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Category "Politics"

9Mar

Daphne Bramham: Canada’s other public health crisis also needs urgent attention

by admin

There is a very real and deadly health crisis in B.C. from which two people died yesterday and two more will likely die today, tomorrow and the days after that.

It’s not COVID-19, and no news conference was hastily called to talk about it.

Most of those dead and dying are blue-collar guys in what should be the prime of their lives.

This is the reality as B.C. lurches into the fifth year of an opioid overdose crisis. It’s a seemingly unending emergency that by the end of 2019 had already killed 5,539 people here and more than 13,900 across Canada.

Five years in, this crisis has become normalized, with the only certainty as we face another day is that first responders are now better at resuscitating victims because, year over year, the calls have only continued to increase.

Last week, Prime Minister Justin Trudeau appointed his top ministers to a committee tasked with responding to the COVID-19 crisis. At that point, Canada had only 30 confirmed cases. Of the 21 B.C. cases, four of the patients have fully recovered.

Not to belittle the concerns about COVID-19 becoming a global pandemic, but with nearly 14,000 dead already, no committee — high-level or otherwise — has yet been struck to devise a national addictions strategy that would deal not only with opioids, but also the biggest killer, which is alcohol. A 2019 report by the Canadian Institute for Health Information found that 10 Canadians die every day from substance use, and three-quarters of those deaths are alcohol-related.

During the 2019 election, the issue flared briefly after Conservatives placed ads — mainly through ethnic media — claiming that Trudeau’s Liberals planned to legalize all drugs, including heroin.

Already beleaguered, Trudeau not only denied it, he quickly disavowed the resolution overwhelmingly passed at the party’s 2018 convention that called on the Canadian government to treat addiction as a health issue, expand treatment and harm reduction services, and decriminalize personal-use possession of all drugs, with people diverted away from the criminal courts and into treatment.

Trudeau disavowed it again this week when a Liberal backbencher’s private member’s bill was put on the order paper.


Liberal member of Parliament Nathaniel Erskine-Smith (in front) pictured in 2018.

Adrian Wyld/The Canadian Press

Depending on how you read Bill C-236, it’s either calling for decriminalization or legalization. Regardless, the fact that Nathaniel Erskine-Smith’s bill will be debated at least gets it on the political agenda because unless there are some major changes, Canadians are going to continue dying at these unacceptably high rates that have already caused the national life expectancy to drop.

Erskine-Smith, an Ontario MP from the Beaches-East York riding, favours a Portugal-style plan of which decriminalization plays only a small part.

But parliamentary rules forbid private member’s bills from committing the government to any new spending, so he said his bill could only narrowly focus on decriminalization.

The slim bill says charges could be laid “only if … the individual cannot be adequately dealt with by a warning or referral (to a program agency or service provider) … or by way of alternative measures.”

Erskine-Smith disagreed with the suggestion that it gives too much discretionary power to police — especially since in B.C., it’s prosecutors, not police, who determine whether charges are laid.

Still, what he proposes is quite different from what happens in Portugal.

There, police have no discretionary power. People found with illicit drugs are arrested and taken to the police station where the drugs are weighed, and the person is either charged with possession and sent to court or diverted to the Commission for the Dissuasion of Drug Use to meet with social workers, therapists and addictions specialists who map out a plan.

Since private members’ bills rarely pass, Erskine-Smith doesn’t hold out much hope for his.

It created a firestorm on social media, with some recovery advocates pitted against advocates for harm reduction, including full legalization.

Related

Federal Conservatives also repeated their trope that drug legalization is part of Trudeau’s secret agenda.

Meanwhile, Alberta’s United Conservative government inflamed some harm-reduction advocates with the release of a report on the adverse social and economic impacts of safe consumption sites, even though it didn’t recommend shutting them down.

The report acknowledged that they play an important role in a continuum of care, but it also called for beefed-up enforcement to lessen the chaos that often surrounds them.

The committee questioned some data provided to them that suggested Lethbridge — population 92,730 — may be the world’s most-used injection site.

The committee also questioned why some operators report all adverse events, including non-life-threatening ones as overdoses, leaving the impression that without the sites “thousands of people would have fatally overdosed.”

Among its recommendations are better data collection using standardized definitions as well as better tracking of users to determine whether they are being referred to other services.

More than a year ago, Canadians overwhelmingly told the Angus Reid Institute that they supported mandatory treatment for opioid addiction.

Nearly half said they were willing to consider decriminalization. Nearly half also said that neither Ottawa nor the provinces were doing enough to ease the epidemic.

It seems Canadians are eager for change even if they’re not yet certain what it should look like. The only ones who seem reluctant are the politicians.

dbramham@postmedia.com

twitter.com/bramham_daphne

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4Mar

No-fault ICBC insurance legislation light on details, heavy on cabinet orders

by admin


ICBC headquarters in North Vancouver.


Mark van Manen / PNG files

VICTORIA — Attorney General David Eby has unveiled the legislation necessary to dramatically overhaul auto insurance in B.C., though in many cases it leaves key details to be decided later by government.

Eby tabled Wednesday the enabling bill required to convert the Insurance Corp. of B.C. to a new, no-fault auto insurance system on May 1, 2021. The 47-page bill in dozens of instances points to regulations yet to be developed by cabinet, and which won’t be debated by MLAs in the legislature, leaving unclear large swaths of details in what is the most significant change to ICBC since its inception four decades ago.

Eby said it was a deliberate strategy to give government flexibility to set the proper benefit levels, rates and rules after meeting with health-care representatives in the coming months.

“It was very important to me and to government that this care-based system be directed by people who have experience in the area, whether it’s practitioners, or as people who have experienced a disabling accident and they’ve had to live with it,” Eby said. “And these are the folks who know best about what benefits should look like, and how they should be delivered. There are questions that need to be answered.”

