1974 Legislative Session: 4th Session, 30th Parliament

HANSARD

The following electronic version is for informational purposes

only.

The printed version remains the official version.

Official Report of

DEBATES OF THE LEGISLATIVE ASSEMBLY

(Hansard)

THURSDAY, NOVEMBER 7, 1974

Afternoon Sitting

[ Page

4519 ]

CONTENTS

Afternoon sitting Routine proceedings Public Schools Interim Arbitration Procedure Act

(Bill 173).

Hon. Mrs. Dailly. Introduction and first reading — 4519

Oral Questions

Dunhill Development Corp. Involvement in Seattle

project.

Mr. Bennett — 4519

Payments from the Traffic Victims Indemnity Fund.

Mr. Gardom — 4519

Proposed commission on electoral boundaries. Mr. Wallace — 4520

Gulf Island-Mainland Remembrance Day sailings.

Mr. McClelland — 4520

Interest demands on unpaid government bills. Mr. Morrison — 4520

Land Commission involvement in Richmond zoning hearing.

Mrs. Jordan — 4520

Results of grass-fed beef sale. Mr. G.H. Anderson — 4521

Trans-Canada Highway closure. Mr. D.A. Anderson — 4521

Need for companion legislation to Bill 147. Mr. Curtis — 4521

Review of big game limits. Mr. Smith — 4521

B.C. Inflation-fighting measures. Mr. Gibson — 4521

Advertising of Premier's tour. Mr. Phillips — 4522

BCR work stoppage. Mr. Fraser — 4522

Prosecution of drivers without renewal certificates.

Mr. Gardom — 4522

Department of Health Amendment Act, 1974 (Bill 166)

Second reading.

Hon. Mr. Cocke — 4522

Mr. McClelland — 4524

Mr. D.A. Anderson — 4528

Mr. Wallace — 4531

Mr., Rolston — 4533

Mrs. Jordan — 4536

Mrs. Webster — 4542

Mr. Curtis — 4544

Hon. Mr. Cocke — 4545

Landlord and Tenant Amendment Act, 1974 (No. 2) (Bill

169).

Second reading Hon. Mr. Macdonald — 4548

Mr. Bennett — 4550

THURSDAY, NOVEMBER 7, 1974

The House met at 2 p.m.

Prayers.

Mr. W.R. Bennett (Leader of the Opposition): Mr.

Speaker, with us in the gallery today, from Duncan, we have

Mayor and Mrs. Paskin. I urge this assembly to bid them

welcome.

Hon. W.L. Hartley (Minister of Public Works): I would

like the assembly to join me in welcoming the mayor, the town

clerk, and Alderman Araki from Hope.

Hon. E.E. Dailly (Minister of Education): Mr.

Speaker, in the gallery today, and also later on this

afternoon, there will be students from Burnaby North Senior

Secondary School in North Burnaby. I'd like the House to

welcome them with me.

Hon. P.F. Young (Minister of Consumer Services): Mr.

Speaker, we will have with us today at 3 o'clock the grade 10

class of the Eric Hamber Secondary School. Mr.

Roxborough-Smith, their teacher, is accompanying them, and I

would ask the House to give them a welcome now, please.

Mr. D.E. Smith (North Peace River): Mr. Speaker,

seated in the Speaker's gallery this afternoon we have a

journalist from Fort St. John, the editor of the Alaska

Highway News . I hope you will welcome him to these

precincts.

Hon. L.T. Nimsick (Minister of Mines): Mr. Speaker,

we have in the gallery with us today two very fine people from

Sparwood, Mr. and Mrs. Ezner DeAnna. Also Mr. Frank Nolan.

Introduction of bills.

PUBLIC SCHOOLS INTERIM

ARBITRATION PROCEDURE ACT

Hon. Mrs. Dailly presents a message from His Honour the

Lieutenant-Governor: a bill intituled Public Schools Interim

Arbitration Procedure Act.

Bill 173 introduced, read a first time and ordered to be

placed on orders of the day for second reading at the next

sitting of the House after today.

Oral questions.

DUNHILL DEVELOPMENT CORP.

INVOLVEMENT IN SEATTLE PROJECT

Mr. Bennett: Mr. Speaker, to the Minister of Housing: I notice in an

article in the Seattle Times

that Dunhill Development is doing a $5 million project in

Seattle. While I know it isn't the government-owned project, it

has the same in management that the Woodbridge Development…the team that the government was so eager to hire when they

bought the original company. I wonder how they allocate their

time between the $5 million Seattle project and our own B.C.

corporation when they are on contract.

Hon. L. Nicolson (Minister of Housing): I would like

to know which particular principals you're referring to before

giving you a detailed answer.

Mr. Bennett: Well, the principals of the company, Mr.

Paulis and Mr. Dalberg. This was the management team that you

bought a company to acquire — a team which has cost British

Columbia a lot of money. I notice that they are busy in

financial activities in Seattle, and I wondered, when we paid

them such an expensive contract, how they allocate their time

between $5 million projects in Seattle and the business they

were hired to do for you in B.C.

Mr. D.M. Phillips (South Peace River): The government

makes them millionaires then they go to the States and build

houses.

Hon. Mr. Nicolson: They have a full-time

administrator in Seattle. They spend considerably more than 40

hours a week on the job in Vancouver.

Mr. Phillips: And there's a shortage of housing in

British Columbia, so a B.C. government-owned corporation goes

to Seattle to build houses.

Mr. Speaker: Order, please.

PAYMENTS FROM THE TRAFFIC

VICTIMS INDEMNITY FUND

Mr. G.B. Gardom (Vancouver–Point Grey): Is the Hon.

Attorney-General prepared to inform this House of the existing

financial arrangements and agreements between his department,

himself, and the Traffic Victims Indemnity Fund concerning

payment of hit-and-run and insured motorists' victims?

Hon. A.B. Macdonald (Attorney-General): The answer is

no, Mr. Speaker.

Mr. Gardom: As a supplemental, Mr. Speaker: is the

Hon. Attorney-General aware that since the first of this year

about 125 such claims have been referred from the Traffic

Victims Indemnity Fund to the Insurance Corporation of B.C.?

And they've denied recovery. Is he aware of that fact?

[ Page 4520 ]

Hon. Mr. Macdonald: I'm aware of a number of claims,

undoubtedly. The exact number, I don't know. There's a dispute,

which is a valid dispute, as to whether or not the private

companies should not have picked up claims which they have

since refused to pick up. In view of the fact that that dispute

may even have to be adjudicated upon, I am not prepared to say

more at this time.

Mr. Gardom: Are you proposing action against the

private companies?

Mr. Speaker: The Hon. Minister has answered the

question.

PROPOSED COMMISSION ON

ELECTORAL BOUNDARIES

Mr. G.S. Wallace (Oak Bay): Could I ask the Premier

with respect to the Premier's statement in June that a commission to review provincial electoral

boundaries would be set up before the end of the year: has such

a commission been set up, and who are the commissioners?

Hon. D. Barrett (Premier): Not yet set up, Mr.

Member. We hope that things settle down in the House a bit, in

terms of location, so they can get on with their work without

interruptions. (Laughter.)

Mr. Wallace: Supplementary, Mr. Speaker. Has the

Premier any particular date by which time the commission will

be set up?

Hon. Mr. Barrett: Yes, before the next election.

Mr. Wallace: Just a quick supplementary, Mr. Speaker.

Could the Premier confirm that the terms of reference will

ensure that the recommendations of the commission will be

implemented without any alterations by the government?

Hon. Mr. Barrett: Mr. Member, the terms will be

defined publicly. We will not go through the same charade as

some of us experienced before.

GULF ISLANDS-MAINLAND

REMEMBRANCE DAY SAILINGS

Mr. R.H. McClelland (Langley): Mr. Speaker. A question to the Hon. Minister

of Transport and Communications. I wonder if the Minister could help the people

of British Columbia to define the terms laid down in an advertisement in the

paper regarding Remembrance Day sailings on the Gulf Islands-Mainland ferries.

As I read the terms and all of the errors which are in here, it looks very much

like it says that you start at Galiano Island; you do not pass Go; you follow

thy arrows, or else you go directly to jail; unless you roll a double 4, then

you go to Tsawwassen and start all over again.

They are very difficult, and you need an IQ of about 300 to

find out where you are going and when you are going and why you

are going. I wonder if the Minister would straighten us out and

tell us whether or not the ferries are even sailing on the

Remembrance Day weekend, because it is very confusing.

Interjections.

Mr. Speaker: Order, please. Order!

An Hon. Member: Take it as notice.

Hon. R.M. Strachan (Minister of Transportation and

Communications): No, I won't take it as notice. I don't

want to cast any reflections of any kind on the intelligence of

the Member who asked the question.

An Hon. Member: Right, right.

Hon. Mr. Strachan: But I want to point out that the

people of the islands have no difficulty at all in following

that procedure.

INTEREST DEMANDS ON

UNPAID GOVERNMENT BILLS

Mr. N.R. Morrison (Victoria): My question is directed

to the Premier as Minister of Finance. Is it not a fact that

accounts have been submitted to the province for interest on

the bills that have remained unpaid for quite some time, and is

it the government's policy to pay that interest? Have you

received any bills for interest on the outstanding

accounts?

LAND COMMISSION INVOLVEMENT

IN RICHMOND ZONING HEARING

Mrs. P.J. Jordan (North Okanagan): I'd like to

address my question to the Hon. Minister of Agriculture, who we

haven't heard from for some time.

In view of the fact that Mr. W.P. Lane, present chairman of

the B.C. Land Commission, was the chief municipal solicitor for

Richmond, and who by order-in-council has had his zoning

decision overruled, will he be invited to the public hearing to

'give reason for the original order of the Land Commission? I

understand he was counsel for 15 years.

[ Page 4521 ]

Hon. D.D. Stupich (Minister of Agriculture): No

decision, Mr. Speaker, has been made with respect to when or

who will conduct the public hearing.

Mrs. Jordan: A supplementary, Mr. Speaker. Could the

Minister tell us whether Mr. Lane has submitted his resignation

to the government on the grounds of political interference?

Hon. Mr. Stupich: No.

Mrs. Jordan: Not yet.

