British Columbia Hansard — Tuesday, June 16, 1981 — Morning Sitting (32nd Parliament, 3rd Session)
32p 03s 810616a
British Columbia — Debates (Hansard)
1981 Legislative Session: 3rd Session, 32nd 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)
TUESDAY, JUNE 16, 1981
Morning Sitting
[ Page
6199 ]
CONTENTS
Routine Proceedings
Committee of Supply: Ministry of Health estimates. (Hon. Mr. Nielsen)
On vote 106: minister's office –– 6199
Mr. Cocke
Mr. Levi
Mr. Mussallem
Mr. Hanson
TUESDAY, JUNE 16, 1981
The House met at 10 a.m.
Orders of the Day
The House in Committee of Supply; Mr. Davidson in the chair.
ESTIMATES: MINISTRY OF HEALTH
(continued)
On vote 106: minister's office, $205,728.
MR. COCKE:
Mr. Chairman, we're dealing with the minister's vote. There are of
course a number of items that one could deal with under separate votes
under the minister's aegis. The trouble is that so many votes in the
health field overlap. As a result you often find yourself dealing with
long-term care, and then you're dealing with mental health and other
areas. We've been talking about the whole question of home care and how
it relates to the field, and how it is a great assistance in reducing
the impact on the long-term care and acute-care facilities.
recent months and years I've been watching our facilities described, I
believe, as psychogeriatric facilities. I've been seeing a reduction in
the number of beds that one would find in such places as Valleyview.
I'm talking of a major reduction. The Valleyview care centre has
reduced its population to something of the order of 400 at the present
time. The impact on the system is that people described as "senile" or
with a psychogeriatric condition find themselves in other areas of
long-term care or find themselves on a very long waiting list and in
the care of their families.
In the Rasmussen report we find
recommendation 5, that separate facilities be designed to meet the
special needs of the very difficult psychogeriatric client. I agree
that the last thing we need are the monstrous facilities of the past.
But until such time as there are facilities to take the place of those
monstrous facilities, it strikes me that we should not be either
leaving people adrift or misplacing them in the system.
Long-term
care facilities, either intermediate care, personal care or extended
care, are for people who are physically disabled to the extent that
they require in-facility care. Generally speaking, we're talking about
physical disability. When we mix this group with people with mental
disabilities, who are totally lost in the world, have little or no
recall and who are acting out, one way or another, through no fault of
their own.... When we put people in facilities where there are those
who are physically disabled but the others are psychogeriatrics, who
spend most of their time screaming or disturbing those around them, I
think we are not doing a great service to the system.
believe that Anne Rasmussen's report should be looked at very carefully
in the context of the whole question of long-term care. I know for some
time there was an opinion out there that we should place all people who
are chronically ill at a certain level within the same facility. But it
is not working out, and it strikes me that the Rasmussen report should
be looked at very carefully in this respect. While we have an
increasing population in the province we also have an increasing
population of elderly people, and at the same time we have a decreasing
population in facilities which used to house that particular level of
care. Where are they going?
I have visited such places as
New Vista in Burnaby, and New Vista can hardly be described as a place
that would be at the level for those people who are psychogeriatric:
it's just a personal-care level with some intermediate care. I have
visited in other facilities around the lower mainland, and I find the
same thing. We are assessing people with a physical disability and
overlooking a mental disability. I think that should be looked at very
carefully, because if it's a disturbing influence on those in the
facility, then we are not providing the lifestyle that should be
guaranteed to those pioneers and to others who are affected by a
physical disability. I would hope that the minister is going to take a
very good, hard look at this, because it strikes me that this has been
a policy for some length of time.
Carrying on for a moment
with long-term care, I noted that when the Hospital Employees Union did
their report, they called for better fire safety standards. I wonder
what the minister is going to do about that. Looking at the report by
the Rasmussen committee, I draw the minister's attention to
recommendation number 20. It very clearly indicates that there are some
real problems in this particular area: not enough fire drills, not high
enough fire safety standards and, beyond that, not nearly enough
training. So it also is an area that I think the minister should take a
look at. This morning I'd like him to give us his opinion of this
particular area.
We've been talking about the whole question
of long-term care and home-care service as it applies. I've been trying
— and it's very difficult — to get information from different
districts, particularly all districts. I have talked to enough people
around New Westminster, and here's another problem that we find in this
whole question of home-care service. We find, for example, that the
acute-care early-release home-care program is allotted something of the
order of $30,000 per year in New Westminster. What does that represent?
This represents five patients, four hours per day, twice a week. When
you break that down and think of the numbers of people on early-release
programs — being released from a hospital in order that the bed can be
made available for somebody else coming in.... I think it's a great
idea, but what happens when they only have that much money? The program
continues, but it tends to move over into the long-term care program
and bleed that program.
You see, the long-term care program
in the same area gets about $100,000 a month. Therefore they're called
upon to do some of this program. They don't like to turn people down,
nor can they turn people down. It would be counterproductive to what
they're trying to do in the first place: make beds and facilities
available, and ensure that people are in the least alienating
environment, their homes.
One other factor comes into this
whole mix: a rumour. I'd like to ask the minister whether this rumour
is true. We hear that home-care service for the terminally ill is also
to be transferred to the acute home-care program. If that's the case,
this teeny little program had better be reinforced or we’re in deep
trouble. I'd like a couple of answers to those questions with respect
to this whole service.
I would like to go to the report on
long-term care by the B.C. Health Association and read a couple of
stats that I think should bring us into line with what's occurring
today. In the first place, 7.8 percent of people in acute-care
hospitals are waiting for home-support service. In my mind that figure
asks how home care can be available to those people now in their homes
when we can’t even make it available to long-term care people who are
actually in hospital today. I figure
[ Page 6200 ]
that
the minister should review this report very carefully. I feel that the
B.C. Health Association has always been very conservative in rapping
people's knuckles; they just don't go around doing that sort of thing.
I think this is a very significant factor.
Further on in the
report they make recommendations. On page 27 they recommend that the
government be asked to allocate, as a matter of urgency, sufficient
resources for all aspects of long-term care programs so that its
objectives can be achieved without continuing detriment to the
acute-care hospital services available to the people of B.C., and then
free the allocation of resources to the home support program, such as
home care, homemaker, respite and adult-care programs, sufficient to
meet the identified needs.
Mr. Chairman, if we haven't
proved anything else in the course of these estimates and in the course
of the past few weeks, we have proven beyond a shadow of a doubt that
there is a real, urgent need for home care. That need has been
identified in this report, in conversations with every district and in
the mail. I'm sure if my mail is yea-high, the minister's mail must be
twice or three or four times as high. For heaven's sake, if we don't go
away from these estimates with anything else, let's go away from these
estimates with a commitment from the government to get in there and
give priority to this most important service. It's utterly essential.
Incidentally,
I referred to the fire regulations. I refer the minister to the
long-term care report by the Hospital Employees Union and to the
recommendations on page 105 where they ask for new guidelines, that
staff be hired in the fire marshal's office to enforce the guidelines,
that there be smoke detectors and sprinklers in all facilities and that
fire training be provided to all staff, particularly new staff members,
etc. There are six recommendations and they should be very carefully
looked at.
