exercising its authority. That possibility, however, is incidental to the purpose of discretion, which
is to ensure that all medically required services are paid for by the government.
31 The situation is more complicated in the case of the Hospital Insurance Act. Section 3(1) of
the Act states that "every qualified person or beneficiary is entitled to receive the general hospital
services provided under this Act". Unlike the Medical and Health Care Services Act, the Hospital
Insurance Act defines the services it provides with some precision. Mirroring the definition of
"hospital services" in the Canada Health Act, s. 5(1) of the Hospital Insurance Act describes the
"general hospital services" that are to be provided by acute care hospitals as follows (equivalent
provisions list services for extended care and out-patient facilities):
5.(1)The general hospital services provided under this Act are
(a)for qualified persons requiring treatment for acute illness or injury: the public ward
accommodation, necessary operating and case room facilities, diagnostic or therapeutic Xray and
laboratory procedures, anaesthetics, prescriptions, drugs, dressings, cast materials and other
services prescribed by regulation;
...
but do not include
(d)transportation to or from the hospital,
(e)services or treatment that the minister, or a person designated by him, determines, on a
review of the medical evidence, the qualified person does not require, or
(f)services or treatment for an illness or condition excluded by regulation of the Lieutenant
Governor in Council. [Emphasis added.]
32 It could be argued that by including a list of the services to be provided in hospitals that
does not include sign language interpretation, the Hospital Insurance Act implicates s. 15(1) of
the Charter. In my view, however, it is preferable to read the Act in conformity with s. 15(1).
Though the statute entitles beneficiaries to a specific list of services, hospitals are left with
substantial discretion as to how to provide them. This discretion operates in two ways. First, it is
clear from the regulations enacted pursuant to s. 29(b) of the Act that no individual hospital is
required to offer all of the services set out in s. 5(1). Those regulations state that the hospital
services to be provided shall include "such of the following services as are recommended by the
attending physician and as are available in or through the hospital to which the person is
admitted" (emphasis added); Hospital Insurance Act Regulations, B.C. Reg. 25/61, as amended,
ss. 5.1, 5.7 and 5.8. Generally speaking, the province does not fund specific procedures or
services. Instead, it provides hospitals with a global, lump sum payment intended to reimburse
them for those listed services that they do in fact provide. This is clear from s. 10(1) of the Act,
which reads as follows: