1992 Legislative Session: 1st Session, 35th Parliament

HANSARD

The following electronic version is for informational purposes only.

The printed version remains the official version.

Official Report of

DEBATES OF THE LEGISLATIVE ASSEMBLY

(Hansard)

MONDAY, JUNE 22, 1992

Afternoon Sitting

Volume 4, No. 24

[ Page 2837 ]

The House met at 2:06 p.m.

Hon. R. Blencoe: In the House today are a group of young people from Quadra Elementary School. As we all know, this is the end of the school year. Many schoolchildren are visiting the precincts to learn about how the process works. This group of young people were in my office this morning when I came back from a meeting. They had virtually taken over. It was good to see. They are accompanied by their teachers, Corinne Susut and Darlene Longridge. Would the House please make these young people welcome today.

L. Hanson: In the gallery today is Dr. Avigail Eisenberg, who is a political scientist from UBC. She will be speaking to the legislative interns later today. Would the House please make her welcome.

J. Pement: I'd like to introduce to the House today Mayor John Backhouse from Prince George. I knew John from previous times. At one time he was head of the regions for CNC, and I got to know him very well then. I know that he is well appreciated as mayor of Prince George. Would you welcome him to the House today.

Introduction of Bills

REVENUE STATUTES

AMENDMENT ACT, 1992

Hon. G. Clark presented a message from His Honour the Lieutenant-Governor: a bill intituled Revenue Statutes Amendment Act, 1992.

Hon. G. Clark: Bill 73 provides the government with the legislative authority to enter into agreements with the federal government under the Liquor Distribution Act and the Tobacco Tax Act to collect the provincial tobacco taxes and alcohol markups on personal importations at international border points.

I move the bill be introduced and read for the first time now.

Bill 73 introduced, read a first time and ordered to be placed on orders of the day for second reading at the next sitting of the House after today.

FINANCIAL INSTITUTIONS STATUTES

AMENDMENT ACT, 1992

Hon. G. Clark presented a message from His Honour the Lieutenant-Governor: a bill intituled Financial Institutions Statutes Amendment Act, 1992.

Hon. G. Clark: Hon. Speaker, Bill 65 amends the Financial Institutions Act and the Credit Union Incorporation Act, which provide the regulatory framework for financial institutions operating in British Columbia. This bill corrects errors, omissions and problems in the practical application of the Financial Institutions Act and the Credit Union Incorporation Act. The amendments contained in this bill clarify the intent of the two statutes, but do not affect the underlying policy. I commend this bill for your consideration and urge its passage.

Bill 65 introduced, read a first time and ordered to be placed on orders of the day for second reading at the next sitting of the House after today.

TAXATION STATUTES

AMENDMENT ACT, 1992

Hon. G. Clark presented a message from His Honour the Lieutenant-Governor: a bill intituled Taxation Statutes Amendment Act, 1992.

Hon. G. Clark: Hon. Speaker, Bill 69 proposes a variety of amendments to the Hotel Room Tax Act, the Motor Fuel Tax Act, the School Act, the Social Service Tax Act and the Tobacco Tax Act. For the most part, the proposed amendments to the taxation statutes are administrative measures. However, some more substantive measures are also proposed to close tax loopholes that have resulted in erosion of tax revenues. The amendments also reinforce existing enforcement provisions of the act. Bill 69 also amends the School Act by introducing compliance measures that will encourage municipalities to remit school tax amounts at the time required under the act.

I move the bill be introduced and read a first time now.

Bill 69 introduced, read a first time and ordered to be placed on orders of the day for second reading at the next sitting of the House after today.

FOREST AMENDMENT ACT (No. 3), 1992

Hon. D. Miller presented a message from His Honour the Lieutenant-Governor: a bill intituled Forest Amendment Act (No. 3), 1992.

Hon. D. Miller: The bill amends the Forest Act to improve the Forest Service's ability to protect recreation resources and manage recreation throughout British Columbia's forests. This bill addresses more than a decade of public demand for better management of forest recreational resources. It enables regulation of public recreation anywhere in provincial forests to protect recreation resources. It enables designation and regulation of interpretive forest sites that are used as outdoor classrooms for discussion of the nature and management of forests. It identifies recreation offences and empowers forest officers to stop individuals and request identification.

Hon. Speaker, this bill will enable the Forest Service to address many of the public's concerns about the management of forest recreation.

Bill 79 introduced, read a first time and ordered to be placed on orders of the day for second reading at the next sitting of the House after today.

[ Page 2838 ]

TOBACCO PRODUCT

AMENDMENT ACT, 1992

Hon. E. Cull presented a message from His Honour the Lieutenant-Governor: a bill intituled Tobacco Product Amendment Act, 1992.

Hon. E. Cull: The amendments to the Tobacco Product Act outlined in this bill focus primarily on restricting access to tobacco for children and youth. This will be achieved by the means of two legislative mechanisms.

[2:15]

The first of these is the addition of new controls respecting tobacco sales or the power to enact such controls by regulation. These controls directly reflect the recommendations of the British Columbia Royal Commission on Health Care and Costs.

They involve forbidding the sale of tobacco to persons who are under a specified age; requiring proof of age prior to sale from persons who appear to be under the specified age; forbidding the sale of kiddy packs -- those cigarette packages which contain fewer than a specified number of cigarettes; forbidding the sale of one or more cigarettes from an opened package; forbidding the sale of tobacco from vending machines except where the machine is supervised and controlled to ensure that children and youth are excluded from using it; and requiring the display of mandatory health warnings at the point of sale.

The second legislative mechanism is the establishment of a mandatory licensing scheme for all persons selling tobacco. This scheme will be an effective means of enforcing restrictions on the sale of tobacco products to children and youth and will assist the Ministry of Finance in controlling theft and the smuggling of tobacco products.

These amendments are significant, as most persons who become smokers are using tobacco regularly by the age of 18. By introducing these measures we hope to be able to deter young people from smoking and thereby reduce the social and economic costs of addiction.

These amendments provide a framework within which regulations may be developed to address these important issues. I intend to introduce a motion to refer the development of regulations on these matters to the Select Standing Committee on Health and Social Services, and I have filed with the Clerk of the House a motion to refer, which will appear on the order paper tomorrow.

Bill 72 introduced, read a first time and ordered to be placed on orders of the day for second reading at the next sitting of the House after today.

Oral Questions

B.C. TRANSIT

G. Wilson: My question today is to the Minister of Finance, responsible for B.C. Transit -- a multiple-choice question for the minister today. Why did the minister fire the mayor of Vancouver from the B.C. Transit board: (

a) because the minister thought the mayor was incompetent; (

b) because the mayor criticized the removal of the supplementary homeowner's grant; (

c) because the patronage list didn't include him; or (

d) because Bob Williams, the real Premier, told him to?

Hon. G. Clark: I thought the Leader of the Opposition would congratulate me for removing his competition from a high-profile position.

The mayor of Vancouver has from time to time sat on the B.C. Transit board, but by no means is that the exclusive domain of the mayor of Vancouver. In addition, we have half a dozen members of the transit board from the city of Vancouver proper, and of course the minister responsible is from the city of Vancouver proper. We in this party believe in regional representation with some gender balance. We strove to do that. One of the ways of doing that is that the elected representative from Vancouver is now Libby Davies.

G. Wilson: Nice try, but the correct answer was (d).

Supplementary then. Who dreamed up the tax on parking spaces: (

a) the former transit board; (

b) the new transit board; (

c) the minister; or (

d) Bob Williams, the real Premier of B.C?

Hon. G. Clark: Prior to our attaining office on this side of the House, B.C. Transit commissioned a study by Mr. Jim Cosh and Peat Marwick to review all of the available options. A plethora of options were put forward by Peat Marwick for B.C.Transit. The former transit commission simply received that very detailed report. When we were looking at ways we could deal with the deficit left behind by the previous administration, it became apparent that the transit commission wanted the government of British Columbia to raise the gasoline tax.

As we all know, members of the House, we have a serious problem in the lower mainland with respect to cross-border shopping. We chose not to raise either fares.... They also wanted fares raised. The mayor of Vancouver has specifically demanded that we raise the gas tax and bus fares. We chose to provide a couple of other options for the regional transit commission. We are not imposing the parking-lot tax. We have provided an option for the Vancouver Regional Transit Commission, should they so desire.

G. Wilson: Once again the correct answer was (d), and that might give the minister a clue to the answer of the following question. Why was the board increased from 12 members to 19: (

a) because 19 is the minister's lucky number; (

b) because the patronage list was too long; (

c) to ensure that the board would be as unworkable as possible; or (

d) because Bob Williams, the real Premier of B.C., told him to?

Hon. G. Clark: The previous board had only elected politicians on it -- although, in this case, they were almost all defeated politicians. We wanted to add more than just elected politicians, to add some people with some technical expertise in the area, like Setty Pendakur, who teaches transportation planning at the School of Community and Regional Planning at UBC. In

[ Page 2839 ]

addition, we wanted to get better regional representation. The previous board had one person from outside the lower mainland, the mayor of Kelowna. We have the mayor of Prince George on this. We have a member of the council from Kamloops. We have someone on from Nelson, I believe. So we have better regional representation than ever before in history. We have lay people, as opposed to elected people, on the board for the first time in history. We have lay people, as opposed to elected people, on the board for the first time in history.

We have gender balance for the first time in history, and we try to better represent the ethnic diversity of British Columbia with this board. I'm very proud of it. It is a bit large, but that's the price of trying to include more people in the planning process in British Columbia.

WINE INDUSTRY

H. De Jong: My question is to the Minister of Agriculture. First of all, welcome back, Mr. Minister. Given the excellent feature in Sunday's Province newspaper on the spectacular success of British Columbia's premium wine industry in the wake of free trade, can the minister tell us what steps he is presently taking to ensure that the industry continues to gain easier access to the American market?

Hon. B. Barlee: First of all, we're more concerned about our own markets. That wine trade has grown from about zero percent to 3.5 percent of the market, which is very good. Next month I am journeying to the Okanagan accompanied by two other ministers: the Minister of Tourism and the minister sitting in front of me, Small Business, Trade and Development.

We believe the VQA program is extremely successful. We have planted another 600 acres from the original 900, so we're up to 1,500. That's significant growth. We think there's room for more growth. We are aiming to double our capacity in wine-making. A lot of these small estate wineries in the Okanagan and elsewhere in British Columbia.... There are 25 of them all-told. There were half a dozen of them a couple of years ago. The growth there has been literally staggering.

As you know from that article, British Columbians are the greatest wine-tasters in the world per capita, so our own market is the first one we're concerned about. I think we'll do very, very well in that market. If you ask me this question next year, which I doubt you will, you will probably see that the figure has gone from 3.5 percent to 6 percent.

H. De Jong: The Province reported that, with the help of the previous administration I am sure, as well as the current administration, premium wine sales have doubled in volume and dollar amounts in the free trade agreement as consumers began to realize that British Columbia's high-quality wines are second to none. Can the minister explain when other commodities can expect a similar degree of support from this government to encourage consumers of all British Columbia products to buy B.C. because of its unmatched quality?

The Speaker: The hon. Minister, for a brief reply.

Hon. B. Barlee: Certainly, I will give you a very brief reply. First of all, I examined very closely, as I was travelling at 80 kilometres per hour just outside my riding actually.... I saw that the previous administration had made a valiant attempt. They put up a sign that said: "Buy B.C. First." That was 50 yards from the border. You would have needed a howitzer to stop the 50,000 cars going across the line every day.

We are taking a much more creative approach. We realize that it has to be a push-pull strategy. We've examined the strategies in five other jurisdictions. Only one has worked. That happens to be in the state of Oregon. It didn't work in Ontario. It didn't work in Alberta. It didn't work in British Columbia, obviously, because our traffic has grown staggeringly. It did not work in New Brunswick. We're getting all the stakeholders at the table, from the producers right through to the unions, processors and retailers. We've even had the mayors at the table. So I think that when we come out with our Buy B.C. program....

The Speaker: Order, please. Minister, would you wrap up your reply, please.

Hon. B. Barlee: Certainly, Hon Speaker.

I think that when we come up with our Buy B.C. program, it will be extremely effective indeed.

The Speaker: Final supplemental, hon. member.

H. De Jong: While many British Columbia commodity growers have trouble first of all finding workers -- such as the soft tree-fruit industry, the soft-fruit industry and perhaps even some of the vegetable growers -- has the minister determined what impact the government's planned minimum wage increase will have on the competitive viability of these commodity groups? Can he also tell us what specific steps he's taken to ensure that the industry's demand for workers is met?

The Speaker: Again I encourage the minister to be brief in his reply.

Hon. B. Barlee: I'm very brief. Thank you, hon. Speaker. I'm extremely brief indeed.

The minimum wage is $5.50 an hour. Virtually all the farmers I know are honourable men, and they pay somewhere between $7 and $8 or $9 an hour. I have not had one farmer mention that $5.50 an hour presents a significant burden to him. Even those farmers who are having some difficulty, and there are very few in our 175 commodity groups, can handle, I think, the $5.50 an hour, which is approximately $44 a day.

EFFECT OF CAPPING DOCTORS' INCOME

L. Reid: My question today is to the Minister of Advanced Education, Training and Technology. What effects would capping physicians' income have on British Columbia's ability to attract and retain medical specialists graduating from our universities?

[ Page 2840 ]

Hon. T. Perry: I'm sorry; I missed the first part of the question.

The Speaker: That's because there was not order in the House. Would the member like to repeat? We will extend question period to allow for this repetition of the question.

L. Reid: What effects would capping physicians' incomes have on British Columbia's ability to attract and retain medical specialists graduating from our universities?

Hon. T. Perry: I was so excited to get a question that it took me twice to hear it.

Any hon. member who takes the time to think for a moment will realize that British Columbia remains, and will remain, an extremely desirable place to live and to practise medicine, nursing or any other health specialty. In comparison with any other place in the world that one could possibly be working, this is probably the best place to work.

L. Reid: We already have difficulty retaining graduates in specialty medicine in British Columbia. What measures is this minister considering to stop the exodus of specialists from this province after they graduate?

Hon. T. Perry: First of all, with all due respect to the hon. member, there is no evidence that I'm aware of that there's an exodus of specialists. If anything, our problem has been that too many Canadian doctors from other provinces and doctors from the rest of the world want to work in British Columbia. That's what led to the former government's attempt to deal with the situation through Bill 41, a policy which, as we all know, failed miserably.

There are perhaps a few particular areas such as neurosurgery and geriatrics and certain areas of psychiatry where my ministry is working in very close consort with the Minister of Health to deal with those issues. We look forward to continuing cooperation with the faculty of medicine at UBC to deal with those problems.

The Speaker: A final supplemental, hon. member.

L. Reid: As the sole physician in cabinet and as the Minister of Advanced Education, was your insight sought at any time regarding Bill 13?

The Speaker: Hon. member, I regret to say that question is out of order.

[2:30]

NATURAL GAS EXPLORATION

AND STORAGE IN FRASER VALLEY

G. Farrell-Collins: I had a question for the Premier, but I see that he has packed up and gone home for the summer. I was going to then send the question to the Minister of Energy, but she's not here either.

I'll go down the seniority list to the Minister of Environment. I'd like to quote from a letter the Premier sent to some people in the Fraser Valley. He said: "I want a moratorium on natural gas exploration and storage in the Fraser Valley. I also want Anderson's 59 recommendations brought back to the Fraser Valley residents for full public consultation so all questions can be answered about the environmental and economic impact of drilling and storage." Why was that not done? Why did the Premier lie to the people of the Fraser Valley?

The Speaker: Order, please. I would ask the hon. member to withdraw that final comment.

G. Farrell-Collins: Sorry, I didn't meant to call the Premier a liar; I meant to say that he was just like Brian Mulroney.

The Speaker: Hon. member, I request again that you unequivocally withdraw the comment.

G. Farrell-Collins: I will withdraw the comment and the reference to the Premier as a liar. I will only say that perhaps he misled the people of the province.

Hon. J. Cashore: We are consistent with everything that the Premier has said. No further drilling has been approved. We have simply authorized the companies to seek such approval through a stringent and appropriate process that would involve more consultation with the public, more consultation with the citizens' advisory committee and the examination of the application by regulatory bodies, including the Agricultural Land Commission and the Ministry of Environment. We are consistent with what we said we would do. And yes, the recommendations of David Anderson are paramount in this process.

G. Farrell-Collins: Perhaps the minister is not aware that that community advisory committee is actually appointed and chosen by the industry itself, not by the people who live there.

My next question goes down the seniority list even further to the Minister of Municipal Affairs. I'd like to ask the minister why, in spite of two surveys in the municipality of Langley that said 80 percent of the people were opposed to gas drilling in the valley and numerous unanimous votes by Langley Township Council opposed to this proposal, he thinks it's fair for the Premier to ram this project down the council of Langley.

Hon. R. Blencoe: This issue is under full review and is being handled properly by the government.

The Speaker: The bell ends question period. I had suggested that question period would be extended to allow for the repeat. It is my understanding that it was done before the bell was rung.

[ Page 2841 ]

AIR AMBULANCE CONTRACTS

Hon. L. Boone: Hon. Speaker, I'd like to answer some questions from the opposition taken on notice last week. The first one had to do with Carson Air Ltd. The government has entered into a standing-offer agreement with Carson Air for air ambulance service over two years from three interior cities: Kamloops, Kelowna and Prince George. Under the agreement, Carson Air will provide these services on a needed basis. Carson Air won this standing offer through a competitive process, which included informing industry of government's requirements well in advance of issuing the standing-offer request.

In order to provide the service in all three locations, Carson Air needed to establish bases in Kamloops, Kelowna and Prince George. An implementation and action plan has been put in place to ensure timely completion of these bases in Kelowna and Prince George by June 26 and in Kamloops by June 29. A preliminary on-site inspection of the proposed facilities in Kamloops and Kelowna has already been carried out.

The second question is in regard to the services of the charter operators that previously provided ambulance service. Seymour Air of Kamloops and Southern Interior Flight Centre of Kelowna have been used while awaiting satisfactory completion of bases in these centres by Carson Air. The agreement with Carson Air is based in large part on this company's ability to provide two-stretcher capacity in delivering air ambulance service.

The previous operator was unable to provide this, although their management was informed of this requirement over a year ago; thus the company was unsuccessful in competing for the current work agreement. It is not unusual for a regional company which previously had limited markets for its services to need to expand its facilities when a large job of work has been won and is being done.

The final question has to do with the examination of the charters. The request-for-proposal process provides first for a complete examination of the records of an air charter operator who competes for government work; and an inspection of the operator's premises, the aircraft and the operating base follows. Any agreement between the government and an air charter operator is conditional. The contractor must meet -- and must continue to meet -- the standards of government air services and of the B.C. Ambulance Service. To this end, subsequent inspections are done as frequently as government officials feel necessary during the period of the agreement.

Presenting Petitions

D. Mitchell: Hon. Speaker, I beg leave to present a petition.

Leave granted.

D. Mitchell: I have the honour to present a petition to the House this afternoon. This is a petition signed by some 80 physicians from the North Shore of Vancouver -- North and West Vancouver -- who are alarmed at the prospect of Bill 71 being introduced in the House and are concerned that it might spell the end of medicare in our province.

Hon. D. Zirnhelt tabled the 1990-91 annual report of the Ministry of Regional and Economic Development.

Orders of the Day

Hon. G. Clark: Adjourned debate on second reading of Bill 71.

MEDICAL AND HEALTH CARE

SERVICES ACT

(continued)

V. Anderson: I would summarize what I was saying before we adjourned this morning: simply that I recommend before we proceed further that this draft bill which has been brought forward go back to the communities so that they may respond to and interact with it. I also recommend that it go to a legislative committee so there can be full input from the community at large.

Hon. T. Perry: I welcome the chance to speak to this bill, which I will support, not least because it gives me the opportunity to respond at some length and in some depth to many of the physicians who have written to me over the last two months expressing concern about the confrontation in which they and the government have found each other.

It's been difficult to respond to them, because the situation has evolved very rapidly. I've been through about five drafts of a letter trying to give a thoughtful and useful response to physicians who have been concerned, partly because I know many of them and have worked with many of them and respect their opinions and their concern.

In the barrage of propaganda which has enveloped this issue, sometimes it's been difficult to know how to respond in a way that would be not only honest and forthright but also revealing of some of the complexities which the government has faced in attempting to ensure that we do preserve what's best about our medicare system. So I'm going to speak not only in support of the bill, but in direct communication with all British Columbians, particularly those in the medical field who have felt concerned about how things have gone in the last three months.

I note in today's Vancouver Sun a letter from a Dr. Caroline Wang in Richmond under the heading "NDP Tactics Can Only Damage Medicare System," which I think reveals a very limited understanding of the dilemma which the public and the government on behalf of all taxpayers face in trying to preserve a medical and health care system and sickness care system which has become the envy of virtually the entire world. Among other things, Dr. Wang says in her letter: "Most people don't realize that the fixed global cap translates into a progressive reduction in doctors' real net income in the future to about 50 percent after five years."

[ Page 2842 ]

If that was true, it wouldn't be surprising that so many physicians are concerned. Perhaps one of the reasons they're concerned is that they do believe that's true. I submit that the reality is quite different and that the public -- including doctors, who also, after all, are taxpayers and who have families that depend upon the administration of the province to maintain a sound fiscal policy -- will come to understand that reality is somewhat different.

I refer to an advertisement published in the Vancouver Sun on Saturday, June 20, which suggests that the new Medical and Health Care Services Act, the act that we are debating, will result in the following -- and there are six clauses in the advertisement. The first refers to longer waiting-lists for surgery and treatment. I will explain in a moment why I think the bill has nothing whatsoever to do with that and will in fact help us to alleviate the problems of unreasonable waiting-lists.

The second clause refers to the elimination of doctor-patient confidentiality because of the government's new access to your personal medical files. When I read the draft bill, I was concerned. I raised this issue in particular with the government officials responsible for drafting the legislation, and was assured in consultations with the B.C. Medical Association and with the College of Physicians and Surgeons that this issue was being addressed to their satisfaction, and I believe that it has been.

If it has not been sufficiently addressed, the Minister of Health -- my colleague who's sitting here with us right now -- has made it abundantly and patently clear to the medical profession that she will entertain and is prepared to pass reasonable amendments to the bill at the committee stage.

So there is still plenty of time for those amendments to be proposed if there's legitimate concern about patient confidentiality. The government has absolutely no interest in reducing or diminishing patient confidentiality. It's quite the contrary, in fact. The Freedom of Information and Protection of Privacy Act, which will be passed in the Legislature this session, indicates our commitment to the protection of privacy.

The third clause here refers to restrictions on tests that doctors can order. I think that this is a major misunderstanding of the intent of the bill. The intent of this bill, very clearly, is to encourage a medical system -- a sickness care and health care system -- that is efficient and effective. Those words go back to one of the great pioneers in the post-war period -- Cochrane of the University of Wales -- who described the notion of effectiveness and efficiency in medical care at the end of World War II.

He became a pioneer in the development of controlled clinical trials and in the attempt to apply knowledge to ensure that our medical care is not only useful -- does more good than harm -- but also efficient in the way that it spends the public's or anyone else's money.

Clearly the intent of the bill is to devise incentives with the cooperation of doctors, including but not limited to those who will be represented on the new Medical Services Commission; with the cooperation of the public, which will now for the first time be represented on the Medical Services Commission; and with the cooperation of the College of Physicians and Surgeons of B.C., the University of British Columbia faculty of medicine, specialty societies and advisory councils within the medical field.

In fact, it's in cooperation with anyone who has useful knowledge to bring to bear on this subject, so that we waste less money on medical tests and can guarantee that those medical tests -- including the expensive ones which are really necessary for the beneficial treatment of sick British Columbians -- are available when we need them.

[2:45]

The fourth clause here refers to difficulty in obtaining new technology. I submit that, quite to the contrary, the Minister of Health, her officials, cabinet and caucus of the government side have all thought seriously about this issue. Their insight has been sought, along with the insight of many other British Columbians, including literally hundreds, if not thousands, of physicians who have communicated with the government and with whom the government has communicated directly, whose counsel the government has sought in various ways. It should lead to the protection of a system in which useful new technology is available.

I remind those members of the House who are veterans, and perhaps I inform those who are not, that I was one of the staunchest proponents of the institution of useful new technology. For example, I was a very strong proponent of the technology that allows people with chronic renal failure, through the use of a recombinant DNA human molecule called erythropoeitin, to have a normal or close to normal blood count and feel stronger, even when they receive chronic renal dialysis.

I was a very strong proponent of that technology, and I will remain a strong proponent, as a member of the cabinet and government caucus, as a member of the Legislature, as a citizen of B.C. or in whatever capacity. Useful new technology can help people to lead healthier lives, lives of greater quality, and it can sometimes defer or even prevent death. That technology is something we strive to protect in this legislation by enhancing the efficiency to reject useless technology.

Some technology is useful for some people and useless for others. Some technology, although it's highly billed by doctors -- including prominent American doctors who make fortunes out of the promotion of a new technology, attempting to pawn it off on the rest of the world as if it were God's own medicine.... They would like us to rush into adopting that technology before it's even proven to be useful. The history of medicine is replete with examples. Gastric freezing: putting a probe into somebody's stomach to freeze it to try to treat ulcers.

Internal mammary ligation: a technology to deal with coronary artery disease, subsequently proven to be useless. In its time, in the late fifties, it was championed at the Royal Victoria Hospital -- in those days, the greatest hospital in Canada and one of the greatest in the world -- as one of the finest technologies available. Those we can do without. This bill will help us to protect ourselves from useless technologies and protect our ability to pay for good ones.

[ Page 2843 ]

The fifth clause refers to a permanent loss of doctors. Perhaps that's what inspired the question from the hon. member for Richmond East. Perhaps she has been stampeded into believing that doctors will flee British Columbia in search of the balmier climes of California, where they can pay massive malpractice insurance because the medical climate is so fractious there. Lawyers dominate practice so much that doctors order hundreds of thousands of dollars of useless tests per person, per year.

Doctors end up in private practice in a city like Seattle, condemned to continue practising past retirement age because they're still potentially liable for past practice and have to generate enough funds to pay their malpractice insurance. I'm less worried about that.

I share the member's concern that we can do better in certain specialties, because the specialties are so demanding and difficult, be it neurosurgery, or so relatively poorly paid, be it geriatrics. This bill may help us, paradoxically, to deal with the issue of the geriatrician, the person who in future will be responsible for the complex health and sickness care of a quarter of our population, or perhaps more, who will be over 65 in the not-so-distant future. They are now discriminated against by the fee-for-service system. Their services are undervalued.

Their so-called cognitive services are sometimes made fun of by procedurally oriented doctors. I remember being in those discussions myself when a prominent procedurally-oriented doctor made fun of the whole idea of cognitive value in medicine. For those who aren't used to such big words, that means thinking before you act. That means listening to a patient carefully, thinking about what's wrong with them, looking for the non-technological solution where it will help -- like perhaps getting somebody to live on one floor without stairs, rather than designing an elevator to get them up the stairs.

The final clause here relates to a denial of the doctors' right to negotiate. The issue is much more complex than it looks. The doctors have argued that simply ensuring binding arbitration would fix all of our problems. This Legislature, as members well know, is elected to decide on the budget of British Columbia. We take a very difficult, onerous responsibility, but also a very solemn one. We are the people in whom the public puts its trust to determine how much money shall be spent and how it shall be spent.

To agree irreversibly to binding arbitration would have transferred the power over a budget item of $1.27 billion this year into the hands, potentially, of one individual -- one individual with that much power, without any direct accountability to the people of the Legislature, as the Minister of Health and the Minister of Finance now enjoy. One may or may not like the conclusions they reach, but at least this Legislature has the power to question them, ultimately to disapprove or approve of their decisions. Ultimately the public has the final power to ensure they're accountable.

A binding arbitrator has no such accountability to the public for her or his decisions.

Let me come back, before I forget, to the issue of the longer waiting-lists for surgery and treatment. In fact, one of the fundamental principles of this bill is one which I say with some sadness.

Not all members of the medical profession have readily welcomed the principle that we should examine very carefully the use of protocols and guidelines to ensure that the surgery done in British Columbia is only necessary surgery, and ensure that we are operating on patients who need and can benefit from the surgery and eliminating those cases where the benefit -- although commonly accepted, perhaps, in medical parlance -- has not been proven scientifically or where benefit is questionable. By doing that we could, in fact, shorten our waiting-lists.

We could ensure that people receive health care in a timelier way and that those people who might not benefit from surgery which they presently undergo are spared the pain, the cost, the suffering and the potential risk to their life.

That is a principle first put forward by a surgeon named Codman in Boston in 1909, or thereabouts. He was so unpopular with his colleagues that he was virtually driven out of Boston, then the leading medical centre of the world, because he dared to suggest that results should be evaluated. We've come a long way since then, thanks to Cochrane in England and others, but we have a long way to go.

When the medical profession presented its final arguments to the Royal Commission on Health only a year and a half ago, and the commissioners asked whether the development of protocols would be a good idea, I regret to say that the College of Physicians and the B.C. Medical Association passed the buck. Neither of them were willing to assume the responsibility. They said it's not our problem. You ration if there must be rationing. Let the government ration. In effect, what they said was if there is a problem with money, make the decisions at the top. Don't consult us.

Don't ask us, with our professional expertise at the bedside, to make the most efficient, rational decision in the patient's interest.

I disagree with that approach, and I argued it as a hard as I could when I was in the position of the member for Richmond East as the opposition Health critic. In living rooms, in medical offices around the province for two and half years, I argued that point, discussed it with doctors, pointing out that once the public understood what the real budget situation was in this province -- not the phony balanced budgets presented by the former, Socred government, but the real situation -- we would have to tighten our belts. We'd have to start spending smarter.

I argued that I would rather the bedside physician, who is best poised and best equipped with the most knowledge to make those decisions rationally in the interests of sick people, made the tough decisions if they have to be made, not those of us who sit at some further distance. That's what this bill is about. This bill is not only putting the responsibility but the power to make good decisions into the hands of those who are best equipped, not only through the commission but through the incentive to physicians that if they practise smartly and wisely, they can be well paid for their work.

If they practice anachronistically, if they practise without respect to the ultimate ability of the public of B.C. to pay, it will cost them as well.

What are the alternatives? I realize this is a wrenching change for many in the medical profession who have been brought up in a tradition, frankly, of

[ Page 2844 ]

profligacy. The medical schools have taught profligacy: order this and that test, never worry about it; if you don't order enough tests, your superior in the hospital ward will come down on you the next morning and say: "Why didn't you order that test?" That's the tradition we've grown up with in the period since the fifties when government finances and revenues were growing out of control. We have to change that profligacy; we have to teach and think smartly, because there's no such thing as a free lunch.

What's the alternative? The alternative is clearly higher taxes. Physicians are generally high-income earners in our society. The alternative for them if we do not respect the fact that we would have had a budget deficit exceeding $3 billion this year had the government not acted and that we still have a large deficit, even despite very tough spending decisions, is higher taxes. I don't think that the leadership of the medical profession has been as honest as it might have been with the doctors of B.C. as citizens in pointing out that there's a real dilemma that all of us face.

I want to address one other issue. I could speak all day on this, but I'm worried about running out of time. Many of my friends in the profession of medicine -- colleagues when I actively practised medicine, teachers -- have been concerned that the government acted arbitrarily, in haste, without consultation. I think that in the best of all possible worlds things might have been done more sluggishly. If there are bruised feelings on their part along with other members of the government, I regret that.

But to imply, as the advertising campaigns have done, that there was no attempt to listen to their concerns or deal with alternatives is simply not true. The Minister of Health has bent over backwards -- at night, weekends, weekdays, extra days of the month -- along with her colleagues. Virtually every MLA has taken to the consulting rooms to talk to doctors, brought the doctors into their constituency offices, read the mail, spoke to people over the phone, and I've done my share as well. I am well aware of the concerns of physicians.

I have attempted to explain the dilemma in which the government must respect the interests of the taxpayer, must control the budget deficit and must guarantee that we protect what's best in the medicare system. Lest there be any British Columbian who feels that a full, careful, honest, sincere effort was not made by government to meet the concerns of the medical profession, let me assure them one could hardly have done more.

That story has not been told in public. In my view, the government has been remarkably restrained about describing to the public how carefully we have tried to meet the concerns of the doctors. Their concern was that ICBC costs were being offloaded onto medicare. In effect, they were talking about themselves offloading ICBC costs onto medicare. But we offered to discuss that with them.

They were concerned that the government would not back them up if patients came into their offices seeking unnecessary tests. The Minister of Health, the Premier, myself and all other members of cabinet made it clear that we would back up doctors if they practise -- and when they practise -- rational medicine, and that if politicians have not backed them up in the past, that will certainly change from now on.

We invited them to consider ways in which we could address the medical-legal issue and whether medical-legal pressures are driving doctors to perform unnecessary tests. We've showed the maximum possible openness to any suggestion they had as to how costs could be curtailed and the system made more effective. What's more, and much more important, we remain open to that.

The government will remain open not only because it wants to, but because it must. For our health and sickness care system to function well, we must have the cooperation of the physicians. We must ensure that they realize that they are not being victimized differently from every British Columbian who must come to grips with the fact that government has been outspending its resources for years -- not only federal, but provincial governments. Unless we get our house in order, our society is economically doomed. We will lose the ability to pay for essential services.

We must come to grips with the fact that we were the party who founded medicare in British Columbia. We fought those battles when it was very tough to get elected, when it was very tough to be the government in Saskatchewan in the 1940s and when it was very tough and often painful to be an opposition CCF or NDP member in British Columbia in the 1950s.

We fought for a system that would guarantee that every citizen had equal access to high-quality sickness and health care, regardless of their economic status. Anyone who thinks we're going to back away from that one millimetre had better think again.

[3:00]

C Tanner: What's the rush?

Hon. T. Perry: I hear the member for Saanich North and the Islands asking what the rush is to pass this bill. There is a clear constraint on the government which the Minister of Health has enunciated time and time again. This government will operate under the parliamentary tradition by a legislated budget, not by special warrants passed in the backrooms in the middle of the night in secret to deal with whatever the overrun is.

The government offered, time and time again, the ability to negotiate within the budgetary means of British Columbians virtually any contract that the BCMA would have cared to settle, as long as it respected the ability of the taxpayer to pay. The government could not have gone further in seeking alternatives to a legislative solution, had the medical profession, through its leadership, been willing to do so.

Perhaps it was the advice to the BCMA of Mr. Kinsella, who would have no interest in the preservation of medicare, and who probably tried everything in his book while he was a member of the former government to bring down medicare, because he doesn't fundamentally believe in it. He believes in a

[ Page 2845 ]

system where the rich get richer, the poor get poorer and the atavistic nature of people is enhanced.

That's what Mr. Kinsella stood for in government; that's why he worked for the former disgraced Australian Premier, Mr. Bjelke-Petersen. That's the kind of guy who has been advising the BCMA. If they would listen to the saner voices like Dr. Basil Bolton, who wrote in the Victoria Times-Colonist recently, and many of the people I have met with over the last two months, perhaps they would have accepted the hand extended by government to find an alternative solution.

The urgency to pass the bill is to make sure that the taxpayers of B.C. are protected, and that the medical system does not come into disrepute. If the Minister of Health did nothing, we would either reach potentially a substantial budget overrun or a point at the end of the fiscal year when doctors would have to be taxed back through proration such a substantial portion of their fees that they would find that situation much more unpleasant than what they face now.

Interjection.

Hon. T. Perry: I hear the fiscally responsible member for Saanich North saying one more overrun makes such a difference.

C. Tanner: I said one more overrun could make so much difference.

The Speaker: Order, please. Hon. members, only one member can have the floor for debate at one time. Please proceed, hon. minister.

Hon. T. Perry: Hon. Speaker, all overruns are important. Perhaps physicians in their angst, feeling they have been somehow peculiarly singled out, fail to recognize what happened in the budget to other ministries through necessary cost-containment measures. My colleague the Minister of Agriculture would have liked to have had an increase in his budget, and he took a substantial chop; my colleague the Minister of Economic Development the same.

My colleague the Minister of Tourism would have liked to have been able to spend more money to promote B.C.'s second-most-important industry and was not granted the power to do so by the Treasury Board, the cabinet and the Legislature ultimately. I wouldn't have minded having a few more pennies in Advanced Education. We could have brought a few more students into the universities this year. In fact, although we got a 4.3 percent increase, members on the opposite side and on this side have pointed out that it would have been very nice to have more. All of us are facing that dilemma, hon. Speaker.

This bill will give us the tools to flexibly begin to address the dilemma of financial accountability and at the same time rationalize our medicare system so that we get the absolute maximum for our money.

Let me come back again to some of the issues the doctors have raised and the key issue for the public. Is this bill eroding medicare? Absolutely not. This bill, in our judgment, is essential now to preserve the key characteristics of medicare: equal access regardless of one's economic status; equal access, whether you are rich or poor, to good treatment; not to be dependent upon the goodwill of a physician, as the physicians have always had traditionally; not to be in the position where one must rely on being a charity case.

That's the fundamental characteristic of medicare that has made it so popular with the Canadian public. It's so popular that all political parties, even the Reform Party occasionally, endorse that concept.

Through the new act we have the potential, if the physicians will come along with us, if they will stop to think for a moment and recognize that they are not being singled out for punishment, that they are citizens like all other citizens and that we rely on them to make the system work well for British Columbians including themselves, their children, their families, their heirs, their neighbours, their friends and everyone around them in their community.... If they will come along with us, we will make the system work better than it ever has. It will be a more rewarding system to work in.

It will be one in which the efforts of a physician who tries to get a teenage girl to stop smoking or to not take it up in the first place, who tries to prevent an unwanted pregnancy or who prevents AIDS through careful counselling or who does the most difficult job of all in dealing with a patient with terminal AIDS or Alzheimer's disease is fairly rewarded and has redress against the erosion of their income, which took place under the previous existing system, where fees went up regardless of the true overhead.

There are reforms in this bill which, if the doctors and others will look at them, will be seen to provide the potential for a more effective, healthier health care system. Hon. Speaker, not only do we need it, but we clearly need the physicians of British Columbia to take a look, wake up, smell what's happening around the rest of the country, get in step with the rest of society facing the kinds of challenges that the Premier's summit on our economic future faced last week and realize that we've got to go forward now. This is not the time for recriminations; this is the time to get on with building a healthier and better province.

H. De Jong: I seek leave to make an introduction, hon. Speaker.

Leave granted.

H. De Jong: It gives me great pleasure to introduce to the assembly this afternoon 30 students from the Upper Sumas Elementary School, together with their teacher, Mr. Hardington, and several parents. This is a country school, which is extremely well supported by the parent body. I would ask this House to give them a hearty welcome.

A. Warnke: I would like to rise and make some comments on Bill 71. I listened with interest to the previous speaker, the Minister for Advanced Education, who I know, and I think we all know, has a special interest in this field. There were occasionally a few phrases in there that, upon further reflection, could be applied to the government's approach to this bill. For

[ Page 2846 ]

example, the hon. minister said, quite correctly, that we should think before we act and that, indeed, you consult with the patient. Well, let us consult with the public.

I don't doubt for a moment that the Minister of Health really worked and bent over backwards, as the previous minister mentioned, to consult with the medical community. Hopefully she has done that. But as late as eight days ago -- and as I reflected on the press reports, and so forth, throughout all of last week -- members of the British Columbia Medical Association had very serious reservations as to where this government is going with regard to legislation.

As far as bending over backwards is concerned, this bill was introduced on June 16. It has 52 sections within it. It's not a small bill; it is quite comprehensive. All my colleague from Saanich North and the Islands was pointing out is that given the comprehensive nature of the bill and given the view of the BCMA and others in the medical community on it, perhaps it would be prudent for the minister and the government to consult more with the public and the professions, and to reflect a bit more and think before they act. That little phrase "thinking before acting" is certainly appropriate in this particular case.

Another point that the Minister for Advanced Education raised is also worth reflection. The minister did say that he and other members, especially the Minister of Health and the cabinet -- he included the cabinet -- had put forward that all the medical profession has to do is apply rational medicine. What is rational medicine? As advanced from that side of the House, it seems to be that if you agree with this government, that's practising rational medicine; if you disagree, that's irrational medicine. That kind of logic fails the test of how to put forward legislation.

I think there are some very valid concerns about backing up a little and thinking about the legislation that is put forward here.

For example, I have some concerns in this particular bill with regard to confidentiality. We're into second reading right now, and at the committee stage we will explore

section 43 much further. But I will say that when I take a look at that particular section, the

preamble seems to cover many different areas, but then one has to recognize that there are exceptions, and these exceptions create a problem in terms of the administration of the act.

When we begin to reflect more on confidentiality, as members of the medical community have expressed, there is a problem with it. When we are talking about the possibility of releasing files or having certain members -- I guess the term is "bureaucrats," but they're government officials of various sorts -- have access to very sensitive information, I will say this, hon. Speaker: there are members of the public who are extremely nervous and sensitive about any government official, any government, regardless of party, having access to that kind of confidential information.

We in the government always have to be very sensitive about the prospect of having sensitive material available to members of the government. Patient files do contain extremely sensitive information, whether it involves someone who has HIV, someone having an abortion, someone perhaps having a record of psychiatric care. This is very sensitive material that individuals in our society are very sensitive about. To just pass legislation and open up that process is something that we have to be concerned about.

Mind you, the Minister of Advanced Education qualified it in such a way that.... Alongside Bill 71 there is yet another bit of legislation before the House, the Freedom of Information and Protection of Privacy Act. Presumably, if that is passed, it will be sufficient to protect the individuals. The last thing we want to do now is debate Bill 50. We will get to it sooner or later. On that point, the provisions protecting the individual in Bill 50 are irrelevant to the protection of the individual in Bill 71. In that context, it is a fallacious argument to say that we are protecting the individual here in Bill 71.

No, we're not, hon. Speaker. We have to have that protection for the individual in Bill 71. That is most critical; it is most important.

Therefore what we need is a procedure that if there are these documents, there is a procedure for obtaining access to such sensitive information. We have to protect that in order to protect doctor-patient confidentiality. Indeed, a cynic might well say: "Why is the government so inquisitive?" It doesn't show up only in this legislation but in other legislation as well. The government has introduced bills from time to time that are kind of inquisitive as to what documents and what files professions in our society have.

[3:15]

[H. Giesbrecht in the chair.]

There is a pattern here as well of yet another profession in our society being the target of this government, a supposedly very affluent profession in our society that can afford to go through some radical changes. Oh, the government has argued, the Minister of Health has put forward that we are now going to create a new consultative process; we are going to establish a particular commission in the context of co-management.

I would say this: as I see this bill being presented before this House, I see this fancy term "co-management" as nothing but window-dressing of a concept I see in another jurisdiction, particularly that of the Federal Republic of Germany, and the term is "co-determination." It is a concept I know quite a bit about. I'm not going to bore the chamber here with another elaboration of Germany....

Interjection.

A. Warnke: I guess some people do in fact want us to talk about it.

Co-determination in Germany is a process by which various groups do come together in a particular committee. In fact, the input of those various groups does help to shape public policy, and it is a move in the right direction. However, in this particular situation there is this concept, and then it's window-dressed under the context of co-management. But does it really resemble the model of co-determination? On closer examination, no. What the Minister of Health has introduced here is that there are three elements

in-

[ Page 2847 ]

volved in this new co-management model: the public, the providers -- which is another way of saying the medical profession -- and the government.

