2004 Legislative Session: 5th Session, 37th Parliament
HANSARD
The following electronic version is for informational purposes
only.
The printed version remains the official version.
(Hansard)
TUESDAY, MARCH 9, 2004
Morning Sitting
Volume 21, Number 10
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CONTENTS |
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Routine Proceedings |
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Page | ||
Committee of Supply | 9253 | |
Estimates: Ministry of Health Services (continued) | ||
J. MacPhail | ||
Hon. C. Hansen | ||
V. Roddick | ||
Proceedings in the Douglas Fir Room |
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Committee of Supply | 9265 | |
Estimates: Ministry of Community, Aboriginal and Women's Services (continued) | ||
J. Kwan | ||
Hon. I. Chong | ||
Hon. M. Coell | ||
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[ Page 9253 ]
TUESDAY, MARCH 9, 2004
The House met at 10:03 a.m.
Prayers.
Orders of the Day
Hon. M. de Jong: Mr. Speaker, I call Committee of Supply. For the information of the members, in this chamber we will be considering the estimates of the Ministry of Health Services and in Committee A continued debate on the estimates of the Ministry of Community, Aboriginal and Women's Services.
Committee of Supply
The House in Committee of Supply B; J. Weisbeck in the chair.
The committee met at 10:05 a.m.
ESTIMATES: MINISTRY OF
HEALTH SERVICES
(continued)
On vote 25: ministry operations, $10,404,260,000 (continued).
J. MacPhail: I got some feedback last night from the estimates, and I just want to ask three questions around the Abbotsford hospital. These came from local citizens. I'm giving them to the minister so that his staff can get the answers. I'm not asking for them right now. Okay?
Apparently the local media and/or the citizens know that while the minister said there's been an increase in the function and the scope of the hospitals, the actual number of beds at the new hospital is not anticipated to be any bigger than the current bed count. Let me just say that this hospital, the new Abbotsford hospital — the Abbotsford MSA — will have a total of 292 beds. That's the equivalent of Abbotsford, Mission and Chilliwack as it stands now — the number of beds.
It isn't the number of beds that increased the cost of the hospital by almost 94 percent. If the minister could break out the portion of the increased cost and attach increased scope other than the bed count to it, I would appreciate it.
Actually, it was pointed out to me last night that I didn't question anything on the fact that this new hospital is going to be designated a regional hospital. Therefore, does the regional designation mean the catchment area of the hospital expands? What does that mean in terms of this hospital being designated regional for the other three hospitals in that area? What does it mean for them? Those are the questions that the staff can perhaps get.
I'm wondering whether the minister had a chance to get the information around the actual increase in FTE nurses. I think he said that from '01 to '03 there were 671 more nurses practising. Is that FTE, or if not, how many FTEs? If he hasn't been able to get it yet, that's fine.
Hon. C. Hansen: The member, with regard to the Abbotsford hospital, indicated that there were going to be three questions. Her first question was around the increased scope that in fact does not amount to an increase in the number of beds. Therefore, what were the other aspects of the increase in scope? I have that information here, which I can provide to the member. She also asked about the catchment area. I wasn't sure if there was a third question as well. Those were the two that I had written down.
J. MacPhail: The new hospital has been designated a regional hospital. What does that mean in terms of services at the other three hospitals in the area? Are they affected by the designation of "regional" at the new hospital?
Hon. C. Hansen: I will try to address the three questions that the member raised regarding Abbotsford — to have those on the record now rather than at a later date, as the member had suggested. First of all, with regard to the number of beds, what we have seen over the last two decades is a steady decline in the number of acute care beds that we need in the health care system, partly because of some really profound changes in the way procedures are done. One example that sort of sticks in my head is around gallstones, for example, which used to involve a six-day hospital stay and now can be done as an out-patient on an ambulatory care basis.
If you look from 1985 to the year 2000, there was actually a reduction by about 50 percent in the number of bed-days that were used in our health care system in the province. That trend has certainly continued over the last number of years as more and more procedures can be done on an out-patient basis.
When we start looking forward, we're not going to need…. Yes, there are some population growth pressures, but we won't need the same number of beds per capita as we did ten years ago. The expansion of scope that we see in the hospital is around ambulatory care. There are diagnostic procedures, infection control, which we talked about yesterday. I've got a three-page backgrounder that I will send over to the member, which really outlines where the expanded scope is that we announced last September. I'll provide that to the member.
The other question with regard to the designation as a regional hospital. Basically, MSA Hospital today operates somewhat as a regional hospital, although there are certainly some services that will be expanded with the new hospital — for example, cancer treatment. Residents of the eastern Fraser Valley today would be going into Vancouver for their cancer care, whereas with the new cancer centre based at Abbotsford, it will in fact be able to serve the Fraser Valley generally.
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When you talk about the catchment area today, it might include the eastern Fraser Valley. When the new cancer centre is in place, that catchment area would include the Langleys, the Surreys, so it's going to become the closest cancer treatment centre for a pretty big chunk of the population in the eastern lower mainland. The catchment area is not something that is tightly defined, but clearly with the expansion of services, it will be able to serve a wider geographic area. With the other areas — diagnostics, for example…. With the new MRI and the PET scan that are being provided for, although they may not be there right from the first year, certainly space is being built for that.
Actually, there is cancer care at Surrey today, but this will expand that service for the Fraser Valley and will clearly be beyond the catchment area that is commonly seen to be served at this particular stage.
With regard to nurse FTEs, in 2002 there were 19,500 FTEs. In 2003 that increased to 19,624. Now, this is based on HSCIS data, and I think the member is probably familiar with the HSCIS data, which is preliminary data. It is really only once we get to the end of a data collection cycle that we're able to give some certainty around that data. The HSCIS data as of September 30 indicates we currently have 19,624 FTEs.
J. MacPhail: Just follow-up questions, and this will conclude the matter around Abbotsford, I hope. I'm sure it will. What effect does the designation "regional" and/or the size of the new Abbotsford hospital have on the other…? I know of two hospitals in the area, Mission and Chilliwack. Is there a third as well? Sorry. I said three, but I wonder whether I misspoke. I can only remember Mission and Chilliwack. What effect will that have on the services and/or the beds at those other two hospitals?
Also, could the minister tell me what is the bed per…? I think it's a thousand people that the count is normally. How many beds per thousand will there be at the new hospital?
Hon. C. Hansen: With the new MSA hospital, what we are building there is a centre of excellence for the eastern Fraser Valley. The primary objective is to strengthen the services that can actually be delivered within that eastern Fraser Valley health service delivery area. A lot of those services now can only be accessed by residents of that region travelling outside of the region to get access to care. Yes, we are looking obviously at that network of facilities in terms of how they can best fit into the model for 2010 and beyond, but a lot of that work is still yet to be done. So, you know, we have seen some of it. Chilliwack, for example, has become the centre for eye surgery for that region. We'll be looking at other innovations and other ways of best using these facilities as we go forward, but nothing has been locked in stone yet in terms of where specific services may be located as we go forward.
I'll read a quick little paragraph here. It says: "Each community hospital will have a permanent role to play. Staff at each hospital will be involved in planning for the development of these centres." It's all part of the overall plan to get away from looking at each hospital as an island unto itself and instead build networks of facilities that can work in concert with each other to make sure that patients get access to care.
Interjection.
Hon. C. Hansen: We'll have to get back to the member on that. I don't have that with me right now.
J. MacPhail: Sorry. I yelled across inappropriately, Mr. Chair, which is highly unusual.
Interjection.
J. MacPhail: What is it — inappropriate or highly unusual?
How many beds per population are there? The minister is going to get back to me.
There's been an expansion of 124 FTE nurses in two years under this government. That's for the entire province. I still make my point, Mr. Chair, about curiosity around how these surgeries — the $20 million of expanded surgeries…. Indeed, eliminating or greatly reducing the wait times and wait-lists for surgeries can only work with the proper amount of nursing as well as operating room time and physician time. So there's much more work to be done in this province around recruitment of nurses.
I did have a chance to review the estimates discussion around nurse practitioners that the minister had with my colleague from Vancouver–Mount Pleasant, so I am not going to explore that further than what she did. However, in terms of primary care there are more health care professionals that can work in a primary care model to avoid emergency room admissions. I'm wondering whether the minister has any examples of successful models in British Columbia of the inclusion of health care professionals to make primary care workable.
Hon. C. Hansen: I realize, as we're trying to develop an exhaustive list…. It would take a long time to get the exhaustive list, so what I'll do instead is just give a couple of examples for the member.
One of the ones that actually just came across my desk yesterday was with regard to the NurseLine in B.C., where last year we incorporated a pharmacist to work with the NurseLine to provide advice — particularly beneficial after hours. I just learned yesterday that the NurseLine has won an award for innovation from one of the national pharmacists' associations.
Other examples include the Spectrum Clinic in Vancouver. It's a primary care model to care for individuals who in the past have been high users of emer-
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gency rooms, particularly at St. Paul's Hospital. They're working with nurses, and they have a pharmacist, as well, working with them. They have seen a noticeable decline in the number of emergency room visits and the amount of hospitalization with that particular target group of patients.
Also, at UBC there's another great model in place that involves collaboration between nurses and doctors; likewise with Fort Langley and the primary care model they have there. Another one that I think a lot of people are talking about across Canada is the model in place at Chase in B.C., where not only have they got the involvement of the nurses and the doctors but also, as I understand it, podiatrists, physiotherapists and dietitians — all as part of that primary care model.
Actually, there's another example that was just handed to me. That's with regard to the south community birth program that is in place in South Vancouver to give a new care option for expectant mothers. There it's working with midwives, doulas, physicians and nurses — another good example.
J. MacPhail: The federal government has provided $74 million until 2006. The minister said yesterday that 30 percent had been spent. What is the process for projects going forward and/or permanent funding to expend the rest of the money?
Hon. C. Hansen: First of all, in terms of the overall amount, it has been allocated 70 percent specifically to each health authority. The 70 percent is divided up based on our population needs–based funding formula. The individual health authorities get to choose what their priority projects should be within that health authority. They have to report that back to us, obviously, because we in turn are accountable to the federal government with regard to how the $70 million is spent.
The other 30 percent of this money is to go towards provincewide initiatives, or initiatives that really cross health authority boundaries. The priorities will be set by a steering committee that has been made up of health authority representatives. That steering committee will jointly work to determine what the priorities should be for those provincewide programs.
This is the allocation in terms of the 30 percent that has already been spent. But also, it'll be in this structure that we will set the priorities for the remaining dollars in the primary health care transition fund.
J. MacPhail: Is the province contributing any money to the primary health care transition fund?
Hon. C. Hansen: The $74 million is within a fairly narrow scope. With the federal government, for example, when they allocate the $74 million for primary care, none of that money can go to pay doctors. So we still have to pay for the physician services through the normal routes of billings through the Medical Services Plan. We have also put in so far, to date, an additional $8 million of provincial money to support some of these programs.
I think generally you have to look at the broader picture of where primary care initiatives obviously have to fit into the health care system. It is through the rest of the provincial budget that we pick up all of those other support services and things that integrate with these primary care projects. I think it would be hard to tabulate how much the provincial government is putting in specifically to support the $74 million of expenditures that come from the federal government, but it is a considerable amount.
J. MacPhail: How many general practitioners or family physicians are paid on the alternate payments system out of the total GPs in the province?
Hon. C. Hansen: I mentioned last night that there are 4,500 GPs in the province. In terms of the alternate payments budget, that goes to support about 10 percent of all of the doctors in the province. The vast majority of them are specialists, so the percentage of family doctors that are on alternate payments would be a very small percentage.
J. MacPhail: Is there any discussion amongst these projects around moving physicians to the alternate payments system and for those that…? Basically, it is salaried doctors. That may be a bit too general to describe it, but for laypeople it's doctors moving from a fee-for-service model of payment to a salary payment. Is there any discussion or any projects ongoing around moving physicians to a salaried model and perhaps doctors not absorbing their own overhead costs, which now is done on a small business–private sector model?
