licensed practical nurse program, it would only be one year for them. It would be a very short training time for those students. There may be some opportunity in that area.

Hon. C. Hansen: Yes, I think the point the member makes is a very good one. We are also looking at the development of what are called laddering programs. If you get an individual who spends that year of training to become a licensed practical nurse, they can use those credits. That training becomes an integral part of going on to become a registered nurse. In the past the training for these various levels was all isolated. If someone got training as a licensed practical nurse, they'd still have to go back and start over again if they wanted to become a registered nurse. I think that creates some tremendous opportunities for young British Columbians to get into the health professions.

I was talking to an individual recently who was training to become a residential care aide. Once that's complete, she'll go on to become a licensed practical nurse and hopefully go on to become a registered nurse after that. I think that's opening all kinds of great opportunities for young British Columbians that weren't there in the past.

R. Lee: My second question is on the College of Traditional Chinese Medicine Practitioners and Acupuncturists of B.C. That college was established last year, I believe. Effectively, as of June last year, all the practising acupuncturists in B.C. have to be registered in the college in order to practise. I wonder, because there were some changes in complementary medicines last year, what the status of that college is at this moment.

Hon. C. Hansen: I know there is always confusion over the roles between Health Planning and Health Services and the regulation of the colleges. The relationship between the colleges and government falls under Health Planning, but I'm going to do my best to field the member's question.

This is a great benefit, I think, to individuals who utilize traditional Chinese medicine. The college is set up as a self-regulating body. Individual practitioners themselves have control over the integrity of their profession, the training requirements, the accreditation, and also ensuring there's a requirement that members continue their education even after they're certified. It's not something that government controls. It's arm's length from government, but we certainly set up the regulatory framework in which they operate.

I think the establishment of the college is good news for the public. It's also good news for the practitioners that they are recognized as full and bona fide health professionals in this province. I think it's good news, and there's certainly good progress being made.

R. Lee: My next question is about ambulance services. You know, firefighters used to handle some kinds of first response in some areas. In many cities they are trained for first response. Right now a lot of emergency situations are handled by ambulance or paramedics only. Are there any plans to use firefighters more in handling emergencies?

Also, I understand that many firefighters are only trained in the first level of first response. They don't have the opportunity to be trained in higher levels. My question is: are there any plans to utilize the expertise of firefighters more? I also understand that in many, many areas you have more fire halls than hospitals. In terms of fast response, it would be nice to have the firefighters do it.

Hon. C. Hansen: There is a provincial first-responder committee that looks at the relationship and cooperation between the various services. The goal is to make sure that we meet those needs through the most appropriate vehicle. I think the member mentioned that, particularly in the lower mainland, there are a lot more fire halls than there are ambulance stations, so in many cases the fire service is able to get there more quickly than the ambulance.

The work of the first-responder committee is to make sure that those programs are integrated at the level of ambulance dispatch. They will work through the algorithms, given the purpose of the call and what the needs are, to make sure that the appropriate response is there. The best-trained ambulance paramedics will obviously be called upon to go to the most urgent cases. Then there's a whole series of backup support, and the fire service is clearly very much part of that backup support.

It's an area in which there is good cooperation. I think there are opportunities to make sure that patient needs get met throughout the province within critical time lines. We look forward to that kind of cooperation continuing.

R. Lee: I've also heard some complaints about not getting an ambulance and about the firefighters not getting notification in that kind of program. I think that more cooperation and some kind of efficiency inside the program are probably in order.

Hon. C. Hansen: We will, through the first-responder committee, be looking at those opportunities as to how we can improve on what is already a very

R. Harris: Rural hospitals and the manpower planning and training that goes on within them. It's well documented — the difficulty we've been having in terms of retaining people and attracting them. I thought maybe you might outline for me how, through the new structure, individual facilities are going to actually handle the training or the manpower planning to ensure that down the road there are in fact the right trades and professions as they move through it. I think initially it was done through the individual practitioners — the nurses doing their own and that sort of idea. Maybe you can explain to me how that's going to work under the new structure.

Hon. C. Hansen: I think this is an area where there has been a tremendous weakness in the health care system over the last number of decades, because there was no forward planning in terms of the human resource needs that the health system needs for it to function into the future. The Ministry of Health Planning is actively pulling together a ten-year human resource plan. The reason that time horizon is there is because you can't train some of the professionals we need in the space of a year or two years. It really does need that ten-year horizon to make sure that future needs are met.

The other thing that's happening is there is a much closer relationship now between the Health ministries and the Ministry of Advanced Education to make sure that those future needs are anticipated, first of all, and that our post-secondary institutions are responding to that need in a timely way so that future demands can be met.

R. Harris: I'd like to talk a little bit about capital planning. Renal dialysis is a service in the northwest that…. It's one of the few areas of the province that still doesn't have that service. I understand that the new structure will allow for the decision-making in terms of providing these kinds of services to happen in a more prudent and timely manner. Maybe you could explain to me how the capital planning will work in the future in terms of when hospital regions want to acquire new capital equipment and that process, and how the health authority will in fact manage that.

Hon. C. Hansen: The renal program in British Columbia is administered through the provincial health services authority, so it is very much a provincial program. They are now developing programs to ensure that those needs get met across the province. They do that in working very closely with the regional health authorities. The regional health authorities obviously play the front-line role in delivering those services and ensuring that the equipment the provincial health services authority feels is necessary for those programs can be properly housed and operated at the regional level.

They are working on that now. I don't have any specific news for the member with regard to the renal program in his particular communities, but I know they are actively working on trying to come to decisions on that as soon as possible.

Generally speaking, on the general question around capital, there is a transition going on. In the future the health authorities will be responsible for ensuring their capital needs and operating needs are integrated into one budget. It will certainly give more flexibility to the regional health authorities to meet their priority needs in a way they did not have the flexibility for in the past. I think that's good news and will provide for better and more timely decisions in the years to come.

J. MacPhail: I gave the minister some questions about Pharmacare that had been referred to him by several of his colleagues. We can go through those as we examine the plan to move to an income-tested model. I note that the minister himself in the leaked document, the service plan and the announcement made around reductions in coverage in Pharmacare said that there will be an income-tested model in place as of January 2003 and that there will be — let me choose my words very carefully — savings to the government of about $400 million. I'll decide later whether I want to call them cuts.

Let's start with: how does the minister intend to implement an income-tested Pharmacare model, and how will he get $400 million worth of savings by so doing?

Hon. C. Hansen: The income-tested model is being worked on. It's actually a very complex redesign of the software that we use to drive the Pharmacare program. Essentially, as a point of departure at least, we have looked at the Manitoba model that they have in place for income testing. It would mean individuals would apply for coverage under Pharmacare and in doing so would allow us to source their net income off their T4 slips with their Revenue Canada filing, which is part of the protocols we have in place with the federal government. We would be seeking the authorization of the individual for us to access that information as is done in many other programs.

As a result of that change, a significant number of British Columbians will see their deductible drop. I know I've certainly had many letters and telephone calls from individuals who are low-income, who are faced with that deductible even if they're on premium assistance. The deductible was $600 and is now $800,

which is a pretty big hardship for a lot of low-income families. This income-tested system will allow us to reduce that deductible for many low-income British Columbians. The net result is that higher-income British Columbians will be facing a higher deductible. Out of that change we see there will be net savings to the Pharmacare program, which are reflected in the budget numbers that she sees.

J. MacPhail: It will help if the minister can just be forthright about who's affected and who isn't. Virtually no one is lauding this government for the changes they've already introduced to Pharmacare — no one. If the minister has people on record, bring them forward. The highest anxiety among seniors about what this government intends to do to support seniors was started with the introduction of the changes — the cuts — in Pharmacare coverage for seniors.

I'm sure that next the minister will stand up and say, "Oh well, we just increased the deductible for seniors from $200 to $275," except that as of January 1, thousands of seniors sometimes had to pay $150 up front, out of their pockets, for prescriptions because they had to pay $25 per prescription.

I also heard the minister in a previous debate yelling across the floor at me that low-income seniors were unaffected but that somehow a senior who earns $20,000 after deductions is a well-off senior. In my riding — which is a large, urban, east side riding where the rents are much lower than in the minister's riding — seniors pay at least half of their disposable income for rent. Transportation costs have just gone up for seniors. They're paying more in MSP premiums. They got a very, very minute tax cut.

I remember this clearly, because I was quite taken aback by this minister yelling this across the floor at me. He tends to be one of the people in this government that is a little more understanding of the broad range of income levels in this province. He was yelling across the floor at me that it's $20,000 after deductions — after deductions, as if that made all the difference in the world.

That's just what's happened so far. The next step is to go to an income-testing model, where 420,000 seniors will pay more and 20,000 low-income seniors will pay less. Perhaps the minister could tell me how that works to the benefit of seniors.

Hon. C. Hansen: First of all, just to make sure that the record is correct, I have never referred to well-off seniors in the context of the Pharmacare program. I have differentiated between low-income seniors and higher-income seniors.

Just to correct the perception that the member may have created in her comments, when we talk about the threshold levels for premium assistance in the province, we are talking, under the system that is currently in place, about a net income of $20,000. The deductions that seniors are allowed to apply to that would mean that a husband and wife both over the age of 65 would be entitled to $9,000 in deductions before they arrive at that threshold level. Under the system that is actually in place as of today, a husband and wife earning $29,000 a year would still qualify for that premium assistance.

The good news is that as of May 1, the threshold levels are going to be increasing by $4,000 — so, in fact, you would see a husband and wife both over the age of 65, earning $33,000, still qualify for premium assistance. They'd be facing a maximum deductible of $200, which is the same maximum deductible that was in place prior to the changes we announced.

I think a lot of the angst that the member referred to was in fact caused by a lot of people in the province who were running around fearmongering with seniors just because we were only reviewing the Pharmacare program. The big banners that said, "Keep your hands off Pharmacare," were banners that were printed and used before the announcement was even made. In fact, it was the member herself that made the announcement on behalf of government because she got hold of a leaked document a week before the announcement was planned.

I think a lot of the fearmongering and angst that was created among seniors was started before the announcement was even in place. I think a lot of seniors who then saw what we had done with those changes recognized that we were protecting low-income seniors.

As we move forward into the income-tested model, there is a recognition that there are a lot of very wealthy individuals in this province who could afford to pay more for that deductible, whether they are seniors or not. The income-tested model will allow for those with higher incomes to pay more for their deductibles. It will also allow for a significant number of low-income families to in fact pay less with the new income-tested model that will come into place next January.

J. MacPhail: It's a bit patronizing of the minister to somehow suggest that seniors were misled and fooled and that somehow the protests were without basis. After the announcement was made — once again, an announcement that had to be revealed through a leak…. That happened in December. The system change was going to be put in place four weeks hence. The government wasn't even going to give seniors notice that on January 1, they would have increased costs for prescriptions, so maybe they'd better not spend so much at Christmastime. That's why the announcement was leaked internally. The seniors themselves are the ones who are saying, after the system is in place: "My God, this is costing us a lot more than before."

Certainly, seniors continue to be at the forefront of people who are concerned about cuts to Pharmacare. I met with some seniors on the first Saturday that we went back to our ridings. They were a very diverse group of seniors who were there wanting to talk solely about the cuts to Pharmacare that they and their senior

neighbours were experiencing. I don't understand why this government still thinks it can label everybody fearmongers or special interest groups and say that that's enough to explain why nobody should be concerned. Seniors are desperately concerned about this.

This isn't fearmongering, then. This is the minister's own document that says the changes leading to an income-testing system will be effective January 1, 2003, and that 420,000 seniors will pay more and 20,000 low-income seniors will pay less. Is that document wrong?

Hon. C. Hansen: The numbers that are contained in the briefing document that she obtained are one scenario. The ministry is looking at a whole range of options in terms of how this income-tested program would be designed. Until such time as we make decisions in terms of how it will be structured, it's only speculation as to how it may impact on any particular group. The numbers that are there are numbers that would be affected if that particular model were to go forward.

I think it's important to recognize that right now the maximum deductible that is in place for low-income seniors — and almost 50 percent of seniors qualify for premium assistance — is $200. That's the same maximum deductible that was in place a year ago. Every January seniors start the process of reaching their deductible, so the fees that seniors are paying this year towards their deductible are certainly no different than they were in previous years, for those who are on premium assistance. Those who are not on premium assistance — I refer to them as the higher-income seniors — did see an increase of $75 in their deductible, and they also saw an increase in the amount they would pay per prescription go to $25.

As I said earlier, we went to great lengths to ensure that low-income seniors were protected. The numbers that are presented in the briefing document that she obtained pertain to one particular scenario, but there's a whole range of models that are being explored by the ministry.

J. MacPhail: I'm not even sure the minister understands what his changes, effective January 1, 2002, did to seniors. I don't think he understands, from him sort of saying: "Oh, they were nothing."

I have had seniors put pen to paper and explain to me how they were hit in January with a bill for $150 for their prescriptions. They had six prescriptions, they had to pay $25 upfront for those prescriptions, and they didn't have anywhere to get the money. Well, they did, actually. They chose to cut back on food. I didn't make that up. In fact, the vice-Chair of the legislative Select Standing Committee on Health was at a meeting where several seniors made exactly that point to her — exactly that same point.

The minister's saying that nothing's really changed, or it's just $75 per year more, really, really underestimates — or perhaps he's not aware of — the effects of those changes. Let's be clear: the changes were all about savings, and savings mean cuts. Savings mean somebody else, other than this government, pays for a health care service that used to be paid out of the public purse.

Let me ask this, then. Here we are, eight months away from the implementation of this system. I know how the federal government works; I know that this government should bring in legislation. I expect he's probably going to stand up and say: "Oh no, the system hasn't operated on legislation so far, so we're not planning legislation." This government should bring in legislation when they go to an income-testing model, and the government has to work out the changes with the federal government and then serve notice to the public.

I expect the minister does know what system isn't going to be in place. If he doesn't, the ministry's really, really far behind schedule. Also, if the public refers to the supplemental estimates, it's very clear that there will be a $400 million cut to the Pharmacare budget. Let's start in order, then.

The planning process. The Minister of Health Planning referred all these questions to the Minister of Health Services — every single one of them.

Hon. C. Hansen: For the Pharmacare consultation that we undertook last year, we sent out dozens of letters inviting input from a variety of groups, including seniors organizations, unions and different organizations that would have an interest in the Pharmacare program. We had asked for them to put in their submissions by September 31 of last year. In some cases the submissions came in after that. We certainly tried to incorporate those ideas. We tried to draw on those inputs that we got over the fall in designing the changes that we announced in December.

Hon. C. Hansen: No. There wasn't a formal release of a document that resulted from the consultation, but we certainly took the inputs that we had received from those various organizations and incorporated them into our planning process.

The other thing is that in addition to the responses to the letters that we sent out, because we made public the fact that we were involved in that consultation process, we received a lot of unsolicited letters and input as well, which again became incorporated into the planning process.

J. MacPhail: When the government is planning a $400 million saving, really, in this case it does mean the government's cutting their contribution. This government is cutting by $400 million their contribution to Pharmacare, and somebody else is going to have to pay it.

Why didn't the government release the consultation? I don't understand that. If the government relied

on that to make their Pharmacare changes, wouldn't it have gone a long way to resolve people's concerns that somehow the government was out of touch with seniors and low-income people, if the minister had released the consultation?

Hon. C. Hansen: The consultation was quite broad. The range of inputs we got was quite broad. What we felt was most important was to make public the decisions around Pharmacare changes. Certainly, we valued the inputs that came in from a variety of those groups, and those were incorporated into that planning process. I'd also just like to point out that of the various positions that came in, one of the issues that was…. I wouldn't say it was the majority of the submissions, but certainly a common recommendation across many of the submissions that came in was to move to a model that incorporated ability to pay and financial means-testing. It was certainly as a result of the inputs we got from that consultation that we designed the changes that were announced.

J. MacPhail: Well, why doesn't the minister just release the inputs? I don't understand that. Why are they secret? Why is it that those of us who are concerned about Pharmacare…? Why can't we see the submissions? I don't understand what's so secretive about it. Let's have a look at what people were saying. Will the minister release them now?

Hon. C. Hansen: There was certainly never an intention that we would release it, because it was an internal document leading to part of that planning process, but there's certainly no reason why we can't release it. If the member would be interested in reviewing it, I'd be pleased to make a copy available to her.

J. MacPhail: Yes, of course I would like a copy, as would the, I guess, hundreds of thousands of British Columbians that are going to be affected by this.

I must say that for someone to suggest that a model based on ability to pay results in an income-testing program that cuts $400 million from a $700 million program would probably be a stretch. I will be very happy to see the kind of input where an ability-to-pay model coincides with a cut of $400 million in Pharmacare coverage.

Let me ask the minister this: what's wrong with a progressive tax system being an income-tested model?

Hon. C. Hansen: Certainly, the objective around moving to an income-tested system is to make the program more progressive. I think it's important to point out to the member that the savings of $400 million that she's talking about are over a three-year period. We're looking at a Pharmacare program where the cost pressures, the increase over the last number of years, have been in the range of 16 to 19 percent per year. Clearly, that's not sustainable. We could not continue with the status quo, and we had to find new ways of ensuring that priority needs of British Columbians get met. The Pharmacare program we had in place resulted in government paying, by far, the highest percentage of medication costs of any province in Canada.

We felt that was something that was not sustainable and could not be continued in the model it was. We felt it was something that was not sustainable and could not be continued in the model it was. Change was necessary, and we've tried to design the change in a way that meets the needs of those who are the most vulnerable as a first priority.

The other thing I want to point out is that if the member looks at the budget projections over the next three years, the budget for the Pharmacare program at the end of the three-year period is actually greater than it is today. We do see those cost pressures continuing to grow, even with the move to the income-tested system we are proposing.

The one thing I am very confident of is that we actually have real numbers plugged in for our projections on Pharmacare, unlike the budget we saw a year ago, where we had the Pharmacare budget deliberately underestimated by $92 million.

J. MacPhail: This minister is very good, and he does get away with it. It was just the same way this afternoon when he tried to say it was somehow the previous government's action that allowed Grant Roberge to get a $300,000 going-away party, when he knows that's dead wrong. He did. You went out into the hallway and said it was the previous government's contract, and that minister had no control over that contract and that gross, obscene payout of a person who quit. Now he's saying that somehow they had to do….

The Chair: Order. Order, members. I would suggest the members address the Chair.

And now he's saying that somehow in the past, the previous government deliberately misled on Pharmacare costs. Wrong. What we did do was put everything in place to try to get Pharmacare costs under control, where we wouldn't off-load it onto the most vulnerable. If the costs weren't covered, we came in here and got more money for it, but we didn't off-load the costs onto the most vulnerable as this government has done. This government did this. Talk about a progressive tax system.

Here's what this government did. On day one, going into office, they gave the biggest tax cut worth thousands of dollars to the richest. Then they said: "Oh, I'm sorry. We need to cut Pharmacare, so we're going to put in a system of ability to pay. The people who we're saying have the ability to pay are seniors who make $20,000 or more."

Whereas if this government had done this, simply done this — if they had allowed a progressive tax system to remain in place, where those who have the abil-

ity to pay would pay through the tax system — seniors would not now have to pay an unbelievably huge increased cost for Pharmacare. The government didn't want to do that. They wanted to say: "Give the richest a $4,000 or $5,000 or $6,000 per year tax cut."

J. MacPhail: That's what it was. A senior with $20,000 got a tax cut of $200.

J. MacPhail: Okay, let me see. Let me see what's fair. Okay, a senior getting a $200 tax cut is the same as a rich person earning $100,000 getting a $4,000 tax cut. That's what this government talks about as a progressive tax system. In order to pay for that, who really gets harmed? It's a transfer from the poor to the rich. That's exactly what happened — the combination of moving to this income-test model for Pharmacare and giving the biggest tax cuts to the richest in this province. There's no other way of describing it — no other way.

Sure, the richest, which his consultation says should pay for it…. Say you move to an ability-to-pay model. Well, an ability-to-pay model is a heck of a lot easier for someone earning $100,000 to pay when they've just had a tax cut of $4,000. It's a lot easier for them to pay for their drugs than a senior now. Let's even take a $60,000-a-year family. I'm sure the Minister of Labour won't be able to yell across the floor about that.

Let's take a family earning $60,000 a year. Their tax cut is completely gone already as it is, and they're going to have to pay more for Pharmacare. Somehow this minister thinks that's okay. All I can say to him, Mr. Chair, is that it isn't fearmongering. It is not fearmongering for anybody to point out the transfer of program costs onto the shoulders of the middle- and low-income in this province, which is what this government has done.

If this government is serious about saying that the reforms are exactly what the public wants, why is it that I have to stand up and ask for the basis upon which they made that decision? Am I going to have to do the same for the changes when this government eliminates the reference drug plan as well?

Hon. C. Hansen: I'm not going to go into the review of the reference drug program as that's one that clearly falls under the responsibility of Health Planning, and I think the member may have canvassed it at that time.

For all of her comments tonight, I want to just put this back into perspective for somebody that's trying to follow this debate. Last year the budget for the Pharmacare program was $708 million. That was far different from what they had budgeted, because clearly I don't think they came clean with the public as to what they were planning in changes to Pharmacare in order to deal with that $92 million cost pressure that was not included in last year's budget. We had to deal with it, and there was more money put into the program as a result of the July update from the Minister of Finance.

In this fiscal year that has just started — the estimates that we're debating for the year started on April 1 — the budget is an increase of $10 million to $718 million for Pharmacare. With the introduction of the income-tested program, it does result in the following year in a reduction of that budget to $630 million. So it's a reduction of about $90 million, which is, interestingly, what they had underbudgeted last year — and didn't tell us how they were planning to meet those targets.

In the following year we see continued growth in the Pharmacare program, bringing it up to $723 million, which is a number even higher than it is today. We are going to continue to see growth in the Pharmacare program. The changes that we make will actually make it fairer for more British Columbians, based on ability to pay.

I found it interesting as she was arguing about the tax cuts. What we are doing in implementing the income-based testing is exactly the kind of progressive program that will allow those that can afford it to pay more and those who are of lower income to make sure they are properly supported.

In terms of changes to the program in terms of non-seniors in the one scenario, as I mentioned earlier, it's just one of the scenarios, one of the models that's being looked at. It happened to be the one that was set out in the briefing document that she got her hands on. You'd actually see 160,000 families in British Columbia see their Pharmacare costs reduced as a result of the income-tested program. Again, in terms of non-seniors, there would be 130,000 that would see their costs go up.

In the case of seniors where the deductible is already at the low level of either $200 or $225, there may be a higher portion go up, but that's only because the deductible levels are already much lower than they are for the rest of the population. It is an opportunity to bring fairness to the system. It's an income-tested system that allows those families and individuals of higher incomes who can afford to pay more, whether they're seniors or non-seniors, to be asked to pay more for their Pharmacare program.

In doing so, if you look at the overall budget, it really makes a bit of a dint in the cost pressures. Clearly, we continue to see the Pharmacare budget at the end of three years being even higher than it is this coming year and higher than it was in the year that's just ended.

J. MacPhail: Let's just be clear about the facts. Pharmacare was always fully funded under previous governments, and that government always balanced its books in the last three years. You know what? For this minister to somehow justify his actions through past actions is simply ridiculous. Perhaps what the minister

could do is come clean and say there will be $400 million less — okay, let's say over the next three years — that this government will pay for drug costs that either will not get covered now or will be off-loaded out of the pockets of working people and seniors or onto private insurance companies.

That's exactly what this government's doing. I'll tell you something. For the minister to somehow say: "The fact that we're going to an ability-to-pay system is exactly the same as a progressive tax system…." The only reason this government is going to an ability-to-pay system and charging double jeopardy on the low-income is because they gave the gigantic tax cuts to the rich. For the minister to somehow think that nobody understands that out there…. Everybody understands that. The rich, the middle-income and the low-income understand that the reason health care cuts are being made and education cuts are going to be made is because this government went in and gave a huge tax cut, which they never announced during the election, to the richest — $1.5 billion, as a matter of fact; $1.5 billion that they never told anybody about during the election.

The ability-to-pay system, a progressive tax system, is supposed to allow for a universally accessible health care system, including Pharmacare. I do find it interesting that this government argues that they have to be first in Canada for the lowest tax rate for the richest. That's what they want to be first in Canada for, but they don't want to be first in Canada for Pharmacare coverage. They don't want to be first in Canada for legal aid. They don't want to be first in Canada for public health funding.

Let me put this to you, Mr. Chair. I expect, actually, that there will be deeper cuts to Pharmacare. Just before supper we saw that the minister was going to have to find $25 million to fund a vaccination program. On the one day they said they weren't going to, and now they're going to do it. So I expect there will be even deeper cuts to Pharmacare.