Wednesday’s legislation is “a framework” for how no-fault insurance will work, said Eby.

“There is a lot of content to the bill and there are key parts in there to provide assurances to British Columbians that what we mean what we say,” he said. “When we say $7.5 million (maximum benefits) that’s in the bill. It’s set out in the language of the law so people know that is a serious thing.”

No-fault insurance means people involved in vehicle crashes can no longer sue for damages — except in cases involving court convictions for offences like negligence, street racing, impaired driving or in cases of faulty manufacturing, botched repairs and the over-service of alcohol by a business.

Instead, people will receive benefits, payments for medical treatment and compensation directly from ICBC, using amounts set by the province depending on the type of injury.

Opposition Liberal critic Jas Johal said the no-fault legislation simply creates a bigger, bureaucratic ICBC where injured people have little say in their recovery.

“This legislation does nothing to address the core challenge facing B.C. residents, which remains astronomical ICBC rates,” he said. “The NDP priority seems to be preserving a 46-year-old state run monopoly, rather than finding ways to dramatically reduce rates.”

The switch will upend B.C.’s litigation-based insurance model, in the process saving ICBC an estimated $2.9 billion in legal fees and pain, suffering and injury claims in 2022. That will result in an average 20 per cent reduction to ICBC insurance premiums in 2021, the Crown corp. estimates.

ICBC said the increase in maximum lifetime benefits to accident victims — to $7.5 million from $300,000 currently — will help those seriously injured get access to rehabilitation, care aides and supports for as long in their lives as needed.

Justina Loh, executive director of Disability Alliance B.C., said she supports the move: “We’re glad that there’s going to be more support and that people can access up to $7.5 million in benefits.”

But she acknowledged not everyone is pleased.

“In the disability community it’s a bit divided, meaning some people are feeling a bit more concerned about the changes,” she said, referencing brain-injury advocates as an example. “Some groups are feeling more concerned, and others are just waiting to see what happens.”

Wednesday’s legislation did spell out a legal “duty” for ICBC to advise people of benefits and ensure they receive all their entitled amounts. However, critics say it’s hard to trust ICBC to provide proper benefits when the Crown auto-insurer is facing immense political pressure to stem its financial losses.

“Minister Eby has made clear, and British Columbians have acknowledged, they’ve lost trust in ICBC, but today we’re being asked to put our lives in their hands,” said Aaron Sutherland, vice-president of the Insurance Bureau of Canada, which represents private auto-insurers. “British Columbians should be concerned about that.”

The Trial Lawyers Association of B.C., which is expected to launch a court challenge against the no-fault legislation, said Wednesday it’s still reviewing details of the bill.

rshaw@postmedia.com

twitter.com/robshaw_vansun

2Mar

Rob Shaw: Cuts in B.C. budget overshadowed by pipeline protests

by admin

VICTORIA — The ongoing Coastal GasLink pipeline protests have put Premier John Horgan’s government in crisis mode for the past month.

But there is one silver lining for the Horgan administration: The blockades have completely overshadowed analysis of the new provincial budget.

That’s a good thing for the NDP. Because the more you read Finance Minister Carole James’s latest fiscal plan, the more you realize what an uncomfortable document it is for New Democrats to support.

It’s essentially an austerity budget, full of quiet hacks and slashes to programs and services you would never have imagined facing the sword under an NDP government.

James has cut funding for public transit, civilian-led police investigations, food inspection, environmental protection, parks, conservation officers, forestry enforcement, First Nations initiatives, international trade, small business, mental health policy and research, road safety, tourism, anti-racism and hate speech prevention programs, multiculturalism and sports.

The figures are buried deep within the line estimates of the budget itself, and conveniently never mentioned in the many pages of semi-factual government communications material.

“Budgets are about choices,” James told reporters at the Feb. 18 budget lockup.

“It’s about taking a look at the resources we have, and the priorities that we have as a government. I think if you had taken a look at the past governments what often would happen at this time, when you saw moderation in the economy, is that you would see programs and services cut. You would see programs eliminated. You would see services and supports for families eliminated. We’re not doing that.”


Finance Minister Carole James will have one more budget to release before British Columbians go to the polls again in 2021.

Don Craig | Government Communica /

PNG

James is on year two of mandatory cuts across all ministries, to achieve $300 million in annual “discretionary” spending.

What’s been trimmed so far? James and her ministry won’t produce a list, insisting it’s hard to track because the money goes back into services (despite the fact each ministry is required to submit to her a clearly itemized list of potential cuts and consequences).

Still, you can spot the cracks in the facade.

B.C. Transit has warned about a stall to ridership growth after government shrunk its operating grant. James told transit to draw from its operating surplus to make up for the changes. By next year, what was once a $42-million financial cushion against any unexpected changes to bus service levels will be gone, as B.C. Transit empties its piggy bank to help the NDP balance its budget.

What are the other implications of the budget?

Safety inspections for meat, seafood and agri-food products cut by almost 12 per cent.

RoadSafetyBC, which runs traffic safety programs and monitors unfit drives, cut three per cent cut.

The civilian-led Independent Investigations Office that oversees death and serious injury cases against police cut three per cent.

Environmental protection, air and water quality monitoring, managing pesticides and responding to high-risk environmental emergencies cut three per cent.

BC Parks maintenance cut two per cent, and conservation officers patrolling those parts cut two per cent.

Forestry enforcement cut six per cent.

International trade cut seven per cent (but, presumably, not overseas trade junkets by cabinet ministers).

Small business, immigration and refugee worker programs cut 2.4 per cent.

Tourism, arts and culture cut 1.5 per cent.

Anti-racism and hate speech prevention programs, along with creative economy funding, multiculturalism and sport cut two per cent.

Some of the reductions are particularly jarring, given James’s own budget speech.

“We know that delivering on these priorities means strong climate action, meaningful reconciliation with Indigenous peoples and a commitment to equity, diversity and inclusion,” she said.

What then to make of a 13 per cent cut to B.C.’s “climate action” program that “provides support for the activities required to meet the province’s climate action target”? Those targets are supposed to be met by the government’s new CleanBC plan, which is a centrepiece of the NDP-Green power-sharing deal. If that worried the Greens, and independent MLA Andrew Weaver, they didn’t show it — all three voted in favour of the budget Thursday.

Then there is the ongoing reconciliation crisis with First Nations, sparked by the pipeline protests. For some reason, the government chose this year to cut the Ministry of Indigenous Relations and Reconciliation by almost 10 per cent.

Horgan admitted to reporters Thursday his government has more to do to improve mental health and addictions. But his government shaved almost five per cent off the division in charge of researching and growing new mental health and addictions services.

It’s true the budget does offer small inflationary increases to cover caseloads in social services, disability, child welfare, education, and elsewhere. Health care, as usual, got the biggest lift. And there’s just enough cash for affordable housing and $10-a-day child care plans to keep them on their 10-year-long implementation schedules.

The money wasn’t enough to avoid criticism from community groups that the province continues to underfund victims of crime and sexual assault survivors. Long-time NDP supporters who wanted to see an increase to social assistance, disability and shelter rates were also left disappointed.

Overall, it was the kind of budget that could have been written by the previous B.C. Liberal government during its heyday of prudence, caution and austerity.

James did have a choice.

With the economy softening, and international uncertainty rising, she could have dipped the budget into deficit to continue funding the NDP’s ambitious election promises and social programs.

Despite encouragement from some left-leaning economists, James chose not to go that route.

The result is a budget full of cuts that would be toxic for the NDP to take to voters in an election campaign. Perhaps the biggest take-away from the whole exercise is that Horgan must be extremely confident he’s not going to the polls this year.

Luckily for James, she’s got one more budget before the next election.

Expect that one to miraculously open the floodgates of spending in all areas, washing away the bitter taste of this year’s cuts and clawbacks to government services. Then, the NDP will put this Liberal-lite austerity budget on the shelf, and never, ever, speak of it again.

rshaw@postmedia.com

twitter.com/robshaw_vansun

28Feb

Ian Mulgrew: Marathon medicare trial finally ends

by admin

The interminable constitutional trial over the provision of private health care in B.C. — dubbed The Flying Dutchman of the B.C. Supreme Court by lawyers — finally made it back to harbour Friday.

In many ways, what should have been an intellectual cruise involving a few months of written argument and data from the medical system became a veritable Royal Commission that has generated a library of evidence. It involved 194 days of proceedings over 3 1/2 years that mocked timely justice and badly bruised the belief that the courts can act as an effective brake on bad government by providing a remedy to unconstitutional law-making.

The length of time and cost of the case are an argument that the courts are no longer capable of efficiently resolving such thorny questions of social policy.

As intervener lawyer Joseph Arvay said: “This case would appear to be, at least in my experience, the most complex Charter case I’ve ever seen. And one that truly does test the institutional competence of the court.”

At a time when more and more Canadians think the country isn’t working, the dysfunctional legal system must be considered a primary reason. Indigenous people have run into the same problem trying to hold governments to account through litigation — they too have found themselves bogged down in endless process that pours millions-of-dollars into lawyers’ pockets.

The duration brought its own risks and demands on memory — the constitutional challenge of two provisions of the Medicare Protection Act was nearly derailed late last year when B.C. Supreme Court Justice John Steeves required health care. This week Steeves couldn’t remember what prevented the government from enforcing the law.

“There is in place a consent order allowing private surgical services to continue,” Dr. Brian Day’s lawyer, Robert Grant, explained — issued by Justice Janet Winteringham following an injunction she granted in November 2018 after Victoria amended the law and planned enforcement, though its validity was in question.

“Did I sign 
that (order)?” the justice asked.

“No, it carries on from Justice 
Winteringham,” Grant replied.

“So, it has to do with the amendments, as I say, that occurred during my trial,” Steeves said.

“Exactly,” Grant said. “And what it did is effectively to 
confirm they won’t be employed until your lordship 
ruled, so that allowed the status quo to continue.”

“Maybe (government lawyer Jonathan) Penner can give the minister my 
compliments for making my job easier,” the justice quipped.

Two private clinics and a handful of patients launched the litigation roughly a decade ago because the constraints on dual practice by doctors and private health insurance would force private clinics and diagnostic centres across the province to close. No evidence or data was offered by either government to support the assertion that the private clinics cause harm to the public system and B.C. has not measured the impact or effect of the clinics that have existed for a generation.

“They would have welcomed an opportunity for an impartial objective empirical study,” Grant said. “It might have made this litigation unnecessary as it would have confirmed that private surgeries did not have any adverse effects on public surgeries.”

The Vancouver lawyer accused the government of grossly mischaracterizing and misrepresenting evidence in closing statements he said were little more than fearmongering. He pointed out B.C. has had de facto private health care for 20 years and the sky hasn’t fallen.

To end that status quo, he added, would make the public health system even more overcrowded as the 65,000 private surgeries done annually join already historically long waiting lists.

“Nobody gets 
ahead in the public queue by having private 
surgery,” Grant explained. “What happens is you leave the queue. 
You’re not jumping the queue, you’re leaving the 
queue.”

Instead of relevant data, the federal and provincial governments resorted to fervid rhetoric about the prospect of U.S.-style health care and the poor languishing in dirty beds at the mercy of greedy, unscrupulous physicians. At one point they accused a respected neurosurgeon of having “scaled back public work because he wanted more time to smell the roses and read a book.”

