1989 Legislative Session: 3rd Session, 34th 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)

THURSDAY, APRIL 27, 1989

Afternoon Sitting

[ Page

6409 ]

CONTENTS

Routine Proceedings

Oral Questions

Downsizing of federal civil service. Mr. Harcourt –– 6410

Mr. G. Hanson

Mr. Sihota

Ms. A. Hagen

Day care funding. Ms. Marzari –– 6411

Committee of Supply: Ministry of Health estimates. (Hon. Mr. Dueck)

On vote 35: minister's office –– 6412

Mr. Clark

Mr. Rose

Mr. Lovick

Mr. Bruce

Ms. Marzari

Ms. Smallwood

Mr. Long

Mr. G. Janssen

Mr. Sihota

Committee of Supply: Ministry of Attorney-General estimates. (Hon. S.D. Smith)

On vote 13: minister's office –– 6435

Mr. Sihota

THURSDAY, APRIL 27, 1989

The House met at 2:06 p.m.

HON. MR. VEITCH: In your gallery today, Mr. Speaker, are

several very good friends of mine and very good, famous British

Columbians. We have Bill McCarthy, president of the Burnaby-Willingdon

constituency association, and his wife Delores. We have Mrs. Alice

McCarthy, Bill McCarthy's mother. We have Mr. Stan Milacek, Mrs. Eliska

Milacek and their daughter Barbara. We also have a very famous

philanthropist, Mr. John Jambor, who was responsible for bequeathing a

building in the Metrotown area of Burnaby worth $35 million to the

Cancer Control Agency. He is one of the great philanthropists of our

time. I would ask the House to bid them welcome.

MR. BARLEE: I would like to take the time today to introduce

my great-aunt, Elizabeth Strickland, who comes from Lakefield, Ontario,

a quaint little village north of Peterborough.

She has some flaws. One is that she is a longtime Tory, but she is a

very nice person otherwise. She invariably dresses in blue. She heard

via the news services that our family name had been sullied in this

House yesterday. She was quite upset about it, so she flew out and

insisted on an explanation.

I explained that the Speaker of the House had insisted that I use a

badminton racket, have one hand tied behind my back and serve

underhanded all the time. She thought that was grossly unfair and

insisted on a fair match this morning. We played the fair match this

morning. As usual the Speaker allied himself with an excellent player,

which he usually does.

We beat them the first set, but they made a mistake. They insisted

upon a second set. We beat them the second set, and then they had the

temerity to insist upon a third set. I thought that was a little too

difficult. At 3 to 1 in the third set, something rather untoward

happened. The Speaker took off his white shirt and waved it in the air.

I assumed this was an admission of absolute surrender. My great-aunt

called it "striking the colours," which I think was fairly close.

Anyway, she is returning to Lakefield, the old family home. She's

very happy. I would like both sides of the House to extend her a warm

welcome.

MR. SPEAKER: The Speaker might just mention that he'll do just about anything to keep all sides of the House happy.

HON. MRS. JOHNSTON: That was far more interesting than the submission I put forward yesterday.

At this time I would like to ask the House to please welcome John

Mills, executive director of Sport B.C., Julie Hunter, public relations

officer of Sport B.C., and Michael O'Connor, a solicitor in Victoria.

MS. EDWARDS: I'd like to introduce today Wayne McCory, a veteran

of the fight for Valhalla Provincial Park and a wildlife biologist well known

for his expertise in the study of grizzly bears. He is here working with his

sister, Colleen McCory, and Grant Copeland, also of the Valhalla Wilderness

Society. I'd like you to join me in making them all welcome.

HON. S. HAGEN: It is with a great deal of pleasure that I

introduce to the House today members of the B.C. Council of Women, with

whom we had a very informative and good meeting at the Cabinet

Committee on Social Policy. The following women are in the House today:

Beverley Clark, Jean Crowley, Mary Higgins, Florence Thrupp, Esther

Hall, Margaret McKee, Evelyn Harrington, Rita Duffy and Dorothy Beach;

they're traveling with Bill Higgins. Would the House please assist me

in bidding them welcome.

MS. A. HAGEN: On behalf of our caucus I'd like to join the

Minister of Advanced Education in welcoming the members of the B.C.

Council of Women, with whom we'll be meeting this afternoon. It's a

great pleasure to have them in the House today.

HON. MR. DUECK: This afternoon it gives me great pleasure to

introduce some people from down under — Kiwis from New Zealand. These

Kiwis happen to be my brother and his family: David Dueck, Bette Dueck

and their daughters Katherine and Deanna. As we met with my brother and

family over the last couple of days and talked about the health care

system — I have to get a little political here — he tells me that no

one is going to tell the New Zealand government that this health care

system we have in British Columbia is the best throughout the world by

any means. Would the House please make them welcome.

MR. PERRY: Mr. Speaker, I've never tried to tell a New Zealander anything and am not about to now.

I would like to welcome to the House Ms. Angie Todd-Dennis, who is

presently from Prince George but will be a new constituent of mine on

July 1 when she takes over as coordinator at UBC of the First Nations

health care professions program. The goal of that program will be to

encourage the participation of native people in all of the health

professions in B.C. It's something I'm sure we look forward to on both

sides of the House, and we'll be following her work with great

interest. I would like to welcome her.

MR. PELTON: In the gallery this afternoon are 45 students

from Pemberton Secondary School. These bright young British Columbians

are accompanied by their teacher, Mr. Jim Williams, and I would ask the

House to please make them welcome.

MR. SIHOTA: Just following through on the introductions made

by the good Minister of Municipal Affairs, I too would like to welcome

Mr. Michael O'Connor here today. Mr. O'Connor is the individual with

whom I articled. I know many in this House, mostly on the other side,

have questioned from time to time my legal skills. Since it was Mr.

O'Connor who guided me through my articles, I think now you

[ Page 6410 ]

know who to blame. Would everybody please give a warm welcome to Mr. O'Connor.

MR. BRUCE: Mr. Speaker, in your gallery today are some

friends of mine and, believe it or not, they're not from the

constituency of Cowichan-Malahat but from that great constituency of

Nanaimo. I would ask that you please welcome Dick Winkelman, Margaret

Hughes, Joy Cameron, Barb Thorne, Al Vance and my constituency

secretary Crystal Cosby.

MR. LONG: Mr. Speaker, today in the gallery we have visiting

a good citizen of Powell River, Mr. Sid Forstrom, and I would have this

House make him welcome.

Oral Questions

DOWNSIZING OF FEDERAL CIVIL SERVICE

MR. HARCOURT: I have a question to the Premier. A few years

ago he was criticizing the Bennett government's restraint program as

mean-spirited. Today he is suggesting the federal government cut its

public service by 25 percent as a start.

[2:15]

Mr. Premier, which of the 25,000 federal civil servants in British

Columbia –– 6,000 in Victoria alone — do you want to see on the

unemployment lines?

HON. MR. VANDER ZALM: First of all, I take some exception to

the suggestion that because people are employed in the public service

now they would automatically become unemployable if they somehow were

to look for opportunities in the private sector. I think many of them

are very capable of becoming involved in the private sector.

I also had the pleasure of just coming back from the constituency of

Esquimalt where I addressed a good group of citizens — I'm sure a fine

mixture from across the constituency, including the MLA for the area. I

made the same suggestion there: that the federal government, as opposed

to reaching into the pockets, should consider their own house and

attempt to bring about some savings there.

One way would be to reduce the size of government, reduce the size

of bureaucracy, reduce the pressures of government. Frankly, I

suggested to that audience of people, fairly representative of the

constituency of Esquimalt, that possibly if the whole of that

bureaucracy from Ottawa were reduced by 25 percent, most people in this

country really wouldn't be too aware of it and would probably feel

quite pleased about that move.

Those people were very supportive. They thought this was great. So

why should some people in politics, some political parties continue to

insist that bigger is better and that we must somehow have more

government, more people, involved in the bureaucracy? Yes, I believe

that governments must reduce. We have a tremendous, however bitter,

lesson in the budget from Ottawa we're looking at today.

The lesson has to be that you can't continue to spend excessively

and see government grow in all directions without at some point having

to come back to the taxpayers and say: "You reach in for that last two

bits, if need be. It's ours; we need it. We're in trouble; tax, tax,

tax." That sounds like the NDP.

I agree with the Opposition Leader that we can't just practice

restraint all at once. It has to be an ongoing thing. We, as people in

government — which is why I am a proud Social Crediter — must practice

restraint all of the time when we're dealing with the public's money.

We can't do as the Leader of the Opposition would have us do: spend,

spend, spend. It can't be done. We have to be responsible with the

taxpayers' money, and today more than ever. I am proud to be the first

to stand up in this question period and say to all of the people

listening, regardless of where they live in British Columbia, that we

as citizens of this great province can be proud that we have the best

fiscally managed province in the whole country. We have done our job

well, and we'll continue to do it well.

MR. HARCOURT: Yes, I can see that you and your government are

proud of cutting out the child-abuse workers in this province, and the

environmental and forestry officers and the rentalsman.

Once again, to the Premier, which vital federal health and safety

services are you willing to cut? Are you willing to cut the

environmental officers who blew the whistle on Howe Sound pollution, or

the coast guard that deals with oil spills, or search and rescue? Which

services, Mr. Premier, do you want to cut?

HON. MR. VANDER ZALM: The question is: which services would

we cut? Let's look at the record. We have brought about a balanced

budget. We have established a rainy-day account in excess of a billion

dollars. We have reduced the accumulated deficit. We're paying less

interest this year than we did last year. We cut the sales tax. We

increased spending on educational programs, health programs and the

environment by 90 percent. We're doing a wonderful job, and I welcome

these questions. It gives me an opportunity.

Let me say also that I've often said that the NDP and the Leader of

the Opposition tend to live in the past. We did have restraint as an

issue in the 1983 election. Who was elected? Social Credit. We had it

as an issue in the 1986 election, and who was elected? Social Credit.

MR. G. HANSON: Mr. Speaker, beyond bombast and rhetoric, the

Premier owes the people of the province an explanation. Is he proposing

that federal fisheries research be cut, the people who protect our

vital fish stocks?

HON. MR. VANDER ZALM: I shouldn't answer that question, I

realize, but I will. I want to have this opportunity of telling the

opposition again what a wonderful job we're doing and how things are

happening in this province.

[ Page

6411 ]

Let me say this. Let's reflect for a moment on the federal budget

and realize that 35 cents out of every dollar collected in all sources

of revenue by the federal government goes to pay only the interest on

the debt — only the interest. Compare this with British Columbia, where

it's 4 cents — not 35 cents but 4 cents.

Let's consider that despite all these measures, we still have a

deficit greater this year than last year. If we assume that somehow all

this will go away, as the NDP tends to think and speculate all the

time, we're wrong. All people, regardless of whether they live in the

east or the west, whether they work in the public service or the

private sector, will obviously need to put their shoulders to the

wheel. We'll all need to work a little harder to get rid of this

deficit. And working harder means that we all produce perhaps a bit

more than we might have previously. It doesn't mean, as the member for

Victoria is suggesting, that we bring in more bodies or somehow

maintain the government at the size we've seen in the past. No, Mr.

Speaker, realistically the federal government must reduce the size of

its government. It must reduce the size of its bureaucracy.

MR. SIHOTA: Mr. Speaker, the Premier gives the speech that I

heard at the chamber of commerce in the Western Communities. Your

comments of 25 percent.... We ought to be mindful of the fact that in

Esquimalt–Port Renfrew we have a large military base. I don't think the

25 percent comment went over well with that important segment of our

population. I don't think your comment with respect to....

Interjections.

MR. SPEAKER: Order, please. Has the member got a question?

MR. SIHOTA: In Esquimalt–Port Renfrew we have a penitentiary

at William Head. With respect to that comment about 25 percent, is the

Premier telling those people who work at William Head in Penitentiaries

Canada that we ought to cut back the guards at federal penitentiaries?

Is that what he's suggesting when he talks about the 25 percent?

HON. MR. VANDER ZALM: Unfortunately, it's obviously not for us to

deal with the federal budget, however much I — and I'm sure many on this

side — would appreciate that challenge. It's not our job, so I really can't

get into the specifics of it. But I don't think we should assume, as

the NDP does, that we can't look at all these institutions of government

and somehow bring about greater efficiency or do things differently; that we

must be locked into the past, continuing to do things as they have been done

in the past. I fear for our children and our children's children. They deserve

a future. They shouldn't be burdened with a tremendous debt because we have

socialists in this country who think there's no tomorrow.

MR. G. HANSON: I hope those keeping the clock will take into

account the time so that we can ask the Premier what specific cuts he

would like to make. What specific cuts in educational and social

programs affecting native people in this country are you going to cut?

HON. MR. VANDER ZALM: As I listen to the line of questioning,

I become more aware of where the differences are between a socialist

philosophy and the free enterprisers. The socialists are selfish; they

want everything for themselves today. We say there's a future; there's

a tomorrow; there are our children; there are our children's children.

Don't you care a bit about their future? Do you believe that the

socialist philosophy of "Spend today; I want it today, all for myself"

is the answer? I don't believe it. The majority of British Columbians

don't believe it. That's why they continue to elect a free enterprise

government.

MS. A. HAGEN: Governments provide services for people. The

Premier has talked about cutting services for people. In cutting 25

percent of the federal staff, does he propose to cut those people who

help our expanding senior population with Canada Pension, supplements

and old age security? Are those the kinds of cuts this Premier is

contemplating?

HON. MR. VANDER ZALM: Again, that's a bit of a philosophical

question. Are we really serving our people? Are we really providing for

our seniors? Are we really providing for our children by increasing the

size of government, by making government grow bigger? Or, instead of

spending money on government, should we be spending it on people? I say

it's people first.

DAY CARE FUNDING

MS. MARZARI: I have a question about children and our

children's children — a question about the government's job of

protecting people for whom government is their last line of defence.

This is a question to the Minister of Social Services — we'll give the

Premier a rest.

Over the last year you have sat on your hands while the federal

government has been developing programs for day care in this country.

Now that we know the federal budget has cut off all future spaces for

child care, I want to know what this government is going to do and what

you are going to do. Are you going back to the federal government to

fight for money for spaces, or is this provincial government going to

rectify the mistakes of the past in not going for a better deal with

Ottawa and providing some spaces for our children and our children's

children in this province?

HON. MR. RICHMOND: Yes, the federal government has suspended

its child care legislation. That's not all bad, because the bill that

was written was not all that good. It had some good parts and some

flawed parts. Will we deliver the services? Yes, we will. We will look

after child care — day care spaces,

[ Page 6412 ]

if you want to call them that. We are going to be doing some

intensive lobbying with the federal government to get them to expand

the parameters of the Canada Assistance Plan. At the moment the CAP

does not allow for subsidized day care in commercial day care spaces.

We will be going after them to lobby them for that.

[2:30]

MS. MARZARI: Commercial space?

HON. MR. RICHMOND: No, to include commercial spaces as well

as non-profit. At the moment they don't do that. We think the program

should be expanded to apply to commercial spaces. Some of the finest

day care we have is in commercial day care spaces.

We will also be lobbying the federal government to expand CAP to

include start-up costs and capital costs for day care spaces, because

we realize we need more day care spaces in this province. We will be

lobbying them to expand the Canadian Assistance Plan to accommodate

that.

We will be pressuring them on many more things, now that they've

cancelled their child care legislation to broaden the base of CAP so

that we, in conjunction with them on a cost-shared basis, can expand

child care into many other places: the workplace, schools, private day

care and into the unlicensed day care, which is some of the best day

care we have in this province.

But I will tell the people of this province and the opposition that

we don't need more federal civil servants to do the job. We can do it

more efficiently, as the Premier says, by cutting the size of

government and putting the money into services for people.

Orders of the Day

HON MR. RICHMOND: Mr. Speaker, I ask leave of the House for

three select standing committees of the House to convene this

afternoon: the Select Standing Committee on Health, Education and

Social Services; the Select Standing Committee on Tourism and

Environment; and the Select Standing Committee on Finance, Crown

Corporations and Government Services.

Leave granted.

The House in Committee of Supply; Mr. Pelton in the chair.

ESTIMATES: MINISTRY OF HEALTH

On vote 35: minister's office, $333,960 (continued).

MR. CLARK: I want to talk about questions raised at a recent

court case regarding the Children's Hospital pathology lab. Four people

were charged, ultimately, and three were convicted as a result of that

case. I'm glad that the minister has some other staff here to deal with

some specific questions arising out of that, questions that suggest the

Ministry of Health has inadequate management and monitoring

capabilities, questions that reveal clearly a failure of the restraint

program and the extraordinary lengths that hospital employees went to

in attempting to buy capital equipment using operating funds, questions

that suggest that public money was used for personal benefit and that

the ministry did not know about it, and that, in turn, raise the

suggestion that other departments in the hospital and in other

hospitals could be involved in the same fraudulent or at least

deceitful activities.

I want to be very careful here in questioning the minister regarding

this court case. A lot of allegations were made against individuals who

were never charged with any offence, any wrongdoing. I do not want to

unfairly attack any of those individuals. However, it seems to me that

the allegations are so serious and the unanswered questions so many

that I think the minister must attempt to answer them. I will try very

carefully not to impugn anybody's reputation and not to repeat

allegations that appear to be completely unfounded, but there are lots

of allegations regarding the management of that particular branch of a

particular hospital that really beg many questions.

I know the minister is aware of this case, and I'd like to briefly

outline how this scam, or the schemes, worked. There are several

schemes that came out in the court case. As an interesting sidelight,

the best description of these fraudulent activities is contained in a

report by David Hooper, who as members may know is the forensic

accountant who helped to unravel the Coquihalla overspending. He was

hired by the hospital to deal with this case.

Let me put it in layman's terms. In order to get around the

provincial restraint program in '83-85, the pathology lab at Children's

Hospital and probably other departments devised a scheme whereby

certain suppliers were able to shift operating funds into capital

funds. Essentially it worked this way: if the pathology lab needed

5,000 test tubes, it would normally be able to pay less than the full

market price. In other words, they would receive a discount. Rather

than receive a discount, the suppliers carried on their books a credit

account, a premium account. These so-called credit accounts were built

up by at least three companies that came to light in the court case:

Western Scientific Services Ltd., Beckman Instruments and Kodak, three

rather large companies — some, of course, like Kodak, larger than

others. We don't know if there were other companies that carried credit

accounts. We don't know if this scheme was devised which really

undermined public accountability. We don't know if other hospitals did

it or if other companies did it. I'll return to that in a minute.

As far as the hospital and the Ministry of Health were concerned,

the money was spent on test tubes or supplies. Therein, I submit, lies

the root of the problem, because the credit accounts became

unaccountable. The money, as far as the government was concerned, was

spent, but there were credit accounts with suppliers to the hospital.

The money, then,

[ Page 6413 ]

could be spent on anything, and in fact, as we'll see, it was spent on other things.

Let me quote Mr. Hooper: "We have not carried out an in-depth

analysis of accounting procedures. It is, however, evident that false

invoices totalling in excess of $1 million have been approved and paid

by the hospital." In two years in one department of one hospital a

million dollars in false invoices was paid by the provincial

government, $1 million built up in credit accounts, to be spent on

anything that those in the know wanted. I'll return to the credit

accounts in a minute.

If it weren't for the other more brazen schemes, the other outright

fraud, those credit accounts would probably be undetected today. In

fact, they would be; I don't think there's any question about that. But

because the credit accounts undermined accountability because of the

case with which they could circumvent the rules — both the rules of the

restraint program and the accounting rules of the hospital — I submit

that, at least in part, that led to the temptation on the part of some

employees to dip into it in other ways.

They formed phony companies. The phony companies had exotic names

like Space-Age Information and Labtronics Systems. They used the phony

companies and billed the hospital directly for services that were never

rendered. The people who did that — at least the people we know about —

were convicted with fraud. I don't want to deal with that aspect; I

want to deal with the credit accounts, more to the point. By and large,

those two schemes running parallel were separate and distinct. As I

say, I won't spend time on the phony, fraudulent accounts, because

those individuals really were convicted.

I do want to spend some time on the credit accounts and on the links

between the two schemes. One of the links is alleged to be the

Knowledge Network. The Knowledge Network was involved in fraudulent

activity, and some individuals were fired because of that. I want to

get into that in a minute.

Let me deal with those credit accounts. Mr. Hooper said: "The

transactions relating to the acquisition of capital equipment against

the operating budget, although deceitful, do not appear to be criminal.

Whenever controls are circumvented, for whatever purpose, there is

always the danger of criminal fraud. We cannot, therefore, be certain

that such has not occurred in this area."

The evidence at the trial suggested that the restraint program

spawned real problems at the hospital in terms of capital equipment

supplies. Capital equipment is purchased 50 percent by the province and

50 percent through the hospital, essentially, and because the capital

budget was cut by the province, capital equipment was in scarce supply.

Operating funds were easier to get because the fee-for-service system

meant that from the hospital's point of view those operating costs were

fully funded: they simply billed MSA. So operating funds were easy;

capital funds were extremely difficult.

Most of the testimony at the trial suggested that one individual was

primarily responsible, and that individual was convicted. But there

were allegations made that the circle of knowledge regarding these

accounts was much wider; that many, if not most, of the doctors knew

about the accounts; that senior executives and accountants at the

hospital knew of the accounts.

As far as I know — and maybe the minister can respond — no doctor

was ever rebuked, no accountant at the hospital was ever called to task

and no supplier — the other half of the equation — ever paid any

penalty for these deceitful accounts. I call them "deceitful accounts"

because that's how the accountant described them.

Let me deal with what was bought through the credit accounts and who

knew about them. First, most of what was bought was necessary

equipment. For example, a Tektronix logic analyzer — whatever that is —

for $18,000; centrifuges for $9,000, and test tubes. Most of the funds

built up in the credit account were used for legitimate things that the

hospital needed.

Let's go through some of the testimony to see what else was bought.

It's fascinating reading, and I have the transcripts here. The head

technologist in the pathology lab, which is commonly known as the blood

bank, from '82 to '85, Nancy Lelievre, testified that not only was

there a credit account with Western Scientific Services but there was a

sub-credit account just for the blood bank. She says: "That's right, we

kept our own records."

What did they buy with that? They bought lots of things and, as I

said, many legitimate things. But they also bought an Akai stereo

system for $1,602.43 and silk hanging plants for $1,500. This was at

the height of the restraint program that they went out and bought silk

flowers for the blood bank and a new stereo system using the credit

account, unbeknownst to the Ministry of Health and unbeknownst to the

hospital.

The evidence is that what she did, essentially, was call up Western

Scientific — which doesn't do business in hanging plants or in radios —

and say: "We'd like some hanging plants." They said: "Well, we don't

supply hanging plants." So she suggested where they might buy them at a

particular plant store and then they would send someone down and buy

them and bill the credit account. No one knew about it, but the plants

would appear one day, just like the stereo system.

