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Category "Politics"

7Dec

Broadbent pushes B.C. government for justice-based accessibility law

by admin


Shane Simpson, Minister of Social Development and Poverty Reduction, at a community consultation session for new accessibility legislation in Vancouver on Nov. 2, 2019.


Gerry Kahrmann / Postmedia News Files

As the B.C. government develops accessibility legislation, a left-wing think-tank is calling on policy-makers to consider how historical injustices and continuing discrimination have led to a society that still excludes the deaf and disabled.

From Sept. 16 to Nov. 29 of this year, the Ministry of Social Development and Poverty Reduction collected public feedback to help develop the new legislation it says will “guide government, persons with disabilities and the broader community to work together to identify, remove and prevent barriers.”

A framework shows how the legislation could work by including standards for service delivery, employment, information, communication and transportation. Minister Shane Simpson said he wants the legislation tabled in the fall of 2020.

The Broadbent Institute commissioned consultant Gabrielle Peters for its submission, which she said is focused on justice and rectifying decades of oppression and discrimination.

“I wrote this because we’re doing it wrong,” said Peters, a Vancouver writer with chronic health issues who uses a wheelchair.

“We have to change how we think about accessibility. We have to change who we think about in terms of accessibility, in order to start doing it right.”

The Broadbent submission first discusses the historical impacts of colonialism, eugenics, institutionalization and sterilization on deaf and disabled Canadians.

It then looks at how those experiences have led to deaf and disabled people being disproportionately represented among the poor, homeless and as victims of violence. They are excluded from education, employment and public and community life, and face barriers in the health care system, the submission says.

“Nearly half of all Human Rights complaints (49 per cent) in Canada are disability related,” Peters wrote. “Discrimination against disabled people is rampant while simultaneously being almost entirely invisible in the public discourse about discrimination.”

Broadbent makes 16 recommendations it says will help repair that damage, the first being the legislation should consider the phrase “nothing about us without us” by including “deaf and disabled British Columbians” in its name.

“Decisions about what was best for disabled people made by the province’s respected leaders resulted in the worst outcomes and a shameful period in this province’s history,” Peters wrote. “This new legislation must spell out whom it is for and what it is intended to begin to rectify and prevent.”

The second recommendation urges government to write legislation that goes beyond making B.C. “barrier-free,” and works to fight oppression. It recommends that government name ableism as the source of systemic oppression of disabled people and the cause of inaccessibility.

The third recommendation calls for the legislation to be intersectional. This would mean recognizing that class, race, religion, ethnicity, sexual orientation, gender identity, and other aspects of a person’s identity and life experience are linked to various other systems of oppression that marginalize disabled people and make parts of B.C. society inaccessible to them.

The full submission can be read at broadbent.ca. Peters said she hopes it shows to readers that accessibility “isn’t a gift” to be handed to deaf and disabled people, but a human right that they’ve been denied.

The submission also features contributions from harm reduction policy specialist Karen Ward and from urban planner Amina Yasin, who write about racism, ableism and the built environment.

Maria Dobrinskaya, B.C. director for Broadbent, said the submission’s justice-based approach could guide other ministries in their approaches to housing policy, municipal bylaws, transit and other issues.

Government may choose not to implement all 16 recommendations, Dobrinskaya said. But she is pleased the submission will reach the desks of Minister Simpson and other policy-makers, adding that “it’s important that it’s on the record.”

“I think it is very broad in its scope,” she said. “I’m hopeful though, that the comprehensive nature of the approach that we took helps to inform more specific focus on policy that the ministry will be looking at.”

The federal government passed Canada’s first national accessibility legislation in May, meant to “identify, remove and prevent” accessibility barriers in areas that fall under federal jurisdiction. Those include built environments, federally run programs and services, banking, telecommunications and transportation that crosses provincial lines.

That legislation, however, doesn’t address barriers within provincial jurisdiction. Manitoba, Ontario, Quebec and Nova Scotia have passed accessibility laws, and Newfoundland and Labrador are developing their own, too.

But B.C. — where more than 926,000 people older than 15 have some form of disability — has lagged behind.

neagland@postmedia.com

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5Dec

Daphne Bramham: ‘Terrible, terrible tragedy’ at Surrey recovery home should have been preventable

by admin

Late last month, a man in his 30s with a long history of addiction doused himself with gasoline and set himself on fire in the garage of a Surrey recovery house.

Two other residents went to hospital and were treated for smoke inhalation as a result of the two-alarm fire.

The B.C. Coroners Service is investigating. So is the Surrey fire department.

Self-immolation is tragedy enough. But what makes it worse is that the man’s death is directly attributable to years of appalling neglect. For two decades, B.C. failed to regulate residential addiction treatment facilities or ensure that they met even the most basic standards.

The man, who has not been officially identified, died in a government-registered treatment home where he was supposed to be monitored, supervised and helped to attain long-term recovery.

What intensifies the tragedy is that his was the third death in a year in a house run by Step by Step Recovery Society. One of the society’s five directors, Debbie Johnson, owns the house at 138A Street that was badly damaged in the fire.

Between November 2018 and March 2019, there were 65 separate breaches of the Assisted Living Registry’s regulations at the five Surrey houses that the society was operating.

Those infractions — the most recent of which were investigated in March — range from inadequate food to unqualified staff to unsafe facilities to failure to ensure residents are not a danger to themselves or others.

At the house on 138A Street where the most recent death occurred, there were 11 substantiated complaints. Only one was dealt with, according to the most recent report posted on the Assisted Living Registry’s website.

The pest control people did get rid of the mice.

But, according to the report, no action had been taken to address verified complaints about safety, about untrained, unqualified staff, and about the lack of any psychosocial supports aimed at helping people attain long-term recovery.

The society voluntarily closed two of its houses earlier this year.

But of the three still on the registry, all have substantiated complaints that haven’t been dealt with. In March, nothing had been done at the houses on 78A Avenue and 97A Avenue that were deemed unsafe for the needs of residents. Verified complaints posted in February about safety and the quality and training of staff remained outstanding.

The question that screams for an answer is: Why wasn’t Step by Step shut down earlier?

