Thursday, November 30, 2006

A wake-up call on treaty progress and costs

On one hand, it's good that there has been no great public uproar over the latest reports on the B.C. treaty process.
The reports, by the federal and provincial auditors general, aren't encouraging. Since the current treaty process started 13 years ago the participants have spent about $1 billion, about $5,900 per native in the province.
And all that effort and money haven't produced a single treaty. The Lheidli T'enneh First Nation near Prince George has signed an agreement, but it still needs ratification by members. Several other deals are reportedly close.
Despite the lack of results, the public appears ready to press.
That's good. There's a legal obligation to compensate First Nations for land that was taken from them without their consent. Negotiated treaties are the best way to do that.
And the lack of treaties has left big questions about land ownership and management across much of the province. Until those are resolved, investors are going to be nervous about projects in B.C., costing jobs and economic activity.
Finally, there is an obvious need to improve the lives of natives, erasing the huge gaps in health, education, economic circumstances and social stability. Treaties are part of that process.
So it's welcome that British Columbians and Canadians appear ready to press on despite the high costs and lack of progress.
But it's also important that we learn from these reports and push all three parties to the treaty process to do a better job. It's one thing to accept the need for treaties and acknowledge the reality that the job is complex. It's another to watch complacently as the parties churn through another $1 billion over the next 13 years.
When the B.C. Treaty Commission was proposed in 1991 it was supposed to bring together representatives of the federal and provincial governments and First Nations. The commissioners were to help fast track treaty settlements. They were to oversee talks and keep the parties on track.
The governments predicted that with the commission's help and goodwill all outstanding claims would be settled by 2000.
So what's gone wrong?
The commission hasn't worked as planned. It has been a timid watchdog. When it has pressed the parties for more effective approaches, it's been politely ignored. Back in 2002 the commission suggested moving some big issues - like taxation questions - to regional or provincial negotiations. That way, the two governments and First Nations could attempt to set out some broad principles for settlement instead of tackling the same questions at 47 different treaty tables. The idea went nowhere.
The auditors' reports found governments haven't done their part to push things forward. The Liberals' foolish and now-ignored treaty referendum stalled talks. Both governments have sent negotiators to the table with mandates so limited that settlement would be impossible. Governments have chosen to focus on a few treaty tables, partly to save money, and other talks have stalled as a result.
Even positive moves, like Premier Gordon Campbell's attempts to create a new relationship with First Nations, have created problems. The interim agreements on land use and revenue-sharing reached as part of the new relationship provided First Nations with the benefits of treaties without having to give up any of their claims.
There are no easy solutions. It makes sense to reach interim agreements, for example, both for First Nations and to allow economic development, even if they make treaties harder to reach. And there is no escaping the reality that the courts are always looming over the process, an alternate battleground when things go badly for any party. First Nations are tempted to wait and see what the next legal ruling brings.
But the reports suggest a bigger problem. Despite the big money being spent, there has been little sense of urgency or commitment to getting deals done. That focus needs to be much sharper.
Footnote: The reports note that First Nations now have borrowed about $290 million to fund their role in treaty talks, money that was to be repaid from cash settlements. Repayment was to start 12 years after the first loans were made to a First Nation, but governments have not enforced the provision. The expectation now is that loans will be forgiven.

Tuesday, November 28, 2006

Abbott flounders in dodging private ER issue

If Health Minister George Abbott wanted to insult British Columbians any more effectively this week he would have needed to go door to door giving people the finger.
The opposition raised important health-care questions this week as the three-day sitting ended. Two-tier health care has been expanding in B.C. for a decade, as clinics offer speedier, better treatment for patients willing to pay extra.
The latest incarnation is the boldest. The owners of the False Creek Surgical Centre are opening a private emergency room this week. Come up with the $199 examination fee, plus extra for tests and treatment, and you won't have to wait around in an overcrowded hospital emergency room.
Some people think that's fine. But Canadians have so far decided that people's access to health care shouldn't depend on how rich they are. Parliament passed the Canada Health Act to create a law to make sure that doesn't happen. It's illegal to charge an extra fee for medically necessary procedures in Canada. Most people support that idea. If a child is injured, or a grandparent falls ill, we have decided that their treatment shouldn't depend on how much the family can afford to pay. We've agreed to ration health care based on need, not by auctioning off access to the highest bidder.
The surgical clinics, and now the private ER, violate that principle. If two children fall ill, rich parents can buy quick treatment. The other child, even if sicker, will wait in an often crowded, dismal and chaotic hospital emergency room.
The NDP tried to ask questions about the private ER in the legislature. Abbott's response was appalling.
The first question, from NDP leader Carole James, asked why Abbott was apparently caught off-guard by the new business. The operators offered the health ministry a briefing 10 months ago, but he only learned of the plan last weekend.
Abbott didn't answer. Instead he went off on a rant about the NDP government's failure to do anything about the False Creek Surgical Centre when it opened in 1999.
He's right. The New Democrats can be blamed for allowing private two-tier care to take hold. But the public is not much interested in what happened seven years ago and Abbott is the health minister today.
James tried again. Abbot responded by listing other private surgical centres that opened their doors in the 1990s.
You get three tries in Question Period. James used her third to ask about other two-tier care issues raised in the last year, including the opening of the Copeman Clinic in Vancouver. Abbott responded by noting federal NDP leader Jack Layton had hernia surgery done in a private Ontario clinic - hardly important to British Columbians wondering if they should start saving to ensure they can afford first-rate ER care for their parents or children.
Maybe Abbott is still smarting from the shoddy way NDP cabinet ministers responded to Liberal questions. Maybe he thinks the legislature is just a place to talk trash and score political points.
But I like to think the New Democrats were booted out, at least in small part, because of their refusal to recognize that MLAs - even opposition ones - were asking questions on behalf of the people who elected them and deserved serious answers. Even when the questions were couched in their own political rhetoric.
Spout nonsense in response and you insult all British Columbians who want real answers. These are real, important questions. The Liberals have failed to address the expansion of private two-tier care. They introduced and passed legislation to make it easier to enforce the Canada Health Act in 2003, but Premier Gordon Campbell then decided not to implement it. Issues like the Copeman Clinic and the private sale of MRIs on equipment in public hospitals drag on with no resolution. And the ministry didn't even think the private ER issue was worth a meeting with the owners.
It's a shoddy way to let public health care erode.
Footnote: Abbott was more forthcoming outside the legislature. He allowed that he shouldn't have been in the dark about the clinic's plans 10 months after ministry staff was told of them. And he said it appeared that the private ER violated the Canada Health Act and B.C. medicare protection legislation. The doors open this week.