Before one or two of my colleagues get into the
estimates, I would like to talk a little bit more about this whole
question of alcohol and drugs. First, I refer to the Cadillac program,
the heroin treatment program, and I would like to ask if it is true
that the roughly 300 public servants are being seconded to the
non-profit programs within the communities. I'm not going to do a value
judgment on that, but I would like to know whether or not it's true. I
know something has to be done, because we've talked about the Cadillac
program for some time now. That heroin treatment program received all
of the resources they felt they needed, but there were very few clients
for them to look after. So I would like to know what's happening in the
area of the integration of the different programs. As I recall, there
were three under a previous minister. There was the alcohol and drug
program, the non-profit community program, and the Cadillac of them
all, the heroin treatment program. I gather, from what we see now, that
there seems to be an integration going on, and I would like to know in
what direction it's going.
The member for Cariboo (Hon. Mr.
Fraser) should be very interested in this. It is a report put out by a
task force on municipal policing costs in B.C. You would wonder how
that has anything to do with health. Well, it sure has a lot to do with
health in Williams Lake, I'm here to tell you. This report tells us
that in Williams Lake the SIPPs.... That's a beautiful new acronym
which stands for "state of intoxication in a public place." It seems to
be an appropriate acronym, because this is their way of describing the
number of people being charged with having been in a state of
intoxication in a public place. We have statistics for the province.
The provincial high in terms of per 1,000 population is Williams Lake.
Interjection.
MR. COCKE: My colleague says that's not a particularly good way of describing this, but it is the provincial high nonetheless.
Williams Lake we have 265.04 per 1,000 population. Contrast that with
Vancouver with 32.26 and Victoria — good old staid Victoria — with
22.59. Let's go back to the figure of 265.04. They're ranking in the
province as number one. What do they have to contend with this other
than the police? Zero. They have no program whatsoever provided by the
alcohol and drug administration. For heaven's sake, a past minister
provided a heroin treatment program in Powell River. I don't know if
anybody was ever found with heroin in Powell River. It was a very
expensive program. Yet now we've all acknowledged that this is our
major problem in this province; alcohol is the most abused of all
drugs. We find an area like Williams Lake with no program, and yet they
rank number one in this report. This report has been out for some time
— not too long, but it's been out for a while.
Isn't it
interesting that number two is Fort St. John? I'm sure that the member
for North Peace River (Mr. Brummet) would be interested in that.
They're way down in terms of state of intoxication in a public place.
They're down to 106. Can you imagine that number one is 265 and number
two drops down to 106 per 1,000. This police report is telling us that
you've got to do something about it outside of locked cells. You've got
to do something about it in terms of rehabilitation and detoxification,
and of what the Alcohol and Drug Commission or the drug and alcohol
program — or whatever you're calling it this week — should be doing.
It's not being done. If the member for Cariboo won't fight for it, we
on this side of the House will.
I want to go over what they
say in this report. They say: "The issue is not just the number of
arrests but also the number of individuals who are arrested time and
time again. These chronic alcoholics need medical attention, not just a
chance to sober up in a drunk tank." That's the key. We can go on with
this drunk tank business over and over. Sure, they die off. But these
are human beings — people with minds, bodies and souls. They should be
treated as well as anybody else in the province. If we have a
particular area where the flames are high, then for heaven's sake let's
get some firefighting in that particular area. I believe it's a sin to
leave Williams Lake in the state it's in when you consider....
Interjection.
MR. COCKE: That's not an acronym; that's actual. It's not a SIPP.
believe that we should really take a look at those two areas. In
Williams Lake 75 percent of all crime is the crime of drunkenness. The
Attorney-General and the Minister of Health had better get together on
this one, because if that's the case up there something should be done
immediately. I believe that this report I'm placing is a report that we
should all read. I think it's pretty significant, with respect to
health care, when we read these particular pages. They certainly apply
to some of the immediate needs.
This report goes on to say on page 243: "One problem occurs where facilities are not available in places such as
[ Page
6201 ]
Williams Lake, Fort St. John, Terrace, Quesnel and
Prince George, where the SIPP problem is most acute." They go on to say
that Prince George does have a 20-bed facility used for short-term
holding purposes.
We have to do better than we're now doing.
Those are two statistics out of a report that should draw the
conclusion that something had better be done very quickly; otherwise we
are culpable, that ministry is culpable and everybody else with any
kind of obligation — and that means every legislator in the province —
is culpable. I call on the minister to move in there quickly.
Otherwise, what are we going to see in the next statistics? The
statistics that we're not reading or seeing now are the other
ramifications of this. How many people are in the care of the health
system with cirrhosis of the liver, heart disease and all the other
illnesses that can be related to this particular chronic problem? I
think that is a devastating figure, and I think we'd better put our
heads and hearts to work and see to it that this situation is modified,
mitigated and put right as quickly as possible.
HON. MR. NIELSEN:
Mr. Chairman, the member brought up a number of issues. Responding to
the last one first, I think the emphasis for some period of time in the
province with respect to the Alcohol and Drug Commission has been on
the hard drugs, particularly heroin and some of the other less —
forgive me for using the term — "romanticized" drugs. I think that the
greatest emphasis the Alcohol and Drug Commission should be responding
to is the problem of alcoholism. I spoke with the new executive
director, John Russell, the other day, and we had quite a discussion
with respect to just that point. In speaking with Mr. Russell, I
emphasized my opinion that the Alcohol and Drug Commission should focus
primarily and with great emphasis on the problems of alcoholism and
alcohol abuse in our society. I think the attention paid to the
so-called hard drugs such as heroin and others has been somewhat of a
tradition. It's been viewed by many people historically as a scourge in
our society, because of its involvement with crime and the
international intrigue of heroin smuggling, and it has received a
somewhat disproportionate amount of emphasis because of that, I think.
agree with the member for New Westminster (Mr. Cocke) that alcoholism
could perhaps be identified as the number one health hazard in the
province, relating to many avenues of life — the personal deterioration
of the individual, but perhaps equally important, the impact upon
others both physically and socially. One cannot ignore the carnage on
the highways which may be directly attributed to alcohol.
The
member mentioned the situation in Williams Lake, and I appreciate that
some community in the province is going to be in the position of having
an extraordinarily high number of these people who are classified as
intoxicated in a public place. Williams Lake, with respect to the
Alcohol and Drug Commission, only has an out-patient counselling
service at the moment. The out-patient counselling service appears to
be inadequate for the demand in that community. I will certainly advise
Mr. Russell to respond as quickly as possible to Williams Lake, Fort
St. John and other identified communities where the incidence of repeat
alcohol-associated problems occurs.
The member for New Westminster mentioned that a very high percentage of the
crime identified in such a community is that of being drunk. I would perhaps
not find it difficult to agree that this particular problem need not be considered
a police problem. If the person who is drunk is causing disturbances, then I
suppose the police have an absolute duty to become involved; but the drunkenness
itself may be much more appropriately responded to by other actions than police
action.
trust that most people in the province would appreciate the major
problem that the abuse of alcohol causes in our society. Mr. Russell of
the Alcohol and Drug Commission, I and others have recently been
discussing the continuing problem of the effects upon teenagers with
alcoholic problems. It's a sad reflection on our society that there are
so many teenagers who have been identified as having a serious
alcohol-dependency problem. We also wish to emphasize, through the
commission, the ways and means of attempting to respond to that,
because it is an alarming problem and one which is growing. There are
probably literally dozens of theories as to why this problem is before
us today and why it is increasing in scope. As one of their priorities,
the members of the commission will be attempting to identify how the
situation with respect to the young drinkers and to those pockets in
the province which are identified as having a chronically serious
problem associated with alcohol abuse may be improved. We will
certainly respond to that. There are 53 voluntary non-profit societies
operating programs in the province, and clearly more emphasis is
required in more specific areas.
To conclude, I do believe
that over a number of years in British Columbia perhaps more emphasis
than was required was placed on the so-called hard drugs, and that the
problems of alcoholism and alcohol abuse did not receive the full
attention they should have. We'll see if we can modify that attitude
somewhat. Unfortunately, it's a problem that will be with us forever, I
suppose; but at least a great deal can be attempted to try to resolve
identified situations. We hope that one of the people on the commission
will have direct access to the Attorney-General's ministry, and that
such reports as the member referred to would therefore be an integral
part of the commission's study rather than peripheral reports which may
or may not find their way directly to the commission. The
Attorney-General's ministry, along with other ministries, has an
important role to play in providing precise information to the
commission.
The member for New Westminster spoke of
Valleyview. The Valleyview situation may be viewed differently,
depending on how you wish to view it. I believe that there were
approximately 417 patients in Valleyview last year. About 40 to 45
percent of those who left were discharged back into the community. As
the member would know, there is the desire at Valleyview, as in other
institutions, to try to treat the people with such success that they
may re-enter the community. A number of people who have been at
Valleyview have returned home; others have been placed in extended-care
facilities or in intermediate-care facilities. We're dealing with a
group of people who are at an advanced age — over 70, up to 105 — and
their conditions vary a great deal. But there is an attempt being made,
as there has been for some time, to have these people return to the
community wherever possible. I believe the level of care at Valleyview
is adequate. The facilities found for those people who were discharged
are generally appropriate for their condition; there will always be
exceptions. It isn’t an attempt to deliberately reduce the population
but rather an attempt to redirect the population in that facility to
other appropriate community facilities where they may be available.
[ Page 6202 ]
The
member mentioned the fire safety standards question, which was brought
forward by the HEU report with respect to long-term care facilities. In
their investigation the program directors responsible for the long-term
care facilities also identified situations where fire safety standards
were not at the level demanded by the fire marshall. I believe the fire
marshall has made it clear that they expect modifications to be made.
That program is a priority with the long-term care director.
[Mr. Strachan in the chair.]
There
are some facilities that would have to be upgraded. The new facilities,
of course, maintain those standards demanded by the fire marshal. In
some instances it would be a matter of major renovation. Perhaps the
decision would be to replace the facility with the standards of today
rather than renovating an existing facility. Where facilities are found
to have safety standards which are far below the requirements and could
be modified relatively easily they would be expected to do that very
quickly. Of course there is a cost factor involved that must be
considered in the rate structure which is provided to the long-term
care facilities to permit recovery of the capital costs of modifying
the safety standards relative to the fire marshal's programs.
There
have been some major problems in facilities throughout the province
with respect to attempted renovation or expansion. As members would
know, when certain expansions or renovations are undertaken, it
generally falls under a new permit. Therefore the entire building must
be modified to meet the fire standards. It's a continuing situation,
but I believe it's one that's well understood. Action is being taken to
try to bring them in line.
I wouldn't want the House to miss
a point which I think is important. While we can discuss specifics and
details about programs relative to long-term care, I think all of us
can still appreciate that it wasn't long ago in British Columbia when
senior citizens or their families were faced with tremendous costs and
pressures in sustaining a senior citizen in a personal-care facility —
or whatever terminology may have been used at that time. The costs were
extraordinarily high. The number of facilities was not unlimited.
Decisions made by families were sometimes very difficult. In many
instances it led to a tremendous amount of disruption in the home and
very difficult personal situations.
That has been vastly
improved with the long-term care program. It's a relatively new
program. We appreciate that. Actually, it's only about three years old.
It's being improved constantly. It is providing a very good service to
many people, not without its imperfections and problems which have been
specifically identified. It does provide a very good service to a large
number of people at minimum personal cost. I think those people who
have been able to introduce the system and maintain that system should
have some recognition.
MR. LEVI: I want to deal with
two things. First of all, I want to talk about the problem of urea
formaldehyde, and then I want to talk about long-term care.
the minister aware that because of the failure of his community health
department to do anything about this problem, thousands of people in
this province are slowly being gassed to death by formaldehyde gas? I
say this because the problem of the formaldehyde gas comes from the
insulation in an estimated 8,000 homes that we know of in British
Columbia. The ministry has yet to tackle the problem in any meaningful
way through its community health branch.
One of the problems
here has been that there seems to be a feeling in the government that
it's really a federal problem and to therefore let the federal people
carry the can for it. But the problem is really divided into two. One
is the health problem, and the other is the financial problem. People
who own their homes are suffering. I've written to the minister's
colleague, the Minister of Consumer and Corporate Affairs (Hon. Mr.
Hyndman), about both problems. I want to address my remarks to the
minister. What is his ministry going to do? I've been in touch with his
ministry, and all they're doing on this problem at the moment is a
review of the literature.
For the minister to get an idea of
what the problem is, I'll tell him of a personal experience I had last
Saturday afternoon. I visited the home of a man in Vancouver, a Mr.
Owens, and spent two and a half hours there. That house was insulated
with urea formaldehyde in 1977. As Mr. Owens pointed out, he owns the
home. He accepted the publicity from both the federal and the
provincial energy departments that everybody should make an attempt at
conservation. He was aware of the studies that Hydro had done about
heat emissions from houses needing insulation. So he went in for the
insulation in 1977. In April 1981 he read an
article in the Sun
which said that there are some very serious problems arising as a
result of this insulation breaking down, particularly health problems.
There is a range of other problems, but I want to deal with the health
problem because it is within this ministry.
In April 1981 a
building-practice note was issued by the National Research Council of
Canada, talking about urea formaldehyde foam insulation. In one
section
they state:
"Occupants of homes in which this
insulation was installed have become concerned about the effects of
material on their health and on their homes" — let's stay with the
health question. "Experts agreed that the likelihood of health problems
occurring depends on the duration of exposure and concentration of
formaldehyde. In some homes only precautionary steps will be required
to reduce the exposure to near-normal levels. In other homes a few
additional measures, less complicated and much less expensive than the
removal of the foam, will be necessary. In a small percentage of the
cases it will be too difficult to reduce exposure and the foam will
have to be removed. Steps taken to reduce exposure will usually
eliminate any risk to the building structure."
On page 3
they have a description of the symptoms. I want to read this because I
went through some of these symptoms last Saturday.
"Exposure
to formaldehyde can cause eye, nose and throat irritation, coughing,
asthma-like symptoms, headaches, dizziness, nausea, vomiting and
nosebleeds. The severity of the reaction depends on the formaldehyde
concentration, the duration of exposure and the sensitivity of the
individual."
I spent two and a half hours last Saturday
afternoon in this house and became aware of eye irritation and an
itchiness of the hands. I was accompanied by my wife, who got quite
nauseated when we went outside. We spent some time talking to these
people, who were in the most unbelievable situation. I am suggesting
that the Ministry of Health has done nothing to assist these people in
respect to the health question — I'm not talking about the compensation
aspect at the
[ Page 6203 ]
moment.
At this stage of the game when this subject has been known as being
dangerous, that ministry has done nothing more than start a review of
the literature. That's a very shocking state of affairs. First of all,
as I indicated to some of the people I spoke to yesterday, never mind a
review of the literature. There are buckets of literature. I can send
them a boxful of it. United States Senate committees have looked at it.
The federal government has looked at it. What the ministry has to do —
and do quickly — is start setting up some standardized health-testing
procedures, get into these houses and advise these people on just what
danger they are in.