RESULTS OF GRASS-FED BEEF SALE

Mr. G.H. Anderson (Kamloops): I would like to ask the

Minister of Consumer Services, Mr. Speaker, if her staff

monitoring the grass-fed beef sale on the mainland bears out

the reports that were in the press today as to its

acceptance.

Hon. Ms. Young: Mr. Speaker, I'm only aware through

the media of the experiment that the store in question is

conducting. In my view, I think that the success of this

experiment certainly proves something that a great many of us

have said for a long time.

Frequently we've been told that the fancy packaging we get

in grocery products is because of consumer demand. I think that

this amply demonstrates that consumer demand has nothing to do

with these decisions. When given the opportunity between fancy

packaging or marbled beef and a very good price, the consumer

will pick a good product for a good price every time.

TRANS-CANADA HIGHWAY CLOSURE

Mr. D.A. Anderson (Victoria): To the Minister of

Highways, Mr. Speaker. Has the Minister received representation

by the Minister of Public Works (Hon. Mr. Hartley) from

businessmen in Boston Bar urging compensation or other

assistance for those adversely affected by the continuing daily

closure of the Trans-Canada Highway through the Fraser

Canyon?

Hon. G.R. Lea (Minister of Highways): I'll take that

as notice, Mr. Speaker.

Mr. D.A. Anderson: May I ask the Minister a

supplementary?

Mr. Speaker: I don't think you can if he's going to

answer later. You ask your supplementary then.

NEED FOR COMPANION

LEGISLATION TO BILL 147

Mr. H.A. Curtis (Saanich And The Islands): To the Minister of Finance. In view of the introduction of Bill

170 earlier this week, the Assessment Amendment Act, does the

Minister recognize the need for companion legislation to amend

Bill 147, the Assessment Authority Act, in order to adjust the

operating revenues which will be made available to the

authority to carry out its activities during 1975?

Hon. Mr. Barrett: Yes, Mr. Member, we are aware of

that, and we will make the necessary amendments available to

the House in the spring. As you know, this legislation is a

response to the excellent committee work done by all Members of

the House. I might say, as I was going to announce during the

introduction of second reading, that I'd welcome any input on

this particular bill. We are prepared to amend this with any

positive suggestions after second reading if the House Members

want to add anything to it.

Mr. Curtis: A supplemental. Thank you, Mr. Speaker,

through you to the Minister of Finance. Is the spring session

not too late for this amendment, in terms of the fact that the

assessment authority operations has been predicated upon a

budget which in fact is reduced considerably as the result of

the intent of Bill 170?

Hon. Mr. Barrett: My information is that it is not

too late.

REVIEW OF BIG GAME LIMITS

Mr. Smith: My question is directed to the Minister of

Recreation and Conservation. The last report, Mr. Minister,

from your department concerning game limits, bag limits, this

year indicates a very great reduction in most major big game

species. In view of the fact that the take or the bag limit is

down so drastically, has the Minister directed his staff to

review the bag limits and open seasons for next year with a

view to reducing them or perhaps even eliminating them in some

areas?

Hon. J. Radford (Minister of Recreation and Conservation): No review will be considered until the end

of the current season.

B.C. INFLATION-FIGHTING MEASURES

Mr. G.F. Gibson (North Vancouver-Capilano): To the

Premier and Minister of Finance, Mr. Speaker. In the wake of

the federal-provincial conference between the Prime Minister

(Hon. Mr. Trudeau) and the Premier on inflation, the conclusion

of which I believe the Premier broadly agreed with, and

pursuant to an announcement by Premier Schreyer the other day

of a cancellation of $40 million in capital

[ Page 4522 ]

projects in Manitoba to fight inflation, has the Government

of British Columbia any plans along this line?

Hon. Mr. Barrett: Well, no, Mr. Member, we are

committed to capital projects on schools and hospitals that

have been made desperate on the basis of priority because of

previous neglect. That was not the situation in Manitoba, where

fortunately they did not….

Interjections.

Hon. Mr. Barrett: Mr. Speaker, they're so confused

from yesterday's question period that they are trying to put

themselves together again. I'm trying to answer the Member's

question.

Interjections.

Hon. Mr. Barrett: Oh, please don't be rude.

Mr. Speaker, what I'm trying to tell you is that there will

be no slowdown in terms of schools and hospitals, as we have a

great deal to catch up.

ADVERTISING OF PREMIER'S TOUR

Mr. Phillips: Mr. Speaker, I have before me a picture of the

smiling Premier that says: "Premier David Barrett wants to hear

from you and your community" — regarding the Premier's 1974

autumn tour. It is signed: "The Government of the Province of

British Columbia." It was in the Terrace Herald on

October 9, 1974.

I would like to ask the Minister of Finance what department

of his government paid for this blatant government advertising

to sponsor his tour?

Hon. Mr. Barrett: Mr. Speaker, first of all, I know

the Member is too modest to ask for an autograph. But if he

quietly sends it over, I'll autograph it for him.

Secondly, it is the custom of the office of the Premier,

established by the former government, to have these ads paid

for. Rather than destroy everything the former government did,

I decided that that was one tradition we would continue.

Mr. Phillips: A supplementary question, Mr. Speaker.

The Premier has shown that he has made another about-face. In

the Victoria Times on Tuesday, March 21, this very same

Premier condemned this policy and takes the government to task

for this spending. So am I to take from you, Mr. Minister of

Finance, that you have made another about-face?

Hon. Mr. Barrett: Come to the meeting and I'll explain it to you in

public.

BCR WORK STOPPAGE

Mr. A.V. Fraser (Cariboo): My question is to the

Minister of Labour and vice-president of the BCR. What are you

doing to resolve a serious work stoppage on the BCR?

Hon. W.S. King (Minister of Labour): Well, the

problem of the labour dispute on the railway is before the

Labour Relations Board — at least, part of it is. Under those

circumstances, since bargaining is continuing, I really do not

feel it is appropriate for me to make any comment at this

time.

PROSECUTION OF DRIVERS

WITHOUT RENEWED CERTIFICATES

Mr. Gardom: To the Attorney-General, Mr. Speaker.

There are a number of people, Mr. Attorney-General, who have

not received from ICBC notification of request for renewals of

their drivers' certificates; yet these people are being

prosecuted. They can face fines up to $250 and 10 demerit

points. I understand that the reason they have not received

these renewals is as a result of a breakdown in procedure in

ICBC. Under these circumstances, Mr. Attorney-General, are you

prepared to agree to a stay of proceedings against these kinds

of cases?

Hon. Mr. Macdonald: I'll take the matter under

advisement.

Orders of the day.

Hon. E. Hall (Provincial Secretary): Mr. Speaker, I

move we proceed to public bills and orders.

Motion approved.

Hon. Mr. Hall: Second reading of Bill 166.

DEPARTMENT OF HEALTH

AMENDMENT ACT, 1974

Hon. D.G. Cocke (Minister of Health): Mr. Speaker,

early last spring we announced the setting up of a committee

charged with the responsibility of looking into the feasibility

of reorganizing the Health department of this province.

As you know, early in October of this year, we released the

general thrust of the report of that committee. It was an

in-house committee; it was a committee that responded to a

crying need, a desperate need that had been indicated for a

number of years. We in opposition had discussed the

[ Page

4523 ]

fragmentation of the health delivery system by virtue of the

fact that we did have a number of separate departments.

So after having put together this report, we organized a

meeting of the department which was held at Riverview in the

educational centre. We had 150 senior staff there — we didn't

miss the Member for Vancouver–Point Grey — and those people

spent two days of intensive study and discussion around the

whole question. After all, their future and the futures of the

people with whom they work are greatly dependent upon the

outcome of the implementation of this particular report.

The report, as you know, is a report on the reorganization

and it was endorsed generally by that large group. It was

established that the department should set up a way to better

co-ordinate its activities, to provide a vehicle for better

distribution of health care in the Province of B.C. These are

all areas that people really recognize need a great deal of

work.

We've also recognized that health care has to be

streamlined, if for no other reason than the very cost of

health care is escalating — both sides of the House will

certainly agree to this — more quickly than we'd like to see.

At the same time, we are dedicated to providing the best level

of health care we can in this province.

So the committee looked carefully at the model for

reorganization. We looked at the Foulkes report. It was found — and I concur with the committee in this — that it would have

been impossible under the present circumstances to do that kind

of wide-sweeping reorganization which was called for, not only

within the department but also from the grassroots, given the

time span that we're given.

Remember this: the report itself indicated that you have to

be able to put the department together in a period of a year to

14 months; otherwise the thing breaks down as it has in other

provinces where there's a tremendous amount of shock and

feeling of, "I wonder where I'm going to be next." So

therefore, we felt this kind of change is the kind of change

that we should bring about.

We think we've done the right thing because we haven't

closed off the ends. We recognize that it's been called for

that we go the PPBS route in this province: Planned Programmed

Budgeting System. But it's impossible in light of the fact that

they're trying it in other jurisdictions — they're trying it in

Ontario; they're trying it in Ottawa — and having a great deal

of trouble with it. Why should we invite that kind of trouble

at the present time? So Treasury Board indicates that this is

the way they would best like us to go.

Decentralization is still a major objective, but you have to phase in decentralization.

We want to organize in compatible regions; we don't think the regions are set

up compatibly at this point. We want to think in terms of co-terminus boundaries;

we want to think in terms of the size of regions where people can relate to

one another. There's an awful lot that has to be done. I don't think it would

be fair to ask any government department to reorganize in such a way that it

would actually revolutionize itself into disarray. So that's why we went this

direction.

Why reorganize? Well, we have four separate departments,

each reporting without an organized input from the other

departments, many overlaps and, of course, vacuums created as a

result. So basically, Mr. Speaker, the need was for a vehicle to

present that policy, to overcome the problems and to improve

that co-ordination. So the programme is one Department of

Health, a senior deputy and two branches.

There will be a branch dealing with community needs:

community health service, public health, home care, community

mental health, community health centres and community care

licensing facilities. That's one side of the department, and

that's a branch.

The other side will be the institutions: insurance services,

hospital insurance, medicare. Government institutions,

incidentally, will be brought into that. You'll find yourself

now with Mental Health actually becoming a real part of the

Department of Health, representing on one side in the community

services and on the other side just exactly the same as the

hospitals under the institution aspect of the department.

Also on that side, we'll have the emergency health services

commission, we'll have the forensic psychiatric services

commission and, eventually, a diagnostic services authority.