I want to read you what she says on page 83 of the testimony. This

is a question asked by Mr. Rankin, and it deals with restraint: "In

addition to the credit account with Western Scientific, there was a

policy decision made in December of 1983 when the program heads — in

your case the head techs — were told that there was an administration

decision to spend all of your budget within the fiscal year." They

didn't want a surplus. In other words, they had to increase their

expenditures to remove any surpluses at the end of the fiscal year. Do

you recall that? She said: "That was a pretty standard remark around

that time." Each year from 1983-84, '84-85, '85-86 they had to increase

their expenditures in order to use up any

[ Page 6414 ]

surplus in the operating account in order to build

up credit in a

credit account — a deceitful account — in order to buy capital

equipment. And she says: "Yes." She's asked: "That was accomplished by

pre-billing or bulk buying?" "Yes." "And every head tech was involved

in that, is that correct?" She said: "Yes, that would have been

something that was done at the head tech meeting." "Were all head

technologists in that division of the hospital present?" "Yes." "Do you

recall that happening?" "Yes." "Was it administration policy?" She

said: "I understood that it was the hospital's policy to deliberately

spend in advance of need in order to build up credit accounts so that

they could dip into it for capital funds.

There is evidence on the following page that Dr. Hardwick, the head

of the pathology lab, knew about it. There's evidence that the

testimony is that not only did he know about it but that Mr.

Tegenfeldt, the executive director, knew about it. These are

allegations in testimony made by one of the witnesses that very clearly

there was a wide circle of knowledge with respect to this issue.

What else did Nancy get through this credit account? Well, she got

$10,000 to form a social fund for doctors. She was told that Dr.

Hardwick would like a social fund — that's the evidence. She sent an

invoice to Western Scientific for technical consulting services.

Western Scientific knew that this woman was not providing any technical

consulting, yet they paid her $10,000 for the social fund.

[2:45]

What did they spend it on? Apparently $1,500 out of this credit

account went for a Christmas party for the staff at the pathology lab.

They bought a Santa Claus suit for $150 out of this credit account.

They were dipping into the account for anything they wanted, because it

was unaccountable, and the fund was building up. That's absolutely the

evidence in this court case.

This is the testimony of Gisela Black, the head technologist in the

physiology department, which is the chemistry department. She is asked:

"I take it one of the problems that you had as a head technologist in

1984-86 was the restraint program of the government...." She said:

"Yes, all technologists had this problem." They asked: "Were you aware

of the credit accounts with Western Scientific?" She said: "No, I was

aware of another credit account with another company called Beckman

Instruments, which was set up in 1983."

She corroborated the evidence that they didn't have any money from

1983 to 1985, so as a result of that they formed this credit account

with Beckman Instruments. She claims in her testimony that Dr.

Lockitch, Dr. Wadsworth and Dr. Dimmick all knew about the Beckman

credit account, and all dipped into it for whatever was necessary for

the lab and for some things, as you'll see, that obviously weren't

necessary. No one, Mr. Chairman, knew how much was in the credit

account.

Ms. Black becomes the head of this department; she finds out about

the credit account and asks how much is in it. No one knows. It took

her months to get an answer from Beckman Instruments as to how much was

in the credit account. Mr. Hooper said they'd lost all control of how

much was in these credit accounts. It turns out that $65,000 had built

up in that credit account that they could then dip into for whatever

they wanted, unbeknownst to the Ministry of Health and apparently

unbeknownst to the hospital. That's the allegation; that's the

testimony they gave. It was unbeknownst to anybody except for this

little department of the lab and the company.

I see I'm out of time, and I will need a little more time.

MR. CHAIRMAN: Before we continue, perhaps I'll let the opposition House Leader interject first.

MR. ROSE: I was so fascinated with the story that I hated to

see the interruption. But my hon. friend ran out of time, and I'm

posing as the intervening speaker.

MR. CHAIRMAN: The Chair is also fascinated with the story.

But before we proceed, perhaps the hon. member, with all due deference,

could point out to the Chair the relevancy of these interesting facts

to the estimates.

MR. CLARK: Mr. Chairman, I think that will be easy. It will

become easier as I move along. The questions raised question the

ability of the ministry to manage public funds. Some of those funds

that I want to ask questions about are still in existence today, and I

have to lay the case before I get to the current....

MR. CHAIRMAN: The only other thing I might mention before we

proceed, hon. member — and I'm quite prepared to let you proceed — is

that we must remember that under the rules, as have been read a number

of times during estimates to this point in time, we should not be

dealing with things that were beyond the purview of the current

minister.

MR. CLARK: I understand that. I want to lay the case before the.... I will do that, Mr. Chairman.

Just to clarify, I'll be going through the case to raise the

questions to see how they've responded to the allegations in the court

case. The court case finished only two months ago, so we want to see

what response the ministry had to these allegations. That's why I gave

notice of these remarks.

Ms. Black in her testimony also talks about the Kodak credit system.

The evidence is that apparently Kodak suggested a means by which

operating funds could be transferred to capital funds. It was their

suggestion; they set it up. According to Ms. Black, Mr. Tegenfeldt, the

executive director, was in full knowledge and support of this scheme

essentially to transfer funds deceitfully from operating to capital

funds.

Ms. Lockitch — head of chemistry and stat lab — reported to Dr.

Hardwick. She testified that she knew all about the premium accounts

with Beckman. She testified also that Mr. Tegenfeldt knew about them.

She testified that they all knew about them, and they were all dipping

into them.

[ Page 6415 ]

John Leung testified, and his testimony was among the most

fascinating. Mr. Leung testified that he purchased an Oriental rug

worth $4,000 from the Great China Wall boutique and an Oriental flower

stand at the same shop for $1,000. Western Scientific, this hospital

supply company, picked up the tab. Where did the rug go?

The rug went into the office of Dr. Hardwick, the head of the

pathology lab. The rug was so thick that on the weekend.... John Leung,

Gordon Hardwick — Dr. Hardwick's nephew — and Dr. Hardwick's son David

Hardwick had to come in on the weekend to install the rug. The

testimony is that a carpenter had to come from Shaughnessy Hospital to

take two inches off the door, because the door wouldn't open because

the rug was so thick.

Mr. Chairman, this is in a climate when beds were being closed and

the restraint program was at its peak. Dr. Hardwick got a very

expensive Persian rug just before Christmas of 1985 paid for by this

credit account, again unbeknownst to the Minister of Health, the

Ministry of Health or the hospital. Dr Hardwick to this day claims he

knew nothing of the credit account and had no idea where the Persian

rug came from, even though his son and his nephew installed it.

MR. LOVICK: Omar Khayyám or somebody flew in and dropped it off.

MR. CLARK: That's right. He came in on Monday and had this

Persian rug here, except he couldn't close his office door until the

carpenter sawed off a couple of inches. I could go on, but suffice it

to say that the evidence points to a much wider range of knowledge. I

want to deal briefly, though, with the companies themselves.

The evidence is that Kodak instigated the idea; they suggested it.

There are some questions. Does Kodak still do that today? Was there an

investigation? Is there an investigation into Kodak's involvement with

these deceitful accounts?

Beckman Instruments. No evidence with Beckman Instruments, by the

way, that the credit was used for anything but legitimate goods, but

the staff were all aware and the testimony is that the executive

director was aware of this deliberate attempt to undermine normal

accounting procedures in order to launder money through the operating

account for capital account.

Western Scientific raises a whole series of questions, and I'd like

the minister to try and deal with these later. Western Scientific is

owned by John Eccles. John Eccles is the husband of the current head of

pathology at VGH. In other words, this is all about pathology at

children’s hospitals, and one of the key companies that instigated

this deceitful account is married to the current head at VGH. So it

raises questions about whether that practice still exists.

The company submitted false invoices worth $907,345.66 and provided purchases

totalling $810, 216.92. Let's look at what Western Scientific bought and

their markups. They bought an 11-cubic-metre fridge. The price Western Scientific

paid was $3,700. They charged $9,000 to the account; the markup was $5,145.

They bought another fridge. The price was $2,526. They charged the hospital

$5,457, for a markup of $2,754.

They bought a Wang computer. The price Western Scientific paid was

$23,375; they charged the hospital $48,257, for a markup of $24,882.

In each of these cases so far, there was a 100 percent markup. The Akai

stereo: they paid $855; they charged the hospital $1,602, for a markup

of $747. The famous silk plants I talked about: the price they paid was

$707.11; the charge was $1,513; the markup was $806.11. Remember that.

They said: "We don't know anything about plants." The head

technologist suggested they go down the street to a plant store. They

went down and picked up the plants that the head technologist picked

out. They paid $700 for the plants; they charged the hospital $1,500, a

markup of $800 for the trip down to pick up the plants.

Software. The price was $33,000; they charged the hospital $53,000,

a markup of $19,000. Video equipment. The price they paid was $7,000;

the charge to the hospital was $19,000, a markup of $12,000. Technical

consulting — remember they got $10,000 in false invoices for the social

fund. Western Scientific took $3,000 as their profit markup for

transferring, for laundering, the money through to the nurse. They even

took a markup of 30 percent on the phony bills they submitted for the

social fund. It was a licence to print money.

Here are the questions. Western Scientific was not charged. What

happened to Western Scientific? The court case is settled, but Western

Scientific — the company that participated, deliberately laundered

money and submitted $900,000 in false invoices — was never charged.

In fact — and these are questions I would like the minister to

answer shortly — as I understand it, a credit account of thousands of

dollars still exists from Western Scientific, built up during those

years. A memo went out from your ministry recently telling people to

purchase from Western Scientific to use up this credit account. That's

what I understand; that's what the evidence is in court.

Is there still a credit account with Western Scientific? Why were

they never charged? Why are we still continuing to do business with

these people? Why were they not required to pay back any of the

difference? Why are we still dealing with that? Are they doing this at

any other hospital, given the fact that his wife is now the head of the

lab at VGH?

There are lots of questions regarding Western Scientific's

involvement. All the goods they purchased — not so much the legitimate

ones but all the illegitimate ones, like silk hanging plants, Persian

rugs and Akai stereos — were twice as expensive as the hospital buying

them itself, because they laundered it through and took a markup of 100

percent on many of those documents.

What else came out at the court case? This touches on the whole range of remedies, and I want to hear

[ Page 6416 ]

what the minister has to say about remedies to this practice.

We now know that the husband of one of the doctors, Dr. Lockitch,

owns a company called Sands Technology that sells computers. The

pathology lab at Children's Hospital has three Professional-1 computers

from Sands Technology. The only computers anywhere in the system that

were bought from Sands Technology exist in the pathology lab, and the

husband of one of the doctors who use the computer owns the company.

How did that happen? And what happened to Dr. Lockitch? She's still

working there, as I understand it.

A suggestion at the trial was that one of those computers was paid

for by a repair bill. Again, they submitted a repair bill to operating

account, and in return, instead of a repair — it was a false invoice —

they got another computer. The company, Sands Technology, was never

charged. The doctor continues to work there to this day. Is there

anything on her record with respect to this, and how did that happen?

Was there any investigation arising from this case, which just finished

two months ago, regarding Dr. Lockitch and how she managed to convince

the hospital to buy her husband's computers?

We now know that Gordon Hardwick, Dr. Hardwick's nephew and Walter

Hardwick's son, works in the pathology lab as a kind of joe boy. What

did Gordon Hardwick do besides work as assistant technologist? He

formed a separate consulting company called Cowsa Consultants. The

evidence was that he worked 20 hours a week, essentially moving

equipment around. He started playing on the computer. The evidence was

that he couldn't work more than 20 hours a week because he was a

casual, so he formed a private consulting company and then billed the

hospital for extra fees. Is that allowed? Is it normal practice for

staff at hospitals to form private companies and then bill for extra

jobs? Even if those jobs are legitimate, it strikes me as rather

unorthodox. I wonder if the minister could comment on that later on.

[3:00]

What's the policy today regarding employees of the hospital forming

private companies and billing for other services beyond their

eight-hour day? I don't know. We now know that Tim Hofmann, who works

at VGH, also has a private company called Micromed. He works full-time

at VGH, but on his time off he goes to Children's Hospital, does some

consulting work and bills through his private company. This may be

quite legitimate, and I'm not saying it isn't. I'm saying that when you

read the evidence, there seems to be some question about cost control.

There's a question about policy of the hospitals with respect to

individuals forming private companies and putting bills through in

addition to their regular salary.

We now know that at VGH two program heads, Paul Cassidy and Leslie

Blows, were fired and required to pay back $70,000. Did Mr. Cassidy and

Mr. Blows pay back the $70,000? That was unclear in the trial, and I

wonder if the minister could answer that. Why is it that Mr. Cassidy and Mr. Blews, who were fired and forced

to pay back $70,000, were never charged, when people with clearly

lesser crimes were charged and convicted? Mr. Cassidy is now living in

Scotland, I understand. Apparently, the answer from the police was that

Vancouver General Hospital never pressed charges, but Children's

Hospital did.

The evidence clearly points to Mr. Cassidy being one of the

masterminds behind this whole fraudulent scheme. We know that Cassidy —

the same individual who now lives in Scotland — essentially stole

$70,000, in part through having complete control over billing through

Knowledge West, a subsidiary of Knowledge Network. Again, I don't want

to cast aspersions, but we know that Knowledge Network is chaired by

Walter Hardwick. We know the pathology lab is run by Dr. Hardwick. We

know that part of the scam by Mr. Cassidy was to funnel money —

invoices — through the Knowledge Network. Disturbing questions are

raised regarding the Knowledge Network's involvement in this kind of

operation and why the government didn't know about it.

Let me deal just briefly with some questions regarding Knowledge

Network. The system was designed to link three hospitals between '84

and '86. A question at the trial: "Did it get off the ground?" Answer:

"Not really, no. We got the link but we never used it." The allegation

— and I would like the minister to clarify this — was that $15,000 a

month was paid to Knowledge Network for this link that was never used.

What did the hospitals pay to Knowledge Network? What did we get for

it? Who made the decision? And what investigations have been pursued as

a result of that? The evidence is that $15,000 a month was paid for

three years and apparently nothing came of it.

There's a series of other questions which I'll now get to. Regarding

Mr. Hardwick's involvement in a policy of deliberately overspending the

operating budget in order to build up credit accounts, as some of the

testimony suggested, the question is: could that happen today? We have

a problem in the public sector, in my view. If any money is left at the

end of the fiscal year they spend it, because they know it will be cut

the following year. It's a classic kind of Soviet system: you penalize

efficiency. This government, in this ministry, appears to have

subscribed to that view: penalizing efficiency. Not only did they

penalize efficiency — the testimony is that they overspent deliberately

— but they built up phony credit accounts in order to launder capital

goods through them. What action has been taken to make sure that

doesn't happen again?

MR. CHAIRMAN: Times up, hon. member.

MR. LOVICK: I notice that the Minister of Health has been

paying very close attention to all these questions and does indeed seem

to be keeping track. I think we would all be better served, then, if

perhaps the member for Vancouver East would continue. I would ask if he

might continue this rather interesting discourse.

[ Page 6417 ]

MR. CLARK: I'll be finished very shortly. I just have a

series of questions now arising out of the court case. I know the

members are finding it fascinating, as I did when I read this

transcript.

The questions are around who was involved in this deal and why? Was

there any penalty paid for the knowledge of, the acquiescence in, this

deal? Did Mr. Tegenfeldt, the executive director of the hospital, know

about the credit accounts? That's the evidence. If he did know about

them, what did the ministry do about it? He's still the executive

director of the hospital. It's rather intriguing that they could

deliberately undermine every accounting system, be found to be

deceitful by Mr. Hooper and be undermining the government's own

restraint program, and apparently he is still the executive director of

the hospital. He apparently countersigned many of these credit

accounts. I wonder what investigation took place with regard to that?

Thirdly, did Dr. Hardwick know about the credit accounts? It's hard

to believe he didn't; he had a Persian rug at the height of the

restraint program. He had to call the carpenter from Shaughnessy

Hospital to take two inches off the door, and apparently....

Interjection.

MR. CLARK: I said it three times. But the question is: he

said he didn't know where the rug came from. Well, maybe he didn't, Mr.

Chairman; that's quite possible. But I wonder what investigation took

place within the ministry with regard to that.

Fourthly, the evidence is that Kodak suggested, Kodak deliberately

designed, a scheme to undermine normal accounting procedures. How many

times did they do that? The evidence was that this was a conscious

policy of Kodak at every hospital in the province to assist hospitals

to launder money from the operating account and move it into capital

accounts. That came out incidentally in this trial. I would like to know

how many times they have done it, and how much we have lost because of

it. Who is keeping track of it and could it happen today — or does it

happen today?

Fifthly, Mr. Hooper says that Beckman Instruments is a major

supplier. Hooper says: "Staff in the accounts payable department were

aware of this arrangement, but no records were kept of the balance."

The accounting staff knew they were credit accounts but didn't know how

much was in them. Mr. Hooper says: "Obviously, the accounts controls

were not functioning properly." In how many other hospitals is that the

case? Are there still credit accounts in existence, and what steps has

the ministry taken to make sure it doesn't happen again?

Sixthly, what investigation was done into Western Scientific, and

why are they still doing business in British Columbia with the

hospitals? Why are there still credit accounts in existence with

Western Scientific? Why did your ministry recently tell people to buy

from this company when all of this evidence came forward?

Interjection.

MR. CLARK: I don't know that, sorry.

Why was no action taken against the companies that were complicit in

this deceitful arrangement? Those are questions which just spring out

of the testimony, and I wonder how the minister would answer.

Just to wrap up and give the minister some chance to respond, there

was disturbing evidence that restraint caused people to devise special

mechanisms to buy capital equipment. The department clearly is in

financial disarray. Clearly the evidence is absolutely staggering that

this one department of this one hospital was in complete and total

chaos when it came to financial accountability. There were uncontrolled

expenses, incomplete records, credit accounts with at least three

companies, false billings by false companies, fraud and convictions,

nepotism, inside deals, husbands of doctors getting special treatment;

and many people knew about it in that department. That's a glimpse into

one small corner of the system.

It really calls into question the ability of the ministry to monitor

the accounts in hospitals and what's going on out there in the real

world, because this is a real eye-opener. I would like the minister to

try and answer at least some of the questions which I raised today.

HON. MR. DUECK: Mr. Chairman, I'm glad that he said to answer

at least some of the questions, because there is just no way that I can

answer all of those questions. As a matter of fact, I would like to

have a list of all the questions asked.

I am as disturbed as you are, if that's what is happening and still

happening. You must remember, to begin with — and I'm not using that as

an excuse at all — that hospitals are operated by a society. We give

them a global budget and they do the management. They have the

administrators, accountants, external auditors. Surely you don't expect

me to go in and check with the external auditor to see whether he in

fact found the problem.

The case you are referring to: yes, there were some people charged.

It was investigated thoroughly. It went through the courts. If there is

still something going on in these hospitals or one of the hospitals,

I'm the first one to stand here and say that I am absolutely horrified

that perhaps we haven't got to the bottom of it. I know some of these

people personally. I wouldn't want to cast any aspersions on them

individually, because I don't know.... I will certainly take into

consideration and investigate some of these things that you have just

mentioned: credit accounts still operating and certain companies still

being used.

Incidentally, the auditor-general reported that using these two

accounts — capital and operating — was quite in order. It bewilders me

a bit. I cannot stand here and say: "So what? It happened." Not at all.

I think you have to go back further and say that in society today,

whether it's a hospital or a corporation, if someone holds up a bank

with a gun, gets a thousand dollars and walks out and isn't caught....

Do I say that's right? No, but there is a system that fol-

[ Page 6418 ]

lows. If he gets caught, he goes through the courts, and there is

going to be a penalty. When we deal with public funds, we have to be

very careful that the taxpayers' dollars are not spent that way. Mind

you, the bank's money is also taxpayers' money.

Quite frankly, what you are bringing out today is something I'm very

concerned about. Even after we have finished the estimates, if you have

any information I don't have, I want to know about it. We are certainly

going to look into it further.

We have external auditors that audit these hospitals. We also have

review teams that go into hospitals. If all of these people missed

that, then obviously something is wrong with auditors such as Price

Waterhouse. They are not an insignificant firm. Are you suggesting that

they go in there and don't know what they are doing?

AN HON. MEMBER: It's a mystery.

HON. MR. DUECK: Yes, it is. Do I then say: "Price Waterhouse, I'm sorry. We will have to get a different auditor"? It shocks me.

You rightly said there was only one hospital. How many more are

there? We have good people in most hospitals. I don't think we should

cast aspersions in general, because some people were charged and others

may be guilty and got away with it, that we have 137 hospitals

throughout British Columbia that are cheating the taxpayers. God help

us if that's so; surely it could not be so.

As a result of the police investigation — it was not a small matter

— four people were charged, with three sentences passed and one

acquitted. During the course of the investigation, two separate

auditors were brought in to investigate the actual fraud case and the

financial control system in those hospitals.

Interjection.

HON. MR. DUECK: Yes, but you're saying it's still going on.

They checked the systems. David Hooper from Clarkson Gordon was

responsible for the investigation of the fraud case. In

summary, he has

confirmed that only one person employed at Children's Hospital was

involved. Another chartered accountant firm, Price Waterhouse, was

brought in to investigate the financial control system of the hospital.

It was confirmed that the financial system in place is sound. Some

recommendations were made and subsequently implemented by that

hospital. It was concluded that it is the working of the current

financial control system that detected the fictitious invoices. It is

considered by the hospital that the case is now closed.

If you have evidence other than that.... I am not joshing. I should

be as concerned as you are, and if there are some other things that we

should investigate further, we will do so.

Vancouver General Hospital also brought in a number of investigators

and the police to investigate the fraud case. As a result, the hospital

has recovered its loss, as indicated in our memo. The hospital's

external auditor — not their accountants — had been working with the

hospital to ensure the integrity of the current financial control

system. The hospital also considers this fraud case to be closed.

As both hospitals are operated by autonomous societies, and both

police and private investigations have taken place and charges have

been laid, it was felt that it is not necessary to conduct another

investigation. However, we have again circulated a memo of our policy

to all hospitals. There were obviously some errors or loopholes or

directions that they took other than the circular or the policy that is

in place.

[3:15]

We've tightened it up, and I believe that under the current system

this could not happen. However, some of the statements that you made

still bother me. They get very close to pointing a finger at certain

individuals. If you want to state those things later on to me, even on

the outside and not in the safety of the House.... I mean this very

sincerely; we want to do that because — good grief — I've got a problem

with money and hospitals, and to think that it's going out the door is

certainly not my wish.

I do not believe — and I do not accept the theory — that the deficit

financing or the shortage of funds in the hospital creates this

situation. I can't accept that. As a matter of fact, I would say it's

the other way around. We have adequate funding in place, and somebody

was playing games and perhaps got away with it for some time. Hopefully

it will never happen again. I suppose you can look in every situation,

and you will find in society, in companies and in banks — for heaven's

sakes, they should be more careful than ever — that a lowly clerk had

been able to get away with defrauding a bank for some time. It's

certainly not acceptable, but it does happen, and I accept that it has

happened in this case. We will certainly take every possible measure to

see that it doesn't happen again.