How does one become a member of either one of these three sectors, to become part of this co-management model? That's not in here, and the reason why it's not in here is because this bill has not been thought through. Once again -- and this has happened over and over again, as we've seen, in certain legislation brought forth -- there's not something called "follow-through" in the legislation that's before us. What constitutes the public body? It's appointments. Who does the appointing? Who represents the medical profession? Who represents the providers? Appointments, hon. Speaker.

And appointments is a way for a government to develop a stacked deck to push forward its agenda, its public policy views, and force them on the rest of the public. Not really true members of the public, because the public at large.... And one hon. member says that they're all going to be elected. The members of the public body are going to be elected. By whom? All of the electors of British Columbia? That's simply not true. This is not the way it goes in this legislation. Members on that side don't even know their own legislation.

The process is flawed. The process does not involve a really thorough follow-through. It therefore goes back to the original point that I raised: this government must think before bringing forth legislation. I will use the phrase of the Minister of Advanced Education: thinking before acting, consulting with a patient. Yes, that's so true. Consult with the public, consult with the medical profession, consult with the people who are really affected, and not some adviser set up by this government.

H. De Jong: I will speak very briefly on Bill 71, the Medical and Health Care Services Act. This is not, as I see it, a doctors' bill. It's not a specialists' bill. In my opinion it looks like it could be a black-cap act.

A member on the government side said this morning that this bill recognizes the conclusion of discussions over the past 25 years. I've been told that it's quite different; I've been told that little or no consultation was held prior to the drafting of this bill. British Columbians and politicians have, for many years, spoken about our health care system proudly. I suppose the reason for the general public support has been that it is affordable. The government is very quick to blame the current problems it faces on the previous administration.

While medical premiums have gone up over the years, I vividly recall the voices of the now-government members, who were then in opposition, opposing premium increases for the continuation of good health care services. Little did they realize, or at least want to admit, that when all other things go up in cost, it includes the cost of providing health care, which then necessitates the revision to premiums.

I realize that this bill is not specifically about premium increases and so on. This bill goes to the heart of the delivery of medical services. This bill, like a number of other bills that have been presented in this House by this government, is another attempt to move the Ministry of Health totally under the control of a commission. I can see why the government is moving this issue, because health care delivery has had some controversy over the past years. I can see that they wish to move it into a commission. That then leaves it at arm's length from the government and, in particular, from the Minister of Health.

Health care is, without a doubt, difficult for politicians to deal with, but it is particularly difficult for a socialist government. The reason I say that is that on the one hand it is a social type of service, with very limited premiums attached. When somebody visits the doctor's office, there is no cost attached; it's free. On the other hand, though -- this, of course, is difficult for a socialist government to comprehend and work with -- the doctors and the professionals delivering the services are independent. They are private enterprisers.

Unlike previous governments, which perhaps had some difficulties but always finalized negotiations satisfactorily to both parties, this government does not appear to be doing that or to wish do it. They wish to do it through

an act in this House. This government has chosen a different route. First they introduce Bill 13, a bill primarily capping the doctors per se. Now this bill does basically the same thing, except in a more subtle way. It is a subtle approach to remove, first of all, the reality of the difficulties from the minister responsible. This minister and this government, when in opposition, have made all kinds of statements with respect to health care and its delivery, and those statements are now coming to haunt this government. That's why it's so difficult for them to deal with it. This is why they are presenting this bill. This bill is just a bill to avoid the reality.

One of the government members referred to this bill as a bill for wellness. This is not a bill for wellness. This is a bill by a government that knows how sick it finds itself to be. This bill is another example that this government is not capable of representing the people for the most essential service: health care. So why the rush for a bill on which depends a good health delivery system, which the people of this province have enjoyed for so many years?

I know -- or at least I hope I know -- that most of the members on the government side of the House are still interested in the best delivery of health care. This, however, is not going to be achieved by rushing this bill through the House. This government appears to have no problem placing moratoriums on a number of other issues for government to "get a better handle on it." Why not place a moratorium on this bill and allow the people to speak and to negotiate about it in a proper way so that proper health care, which the people of this province have enjoyed for so many years, may continue?

After all, every elected member to this House is ultimately responsible for the best-run health care system, now and for the future, a system that is undoubtedly difficult to make perfect, however essential for those who deliver and, above all, most important for all British Columbians.

G. Farrell-Collins: I too am pleased to rise and participate in this debate on Bill 71 and make a few comments. It's been interesting to listen to the debate as

[ Page 2848 ]

it has progressed through today and hear some of the comments that have been made by the NDP backbenchers in support of their minister. It's an unusual procedure in this House when we have the NDP back bench supporting the ministry and actually getting up and speaking to a bill. It makes for interesting reading in Hansard afterwards, and it makes for interesting comment, to finally get some lively debate in the House.

Earlier today the member for North Vancouver-Lonsdale made a rather lengthy speech and a presentation where he talked about a number of things. One of the cornerstones of his discussion and his debate had to do with the idea that we had to create a wellness in the community, and we had to start to deal with preventive medicine as opposed to curing the ills after they had already occurred. That's a very good point and a very good proposition. It's something that we would all like to see. We've all talked about healthy communities and trying to get people well before they even get sick.

If that were truly the intent of the government, I have to ask myself why the same government recently cut $2 million from the Sport B.C. budget, virtually gutting the organization.

Sport B.C. is a group that is funded and uses that money to encourage amateur sports in British Columbia. Amateur sports for people: children, adults -- people of all ages -- participating in their communities in baseball, softball, soccer, swimming, and whatever types of sport there are that people get involved in. Those are the types of things we want to encourage. We want to encourage people to be physically fit. We want to encourage people to be participating in an active way and have a good, healthy lifestyle. Fitness is one part of it.

[3:30]

Why is it that this government, which speaks so strongly of preventive medicine and a health care system that encourages people to participate and to become healthy before they even get sick, would turn around and cut $2 million from the budget of a very good organization like Sport B.C.? When we look at that sort of issue, and we look at the motivations of this government, we start to question the dichotomy. Is one part of this government talking to the other part? Was there any consultation with the Minister of Health when the decision to cut this $2 million from Sport B.C. was made? Did cabinet discuss it?

Of course, members won't tell us whether they did or not, but it really begs the question: is one part of this government talking to the other part? When we have a bill like Bill 71 come along, and we have members opposite speak so strongly in favour of it, I wonder where the voices of those people were when the opposition rose in this House and questioned the government on the spending of that money and on the cancellation of that money. Where were those members? Where were their voices when the opposition was questioning the government about that decision? They were probably quite quiet.

We have before us now Bill 71. It was brought in towards the very end of this session of this Legislature, and it incorporates a number of things. Among them, it incorporates Bill 13 almost in total. This bill, the one that dealt with the capping of doctors' salaries and the capping of payments to doctors in this province, is no longer before this House. The government brought that bill off the order paper and is going to let it die, just let it sit there and disappear into thin air.

We all hoped, when it did that, that the government had realized it had made a mistake, that that was not a way to go, that it should not be forcing some sort of an agreement like that on the physicians of this province.

This is the same government that speaks and cries so loudly about free collective bargaining. I always thought that when members meant free collective bargaining, they meant that all British Columbians had the right to get together in a collective and negotiate a contract or a deal with the government to receive remuneration. People get together and form unions; they negotiate with the government, or they negotiate with private corporations for their salaries, for their remuneration. Why is it that doctors can't get together and negotiate in a collective way with the government?

I question that. I asked the minister: why does that occur? Why would the ministry choose to not negotiate with the doctors, to say that doctors don't have any collective rights,

whereas unions in this province do? Why does somebody in this province have to belong to a union before this government will give them the rights that they deserve?

We asked that question in this House some time ago; we asked the Minister of Finance. He said very clearly: the doctors are not part of a union; therefore they don't have collective rights or any right to collective bargaining. That's just fundamentally wrong. We have in this country a Charter of Rights that deals with freedom of association, and those people can band together, form a collective group and do as they would in this case. Why is it that doctors are being excluded from this?

We now have Bill 71, but we've had other bills before this House that the government has, upon second glance.... The other day we heard the Attorney General say: "We've taken a second look at this bill. It isn't any good, and we've decided to get rid of it." I believe it was Bill 32. I would suggest that the government take another look at Bill 71, take a hard second look at it, and see the flaws that exist in it. Let it die on the order paper also.

Or, if the government doesn't want to do that, then perhaps members can let this bill go through second reading, if they so choose, and send it to the standing committee that deals with health and social services. Give this committee of the Legislature some time to tour the province, to go into the communities and talk to the people who have health care delivered to them, to talk to the doctors, the patients and the other health care workers -- all the users of the system -- and give them a chance to contribute and comment on Bill 71.

We just had an instance today in this House where the Minister of Health stood up and referred a bill that dealt with the positioning of tobacco-vending machines to a standing committee of the Legislature to tour the province and seek input. Why can we do that on the positioning of cigarette-vending machines, but we can't do it and we can't expend the money on an omnibus bill like Bill 71? Where are the priorities of this government? Where are the backbenchers from this NDP

[ Page 2849 ]

government, whose one job -- if a backbencher has a job in a parliamentary democracy -- is to reach up and shake the cabinet ministers when they start to get out of line. Where are the backbenchers from the NDP standing up and saying that this bill has some problems with it, and it should be...?

Interjection.

G. Farrell-Collins: Here is one of the backbenchers now, the most prominent one. I wish he could enter the debate again and explain why he doesn't think this bill is important enough to go before a legislative committee. Yet the bill that was tabled today, the tobacco bill that had to do with vending machines, is important enough to go before a legislative committee. It's extremely unusual, and I think the government really has to take a serious look at this and decide what their priorities are.

Bill 71 has a number of flaws in it, which have been reiterated by members of the opposition and members of the third party a number of times. They've looked at various sections in Bill 71, and we've had some serious concerns with them. One of the main parts of Bill 71 is the fact that it incorporates what was in Bill 13, which no longer exists as far as we're concerned; that deals with doctors' salaries and a cap on their fees. It also deals with the way in which we would hope this government would be negotiating with doctors to come to some sort of an agreement.

[The Speaker in the chair.]

Some statements were made by the parliamentary secretary to the Minister of Advanced Education -- I'm not sure what his exact title is -- the member for Burnaby North. He read into Hansard sections of two letters that were sent by the British Columbia Medical Association to the Minister of Health. As we've come to expect from this government, the information that was forthcoming was rather selective. It didn't include what the real facts were or the whole context of the letter. It only included those parts that said, in fairness to the BCMA, that some parts of what the minister was doing were good.

The member, in quoting that letter of May 21, forgot to quote a part which I'll quote now for the benefit of the House, so that people have a bit of context in which to put all of this. One of the paragraphs says: "...I wish to assure you that the British Columbia Medical Association is prepared to devote every ounce of its energy and whatever resources are required to bring about a satisfactory, long-term conclusion to this matter. To this end we are prepared to meet with you at any time." Why didn't the member read that part of the letter into the record?

Hon. E. Cull: We're still waiting.