It is the most incredible situation to
sit with people who own their home, who have worked all their lives to
build it, who find that they've got all sorts of financial losses on
the one hand, and on the other are sitting there in abject discomfort.
We sat for two and half hours with the windows open, because that's the
only way you can exist in the house. There is a danger there, according
to the medical people, particularly for people who have respiratory
diseases. If anything will exacerbate that problem, it's this
formaldehyde gas that is coming out of the walls of some of these
houses.
That ministry has done nothing. There has got to be
a greater sense of urgency about this. Never mind what the federal
government is going to do. The ministry is responsible for health care
in this province. This is an environmental health problem. What is
needed is some standardized testing. The minister has access to all
sorts of resources for this. Go to the B.C. Research Council or to the
National Research Council. Set up some testing and advise people that
if they are living in a house that is injurious to their health they'll
have to get out of it. People have nowhere to go when they're living in
a house that they've bought and paid for. It's different if you're
renting the house; you simply get out of it. People who've spent 25 or
30 years putting together the money to own the house are sitting in
dire danger of their health because of what's coming out of the walls.
It's a great tragedy.
It's interesting that when this
article was in the paper in April, one man, John Owens, got very
vociferous about it. He set up a meeting in the Britannia community
centre, and 70 people arrived. Two weeks later they set up another
meeting, and 120 people arrived. About three weeks ago they had a third
meeting, and over 200 people came. Phone calls were going into the
office of Margaret Mitchell, MP, so much so that they now man the phone
full-time taking down all the information on the people who have
discovered that their houses have been insulated with urea
formaldehyde. There is a great problem in keeping records of who has
what kind of insulation in his home.
Bear in mind that there
was a federal-provincial program which urged people to insulate their
homes. This came from the government — an endorsement to do it. Both
governments have a responsibility. Never mind the divided jurisdiction;
this government has a responsibility in health matters, and it's not
doing anything about it. That's the great tragedy in this thing. If you
do nothing else — never mind reviewing the literature; that's been
reviewed by all sorts of people — set up the testing. What is going on
out there right now is that all sorts of private testing companies are
going around charging people $100 or $150 for testing which really
tells them nothing. In some cases people have had as many as three
tests done by three different people, all showing different results.
This
is a very serious health question affecting not only adults but
children living in the house. There is information about some of the
studies of the sudden-infant-death syndrome done in the United States.
They have tried to figure out whether there's a link between that kind
of insulation and those sudden deaths that take place. In this
government this ministry has so far done nothing whatsoever other than
to review the literature. In the health department in Vancouver they
have a testing procedure. What the minister has to do is get together
probably with the rentalsman, who has the best information on housing
in all of British Columbia — he's got it on a computer — and start
finding out which houses in this province have been insulated with urea
formaldehyde. At the moment the estimate is 8,000 homes in the
province. They're not sure of the total estimate in the country, so
they use figures from 80,000 to 125,000. What is obscuring the health
problem is some of the forceful arguments being made by people that
they need to be compensated for the damage to the house. That is very
true, but that is an entirely separate question and is certainly not
the priority question; health is the priority question.
The
government is going to have to spend some money. If it's a question of
cost-sharing, then I urge you to spend the money and then go chase down
the federal government. You've got to set up the testing facilities.
It's crucial. There are all sorts of other things that can happen. No
doubt there's going to be a need to examine how this material was
allowed to be passed by the Canadian Standards and put into the homes
to create the dangers that it's creating. All of that can come later.
We can only hope that the Canadian Standards people and this government
will learn a lesson when people point out to their MLAs and the
ministers that they have a health hazard and that we will act very
quickly to (
a) detect it, (
b) evaluate what the level of the hazard is,
and (
c) do something about it. So far that has not been done.
I said in the beginning, people are in danger of being gassed to death
in a very slow process. When I was in that house and I left, I became
completely aware of the symptoms those people were talking about. It
was a decided physical discomfort that both of us felt when we left.
One cannot disregard that kind of experience any more than the
experience of all the hundreds of people who have been in touch with
the organization that has now been set up. There is an organization of
all of the people who are trying to do something in the two areas.
I'm
asking the minister to be aware of this problem and to do something
with a real sense of urgency. It's not something that can be ignored.
In this province we have the ability to set up emergency measures from
time to time when we have catastrophes. We have 8,000 homes in which
people are living in an atmosphere injurious to their health, and you
have to set up some very quick measures, particularly standardized
testing, so that people can have some assurance in terms of a
certificate that their health is okay; those that aren't okay had
better have something done about them. For instance, you have what
could be a very serious evacuation problem. What will you do if you do
the testing, and you say to people, "You are living in a house which is
injurious to your health," and they turn to you and say, "Well, what am
I going to do? I own the house. Where am I going to go?" That's the
state of the problem. Nobody from the government has addressed it from
the health side.
I would like the minister to answer the
questions I'm going to ask him. Are you prepared, as quickly as
possible and in the most practical way possible, to do something about
the testing? Never mind reviewing the literature. You can go
[ Page 6204 ]
a number of agencies across North America who will tell you what kind
of testing facilities they've set up and what result they've had.
That's absolutely crucial. You need to know — and you're going to have
to deal with some of your colleagues — how much of this urea
formaldehyde is in the province, and in how many houses — it's also
been used in mobile homes — to find out the level of the problem. The
first thing is that you've got to have that testing. Otherwise there's
going to be a lot of ripoff out there where people are going to get so
desperate they're going to go to these private people who do not have
standardized tests, and it's going to be useless. They're being charged
anywhere from $50 to $150 for a test. That's the function of the
government, because you're in the community health system. This is an
environmental matter, and there's nothing as close as the environment
of one's home.
I would urge the minister, not as a
clash or an attempt to get some publicity, but to go to a few of these
places and talk to these people. This has got to be the most difficult
situation people can find themselves in. Here are people who are
completely independent and who have made their own way in society, and
they suddenly find they have to fall back on the only jurisdiction that
they've generally stayed away from, and that is the government; and the
government has done nothing about this problem so far. I'm asking the
minister whether he is aware of the problem and what actions they are
taking to do something about ensuring that those people who are living
in environments injurious to their health.... What are they going to do
about it? First of all, is the minister prepared to do something about
the testing? I'm completely uninterested in what the federal government
does, because they've got a long-range plan in which they say they're
going to do some sample testing. Health matters are provincial
jurisdictions.
We have an obligation to move quickly to do
something about this problem. This has not been done up to now, and I'm
asking the minister if he would make some comments about this.
HON. MR. NIELSEN: Finished?
MR. LEVI: Are you going to make some comments? I want to get on to long-term care.
HON. MR. NIELSEN: Anyone else?
MR. LEVI: What do you mean? I've just laid it out. Answer that. That's pretty serious. What's the matter, don't you have an answer?
HON. MR. NIELSEN: I'll answer you.
MR. LEVI: Well, answer then.
HON. MR. NIELSEN: Are you running the debate now?
MR. LEVI: There we are. I've spent 15 minutes laying it out. He
obviously doesn't know anything about it. That's the very point I'm
making. That minister's ministry has failed to do anything about this problem.
It's traumatic and serious. All I'm asking the minister to do is to
give this committee some assurance that they're going to move into the testing
area and stop reviewing the literature. Do something specific and concrete so
those people out there can have some assurance that if they are living in an
atmosphere which is injurious to their health something will be done. I'm
asking the minister what he is prepared to do. I can get on with talking about
long-term care afterwards. I would like him to respond. I'm quite prepared
to yield to the minister.
