1975 Legislative Session: 5th Session, 30th 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)

WEDNESDAY, APRIL 16, 1975

Afternoon Sitting

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CONTENTS

Municipal Amendment Act, 1975 (Bill 62). Mr. Gibson. Introduction and first

reading — 1385

Oral Questions

Hay-feeding problem. Mr. Fraser — 1385

Report on powers of Auditor-General. Mr. Gibson — 1385

Federal acquisition of Columbia Valley land. Mr. Wallace — 1385

Vacant government-rented premises. Mr. Bennett — 1386

Municipal land-use regulations. Mr. Curtis — 1386

Use of leghold traps. Mr. Gardom — 1387

Availability of ICBC annual report. Mr. Phillips — 1387

Soliciting of funds by Helping-Hand Club. Mr. McClelland — 1388

Committee of Supply: Department of Health estimates.

On vote 64.

Hon. Mr. Cocke — 1388

Mr. McClelland — 1389

Hon. Mr. Cocke — 1393

Mr. McGeer — 1395

Hon. Mr. Cocke — 1400

Mr. Curtis — 1401

Mr. Wallace — 1401

Hon. Mr. Cocke — 1405

Ms. Brown — 1407

Hon. Mr. Cocke — 1409

Mrs. Jordan — 1410

Hon. Mr. Cocke — 1414

Mr. D.A. Anderson — 1415

Hon. Mr. Cocke — 1418

Mr. Chabot — 1419

Hon. Mr. Cocke — 1420

Mr. Chabot — 1421

Appendix — 1421

The House met at 2 p.m.

Prayers.

MR. G.S. WALLACE (Oak Bay): Mr. Speaker, I'd like to introduce to the

House another good Conservative, a resident of the Premier's riding of Coquitlam.

I have great pleasure in introducing Alderman Les Garrison. I ask the House

to welcome him.

MS. K. SANFORD (Comox): Mr. Speaker, in the gallery today are hard-working

representatives of the Nimpkish band council at Alert Bay. With the group today

is Chief Chris Cook and band members Reneé Taylor, Pearl Alfred, Roy Cranmer,

Gloria Cranmer-Webster and their assistant Del Broadhead. I would like the House

to give them a warm welcome this afternoon.

MR. SPEAKER: The Hon. Second Member for Vancouver–Point Grey is either

standing or sitting down — I'm not sure which. (Laughter.)

MR. G.B. GARDOM (Vancouver–Point Grey): Well, your vision's improving,

Mr. Speaker. I give you full credit for that. Many can see, Mr. Speaker, but

few perceive — you can remember that quotation.

I would like to welcome to the House this afternoon some gentlemen who were

here earlier today — members of the Institute of Chartered Accountants, members

of the Registered Industrial Accountants, Certified General Accountants and

the Accredited Public Accountants of B.C., who have come to see public accountability

in action.

HON. J.G. LORIMER (Minister of Municipal Affairs): Mr. Speaker, I would

like to introduce to the assembly the mayor of the great municipality of Burnaby,

Mayor Tom Constable, and his guests from Quebec. I'm meeting with him shortly

but I apologize that I do not have his....

Introduction of bills.

On a motion by Mr. Gibson, Bill 62, Municipal Act Amendment Act, 1975, 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.

HAY-FEEDING PROBLEM

MR. A.V. FRASER (Cariboo): Mr. Speaker, a question to the Minister of

Agriculture. On Monday the Minister advised the House that he had not had any

communication from any of the cattlemen with respect to the hay feeding problem

in the province. Would the Minister care to revise his statement of Monday in

view of the fact that he had received a letter from the Ritchie Creek Livestock

Association, dated April 7?

HON. D.D. STUPICH (Minister of Agriculture): I'll check. I'll take that

as notice.

MR. FRASER: Well, Mr. Speaker, I have a copy of the letter.

REPORT ON POWERS OF

AUDITOR-GENERAL

MR. G.F. GIBSON (North Vancouver-Capilano): Mr. Speaker, a question

for the Premier and Minister of Finance. Now that a committee appointed by the

federal Auditor-General has made a report to that gentleman suggesting greatly

expanded powers for that office, would the Premier undertake to read that report

and introduce such legislation in British Columbia?

HON. D. BARRETT (Premier): I have not had time to read the report.

MR. GIBSON: Would you read it, Mr. Premier?

HON. MR. BARRETT: Well, if I get a chance to read it. If I get a chance

to read it, I'll read it.

FEDERAL ACQUISITION

OF COLUMBIA VALLEY LAND

MR. WALLACE: To the Minister of Agriculture: could he confirm that the

federal government has acquired options on approximately 400 acres of land in

the Columbia Valley near Chilliwack for training purposes for the armed forces?

HON. MR. STUPICH: Mr. Speaker, I can't confirm it, nor can I deny it.

I've read the reports. I've asked staff to make some inquiries.

MR. WALLACE: A supplementary. I take it, then, that there has been no

consultation with the provincial government. My further question was to be along

the line that, presumably, this is agricultural land destined by the federal

government to be used for a different purpose. To what degree is the provincial

government informed of this? What about

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the whole question of rezoning: has such a proposition been made to the provincial

government?

HON. MR. STUPICH: Well, certainly none that the Minister of Agriculture

is aware of. I discussed it, very briefly, about a week ago with the Minister

of Lands (Hon. R.A. Williams) and he had heard nothing up to that time.

MRS. P.J. JORDAN (North Okanagan): I'd like to ask the Minister of Agriculture,

further, if the Land Commission Act and the powers will stand in court, as opposed

to any action that might be taken by the federal government.

MR. SPEAKER: I think the question is out of order since it asks for

a legal opinion, and I don't think that the Hon. Minister should ever give a

legal opinion.

VACANT GOVERNMENT-RENTED PREMISES

MR. W.R. BENNETT (Leader of the Opposition): To the Minister of Public

Works: I've been asking the Minister some questions regarding the leasing of

public buildings. Yesterday he chose not to answer and referred to his statement

of March 21 in which he used as an excuse that he'd asked for tabling. But I'd

refer to Hansard in which the Minister said: "I just cannot accept what has

been said but I would be pleased to take this as notice and give a full report

at a future sitting."

This is in regard to the Oxford Building which is empty, yet leased, with

rent being paid by the government for almost a year.

Yesterday I questioned the Minister on premises at 10575 and 10579

King George Highway which, at an annual rent of $18,000, have remained

empty since August 1 and were still empty, on personal check, April 11.

Today I would ask the Minister, as part of what appears to be a growing scandal

of incompetence in his department, if he can advise and confirm to this House

that his department has leased 7,817 square feet at 10344-56 137A Street in

Surrey for a five-year period, triple net, and why these premises, which have

been leased at $32,000 a year, have remained empty since April 1 of 1974.

HON. W.L. HARTLEY (Minister of Public Works): The answer to the first

part is no; to the second part, it is wishful thinking; and to the third part:

I'll take it under advisement.

MR. BENNETT: We have three different properties on which leases were

signed and which have remained empty and on which rent has been paid. Just an

additional supplement about this waste of taxpayers' money: could the Minister

advise the House if the continuing vacancy of these premises results from the

inability of the government to hire civil servants fast enough to fill the space

this Minister is leasing?

MR. P.L. McGEER (Vancouver–Point Grey): He doesn't know what a lease

is.

HON. MR. HARTLEY: Mr. Speaker, I think the further question falls under

the third category. The Leader of the Opposition would like to make certain

charges, and is attempting to make certain charges. It's wishful thinking on

his part.

MR, BENNETT: Mr. Speaker, I believe we provided information on which

this Minister could bring answers to the House on three different occasions.

I believe this House deserves an answer in what seems to be a growing situation

of continual government buildings being leased...

MR. SPEAKER: Order!

MR. BENNETT: ...far in advance of their being put to use, and at great

expense to the public.

MR. SPEAKER: Order, please. It appears to be that you are making a speech....

MR. BENNETT: Mr. Speaker, this Minister is frivolous in his answers.

MR. SPEAKER: Order! The Hon. Member is out of order in trying to make

a speech.

Hon. Members, please confine yourselves to one question so that it may be answered

clearly without any confusion arising from three questions at one time.

MUNICIPAL LAND-USE REGULATIONS

MR. H.A. CURTIS (Saanich and the Islands): To the Minister of Municipal

Affairs, before he leaves for his regrettable meeting with the mayor of Burnaby:

The Minister was quoted in The Province this morning with regard to the possible

need for legislation to speed municipal approval for housing developments. I

wonder if the Minister would inform the House if this is a move on behalf of

his department to involve itself in the overriding of land-use regulation which

has been within the jurisdiction of municipalities for many decades.

MR. BENNETT: There are 45,000 civil servants and the Minister can't

even get an answer.

HON. MR. LORIMER: I haven't seen the report in

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the paper, but I presume it is in regard to what I've said in my address in

reply to the budget debate, referring to the fact that we would have to take

a close look at the actions of a few municipalities in regard to holding up

development permits and so on for housing purposes.

MR. CURTIS: A supplementary: I wonder if the Minister is now in a position,

after a number of weeks, to tell the House which municipalities are causing

him concern in this regard. Name names.

HON. MR. LORIMER: No, I have no intention of naming names. I'm quite

convinced that the municipalities involved know who I am talking about and I

am quite certain the opposition know who I am talking about. But certainly there

are very few of them in the province and I have no intention of naming names.

MR. CURTIS: A final supplementary to the Minister: if he is concerned

about the delay in approval of various developments on the part of municipalities,

is he also aware of very considerable delay which develops after a regional

district — many regional districts, in fact, and this is well documented — have

gone through the necessary public hearing and the necessary steps and then must

wait in some instances a number of months, perhaps up to a year, for provincial

government approval of even a very minor land-use change?

HON. MR. LORIMER: Yes, I will agree with the Hon. Member that the waiting

period was scandalous. However, since we've taken office we have shortened that

waiting period. Now if a bylaw is held up more than one month for any reason

other than sending it back for corrections, I am notified of any delays.

MR. CURTIS: It is established then that there is a one-month limitation

in terms of government handling through Municipal Affairs, Highways, or whatever

it may be. Is that what the Minister is telling us is in effect now?

HON. MR. LORIMER: That is correct. If there is a delay of over one month

I receive notification of the delay and why it has occurred.

USE OF LEGHOLD TRAPS

MR. GARDOM: To the Minister of Recreation and Conservation: Information

from the department concerned indicates that in the 1973-74 period there were

106,248 fur-bearing animals trapped in this province, and that by far the majority

of those were killed — or perhaps tortured is the better word — by the leghold

trap. There is a report in The Vancouver Sun , Mr. Minister, of April 14, 1975, that your department is taking the leading

role in developing humane trapping, and to the effect that some 30 traps are

being tested. It also reports that you have made some $5,000 available.

The question, Mr. Minister, is this: Mr. George Clements of the humane-trapping

association says that in 19 months the committee has not tested a single trap,

and this appears to be very contrary to the remarks of the Hon. Minister. I

would ask him which is correct and what is being done to rectify this very cruel

and vicious practice.

HON. J. RADFORD (Minister of Recreation and Conservation): Yes, Mr.

Member, I must say that there has been some delay, and I should explain why,

on the federal-provincial committee in finding out ways and means of bringing

in a humane trap.

First, it is a long process. Five traps are now being tested. You must realize

that first it must go to a firm of patent attorneys to determine the patentability,

then to the engineering consultants to determine whether the device will work

and the estimated production cost. If no prototypes are submitted, and only

drawings, these have to be made first before going to engineering tests for

runs. They have to be field tested, and they are now in the process of testing,

as I said, five traps. But to date none of them have been field tested.