Hon. C. Hansen: Within the remuneration structure for physicians there are a bunch of options, and the most common one, as was mentioned, is fee-for-service. When it comes to alternate payments, there are a few different models. One is salary, another is service contracts, and the other is sessions, where doctors are paid a fixed amount for a certain session of time rather than the fee-for-service. There are hybrids of those. There are mixes of all of the above. I have certainly had conversations with many doctors in the province who would find that kind of an alternative payments model very attractive. We have to make sure we build in the right incentives and align our programs to make sure there is that flexibility.
There are also certainly some real challenges in trying to move from the fee-for-service budget to alternate payments, even when the individual physician finds it a desirable objective. For example, if you have a retiring physician who was on fee-for-service and a new physician who is being brought into that particular position, who would prefer alternate payments, we have some big inflexibilities there which make that very difficult to achieve. Where it makes sense, we're trying to make sure those options are put in place.
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J. MacPhail: I was struck by the statement by the member for Kelowna-Mission last week when she urged all of us in a very passionate way to donate blood and, I think, to also become bone marrow donors. I'm not sure whether she did it in the Legislature, but I know that in a private conversation among several — including the member for Kelowna-Mission — she described the cultural differences and the different approaches from different ethnic backgrounds toward health care, one of which was the value of donating blood and being a bone marrow donor.
I also know that there are different approaches in my own community to health care. I have a riding where 40 percent of my constituents speak Chinese as their first language. In the primary health care reform fund, is there any requirement that there be projects that specifically address different multicultural, different ethnic approaches, to primary care?
Hon. C. Hansen: The first one that comes to mind is the NurseLine, where we can actually provide service to individuals in 130 different languages. Also, I'd mentioned earlier the birthing project in South Vancouver, which is primarily aimed at South Asian and Chinese populations. Also, if you look at the various primary health care initiatives, particularly in Vancouver and in the north, there is very much an aboriginal component to each of those projects.
If you look at the B.C. HealthGuide, we have now published that in Chinese and Punjabi. We have also put out a separate health guide for aboriginal cultural issues in terms of aboriginal health care, which I know has very much involved aboriginal health care providers in the design of the guide, and it has been very well received by aboriginal communities throughout the province. Those are a few of the examples that come to mind.
J. MacPhail: I know that the minister is in no way being deliberately incorrect, but there is a difference between an ethnic approach and an aboriginal approach. I appreciate his commenting on both, but there is a specific commitment both federally and provincially to aboriginal health funding, and that has gone on for over 15 years. I was particularly interested in the multicultural approach.
I would urge our government, both at the provincial and the federal level, to continue to determine an ethnically based approach to provision of health care. I see it every day in my own community where there is a different way of providing health care to children, depending on the community one is from. There is a different way of providing health care to aging people, depending on the ethnic community. There certainly is a different way of providing gender-based health care, depending on the ethnic community that one comes from. I'm saying those are the demands from the ethnic community. I hope our system can become much more ethnically diverse in order to ensure that people don't fall through the cracks.
Mr. Chair, I want to move to the College of Physicians and Surgeons. If the minister could just recount briefly the history of proposed changes and the consequences of those proposed changes since the last time this matter was discussed in estimates last year.
Hon. C. Hansen: There have been extensive discussions going on between the ministry and the College of Physicians and Surgeons around what is a fairly fundamental change in the legislative authority. As the member knows, with the passage of the Health Professions Act, what that will mean for the college is that it will shift from being under the Medical Practitioners Act — where it is today — to fall under the new Health Professions Act once that is proclaimed.
The work that is being done now is around designing the regulatory framework that would apply to the College of Physicians and Surgeons, and we're working actively with them on it. There is good progress on that, and I believe the target date is to have the college move over to the act by the end of this calendar year.
J. MacPhail: How many public representatives, publicly appointed, will sit on the College of Physicians and Surgeons under the new model?
Hon. C. Hansen: There are three now, and there will be three under the new model.
J. MacPhail: During the dispute with the Nanaimo emergency room physicians, I recall there being some public comment — I believe it was by the Minister of Health Services — about an increased role for the College of Physicians and Surgeons in terms of doctors' actions in performing their work. Could the minister expand on what he was hinting at?
Hon. C. Hansen: The overriding role of the College of Physicians and Surgeons is to protect the public interest. They're not there to be a voice for doctors; they're there to look after the public interest. If you look at basically all other aspects of health care delivery in the province, we do have provisions for the delivery of essential services. If one of the health-related unions engages in strike activity, they still have obligations to provide essential service levels within the health system.
When it comes to job action that is taken by groups of physicians, we don't have any similar kind of apparatus to ensure that the public interest is protected. That is the nature. That is what was behind my comments, where I felt that the college needed to be more proactive in ensuring that the public interest was protected, and it came down to the ability of a group of doctors to withdraw care from their patients in an emergency room setting.
As I said at the time, I thought that was bad enough in situations where doctors can withdraw care for, say, elective surgeries, but when you start looking at an emergency room setting, I think that is even more seri-
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ous. My concern was with regard to who it is that steps in and says a particular group of doctors have gone too far. There needs to be better provision of services in the environment of critical services that need to be provided — and with certainty.
I have had subsequent discussions with the college. I have made it quite clear to the college that I don't see their role as interfering with what would be seen as labour relations, but they do, I believe, have an important role to play in ensuring that the public interest is protected. We talked about what kind of tools they have or may need and what kind of guidelines they currently have in place, as opposed to those they may wish to put in place, to ensure that they could provide oversight in cases such as the withdrawal of services in Nanaimo.
J. MacPhail: I raised the example of Nanaimo because it was in that context that the minister made the comments about the College of Physicians and Surgeons, but I think it is very important that at this crucial time in negotiations, we remind ourselves that the Nanaimo physicians in the emergency room quit. They didn't withdraw their services. They quit; they resigned. I think in this country that is still legal. That's permitted. Language is always important in these circumstances.
Indeed, I asked yesterday about what were the resolution mechanisms in place — dispute-resolving mechanisms — if negotiations broke down, and the minister said, ever hopeful, that he didn't have any mechanisms in place to resolve disputes. I assume he is preparing, in worst-case scenario, to work with the College of Physicians to increase the tools and guidelines available to the college in the event of a dispute that begins to affect patient care — either through the government's actions or the physicians' actions. What are those expanded ranges of tools or guidelines that are being considered?
Hon. C. Hansen: To give the member one example, one of the issues that we've been in discussion with the college about is around the very definition of resignation. What does constitute a resignation by a group of doctors? Is there a time when the resignation is inappropriate in that it is…? I think, as the member indicated, there's obviously…. You know, physicians do resign their responsibilities in communities because they move to other communities or they plan to retire or whatever it is. What we need are better definitions around how that resignation should be structured, what kind of notice needs to be given to the health authority and the hospital so that there can be a continuity of patient care in that environment.
That's certainly one example of the issues that we're discussing with the college. We want to achieve that through a cooperative, consultative arrangement. I have every reason to believe that we will be able to work with them to put in place the kind of guidelines that will give them a little bit more clarity in terms of what their role should be when we have circumstances that develop as developed in Nanaimo.
J. MacPhail: Are there other provinces that have a differently functioning college of physicians and surgeons to which this province is looking as a model?
Hon. C. Hansen: Every province in Canada has a college of physicians and surgeons to provide this role of protecting the public interest. I think it's fair to say that in B.C. we've had more instances of job actions taken by physicians compared to other provinces. As a result, we've had to work with the college to make sure that we can respond to those. Given that other provinces haven't been through similar kinds of experiences, they are probably looking to the kind of tools that we develop in this province and the relationship with the college, as opposed to us looking to other provinces, because similar situations have not developed in some of those other provinces.
J. MacPhail: Let me just put a tiny bit of a different spin on it. Perhaps problems haven't developed in other provinces because colleges of physicians and surgeons play a different role, and therefore the physicians in those provinces understand the parameters that guide them in their withdrawal of services affecting patient care. I have a little bit of experience in observing the College of Physicians and Surgeons, for instance, in Ontario. I think that model operates in a very different fashion there than it does here.
This isn't a partisan question. The College of Physicians and Surgeons operated the same way in the 1990s as it does now. I would just urge the minister, as we creep up to the deadline of March 31 with this province having no dispute resolution mechanism: there better be some pretty frank discussion with the College of Physicians and Surgeons and the physicians and the government about dispute resolution mechanisms everybody can agree on so that patient care is not the victim in all of this, amongst all of the parties — the government, the physicians and a college of physicians and surgeons that perhaps isn't doing its full job.
The ombudsman was the person — the independent officer of the Legislature operating on behalf of the public — that used to investigate complaints against professional colleges, including the College of Physicians and Surgeons. On May 7, 2003, the ombudsman in this province released a report on the self-governance of health professions. It looked at the Health Professions Act.
In so doing, he also made this statement. The ombudsman is Howard Kushner in this province. Kushner said that the absence of adequate funding for his office means it is no longer investigating complaints about the colleges, meaning the health professions colleges, except in special cases. As a result, it will no longer be possible for members of the public or a profession to request reviews of a college's actions from a body that is independent of government. "A major avenue of public accountability will be lost," Kushner said.
Since that time, May of 2003, the ombudsman has had his funding cut even further and indeed continues
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to be unable to do any investigations into colleges when the public has a complaint. What is the government doing about this? It does seem to be a serious lack of administrative accountability.
Hon. C. Hansen: First of all, to put it in context, the College of Physicians and Surgeons is set up as a self-regulating body. It obviously receives complaints from the public and does follow-up and in some cases will do some very thorough investigations of practices by physicians, if that is warranted.
In terms of complaints from the public, if they feel the college in turn is not doing its due diligence, there certainly is the ability for myself as minister to receive those complaints. I, in turn, can raise them with the college if that is appropriate. Under the new Health Professions Act, I also could give a directive to any of the colleges, although obviously that is a power that I think would be used with great reluctance and only when totally appropriate.
Also, in the conversations we've had with the ombudsman, he has certainly indicated that if there were issues where he may be able to be of service, we could contact him and he would try to provide what assistance he could. So there are still some avenues available for those kinds of complaints. I think, in addition, that the public members who serve on these colleges have a very important role to play in making sure the broader public interest is protected.
S. Orr: I'd like to seek leave to make an introduction.
Leave granted.
Introductions by Members
S. Orr: We have with us in the House — and I believe they're up there in the gallery; hi, guys — a whole bunch of students from Lochside Elementary School, which is actually in the riding of the member from Saanich. But it is a school that's near and dear to my heart, because I used to be a councillor in that area, and they do have the best craft sales at Christmas. I'd like you to welcome Lochside Elementary School, and with them is their teacher, Ms. Seabrooke. Would the House please make them all welcome.
Debate Continued
J. MacPhail: Unfortunately, I can't accept the minister's assurances — for this reason. We are entering into a very difficult period of time as a result of negotiations. It was this government that removed any dispute resolution mechanisms when it comes to doctors. It was this government that cut the funding for the ombudsman so that he can now no longer investigate complaints brought against health professional colleges. It is this government that perhaps will be the subject of complaints as one of the parties to any dispute between the health professions and the public. Now the public's only avenue available is to go back to one of the parties against whom the complaint may be — the minister himself. It does seem to be a bit moving back to the Dark Ages, where there is no public accountability and no avenue of complaint other than going back to the person who may have been responsible for the travesty or injustice in the first place.
I don't believe for a moment that Mr. Kushner, the ombudsman, would prefer the arrangement of the minister giving him some resources on a case-by-case basis to which he can reply, rather than a properly funded budget where he can operate independently as an officer of the Legislature. It is a very troubling period in which British Columbians are moving, where I think patient care is going to be at risk because of this lack of funding of the ombudsman.
Let me read from the ombudsman's report of May of 2003. It's entitled Acting in the Public Interest? Self-Governance in the Health Professions: The Ombudsman's Perspective.
It's on page 9. It says: "The ombudsman's experience in investigating complaints against the colleges." This is the health professions colleges he is talking about.
"Perhaps the most surprising aspect of our experience in investigating complaints against the colleges has been the sometimes negative responses and lack of cooperation we have occasionally received. We very rarely, if ever, experience this during investigations of other public bodies, and I expect the reasons may lie in some important differences between the colleges and other authorities under my jurisdiction.