HON. MR. NIELSEN: There may be other members. Anyone else?
MR. LEVI:
We want to hear about this. You've had three days of long-term care,
and we're still going on with it. This is a serious problem. Do you
know anything about it, and are you prepared to do anything about it?
That's all we're asking. Come on.
Interjections.
MR. CHAIRMAN: The Minister of Health.
HON. MR. NIELSEN: I rise only because of the urging of the other members who don't have the floor, Mr. Chairman.
course the problem of urea formaldehyde and other substances which may
be hazardous to the health of a homeowner is serious. Many substances
known to science are hazardous to people, and there is no question that
they are in evidence in many homes. Dr. Richards, who is our public
health inspector, has indeed been paying particular attention to this
problem. The Ministry of Health has not been ignoring the problem.
That's a silly statement to make.
The member doesn't wish to
hear about the federal government, which is fine. However, he's going
to have to hear about the federal government, because they have been
and will continue to be coordinating a manner in which homes can be
tested. The member says: "Go out there and test it with the equipment."
Sure, terrific. Please identify the equipment.
MR. LEVI: I identified the mechanism.
HON. MR. NIELSEN:
Identify the equipment which they consider to be reliable in testing.
There will be special units for testing homes in Montreal, Toronto and
Vancouver. The tests were those recommended by the National Research
Council for formaldehyde in the air, formaldehyde in wall cavities and
the moisture content of wood. Our ministry does not have the
sophisticated testing equipment for formaldehyde. There is a very
serious question as to the technical expertise in proceeding with that.
There may be such people available in the country who understand these
tests and procedures and either have access to the equipment or have
the equipment. There's a very strong difference of opinion as to the
reliability of some equipment which is now used in monitoring.
There's
no question that there are complications associated with this urea
formaldehyde. The symptoms have been known and are known to medical
authorities. There is grave concern on the part of people who are
living in such homes with this material. The effects upon them vary
individually depending on their personal condition. The Ministry of
Health, provided with the testing equipment and the manpower with the
technical expertise, will certainly conduct tests on identified homes.
Again, if the equipment and manpower are available, if the process and
procedures are uni-
[ Page 6205 ]
form,
if the air, wall cavities, moisture content and the rest of it can be
tested and if, indeed, it is determined that it is a health hazard,
then the occupants would be so advised. I would question the authority
of telling the people that they have to move out. As I said, there are
many situations and conditions in individual homes or other buildings
where it's a health hazard. There's no question about that.
There
are many people responsible for determining that. The urea formaldehyde
problem is something which has come upon us in Canada over recent
months. The people who are responsible for health, building standards
and other safety standards have not been standing still. They have been
attempting to respond to this. I agree with the member that for the
greatest period of time of this controversy the emphasis has been on
who's going to pay for tearing it out and replacing it, with less
emphasis on the health hazards.
The Ministry of Health in
British Columbia is well aware of the concern. Dr. Richards and others
are in constant communication with people who are believed to have
expertise in this area. It has not been ignored. I don't think there's
a simple pat answer. I'm advised that we do not seem to have the
appropriate testing equipment. There is concern whether our health
inspectors would have had any training in using such equipment in this
specific testing process. That has not been ignored. That is part of
the conundrum they find themselves in. Of course the ministry would
respond to individuals and assist them in determining, to the best of
their opinion at least, what the health hazard may be. But we must get
the equipment. We must be able to test it from a scientific point of
view, know what we're monitoring and what those results say.
is being coordinated across Canada; at least an attempt is being made
to coordinate it across Canada, to have uniform testing and standards,
to try to determine what these levels may be. I don't know how many
homes may have been insulated with urea formaldehyde, but I am sure
that many citizens probably had their homes insulated with this
material and are unaware of it. Perhaps others have different material
and feel that it's giving them problems as well. I cannot give you the
pat answer that it's going to be resolved tomorrow or next week. Yes,
it's urgent — very important. People in the public health sector of the
ministry are certainly not ignoring it. It's something that they would
very much like an answer for, provided they had the equipment and the
expertise to make use of it to determine precisely what the health
hazard may be. There is some argument from the medical side as to what
the danger of the material is, but there is no disagreement that there
certainly are identifiable symptoms which occur and are easily
recognized, directly attributable to the urea formaldehyde substance.
Some
time ago the problem was brought forward to us, involving not
insulation but the wallboard in some of the portable school classrooms
in the province. The public health inspectors responded to that very
quickly, and they were perhaps quicker because the odour of the
substance was so obvious that they were able to offer some judgment as
to its danger. Changes were made and some students were moved out of
these portables. These particular portables have been in place for a
long time, but I gather the wallboard itself was beginning to break
down and some of the gases were being released, and so they were
recognized.
It's not a new question. It is still relatively
current with respect to the foam. We rely to a degree on the federal
government with respect to what resources they may have available and
what resources they make available to us. We cannot resolve this
problem immediately or overnight.
Representatives in the
ministry are responding to it and are attempting to be as up-to-date as
possible on what can be done. We would attempt to accommodate
individual citizens in the province who would request a medical or
health inspector to inspect their homes, within the limitations we have
with respect to equipment or adequate testing procedures. We certainly
would respond to that. It is simply not a situation where there is a
pat answer — where there are acceptable procedures, the equipment is
readily available, and the technicians who can make use of it are
readily available. Representatives in the ministry are in constant
contact with other areas of the country and the federal government to
try to determine precisely what is being done. The federal government
has announced they will be testing approximately 2,000 homes in July on
a priority basis, responding to the homeowners. As I said, special
units will include Vancouver, and testing will be done. I really don't
know how we can respond more quickly to it.
If our people in
public health are advised of available equipment, or tests which would
result in accurate analyses of the air and the rest of it, we would be
very pleased to have that information. I am assured by people in the
ministry that it is just not readily available. The biggest problem we
have right now is the capability of the technicians and others to
respond to this with some determination as to their capability of
testing. There may be some equipment available somewhere which could
perhaps be received. They've been trying and are continuing to try to
determine that. They've been in contact with the National Research
Council and others. I don't know, specifically, if they've been in
contact with the B.C. Research Council, but I would expect they have
been. I can find out for sure. It's certainly not being ignored. I
agree that it's not being resolved, but not for lack of trying or
desire. It's a very complex and difficult problem. At the moment
representatives in the ministry are responding to it to the best of
their ability.
MR. LEVI: Towards the end of the
minister's speech we got to the really serious thing. First of all, if
he reads the Blues he'll find out that we're not looking for any pat
answers. I didn't ask for that. You talked about standardized testing.
You made a statement this morning. If it's picked up by the press that
you are now saying that if people in the province want to be tested
you'll do what you can.... Let me tell you something: that's not the
way you approach the problem. First of all, you've gone through the
whole business of saying that no such testing is available. The thing
is you've got to be very careful about this. You are raising
expectation which you can’t meet. That's the problem.
Yesterday
my colleague the first member for Victoria (Mr. Barber) asked you what
kind of monitoring went on in the ministry of what was happening in the
various sciences and in other jurisdictions around health matters. You
indicated that your people are in touch and that you have an exchange
of information. I want to point something out to you. The minister
would have us believe, Mr. Chairman, that somehow this problem just
came upon us in April. In January 1981 a bulletin was issued by the
Energy, Mines and Resources department of Canada. It's headed: "Urea
Formaldehyde Foam Insulation — Update." They say:
"The fact sheet is designed to inform home owners with urea
formaldehyde insulation about the
[ Page 6206 ]
present situation, to identify the agencies that can be of assistance
and to provide information and suggestions to reduce and prevent formaldehyde
problems. On December 18, 1980, Health and Welfare Canada announced a temporary
ban on the use of urea formaldehyde foam insulation for home insulation. The
National Health and Welfare expert advisory committee was established to study
the potential health hazards of UFFI and recommended a ban on the use of the
product pending the final results of their investigations, expected early in
1981."