I might add that our programme to dissolve or ban the leghold trap is compatible

with the Association for the Protection of Fur-bearing Animals. As a matter

of fact, in a letter that Mrs. Bunty Clements, president of the association,

wrote to The Vancouver Sun but which they failed to print, she states: "This

association feels that more has been done in the last two years by the B.C.

government than in the last 20 years, but much more needs to be done."

MR. GARDOM: To the Hon. Minister. It appears therefore that the quoted

statement of the Minister referring to 30 traps being tested is incorrect. In

fact it's five. But I think, in the interests of this very, very serious problem,

there has been a very effective lobby of a number of serious people and they've

arranged for a special showing of "Canada's Shame" tomorrow in the Legislature.

I recommend all Members to be present if they possible can.

AVAILABILITY OF ICBC ANNUAL REPORT

MR. D.M. PHILLIPS (South Peace River): Mr. Speaker, I'd like to direct

my question to the Minister of Transport and Communications in charge of the

Insurance Corp. of British Columbia. Will the Minister advise the House when

the annual report of the Insurance Corp. of British Columbia will be available

to the Legislature?

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HON. R.M. STRACHAN (Minister of Transport and Communications): Soon.

MR. PHILLIPS: Supplementary, Mr. Speaker. Will the report be available

before the estimates of the Minister will be debated on the floor of this Legislature?

HON. MR. STRACHAN: I certainly hope so.

MR. PHILLIPS: Further supplementary, Mr. Speaker. Is the report presently

being prepared?

HON. MR. STRACHAN: Why, certainly.

MR. PHILLIPS: Arrogance! Arrogance!

HON. MR. STRACHAN: I answered every question.

MR. GARDOM: Supplementary. Is the Minister prepared to inform the House

if that report is prepared now?

HON. MR. STRACHAN: I said certainly.

MR. GARDOM: It is now ready and prepared?

HON. MR. STRACHAN: No, I said it is being prepared. You asked if it

was being prepared and I said certainly.

MR. GARDOM: Is the Hon. Minister prepared to request the House Leader

to have his estimates stepped down until such time that that report is available

prior to his estimates coming on the floor of this Legislature?

HON. MR. STRACHAN: I answered that question. I certainly hope so.

MR. R.H. McCLELLAND (Langley): A point of order, Mr. Speaker. I don't

ever recall in this House ever before, after a Member has been recognized and

is about to ask a question, that the bell rings and question period is over.

It's a very unusual procedure, and I hope it's one that we won't follow any

longer.

MR. SPEAKER: I think I recognized the Hon. Member as the bell rang.

Whether that happened or not, I really don't know how at this stage one should

tackle the matter. The time limit is up. Once the time limit is up, question

period is over.

Interjections.

MR. SPEAKER: As far as I'm concerned, I'll look at the matter, but I

seem to recall that nothing was said by the Hon. Member by way of questions.

He was merely recognized by me and then the bell rang.

MR. McCLELLAND: Mr. Speaker, I really think we're embarking on a dangerous

precedent here. I'd like to ask for leave to continue with my question.

Leave granted.

SOLICITING OF FUNDS

BY HELPING-HAND CLUB

MR. McCLELLAND: Mr. Speaker, my question is to the Attorney-General.

I'm wondering whether or not the Attorney-General has had any complaints in

his office regarding an American outfit called the Helping-Hand Club, which

is soliciting money in Canada through a Surrey post office.

HON. A.B. MACDONALD (Attorney-General): I'll check on the matter. It

hasn't come to my personal attention. If the Member has any information, I'd

appreciate it.

MR. McCLELLAND: Would the Attorney-General take the matter to an investigation

if I send him the information on it?

HON. MR. MACDONALD: Well, I won't undertake an investigation, but I'd

certainly like to look at it and see whether it warrants an investigation.

Orders of the day.

The House in Committee of Supply; Mr. G.H. Anderson in the chair.

ESTIMATES: DEPARTMENT OF HEALTH

On vote 64: Minister's office, $96,345.

MR. R.H. McCLELLAND (Langley): I defer to the Minister if he wishes

to make an opening statement.

HON. D.G. COCKE (Minister of Health): Mr. Chairman, just a word or so.

We have a large budget to be debated. I'm quite prepared to answer the questions

that are put before us.

One question that I might anticipate is something that happened a couple of

days ago in North Vancouver — it occurs to me that maybe I should set the record

straight just very quickly — and that was the whole question of the parking

lot around the Lions Gate Hospital. That parking lot was one that had been approved

in principle by the Department of Health, not certainly as elaborate as what

was required or wanted, but certainly as far as the

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Department of Health could go on a parking lot. Then the district decided to

move in another direction and acquire property which wasn't rezoned — or the

city council decided not to rezone it.

Then the word came out that it was as a result of the Department of Health

in the first place turning down the parking lot, which was not at all true.

I just wanted to say that.

As far as the estimates are concerned I think that I should leave it to the

opposition to ask the questions, and I'll be prepared to answer them.

MR. McCLELLAND: I'm certainly happy that the Minister cleared up that

question of the parking lot. That's probably the most pressing issue in the

province today.

I'm glad, too, that the Minister said he is prepared to answer questions about

his department. Unfortunately, the government has decided to embark upon a course

in which it is impossible to have enough time to get the answers to questions,

because we have, in this estimate of several hundred million dollars, been given

the great and glorious time of three and a half hours to debate the Minister

of Health's estimates.

I think this government is turning out to be, in two and a half or three short

years, a government of broken promises. It has broken the most important promise

of them all, the promise to ensure that democracy continues in British Columbia.

It certainly can't continue under the kind of dictatorial

schedule that this

government placed before the Members of the opposition yesterday with regard

to the debate of the most important part of the democratic process, the estimates

of the Ministers of the Crown.

Now we find that whenever we get into an area which becomes a little touchy,

the government will shut the door on that debate, never to be considered again.

MR. D.T. KELLY (Omineca): You're wasting time.

MR. McCLELLAND: It doesn't matter about time any more, Mr. Member, whoever

happens to be saying that down there, because we can't do anything with this

government any more anyway. We can't debate the most important part of the democratic

procedure because the government has stifled the opposition and gone behind

closed doors because they are afraid to be accountable to the people of British

Columbia.

The Minister of Health will follow the lead set by the Minister of Education

(Hon. Mrs. Dailly) yesterday when she told us in this House: "You've lost your

chance to get the answers to the questions in my department." She said that

in the House yesterday, Mr. Chairman, and that is what the Minister of Health

will do as well. The Minister will cut off the debate.

Mr. Chairman, I said earlier that this government has proved to be the government

of broken promises, and probably the most critical area where that promise has

been broken is in the area of intermediate care for the people in need in British

Columbia.

We see millions of dollars ready to be spent for the B.C. Medical Centre, and

that's fine. Millions of dollars being spent on increased staff, and I guess

that's fine as well. Millions of dollars being spent in many other areas, which

are all good, but not one nickel in the budget for intermediate care. Not a

nickel.

I suggest that our priorities in this province are in the wrong place.

There was a recent report from the Greater Vancouver Regional Hospital District

which said that 3,500 intermediate-care beds are needed right now — not next

year or next week or next month or next decade, but today. We are 3,500 intermediate-care

beds short in British Columbia, and 4,000 will be needed by 1981. Yet not one

nickel in this budget for intermediate care. Not a nickel. Last year at least

we had $1 million in there which would pay for staff, or something. This year,

not a nickel for intermediate care.

Many of the Members of the House travelled a couple of years ago with a committee

that went all over British Columbia trying to assess the health care needs of

British Columbia. We found overwhelming.... The Member for Chilliwack (Mr.

Schroeder) will verify, the leader of the Conservative Party (Mr. Wallace),

the Member for Dewdney (Mr. Rolston) and the Member for Vancouver-Burrard (Ms

Brown) will all verify that the one thing the people in British Columbia told

us was that there was an urgent need for intermediate-care beds in British Columbia.

The Member for North Okanagan (Mrs. Jordan) was there too.

We heard it over and over and over again that there are these people — and

I've said this before — who are caught in the twilight zone of health care.

They are not covered under acute care; they are not covered under extended care.

They are in that area in which they are not being looked after. That's a shame

that we are faced with today because there are many of them who are being penalized

both psychologically and financially because we are not making the facilities

available.

We found overwhelming concern throughout British Columbia for these people.

The Minister says that we are developing a home-care programme, and that's good

too. Certainly we need to extend home care and preventive care, and all of the

other programmes — early discharge and whatever they are — but we cannot do

it in isolation. The programme must be developed with a system of intermediate-care

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facilities so that those people can be looked after and brought within the

financial structure of the system so that they don't lose their life savings

just because they happen to be sick.

AN HON. MEMBER: Sick is sick.

MR. McCLELLAND: That's right. The Member says: "Sick is sick." And it

is, and health care is health care. It doesn't matter what level you happen

to be at. If you are in extended care you are just as sick as you are if you

are in acute care or if you are in intermediate care.

Let's get rid of all these labels. Health care is health care ... is health

care is health care, and the people of British Columbia have a right to demand

full health care regardless of the level of their condition.

The Minister says that the system can't be developed overnight. Well, sure

it can't be developed overnight, but the Minister's had three years almost — three

years and nothing has been done towards developing an intermediate-care system

of facilities. We've wasted those two and a half to three years and the patients

in need of care in British Columbia are the people who have to suffer because

of it.

The Minister attempts as well to tell us that prevention is the way to go,

that we don't need to spend millions of dollars to develop intermediate-care

facilities just as long as we have a programme of prevention. That's important,

but prevention isn't a substitute for health care, no substitute for the needs

of the people. Prevention is a long-term educational process which also won't

happen overnight, and which needs to be vigorously pursued, but in conjunction

with the development of the kind of programmes that need to be developed to

meet the needs of the people of this province.

The people who are involved and who are in need of intermediate-care facilities

must get coverage on exactly the same basis as other levels of care, with no

financial penalties. Once again this government has broken its promise to a

large segment of the people in need in this province.

I'd like to move on to ask a couple of questions about some of the things that

have happened in health care in the province in the past; and I refer to the

health security research project. I may have missed an announcement from the

Minister's office, I'm not sure. If I did, I'm sure the Minister will tell me

about it. But I don't recall seeing any announcement which terminated the health

security research project or replaced it with something else, or moved Dr. Richard

Foulkes into a different position, or renamed the health security research project.

I do think that it's time the people of British Columbia were told, first of

all, what the total bill for that health security research project was — the

bill that the taxpayers are going to have to pay for a report of questionable

value. What was the final bill? Was it $750,000? Or was it $1 million, $1.25

million, $1.5 million, $2 million? How much did it cost the people of British

Columbia to prepare the final study of the health security research project

under Dr. Richard Foulkes?

I think, too, that the people of British Columbia have a right to know where

Dr. Foulkes is now within the government hierarchy — the Department of Health

hierarchy, at least. Is he still actively employed? Is he doing more research?

Is he co-ordinating the research that's already been done? Is he providing new

input to the Health department? Exactly where is he, what is his salary, and

is the Department of Health still paying him?

The Minister in his estimates this year has an intriguing new development called

the consultant to the Minister: $61,455. I think the people of British Columbia

have a right to ask who that consultant to the Minister is or will be. Will

it be Dr. Richard Foulkes? To a consultant to the Minister: $61,455. Is that

the new job for Dr. Richard Foulkes? Has he already been appointed? When will

he be appointed? If it isn't Dr. Foulkes, who is going to get that job and what

will the criteria be for that position? Or is Dr. Richard Foulkes, going to

be the head of the new health advisory council, which is also a new vote in

the Minister's estimates for $140,000?

The health advisory council: what will it do? When does it start to operate?

What can we expect in the way of new ideas and programmes from that health advisory

council, and who will be its head? And what relationship does that health advisory

council have to do with the health security research project, if any? I think

these are questions that the people need to know, because they want to know

where the tax dollars of this province are going, when they should be going

to provide intermediate-care beds in British Columbia.