“This is an egregious mischaracterization of the evidence,” Grant told Steeves. “In fact (the doctor) suffered a family tragedy. His wife developed terminal cancer — and he needed to scale back his public on-call commitments as he couldn’t be operating all night due to his family’s needs … With his wife’s illness and passing, he could not do this with four children.”

Grant swept the broader accusations aside too:

“If there was one shred of 
evidence that doctors practising 
in the private system, just one piece, one example 
of a doctor performing private pay surgery, 
shirking a commitment to the public system or 
causing any problem at all for the public system, 
we can be certain they would have called that 
evidence, but they didn’t.”

He urged Steeves to draw an adverse inference from the government’s failure to call a single doctor or senior administrator to give evidence about problems the public system had experienced as a result of private surgeries.

“The evidence in this trial shows thousands of British Columbians wait too long past government-mandated medically maximum acceptable waits for their condition, risking progression of disease and in some cases shortened lifespan or death,” Grant concluded. “In evidence in this trial, is the fact that in one year, in just one health region in B.C., Fraser Health, 308 patients died waiting for medically necessary surgery. B.C. patients need a ‘safety valve’.”

Before the courtroom emptied, Steeves said: “I’m looking forward to completing my judgment and setting my name on it, and, once I’ve done that, I’ll join the rest of the world watching the progress of this case with great interest.”

He is expected to take several months, perhaps longer, on his ruling. Appeals are expected to follow, which means a final decision could be two, three or more years away.

Outside of court, Day, the face of the litigation, said he was relieved that the trial was over.

“Suffering patients — the more than 30,000 a year who wait past the government’s own maximum acceptable wait times, and the 18-a-week who die on public wait lists in B.C. — need the justice system to rescue themselves from their plight,” he said. “It’s astonishing that we are the only country on earth that outlaws private health insurance.”

imulgrew@postmedia.com

twitter.com/ianmulgrew

25Feb

Daphne Bramham: It’s not enough to just keep overdose victims alive

by admin

There was some good news in the 2019 data from the B.C. Coroners Service. Overdose deaths in the province declined for the first time since fentanyl-tainted drugs hit the streets and a public health emergency was declared in 2016.

The decrease was significant — down 36 per cent from 2018 — even though the death toll remains heartbreakingly high. As B.C. enters its fifth year of the crisis, nearly three British Columbians are dying every day.

It does mean that all of the money poured into this crisis — for naloxone kits, the training for paramedics, medical professionals and laypeople in how to use naloxone, more supervised consumption sites, and more people now on prescriptions for drugs like methadone and Suboxone to staunch addicts’ opioid cravings — is keeping more people alive.

But that’s really where the good news ends.

Alarmingly, the number of 911 calls has continued to climb.

Paramedics and other first responders took more than 24,000 calls last year, with calls spiking to more than 130 overdose alerts on “cheque days” or “welfare Wednesdays.”

Being revived from an overdose or living with an opioid addiction comes at a high cost.

Opioids affect the receptors in the brain, causing breathing to become dangerously slow, which in turn slows the heart and sometimes causing cardiac arrest. When the hearts doesn’t pump at capacity, less oxygenated blood makes it to the brain. Without oxygen, brain cells die — and they don’t regenerate.

It’s called toxic brain injury.

Within the coming weeks or months, the B.C. Centre for Disease Control will release data on the prevalence of brain injury among opioid users, including those who have been successfully restored to life with naloxone.

“We know that many hundreds of people will need a lifetime of care,” said Dr. Perry Kendall, who raised the alarm during the coroner’s news conference earlier this week. “It will be a tremendous burden.”

It’s far from the only one.

The burden carried by first responders is different and no less costly. They are burning out and checking out of the system, unable to cope physically, mentally or emotionally with the constant stress of being called to deal with all the overdoses.

Related

This is not to say that harm-reduction measures aren’t working. No one disputes that they are keeping many people alive.

But until now, little attention has been focused on the quality of their lives, post-overdose.

Five years into the public health emergency, Chief Coroner Lisa Lapointe said B.C. still doesn’t have a comprehensive system that includes prevention, treatment and recovery.

The lack of a seamless system is particularly problematic and even deadly for people in rural areas and those coming out of jails and prisons, according to Dr. Nel Wieman, senior medical officer at the First Nations Health Authority.

The numbers back that up. The death rate in the Northern Health Authority, at 22.5 per 100,000, trails Vancouver Coastal, which has the highest rate, by a mere half a percentage point.

Regardless of where they live, Lapointe said families frequently tell coroners how their loved ones managed through detox only to come out and die while on the waiting list for a recovery bed.

The problem isn’t necessarily that there aren’t enough treatment beds. On most days, some lie empty because the government only funds treatment for welfare recipients. Everyone else has to pay their own way. And except for those with generous employee benefits, many can’t afford treatment that comes at a cost of $900-plus a day.

Lapointe also decried the lack of provincial treatment standards. Different operators have different approaches. Some aren’t evidence-based. Some are strictly abstinence-based and refuse to accept people on drug therapies such as methadone and Suboxone, even though without that, they are more vulnerable to overdose if they relapse.

Decriminalization is touted by some as the answer. Without fear of criminal charges, the theory is that people would be more willing to seek help.

They point to Portugal, where decriminalization was brought in as part of a massive overhaul of its drug treatment system.

But decriminalization has only worked there because Portugal also boosted spending on the other three pillars — prevention, enforcement and treatment.

Here, the crucial elements are missing. With a minority government in Ottawa, the Liberals already have enough problems on their plate to risk raising the controversial idea of decriminalization.

Meanwhile, most provinces, including B.C., haven’t invested enough in the infrastructure to put a Portugal-style model in place.

This week, Mental Health and Addictions Minister Judy Darcy agreed that there are enormous gaps in B.C.’s fragmented system.