"Most public bodies recognize that they are directly accountable to the public and, more specifically, to the electorate. The ministers who direct government operations are constantly held accountable through the Legislature, through the media, through complaints to MLA constituency offices and through the independent officers of the Legislature. These include not only my office but also the offices of the auditor general and the information and privacy commissioner. Public bodies are accustomed to the idea that they are accountable, and while they may not always enjoy the scrutiny of outside bodies, they recognize the necessity and generally cooperate with us in good faith.
"It would be unfair and irresponsible to say that the colleges are indifferent to the public interest. There is no doubt that for the most part, the colleges strive to ensure that the public is protected from what the professions define as being unsafe or unethical practitioners. However, this does not mean that the colleges consistently function as though they were directly accountable to the public. It may be that because the college directors are elected by the registrants, who also have the exclusive responsibility to fund college operations through what are sometimes viewed as very expensive licence fees, the sense of accountability to the public is minimized."
That's pretty serious. What changes in the new health professions act will mitigate these concerns raised by the ombudsman?
Hon. C. Hansen: With the new Health Professions Act, what it does provide for is a more comprehensive
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ability for the minister to make inquiries of the colleges, which they have a responsibility to respond to. Also, it puts in place the provision for a directive from the minister, which the college is obligated to respond to. There is more transparency around the business processes of the colleges, including areas of discipline. The final point is that under the new act we have either sustained or increased the amount of public membership on these colleges.
Just to refer quickly to the act itself, under the section titled "Inquiry" it says: "18.1 (1) If the minister considers it necessary in the public interest, the minister may appoint a person to inquire into (a) any aspect of the administration or operation of a college, or (b) the state of practice of a health profession in (i) British Columbia, (ii) a locality, or (iii) a facility." It goes on for the rest of the section, which basically sets out the ability for the minister to conduct an inquiry involving affairs of the colleges.
J. MacPhail: Will that person to inquire into the practices be an independent person outside of government?
Hon. C. Hansen: It would largely depend on the circumstances of the issue at hand, but it would be up to the minister to designate a person and to be accountable for the person that is designated.
J. MacPhail: Well, I would certainly urge the government to interpret their own legislation as the requirement to appoint a completely independent person from government and from the college to investigate complaints, because we are on the verge of having a self-regulating body with absolutely no overview from an accountability point of view. That would be extremely unhealthy and, I would say, harmful to patient care.
Can the minister tell me who the public appointees to the College of Physicians and Surgeons are now? What are their names and what are their backgrounds, please?
Hon. C. Hansen: I have to correct what I said earlier when I said there were three public members. There are in fact five public members. I will get those five names to the member as soon as I am able to.
J. MacPhail: If there are currently five public members, the minister then said there were going to be three under the new act. Does he mean there will be five under the new act?
Hon. C. Hansen: Yes, that's correct.
J. MacPhail: I would appreciate the names and background of the five public members.
V. Roddick: To the Minister of Health: contained in the three-year rollout plan of service and budget plans of the health authorities is a directive to work to ensure that there is some mechanism or method of community input — that a community liaison committee, for want of a better description, be established. The Save Delta Hospital Society has been working for over a year on this issue in my riding alone. Can the minister please comment on how the health authorities throughout the province, my constituency included, are progressing on this important issue?
Hon. C. Hansen: One of the things we've made clear to the health authorities is that they do have to make sure they engage with the communities they're serving so that there is an avenue for input. I know there are some who have suggested some models that might be applied to the entire province. What I've found is that one-size-fits-all solutions don't work around this province, because we need to make sure that…. Whatever works for those communities and the health authorities may differ from region to region.
We have put in place some consultative processes which I think are working quite well in some parts of the province. In other parts of the province they're not working quite as well. I have certainly had some very good meetings, as the member knows, with representatives of the Save Delta Hospital Society. We have all agreed that there needs to be an opportunity for that kind of input from the community to the health authority.
I think what often happens is when they start to work out the machinery of that, it starts to gravitate back to a desire to have a comanagement model. Certainly, some of the documentation I have seen come forward that has been proposed doesn't reflect what I thought had been discussed at the meetings I was part of — which was one for community input. Then it sort of comes back a couple of months later in a model that looks like comanagement. The comanagement model I don't think works, because you wind up without the proper accountabilities in place.
I have certainly urged the health authority to make sure they put appropriate community consultation mechanisms in place, and it is my desire to see that in place in communities throughout the province. As I say, I think the health authorities are making some progress in that regard, but I think we still have a long ways to go to have a truly effective mechanism so that communities feel they have that opportunity for meaningful input.
J. MacPhail: Mr. Chair, I would like to move to negotiations amongst other health care workers now, separate and apart from physicians. Can the minister tell us who is in negotiations in the health care sector, the date of expiry of their collective agreements and the status of the various negotiating tables?
Hon. C. Hansen: First of all, with regard to the status of collective agreements, all of the collective agreements in the health sector, with the exception of the B.C. Ambulance Service, will expire on March 31.
[ Page 9260 ]
To date there have been substantive discussions at the community health table, and there has been a tentative agreement arrived at, which I believe is now out for ratification by employees and employers.
With regard to the facility table, I'm told that it has met on six occasions starting on January 9 and that the parties engaged in full bargaining proposals on February 19. Future dates are set for the week of March…. Obviously, this was written previously, but subsequent dates were as of the first week of March. With regard to the paramedical table, they have met, and there have been discussions with HEABC.
The HEABC has also offered to commence bargaining with the nurses, so HEABC served notice to the nurses' bargaining association on December 30 asking them to commence bargaining on January 9. The nurses' bargaining association was not prepared to meet. HEABC has sent several subsequent requests asking for bargaining dates, and the nurses' bargaining association has so far refused to set dates to commence negotiations.
J. MacPhail: Has there been any commencement of establishment of essential services?
Hon. C. Hansen: Yes. The health authorities have started to develop their essential services plans, but it has not yet gone to the Labour Relations Board.
J. MacPhail: Who is leading the bargaining at the three tables?
Hon. C. Hansen: The HEABC is leading the bargaining at all of those tables.
J. MacPhail: I assume the minister means that the staff, the employees of HEABC, will be conducting the bargaining. The minister is nodding his head.
The Minister of Finance, the Premier and the Minister of Health Services have been very clear that there will be no wage increases. Can the minister outline for us what the objectives are of the employer in this bargaining, other than zero wage increases for three years?
Hon. C. Hansen: I think it is fair to say that what the employers are seeking is stability and the ability to manage budgets in a responsible way that maximizes the number of dollars that can be focused on direct patient care. When the member says the bargaining mandate is no wage increase, that is not the case. What we have said is that we cannot increase the cost of the budgets for remuneration.
We have made it quite clear that there is lots of room to negotiate within the mandate that has been set out. For example, if a particular union would like to refocus dollars from the benefit side to increase wages, that is a possibility we would be prepared to discuss with them. Alternatively, they may want to see an increase in benefit structure. Again, if it means reallocating from wages to benefits, that's a possibility.
We're not talking about the status quo. We believe there is lots of latitude for negotiation, but our objective at the end of the day is to live within the financial means we have. That means the total budget for remuneration cannot be increased, but there is still lots of latitude for discussions.
J. MacPhail: I'm sure the employer thinks there is lots of latitude for discussion because it is the pay packet of the workers that will remain absolutely the same, and if the worker needs more in terms of supporting her family through benefits, then she will have to give it up in wages. I would suggest that the zero-sum game is a zero-sum game. The worker — despite inflation pressures, despite family pressures, despite increased health costs on their own family — will be getting zero in terms of disposable income and/or benefits. The minister will be hard-pressed to sell as credible that "Oh, there is lots of room for discussion." Sure, if you are willing to make a concession in one area, you might get back to zero in another area.
But I was thinking more along the lines of occupational health and safety, for instance, and reduction of sick time, reduction of injury on the job. What progress have we made in those areas since Bill 29 was brought in? Are there any objectives being set at this current bargaining table around worker health? Patient safety?
Hon. C. Hansen: Just to share with the member a few statistics around the issue of health and safety in the workplace.
From 2002-03 the average sick time per regular nurse FTE decreased by a little over 1 percent. From 1999-2000 to '02-03 the rate of long-term disability claims for nurses is estimated to have decreased by 13.2 percent. Average overtime per nurse FTE taken over a two-year period from 2001-03 has decreased by 19 percent. From 2002-03 overtime levels increased, most among full-time nurses.
I'm just trying to pick out the ones that are specifically health and safety related here. In terms of, again, long-term disability, incident rate per thousand has gone from 16.7 in 1999-2000 down to 14.5 in '02-03.
There is also a report that the member may be familiar with from the Canadian Nursing Advisory Committee, where today in this province the chief nursing officers from the various health authorities are working together to implement the recommendations of the CNAC report. Also, the OHSAH continues to play a very important role in terms of workplace safety. My understanding is that they just recently won an award from CIHR for the work they're doing. Also, there is work being done collaboratively between the Workers Compensation Board, OHSAH and the health authorities to address workplace safety and health issues.
J. MacPhail: Where do the health authorities…? Well, no, I think the ratings are per hospital. In terms of
[ Page 9261 ]
WCB ratings for assessments, where do hospitals stand now?
Hon. C. Hansen: In fact, WCB rates have come down for the first time in many, many years in the health sector. One of the things that is directly attributable, just as an example, is the dollars we spent two years ago on beds and lifts, which has had a significant impact in reducing workplace injuries.
J. MacPhail: That's good news. What's the change in terms of the assessment? For those that don't follow WCB, each employer classification gets assessed a premium rate according to their health and safety record. The better the record on health and safety for workers, the lower the assessment. So what's been the change?
Hon. C. Hansen: I don't have that detail with me in the chamber, but I will endeavour to get it for the member.
J. MacPhail: Are there any proposals put forward by the employer in this round of bargaining to enhance worker health and safety?
Hon. C. Hansen: I gather the shift was made several years ago with the establishment of the occupational health and safety agency to take health and safety issues from the bargaining table and put them into OHSAH, which is with joint input from both employers and union.
I can remember the first briefing I ever had on OHSAH, when I was still a member of the opposition. They outlined that cooperative, collaborative role they had with the union reps and the employer reps working together around health and safety issues and really taking it out of the more confrontational environment we see at the bargaining table. I think that was an initiative we have certainly continued to support. I think we see the good work of OHSAH continuing to try to address those workplace issues.
J. MacPhail: Are there any proposals on the table from the employer regarding severance changes?
Hon. C. Hansen: Not to my knowledge.
J. MacPhail: I was asking about severance changes for bargaining unit employees. I am going to begin to ask questions about severance arrangements for non–bargaining unit arrangements. Perhaps the minister could just outline for me what the severance provisions are for non–bargaining unit employees.
Hon. C. Hansen: This flows from the Public Sector Employers Amendment Act, 2002 that was passed during the third session. In part, this bill restricts severance packages that may be paid to executive staff employed in the public sector. Effective January 1, 2003, the total notice period and severance payments cannot exceed 18 months. This has been reduced from the previously permitted entitlement of 24 months. Payout of vacation entitlements is now limited to any unused portion of the current year or the immediately preceding year. It is no longer possible for executive or excluded employees to bank vacation entitlements for several years for payment upon termination. Those are some of the changes there were in what we knew at that time as Bill 66.
J. MacPhail: Fine. Let's get into executive severance now if the minister wants. I actually wanted him to repeat what the severance arrangements were for bargaining unit employees as per the collective agreement, but I'm sure his staff can get that.
The minister will be well aware that the Hospital Employees Union released a news release February 27. It went unnoticed, I think, in terms of the media — and fair enough. It's been a busy few weeks in terms of government activity here in Victoria. Robert Smith was appointed by this government in March 2002, before the changes to the Public Sector Employers Act that limited severance to 18 months. Even though it was this government that made the severance arrangements with Mr. Smith and they had claimed to want to be extremely frugal, Mr. Smith has a contract where the severance provisions are for 24 months' salary.