G. Farrell-Collins: The minister says we're still waiting. If the minister would agree to deal fairly with the physicians of this province, I'm sure they would be more than glad to consult with the minister and to negotiate on a fair basis, just as we would hope the government would negotiate with all groups on a fair basis.

We move down the letter, and there's another paragraph that the member forgot to mention when he read this letter and was making his statement. I'll read it for him, so we have some balance in the debate and we know exactly what was in the content of these letters. It goes on to say: "I am concerned, however, that your letter of May 19 does little to advance the current state of our mutual understandings. It would appear that the contents of the letter are directed more towards public consumption than towards heightening the awareness of the BCMA's executive." I wonder why the member forgot to read that portion of the letter into Hansard

We have another letter, dated June 2, to the Minister of Health, and there are two paragraphs that, again, the member for Burnaby North forgot to read into Hansard . I'll do that for him:

"The innovative approach of expanding the Medical Services Commission into an equally represented tripartite board -- government, public and medical profession -- with appropriate authority certainly presents a concept that can be built upon. However, the principle of empowering such a commission with the authority to arbitrate on fee disputes and deinsurance of services requires careful examination.'

That was what the physicians were calling for. That was the intent of what they said, and it was the intent of the letter that was partially read into the record earlier. It goes on to say:

"The specifics involved in the selection of commission members and the chair, the full terms of reference of the commission, the conflict-of-interest issues that may arise in an arbitration environment and the integrity of the commission as perceived by all three stakeholder groups also require detailed scrutiny. In sum, while the framework is there, a careful and painstaking craftsmanship will be necessary to ensure a mutually satisfying and lasting solution. Your ultimatum, however, that this tripartite agreement be written into the new Medical Services Act, and that this act be introduced, debated and passed and enacted prior to the end of June...is simply not appropriate."

I have to agree very strongly with the comments that are contained in this letter as it pertains to Bill 71.

There are some directions that the government is taking in Bill 71 that have merit. Numerous people in the community have said that; the opposition has said it too. We are a constructive opposition. There are some good things in this bill. But we cannot rush a bill of this importance and significance through the House in one or two days of debate. It's simply not responsible. It's simply not feasible. It is irresponsible of the government to try to do that, and we will not allow that to happen. We will ensure that this bill gets proper scrutiny.

If this government had its priorities straight and was concerned that this be a good bill, that it last for the long term, that it make some significant improvements to health care that will last throughout the next few years, that it, indeed, set us in the right direction, then the government would not be afraid to take the time to commit this bill to the Select Standing Committee on Health and Social Services and allow that committee to

[ Page 2850 ]

consult, to call witnesses and to take it around the province and discuss it.

This House will more than likely sit in the fall, and at that time the people of this province would know, when this bill came before the House for third reading, that it was vetted. It would have been taken around the province, and they would have had a chance to comment on it, rather than having a bill that was rushed together, cut and pasted from some other bills that didn't look very good, weren't working or weren't publicly palatable, putting it together and bringing it before the House in this fashion. I think it's simply irresponsible of the government.

If the backbenchers who spoke so vociferously against some issues in this House and who talk about decency, honesty and good government would speak as strongly against the process by which this bill is being brought before the House, the minister might sit up and take notice. In the end we would have a better bill that was going to stand the test of time and serve this province and the people of this province better. I think that's the direction the government should take, and they should listen to their own comments.

There are some concerns with Bill 71. My personal concern -- it's one that the member for North Vancouver-Lonsdale spoke about, but didn't seem to have any concern at all about -- is the fact that personal medical records can now be accessed under this bill by adjudicators or inspectors -- I love that word "inspectors" -- who happen to be physicians. Well, so what? It doesn't matter whether they're medical practitioners or not.

If someone is inspecting my personal medical records, I want that to be the doctor that I know, that I've chosen to go to and that I've chosen to consult with and confide in, not somebody appointed by the ministry to come in and rummage through my medical files in the hope of digging up and saving a few dollars here and there somewhere down the line. I have a real problem with that, and I think there are a lot of people in this province who would have a similar problem with government-appointed inspectors, whether they were medical practitioners or not, inspecting their personal files.

I have a strong feeling about that. I would hope that the government would come to its senses and would not allow that to happen. It's the thin edge of the wedge, when one starts having government poking its nose into the personal affairs of the people. People's rights to privacy and confidentiality should not be violated; they are sacrosanct. Those rights belong to the people, and it's up to them to decide when personal information about themselves, especially medical records, will be given to government-appointed inspectors.

The government should not be determining whether that happens, when it happens or how it happens. A recent Supreme Court ruling, if I am correct, said that in fact medical records belong to the physician or to the person. I don't remember which it was; it doesn't matter. Certainly government inspectors were not people the Supreme Court decided that they belong to. They belong to the patient and the doctor, who are to consult between themselves, and not with the government.

[3:45]

Why does the government have to stick its nose into every single thing we do? Why is it that the government has to look into our personal medical records? A famous politician who just happened to be a Liberal said that the government has no rights in the bedrooms of Canadians. I would say that the government has no rights in the doctors' offices of the people of the country, either. This bill is certainly going to see that that happens on a regular basis. It's something that's distasteful to me.

I believe that if the government were to consult with the people of this province through the public process -- public hearings, the legislative committee -- it would find that most people feel exactly the same way.

It seems that the opposition -- or the government, I should say; they'll be the opposition soon -- has been talking and dwelling on the expense that's going into pay for the doctors of this province. Whenever I hear that, it sounds exactly like the political position of the past Social Credit government with regard to teachers.

When we look at the histories and biographies of members of the government -- how many are teachers or have been teachers or are married to teachers -- I really question how those backbenchers and even cabinet ministers, for that matter, can take the stance that they have on medical practitioners' fees, when this government spoke so strongly when it was in opposition against the Social Credit position against teachers. At that time the NDP opposition called that political position teacher-bashing.

Interjection.

G. Farrell-Collins: Oh, it's not the same. I guess that's because the member isn't married to a doctor or doesn't deal with the medical community.

Interjection.

G. Farrell-Collins: The member talks about Liberal-bashing. Nice try!

The Social Credit government, according to the NDP, bashed teachers and used teachers as political pawns.

An Hon. Member: Are teachers in Bill 71?

G. Farrell-Collins: We're talking about legislation that deals with doctors and this government's stance on doctors, and how they want to treat doctors in this province. It relates very well to the way the Social Credit government treated teachers. It's amazing how quickly the song changes when a member switches sides of the House and goes from opposition to government. I guess the Social Credit government had their scapegoats and the NDP has their scapegoats. That's the way it works.

Interjections.

The Speaker: Order, hon. members. Please proceed, hon. member.

[ Page 2851 ]

G. Farrell-Collins: I guess there are some teachers in the government who are starting to feel a little warm. We're hitting close to home. This room happens to be air-conditioned, for those people around the province who are watching. If they're feeling heat, it's merely because of the political debate, not the temperature.

The budget for medical services in this province is made up of all sorts of things. Doctors' expenses are only one part of it. Why is this government concentrating so hard on beating up the doctors of this province to keep health care costs down? They quote at length all the things in the Seaton report. My reading of the Seaton report, and the general gist of it, is that there's enough money in the health care system right now to pay for it. We don't need more money. This government has already contributed a bunch more money. I don't know where it went. Maybe it went to the HEU settlement; I'm not sure.

The Seaton report said that we needed a new, constructive approach to health care; we needed to spend the money we had more wisely. What is creative about slapping a cap on doctors' salaries? That's as bland and unimaginative and narrow-sighted and myopic as the Social Credit position of keeping education costs down by slapping a cap on teachers' salaries. It doesn't help. It doesn't do anything.

Interjections.

G. Farrell-Collins: Hon. Speaker, members are babbling once again. I wish they would participate in the debate and come up with something intelligible, that would make sense. Perhaps if they would read their own remarks in other debates in this House, they would have a different position on this bill.

It's becoming very clear, with the things that are in Bill 71, that this government is really no different than the last one. Bill 71 wasn't on the agenda at the beginning of this session. Bill 71 was cut and pasted and stuck together and brought in two days after they pulled Bill 13. Where was the long-term planning? They say that they've been consulting for years. Why did they then have to slap this bill together at the last minute and bring it into the House? If they had been consulting for years, they would have come up with something a little better.

Having done all that consultation, they would know that the people of this province enjoy consultation. They want to be consulted. They would like to see this bill brought before a standing committee of the Legislature and taken around the province so people can have a chance to comment on it. Why would the government, towards the end of the session, rush headlong and try to ram through in one or two days an omnibus Medical and Health Care Services Act that changes the way we do health care business in this province? It's ridiculous.

This government said that they had the intention of getting out of the House by the end of this week. If they bring in pieces of legislation like this, there's absolutely no way that we'll be out of the House by the end of this week. There's a lot of work that needs to be done, and we intend to stay here as long as it takes to see that that work gets done.

Interjections.

The Speaker: Please, the House must come to order if we are going to have debate in the House.

G. Farrell-Collins: It's always more than welcome when the government backbenchers choose to participate in the debate, but more often than not they choose to sit there and holler and do whatever they're told. They clap when they're told to clap and holler when they're told to holler. But I'll get back to the bill, because I know that that's the reason we're here.

We heard this morning from the member for North Vancouver-Lonsdale. I'm always fascinated to listen to what he has to say, because it has absolutely nothing to do with reality. He talked about the misrepresentation of Bill 71. I would challenge the member to sit down and read his own comments in Hansard today and see exactly who's dealing with reality in this bill and who is not. Perhaps the government needs to take this back to the public for a little bit of a reality check.

This bill has some merits. It has some good things in it. It has some potential. There are a lot of things in this bill that need to be fine-tuned. There are a lot of things that head us in the wrong direction. We must treat all health care workers in this province fairly. We must treat the patients fairly, and we must treat the doctors fairly. I would hope that this government would take the positive things in this bill back to the public, and let the public have a chance to comment.

Once we've talked with all of the people who deal with health care, once the physicians have had a chance to negotiate with the minister -- in good faith, I hope -- then this bill could come back to the House for third reading. At that point in time, we would be more than willing, if it's an improved bill, to pass this bill and see that it takes this province into the future, with a health care system that is substantially improved over what we have now.

J. Dalton: We've heard many concerns expressed today on this bill, and I'm sure we're going to hear many more. Of course, we haven't heard concerns from the government side, but they're just parroting what they've been told. We can expect nothing from them of any substantive nature to improve upon this or hopefully give some proper thought and reflection on the content and the implications of this bill.

I'm not going to specifically deal with the concerns about the bill, other than to make some comments about the climate that this bill has created. However, before we get into that discussion I want to point out that you have to wonder: what is the rush on this bill? This bill was introduced June 16, and here we are, less than one week later, and we are now rushing into second reading. The government is hoping that we will collapse, and the media too seems to hope that we're going to collapse, for some strange reason -- get out of here by the end of the week when school closes, and everyone will start the summer.

Well, this opposition is not going to start the summer; you can be assured of that, hon. Speaker.