MR. CLARK: I have just a few points arising.... I said at the

outset, but I should repeat again, that there were lots of people

named. I don't want to cast aspersions or ruin their reputations or

make suggestions; I really don't. Nevertheless it came up time and

again. It seems to me that the logic is compelling that there should

have been an investigation. I want to be assured that there was one,

and this is a recent court transcript.

Let me deal just briefly.... There were two schemes. One was

fraudulent companies and fraudulent billing. The individual in question

who was charged and convicted had the power to sign for $2,000. He

billed $2,000 to his own company. He got away with that; that's hard to

detect. He went to $5,000 — he got a little greedy — and that's when it

flagged the accountants in central accounting of the hospital. They

said: "Wait a minute, he only has the power for $2,000. What's he

asking for $5,000 for?" It turned out to be his own fraudulent company.

So the alarm bells went off, and he was arrested and convicted.

I have no evidence at all to suggest that any of that fraud is continuing anywhere else. I think they did

[ Page 6419 ]

solve the fraud question. But when the accountants — particularly

Hooper — went in to investigate the fraud, they found a separate

scheme, and that was these credit accounts being built up by everybody

in the hospital. No charges were ever laid with respect to the credit

accounts. Those are the accounts that fundamentally worry me. Those are

the accounts which it appears no one ever....

There was no justice done. No one was ever penalized for what was

clearly — by Mr. Hooper's account — deceitful. Clearly they bought

things which they wouldn't otherwise have been able to buy — fancy

things for their own office. And that's what worries me.

Some of those accounts were instigated by the companies as a

deliberate attempt — that's the evidence — to circumvent the rules. It

worries me that we're continuing to do business with these companies.

Maybe they're the only companies we can do business with; I don't know.

We're continuing to do business with them. No one suffered any

penalties; no one was ever charged with anything. It begs a question

about the ability of the government to monitor what's going on in the

hospitals.

I understand the question of autonomy of hospitals. This is a huge

system and, as the minister constantly points out, a very expensive

one. Rather than a restraint program across the board, it would be much

more rational from the province's point of view to go into the

hospitals and really look at how things are run. This particular lab

appears to have a lot of rather dubious things going on.

That's the kind of investigation that I hope the minister will

assure me he's doing. The fraud stuff is dealt with; you're quite

correct. It's done, as far as I'm concerned. But the evidence in the

fraud case raised all these other little anomalies about inside deals,

nepotism....

If I have some assurance that there will be some investigation — and

hopefully reporting — of the question of monitoring of hospitals with

respect to this kind of laundering of operating funds to capital

funds.... Beyond that, I would like the minister, if he could, to deal

with one specific question arising out of that. It has to do with the

Knowledge Network. I don't know all the details, but the evidence was

that we paid an enormous sum of money monthly to the Knowledge Network

for something which was never used. Is that a fact? It may be a

legitimate mistake, but I'm curious because it has never come out.

HON. MR. DUECK: The Knowledge Network I believe was through

the university. I think that question would have to go to the Minister

of Advanced Education (Hon. S. Hagen) ; it was not through my ministry.

I can assure this House and the member that from the remarks made today in

the House under questioning of my estimates, I am very disturbed. I have just

told my deputy that I want to know where that's at — no question about it.

I will even go one further and report back later with exactly what we've

found and what has occurred. I do not wish to spend even 10 cents, never mind

a lot of dollars, because I've got many places where I can use those funds

and where they're desperately needed.

When this came up to begin with, of course, we were surprised,

disappointed, shocked and all the rest of it, but we did give it over

to the police, and it did go through the proper process. At that time I

was satisfied that it had gone and they were convicted; I wasn't going

to get into it personally. But if there is still some area in the

hospital.... We've got a report from Clarkson Gordon and Price

Waterhouse saying that the systems in place are good. I've known good

auditors to fail, too, and I'm not going to take anyone's word until I

find out for myself that it is being looked after and that we haven't

got that fear.

I also want to check one further and make sure that every hospital

understands our policy and that it doesn't happen in another hospital.

That may not be as simple in a small hospital as it is in the large

ones, but we have some pretty big hospitals, and I know that if people

are devious enough, certain things can be done.

I gave you the example before of how a lowly bookkeeper in a bank

can defraud the Bank of Commerce for a period of four years and get

away with it year after year, with all the audits that they do

internally and externally; I suppose it can happen.

What I'm saying to the House today is that I will look into this. I

will make sure that we get to the bottom of it if there is something

still going on and the system still is not properly in place to avoid

this type of crime. And it is a crime, let's face it.

MR. LOVICK: I think it was about a week ago I listened to a

rather extended discussion in question period between the Minister of

Health and my colleague the second member for Nanaimo (Ms. Pullinger).

I wanted to get involved in that process and, unfortunately, was unable

to. Therefore I'd like to pick up from where we left off, if I might,

and start with a question.

I'm afraid I have to raise my question with a little heat, because I

wasn't entirely happy with the response the Minister of Health gave to

the questions from my colleague. As we all know, my colleague is a new

member in the chamber, and it seemed to me that the minister was not

being entirely fair in his answers. He was suggesting that she didn't

understand what she was speaking about and so forth. I want to suggest

that that is not the case and that her questions about the hospital

capital construction project were entirely in order.

We were simply trying to get from the minister as firm a commitment

as we possibly could regarding when the money will be spent in Nanaimo

and when the proposed expansion of some $25 million will occur. The

answer we got back, and it's one I've had for some time now from the

ministry.... I think I understand how the system works as well as any.

We know that there is a planning process, and at the end of that, there

is an initial approval for construction, and finally, subject again to

planning approval, we

[ Page 6420 ]

get the go-ahead with the construction budget. Nobody's arguing that case.

What I want to say to the minister, however, is that if the process

is indeed that elaborate and that far removed and one that takes at

least two years to come to fruition, why then, and how then, can the

minister come into my constituency on the eve of a by-election and

announce that the funding is in place? In short, if it isn't in place

and we have to wait nine months more for it — which is what I certainly

derive from the answer you gave my colleague — then why do we have this

public relations and press campaign going on? You were suggesting, Mr.

Minister, with all due deference, that we were trying to make this into

a political issue. I submit to you that it was you, sir, who made this

into a political issue by trying to get the full announcement and

public relations value out of it.

I would be more than happy now to yield the space to you and allow you to respond to that statement.

HON. MR. DUECK: Mr. Chairman, I would never do that.

Furthermore, I was very kind to the other side. I always am very kind,

because at my age, if I get excited it may hurt my health.

I have to go through this whole process again, I suppose. All

hospitals in the province, when there is a project in the offing, lobby

me continuously. They phone; they come to my office. So did Nanaimo. I

do the best I can to assure them where it's at at this particular time,

where we might be able to get some more funding for the next phase, and

I did exactly that. I went to Nanaimo and said that the planning

process approval has been given, and they were very happy. As a matter

of fact, the board and my ministry get along very well. They were happy

that we finally got to the place where planning money was available and

they could now proceed.

We haven't even got that planning process in my office — it's not

returned yet — and you are asking us to make the next announcement on

the construction phase. I said the other day in the House that I cannot

do that, and I'll repeat it. The intent of my office is, and has been

since I've been the minister, that we do not advance planning money

unless we are quite certain that it will proceed to the construction

stage, but the Finance minister would shoot me on sight if I started

making an announcement of $25 million before the planning process is in

place. I can't do that. I say again that my intentions are good, and I

believe I can proceed. When that planning process is complete and comes

into my office and my senior people go over all the figures and facts

and say it is in order and that we can proceed, I will then put a

request to the Finance minister: "I've got a global budget of $150

million, and I would like to advance so many dollars for this

construction phase that is beginning in Nanaimo." Hopefully that's the

course it will take.

[3:30]

MR. LOVICK: I thank the minister for that answer. I notice he

adroitly sidestepped the principal contention that I offered: namely,

that we seem to be getting, however, all kinds of public relations and

political announcements.

Let me remind the minister of what he said. I'm not disputing that

process. I accept the process; I understand it. What I'm talking about

is the rather aberrant other process that seems to go on despite this

rather lucid and clear and methodical planning and construction process

that you've just outlined.

Interjection.

MR. LOVICK: Which one — lucid and clear? Yes, and methodical. I'm giving you credit. Take advantage. You won't get it too often.

Just in passing, I appreciated your reference to your good

intentions. I know you have good intentions, but just remember: the

road to Hades is paved with good intentions. We know that stuff — right?

The point I'm making is that the minister's opening comments in

answer to my colleague were that planning approval had been granted a

year ago. In a response dated February 9 to a letter that I wrote, the

minister reminded me that this planning process had been going on for

some two years: "Thank you for your letter of January 27, 1989,

regarding the recent approval of construction funds for the expansion

at Nanaimo Regional General Hospital." The next paragraph goes on to

say: "I do this because I want you to know that I am committed to the

planning process and therefore acknowledge the attendant construction

costs that go with it." So we don't disagree.

My question, though, still obtains, I think quite fairly: if it's

not political at all, if there's no public relations value, if we don't

know for sure what's going to happen, why do we then continue to come

into communities such as mine and make public statements that suggest

things are coming along nicely? A rhetorical question, Mr. Minister:

how many announcements of this project will there be before the

sod-turning ceremony occurs? A fair question, I think. I rest my case.

I want to pose a couple of other questions to the minister. Some

time ago I noted with interest a news release from the ministry —

dated, just for information's sake, October 21, 1988 — concerning the

Ministry of Health allocation of some $383,000 for "quick response" to

the Kelowna area. When I read that I thought, what an interesting

concept, and it certainly seems to be a worthwhile one. Could you tell

me whether that same kind of quick response program is being tried out

in other areas? Was this a pilot project? Is there any likelihood that

this kind of project might be introduced to the hospital in my

constituency? I can elaborate if you wish.

HON. MR. DUECK: The pilot project was in Victoria with the

Victoria Health Project. Since that time we've developed one in White

Rock and one in Kelowna, and we plan on another two in the near future;

perhaps in the Fraser Valley and the lower

[ Page 6421 ]

mainland, but exact location has not yet been identified. Provided

that funding is available, we believe it is certainly cost-effective.

And not only cost-effective; I think it's also very good if the

individual can be treated at home rather than in an acute-care

hospital. It's a total focus on looking after people in their homes, in

their community, rather than in an acute care facility.

The Victoria Health Project, the pilot project here in Victoria, had

tremendous success and still enjoys tremendous success — as a matter of

fact, beyond our expectation. You say Nanaimo. I haven't got that

answer for you today, but being a major centre, certainly when this

expands it will perhaps be in keeping with that process.

MR. LOVICK: The minister will very likely get some lobbying

from Nanaimo and the board of directors at NRGH. Indeed, I wrote to

them some time ago, suggesting that given we in Nanaimo are a regional

centre for Vancouver Island, given, moreover, the changing demographic

structure and picture — namely, that we have an increasing more aged

population — my response to this particular announcement is that we

would be a logical place to introduce this kind of cost-saving measure,

certainly a more efficient approach to the provision of health care.

Another direct question to the minister. I must apologize, because I

did not hear the initial reference to this sum of money and what

exactly it was about; therefore I would ask a question now if I may.

When you were talking to my colleague about funds coming into NRGH, our

hospital in Nanaimo, you made reference to the figure of some $529,000.

Would you explain to me please what that was and where it came from?

HON. MR. DUECK: I would have to have a few moments to see

that particular amount. I believe it is a base-funding increase, but I

would have to look that up.

MR. LOVICK: I have only a few questions, and therefore I'll give you my other one right now.