I'd like also to ask the Minister if he can tell us where we're at with regard

to the employees of the government who are salaried physicians and who are now

in conflict of a certain kind with the government because they're being forced,

against their wills, effectively into a union which they don't want and don't

need.

I'd like to ask the Minister if he'll tell us if there is some kind of an ideological

conflict between himself and the Provincial Secretary (Hon. Mr. Hall) with regard

to this matter. It would seem, as an observer on the outside, so to speak, that

the Minister of Health, along with his ideas, has made a commitment and a promise

to the British Columbia Medical Association that the salaried physicians can

be opted out of legislation which puts them in the same category as the professional

employees' association.

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On the other hand, we know that the Provincial Secretary insists that all employees,

regardless of their status, should be under the wing of the professional employees'

association and, in effect, forced into a union against their will — a union

certainly not of their choice.

It's probably important to remember that when the legislation was drawn up

the people who drew up the legislation — the lawyers — conveniently wrote themselves

out of the legislation so that they didn't have to be covered by a union that

they didn't like, One other group, which happens for one reason or another to

have a lot of muscle with the Ministers involved, the nurses' association, also

opted out. Yet the doctors were left in, despite what I understand was a commitment

and a promise from the Minister and from his executive assistant. The only reason

I can draw from that for that refusal to maintain that commitment is that there

is some kind of conflict between two Ministers in government. That conflict

is not only affecting the doctors — the salaried physicians — but it also seems

to be affecting all of the professional employees because negotiations have

now ground to a halt and nobody knows where they stand.

Can we expect legislation this session ensuring that the salaried physicians

will be able to opt out of this legislation? There is a very strong objection

— in fact 100 per cent objection — among those salaried physicians against compulsory

unionization. They've been represented, and represented well, over the years

through the British Columbia Medical Association and they wish to continue that

representation. They don't wish to be forced into some other kind of union with

which they have no agreement and with which they've never had an association.

Morale among the salaried physicians is extremely low, Mr. Chairman, because

of this impasse at the moment. They do not want to be in the professional employees'

association. Just as one reflection of the low morale, the salaried people at

Riverview have taken the extreme position that they'll take militant action

if something isn't done. The doctors have pulled back, waiting for the Minister

to act. They're anxious because they haven't seen any action — no bills have

been introduced at this session. They're anxious. They don't want to take militant

action but they're ready if it becomes necessary.

I can be corrected if I'm wrong here, but the last word I had is that the shortage

of staff at Riverview is quite acute. There is also very little response to

the advertisements which are running to fill those vacancies. I suggest and

the doctors have suggested that this reluctance to begin staffing at Riverview

is directly related to the dispute now before the government with regard to

the salaried physicians. I'm told, too, Mr. Chairman, that waiting time for

admission of acute psychiatric emergencies from the Vancouver area at Riverview has jumped from three days to 10 days. That's

a shocking indictment of the situation, particularly when it could be solved

almost immediately by some strong action by the Minister of Health.

If there is a conflict with the Provincial Secretary, I'd suggest that the

Minister of Health should knock some heads together with his own colleagues

and get that conflict settled as quickly as possible.

If I could move on, Mr. Chairman, to the British Columbia Medical Centre for

a moment at least....

Interjection.

MR. McCLELLAND: Yes, I guess we don't have too much time to deal with

many of these important matters. I know that the clock is running and the Minister

is anxious for 6 o'clock so he can close the doors and not discuss his estimates

any longer. But we'll attempt to get as many questions as possible before the

Minister in that short time limit that we do have under the new rules of closure

in British Columbia.

I wonder whether the Minister will tell us whether or not construction of the

children's hospital at the Shaughnessy site, the UBC Medical centre or one of

the components of the new B.C. Medical Centre will begin this year. There's

a lot of concern among the people of British Columbia about the B.C. Medical

Centre. For one thing, they don't understand it. It looks like some kind of

monolithic centralized bureaucracy which may not deliver the kind of health

care that's necessary for British Columbia.

I hope it will. But if it becomes too big and too central, then it will get

caught up in that kind of bureaucratic structure that we are seeing in so many

parts of government in British Columbia and won't deliver the necessary services.

The idea of a new children's hospital at that site is good. We are in desperate

need of a new children's hospital. There isn't any doubt about that.

But I wonder how much more it is necessary to put into that crowded part of

residential Vancouver without upsetting the whole of the community and altering

the lifestyle and social structure of a rather important part of British Columbia.

When the maternity unit is put into the British Columbia Medical Centre at

the Shaughnessy site, does it mean that all maternity cases, most maternity

cases, or just acute maternity cases in need of special care will be put into

Shaughnessy BCMC site? Where does the general practitioner fit into this whole

question? Is the general practitioner — a kind of cornerstone of medical practice

in this country at least — going to be cut out because the maternity cases are

going to be forced into a super-specialized area in the British Columbia Medical

Centre? Are the personal aspects of patient care going to be down the

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drain because of the cold, impersonal nature that could develop at the British

Columbia Medical Centre? Will the general practitioner be forced in any instances

to hand his patients over to a specialist and be cut out of the patient-doctor

process? Will the B.C. Medical Centre in fact downgrade the need of the general

hospital in our community?

You know, it is interesting that while we are going to centralization to a

large degree in the delivery of hospital services — and we are doing it, I'm

sure, because of a need to lower costs — I am told that in Great Britain today

they have been through that stage and are now going back to square one and developing

community hospitals. They are finding in that country that that is where the

people are sick — out in the communities, not in the large centres where they

work but rather at home, where the family needs care close to home.

Perhaps we are moving too fast in this need to regionalize hospitals and centralize

facilities.

What about patient preference in regard to this British Columbia Medical Centre?

Will the patient have the right to choose? I know that that right is being taken

away from patients to a large degree now, but I don't think it should be eroded

any further. I wonder whether or not that right will be protected when the British

Columbia Medical Centre begins to grow and expand and spread its tentacles into

every area of health care. Will the patient be bounced from doctor to doctor,

place to place, with no regard for his own preference?

Does the British Columbia Medical Centre hope one day to become the site of

all teaching at UBC? Under the Act, the British Columbia Medical Centre must

approve all appointments for teaching. All appointments for teaching! Mr. Chairman,

that gives the British Columbia Medical Centre an incredible amount of power

to control everything that happens with regard to health care in this province

— everything that happens.

Recently, the Dean of Medicine at UBC, Dr. David Bates, said that UBC's teaching

programme is in danger of losing accreditation from the Royal College of Physicians

and Surgeons of Canada because of the moves made by the British Columbia Medical

Centre and the refusal to provide more teaching space at UBC.

I know that the Minister went before Vancouver city council not long ago and

perhaps attempted to defuse some of the criticism of the BCMC before Vancouver

city council. But I think, more importantly than that, it is time that the Minister

gave some answers to the people who are mounting petitions and who are vitally

concerned about the British Columbia Medical Centre, who live in that area of

the Shaughnessy Hospital, and outside it as well, just people who live in Vancouver

and don't wish to see the lifestyle of that community destroyed because of a

major expansion of the facilities of the Shaughnessy site.

In the Municipal Affairs department we heard it again today, in the Housing

Department, the Agriculture department, B.C. Hydro.... Like so many other departments

of government, is the Health department now committed to forge ahead with all

of its plans for the BCMC despite any opposition that might come from the community?

Will it ride roughshod over the concerns of the people who live in Vancouver?

Will it consult? And more importantly, will it take into account the concern

and the wishes of those people? Will the government forge ahead with its plans

for the British Columbia Medical Centre without the necessary zoning approval

from the City of Vancouver? Will it overrule, in fact, as it has the power to

do, the zoning regulations of the City of Vancouver?

There's been very little consultation in advance with the people concerned

in the city; very little consultation. As a matter of fact, even the moves the

government did make to attempt to at least portray some interest in cooperation

haven't been working. The government set up an advisory committee which isn't

allowed to advise on matters of great concern with regard to the British Columbia

Medical Centre.

If I could quote from an

article in the Vancouver Sun in which the British

Columbia Medical Centre citizens advisory committee is upset. It had the ground

cut from under it when BCMC board chairman, Jack Christensen, announced that

the committee is not going to retard progress or delay decision. Then, when

the committee asked what it could advise on — the advisory committee was interested

in what it could advise on — the chairman said: "Well, you can advise on parking,

and you could certainly round the edges off the building".

That's the kind of arrogance we've been getting from this government and it's

appointed officials for too long, Mr. Chairman. You set up a citizens advisory

committee and then the chairman says: "Well, you can advise on parking, and

you can round off the edges of the buildings". What's the point of having the

committee? It's not much wonder that the committee is thoroughly discouraged

and doesn't see any chance for input to this major change in the delivery of

health care in British Columbia.

Now I'd like to suggest that a heck of a lot more study and more consultation

needs to go into the BCMC concept before you go much further than, perhaps,

the children's hospital and the maternity-care wing, whatever it's going to

be. Let's halt any other plans until we really know what that British Columbia

Medical Centre complex is going to do to the City of Vancouver.

First of all, it is in a primarily residential area. The traffic congestion

when that centre goes in will be phenomenal. The social costs to the community

will

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be phenomenal. There will be a serious problem with developing parking areas.

There will be a serious disruption of the residential area. I suggest that disruption

will come whether or not the plans for the BCMC site at Shaughnessy are cut

back, because you can bet that once the foothold is in there, the expansion

will come.

Certainly, the pressure will be on to develop the sort of ancillary facilities

that will come with that kind of a medical centre — private doctors' facilities,

medical centres of individual doctors, drugstores, commercial developments,

apartments needed for the staff of the community. All kinds of peripheral development

will happen regardless of the good intentions of the government might have at

this time. That whole area will, in fact, be institutionalized. No doubt about

it. It can't help it. With the plans you'll destroy a residential community

at a time of severe housing shortage.

I realize that you're going to tell me, Mr. Chairman, that I have about two

minutes left. Once again, I'd just like to regret the kind of destruction of

democracy that's been placed in this House. I have many other questions I'd

like to ask the Minister and perhaps, next year or some other year in this House,

we might get the opportunity to come back and ask the continuing questions.

I would like to suggest that there are some serious concerns in British Columbia

about the delivery of health care, and the moves that the Minister is making

now are moves which cannot be altered and will be there for all time. He's embarking

on several new areas, new directions, and those directions will be forced upon

the people of British Columbia for many years to come. Any other government

that comes in will be forced to live with those changes, at least for some years.

Because of those changes, and the nature of them, and the seriousness of them,

I suggest that the Minister needs to look very carefully at them.

Finally, I just want to re-emphasize that the most important thing facing the

people of British Columbia today in relation to the delivery of health care

is that vast grey area which isn't being covered with intermediate-care facilities.

I think the government has broken its promise again by not including one nickel

in the budget for intermediate care and, in fact, cutting out a vast segment

of our society from the care which is so desperately needed in British Columbia

today.

HON. MR. COCKE: I have every sympathy for this rather new Member in

the House. He's talking about enough time for the estimates. Mr. Chairman, the

estimates used to take something between 60 and 79 hours in this House. We afforded

an opportunity to the opposition for 135 hours. They decided to spend that whole

135 hours on one or two Ministers. We felt that that wasn't good for democracy

so therefore we've given you a kick at the cat, at every Minister, and you don't

really like it. You don't like it because it's just a little bit too fair.

MR. McCLELLAND: Oh, come on!

HON. MR. COCKE: Yes, come on.

MR. J.R. CHABOT (Columbia River): Let's have some serious statements.

HON. MR. COCKE: Mr. Chairman, you know the way they used to get through

the estimates in the old Socred days. We sat here until 2 o'clock in the morning

until that vote was through. What a bunch of nonsense! And they compare that

to today, when everybody gets ample opportunity. A number of Members stand up

and talk all sorts of irrelevancies, and then they talk about broken promises,

Mr. Chairman. It's just a little bit too much to take.