When the New Democrats were elected less than three years ago, she said the drug treatment system had been neglected for so long that it was not able to cope with regular tasks, let alone a public health emergency.

The government is taking steps to fix that. But whether it’s moving fast enough is a conversation that both the coroner and chief medical health officer are pushing British Columbians to have because the lives of many loved ones depend on it.

dbramham@postmedia.com

Twitter: @bramham_daphne

18Feb

B.C. Budget 2020: B.C. finance presents stay-the-course budget

by admin

VICTORIA – B.C.’s finance minister has unveiled a hold-the-course budget, with modest new money for electric vehicle rebates and post-secondary grants, funded by new taxes on high-income earners and sugary drinks.

People with taxable income of more than $220,000 will see a tax hike from 16.8 per cent to 20.5 per cent, in a move the government estimates will generate $216 million in new revenue next year, and $713 million over three years.

“We’re asking those at the top, who benefit the most from our economy, to contribute a little bit more,” said Finance Minister Carole James.

“Nearly half the revenue of this tax increase will come in from individuals with income above $1 million, and even with this tax rate B.C.’s personal income taxes remain very competitive.”

While the new income tax affects a relatively small number of people, a second new tax on sugary drinks will impact far more consumers.

The government will end a Provincial Sales Tax exemption on sugary drinks, like pop, starting July 1, said James. Adding the seven per cent PST to such beverages will generate more than $30 million annually.

“This is a health initiative to look at how we grow healthy young people,” said James.

“I think it’s interesting if you take a look at the largest consumption of pop, sweetened drinks, it is 14-18 year olds. We want to make sure we’re doing our part to set them on the stage of having a healthy life ahead.”

The revenue from the new taxes will help fund a new $24-million grant program to offer up to $4,000 a year for low-income college and university students in September. That grant program will be overhauled to include students taking diploma and certificate courses in trades, education and health-care programs, which were previously ineligible.

“Access to education creates opportunities that span generations,” said James. “It has the power to change a family forever.”

It will also help pay for another extension to existing electric vehicle rebates of up to $3,000, at a cost of $28 million next year.

Overall, the 2020/21 budget, which starts April 1, estimates a $227 million surplus on $60 billion in spending.

Spending is rising faster than revenue, at a 3.1 per cent expenditure increase compared to last year, on 2.6 per cent in new revenue.

The budget, which comes with $900 million in contingency and forecast allowances, is a far cry from the large-scale spending plans delivered by the NDP government since it formed power in 2017.

James continued to warn Tuesday of a softening economy, international economic risks and the need for prudence in spending. The province’s economic growth remains estimated at 1.8 per cent Gross Domestic Product (GDP).

“If you took a look at past governments, what would often happen at this time during a moderating economy is you’d see programs and services cut,” said James. “We’re not doing that.”

Business groups gave lukewarm reviews to the budget.

B.C. Business Council president Greg D’Avignon said he was “disappointed” in the budget.

“The budget is virtually silent on the agenda let alone the implementation of a sustainable economic plan,” he said.

Greater Vancouver Board of Trade gave the budget a “B-“ grade.

She said roughly $300 million in internal government cuts to discretionary spending have proven successful. However, government officials could not provide a breakdown of costs saved by ministry and James said no such list exists because the money is reinvested into programs and services.

While some revenue sources are up in the budget, such as the carbon tax and property transfer tax, other revenues are lagging, including personal and corporate income tax.

B.C.’s share of cannabis taxes from Ottawa sat at $6 million in 2019/20 due to the slow rollout of stores and what critics have said are more attractive prices and products in the black market. However, the budget projects a spike in cannabis revenue to $50 million next year, and $70 million annually after that.

James said $18 million is also being set aside on public health and enforcement for cannabis.

The budget largely holds the line for housing affordability and child care, two key election promises from the NDP government in the 2017 election.

Child care funding in particular is largely frozen for the next three years, and it was unclear Tuesday from budget documents how that impacts the 10-year plan to bring in $10-a-day child care.

The federal government recently renewed its child-care funding payments, which allow B.C. to continue to operate several $10-a-day pilot sites across the province.

Sharon Gregson, from the Coalition of Child Care Advocates, said government honoured its funding commitment for next year, but is concerned it is $200 million short for future years. She said she’s confident the government will revise the funding next year to help keep the $10-a-day plan on track.

On housing, James said government will continue it’s $7-billion 10-year plan to build more housing. Although home sales dropped 1.5 per cent last year, and average home prices fell 1.6 per cent, James said the housing market is nowhere near affordable and prices need to drop further.

“I don’t think there’s anyone who would say we’ve reached affordable housing in British Columbia,” she said.

The NDP government’s speculation tax continues to bring in roughly $185 million annually.

Tuesday’s budget also re-announced the Child Opportunity Benefit payment first made public in last year’s budget. The program, which starts this fall, will pay up to $1,600 per child based on a family’s income up to $114,000 annually.

The largest funding increase in the budget was 9.5 per cent to health authorities and hospitals. Total health care spending now accounts for $24.3 billion, or 40 per cent of the entire provincial budget.

The funding was mostly welcome by health groups, but both the B.C. Nurses Union and the Care Providers Association of B.C. said the missing ingredient was an expansion of the new post-secondary grant program to nursing and seniors care workers.

The second-largest increase was a 7.4 per cent jump to post-secondary education, expanding training spaces for in-demand jobs.

Education for K-12 schools received only a 2.2 per cent lift on almost $6.7 billion in spending, with no additional money set aside for a new contract with teachers above the previously-stated two per cent mandate held by James.

More than half the government ministries – 13 of 20 – will see their budgets frozen or reduced next year.

The government has set aside $11 million to fund a public inquiry into money-laundering over the next two years.

The province will also raise monthly earning exemptions for people on disability by $100, at a cost of $20 million over three years.