Why was this not amended after the changes under Bill 66 that limit severance to 18 months? Why was it negotiated in the first place, and why was it not changed as a result of legislation? This government excels in reaching back and either ripping up contracts or changing contracts.
Hon. C. Hansen: Bill 66, when it came in, was brought in by the Finance minister, so I'm probably not as familiar with the details of that legislation as I should be. I will have to find out more detail around that act in terms of its retroactive applicability.
J. MacPhail: Well, believe you me, this government doesn't need one set of rules to prevent reaching back and breaking contracts or overriding contracts or changing contracts. I'm asking why the Fraser health authority CEO, Robert Smith, is still eligible for 24 months' severance pay when everybody else now is eligible for 18 months' severance pay. It was a contract with this government. Why is it allowed to stand? They break every other contract that doesn't meet their purposes politically or fiscally.
He has a contract that's in violation of Bill 66. Perhaps the government will stand up and say: "Oh well, the reason why he's eligible for severance…." By the way, what is 24 months' severance for the Fraser health authority CEO? It could be as high as $650,000. It's a lot of money. Why does his contract continue to stand? Can't blame the former government — it has nothing to do with that decade of decline or that terrible former government. It's this Liberal government that gave him
[ Page 9262 ]
the severance pay. Why is that allowed to stand, and what other contracts exist now that are outside the parameters of Bill 66 limiting severance to 18 months?
Hon. C. Hansen: Basically, whatever is set out in Bill 66 is what would apply in this particular case. I have to check the exact circumstances around this particular contract to find out how that applies. The member made reference to us acting in violation of Bill 66. We are not operating in violation of Bill 66. Everything we do will be in keeping with Bill 66.
J. MacPhail: No, I made reference to the fact that they could violate Bill 66. They do it with all sorts of other legislation. Bill 29 went in and ripped up the contracts of every other health care worker separate and apart from doctors. Then another bill went in and ripped up the collective agreement in the arbitration procedure for doctors.
Bill 66, even if it isn't retroactive in imposing limited severance on executives in the health authority, could be ignored, and contracts could be renegotiated between highly paid CEOs and health authorities. It seems the government doesn't want to do that in this case. God forbid that people who are making $300,000 a year be limited in their severance according to the law. God forbid.
Does the minister have the executive compensation levels for all six health authority executives with him now?
Hon. C. Hansen: The salaries that are provided for the CEOs in the health authorities are provided within the framework that's set out by PSEC. I don't have the exact numbers for each of the CEOs. We will try to get that for the member. Certainly, they are within the range set out by PSEC.
J. MacPhail: Mr. Smith, the man we're talking about right now who gets 24 months' severance, has a starting salary of $323,000 a year. I have other information about the chief executive officer from the Vancouver Island health authority that was provided through public accounts. As of September 22 of last year — I don't know what his salary is now — Rick Roger was paid a salary of $269,000 plus a bonus of $33,500. I was informed at that time that Mr. Roger was the only one who had a bonus system incorporated into his contract.
I would like the information about executive compensation from the other health authorities. We talked about this yesterday, Mr. Chair, and the minister said he would get the information for me. So, executive compensation — salary, bonus, severance and expense compensation.
Just let me read into the record what the Fraser health authority CEO's benefits are. The reason I'm raising this, of course, is that if you are a health care aide, a nurse or a lab tech — or if you are still lucky enough to be a housekeeping employee working directly for the government for a health authority — if you want an increase to any of your benefits, you have to take it out of your own pay packet. Is that what the CEO has to do? No.
Here's what Robert Smith…. Robert Smith worked under our government as well. Robert Smith worked not only for us — I think through education — but also through Lions Gate Hospital. He received a substantial severance package when he left our government in the 1990s. Here is what Robert Smith's contract gives him. His starting salary was $323,000 a year. He gets 24 months' severance. He gets a monthly car allowance of $580. He gets 35 working days of vacation annually. That's seven weeks of vacation. He gets a pension. He gets a relocation allowance of $50,000. He gets payment of membership fees for professional organizations. In his first ten months on the job — he was hired in March 2002 — he had expenses of $75,000, which included his relocation expenses.
So, yes, I would very much like to know what the contracts are for the executives in every other health authority. We can discuss those after lunch.
How much is Dr. Les Vertesi being paid to be the government's representative on the national health council? I believe the organization is called the national health council, but the minister can correct me if I'm wrong on that.
Hon. C. Hansen: First of all, I will endeavour to get the information about the CEOs' remuneration as quickly as possible. I will not have it for this afternoon, so I apologize. I know we won't be able to pull it together that quickly, but I will get it to the member as soon as we are able to.
With regard to the national health council, this is a body that was set up as a result of the health accord signed by first ministers in February of last year. It is structured by appointments. First of all, there was a process of selecting appointments that involved each jurisdiction nominating four individuals, and then those jurisdictions cast ballots in terms of who the initial 13 members would be. In addition to that, each of the participating jurisdictions was able to directly appoint one individual.
The entire budget for the health council will be borne by the federal government, and the health councils themselves will have to determine what compensation there is for individuals who serve on that board. We know that they would be covered for travel expenses, for example, but at this point I don't think it's determined if there are other honorariums that may be provided. That's up to the health council itself. They will come forward to the respective jurisdictions for sign-off on the budget for the health council, but that is all work that is still in process. They're still a very new organization.
J. MacPhail: Is Dr. Vertesi currently paid under the alternate payment system, or does he claim MSP in his role as a physician?
[ Page 9263 ]
Hon. C. Hansen: To the best of my knowledge, the answer is neither. He has very recently been appointed as deputy director of a health policy facility at Simon Fraser University. I forget the exact title of the health policy initiative at Simon Fraser University.
J. MacPhail: He is an employee now of SFU. Is that what the minister is saying? I'm not clear on what he's saying. Is he paid by a research foundation? Is he paid by SFU? I mean, this man was just appointed a couple of months ago to a very high-profile, very responsible position on behalf of all British Columbians. So what does he do for a living?
Hon. C. Hansen: Actually, Dr. Vertesi has a very extensive biography. I'd be pleased to provide it to the member.
J. MacPhail: Could the minister answer my question, please?
Hon. C. Hansen: As I indicated, Dr. Vertesi is — I believe this is the title — deputy director of a health policy institute that is based at Simon Fraser University. I will endeavour to get the member the exact title of the institute.
J. MacPhail: What was the process for choosing Dr. Vertesi, who also happens to be the brother-in-law of the Premier?
Hon. C. Hansen: Dr. Vertesi's name was recommended to me by a prominent physician in the province as someone who has an excellent track record around evaluation and modelling in the health care sector and for doing the kind of work that is exactly what the health council is set up to do.
The health council is set up to provide accountability with regard to the incremental health accord dollars that were designated as part of the health accord a year ago February. That name came forward to me. I in turn made the recommendation that Dr. Vertesi be designated as B.C.'s representative on this council.
J. MacPhail: Who was the prominent physician?
Hon. C. Hansen: Dr. John Turner.
J. MacPhail: That's the head of the BCMA? Sorry. I'm not familiar with Dr. Turner, unless it's the Turner that's the head of the BCMA. Is that…?
Hon. C. Hansen: Yes. In putting forward Dr. Vertesi's name, Dr. Turner was very clear that this was a personal recommendation from him and that it was not a recommendation in his capacity as the president of the BCMA.
J. MacPhail: Now, this government has made a big deal about how they go through a rigorous process for appointments. In fact, I think they have a person who is in charge of leadership or something. What's the title of the person who is responsible for making all of the appointments to boards and commissions on behalf of the government?
Hon. C. Hansen: I think the member may be referring to Liz Watson, who is the director of the resourcing office for agencies, boards and commissions.
J. MacPhail: Yes, I am. That's exactly who I'm referring to. She does speeches all around the province — all around the country, as a matter of fact — about how this government is doing such a good job in doing appointments through merit, through fairness and through wide research. The government gets all sorts of kudos. And it turns out that one of the most important appointments to the national health council, the body that's going to be reforming the health care system or monitoring the reform of the health care system…. It turns out that it's the brother-in-law of the Premier who gets the job.
And why? Because another doctor with a vested interest in the system, the president of the BCMA, made a private recommendation and wouldn't even go on record on behalf of his own organization. We now have a doctor who has very controversial opinions, is the brother-in-law of the Premier and is now appointed to the national health council.
I went on the website to see who else is being appointed to the national health council. Of all of the appointees most, except three, are Deputy Ministers of Health. Tell me the range of appointments, then. Give me every single appointment to this national health council that's made by the governments of Canada.
Hon. C. Hansen: If you look at the makeup of the council, there are now 25 members on the council. All of them were appointed by governments through one process or another. As I mentioned, each of the participating jurisdictions, of which there are 12, put forward four names. Then those 12 jurisdictions each cast 13 ballots to choose the initial 13 members of that board. I think virtually every single province wound up being represented through that process. There is a mix of backgrounds including academics. There are nurses. There is a whole range of professions.
In fact, one of the things that we did as a checklist was just to see what the attributes would be of a well-balanced council. We wanted to make sure that there was appropriate regional balance across Canada, that various health professions were covered off. Through that process, that was largely the case. In addition to that, each jurisdiction got to appoint one member directly. The member is correct. There were several jurisdictions that appointed their own deputy minister to the council.
Interjection.
[ Page 9264 ]
Hon. C. Hansen: I'm just trying to see if I have that. I think it is four of the 12 jurisdictions, but I may have to confirm that.
If you look at the background of Dr. Vertesi, I think he brings huge skills to that table in terms of the research work that he has done, in terms of the analytical work that he is expert in. Quite frankly, we went out through a process that Ms. Watson initiated to get recommendations of names from around the province, and we got…. I was going to say several dozen. It may not have been that many, but we did get some good names that were submitted to us through that process.
We looked at who had attributes that would be beneficial to the council, who could add a new dimension of support to the council. Certainly, I think if anybody looks objectively at Dr. Vertesi's background, they will realize that he brings huge expertise to that council, and I am very proud of that particular appointment.
J. MacPhail: Isn't it interesting? I don't know why…. The government always, when caught, gets so embarrassed and tries to hide around this. Dr. Vertesi is a direct appointment from the government, their one position that they have on the national health council. Don't muddle it up with all of this other "balance to the council," etc. I will go on at noon and get the list of what the direct appointments were from all of the governments. Not one single brother or sister-in-law was appointed — you can bet your boots on that — of any other government.
I will tell you that the minister is underestimating the number of deputy ministers who are appointed directly by their governments. Now when I quiz him closely, oh, it turns out that Liz Watson was involved in the appointment of Dr. Vertesi. But the minister didn't say that, and in fact, I would question whether Ms. Watson was involved in the appointment of Dr. Vertesi at all.
When was the overview done? When was the call for applications for the government's appointment to the national health council done through Ms. Watson's office? How many applications were actually received or reviewed? And when was Dr. Vertesi interviewed for this very important appointment?
Hon. C. Hansen: The process was undertaken last fall, where there was a call for nominations that went out from Ms. Watson's office. Ms. Watson does not make appointments. She manages a process of trying to identify good and talented people who can provide service to councils and governance to boards, agencies and commissions. So she certainly did her job.
I don't know the exact number. As I mentioned, I believe it was, if memory serves me right, somewhere between about 12 and 18 names that were reviewed as part of that process. Quite frankly, I'm not going to appoint anybody to an agency, board or commission that I am responsible for simply because of who they're related to. I appoint people because of their talent and their skills, and I'm not going to reject somebody simply because of their particular connections.
I am out looking for talent. I will stack up Dr. Vertesi's résumé against anybody that that member might like to put forward.
J. MacPhail: Let's put that to the test, then. Please give me — Mr. Chair, through you — the call for nomination, the range of applicants received through Ms. Watson's office, when the interviews were done and when Dr. Vertesi was selected. It certainly became public that Dr. Vertesi was selected. It wasn't through a news release. The information about Dr. Vertesi's selection amongst the health authorities was far before they issued a news release. They issued a news release after the fact.