B.C. Medical Centre, of course, will be very much inclined in

the direction of the institutional side of the division of the

department.

So the present Act does not permit the latitude needed. The

change, I think, is well thought out by hard-working people.

Under this new bill the reorganization process can take

place.

You will notice in the bill that I can delegate duties. We

couldn't possibly reorganize with people locked into certain

jobs through legislation because you'd have to have any number

of bills come before this House, minor housekeeping bills,

which would really not generate any kind of controversy

whatsoever. So therefore, this bill allows the kind of latitude

that's necessary in order to properly implement our

programme.

As reorganization takes place in an orderly way instead of

spurts, I think everyone will agree with the delegation of

authority. It means that the Minister of Health in the interim

has to take the responsibility. And who better? The Minister of

Health is the servant of the Legislature. So I think that's the

kind of responsibility that should be taken at this time.

[ Page 4524 ]

You'll note that the

schedule on the last few pages of the

Act brings other Acts into line with the Department of Health

Act. It merely makes minor amendments, giving us the latitude

that I've just been describing. So generally speaking, all that

work under the

schedule is clearly a housekeeping process.

There's no doubt that greater harmony can be brought about at

all levels by virtue of an administrative structure such as

we're implementing. This goes right to the delivery of health

service at the grassroots level.

Just to give you an idea — nutrition. We've got hospital

nutritionists and community nutritionists without very much

contact until recently. Now they can share kinds of

responsibilities that are shareable; they can work out a

delivery of that kind of preventive service that I think is

very, very necessary, and do it better.

Home care is another area. You've got your post-acute;

you've got a home-care delivery to chronically ill people. It

really becomes uncoordinated unless you have that close kind of

contact that you'd have under one single department.

It's said the best in the latest edition of the Science

Council of Canada's report: prevention has to begin and has to

take place; you have to build vehicles for prevention.

I'm sorry she's not in the chamber right now, but the

Minister of Consumer Services (Hon. Ms. Young) a couple of days

ago said boycott sugar. Right on! Right on! There is some

needed but we could sure cut down our intake of sugar. I think

the price is a blessing in disguise. I ask everybody in this

House to support the Minister of Consumer Services in calling

for that boycott.

The result will be that people will lose a couple of notches

in their belt and on their waistline. They'll be better off.

It's been called a killer by nutritionists, particularly in

England, recently. There's some discussion about it having as

much to do with chronic artery disease as cholesterol. So

really and truly, it might very well be a blessing.

These are the kinds of things that we have to be thinking

of. Right now our process is to put together a department that

can worry problems in the area of prevention as well as

providing therapeutic services.

The department has worked well, I believe, despite the

structure for the last couple of years. But it's time to

streamline the legislation and to streamline the job. I urge

the House to adopt this piece of legislation which really is

housekeeping legislation.

We have before us great demands. We have the traditional system calling for

programmes. We have programmes that are developing: ambulance services, acupuncture

programmes, forensic programmes, home-care programmes — all of these programmes

that have to have a vehicle that can put them together in such a way as they're

economical and providing a service to people in a way that people require, but

at the same time that don't cost us an arm and a leg.

So, Mr. Speaker, again I say to the House, if we want an

efficient health care system in this province, I suggest very

strongly that the House endorse this bill. I therefore move

second reading.

Mr. R.H. McClelland (Langley): Mr. Speaker, I won't

speak too long on this bill, because I know that the Minister

wants to get away to China in a couple of weeks with the

Premier (Hon. Mr. Barrett) to continue his studies into the

subject of acupuncture, which he mentioned earlier. We won't

needle you too much about that, Mr. Minister.

Before I get into some of the comments that the Minister

made, there are a couple of things I did want to ask the

Minister. They have regard to one of the hospitals under his

charge — Pearson Hospital — which has been a continuing concern,

particularly with regard to staffing at that hospital.

I think it may have been brought to the Minister's attention

before that on December 9, when a Christmas party was scheduled

at that hospital, for some reason, because there was no driver

for transportation service, the people in that hospital missed

their Christmas party.

Later on, as recently as Hallowe'en, another problem occurred

in that the people couldn't get away to attend various other

trips which were scheduled with Hallowe'en.

I wonder if the Minister could answer, in closing the debate

whether or not that job for a driver for that bus has been

advertised yet, and how soon the patients in that hospital can

expect to have their service again. It's a severe hardship on

people who already have certain disadvantages.

Also I wonder whether the Minister could bring us up to date

on the staffing situation at Pearson.

Mr. Speaker: Surely the Hon. Member knows that it's

the general principle of the bill we consider, and not details

that really are probably subject to the question period.

Mr. McClelland: Well, Mr. Speaker, the bill outlines

section 6 that: "The department, under the direction of the

Minister, shall have charge of all matters relating to public

health and government-operated health insurance programmes." I

would say that under that

section all matters pertaining to the

health care needs of the people of this province are fair

comment under the debate in general principle of this bill.

I appreciate the Minister's comments, Mr. Speaker, about

this bill being necessary to improve efficiency, about this

bill being necessary to halt the escalation of health care

costs. All of us on each side of the House are concerned about

those subjects. However,

[ Page 4525 ]

one of the comments made by the Health Minister had to do

with the delegation of authority. I wonder if we couldn't get a

little better definition of where that delegation of authority

will go.

You know, I'm a little concerned, and so is our party, Mr.

Speaker, that there's an undue preoccupation on the part of the

government with administrative development, with reorganization

of power structures. We must caution the Health Minister not to

lose sight of what the real needs are in this province, and

that's to make sure that our citizens receive the kind of

health care they require and deserve. We mustn't be blinded by

this government's obsession to feed the bureaucratic monster

until its growth is out of control.

Mr. Speaker: Excuse me, Hon. Member. Am I to take it

that you're the designated Member to lead in this debate for

your party?

Mr. McClelland: Yes, you may take that.

Mr. Speaker: So it would be 60 minutes rather than

Mr. McClelland: Yes, Mr. Speaker.

Mr. Speaker: Thank you. I just wanted to make that

clear.

Mr. McClelland: What did he say, 60 minutes? I

thought it was unlimited, Mr. Speaker.

Mr. Speaker: Oh, wait a minute. Oh, no, there's no

limit.

Mr. McClelland: That's right. Thank you very much,

Mr. Speaker.

Interjections.

Mr. McClelland: That's right, we must get the rules

very clear.

Mr. Speaker: I'd like to get it in advance instead of

having a wrangle later.

Interjections.

Mr. McClelland: I think that probably the rule is

that the light stays under your desk, Mr. Speaker, and you

don't have to bring it up while I'm speaking. (Laughter.)

But there is a serious concern on this side of the House

that we lost sight of the health care needs of the people in

this province and bury them under this kind of obsession for

control of power structures.

I wonder, despite the Health Minister's comments about not being able to implement

the Foulkes report in its entirety at least, that maybe this is the first step

toward the implementation of that Foulkes report. I get the uneasy feeling that

the Foulkes influence — Dr. Richard Foulkes' influence — is felt far more in

the Health department today than the Minister would care to have us know.

The Foulkes report, as we know, was almost paranoid in its

denunciation of the present system. While the Minister has been

pretty smooth in saying that it's just a report and that it's

just a basis for discussion, Dr. Foulkes is still around and

doing God-knows-what for this government, because we've never

been given a clear indication of what is happening with the

Health Security Research Project at this time.

We in the opposition think that it's time that the Minister

level with the House and tell us exactly what on earth Dr.

Foulkes is doing in the government these days. What is the

Health Security Research Project up to in today's health care

service?

Now some time ago, when this project was first being

proposed to the House, I suggested on March 9, 1973, that this

was not going to be any kind of a part-time project, but that

it would, in fact, become a full-time arm of government. The

Minister assured me that that would never happen. On March 9,

1973, the Minister said that the health security programme

under Dr. Foulkes "is a one-year programme." And he was

commenting in regard to questions I had asked at that time

about the cost of the Foulkes report and the Health Security

Research Project.

The Minister said at that time that there was nothing at all

to say that that particular programme was going to go beyond

next fall.

And then further, about a week later, on March 14, in answer

to another question about costs of the Health Security Research

Project, the Minister said: "Everybody is given a contract that

says he is finished in October." Of course, that's October,

1973. Yet, Mr. Speaker, Dr. Foulkes and his Health Security

Research Project are still around — another year later.

In regard to costs — somebody mentioned the cost of that

report yesterday — I think the Minister confirmed not too long

ago that the cost of that report, rather than the $250,000 or

somewhat less that this House approved, had been about six

months ago in the neighbourhood of $750,000. I would suggest to

the Minister that it must be well over $1 million now. When you

look at some of the new appointments that have been made and

the costs that are obviously still going on….

Interjection.

Mr. McClelland: Well, on order-in-council No. 2567

Frank Keeling is appointed as deputy director of the Health

Security Programme Project — salary

[ Page 4526 ]

$2,083 a month. What's he doing? What's his project? I

thought the project was supposed to be over in October,

No one has asked this House for approval to have that

project continued. Nobody has told us what's going to happen

with that project. Nobody has told us what that project is

doing today and how much it's costing. I'd like to know; is it

costing us $1 million, $1.25 million?

Hon. Mr. Hall: You voted for it in the estimates.

Mr. McClelland: The only estimates that we've ever

voted on in this House were estimates for $125,000 for the

Health Security Research Project — $125,000. Now we're faced

with costs of at least $750,000, and perhaps $1 million and

perhaps more. Don't you think, Mr. Speaker, through to the

Provincial Secretary (Hon. Mr. Hall), that this House has the

right to know how much that project is costing, and has the

right to know what they're doing today? That's the only

question we're asking, Mr. Speaker, and we have every right to

know the answers to those questions.

Hon. Mr. Hall: You voted for them.

Mr. McClelland: Mr. Speaker, we voted in estimates in

this House for $125,000 — that's all — for a programme that was

supposed to be completed in October, 1973, and for which the

Minister of Health gave us assurances….

Hon. Mr. Hall: You voted this year for it.

Mr. McClelland: Mr. Speaker, we never voted this year

for anything for that project.

Hon. Mr. Cocke: No, it's a different project, that's

why.

Mr. McClelland: Well, tell us what it is. Tell us

what it is, that's all we're asking, and how much it's

costing.