I recently received a letter from a doctor in my community who draws

attention to a problem that I think by itself is rather small but may

indeed have significance beyond the specifics of the problem. The

letter, addressed to the administrator of the Cancer Control Agency of

B.C., talks specifically about a new manual called "Cancer Treatment

Policies." The burden of that letter — a copy of which, by the way, was

sent to the Ministry of Health — is that we're apparently sending out

what is a glossy, expensive, good and worthwhile publication using a

kind of broadcast approach rather than to specific and targeted

audiences. The doctor says sending this kind of information to doctors

in communities throughout British Columbia is probably a wasted

expenditure insofar as the great majority of those people do not deal

with cancer patients, and he wonders whether there might be some

cost-saving by a more selective and targeted approach.

Is the minister entertaining any proposals, programs, whatever, in

order to achieve some of those kinds of cost-efficiencies which he

might like to share with me?

HON. MR. DUECK: I'm pleased you brought that up. Of course,

it would be entirely up to the Cancer Control Agency, but we constantly

tell them that they must be very efficient and frugal; they only get so

many dollars and they often ask for more funding. I've made a note of

it and we will check. We don't produce that; the Cancer Control Agency

would do that on their own. I don't want any agency that we fund to

spend money foolishly. We'll check it out.

MR. LOVICK: I appreciate that answer, but I note something

that happened a few minutes ago when my colleague for Vancouver East

was asking questions. The answer there was essentially the same as the

one I just heard: namely that what we do — that is, the Ministry of

Health — is to provide money to hospital societies or to the Cancer

Control Agency, whatever it may be, and then effectively rely on those

agencies, operating independently, to manage their own affairs well. In

your opinion, Mr. Minister, do we have the kinds of financial controls

and efficiency measures built in so that we are indeed guaranteed that

kind of service from all of those agencies, which, as they all claim,

are chronically cash starved? They always say that. Do we have

sufficient assurances from your point of view that we are indeed

getting the value for money we ought to be getting?

HON. MR. DUECK: We have controls in place, of course. When

you talk about a glossy folder being sent out.... I suppose something

like that could be missed, even if our review teams go in. We watch

programs very closely. In other words, no hospital can buy a piece of

equipment that impacts on operations. That's the kind of control we

have on all hospitals. They cannot go into a program that is not

approved by us in advance. Some of them have, in past years, and we

refused to fund it. We let them find the money elsewhere, and they

suffered for it. We found — this was not so some years ago — that if we

didn't do that, I got into trouble, because I also have a fixed amount

of money. Those controls are in place.

If we find a hospital that runs into difficulty.... We have had a

number of them. For example, a letter comes in, or they want to see me,

and they say: "We're running a deficit of $100,000" — or $200,000 or

$300,000, depending on the size of the hospital. We say at that time:

"Fine. Would you like us to come in?" Sometimes, even if we don't say

that, they invite us in, because they want to know how they are going

to get out of that deficit.

We'll send in a review team made up from my ministry. They're very

knowledgeable; they know the operations of hospitals. They can go in,

and in a very short period they can tell you where some of the problems

may lie. If that isn't enough, or doesn't work well, or they say, "We

don't agree with your team, because you're biased. It's the ministry,"

we'll

[ Page 6422 ]

say: "Fine, we'll put in a peer review team, made up of various

hospitals that have no axe to grind, to look at the operation." They

come up with some very surprising evidence. They would probably pick up

something like this.

Not too long ago the Cancer Control Agency had problems. We said:

"Look, that is your problem, unless you can prove to us that there is

something beyond your control." Then we have to look at the funding

area, where the number of patients were, the population increase and

various factors that we bring into play. The Cancer Control Agency

found that they had only about a 60 or 65 percent bed occupancy. Why

were they open? They closed them. That caused me a lot of pain, because

people said: "There's a waiting-list and you are closing beds." Not so.

There was no one waiting for a bed who didn't receive one. The

waiting-list was in the radiotherapy section. That's where we put in

extra dollars, because we saw that it was beyond their control. We put

in $500,000 or $600,000 to start up a night shift to catch up on the

waiting period.

These are the things we do. We come in and help out where we have

to. We don't go in and say: "You've run a deficit. Fine. How many

dollars do you want?" Things that you mentioned — perhaps a small thing

on the face of it — could be much greater. If they are negligent in a

small area, they may also be negligent in a larger area. For example,

have they got too many physicians on staff for the numbers they are

putting through? Are they paying their physicians too much? They are on

salary. Are they doing some things that they should perhaps not be

doing, instead of looking after patient care? There's a tremendous

out-patient program that the Cancer Control Agency has developed.

Incidentally, they are very efficient, and they do an excellent job.

Other than what you mentioned, I have to say that they are

cooperative. They are happy with the ministry, and we are happy with

them. We don't always agree. They want more money; I haven't got it. By

and large, they are operating a good show. I don't know what more I can

say, except that when I see inefficiency.... By nature, being from the

private sector, inefficiency really bugs me. I used to go around in my

businesses and switch off lights after everybody was gone. I don't do

it at home, but in my businesses I was very concerned. I'm tremendously

frugal in that area. I'm cheap.

[3:45]

MR. BRUCE: I would just like to offer a few points to the

Minister of Health. First of all, I appreciate the difficulty of the

demands throughout the province on our health system, with communities

throughout the province looking for new and improved facilities. It

would surprise me if there was anywhere you could go in the province

today that wasn't looking for some type of improvement to facilities

and operations.

On the global side, I would like to mention that without a doubt we have one

of the finest health care systems in the world. I would like to say that some

of the advanced medicine we do in the province is exemplary. I have had some

personal experience with some of the heart units in this community. The work,

the professionalism and the manner of dealing with that is absolutely outstanding.

That being said, of course there are still things and ways that we can improve

upon in regard to our health care, and, as has been mentioned by others in times

past, much of that comes down to how we as individuals look after ourselves.

Just so my good friend the first member for Nanaimo (Mr. Lovick)

does not feel left alone in looking for new and improved facilities: as

he is in his area, so am I in mine. We're not big spenders in

Cowichan-Malahat. We're just looking for a little amount of money.

We're not looking for some $25 million of construction funds to move

ahead. All we're really looking for...

Interjection.

MR. BRUCE: It's a small town but, by golly, it's dynamic.

All we're looking for is some planning go-ahead. Some time ago there

was what I thought was pretty much an undertaking in respect to the

Chemainus Hospital, when we moved it from an acute facility to an

intermediate and extended, that we would see, at least in this year,

the planning process be given the green light. I was wondering whether

the minister could tell me whether or not consideration has been given

to the planning process for the Chemainus Hospital, and whether I might

see a green light. You don't have to say yes or no, just whether or not

there's consideration.

HON. MR. DUECK: I'm not going to say yes or no; I will say that consideration will be given.

MR. LOVICK: Is that my answer?

MR. BRUCE: I'll try and do what I can for you, my colleague

first member for Nanaimo. Maybe with a little persuasion I might be

able to get the good citizens of Nanaimo their $25 million as well;

I'll do what I can.

What I would also like to ask, Mr. Minister, is in respect to the

Cowichan District Hospital. We have been looking there for a discharge

planning unit. It is a well-run, efficient operation. When one talks

about cost effectiveness and control, as there has been some of the

discussion about here today, I know firsthand that they've implemented

several measures. Certainly the value, the efficiency, of the dollar

that's spent there on behalf of this province for the taxpayers and the

citizens of Cowichan is well spent. We're in a position today where a

discharge planning unit would greatly improve the efficiency and the

effectiveness of the dollar spent. That, too, is something that we are

looking for, and I am wondering whether the minister can tell me

whether that's under consideration as well for this year's budget?

[ Page 6423 ]

HON. MR. DUECK: Again, consideration will be given, and I can speak to the member on that later also.

I have the answer to the question that was posed by the member from

Nanaimo. There was in fact $529,000 given April 1, which was to

recognize workload pressures. That, of course, will then form a base

budget for the coming year. So they were recognized for the work

pressure they had at that time.

MS. MARZARI: I want to approach the minister regarding some

aspects of women's health in our province that have traditionally been

overlooked.

As I mentioned some weeks ago, women in British Columbia are looking

for three things, basically: equality, security and choice. I wanted to

address myself to a few areas of women and health that I think could

use some attention, not because they in themselves are the outstanding

needs that pressure the health system today, but perhaps because they

are needs that have been somewhat overlooked, not properly inventoried

and not studied to the extent they need to be, and therefore treatment

services have not been made available to the extent that they are now

required.

I thought I would begin by discussing eating disorders. Very often

in our community now we come across situations of young girls who have

developed a disease called anorexia nervosa. As the young girls grow

older, very often the disease or the eating disorder takes the form of

bulimia. These terms have become almost commonplace in our lexicon in

British Columbia, just as across Canada and North America as people

have discovered it or come upon it and started to describe it more and

more.

These seem to be diseases of women. From the information that I've

received over the last few months, most notably from a whole issue of

the British Columbia Medical Journal , March 1989, devoted to eating

disorders, there are quotes from people, reputable doctors such as Dr.

Roger Tonkin, who runs the youth clinic at the Children's Hospital, and

these doctors are saying that we aren't serving our young girls well.

We have statistics that suggest that one in a hundred girls might have

this disease — five or six in a high school. Of those who develop the

eating disorder, there can be a 1 percent mortality rate. Kids are dying

because they perceive their bodies as being too large, because they

perceive they must fast and that they cannot eat; in fact, they put

themselves into a situation where they literally can't eat.

I am also told by this journal that 20 percent of middle-aged women

have some form of eating disorder. Obviously an invisible disorder,

obviously not something that people talk about. They probably feel a

great deal of shame about it. It's not visible so therefore you don't

recognize it. It's something that people might laugh about or not

regard as serious, but when we look at the mortality rates we can see

that it is very serious indeed.

In the American Journal of Psychiatry it is suggested that up to 13

percent of college women might have a serious eating disorder. That's

not just people dieting or talking about dieting, or people for whom

weight is an issue, but it's a serious disease affecting a person's

ability to function in the community.

I'm putting this forward because I know from talking to Dr. Tonkin,

who operates out of Sunny Hill Hospital in a rickety old shed out the

back of the hospital, because the Children's Hospital is overloaded and

the youth program there seems to have lost beds because of pressures on

the hospital.... Dr. Tonkin has dealt with many hundreds of kids having

troubles — and their parents. I talked with him and other doctors who

run similar services out of St. Paul's and Shaughnessy. I notice here

that Kelowna General also has a program, and there is a limited program

at the UBC hospital. I want to ask you, Mr. Minister, what you can do.

I notice that you are in fact trying to catalogue the incidence of

the disease right now, but I am interested in talking to you and

receiving some response from you on your recognition of this disorder

in many of our young women and what we can do better to relieve the

problem, both by investing more medical service, investing more capital

dollars to provide for better location and better sites for the disease

itself, and in terms of research and study of this particular

phenomenon. It strikes me that the three things that are required are:

the treatment, which is the medical personnel, the psychologists; the

space in which to do treatment; and better knowledge of the disease

itself. Can you talk for a few minutes about that?

HON. MR. DUECK: Yes, the ministry has recognized this particular illness

for some time now, and we have taken some steps to address it. The Ministry

of Health is committed to a coordinated response to the problem of teen-age

eating disorders. The ministry has contracted with McCreary Centre Society at

Sunny Hill Hospital in Vancouver to establish a reference committee to advise

on all aspects of eating disorders. The committee, representing hospital and

community health programs and professionals, will prepare a report on the scope

of the problem of eating disorders, summarize current research, identify existing

resources in British Columbia and propose a framework for a provincial program

response.

In addition, the successful 1988 summer program for youngsters with

eating disorders will be developed further as an option to decrease

hospital utilization. The contract with McCreary Centre Society builds

on work carried out by the Fraser Valley regional mental health

services during the last year. An information booklet was produced

about eating disorders, listing available treatment resources. Training

for Ministry of Health staff was provided, and funding was provided for

the development of support groups through Surrey Community Services in

consultation with community mental health professionals.