What is the rush? I just wish to restate this before I talk about the climate that this bill is creating. Why not,

[ Page 2852 ]

after second reading, allow this bill to be left on the order paper; allow the general public, not just the doctors and the people in health care delivery, but all of the people of this province who are affected by this, to give it proper consideration over the summer months? Put this to committee. Let's use these other vehicles for good use. Let's try and slow down this very important piece of legislation. It's very detailed; there are a lot of implications in here that everyone must properly study.

I wish to make some comments about the unsettling effect that this and other legislation has had on the medical profession. When I make these comments, I'm not just speaking of recently, as of the day that this bill was introduced, or even back when Bill 13 was brought in -- which of course is presumably going to die an honourable or other death, and may it rest in peace. People in the medical profession whom I've talked to, not just recently, had a very strong suspicion that this type of legislation would be coming in; and of course it has proven to be correct.

I wish to take the members of the House back to last October. Everyone here will fondly remember last October. The 17th was the day when all of us were elected to this House. It was four days later that.... It is very vivid in my mind, October 21. It's very vivid because that day, unfortunately, my elder daughter was hospitalized, and as it turned out, she was diagnosed as having diabetes. I can tell you, as a personal aside, that that week of October was rather an exciting one in our household, for obvious reasons.

The day my daughter was admitted to Lions Gate Hospital, my wife and I had a lengthy discussion with one of the neurosurgeons. I had not met this doctor before, but I did know him by reputation, and he's also a good friend of my brother's. He made a point of coming up that afternoon while we were waiting for my daughter to be attended to. He introduced himself, and he went into a lengthy discussion and questions and answers with my wife and me on the whole climate of medical care and where health care was headed in the province.

His comments were in particular, I think, reflecting a concern about the new government, the NDP having been elected just four days earlier. He and many others back then, in October, were expressing concerns about where health care and the delivery system of health may be headed in the province. What we are seeing now is a reflection of that: the bills that are coming forward, and the difficulties that doctors and others in the health care system are encountering. They are not just problems with salaries, or capping expenses and things of that nature.

There are many concerns that people in health care are expressing.

Hon. Speaker, I would like to point out to the House that doctors, in particular -- certainly the doctors that I've known over the years -- do not tend to be politically motivated. They do not get worked up by politics, generally speaking.

Of course, there are two medical doctors on the government side, one of whom has spoken today: the Minister of Advanced Education. There are no other doctors of that sort in the House who I am aware of. Maybe we should also make passing reference that the Liberal Party in Nova Scotia, in its wisdom, has now elected a doctor as the leader of that party. However, that has nothing to do with the climate in this province.

The point that I'm making, hon. Speaker, is that more and more doctors -- I'm referring again to the discussion that my wife and I had last October right after the election -- are getting worked up by the politics of underfunding, of capping salaries, of longer and longer lists for people to get into operating rooms. These are all related problems with health care. It's not surprising that the concerns that people.... I'm sure every member of this House has had phone calls and letters from doctors recently. It should not be a surprise to members that that is so.

[4:00]

Hon. Speaker, Bill 71 -- this legislation that is now in second reading -- reflects that whole climate. Doctors tend to be fairly conservative. Of course, they're very professional, and nobody would quarrel with that. Doctors over the years have not tended to be involved in the political process; now they are very involved in that process. That's an unfortunate circumstance. I don't mean to say that it's unfortunate that doctors get involved in politics. I think perhaps, like any other profession or identifiable group in our society, they should become more involved in politics.

But it may be a little unsettling for people to think that instead of your doctor concentrating on your health problems, he's concentrating perhaps more on his or her political problems. That's not a happy thing for the state of medicine or for the professional nature that doctors and others in the health care system have always reflected. Without question, this bill has added a great deal to this unsettling political climate that doctors are expressing.

I'm sure many, if not all, of the members on the government side have seen the recent BCMA ads with the picture of the Premier, indicating that once he gets out of medicine they'll get out of politics. I think that's a very true statement. As I'm saying, doctors are now into politics, and I'm sure....

Interjection.

J. Dalton: It's not of their own choosing. They don't want to be worked up in this way, any more than any other group chooses to be, or feels that it is, in a sense, forced into that circumstance.

I'm hoping that once we get through second reading, we can pause to reflect more on this legislation. I hope that all parties affected, not just those of us in the House but doctors, nurses, other people in the health delivery system and the people of British Columbia -- the patients, the people for whom we're all speaking -- will have the opportunity for significant input into this very important piece of legislation.

If that is so, then I think that when and if this bill is finally passed through this House, we will all feel much happier. We will have had the opportunity for full discussion and amendments, if warranted and if the government chooses to consider amendments. If we're going to have the gun put to each of our heads this week, into next week or whatever dealing with a very significant piece of legislation like this one, it will not serve anyone any use. It certainly will not serve the

[ Page 2853 ]

delivery of health care any good whatsoever. I trust the government will allow for more reflection, debate and thought on this legislation. I can assure the government members that if you don't, if you think the doctors of this province are angry now, I'm sure they're going to be nothing but angrier as each day goes by. Let us all reflect on those considerations. The next time I go to my doctor, I don't want to think that this person is all worked up about the politics that are created by such a bill as Bill 71. I would like to think that my doctor, who is a professional, will concentrate and not have to be worried about the implications of things such as Bill 71.

That's the climate that has been created by this legislation. It's a very unfortunate circumstance. We all need to have more time for consultation, second thoughts and more debate. That's what I would certainly ask the government side to give serious consideration to.

M. Farnworth: I'd like to rise not to address all of Bill 71, but some of the comments that have been coming from the opposition, in particular the Liberal opposition, over the last hour or so. They're criticizing this legislation. They're saying that what we're doing is wrong. They're saying that what we're doing is bad, and it's not right. They're saying that we should be doing this, and we should be doing that.

I wonder what the Liberals would do. I think we should take a look at some of those other provinces in Canada that have Liberal administrations -- New Brunswick and Newfoundland -- and see what they're doing. As we all know, Liberals are very fond of saying "a Liberal is a Liberal is a Liberal" except, of course, when they've been offered a cabinet post by a Social Credit government. Then they can change. On the whole, they like to do this "a Liberal is a Liberal is a Liberal." Why don't we go to New Brunswick? I'll save Newfoundland for last.

In New Brunswick they not only have a global budget cap; they also have caps on individual salaries. That's not in Bill 71. In New Brunswick they have regional fees. They are imposing freezes and caps. Bill 71 establishes a commission.

We reserve the right in this province to set the global budget for health care. The Legislature's duty and responsibility is to manage the people's money. We're setting the cap -- a global budget. We will be setting up a new commission composed of three members of the BCMA, three members appointed by government and three members agreed to by both the BCMA and the government. They're responsible for determining the priorities within that global budget. That is their responsibility. That is a first in Canada. It's something that other provinces are doing.

The opposition is saying that you shouldn't be imposing caps on doctors' salaries. We're not doing that, but they do that in New Brunswick -- a Liberal government. I find that really interesting. If we go to Newfoundland, which to this Liberal opposition is at the head of the pantheon of Liberal saints, St. Clyde Wells has introduced perhaps one of the most restrictive, arbitrary controls on doctors of any province in Canada. Again, that's a Liberal Premier, a head of a Liberal government. That's who they look to. We're not doing that.

Again, we've set up a commission with three from the doctors, three from the government and three members agreed to by both the public and the doctors. They don't wish to recognize that. Instead, they're unnecessarily attacking and creating fear in people by distorting the truth. The truth sometimes hurts, and maybe that's why they're not here to hear it.

They introduced an audit system in Newfoundland. It saved 2 percent, or the equivalent of $50 million here in British Columbia. Fifty million dollars could be put to really good use in the health care system in this province. If we could save 2 percent, we could address an awful lot of things that people want done. But they don't want us to do that. I don't know why they don't want to save 2 percent, but it seems they don't. Or they say they don't. Maybe they're saying that for political expediency, because as we know, a Liberal is a Liberal is a Liberal, so we have to look to Newfoundland and New Brunswick.

The important thing is to realize that the public is saying: "Look, you've got to get a handle on costs, not just in education, not just in transportation, but everywhere." They recognize the need for that in health care. They recognize that it's the government's right to set the global budget. The Liberal opposition has been scaring people, saying that you'll have teams of inspectors going into doctors' offices and seizing files. Well, that's simply not true. They fail to say, for example, that at the present time audit committees function on two.... They can already investigate doctors' patient records.

What we're saying, and what the Medical Services Commission will be doing under an audit system, is that it will be a medical practitioner -- somebody bound by the oath of confidentiality to the College of Physicians and Surgeons. They're the only people who would have access to doctors' records -- nobody else. For the Liberal opposition to imply that anybody else could go in there is totally wrong.

I think they ought to reflect a little more and do a little more research, because they're trying to play on people's fears, and that's just not right. If they have a point to make, they should make the right point. The fact is that these people who do the audits are medical practitioners and are bound to the same oaths as the medical practitioners a patient is going to see. I think that that's a really important point that needs to be made: that the confidentiality of patients' records is not compromised.

I also think that the Liberal opposition needs to say what they would do. But no, they don't want to do that; they just want to criticize. I pointed out a few of the things that are happening in Newfoundland and New Brunswick, and I think that's a good indication of where the Liberals are coming from. Bill 71 has been part of a process that's seeking to improve our health care system. I think, given time, the people will see that Bill 71 is a responsible bill.

D. Jarvis: My hon. friend over there was saying "a Liberal is a Liberal is a Liberal." I would have to remind him that "an NDP is an NDP is a friend is an insider," one of the 4,000 about to get more jobs. Their salaries range from $76,000 to $400,000 a year on contract. If you

[ Page 2854 ]

took the 4,000 and multiplied it by $80,000, you get $320 million.

M. Farnworth: Point of order. We are debating Bill 71, not the boards and commissions in the province, hon. Speaker.

C. Serwa: Point of order. I am confident that the hon. member was getting to his point. He was merely setting the stage. It's important in the Legislature, especially during the philosophy and principles of second reading, that a member be allowed to set the stage to make his point accurately and clearly, not so that hon. member can understand, because he should, but because of the people watching these proceedings.

The Speaker: The Chair has reminded members from time to time on this debate that one must attain a balance between setting the stage and addressing the principles of Bill 71.

D. Jarvis: That's exactly what I was intending to do.

It appeared that when this government introduced the Freedom of Information and Protection of Privacy Act, it was assumed that the government was truly serious. However, what really appears from Bill 71 is that the intention of one bill does not follow onto another. How else could we interpret this flagrant abuse of people's confidentiality?

[4:15]

This government contends that Bill 71 will allow them to manage the taxpayers' dollars better. Yet in order to do so they want the ability to invade your privacy, to come into your doctor's office, to seize the files and make copies of them -- exactly what it says in

section 6. For what reason could this be other than for an invasion of our privacy? They say it's for proper management. Management of what? This could compromise the Charter of Rights and is subject to the government's wishes, not ours.