Mr. Speaker, that's what concerns us about this obsession

with bureaucracy, with power structures rather than health care

needs. The buildup of these bureaucracies, Mr. Speaker, is

really worrisome to those of us who are concerned about

providing for the social needs of all kinds of British

Columbians over the long haul, not over the short term.

It would be much different if any of these bureaucratic

structures would create more efficiency, but the record of this

government shows that the contrary seems to be true.

Rather than creating more efficiency, as the apparatus continues to build up,

Mr. Speaker, there seems to be pretty conclusive evidence that there's a decrease

in efficiency, because we see day after day in every department of this government,

Mr. Speaker, the things that used to take three weeks now take 3 months, or

6 months, or a year to get done.

As the staff builds up, the jobs don't get done in time, and

the people of British Columbia suffer because of it. And it

costs more ultimately to the taxpayer, because so much

government revenue, Mr. Speaker, is being wasted on just

keeping the wheels turning around. I'm afraid there'll be

nothing left over to keep all of those commitments in health

care delivery that the Minister made when he assumed

office.

I know perfectly well, Mr. Speaker, that the Minister's

intentions are of the very highest order and that he wants to

make sure that the people of British Columbia get the best

health care delivery service that is possible, but because that

money is going to be wasted on keeping that bureaucracy

running, his hands are going to be tied because all of that

money is going to be thrown out the window.

Mr. G.H. Anderson (Kamloops): Oh, poppycock!

Mr. McClelland: The finance Ministers of Canada,

including ours, are going to be meeting very soon, I

understand, to discuss the very subject that the Minister

talked about, and that is the soaring health care costs across

this country. I wonder, Mr. Speaker, when our Finance Minister

is down in Ottawa talking about health care costs, whether

he'll tell the other Finance Ministers of this country that the

pot is going to be dry in British Columbia because we blew all

of our savings on building a wasteful, centralized power

system, rather than a system which would deliver health care

needs in the most efficient manner possible. And because that

money isn't going to be made available, Mr. Speaker, what

happens to those commitments that the Health Minister made to

this House on earlier occasions.

If we don't have the money, if we continue to waste the

money, Mr. Speaker, on imprudent investments in the stock

market; if we continue to waste our money, Mr. Speaker, on

imprudent investments in private industry; if we continue to

waste our money, Mr. Speaker, on that kind of government folly,

how do we fill the gaps that are presently opening in the

health care delivery in this province? How do we take care of

all of those people who are now left out of the health care

delivery system? How do we take care of those people who are

caught in that grey area between the two extremes of health

care — extended- and acute-care services?

If we don't have the money, if we've wasted that money

because of the actions of a Finance Minister

[ Page 4527 ]

and a government which really doesn't understand the

economic realities of today, if we continue to waste our money

that way, how do we cross those boundaries, Mr. Speaker, and

make sure that health care, at whatever level, is made

available to all segments of society?

The Finance Minister talks about Can-Cel. Talk about your

losses on the stock market in B.C. Tel and Westcoast

Transmission, Mr. Finance Minister, through you, Mr. Speaker.

The Finance Minister stood up in this House one day and waved a

copy of The Province newspaper and said, "Oh, what a

good boy am I — I just made $1 million for the people of

British Columbia on the stock market." You've lost $10 million

since then, Mr. Finance Minister — $10 million or $15 million — and that money should have been used to provide the kind of

health care services that we need in this province, not wasted

and thrown away by a slot-machine Finance Minister who thinks

he can gamble away and play crap with the money of the people

of British Columbia. That money should have been spent on

health care delivery.

Interjections.

Mr. Speaker: On a point of order. The remarks that

the Hon. Member is making seem more appropriate to budget

debate than to the specific matters that are in principle to be

discussed in the bill. I would ask him if he could kindly

relate his remarks to the advisability or otherwise of these

changes that are to be made in accordance with the proposed

legislation. Could you kindly get back to the principle of the

bill?

Mr. McClelland: Right, Mr. Speaker, and if we waste

all that money and throw it away on stock ventures and gambling

on the stock market, then we don't have that money available to

take care of the needs which are implicit in this bill, which

is the delivery of health care service in this province.

Mr. Speaker: At that time it would be appropriate to

debate that in the budget when the appropriations are made.

Mr. McClelland: Mr. Speaker, the bill outlines the

Department of Health delivering health care services. If there

is no money to deliver those health care services, well you

might as well throw this bill out the window, because there'll

be nothing left for the people who need those services.

The same thing, Mr. Speaker, with the $100 million that this government has

wasted and thrown away on private ventures — that money should have been spent

to provide the kind of health care services which are delineated in this bill,

mental health services, extended care services, intermediate care services,

acute care services, new hospitals, new facilities for home care, new facilities

for the people of this province, Mr. Speaker, and that's what it's all about.

So how do we fill those gaps if we don't have any money?

When do we start? The Minister mentioned preventive care, and

everybody in this province, everybody in Canada knows that if

we don't get into preventive care programmes then the health

care costs in this country are going to soar beyond control.

But we need the money to get into them.

When do we really start to get into those areas of

preventive health care, Mr. Speaker? We're doing some good

things in this province, in home care, and early-discharge

programmes. But when do we start to expand those programmes?

When do we start to eliminate hospital admission in the first

place, in many cases, and really start saving some money?

We saw evidence in the Victoria papers not too very long

ago, a couple of days ago, as a matter of fact, that points out

very clearly, Mr. Speaker, that too many people occupying a

higher degree of expensive beds than they need to, and the

taxpayer has to pay the shot, Mr. Speaker.

The example is the same wherever you look. Every hospital

district in this province — we've heard evidence that as high

as 30 per cent of the patients in acute beds, are no longer

acutely ill, don't need that kind of service, and could be

treated in less costly facilities. Perhaps even more than 30

per cent, Mr. Speaker, of extended care patients could be

accommodated elsewhere. Where is the programme to provide for

the needs of these people caught in that gap?

You talk about budget, where are the dollars? That's right,

if we don't have the money we can't provide the programme. And

the money is being wasted. Mr. Speaker, you talk about budget,

$1 million budgeted this year for intermediate care facilities

is a drop in the bucket. It won't even take care of

administration. It won't even take care of the paperwork. It

sure won't provide any more beds.

So where are the programmes to fill these gaps? That's the

question that needs to be answered, Mr. Speaker. And here we

have another bill which deals with structural changes, which

deals with power structures, We look back at the Foulkes Report

and we know that once again there was an obsession in the

Foulkes report with power. Power was mentioned over and over

again and at least intimated in that report, rather than health

care delivery. Power was the important substance of that

report. Power!

So instead of a programme that details some new directions,

Mr. Speaker, we're back on the power trip again. I might just

mention, Mr. Speaker, that the home care and early discharge

programmes that I mentioned earlier, weren't started by the

government of the day, they were started by the previous

[ Page 4528 ]

government and pilot intermediate care facilities which are

now on stream in this province, were also started by the

previous government, and there's been no expansion on those

programmes.

Some Hon. Members: No, no!

Mr. McClelland: Of intermediate care. What about the

commitment, Mr. Speaker, by this government to provide a

prepaid dental care system? Where is that? Where is it? That

was a commitment by this Minister and this government. There's

no money, Mr. Speaker., That's why the commitment isn't being

met.

How about the commitment to get more paradental people into

remote areas of the province? Hundreds and hundreds and

hundreds of those people are needed right now to take care of

the dental needs of the children of this province. What about

that commitment?

There's no money, Mr. Speaker, that's why the commitment

can't be met.

What about the commitment to provide more funds for medical

research? There's no money, Mr. Speaker. That's why that

commitment can't be met, because the money has been wasted.

What about the commitment by the Minister to start educating

young people in good health and physical habits? I don't see

any new programmes in the schools for that. Also for preventive

medicine. No money, Mr. Speaker, that's why. Because the money

has been wasted on foolish extravaganzas by the Minister of

Finance.

Finally, Mr. Speaker, I think it's time that the Minister of

Health told the people of B.C. how much his department is

overrun — overspent.

How high are those overruns in the Health department to pick

up such costs as the $1 million or more for the continuing job

for the Minister's friend, Dr. Richard Foulkes, to pick up for

the costs of the increased bureaucracy, to pick up even for the

increased cost of the take-over of the ambulance service — a

programme that everybody in this House welcomed? But we're told

that the people responsible for that emergency programme are

spending money like it was going out of style, with no

budgeting. And that's exactly what happened in the other

department, Mr. Speaker.

I think we should ask this Minister to finally tell us what

the overruns are going to be in the Health department. Is that

department overspent by $20 million? By $40 million; by $103

million? How much, Mr. Speaker?

Interjection.

An Hon. Member: Watch your temper. Just keep chewing

that gum.

Mr. McClelland: That's another reason why the real

health care needs of this province may not be serviced in the

long term, Mr. Speaker — this government is operating as a

short-term government. They're spending money in such an

irresponsible manner that in the next year and the year after

that, and the year after that, and the year after that, just as

we've seen in the Human Resources department, with no budgeting and no accountability, there will be nobody to

carry on those programmes in the future. That's what bothers

the people in the opposition, Mr. Speaker.

So while this bill appears at first glance to be just a

simple housekeeping measure, it sure opens the door. It opens

the door, as the Minister himself mentioned in his opening

comments, for delegation of powers to a health supercrat in the

person, perhaps, of Dr. Richard Foulkes — I don't know. But

certainly the Minister is delegating his powers to somebody as

a supercrat, with that supercrat getting top billing in what

used to be the "Cocke and Foulkes show." Now it has been turned around to be the "Foulkes and Cocke show" with Dr. Foulkes on

top and the man who soon may become the one-man band in the

Health department, with the Minister abrogating his duties and

his responsibilities.

Mr. Speaker, rather than being just a simple — housekeeping

bill, there is fear that this bill may be the first step toward

the implementation of all of the things which are wrong with

that Health Security Programme Project Report, that is the

preoccupation with power, the preoccupation with administrative

structure, to the detriment of the real needs of health care

delivery in this province.

Mr. D.A. Anderson (Victoria): Mr. Speaker, I must say

I was astonished that the final word to the official opposition

were "the real needs of health care delivery in this province."