Isn't it interesting? Unless I had probed this, I would have sat down and it would have been a private conversation between Dr. John Turner, the head of BCMA, and the minister — that he chose Dr. Vertesi.
He doesn't even know what Dr. Vertesi does right now or how much he earns from the public taxpayer. The minister doesn't know any of that. I say, Mr. Chair, for sure Dr. Vertesi was chosen in a secret process, not an open and accountable process, and he was chosen because he's the Premier's brother-in-law. That's why he was chosen — another friend, another insider.
All that information, I hope, can be made available this afternoon so that we can go through the review process that Ms. Watson conducted for this great appointment. That's the first time this government has ever admitted to it. They've been quizzed quite carefully on the appointment of Dr. Vertesi, and Ms. Watson's office never came up once, until I explored it.
Noting the hour, Mr. Chair, I move that we rise, report progress and ask leave to sit again.
Motion approved.
The committee rose at 11:56 a.m.
The House resumed; Mr. Speaker in the chair.
Committee of Supply B, having reported progress, was granted leave to sit again.
Committee of Supply A, having reported progress, was granted leave to sit again.
Hon. M. de Jong moved adjournment of the House.
Motion approved.
Mr. Speaker: The House is adjourned until 2 p.m. today.
The House adjourned at 11:58 a.m.
[ Page 9265 ]
PROCEEDINGS IN THE
DOUGLAS FIR ROOM
Committee of Supply
The House in Committee of Supply A; L. Mayencourt in the chair.
The committee met at 10:13 a.m.
ESTIMATES: MINISTRY OF
COMMUNITY, ABORIGINAL
AND WOMEN'S SERVICES
(continued)
On vote 17: ministry operations, $486,921,000 (continued).
[R. Stewart in the chair.]
J. Kwan: To continue debate with the minister about women's services, yesterday we were dealing with women's centres and the list of services they provide. I had put on the record the many things that women's centres do. As a result of the cut in their core funding, these services will now be in jeopardy because the centres may well close. In fact, many of the centres will be closed, as the women's centre coalition advised us and the public.
[1015]
Let me just continue on, then, with that discussion with the minister. There was a report card done by the women's centres on this issue. In fact, it was a report card to evaluate the government of British Columbia's performance on the prevention of violence against women. Has the minister seen this report card?
Hon. I. Chong: Could she advise which report she may be referring to? I think we have a number of reports. If she has something more updated, it may be one of the ones we have, or it may not be. If she could be more clear as to the date of that report.
J. Kwan: This is a report entitled the government of British Columbia, subject: prevention of violence against women. It was the women's studies department who did this work. It was a report card on the evaluation of government's performance in the prevention of violence against women. The coalition is a coalition of groups, actually, that funded this. It's called the coalition's report card, A Report Card on Women and Poverty. The person who actually authored this is named Monica Townson. It looks to me like it comes out of the Status of Women Canada.
The minister asked about the date. It's April 22, 2002.
Hon. I. Chong: The report the member is referring to, I understand, has been received in the ministry. I've not seen the report. That's why I wanted to clarify the date of it. I know we receive many reports through the ministry. I received more updated ones in the last five weeks since I've been appointed as minister. If the member has specific questions to ask regarding that, we'll try to give her a response for those questions.
J. Kwan: Let me just, then, walk through the report with the minister. It looks like this, just so people know, minister.
The report card starts off with details in providing a statement, which is from the UN from 1994, a declaration on the elimination of violence against women. It states: "The term 'violence against women' means any act of gender-based violence that results in, or is likely to result in, physical, sexual or psychological harm or suffering to women, including threats of such acts, coercion or arbitrary deprivation of liberty, whether occurring in public or in private life."
Then it goes on to give information on the left-hand margin, a series of facts about the situation that women are in today with respect to issues around violence. Then, in the main text of the document it provides for the evaluation of government in this area. It sets out the criteria of how the grading would be produced.
[1020]
Let me just put some facts on the table from this report. It advises that British Columbia has the highest reported rate of violence against women in relationships, at 59 percent. It states that half of Canadian women — that's 51 percent — have been victims of at least one act of physical or sexual violence since the age of 16. It states that of all victims of crimes against a person in 1998, females made up the vast majority of victims of sexual assaults — 85 percent; criminal harassment — 78 percent; and kidnapping or abduction — 62 percent.
Of all female victims of violence in crime in 1998, 51 percent were victims of common assault, 11 percent of sexual assault, 10 percent of robbery, 9 percent of assault with a weapon causing bodily harm and 6 percent of criminal harassment.
It goes on to say that women are much more likely to be victimized by someone they know than by a stranger. In 1998, 78 percent of all female victims were victimized by someone they know — 35 percent by a close friend or a business acquaintance, 32 percent by a current or past partner and 11 percent by other family members — while 22 percent were victimized by a stranger.
Then in 1999 it advises that over three-quarters, 77 percent, of reported victims of criminal harassment were women. Nine in ten female victims in '99 were stalked by men. Then for further facts, while one in five women were stalked by men who were casual acquaintances, most women were stalked by men with whom they have been in previous intimate relationships, usually an ex-husband or ex-boyfriend. That's 58 percent. Four percent of women were stalked by current partners.
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Almost 19 percent of adult women in Canada are poor — the highest rate of women's poverty in two decades. About 2.2 million adult women are now counted as low income, compared with 1.8 million who had low incomes in 1980.
Then it advises that when the Royal Commission on the Status of Women issued its report some 30 years ago, 47 percent of women under 65 who were on their own were considered low income. In the three decades since, the poverty rate of this group has scarcely changed. The most recent numbers show that 41 percent of women in this category have low income.
There are many more facts, and I won't go into all of them right now. Let me close with this one, which I believe is the most recent statistics contained in this report. Let me just double-check to make sure that is the case. Yes, it is.
The most recent statistics in this report: in the year 2000, 27,154 sexual offences were reported in Canada, including 24,049 sexual assaults and 3,105 other types of sexual offences, such as sexual touching, invitation to sexual touching, sexual exploitation, incest, sodomy and bestiality. Women made up the vast majority of victims of sexual assault — 86 percent — and of other types of sexual offences, 78 percent. Those are the most recent stats according to this report.
Let me stop there and ask the minister: is she aware of these statistics as highlighted by the report? What are her thoughts on these facts?
[1025]
Hon. I. Chong: First of all, I want to just say that the report has a number of statistics and facts in it, and I would have to expect that much of it is based on information that has been gathered over the course of a number of years. Being that it was April 2002, perhaps much of that data was gathered from 2001 and prior, to be able to compile that report. So while it is, in fact, a few years old, I guess it's important to ensure that we continue to gather information and gather data to see how well we are moving towards prevention of violence.
Violence is indeed an important issue, and the prevention of it is equally important. That is one of the reasons why, within the service plan, one of my responsibilities will be to look cross-ministry, as well, and develop a prevention strategy to ensure that we can move towards reducing the incidents of violence against women and children. In addition, the areas of responsibility that I have will be to work with the federal, provincial and territorial ministers and to speak to them on a number of issues. One of the priority issues I'm aware of is to deal with violence against aboriginal women in particular, because the incidence of violence there is much higher than in the other population.
I want to also advise this member that there has been, in the past, some funding allocated towards some prevention initiatives. Last year, I believe, $600,000 was spent, and in the upcoming year approximately $1.2 million, I think, will be available to spend on one-time initiatives. To be clear, this government is committed to developing a prevention strategy, to moving forward on efforts to reduce violence. Part of that is to raise awareness and to ensure that everyone is aware that we are committed to that.
If the member would like, I can also advise her of a number of initiatives that were funded in the 2003-04 year. We had Prevention of Violence Against Women Week, which had a Legacy of Hope Walk. Prince George Sexual Assault Society was involved, as well as the Ksan House Society. We continue to support the December 6 day, the national day of remembrance. There were also initiatives — a No Means No initiative for post-secondary youth. We partnered with the Vancouver Canadian Federation of Students on that. There was a women and community safety initiative that was in the Cowichan area, with the Cowichan Valley safer community project and the Cowichan Women Against Violence Society, who were involved in that, as well as the Violence is Preventable Initiative. It is a Children Who Witness Abuse school-based pilot project. We partnered with the B.C.–Yukon Society of Transition Houses on that.
[1030]
Those are just some of the initiatives of 2003-04. As I've indicated, we still have dollars allocated to that in the '04-05 year, and we'll continue moving forward on a number of initiatives to prevent violence.
J. Kwan: Yes, the list of programs the minister put on the record are important programs. I'm not disputing that. Other issues at play here, of course, are that given these stats before us — that is, violence against women is still very much prevalent, still very much exists in our community…. No part of the study looks into the situation in my own riding, as an example. We have the missing women in the downtown east side community. In fact, most recently, I read in the paper — although it wasn't in the downtown east side; it was in another community — that a sex trade worker was brutally beaten by a person. The woman was left unconscious. This happened within this week, what I just read in the paper. Violence very much still exists in our community.
As I was in the gym yesterday getting my little quick workout, I saw CBC Newsworld. It was reporting out a recent study that was done which indicated how abused immigrant women, particularly, are trapped. The Times Colonist actually wrote an article about that report in the paper yesterday. It talked about immigrant women, how they feel trapped, how they feel very much alone.
Let me just put part of the article on the record here. This was a study done by the Canadian Council on Social Development. The article advises that it is peppered with discomforting examples why immigrant and visible minority women are uniquely vulnerable when caught in abusive relationships. It goes on to say that in one case, the husband was so certain of his right to control that he beat his wife for not following his rule to the letter. Then he called the police and reported her, thinking she would be incarcerated.
[ Page 9267 ]
Of course, he was surprised when he was hauled off to jail instead.
The study is titled Nowhere to Turn? and was released to coincide with International Women's Day. It describes the barriers in the way of immigrant and visible minority women reaching out for help when they are being financially, emotionally or physically abused. The report was based on focus groups of community workers from 75 settlement and social services organizations in Vancouver, Calgary, Winnipeg, Toronto, Ottawa, Montreal and Halifax.
It cites that the inability to speak French or English was a major hurdle to reporting abuse and getting help but that there were others, such as the woman's fear that her status as an immigrant will be affected if she presses charges against an abusive partner or sponsor. The report says that the first choice of abused women is often to try to change the behaviour of the spouse rather than report him to the police or flee or break up the family.
It goes on to say that the conversations were the same, city after city. In the information contained in the report from the interviewer, it states that because it is a dirty little secret, it's very, very difficult. Therefore, immigrant minority women oftentimes shoulder these abusive situations on their own, because they have nowhere to turn or they feel that there is nowhere to turn. Violence against women is very much prevalent, and I would venture to say that in the immigrant community it's perhaps even more difficult, given the barriers that exist for them.
On that basis, that is the reality we face today. Maybe the minister can advise: how is it helpful for the government to shut down women's centres or stop its core funding for 37 women's centres across the province? Particularly, as identified by the front-line workers, women's centres are often the first place to which women fleeing abuse go, because they are drop-in centres. It is a place where they feel safe, a place where they could go to to seek support, to seek assistance and not just seek advocacy, as the minister would like to say.
[1035]
In reality, the list of services women's centres provide…. I read off the list yesterday. To refresh everybody's memory, here are all the services that women's centres provide: drop-in and referral; crisis counselling; free telephone, fax, photocopier and computer use; support groups; resource library and information; advocacy; public education; clothing exchanges; hot lunches; job re-entry programs; self-help groups; umbrella for other groups to meet and become established; meeting space for women's groups; women's events, including Take Back the Night, IWD and December 6; community coordination; community leadership on issues that affect women; housing registries; newsletters; volunteer opportunities; volunteer training; free legal clinics; workshops; social opportunities; parenting support; community kitchens; safe homes and emergency shelters.
How is it helpful when the government pulls the core funding for women's centres and therefore risks losing all these services in our community for women who are facing violence today?
Hon. I. Chong: The member knows that we had fully canvassed the area of women's centres last evening. I had advised her that the women's centres provide a range of services and that in fact they were provided two years with which to seek and develop alternate sources of funding for that.