Other programs received funding just enough to cover caseload pressures, such as $131 million over three years for income assistance, disability and other social supports and $121 million for Community Living B.C.

The budget forecasts other small increases for children and youth, indigenous youth, community safety, wildfire management and legal aid.

Social groups said it was not nearly enough money, and government has failed to address the systemic challenges and wait lists for services such as sexual assault support, youth homelessness and legal aid.

“This budget is overly cautious,” said Iglika Ivanova, senior economist at the Canadian Centre for Policy Alternatives.

Government should be stepping up with increases to welfare rates and a coordinated plan for youth homelessness, she said.

Independent children’s representative Jennifer Charlesworth echoed the criticism, saying she’s concerned the government has yet to address major caps in youth who age out of government care but can’t get into post-secondary education.

The forestry sector continues to decline as it faces a softwood lumber dispute with the United States, slumping lumber prices, an eight-month coastal strike with Western Forest Products and a shortage of timber in the interior.

Forestry revenue is estimated to drop 12.5 per cent next year and the projected harvest of Crown timber lands is 20 per cent below last year’s expectations over the next four years.

James announced a new $13-million fund, spread over three years, to retrain forest workers, and revitalize the industry, on top of $69 million in aid previously-announced for the interior sector and $5 million in aid to contractors on the coast.

Forestry workers rallied on the lawn of the legislature Tuesday in protest at government inaction on the sector.

Wilderness Committee of B.C. spokeman Torrance Coste said the budget appears to make cutbacks to the forestry ministry that will make it harder to have the expertise and staff required to complete a review of old growth forests that his group hopes will boost protection for forests.

Capital spending was set to rise, at almost $1 billion next year and $3.1 billion over three years, for added hospitals, schools and health care facilities.

Total taxpayer-supported debt will jump $4.6 billion to $49.2 billion. Taxpayer supported debt-to-GDP will jump from 14.6 per cent to 15.5 per cent. Interest on the debt will eat up 3.9 cents of every dollar of revenue.

“We have an election in a year and a half now and I think we’re in good shape fiscally,” said James.

The budget also provided a third-quarter update to the current 2019/20 fiscal year, which ends March 31. The projected budget surplus has risen to $203 million, from $148 million last quarter.

James said that modest increase is mainly due to an increase in income tax revenue and lower spending on refundable tax credits for the film and TV sector.

rshaw@postmedia.com

twitter.com/robshaw_vansun

12Feb

Daphne Bramham: Lack of addictions treatment for youth needs urgent fix

by admin

As B.C. heads into the fifth year of a public health emergency due to the high number of opioid overdose deaths, Vancouver Island still doesn’t have a single residential-treatment for youth. Provincewide, the number of youth beds and services lag demand.

For youth who do get one of those precious treatment beds, their transition back to community-based services is badly planned and poorly managed.

Had all of that been in place, 16-year-old Elliot Cleveland Eurchuk might have survived his addiction rather than being counted among the 4,850 British Columbians to have died between January 2016 and Oct. 31, 2019.

But the teen’s legacy could be — should be — that Health Minister Adrian Dix and Premier John Horgan making addictions treatment as much of a priority as harm reduction.

Recommendations from the coroner’s inquest into Eurchuk’s 2018 death released on Monday provide some direction: More acute-care beds for youths including a residential treatment centre in Victoria; more and better access to addictions services; and resources for early detection of mental-health and substance-use disorders among youth.

For more, the government ought to dig out its copies of the 2018 report from the B.C. Centre on Substance Use that recommended a “full, evidence-based continuum of care including building an effective and coordinated addiction treatment and recovery system that has traditionally been lacking.”

That report also singled out the need for youth-specific services and treatment including residential care. It also recommended “recovery high schools” where not only are drugs and alcohol are strictly prohibited, treatment and services are part of the curriculum.

Men aged 19 to 59 make up the overwhelming majority of the people who have died of opioid overdoses. But, an average of 18 youths have died in each of the past four years.

The recommendations aren’t only aimed at preventing youth from dying. They’re aimed at providing treatment to prevent their addictions from becoming entrenched.

In addition to the recommendations, the coroner’s report provides a glimpse of the other opioid crisis far away from Vancouver’s Downtown Eastside.

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Eurchuk knew about harm reduction services, but he didn’t get his drugs tested, didn’t go to safe injection sites, didn’t seek treatment or replacement therapies such as methadone or Suboxone.

He’d started using cannabis in November 2015 when he was 13. After injuring his shoulder wrestling a year later, he began self-medicating, buying hydromorphone from a classmate at Oak Bay High School.

In December 2016, he broke his jaw playing soccer and, after surgery, was prescribed hydromorphone for the pain. Two months later, he had the first of two surgeries on his shoulder and was prescribed another opioid, Tramacet, for the pain.

After reinjuring his shoulder that fall, Eurchuk was given another prescription for Tramacet. He was also suspended from school, accused of selling drugs to classmates.

After a second shoulder operation that October, Eurchuk got a five-day prescription for Oxycodone, followed up by a prescription for Tramacet.

In the final months of his life, Eurchuk was routinely using opioids to the point that when he was hospitalized in early 2018 for a serious infection, he got a day pass and got fentanyl and cocaine while he was out. He went into cardiac arrest in the hospital on his return.

He was home briefly in February before being readmitted under the Mental Health Act. Discharged after a week, Eurchuk was in the emergency room of Vancouver’s St. Paul’s Hospital in March because of decreased consciousness and released after a few hours.

On his final day, Eurchuk bought a two-day supply from a street dealer, used with a friend early in the evening and was heavily intoxicated by the time they parted ways. As the evening wore on, people who saw him described him as everything from fine to agitated to disoriented. He was last seen at midnight.

The teen died on the morning of April 10 at home from a heart attack, fluid in the lungs and aspiration caused by “mixed intoxication” from fentanyl, cocaine, heroin and methamphetamine.