Now I think back to two years ago and I think of the previous

Minister, Mr. Loffmark, and I think that no better words could

better describe him and his programmes.

I've been known to criticize the present Minister, which I

do on occasions with great restraint, of course, but I must

congratulate him that in comparison with his predecessor, he's

a pillar of virtue.

I look back and I think of the tremendous amount of debate

that was taken up in that election campaign dealing with health

matters, dealing with the deliberate antagonizing of doctors

and other people in the health field. A deliberate attempt by

the government to set people against medical personnel who

served them. I can only say that the last word to the previous

speaker really did shock me because there has been an

improvement; there has been a distinct improvement under the

present Minister, and I congratulate him for it.

[ Page 4529 ]

Indeed, Mr. Speaker, when I'm on my feet saying a few kind

words — my usual practice — I checked the Hansard of my

last speech on the Health Minister's estimates, and I find that

twice in two paragraphs I congratulated him then for a

constructive and conciliatory approach which the previous

government did not have, and I would repeat that. There are

many things that I would like to say about health programmes,

and many things I have criticized of this government.

Hon. D. Barrett (Premier): A former Tory praised him

for the same thing.

Mr. D.A. Anderson: Well, you better watch out, Mr.

Premier, because yesterday the Minister of Agriculture could

only find one person in the opposition to praise, and that was

the former Tory — and he has tried every party in the House, and

yours is next, so you'd better watch it. (Laughter.)

Hon. Mr. Barrett: Okay, as long as he is going over

to your side. I want to make a public announcement; the answer

is no! (Laughter.)

Mr. D.A. Anderson: Well, it's got to come

sometime.

Nevertheless, back again to the reference to the previous

speaker — the wild statements of excess over budget. Now I

checked on this because I was, like everybody else in the

House, horrified by the Premier's words that every government

department would be overrun. The Premier said it and we were

all horrified. Shame on him. But I checked the Department of

Health and found that in statements of special warrants issued

between the session of 1974 and up to October 31, 1974, there

were only three, and I'll give the figures because I think they

are very modest. I think the Minister should be congratulated

on being one of the very few Ministers who's shown some

restraint.

Hon. Mr. Barrett: You're being factual; that's

damaging to his case.

Mr. D.A. Anderson: Well, I'm being factual, but it's

also damaging to every other one of your Ministers, Mr.

Premier.

Hon. Mr. Barrett: No, no. It's damaging to their

case. There is nothing you could damage with the facts.

Mr. D.A. Anderson: Well, let me suggest that on August 25, special warrant

No. 25 put $70,000 available for a validation study of multi-disciplinary advisory

board on exercise — presumably $70,000 spent buying bicycles, or something like

that. Now that was one; that was a special warrant….

Interjection.

Mr. D.A. Anderson: That was the PNE — the fitness

programme to encourage all those kids going to the PNE to buy

Barrett-burgers and Anderson-burgers. Thank you very much.

Interjections.

Mr. D.A. Anderson: Beg your pardon.

Interjections.

Mr. Speaker: Order, please. You can continue your

excellent conversation outside in the corridor.

Mr. D.A. Anderson: On September 27 there was special

warrant No. 43 — a grant to the Cerebral Palsy Association of

B.C. to the tune of $140,000. Again, outside a budget and

something I'm willing to accept.

October 31, warrant 58, supplementing vote 83, Local Health

Services, $2.5 million. Now these are the three budgetary

excesses, if you like, that I've been able to find — there may

be others — the Minister can correct me on his closing of this

debate.

But I would like to say that he has shown some restraint it

appears; in comparison with other Ministers he's shown a

substantial amount of restraint. I congratulate him for it.

While we may well be critical of odd details there, in terms of

his overall budget, it's not an excessive amount of overrun to

date. More may come later. But at the present time fair's fair,

and the Minister has shown a fair amount of restraint in the

fiscal area.

I would like to say that in his speech he mentioned this: he

talked about costs of the department; costs of health delivery — and I appreciate that too because they certainly are

increasing astronomically. The Foulkes report, which was talked

about again earlier, was something which his speech indicated

to me that he was essentially rejecting in at least its cost

aspect.

The Minister talked about advice from Treasury Board and

says that it's the way to go. Well, I would recommend to him

that he not follow Treasury Board's advice too closely

otherwise he may wind up with the cost overruns of other

departments. Perhaps he should continue with the budgeting

practices which have led to a relatively minor increase over

budget. I would suggest to him that following Treasury Board

advice is probably an unwise thing.

He talked of the planned programme and budgeting and it

would seem to me that that probably would be a desirable

objective.

Now, I've mentioned the Foulkes report. I'd like to say that

I am pleased that the Foulkes report on

[ Page 4530 ]

reorganization seems to have been ignored here. We have a

heavy emphasis on costs, and I think there really must be in

this government department a great deal of cost-watching as

well as cost analysis, because there are virtually innumerable

programmes one can get into to in the health and medical fields — innumerable in terms of dietary programmes. Just about

everything can be done — educational programmes for students,

dental programmes. All sorts of programmes can be put forward

in all good faith, all of which cost a pile of money, and the

real job of the Minister is to sort them out.

I may dispute from time to time how he sorts them out; which

ones he gives priority to. But it does appear to me that from

what he's said today, and this reorganization bill, that he is

at least aware of his responsibility to sort them out on a

factual basis, on a value basis, rather than on the basis

adopted by the previous Minister.

He mentioned community care and chronic care. The question

comes to mind at once, Mr. Speaker, as to why we really have

had nothing done so far on chronic-care hospitals and the

crushing financial burden upon those who are supporting their

parents or other senior citizens in these hospitals. The

enormous cost per month of keeping people in chronic care is of

concern to us all. I would suggest, if it's permissible under

the rules, that when he closes the debate he says a quick word

on that.

It's 2 1/2 years we've been waiting for that. It was a

commitment, I understood, of the government. It was certainly a

commitment. It was certainly a commitment of two other parties,

the Conservatives and ourselves, during the campaign. You have

a full 70 per cent of the electorate who voted for such

programmes, Mr. Minister, and in this instance I would suggest

that the time has come to tell us when we're going to proceed

on these, because I keep on running into people who keep on

saying: "When is it going to come? I know it's coming some

time, but when is it going to come?"

It costs thousands upon thousands per year per individual.

Something akin to the scheme started by the government in

Alberta — probably, I believe, a Social Credit government

started that — would be very desirable in British Columbia at

the present time.

The costs I worked out in '72 would be approximately $20 to

$25 million. It's a chunk of money, but in view of the

tremendous unevenness of the burden which the failure to have a

proper chronic-care programme results in, I think the Minister

might well indicate something along that line.

Now the Minister mentioned the need to delegate duties and

decentralization. I was very pleased to hear it. To date there

seems to be only one Minister who is at all interested in

decentralization, and that is the Minister of Human Resources

(Hon. Mr. Levi). He, from my experience and observations, appears to be virtually

unique in believing in decentralization. From this bill, and

the statements of the Minister, I gather he may have at least

one colleague in cabinet who supports decentralization.

I think it is tremendously important, in particular in the

health field. Programmes set up from Victoria, programmes run

on a province-wide basis or a national basis tend to be

expensive and in health care, let's face it, the dollars and

cents aspect is becoming the most critical at the present

time.

Sure, it is easy to say that if a child is ill, or something

of that nature, or if a child suffers from a certain disease,

no expense should be spared in curing that child. Now this, of

course, we would all like to subscribe to. But we do know there

are budgetary limitations. The Minister knows it, and one way

to get the best health service, I believe, is by

decentralization and by the delegation of duties which he

talked about.

The prevention programme which the Minister mentioned in

passing, when he talked about sugar and other things, I would

like to thank him for. I took

part in the testing, as did many

other Members of this House, Mr. Speaker, and I was told I was

one of the healthier MLAs, but since then I have gained 10

pounds, so I am now back to not eating sugar at the suggestion

of the Minister of Consumer Services (Hon. Ms. Young) who I

trust will also lose 10 pounds with me, or better.

Interjection.

Mr. D.A. Anderson: Well, I think you are referring

again, Mr. Premier, to the 300 IQ points that you tried to find

in the official opposition, and failed to do so.

A word, though, about another aspect of this bill. In this

bill you are taking the requirement that the Deputy Minister be

a medical doctor out. You are, in other words, allowing someone

who is not a medical doctor to take that post. Well, I thought

about this as carefully as I could. I consulted with a number

of people on this point in the medical field, medical doctors,

and they were fairly divided in their views.

I'm going to suggest that the Minister is correct in making

this change. The fact is that the person in question, Mr.

Mainguy, is highly regarded by the medical profession and they

have no doubts about him and his abilities. I think that the

Minister, in his need for flexibility, is probably right. As I

have mentioned before in this House it is, in my view, the

right and privilege of a government, of the executive, to name

a Deputy Minister, whether he be a political appointment or

not. I think in this particular instance we can criticize the

fact that he is a political appointment, but they do have that

right, and I think in this instance the Minister is making the

correct

[ Page 4531 ]

move.

If there are doubts about the correctness of this, perhaps

he could follow the example of the Attorney-General who, of

course, is the only man receiving a QC these days. You can

always give an honorary degree to anybody. The government has

this power and perhaps you could grant an honorary MD to

satisfy those few people who might object.

Interjection.

Mr. D.A. Anderson: It might well be phony, but then

so, of course, is the Attorney-General's QC.

Mr. Speaker, this bill is essentially reorganization. It

does not allow us a full debate on health matters. You've shown

a certain amount of latitude in allowing myself and the

previous speaker, as well as the Minister, in touching upon,

certain things, Mr. Speaker.

I would like to repeat what I said earlier, that it appears

the Minister is on the right track. It appears the bill is well

motivated and is a good bill, and we will of course be

supporting it.

Mr. Speaker, under these circumstances I normally take my

seat and turn it over to the representative of the Medical

Party of British Columbia on my left, here. But he's having a

caucus meeting at the moment trying to determine who is to be

the designated speaker for his party on this issue, and it is

extremely difficult. But if he has solved that problem I will

turn the floor over to the Medical Party of British

Columbia.

Mr. G.S. Wallace (Oak Bay): I just want to make it

plain, Mr. Speaker, before we get into any hassle over the

length of time I can speak, the caucus did decide that I am the

designated speaker. Actually there are problems in caucus

because when I take on the role of Whip, all I ever get is a

backlash. (Laughter.)