You asked if we did anything. I think you went even one further,

with capital construction. This may follow after the total review is

done.

[ Page 6424 ]

We recognize that there is a problem. The hospitals, of course, also

deal with it, although not all are equipped to deal with it, as you

mentioned. Some believe it's just in their mind that they don't want to

eat; we recognize it as an illness. When you talk to physicians who

deal with this, they freely admit that it isn't something you can take

or leave. These people have a problem, and there are quite a growing

number of them. I've only been aware of this in the last couple of

years. I was amazed at the percentage who are sick, and some people are

dying. We've got evidence of that, statistics of people actually dying.

It is a fatal disease if it's not checked in time.

MS. MARZARI: I'm looking forward to hearing about that

report. The faster we move on this the better. It has been an invisible

and neglected area. If we are looking at five or six kids in each high

school suffering from this disease, I think it's a problem of pretty

large proportions.

Another area I wanted to canvass briefly today has to do with another neglected

group of women: older women. According to Canada's health promotion survey

on drug use, over 21 percent of older women are using prescription drugs: namely,

sleeping pills and tranquilizers. This seems to be a phenomenal amount of money

— to put it quite crassly, the bottom line — to be expended on sleeping pills

and prescription drugs.

[4:00]

Those older women, according to the recent survey, seem to suffer

from a disease called loneliness One-third of the women canvassed by

the Health and Welfare department suggested that they saw virtually no

one regularly. Literally one-third of those 21 to 23 percent of older

women saw no one. Their social isolation takes them to the use of

sleeping pills and tranquilizers. It seems to me that there's something

wrong with our system if it finds it cheaper to give these women

prescription drugs rather than provide community jobs or keep them

engaged in society in some way.

I cannot help but make some connection between young girls starving

themselves for whatever reason — their own fright, nervousness, fear of

the future — and these older women not facing reality, by the use of

sleeping pills and tranquilizers. One can only assume that we have a

lot of women in our community — young girls through older women — who

feel very much excluded by our communities and our society.

I further this along and make the larger connection, between that

and what women earn in the workforce, their lack of opportunity and

access to post-secondary education and the professions. I have to see

that women very often get excluded from the mainstream of our society.

My question to you today has to do with the use of sleeping pills

and tranquilizers by older women. Has your department taken any active

initiative as a result of the Health and Welfare study to see what can

be done other than to simply prescribe these pills to women who

obviously are asking for far more than that? Are you coordinating your

efforts with other services and agencies to try to provide a sense of

community, a sense of society, for women who seem to have given up?

HON. MR. DUECK: The Victoria Health Project is a good example

of what we're doing for seniors or what seniors can do for themselves

if there's an initiative started or promoted by us — in this case the

Ministry of Health. We find it very true that many senior citizens go

to a doctor to ask for prescription drugs because they are lonely.

However, I think education is about the best answer for that. It's not

just education for the elderly; it's education for the physician or

druggist. All these people should get involved. Our strategy thus

far.... Again, it's something quite new, and we realize they have a

problem, not just with prescription drugs but also with alcohol.

Because they're lonely, many of these things follow suit. Our strategy

thus far has been that the seniors' drug action program, which we call

the action program, will work with a number of partners — the British

Columbia Medical Association, the Registered Nurses' Association and

pharmacists — to develop and deliver a number of education and training

initiatives to improve prescription practices and encourage informed

consumption of medication. A total of $790,000 has been allotted for

this initiative over the next three years.

I should tell you that there is.... We call it abuse. In some cases

it's a desperation move. I think I mentioned the other day that in

Edmonton a physician did a raid on a number of patients' homes and

found enough Valium to put Edmonton to sleep for ten days. We will take

part of the blame, but I think it's a matter of educating people. The

medical profession, the BCMA, the nurses' association and everyone must

get involved. Seniors must get involved — seniors helping seniors. This

is why the Victoria Health Project, in my opinion, is going to be a

tremendous success, because we are going to get seniors involved with

seniors. When they have some occupation and something to fill their

void, they will be much happier, I'm sure.

We also have a program we just kicked off the other day, as you well

know: Toward a Better Age. That will be one of the topics, I'm sure,

that will come out in the recommendations about the overuse of

prescribed drugs in society. I'm sorry to say that it's not just the

elderly. Prescription drug abuse in all of Canada is absolutely unreal.

We're using more prescription drugs than ever before.

The Ministry of Health is committed to promoting and improving the

health of seniors in British Columbia. One indication, of course, is

the Choosing Wellness program, which we introduced and have just

completed. The program encourages Ministry of Health staff to work in

collaboration with other community leaders to develop and support

community-initiated programs. The ministry also provides Choosing

Wellness education materials for seniors, community facilitators and

others who are taking a leadership role in seniors' health promotion.

We are

[ Page 6425 ]

on the way — perhaps not fast enough, but I think we are doing the right things.

MS. MARZARI: I think the minister has broached the subject

that I wanted to hit here, which is basically that there are many

problems faced by women in our community that are considered health

problems. But they are not necessarily going to be addressed by the

medical model alone, and coordination with pharmacists and doctors

isn't the only answer.

Interjection.

MS. MARZARI: I said that you broached the subject.

We also have to look towards the psychological and the emotional,

which brings me to the subject of the use of psychologists in our

medical services system. I bring up another subject at this point, as I

will a few others, just to look at this.

A number of women and children have been sexually abused in our

community. This is a problem that once again has surfaced in the last

decade, and that we have only begun to understand the depth of. We all

hear horrid stories, terror stories, of what sexual abuse can do to

people — the terror and fear they have for many years, whether it was a

single encounter with an abuser or a systematic period of incest in a

family. Many people are suffering. Perhaps as many as one in four women

has been suggested by statistics that seem to be reasonably reliable,

and certainly a number of men as well. Certainly the case heard in the

Kootenays just in the last few days, in which the judge suggested that

we are in for an epidemic of these cases, is a warning to us all.

Once again, we have an illness in our society. Once again, it has to

be related to mental health. Once again, how are we going to even begin

to deal with this unless we can give those survivors, which is what the

victims call themselves, some protection? Certainly we can't eradicate

the experience unless we go into a full enforcement program, which I

would certainly advocate. We have to deal with it using psychological

and psychiatric services. It strikes me, and many other people as well,

that we have to look at the possibility of providing MSP for

psychological services and counselling to people who have been abused.

Similarly we have to provide that same kind of counselling for women

with eating disorders; similarly towards women who are perhaps using

drugs to avoid reality.

I would put that forward as a suggestion, and ask the minister how

far along we might be in terms of re-evaluating our mental health

services and our capacity to incorporate the psychological service, or

the psychologist, into our Medical Services Plan?

[Mr. Rabbitt in the chair.]

MR. DUECK: We provide psychologist services through sessional payment

rather than MSP. We are not denying anyone who requires that service, but it

has not yet come under the MSP

schedule of fees.

You mention that child abuse and sexual abuse is becoming more

prevalent or more known. I think it's both. I think more people come

out of the closet and mention it and bring it to the attention of

authority, but I also think that there are perhaps more being abused

than ever before. At least, this is the information I have from

psychologists and psychiatrists.

I have a note here that the number of sexually abused children

receiving mental health services has increased from 480 in 1986 to

1,200 in 1988. That's the children. Women also, whether it's sexual

abuse or physical abuse: I think society has to deal with it. We do,

although we are now going across ministries; a lot of that is in the

Social Services ministry.

I should mention too that since 1986, since I became minister.... In

those two and a half years, there's been quite a shift from ministers

protecting their own turf, saying: "This is mine and that's yours, and

don't bother me; it belongs in that category and that ministry." We are

now saying: "What is the problem? Can we deal with it?" We do cooperate

with various ministries. For example, when it comes to abuse, there is

the Attorney-General, Solicitor-General, Social Services and my

ministry. They all fit in, in one way or another. We cannot say: "I'm

sorry, we look after providing a few counsellors; now the other thing

is up to you." Sure, we have a role to play, but at the same time we

must coordinate and we must cooperate. We are doing that.

The Ministry of Health has established a women and health

coordinating committee to provide a forum for information exchange and

policy coordination on women's health issues. This goes back to you

asking if we are doing anything in that area of women's health. The

focus of this committee is to consider health-related issues and papers

which have a particular impact on women and to relay information to

appropriate jurisdictions on women's health issues. Perhaps you can

criticize that we are too late. But it is an issue we are addressing.

We know there is a problem. Maybe over the years it was overlooked.

MR. ROSE: I'm filling in until my colleague comes back,

because he has some questions. But I have two or three comments that I

would like to make.

Interjection.

MR. ROSE: I know. I'm all-powerful. I'll just look after this side. I don't need any help at the moment.

Do you want to declare a brief adjournment? I want to ask some

questions. I understand that the minister has certain personal problems

that he has to attend to. I can well sympathize with him. There are a

number of things that perhaps the deputy could take down and provide

the answers for, when the minister gets back.

[4:15]

The other day I asked how many people — nurses, psych nurses and

others — who have retired at Riverview have since been hired back on a

contract. That was the information that I sought when I spoke in this

debate earlier.

[ Page 6426 ]

The other thing is that I did read parts of "Toward a Better Age." I

wasn't impressed with all of it, but I was impressed with the part that

called for better pensions for people. As you know and as I pointed out

in my little pension speech about seniors the other day, over half of

the people over 65 — in Canada some two and a half million people, so

about one and a half million of those — are so poor that they qualify

for the supplement.

These loneliness problems that were talked about by my colleague

from West Point Grey and the problems associated with drug use and that

sort of thing in the older population, both male and female, might be

due to poverty. A good deal of it is because they are locked up because

they can't afford to get out or go anywhere. They are increasingly

caught between a fixed income which is inadequate, if all they get is

just OAS plus the supplement — most people don't get CPP because they

haven't worked or they haven't worked long enough to qualify — and

ever-increasing costs for rent, food and the like. There is some

indexing on both those programs, but if it is inadequate to begin with,

that indexing is on too small a base.

The minister talks about a better age and better pensions as one of

the solutions to poverty. We're not talking about freebies; we're

talking about contributory pensions that will preclude the contribution

holidays or the employer scoffing off the surpluses. We're talking about

pensions that are adequate, indexed, contributory and with defined

benefits that are related somehow to the current cost of living.

I pointed out the other day that those companies benefit from

inflation. At the same time, defined benefit plans fail to meet the

expectations and the needs of elderly people who have worked all their

lives. The direct question is: what is the minister prepared to do about

this, other than just flag it? Is he going to bring forward through the

Ministry of Labour and Consumer Services or other ministries some sort

of a provincial pension benefit standards act? We don't have anything

like that in this province. We're one of the two provinces without it;

P.E.I. Is the other one.

There have been a number of representations made to me by the

registered nurses that they want to have the power to retire at age 55.

I know we have a shortage of nurses. We're going to have a shortage of

teachers too, but that goes back to a number of things including

restraint. Has the ministry considered this in conjunction with the

superannuation commissioner — to permit those people to voluntarily

retire?

As everyone knows, once you get older, your strength isn't as great.

It seems to me that after 30 years on the job, that length.... You

haven't noticed that?

AN HON. MEMBER: No.

MR. ROSE: You haven't noticed my strength is....

Interjection.

MR. ROSE: After 30 years in service from age 25 to age 55,

surely there should be provision to pay up a contributory pension which

would permit these people to retire if they wish. I realize it's

complicated right now by the fact that you're suffering a shortage, and

I think you're going to continue to suffer a shortage as long as the

rewards for nursing are much greater somewhere else than they are here.