We have Bill 71 before us submitted by a government that professes, in a very sanctimonious way, to have our best interests at heart. Yet it is an indirect violation of every citizen in this province and their right to confidentiality. How can the citizens of this province accept the fact that this government can, at any time, invade their doctors' office -- and ostensibly, that's what they're going to do -- to obtain information given to the doctors in confidentiality? The doctor would end up in jail if he gave out that information on his own. But the government can use this information for anything they feel is necessary for their benefit.

It is not legislation by a government that cares, but legislation by a government that feels that when they govern for a few, it's good for the majority. The Minister of Advanced Education said that the government is prepared to accept amendments. We'll see how well this government cooperates later on, this evening or tomorrow.

I was also interested to hear from my friend over there from North Vancouver-Lonsdale, saying that he had a few friends down to his living room the other day to discuss this bill. I hardly think these friends were really what one would expect. I would like to discuss here a letter from physicians in his riding. Here are three physicians writing under the name of one gentleman on their letterhead. He said:

"I have delayed writing this letter for several days to allow time for your government to clarify and perhaps counter information that I have received from the B.C. Medical Association. However, it now appears that the unbelievable news is absolutely true. The

'open' and 'honest' NDP party, for whom 'a deal is a deal,' has actually unilaterally legislated out of existence at least two deals with the BCMA. These agreements were signed in good faith by the doctors of B.C. and the government after a long period of careful bargaining and consideration from both sides."

I want to say, before I go on, that this letter from physicians in the riding of the member for North Vancouver-Lonsdale was not written to me; it was to the Minister of Finance of your own party.

"I know that you have problems that there is no more money available and cuts need to be made. Even caps may have to be applied. However, in a non-totalitarian country like Canada it is completely repugnant for a provincial government to strip away the bargaining rights of any group with a poorly considered stroke of the legislative pen. It is particularly disturbing and hypocritical when this is done by a party that professes to be the defender of such rights. No consultation, no negotiation, no appeal, for all we know, forever."

This medical doctor goes on to say:

"I have almost always voted NDP in the past, so my disillusionment is particularly painful."

Then he goes on to another group of his friends:

"A teacher friend of mine, who has been a longtime NDP supporter and campaign worker, used the term fascist when he heard about it."

I hope the member for North Vancouver-Lonsdale will at least read this afterwards. He's gone out for a walk, I guess.

"The question is being asked: 'If this is how the NDP behaves in power, who do they represent?' Who is your constituency? You need to know that the reaction from my patients, who I am keeping well informed...."

The Speaker: Order! Could I ask the member to take his seat for one moment.

Members from both sides of the House have, throughout this debate, made great use of letters. The Chair has no means of knowing who those letters are addressed to, who they come from, and whether in fact -- although they may be related to the subject at hand -- they were written related to this bill. Hon. members understand that brief reference to letters can be worked into debate, but I would really urge hon. members to use those at a minimum, because again, the Chair has no way of knowing if they're directly related to Bill 71.

I would ask the hon. member to continue, keeping in mind those comments and relating it to the second reading debate of Bill 71.

D. Jarvis: I have all these letters, so I guess I'd better not talk about them all. Perhaps I could table the letter I'm reading right now. Would that be in order? Thank you; I guess it is.

[ Page 2855 ]

Briefly, I wanted to tell the members in the House that my doctor friend here who wrote to your Minister of Finance stated:

"It is not too late to admit that a mistake has been made. I urge you, for the sake of our enviable system of health care, and for the future of the NDP in government, to examine this issue very carefully."

No wonder Sweden, the heartland of socialism, gave it up. Socialism just doesn't work, and this is more evidence of it. You cannot expect that a good government is a government that requires access to its citizens' private lives.

There is a better way to govern a populace -- not a compromise of its citizenry, but a governing by trust. Bill 71 does not govern by trust. It is a logical evolution to a socialist Big Brother system of government, not a logical evolution to a good medical system. It is a radical step away from democracy. It is the NDP way: surging ahead backwards. This government has a myopic sense of can-doism. What they are doing with Bill 71 is an utterly sincere belief that they can do what is best, that the controls they are putting in will also be controlled by the individual's code of ethics -- code of ethics of doctors. If this be the case, naive as it is, why, therefore, is the clause necessary?

This government's motives are now suspect by the people. Imagine how suspect they will be when this bill does pass. People of this province will not accept this abuse of their personal rights.

Part 6 of Bill 71 states that the government inspector, at any reasonable time and for a reasonable purpose.... This smacks of a totalitarian system. This is not acceptable to us or to the citizens of this province. If we think back to what this holier-than-thou government used to stand for, it is a mockery of their past idealism. Their true colours are coming out. They are marching to a melody alien to the majority of society's ears at this time.

This government is rushing through an ill-prepared bill without full consideration of the professionals in the medical health field. This is a movement of socialist solidarity, and it is a solid deficiency of the principles of good government. It is lacking in the knowledge of what is right. This

section of the bill could be the start of government interference.

Who is to say that it will end here? The NDP do not realize that the fate of all cannot be mortgaged for the comfort of a few, and this is a bill that compromises and will be detrimental to all. My constituents are very concerned, and I got elected partly on the basis that I would be accountable to them. I have all these letters here, and I felt that if I was to be accountable to them it would be your privilege to let me read them to you. I'll just read a few highlights. I am quite prepared to table these letters, if necessary, because they are pertaining the bill.

This one citizen says: "With regard to the recent events surrounding the proposed health care bill, I am angry, frustrated and becoming politically cynical and certainly tired of the lack of respect shown by the government towards the medical profession." That's just one example.

Another letter said: "I am writing to forcefully object to the contents of Bill 13 and to the manner in which it was derived." Now it is Bill 71, and that is what they were referring to when they wrote that they cannot accept the statements of the Minister of Health that she is committed to exploring longer-term solutions through a full, open dialogue with doctors and the B.C. Medical Association. That's from the Minister of Health.

In any event, Madam Speaker, I don't think it's fair to you that I go on and on with these letters. At this time I will say that it's quite obvious that I am against this bill. I wish to thank you for the opportunity to speak.

W. Hurd: It's always a pleasure to rise and debate in this chamber. I wish I could say the circumstances were happier than the debate on Bill 71, which the opposition regards as a tragic mistake for this government and a bill that will only do more to foster the kind of ill will in the medical fraternity that was previously the case with Bill 13.

One of the advantages of participating in this debate after so much has gone on is to note some of the comments that have come from the government benches on this particular bill, comments from the hon. members for North Vancouver-Lonsdale and for Burnaby North about the amount of consultation that's gone on with the medical fraternity leading up to the introduction of Bill 71. They've suggested to us that despite the million-dollar advertising campaign by the B.C. Medical Association, despite all the rancour and bitterness that's gone on, what was happening behind the scenes was a high level of consultation; the government and the doctors knew exactly what they were doing all along.

If you believe that one, we on this side of the House have a used car that we'd like to sell you, because it's pretty obvious that there hasn't been any meaningful consultation. The lack of consultation that gave us Bill 13 has resulted in the logical outcome of Bill 71, which has enshrined many of the same points that we noted in Bill 13. They were merely dusted off and changed with the same lack of consultation.

I was particularly moved by the remark from the member for North Vancouver-Lonsdale about the history of medical insurance and medicare in the province and how Bill 71 fits into the grand scheme of things. In fact, I was so moved that it is my intention to clip that

section of Hansard and send it to the doctors on the North Shore and invite their comments on the medicare insurance in the province -- just so they are aware of how much thought has gone into this particular bill from the members opposite. I'm sure they'll appreciate receiving that correspondence when it goes out in due course.

It's rather interesting that we sit here in the summer solstice, with the first heat wave of the summer taking place around us. The government is desperately anxious to get this session over with and get out into the summer playland, and it has come out with one of the most contentious bills introduced in this session. Bill 71 promises to be divisive and to engender more ill will in the medical community. It will simply not produce the kind of consensus the government claims that it's trying to achieve by introducing this bill in the first place.

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We on this side of the House have to ask ourselves why the doctors in this province have been singled out. Why is it they who have been identified as being part of the problem with our medical health insurance system? Doctors' billings have been the villain all along. As I reflect on the reasons that they have chosen the doctors, I am forced to remember the remarks from the Minister of Finance during the estimates debate previously in this House. He pointed out that such high-income earners as doctors and lawyers had not been paying their fair share in the province, and we were going to make sure that they were.

I really believe that that's the kind of philosophy from the government that has produced these types of bills which identify physicians' billings as the major part of the problem. All we have to do is cap them, and we're well on our way to solving the crisis in medical insurance in this province.

I want to assure the government that everyone in this chamber recognizes the critical situation we're in with medical health care in this province. We're not shirking any responsibility by suggesting that the system of medical health care, as we've known it for these many generations, has to undergo some restructuring. We have to look at costs. We recognize that the fees, the medical insurance and the costs of medical practice are surging beyond the ability of provincial governments to meet. We understand all that, hon. Speaker.

But why single out one group of people who are part of the system and suggest that they are the reasons why the system is running the way it is? It just doesn't make any sense.

We on this side of the House continue to be amazed that we're somehow expected to deal with a bill like this, which is so contentious and is going to engender so much ill will in the medical fraternity, in a time constraint at the end of a session. It defies all logical reason, unless this government really believes that it has to introduce something after Bill 13 has foundered, because to do otherwise would be to acknowledge that the people -- the patients and the medical doctors -- in this province were right all along. I suspect, hon.

Speaker, that this bill is nothing more than a face-saving effort by this government, which has completely bungled its relationship with the physicians in this province.

The hon. member for North Vancouver-Lonsdale referred to letters that he has received from doctors in his own riding. I want to report that I've received many calls and letters from doctors in my own riding, who are working seven days a week in many cases to meet the patient load. They are dedicated physicians who cannot understand why the government has singled them out and chosen them to bear the brunt of responsibility for a health care system which we know is becoming more costly all the time.

Hon. Speaker, the doctors of this province are willing to be part of the solution. They've indicated that to the official opposition many, many times. They are willing to sit down and negotiate a fee

schedule that will retain the sanctity and the economic future of our medicare system. They're willing to do that. To suggest otherwise is to argue that doctors will willingly bill the system into oblivion without a single shred of concern about whether or not our health care system is sustainable. The government is asking us to believe that doctors in this province have no social conscience, that they regard the provincial treasury as a trough to be dipped into and that they are not prepared to even consider alternatives. They just want to bill the system every month and get their pound of flesh.

That's the message; that's the burden that doctors in this province are carrying around as they ponder Bill 13 and Bill 71. They're saying to themselves that this government doesn't understand what it is to be a doctor; they don't understand that the doctors in this province want to be dealt into the process. They don't understand that doctors are not the type of people -- as the hon. member for Vancouver-Point Grey well knows -- who will petition or bill the system into oblivion. They want to be part of the solution, and this government has not given them that opportunity.

As we sit, at the end of the session, debating a bill that will affect every aspect of doctors' relationship with their patients, the way they do business and their future in this province, we have a week to two weeks to deal with the ramifications of this bill. Why in the world couldn't this situation be considered by a legislative committee in this Legislature, so at least we could produce some sort of all-party support for the position that comes forward from this House? Surely, hon. Speaker, the doctors of this province are worth that ki