We, this party, our party….

Mr. D.A. Anderson: You used to get a backlash

before.

Mr. Wallace: Well, the backlash before would involve

a certain amount of looking around, but now at least I only

have to look forward. (Laughter.)

Mr. Speaker, we do support this bill. The debate so far has

ranged rather far and wide and again I hope that small though

we may be in numbers, that I am given the same privilege of

wandering all over the ballpark on health services if I should

choose.

But essentially this bill is to make the Department of Health more efficient

and to provide the wide spectrum of services to the people of the province,

as the Minister said, in the most efficient, economical and yet in the most

up-to-date fashion. There is no question that there are few areas of human endeavour

where the potential to do more is very great. Almost month by month the capacity

for Ministers of Health to become involved in providing a very justifiable and

very valuable increase in the range of health services is just the custom of

the day, and since the budgets must inevitably increase steadily, then the efficiency

of administration and the structure of administration becomes extremely important.

I would first of all like to echo the words of the Liberal

leader (Mr. D.A. Anderson), and say that I personally have the

greatest faith in Mr. Mainguy to carry out the job of Deputy

Minister of Health. I might say that in darker days in this

province during a former administration, people like Mr.

Mainguy served extremely well, in my view, despite some

circumstances which made their job very difficult. So I have no

hesitation in saying that my personal contact with Mr. Mainguy

has been very reassuring and I would agree with other comments

that it is not necessary to have a doctor as the Deputy

Minister of Health. affairs and health services. Most of us, as

doctors, tend to be educated and experienced in one field of

medicine, and I think the most important requirement for the

Deputy Minister of Health in this kind of department, with a

budget of hundreds of millions of dollars, is a man with a wide

outlook on the whole field of health services.

This is not to say that there isn't a doctor somewhere who

might have a very wide outlook, but generally speaking, to meet

both the medical and administrative requirements of the

deputy's job, I think perhaps it would be better, or at least

equally important in the hands of a non-medical person.

There is a tremendous overlap between the different arms of

the health team in meeting the needs of people, and certainly,

again, I would say that in my experience in former days before

this government came to power, there was a distinct lack of

even communication between people in the different divisions of

the department as it was then structured.

I'm not just referring to the political aspects. I'm talking

about men and women who I know personally, working in the civil

service, who in private would tell me how frustrating and

ridiculous it was that two departments would be planning

specific services where there was a very important degree of

overlap but where the actual communication and planning between

the two divisions or departments was negligible.

So this bill, if it does nothing else, and actually I think

it does a great deal more, at the very least establishes

clearly the importance of having all the services integrated to

the greatest degree, and the people in the different divisions

of the department communicating and cooperating.

[ Page 4532 ]

[Mr. Dent in the chair.]

I would certainly agree with the comments which have been

made about the Foulkes report. That, and this was certainly my

main concern about the Foulkes report, was that it emphasized

to a frightening degree, administration.

Now I have said today, and I say again, that certainly

administration, both its structure and its efficiency, are very

important obviously. But I would just make the remark — and I'm

sure the Minister is aware of this — that it can become too

easy to zero in so much on the administrative structure and the

administrative personnel, to lose sight of the patient, to be

so intent on departmentalizing or dividing the total Health

department into various branches and divisions and to have what

on paper appears to be a highly efficient, well-considered

administrative structure. But you go out into the communities

and find that services are either lacking or they're not being

delivered.

Some harsh comments have been made about escalating costs by

the Member for Langley (Mr. McClelland). I think that some of

the comments from the Member for Langley sound rather hollow in

the light of some of the lack of performance of his party.

Certainly he wasn't a member of that party, and I'll excuse him

on that basis, but if he had sat around caucus table as a

member of that party when it was government, he would not have

the gall to make some of the statements that he's made in this

House today. If he wants some affirmation of that criticism of

mine, maybe he should talk to Mr. Loffmark.

Mr. D.E. Lewis (Shuswap): Hear, hear!

MR. WALLACE: That was the kind of administration where the

Minister would mention to me that he couldn't take certain

matters to the Premier because the Premier didn't want to hear

anything about them. That's the kind of system that existed

before. I'm sure that the Member for Langley would not have

made some of the comments he's made today had he known how the

former administration functioned.

When there was a shortage of money, for whatever reason,

what was the first direction in which restrictions were placed

in that administration? Schools and hospitals. You could have

schools, but you couldn't have gymnasiums and libraries. And

you couldn't have hospitals.

I just say that while this government is sadly lacking — and it has been mentioned

already — and this government has certainly fallen down very sadly in the area

of intermediate care, I can well remember the Premier of today sitting down

the row here and making the most impassioned plea and, in fact, a sincere commitment

that the financing of nursing homes would be a top priority if the NDP became

government.

When I criticize as an opposition Member, I like to try and

put criticisms in context. There are some points I wish to make

where I commend this government. But if I have to level one

absolutely just and fair criticism, with regret, I have to say

that this government has absolutely failed miserably in keeping

a promise which the Premier of the day made more than two years

ago, when I sat here in this House and applauded and supported

him. Before that, in fact, I was trying to bring about the same

service when I was a Member of the former government.

I would just repeat, as has been said already, that the

example is there for us to at least look at, if not follow; and

that is in Alberta.

Perhaps while it is a little out of order to get into this

amount of detail, I do hope that the Minister might be given

the same latitude that opposition speakers are being given, in

closing the debate, to comment on the principle which surfaced

some time ago, but which seems to have been submerged again — namely the concept of having the patient pay $5.50 a day for

his care. At a time when Mincome is providing $228 or

thereabouts per month, this concept would seem to meet some of

the criticisms which have been raised about the tremendous cost

of health care.

Again, I find it difficult to follow some of the criticisms

which are directed at this Health Minister or, for that matter,

any Health Minister. It is that every politician consistently

is asking for wider range of service, more service, more

efficient and more often. Then, as soon as that service is

provided, there's an unholy outcry as to the cost.

I think, Mr. Speaker, in discussing efficiency in

administration, we can only go so far in expecting miracles.

The fact is that it wouldn't matter what government was sitting

over there today, or how efficient the administrative structure

was, or how efficient the personnel in that structure. If this

society wants free drugs and ambulance service and acupuncture

and counseling and home care and public health and mental

health services and all the services that are being mentioned

and many more that are being requested, let us at least be

responsible enough to recognize that this costs one large pile

of money.

In debating a bill which provides for the vehicle in

distributing services, I think we're all being a little less

than honest with ourselves unless we recognize, regardless of

the government in power, that the costs inevitably must

escalate. By what degree they escalate is something that is

open for debate, and the manner in which the increased costs

are approached and the funds raised is also, of course, very

much a political issue.

Certainly in this kind of relatively non-partisan

[ Page 4533 ]

debate — and I think all three opposition parties will

support this bill — I think it's timely to put this issue of

costs and the individual responsibility of the citizen clearly

in the picture.

One of the elements of administration in this government,

which I think one should mention, is that when this government

took over, there was deep dissention among the ranks of

hospital employees. By all the rules of collective bargaining

they had bargained and agreed upon a certain wage increase,

which the former administration chose to reduce arbitrarily by

30 per cent — thanks again to Mr. Loffmark.

To be fair, I shouldn't make that last comment and leave it

at that, because I know very well that it was the former

Minister of Finance (Hon. W.A.C. Bennett) who made it plain

that he had less respect for collective bargaining than he had

for cutting costs in the hospital field.

Hon. A.B. Macdonald (Attorney-General): He devalued

the Loff-mark? (Laughter.)

Mr. Wallace: The Attorney-General says: "He devalued

the Loff-mark." At any rate, Mr. Speaker, with some of the

problems we face here and the way in which we spend a great

deal of time on rather serious and sober issues, a little bit

of humour is certainly very welcome. It's always forthcoming

from the Attorney-General, although sometimes he's humorous

when I wish he would be serious.

So this reorganization of the department, I think, offers

real hope for the better administration and efficiency of the

department, as long as we're not losing sight of some of these

factors which neither this Minister or any other Minister of

Health can run away from. If you want more service and better

service, it's bound to cost more money, I hope the Minister of

Health might give us some idea in which direction the

department will function in the matter of the greatest

efficiency in the expenditure of revenues.

I would like the Minister, in closing the debate, to mention

who in the department — whether it will be the Deputy, Mr.

Mainguy — will have the direct responsibility of trying to

improve the relationship with regional hospital boards.

Regional hospital boards were set up in this province with a

very distinct and realistic purpose: to co-ordinate planning

and hospital services within regions.

As I said a moment ago, administration can sometimes look just great on paper

but it certainly is not working well and, in fact, is working very poorly in

the Capital Regional District, as the Minister well knows and as the Minister

has tried to correct. It seems to me, since hospitals are one of the main areas

in the Health department where funds are expended — for example 80 per cent

of the hospital bill is incurred by paying the wages of personnel in the hospitals

— that there is no more important component of the whole health services picture

than the regional hospital boards.

It perhaps comes strangely from me to talk about a greater

need for central action in regard to regional hospital boards.

But I have to ask the Minister, in closing the debate, whether

he would comment on his own appraisal of regional hospital

boards, how well or poorly they are functioning. And if they're

not working well, why are they working well?

To what degree does this new administrative structure…in

what way would it give us hope that perhaps the more personal

attention of the Deputy Minister, for example…. Would he be

the best route, or is the Deputy Minister himself planning any

kind of new avenue of approach to the regional hospital

boards?

The regional hospital board in the capital region is a flop,

and the people in this community are becoming absolutely

frustrated and impatient and very restless that there's so much

talk and very little action. I know that the Minister has been

in frequent communication with the Capital Regional Board in

recent weeks and months and that action has been taken by

order-in-council or will be taken to give more authority to the

advisory committee of the regional hospital board.

But when we debate a bill like this which essentially zeroes

in on administrative functions, and when one looks at how one

vital aspect of administration through the vehicle of the

regional hospital boards has failed, one again has to echo the

comment I made earlier: let us not overemphasize administration

as holding out the kind of miraculous cure for all the ails and

ills of the delivery of health services.

The regional hospital board, I believe, is a concept that

could work well and really has to work well simply to avoid

duplication and excessive costs at various hospitals within the

same region.