Why is the minister referring off the reference drug plan changes? I would assume that the reference drug plan…. Actually, I have all the clippings here. It's unfortunate for the government that they've come out at this time: "B.C. Drug-Pricing Policy Lauded for Cost-Savings" — the reference drug plan. All of the headlines: "Pharmacare Spending Limit Works: Study" — the reference drug plan.

All of these studies are showing that the reference drug plan works, and that's what helped to allow for the Pharmacare coverage to be so good in this province. Why wouldn't the minister who's making changes, putting in a system that's going to cut $400 million from Pharmacare over three years, know what he's going to replace the reference drug plan with? Wouldn't the minister want to know that, Mr. Chair, before he announces all these cuts? Aren't they linked?

Hon. C. Hansen: With regard to the reference drug program review, if the member has gone into the website and looked at the letters to ministers from the Premier at the time we were appointed, the responsibility for the reference drug review was given to the Minister of Health Planning. That's why she's following through on that. The reason we can move forward with our planning in Pharmacare with certainty is because the commitment we made is that as a result of the reference drug plan review, what is of primary importance is the ability to contain costs. If there is an alternative to that program that can allow for the same kind of cost containment, then that's something we want to look at. The language in our new-era commitment was really quite explicit in that regard.

The member is talking about this $400 million of cuts. That's $400 million that's going to be reduced. What she's talking about, when she comes up with that $400 million, is the cost pressures. That is, if we continued to operate the Pharmacare program the way her government had structured it, we were going to see increasing costs in the range of 18 to 20 percent a year for the years to come. If that were allowed to continue, it would result in unfunded cost pressures in excess of $400 million.

We are not talking about cutting the Pharmacare budget by $400 million. What we are talking about is cost pressures, growth in demand that would put those pressures on that budget if we were to make no changes at all. We're making the changes so that we can manage this program in a responsible way that meets the needs of the most vulnerable British Columbians first, making sure there's access to a Pharmacare program for all British Columbians regardless of income, but those in higher incomes are going to be paying higher deductibles. I think that's fair. That allows us to manage our cost pressures in a reasonable way that still provides for an increase in the Pharmacare budget after three years, but allows us to do it in way that's sustainable so that we can live within the means we have in our health care budget.

J. MacPhail: No matter how the minister wants to say this, his government is planning on making British Columbians — if they want to have as good a coverage as they do now for drug therapy — pay $400 million more out of their own pockets or their private insurance company, which used to be covered by the provincial government.

If the minister is suggesting that it's to alleviate cost pressures, why doesn't the minister know what he's going to do with the reference drug plan? The reference drug plan alleviates cost pressures on Pharmacare. Talk about planning.

I did ask these questions of the Minister of Health Planning. She had no answers. She said: "If you're talking about…." Oh no, she said the study was being done. I actually appeared before the minister after her presentation to the Romanow commission, and it was imminent. That was weeks ago. I'm just curious to know where this consultation around the reference drug plan is.

Secondly, the reference drug plan was a leading-edge program now being viewed across North Amer-

ica as a model to alleviate cost pressures on Pharmacare. Surely before the government off-loads those cost pressures onto the individual, they would know what they're going to do with the reference drug plan. Or am I wrong?

Hon. C. Hansen: As I mentioned earlier, the Minister of Health Planning is responsible for that process. I am sure that when the report is completed, she'll provide me with a copy. I'm sure she would even provide the member with a copy when that's finalized.

The instructions that are there…. It's clearly stated in the New Era document that we circulated at the time of the election that we would look at the reference drug program with a view to finding an alternative that would allow for the same kind of cost containment to allow us to manage those costs. The assumption that we're making, which I believe is a reasonable assumption, is that if that committee comes up with an alternative to the reference drug program, it still has to be within the same budget parameters and has to achieve the same kind of cost savings that the reference drug program may have achieved in the past.

J. MacPhail: Why is the government so hell-bent on scrapping the reference drug plan when it's good health and saves money?

Hon. C. Hansen: Again, that's part of the review that is underway. I don't know when that particular document or that review is going to be completed. She may want to direct those questions to the Minister of Health Planning. I'm sure that when it is completed, I'll have a copy and have a chance to read it.

J. MacPhail: It's really been helpful having two Ministers of Health, Mr. Chair. You get answers from neither.

The point on this matter is that this Minister of Health Services is saying he needs to revamp Pharmacare, make seniors and low- and middle-income families pay more for drug costs now than they had to before — to the tune of $400 million. At the same time he's saying that we're going to scrap the reference drug plan, which is an incredibly successful cost-saving drug program.

Let me ask the minister: is the reason this government is going to scrap the reference drug plan because it was brought in by the previous government?

Hon. C. Hansen: I guess I'm a bit surprised at this line of questioning, because the responsibilities of the ministers are clearly set out in the Premier's letters, and the member has had an opportunity to read those. The issues around the reference drug program have been clearly charged to the Minister of Health Planning. The answer to her question is no.

J. MacPhail: There must be a reason why this government campaigned to scrap a program that was successful. What is that reason?

Hon. C. Hansen: In the five years, from when I was first elected, that I spent as an opposition member, I received numerous phone calls and letters from individuals who were frustrated in trying to access certain medications. They were prevented from doing so when their doctor felt it was the best medication available and when they wanted to take their doctor's advice. Yet the reference drug program said they could not get access to that unless they went through the bureaucratic procedure that was, I think, in many cases designed to frustrate access.

The commitment that we made to review the reference drug program was in reflection of the many representations that have been made to us by individuals — primarily seniors is my recollection — who were anxious to be able to get access to the medications that their doctors felt would be most beneficial for their needs.

J. MacPhail: The minister must know now that he's wrong about the reference drug plan because the studies have proven him wrong. It's cost-effective, safe and healthy, which of course is what we were telling the then-opposition critic all along when we were in government: that it was safe, healthy and cost-effective for drug programs. I guess the now minister and his government made a campaign promise to scrap the program, based on anecdotal evidence. Yet when there's anecdotal evidence of seniors by the thousands telling the minister that the changes to Pharmacare hurt them, he ignores them. Isn't that interesting? I guess in those days the people complaining about the reference drug plan anecdotally were right, but the seniors now, who complain desperately about the changes to Pharmacare, are considered a special interest group to be ignored. That's exactly what has happened.

Yesterday I asked the Attorney General a question in question period about when the Lobbyists Registration Act was going to come into place. He had no answer, even though promises were made that it would be in place now. What pharmaceutical companies have approached this government on any matter related to health care delivery services, asking for change?

Hon. C. Hansen: I have certainly had meetings with representatives of some of the pharmaceutical manufacturers. I do not recall them pushing for changes to the reference drug program. They certainly were aware of the commitment we made in the election. I've certainly had inquiries about the timetable on that, which I've referred to the Minister of Health Planning. I'm sure they're going to be as interested in this report when it comes out as the rest of us will be.

J. MacPhail: That would be the first time pharmaceutical companies have approached the B.C. government and not lobbied for scrapping the reference drug plan.

J. MacPhail: The minister says that I never met with the pharmaceutical companies. He's dead wrong — dead wrong. I met with them regularly to try to resolve the concerns they had and still expand the reference drug program for the benefit of British Columbians.

The Lobbyists Registration Act was to deal exactly with the kind of meetings the minister now confesses to. We have to take the minister at his word that they didn't once mention changes to the reference drug plan. That would be the first time. That would be the first time that pharmaceutical companies didn't do that.

I will also say that I will be pushing — now that I know these meetings have occurred — even harder for the Lobbyists Registration Act because it is exactly that kind of meeting that is supposed to be registered, and the content of the discussion is supposed to be revealed as well. Here we have pharmaceutical companies meeting behind closed doors with this government, and the public doesn't know anything about what's going on — other than their Pharmacare costs are going up.

If the minister didn't consider the reference drug plan as a cost-saving program that could ease the pressure on Pharmacare, what other cost-saving measures did he look to before he decided to off-load the costs onto people?

Hon. C. Hansen: I'm trying to make sense of the member's question, when she's asking what we looked at instead of off-loading costs. What we're saying is that we're trying to bring in a more fair system that allows for those with a higher ability to pay to indeed pay more, and those with less ability to pay would pay less. That was the proposal that came forward initially, and we thought it was fair. It brings far more fairness to the system, which is something the member seems to be quite anxious about. That's the measure that we're proceeding with.

J. MacPhail: I guess the minister is saying to me that the only way they looked at controlling drug costs was to say to British Columbians: "You'll pay more out of your own pocket."

Did the minister look at expansion of the generic drug program? Did the minister look at really, really lobbying the federal government hard on drug patent laws? Clearly, the minister didn't look at saying to anybody: "Oh, we should keep the reference drug plan, because that'll reduce costs." He didn't look at that. Did the minister look at some drug programs that make more sense in terms of abuse of prescribing or use?

Hon. C. Hansen: As I'm sure the member knows, British Columbia is faster than any other province when it comes to approving generic drugs. We have certainly pushed the federal government to speed up their approval process for generic drugs. We think there is a benefit there, so that pressure will continue.

One of the things that I'm very pleased to see started is the common drug review by provinces across Canada, which I think will allow us to streamline those processes, find some cost savings and also get more consistency among provinces. That is being put in place as we speak and should be up and running within the next couple of months. We've also implemented a process of best practices that we share with other provinces that allows us to find other ways to better manage our Pharmacare budgets.

We are looking at all options to manage the budgets and to ensure that we keep the Pharmacare cost pressures in line so that these future cost increases can, in fact, be supported by the taxpayers of this province.

J. MacPhail: The minister's briefing book says the pressures over the three-year period for Pharmacare are $420.7 million. Can the minister break down what those cost pressures are?

Hon. C. Hansen: I will gladly read from the same page that she's reading from. The third chart down talks about the cost drivers in health care: increases in participation, utilization and drug costs.

In terms of the demand pressures, we see in this coming year $107.6 million, and we see inflation pressures of $38.5 million. Now, that's based on status quo. If we were to continue the program as it was structured a year ago, we would have seen that increase of $146 million that we would have to manage. The year after that we would see $127 million and a year after that $147 million, for a total of $420.7 million over the three-year period of increased cost pressures that we would be facing if we were to have done nothing and continue with the program as it was designed before.

J. MacPhail: Then the cost pressures are participation…. The income-testing model deals with that. It says if you want to participate, you have to pay yourself.

What solutions did the minister look at in terms of utilization cost controls and drug cost controls?

Hon. C. Hansen: There is certainly a lot of work being done by all provinces across Canada. Everybody is facing these huge cost pressures when it comes to their various Pharmacare programs. As I mentioned before, the program we had was by far the most generous of any province in Canada, but every province is facing that.

There is certainly a sharing of data, which is very useful in terms of developing utilization measures. There is also a sharing of best practices across the country that, again, will help us manage some of those things. We're actually sitting down and talking with some of the pharmaceutical manufacturers around measures that will encourage the proper utilization of some of the new drugs that may be coming on to the market to ensure that new medications are in fact targeted at those they were intended for, and ensuring that there are utilization management strategies put in place at the time that a drug is approved. There's some

considerable work being done on that now, and we're trying to learn from the experience in some other provinces around utilization management agreements.

There is a fair amount of work that's been done in those areas. There is certainly a lot that can be gained from more appropriate utilization of drugs. I think there is certainly lots of discussion around the number of inappropriate prescriptions that are issued and the amount of double-doctoring that goes on. We want to make sure that we continue to look at opportunities for proper utilization.

J. MacPhail: I'm not quite sure why a pharmaceutical manufacturer would have any right to talk about utilization. That's very interesting. It sounds like putting the cat among the pigeons, if you ask me. Pharmaceutical companies are the biggest profit-makers, bar none, in the health care delivery system — the biggest profit-makers bar none. They're the most aggressive lobbyists to have their way too. No. I'm sorry. Next to the tobacco companies, the pharmaceutical companies are the most aggressive lobbyists to have their way in health care, in my experience.

That all sounds kind of fuzzy, frankly. It would be helpful for people to know that when they're paying so much more out of their own pockets for Pharmacare, the government is actually managing costs elsewhere as well. That all sounded incredibly fuzzy.

It's good work to do, to look down the road. I wouldn't work with the pharmaceutical companies on any of it.

J. MacPhail: You're damn right. I wouldn't work with the pharmaceutical companies on anything to do with reducing cost pressures — absolutely. In fact, the pharmaceutical companies took our government to court over the reference drug plan and lost several times on that front. That's how far the pharmaceutical companies were willing to go — to take a government to court to say that the government has no right to try to reduce their pharmaceutical costs. Those are exactly the people that this government's working with now. That's good news.

How many other provinces or states are looking at the reference drug plan of British Columbia to control drug costs, which is a pressure listed here?

J. MacPhail: Well, that's interesting, because the discussion is ongoing. Several provinces — Ontario, Newfoundland, the prairie provinces — and several states are asking specifically how they can transfer the reference drug plan to help control drug costs in their province. It's a bit of a surprise that the minister would not be aware of that. He just said that he was having ongoing discussions with provinces about how best to control drug costs. The Romanow commission is looking at it as well. It's quite a surprise.

What's the timetable for the minister to let British Columbians know when and how they're going to have to pay more?

Hon. C. Hansen: I cannot give the member a specific time line at this point, other than that we are working aggressively on the different models being considered around this particular plan. Certainly, we would like to give as much notice as possible to allow for timely implementation of this program, so we are anxious to be able to unveil the details as quickly as possible, but we have a way to go before we will get to those details.

J. MacPhail: What are the anticipated administration costs for going to an income-tested model?

Hon. C. Hansen: The budget for implementation of the new plan is $4.7 million in this coming fiscal year.

J. MacPhail: Is that based on complete cooperation with the federal government? Will there be costs saved by using the federal government's system?

Hon. C. Hansen: There is no additional cost for access to the data from the federal government. We already use that data. For example, the premium assistance applications already tie into tax returns. That relationship is already there. Clearly, we're working with those officials at the federal level visàvis this particular program, but there will be no additional costs on that front.

J. MacPhail: I would assume, then, that legislation is required for this because there are privacy concerns. Whenever information is shared for income purposes, there are privacy restrictions. Pharmacare has not got any legislative base now, because there was no requirement to provide any private or personal information. I assume legislation will have to be introduced this session in order to implement the system, for the changes necessary for the upcoming income tax year.

Let me ask this question. I assume it's a given that there will be legislation. When the minister says he's going to use the information from the Canada Customs and Revenue Agency, is that to set up a provincially based income-testing system, or is it a system that will be delivered through the Canada Customs and Revenue Agency filing of income tax forms?

Hon. C. Hansen: We do not need any changes to legislation to implement this system. Basically, the process is not unlike the process already in place for

premium assistance. What it requires is a signature, just as we do now under premium assistance programs, to authorize us to access that particular line item off of income tax returns. That process is in place, the relationships are in place, and no new legislation is required.

J. MacPhail: Yes, I'd heard that that was the internal discussion amongst the government members — that no legislation was required. I don't agree, and I'll be pursuing that matter vigorously. I think that for sure, moving to an income-tested model, legislation is definitely, definitely required.

My last question in this area — so if any other members have any questions about Pharmacare…. Anyway, members can ask questions whenever they want, but I'll be moving on. My last area to explore in the area of Pharmacare is the off-loading of costs onto private insurance companies. Has the minister had any discussions with private insurance companies about costs they'll have to bear as a result of downloading from the government?

J. MacPhail: Have any of the staff? Private insurance companies have been silent on this matter?

Hon. C. Hansen: I know that when we started the consultation process on Pharmacare review last fall, of the several dozen letters I sent out to organizations, my recollection is that I did send a letter to at least one, maybe several, of the insurers inviting their input as part of the consultation process. To the best of my knowledge, they have not requested a meeting, certainly with me as minister or with officials, that we're aware of. But we have recently initiated discussions with them to involve them with the rollout of the new income-tested program to get their input as we move through this stage.

J. MacPhail: I'm asking this because when I asked if the minister had done any exploration of the consequences of off-loading onto private insurance companies, the Minister of Health Planning specifically said: "I'm advised that Health Services has some information for the member." It's exactly the same question I just asked this minister. The Minister of Health Planning said: "I'm advised that Health Services has some information for the member if she wishes to bring that up in those estimates."

Hon. C. Hansen: We've been sort of putting our heads together here. I have nothing to add in addition to what I outlined before in terms of the relationship between the Ministry of Health Services and the third-party insurance companies in the province. We wrote to them as part of the consultation process, and we are initiating discussions that have not yet happened with regard to some of the policy changes that may be still to come around this income-tested program.

J. MacPhail: Well, as the minister is well aware, there's a completely direct link. Two things happen when Pharmacare coverage is reduced: either the private insurance company picks it up and increases premiums for the family, or else they reduce coverage. No private insurance company is going to absorb the off-loading without consequence.

There are also designs. One can design an income-testing system that works in conjunction, rather than in an adversarial way, with private insurance companies.

I'm really quite surprised that the private insurance companies haven't approached the minister or the ministry on any of these matters. It makes me nervous. I'll be frank with the minister: it makes me very nervous. Come January 1, 2002, there will be people who will become greatly affected by these changes. Many may be looking at their private insurance companies to pick up the difference. In just the same way as the increased MSP premiums now charged by this government are having a huge impact on employer costs and business costs in this province to the tune of tens of millions of dollars, this will be a business cost pressure as well on employers who provide extended health benefits.

The planning is essential, or else families who have ongoing, regular pharmaceutical prescription drug costs may be left without any protection. We saw a little bit of that. I don't know if the minister was at the Canadian Diabetes Association breakfast about a month or so ago. We heard three heartfelt stories about how the cuts to health services by this government affects diabetics and puts cost pressures on them that they were unprepared for. The same thing will happen on January 1, 2003.

It will be interesting to know when I will next be able to question the minister on this matter. No legislation is going to be introduced, and the changes will come into effect prior to the next fiscal year when there are estimates. I hope the minister and I can work in a way where there's an information exchange as this program design unfolds. I will be looking for that information both expeditiously and in a very concerted way.

Hon. C. Hansen: I'd be pleased to try to facilitate that information as it becomes available. If the member would be interested in briefings on this subject from time to time, we'd certainly try to facilitate that.

Before we move on, I don't want to leave her comment about the third-party insurers.

We have to put into perspective the fact that prior to these changes, the provincial taxpayer was picking up 56 percent of the costs of medications in British Co-

lumbia — considerably higher than any other province and considerably higher than the Canadian average, which I believe, off the top of my head, is 43 percent. If you look at the burden that is placed on extended health programs and on those private insurance companies…. In fact, if you look at it from the perspective of an employee who's on a national program with a national company, let's say, with the federal government but living in British Columbia, the taxpayer in British Columbia is picking up a bigger portion of that, whereas in other provinces it is built into that extended health program.

With all of the changes we're contemplating, we still wind up with British Columbia being one of the most generous provinces when it comes to the coverage we're providing, as a percentage of the total medication costs. We believe this is not an undue burden for the private insurance companies. We have made it quite clear. Our intentions were clear as of January of this year that we were moving to that income-tested program. We certainly will be having discussions with those third-party insurers to make sure they can anticipate the changes as soon as we've come to decisions and conclusions around the model that we will be implementing.

I. Chong: I want to thank the Leader of the Opposition for allowing me to ask a few questions on Pharmacare. I had indicated yesterday that I would return to the chamber from time to time as the issues arise to put my questions to the minister as well. I do want to say, however, that I have been listening to the debates, and many of the questions she raised have already been answered by the minister, so I don't need to repeat them.

I did want to share with the minister a concern I had from some constituents of mine that go as far back as last fall, prior to any announcements being made. The comments aren't all negative. I know there was concern in the community because at the time, there was talk about changes to Pharmacare, and the plans had not yet been worked out. People were speculating. That's the difficulty with changes: people start to speculate. We have rumours and fearmongering, and before you know it, your office is flooded with phone calls.

I have to admit that some of the questions that came in were quite valid, and I would like to share that with the minister at this time. In particular, one constituent was concerned about the reduced coverage of prescription drugs. He was concerned not for himself so much as he was for others he knew — whether seniors were going to have to make choices, especially those who have multiple prescriptions, and whether there was any consultation that the ministry staff were entertaining with doctors or pharmacists that somehow the prescriptions and medications could be reduced or consolidated in a way that there wouldn't be wasteful amounts of medications.

Doctors sometimes prescribe medications to treat a symptom, and it takes a while for it to take effect. We can have people getting a prescription for a 30-day period, but within a week we know it doesn't work. Then they go back and get another prescription. These prescriptions end up in a drawer and end up being, unfortunately, flushed away, which they probably shouldn't be. This happens time and time again. This particular constituent did say: "How do we stop that kind of waste?" Certainly, we want to save the dollars, to put them back into the system to allow for those who really need medications.

The question was: how can we work with doctors and patients to reduce the costs of prescriptions? Can the minister enlighten me on that?

Hon. C. Hansen: We have in place an excellent program that has been worked out in cooperation with the Pharmacy Association, for trial prescriptions: seven-day trials that are provided without dispensing fees. We absorb the dispensing fees so that we can ascertain that it is in fact the correct medication for the senior to be on and that there's not some kind of reaction. That's considered to be quite beneficial to seniors and provides for better management of their care.

Also, we do put limits on the amount of supply. I know that's a two-edged thing. In some cases, people say: "Why can't I have a one-year supply so I can reduce my dispensing fees?" But I think the opposite is that you do wind up with a lot of wastage of prescription medication, so we do have programs in place to try to manage that.

The whole duplication of prescriptions. You've got individuals that will go out and see several doctors and get several prescriptions. That is a big problem in our health care system. The inappropriate use of medications accounts for a significant percentage of admissions to acute care hospitals because of improper management of prescription medications. Clearly, there's a lot that we could do better to try to manage medication use among individuals. We do have one of the best tools in the country in the PharmaNet system we have. I think there's a lot more that we could be utilizing the PharmaNet system for, for that kind of research: looking at where there is inappropriate use of medications so that we could prevent some of the misuse and, as a result, prevent some of the pressures that get put on our acute care hospitals.

I. Chong: I thank the minister for that. I think it's important that we do raise these issues and that he and his staff are aware. The fact that he is able to share some clarification on that is heartening.

I believe that the trial prescription is still not as widely used as it perhaps should be. I won't say that's the single-most complaint that I'm hearing about Pharmacare. When people come in and speak to me about Pharmacare, when I share with them the changes to it, and they come to understand the need for change because of the cost pressures, they do say: "Well, you know, I know of this case…." They are seniors who come and see me, and they know of their friends and

other members of the family who are facing the same situation. They say that they aren't getting the seven-day prescription, that they in fact are getting it for a much greater period. And of course those with multiple prescriptions continue to contribute to waste in the system. If it's as much as even 10 percent of the entire Pharmacare budget, that's a substantial savings.

I hope that in answering, the minister has also taken note and that perhaps next year when we return to this chamber, we can take a look and see what progress we've made on that. If it means working more with doctors and pharmacists or whoever is involved in the process, where we can coordinate better, where we can find cost savings…. I think everybody is of that mind.

The other issue related to prescriptions, as well, is that I've had constituents come into my office and say that they had been on a prescription for a number of years — maybe five or seven years. I guess your body does develop an immunity to it. What was of concern was that a new drug or medication would come out which would perhaps be more costly, but the person would require less of it. Their doctors would say: "This would be a better drug. It is a little bit more expensive, but in fact it would be more effective for you. You could possibly reduce these two or three other medications which complicate it." But there would seem to be no process to allow for that to happen. Again, it's like a consolidation, where you take one expensive one as opposed to three less expensive drugs.

Again, can the minister advise what actions his ministry is working on in that area and whether we can look at some dialogue with those involved in this to see if we can't make a more effective system for our seniors, particularly?

Hon. C. Hansen: The member makes some very excellent, excellent points. I think it's part of the ongoing work of the ministry, and certainly there's a lot more we could be doing, looking at that whole area. We do, when we're reviewing a new medication that's being proposed for listing…. If it is going to result in replacing one, two or three other medications, then the cost savings from the reduction in the use of those other medications is factored in when we're looking at the pharmacoeconomic benefits of a new product that may be coming available. We do look at it to a certain extent, but I think that as the member points out, there's a lot more we could be doing. We'll certainly pursue that.

I. Chong: I have two other areas in Pharmacare I'd like to pursue, just for the benefit of the Leader of the Opposition, so that she knows for timing and that.

One is the area of the drugs that are delisted — again, a significant amount of confusion. A constituent was quite concerned when she had gone recently to receive a renewal of a prescription. She realized she had to pay substantially more for it, and it was explained to her that it was a drug that was delisted. When she contacted my office, I indicated that from time to time pharmaceuticals and prescription drugs are delisted, and that's a routine process. I'm just wondering if the minister can provide clarification on the record for me of what process of delisting takes place and an average of the number of drugs that are delisted — just more information on this so I can have something to refer to on a constant basis for my constituents who do frequently ask about why drugs become delisted.

Hon. C. Hansen: Certainly, delisting is as important a component of our Pharmacare management program as listing new medications. I guess if we wound up with simply a one-way street when it came to constantly listing new medications, without reviewing the existing ones, we would wind up becoming quite top-heavy as a program.