And the Member for Columbia River (Mr. Chabot) asks for some serious statements!

He's the one Member who should never make that request, Mr. Chairman.

Mr. Chairman, I'd like to deal just for a few minutes with intermediate care.

Not one nickel. That's what the Social Credit Member said. Not one nickel. Millions

of dollars for increased staff, he said, but not one nickel for intermediate

care. The Member didn't even bother to do his research, Mr. Chairman, as usual.

There's $10 million.

MR. McCLELLAND: Where?

HON. MR. COCKE: In the Minister of Human Resources' (Hon. Mr. Levi'

s) department — $19 million, Mr. Chairman, for intermediate care alone. and $6

million in my budget for home care for the same clientele, Mr. Chairman.

Interjection.

HON. MR. COCKE: He is flush-faced, Mr. Premier. But you know he won't

feel real shame. Not the way he should.

AN HON. MEMBER: He doesn't know shame.

HON. MR. COCKE: Mr. Chairman, it would be nice if just once those people

could come in here with the research done. After all, since we've been government

we've provided them with all sorts of money for research. Why don't they do

it?

Mr. Chairman, we have as much feeling and as much conscience about this area

as anybody. We, for instance, took over the extended care system left to us

by the Social Credit Party. There were half enough beds. We've been trying desperately

to create those

[ Page

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beds, and we can go over that in great detail, if you want to, later on in

the estimates. But the fact of the matter is we're still building extended-care

beds, and have finally almost caught up to the needs in Victoria. You know,

it's not that fast, to plan and build. We know that, certainly, when you have

to have a regional hospital district who decides that they want to make that

a priority. One of the things that we've had here, unlike the situation in acute

care, in the Capital Regional District is emphasis by the regional district

on extended care. Therefore this area is not too badly off compared to, say,

Vancouver with 1,100 beds short in extended care today — extended care which

started in 1966.

Mr. Chairman, we agree very much that intermediate care has to be certainly

a priority, and it has been with us. This $19 million is a lot of money that's

going into this area. The home-care money — there's a lot of money that's going

into this area. And, Mr. Chairman, we want to see that fully integrated system

of health care. One of the reasons that we're talking at great length with the

Minister of Health and Welfare in Ottawa is around this whole question because

we want them to adopt that same attitude.

So, Mr. Chairman, the two departments most closely concerned are dealing with

this area and dealing with it in a way that it's never been dealt with before.

Many, many community projects are being assisted, financed by this government

in order to get intermediate care on line.

To get away from intermediate care, that Member talked in terms of the Health

Security Programme Project. The consultant to that project was Dr. Foulkes.

Dr. Foulkes now finds himself in vote 75 as part of the community health services

development. Dr. Foulkes' work now is on health sharing — that's sharing costs

with the federal government and other levels of government. He's also being

asked to took in on the whole question of the four pilot projects that we have

going in community human resources and health centres. So that's his work.

The homework of the Member also comes to the forefront in his

discussion of the consultant to the Minister. I don't know how many

times last July ... when we made the appointment of Jim Mainguy who was

an assistant deputy and raised to consultant to the Minister until such

time as we could create the establishment for the new deputy of our

department, and that's where he finds himself today. So this was not a

consultant in the form that you suggested.

Again, it is so easy to find out. Just a little bit of homework, Mr. Member,

instead of getting up and raising questions and innuendo in the way it seems

quite natural for you to do. I just suspect that you should turn around sometime

when you have your research assistant in the House and ask him to kindly get

you some facts before you come in here. The order-in-council was passed and

he was advised at that time what it was all about.

Mr. Chairman, he said also: "What's the connection of the health advisory council

with Dr. Foulkes?" The health advisory council was recommended by the College

of Physicians and Surgeons, the Medical Association, the RNABC and practically

everybody else involved in health care in the province over the last number

of years.

We have now put the money for the health advisory council in our budget, We

have not got a chairman for it yet. We have so far circulated a number of groups,

including the Medical Association and others, asking them for nominees for this

very important body whose job it will be in the future, once it is structured,

to look ahead in health care and to give advice where it could be given independently.

Interjection.

HON. MR. COCKE: Independently of the department; they will be outside

the department.

It has been recommended over the years, and I don't really think I must go

into a great deal of information on this by virtue of the fact that so much

of it has been public discussion, particularly over the last few months and

over the last number of years. Dr. Corbett of the Medical Association has been

calling for a health advisory council for British Columbia for at least a decade.

Now we hope we can put it all together in such a way as to make it a really

beneficial aspect of health care in the province. I can't guarantee it. All

I can say is that it's in the budget, and providing we can get the right kind

of cooperation, the right kind of people and the chairman, who is going to

be very, very important to this, it will go ahead.

The Member asked about salaried positions. Needless to say, the salaried position

situation has been very much in the forefront recently. I don't think it would

be in the best interests of anyone if I were to stand here and inflame the situation,

and I am not going to. I would suggest to other Members that they take that

as some leadership. There's no ideological conflict between the Provincial Secretary

(Hon. Mr. Hall) and myself.

As far as shortage of staff is concerned, Mr. Member, the shortage of staff

in that particular area which you talked about has been with us virtually since

day one. There was a little while in my tenure when that lack of shortage of

staff was almost brought up to optimum, but again we find it.

One of the very, very hard things for a psychiatrist to do is work in the institutional

setting when there are other ways of working in that particular field. I just

have to say that I would hope that psychiatrists will pay a little more attention

to an area that needs them.

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About the construction of the children's hospital — I understand that the construction

of that complex, which will be a children's hospital and maternity, will take

place this year. I would hope that it gets off the ground and running. This

province desperately needs it.

The Member discussed the centralized bureaucracy of BCMC. That's precisely

what we tried to do in creating BCMC — create a situation, or at least a vehicle,

whereby the different conflicting groups could get together and formulate policy

around the best direction for teaching and health care in the Province of British

Columbia. What we did is get some very very active, thoughtful people and put

them on a committee headed by Jack Christensen who, incidentally, has never

taken a nickel, nor has his BCMC group. He is an industrialist who is prepared

to really work for the community, and, as a result, took a lot of abuse from

Members of the opposition and the public at large.

Mr. Chairman, I think it is quite absurd to listen in this House to the kind

of criticism that we heard around what the BCMC is doing and how they are doing

it. They have 23 committees reporting to BCMC. "No consultation," the Member

said. But 23 committees report to BCMC; it is an entirely different concept

than what the Member discussed in this House.

Mr. Chairman, the maternity situation will be part of that new concept at the

Shaughnessy site, but I want to remind you that the BCMC isn't only there. BCMC

is attached to all the teaching sites; St. Paul's, General, G.F. Strong and

others. The Member says: "What are we going to do about maternity? Are we going

to make it really highly sophisticated?" Yes, I hope we are going to have highly

sophisticated procedures there. It is going to be high-risk maternity. But there

is also going to be primary care.

Mr. Chairman, what I've done is to ask the Salvation Army, who run Grace Hospital,

to run this particular unit as well. As a matter of fact, ultimately I would

suspect that we will phase the Grace Hospital into this particular unit. I think

that that would serve well. Implicit in their service over the years has been

Grace's recognition of the importance of GPs and a recognition of the importance

of the people who are involved with primary care in maternity. They are not

going to let go of that if in fact they take up the challenge we have offered.

I suspect they might very well. In any event, what we are trying to do is to

develop a system whereby we have something we have not had heretofore, and that

is a hospital system that lends itself to teaching.

Mr. Chairman, when that Member said that BCMC is the cause for the college

suggesting that they were not going to accredit UBC as a teaching facility,

it has got to be ludicrous. They were talking about the clinical facilities,

the clinical facilities that have been neglected over these many, many years

— VGH, St. Paul's, et cetera, et cetera — that couldn't get a nickel. So let's

not hear that kind of rubbish. What we are doing is trying to provide them with

space outside the hospitals until we can upgrade the space. What that Member

was talking about is not going to happen. But I suggest to him that he do his

homework.

Once again, Mr. Chairman, I just want to say that we want to forge ahead. We

don't want to walk roughshod over anybody in the Shaughnessy area or any other

area. But there are 47 acres there; they have always been hospital acres. We

think that some of those acres should be properly utilized. Yes, there should

be plenty of green space. No, it should not detract from property values. Yes,

we think that the City of Vancouver, if they are asked to build special doctors'

offices up there, will have to respond in their own way. If they want to permit

that, then that is an attack on the community. I don't think it needs doctors'

offices up there. They have doctors' offices all around Broadway and other areas

that are very close.

Mr. Chairman, I suggest to you that Jack Christiansen and his group are doing

an excellent job and they are certainly getting cooperation from my department

when they are asking for it. I think we can forge ahead in health care if, in

fact, we are given an opportunity.

MR. P.L. McGEER (Vancouver–Point Grey): Mr. Chairman, I realize that

in the past it has been possible for Members to follow up with supplementary

questions, but I think that if all three parties will have an opportunity to

ask questions during the estimates, we are going to have to forgo that luxury.

AN HON. MEMBER: Oh!

MR. McGEER: We have been presented with an absolutely unique form of

closure in this assembly. I have been in opposition — it's a dubious honour,

Mr. Chairman — longer than anybody on the opposition side has been in opposition.

I have watched one government go, and it won't be very long before another one

is going to go. But regardless of whether governments come and go, this is the

forum of the people. We have been sent here by the people to have those Ministers

who sit on the Treasury Board held accountable for their actions.

Looking in the past, I cannot imagine how a situation that we have had in the

past, where a Minister has been accused of gross indiscretions, where it was

known that if he had to appear on the floor of this House and answer his salary

vote there would be a revolution, practically.... Therefore resignations have

been asked for in this House rather

[ Page

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than have a Minister's estimates come to a vote. But in the present rules it

wouldn't matter if a Minister committed some gross indiscretion.

MR. CHAIRMAN: Hon. Member, we are on vote 64...

MR. McGEER: All he has to do would be to sit for three or four hours;

then his vote is called and you go on to the next one.

MR. CHAIRMAN: ...responsibilities of the Minister of Health.

MR. McGEER: Mr. Chairman, it is a fact. I know that this Minister isn't

going to have to face that kind of an inquisition this afternoon. By and large,

the Minister has done a creditable job. But the day will come....

HON. D. BARRETT (Premier): Shame! Withdraw! Withdraw! You're accusing

the government of doing a good job. Shame!

MR. McGEER: Give me a chance to continue, Mr. Premier.

AN HON. MEMBER: Quit while you're ahead.

MR. McGEER: Give me a chance to continue, Mr. Premier.

HON. MR. BARRETT: No wonder you've been in opposition so long.

MR. CHAIRMAN: Order, please.

MR. McGEER: The Premier has got many years in opposition to face if

he's to stay in politics, and it behooves him in the interests of himself or

his party not to rob this assembly, and the Members who are sent here by the

people, of traditional rights.

MR. CHAIRMAN: Could we return to vote 64, Mr. Member?

MR. McGEER: Mr. Chairman, there is not an assembly in Canada that has

less protection today in the matter of accountability of the Ministers of the

Crown than the Legislature of the Province of British Columbia.

MR. CHAIRMAN: Order, Mr. Member. Can we get to vote 64?

MR. McGEER: The Members have been stripped of their rights to question

and to hold Ministers accountable. Let us not for one moment lose sight of that

fact. It has happened in one single day. The opposition didn't agree to these

rules on limitations of debate, and what the....

MR. CHAIRMAN: The matter under question is the responsibilities of the

office of the Minister of Health. Will you stick to vote 64, please?

MR. McGEER: Is it not his responsibility as a member of the executive

council to set overall policy? He is an guilty as any other Minister of the

Crown with respect to the rules that have been brought into this House. The

opposition never agreed to this. They don't agree to it now. The government

has proved its incompetency in managing the House, as it has in managing the

affairs of the public outside the House.