I would like to say that I certainly would agree — and, I believe, all members of this House would agree — that violence against women is not acceptable. All of us in this House understand that this is a very important issue for all of us in our communities and that violence against women has very deep emotional and societal costs. Again, all of us would need to work together to help stop the violence against women. That's one of the reasons why this ministry is committed to a prevention strategy, and I will be working with that.
One of the areas I will be looking at is distinct populations, as the member has indicated, to find out what initiatives should be brought forward to deal with that. It's also important that we are in a ministry that includes multiculturalism, which would allow us to work across cultures and to identify those special or unique needs in order for them to develop prevention strategies. I am looking forward to the work that's ahead to assist them in developing those prevention strategies.
J. Kwan: On that basis, given that the minister already recognizes the prevalence of violence against women and the need to address this issue, why would this minister support a government that is cutting funding to women's services?
It's true that some of the services are still maintained — as the minister stated, $32 million worth. But the budget was $52 million — a $20 million cut, $1.7 million of which goes towards women's centres. Even though the minister keeps on saying, "Well, we told them two years ago that we're going to shut them down; they should find alternate funding," the reality is that they haven't been able to find alternate funding.
The B.C. Coalition of Women's Centres has advised the minister that they're not able to find alternate funding. They've advised that finding alternate core funding is extremely difficult in the best of times. Now they're not able to find that funding, and women's centres are closing as a result of this cut.
What are the minister's suggestions for these women's centres, which are providing the services to address violence in our community? Where would the minister say they could go and get funding? Maybe the minister can advise definitively where the women's centres could go to access alternate funding to keep the doors open for women's centres and to make sure that those suggestions the minister is going to provide will actually provide for the core funding the women's centres need. Maybe the minister can advise, and maybe….
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I will actually ask the women's centres if they haven't tried already to go in those directions. If they're not able to get the moneys with these alternate places that the minister is suggesting, then maybe the minister will commit that she will fund it and ensure that women's centres are kept open.
[1040]
Hon. I. Chong: Again, as I had stated to her on a number of occasions last evening, our government is committed to focusing funding on direct essential services to women. Those are the areas of transition houses, second-stage housing, safe homes and counselling programs under our Stopping the Violence programs for women who have experienced abuse and the Children Who Witness Abuse programs.
We have, in fact, increased funding in those areas. From the budget year of 2001-02, transition houses were funded in the amount of $22.4 million. In our current year's budget, '04-05, the funding is at $25.1 million. In addition, our Stopping the Violence program has increased during those same time periods from $5 million to $5.5 million and our Children Who Witness Abuse programs from $2.1 million to $2.3 million.
Again, this government has had to make some tough decisions, but in making those decisions, we made a commitment that we would protect and deliver programs that would be sustainable in the area of direct essential services for women escaping violence. These are those programs, and these programs in fact have been protected and increased.
J. Kwan: By that statement is the minister saying that providing $1.7 million to women's centres is not sustainable for this government and that they don't provide for direct access services for women? Is that what she's saying about women's centres?
Hon. I. Chong: What I am saying, and what I have been saying, is that the funding to women's centres would not be continued as of March 31, 2004. That was a decision made as a result of a core review process we had two years ago, and women's centres were advised of that. They were advised of the programs we would continue to protect, and those are the direct essential services which I have listed.
J. Kwan: Well, maybe the minister can advise, then, why women's centres were singled out for cuts. Is it the case that they don't provide for direct essential services? The minister kept using the notion of sustainability. Is she saying that funding women's centres to the tune of $1.7 million is not sustainable?
Hon. I. Chong: I think the member is aware that a core services review was done across government, across all ministries. As a result, each and every ministry had to look at what was core to that particular ministry and the programs that the ministry would continue to provide funding for. In this particular area, the direct essential services for women escaping violence were identified as core to this ministry, and they would be maintained.
[1045]
J. Kwan: Then by the same token, the minister is saying that the core services review identified programs that were core to the ministry, and therefore they were maintained. By the same token, for those programs that were determined to have their funding eliminated or cut, the flipside of it would be that those services getting a funding cut are deemed to be not core to the ministry or core to the services which the ministry provides. Am I not right in understanding this logic? Women's centres are deemed by this government not to be core essential services for women, and therefore they are being cut.
Hon. I. Chong: As I've indicated to the member, we had to make some tough choices when we assumed the government role, and we in fact made those decisions. We determined that there were three distinct areas that needed protection, needed to be continued, which are those programs. I've already indicated to her what they were. As a result, we have maintained and we have kept them. What we have been able to do in ensuring that they would be maintained and would be sustainable is increase funding for those three distinct programs.
J. Kwan: You know, it would do the minister good if she just answers the question directly. She won't. I think that anybody who follows the debate will understand from the minister's answers that this government…. This minister concurs with this government's decision and is advocating for this government's decision to cut women's centres funding. This government deems that women's centre services are not core to the ministry services. Therefore, in this core services review the women's centres funding has been eliminated.
Let me just try this with the minister himself — whether or not the logic, in my understanding, of how the core review came to decide that women's centre services should be cut…. Am I right, with this logic, that women's centre services were not deemed to be core services of this ministry? Therefore, given that the evaluation to determine what is core is core essential services for women, women's centres funding is being eliminated. They were deemed to not provide for those core essential services. Am I right in understanding the logic? If I am not, please correct me.
Hon. M. Coell: I think that I would try and answer the question by describing this. The focus and goal of the ministry is the prevention of violence. We looked at all the programs, and we looked at the counselling programs and then transition houses and safe houses as being the most important and the most direct services that we could provide. We protected and enhanced funding for those programs.
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[1050]
J. Kwan: The minister says that prevention of violence is then the focus, the first priority, for government. Isn't it the case that women's centres do provide for prevention-of-violence programs as well? They provide for crisis counselling. They provide for public education. They provide for safe houses. They provide for emergency shelters. They provide for, I would say, the prevention of violence, part of which is to help women to become financially independent on their own. They provide for volunteer training, volunteer opportunities, job re-entry programs, self-help groups, connections, support groups, resources, housing — to actually be able to flee the home in terms of access to housing registries.
Aren't these all programs related to prevention of violence as well?
Hon. M. Coell: To try and answer the question for the member, when we purchase services through the ministry, we want to make sure as to the exact type of services we're purchasing. We wanted to make sure during the core process what the essential service was that we should be purchasing.
Then we looked at the transition and the safe houses, the counselling programs to know exactly what we would be purchasing, how those programs would be delivered and the outcomes we would hope to achieve in stopping violence against women. In many instances — and I think the member has asked a good question — we wanted to make sure those important programs were protected and enhanced, and we have enhanced them with increased dollar amounts.
At the same time, we also wanted to acknowledge that there are a variety of other programs in the community that serve women. And they will continue to do that in a variety of ways throughout the province. But our core services that this ministry would fund would remain the transition and the safe houses and the number of counselling projects that during the core review we felt were the most essential for the ministry to fund.
J. Kwan: Actually, it's good information that the minister shared. That is to say, in that evaluation the minister deemed that transition houses, direct counselling programs, etc., provide for direct service and therefore direct results that the minister is hoping to achieve in the area of violence.
Is the problem with women's centres such that, because they provide for so many services and therefore…? Or is it that the minister has not received enough data about what exactly women's centre services are and how they achieved the goal or worked towards the goal of stopping violence in our community? Is that the problem here? Would the advice to women's centres be to actually sharpen that material or bring those kinds of information for the minister's evaluation? Then maybe the picture would have changed. Is that the problem here? Because I'm just trying to assess exactly what the problem is. What process did the government undergo in the core review?
It is only $1.7 million within the scheme of everything. When they brought forward the tax cuts for the highest-income British Columbians, worth almost $2 billion, the government deemed that to be sustainable. But the government has now deemed $1.7 million of core funding for women's centres is not sustainable.
I'm trying to figure…. It must not be the money; it must be something else. So what is that something else? It sounds from the minister's response like they haven't deemed women's centres to have provided enough data or background information or statistics to back up what they do and how their programming actually achieves and works towards the goal of preventing violence in our communities.
[1055]
Hon. M. Coell: An interesting comment.
I think I would answer the question in two ways. One is that we have a definite number of dollars we can spend on any given program. The core review focused our attention on what we thought we could accomplish with a certain amount of money to be able to increase that money for programs. A number of the women's centres do offer some of these other programs that we have deemed to be the most important — the transition houses, the counselling programs. They would be capable of bidding on those as they come up for renewal and as new programs are announced.
Those specific programs — I know the member and the Minister of State for Women's and Seniors' Services have been discussing them over the last few hours. Those programs will still be there and will be enhanced. There will be opportunities for groups to come forward to offer those programs this year and in the coming years. In specifically looking at what we felt as government were the essential and necessary services, you fall back to looking again at transition and safe houses and the counselling services that were there.
J. Kwan: The minister keeps falling back to transition houses and those programs, and yes, those are valuable programs. I'm not disputing that. What I'm disputing, though, is that women's centres complement transition houses, crisis centres and other programs that exist in the province.
In some cases, as identified by Susan Dumontet, who is from the Penticton area, the cutting of 100 percent of women's centres funding would devastate B.C. women's centres, which in some cases may be providing the only services available to women in some of B.C.'s rural and northern communities. Some centres depend entirely on the $47,174 they receive annually from the Ministry of Community, Aboriginal and Women's Services — an amount which, they identified, barely covers such basic expenses as a single staff person, rent and telephone. In light of that, what we do know is that with this cut, these women's centres will shut. Yes, they can bid for other projects, but we're not
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talking about project funding here. We're talking about core funding.
I know this minister was formerly, in his previous life, a social worker. I know he can appreciate the importance of core funding for non-profit organizations. In my former life I was an advocate in the community, and I can definitely appreciate core funding and how that keeps an organization going. You can go from project to project, but without some basic core funding, your organization can hardly survive. That's the reality of it.
There is nowhere that I know of out there that provides core funding. Both ministers talk about seeking alternate funding. I'm not talking about project funding. Can the ministers advise where women's centres can go to get core funding? I would ask for specific answers in terms of direct programs, who to apply to and where one could get core funding for women's centres. I would hope, in the minimum, that the minister would actually acknowledge the importance of core funding for non-profit organizations.
[1100]
Hon. M. Coell: I think it's important to know that in making this decision, when government…. If you go back to the changes that have been made under core review in this ministry and you look at the transition house program, its budget has gone up approximately $2.5 million to this year. The Stopping the Violence counselling has gone up about half a million dollars, and the Children Who Witness Abuse counselling has gone up about $200,000.
That was a decision of government. I think, as the Minister of Women's and Seniors' Services has pointed out, sometimes you make difficult decisions in government. I can assure the member that this is one. The money that may have gone into women's centres is now going into those other programs. Government had a decision to make as to what programs would be funded and what ones wouldn't. I think it's clear to see that there are additional funds in those three programs over the last three budgets.
J. Kwan: Well, no. Actually, the budget for Stopping the Violence and regional programs for 2001-02 was $53,943,000. They weren't broken down into transition houses and so on and so forth. The reality is that the overall budget for this line item, according to the budget book…. This is the March 31, 2002, budget book, because I'm going back to what the funding was — not this year, not last year, but what it was — shortly after the government took over office. In 2000-01, it was $47,556,000. Then it moved to $53,942,000 for '01-02. Then if you look at the budget today, it's gone to somewhere around $32 million. It's a substantive reduction.
It doesn't wash when the minister says: "We've increased transition houses' and Stopping the Violence programs." The reality is that the overall line item, that vote of what the funding was in 2001-02, was at $53 million — almost $54 million. More than $20 million has been eliminated. That is what the budget book says. The argument the minister puts forward doesn't wash. Let me just be clear about that.
Let me just pause for a moment here as well. Let me also put on the record, as I put on the record yesterday, how economic the women's centres' services really are. This individual, Susan Dumontet, has actually gone out of her way to tally for us the expenses per woman helped by women's centres for the province. It is $5.65 per woman. That's how much it costs British Columbians to help women with these services — $1.7 million in assisting 300,569 women. That works out to $5.65. That's how economic these services are. If you consider that in the overall context of every woman and girl in the province, it's 91 cents. It's not even worth a cup of coffee. That's how economic these services are for women.