This
was a ban put on by the National Health and Welfare expert advisory
committee. I ask the minister to check in his department to see whether
they received notification. They go on to say:
"Canada
Mortgage and Housing Corporation has withdrawn its acceptance of urea
formaldehyde foam insulation. Homes insulated with the product after
December 18 are not eligible for Canadian home insulation program
grants." That's the second indication — not in April, but in December
and in January. "The National Research Council of Canada is currently
preparing publications to assist homeowners and contractors in
identifying, preventing and correcting UFFI problems."
They then go on to describe the symptoms, which I talked about before.
What
we have here may be — let the minister find out before we make some
blanket statement — a breakdown of communication between the federal
ministry of Health and all the provincial Health ministries as to what
those people are doing about a very serious, dangerous matter. Two
separate bulletins were sent out, one in December, one in January, one
withdrawing it under CHIP — the Canada Mortgage and Housing insulation
program — and the other outlining what the problems are.
This
is not a new thing. The history is not terribly important right now.
We've got to meet a problem. There has been a fair amount of warning on
this problem. This thing did not just come upon us in April. I would
like the minister to tell us — if not this morning, this afternoon —
when they were first advised of this. Don't tell me you were first
advised at the time of the school thing that that was all your ministry
knew about it and then you looked at the problem and decided to do
something about it. I can tell you that in December 1979 the United
States Senate had a three-day hearing on this problem. Most of the
Scandinavian countries dealt with it four years ago and got rid of it.
cannot have the minister standing up and speculating that it may or may
not be dangerous. I'm not interested in that any more. I'm saying that
a greater effort simply has to be made to do something about the
testing. It may be that the federal government is going to test, but
it's only going to test a few houses in Vancouver. Who is going to test
the houses in Coquitlam, Burnaby and Powell River, where they have
some? Regardless of what the federal government does.... If they are
using some equipment and if you can possibly obtain it, fine. But you
have to have something in place when they're finished. You have to be
able to say to the people out there, who are getting extremely worried
about the health question, what you're prepared to offer them — not the
statement that you just made. All you're going to do is drive most of
your bureaucrats mad, because you said just before: "If people want to
get their houses tested, phone us and we'll see what we can do." Well,
the program has to be a little bit more definitive than that.
There
is an enormous amount of information on this problem. If you have to
send one of your people down to Washington, D.C., then send him down to
talk to people who have dealt with this on an expert level. They've
dealt with it. They are dealing with it every day. There are numerous
scientific agencies looking at this problem. Be in touch with the
Scandinavian countries; see what they are doing. One has to have a
sense of urgency about this.
If you are going to rely
primarily on the federal government's action, then you are abrogating
your responsibility as the Health minister. Health is a provincial
matter; that's the key thing. You have to take some initiative. You say
that your ministry is aware of it; yes, they are. But I point out to
you, Mr. Minister, that all they're doing at the moment is reviewing
the literature. This is not the preparation of a PhD thesis. All of
that work has been done. Testing has been done in a range.... The
University of Washington looked at it two years ago. There are people
down there who can assist you. You have to move broadly and go to
various jurisdictions. The problem is on your desk; it's not on
Ouellet's desk. He's down in Ottawa; he's going to do his political
number and do some samples. But you're going to be left with the basic
problem of dealing with people in this province. If he's doing 2,000
across Canada, then we'll be lucky to get 100 homes tested in
Vancouver. That's the problem. Nobody's looking for pat answers.
The
minister stood up, and what he was really doing was speculating. We
don't want you to speculate. There are numerous places where your
ministry can go, but they've got to get beyond the stage of reviewing
literature. That's the crucial part. I don't feel that the minister has
the sense of urgency that's needed here, because we rarely have the
situation where people are actually living in accommodation that is
injurious to their health. I don't want the minister to speculate
whether it is or isn't. It has long been established by various
international agencies that it is injurious to health. Why do you think
CHIP cancelled its use? How definitive the sickness is has not been
established, but then we don't have that kind of establishment of
sickness to that kind of degree anyway. What we have is a fair warning.
What we want to hear from the ministry is that they are going to
address the problem beyond the stage of the review of literature.
That's what they're not doing. They're not doing that at all.
MR. MUSSALLEM : It's interesting to hear the hon. member for Maillardville-Coquitlam.
I find nothing specifically wrong with what he said. I don't know how accurate
he is. I'm not sure of that.
must remind the minister about an interesting incident that happened
here a couple of years ago, when one of my constituents came to these
buildings during a session and presented the Minister of Health with a
very detailed report on how vital and dangerous rats were in the
schools and the carcinogenic effect they were having on the students.
They said that cancer was rife in the schools, and this was the cause.
During the summer holidays, he brought out his facts. The study even
had bones of the rats. During the summer holidays when schools were
closed down, the dampness in the pipes of the ventilating systems were
right for poisoned rats. The poisoned rats would somehow find this
dampness. I don't know why that was. They would die and decay. All this
dust would eventually circulate, because he would find
[ Page 6207 ]
nothing
but bones. Where did the rats go? They went into the circulating system
in the schools. He said that this was one of the dangers and is why
cancer is so rife in our society. Well, perhaps. I'm sure that if
anybody breathed enough from one rat they'd get cancer of some kind.
What I'm saying is that it wasn't a popular thing to discuss. Nobody
wants to hear about dead rats in the pipes in schools.
Anyway,
the scientists of the department found out that even if there were, the
amount that could reach any one student at any one time was so
minuscule.... As a matter of fact, to bring up the point again of
whether I would drink Fraser River water.... They say that it will
poison you. It doesn't, because there's so much water going down the
Fraser River.
Another thing I want to tell you is that it
was only a few years ago in New York City.... The newspapers were full
of it at the time. They referred to it as the deadly snowfall. It
happens in any great city, but New York is the one that comes to mind.
It was in those days that they were using lead paint. The lead would
flake off the buildings. The children playing in the concrete jungles
of that city would receive lead poisoning. This was saved by the fact
that lead is no longer used on buildings. It is not a question of
whether the thing is deadly, but how much you get of it. In small towns
we still painted with lead. It didn't matter. It was how much.
For
example, today we are in our gardening time. We are using all kinds of
poison. Malathion is a deadly one. If you get Malathion on your hands
and you don't wash your hands, you'll get really sick. If you get
enough of it you could be very sick. Malathion is in common use. Any
gardener will tell you it is used every day but that it's very
dangerous. If you get the bait used on slugs on your hands and put it
in your mouth, it could make you a little sick; if you got enough you'd
be like a slug — you'd soon be gone. All these dangers are around us
all the time. The question is how much.
Before we get too
excited about the urea formaldehyde thing it should be tested to find
out the facts. That's something we don't know. The minister is coming
to that. I've got to compliment the minister on the massive way he's
handling the questions and how well informed this House is today by his
answers. I congratulate the opposition on digging around too. They do a
little bit, and they're doing very well.
[Mr. Davidson in the chair.]
What
I want to bring out today is the shock and dismay I feel at the
enormous and unbelievable cost to the Ministry of Health caused by the
consumption of liquor on our highways. I want to mention one particular
thing. Mr. Chairman, I'm not getting off the subject; it is costs of
the Ministry of Health I'm talking about. In our constituency, six
young people were killed in six days on the highways. I have a picture
here in this newspaper, but I won't display it, because we're not
allowed to any more. The minister has a copy and the member for New
Westminster (Mr. Cocke) has one. It is a picture of the hand of a
person, a dismembered body. This is a terrible thing. This is liquor.
The deaths were caused by liquor consumption. These people are dead.
They're not that much cost now, but the social cost to our society, the
enormous cost.... As a result of these accidents some may never leave
hospital. The enormous cost of drinking and driving in our society is
absolutely unknown to us. I would venture to say that if we went into
it in full detail we would be able to say.... I have no idea of the
figures, but I would venture to say that $1.5 billion is the cost every
year to the province of British Columbia.
I asked Inspector
Wilson of our RCMP in Maple Ridge what he thought of it. He said:
"Well, you can quote me. We can never stop drinking, but our penalties
are not severe enough." The Minister of Health must take action. The
Ministry of Health must realize the enormous amount it's costing them
to maintain this drinking and driving on our highways. It's not only
the Ministry of Transportation and Highways; it's the Ministry of
Health; it's their responsibility. We need more from the Ministry of
Health. The advertising campaigns we've had have been good, but they've
accomplished very little.
I think there are several things
we can do. One positive thing is that our writers in this legislature
and in the media should get out on a campaign and show what is
happening to our young people and our older people, happening all
around, and the cost to our hospitals — it's unbelievable and
disastrous.
Inspector Wilson said that we cannot stop
drinking. But he said we could make the penalties much more severe.
There's no use going before a judge, and he says: "Three months for
your driver's licence." He said: "Take it away for life." Mind you,
that's not for him to say. But this is the feeling that's out there in
the field. I merely tell you that. I also think that we should raise
the drinking age to 21. This would probably not stop, but it would
reduce some of the improper use of alcohol by the young. They'll still
get it, but not as much. If we get back to the age of 21, it would be
helpful and would reduce the enormous cost to the Ministry of Health.
Some of these children that I'm talking about in these wrecks in six
days.... Some of them may never leave hospital. It will cost hundreds
of thousands of dollars. To the families and to all concerned the
tremendous and horrendous cost of liquor in our society cannot be
overemphasized.
I call on the Minister of Health to take
serious consideration.... He's worrying about hospital costs. Within a
few years the hospital costs will consume the entire budget of British
Columbia if we go on escalating at the present rate. Obviously
something must be done. One place we can do it and save billions is the
drinking habits of our people. It's the responsibility of all society —
mothers, fathers, schools, and the media in particular could do a
tremendous job and save the lives of our people in British Columbia.
HON. MR. NIELSEN:
In speaking of that topic, the member for Dewdney perhaps illustrates
the great difficulty that all of society has; it is a topic that is
talked about a great deal, and really very little is done. I agree with
the member for Dewdney that the penalties which have been popular seem
to have very little, if any, impact on the overall carnage on the
highways associated with drinking drivers. I think most areas in Canada
continue to disregard the seriousness of that problem, and they are not
yet prepared to come to grips so that the penalty is such that drinking
and driving would simply not be considered by individuals. The
activities of people on the roads, whether they drink or not,
contribute greatly to that incredible cost to our society. The Ministry
of Health has a certain amount of input into it and tries to bring to
the attention of others the tremendous cost — not only in dollars but
in injury — to so many people. In some facilities in the province, we
have people who are suffering from paralysis. A very large percentage
of those people are in hospital because of traffic accidents, and many
of those accidents can
[ Page 6208 ]
linked to the abuse of alcohol. I want to say that I agree with the
member for Dewdney in his consideration of how serious a problem it is,
but I think it is society's decision by way of governments across
Canada and elsewhere, to look at it as a very serious and totally
unacceptable situation. I believe the penalties must be appropriate to
the offence, rather than the nonsense we've lived with for so many
decades.
MR. HANSON: Mr. Chairman, at this point in
the minister's estimates, I would like to move on to a problem that
affects the most severely disabled people in our society. Recently I
met with parent groups from the Pearkes clinic and other people
concerned about the lack of financial support given to the severely
disabled and their families, and the various kinds of treatment,
therapy, appliances and so on that they so desperately need. Before I
begin, I would first like to read to you the 1975 United Nations
disabled persons declaration which states:
"Disabled
persons have the inherent right to respect for their human dignity.
Disabled persons, whatever the origin, nature and seriousness of their
handicaps and disabilities, have the same fundamental rights as their
fellow citizens of the same age, which implies first and foremost the
right to enjoy a decent life as normal and full as possible."
you recall, Mr. Chairman, in the throne speech that we heard some
months ago, there was an undertaking on the part of the provincial
government. I would like to reiterate those comments:
"Next year has been proclaimed International Year of the
Handicapped by the United Nations. During 1981 my government, under the direction
of my Minister of Education will initiate regulations pursuant to certain sections
of the Human Rights Code of British Columbia to specify a handicap as a characteristic
in which discrimination in services, facilities, accommodation and employment
are unequivocally prohibited. Major positive initiatives to improve opportunities
and access for the handicapped will be undertaken by government ministries with
social mandates, notably Health, Labour, Human Resources, Housing, Education
and Municipal Affairs."
In other words, Mr. Chairman, the undertaking was made in the throne speech
to take positive action in certain ministries. Hence I am raising these issues
here today.
have a number of letters from physicians working with severely
handicapped people that identify what specific shortcomings are
presently there in terms of inadequate support. I have a letter I would
like to read portions of into the record from a doctor who's an
orthopedic surgeon. His name is Dr. Wahl, and he works here in
Victoria. He outlines to the minister's predecessor some two years ago,
using one case as an illustration, the incredible financial impact a
severely disabled person has on that family. He states: "I have been an
orthopedic surgeon attending a particular child for two years. The girl
is severely afflicted with a myelomeningocele problem, with extensive
paraparesis. She's had multiple surgeries in the past, which has
resulted in bilateral amputations as well as extensive hip injuries,
done in Vancouver." He goes on to point out to the minister that he was
astounded by the lack of financial support for this girl who had to
make repeated trips to Vancouver for treatment and therapy. I think
most British Columbians would be shocked to know that the annual limit
for therapy and treatment for a severely disabled person in British
Columbia is $75. He goes on to point out that the cost of various
braces, prosthetic devices, orthotic devices and so on that are
required is extremely high. They have a great problem in getting
custom-fitting of these devices. There is very little in the way of
professional capability for designing and constructing them. It is
often done by volunteers. It a well-accepted fact that there are very
few professional people available. It's often entirely on the basis of
volunteer help and volunteer financial support through things like the
"Telethon," Easter seals and so on, which are welcome. But the base
support should really come out of general revenue; it should be there
to support the families in a much more positive and aggressive way than
at present.
This orthopedic surgeon goes on to explain that
as people get older they have to be refitted with these devices every
year or year and a half. According to the regulations, the MSP will
only pay 80 percent of the cost of that particular device, with a
certain limit of, I believe, $1,000. I have it here, and I will get to
that in a moment. The point is that these things are very expensive; it
involves the family paying the money on the barrelhead to the supplier.
It may mean $500, $600 or $700 just to cover the 20 percent which the
family has to pay. Then, of course, in a year's time they are faced
with it again. So that is completely inadequate.