There's not a particular timetable we follow that says it has to happen every so many months, but clearly it's an ongoing process of trying to identify medications that are no longer of benefit to the formulary that may be replaced by newer, sometimes less expensive medications that would make the other ones redundant. That is an ongoing process by the ministry, but there's not a formalized timetable for it. It's just whenever the need is there for a delisting to go ahead.

I. Chong: The final area I'd like to pursue in terms of Pharmacare has to do with the deductible amount, the $200 threshold that seniors once had, moving up to $275. The Leader of the Opposition already alluded to this, but my question is more about how it does affect seniors. I would agree that a number of seniors are concerned. Because it began at the beginning of the year, the upfront costs to them can be significant in the first few months of the year, if in fact they're going to need the medication for remainder of the year. They have to pay for it in the first two or three months of the year, when they are on a fairly low income or on a steady income for which they've already made allocations for their household budgets, etc.

I'm wondering whether any consideration has been made, then, because we know — or I would hope that we know — the extent of seniors who, each and every year, do claim their maximum of $200 or maximum of $275. Those seniors, we know, will reach that maximum, and thereafter our government would have to be paying for those costs anyway. I wonder whether we couldn't somehow have averaged it over the months to see how viable that is. Not all seniors will use the maximum, and I acknowledge that, but there are some people, I would imagine, in the system that do use their entire amount.

I have to admit I used to do tax returns for people, and I used to have to file their forms every year, and I would see that every year they would use the maximum threshold for prescriptions before they would move on to having government pay for those costs. In an effort to

see if we can't help mitigate those costs for those seniors, I'm wondering if that approach has been considered and whether it can be considered, if not this year, in a future year perhaps to show we are still working with these new changes and these new structures and that those people who will be impacted aren't impacted so quickly at the beginning of the year. If the minister could shed some light on that, I'd appreciate it.

Hon. C. Hansen: Certainly, the ministry has looked at this issue and tried to see if there are ways we could make the kind of adjustments the member is proposing. We're still working on it. It may be quite difficult for us to do it within the framework that we have, but I am aware that there is certainly…. There is one drugstore, for example, that has developed a program to allow seniors to spread out that deductible cost over several months or over a 12-month period, and there may be other innovations like that, which will come along. We're certainly looking to work with the Pharmacy Association to look at ways we can make sure the impact is lessened on those seniors who are impacted by it.

I. Chong: I want to thank the minister for that, because I think that's what is important. I know my constituents hear that there is opportunity to work on that initiative and look at innovative ways, wherever possible, to work with the Pharmacy Association — if that's where the connection should be — to see how we can best meet the needs of our constituents and seniors who are affected by this.

Overall, I am receiving some comments from constituents who are pleased to know that we are paying attention to the costs of Pharmacare. At the same time they want those who are able, to pay it, and for those that aren't able, they want to know that our government is working towards a change in that.

I was also interested in the area of income testing, as the Leader of the Opposition had raised that. We're waiting to see how that is developed. It comes into effect as of January 1, 2003. I will leave it until that time and hope to see those plans and changes brought forward at that time.

I do want to say, though, just for the record, that I have also had constituents come into my office and say that it was about time that income testing was looked at so that those who are able to pay for those costs will do so and preserve our very precious health care dollars that we have for those who are most in need. I have heard from both sides on the issue, and I know we'll continue to watch that. I'll be asking the minister in due course on that.

Those are all the questions I have on Pharmacare. I'll yield the floor back to the Leader of the Opposition or other members who have questions. I thank the minister for his help.

J. MacPhail: I'm going to go to the last area that I wish to explore with the Minister of Health Services. We can either then move to the Minister of State for Intermediate and Long Term Care, or we can wait until tomorrow to start that.

I want to go to the area of surgical wait-list registry. I've looked at the website, which was last revised December 18, 2001. Could the minister please update us about the successes and challenges concerning the surgical wait-list registry?

Hon. C. Hansen: I'm not sure if the member is looking for specific data out of the wait-list numbers. We can certainly address any of those specifics that she may like to address. We try to update the surgical wait-list report that appears on our website as often as we can.

We certainly have active and good participation by the health authorities in feeding information to us on the wait-lists in various parts of the province affecting various surgeons. We try to post that in as timely a fashion as we can. As I say, if the member wants to get into specific numbers, we can certainly do that.

I guess the other area around wait-lists that is of interest and quite exciting, I think, is the Western Canada Waiting List Project. We're working with the other western provinces to develop the protocols that doctors can use to ensure we get standard prioritization of patients who are waiting for surgery. It's so it's not simply on a basis of the patient who's been on the wait-list longer getting access to the care, but that there is a prioritization that we call upon our physicians to make.

This Western Canada Waiting List Project is developing the protocols to ensure there is a standard interpretation, so what is considered a priority by one physician is in fact a comparable judgment call that would be made by a different physician elsewhere in the province. I'm certainly prepared to get into the details that the member may want to pursue.

J. MacPhail: No, there was no criticism. I didn't mean any criticism by naming the date. I'm just saying that's the last time I had the information.

I'd be interested to know about the western Canada project, but more specifically I would like to receive information about trends of success of the surgical wait-list registry working to deal with whatever pressures the system has. Wait-lists are always a tool that people judge the system by, sometimes appropriately and sometimes inappropriately.

I would like to know how it's working in terms of managing efficient use of resources and what changes, if any, will be made to the wait-list registry because of the regional health authority changes.

Hon. C. Hansen: First of all, in answer to the member's direct question, there are no changes that are being contemplated with regard to the registry. What comes out of the registry is the best aid in Canada. In fact, we're one of the only provinces that are actually in a position to respond to some of the tracking of federal indicators that is being sought on a national basis.

On the success of the registry, there are certainly anecdotal stories that suggest there are two sides to it. On one side, you get individuals that can go into the registry, find a surgeon that has a shorter wait-list than they may be facing with a different physician. It allows them to determine where they can get the quickest access to the surgery they may need.

The other side of it is that you have individuals who take the data off the wait-list, and if they see a doctor who has a long wait-list, they make the assumption that may be the best doctor, being in the greatest demand. They will choose to see if their surgery can be done by that particular doctor. Anecdotally, at least, there's two sides to that.

In terms of evaluating results out of the wait-list, it's not something that we have been able to make a lot of progress on. It's certainly a useful indicator and a useful tool to some patients around the province. We're very anxious to take it to the next step using the criteria being developed by the Western Canada Waiting List Project to use the registry and that data to better manage the wait-lists so that we can determine that, in fact, those who have priority need for access are getting the priority need for access on a consistent basis across the province. At this stage we don't have the ability to make that determination, but we're certainly working with physicians and with those that are piloting the wait-list project to move that forward.

J. MacPhail: I note that the website says specifically that the wait-list registry's purpose is to have the patient work with their doctor to…. Oh, here it is — sorry. "This website provides information to help you understand" — talking to the patient, I guess — "wait times and to help you explore options to receive surgery in a more timely way."

The reason I'm asking about the success of the surgical wait-list registry, as I'm sure the minister is well aware, is because of the controversy that's arisen over the course of the last two days about jumping the queue. Or at least that's the allegation. One can jump the queue into a private surgical — what do we call them? — profit centre by paying a fee.

I noted at the time that the minister himself said there was no public policy framework to guide the operation of private clinics around this matter. That's fair enough, because I find that particular doctor always on the cutting edge — Dr. Brian Day. I disagree with almost everything he advocates in the area of health, but clearly he has the support of his physician colleagues.

I quote from an article. It may be inaccurate, but I quote anyway. Dr. Heidi Oetter, the head of the B.C. Medical Association, doesn't have a particular problem with Dr. Brian Day charging people $500 to jump a queue into a private surgical clinic. They are linked to this extent. If our system can properly refer patients in the most timely and efficient way to a surgical procedure, then the ability for Dr. Day to hyperventilate people into his clinic in a hysterical way…. The better off we are. That's what I'm asserting.

As I recall, one of the issues with physicians was that physicians themselves have comfortable referral patterns that may be based on who they went to medical school with. Fair enough. They know that physician, etc. That was why I was asking the question on whether there would be any change based on health authorities for referral patterns.

Then my next question was: how can we improve the surgical wait-list registry to really undermine Dr. Brian Day? I use him specifically because he really is out there at every single opportunity, advocating people to pay more for his medical services.

Hon. C. Hansen: I think that, first of all, one of the changes we will see is better use of information technologies among the six health authorities. There was a real inconsistency throughout the province in the past with regard to how far along some of the health authorities were with regard to information technologies. In fact, I think the only consistent part was that everybody had a long way to go to get to where they needed to be, but some really hadn't even started the process.

I think that with the consolidation of health authorities, we now have that size that is of a critical mass that allows them to get on with the job of making better use of information technologies. I think what will flow from that is more timely information on wait-lists being put into the registries that individuals will be able to access to determine the names of surgeons that may be able to provide surgery faster than the one that may have been recommended to them.

The other thing that's important is that in the deliverables that we are expecting of the health authorities, all six health authorities have to work together to determine procedures that will result in a more appropriate prioritization of individuals who are on wait-lists waiting for surgery. Again, some of that will flow from the Western Canada Waiting List Project, but we are also, in our performance expectations of the health authorities, clearly indicating to them that we expect them to make this one of their priorities, to ensure that those who have priority needs get access to the care they need.

J. MacPhail: Did the Minister of Health Services have any prior knowledge of the scheme that Dr. Day is advocating, of paying to jump the queue?

Hon. C. Hansen: No, the first I knew about it was when I read the Vancouver Sun from the other morning.

J. MacPhail: That would continue the practice of Dr. Brian Day, so I'm glad this Minister of Health Services is being treated by him in the same fashion as everybody else.

It's so clear, when you read Dr. Day's initiatives, that he's sought legal advice on what he's doing. As I understand it, what he's doing is saying that if a patient

goes around the family physician and straight to a specialist, there's no determination of "medically necessary," because no one has actually been asked the question. Therefore, it's not a medically necessary service, and there's no violation of the Canada Health Act. Physicians are not allowed to charge for "medically necessary" services, but if a physician has no determination, before the specialist, of whether it's medically necessary because there's no visit, then it's not medically necessary. That's exactly what Dr. Day is doing. This is not a challenge to the Minister of Health Services. I'm just offering what I hope is advice, seen in the best possible light, on what the Minister of Health Services should be investigating here. If the patient goes directly to the specialist, self-referral, there's no violation.

There is a system in America that replicates that. It's in the area of pharmaceutical prescribing. The women, and some men, who read Vogue magazine in the United States can self-prescribe. You can actually self-prescribe pharmaceutical treatment in the United States. You can open up a Vogue magazine and read about an arthritis drug, and you can go to your doctor and say: "That's my symptom, and I want that prescription." That's legal in the United States. It's called direct-to-consumer advertising of drugs. Fortunately, we in Canada — and I hope it is still the case — outlaw that. A Vogue magazine in Canada doesn't allow that kind of advertising.

You know what's happened as a result of that direct-to-consumer advertising of prescription drugs in the United States? Drug costs have skyrocketed. In fact, there's been a huge increase in inappropriate medication too.

So now we have a situation where Dr. Brian Day wants to apply that principle for the delivery of surgery as well. He's saying that as long as you, as a consumer, self-diagnose and go directly to the specialist by paying a fee to get to that specialist, everything's okay.

I urge the minister to look very carefully at doing everything possible to ensure that if indeed it's determined that what Dr. Brian Day does is legal, if there are any extra cost pressures put on the public health system as a result of his skating around the law, he has to bear that. The private clinic has to bear the cost of that increased cost pressure.

What I know is there's a very important relationship in primary care delivery. That is that your primary care physician — your family physician — is the best person to manage your health risks and to manage health care treatment across all spectrums, whether it be pharmaceutical treatment or surgical treatment or alternative medicine or preventive. That's why, as a lay person, I assume that there has always been a requirement for a family physician to see the patient first before any further referral.

We may now have a situation, if Dr. Brian Day is allowed to do what he does, where there will be way too much surgery going on, and those surgeries may result in increased cost pressure to the public health system if indeed other more effective, appropriate health care treatments aren't tried first.

When the minister is developing his policy to deal with this particular situation, I would urge him to look at that being at least one of the areas he examines if, God forbid, what Dr. Day is advocating is determined to be legal.

Hon. C. Hansen: I appreciate the member's comments. We certainly will be examining that, and we will consider the particular aspect she has raised.

We are trying to learn more about what is proposed by that particular project that's been in the media, first of all, to determine if it is consistent with the Canada Health Act. If it is determined, as the member suggests, that perhaps it is consistent with the Canada Health Act, we will certainly be evaluating the ramifications in all respects and will certainly include the one she has suggested.

J. MacPhail: Before we move on to the Minister of State for Intermediate and Long Term Care, I have one question that still remains that was referred to the Minister of Health Services. That's around what hospitals provide abortion services. If I could have that list, please.

Hon. C. Hansen: Actually, there was a piece of legislation that was brought in by her government in spring of last year — I guess it would be probably 13 months ago now — that provided a schedule which listed all of those acute care facilities in the province. There has been no change to that list since that time.

J. MacPhail: That was the information I was looking for, so thank you very much.

I have one question to put to the minister, and he can refer it to the Minister of State for Intermediate and Long Term Care, but I don't want to move on or suggest…. I'm finished asking the Minister of Health Services questions, but it was referred from the Minister of Human Resources to the Minister of Health Services. My colleague the member for Vancouver–Mount Pleasant asked the Minister of Human Resources what would be happening with homemaker services, and he stated that he felt this was a duplication of services that would be better delivered by the Ministry of Health Services. The Minister of Human Resources was explaining the cancellation of homemaker services under MHR.

If that's appropriate to refer to the Minister of State for Intermediate and Long Term Care, that's fine. The Minister of Health Services is nodding yes, just for the record.

J. MacPhail: No, Mr. Chair. I'm just saying that I'm finished my questions of the Minister of Health Services. I don't know whether anyone else has. We're

I'm going to start by asking the Minister of State for Intermediate and Long Term Care how she plans to meet her two goals that are on her accountability statement. Goal No. 1 is "I am accountable for achieving the following results for 2002-03: a 2 percent increase in the number of home and community care clients with high care needs living in their own home." It's kind of related to the question I just put to the floor.

Hon. K. Whittred: Responding to the member, the performance standards outlined in the service contract are the vehicle, I think, through which we anticipate that the policies laid out by the ministry will be achieved. It is our belief that when we put certain standards in place for the health authorities to achieve, in order to achieve those goals, they're going to have to, I guess, follow certain paths. In following those paths, they will not only provide the health care we want, but they will also be guided toward the sorts of policies the ministry has put in place.

In terms of home and community care, I should point out to the member that there really has not been any change in this area fundamentally since about 1997. We're looking to those performance measurements that were put in place to act as a kind of beacon that will motivate, I guess, or direct the programs the health authorities will deliver in order to achieve those outcomes.

J. MacPhail: Okay. I'm not quite sure I understood that. Is the minister saying that the goal about how many people with high care needs will be getting home and community care living on their own will be part of a performance contract with the regional health authority?

J. MacPhail: I gather that hasn't been established yet. That is being worked upon right now. When will the performance contracts in this area be ready?

Hon. K. Whittred: That expectation you have outlined is part of the performance contract. Those are in place, and they are at this time being discussed by the health authorities, by the boards. We hope to have those in place by about the end of the month.

J. MacPhail: The next goal from the accountability statement of the Minister of State for Intermediate, Long Term and Home Care is a 5 percent decrease in the percentage of total in-patient days that are alternative level-of-care days. Can the minister explain what that means?

Hon. K. Whittred: Yes. I think the member will recall what an alternate level of care is. Those are the people that are inappropriately occupying acute beds when they would be more appropriately placed, perhaps, in a residential care setting or in a community program. There are a number of alternatives. You can see, as I said before, this is a beacon that will guide the policy and offer direction to the health authorities as they look to completing their programs.

Hon. K. Whittred: Yes, that will be part of a service contract. If the health authority completes that goal, of course, it will go a long way to achieving the goal we're all trying to reach, which is to cut down on the utilization of acute care beds and place people in more appropriate settings.

J. MacPhail: I'm wondering, for clarity of discussion, if the minister could turn to the estimates book, vote 31, note (f). It describes the regional health sector funding, a subvote that "provides government transfers for the management and delivery of health services."

I want to just quickly go through the list. Maybe it would be more appropriate for staff to just tell me what areas I should be exploring with the minister in terms of regional health sector funding. I've chosen mine, but there may be more.

Do you know where I'm at? It's vote 31 in the estimates book. These are very complex. It's page 144.

J. MacPhail: Yes — absolutely. I want to make sure that I'm asking the minister questions about the appropriate areas of her responsibility. For instance, I had determined that under regional health questions, I would ask the minister questions about health services for community living. I would ask the minister questions about continuing care service and extended care. I don't know whether that's correct or not.

I'm just asking the minister if she could clarify for me, in the regional health sector funding responsibilities, the areas that the minister is responsible for.

Hon. K. Whittred: Yes, the member is basically correct. I'm just trying to find all the different ones here. They are facilities licensing, health services for community living, continuing care services, extended care, residential care services, community services and direct care services.

For the minister, I think we should do some housekeeping here in the last five minutes or so, Mr. Chair, for me to put the minister on notice about questions that I had asked the Minister of Health Services. Maybe she was in the chamber at the time. There will be questions referred to the Minister of State from the Minister of Health Planning on changes to regulation in child

care. That was part of the document. I'll be spending a little bit of time on that, so I doubt that I should start that right now.

The other thing that I hope the minister will understand is the information that the health authorities are now working on their performance contracts and health plans. They should be ready by the end of the month, and as the minister knows, there are some that have been made public. I will be exploring those with the minister, particularly the one for the Vancouver coastal health authority, in terms of how they affect intermediate and long-term care.

Maybe the easy one for the minister to start with is the one referred to her by her colleague the Minister of Human Resources. Shall I read it again?

When my colleague the member for Vancouver–Mount Pleasant asked the Minister of Human Resources what would be happening with home care services, the Minister of Human Resources said he felt this was a duplication of services that would be better delivered by the Ministry of Health Services homemaker services. Hence, the Ministry of Human Resources has cancelled homemaker services under the Ministry of Human Resources.

Hon. K. Whittred: Yes. I don't think the homemaker services referred to in Human Resources have anything to do with the Ministry of Health. I think the homemaker services that would be utilized in the Ministry of Human Resources would be those services that that ministry chooses to purchase from whichever agency. I don't think they're referring to home care services that are provided though the Ministry of Health.

J. MacPhail: Then does the minister have any understanding of why the Minister of Human Resources would say this? He's cancelled a whole program of homemaker services based on his view that these are better delivered by the Ministry of Health Services, so I'm perplexed.

Hon. K. Whittred: Yes, I repeat that I believe that the homemaker services that the member is speaking of are not the responsibility of the Ministry of Health. In the Ministry of Health we do provide home care. These are services that are delivered to a whole range of clients in a variety of programs, all designed to enable the client to live independently in their own home.

J. MacPhail: All I can do, then, is seek greater clarification from the debate. I'll do that overnight. The Minister of Human Resources made a very clear statement that it was a duplication of services, and that's why he was cancelling it.

Of course, the Minister of State for Intermediate, Long Term and Home Care must be well aware that this is very controversial, that there are many people — seniors and people with developmental and physical disabilities — who are very concerned about the cancellation of those services. They're concerned about them on the basis that that kind of homemaker service provided by the Ministry of Human Resources was what kept them in their homes.

Anyway, it's a mystery to me as well as, clearly, to the minister of state and can only be explained by the Minister of Human Resources. We will seek clarification on that. It's a never-ending seeking of information, Mr. Chair.

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

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

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

The Chair: Before we start, do you want to reintroduce your staff, just for those who have not been here before?

To my right is Deputy Minister Robin Ciceri. Behind me is Ruth Wittenberg, assistant deputy minister, and Andrew Wharton, assistant deputy minister.

J. Kwan: To continue on with my questions from the previous day, we were canvassing around child

care subsidy and also part-time and full-time work — in those two areas. I'd like to carry on with questions around, first, the part-time work piece. Can the minister please advise how many recipients are now on the system who are also working part-time?

Hon. M. Coell: The total number of people declaring income assistance is 11,540 out of 104,463.

Hon. M. Coell: Out of a total of 104,463 — that's the number of people who would be eligible to declare an income exemption, excluding persons with disabilities — there are 11,540 people who are claiming an income exclusion.

J. Kwan: From that number, does the minister have a breakdown of the number of hours of work these individuals are engaging in, in the workforce? I'm just trying to get at how much work people are doing in terms of part-time work. Is it 20 hours? Is it seven hours? Is it an honorarium that they receive? Is there some sort of breakdown in those kinds of ranges?

Hon. M. Coell: There's a range that people declare. From $20 to $100 would be your average. They just have to declare income. They don't have to declare the number of hours. They could be working for $8 an hour, $10 an hour. It would be different because of that.

J. Kwan: Going by the pay rate, then, the minister mentioned the average is $20 to $100. Is there a breakdown of how many people are in that range? How many people are in the upper range, and how many people are in the lower range?

Hon. M. Coell: We have the ability to get that information. It would take a bit of time. We could probably break it down between $20, $50 and $100 — how much people would be declaring as earnings exemption — and get that for the member.

J. Kwan: If the minister could provide me with that information, I'd appreciate it.

Could the minister also please advise how many are…? Does the ministry track how many people are getting the earnings exemption and are presumably working part-time? Of those, how many moved off onto full-time employment?

Hon. M. Coell: In the past the ministry hasn't been able to track that. We're going to be doing outcome surveys this year to start that tracking. It would be nice to be able to have a long-range look at the different programs and how they were affected. That hasn't been done, but we're going to start, this year, doing outcome surveys for people. Then we'll be able to track the different programs as well as the different groups, whether they be single men, single women, couples, two-parent families or single-parent families.

J. Kwan: Could the minister please advise how the child care subsidy works within the ministry? In the earlier document from the ministry there is a different formula that applies for child care subsidy for someone who is above the threshold for eligibility. I think it's 60 cents on the dollar. Since that time, when I went back to look at the website, that information has changed. Accordingly, section 8(2)(b) says that 60 percent of the excess amount of monthly net income will be used to determine the amount of the child care subsidy. Does that mean that all those people making more than the threshold income will have their income level subtracted by the income threshold level and their child care subsidy will be 60 percent of that final number? Could the minister please clarify this change in the regulation?

Hon. M. Coell: I think there are a couple of issues here. The subsidy rates are unchanged, but the threshold that determines a parent's eligibility is now $285 lower. Income thresholds will still vary according to family size and income. I can give you an example. A single parent with one child between the ages of three and five in a licensed family day care will now be eligible for a $354 subsidy if his or her monthly income is below $1,297.

I could give you another one. That might clarify it a little better. A couple with three children between the ages of three and five in a licensed family day care will now be eligible for a $1,062 subsidy if their combined monthly net income is below $1,786.

I think maybe I can clarify the other question. The parents will still continue to be able to earn income beyond their threshold, but the reduction for income above the threshold is now increased to 60 cents on the dollar. It was 50 cents on the dollar before that. Hopefully that clarifies it for you.

J. Kwan: Let me just break it down into segments. On the threshold question. As an example, then, for a family of two persons, where their threshold income prior to the change is $1,082, you subtract $285 from that. Would their threshold be $797 effective April 1? Am I doing this calculation correctly, then?

Hon. M. Coell: For the example the member offers, for someone who's working, the threshold would then be $1,297. You get an extra $500 if you're working or in school.

J. Kwan: Just so I get it straight, for the example I used, which is for a two-parent family prior to the change, the threshold is $1,082. Effective April 1, because the threshold has dropped by $285, it comes to $797. But the minister also says if neither individual is working, then you add an extra $500 to their earned

income, bringing their threshold up to $1,297. So that's correct. It applies in every instance.

For a three-person family, where their threshold income was formerly $1,275, effective April 1, subtracting $285 from that gives you $990. Then you add another $500 to that, and that gives you $1,490. I'm just trying to get a sense. Is that the application of the calculation for the threshold on the basis of those numbers then? Okay. Thank you. I'm just trying to get through the subsidy side and trying to figure out what that looks like.

Can the minister then explain if he's above the threshold? Using the example again for the two-person family, the threshold now is $1,297. Let's say the family unit makes $1,300, so they're above the threshold by $3, just as an example. How will the subsidies work then? Is it the extra $3 that they make 60 percent of, which would be utilized towards the calculation for subsidies? Is that how that 60 percent would work? Could the minister please explain it to me?

Hon. M. Coell: I'll do my best here. If the threshold was $1,297 and they exceeded that by $3, then at 60 percent you would reduce it by $1.80 of the net income. I think that's the important part. It's the net income, not the gross income. So off the maximum subsidy you would save $3.68.