The stats I put out earlier: one in two women in British Columbia is a victim of sexual assault, one in three is a victim of wife assault, and one in five women faces other physical assaults. These are the kinds of stats we're faced with, and it costs us, when we consider the population base of every woman and every girl in the province, 91 cents — not even a buck.
[1105]
So the argument that it's not sustainable, quite frankly, doesn't wash. The argument that the government deemed it doesn't yield direct results, I would argue, doesn't wash. The argument that the services that women's centres provide are not direct essential services for women doesn't wash. As we identified yesterday, a number of their services are direct essential services which they provide.
In addition to that, in some communities women's centres are the only resource. There is nothing else there in the rural communities. I know that both ministers have travelled to other provinces. Especially in the winter months when conditions are bad, if you're fleeing a violent situation, you can't get on a 24-hour crisis line and phone some other place in some other community for assistance. You need to go somewhere then and there. You need to go somewhere in your community where you can actually get assistance and get the support you need immediately. Without transportation support people can't go to another location. That's the reality of it. It's complex because of weather conditions. They do complicate things.
Let me just set that aside. The reports that evaluated the government's performance on this deal with other issues as well. Aside from the data around the violence women face in our communities, it also deals with impacts on other programs for women. Could the minister of state advise if she is aware of other programs that impact women and that are being eliminated by her government?
Hon. I. Chong: The member knows that our government has made changes to a number of programs. Those changes were necessary to ensure that the programs that were maintained would be sustainable in the future for the people who need them. The changes
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to programs, once done, should be evaluated over the longer term to allow for the benefits and the overall sustainable management to be realized. That will be continuing.
J. Kwan: Yes, the minister identifies that I am aware of the cuts to the programs. My question is not whether or not I know the government has cut programs to support women and their families. The question is: does this minister know that their government has cut programs? If she does know, what programs is she aware of that the government has cut? That's my question.
Hon. I. Chong: As I indicated, our government has made a number of changes. Those changes have been identified in all the service plans that have been published each and every year. I do review the service plans as she, I know, reviews the service plans. I would say that every member of the House is aware of the changes our government has made.
The changes are a part of a long-term plan. People are always suggesting that governments should plan long term. That's what our government is doing. The long-term plan will, in fact, improve the quality of life for women and all people in British Columbia by ensuring that we have programs that are sustainable in the future for people who need them.
[1110]
J. Kwan: The minister claims that she knows. As I've already identified for the House, and as the minister has identified, yes, I do know, and I can name a bunch of the programs. I have been naming a bunch of them. I would ask the minister to name a couple of the programs that she knows are being eliminated — in terms of funding or funding being cut by this government — that impact women directly. Could she name a couple of them even?
Hon. I. Chong: As I've indicated, our government has made changes to a number of programs, and they were to ensure the sustainability of these. I hesitate to get into other ministries, because we are in the Ministry of Community, Aboriginal and Women's Services, but I am aware in some ministries that…. We have better employability programs, I know, in the Ministry of Human Resources to assist people to help them off income assistance — a culture that was created for dependency.
I know, as well, that changes to some of our programs have allowed this government to fund more child care spaces. A number of changes have been made to programs to ensure the sustainability, and these will be evaluated over the long term to ensure that the benefits can be realized.
J. Kwan: I'm almost in shock with what I hear from this minister and the rhetoric that spills out of her mouth. I'm almost in shock. Let me try the real minister. It appears that the Minister of Women's Services is not in any way an advocate for women — in any way at all. It's obvious from these debates. At least I could get some answers from the minister, the real minister. Let me try the real minister.
Is he aware, and I'm sure he is, of cuts in the programs by this government that impact women? Could he name some of these programs?
Hon. M. Coell: Looking at the estimates of this ministry, one that the member may notice is the bridging programs that used to be in this ministry. The budget is reduced in this ministry by about $5 million. That money was transferred to Human Resources, who redeveloped the bridging programs, the PEERS program for women who are leaving abusive relationships. What we wanted to do…. You may see a reduction in this budget and think that the programs were cancelled, but indeed they were actually transferred and enhanced by another ministry.
The idea was to take a program that was sort of isolated in this ministry and integrate it with the employment and training program so that there was a continuum built in Human Resources that women leaving abusive relationships could be integrated back into employment programs and have the support they need. In many instances, I think the member may look at this budget and see a decrease, but what you have to do is balance that off with the increase in another budget and the expansion of those programs.
I think many times when a government changes, as the government did a few years ago, you're going to see a realignment in budgets. There are a number of places in this budget where you see a realignment where programs have been shifted to other ministries. Again, when you look at the transition house budget going up by $2.5 million in this ministry and women's centres going down by $1.7 million, there has been a realignment with what government has seen as its mandate and its desire to see programs enhanced in some areas and eliminated in other areas.
[1115]
J. Kwan: Well, at least this minister was able to name one program for which the government has reduced its funding. Now, he gave an explanation in terms of where the money went. That's encouraging, because it actually shows that the minister knows there are program changes that impact women, unlike the Minister of State for Women's and Seniors' Services who could only give out the government's spin, time after time.
Let me ask the minister this question, then, because I seem to have a better debate in terms of getting information from the minister. He says the bridging program was realigned. It was transferred to another ministry and, in fact, that budget was enhanced. That's one program.
There's another program that I know. It's not necessarily in this ministry, but it impacts women. I don't want to get into details around the cuts but, it's safe to say, just to ask this basic question whether or not cuts
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to all legal aid for family law and poverty law impact women. Is it the minister's opinion that these cuts impact women in a negative way? Does he agree with that?
Hon. M. Coell: I would be unable to answer that, in that I'm not aware of the budget numbers for that ministry. I can tell you that I think we have one of the most generous programs in Canada. As a matter of fact, I think we provide the highest amount of legal aid of any province in Canada, behind…. I shouldn't say…. I think Ontario and Quebec might be higher than us. Maybe what we need to focus on is that we do provide a very high level of legal aid and have, I think, a very high level of expertise in legal aid lawyers in British Columbia.
J. Kwan: Let me share this information with the minister. We used to provide the highest level of legal aid — not any more, not since this government took office and cut all legal aid for family law and poverty law in British Columbia. All administrative law is no longer being funded through legal aid, so nobody can get access to those services.
How does this relate in terms of impacting women? Here's how it relates. Women need access to a fair, safe and equitable legal process in obtaining custody-access agreements, property settlements, separations agreements and other family law matters via the legal aid system. That is one central piece for women, especially women who are fleeing violent situations, women who have children.
I understand, for sure, what that means for people, in that I'm recently a mother. I can't imagine, in a situation, where if I were…. It's not the case, but if I were to face violence in my home and if I had to leave without my daughter, it would kill me. It would kill me, and I would not be able to do it. Someone could beat me to death, and I would not be able to leave my daughter. I can tell you that definitively, even though I have not experienced violence in the home in my life.
I can tell you that the parents and mothers I spoke with feel exactly the same way. If they don't have the support and access to legal support to win custody battles in a violent situation, they have told me they will never leave that violent situation because they cannot leave their children behind. I totally understand that, as a new mom, and I'm sure people in this House — the ministers — can appreciate that sentiment. I am absolutely sure that everyone in this House understands that.
Here we have a situation where access to a fair, safe, equitable legal process is essential for women in leaving violent situations — absolutely essential. Yet the government, in its wisdom, has cut legal aid for family law. There is no provision for that kind of support so that women could get fair, safe, equitable legal process.
I would argue that this impacts women directly. Would the minister not agree?
[1120]
Hon. I. Chong: The legal aid services that are being provided for women do include a number of things. I'll just state them for the record: for victims of domestic violence, where we're dealing with restraining orders; with children at risk and supervised access orders; legal aid services for needing to change custody or access orders to ensure the safety of the particular applicant or the children; as well as services needing a non-removal order to prevent children from being permanently removed from the province. Those services are still being provided. If the member would like more detail, she may be able to ask the Attorney General.
The Minister of Community, Aboriginal and Women's Services has already indicated that British Columbia in fact had one of the most expensive legal aid plans in the country. Even after the changes that have been made in our budget, here in British Columbia we still provide the second-highest legal aid funding amongst the provinces. We are second only to Ontario. I want to put that back on the record.
Legal aid will continue to be provided in a number of areas, which I've mentioned, and in particular, as the member has raised, in cases involving domestic violence and in child protection matters. There will be, as well, legal aid in some family law cases as well as in mental health reviews. Those will continue.
I want to ensure that while the member may wish legal aid to cover and encompass all things, these are the areas that still will be available and will be continued.
J. Kwan: No, it is not true. Legal aid has been substantively cut across the province. It's been cut in the areas of family law. It's been cut in the areas of poverty law. It's been cut in the areas of administrative law.
In fact, not so long ago, I had a constituent who came in who needed legal aid for a custody issue, and they did not get legal aid on a custody issue. Last year when this matter was being debated with the Attorney General, I brought it to the Attorney General's attention during estimates debate, and he said: "Oh, well. That's just the way it is."
So it's not true for this minister to sit and state in this House that all these services are still provided to women. It is not true. They are not being provided to women, and the Attorney General has acknowledged that already.
Please, Mr. Chair, it's a bit much, quite frankly. We know that women are faced with these situations. We know that these cuts impact their lives significantly. What does it take for this government, for any members from this government, to actually acknowledge the impact? I would actually…. Well, not that it would actually make me happy, but at least I would understand that the government knows what they're doing insofar as this: they consciously made the decisions to cut these programs knowing what the impacts are. They did it anyway because that is their ideology. If they stated that on record, I could actually move on and say, "You know what? I don't like the ideology. I
[ Page 9273 ]
don't agree with it. Here are the reasons why," and then we can move on.
But for the ministers to pretend that somehow they cut these programs and there's no impact for women and there's no relationship for women in impacting their lives is completely laughable. It is embarrassing. Does the minister think that I or the public or the people who are advocating for these programs are stupid? Do the ministers think that the people who make these arguments and advocate for these programs think that all of these cuts collectively have no impact whatsoever for women and that we're completely crazy in our advocacy?
[1125]
No, that's not the case. People stand up on these issues, spend time to go to the Finance Committee to submit a submission. People actually do report cards on evaluating how the government is doing, using criteria on services that impact women significantly, particularly around the issue of the prevention of violence against women.
When they put out a report that states that the criteria to qualify for a passing grade include: providing women access to a fair, safe and equitable legal process in obtaining custody access agreements, property settlements, separation agreements and other family law matters via the legal aid system; ensuring access to court houses, victim services, family advocates, especially in rural communities; adequately funding systems such as the ombudsman and Human Rights Commission, which enable women to seek redress on issues of discrimination and human rights, especially in government services; asserting first nations aboriginal legal and social rights as sovereign nations with the recognition of historical injustices….
When they use these items for evaluation to determine whether or not the government has made a passing grade and they come up with a failing grade for the government, do the ministers think that these people are completely out to lunch and that they don't know what they're talking about? It is a study that comes out of, after all, the Status of Women Canada, a report card on women and poverty by a woman named Monica Townson — people who actually study this stuff.
As you look at this report, every little thing they cite is referenced and refers you to some documentation that they obtained the information from. They didn't just dream it up. They didn't just make it up so that they can do this work. It actually is the case.
Why is it so hard for the ministers just to own up to their responsibility and say: "Yeah, we made these cuts because our ideology doesn't support what the advocacy groups are saying"? Why don't they just own up to the truth and admit it to the public? That's all I ask. At least then I could say: "All right. I don't agree with your ideology."
You know, I actually have respect for a fellow that I served with for three years on city council, the former councillor in the city of Vancouver — George Puil. We never agreed on virtually anything. We disagreed on about 100 percent of everything to the point where…. When George Puil was on city council, even when I moved a motion that he would speak in support of — just for the sake of it — he would get up and vote against it just because I moved it.