MR. CHAIRMAN: Mr. Member, if you do not wish to speak on vote 64, the

Chair will recognize another speaker.

MR. McGEER: I have a dozen questions, Mr. Chairman...

MR. CHAIRMAN: On vote 64, I hope.

MR. McGEER: ...that I propose to ask the Minister — specific questions

that deal with the way he has conducted his specific Ministry, quite apart from

the role he has played as a Member of the executive council.

Before doing that, I'd like to welcome some new faces behind the Minister,

particularly Mr. Mainguy who is the new Deputy Minister. We wish him and the

other officials well in their new duties.

The centre-piece of the Minister's policies with respect to hospitals has been

the B.C. Medical Centre. And the centre-piece of the B.C. Medical Centre is

the construction of new facilities at the Shaughnessy Hospital site. A number

of us, I among them, warned from the beginning of the problems that were going

to arise. Some of the pigeons are coming home to roost.

No one has spoken more eloquently of the democratic attitudes that the new

government has, its desire to consult, to be an open government, than that Minister.

Yet it seems clear today that he is prepared to ride roughshod over the City

of Vancouver and to bulldoze citizen committees who are concerned about the

quality of life in their neighbourhoods. "Phony committees," says the Member

for Vancouver–Little Mountain (Mr. Cummings).

Mr. Chairman, just today, that Member who represents the area that has become

so controversial, received in the mail, as I did, a brief from the Citizens'

Hospital Action Coalition. These groups are

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against the Minister and his Shaughnessy plans.

I ask you, Mr. Chairman, and the Minister as well as the Member, whether these

groups are phony groups. The Cambie Ratepayers' Association, is that a phony

group? The Douglas Park Community Association, is that a phony group? The Social

Planning and Recreational Council of B.C., is that a phony group? The Shaughnessy

Action Committee...that's phony? All right, the first three aren't. The Shaughnessy

Action Committee which has collected thousands of signatures on petitions against

the Minister's plans in that Member's area — and the Member says: "It's a phony

committee."

Interjection.

MR. McGEER: Well, the Minister has been given the signatures, Mr. Member.

I don't need to table them because the government has received them. The Marpole-Oakridge

Area Council, is that phony? Mr. Chairman, through you, to the Minister of Human

Resources (Hon. Mr. Levi), is that a phony committee? The British Columbia Council

of Consumer and Health Services: I'd like to ask the Minister of Consumer Services,

is that a phony committee?

The Red Door Information Centre. There is one for the Member for Richmond (Mr.

Steves). Is it phony? Maybe it is.

The Renfrew-Collinwood Information Centre; the Dunbar West–Point Grey Property

Owners' Association; Cedar Cottage Ratepayers' Association.

AN HON. MEMBER: That's nonsense!

MR. McGEER: That's nonsense? The Fairview Ratepayers' Association —

are they nonsense? Shaughnessy Hospital Citizens Advisory Committee. How about

that one?

Interjection.

MR. McGEER: Oh, oh! Mr. Chairman, am I deaf?

The Shaughnessy Heights Property Owners Association — how about them?

MR. CHAIRMAN: Could you relate your remarks to the Minister's responsibilities,

please?

MR. McGEER: I'm right on, Mr. Chairman. I'm explaining to him the citizen

committees in the City of Vancouver who are opposed to the plan that Minister

brought forward.

Downtown-Eastside Residents Association. I tell you, Mr. Chairman, when the

Shaughnessy Heights Property Owners Association and the Downtown-Eastside Residents

Association can agree on something, Ministers ought to take notice.

The Grandview Community Centre.

Those are 16 associations — in my opinion, unlike that of the Member for Vancouver-Little

Mountain (Mr. Cummings), real and valuable associations, not phony ones — which

have formed themselves into the Citizens Hospital Action Coalition.

Mr. Chairman, when the government announced its plan for a super hospital at

Shaughnessy it committed the one sin which this government had criticized repeatedly

other governments doing: it failed to do an environmental impact study, That

study was done by the City of Vancouver planning department. It was done because

the City of Vancouver knew that when that major hospital complex went ahead,

if it were to go ahead, they would be faced with a fait accompli and requests

for zoning changes.

The implication, Mr. Chairman, of what this major hospital complex would do

to a residential neighbourhood was absolutely shocking.

MR. R.T. CUMMINGS (Vancouver–Little Mountain): There are 1,400 beds

there now. Tell the truth.

MR. McGEER: The City of Vancouver, Mr. Chairman, formed an advisory

committee, because they thought the citizens ought to be consulted — not the

Minister, not the NDP government, the City of Vancouver.

Mr. Chairman, the Minister wouldn't meet with that committee once he learned

they were opposed to his plan. Ask that citizens' committee how many meetings

they have had with the Minister. They had one. The Minister found out that they

were opposed to him and that finished that citizens' committee.

There were 15 other committees who were just as opposed as this one, and they

formed themselves into the Citizens Hospital Action Coalition. Will the Minister

meet with them? No, sir! There isn't any meeting with these committees. Why?

Because they are opposed to his plan.

Unfortunately, Mr. Chairman, there isn't a single facility being planned for

that Shaughnessy site which could not be placed in some other location to better

effect. That's basically the problem. When you begin to examine this plan it

is faulty, not just on environmental impact grounds.

Interjection.

MR. McGEER: Well, that's what the planners said before the Minister

came in with the plan that everybody is opposed to.

I'd like to ask the Minister how much money has so far been wasted on architects'

fees for plans that never will be implemented. Is it half a million dollars?

Is it $3 million? How much have we wasted at this

[ Page

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point?

Secondly, is there still going to be a plan to put underground parking on that

site at $5,000 a stall? The highest priority, as I understand it, in development

of that site was to commence with the underground parking. This was with the

Health Resources Fund — $52 million — that had been held in abeyance for the

development of teaching facilities for medicine in British Columbia. At the

time this money was not being spent, the medical school, for lack of facilities,

was taking in 80 students and graduating 60. But the College of Physicians and

Surgeons was licensing 300 doctors a year, and anywhere from 300 to 400 qualified

students were being turned away.

Then the priority went to underground parking at $5,000 a stall. Is it going

to go ahead or isn't it? Will there be underground parking?

The next, Mr. Chairman, concerns the facilities that are actually on the Shaughnessy

site. I don't know how many Members actually go and tour hospital facilities,

but I have occasion to do that professionally. I can tell you that that Shaughnessy

hospital is at least half empty. There's a desperate shortage of beds in British

Columbia and we have a hospital that's not running anywhere near capacity. As

I understood the plan that we paid several hundred thousand dollars for, it

was to tear down functioning beds in British Columbia at a time when there was

a bed shortage.

Members have stood here — the Member for Oak Bay (Mr. Wallace) and myself and

that Member when he was in opposition — complaining about the lack of beds.

So our first step would be to tear down good beds. My question is: will hospital

beds be torn down on the Shaughnessy site in order to build new hospital beds?

My next question is: where will the Grace Hospital go? What will be its physical

location? Will that hospital maintain its professional and administrative integrity?

If it's not going to, if it's to disappear as an entity, I would ask the Minister

to say so today. If it's going to maintain its integrity....

Interjection.

MR. McGEER: I thought the answer was equivocal; I thought it was vague.

That's why I'm asking it again. No doubt the Member for Langley (Mr. McClelland)....

Interjection.

MR. McGEER: You said you hoped it would be part of a new unit, but that's

not precise. Where will that physical unit be? Will a number of...? You said

it would be gradually phased out. I didn't understand that.

AN HON. MEMBER: Where were you?

MR. McGEER: What I'm asking is what will happen to that hospital.

HON. MR. COCKE: I said that I have asked Grace to run the new hospital.

MR. McGEER: The new hospital. How many beds will that new hospital be

and where will it be physically located? Where will the Children's Hospital

go?

HON. MR. COCKE: Right there.

MR. McGEER: That'll be along with it. Will the Children's Hospital run

as an entity in that location on the Shaughnessy site?

HON. MR. COCKE: Right.

MR. McGEER: On the Shaughnessy site. The southeast corner?

Will good hospital beds be torn down to make room for that?

HON. MR. COCKE: No.

MR. McGEER: Will it be underground parking?

Interjection.

MR. McGEER: Where's the cancer institute going to go? Will it be moved

to the Shaughnessy site as well? Physical facilities? Will it move to the McGavin

building at 10th and Heather? Where's the cancer institute going to go? Will

the Minister be inclined to accept a proposal, if he ever gets to hear it, from

the citizens' advisory committee which suggested a site near the endowment lands.

Where will the obstetric and pediatric facilities at the Vancouver General

Hospital go? Will they be rebuilt at the Vancouver General Hospital? Will they

be incorporated into the new Shaughnessy site? If so, who's going to run it

— Grace and the Children's or pediatrics and obstetrics from the Vancouver General

Hospital?

The next question: will there be a hospital built in the east end of the City

of Vancouver? Has that got higher priority than rebuilding hospitals that already

exist? In other words, can the people in the east side of Vancouver reasonably

expect a new hospital for them before other hospitals are torn down.

Will the Vancouver General Hospital become larger or smaller in the future?

What does the Minister plan to do with the facilities at the Vancouver General

Hospital? How many beds will it have five years from now if the Minister is

still the Minister?

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Will there be a willingness on the part of the Minister and his planners to

abide by the zoning regulations of the City of Vancouver?

We very much respect the efforts that Mr. Jack Christiansen is making as chairman

of the superboard, but he is an appointee of the Minister. He is the Minister's

lieutenant and if his wishes are to be put forward they become the Minister's

wishes, and the Minister has to decide whether he wishes to run roughshod over

the City of Vancouver as well as the citizens' groups.

Will the Greater Vancouver Regional Hospital District be required to review

any plans of the B.C. medical centre? The GVRHD is the responsible hospital

planning body. They've been in business longer than the BCMC. Will they be the

final voice in those plans before the government gives the go-ahead?

And yes, Mr. Member for Vancouver–Little Mountain (Mr. Cummings), will there

be a teaching hospital at UBC? I want to say that this has been the consistent

recommendation for 20 years and regardless of what happens under this Minister's

direction, it will remain a top priority because there is $100 million worth

of basic science facilities located around that site. Those facilities were

built with the idea of a teaching and research hospital being the guts, if you

like, of a teaching and research complex. It's something which has been done

with great success all over North America, including Canada.

The plans for that hospital site at UBC were built in another province in Canada.

We planned it; we spent the money planning it; they got the plans for nothing,

and they built it. The cheapest major advance we could make in hospitals in

British Columbia today would simply be to take our plans back again because

they've gone right through the working drawing stage. You could start digging

a hole tomorrow and put that hospital up. The complete plans exist for it. Instead

of that, for future acute hospitals there has been a proposal put forward by

Mr. Christiansen's committee that would involve tearing down good hospital facilities,

redesigning hospitals. This is a waste of time, a waste of taxpayers' money

and a waste of precious hospital beds, all being done over the facts of the

City of Vancouver and sixteen citizen groups.

Now, my final question is: will the Minister not take it from me but agree

to meet with these people? Will the Minister agree to that? The Minister sits

there frowning. Will you agree to meet with them — just yes or no?

HON. MR. COCKE: I'm not going to give you a yes or no.

MR. McGEER: You see, it's a pretty simple, direct question: "Will you

meet with the citizen's committees that represent the people of Vancouver?"

and he can't answer that.

HON. MR. COCKE: Will you sit down and let me answer the question?

MR. McGEER: A yes or no is simple enough.

HON. MR. COCKE: Knock it off.

MR. McGEER: "Knock it off," says the Minister. If you're going to meet

with them, say yes; if you're not going to meet with them, say no. But don't

ask for the floor so that you can fan around.

HON. MR. COCKE: Oh, ho! So you fan around and you....