J. Kwan: So the calculation for individuals whose income exceeds the threshold is the remainder of the income that exceeds the threshold, and 60 percent of that amount would be deducted from their subsidy rate. Am I understanding the calculation correctly? According to the B.C. Benefits manual, which I just got for April 1, 2002, it lists under section 8(1), "Amount of subsidy": "If a family's monthly net income calculated under section 9 does not exceed the threshold income level calculated under section 10, the amount of the child care subsidy is the amount set out in Schedule A…for the type of child care provided."

That is to say, under that section, if you qualify, if your income does not exceed the threshold — and we've calculated the threshold to be the original amount prior to April 1 minus $285 plus $500; that would be the threshold amount — then you get a subsidy per the schedule A. Then:

That 60 percent of the excessive amount monthly net income applies only to the extra income beyond the threshold — 60 percent of that.

J. Kwan: Great. Now I understand how that calculation works. It changed from an earlier website that my staff had pulled up. It was 60 percent on the dollar, but now it's 60 percent on the excessive amount. Okay, we've got that clear. Thank you.

Now, does the minister have information on how many income assistance recipients have children who are seven years and under, and how does that break down, also, from three years and under currently on the system?

Hon. M. Coell: In the age grouping three to seven, there are 9,950 single parents.

J. Kwan: So for those who are in the age bracket of three to seven, are there only 450 recipients who are in that category?

Hon. M. Coell: The first category is zero to three, 9,500. The second category, three to seven, is 9,950.

J. Kwan: If I'm doing my calculations right, then, for the category zero to seven, you have 9,950, and that includes the zero to three, of which you've got 9,500. So the difference is 450. Or is it in addition, so you've got 9,950 for zero to seven, and in addition to that, then, you've got 9,500 that are zero to three? Then, in total, you have 18,450 income assistance recipients who have children between the ages of zero to seven.

J. Kwan: The impact of the change, effective April 1, on income assistance recipients with children who are older than three years would be 9,950, and they would be impacted with the change.

J. Kwan: Could the minister please advise how many child care spaces are available in British Columbia?

Hon. M. Coell: We don't have that information in this ministry. We administer the program, and we don't keep a record of what child care opportunities are available in the various categories.

J. Kwan: In a recent interview on, I think, January 29, 2002, the minister had an interview with B.C. Almanac on CBC where he stated: "We won't be eliminating people from income assistance if we can't find them adequate child care."

Am I correct in assuming that this statement the minister made will be reflected in the upcoming policy

changes? That is to say, if people are unable to secure child care, they won't be penalized by the ministry on their access to income assistance.

Hon. M. Coell: Yes. If someone is on income assistance and cannot find adequate child care, they would not be removed from income assistance.

J. Kwan: Could the minister please advise what is the onus of proof to indicate that they are unable to secure child care? Does it only apply to licensed child care? What is the onus of proof?

Hon. M. Coell: The current policy would not change. It would be license-not-required day care as well as licensed. That's the current policy now, and we don't see any significant change to it.

J. Kwan: There is a significant difference in terms of policy change. That is, effective April 1, some 9,950 children would be in need of child care; they are between the ages of three and seven.

I know from the government's side, they have revamped the child care program. The previous government initiated a universal child care program. That is no longer in place. The difference would be if a parent is unable to find child care spaces. Now there would be an increased number looking for child care services because of the policy change from government. If their child is beyond the age of zero to three, they are now forced to look for child care. If the system cannot provide child care spaces for those additional children — almost 10,000 children — then those people unable to find spaces would not be cut off income assistance. They would not be penalized by the policy change. That's what I'm trying to get at.

On the question around the onus of proof, would a parent simply advise the FAW that they were unable to secure child care spaces and maybe show wait-lists of places to which they applied for child care but where space was not available? Would that be sufficient as an onus of proof to indicate that they were unable to secure child care services?

Hon. M. Coell: Our experience is that clients often use family members or friends by choice rather than seeking external child care, so that's an option. Many in that group we're speaking of have the subsidy already because they are seeking work or, I suspect, could be in training programs as well.

J. Kwan: In the instance where an individual does not have family or friends…. In fact, my girlfriend — who just gave birth to her second baby, a baby girl, an Easter baby, this past weekend — had to be on a wait-list for more than a year to get her first child, who's two years old now, into day care, into child care services. She had to wait for a year to get through the wait-list to do that. She has no family or friends to rely on for child care services on a continuous basis if she's to return to work.

There are many instances where people don't have access to family or friends who can provide for ongoing child care services on a regular basis. For them to go on a wait-list of some sort takes a long time. As an example, I know that my friend went on three or four different wait-lists hoping for one to come through, but it took her almost a year to get through the wait-list.

In instances like that — for individuals who don't have family or friends to rely on and who have gone to two or three child care services trying to get their children in but have been unable to do so — would that be sufficient proof for the ministry to illustrate that this person was unable to obtain child care and therefore would not be penalized by government on this issue?

Hon. M. Coell: Yeah. That would be something the financial assistance worker would deal with. In any event, we would not be cutting someone off if they were unable to find child care. We spoke the other day about the three years, then the need to seek work for two years, and then at the end of the two years there would just be a reduction in that individual's income assistance. There isn't an opportunity or a desire for the program to have a single parent cut off. That would go for day care as well. If they were unable to find day care, it would not have an effect on their eligibility for income assistance.

J. Kwan: I want to be absolutely clear on this point. It's not just a question of eligibility. Will the person be penalized in any way? The minister has said they will not be cut off income assistance, but would they see their income assistance amount, the rate which they're receiving, reduced?

Hon. M. Coell: I think you're looking at five years out now before that would even be taken into consideration. Judging from the policy direction in which we're going, I think they would be temporarily excused at that point. As I say, you're really five years out, with the three years, the two years and then a reduction in the income but not being cut off. I can't see a policy direction where someone would be cut off because they couldn't find day care at that point. There is just the reduction in income into the program.

J. Kwan: That's assuming that if a person gave birth to a child and actually had the child from birth, then — perhaps the minister is making the assumption — the person can get on the wait-list to get through it, but there are different circumstances with different people. They may have come to a child through marriage or through other means, by which, then, they may not have been waiting on the wait-list.

The point is this: what kind of onus rests with the individual to illustrate that they were unable to obtain child care? I, as an example, got married last year. I became an instant mother the day I got married. I didn't wait to see if I could get child care. Now, luckily for me, those arrangements were made beforehand, so I didn't have to worry myself around that. But there are circumstances in which some people may come into a situation where they may not be able to find child care for whatever reason. I don't want to make up all the examples of what could happen, but those things could happen.

I want to understand, and I hope I can get the answer from the minister, that if a person is unable to get child care support, child care services, because of this change by government requiring income assistance recipients who have children three years and up to be working, that that individual, that family unit, will not be penalized in any way if they're unable to obtain child care services. The onus of proof would be something along the lines of the individual going to — I don't know — a couple of child care service agencies in their own community to see if they can actually get on. If they're unable to because there's a wait-list, that is enough proof to demonstrate that the person is unable to obtain child care services, and therefore, that family unit would not be penalized. By being penalized, I mean not just for them not to be cut off income assistance, but I also mean that their rates would not be reduced in any way, shape or form.

Hon. M. Coell: The current policy is that they would have to have contacted centres re space and looked for opportunities for child care. I think the answer the member is looking for is that they would not be cut off and that they would be temporarily excused from seeking work if there were no day care and they were unable to find day care to accept employment.

J. Kwan: That's part of the answer I was looking for. The other part is that, aside from being cut off, will they see their rates reduced?

Hon. M. Coell: No. What I'm saying is that they would be temporarily excused, so their rates wouldn't be lowered. That's the policy direction we're moving in.

J. Kwan: Thank you very much to the minister for that clarification. Then the person, if they're unable to seek child care services, would not be penalized in any way. They would not be cut off income assistance; they would not see their rates reduced. They will be what the minister calls temporarily excused from those penalties that would be imposed otherwise.

On the question around temporarily excused, is there a time limit applied to it? Is it when the wait-list is freed up and the person is able to bring their child to the child care service? Is there a time limitation to the temporarily excused piece of this exemption?

Hon. M. Coell: I think it would be very similar to the policy today. The answer would be no, but we would expect them to continue to pursue opportunities for child care.

J. Kwan: The Canadian Centre for Policy Alternatives believes that no serious studies had occurred when the decision was made to make single parents with children over three years of age employable. Could the minister please provide the House or the opposition with any studies the ministry has undertaken with regard to this issue?

Hon. M. Coell: The member asked for some of that information the other day. It will come with the package — the cross-jurisdictional look that we did in developing the policy.

J. Kwan: I just want to clarify with the minister then. In the information I asked for yesterday, then, I can make the assumption that all the information forthcoming will be related to all the areas of change. It's not just the one area in which the question was raised but all the changes in the welfare reform. If that's the case, I won't ask for that information anymore in other areas. I will just assume it's all coming as a package.

Hon. M. Coell: With response to this issue and the time exemption, we'll do the most comprehensive job we can of getting that information to her.

I want to just touch on the question around child care for working families who are low income relative to the subsidies they would be able to receive. I want to establish the assistance that individuals would require in order to engage in the workforce and make a low income but at the same time receive sufficient moneys from their subsidies to make it viable for them to be in the workforce. I want to just go through some examples of that.

Could the minister please advise what the going rate of child care costs right now in British Columbia in the lower mainland are? I think the lower mainland rates are actually higher than those of the rest of the province.

Hon. M. Coell: Human Resources just administer the program. We don't monitor the rates. The program design is really with CAWS. I don't know if there is anything I can add — no.

J. Kwan: I'm just trying to establish, for people who will be making a minimum wage…. In light of what we were discussing yesterday in terms of part-time work and sometimes full-time work, I know yesterday the minister used the example of 37 hours, which is really nearly full-time work. According to Statistics Canada, I think the rate they use to establish what is deemed to be full-time work or part-time work is this: if you work

30 hours or less, that's deemed to be part-time work. If you work 30 hours or more, that is deemed to be full-time work. On the basis of this, I'm trying to understand the affordability of child care for individuals and then, on the basis of their income, to see whether or not this is a viable option for British Columbians.

Some information I have obtained indicates that, as an example, the average rate for child care is about $915 on the west side of the city in the lower mainland. On the east side it's $855. On average you're looking at about $900. That also varies slightly with the different ages. For toddlers, 18 months to three years, the average for the city is about $822. From 30 months to five years the rate also varies to $546, and then kindergarten care is $507. So those rates vary. The provincial rate is slightly different, although not hugely different. I think it just reflects the costs of living in the lower mainland.

On the basis of those kinds of calculations, if you were a single parent who was working in a part-time position, with an income of $8 an hour — assuming we're going to use the $8 rate — for, let's say, 30 hours a week, that would bring your income to $960, I think. If $960 is your income and you subtract the going rate for the cost of child care, the person almost pays their entire salary for child care. From that perspective, the net impact for that family is that they can't afford to work. Literally, their entire income is going into child care support.

In those instances where people are faced with those kinds of choices, what would the minister advise them to do? Should they quit their work and be on income assistance, or should they stay working when the net impact is such that their net income after child care expenses would basically yield zero dollars to support themselves?

Hon. M. Coell: I don't have all the information the member is requesting. It really belongs to the Ministry of Community, Aboriginal and Women's Services.

We talked the other day and looked at some examples. An example I had was of someone who'd moved off income assistance and was working at $8 an hour for 37 hours per week. Their total net income would be $1,483. They would be eligible for the maximum subsidy, which would range from $394 to $585, depending upon the child's age. At the minimum wage, that person would also not pay MSP for themselves or the child.

J. Kwan: I'm working the calculations of this on the basis of an individual who's making $8 an hour, 30 hours a week, times four — that gives that individual $960 a month. That person has a child who is over three years. The maximum rate subsidy is, I believe, $368. That would give the person $592 for support and shelter. Relative to the individual who is on income assistance, who will be receiving…. Where is my chart? Maybe the minister can advise me how much that person would be receiving.

Just to illustrate, how far ahead would a person really be in those scenarios, given the change and the kind of hardship that it could cause people? Maybe they actually wouldn't be all that much ahead after all.

Hon. M. Coell: I've quickly done the category so that we're talking the same numbers. For a 30-hour work week at $8 an hour, after the B.C. child tax credit, the B.C. sales tax credit, the B.C. family bonus and the GST credit, the net pay that person would be taking home would be $1,234. They would be eligible for the maximum subsidy, depending on what age their child is, of up to $585 per month. I think that's the number the member's looking for.

J. Kwan: That individual who is on income assistance would also be eligible for the family bonus, the GST exemptions and so on. Assuming that, then those numbers are actually a wash — right? It's not actually an additional benefit to the person. The only thing that really is a benefit would be the child care subsidy to which the individual would be entitled.

If the person has a toddler or a preschooler from the ages of three to five, the maximum child care subsidy is $368. If you don't account for the dollars that would be additional income because people on income assistance would also be eligible for that, it brings you to a net support portion for this individual and their child of $592. The rate for income assistance for that family unit, I believe, is…. For a one-parent family the shelter portion is $520, and the support portion is $325.58. That will give you a net of $845 approximately. The person is actually behind then, and that, I guess, is the point I'm trying to illustrate to the minister.

The rules the government has brought about actually don't necessarily benefit people who are unable to find full-time employment and are in a part-time employment situation. In fact, the stats in British Columbia show that there are a lot of people who are working at that part-time rate. In B.C. the share of all employment that is part-time has increased from 15 percent in 1996 to 20 percent in 1999. The retail trade and accommodation, food and beverage services sectors accounted for nearly a third of all part-time employment in 1999. The trend is such that part-time work for people is going up, not going down.

The minister yesterday spent a lot of time talking about how the trend and what they are trying to do is actually to get people into full employment. The reality, the trend in the marketplace right now, in the employment sectors right now, is that part-time employment is going up, so people are going to have a harder time finding employment.

In terms of the part-time rate for women, 30 percent of all employed women 25 and older are employed part-time. Less than 11 percent of employed men aged 25 and older are employed part-time. Women are predominantly employed in the service sector, which has a high part-time employment rate. Some 73 percent of all women employed part-time are doing so because of family reasons: responsibilities, children and family, disability, personal illness and so on. People are actually in that situation for a variety of reasons.

The penalizing approach of the government's new policy of cutting people off income assistance or reducing their amount once their child turns three and older and forcing them into full-time employment will actually yield a negative for those individuals or family units as opposed to a positive. That's the point I'm trying to illustrate in terms of figuring out what the numbers look like. According to my calculation an individual is actually going to be behind as opposed to ahead.

I hope the minister will take this matter into serious consideration and perhaps work with the Minister of State for Women's Equality. I know her approach for women who are living in poverty is simply to go and make more money. I'm sure that people do want to go and make more money, but sometimes they're not successful in doing that. We need government's support in assisting these individuals and government's understanding in making sure that these family units are provided for and not negatively impacted. That's the point I want to make.

I hope the minister will talk with the Minister of State for Women's Equality on this very important issue, because over 50 percent of the population are women. As we know, a large portion of women, many of whom are single parents, are working part-time. With this new policy, they are going to be negatively impacted and jeopardized.

With that, hon. Chair, I'm going to yield the floor to my colleague from Vancouver-Langara, who I understand has some questions, and I will let other members of the House ask the minister questions.

V. Anderson: I want to commend the opposition critic in the questions she's asking. I think, listening to her over time, that she's done an excellent and comprehensive job. I hope I won't repeat. I'll just pick up a little bit, because you were on one of the topics I wanted to raise.

In listening the other day, the minister indicated that $483 was the amount of money a person would get in the example they were giving, as against $1,725 if they were working 37.5 hours, indicating that they would be better off working than receiving assistance. Those were net figures.

I wanted to ask in that regard, following up on the discussion here: did that take into account other factors like the cost of child care, which you have to pay over and above what you might receive? Does it take into account the travel expense — your bus expense, which is $3 a day at a minimum at the present time — which adds up? Does it take into account the extra requirement for expenses and clothing and all those other things that a person must have if they're going to work? I just want to know if we are comparing the actual expenses — not just the net but the expenses that are involved in going to work — when we're comparing these two figures.

Hon. M. Coell: I think the example that we were using was the employable single parent with one child aged three to five. We went through looking at the maximum that someone would get with B.C. employment and assistance and the other programs they would be eligible for and then someone working a 37-hour work week at $8 an hour. The bottom-line difference in net income was $1,123 for B.C. employment and assistance, and for someone at minimum wage for 37 hours a week it was $1,483. Now, that person would be eligible for the maximum of $394 to $585 child care subsidy.

There are a couple of other areas. If they had a typical family maintenance order of $300 — that's the average — they would be keeping that, as well, which they don't on income assistance anywhere in Canada. The Canadian provinces absorb the maintenance order, so that could be another $300 that person could keep if they had a maintenance order. The other thing is that we believe, with the job placement programs — now having a bank of 5,000 of them — the average income is $10 an hour.

We were taking the low end of someone who's not starting out but obviously is in their twenties and showing that there is a significant financial benefit to even working at minimum wage rather than being on income assistance. I think what we're looking at, too, in the long run is that the minimum-wage job is often a stepping stone to another job that pays more money. You're not able to make that stepping stone if you're on income assistance. You're in an area where there's no advancement, no ability to get the next job that might pay a bit more. It was just showing a continuum of what the difference in costs was.

I do agree with the member. When someone's working, there are added costs of bus fare and a number of other costs that I'm sure would be attributable to work. At the end of the day, even when you look at those, I think there's still a benefit for someone to be in the workforce and to be working their way up the income ladder with advancement. Hopefully that's answered the member's question.

V. Anderson: I appreciate that discussion. I was surprised by your comment that this person who was receiving maintenance payments would be able to keep the single, the $300 a month. I thought that had been cancelled for people in this category.

Hon. M. Coell: They would be able to keep that because they're not on income assistance. In Canada all of the provinces now absorb the income from family maintenance before someone starts to receive income assistance. That can range from $75 to $500 or even more in some cases. If the person was working at minimum wage, they would keep the benefit of that.

V. Anderson: Thank you. I appreciate that. While we're on the finance side, I've been asked to ask you another question. If a person is receiving income assistance and they're a disabled person receiving a pension

outside and the pension is increased, is the increase in that pension deducted from their overall income?

Hon. M. Coell: That would be the case. It would actually be deducted, because that's unearned income.

V. Anderson: I wanted to raise the question of shared parenting and the rationale behind one parent being able to get the full amount of assistance if they have care of the child for 16 days. It seems to me that if one parent has the child for 16 days, the other parent is going to have the child for 15 days in a normal month. Yet one parent is receiving income, and the other is not, apart from shelter. It seems to me there is an inequity there, and I'd like to get that clarified.

Hon. M. Coell: Thank you for the question. I appreciate an opportunity to clarify that. You're looking at a situation where you'd have joint custody and shared parenting. Both parents would get the shelter amount. One would get the support amount, that one being the primary parent. They can share it if they wish. They also share the B.C. tax credit and the B.C. family bonus. Now, those three things are a lump of funds. Depending how their relationship or their shared parenting goes, they could split that, or they could have another arrangement for it, but those are the three areas that are up to them to share.

V. Anderson: Let me ask about the shelter allowance first of all. Assuming that one parent has the child for 15 days and the other parent has the child for 15 days, do they both receive a full shelter allowance?

Hon. M. Coell: Yes, they'd both receive the full shelter allowance, because they would need to have that money in order to keep the residence. Then one would get the full support payment, or one would get the B.C. child tax credit and the B.C. family bonus. In many instances, I think, people actually get together and share them. That's how they would use it.

V. Anderson: It confuses me. Each parent has the child for 15 days. You need a house for both of them. You agreed with that one. Why is it that one parent has to feed the child for 15 days and the other parent receives the money for the full time? It seems to me it would be logical that if a child is with one parent half the time and with the other parent half the time, at the very least, each parent would get income assistance for food and other items for the time the child is with that parent.

Hon. M. Coell: I'll try and be clearer. In a joint custody case where you have shared parenting, you still have one primary parent. They're both on income assistance. They would both get shelter. The maintenance for the child would come through the B.C. family bonus, which would be approximately $225, and that would go to the primary parent. In a joint custody case they could agree to split that and each take part of it for the support for the child.

V. Anderson: In joint custody, while maybe technically there is a primary parent, practically they're not primary parents. It depends on how well they get along. I'll leave it at that for the moment. Thank you.

I then wanted to go back briefly to some clarification of terminology, which I mentioned to the minister before. We've heard about continuous assistance. There are people who are going for work, and then there are people on continuous assistance who may be going for work part-time because of disabilities. Everybody has the opportunity to work, but there are two separate categories, as I understand.

I'm confused about what the requirements or the reasons are by which people are in different categories. As I look at the listing, I get DB-1, DB-2 — people 65 and over; I understand that one — and people who are temporarily excused. There are three categories, and I'm wondering what clarifies the distinction between those three different categories: DB-1, DB-2 and temporarily excused.

Hon. M. Coell: Actually, we had a discussion a day or so ago. It's difficult, because we're going to be bringing in legislation where these questions could be asked again, and hopefully, they will be.

We'll have a temporary assistance category and a continuous assistance category. Inside the continuous assistance you'll have people with multiple barriers who will be on continuous assistance. You'll also have people with disabilities in both of those groups who can't achieve financial independence through employment.

In the temporary assistance area you're also going to have people with disabilities who will receive a higher rate. They are people who can achieve employment, and we're going to have some target strategies to help them seek employment. That could be someone who is blind who wants to work and is working in a number of opportunities. They will be able to have the higher rate but will be able to seek employment. The employment strategies for disabilities that we'll be bringing forward in the next month or so will assist them to do that.

In the present system, there is a range of people with varying degrees of disabilities who fit into those two categories. If that is not clear enough, I welcome more questions.

V. Anderson: No, thank you. That's clear enough for the moment. We'll have a chance to discuss it in legislation.

J. Kwan: I'm sorry to do this, but I need to recanvass with the minister some of the subsidy dollar issues and the threshold, because I just received a discrepancy in the numbers. The ministry website shows that the

$500 per month…. If the parent in the family earns a wage from employment, it is added to their total income to bring up their threshold by an additional $500. The website actually now says $215.

I'm confused, because when we talked earlier about the threshold numbers, I used the example of a family size of two persons where prior to April 1 the threshold was $1,082. If that family unit was earning a wage from employment, you added $500 to the threshold. Before the change the threshold for that family was $1,582. Effective April 1, there's a deduction of $285 from that threshold of $1,082, and the minister advised me earlier that the person is still entitled to an additional $500 added to that threshold, which would bring it to $1,297.

First, I want clarity. Is it $500 they'll be able to add, or is it $215? The current information from the minister's website states that it's $215.

Hon. M. Coell: Rather than adjust the base threshold, we adjusted the add-on amount. The member has adjusted the base threshold. Actually, they both result in the same number of $1,297. It's just a different way of doing the calculation.

J. Kwan: Formerly, what we talked about in terms of the formula — its application to the threshold — was such that, prior to the April 1 change, the threshold was $1,082. If a person was not on income assistance but was earning a wage by employment, that person's threshold of $1,082 would have had $500 added to it, which would have brought it to $1,582. Since the change, that amount has been reduced to $1,297. To arrive at that calculation, you would see a reduction of $285 in the threshold of the $1,082, which would give you $797, and then you would get $500 added to the threshold.

Okay. It confused me, because the website actually had a different number of $215. I wanted to make sure. Is it $215 or $500? Either way, however you calculate it, it's the base number that we would use for different calculations, and it wouldn't impact the threshold.

On that basis, I just want to clarify this point. Earlier, when we used the example of 30 hours at $8 an hour, which would yield a person $960 of income, the minister added child care benefits, GST refunds and so forth to that income, which then gave the person the net income of $1,483.

J. Kwan: I think the minister said $1,483. If the number used is correct, then that would make the person's income above the threshold for the full maximum subsidy. The minister actually said the individual would be entitled to a maximum subsidy. Maybe the minister can clarify that for me.

Hon. M. Coell: The child tax credit and the family bonus are both exempt. They don't add towards income.

J. Kwan: Oh, okay. Then maybe I can ask this question of the minister. This also came via e-mail from other people who are interested in trying to understand what is being calculated as their net income in the calculation for child care subsidy.

The website actually gives you a list of items, which includes employment income; self-employment income; maintenance paid to a spouse or a child in the family; employment insurance; WCB benefits; training allowances; investment income, including interest, tips and gratuities; money earned by providing room and board; rental income of any kind; grants, loans, bursaries or scholarships, except the amount for tuition and books; and with respect to the B.C. student assistance program, $50 of the amount received for each week covered by the award. Those things are exempted. Family tax credits, the child tax credit and those kinds of things are not calculated as part of the net income. Maybe the minister can give me a list of items that are not calculated towards net income.

Hon. M. Coell: I think the easy answer, rather than having me read them all out again, is yes.