The legislation didn’t allow it. The Assisted Living Registry had no power to take immediate action to suspend or attach conditions to a registration.

Instead, all that the registry staff could do was try to work with the operator to get them to conform.

There are dozens of other niggling questions. If this were a well-staffed facility, someone might have realized that the man was struggling before he went to the garage. If it were a well-run, supportive house, it’s unlikely he would have had access to gasoline.

With better rules and oversight, those other two deaths at Step by Step might not have occurred either, and maybe other deaths could have been avoided over the past two decades.

Two decades. That’s how long B.C. went without any regulation of residential treatment centres.

That finally changed on Dec. 1 — 21 years after a previous NDP government brought in regulations only to have them scrapped in 2001 by the B.C. Liberal government that described them as too onerous.

The Liberals did promise new and improved rules in 2016 after a Surrey mom was killed outside a hockey arena by a resident of one of the unregulated facilities. But those rules were never enacted.

In 2017, a coroners’ jury recommended regulations following a 20-year-old man’s overdose death in a Powell River treatment centre. Those regulations were finally released in August 2019 and operators — including Step by Step — were given three months to get ready for the changes.

In the last four days, the registrar has cancelled all five of Step by Step’s registrations. A letter has gone to the operator. And, according to the emailed response from an addictions ministry spokesperson, the operator is “expected to begin an orderly transition of current residents to other registered supportive recovery homes.”

The email also said that Surrey’s bylaw department will work with the operator to place the remaining residents to ensure that no one is left homeless as a result of the closures.

It’s a glimmer of good news. But it all happened four days too late for the unnamed man, for 21-year-old Zachary Plett, whose family will grimly mark the first anniversary of his death at Step by Step last Dec. 15. And it comes nearly 13 months after Step by Step staff took two full days to discover the body of a 35-year-old who overdosed in the house on Christmas Eve.

“Why they had to wait to get these regulations in place is beyond me,” Zachary’s mother Maggie Plett said Thursday. “They should have been done sooner.

“It’s just a terrible, terrible tragedy.”

dbramham@postmedia.com

Twitter: @bramham_daphne


Recovery house regulations timeline:

1998: The NDP government brings in the first regulations under the Community Care Facilities Act.

2001: The B.C. Liberal government scrapped those regulations as part of its deregulation drive, declaring the requirements too onerous.

2014: A Surrey mother is murdered outside a hockey arena by a man living at one of the unregistered houses. At the time, Surrey alone had as many as 250 flophouses purporting to offer supportive housing for recovering addicts.

2016: In the spring’s Throne Speech, B.C. Liberals promise regulations, enforcement and a public registry.

In December, Surrey council voted to require all recovery houses to have business licenses, capping the number at 55 and requiring all of them to be listed on the B.C. government’s Assisted Living Registry.

The amendments to the Community Care and Assisted Living Act were never enacted or enforced.

2018: The B.C. coroners’ review of an overdose death in a Sechelt recovery house recommended that by September 2019 there needed to be better regulations for public and private residential addiction treatment facilities, as well as heightened enforcement.

The government agreed and set up a committee to develop standards to “help ensure quality and consistency and enhance understanding of the services across the province.”

April 2019: The deadline set by the coroner for a progress report came and went, but in a letter from the Ministry of Mental Health and Addictions in May, it promised to have a final report ready for September.

August 2019: Addictions Minister Judy Darcy announces that the 2016 regulations will finally be enacted along with some additional requirements on Dec. 1. To prepare for the changes, the government offered $4,000 in grants to operators licensed by the health authorities or registered by the ALR to offset staff training costs as well as an increase in per-diem rates for residents after more than a decade of having been stuck at $35.90.

3Dec

B.C. wants federal health funding lift before national pharmacare program

by admin


B.C. Premier John Horgan speaks at The Council of Federation provincial and territorial Premiers meeting in Mississauga, Ont.


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VICTORIA — B.C. wants more money from Ottawa for health care before a national pharmacare program is created, says Premier John Horgan.

Horgan echoed other provincial and territorial leaders at this week’s Council of the Federation meeting in Toronto by calling for a 5.2 per cent increase in the annual federal health transfer, instead of the planned three per cent, as a first step before the federal government proceeds with universal prescription drug coverage.

“We were welcoming a discussion about a national pharmacare plan, but those of us who really already have significant plans would prefer that we first and foremost get back to a more equitable distribution of resources to deliver health care broadly,” Horgan said Monday.

An additional $30 million would flow to the province this year, were Ottawa to agree to increase transfers to the amount specified by the premiers.

Other premiers were more hesitant about a national pharmacare proposal, which Prime Minister Justin Trudeau promised in the election. They agreed to lobby for an opt-out clause if Ottawa decides to push the program into reality.

“Don’t start broadening health care when you can’t get it right now,” said Manitoba Premier Brian Pallister. “We need sustained funding.”

Canada’s current drug coverage system is a fragmented and unfair patchwork of more than 100 government-run plans and 100,000 private drug insurance programs, according to a June report by the federally commissioned Advisory Council on the Implementation of National Pharmacare. One in five Canadians have no drug coverage or inadequate coverage, the council found.

A single national system for prescription drugs would mean a copayment of as little as $2 a person for essential medicine and $5 a person for other drugs, as well as exemptions for those on social or disability assistance and a cap of $100 a year on any household payments, according to the council’s recommendations.

B.C. is budgeted to receive $5.4 billion in federal health transfers this fiscal year.

The province spends $23 billion of its $58.3-billion annual budget on health care and pharmacare.

Health Minister Adrian Dix said B.C.’s increases to health spending have outpaced the growth in federal transfers, and addressing that immediate financial pressure on existing services is the priority.

“Our priority is the Canada health transfer,” Dix said Tuesday. “But if (the federal government) comes forward with pharmacare proposals that actually have financial support behind them, then obviously that’d be of interest to every single province.

“What we’re saying is let’s get our fiscal house in order on the Canada health transfer, and then we can have that discussion.”