MR. McGEER: No, I'm asking you a direct question and you're avoiding

it. For some reason you do not want to meet with them and you don't want to

take the consequences.

Interjections.

MR. CHAIRMAN: Could we have order, please?

MR. McGEER: You'll just bulldoze right over the top of them. You're

not interested in democracy. You're not interested in all those things that

you espoused when you were in opposition and which you stand up so pontifically

to state. Even in the House today you're not interested in democracy at all.

You're not interested in what the citizens' groups want. You're merely interested

in pushing plans ahead over the legitimate and wise objections of people who've

been planning hospitals in that area a lot longer than you have.

MR. CHAIRMAN: We have a point of order, Mr. Member. The Hon. Second

Member for Vancouver South.

MRS. WEBSTER: On a point of order, I understood that people, when they

got up to speak, were to address the Chair, not the Minister.

MR. CHAIRMAN: Your point of order is well taken. Mr. Member, will you

continue, please.

MR. McGEER: The Member's point is very well taken, and I apologize to

the Member. I got carried away there, Mr. Chairman, because I thought it was

a pretty simple, direct question, and I got exasperated when the Minister refused

just to give simple assent to meet with the group.

You see, Mr. Chairman, those people are in

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Victoria today...

HON. MR. COCKE: So that's why you're bringing it up.

MR. McGEER: ...and if the Minister were really sincere about his desire

to listen to these groups, he would agree to meet with them this very afternoon.

I realize that we aren't going to have opportunities to follow up on questions,

but I certainly want to give the other Members in the House an opportunity to

ask, I'm sure, what is a very interesting series of questions of the Minister.

HON. MR. COCKE: That was a most interesting, but not unexpected, presentation

by the Member for Vancouver–Point Grey. That Member runs in the face of a wind

that he knows blows. He knows that taking hospitals to the university is quite

convenient for academics such as himself, but not always convenient for the

patients, who might prefer to have some kind of more central facility. So let's

not kid ourselves about who is on what side and why and whose friends are who.

Mr. Chairman, I know perfectly well that that Member has been espousing the

fact that every facility in the world should be out at UBC for some length of

time. He is so concerned about the East End of Vancouver. "When are you going

to build a hospital in the East End of Vancouver?" he says.

MR. McGEER: On a point of order, Mr. Chairman, the Minister made a misstatement.

He said that I was in favour of every facility being at UBC.

MR. CHAIRMAN: You can correct a misstatement...it's not a point of

order.

MR. McGEER: I'm against the 300-bed hospital for extended-care patients

which the Minister is building at UBC now.

HON. MR. COCKE: Mr. Chairman, it was the university group that felt

that it should go there, so who is to say? But the fact of the matter is that

what we have done isn't laid down as an edict. What we have done is set a vehicle

to work in Vancouver: the democratic process that those people so beautifully

understand. We took all the warring factions, and that Member was a member of

one of those warring factions — the academics who insist that everything around

teaching be built out at UBC in a nice monument to their own intelligence —

and it was to put these warring factions together that BCMC was developed. The

children's hospital, St. Paul's Hospital, Shaughnessy, Vancouver General, G.F.

Strong Rehabilitation Clinic — all of these groups plus interested people in

the delivery of health care are represented.

There has been no announcement of a super hospital at Shaughnessy. The only

announcement that I have had any

part in at all has been a children's facility

with a maternity facility adjacent — the only one.

Interjection.

HON. MR. COCKE: Cancer is a priority. What are the things we are looking

at? You have to know directions. We are looking at using part of the Shaughnessy

area that the Member was talking about as being empty or near empty for cancer.

That is the area that is already built and developed.

As long as I'm Minister they won't be tearing down any hospitals that can

produce. They certainly won't. The fact that people suggest it in conceptual

plans doesn't make it a fact accomplished. But that Member indicates that it

does. In his great concern over the residential neighbourhood, it seems to me

it is a nice backing for his all-time position, and that all-time position has

been: Let's build that fine thing out at UBC so that we have a convenient access,

rather than building it where the people are. Mr. Chairman, the East End and

the West End are served by that corridor of health facilities that find themselves

in the Vancouver area.

[Mr. D'Arcy in the chair.]

I indicated to the citizens' groups and a number of other interested people

when I attended the City Council meeting not too long ago in Vancouver that

I am not interested in a very heavy concentration that was originally suggested.

But I certainly am interested in seeing some of that 47 acres used properly

for health care and the remainder in open space and space that we can be proud

of.

I suspect that that hospital was there before any resident who came before

city council that night or before any of these interest groups lived in that

area. Why? Because the land was assembled and the hospital built in 1909 or

1913 somewhere. That's when that hospital became a hospital. Not the day before

yesterday. Not at all.

It is something like building next door to an airport. You know it's there.

As the planes get bigger you get more and more frustrated, but you built next

door to an airport, Mr. Member, and when you build next door to a hospital ...

and it strike me, Mr. Chairman, that hospitals have to be somewhere. It wouldn't

matter where you built it. Unless you built it out in the middle of that forest

in the UBC endowment lands there would be some neighbour complaining. We all

want service from hospitals; however, we don't want them next door.

I have asked the BCMC to see to it that among their 23 committees there be

a committee for the

[ Page

1401 ]

concerned groups. I happen to know why SPARC was on there. I talked to the

SPARC people. Most of those groups, except the immediate neighbours, were interested

in development but not to the extent that was suggested in the conceptual plan.

So don't try to suggest to this House that all those groups are completely

in disagreement with properly planned services being developed out there, Mr.

Member. No, sir, they are not.

Mr. Chairman, I said we set up a vehicle to do a job — not to do it ourselves,

but to do a job. I suggest to you that in the long run that group headed by

Jack Christiansen, whom this Member so quickly jumps up and defends but defames

...I can't understand the kind of argument you have with yourself. He is a

completely independent person on there. Can you imagine him going through all

the work that he is going through for nothing and taking the direction that

you are suggesting?

Mr. Chairman, no money has been wasted.

MR. H.A. CURTIS (Saanich and the Islands): Mr. Chairman, I don't intend

to use all of the allotted time for one speaker. I also share the hostility

which has been spoken about on this side of the House with respect to the even

more strict closure which has been enforced on the opposition in debating estimates.

One feels that perhaps local issues or regional issues should not be raised

in view of the fact that time is so limited. Nonetheless, I do want to ask the

Minister to bring us up to date as of today, the middle of April, 1975, on acute

hospital construction and planning in the Capital Regional District — the latest

status, if the Minister can do that, regarding plans and schedules.

There is strong concern in greater Victoria, in the capital region, and if

it were not a matter of life and death, Mr. Chairman, the chronology of the

years of discussions and studies and reports and debate at the regional hospital

district level would be humorous — I say, if it were not a matter of life and

death.

As far as I can determine, this Minister is not at fault with respect to the

delay; nor is the provincial government. I make that very clear. I think that

when we are in opposition it is our job to oppose, but also, when we assess

a situation in such a way as finding it possible to compliment a Minister, it

is also important that we do so. I do that with respect to this Minister whose

estimates are before us.

He must share with us in this area a growing concern and a very serious frustration

over the continuing delays. As the Minister knows, there have been studies upon

studies, studies rehashed, studies of studies, debates, referrals and delay.

The months and the years have ticked by and we are still not very much further

ahead in terms of acute beds in this area. What a staggering number of words

have been written and spoken on this subject!

I have a series of very brief questions to the Minister. Hopefully, he will

find it possible this afternoon to give us some answers.

At what point is he going to find it necessary to meet again with the capital

regional hospital district and perhaps engage in stronger talk than may have

taken place thus far?

With respect to the Saanich Peninsula Hospital acute wing, I note with interest

and I am sure the Minister will recall that it was March 25, 1974, that this

matter was debated in this chamber. The Minister quite optimistically and correctly

indicated at that time that he hoped a decision would be made. Yet we are still

awaiting action with respect to the Saanich Peninsula acute wing.

What about a new acute care hospital in the more northerly portion of the greater

Victoria core? Is his department addressing itself to that subject in any way,

shape or form? If so, what approximate time frame is being considered?

Would the Minister also tell us about his department's view concerning the

long-term future of the Victoria General Hospital as it stands at the moment,

which has been the subject of continuing and repeated debate?

Finally, a matter I've discussed with him and on which we have had correspondence

is community medical centres — it may be another term, but small medical centres

— in those portions of the constituency I represent in the Gulf Islands. On

Mayne Island, the Minister will recall, as of very recent date no action has

been taken, to my knowledge, with regard to that type of facility. The residents

of Mayne Island and other islands are awaiting that kind of model which was

spoken about a year ago.

Mr. Chairman, Saanich Peninsula Hospital; what about a new acute-care hospital

in the longer term; the future of Victoria General Hospital; and community medical

centres?

I think that I can speak for a number of people in this area with regard to

the growing disappointment concerning the lack of action and the inability to

make a decision at the regional hospital district level over the past number

of years. I experienced considerable frustration while I was on the regional

hospital district board. But, more importantly, we have a situation now which

I think is vital, and I hope the Minister can take whatever time is necessary.

I noticed he was distracted for a moment by a note, but I would hope that he

could answer some of these questions. Thank you.

MR. G.S. WALLACE (Oak Bay): The health budget, of course, is such an

enormous one that it's very difficult to cover the subject adequately. I think

that each of us in the opposition has the choice of either taking a rather quick

overview of the total situation or trying to pick specific issues which

[ Page

1402 ]

appear to have priority interest. I shall try to follow the latter approach,

but inevitably I'll be leaving out many issues which I would very much love

to discuss with the Minister.

The biggest problem, after a long period of national and provincial study,

is apparently a tremendous difficulty in getting the modern concept through

to both the citizens and particularly to politicians at all levels, and that

is the fact that the answer to many of our hospital problems is the levels-of-care

approach and the fact that despite numerous publications, going right back to

the federal government task force reports of about eight years ago, we still

seem unable to implement what is staring us in the face as the most obvious

and sensible and economic answer to the delivery of health care.

I hate to go on repeating what I've said in the House many times, because I

know we're moving in that direction gradually. But, oh my goodness, the speed,

in my view, with which we're moving is really regrettable. I, like the former

speaker, don't believe that we can lay all the blame by any means at the door

of this Minister or this government. Nor am I here to be an apologist for the

federal government, which, really, I would put high on the list of the real

obstacles to a rational and nationwide integration of the various levels of

care, which would result not only in the most appropriate kind of care being

given in the most appropriate kind of facility but would result in the most

economical use of the dollars that are available for the total spectrum of health

care.

As I said in my opening comment, that seems all rather philosophical to some

people. Let me make it very plain: the practical consequence of not doing that

at the present time is the utter shambles we have in the greater Victoria area.

We have post-anesthetic patients being looked after in clothes-closets. I have

the clipping here, a headline from January 13: "Old Soul in Closet." Then when

this was reported, the nurse said: "We even had to put one old soul in a linen

closet. Of course, she was out to lunch" — meaning she was under the anesthetic

— "so it didn't bother her."

I think, Mr. Chairman, that this kind of situation, in a supposedly affluent

province and in the capital region, is nothing short of a scandal. I repeat

that this is by no means the fault of one person or one level of government

or one layer of politicians, but I do wish to God they'd all get together, because

we've already got some evidence, for example, of the speed with which this Minister

is prepared to approve certain things if the regional hospital board politicians

would get off their butts and come forward with some specific proposals. I'm

talking, for example, of the speed with which it has been agreed to build another

150 extended-care beds at Glengarry Hospital. That decision was taken quickly

enough.

The other element in all this business of trying to follow the simple, logical

steps in the integration of levels of care that's right in front of our nose

surely has to be typified by the very most recent study done here in the greater

Victoria area. To add the final indignity, the regional politicians, appointed,

elected by the voters of this area, have the audacity to go behind closed doors

because they're not happy to reveal in public the contents of the consultant's

report. I don't know who these politicians think they're representing, but they're

certainly not representing me very happily, and I'm a taxpayer.