So with that last negative note, I wonder if the Minister

would comment on that, unless there are others wishing to

speak.

MR. P.C. ROLSTON (Dewdney): With all the Members here

supporting Bill 166, the Department of Health Amendment Act, it

brings back one of the nightmares I had as a newly elected

greenhorn MLA from Dewdney riding going to a meeting once with

the medical staff of the Maple Ridge hospital and listening to

these people. This was after a month and a half of being an

MLA.

Then I was invited to meet all the doctors, all 30 doctors,

at Maple Ridge. I think there were some of the members of the

board of the hospital. Maple Ridge, of course, being a growth

area in the lower mainland…. We went down to the basement of

this

[ Page 4534 ]

hospital into the boardroom, and the great, steel fire-door

rolled shut and I could hear a click. I felt that the lights

were being turned on this greenhorn MLA from Dewdney, where

very competent doctors like Gallagher, Terwiel and a great

number of people put me in a bear pit. I felt in a pretty

vulnerable position for a couple of hours as they let out a lot

of bile about 20 years of just what was not happening in health

care — not just in Maple Ridge but in many parts of the

province. These were doctors who were genuinely concerned with

the delivery of health care. There were just such a range of

things.

Certainly they were after me and they didn't know what to

think of our new Minister, I'm sure. They're very confident in

him now, but it was then a whole new ball game. You know, when

you're dealing with health care, you're dealing with life and

death, and it's a pretty personal business. There was a

tremendous amount of hostility, if I can use the word, that

came out during that meeting, much of it towards me. I think we

left resolved that we were going to, first of all, basically

get some sense of organization into this very large

structure.

I must say that I don't know if I ever did understand the

medical services aspect as distinct from the hospital

insurance. I still have a lot of uncertainty there. I can

better understand the mental health branch. I think I can best

understand the public health branch. But it was confusing to

have four separate Ministries, each with a Deputy Minister.

Then there was the confusion that I guess in many

constituencies existed between the public health and also

mental health, often with separate jurisdictions, separate

boards, separate staffs — sometimes, fortunately not in Maple

Ridge, in separate buildings. And then there was the

relationship of these people to the clinics and especially to

the hospitals.

The real misunderstanding that I felt between public health

officers and private medical people — I just found in my first

year as an MLA that this was something that had to be cleaned

up. First of all, there was the basic need for a sense of

order, a sense of direction, surely a simpler system of

accountability. I know that this reorganization is going to do

that. At least it simplifies it down to, you know, the senior

Deputy. Incidentally, it seems common sense that you get the

best person; it shouldn't be the profession that determines the

slot. Long ago in the church we felt that you don't need to

have a clergyman to be the head of the United Church of Canada — at least the earthly head. We've long since got over that

kind of a problem and look forward to some other churches

taking a similar position.

An Hon. Member: Earthy or earthly?

Mr. Rolston: Earthly, yes.

There is now a community services aspect of medicine and of

health care. We're thinking of public health and mental health;

we're thinking of the whole better utilization of these staff

in the community. Of course, there's the other side; there's

the institutional, the medical, the hospital side.

If I could just say something first about the medical — the

doctors…. I was impressed with an editorial in the B.C.

Medical Association, I think half a year ago, talking about the

doctor-patient relationship — something that I think all

governments want to promote. One thing I would certainly hope

is that there would be a…. I don't believe this is

deteriorating as badly as many cynics say. I guess it's the old

kind of relationship where the old family doctor went to see

people who had incurable illnesses.

Here we could think of illnesses of diphtheria and the croup

and tuberculosis and pneumonia and polio, many illnesses which

are still with us but not so prevalent as they were in the days

when the doctor obviously had a much more regular kind of

relationship with these people. With special drugs now and much

better hospital facilities, better preventive medicine, I would

hope that that kind of a relationship isn't quite as necessary.

But what is important…I think this is still an important

relationship. Maybe the doctor's not up on a pedestal. Like the

clergyman, he's not up there on a parapet like he sometimes

was.

Interjection.

Mr. Rolston: Well, yes. That's another matter,

another debate.

But we want to relate to these people. There has to be a

sense of the patient and the physician as equals — not equals

in the sense of knowledge but certainly equals in the sense of

humanity and as persons. One thing this will mean is that the

patient will help himself, that he will take greater

precaution, preventive medicine; there will be less anxiety,

less trauma in getting a physical and healing.

I am sure that there is a greater volume of work done by the

doctors, and therefore the relationship of the patient is a

little different. I hope that the medical people and, I hope,

this new reorganization will ensure that there will be less of

a kind of responding to illness and, more hopefully, that this

reorganization will help that there's more preventing of

recurring: illnesses. If it's a fellow who has athlete's foot

and he's still having difficulty…. I met a fellow recently

who'd been taking pills off and on, not very systematically.

You know, he should have gone in. If that was a problem three

years ago and it's recurring, it's time that he automatically

take the incurrence to have that prevented.

I'd like to ask a question, Mr. Speaker, on the

[ Page

4535 ]

whole business of personnel management. I think that in my

experience in two years in serving the constituents of Dewdney,

sometimes there are problems with the personnel management. I

trust that this new reorganization will do a real job on this.

Dr. Foulkes several times referred to the need for better

morale and better management of the top people in the health

sciences, more attention to the needs of these people, more

attention to the needs of the women workers in this profession — certainly much more training of the general practitioners.

I'm hoping, Mr. Speaker, that the Minister will laud the

University of British Columbia, which is now more aggressively

trying to train Canadian indigenous public health officers. I

realize there are financial reasons why often people come from

Scotland and England because of special training programmes in

public health. But maybe the time is coming….

Mr. Wallace: What have you got against the Scots?

Mr. Rolston: Nothing, nothing at all. But there are

programmes. I'm looking forward to speaking next week, if I can

be out of this chamber, to the med students of UBC on aspects

of public health and marriage preparation. I would hope that

there's more money, and I hope this reorganization will promote

that — more training of the family physician, more training of

people who want to go into medicine who come from the boondocks

and are willing to go back to the boondocks. Dr. Foulkes

referred to that.

People who came from Masset who can be encouraged to come

down and take a full medical programme, either the MD

programme, or maybe the paramedical programme, who have that

kind of mindset, you see, who want to go back to the Queen

Charlotte Islands, or to Hazelton, or to Terrace, or the

Kispiox Valley — it could be that that is one alternative, that.

We can have a programme and maybe subsidize these people

through med school, knowing it is more likely that,

continuity-wise, they will go back to those areas.

I have lots of questions when we talk about reorganization

of the doctor-hospital side of your Ministry. I have questions

about labs. I find that the labs in the hospitals that I work

with are incredibly crowded — just bad, really bad. Of course,

there's a lot of pressure on them. There is tremendous pressure

on the little lab in Mission — a reasonably new hospital. But

if there's going to be more and more lab work done in the

hospital — if I understand our policy, if we're going to move

more and more towards lab work in the hospital rather than the

private labs run by doctors — it's going to be unbelievable

pressure on labs in the hospitals. Quite frankly we just don't

have the wherewithal in my riding to deliver that now — certainly not in Mission. Just big changes are going to take place there.

Of course, equally, I would say that as we develop emergency

programmes, with our excellent emergency facilities starting

this summer, there's again more and more pressure on the

emergency parts of hospitals as an aspect of outpatients, and

there's got to be a great deal more facility there.

It might interest the House that a small hospital like

Mission — a hospital that was built with 54 beds and now

actually has 60 beds, and is usually filled at 60 beds — it

might be of interest that there are 13,000 outpatient visits a

year in the Mission Hospital. Nearly as many as the Langley

Hospital, a much, much larger hospital, but nearly as many — 13,000 outpatients.

I'm thinking of, again, the lab — tremendous pressure on the

x-ray, increasingly more and more pressure on physiotherapy.

Again, many of our hospitals just weren't designed with that in

mind.

We're now having full-time staff people in some of the

smaller hospitals. CARS have done a great job in the past, but

this is kind of changing as we move more into physiotherapy.

Maybe as we talk about that, Mr. Speaker, it's fair to ask the

Minister what the relationship of physiotherapy and

occupational therapy is to the Workers Compensation Board where

often a fellow from away off in a remote area has to come down,

either to the facility of the Workers Compensation Board on

33rd Street, or in Shaughnessy, or in the new facility

presently under construction in Richmond. Couldn't much of that

occupational and other physio work be done in that hospital?

Surely that's the way we're going. Again, design-wise and

space-wise, the whole organization of the hospital side of your

department needs to incorporate that in its planning.

I am delighted that we are getting 60 acute-care beds in the

Maple Ridge Hospital. I continue to ask the Minister, and I

have talked to your construction department many, many times

…. I thought we were going for the psychiatric wards. as an

essential ingredient in most medium-sized general hospitals. I

can think of Nanaimo, for instance — a medium-sized general

hospital with an excellent psychiatric ward. I just assumed

that was the way we were going.

I keep asking the Minister and his department if we could

have 60 beds plus a psychiatric ward which I would assume is

the less-expensive facility; it doesn't require the heavy

medical costs of acute-care beds, but would be part of the

organization of hospitals in our province. It would get the

whole bit about being close to the community, and the various

healing people in the community would help the people in mental

and emotional distress.

These are some things I wanted to add to the debate on the

medical-hospital side of the Ministry, I know there is

tremendous pressure on the B.C. medical facility and that you

are going to increase

[ Page 4536 ]

Shaughnessy alone from 600 to 1,120 beds. There are at

least four large diagnostic centres now in Vancouver which will

be part of the B.C. Medical Centre, and presumably people in

B.C. can zero in on certain centres for special work.

There will be morale and a great deal of confidence, not

just in pediatrics but in many things — just as in Toronto the

people think of the Sick Children's Hospital. All 8 million

people of Ontario zoom in on that tremendous diagnostic centre

in downtown Toronto for special referrals. Again, we are

decentralizing health as much as we can, but there are some

special referrals which must be done.

Before I leave that aspect, there is this whole business of

training: we need tremendous training, and lab technicians. A

great deal needs to be done in just basic management people. At

last we have a dietician in the Mission hospital. We have

waited, but now we do, and we appreciate that.

There is the whole paramedic thing — respiratory people, a

variety of technologists in respiratory work and, of course,

nurses. And there has been a great deal of debate on the need

for doctors.