Interjection.

MR. ROSE: I don't know about that, but I've had experience

with my own family of a niece going down and working in California

because she frankly made more money. And they may be coming this way

now. I know that Toronto, for instance, is importing them from England.

They go from England, where they're trained, to Canada — like we used

to steal many of our teachers right after the war from another

jurisdiction and paid for by another society.

The minister is here now, so I don't need to pad anything further.

The minister has satisfied his needs. He's been out, and he's back.

The three questions are.... Nurses retiring at 55 on an adequately

funded superannuation pension: can it be done? Have you investigated

into it? You outlined it in "Toward a Better Age." How many retirees

have been hired back at Riverview? Those are the two or three items I

wanted to talk about.

HON. MR. DUECK: Those are good questions, and I haven't got

very good answers, because they are complex. Nurses retiring at 55....

Of course, right now I hope no one retires at 55, because we can't

afford it; we need them.

However, in the future, this is something they have to consider in

their negotiations with their employer, rather than through us. It may

become a policy with us at some time in the future; I'm not sure. I

have not delved into that at all.

Seniors. There are more and more seniors coming on the market now

with private pensions that are indexed. There are more seniors living

the life of the golden age — if you want to put it that way — with more

money than they had before. When we made up the strategy paper, that

was one of the questions asked. That was one of the concerns that was

put forward. It will certainly be discussed when the task force goes

out. We'll see whether they're interested in that issue, and whether

they want to take it further.

In the consultation process, if you saw the paper we issued, there

was a wide range of suggestions from people that they would like to

discuss. Hopefully, when that comes back, we'll have a better idea of

what their concerns are. I don't know if I addressed all your

questions, or if there was another one.

Interjection.

HON. MR. DUECK: I think I addressed that yesterday. There were 14. I believe you were out of the House when I brought that information back. We

[ Page 6427 ]

asked 50 if they would like to come back on contract, and in fact, 14 agreed.

MR. ROSE: I don't know if the minister is aware, but the

current superannuation arrangements we have in the provincial fund for

municipal workers and the like really don't permit retirement at 55

years. Sure, it could be bargained for. But when the government

embarked upon its early retirement program and encouraged people — many

middle-management people took advantage of it with, I think, some

disastrous results as far as the ministries were concerned for a while

— they had to pay into the fund some $25,000 per retiree between the

age of 55 and 60 years. Right now you cannot retire without penalty,

even if you wanted to, even if you are dragging yourself along.

There is another point I want to make and have the minister look

into. I haven't got the figures before me, but I think you will find

that there are very few private pension plans that are indexed to

inflation. Most are plans that shrink 50 percent of their value within

ten years at 5 percent inflation. The only ones that I know of are

those in the auto industry, and they were won by a tough guy by the

name of Bob White. Elsewhere any indexing or retroactivity is fiercely

resisted by the pension industry. If we can't fight them, we'll have to

do it through a government plan.

Interjection.

MR. ROSE: The politicians are not doing anything about it, that's why.

MS. SMALLWOOD: Just recently I met with a delegation of

Friends of Fred. The minister may have already heard from this group.

It is a group that is organizing in Surrey in support of the bone

marrow transplant program with the Red Cross.

Fred is a 30-year-old man who lives in my constituency of Whalley,

and his friends are organizing to try to encourage people to go down to

register for testing to see if they are compatible with Fred's blood

type. In that process, however, we have come to realize that while we,

through the Red Cross, have perhaps the most advanced registry — thanks

to the initiative of the RCMP and a donation by the Lottery Fund to the

Bruce Denniston Bone Marrow Society who actually got the registry off

and running, one of a very few in Canada that have several people

registered on it — the problem is that while there is a 70 percent

success rate in unrelated transplants of bone marrow, there is a bit of

a holdup in that there are only two recruiting officers and two and a

half lab technicians. The initial blood test takes five to eight hours

and must be done within 24 hours of taking the sample.

While the government made the first commitment of that $300,000

through the lottery, the commitment is not, as I understand it, an

ongoing commitment to the registry. The more that people get involved

with this process, the more obvious it becomes that it is a very

cost-effective way of saving people's lives.

I would like to know from the minister during his estimates whether

he anticipates any support going to the registry. If not, why not?

HON. MR. DUECK: I should also add the name of Harold Long to

that list of people who got the Denniston program underway. I

shouldn't mention Harold Long by name, should I? The member for

Mackenzie must be noted at this time as being very instrumental. As a

matter of fact, had it not been for that member, this program would not

have got off the ground, and I have to give him that credit. As a

matter of fact, he went at it so hard that at times I didn't know how

to get rid of him.

We did go to the Red Cross. The Ministry of Health — I have to give

credit to our people — spent hours and hours putting this thing

together with the Red Cross. Then moneys were made available through

the lottery to the Red Cross as a one-shot deal. Of course, Red Cross

is funded by the province, so it is funded on a regular basis through

the Red Cross Society. But it was a one-time $300,000 amount that we

gave to this registry, which is operating very successfully now.

The problem is that it takes anywhere from 100,000 to 750,000 donors

to find a match. We are working now to perhaps tie into the United

States, if we haven't already done so, and to Europe, so that when

someone needs a match, that's on the computer — they can go down the

list and we can find the match. You're right: anyone who has only the

one chance to get a bone marrow transplant, or else life is at an

end.... It is very important.

It's a complex system, because it requires so many matches, but I

think we're well underway. I'm proud of the program. I'm really happy

that we did get it started, but I can't give enough credit to the

member for Mackenzie for bulldozing this thing to the stage where it

was possible to go ahead. Much credit goes also to the people from his

area and the RCMP who were involved.

[4:30]

MS. SMALLWOOD: I would like to recognize the member and all

of the community people who fought for the registry, the RCMP and the

many private donors, as well as the money made available through the

lotteries to get this registry up and running.

Now that the minister has recognized that this is a very valuable

resource we have here in the province, I want to stress that for

someone who is dying of leukemia or another related illness and is in

need of a bone marrow transplant, and for the family and friends of

that person who want to help, willingly giving of their time, of their

energy and of their financial resources.... The Friends of Fred, for

example, have organized in the next month a huge garage sale, a dance,

a fun run, a soccer tournament, a slow-pitch tournament, all in support

of bringing money to the Bruce Denniston fund to match the province's

donation of $300,000. However, in addition to raising money in support

of the society, they are encouraging people to go down and be tested to

get their names

[ Page 6428 ]

on the register in hopes that they themselves may be the match for

their friend, for Fred. The numbers that I have for that match are that

for a common match it's one in 450; for the more uncommon matches it

goes all the way up to 7,050. Perhaps those are the numbers you just

gave.

This organization is hoping to give some support to their friend

beyond the raising of money for the organization, and perhaps some

support to other people. As they continue to organize, people come to

them. A mother with a four-year-old child has just joined the Friends

of Fred in hopes that her child may also find a donor.

The problem, though, that I want to bring to the minister's

attention.... There is a need for ongoing support for this program.

It's fine to get it up and running, but it does need ongoing support.

The problem is that it takes time to process those who want to be

tested and find their name on that register. The problem in the

time-lag seems to be in the resources the registry has at its disposal.

Again, the registry has two recruiting officers and two and a half

technicians. There is a time problem with the two and a half

technicians and the lab time available for the tests that need to be

done to get those people on the register.

I'm hoping that the minister will see the value of this registry and

continue to support it and allow the processing of all of these people

that the Friends of Fred have found, some 200 to date. I think only 60

have been processed, and the organization has only just started. In

hopes that we are able to find a match for Fred's bone marrow and for

that transplant, we need to process a lot more people. We believe that

Fred may be of native Indian ancestry, and one of the genetic markers

may indeed be the marker that is necessary from the native Indian

community. A call has gone out in that community, which will mean that

increasing numbers of people will want to be tested to see if they are

compatible and can donate bone marrow. I want to emphasize, before I

sit down, that to be able to process and staff the tests that are

needed in time to help this young man — Fred's time is somewhat limited

— there needs to be support for the registry. I ask the minister to

consider that.

HON. MR. DUECK: It is gratifying to hear that when someone is

in trouble — you mention the Friends of Fred — so many people get

involved. It makes me feel good that we still have people in our

society who are willing to volunteer, give money and give of their time

without.... They don't ask for any recognition; they do it because they

feel it's their duty. We don't ever want to take that away from them,

of course.

As for not having enough technicians, I am not aware of the Red

Cross even requesting any extra funding for that. It may be so. We'll

look into it.

I want to explain that the numbers I mentioned — 100,000 to 750,000

— are unrelated compatible donors. The figures could be skewed if you

mixed them with related relatives, for example. Then, of course, it

goes way down. I think the matches are really the problem, because it

takes such a massive number of matches before they can find one that's

compatible. That takes time and money.

I'm glad people are getting behind this and helping out in whatever

way they can; they've obviously shown that in this case. We will look

further to see if there is a holdup, and see if some of these people

can't get in to get matched. Maybe there's something we can do.

MS. SMALLWOOD: I'd like to thank the minister for making that

commitment. I assure you that both I and the organization from Surrey

will be back to you. It is a very energetic group.

Interjection.

MS. SMALLWOOD: I understand the commitment was to look into it.

I also understand, from what the minister said, that he recognizes

that it does take a large number of people to process those people.

Given the time required for testing, we need an increased number of

technicians and more lab time. I think it's a logical conclusion, but I

look forward to the minister's inquiries into that and hope that out of

those inquiries the minister will find some money for additional

support.

MR. LONG: With regard to bone marrow and the conversation

that has been going on here, I would like to thank the Health minister

for his involvement in obtaining money for bone marrow in the past,

which my town of Powell River was very much behind.

I think one of the problems we were running into and one of the

reasons the Health minister went to bat and funded it by matching the

funds of the private sector for bone marrow, and got it into place for

the people who have leukemia.... That is one thing. But I think that

down the road, probably nationwide, we should be looking at why bone

marrow was left out to start with. We have organ donors, which is a

solid substance, and we have blood donors, but somehow bone marrow

slipped through the cracks. It was neither organ nor blood. Now that

the Red Cross has taken on this role of looking after bone marrow, I

think maybe it's time we looked at encouraging the Red Cross. They

already have their donors in place, they already have identification of

most blood, and they already want more of the blood donors to be bone

marrow donors at the same time. The funding for blood donation could be

enhanced, and it could possibly work as blood and marrow donation,

rather than just blood. I don't know how far it's gone through the

ministry, but I would encourage that, because it makes one avenue for

blood and marrow. I think that would cut our costs in the long run.

It's just a suggestion. I know it would help so many more people,

seeing that we already have the bulk of the cost paid for through the

blood banks. And it would make the marrow come on faster for more

people in the future.

[ Page 6429 ]

MS. SMALLWOOD: Just one further question. As the previous

speaker was making his plea for that change.... When I was talking to

one of the recruiters at the bone marrow clinic, she indicated that

there was some federal funding in the budget for the Red Cross. Has the

minister or his staff had any discussions with federal counterparts

with regard to that? While the Red Cross program for bone marrow

transplants has a component in each and every province, I would hope

that the Red Cross or the federal ministry of health recognizes that

B.C. has the only functioning, up-and-running component. That should be

recognized and supported, so that if there is any further money coming

from the federal budget, the project underway here in B.C. should be

recognized and get a good portion of that money to keep it going.

HON. MR. DUECK: Mr. Chairman, I didn't mention it before, but

we were in some competition to have that bone marrow unit in Vancouver

and British Columbia rather than in central Canada. We had quite a

problem getting it here, but I should mention that the Red Cross is

funded by all the provinces, so they all have a stake in this. The Red

Cross is, in fact, funding