I think the sooner this message gets through to all levels of politicians involved

in any kind of health-care programme or the provision of facilities.... Let's

at least get it out on the table. I just don't feel that this is an appropriate

area where studies should be going on behind closed doors.

Let me just quote from The Sidney Review of Wednesday, April 9. It sort of

touches upon some of the issues raised by the former speaker, the Member for

Saanich and the Islands (Mr. Curtis). I will quote. The headline says, "Secret

Study Exposed," as though this was another CIA operation, or some high-level

secret situation that would be to the detriment of people to learn the details.

"A copy of the secret Agnew, Peckham and Associates report

on the role of regional hospitals indicates that the decision last week to proceed

with the 75-bed acute-care hospital for the peninsula does not agree with the

consultant's recommendations. In a copy of the report obtained by the Review,

from a source close to the commission, the Toronto-based consultants recommended

strongly that any new hospital for the peninsula be located further north than

the projected site on Mt. Newton Crossroads."

Mr. Chairman, I'm not here to argue whether it should be north, south, east

or west. All I am saying is: let's get the facts,, the data and the opinions

of hospital development in greater Victoria out on the table, if for no other

reason than that it becomes public knowledge within a day or two of the meeting

anyway. If I can be a little facetious, I would say that Prime Minister Trudeau

and Premier Barrett know how difficult it is to meet behind closed doors and

maintain confidence about what was said.

So, first of all, I think the acceptance of the logical, sensible attitude

to levels of care.... The old idea where you had a general hospital and a person's

home, and you were either well enough to be at home or you were so sick you

had to be in the general hospital.... That's 50 years old, that idea. We have

several levels of care where the appropriate kind of facility and the appropriate

intensity of personnel qualifications should be available.

I know that I get worked up about this. But I spoke in this House.... I think

that the first speech

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1403 ]

I ever made in 1970 was on just this subject. As I say, it isn't nearly as

difficult to implement many of the factors in this kind of programme as we might

imagine.

I don't want to spend valuable time arguing as to whether it would be this

figure or that figure or the next figure. But we are moving in the direction

where I feel the 6,000 patients that the Minister mentioned in the supplement

to the budget is a ballpark figure for the number of people who require the

type of care that we call intermediate care.

Unfortunately, terminology has caused more confusion than clarification when

I meet with various citizen groups or with patients. But all we do know is that

if you are in an acute-care bed or an extended-care bed, you pay $1 a day. If

you finish up in a nursing home, it can be $700 or $800 a month. That we do

know, and there is no terminology or semantics in the whole wide world that

will cover up that fact, nor should it. So that's my proposal, and I'd like

the Minister's response.

I agree that if any of the parties on this side were in your shoes today, we

would be facing the same difficult decision about the financing of the dimension

of costs related to intermediate care, I simply say that under these circumstances,

and in the continuing absence of federal cost-sharing, does it not make a lot

of sense — using a phrase which the Minister of Human Resources (Hon. Mr. Levi)

uses frequently — to move the money around?

Does it seem just that a person in extended care lives for $30 a month, and

perhaps receives Mincome of $238 a month — and in fact has spending money, for

lack of a better phrase, of $200-plus or minus a month —

whereas a person who

may well have worked hard and saved a few thousand dollars in the bank through

their lifetime, gets stuck with paying a bill for several hundred dollars a

month? It just doesn't seem right, and I know the Minister agrees with this,

because at a previous time the Minister himself suggested that possibly a higher

level of patient participation in the daily cost, as long as it didn't inflict

hardship on the patient, would make moneys available to widen the programme.

I'd like his response to that.

The figure at that time was $5.50 a day that was suggested. Again, I am not

arguing whether it should be $5, $6, $2, $3, $4. I'm just saying that the principle

to me seems sound. But surely we should equalize the justice of the system whereby

some people are actually saving money by being in extended-care hospital beds,

while other people simply spend their savings up until they have to go on welfare.

I don't think that's a fair system at all.

The emphasis the Minister has placed at different times on home care is admirable.

I don't know whether he's going to the annual conference of the homemakers in

Nelson this year. I hope, if he possibly can, that he will go there, because

the homemakers could make a tremendous contribution to the very vital goal of

keeping people in their homes and receiving care which, if unavailable, means

that the patient finishes up in some kind of institution at greater cost and

at much greater distress to the patient — and we've been over that many times.

There again, there doesn't seem to be a province-wide, uniform approach to the

financing of home care.

I've had a lot of correspondence lately from up island in particular, where

they've worked out their cost to be $4.50 an hour. I don't think that is unreasonable,

but there again, a person on a limited income, who perhaps needs four, six or

eight hours a day, finds that a substantial cost. So once again, could we not

move the money around and try to equalize, as far as possible, the cost to each

individual regardless of the type of care they require?

It's a problem that I think has to be solved, otherwise we keep finishing up

with a situation we have right here in Victoria. I've checked as recently as

today, right today and in the Jubilee Hospital, today, we have 55 people qualifying

for extended care who are occupying acute beds.

In the Eric Martin Institute one-third of all the patients are not really acutely

ill to the degree that they require that kind of facility. As with the Victoria

General, which had to look after a post-op patient in a clothes closet, we have

both hospitals in this city using treatment rooms, classrooms, conference rooms

and hallways at times to cope with the needs of acute patients. At the same

time we have 50 or 60 patients in that same building who don't need to be there

at all. The occupancy rate of both hospitals is close to 100 per cent which

is unsafe and really is above the level of occupancy which accreditation standards

suggest are safe.

So all I'm saying is that we must, all of us, try to get the sense of urgency

through to our elected officials at the municipal and regional level. If that

kind of urgent response is forthcoming, I would like to think that the Minister,

today, would give the same kind of rapid commitment that — while he can't guarantee

to approve everything that comes to his desk, he does acknowledge that we have

a very serious problem in the greater Victoria area — some of these measures,

which could be taken fairly rapidly by the regional hospital board, would be

approved.

I personally would appeal to the regional hospital board: would they please

hasten, expedite — any word we want to use — to come forth publicly at the earliest

possible moment and tell the people of the greater Victoria area what their

considered proposals are out of this study of a study. We had the same study

by the same consultants in 1968; we now have another one in 1975. It would be

a tragedy beyond belief if this recent study went the same way as the

[ Page

1404 ]

last one.

Mr. Chairman, as I said earlier, there are many subjects I would love to speak

about but one that I think deserves the highest attention is the commitment

by the Minister to try to do something about the early diagnosis of breast cancer.

The figures show that approximately one in 15 women will develop breast cancer

during their lifetime.

I don't want to go into a long, clinical discussion about the matter, but one

or two questions arise. The Minister has got a $ 1.1 million item in the budget

for a cancer programme, which I presume relates mainly to his proposed breast

cancer screening programme. I want to choose my words very carefully because

I commend the Minister for what he's doing, but I want to try to put this whole

subject in context.

Today the diagnosis of breast cancer in a woman, in terms of that woman's future,

is relatively little different than it was 40 or 15 years ago. Now that's a

very sobering fact. Therefore, while it obviously makes sense to diagnose any

cancer early, or as early as possible, I would not like to think that by setting

up screening programmes we are offering to the women of our province any measure

of false hope that if it's diagnosed this month rather than next month, we have

treatments available which will proportionately enhance that patient's survival

rate.

If there's one area of cancer which is the most frustrating for surgeons and

physicians to treat, it has to be breast cancer. Each of us has had patients

where the original lump appears to be very simple and very early, and yet within,

sometimes, months the patient is in serious trouble and deceased within perhaps

a year and a half. Other times a lump is discovered which, under the microscope

appears to be fairly well advanced and one either operates or radiates with

a feeling of hopelessness, yet that patient is still alive five years later.

While I certainly commend the Minister for taking what measures are available

for screening and early diagnosis, I think it's fair to put the matter in context

and say that our methods of treatment, unfortunately, have not shown increased

degrees of success over quite a number of years.

I would like to ask the Minister if he's had any discussions or consultation

on the proposal put forward by a Dr. Michael Richards who is sponsoring a programme

called "Keep Women Alive." He's emphasizing the point I just tried to make:

all our breast cancer has been crisis-oriented after the diagnosis has been

made and we've tried to improve and enhance treatments. Yet we know precious

little about the cause and some of the predisposing factors which might tend

to increase or decrease a woman's chance of getting breast cancer. He's suggesting

that in the computer age it would be possible to ask a relatively small number

of questions at periodic intervals in a woman's life and computerize this to

try to come up with some kind of pattern of factors which would at least highlight

the most vulnerable groups among women, such as the whole element, for example,

of bottle-feeding or breast feeding. Breast cancer has increased and is more

frequent in those women who bottle-feed their babies. The whole question of

whether they bear children or not bear children is obviously another factor

which is already known. There must be many others.

Without going through a long lecture about the clinical aspects, I'm just wondering

if the Minister has been consulted on this question of participating — not only

by B.C.; it's actually proposed to be an international study. I believe that

the National Council of Women has taken the initiative in setting up an office

with an address to which women can communicate. It seems to me that if we knew

more about the cause, we would obviously know more about the prevention.

The last point on the subject of breast cancer: I wonder if the Minister could

tell us which particular technical procedures are to be used in the programme

he is setting up. We know that the term "mammography," which relates to the

x-ray of the breast, has been used. Again, I have to say that anybody who reads

the literature objectively has to acknowledge the limited value of mammography.

It's better than not doing it at all, but it's very expensive.

I don't want to appear in any way to be pouring cold water on attempts to enhance

diagnosis. All I'm saying is: let's keep some of our sense of balance. Is the

Minister planning some of the more refined techniques like thermography, the

use of heat tests, to try and make earlier diagnosis? I'd be interested in hearing

the Minister's answer to some of these questions.

On another subject, I would like to touch upon the whole question of the publicity

that arose over the possibility of the medical school at UBC losing its accreditation

because of inadequate facilities — the whole matter of space and staffing and

a variety of other points that were mentioned. It said that the academic staff

were certainly dedicated physicians but they had inadequate facilities. Dr.

Bates, who is the Dean of Medicine, expressed real concern at the fact that

either UBC might lose some of its accreditation, or, in fact, it might be necessary

to reduce the number of medical students who could be taught at UBC medical

school.

Mr. Chairman, if there's one thing we don't need, it's a decrease in the number

of young B.C. men and women entering medical school. That's a whole subject

we could debate for a long time. As the Minister knows, this government has

already increased the number in the last year and I understand there's a projection

for the next three or four years to go to 160 students, if I'm correct — I think

that's the figure.

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1405 ]

This came as a real surprise to me — the information that I read in the newspaper

back in early February — that, in fact, Dr. Bates was concerned that the situation

might lead to real problems. I wonder if the Minister can assure us that something

is being done in this direction.

As I say, we haven't time to go into details, but the statistics show a very

distressing fact that many sons and daughters of B.C. residents just haven't

the vaguest hope of entering medical school in this province because they have

something in the order of nine applications for every vacancy.

The last time I checked, I think the average marks of the people who were accepted

were somewhere in the high 70s or low 80s, which means we have many excellent

young men and women, probably very dedicated to the concept of a medical career,

but with marks in the 70-to-79 range, who just cannot obtain admission to medical

school. Even some of the students who have higher marks than that have great

difficulty. We have B.C. residents travelling to various parts of the globe

in order to obtain a medical education. I hope the Minister would perhaps touch

on that.

I also would like the Minister to comment on any plans he has to try and develop

more harmonious relationships between interns and residents and their employing

hospitals. It is a big issue in itself. We have had the recent withdrawal of

services by the residents and interns. I don't know whether this was mainly

due to inexperience in the bargaining process or what it was. As I say, it is

a complex subject. It's one of the first times that it has happened in this

province, if not the first time.