J. Kwan: Are there items I haven't mentioned that would not be calculated towards a net income? Does the minister have a list of that? If it's a long list, the minister can provide that information to me in written form later. If it's a short list, I wouldn't mind getting that on the record. People are wondering about this question.

Hon. M. Coell: The list is actually in the B.C. Benefits (Child Care) Regulation, section 9(2)(a) to (n):

When calculating net income, those are the B.C. Benefits regulations that would not be considered as part of the income and that would be continued.

J. Kwan: The minister mentioned the support portion of student loans would not be calculated towards income. Did I hear the minister state that correctly? Listed in the list of monthly net income that is calculated is just simply the word "loan," except for the amount for tuition or books. So the support portion, then, is not calculated towards net income. Student loans effectively are not calculated towards net income for the purposes of subsidy calculations.

Hon. M. Coell: Actually, I didn't say that. It was item A: any income earned by a child attending school on a full-time basis. That was the one that's not calculated as income.

J. Kwan: Student loans, then, would be calculated towards income, except for the portion that's utilized towards tuition or books. All student loans would be calculated towards income.

Hon. M. Coell: I think the confusion is with respect to the B.C. student loan program. Of the amount received each week, $50 is not considered to be income.

J. Kwan: Maybe I can read this into the record. I got this e-mail from an individual from Kelowna. This is her situation, so I'm trying to figure out for her how she's being impacted. I'll read parts of her e-mail into the record, and maybe the minister can respond to that.

It goes on to talk about the cuts in the educational system, so I'll skip over that. Then it reads: "The government has also made cuts to child care, which will essentially mean that I will use approximately $1,000 per month or more from my student loan for child care."

Then it goes on to talk about issues around child care, the tuition fee increase and the impacts for the individual on that and also the increase for MSP premiums. Then it reads:

The person wants me to highlight this issue as a concern, because student loans would cause a problem for her in the area of child care. Now the person is faced with a situation where she may have to quit university. That is the concern. She has a list of questions around what types of income are included in the calculation and the difference between the maximum subsidy and the actual day care rates.

How do you suppose a single parent or working poor will be able to provide for child care for the children with these new cuts? The cuts to child care subsidy will leave some post-secondary students unable to continue with their studies because they will be unable to pay for child care along with an increase in tuition. How is this putting students first? Or do the poor students and students with young children not count?

It goes on to say that a couple of weeks ago she spoke with — she uses the name — the Minister of State for Women's Equality's office about student loans being used as income. They said they were reviewing this policy and were thinking of eliminating it. However, now she cannot get a straight answer out of them, which is very frustrating.

The questions I'm asking are just trying to shed some light for individuals who are in these kinds of situations and who are wondering what is going on out there. How will they, quite frankly, make ends meet and be able to continue their educational pursuits or career development?

Hon. M. Coell: We don't have enough specifics of the person — whether they're on income assistance, whether their family's on income assistance. It sounds like it may be more of a student financial loan issue than one for this ministry. I would suggest they dial the 1-800 number we've got set up right now. It's 1-800-668-2800. It's set up to discuss some of the changes with clients or people affected by our ministry programs. I think the issue of the student loan is something I'm not able to deal with for this person.

J. Kwan: I think the issue is partly student loan. The other big part, as I understand it from the e-mail, is around the subsidy and the child care subsidy component, which the minister does have responsibility for.

I won't belabour this point. What I'm going to do is actually, perhaps, have the individual contact the minister's office to get specific details around her eligibility on the subsidy question. I think that's the focus, where she is now, saying she's not qualified for the subsidy, and as a result of that, she may have to drop out of her studies in her pursuit of a nursing degree. I'm going to leave that, but I'll ask the person to be in touch with the minister's office to further pursue that issue.

I'd like now to turn to a quick question around the children in the home of a relative program. Could the minister please advise: how many people are in this situation right now? How much does that cost the ministry?

Hon. M. Coell: As of February there are 4,538 people in that program, and it costs $1.52 million per month.

J. Kwan: Then, given the changes coming into place and this program will no longer be in place, is it the anticipation of the ministry that it will save $1.52 million?

Hon. M. Coell: I'd like to clarify that actually. In the new policy, children living with relatives who are legal guardians will now be considered as part of the family. Therefore, they will no longer be eligible for the assistance. Guardians of child relatives who apply for income assistance may now list the children as their dependents, and their assistance would be given in that way. Legal guardians will still be able to continue to be eligible for the child tax benefits, depending on their income. Children living with relatives who aren't their guardians are still eligible for the assistance, provided the family is not receiving child support funds from the Ministry of Children and Family Development.

J. Kwan: Of the 4,538 individuals who are in the Child in the Home of a Relative program, how many will no longer be able to receive income assistance support on the issue around guardianship, with respect to that particular change to the ministry's policies?

Hon. M. Coell: We've estimated that about 1,790 children who live with relatives who are their legal guardians and have sole custody of the children will be affected.

J. Kwan: For the 1,790 people, how much is that component in relation to the ministry's budget?

Hon. M. Coell: We don't know whether some of those 1,790, when they're assessed, may be eligible for income assistance that aren't eligible right now. If that doesn't change much, that represents about 40 percent of the monthly $1.5 million cost.

J. Kwan: Is that the amount that the ministry is anticipating will be savings to the ministry — 40 percent of the $1.52 million?

J. Kwan: Did the Ministry of Human Resources consult with the Ministry of Children and Family Development to assess the impact this change in support payments would have on the protection and well-being of children?

J. Kwan: In terms of net savings to government then, is there actually a net savings? Some of those costs may well just be transferred to the Ministry of Children and Family Development.

Hon. M. Coell: We anticipate there'll be no impact on the Ministry of Children and Family Development.

J. Kwan: In your consultation with the Ministry of Children and Family Development, you're anticipating that there'll be no transference of children to the ministry because of the change in the Human Resources program. Therefore, there's a zero dollar impact. Is that the assumption that the ministry's working with right now?

J. Kwan: We canvassed this earlier. Just to refresh my memory, I understand that the minister will be monitoring this number with the Ministry of Children and Family Development. If I didn't ask then, I'd like to ask the minister now to please provide that information to the opposition caucus when the numbers become available.

J. Kwan: I'd like to now move on to the seniors supplement issues. How much money does the Ministry of Human Resources spend on the seniors supplement?

Hon. M. Coell: This year the program would be $15 million. The change is that it will be phased out as the federal government increases theirs over a period of time.

Hon. M. Coell: It would depend on the rate of increase that the Canadian government gives. We don't want to see a decrease in the amount. If it takes a number of years, we would just reduce ours as they increase theirs, so there isn't a drop in the monthly amount.

J. Kwan: There's not going to be a net decrease in income for seniors, because the anticipation is that the federal government will increase the old age security for seniors. So, therefore, no senior would see a decrease in their rate?

Hon. M. Coell: Yes, that's correct. They should see no net reduction in their total income.

J. Kwan: That's for people who now receive the supplement, as well as people who will be coming on stream who don't receive supplements. If people apply now, and the federal government has not increased the old age security rate for seniors yet, would they still be entitled to the supplement until the federal government brings in their program of increase? So there's no net reduction for seniors overall with this policy change.

Hon. M. Coell: People will all be treated the same. People coming on will be treated the same as the people on. It will be reduced as the federal government increases theirs. People coming on now would receive the supplement but would have it reduced as the federal government increases it.

J. Kwan: What seniors will lose, then, is that instead of getting a top-up supplement from the province in addition to the federal government's increase, they'll only be getting the reduction from the provincial government. But at the end of the day, there's no net loss from the current rate now. That's how I understand it.

Could the minister please advise how much seniors receive now from the federal old age security and the guaranteed income supplement? What is the rate for each?

Hon. M. Coell: The current minimum income guarantee for a single senior who has resided in Canada for at least 40 years is $1,018.04. That would be $12,200 per year.

J. Kwan: Does that figure include the guaranteed supplement? What is the guaranteed supplement amount, if it's not included?

J. Kwan: Seniors who are on the system now would not see their rate reduced. Seniors who are coming on stream would still be qualified for the supplement until such time as the federal government comes in with their rate increase so that there's no net loss. Okay. That means, I suppose, that instead of getting an additional $50 when the federal government comes in with its program, they only lose the provincial portion.

Security deposits. Can the Minister of Human Resources advise what changes are being brought about on security deposits?

Hon. M. Coell: As of April 1 the new policy is that security deposits will be immediately recovered from the B.C. employment assistance cheques at $20 a month. The security deposit reduction will begin on the second cheque after the security deposit is issued. All B.C. employment assistance clients will be limited to a maximum of two outstanding security deposits. A third deposit may be issued where a recipient is fleeing domestic abuse and has to move as a result of a sale or a demolition of a residence as well.

J. Kwan: Formerly, individuals who needed a security deposit would be able to get one from income assistance through their welfare office and that amount would not be deducted unless the individual incurred multiple security deposits. Now, the change would be that even your first security deposit acquired from the ministry would be deducted.

J. Kwan: When the deposit is returned to the recipient, is the recipient entitled to the full amount of the return? Or is that amount deducted from their cheque or returned to the ministry's office?

J. Kwan: Well, I don't understand the logic of that. The recipient has paid out. With the change in policy now, the recipient is paying for their own damage deposit, because that amount is being deducted at $20 a month off the person's paycheque. When the deposit is returned to the recipient, why would the recipient not be entitled to that money? That's money the recipients themselves have paid. The ministry is benefiting, making a profit off, income assistance recipients on damage deposits.

Hon. M. Coell: Sorry, I didn't understand the question. The recipient would get back the damage deposit that has been collected — the individual, not the ministry.

J. Kwan: And that amount would not be deducted off the income assistance recipient's cheque.

J. Kwan: If the individual is unable to collect the damage deposit back from their landlord…. I know there are many, particularly in my own riding. The landlords are very unscrupulous; they take that money and don't return it. In that instance, would the recipient be able to get assistance from the ministry so that they could try to get the moneys back from that unscrupulous landlord?

Hon. M. Coell: The change is that we would issue a second one if someone were not able to retrieve the damage deposit. The onus would still be, as it is today, on that person to try and receive the damage deposit. If there was no damage to the premises, they would have a course to pursue that. As I said, the third damage deposit would be issued if somebody were fleeing domestic abuse or violence or as the result of the demolition of a residence, if a building were being taken down.

J. Kwan: I raise this point because I'm concerned. In doing the estimates of the Attorney General, we know that the Attorney General's office is cutting advocacy support to the tune of some 40 percent, 38.8 percent, in the community, much of which provides for assistance

in residential tenancy disputes, including damage deposit issues. That support is now gone from the Ministry of Attorney General over the next three years. It's being phased out.

In the meantime in this ministry we have a situation where people will not get assistance from the Ministry for Human Resources for the return of a damage deposit. Every time they need one, that amount would be deducted from their cheque by $20 a month, to a limit where they would only be able to get a maximum of two. Only if you're faced with issues around domestic violence or demolition and the like would you be able to obtain a third damage deposit.

It seems to me that the people who are going to be penalized by the change in this policy, combined with the changes with the Attorney General, are the people themselves — that is, the income assistance recipients, low-income people. Are there any efforts at all, then, by the ministry in trying to obtain damage deposits back from unscrupulous landlords?

Hon. M. Coell: Actually, in East Vancouver, as the member may be aware, we're working with the Vancouver police and our MHR offices to address the problem of landlords who don't return the damage deposit cheque. They're working with our staff in East Vancouver.

We've also prosecuted some landlords who have refused to return deposits. I think there was an example — that would be in Kamloops — in the last little while.

J. Kwan: Is there any attempt to collect the damage deposits and perhaps put them in trust in one account so the landlords don't actually get access to those moneys? I understand that you can pursue them and bring them to court and all that kind of stuff, but in reality a lot of people don't end up getting their damage deposits back, especially those who are on income assistance and those who are low-income individuals.

Would there be any pilots or attempts from government, from this ministry, which clearly has a vested interest in protecting its client base from being ripped off by unscrupulous landlords? There would be an interest for government to actually take action in that. Are there any plans for pilot projects in this regard? Maybe get the damage deposit, hold it in trust, and when the person moves, if there's no damage incurred, those dollars are returned with interest back to the recipients.

Hon. M. Coell: It's not something we're currently looking at, but I'll ask staff to consider it.

J. Kwan: I just want to ask a quick question in this area here. I'm mindful of the time, and I'm hopeful that we can finish the estimates for this minister by 6 o'clock.

The minister said that the third time in which an individual needs a security deposit, they'll be able to access it if they're faced with domestic violence. What happens if it's the fourth time? Is it just a flat no then, and the person is on their own?

Hon. M. Coell: We would have the authority to look at that on a case-by-case basis.

J. Kwan: Then I take it from the minister's answer that it's not a hard-and-fast no — on the third time, you're out. On a case-by-case basis, people would be assessed accordingly.

I'd like to ask the minister a question around shelter costs. In the ministry's service plan, it states that the shelter allowance will reflect regional differences. Does this mean that the income assistance recipients in Vancouver will finally be able to receive an amount that actually reflects the higher costs of living that occur there than in other parts of the province?

Hon. M. Coell: In the service plan, we look at an implementation in '03-04. We haven't developed that policy as yet, but it would be based on the local CMHC indexes.

J. Kwan: The most important thing about that, of course, is that it would actually reflect the cost of living in the different regions of the province — utilizing the CMHC index, which I don't have a problem with. Even if the shelter costs go up, government would actually increase the cost for the shelter portion. That's what I'm trying to get at.

Hon. M. Coell: We haven't made that decision yet. We're looking at '03-04 and basing it on the CMHC indexes. As for numbers or increases or decreases, that decision hasn't been made as yet.

J. Kwan: When I read the service plan, which states that the shelter allowance will reflect regional differences, I have to assume that it means increases or decreases. In some areas it is cheaper to rent; in other areas it's more expensive to rent. One can only assume that the ministry will actually be looking at it going both ways. It doesn't make sense if you say you're going to reflect regional differences and then in areas where the rent is higher, you're actually not going to reflect that difference — only in the cases where it's lower. I want to point that out to the minister for his attention.

Of course, my expectation, and I would think the public's expectation, in reading the service plans is such that it would actually be a true reflection, going up or down and not just one way. It is an important point because in some communities the cost of living is much higher. If it's going to be a true reflection, it has to reflect the increases as well.

On the issues around earnings exemptions, how much money does the Ministry of Human Resources anticipate saving by eliminating the earnings exemption?

Hon. M. Coell: I think we touched on this earlier. The number of people eligible to declare an earnings exemption was 104,463. Of those people, there are 11,540 people declaring varying rates of income exemption at this point.

J. Kwan: I think those numbers actually correspond with the people who are part-time workers. The people who are claiming earnings exemptions are the same as the people who are part-time workers.

Hon. M. Coell: That's actually correct. If they were working full-time, they wouldn't be eligible for income assistance.

It's 11 percent of the eligible caseload who declare any income at all. That's the 11,540. Those would be varying declarations, from $20 to probably $100.

J. Kwan: Does the minister have readily available the dollar amount that goes with it in terms of savings to the ministry?

Hon. M. Coell: No, actually, I don't. We'll probably know that later in the year. They're not all declaring $100. There's a varying category. Some declare income in one month and then not in the next month. Some declare $100 one month and then nothing for three months and then $20. It's difficult to calculate that.

J. Kwan: The minister will have that information at the end of the year. Maybe the minister can provide that information to me when the year ends. I would appreciate that.

What are the other provinces in Canada doing with regards to earnings exemptions?

Hon. M. Coell: There are two categories. One, continuous, has the earnings exemption at $300, and there are no earnings exemptions in the temporary category.

J. Kwan: Maybe, to save time, the minister can provide the opposition with a list of what the other jurisdictions are doing, what the other provinces are doing, and where the exemptions apply and how much.

I'll ask this question of the minister. In terms of studies being done as to how people will be affected by the elimination of the earnings exemption, I'm particularly interested in knowing whether or not there's any correlation between earnings exemptions and securing permanent employment.

Hon. M. Coell: We'll add that to the information regarding the websites and the other hard studies, and we'll get those to the member.

I'd like now to ask questions around the homemaker services. Homemaker services will no longer be available to recipients of income assistance. Could the minister please advise who is currently eligible for this service?

Hon. M. Coell: The former policy was that the homemaker services was a means-tested program that provided short-term, emergency homemaker services. Funding for the homemaker services was full or partial depending on factors such as the family size, income or disability status.

The new policy is that we've eliminated the homemaker services. They are available through other channels that the health regions would be responsible for.

J. Kwan: Is the minister indicating that those individuals who would not be able to get homemaker services would be able to get those services through the Ministry of Health Services?

Hon. M. Coell: Yes, that's correct. If they met the criteria that Health Services and the regions would have, they would be eligible — same as they were means-tested when we used to run them as well.

J. Kwan: How does the threshold for eligibility between the Ministry of Human Resources when they were providing for homemaker services differ from that of Health Services?

Hon. M. Coell: We didn't monitor it in exactly the way the member…. We were delivering the service because the people were our clients. Now that service is available to anyone who meets the criteria within Health Services. We felt it was a duplication of service that we were providing.

J. Kwan: I'm trying to get at whether or not there is an elimination of services. If the minister is suggesting there's a duplication, then one would assume there is no gap in which some individuals might have fallen through. Eligibility for homemaker services with the Ministry of Human Resources will be the same as that being provided under the Ministry of Health Services. It's just a transference of provision of services from one ministry to another. Am I right in making that assumption?

Hon. M. Coell: When we went through the core review, this was one of the programs that wasn't seen to be part of our mandate — providing support for income assistance.

The Ministry of Health Services has the mandate to provide home support and home care services. Currently the health authorities deliver home care services, including home support, home care nursing, community rehabilitation and other types of home-based services as well. That fits in with their mandate. We just

felt that we were duplicating that service for people who were eligible for it. Even though they are on income assistance, they are still eligible for programs delivered by the health authorities.

J. Kwan: Listening to the minister's answer…. If the issue is around duplication, then it's just a transference of the provision of this service from one ministry to another. Assuming that is the case, then nobody would actually fall through the cracks in terms of accessing homemaker services. I know that in the big House the Ministry of Health Services estimates are going on right now, and I have asked my colleague to make sure she canvasses homemaker service issues.

As an example, in my travels, I was in Williams Lake several weekends ago. I met with a group of seniors whose homemaker service provisions have been reduced. They're on seniors old age pension. Most of them are 80-plus, but some of the younger seniors who are not on old age pension are receiving income assistance. Their homemaker service provisions have been cut back quite severely. Almost all of them told me they were only receiving personal care of one hour a week. They have chosen to have someone to assist them to take a bath once a week. They have no support for cooking, for cleaning, for shopping — nothing. They're on their own.

It had just begun when I was there. It was the first week that it had begun. Many of them said they would manage. But I have to tell you, hon. Chair, I worry very much for these seniors. I don't think they're able to manage. Many of them that I spoke with couldn't even get off their chairs to move around their own apartment, let alone be able to manage the rest of it.

I'm assuming from the minister's answer that there would be no cracks into which individuals would fall. It's just a simple transference of service provision from one ministry to the other.

Could the minister please tell me how much money this program cost the ministry?

Hon. M. Coell: The cost per year of the program was $1.4 million. Just to add to my initial comment, it was short-term home care, whereas the Ministry of Health Services maintains the long-term home support and home care services and the delivery of the home care nursing as well.

Recipients of income assistance were eligible for that, and I think in many instances were using one or the other. We were just running a program that was best left to the health authority to run and coordinate rather than duplicating the administration and staff and the delivery of service.

J. Kwan: What has the ministry done so far to notify recipients of homemaker services that it would not be providing that service after March 31, beginning April 1?

Hon. M. Coell: We've notified the contractors who will be notifying clients. Many of the contractors are the same contractors that work for the health authorities as well.

J. Kwan: If an individual is in the mid-stream of the change…. Let's say someone has broken an arm or a leg or maybe both and is unable to do a variety of chores, including cooking, cleaning and so on and needs homemaker services for a temporary period. If a person is in that situation now, would they be able to continue to get homemaker services from this ministry? Or is that person just simply cut off, and then they have to make their own arrangements to try to get services from health services?

Hon. M. Coell: As I mentioned, it's generally the same contractors that are doing the work for both this ministry and Health. If someone fit the criteria, they would continue to provide the service.

Again, ours was only a very short-term basis for homemaker services. I suspect that the contractors, in coordination with the health authorities, would be dealing with individual cases as to whether they fit the criteria to continue the temporary service.

J. Kwan: I'm assuming the criteria of Health Services and Human Resources are the same. The minister was saying it's a duplication of service, and this is aimed to save administrative costs. The eligibility for someone to get homemaker services under the criteria of Human Resources would essentially be the same as that of Health Services, so the person should not be in a place where they would not be able to access homemaker services. Am I right in that assumption?

Hon. M. Coell: The mandate of the program was to supply short-term health care. That mandate is also shared with the Ministry of Health Services. The criteria may, over the years, have changed within our ministry as compared to what the new health authorities may be developing. There may be some changes. I wouldn't want to leave the member with the idea that it's just a direct transfer.

We felt that our recipients, if they needed home support or home care services or home nursing care, would be better getting that directly from the health authority than through us, as our mandate really isn't in those areas. I think that's as clear as I can make it at this point.

J. Kwan: From my perspective, I'm not necessarily concerned about who provides for that service as long as someone provides for that service and, in the process of transferring the provision of that service from one ministry to another, nobody finds themselves without access to that service. That's what I'm trying to get at, and that's what I'm worried about.

Yes, this is for people with temporary services. I understand that. But in the Ministry of Health Services they are already faced with huge pressures, to the point where the hours for people who need permanent

homemaker services are being cut back. I don't know how that provision would be made available.

What I'm trying to get at is that from the minister's point of view, the clients that the minister had been serving and who were getting access to homemaker services don't end up finding themselves without the support they need, even if it was on a temporary basis. People could sustain injuries or a variety of different things for which they will need homemaker services, and I want to make sure they are not going to be left without. If they are left without, I can assure the minister that those individuals will end up costing the system even more than they do now for the provision of homemaker services, and the net savings for government would actually not materialize. It may cost the government even more money. The person may end up being in intensive care, emergency services and so on, and those costs would just simply escalate. It's not assisting anybody by taking away this service for individuals. That's why I'm going down this road.

I will try, if I can get into the big House, under the Health Services ministry estimates, to ask those questions of the Minister of Health Services.

I'd like to now ask about medical services. What medical services will be maintained effective April 1 with the changes in income assistance reform?

Hon. M. Coell: For people who are receiving income assistance from B.C., supplementary health assistance items such as extended therapies, medical equipment and supplies will continue to be provided.

Hon. M. Coell: That would be for all groups of people who are receiving income assistance.

J. Kwan: The medical services that would be eliminated. According to the Action Committee of People with Disabilities, who met with the minister on March 11, 2001, eye exams, dental benefits, medications and treatment will be delisted. They also raised concerns around massage physio, chiropractic treatments and speech therapy. Could the minister please advise which medical services would not be provided?

Hon. M. Coell: Those are all services that this ministry didn't provide. They would be in the Ministry of Health Services. They were changed for everyone in British Columbia, but they're not services the ministry ever had a budget for or ever provided.

J. Kwan: No, that's not true. I'll just use dental services as one example. There was the Healthy Kids van that travelled around the province, and dental service was provided for low-income children, particularly those on income assistance. They could access it. I could use another example in my own riding: a dental clinic was set up in the downtown east side community where low-income children could get access to it. And that's been provided for, so it's not true to suggest that these service weren't provided for.

Hon. M. Coell: Sorry, I probably misunderstood the question. We still have the Healthy Kids van, and the van still does tour around the province. We still cover some dental costs in this ministry. I was referring to the changes in Health Services that were announced, I think, about six weeks ago.

J. Kwan: Maybe I can get clarification from the minister. The health service provisions which the ministry is providing, and had been providing prior to April 1, will continue, and that's irrespective of what goes on in Health Services.

Maybe I'll save the issue around basic needs for last. Let me just turn to the issue that has been raised by the B.C. Coalition of People with Disabilities. They have been sending correspondence around the issue to me and, I believe, all MLAs. The letter they've sent, actually, highlights the Disability Benefits Program Act, which they state is a necessary starting point.

The group has been gathering support to endorse their position that the government maintain two separate acts with respect to people with disabilities. They have now been able to obtain, as of March 19, the endorsement of some 279 groups from across the province to support what they call a non-discriminatory definition of disability. Could the minister please advise: what is the intent of the government with respect to this? Is the government going to be eliminating the two separate acts as they relate to disability benefits programs?

Hon. M. Coell: Actually, I touched on it yesterday. It's the intention that we would be tabling two acts, one for people with disabilities and one for temporary assistance — an employment and assistance act and an employment and assistance act for people with disabilities.