Attempts to revive him with naloxone, chest compressions, suction and a defibrillator failed.

While the government will provide a written response to the coroner’s recommendations in the coming weeks, last summer it committed $2.4 million over three years to addictions and mental health programs.

It has opened four youth detox beds in Victoria. There are eight Foundry Centres across the province providing comprehensive supports with three more being developed.  And, this spring, a 20-bed treatment facility in Chilliwack is scheduled to open.

There is no guarantee that better acute-care treatment, earlier interventions and more comprehensive community services will save the lives of every addicted youth or that they would have saved Eurchuk.

Addiction is, after all, a chronic, relapsing condition.

Elliot Eurchuk was just a kid and there are others like him. They deserve the best chance possible to grow up to be healthy adults.

dbramham@postmedia.com

Twitter: @bramham_daphne

6Feb

B.C. lawyers promise to consider whether to challenge no-fault plans

by admin


BURNABY October 24 2019. The ICBC Claim Centre at 4399 Wayburne, Burnaby, October 24 2019. Gerry Kahrmann / PNG staff photo) 00059159A [PNG Merlin Archive]


Gerry Kahrmann / PNG

Groups affected by the Insurance Corp. of B.C.’s move to a no-fault system say they’ll be scrutinizing the change closely following the government’s surprise announcement.

John Rice, president of the Trial Lawyers Association of B.C., said he was “deeply disappointed” by the move. The association will be investigating whether the proposed reforms should be challenged in court.

“You’ll remember that just in the spring of last year this government introduced sweeping legislative changes that contemplated the concept of a cap on what the government promised would only be minor injuries,” he said.

“But in fact, that cap included brain injuries, depression, PTSD, chronic pain … really serious stuff. And only nine months into this new law, government is effectively announcing that the policy scheme that they have pursued for the last two years has failed.”

Rice said the government changed the policy out of the public eye, so the legal community was in the dark when it made its announcement Thursday. His association is now looking closely at the proposed reforms and considering its next steps.

“If the government and the attorney general of British Columbia have passed a law that in the view of constitutional law experts is unconstitutional, then it’s the mandate of the Trial Lawyers Association of British Columbia — its mission — to protect the rights of British Columbians against anyone, including our own government,” Rice said.

However, several provinces already have no-fault insurance.

Rice said successive failures by government have meant that it has taken the once-profitable “crown jewel of public auto insurance in North America” and put it in crisis.

“Their solution is to create a much bigger fire in a much bigger ICBC dumpster,” he said.

Justina Loh, executive director of Disability Alliance B.C., said her organization is hopeful about the reforms and will be consulting with ICBC to make sure its regulations and policies don’t prevent people from getting the benefits they need.

Loh said the alliance wants to see a streamlined, efficient system so that support is not delayed.

“At the end of the day, we just care about the well-being of everyone, people who’ve suffered any type of injury for motor vehicle accidents, if they’re pedestrians, cyclists, anything like that,” she said.

“We just want to make sure they’re able to get all the support that they need, so not just physical support for OT (occupational therapy) or PT (physical therapy), but if they need support for housing, for transportation. There’s so many expenses that you can incur from either a catastrophic accident or some type of motor vehicle accident.”

Aaron Sutherland, vice-president for the Insurance Bureau of Canada’s Pacific region, said that just because a province chooses a no-fault system, it doesn’t mean drivers shouldn’t have a choice in who insures them.

“Whether it’s a tort system like today or a no-fault system that government has announced, the big thing to make sure that rates are affordable as they can be is to make sure drivers have a choice,” he said.

Sutherland pointed to Quebec’s hybrid coverage method, where a mandatory public insurance plan covers bodily injury, and in some cases physical damage, such as hit-and-run, while all other coverage, including property damage, is purchased from private insurers.

The average insurance premium there is just $717, he said.

“We currently pay more for auto insurance than anyone else in the country and while it’s great to hear projections that rates are going to be coming down, I think we have to wait to see what ultimately happens,” Sutherland said.

“I think just last year government introduced a whole bunch of other reforms that were supposed to improve rates. And, of course, that didn’t happen.”

With files from Rob Shaw

neagland@postmedia.com

twitter.com/nickeagland

4Feb

Daphne Bramham: Urgent overhaul of long-term care funding and oversight needed

by admin


In 2017-18, for-profit operators failed to deliver 207,000 hours of care for which the B.C. government paid them.


AlexRaths / Getty Images/iStockphoto

Some corporate-owned, long-term care homes in B.C. are getting money for nothing, while not-for-profits may be getting less than they need for their services to be sustainable.

But the bottom line is that the losers are both vulnerable seniors and taxpayers who are footing the $1.3-billion annual bill.

To be clear, it may be unconscionable, but for-profit operators who run a third of all the long-term homes and beds in B.C. are not breaking any rules. Just as it’s fair to assume that not-for-profits, who account for another third of the total, aren’t deliberately leaving money on the table.

The problem is that the system is broken.


B.C. Seniors Advocate Isobel Mackenzie (Richard Lam/PNG)

Patients and their families have been complaining for years. On Tuesday, B.C. Seniors Advocate Isobel Mackenzie clearly set out the evidence in her report, A Billion Reasons to Care, which comes within a few months of Island Health taking over three privately operated homes.

Mackenzie’s funding review is a scorching indictment of the government’s failure to properly manage one of the largest contracting relationships it has with service providers. To some extent, Mackenzie said, the government is handing long-term care operators blank cheques.

She said the rules haven’t kept pace with the fundamental shift in government procurement policy that began 20 years ago when long-term care was contracted out to private operators who were then allowed to opt out of the Health Employers Association of B.C., which once bargained on behalf of all publicly funded, health-care employers.