I think it is a very distressing situation, particularly when the physicians

concerned are prepared to tell lies about the situation. I don't use that word

carelessly. The physicians and interns stated that they were booking off sick.

I think it is tragic when physicians, of all people, take that kind of liberty

with the truth when they know very well they were not sick. Now if they want

to withdraw service, that is one thing, but to try and kid the people of British

Columbia that they were sick I think is following a tragic example that I would

criticize, really, in any group.

I don't for a moment dispute the fact that residents and interns work very

hard. I was interested in one of the reports on this issue where the reporter

entitled the report: "Weary Doctors Make Mistakes." That is absolutely right.

If you are working 60 or 70 or 80 hours a week and part of that is in the emergency

department of a hospital, I don't think that that promotes confidence in the

recipient of your care.

I don't dispute for a moment the difficulties of residents and interns and

the dangers that arise from working very long hours. But I would like to ask

the

Minister if we could not perhaps develop some better system of bargaining with

these employees, whether we could not take some new initiatives in the hope

that this kind of very serious situation doesn't arise again. At least, can

we try and take some preventive steps?

I'm not sure when my half hour is up, but I have just time.... I have been

more interested recently in the whole question of child abuse and the great

difficulty in trying to pin down some of the examples of the battered child

syndrome and, again, try to start with prevention rather than dealing with the

problem after it has happened.

The Vancouver parent-teacher council met, I believe, with the Minister last

month. They put forward certain proposals — which I needn't detail here because

I am sure the Minister is, aware of them. A few months ago or late last year

— I can't remember the exact date — we had some tragic examples of children

dying in this province. In these cases — again, I certainly will not mention

names and not even specify areas, but we all know that incidents occurred —

from the evidence that was made public it appeared that all these three episodes

that I remember were preventable. The Minister of Human Resources (Hon. Mr.

Levi) answered a question that I placed on the order paper numbering the inquiries

that had been made and giving some useful statistical information.

MR. CHAIRMAN: I would like to note to the Hon. Member that what he was

concerned about a minute or so ago is indeed about to happen.

MR. WALLACE: Yes, thank you, Mr. Chairman. I will quickly terminate

my comments.

It is obvious from the concern in the community and the letters I've received

that the question of child abuse in the tense, hectic pace in which we live

and all the social and financial and economic problems that many parents are

subject to ... that the incidence of child abuse, whether it is detected or

undetected, appears to be very much on the increase. I wonder if the Minister

could give us some idea of what particular plans his department has either to

follow recommendations of the parent-teacher council or possibly to incorporate

it as a very specific part of the study of this combined committee to do with

children which was announced in the budget speech. Will child abuse be very

much a specific and integral part of that study?

HON. MR. COCKE: Mr. Chairman, first, the Member for Saanich and the

Islands (Mr. Curtis) discussed the whole question about the regional district

and lack of action and whether we are addressing ourselves to a hospital in

the north end.

No, we are not. As a Health department, Mr.

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1406 ]

Member, what we're addressing ourselves to, and as I tried to indicate to the

Member for Vancouver–Point Grey (Mr. McGeer), we ask regions and districts and

areas to do their own planning and work. Sometimes, Mr. Chairman, through you

to the Member, planning occurs and nothing results thereafter, or planning doesn't

occur and nothing results as a consequence.

I would hope that there will be some very definite action in the area. One

thing that kind of concerned me, however, was the fact that almost a whole area

in the District of Saanich called for a small acute-care hospital adjacent to

and part of the Saanich extended-care facility. If the Member for Oak Bay's

(Mr. Wallace) announcement of the new report and what that report incorporates

is true, then it would appear that that won't be part of the direction, and

that might very well be sad. In any event, what we're asking is that the regional

district come up with its proposals. As the Member for Oak Bay said, when proposals

come forward I think we react to them very quickly. There was a proposal for

150 beds...

MR. WALLACE: Glengarry.

HON. MR. COCKE: ...at Glengarry, I think, recently, and we said,

"Yes, go right ahead. They're needed."

So, in any event, we agree that there is a huge priority here. I can't tell

you when, Mr. Member, I'll make any further demands. I think I've made a number

now, and I think that they know perfectly well that we're quite serious here

and we want things to occur in the Capital Regional District around the creation

of properly co-ordinated acute-care facilities.

Regarding the community medical centres in your area, we have met with the

regional district and we have given approval in principle for two — one at Mayne

and one at Renfrew.

MR. CURTIS: What was the second one?

HON. MR. COCKE: Port Renfrew.

We have done a lot of this, this government. In order to attract either professionals

or to create an opportunity for service, we've created facilities or are in

the process of creating those facilities.

Getting on with the Member for Oak Bay, he says: "Let's move money around in

the whole intermediate-care field," and so on. I agree, Mr. Member, that there

has to be a lot of moving around of money. One of our problems is, of course,

we're bound up with our own rules and our ties with the federal government.

At the present time, there's $19 million roughly being spent on intermediate

care by the government through the Department of Human Resources. But then,

you see, the trouble is that's tied down to those people who require assistance

from that department by virtue of their lack of wealth.

Interjection.

HON. MR. COCKE: I can't hear you, Mr. Member, and you might wait until

you get the floor and then we'll get on with it.

There has to be a new approach to chronic care. That's one of the things we're

talking to the federal government about. We feel, for an example, with our Mincome

programme and people's pension plans and so on, that a person, once they're

in a chronic-care situation where they need care, the best thing to do would

be to charge room and board and then let government services — that is, the

insurance benefits — pay the remainder; that is, the nursing services, et cetera.

This is the approach that we're looking at very carefully at the present time.

It seems to be that what we need is a plan, however, that has some universality

but, at the same time, isn't so rigid that it wrecks the economic viability

of a family. Say, for example, there is a husband and wife and one is taken

away into that environment, the remaining person might need more in order to

keep up the family situation. There are a lot of problems around it but, as

far as I can see, the easiest way to go would be in that area. I just hope that

we're able to produce something through the health, as opposed to the other

direction, because I think we can provide a wider benefit than we do at the

present time, naturally, because of the restrictions of the Human Resources

Department. As I say, that's where it's presently being done, and there is $19

million being spent other than the $6 million that we're spending in our area.

You see, all the people in the Dogwoods and the Tillicum and, of course, the

new Ponderosa when it comes on stream; those people that are at Skeenaview,

and others, are being paid for by the Department of Human Resources because

of this kind of anomalous situation. The others within our own institutions

where we can control it...no one has been charged more than $10 a day or $300

a month. So we are expanding. It is going to take some time to create the facilities

we need. But, in any event, that's our direction and we'll just go as quickly

as we possibly can.

The early detection of breast cancer is an area in which I think a great deal

has to be done. We have seen the New York study; I am sure you have. The second

study hasn't been reported yet — at least it hasn't come to my attention — and

that's the second five years of the ten-year study. I hope that we will have

access to that soon. It is awfully important as there hasn't been much advance

made in this area.

We feel that in securing the services of a man from the research world it might

just help us a great deal in this regard. As you know, Dr. Tom Hall has a tremendous

background in research and has a tremendous background in the area of chemotherapy,

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1407 ]

and is highly thought of in the whole cancer world. I hope that that puts us

ahead.

He is talking about a great many things — screening for different areas and

so on. We're not quite sure just how far advanced some of the screening processes

are. They are suspect still by researchers and so on, but at the same time we

have to take some chances.

Thermography you suggested is an area in which we can get interested. We have

taken a very close look at what was going on in Montreal. We find a tremendous

number of false hot spots and a tremendous amount of psychological and emotional

concern over this. Many people are suggesting that thermography is very iffy.

Mammography, of course, is something we are providing to a number of hospitals

so that we can produce a great many more areas in the province where people

can go in for earlier detection — on a referral basis for the time being, but

ultimately it could lend itself to a screening process when and if we can get

that kind of situation off the ground.

I, for one, happen to be one who is very interested in xeroradiography because

it looks kind of impressive, but then, on the other hand, there are many experts

around who are unimpressed with this. So it is a very difficult area, to deal

with and all we can say is that we are bringing in the best people we can find

and saying to them: "For goodness' sake, give us your best advice in helping

solve this problem as best it can be solved."

Around the question of interns in residence — it was a surprise, Mr. Member,

that we ran into that area. There was no bargaining system for them. They have

always been viewed as students heretofore; they became workers and under those

circumstances there will have to be some system of regularized bargaining for

them. I am quite sure that kind of thing will happen.

As far as child abuse is concerned and my meeting with the parent-teacher council,

we did have a very good meeting with them. I think they were delighted to see

that the Berger commission had on it Dr. Segal whose real emphasis and whose

real direction has been around this area for some time. He is a well-known pediatrician,

and we have had some excellent reports from him. As a matter of fact, they met

with him very shortly after meeting with me and I think we have some very good

direction in this area.

Just so that I can get this on the record — there are many more reports now.

The medical profession is reporting a great many more situations that they have

had brought to their attention and we are, I think, getting much closer to being

able to provide help in this area. To provide help in this area a great deal

of therapy has to be directed on a preventive basis towards those people who

very clearly look like they can fall into the category of child abusers. One

of the things that has come out of the research is that if you want to find

a person who is likely to abuse a child, find a person who was abused himself

as a child. There is a lot of work going on in this area. I suggest that it

will have to continue because there is a long way to go in that particular area.

MS. R. BROWN (Vancouver-Burrard): I would like to add a few words to

some of the things that the Member for Oak Bay (Mr. Wallace) had to say about

the matter of breast cancer and the early screening procedure.

In particular, I want to thank the Member for Oak Bay for bringing up the matter

of the real lack of research done in this area and the fact that, even though

it is one of the major killers, as far as women are concerned anyway, certainly

the techniques and methods used to treat it have not changed much over the years.

I would like to support his call for funding for research in this area. I realize

that most of the medical research is funded by Marc Lalonde, the federal Minister

responsible for this area. As you know, Mr. Lalonde is cutting back on the amount

of money that he's putting into medical research. It certainly is not one of

the areas which he considers a priority. I don't think that we can continue

to rely on the research being done in other countries. I think we're going to

have to start doing some more of this ourselves if we are going to do anything

about the quality of medical practice in this country. So I would certainly

like to support his request for some funding for research in this 'area as to

the causes of breast cancer, not just the treatment.

As women we have always been told that the best kind of treatment available

is the very early detection. The Member for Oak Bay (Mr. Wallace) says that

this is not true. He has treated cases where the detection was quite late and

the women lived and there have been other cases where there was very early detection

and the women died. So there goes another one of our myths. Certainly that's

one of the reasons why we've always supported the call for early screening,

because we were always led to believe that the very earliest detection of this

cancer was certainly the best way of dealing with it.

Breast cancer is not a statistic to me. I am in the age group where continually

more and more of my colleagues and more and more of my friends are coming down

with breast cancer and dying of it, quite frankly. I don't know of any one of

them who has managed to survive more than the five years — usually it's a year-and-a-half

that they go. So this is of great importance to us. I would certainly like to

see us get into the research end of it because I can't see how we can devise

any kind of treatment if we don't know what causes the thing. I'm interested

in all forms of cancer but I think that this is one particular area that has

been neglected, as has most research

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that has to do with illnesses in women anyway. No one has ever paid that much

attention to researching the illnesses that strike women more particularly than

any other sector in the community. Certainly this is one way in which we as

a government can set an example.

What I specifically wanted to talk about is Vancouver General Hospital. VGH

happens to be in my particular riding so I have to follow what happens to the

hospital very closely. It's one of the few hospitals in the province which conducts

abortions; it's one of the few places where women who want to have an abortion

can go and have it done. I don't know whether anyone has been following the

controversy raging in the media over this but apparently an attempt is being

made by people who are against abortion — the people who call themselv