The federal advisory council, chaired by Dr. Erik Hoskins, recommended Ottawa cover all the additional costs for provinces in creating a national pharmacare program. That includes $3.5 billion by 2022 to launch a national system for essential medicines, and then $15.3 billion by 2027 after the system rolls in more coverage for different drugs.

National pharmacare would save an average Canadian household $350 a year in drug costs, businesses an average of $750 an employee for drug benefits, and employees $100 a year in plan premium payments, read the report.

Whether Ottawa can afford such a program, if it will introduce new taxes to recover the costs, or whether it expects the provinces to pick up part of the tab, are some of the questions expected to be addressed by the Trudeau government in Thursday’s federal throne speech.

It’s routine for premiers to push Ottawa to increase federal health transfers, said Steve Morgan, a professor of health policy at the University of B.C. who has studied national pharmacare for 25 years. But what’s different now is that politicians from the federal Liberals and NDP, which control the balance of power in Ottawa, promised action on national pharmacare in their election platforms.

“You’ve got a majority of a parliamentarians in Ottawa now who were elected as members of parties that had this kind of promise in their platforms, and that would suggest the provinces can expect significant funding,” said Morgan.

“But it will be funding with strings. Provinces just like more money without accountability. And pharmacare is a very significant offer of funding, but there will be very clear accountability. That’s exactly how we got Canadian medicare.”

A national program would also save between $5 billion to $7 billion annually in drug costs because Canada could exercise its bulk purchasing power and get better deals from manufacturers, said Morgan.

Politicians can expect pushback from private insurance companies and global pharmaceutical firms that stand to see profits reduced by a national Canadian program, he said.

“British Columbians should care about this because our system of financing medicine is an uncoordinated patchwork of public and private drug plans that results in many people falling through the gaps,” said Morgan. “It also results in everybody paying higher costs than they need to pay because truly universal systems of prescription drug coverage … those systems have enormous purchasing power on the world market for pharmaceuticals and may dramatically lower prices.”

rshaw@postmedia.com

twitter.com/robshaw_vansun

25Nov

NDP members want free patient parking at B.C. hospitals, but minister demurs

by admin


NDP members have backed a call for government to remove paid parking from hospitals for patients and families, similar to a plan by Jon Buss, pictured outside Surrey Memorial Hospital, and his HospitalPayParking.ca campaign.


PNG

VICTORIA — B.C.’s New Democrat party members are urging their government to make hospital parking free for patients and families, but the minister responsible isn’t ready to commit to any such action.

NDP members at the party’s weekend convention passed a resolution that called on the provincial government to “eliminate parking fees for patients and families visiting hospitals in B.C., while taking an evidence-based approach to ensure spaces are available and the system is not abused by those who are not patients or their family members.”

The resolution, which passed on the convention floor, said that parking fees are “a hardship during some of the most stressful moments in a family’s life” and “give private companies the chance to profit from parking violations incurred by sick or grieving people using a publicly run service.”

The fees — which range by health authority, but at the Vancouver General Hospital parkade are $3 per half-an-hour or $18.75 per day — also create a financial barrier within the health care system, according to the resolution.

Health Minister Adrian Dix said his ministry is still reviewing the hospital parking issue, but noted that some of the revenue goes to hospital foundations, supports health care, and offsets expensive parking enforcement services.

Revenue generated from parking fees at all health authorities is approximately $40 million annually, up from $15 million in 2003.

“It’s actually challenging, especially in some communities, to offer low-cost parking and police low-cost parking,” he said. “So it’s a challenging and complicated issue. But it’s one of the issues that the premier has directed me to look at. And so we’re doing that right now. The resolution at the party convention will inform that process as well.”

John Buss, founder of the HospitalPayParking.ca website that is advocating free parking for patients and those visiting them, said he was pleased with the resolution. Buss said he has been participating in the provincial review process and is “very hopeful” Dix has heard the public outcry.

“The issue is, when do we get Mr. Dix to stop reviewing and start doing,” said Buss. “Our group’s fear is it’s going to be used like the tolls on the bridges and we’ll bring it up at election time. Please promise us we don’t hold this issue as a piece of bait for the next election.”

Opposition critic Norm Letnick said a one-size-fits-all solution to hospital parking won’t work and that he’s sympathetic to the cost pressures facing Dix.

“Right now, he’s using those dollars to provide services,” he said. “Philosophically, I’ll wait and see what his position is, because he’s government. And if we don’t like it, we’ll criticize it.”

Dix was equally noncommittal about a separate review passed by NDP members calling for the introduction of a publicly funded dental care plan in the next election, which would start with children and youth before expanding to adults when funding is available.

“Certainly it’s something that we’re open to, but, again, the health care system has currently a $20-billion budget and we have to act within that budget and set priorities within that budget,” he said.

While a limited number of dental surgeries are covered by public healthcare, most are only covered by private extended health insurance plans.

The first priority is incremental improvements for dental coverage for low-income citizens and those with developmental disabilities, said Dix.

Premier John Horgan publicly declared interest in the idea last year. While Dix would not state an estimated cost on Monday, a dental coverage proposal in Ontario was estimated to cost roughly $1.2 billion annually.

Letnick said the government should first focus on making sure national pharmacare programs promised by federal parties don’t download costs onto provinces before considering expensive programs like dental coverage.

rshaw@postmedia.com

twitter.com/robshaw_vansun

24Nov

Rob Shaw: B.C. preps its priority requests for the new federal cabinet

by admin

VICTORIA — Prime Minister Justin Trudeau’s new cabinet ministers may have barely found their offices after being sworn in Wednesday, but they will soon be getting urgent calls from their B.C. counterparts who have a long list of items they want to see action on from Ottawa.

Among the top issues for B.C. are priority cash for child care, housing, and money laundering.

Premier John Horgan’s promise of $10-a-day child care currently only exists in 53 prototype sites funded using $60 million from a federal early learning child care agreement set to expire on March 31.

B.C.’s minister of state for child care, Katrina Chen, said she is “eager to have that renewed” by Ahmed Hussen, the new families, children and social development minister.

“I’m staying cautiously optimistic we will have that conversation soon and make sure there’s stability for families,” said Chen.