J. Kwan: Am I right in assuming that the request from the B.C. Coalition of People with Disabilities to maintain the two separate acts and to recognize the special, unique needs of people with disabilities is being respected with the two pieces of legislation that would be brought to the House?

Hon. M. Coell: Yes. In fact, that's been a priority for us. We would like to have strategies that help people with disabilities find employment to the best of their ability. We want to have an exemption rate at the $300 level and want to have a number of other issues that will allow people with disabilities to achieve the high-

est potential they can with their lives. I'm glad the member asked the question again, because I appreciate the opportunity to elaborate a bit. In the coming weeks we'll have an opportunity to do a little bit more explanation.

J. Kwan: I've received the correspondence from the Coalition of People with Disabilities. I've also written the minister on this issue, urging the minister to respect the community's wish on this front, so I am glad to hear that the minister is going to be respecting that. Of course, we'll be canvassing that issue once the legislation hits the floor.

Let me ask a broader question then. How does the Minister of Human Resources respond to the report published by SPARC-BC, entitled, Falling Behind: A Comparison of Living Costs and Income Assistance Rates in B.C., which states that the current income assistance rates in B.C. are not sufficient to meet the needs of recipients? It finds that the benefits currently cover only 45 percent to 65 percent of living costs. How does the Minister of Human Resources respond to this report in light of the changes that are being made to eligibility restrictions, the reduction in rates and benefits and restrictions to child care subsidies?

Hon. M. Coell: We are aware of the report. I guess the changes in the program that we want to see developed has a continuous assistance, has higher rates for persons with disabilities and different strategies for people with disabilities. At the same time, assistance is only intended to be temporary. We've taken the tack of building programs that will enable people to get back into the workforce, with the simple thought that a job is the best social safety net that an individual or a family can have. Our emphasis will be on getting people back into the workforce and supplying them with the programs and the support they need to remove themselves from income assistance and into permanent employment, and at the same time, recognizing that there are needs of people with disabilities and setting up a program for them that allows them to achieve their greatest potential, developing strategies and programs that will help.

The rates in the programs of the previous government and this government do reflect family circumstances. They've had additional benefits in the past; we will have those in the future. The additional benefits are paid for children through the B.C. family bonus and the child tax credit. Those are initiatives that we've supported and will continue.

There are many attitudes on welfare or income assistance in Canada. The attitude we've taken is that we're going to put the emphasis into employment, employment placement and training programs, into the ability to get people into the workforce, not just to get their first job but the ability, the motivation and the confidence to get their second and their third job and to move up the income ladder. I think that's a goal that, I hope, most Canadians can appreciate.

Over the last number of decades there have been many programs, both at the federal and the provincial level, that attempted to do that. As I said early in the estimates, the previous government put some pilot projects in place that we supported and that we're building on, to make an attempt to do what we can to help those people on income assistance. I've read, as I'm sure the member has, numerous reports with different ideas and suggestions and will continue to do that as we move forward with the policies and the program that we'll be putting forward in the coming weeks.

J. Kwan: My concern, of course, is that the people who are unable to find permanent, full-time employment will be left without support. With the time limit restrictions that are being brought forward, for those who will be cut off and for family units who will have their rates reduced, I worry that the individual or the family will not be able to survive and that we will actually see an increase in homelessness, perhaps an increase in the crime rate, an increase in other costs to government, health care, and the list will go on. I worry very much.

I represent a community that has the lowest income of any other riding in all of Canada. We're known as the poorest riding in all of Canada. We have a postal code that begins with V6A, where people don't even bother sending their junk mail because people there are so poor, there's no point in advertising sales and whatnot. People there cannot afford even the bare minimum. I worry that we'll see more and more people who will fall into that category through no fault of their own.

I don't buy the notion that people are on income assistance because they're lazy or because they're not motivated. Every one of the people that I've met with in all of my close-to-ten years, now, working in the community, both in my capacity as a politician as well as a community worker…. People, by and large, don't want to be on income assistance. They want some support, they want to get through the tough times, and they want to be self-sufficient, but they do have difficulties facing those ongoing challenges in improving their living conditions.

I'll be monitoring very closely with respect to what happens with these impending changes — well, these changes that have already taken place. I keep forgetting that the end of the fiscal is now over, and we're into the month of April.

I have a number of questions relating to the restructuring of the social safety net, but before I go into that, maybe I could just ask the minister to provide this information to me so that he doesn't have to answer the question at this point. I'm mindful of the time and want to move through the estimates before the supper break.

I'm asking the minister to provide information on a variety of areas for which people on income assistance are eligible and because of the changes may not be eligible anymore. I'd like to get the minister to provide,

first, how much funding will be allocated to each of these benefits. Will there be any changes in eligibility? How much funding was provided last year for this benefit?

The benefits are alcohol and drug rehab user fees, alcohol and drug treatment, B.C. family bonus top-up benefit, burial or cremation support, camp fees, Christmas allowance, clothing benefit/special care, the comfort allowance, the community volunteer benefit, the co-op housing association share purchase benefit, the crisis grant, the family maintenance program, the guide animal allowance — we already canvassed the homemaker services program — the identification documents, interpreter and translation services, lost/stolen cheques, moving costs, school startup allowance — we already canvassed security deposits — the training initiatives benefit, the transportation living costs to attend a hearing and user fees for special care.

If the minister can provide the information to the three questions I have asked, I won't ask for it again.

J. Kwan: On the restructuring of the social safety net. Does the Minister of Human Resources know how many current recipients will be affected by office closures?

Hon. M. Coell: We're closing approximately 36 offices over the next two years. We'll still have 160 offices. Most of the offices that are closing are two-person offices, and we're reassigning the caseload to the next nearest office, for two reasons, I guess. You're going to have a staff pool that can use the increased staff as well as the expertise of the staff. In some places, out of those 36, we're looking at joint offices with other ministries and more use of automation and 1-800 numbers, kiosks and the like. That's down the road a bit as well.

The ability to deliver the service that we're delivering now, I feel, will be as good as it is today, possibly even better. I am very optimistic that when you put more staff together, you get a synergy there and their expertise to work with some of the new programs we've got. We'll continue to monitor the changes and the effects of the changes over the next two years as well.

J. Kwan: What will the ministry be doing to accommodate people unable to travel and who don't have access to a telephone or the Internet?

Hon. M. Coell: Actually, this item has been brought forward to us by a number of rural communities. There are areas where we feel we could actually have a FAW drive from Smithers to Houston to deal with that individual. I think you would probably be dealing in most cases with people with disabilities who are not able to access transportation. In many cases in rural B.C. there isn't transportation. We'll be trying to do the best we can, having financial assistance workers actually travel to meet with people where appropriate.

J. Kwan: What is the budget allocated for the travels of such a FAW in the communities? In instances where individuals need assistance more readily than to have someone travel there, what would happen to them in terms of that time lag?

Hon. M. Coell: Like I say, we haven't reduced the regional travel budget. One of the reasons for closing some of the offices is that a vast majority of the clients weren't coming into the office. Their cheques were being mailed. On the occasion when someone needs to see someone and can't do business over the telephone, we thought there wouldn't be an increased cost for the small number of times that someone would have to travel to meet with the client.

J. Kwan: Well, what if someone showed up at an office that is now closed and needed to apply for income assistance? There's a whole procedure of application. It's not a matter of something you can deal with quickly. How would those individuals be assisted when there's no office to which they can apply and if they can't access a telephone or Internet or travel to the closest office to them?

Hon. M. Coell: In an instance like that, I think we would coordinate with a community agency to use their telephone or their computer, and we would actually take the application over the phone. That is done now as well. There are lots of areas of rural B.C. where people can't get to an office but need assistance. They will dial a 1-800 number and get the assistance they need.

J. Kwan: I am concerned about the closure of the offices and the issues around access. Would the minister please provide the opposition the progress with respect to these travelling FAWs who'll be going to different communities: how often that happens, what the cost is and the nature of the cases in which the travelling FAWs would be engaging? Would he provide the information to the opposition when it becomes available?

Hon. M. Coell: Yes. That's something we would be monitoring to make sure that offices weren't closed inadvertently and caseloads went up. The other thing is that history shows that varying degrees of unemployment and changes in employment throughout the province have caused offices to open and close because of the circumstances in different areas. We will be monitoring that, and we will share it.

J. Kwan: What steps has the ministry taken to ensure the staff are well versed on the changes that have come into effect? To our understanding, districts weren't receiving training until March 28 with respect to the changes.

Hon. M. Coell: I've been involved in some of the meetings that have taken place. We've had extensive briefings with the REOs. The use of internal communications e-mail has been a way that we've got the message out, because we do have almost 3,000 employees. We've used policy bulletins. We've used posters and brochures. We've used Internet updates to individual staff people, just sort of building for the last month and a half on the changes and the effects of the changes.

We also did something that was innovative. We did Train the Trainers. We trained an entire group of people who went out in the last couple of weeks and were actually training staff and working through the different offices. There may be some offices that got training before others, but I'm informed that to this point everyone has received the right training, the right information and the right background to implement the changes that were made on April 1.

J. Kwan: That's interesting, because if the training has been going on for a month or a month and a half…. I can tell the minister that when I was up in Williams Lake, I spoke with some FAWs, and they advised me at that point that they had not yet received any training whatsoever. Other than what they've heard on some of the announcements, maybe, they have not received any training. So that's interesting, and I'll double-check that piece of information with others.

I understand that a letter was not sent out with the cheque issue of March 20 to advise recipients of changes. Have letters gone out to recipients advising them of the changes beginning April 1?

Hon. M. Coell: Actually, with the method we used, we did not send it with the cheque. We sent the letters to individual clients. Those letters have all gone out. I've actually spoken to a few people who've received them, so they should all be delivered by now.

J. Kwan: All income assistance recipients would have received a letter from the ministry advising them of the changes.

Hon. M. Coell: They would have got a letter outlining the changes that would have pertained to each individual client.

J. Kwan: I'd like to ask the minister this question. On April 1 the ministry implemented numerous changes to B.C. Benefits. These changes involve changes to the B.C. Benefits regulations, yet so far there have not been any orders-in-council or ministerial orders. How can these changes be implemented without the proper changes to the regulations?

Hon. M. Coell: Actually, the orders-in-council were deposited last Thursday.

J. Kwan: Could the minister please provide the opposition with a copy of that? We haven't been able to identify it. As far as we can tell, there have been no orders-in-council. If we've missed them or we haven't received them…. If the minister can provide a copy of that, I'd appreciate it.

Hon. M. Coell: It should be on the register of regulations. If I can ask the Chair, maybe the Clerk would know that.

J. Kwan: I'll double-check during the dinner break to see if it's in fact there, but the last time we looked, we didn't see it. It could just be that we missed it, because we're looking for a lot of things these days on the computer. Every minister seems to say, "Just go and do the research" — with the two of us and our small but hardy band of staff. I should say also that the interns have done a great job, great work with us.

I want to ask the minister this last question, and I am noting the time. Could the minister please advise…? With the closure of the offices, is the ministry anticipating that the caseload for FAWs would increase? What is the current caseload now, and what are they anticipating the caseload would be with closure of offices and, potentially, increases in applications because of the resource sector downturn?

Hon. M. Coell: A number of issues, I guess, with regard to…. We were looking at the resource sector the other day. It's difficult to tell how many people will come onto employment insurance as effects of the forest industry and how many will eventually be on income assistance. That's very difficult to tell. The financial assistance worker caseload is done by the REOs, the regional executive officers, and they ensure that each FAW and their caseload match. Some are able to take a little bit more, and some take a little bit less. We try and have an average. The FTEs to support the need are being redistributed.

I guess the other thing to look at in the service plan is the anticipated success of the employment and training programs. We've looked at the last three or four years of the pilot projects, and they've seen an average of about 8,000 a year come off income assistance into employment, so we're going to see a reduction of people on income assistance because of the programs.

I'm optimistic that the changes we make in the reduction of offices will match the reduction of people moving into employment and the reduction of FTEs as well. It's something that, as government, we'll monitor to make sure it's moving smoothly. I'll rely on our senior staff to give me updates on that to make sure we've got the appropriate number of staff to meet the needs of the clients. That has changed over the years. When you look back to when we had huge increases of people on income assistance in the mid-nineties, there were increases in staff. Then, when the caseload went

down, people weren't rehired as they retired. There always is that yearly adjustment in any event.

Hon. M. Coell: It's difficult to tell, because different offices are configured differently. We have some that primarily give out cheques and have a lower ratio of FTEs to clients. Others deal with child care. We've got offices that specialize in people with disabilities. Again, they have a lower caseload. It's hard to say. The average probably isn't the right way of looking at the ministry caseload — at this point, anyway.

Maybe the minister can, then, provide the opposition with this information in writing — that is, the caseload situation with the different offices in British Columbia and also relative to their area of focus. If it's just the issuing of cheques, I can appreciate that their caseload would be higher, but if it is perhaps more complicated in terms of dealing with casework, then the caseload may be lower. If the minister can provide that information, I will leave my questions at this point.

Why I'm asking these questions is this: I have run across FAWs who have advised me that their caseloads have gone from 300 to 500, as an example. I just want to see what is going on out there and what the situation is. If the minister can provide me with that information, I would thank him and his staff for their cooperation and for providing the answers to my many questions in the estimates of the Ministry of Human Resources.

It is one of the most important areas within government to ensure that British Columbians do have assistance where they need it and that people are not left without in our broader community. Because of the broad, sweeping changes that have been brought in by this government, which I worry very much will jeopardise the quality of life for many British Columbians and perhaps put them at risk, I attempted to canvass in detail the changes that are coming.

I also appreciate the minister's patience, because from time to time we did cross over on questions that will be dealt with through legislation and that, I understand, were in a sort of tricky space of dealing with issues in estimates that will also cross over to legislation.

Having said that, I'd like to thank the minister and his staff for their information. I'd like to simply close with this: I do worry about the direction of government in that the welfare reforms leave potentially negative impacts on many British Columbians.

Hon. M. Coell: With regard to the last request for a caseload by office or region, we will do our best to supply both — office and region.

Thank you to the member for her questions and also for the questions I received from other members of the House. It's an opportune time for us to discuss the issues as we're making changes. As I alluded to earlier, I'm optimistic that the changes we're making will help people get back to income and employment that is better than what we can provide in income assistance.

We have great challenges ahead of us. We have great opportunities ahead of us. I welcome the opportunity for members of the opposition and members of the House to monitor and to point out where we can do things better. The bottom line here is to increase the well-being of British Columbians, and we're attempting to do it in the best way we know how at this time.

ESTIMATES: MINISTRY OF
ATTORNEY GENERAL AND MINISTRY
RESPONSIBLE FOR TREATY NEGOTIATIONS
(continued)

J. Kwan: Welcome, hon. Chair. I think this is the first time you've been Chair in this House.

I'd like to ask the minister some questions relating to treaty negotiations, or I can continue on with my other questions. I know that earlier I gave the minister a list that was to deal with administrative justice, court services, Crown services, public safety policing, general and then treaty negotiations. But given that the treaty issues have actually surfaced, I thought I'd just go right to that. If the minister prefers I can just keep with that order. I'm okay with that, as well, if his staff is not here.

Hon. G. Plant: Well, we were kind of expecting that the member would follow the order she had indicated earlier that she would. The staff I have with me are Ministry of Attorney General staff, not treaty negotiations office staff. So I'm not going to be as assisted by staff as I would be if they were actually here. It would certainly be more likely to be productive if the questions were in the areas that the member originally indicated she would pursue.

J. Kwan: I don't have a problem with that. I thought I could go to the treaty issues because that's a higher priority for me. If we are tight on time, then I may skip over some of the other pieces. But that's okay; we can do the treaty negotiations last. That's not a problem.

Just to follow up on issues around administrative justice, I'd like to ask the minister questions around the child, youth and family advocate piece. A press release was issued on February 7, 2002, which announced that the children's commissioner and the office of the child, youth and family advocate will be combined into the

new position of the children's officer. Could the minister please advise why the government took this action?

Hon. G. Plant: The government commissioned a report from a lawyer named Jane Morley. We asked her to look at issues in relation to the different agencies that have responsibility for various types of matters that government is concerned with in relation to children at risk and children who die in unexpected circumstances — children in care, and so on. We wanted to be sure the organization of the delivery of these services was effective, did not involve unnecessary duplication and ensured that government was actually making sure it discharged its obligations in respect of the children at risk.

Ms. Morley came back with a set of recommendations in a report, and the government took her report under consideration. As part of the work facilitated by the administrative justice project, government announced a series of decisions that will, as and when implemented, lead to the reconfiguration of responsibilities of organizations that have responsibility for children. That reconfigured system will in due course appear in the form of legislative proposals that will be debated in the House.

J. Kwan: The children's officer's position is not a statutory officer's position. Formerly the child, youth and family advocate was a statutory officer of the Legislature and was, therefore, independent of government interference. Why wasn't the children's officer position made a statutory officer?

Hon. G. Plant: The proposal is that the children's officer will be a statutory officer. We don't believe the children's officer will be created as an independent officer of the Legislature. However, what has happened is this. We as government have announced our policy intentions in broad outline and in some detail, but the implementation of those intentions will require legislation. When the legislation is introduced, we'll have a good opportunity in the Legislature to debate issues around why government is moving from one approach to a new approach.

J. Kwan: Well, currently the children's officer reports to the Attorney General, not to the Legislature. That is my understanding of that process. Isn't there a conflict of interest if the children's officer reports to the very government which it is monitoring and criticizing?

Hon. G. Plant: Actually, the children's commissioner, which is one of the current statutory positions with responsibilities in the area of protecting children, is a statutory officer. It is an office created by the Children's Commission Act, and the officer reports to the Attorney General.

J. Kwan: Yes, but that, compared to the children's commissioner and the office of the child, youth and family advocate formerly…. Those positions were officers of the Legislature which reported not to the minister but to the Legislature, so there was not only the appearance but the actual reality of complete independence. Now that the children's officer position has been collapsed into one and it reports to the Attorney General and not the Legislature, will the minister be considering actually making that position or that role completely independent of government and making that role, then, into an officer of the Legislature?

Hon. G. Plant: I don't want to say that's not a legitimate question — it's the kind of issue we certainly thought about when we were giving consideration to the Jane Morley report — but it is pre-eminently an issue that should be raised in the context of a debate around the legislation, not the estimates of the Ministry of Attorney General, in my view.

J. Kwan: We just went through the estimates of the Ministry of Human Resources. There were a lot of issues that crossed over between estimates and issues that would be tied into legislation in the House. We canvassed these issues more broadly because of the closeness of the two matters. It's fine that the minister doesn't want to address this issue.

In my view, it also falls into the purview of the minister in the estimates. It is his area of responsibility. The decision, in terms of establishing that the children's officer reports to the Attorney General and not to the Legislature as an officer of the Legislature, I think, falls within the purview of the Attorney, but he doesn't want to address these issues.

We can canvass those in the House, but the decision has already been made. It wasn't that we would canvass in the House whether or not the decision will be made, which is why I'm canvassing it here in these estimates.

In my own view, I think it is a conflict of interest, or it would create a perception of conflict of interest in the minds of the public. The children's officer ought to be one that is completely independent of government and one that should be reporting to all members of the Legislature, because its role is to monitor and criticize government. To ensure full independence, any report that the officer comes forward with should be one that is tabled in the Legislature and not within the ministry. I think that would enhance the government's new-era commitment of accountability, openness and transparency.

Instead of moving in that direction, it seems to me that the government is moving the other way. Whereas before, officers of the Legislature in relation to child, youth and family advocacy work was work that was completely independent of government. Now, we see a situation where we're taking a reverse trend. I think that is contrary to the government's new-era agenda in terms of openness, accountability and transparency.

I'd like to ask the Attorney General questions around the Human Rights Commission. The Attorney

General has expressed a desire to use alternative dispute resolution methods to resolve conflicts rather than having cases go to court.

The B.C. Human Rights Commission reduces the burden on the judiciary by providing mediation for human rights cases. If human rights and alternative dispute resolutions are such a priority for the Attorney General, has the government cut the commission's budget by one-third and reduced its capacity to provide alternative dispute resolution services? If that's the case, how would it advance, help and assist in dealing with cases and referring cases through the dispute resolution through the Human Rights Commission?

Hon. G. Plant: Actually, this is not intended as a comment on the individuals who have done this work. I think the Human Rights Commission is not regarded as a leader in agencies that do alternative dispute resolution very well. In part that's because of the mandate the commission has under its current statute. It actually doesn't spend enough time trying to resolve the complaints that come before it. It spends an awful lot of time — sometimes months and months and years — investigating complaints that are filed.

That is one of the reasons why I have asked the administrative justice project people to focus some attention on our human rights machinery. I think what we need to do in this province is find better ways to maintain protection from discrimination, ways that are more effective, efficient, affordable and fairer — in particular, ways that will enhance the prospect of early resolution of human rights complaints.

We're looking at the options which exist for doing that. That is why there was a background paper released on this specific topic, which was available for public response. We've had a look at the submissions that have been received. We are working on coming up with a set of proposals that will achieve objectives which I believe the member would support and which will improve the protection of human rights in British Columbia. Again, those are primarily legislative proposals, which I know we'll have an opportunity to debate at such time as they are introduced.

In the meantime, we have reduced funding to the Human Rights Commission for the current fiscal year. We believe that as we move through the changes, which I think are inevitable and will be welcomed by most people, we'll find there is enough money in the system to do the things that need to be done to protect human rights in British Columbia.

Hon. G. Plant: I'll certainly find the answer to that, if I can. The commission, of course, is independent of government but reports to government regularly on what it does and reports to the public. I'll certainly try and get an answer to that question.

J. Kwan: Accompanying that answer, I wonder if the minister could also provide information with respect to the caseload. How many of those, right now, are sent off to alternative dispute resolution to be handled in that format, and how many of them actually go through the entire process within the commission?

I'm just trying to establish a bit of a baseline in terms of what it was before and what the changes will be so that we can make a comparison once the alternative dispute resolution approaches have been put in place by this government. If the minister can commit to providing that, then I'll move on to another question.

In July of 2001 Ms. Mary-Woo Sims was fired from her position as chair of the B.C. Human Rights Commission. Her term was due at the end of March 2002, I believe. Could the minister please advise how much was spent on her severance package?

Hon. G. Plant: I don't have the exact dollar figure, but I can advise the member that she was paid out to the end of her statutory term.

J. Kwan: I actually don't know how much she was being paid. Can the minister provide that? If he doesn't have the actual figure, he could also send that information along with the other information that I'll be receiving from the minister.

Hon. G. Plant: We'll certainly see if we can get the exact amount for the member. If we can't get the exact amount, I know we'll be able to give the member something close to it.

J. Kwan: I'm not necessarily looking for an amount to the last cent, but a ballpark figure — $50,000, $30,000, $100,000, whatever the case may be. I appreciate that.

I just want to focus a little bit on the issue around alternative dispute resolutions. One of the areas in which there would be impacts, particularly for British Columbians, is the area around security deposits. We canvassed this in the Ministry of Human Resources.

As I understand now, effective April 1 in the Ministry of Human Resources, recipients who formerly were able to get support from government to pay for the damage deposit will no longer be able to do so. The amount they receive for a damage deposit from government will be deducted from their cheque by $20 a month until that amount is paid back. They have up to two tries to get the damage deposit. On the third try the individual would only be able to obtain the damage deposit if they were faced with domestic violence issues or if the housing in which they lived had been demolished, so they were forced to live…. Extenuating circumstances, as such.

My concern around damage deposits is this: there are a lot of British Columbians who are unable to get their damage deposits back from unscrupulous landlords — not to say all landlords are there, but some are. I know a lot of them in my own riding, in Vancouver–

Mount Pleasant, from whom people are not able to get their damage deposits back. I asked the Minister of Human Resources, then, to see whether or not there are initiatives within government, pilot projects or the like, which try to hold in-trust damage deposits so that the individual who's paid the deposit would not actually lose those moneys.

Would the minister be looking at, perhaps, bringing forward a pilot project in the area of damage deposits, so that individuals don't end up losing their money to unscrupulous landlords?

Hon. G. Plant: The minister responsible for the administration of the Residential Tenancy Act is the Solicitor General. I think a damage deposit trust fund scheme would be a policy initiative that, if it were to come from government, would probably come from that ministry. We have no initiatives underway in our ministry to pursue the creation of a trust fund damage deposit scheme for residential tenants along the lines that the member has proposed.

J. Kwan: I thought the minister might be interested in this area because it is a part of the administrative justice areas that fall under the minister, particularly in light of the fact that legal aid services, where a lot of the advocates provide assistance for people to deal with residential tenancy disputes, will be reduced by some 38.8 percent. A lot of advocates do deal with damage deposit issues. If we can actually find a way to minimize those kinds of disputes, so that the people don't lose their money, you could actually also reduce the caseload for advocates. It would actually go towards furthering, I think, the goal that the minister espoused earlier on in these estimates. I was hopeful that the minister might take this on as a challenge.