Rules are non-existent, vague or not uniformly applied. Direct care hours, for example, aren’t necessarily separated out from the hours that care aides spend on food service or housekeeping. Financial monitoring is scant with no requirement for detailed or audited reports.

In 2017-18, for-profit operators failed to deliver 207,000 hours of care for which the B.C. government paid them. Were they fined? No. They got to keep the money.

Meantime, not-for-profit operators delivered 80,000 hours of care more than they were contracted to provide. Those extra hours were paid for either by lower costs in another area or by other funding sources.

It is true that all operators face a staffing crisis that Mackenzie describes as being of epidemic proportions, with nearly 90 per cent of care homes not able to meet minimum staffing guidelines.

But it’s partially self-inflicted. For-profit operators’ wage costs for each hour of direct care is lower across all classifications than the costs at not-for-profits and the homes run directly by health authorities.

Some for-profits are paying care aides, who provide two-thirds of the care, nearly a third less than the industry standard, which works out to $6.63 an hour. Part of the difference is that for-profit operators are more likely to hire part-time rather than full-time workers, which eliminates the need to pay benefits.

Raise the salaries, says Mackenzie, and workers will follow the money.

The government and health authorities should also follow the money. Rather than setting a minimum wage or requiring that all operators pay the industry standard, Mackenzie says to simply end the incentive to not deliver the care. If operators didn’t deliver 207,000 hours of care, they should have been required to give that money back.

But there are no penalties in any of the contracts. Don’t deliver and, ka-ching!, the bottom line suddenly looks a lot better as taxpayers’ money transforms into shareholder profits.

Disturbingly, Mackenzie found that contracts varied both between and within health authorities.

“All spoke to delivery of care,” she said Tuesday. “But none specified the type of care. None outlined any legal requirements to provide the care. And none had explicit penalties for non-compliance.”

Every health authority also had different reporting systems. Different ones allowed expenses to be claimed differently. There were also anomalies between the profit and non-profit operators, including for-profits having surpluses 12 times higher and profits three times higher.

The health authorities allowed for-profit operators to claim building expenses at 20 per cent of their revenues compared to the not-for-profits’ nine per cent. They also allowed mortgage interest rates considerably higher than market rates, double the depreciation rates, unexplained lump-sum payments to contractors working for affiliated companies, unspecified management fees in addition to administrative expenses that are higher than non-profits.

One concern Mackenzie has about non-profits claiming lower building expenses is that they will not be able to upgrade their facilities as they age, meet any new accessibility requirements that may be required, or expand to meet the tsunami of demand from an aging population.

It all needs to change and change quickly before even more public money is funnelled into corporate profits at the expense of vulnerable seniors who aren’t getting the care they need and deserve.

dbramham@postmedia.com

Twitter: @bramham_daphne

31Jan

TransLink hopes to mitigate effects of subsidy cut for accessible taxis

by admin


Wheelchair-accessible taxis outside Canada Place.


Arlen Redekop / Vancouver Sun

TransLink will do everything it can to make sure its customers with disabilities who use taxis aren’t affected by the Vancouver Taxi Association’s decision to stop subsidies for drivers of accessible taxis, according to its CEO.

HandyDART, a door-to-door shuttle for people with physical and cognitive disabilities, is a service offered by TransLink, and over the last two years about 12 per cent of its rides were provided by taxis. About one per cent of its rides use wheelchair-accessible cabs.

This week, the Vancouver Taxi Association, which represents taxi companies that operate in Vancouver and adjacent municipalities, said it will no longer provide incentives for drivers of accessible vans, such as waiving fees or offering bonuses, because it can no longer afford it now that ride-hailing has entered the Metro Vancouver transportation market.

It said companies will continue to serve customers with disabilities as best they can.

TransLink CEO Kevin Desmond said they are in discussions with the association to find out what the impact might be for HandyDART and TaxiSaver customers.

“We want to do everything, working in close collaboration with the taxi association, to ensure there would be no negative impacts on our customers, so those conversations are ongoing,” Desmond said.

Association spokesperson Carolyn Bauer said on Friday that she did not wish to comment on the decision, but the province is working with taxi companies to figure out how to allocate the 30-cent per-trip fee for non-accessible ride-hailing vehicles to “support a sustained and improved level of accessible vehicles on the road.”

HandyDART Riders’ Alliance co-chair Beth McKellar said she was unsure how HandyDART users would be affected if the subsidies are eliminated and fewer accessible taxis were available, but said TransLink relies too heavily on taxis to supplement service. She was livid at the taxi association’s decision.

“This is so wrong — so, so wrong,” McKellar said. “I’ve just been so disappointed with the whole mess. We get hit hard enough with our afflictions every day, our transportation shouldn’t be at risk.”

According to a recent report on modernizing the taxi industry, accessible vehicles cost more money, time and fuel to acquire and operate.

“When a taxi licence share is worth hundreds of thousands of dollars, taxi companies have no difficulty absorbing the higher cost of these vehicles and can offer drivers concessions on their dispatch fees to offset the higher costs of operation,” the report said. “However, if licence values fall, or are already low, finding willing taxi companies and drivers becomes problematic.”

B.C. Taxi Association president Mohan Kang said most of his member companies — which operate outside of Vancouver — offer what he called incentives to drivers of accessible taxis and there is no plan for them to stop doing that.

“We are committed to providing the service to people with disabilities on a priority basis as we did before,” Kang said. “That’s our stance, that’s the association’s stance.”

Justina Loh, executive director of Disability Alliance B.C., said she understands the position taxi companies are in, but she found it disappointing that it has come to this.

“We’ve been trying to just push the government or the municipalities a bit to step in and maybe provide some incentives for the taxi industry so that they can continue to have an accessible fleet, just because not having one means that people with disabilities are left out,” Loh said.

jensaltman@postmedia.com

twitter.com/jensaltman

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