The NDP promised $10-a-day child care in the 2017 election, but the phase-in of the plan will take a decade. In the meantime, Chen said B.C. has been analyzing the prototype sites — where roughly 2,500 lucky parents pay only $200 a month per spot — to see how they have been working. Preliminary results are coming soon, she said.

The federal agreement, which was worth $153 million over three years, also helped pay for expansions to the Aboriginal Head Start early learning and child care programs.

Hussen, Ottawa’s former immigration figure, will be an in-demand minister in B.C. due to another portfolio he holds: the Canada Mortgage and Housing Corporation.

B.C.’s ambitious goal to build 114,000 new units of affordable housing over 10 years will need continued support from agencies like CMHC, as well as more funding from federal Finance Minister Bill Morneau to cost-match B.C. programs, additional land from federal agencies, and extra dollars to help with supportive housing services. That’s not to mention a comprehensive homelessness strategy that B.C. has asked Ottawa to draft.

Attorney-General David Eby’s planned crackdown on money laundering provoked a public pledge of cooperation from Ottawa last year, but apparently none of the promised funding ever actually arrived.

“We’re unfortunately still waiting for the federal government to come through with the promised funding for additional enforcement for the RCMP to be doing policing related to money laundering in our province,” Eby told reporters this week.

Luckily for Eby, the federal point person for money-laundering, Bill Blair, was promoted in Trudeau’s new cabinet to Minster of Public Safety, where he will now be in charge of the RCMP.

“As soon as I get a chance to get Mr. Blair on the phone and congratulate him on his appointment, I will be pressing him for that money as soon as possible,” said Eby.

New federal Health Minister Patty Hajdu is making early sounds of support for a universal pharmacare program, to cover the cost of prescription drugs for Canadians. But B.C. Health Minister Adrian Dix will be one of the first calls to her office to warn that no such plan will work if it means downloading extra costs onto provincial budgets. It is an especially important point when you considering B.C. is currently struggling to keep its books balanced.

Rookie minister Seamus O’Regan is undoubtedly cramming to get himself up to speed on his new Ministry of Natural Resources. One of his top briefing items will be the high-profile request from Horgan to Trudeau that Ottawa increase the flow of refined gasoline in the federally owned Trans Mountain Pipeline to help lower the costs of gas for Lower Mainland drivers.

This took on renewed importance due to a recent report by the B.C. Utilities Commission that again highlighted an unexplained 13 cents per litre cost on B.C. motorists. Bruce Ralston, the B.C. minister handling gas pricing, is expected to push this as a priority item with the federal capital.

Delta’s Carla Qualtrough was moved from the federal public services ministry to the new Ministry of Employment, Workforce Development and Disability Inclusion, where she will be fielding requests from B.C. Social Development Minister Shane Simpson for expanded social service funding.

That includes boosts to federal employment insurance, early retirement and retraining grants for B.C. forestry workers who have lost their jobs, as well as expanded federal aid packages for anyone who is about to be displaced by a contentious agreement between First Nations and the two levels of government to save the endangered woodland caribou population near Prince George.

The larger issue of First Nations reconciliation may see federal minister Carolyn Bennett, who retained her portfolio, taking lessons from B.C. as it becomes the first government in Canada to enact the United Nations Declaration on the Rights of Indigenous Peoples.

B.C. wants Trudeau to make good on an election promise that “the federal government will be there as a partner” on a replacement for the aging George Massey Tunnel (likely a new tunnel).

Coming up with that cash will be the job of new federal Infrastructure Minister Catherine McKenna. While she has the chequebook open, Lower Mainland mayors want to see extra funding to expand the SkyTrain line all the way to Surrey — a key decision that could influence whether the B.C. government matches its own funding to expand the project.

Some working relationships between B.C. and Ottawa were disrupted by the new cabinet shuffle.

The Horgan government had found an ally in federal minister Jonathan Wilkinson of North Vancouver, who moved quickly to save salmon endangered by the Fraser River rockslide late this summer, and put a priority on B.C.’s request to crack down on open-pen salmon fish farms.

Wilkinson’s shuffle to the larger portfolio of Environment and Climate Change means the B.C. NDP-Green alliance has a powerful partner in its ambitious plans to reduce greenhouse gas emissions.

But it also means the federal fisheries file reverts back to an MP from Atlantic Canada (in this case Bernadette Jordan from Nova Scotia), which history has shown means much less help for B.C. on its fisheries problems.

Two other B.C. MPs have cabinet jobs, giving the province four seats at Trudeau’s table. Harjit Sajjan remains in the defence portfolio. Vancouver Quadra MP Joyce Murray was promoted to Minister of Digital Government — a job so nebulous that who knows what that means for the province, if anything.

Horgan has said he has had a good working relationship with the federal Liberal government. But as Trudeau grapples with his reduced minority, and Horgan enters the back half of his mandate, it’s clear B.C. is looking for less talk and more action from the prime minister’s newest cabinet.

rshaw@postmedia.com

twitter.com/robshaw_vansun

20Nov

Ian Mulgrew: Government in denial over medicare crisis

by admin

The B.C. government just doesn’t want to admit how wide and deep the crisis of waiting for diagnostic and surgical services in this province really is.

After three years of legal wrangling, the final summations in the marathon B.C. Supreme Court medicare constitutional trial are making clear the length and seriousness of health care lineups in B.C.

How threadbare is the government’s defence?

It boils down to little more than don’t blame us — it’s those greedy doctors who don’t act appropriately, exaggerate their waiting times and fail to hire good office staff or those patients who don’t follow the best self-help
 advice.

The government even insists the detailed data it has been collecting for more than a decade from every B.C> hospital on every surgery shouldn’t be trusted.

In the landmark challenge over provisions of the Medicare Protection Act that curtail access to private care, the plaintiffs’ lawyers this week are reviewing the mountain of evidence that has been presented.

And it is damning.

Lawyer Selina Gyawali enunciated the harms caused by the lengthy queues for diagnostic and surgical services — potential risks to life 
and long-term heal, pain, disability.