Will the minister perhaps be working on this issue with the Solicitor General then?

Hon. G. Plant: Let's separate out two somewhat distinct issues, although I would accept that there's a relationship between the two of them.

The first is the issue of whether there should be a new regime in place for what are called damage deposits. That's an aspect of residential tenancy policy and is pre-eminently a matter for the Solicitor General.

The second issue, which is distinct but related, is the member's interest in a system of resolving disputes in residential tenancy matters that is affordable, accessible and fair. The member points out that disputes in the residential tenancy world often concern damage deposits. Sometimes the damage deposit is a lever in disputes between tenants and landlords about other issues, and sometimes it's a stand-alone issue.

The Solicitor General is working on a revised residential tenancy act. I am interested in dispute resolution, generally speaking, and the administrative justice project is very interested in dispute resolution with a view to ensuring that agencies across government, like the residential tenancy branch, actually can provide a service to the public that is as efficient, affordable and accessible as possible.

I have to say that in this area my view is that it's good public policy to work towards dispute resolution that involves lawyers and even advocates as little as possible. We should work towards having in place dispute resolution mechanisms for residential tenancy issues that can be dealt with and handled for the most part by the tenants and the landlords themselves.

Now, that's not going to work for all cases. Certainly I know the member's interest in individuals on B.C. Benefits, on social assistance. Many of those people will have challenges around obtaining some degree of comfort about using any kind of dispute resolution process that has a degree of formality associated with it. I understand that challenge. I think it's all the more reason to ensure that the residential tenancy branch or Solicitor General's ministry designs a process that is as accessible to ordinary citizens as possible.

While we are working through the administrative justice project to try to get some good principles in place across government that will assist all ministries — and particularly will assist all agencies and tribunals — as they increase their use of alternate dispute resolution techniques, the primary responsibility for residential tenancy policy, in this area as in other areas, is the Solicitor General.

I don't mean to put the member off on that. I do have an interest in this issue. We are, in my ministry, paying some attention to the policy development work that the Solicitor General is doing and will continue to do so.

J. Kwan: The reason why I raised this issue, as the minister has identified, is that it is linked. If there is an opportunity through which we can put together or government can put forward an approach that would minimize dispute, that perhaps is the best dispute resolution format. The trust fund, as one possibility, could well reduce the number of cases that need to go to residential tenancy branches for resolution. It would, of course, minimize the need for lawyers or advocates for assistance for people who are faced with that difficulty.

I do know a significant number of people, particularly low-income individuals and people who are faced with multiple barriers, who get — quite frankly, for lack of a better word — ripped off by unscrupulous landlords. They do it just because that's how they do business. People lose their money as such, and government loses money as such, through damage deposits — although now the practice has changed in that the individual actually has to pay, through monthly deductions, for the damage deposits. The hardship, I think, on individuals is going to increase because of that, and a lot of people don't have the resources to try and fight the landlords to get the damage deposits back. I hope the minister will work with the Solicitor General to devise a scheme on the issue around damage deposits.

I understand that the member from Chilliwack actually has questions for the minister, so I'm going to yield the floor to him so that he can ask the minister questions.

B. Penner: I appreciate the opportunity to ask the minister a number of questions pertaining to his portfolio.

Following up on the discussion I was just listening to pertaining to a trust fund for damage deposits, I'm wondering if the minister is aware of what the previous government's response was to this suggestion. I know, working in opposition with the minister when he was a critic in the area, he and I had an opportunity to discuss this topic on a number of occasions. In fact, we met with a group that advocates on behalf of tenants. They expressed to us, if my memory serves me correctly, their frustration at a lack of response from the previous government.

I presume that the previous government and the Ministry of Attorney General, as it then was, would have received that proposal several years ago, and there probably was some reason why it wasn't implemented. I wonder if the minister could comment on that.

Hon. G. Plant: I did have some familiarity with this issue when I was a member of the official opposition. We did look at the proposal that was advanced around the creation of a security deposit trust fund, and at that time I was not convinced there was a problem that would be fixed in a way that made good public policy sense by the proposal.

That was, of course, before we became government. Since the election the responsibility for residential tenancy matters has been that of the Solicitor General. I do have the interest that I have explained, and which the opposition member and I have discussed, around dispute resolution. That is an interest I have across government, although my actual responsibilities are more limited than that. I think the question around a trust fund to secure the payment of damage deposits is probably a question that more properly belongs within the purview of the Solicitor General than my ministry.

B. Penner: I appreciate that advice from the minister. It is an area that I, too, was interested in over the last number of years. I remember from their meetings with the tenants rights advocacy group that a number of jurisdictions, maybe a handful or less in the Maritimes and also a state in Australia have implemented such a system, but I'm not sure if it's really caught on beyond that.

I have just a couple of very brief questions pertaining to legal aid. The minister will probably be able to answer these, hopefully, without assistance from his staff. We're aware that the number of community offices operated by the Legal Services Society is going to be reduced and that there are going to be a number of regional offices in their place.

In addition, I've heard that there will be what has been referred to as local agents, I believe, for receiving applications from members of the public for legal aid services. I wonder if the minister can explain for our benefit as members of the Legislature how he sees these local agents operating. Will they be government employees? Will they be lawyers in private practice who are given extra responsibility to act as agents for the Legal Services Society? Have any decisions been made around that?

Hon. G. Plant: The Legal Services Society is still working towards the implementation of the service delivery model they expect to have in place for the next three years. The member is right. That's the model that will have seven regional offices and 24 local agents.

My understanding is that the local agents will be lawyers in private practice who will have an arrangement with the Legal Services Society for doing the kind of work, including file intake, that the member talks about. These local agents will not be government employees. They will not even be employees of the Legal Services Society, so far as I know. They will be lawyers in private practice who will have some responsibilities to the Legal Services Society.

Something like that model already exists. The service configuration that has prevailed up till now included some 45 community law offices and 15 local agents. The society has some experience with the idea of using local agents and will hopefully be able to build on that experience as it implements the new service delivery model.

B. Penner: The Attorney General will know that I have some familiarity with the Legal Services Society and the provision of legal aid in British Columbia. It's my recollection that, at least in years gone by, in addition to relying upon community law offices, one would frequently see in the courthouses across the province Salvation Army volunteers and others taking applications for legal aid from people who were at the court facilities needing assistance.

That might be one model the ministry or the Legal Services Society might wish to consider: making use of existing volunteer agencies as a point of contact for the purposes of citizens making application for legal aid or legal services. That certainly was the case in the early 1990s, where anything from the John Howard Society to the Salvation Army and probably a number of other volunteer agencies that have a footprint in different communities in the province would take on that task as part of their obligation to society or their attempt to help people in general.

Ultimately, the decision to provide legal aid was not the decision of, for example, the Salvation Army in Chilliwack or the John Howard Society in Abbotsford. They would simply take the forms and forward them on to the appropriate Legal Services Society office, and staff there would make the ultimate decision as to whether the person was eligible for legal aid. I'd ask

Hon. G. Plant: I appreciate the member's contribution and suggestions. We'll certainly make sure they're brought to the attention of the society as it continues to work on implementing a model for service delivery which reaches the broadest number of people in the most effective way within the financial limits it will have over the course of the next three years.

I think the member may not have been part of this discussion, but the opposition member and I had a longer discussion about legal aid issues. I think that during the course of that, I pointed out my interest in continuing to understand the ways in which a wide variety of actors across society, including non-profit organizations, lawyers in private practice who do pro bono work and lawyers who have other ideas for how indigent legal services can be provided…. All of those are part of a complex picture of how society responds to the need to ensure that citizens who can't afford access to conventional legal advice nonetheless have a measure of access to justice.

We've had a good debate in this debate about the extent to which we're going to meet those objectives and how we're going to do that over the next few years, and I welcome the member's continuing contribution in term of suggestions for different ways of doing things that will ensure people do have access to advice and representation when they need it most.

Just to wrap up, then. The minister has indicated that seven regional offices are contemplated for the Legal Services Society. Is that number essentially now set in stone, or is there still some contemplation about the exact number and location of those seven regional offices? If the locations have been determined, I wonder if the minister can share those with us.

Hon. G. Plant: Our understanding is that their planning process is pretty far advanced on that basic issue of the configuration of seven regional offices and 24 local agents. I'll be happy to provide the member with the list of locations of those offices. I don't have it here with me, but I'm sure we can get it. I'll get a copy to the member.

B. Belsey: I have a few questions on legal aid. I know you've been answering these questions for quite some time. If I'm going to ask some questions that you've already had to deal with, I apologize.

It's my understanding that the Legal Aid Society no longer exists. It was replaced, or at least the board was replaced by Ms. Morley, I believe it was. There has been talk of closing down a number of offices. We were talking just a few minutes ago about maybe four or five regional offices and then 15 or whatever legal agents.

I'm curious as to how we're determining what offices close and what offices stay open. Are we looking at populations in areas? Certainly from my point of view there is the remoteness of a lot of my communities, including the Queen Charlotte Islands where there is one lawyer on the island. I'm just curious as to how we are going to deliver this service or provide this service to my constituents.

Hon. G. Plant: The service that the member refers to has not traditionally been provided by government directly. What government has done is fund, by means of a grant, a society called the Legal Services Society. It's a society that is created and continued under a statute of British Columbia with responsibilities for the provision of legal aid services. Government is reducing its grant to that society over the course of the three years of the service plan that was tabled with the budget documents by the Minister of Finance in February. It is the society that determines the configuration of its service delivery. That has been generally true, and it continues to be true today.

The society continues to exist. The member is right that the board of directors of the society was replaced by a trustee appointed under the provisions of the Legal Services Society Act some weeks ago. The trustee is the trustee for the society and by law has the same duties, responsibilities, rights and obligations, I guess, as the board would.

We are talking about a large and complex organization. In broad terms, the way it has delivered services over the past number of years has been by funding lawyers in the private bar through a tariff system for some kinds of work — largely criminal legal aid and to some extent family legal aid. It has also funded the operation of community law offices and native community law offices across British Columbia. There were some 60 locations of community law offices present in the province — 45 community law offices and 15 local agents.

As a result of the expenditure reduction, the society has decided to reorganize how it provides services. It will move to a model of seven regional offices and 24 local agents. In part that's because the reduction in the funding for the society is going to mean a significant reduction in the kind of work that has been done by community law offices.

The Legal Services Society will continue to maintain coverage for adult and youth criminal matters, matters involving domestic violence, child apprehension and cases where mental capacity is at issue under the Mental Health Act or the Criminal Code provisions. We also will have significant amounts of money available for legal advice and justice services around family issues and a legal education and information program.

There will definitely be an impact on communities in British Columbia that have had the presence of a community law office or a native community law of-

fice. There will be a change in those communities in terms of the access to the kinds of advice and representation that members, citizens and residents in those communities who could not otherwise afford the services of a lawyer have been able to get through a community law office.

Partly because of that, we're working hard to give consideration to some of the ideas that I talked about in my answer to some of the questions from Chilliwack-Kent. The opposition member and I had a vigorous discussion about some of the impact that she believes these changes will have on people in communities she has experience working with from her days as an advocate.

We're going to face some challenges. There is a political argument that can happen about why we're in those circumstances. We've had some of that political discussion, also, in the course of this estimates debate.

We have work to do as government. Communities and the bar are all part of the project that we face to try to mitigate the impact of these changes and ensure that people have the access to justice that we as a society can afford, given our financial situation, and that we have determined is a matter of priority, and that we believe we ought to provide where and as we can.

B. Belsey: I share the concerns you and many of the other ministers have as to how we try and divvy up the resources we have through the various communities.

I just wanted to make sure you understood, and I'm sure you do. I'll repeat that it is extremely difficult for some of these coastal communities to access services today. As we start to trim them down and become more fiscally responsible for the funds we have, it gets even more difficult. For somebody to travel down a road, and maybe it's an extra hour away to get to the service, that's one thing. When you've got to travel four hours by boat or maybe by plane and then get in a car and travel down a road, it becomes even more difficult.

Certainly legal aid service in my community, and I'm sure in communities around the province, is a huge issue.

My second question this evening. In the many meetings I have had and conversations I've had with constituents in my area regarding legal aid services they've come up with a number of ideas about how we can continue at the service level we provide today.

There's one idea that came up, and I just wanted to share it with you and get your thoughts. One group has suggested that if the Attorney General were to appoint a group that would be responsible for collecting the 7.5 percent tax on legal fees and, in that group, provide legal aid services around the province — not unlike, maybe, what we do with hotel tax where roughly 2 percent is collected, and then that money is used for tourism marketing around the province or outside the province but for services and facilities in the province. Maybe it's not unlike the MSP, where we collect money from individuals and then use it for medical services.

I'm just wondering what the Attorney General's thoughts may be on that kind of a proposal.

Hon. G. Plant: I'll answer the question the member has posed in a minute. I want to spend another minute or two dealing with some of the thoughts that occurred to me as I listened to the first part of his question, as he talked about his concerns about the impact of legal aid reductions on the more remote communities in his constituency.

I think that nowhere in British Columbia is what I am about to say more true than in the constituency of North Coast. It was as true a week ago as it will be next week. What we think of as the delivery of government services is a hugely different reality for people who live in Klemtu or Bella Bella or Port Edward than it is for people who live in Richmond or Kelowna. That has always been the case, and I think it will continue to be the case.

Here's the way that this challenge gets transformed into something that looks like an opportunity. When we began doing the core review exercise in our ministry — when I began working with my staff to do that exercise — we recognized that to a certain extent some of our expectations around what access to justice means are conditioned by our acceptance of the way in which we currently do things. We take those things for granted and perhaps ought to be rethinking them more vigorously.

Let me be more specific. For many people, the phrase "access to justice" is a prism into things like this: sitting in a lawyer's office, sitting in a courtroom, watching a courtroom being built, hiring more Crown counsel — all of those conventional responses to the need for access to justice. But access to justice is something more fundamental than a building or an individual sitting across your desk in an office. Access to justice is about citizens having their disputes resolved. It's about people who are accused of crimes being tried and, if found guilty, held accountable for those crimes. It's about people getting advice that they need. It's not so much how they get the advice but the quality of the advice. It's not so much whether the dispute is resolved in a room that looks like X or a room that looks like Y. It's more about whether the dispute is resolved to their satisfaction.

What we know about the way the system works now, when we think about it for a moment, should cause everyone to give themselves a bit of a shake and say: "We have to do a better job of focusing on improving outcomes, the outcomes that matter to citizens, than we do now."

As I've said in other contexts, and I think it's important to point out here, lawyers know that 95 percent of all civil litigation is settled before it gets to a courtroom, but we manage all civil litigation as though it were to get to a courtroom. There's a disconnect between those two realities. Imagine how much more acute that disconnect is for somebody who lives in Bella Coola and faces a journey to a courtroom. Well,

maybe they will actually have access to a circuit court in a town like Bella Coola. But if for many people in rural British Columbia, getting a dispute resolved in a way that involves adjudication involves travel of long distances, then clearly we need to think about how we actually operate the justice system to see if we can solve people's problems, get their disputes resolved, provide them with advice and even deal with the needs of the criminal justice system closer to home. Frankly, I think that means we have to start re-conceiving what and how justice works.

It's a tough challenge because many people in the legal system will point out, rightly, that our institutions have worked quite well in their present form for hundreds of years. Change is a difficult thing to achieve but, I believe, a very important thing to talk about.

I say that by way of response to the question that the member poses or the concerns that the member raises on behalf of his constituents. In the most respectful way possible I want to challenge the assumptions that underlie those concerns and to see what we can do as government to respond to the deeper need, if you will. Rather than saying the answer is that the only way of providing legal advice and representation to people who live in smaller communities is by having a community law office in their community, can we think of some other way to do that? That's the simple way of expressing that more complicated, or convoluted, exposition.

I respect the member's concerns, and I just want to say that I'm prepared to be pretty open-minded in my approach to how we respond to those concerns. I have to say that I don't act alone, and government doesn't act alone here. We are partners in many aspects of the way the justice system works with the judiciary. They have to be a part of the process of rethinking how we do things so that we respect the independence of the judiciary and the important values that are associated with that.

The member puts on the table — or on the floor — a proposal, which I have heard before, with respect to whether or not the tax collected on lawyers' services, which is part of the sales tax of British Columbia, could in some way be set aside as dedicated revenue and the dedicated revenue stream be used for the provision of legal aid services. There are some obstacles in the way of that proposal that I have identified — or had identified for me, as I have asked people to give some consideration to that proposal.

The first is this fairly simple one. I'm not a revenue minister. Revenue decisions are made by government but are primarily the responsibility of the Finance minister. The sales tax on legal fees is a sales tax, and like the rest of sales tax it is part of government's overall tax policy. I have no individual authority or control over what happens to that revenue. That doesn't mean I can't be an advocate at the cabinet table for a continuous reconsideration of whether that tax makes good tax policy. I strongly urged government before I became a member of government to rethink that tax, and I haven't changed my views about that tax since I became elected.

Perhaps more to the point, the challenge is this. Well, let me conclude that point. Sorry.

The practical effect of diverting any part of the revenue that is in the consolidated revenue fund now into a special fund for particular services probably would mean there would have to be expenditure reductions in relation to those other services. There is a limited pool of money. We're using it all to fund the services we provide, and if you were to take some of that money out of that pool, there'd be less available to fund services. A political discussion about that proposal could involve asking the question: "Well, should we take money from health care or education as a result of that proposal?"

The other point I wanted to make, though, is that the obligation the courts have found to exist in some circumstances to provide funding for people who can't afford counsel is an obligation on the Crown. It's an obligation on governments. I don't believe — and I think I've received advice to this effect — that the Crown could delegate away that obligation. I don't think we could create a freestanding organization and give it the authority to collect revenue and then say: "You will be responsible, entirely responsible, for the provision of legal aid services." At the end of the day, there would still be the prospect that in a particular case, if the society or the organization didn't fund services that the court thought should be funded, the court would not look to the society. The court would look to government, and that's where the responsibility ultimately lies.

It's an idea I've looked at, but at this point I don't think it makes good sense or is practical. It doesn't make good sense in terms of its implications on other revenues of government, and I don't think it's achievable in terms of providing a truly appropriate vehicle for delivering legal aid services that would, in fact, meet all of the public policy needs that have to be met.

I don't slam the door on the idea. We have actually had a look at it. Someone can come along with a different way of looking at it. I'm not opposed to that, but I have to say that I think we're pretty well on the course we're on for the foreseeable future, and what we need to do is focus our energy on how we can ensure that the dollars available reach the widest number of clients for the greatest number of causes.

B. Belsey: I'd like to thank the Attorney General for his assistance in helping me understand some of those questions.

R. Lee: I have just one or two questions. On the description for vote 14, page 70, it's mentioned that the recoveries for legal aid's cost, including criminal offenders and immigration, are received from the federal government. I notice that for the external recoveries,

the recoveries increase from last year from $1.79 million to $2.97 million. Does it mean that the recovery on those services will be increased over last year?

Hon. G. Plant: I didn't quite catch the page reference with certainty, but I think the member was on page 71 of the estimates.

Hon. G. Plant: Looking at the internal recoveries for ministry operations, criminal justice — is that right?

R. Lee: No, it's under "Justice Services, External Recoveries." I believe that's part of the legal aid recovery from the federal government.

Hon. G. Plant: On page 71, for the justice services aspect of ministry operations there is a line item for external recoveries, and the amount is scheduled to increase from $1.79 million to $2.97 million. According to the explanatory note on page 70, the recoveries in relation to justice services come from a number of sources, one of which is the federal government for enforcement activities in relation to family justice programs. I'll just see if there's anything more.

Madam Chair, I can provide some more detail. That $2.977 million number represents a contribution from the federal government towards the costs of the Air India case in the amount of a million dollars; something called the family justice initiatives project in the amount of $1.63 million; and something called the comprehensive child support services project in the amount of $350,000.

R. Lee: On page 70 under (f)(ii), "Legal Aid," it's mentioned that there are recoveries for legal aid costs, including criminal young offenders and immigration, received from the federal government. Where did those moneys go?

Hon. G. Plant: Those are general recoveries to government. I think they are under the CHST. The allocation that is usually made in popular discourse to legal aid has to do in part with an extrapolation from some previous spending amounts and, also, actual agreements with respect to the federal government's contribution to legal aid services.

My understanding is — if this where the member is going, we could get there faster; but if not, he'll correct me — that we expect the federal government's contribution towards the provision of legal aid services in British Columbia in the current fiscal year to be, roughly speaking, somewhere between $9.5 million and just over $12 million. The extent of the amount will turn on things as they develop over the course of the year.

R. Lee: The federal government doesn't cover 100 percent of those costs mentioned in (f)(ii). It's not 100 percent recovery from the federal government.

Hon. G. Plant: I don't know that I completely understand the member's question. The federal government does contribute in part to the costs of delivering legal aid services in British Columbia. Unfortunately, over time their share of that contribution has declined. Although I don't have the exact numbers in front of me, I think that at one point the federal government contributed on the order of 50 percent to young offender and criminal legal aid and adult criminal legal aid. At any rate, the federal government contribution has, over time, declined to below 30 percent.

The federal government also contributes this year to the provision of immigration refugee legal aid services. Even that represents only a small portion of what we expect we will actually be spending in British Columbia on refugee and immigration legal aid services in the past fiscal year and in the current fiscal year.

R. Lee: It's not dependent on the number of immigration or refugee cases. It's dependent on the block funding. Is that correct?

Hon. G. Plant: The member is right in relation to these items. They are provided in a block funding amount.

R. Lee: My next question is on court services. On page 20, "Court Services," there's actually an increase of more than 10 percent over last year on the security and escorts item. Also, there's a $1.4 million increase on registry and trial support. What kind of area would those expenses go to?

Hon. G. Plant: In relation to registry and trial support, there is expected to be an increase of about 1.2 percent, representing just over $1.4 million. I'm advised that the increase in the budget is primarily due to salary and benefits increases, building occupancy charge increases and facility projects, program staffing shortfalls, non-salary operating pressures, reversal of municipal bylaw hearing recoveries and Air India trial funding. Now, those increases are offset by budget reallocations to the security and escorts sub-subvote, an amortization budget reduction, savings from courthouse closures and some general budget reductions and program transfers. That is a summary of the operating budget expenditures for the registry and trial support division of the court services branch.

Then with respect to security and escorts, there is a 10.5 percent increase in the operating budget of that division, which is an increase of just over $2.6 million. This increase is primarily due to salary and benefits increases, program staffing shortfalls, non-salary operating pressures, Air India trial funding and budget reallocations from the registry and trial support sub-subvote. The increase, however, is offset by courthouse closures and general budget reductions. Those are the two parts of the court services budget that the member was asking about.

R. Lee: You mentioned that that's offset by a budget reduction. Actually, it's not a budget reduction; it's a

budget increase. I just want to see exactly. Is there an increase in services in the security and escort services?

Hon. G. Plant: The short answer to the member's question is no. I should have been a little clearer in my explanation of the last set of numbers.

In both divisions of the court services branch that I was talking about, there are some increased expenditures, and there are also some reductions in expenditures. The numbers I gave are the net. They are the result of the increase minus the reduction. Some of the increases are as a result of cost pressures over which we, frankly, have very little control, including salary increases and things of that nature.

In some of the decreases the reductions are, of course, as a result of the service plan commitments that we've made in areas like courthouse closures. There will be no increase in services from the court services branch.

J. Kwan: I can't resist making some comments around some of the issues that have been brought to the fore.

First, on the issue around the trust fund in relation to residential tenancy rights issues in relation to the security deposit. It is true that the previous government started to work with a variety of community groups, particularly the group that advocated for such a trust fund — the Tenants Rights Action Coalition. I remember very well meeting with the then executive director of TRAC — Mike Walker, not Vanessa Geary — when I was first elected in 1996 around these issues and engaging in intense and deep discussions with him.

Then, over the course of that period there were a lot of proposals brought forward on which I worked with the previous government in bringing this matter for consideration. The last Attorney General was interested in implementing such a trust fund, but not all of the work in that regard had been completed. There has been a lot of lobbying, including the lobbying work with the then Liberal critic members.

I think to suggest that the previous government didn't try to bring this about is completely false. There was much work done in that area. More work needs to be done — there's no doubt about it — which is why I'm pursuing this line of questioning. I hope the minister will continue to pursue that to bring it into reality. By doing that, if the government does in fact pursue that area, it would gain the support of the opposition. I do believe it's an important area. It was something that I worked on when I was on the government side. It needed a lot of work, and I think it still needs some more work to bring that to full completion.

On the issue around legal aid, I had pretty well finished my questions. I do want to ask a couple more questions on legal aid, particularly as it relates to dispute resolution, seeing as the matter has been opened up again by members,.