I totally understand that, because he does not like anything that I represent, and he said it. He said it, even though I made valid points from time to time, in his opinion — he didn't like that. Just for the sake of it he voted against it, and he was upfront. He told me every time where we disagreed, why we disagreed, and he has a different ideology than me, and he went on and said it and put it on record. Then I said: "Okay, George. I don't agree with you, and here's where I stand. You vote your way, and I vote my way." That's just fine by me. From time to time, he would actually make valid points, and I would say: "Hey, I actually do like what he says." I actually supported him and voted in support of his motions.
At least then we can have a decent debate, an honest debate about where we are, as opposed to being so evasive and in this process, I think, devaluing and making a mockery of the advocates out there who are fighting so hard to make advances for women. So I would just ask the ministers just to own up to their points of view and their ideology. I asked the ministers this question.
Let me just finish the report card. The report card gave the government a failing grade on the criteria I have listed. Where they got the criteria from…. The four points on which they assessed whether or not the government passed the grade are from the Declaration on the Elimination of Violence Against Women from the UN declaration. That's how they formed those four points.
[1130]
They're not arbitrary. They didn't come out of thin air. They didn't dream it up. Then they matched it up with what the government is doing across government on programs and services that impact women. In that process they have identified cuts to women's centres, to home care services, to rape crisis counsellors, to family advocates, the public sector cuts, cuts to grants and contracts of non-profit service providers to identify that there is no more gender analysis completed prior to the budget process. There used to be a thing called the "gender lens" that the government used to use for evaluation of government programs. That is no longer the case.
It makes note of the cuts for income assistance, the increases for MSP premiums, the delisting of MSP services, the scrapping of pay equity legislation, no recognition of women's unpaid labour as work, the reduction of minimum wage known as the training wage, cuts to universal child care, cuts to the debtor assistance program, the elimination of the ministry itself and the cuts to legal aid as identified. All of these things they took into consideration, and that's how they came up with their grade — a failing grade for this government.
Okay. Let me turn back to the question around funding. The minister says women's centres can go
[ Page 9274 ]
seek alternate funding. They knew that this funding cut was coming two years ago, and I asked both ministers specifically for an answer — where would they suggest the women's centres go to get core funding? Where and who can they apply to, to get core funding to replace this cut?
Hon. I. Chong: For the information of the member, at the time the women's centres were advised to seek alternate sources of funding, they were also provided with a one-time grant of $3,000. They were given that to assist them in finding out what was available in their communities. They know best where they can partner with community organizations. They know best how to seek funding in the areas for the services they wish to provide. The women's centres were given their notice. They were also provided with some one-time funding, and they were each encouraged to look at all the sources that may be available to them, including partnering with local organizations within their communities to see how they can continue to provide the range of services that they wish to continue to provide.
J. Kwan: It's true. The government gave them a one-time funding of $3,000 and told women's centres to go find alternate funding elsewhere. Interestingly, here's the information from the women's centres themselves as they are listening in on this debate.
Here's what they have said about their efforts in trying to find funding. "Women's centres have made scores of applications to the National Crime Prevention Centre, the Canadian Women's Federation, the National Homeless Initiative, the Law Foundation, the Global Fund for Women" — which is a U.S.–based fund, by the way; they've actually gone outside of Canada to try and find funding to sustain them — "the United Way, etc., etc., etc. But women's centres have many difficulties." Then it goes on to list the difficulties they experience which include that most organizations aren't structured to take them on as a partner, because women's centres have women-only boards and operate as a collective with consensus decision-making. Sometimes that doesn't work with other partners because of that structure.
This is a huge practical problem, especially in smaller communities that have been so hard hit by cuts from this government in finding an organization or organizations that can put up $40,000-plus to house the centre, pay for the overhead and pay the wages. Reality hits. As much as the government will say, "Here. Here's three thousand bucks. Go and find some core funding elsewhere," reality has hit the women's centres. When they try to do that, they're not successful on a number fronts.
It's not like the women's centres haven't tried. It's not as though they just sat back and said: "Well, let's just wait for two years to roll by and have our centres close." It's not like they didn't actually look everywhere, in every corner, under every rock to try and find funding to keep the services going. In my travels when I went to visit the women's centres and the dedicated staff that are there, they are working day and night and volunteering their time doing all of this work, not just to apply the services but to find a way to keep the centres open. They are at wit's end, and they are not able to do it. As recently as February they are now saying…. Actually, as recently as yesterday, I should say, the Coalition of Women's Centres is now saying they don't have the funds and they don't know what to do and how to keep the centres open.
[1135]
That's the reality. The minister can stick her head in the sand all she wants and say: "Go and find funding elsewhere. We gave you $3,000 of transition money to do that two years ago." She can say that all she wants. The reality is…. She will find this out. If she doesn't know already from this debate, she will find this out when she meets with the B.C. Coalition of Women's Centres. They will tell her that is the reality.
Here we have a meeting. The ministers will be meeting with the women's centres' representatives, I believe, on Friday. They are going to be asking the minister, I believe, to reverse the decision on the cuts, which we have canvassed in this House. Both ministers have said no, they won't do that. They won't advocate for the women's centres around the cabinet table. That's just the way it is. So, here we are.
What will the ministers tell the women's centres when they travel down here to Victoria, hoping against all odds that they might receive some good news? What is the minister planning on telling these women?
Hon. I. Chong: The B.C. Coalition of Women's Centres have asked for a meeting, and I have accommodated that by having a meeting. I expect they will be telling me a number of things.
I just want to say that the direct essential services that government is committed to continue funding for — and I've listed them a number of times — are provided in every community where there is a women's centre. There is either a Stopping the Violence counselling service or a transition house or a safe house in every community that also has a women's centre. Women escaping violence will have access to these direct essential services.
J. Kwan: I'm going to come back to that, because representatives have actually identified that some communities would not have these services. I'll come back to that. I didn't make it up. The women's centres' folks themselves, the people on the ground from those communities, are saying that.
I don't mean access to services. Maybe that's the way in which the minister is defining it. You can have access to services by picking up the phone. You can get 24-hour crisis line service. That, to me, is not direct access service for someone who's fleeing violence out in some northern rural community. That, to me, is not adequate support. I certainly would not qualify that as providing direct access service to women in need. I'll come back to that in a minute.
[ Page 9275 ]
The minister actually did not answer the question, though, of what she intends to tell these women's centres. One thing I know they want to ask the minister is to stop the cuts. The minister was not able to offer where the women's centres should go to get this infamous ultimate funding that's out there somewhere. The minister is not able to identify even one place where the women's centres could go to get this ultimate funding. Maybe the minister can advise — what will she tell these women's centres representatives? I know they're going to be asking the minister to stop the cuts.
Hon. I. Chong: As I've indicated, the coalition has requested a meeting. For that reason, I will be meeting with them. I will be accommodating that meeting, and I expect that they will share with me much of the information this member has. I intend to meet with them and listen to them.
J. Kwan: Yes, and what will your response be to them?
Hon. I. Chong: Well, I haven't had the meeting yet. I will have that meeting this week.
J. Kwan: I can tell the minister right off the top, because they have advised me that they're going to ask the minister to stop the cuts. What's the minister's response to that?
Hon. I. Chong: As I've indicated, I'm going to wait till I have my meeting with them on Friday. I will listen to what it is they have to say, and we will have that dialogue on Friday.
[1140]
J. Kwan: I will certainly assist insofar as to ensure that the women's centres…. In fact, I know they have it, because they have been listening in on this debate since we've been having it. So far, what I've been able to canvass from this government and from both ministers is that they would not reverse the cut in spite of what the Premier has said — which is that it is up to the minister himself to decide whether or not he wants to get the funding.
It is up to, I would say, both ministers to make that decision, given that both ministers are involved with women's centres in terms of their funding and responsibility for them. It would be up to both ministers to make that determination, and both ministers, on record yesterday, have already stated that they would not reverse the funding cut even though they have the authority to do so.
Yes, I understand this core review exercise has been done. Previous governments have made decisions around budgets as well. As established yesterday, they have decided to make cuts. Their predecessor might have decided to make a cut on a particular program. A new minister can come in and decide: "Hey, you know what? I'm not proceeding with that. We're going to change that, and we're going to find the money somewhere in the budget to do that." That's been done before. The opportunity is available to both of these ministers to take that action, and yesterday they were on record to say they will not do that.
The persons who will be held accountable will be these two ministers, who have a direct hand in the decision-making efforts of cutting women's centre funds, which are, in my view, more than sustainable when we actually look in the context of only spending 91 cents on a population base that is based on women and girls in the province — in dealing with women who need access to women's centre services. For me, that is very sustainable, very affordable, for any government. I would go on record to say that. And this government has already decided they would not fund them.
Well, let me just say I wish the women's centres luck in their meeting with the minister. Maybe they'll have more persuasive powers than I've been able to garner to date. I've tried my very best. I've tried going hard at it. I've tried using logic and facts. I've tried a sort of reduced, toned-down approach. I've tried even putting out personal stories that I've heard of situations with people. None of this is having an impact. None of it is moving the ministers at all in terms of the plight that women who need women's centres across the province are faced with as a result of this cut in the core funding.
I feel sad, actually. The day after International Women's Day I sit there and think: we want to brag about advances, and it's a sad thing that for British Columbia those advances are continuously being hampered by this government's direct policies and direct decisions.
Let me talk about impact on services. Oh, I'll come back to that. Let me just talk about this other item: impact on services with respect to sexual assault centres. This is information from Kamloops.
"The sexual assault counselling centre and the Kamloops community were quite affected this year by the provincial government's cut to the sexual assault centre's program — a 100 percent cut. As well, all other sexual assault centres in British Columbia had this same elimination of funding, effective March 31, 2003.
"The most significant impact of this sexual assault centre program loss to our community was the elimination of the sexual assault crisis line, which has been in operation for 20 years in Kamloops. This was especially hard on our communities because for the past six years our crisis line was the only crisis line in this city and surrounding region.
"We responded 24 hours a day, 365 days a year, to depressed and suicidal people, those experiencing mental health problems, callers with families or children in crisis, those having flashbacks about past abuse, and recent victims of sexual violence and partner-battering in need of immediate assistance.
"We believe that Kamloops is now perhaps the only community of its size in Canada that has no community crisis line. This is all the more serious a situation for residents of Kamloops who are suicidal or in crisis. None of the current provincial 1-800 B.C. crisis lines will even talk
[ Page 9276 ]
to a suicidal person from Kamloops or a person in crisis because there are no community crisis line services to refer them to."
Let me just stop there. I'd like the minister of state's response on this.
[1145]
Hon. I. Chong: I would like to say that the items the member refers to are under the responsibility of the Solicitor General, the minister responsible for public safety. I do know there are a number of programs in that ministry. There are some community-based victim services programs. There are also some police-based victim services programs. There is also VictimLink, which is the 1-800 crisis line, and also crime victim assistance programs.
These are all, as I stated, under the responsibility of the Minister of Public Safety and Solicitor General. His redesign of these programs is to focus primarily on, in one of these programs, abused women and sexual assault victims. In fact, some of the programs are now serving victims in the multicultural and aboriginal communities, just to give an example. However, if the member is interested in specific programs and how the redesign is working, then she would be better served to ask the Minister of Public Safety and Solicitor General.
J. Kwan: It's a funny thing, Mr. Chair. Here you have the Minister of State for Women's Services. Even though her ministry does not directly deliver this program, you would think that sexual assault centre programs — a pretty direct women's service…. You would think that, to use the minister's own terminology of "direct access for women's services," "direct essential women's services" — those were the terms she used — sexual assault centre programs are pretty essential direct access services for women and that, given her title as the Minister of State for Women's Services, she would have more to say on this than: "Oh, don't ask me. Go ask the So. Gen."
It is completely shocking that this minister would continuously pass the buck in areas that she should have a voice in. That is not so for this new minister in her new role. She has chosen to actually step into a very tight box, put on blinders and not look beyond the boundaries of this very small, tight box that she says the government has created for her. Interestingly, women's centre services don't stay in the neat box and boundaries that this government likes to think they should, because that's not reality.
How time flies when you're having fun. We'll come back to this.
Noting the time, I move that the committee rise, report progress and ask leave to sit again.
Motion approved.
The committee rose at 11:50 a.m.
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