As everyone who has suffered waiting for treatment can attest, it isn’t just a matter of inconvenience or impatience.

“Waiting for medically necessary treatment causes emotional and psychological distress and prolonged physical suffering, creates dependence and 
immobility, and leads to risks of permanent physical degeneration and of death in 
the case of life-threatening conditions,” Gyawali told Justice John Steeves.

Yet in spite of benchmarks and targets for treatment having been set and refined over a generation, the province isn’t meeting them.

Gyawali pointed out Victoria’s own witnesses testified and the data showed that B.C. has failed and continues to fail to provide medically necessary care within its targets. Thousands of patients are routinely waiting beyond the maximum acceptable waiting times for their procedures, across all priority areas, every year, she said. The data for all surgical specialties across all priorities shows that B.C. patients frequently wait many months for a consultation and many months for surgery.

“These failures continue in the face of a 20-year government effort across different federal and provincial governments to address the issue of patients waiting too long for medical care in the 
public health care system,” she added.

Government lawyers, however, throughout have tried to suggest “there really isn’t a universally accepted method of establishing wait-list benchmarks.”

They played down the significance of the waits by referring to them as being “non-emergency” surgeries and cast aspersions on the Surgical Patient Registry that tracks every operation.

The government, which parses waiting time into different phases, does not publicly report but collects the time it takes to see a specialist, called Wait 1, or the time lined up for diagnostic testing (Wait 3), though the wait for each of these can be many months.

The main performance measure is from the patient’s decision to have the operation until surgery (Wait 2), which represents only part of the actual time awaiting treatment.

“Although the defendant’s witnesses could not identify any established problems with the Wait 1 and Wait 3 times, the province repeatedly claimed that it is not reliable,” Gyawali noted.

“It has not, however, done anything to test or correct the anecdotal claims of unreliability. By claiming that the information is unreliable, the government can justify not reporting or using the information. Obviously, these numbers would show even longer wait times.”

From the patient’s perspective, the wait begins with a referral from the general practitioner to a specialist, the time to an appointment with the specialist, the delay while diagnostic procedures are performed and lasts until treatment by the specialist.

Still, the data across all specialties and priorities between 2011 and 2017 show well over 30,000 patients (or more than 40 per cent) were waiting beyond the target on the last day of the last quarter of each year, Gyawali told Steeves.

Between 2011 and 2017, more than 16,000 patients (more than 22 per cent) were waiting each year beyond the longest maximum acceptable wait time of 26 weeks. Even for serious 
procedures like hip replacements and cancer therapies, a 2018 report showed fewer patients were receiving treatment and those who did were waiting longer.

“This counters the B.C. government defensive suggestion that while wait times continue to be unacceptably long, the number of procedures performed is increasing,” Gyawali said.

As he has throughout, government lawyer Jonathan Penner objected to pretty well all of it.

“All right,” Steeves said. “Well, I hope I made it clear 
before that I am not going to do a forensic 
accounting of the hundreds of thousands of 
surgeries in this province, so — and as our 
recent exchange, I’m not sure it matters.”

“The document I’ve actually been 
able to present to you was a document tendered for 
the truth of its contents and it’s a ministry 
document,” Gyawali replied.

“The document agreement was very 
clear,” Penner complained. “The truth of the contents relates to 
facts, not opinion. This is expert opinion.”

This wasn’t anyone’s opinion, it was the government’s own data.

“What is clear from this data is 
that despite all the initiatives undertaken by the federal government, the province, and health 
authorities and the physicians, since the Chaoulli decision in 2005 and in particular over the past 
several years in B.C., there has been no meaningful 
progress in reducing wait times, even for the 
focused procedures such as hip and knee 
replacements and colonoscopies,” Gyawali concluded.

“It is clear that 
the government will never provide the timely 
diagnostic and surgical services that each and 
every patient needs to alleviate their suffering and protect their health.”

The summations continue.

imulgrew@postmedia.com

twitter.com/ianmulgrew

17Nov

Ian Mulgrew: Final arguments, finally, in Big Brother medicare case

by admin

The plaintiffs call it the medical equivalent of Orwell’s Big Lie: that B.C. has the best health care system in the world and it’s egalitarian.

Indeed, the evidence shows operating rooms sit empty while surgeons twiddle their thumbs and waits for surgery and diagnostic services grow to historic lengths and a slew of exempted patients jump the queues.

The case took a decade to get to court and it’s dragged on for three years, but B.C.’s marathon medicare trial lurches back to life Monday after a hiatus, with lawyers making final submissions.

The plaintiffs — private clinics and a handful of patients — claim draconian provisions in the B.C. Medicare Protection Act should be struck down because they prevent people from paying for private health care to avoid waits for publicly funded care that endanger their health, or buying insurance to cover such care.

They argue the B.C. law violates sections 7 and 15 of the Charter of Rights and Freedoms and are not saved by Section 1, which allows “reasonable” limitations on freedoms.

B.C. Supreme Court Justice John Steeves must decide whether they’re right.

There is a library of documents and data entered as evidence but the case rests on a simple argument — though one plaintiff’s lawyer, Peter Gall, takes more than 500 pages to summarize it.

The constitutional challenge does not argue the province caused any harm, but rather that Victoria is preventing individuals from avoiding or alleviating the social, interpersonal and psychological harms of waiting for treatment.

The case was not about dismantling medicare.

Until the mid-1980s, the government funded all surgeries and did not restrict operating times, so effectively there were no lineups.

But ballooning health costs led to the rationing of services and restrictions on surgery that produced long waits that were already a crisis in the 1990s. The court heard some surgeons have so little operating room time they struggle to do enough surgeries to maintain their competence levels.

Dr. Brian Day, the face of the litigation, testified that health authorities and provincial Crown corporations, such as B.C. Hydro, paid for private surgeries for their employees, as have Canada Post and unions including those for nurses, plumbers, postal workers and boiler workers. The Cambie Clinic he helped found in 1996 has also provided private surgeries and services for judges and senators.

The Supreme Court of Canada has wrestled with the issues before, in a Quebec case known as Chaoulli. But t only the prohibition on private insurance, not the ban, as in B.C., on doctors practising in both the private and public sphere.