If in this
International Year of the Disabled we're going to do something
positive, we have to look at increasing the financial assistance for
therapy, for the required physical appliances and their fitting, and
and so on. We hear great lip-service paid to the idea of mainstreaming
people into the school system and into society but very little about
the actual moneys necessary to provide the support mechanisms to ensure
that those persons have the opportunities they deserve.
Saskatchewan
has had the SAIL plan in place since 1975. I'd just like to read the
preamble of this plan, because I think it identifies the problems faced
by the parents of the severely disabled people. SAIL is Saskatchewan
Aids to Independent Living. "The basic program: SAIL is a plan to
assist handicapped persons in Saskatchewan to improve their quality of
life in the community through the provision of: (
a) prosthetic and
orthotic appliances without cost to the patient" — not 80 percent, not
40 percent, but no cost to the patient at all.
Dr. Wahl,
whose letter I quoted from a moment ago, pointed out that the problem
faced by his particular patient was the tip of an iceberg, but it is a
very small iceberg. Using Dr. Wahl's comment, I would like to make that
point to the minister. The difficulties faced by these people are the
tip of the iceberg, but it is a very small iceberg, and a relatively
small amount of money would make life a great deal easier for people
struggling against extremely high costs for therapy, appliances and
their continued needs in society.
The SAIL program, in
addition to prosthetic and orthotic appliances without cost to the
patient, provides equipment on a free loan basis, including basic
mobility aids, environmental aids and respiratory equipment, and repair
service. I think the objectives of the SAIL program warrant reading
into the record. I think British Columbia would be well advised to look
seriously at the SAIL plan and the possibility of instituting it here
in British Columbia. The objectives are:
" (
a) to remove the financial burden faced by disabled persons
in obtaining necessary medical appliances and equipment; (
b) to reduce institutional
[ Page 6209 ]
health service costs by assisting handicapped persons to live
in their home environment in the community in lieu of receiving institutional
care; (
c) to consolidate under one program the provisions of equipment to the
handicapped undertaken by various government agencies; (
d) to coordinate the
provision of equipment; and (
e) to encourage and promote research into better
equipment."
think it's very difficult for most of us to appreciate what
difficulties are encountered by severely disabled persons, I'd just
like to reiterate that these are people with full mental faculties who
want to live and operate as well as possible in the mainstream of
society; but at the same time you can't look to their families to
provide all the financial support, in-home care and so on that is
required. The families that I have recently met are very dedicated
people. They have devoted much of their time to making sure that their
children have every possible opportunity. In many instances, I believe,
it is done at great personal financial sacrifice to themselves. I think
that it's time, in this International Year of Disabled Persons, to give
formal recognition to this problem and have the minister respond to a
number of specific points. I'd like to outline these now.
First,
rather than a $75-dollar-per-patient-per-calendar-year limit on therapy
and physiotherapy services, there should be 100 percent coverage
available for all therapy sessions, provided that all the medical
justification is provided and that it is required. Equal consideration
should be given also to charges for occupational and speech therapies
for which there is no fee basis.
Second, 100 percent
coverage should be available for prosthetic and orthotic fittings,
equipment and equipment repairs. As I indicated, it is presently 80
percent paid, but the families must put forward the money and then be
rebated that amount from the Medical Services Plan, which is often a
financial hardship too. Included in that provision are the necessary
fittings and custom-fitting that is required as well. I think more
specialists who deal with the specialty fittings should be brought into
British Columbia. We can't rely totally on the generosity of volunteer
help and volunteer agencies. We really should have some on-line,
working-level specialists paid for by the provincial treasury.
Third, 100 percent coverage should be provided for physical-speech and occupational therapy equipment, and repairs as well.
Fourth,
services for children diagnosed as having perceptual and motor
integration problems should be reviewed and improved, particularly
where they are integrated into the public school system. I think if
we're going to continue on the orientation, as we all agree to in this
House, of mainstreaming disabled people into the school system and into
the broader society, we must provide technical and professional support
in the school system to ensure that severely disabled people have
access to what they require.
I'd like to take my place now and have the minister respond to the points I have made.
HON. MR. NIELSEN:
Mr. Chairman, I can't respond in precise detail to the percentages and
the specific services which the member identified, but I certainly can
respond in a philosophical way, to look at the entire problem. Those
within our society who are severely disabled — I think I understand the
definition as the member speaks of it — should be given every
consideration with respect to any financial hardships they or their
families may suffer because of that disability. I think those financial
hardships should be minimized, if not totally eliminated. There are
relatively few people who are in that category, and I think the member
pointed that out. We're not speaking of a large number of people, but
about people who have a severe disability, and the difficulties of
responding to that are immense. I would agree with the member that one
of the difficulties which they must respond to is financial hardship.
It should be eliminated as a problem.
There are many programs throughout the province which offer treatment for people
who are in this position. There are many organizations who assist as well with
respect to transporting people and with housing. There is also the great difficulty
of producing various devices, which are generally custom-made for the individual
and frequently require a tremendous amount of innovation. We do have a scarcity
of technicians in the province which is frightening. The capability of producing
some of these devices is really a very fine art and a high degree of skilled
craftsmanship is required. I have been attempting over a number of years to
interest people in promoting the training of such craftsmen. I know of Pentland's
in Vancouver and their workload. They have a very real problem training people
in that industry. I understand the gentleman who owns the company is considering
retiring, if he hasn't already. He was very concerned about who would follow
in his footsteps. He had been taking steps to train a number of people. It’s
a very specific skill, and one which we should be promoting. I don't know
what the practicalities are of offering these courses in trades schools. I gather
they're pretty difficult. But I agree that it's an area we should be
emphasizing very much. Mr. Member, I'm going to have to speak with our Medical
Services Commission people with respect to what programs may be available.
I'm
not concerned that modifying or eliminating percentages, or limiting
the number of visits, hours or whatever, would be a severe hardship on
the people of the province. It would not be, because we are again
dealing with a relatively small number of individuals.
There
are many other people who are less severely handicapped in our society
who do find financial implications to be a significant factor in
assisting in the relief of their hardship. Perhaps that should be
looked at as well. I have to be careful that I'm not responding to some
of these situations strictly from a personal point of view or from
personal experience. For example, there are children who have visual
problems, and just the simple supply of eyeglasses can be a
considerable hardship on a family, particularly if the children are
young and lose their eyeglasses on a regular basis. When they are
replaced by eyeglasses which cost several hundreds of dollars a pair,
it can become quite a hardship on a family, even though the federal
government recognizes a certain income tax exemption for someone who is
designated to be legally blind. There are many other problems
associated with those who are less severely handicapped, including
youngsters who require corrective devices for various problems which
are corrective. There is a financial burden on many of those families,
and I have no difficulty in responding in a very positive way, from my
point of view, into investigating how much of that could be alleviated.
our province we have a history of people taking a great deal of time
and effort in trying to better the lives of people who are suffering
from severe handicaps, and it has contributed greatly to the treatment
which is available throughout the province.
[ Page 6210 ]
can't really respond in specifics at the moment, and I would be pleased
to do that later. I find that I have virtually no area of disagreement
with what you have suggested. It's a matter of producing those results,
investigating in some detail the specific programs and speaking to
experts in the field about what could be modified or improved to give
these people a better opportunity of rehabilitation, or at least remove
some of their legitimate hardships.
The House resumed; Mr. Speaker in the chair.
The committee, having reported progress, was granted leave to sit again.
Hon. Mr. Gardom moved adjournment of the House.
Motion approved.
The House adjourned at 11:58 p.m.
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