The Attorney General has identified alternative dispute resolution as a means of resolving legal disputes. In response to this, the poverty law section of the Canadian Bar Association has stated: "We expect the minister would admit that there are limitations on when alternative dispute resolutions can resolve an issue, including many poverty law issues. As an example, alternative dispute resolution is of little help when an unemployed homeowner faces a foreclosure. The client needs at least summary legal advice from a lawyer about their legal rights."

I'd like to ask the minister: what is his response to this statement made by the Canadian Bar Association?

The general response is that I believe we can, in fact, make significant progress in reducing the incidence of conventional litigation across a wide variety of types of legal problems by expanding the use of alternate dispute resolution techniques. But the fact that I believe that is by no means inconsistent with my recognition that not all disputes can be resolved short of litigation.

We will always have the need for a court system to provide a place where citizens can have impartial adjudication of the disputes they cannot resolve out of court — that adjudication being by an independent judiciary.

With respect to the specific example concerning a homeowner who is facing a foreclosure proceeding, I have to say that I've had some experience with this kind of situation from my days in practice. Oftentimes it is possible to give a person in the position of a respondent in a foreclosure application a fairly good and sensible amount of legal advice with respect to their options in a very short amount of time — for what would amount to 20 minutes' or half an hour's worth of study and advice by lawyers whose hourly rate is relatively affordable.

I think that for many homeowners who have been unable to keep up the payments on their houses, if the prospect of foreclosure is sufficiently important to them, they are going to be able to find the $30 or the $40 or the $50 that will, for many of them, give them access to the advice they will need to understand their legal rights in relation to the risk of foreclosure.

It won't be the case for everyone. I think what we need to look at in that context is the larger discussion that we've already had. British Columbia, frankly, is probably almost alone among the provinces in Canada as a jurisdiction where that kind of information and advice has been provided at the state's expense. We can't afford the fullest possible range of legal aid services at this point in our province's economic and fiscal history.

I think that when you take those things together, you recognize…. I would argue that this example di-

rectly points the way to the reality that for many people facing an issue that is, frankly, a civil dispute, it is possible to get advice and help, and sometimes even representation, for relatively modest amounts of money from lawyers who are competent and perfectly well qualified to give that assistance and willing to do so for relatively modest charges.

J. Kwan: I suspect that if you were faced with a situation of foreclosure, which pretty well means that you have very few financial resources, hiring a lawyer or seeking legal advice at an expense is an additional burden. That may well not be an alternative.

On the flip side, of course, with respect to providing assistance through legal aid in this area…. Actually, LSLAP used to provide a very good program that was funded through legal aid. The law students actually provided legal advice to clients. It was a good program for students, who could get some experience and at the same time provide a service for those who needed that kind of expertise. The funding in the LSLAP program is also being reduced. That, too, would put additional pressure. Ways in which there are opportunities to provide the services at a much cheaper rate — those, too, are on the chopping block, making the stresses in the system even more heightened.

The Canadian Bar Association further points out that they are concerned that the alternative dispute resolution mechanisms appear not to be effective or in place for many disputes between individuals and the government, including for social assistance benefits disputes. That's another area in terms of pressures — again, targeting people who are the poorest of the poor, who couldn't get access with the legal aid cuts in this area.

I think the Canadian Bar Association points out very well that on the issue around funding legal aid services, it needs to be dealt with on a needs-assessment basis. They further pointed out that with respect to poverty law services, per-capita spending data means nothing when poverty law services are being singled out for elimination. They further state that they make no apologies for arguing that per-capita legal aid funding in any province is fundamentally inadequate, whether the province is at the top or the bottom of the per-capita list. Meaningful access to justice for all should be a national priority. I have to say: I can't agree with them more on this front.

I won't go further into the legal aid issues, because we have canvassed that fully. I will ask the minister this last question around legal aid.

In the submission made to the Attorney General by the poverty law section of the Canadian Bar Association, four recommendations were made:

1. That the Attorney General declare a one-year moratorium on funding reductions to the Legal Services Society and other law-related advocacy agencies;

2. That during such a moratorium, the Attorney General expand its Legal Services Society Act amendments discussion paper to conduct a comprehensive consultation on the delivery of legal aid in British Columbia;

3. That the Attorney General take a leadership role in a federal-provincial dialogue on the funding for and standards for service delivery of legal aid in Canada; and

4. That the Attorney General expand the mandate of the administrative justice project to fully consider the advocacy needs of low-income individuals who access administrative tribunals.

I'd like to ask the minister's response to these four recommendations that have been put to him by the Canadian Bar Association. I believe these proposals were submitted on March 15.

Hon. G. Plant: The four recommendations that the member refers to were contained in a paper that I was presented with by members of the Canadian Bar Association subsection that she has referred to. We did have a discussion about some of those issues. We've agreed to meet again, and I hope we will meet on a regular basis to continue to explore ways in which we can expand the range of services available to the widest net possible of people who absolutely and critically need advice and representation that they cannot pay for themselves.

The recommendations, I think, are going to be difficult to implement. We will not be imposing the moratorium that's been proposed. We're here debating estimates for the Ministry of Attorney General that include the provision for a reduced grant to the Legal Services Society. That society, I think, has already made significant progress in terms of deciding what services it will be delivering over the course of the next year and, indeed, the next three years. We're well along the way in terms of thinking about how those services can be delivered.

One of the suggestions has to do with a federal-provincial dialogue on legal aid issues. I have certainly been giving some thought to that. I can tell the member that I have had discussions with the Attorney General of Ontario about legal aid issues. I think that over the next months and years there will be increased interest at the federal-provincial-territorial table around legal aid issues.

The administrative justice project is concerned with ensuring that administrative agencies function in a way that reduces the incidence of unnecessary litigation and, in that respect, is very fundamentally concerned with access to justice for all British Columbians, including those who can least afford the conventional retainer of a lawyer.

I do take that particular recommendation seriously. As we move forward, I think it's important that the project bear in mind that different people have different levels of ability to afford legal advice and representation. I'm grateful for that suggestion. Certainly I look forward to the continued input of the Canadian Bar Association and its subsections on all of these issues.

J. Kwan: There were two parts to my question to which I didn't hear a response from the minister. One

was in relation to the issue around consultation on the delivery of legal aid in British Columbia as related to the Legal Services Society Act amendment discussion paper.

In the brief that they presented to the Attorney General, dated March 15, 2002, there were grave concerns raised by the Canadian Bar Association with respect to the time period allowed for a response. The document was tabled on March 4. The Legal Services Society Act amendment discussion paper was tabled to them on March 4, and they were expected to provide a response by the 18th. In the brief itself, under appendix 3, they stated how impossible, quite frankly, the request was for them to provide a meaningful response back to the minister.

In part of the recommendation they asked the minister to expand the time period so that they could conduct a comprehensive consultation on the delivery of legal aid in British Columbia. Is the minister entertaining that request?

Hon. G. Plant: The subsection's request in that respect was tied to their first request for a moratorium in the imposition of the spending reductions. We have had a discussion paper out there, as the member herself points out. We do need to move forward with the project of reconsidering the mandate and governance of the Legal Services Society. I told the Legal Services Society board of my interest in and my urgent commitment to that project when I met with them on January 18.

We have issued that discussion paper. There has been input received, and we are moving forward. If we delay, then there is the reality that we may end up spending more money than we should on things like transition costs. I think it's important that we get to a new model that meets the public interest in terms of the provision of services in a way that's affordable and accountable and that we get to this new model as quickly as we possibly can. That's what we're doing, and that's what we're working towards.

J. Kwan: Yes, in that recommendation the issue around consultation was tied to the moratorium, but in the appendix itself the request is not tied to the moratorium. I'll read the appendix, then, into the record, because I don't want to misconstrue what was being asked of the Attorney General.

This comes out of the submission to the Attorney General on legal advocacy funding from the poverty law section, Canadian Bar Association, B.C. branch, on March 15. Appendix 3 reads as follows:

This request here in the appendix is completely independent of the issue around the moratorium, although I think the issue of the moratorium is an important one, because it really does then allow for consultation to take place, for it to be meaningful and for a strategy and plan to be developed.

On the question around needing to sort of rush through to develop this new model, I would hope that the government would reconsider the matter. I think it is more important to develop a model that is based on meaningful discussion with the broader community, particularly those involved in the delivery of the services and those receiving the services who would be impacted, and then, having engaged in that process, to come up with a model that works. I don't oppose finding efficiencies and ways to do things better. I don't oppose that at all. But if you rush through it, then you may well put in jeopardy bringing together the most appropriate model.

In this case you risk, I think, access to justice for British Columbians. I think that ultimately that's something we don't want to see. I believe the Attorney General doesn't want to see that either. Nor does the Attorney General, I think, want to set a standard that lowers the standard for British Columbia in terms of access to justice. I believe the Attorney General wants to see a standard that is higher and actually improves it.

Would it not be wise to hold back and say: "Look, let's just take a little bit more time, a little bit more care, and go through this appropriately and properly and make sure it is done right"?

Hon. G. Plant: Well, the member in her comments referred to the need to work with the people that provide the services. In this case the people that provide the services are the Legal Services Society, and we've certainly been working with them quite closely as we continue the public policy investigation and consideration around the issues raised by the discussion paper.

J. Kwan: With all due respect to the minister, others have different opinions on that. Those from the Legal

Services Society have a different opinion with respect to the minister's participation in the consultation process. The Canadian Bar Association, while they're not the Legal Services Society, are certainly people who are in the profession and who see those services delivered in the community, and they have raised concerns with the minister as recently as March 15. They asked the minister to slow down and to respect the bar and the bench to ensure that there is meaningful consultation in that process. I don't think it is in best interest of British Columbians to rush through, and certainly it's not in the best interest of ensuring that access to justice is afforded to all British Columbians.

My other question related to the minister from the Canadian Bar Association centres around the mandate of the administrative justice project. It was asking the minister to consider the advocacy needs of low-income individuals who need to access administrative tribunals. Would the minister be entertaining the expansion of the mandate of the administrative justice project?

Hon. G. Plant: I think the terms of reference of the administrative justice project are probably broad enough to encompass the issues the member wants to see pursued. I've already indicated that as we move through the months to come in the work on this project, we will give consideration to the concerns she has expressed.

Among the objectives of the project is the objective of ensuring that administrative agencies meet the needs of the people they serve. That's the very first stated or enumerated objective, and I think it speaks directly to the concern expressed by the member.

J. Kwan: One of the areas in relation to the administrative justice area is the tribunals relating to income assistance. The change has already been brought about from the government, and that is that the tribunal members would be appointed by the government, whereas formerly, in the administrative justice side on that issue, the tribunals would be formed by three individuals. The chair is chosen by a representative of the ministry and also by a representative of the client. The client has the choice to choose a person to be on that tribunal and so, too, does the ministry, forming a three-member tribunal. But now all of those tribunal members will be appointed by government. Therefore, the independence, if you will, of the representation on that tribunal will no longer be afforded to the client or to the ministry. They will no longer be able to choose their representative on that. It's all going to be chosen by government.

On that issue, the advocates in the community, as well as the clients, have raised concerns. Will the minister consider changing that component of the representation on the tribunals for Human Resources appeals?

Hon. G. Plant: Well, I don't think the change the member is referring to has taken place. If it is to take place, it can only happen as a result of legislation. The issue the member raises is one that I think could be pursued in debate over legislation, when it's introduced. In terms of the general issues raised by her question, I guess I may as well put on the record this point. She says there's a concern that tribunal members appointed by government cannot be independent. Well, judges are appointed by government, so I don't think I accept that proposition.

J. Kwan: Well, in the areas where it impacts income assistance, it is my understanding that the changes, the welfare reforms, have already taken place. That's for it to be effective April 1, irrespective of the fact that legislation has not been brought in, and irrespective of the fact that some of those regulations related to legislation may not have been brought in either. The changes have already taken place, effective April 1, so that ties into the appeal process and so on. I think there was a press release that was sent out from government advising of the change in that area. Yes, we will have another opportunity to canvass these issues in the Legislature when the legislation is introduced, but the fact of the matter is that changes are happening without legislation, especially in the areas around welfare reform.

On the question around independence, the issue is, yes, independence, and there is wide concern from the broad community that the appointments of the tribunal members will all be made by government. On the issues around welfare, the former system was such that appointments of who sits on a tribunal in making a decision on an issue of an appeal…. There was representation that could be chosen by the client, and representation could be chosen by the ministry. Jointly, those two representatives chose a chair as a third person, and that formed a three-party tribunal panel to deal with welfare reforms. I think that was viewed by the broader public as a fair process, as one where people could ensure that they had their own representative on the tribunal, but now that's been taken away. The appointments are only made with government.

Concerns have been raised. I can canvass those issues when the legislation is tabled, and I intend to when those matters are before the House in the Legislature. I thought I'd take this opportunity now, as we're engaging in the administrative justice issues with the Attorney General.

Let me now turn to the issues around courts. In a statement made by the Attorney General in February, the ministry is currently working towards establishing municipal bylaw courts with a community panel instead of a judge. When does the ministry expect to implement this policy?

Hon. G. Plant: This project is part of the community charter development. I'm informed that a discussion paper on that proposal on the specific issue or, at least, including the specific issue of municipal bylaw enforcement reform will be released soon. I'm getting further confirmation of that. We are expecting to release a consultation paper to get feedback on the pro-

This is something that has been talked about for a long time, and it was an issue that formed the subject matter of a forum at the UBCM convention last fall. I know that people in my ministry have been working on developing some options. Those options will be made available for a broader public discussion shortly.

J. Kwan: There are some unresolved questions, and I would imagine that through this discussion process some of these questions would then be answered. They include: who appoints the citizens panel? Who will pay the costs of the hearings? Will the province or the municipalities receive the proceeds from fines? I imagine those questions will be answered through the process, and I see the minister nodding.

The minister also stated that the work would be completed shortly. Could the minister just give me some sort of time frame?

Hon. G. Plant: As I said in my last answer, this is part of the community charter and is, therefore, linked to some extent to what government is doing in the next phase of the community charter project. In terms of releasing a discussion paper that includes a consideration of the reforms to the municipal bylaw dispute process, I think we are looking at a matter of weeks not months. We're close to getting something out there that will, among other things, if not answer, at least identify some of the questions that the member herself was raising a moment ago.

J. Kwan: That discussion paper will be part of the community charter discussion paper, the White Paper, then. It won't be a separate discussion paper. Am I right in understanding the minister?

Hon. G. Plant: I'm not sure there has been a final decision on the relationship between the two. Clearly the broad umbrella of the community charter is concerned with municipal powers and that obviously includes a consideration of bylaws and bylaw enforcement. My ministry has had a particular interest in the dispute process. Whether one paper gets released at the time that the draft of the community charter gets released or not…. I'm not sure that's been completely decided yet, but we're certainly getting close to the release of a paper that will deal with this bylaw dispute process.

J. Kwan: Whether or not it's the same discussion paper, that's one thing. The minister is unsure around that. Is the anticipation that legislation in this area will be brought to this House this year then?

Hon. G. Plant: I don't think it's wise to foreclose options completely, but the way we're moving through this project, I think it's very unlikely there is going to be legislation in the spring session, particularly if this project continues to be linked to the larger community charter project. The timetable for that stretches out a little bit. We're working as hard as we can towards getting information out there for the public to have a look at. That, to me, is what we're focused on as the next step: to make sure we get public input and more municipal government input on how we can change the bylaw dispute processes, particularly in the area of disputes that are not as serious.

J. Kwan: Not to close options for the minister, I'm just trying to get a tighter time line — that's all — in anticipating when these matters will be surfacing. Is the minister anticipating this matter will be brought before the House in the fall session?

Hon. G. Plant: We're working on one step at a time, and the first step is to get a consultation paper out there. I haven't seen the final form of the proposal we're working on for the purpose of getting something out to the public. I don't want to foreclose the possibility that we'll get input that will require us to rethink some parts of this idea seriously enough to change the timetable.

I understand the member's interest in getting a more specific time horizon around this, but I can't give it to her. I can tell her that we are a matter of, I think, weeks rather than months away from being able to release a discussion paper. When we get to that step and certainly when I've had a chance to see the details proposed in that paper, then I think we'll be in a better position to answer the member's question about what the timetable is for legislative introduction if that what this ultimately comes to.

J. Kwan: All right, then. I guess if not in this year's estimates, maybe next year's, if it's not introduced before then.

I'd like to ask the minister a question around the Vancouver drug court. In November of 2001 the province and the federal government established a new Vancouver drug court. Could the minister please advise what kinds of services will be provided to people who choose to receive treatment through this program? What is the status with respect to the Vancouver drug court since this announcement in November?

Hon. G. Plant: This is a project that engages more than one ministry of government. In particular, the lead with respect to the organization and provision of rehabilitation services is the Solicitor General. We have involvement in my ministry, primarily in the court services and criminal justice components of that. From my ministry, we support the dedicated Crown….

Hon. G. Plant: Oh, it's the federal Crown. That's right, because it's narcotics offences. The rehabilitation services that are a key component of this are, I believe,

under the leadership of the corrections branch of the Solicitor General's ministry.

In general terms, so far as I understand it, the project is up and running. The court is in operation. It's early days yet for the evaluation, but as the member may know, part of the commitment to fund the court over the life of the pilot project includes a commitment to evaluate, so we'll have a sense of whether or not it's actually making a constructive difference in the lives of the offenders that are brought before it.

I think there have been about 100 accused persons who have come before it. As the member may know, the court commenced operations on December 4 of last year. There's a dedicated judge, defence and Crown counsel, and there's a probation officer and a drug treatment program director.

The court will be funded over four years by a $1.7 million grant from the federal government with matching funds from the province. The program will counsel up to 25 people in the first year, with the number gradually increasing to 100 by the fourth year. In fact, it looks as though the experience may be that we are ramping up faster than was originally intended when that sentence was first written.

To repeat, I think an important element of any project like this is that there will be evaluation to ensure that it does in fact reduce recidivism among participants and that it makes for good, cost-effective use of tax dollars.

J. Kwan: So the total cost for the Vancouver drug courts is $3.4 million — $1.7 million from the federal government and $1.7 million from the province. How does the $1.7 million from the province break down? How much is the Attorney General's portion? How much are the other areas?

Hon. G. Plant: The approximate breakdown includes, at least for the last fiscal year…. I think the $3.4 million that was referred to is an amount to be spent over the total three or four years of the project. It's not an annual amount.

I'm looking at a document here that has some approved recoveries from the federal department of justice allocated to corrections of $313,000, approved recoveries from the federal department of justice for the court services component of the drug court of $124,000 and approved recoveries from the federal department of justice allocated to criminal justice of $63,000 for a total of half a million dollars.

Then, expenditures that I think are provincial responsibilities, at least for the purposes of this budget delegation document for last year, look like this: expenditures allocated to corrections of $721,000; expenditures allocated to court services of $124,000; expenditures allocated to criminal justice of $105,000; and expenditures allocated to community justice, the branch that I think probably relates to legal representation for accused persons, of some $50,000.

It seems to me from this overview, which is a total of $1.5 million, that the larger component of the expenditures is related to the rehabilitation and treatment side of the program as opposed to the staffing of the court and the Crown and defence counsel part. But it is a courtroom, so it operates with a judge and with defence counsel and Crown counsel. They are funded as part of the project.

J. Kwan: I don't know if the minister has this information in his breakdown. Does it say in that budget what portion is attributed towards urine testing?

J. Kwan: I know that in the big House the Minister of Health Services is going through his estimates process. Maybe that's the area, the Ministry of Health Services, to ask this.

Is it the minister's understanding that for the drug courts piece, Health Services is also providing funding to support the drug courts? Is the $3.4 million over two or three years for the life of the project all of the amount of dollars being dedicated for drug courts, or are there additional dollars that are not identified in the information the minister has provided?

Hon. G. Plant: I'm not going to be able to answer the question, and this is why. The aspect of the project that the member is referring to is the responsibility of the corrections branch, not my ministry. It does involve from time to time, apparently, services contracted out to the Ministry of Health Services. I think we should be able to give the member some more information, or at least, I can ask my colleagues to give the member more information about those issues — more information, certainly, than I have available right now.

J. Kwan: I would appreciate it very much. I was under the impression that drug courts fall under the Ministry of Attorney General. I know it ties to other ministries, as well, but I was under the impression that the lead would be the AG's office. If I'm incorrect in that, if the minister could endeavour to talk to his colleagues and provide me a full breakdown of what services are being provided, of how much and all the details around the drug courts, I would appreciate it. The issue of the Vancouver drug courts is a big issue in my community, of course, which is why I have a keen interest in that. Thank you.

Staying with the theme of courts, let me move to the issue around the closure of the 24 courthouses. A letter written by the Attorney General on February 8 stated that the courthouses were being closed because they were "poorly utilized by the public and judiciary." However, courtroom-use statistics contradict the Attorney General and demonstrate that many of these courtrooms are utilized at or more than maximum capacity.

Delta's courtrooms are utilized 89 percent of the time. Burnaby's five courtrooms currently run at 126 percent of capacity. Maple Ridge courtrooms are operating at 138 percent capacity. Squamish is operating at 106 percent capacity. Could the minister please explain? How can the minister justify the closing down of these courtrooms when they are currently working at or above capacity?

Hon. G. Plant: As part of the core review and the budget processes, we were required, in effect, to look at making better use of tax dollars in terms of their allocation towards supporting court facilities in communities across British Columbia. As the member knows, the service plan summary announcement on January 17 included an announcement that 24 communities where there is a fully-staffed courthouse would be closed, the intention being to close 23 of them by May 31, and the twenty-fourth — that is, Delta — would be closed at the end of October.

We looked at a variety of considerations as we worked through a process of determining what the impact of a reduced budget would be on our ability to support full-time court facilities in British Columbia. One aspect of this discussion that is not often referred to, but I think is very important to remember, is that in addition to the 68 courthouses in British Columbia that were staffed on a full-time basis, 31 communities are already served on an itinerant or circuit court basis. None of those facilities are affected by the decisions that we made and announced on January 17.

Since January 17 we have been working with people in a number of communities across the province to see whether options exist for the provision of itinerant or circuit courts in communities where the courthouse that is currently there is a courthouse that is, in fact, relatively lightly utilized. That would be, in my view, a good indicator of the kind of place where we should think about providing court facilities in some model like a circuit court.

Our primary consideration in examining the impact of likely budget reductions on our ability to staff 68 full-time court facilities was maintaining access to justice across British Columbia. As we looked at the configuration of court facilities in the province, we did so with that primary consideration in mind.

We also had regard — as I did say publicly, and have said pretty consistently since the middle of January — to issues like the extent to which facilities were being utilized, the state of repair of some courthouses, the prospect that we would have to spend money on repairs or renovations, the distance to a potential receiving location and the availability or capacity at that receiving location to absorb an increase in workload. We looked at things like staff configuration, and we looked at a range of other considerations.

When you look at the issue of court utilization, it does become apparent that, at least with respect to about 20 of the 24 courthouses on the list, the facilities that are there now are relatively underutilized. In some cases, at the lower end of the list, court was sitting 30, 40, 50 or 60 days a year — that is to say, two, three or four days a month. It seems to me that it is difficult to justify maintaining a full-time presence of court staff and court registry staff, with the lights on every day, for a court that's only being used as a courthouse three, four or five days a month.

It is also true that in the cases of Burnaby and Maple Ridge, and, I think, Squamish, and to some extent Delta, the facilities are, in fact, already well utilized. The challenge there was to take into consideration other factors, including the ones I've identified like the state of repair of the facilities, the prospect of renovation or repair costs in the future and, also, the overall need to reconfigure the distribution of courthouses in a way that maintains access to justice to the greatest possible extent while also allowing government and this ministry to achieve its expenditure reduction targets.

In the case of Maple Ridge, for example, it is right to point out that the Maple Ridge courthouse is a busy courthouse many days of the week. But, in fact, not very far from Maple Ridge is the Port Coquitlam courthouse, a nearly brand-new facility currently only half full, with lots of room for an increased caseload. In fact, part of what we have done has been to reallocate staff in the court services branch so that in some cases the registries in receiving locations are going to have additional staff to cope with the additional workload.

Another example of the dialogue that's been happening is we've been working closely with the judiciary and other justice system partners since the announcements were made in mid-January. We have looked at some of the decisions that we announced in mid-January, and there are some changes being made. We thought that the best location for the cases that would come out of Delta was probably Richmond. After listening to and working with the judiciary and certainly after listening to the police and the council in Delta, they sent a strong message that they would rather see criminal cases from Delta go to Surrey. That is what we understand is now going to happen. I think family and civil cases will probably still go into Richmond, where there's room for them. We think there's room in Surrey to accommodate this increase in caseload.

This is a project that continues. We continue to be in discussions with municipal governments and others across the province to make sure that we explore all possible options for maintaining a judicial presence in towns that have been accustomed to having a courthouse. I think we can do a lot of work within the limited financial resources that we have to ensure that people have access to justice in their communities. It's a discussion I expect will continue as we continue this debate.

For now, Madam Chair, noting the hour, I move that the committee rise, report progress and ask leave to sit again.