The majority struck down Quebec’s laws, so private insurance is allowed in Quebec for the three surgeries that had the longest waits. The sky did not fall. Medicare endures in la Belle Province.

For more than 20 years, private diagnostic and surgical services have been available in B.C., performed by specialists who are also enrolled in the public system, and the sky has not fallen either.

Despite being aware that private clinics were thumbing their noses at the law, the government did nothing until recently.

Although Chaoulli directly addressed the insurance issue, three other cases are at the heart of B.C. case — known as Bedford, PHS Community Services and Carter.

They focused on government actions that did not directly cause harm, but prevented people from helping themselves.

In Bedford, Criminal Code provisions against keeping a bawdy-house and living on the avails of prostitution prevented sex workers from taking steps to protect themselves from violent pimps, johns and other predators, such as by hiring security guards or ‘screening’ potential clients.

The situation in Carter was analogous — the impugned law prevented people from ending debilitating suffering through physician-assisted suicide.

Similarly, in PHS Community Services, drug abuse and addiction caused harms but the law prevented individuals from alleviating them.

All three were rooted in the precedent set in the high bench’s decision in Morgentaler, which struck down restrictions on abortions because they violated the security of the person.

In the medicare case, the same principle is at stake, the plaintiffs say — the law prevents people from taking steps to address their own health needs and avoid additional harm caused by waiting for treatment.

They maintain the government has taken a wrong turn — gone from ensuring that everyone has timely access to health care to deliberately erecting barriers to prevent people from obtaining access to care.

Provincial data from March 31 submitted in court confirmed none of the health authorities even came close to meeting the target of testing 85 per cent of patients needing colonoscopies within the maximum acceptable wait time.

Thousands of patients suffer and may have their chances at recovery compromised as a result of the delay for a critical diagnostic procedure — and the number is increasing every year.

The trial heard “non-acute” plastic surgery cases — vital procedures such as breast reconstruction following a mastectomy, facial reconstruction after facial palsy and mastectomies for those with a high likelihood of developing cancer — are often delayed.

There was evidence patients are enduring lengthy and harmful waits beyond the maximum acceptable waiting times for cataract surgery.

Victoria has outsourced many publicly funded cataract surgeries for years to private clinics in order to provide more timely care. Nonetheless, queues persist due to increasing demand.

Despite the focus on hip and knee surgeries, there was evidence B.C. has never come close to meeting the federal benchmark for replacement surgeries or the maximum acceptable waiting times for the more urgent patients.

The evidence showed adult and child patients waited well beyond the maximum acceptable time for a variety of spinal surgeries, with continuing pain and disability and, in some cases, substantial risk of permanent damage.

Waiting times for diagnostic imaging in British Columbia, such as MRI and CT scans, were said to be among the longest in Canada and much longer than in other OECD countries: Only 46 per cent were receiving their MRIs within the maximum acceptable waiting times.

Yet the newly proclaimed amendments to the B.C. Medicare Protection Act remove the option to get private MRI or CT scans.

The indictment went on and on. The system provides a reasonable level of care for many, especially emergency and acute care, but it fails many others.

There is the capacity to perform additional surgeries, but the government won’t or can’t pay for them.

In essence, the court is being asked to stop the government from denying you the right to pay for your own better health or buy private insurance to do the same.

Final submissions are expected to run into next month and Steeves to deliberate into next year.

imulgrew@postmedia.com

twitter.com/ianmulgrew

11Nov

Rob Shaw: Should the NDP government go big if it is pushed into a deficit?

by admin

VICTORIA — Finance Minister Carole James is scrambling behind the scenes to keep B.C.’s budget from slipping into the red.

But some New Democrat supporters must be wondering if it’s even worth the hassle, in light of the recent federal election.

Voters there issued a collective shrug to the idea of years of government deficits, as long as the money would ease the cost pressures they are facing on all sides, from housing affordability to child care and health care.

Parties that had no plans to curtail deficit spending captured more than 55 per cent of the popular vote collectively. And only three per cent of uncommitted voters in an Angus Reid poll before voting day last month said debt and deficits were a top issue.

But back in B.C., James and the New Democrat government are still scrounging for every penny to keep their budget in the black.

The province’s second quarter financial results, to be released later this month, are expected to show James’s razor-thin $179-million surplus forecast under siege by a softening economy, slowing housing market, collapsing forestry sector and the roaring financial dumpster fire that is the Insurance Corp of B.C.

It may still be possible to keep the books balanced this year by blowing out contingency funds and cutting discretionary spending.

But what about next year’s budget, set to be tabled in February?

James is scraping that together right now as well. You can imagine what kind of miserly money management will be required to eke out a small surplus in the current circumstances — not to mention with the looming threat of a $1-billion court challenge to ICBC caps on minor injury claims.

It’s going to be ugly.

NDP supporters hoping to see accelerated $10-a-day child care, more money for unionized workers, and big boosts to core services like education, health care, welfare, disability and shelter rates can kiss those dreams goodbye. 

All of which presents a dilemma for the government.

Does it want to spend the final two years of its mandate talking about prudence, caution, AAA credit ratings and all the other budgetary catchphrases famously uttered by the previous Liberal government as it wrestled away bus passes from the disabled and maternity benefits from low-income mothers in the name of modest surpluses?

Or does it embrace a deficit?

On its surface, that’s dangerous territory for New Democrats who have spent 16 years being painted by the B.C. Liberals as reckless financial managers for deficit budgets in the 1990s.

But again, look to last month’s federal campaign. Polls pointed to voter priorities of affordability, cost of living, climate change and health care — coincidentally, many of the central planks of the B.C. NDP’s 2017 election promises that won over urban voters in Metro Vancouver.


Finance Minister Carole James delivers the last provincial budget in the legislature. She’s struggling to keep it balanced as economic growth cools.

CHAD HIPOLITO /

THE CANADIAN PRESS FILES

Perhaps there is a third option for the B.C. NDP government.

It doesn’t just slide into a small deficit while kicking, screaming and cutting the same services it promised the last election to increase. It uses the deficit as an opportunity to unshackle itself and make strategic investments in affordability programs with tangible benefits for cash-strapped British Columbians.

One option could be to immediately implement the $10-a-day child care plan that was a centrepiece of the last election but is set to be phased in over a decade.

That could cost as much as $1.5 billion. Would thousands of parents care about a $1.5 billion provincial government deficit if they stood to save hundreds of dollars a month in child care fees?

The same could be asked about a radical housing affordability plan. Or a resurrected renter’s rebate, aggressive electric vehicle subsidies, major boosts to transit, or funding for new family doctors.

Besides, the NDP knows that no matter what it does it’s going to be attacked by the Liberals for “killing the economy,” as Liberal leader Andrew Wilkinson recently tweeted.

At least by picking an issue to hang the deficit on, the NDP would be daring the Liberals to campaign against it in the next election — whether that be scrapping the $10 a day child care program, or something else.

If Premier John Horgan is actually considering bold deficit spending, he’s not letting on.

“We have a downturn in the economy that is affecting the global economy, not just B.C.,” Horgan said when asked earlier this month.

“But I have read two banking reports this week that continue to show B.C. leading the country in economic growth.

“We are going to continue to do our best to protect services, first and foremost, and ensure that we can continue to keep our books balanced.”

Economists are split on the idea.

“Even if you get up to a deficit of a couple of billion of dollars, in the context of the B.C. economy, you’re looking at less than two thirds of one per cent of GDP and that’s still a relatively modest deficit that is not something to worry about,” said Alex Hemingway, an economist at the left-leaning Canadian Centre for Policy Alternatives.

In the long-term, government should find additional revenue, said Hemingway. But some immediate deficit spending on key items like housing and child care could actually produce economic returns, he said.

“Those are investments that can actually pay off in a big way in the long term,” said Hemingway. “So I think you can just as easily argue that it’s economic folly not to not to make those investments where those social needs are real.”

Jock Finlayson, executive vice-president at the right-leaning B.C. Business Council, said the NDP’s budgets are already “poised on a knife’s edge” and the real solution is to craft an economic development plan.

“If you have a severe economic downtown, then running a budget deficit is much more defensible,” he said. “We’re not in that position. We have an economy still growing. It’s not growing as fast as it was two or three years ago, but it’s still growing above the Canadian average.

“The second conundrum is that you’re talking about things like forest revenue being down, ICBC financial challenges, these are sort of transitory, they are not permanent necessarily. But to start enriching ongoing social programs and the social safety net, then you are hardwiring permanent cost increases into what government does.”

Difficult choices for an NDP government staring at the back half of its mandate. But choices that may ultimately determine whether voters give the party a second term in control of the provincial purse strings.

rshaw@postmedia.com

twitter.com/robshaw_vansun

15Oct

North Vancouver woman says some disabled Canadians feeling left out of discussion during election campaign

by admin

Amy Amantea tuned in to the English-language federal leaders’ debate with modest hope there would be at least some discussion of issues relevant to disabled Canadians.

The first half of the campaign had passed with barely a reference, even from the party that had delivered a historic achievement in national disability policy. Earlier this year, the Liberals made good on a 2015 campaign promise when the Accessible Canada Act received royal assent, marking the first time any government had enacted accessibility legislation at the federal level.

The government estimates one in five Canadians over the age of 15 is disabled, and Amantea, who is legally blind, hoped leaders would use the Oct. 7 debate to address some of the many issues they face. But those hopes faded as the debate progressed, giving way instead to doubts about how Canada’s disabled residents would fare after the Oct. 21 election.

“We have a lot of very unique needs and circumstances in our community that don’t get addressed,” Amantea said in a telephone interview from Vancouver. “Just a nod, just a mention would have been kind of nice, but it was not to be.”

Amantea said that relative silence has persisted into the final week of the campaign, giving rise to concerns throughout Canada’s disabled community. Many fear that parties who fail to make mention of key issues facing disabled Canadians while courting votes may prove even more dismissive once those votes have been cast.

They point to party platforms and public pledges, most of which make scant mention of either the Accessible Canada Act or disability-specific measures on issues such as infrastructure, health and affordable housing.

The Liberals response to questions on disability policy largely focused on past achievements. Spokesman Joe Pickerill did offer some future plans, including doubling the disability child benefit, establishing a $40-million-per-year national fund meant to help disabled Canadians find work, and simplifying the process veterans use to access disability benefits.

The Green party did not respond to request for comment, and the People’s Party of Canada said its platform contained “no policy related to disabled persons.”

The NDP did not provide comment to The Canadian Press, but made several commitments to strengthen the Accessible Canada Act in a letter sent to an Ontario-based disability advocacy group.

The act, while widely acknowledged as a significant milestone, was also broadly criticized by nearly a hundred grass-roots organizations across the country as too weak to be truly effective. Such critiques continued even after the government agreed to adopt some Senate amendments sought by the disability groups, who hoped future governments would continue to build on the new law.

Only the NDP agreed to do so when approached by the Accessibility for Ontarians with Disabilities Act Alliance, which contacted all major parties in July.

“The Liberals hailed this bill as a historical piece of legislation. But without substantial amendments, it is yet another in a long line of Liberal half-measures,” reads the NDP’s response. “New Democrats are committed to ensuring that C-81 actually lives up to Liberal party rhetoric.”

The Conservatives, too, pledged to “work closely with the disability community to ensure that our laws reflect their lived realities.” Spokesman Simon Jefferies also noted party members pushed to strengthen the act but saw their amendments voted down by the government.

The vagueness of these commitments troubles Gabrielle Peters, a wheelchair-user and writer.

“Canada’s approach to accessibility has been to grant it as a gift they give us rather than a right we deserve,” Peters said. “Now that we have the ACA, the concern is that the broader public and the government think the issue is resolved when this law is, at best, a beginning.”

Other disabled voters expressed concerns about the handful of relevant promises that have been put forward on the campaign trail. In addition to pledging expanded eligibility for the disability tax credit, the Conservatives have said they would implement a $50-million national autism strategy focusing on research and services for children. The NDP and Greens have followed suit with similar proposals and larger pots of cash.

While widely lauded among parent-led advocacy groups, some autistic adults view the proposals with skepticism.

Alex Haagaard, who is autistic and uses a wheelchair, said that while much modern disability policy including the ACA tends to apply a social lens, discussion of autism is still framed through the outmoded medical model that positions the disability as an ailment to be cured rather than a part of a person’s identity.

Haagaard said action is clearly needed to help parents seeking supports for their children and teachers working to integrate autistic students into their classrooms, but said current attitudes at the heart of the campaign rhetoric are troubling.

A national strategy, Haagaard said, also risks undermining the goal of broader inclusion for other disabled populations.

“That is counter to the goals of disability justice to silo autism as this individual condition that warrants this level of attention compared to other disabilities,” Haagaard said.

Like Amantea, Peters felt let down by the leaders debates, citing the prevalence of discussion around medical assistance in dying over other issues that affect disabled people. The subject is polarizing, with many advocacy groups and individuals asserting such legislation devalues the lives of disabled people and places them at greater risk.

Such a narrow focus, Peters said, shows all parties’ failure to reckon with or address the diverse, complex needs of an overlooked demographic.

“What strikes me as missing in policy and in this election is us,” she said. “Disabled people. The not inspirational, not motivational, not middle class, not white, disabled people of this country. In other words — most of us.”

7Oct

Daphne Bramham: Elizabeth May looking ahead to how Greens might influence a minority government

by admin

Elizabeth May is surprisingly cheerful for an environmental crusader worried that the civilization may be on the brink of collapse by the time her 43-year-old daughter reaches May’s own age of 65.

It’s because after being a party of one for eight years in Parliament and only graduating to a party of two earlier this year, the Green party leader says this federal election — her fourth — feels different.

Support is coming in unexpected places, she says forcing her to run something closer to a truly national campaign and visit ridings that weren’t previously on her itinerary.

The polls reflect some of that. May has the highest approval rating of the leaders on the CBC’s Leader Meter.

Her party’s support has nearly doubled in the past year to close to 10 per cent, which would translate into anywhere from one to eight seats with four seats being the consensus prediction.

https://www.youtube.com/watch?v=U5XFIb8P_Do?version=3&rel=1&fs=1&autohide=2&showsearch=0&showinfo=1&iv_load_policy=1&wmode=transparent

But the Greens have been here before. They polled at close to 10 per cent in 2010 long before the prospect of a dystopian future drove tens of thousands of Canadians into the streets last month.

Many of those marchers, like the climate strike’s founder Greta Thunberg, are too young to vote and are too young to be surveyed about voting intentions in Canada’s upcoming federal election.

As a politician, May laughingly told The Vancouver Sun’s editorial board that she should be talking about measuring for new curtains in the prime minister’s resident in anticipation of moving in.

But she’s a pragmatist and what is within reach in 2019 is holding the balance of power — or the balance of responsibility, as she describes it — in a minority government.

Unlike the B.C. Green party, May would make no deals to support either the Conservatives or the Liberals.

She’d use her few seats as a club to force the prime minister to either bend policies — especially on the environment — to something closer to the Greens’ platform or she’d bring down the government.

For many, the Greens’ plan is scary, requiring radical and fundamental changes to retool the Canadian economy, its social programs and even individuals’ expectations and habits.

May admits that.

By 2030, her plan would cut carbon emissions by 60 per cent from the 2005 levels, limiting temperature rise to 1.5 degrees Celsius above global pre-industrial averages. Within a decade, a Green Canada would be fully powered by renewable energy.

Quoting an October 2018 Intergovernmental Panel on Climate Change report, May says it’s all do-able and that the needed technology already exists to avoid going above 1.5 degrees C.

Citing a National Research Council projection, the Greens’ platform says four million jobs would be created in energy efficiency retrofits compared with the 62,000 Canadians working in oil and gas in 2018.

But May admits some will disappear and talks about a “just transition” for workers that would include more education spending, bridging of some workers to early retirement and a guaranteed livable income, which would replace and build on disability payments, social assistance and income supplements.

“It’s a tough choice and I’m not saying that people will never sacrifice,” May said. “But we’re talking about whether our children are able to have anything above a deteriorating human civilization all around them …

“A functioning human civilization is at risk within the lifetime of my daughter to be able to have basic elements of a functioning human society.”

But if the Greens hold the balance of power in a post-Oct. 21 Parliament, it’s not just the environmental agenda that may influence new legislation.

May frequently references the 1960s minority government of Liberal Prime Minister Lester Pearson that with support of the NDP (then named the Co-operative Commonwealth Federation), which resulted in universal health care, the Canada Pension Plan, unemployment insurance and the flag (which, bizarrely, was the most controversial).

So beyond an improved climate plan, what do the Greens want? Proportional representation rather than a first-past-the-post voting system has always been high on its list both federally and provincially. The Liberals promised it in 2015 and reneged. A Liberal minority government might be willing to rethink that.

The Greens’ platform calls for decriminalization of drug possession and access to “a safe, screened supply.” The Conservatives have resolutely said no, while the Liberals have said no for now.

May is actively supporting Wilson-Raybould’s bid to win re-election as an Independent in Vancouver-Granville. Wilson-Raybould was forced out of the Liberal Party after she publicly accused Justin Trudeau and his staff of inappropriately pressuring her to stop the prosecution of engineering giant SNC-Lavalin.

The only reason there is a Green candidate in that riding is because running the party’s constitution requires one in every federal riding.

But would May be willing to bring down the new government — Liberal or Conservative — if it agreed to negotiate a deferred prosecution agreement?

May could play a pivotal role in forging a better response to the climate emergency and even help return Canada to a leadership role if she can muster the kind of patience, diplomacy and intelligence that NDP leader Tommy Douglas exercised in the 1960s.

And if she can’t? Well, we’ll have another election sooner rather than later and by then, at least some of those climate-striking kids will have reached voting age.

dbramham@postmedia.com

Twitter.com/bramham_daphne

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