Anyway, we are talking about one side of your Ministry. The

other side, of course, which I especially get excited about, is

the community side: the community health, the public health,

the mental health, parts of physiotherapy, and you mentioned

home care.

I laud this because, first of all, it helps me to see to

health care in the whole sense, the total sense. We don't make

that gray distinction between mental health and physical

health. If I understand Dr. Foulkes, this is certainly one of

the things he was trying to emphasize. I would like to say that

theologically, or any other way, as we see health, if a guy is

sick, he's sick. It doesn't matter if it is physical or

emotional.

We need to have a community facility which can really deal

with that so we can support that person — the Minister has heard

me many times asking. As we talk about the whole health, we

talk about family health, emotional health, marital health. The

Minister has heard me, and I hope at some time there can be an

honest exchange of feelings on the need for helping in

counseling and training people for marriage and developing the

family. I fully respect the Minister; he is responsible for the

marriage Act; it is under his charge, and I respect his

reservations about certain people….

Deputy Speaker: Order, please. I would ask the Hon.

Member to direct his remarks more directly to the principle of

the bill.

Mr. Rolston: The marriage Act is under…. Well,

reorganization includes a lot of things. We'll get to that

debate sometime, I hope.

Anyway, total health: there is total preventive health in marriage and family

— physical and emotional.

Finally, of course, on the community side, once again I

would reiterate a plea I have made twice before for health

boards for an area. I realize it is not incorporated right now

in this amendment, but I would think that ultimately the day is

coming for a health board which would incorporate mental

health, public health and the hospitals. Presumably, it would

be contiguous to the regional districts. Now, that can present

problems because there are some places where it doesn't quite

make sense.

If the Minister could realize that, for instance, the

specialists come from Abbotsford and Chilliwack to the Mission

Memorial Hospital and, therefore, we are drawing from other

regional districts. The Member for Chilliwack (Mr. Schroeder)

realizes this. That medically makes good sense; we're on the

same telephone exchange and there is a referral system. The

Minister has bought an excellent referral telephone deal where

if there are acute problems at night we have a referral system

where we can get a specialist in Chilliwack or Abbotsford to

whip into the Mission hospital and deal with the case.

Unfortunately, politically that is in another regional

district. I am not sure what you do with that one. There are

already moves to see if politically the capital costs for

hospitals could be attached another way. Goodness knows, that's

another discussion.

It brings up the whole need to look ultimately…. Maybe a

year or so down the road you will see a need for simply a

local, indigenous health board, bringing all the people

together, co-ordinating, but in no way sacrificing individual

patient-doctor relationship at all. I think it would

co-ordinate the programmes.

For instance, we are still a little anxious that doctors in

Maple Ridge better use the new home-care programme. It's early;

it's the first month and it's slow getting going. But I think

such a board could say: "Look, you guys, this is the thing. We

are going for home care now. We hope to have 15 patients cared

for at a given time — we've hired coordinators and staff. Let's

use this. You asked for it over the last few years; let's

really use it."

Of course, I think it would avoid a proliferation of the

private hospitals and some of the small personal-care homes

that aren't really appropriate or aren't working that

creatively with the total health team of that area.

So I support the legislation. There is nothing more basic to

all the Members than feeling whole and feeling healthy.

Mrs. P.J. Jordan (North Okanagan): Mr. Speaker, I

really had to sit up and take notice of the former speaker's

statement. I am sure I didn't hear

[ Page 4537 ]

correctly when he was championing the cause of itinerant

surgery.

To anyone who is not familiar with it, itinerant surgery is

when you have surgeons travelling long distances to perform

surgery and leaving immediately after. This has to be done in

rare cases and it's something that we should be guarding

against very much in the future. I hope the Minister would do

this.

It sounds nice in blueprint, Mr. Member for Dewdney (Mr.

Rolston), but the problem is that every operation is not

completely successful and it's not without its complications.

If your specialist comes in and does gastric surgery and

leaves, or your gynecologist comes in and does a Caesarian and

leaves, and a bleeder develops, it's a matter of life and death

within minutes. There wouldn't be the facilities in terms of

emergency and surgical services that would be required at hand

to save that patient's life.

So I do hope the Hon, Minister of Health will take the

Member for Dewdney in hand and certainly not control him but

explain to him that that approach to medicine would be another

bill leading us backwards into the future. I personally believe

that itinerant surgery is not something that we should

encourage. I think I would get very strong backing from the

medical profession as a whole, and I don't mean just

physicians.

I rather enjoyed the Member for Dewdney's delightfully fresh

statement that when he was first elected he was taken

downstairs by some doctors and he felt genuine hostility. I

wonder if that Member has been out in the province lately to

talk to farmers, insurance agents, taxpayers, little people? I

suggest that there is a great feeling of hostility that I hope

will be as effective on you in terms of your voting on some of

this legislation as your thoughts were and your reaction was to

the medical aspect. I would just say, in all good humour, that

if I were you, I wouldn't preen my feathers too soon because

you may be plucked sooner than you think.

You just read an

article that may well have been the

plucking of a couple of pinfeathers….

Deputy Speaker: Order, please!

Mrs. Jordan: …in the honeymoon of medicine that's

going on under this administration.

Deputy Speaker: I would ask the Hon. Member to

address the Chair, please.

Interjection.

Mrs. Jordan: Well, on acupuncture, I'll certainly give the Minister

credit. He had an open mind; he has had proper authorities investigate it and

has stopped any professional bias that might remain or have prohibited it. I

would caution him not to go overboard.

Certainly, in light of all the commissions that have already

been over there, I must seriously question just what advantage

there is going to be to the health care of British Columbia by

the Minister going to study acupuncture in China, But that's not what I intend to talk about.

Hon. Mr. Cocke: That wasn't announced.

Mrs. Jordan: Well, you were so reticent to announce

it, we thought we'd better announce it for you. You wouldn't

want to keep the people of British Columbia in the dark, Mr.

Minister, I know.

In the old bill that this seeks to amend,

section 3 gave the

Minister management and direction of his department but had no

provisions, we agree, for wholesale delegation by the Minister

of his duties and responsibilities.

The new bill does provide in

section 2 that the Minister

preside over and be responsible for his department, and it also

provides a wholesale delegation of power. To sum that up in a

few simple words, I believe what it says is that the Minister

will move out of direct daily involvement in his department and

will delegate his former functions under the old third

section

of management and direction to someone else.

One must look upon this with mixed emotions because there's

little question that medicine is a changing science and a

changing art. Restructuring is always required; structures must

move forward as do the arts and science. So I am prepared to

support this bill on the basis of this need.

I wouldn't want to disappoint the Minister and not ask this

vital question: is it the bill that makes Richard Foulkes the

Minister of Health?

But I don't want to dwell on that sort of thing. I do want

to ask if it is really desirable, at a time when health-care

policy in this province is undergoing and expecting to undergo

fundamental changes, that the Minister should be getting less

involved. One would hope that this is a procedural matter and

that the Minister will be involved as much as he has been since

talking office.

The reason one has to ask this question is that we've seen

bills like this before in the House and we've seen disastrous

results. We know that the Minister himself is a director of

ICBC. Whether ICBC is a result of his direct involvement in

this programme or the lack of it I'm not in a position to say

at the moment. But it can hardly be used either way as a vote

of confidence for this Minister who is one of the few Ministers

who has some association with business in the government.

I think it would be a shame if this bill was, in effect, a

removal of some of the Minister's direct

[ Page 4538 ]

responsibilities by delegation with a view that he should be

shunted to the left to take a more direct involvement in ICBC — and I don't intend to discuss ICBC.

But with due respect, the Minister has proven himself

certainly one of the more successful Ministers among his

colleagues. I suppose one could say he stands out well above

the group of inefficiency experts that surround him, But I

believe it's because the majority of his time has been spent in

this field of medical and health care.

We hope, Mr. Minister, very much that this bill will not, in

essence, move you from a close relationship with this field.

The programmes that were initiated before your administration

were on stream when your administration came into a position of

authority and have grown. Some were initiated by yourself. But

it's absolutely essential at this time that there be vital

involvement by the Minister.

I don't want to be too critical of the Minister. As I say, I

think he's one of the better Ministers in that group of

inefficiency experts. I'm not really sure, when you look at

what they've done whether that's saying much, but I do mean it

as a compliment.

Certainly he has shown himself very adept in the public

relations area. One can sense, just at the debate of this bill,

a very finely-tuned public relations circle going on. When the

bill comes into the House, just on the day when it's about to

be debated. by the government — poof! — a really glowing

article comes out in the Vancouver Sun on the B.C.

Medical Centre. And then the bill doesn't come on the floor for

debate. While the Sun said that there would be more

feature articles day by day, the next day the

article doesn't

appear. But then when the bill is thought to come up again, the

next

article appears. I don't intend to go into great detail on

those articles — I think there'll be much time….

Interjection.

Mrs. Jordan: I'm not saying he's got the Sun ,

but I suggest he does know the reporter very well and this has

been very helpful, As I said, it's a masterful and finely-tuned

public relations programme, and he has shone in this area in

his administration.

But what has to be borne in mind in speaking to this bill

is, as I mentioned, the fact that the bill permits the Minister

to shuffle many of his usual duties over to officials.

One area of concern that comes up, when you think of what has happened in other

departments of your government, is the whole area of mental health. We believe,

and the professions believe, that this is an incorporation — and everyone's

pleased about this — of mental health under more direct involvement, with a moving

of some specific instances to the Minister of Human Resources (Hon. Mr. Levi).

I hope that Minister will confirm that that is, in fact, the approach he intends

to take and that there isn't going to be a shifting of more mental health services

to the Human Resources department.

Also, he might briefly outline the future of mental health

in British Columbia.

I must speak for a moment on costs. Really, it's the first

time that he has spoken with even a mild inference that costs

might be a matter of concern. It's like the old missionaries:

we don't talk about money; the good Lord will provide. And He

usually did, through the generosity of other people. The

Minister has adopted this attitude around the province and

hospital boards have this attitude.

I think that wage-and-contract negotiations have been

negotiated with this attitude in mind. It's very commendable,

but it seems to me, Mr. Minister, that the chickens are going

to come home to roost and you must be much more specific in

your concerns.

I would refer you to one of the Sun articles where it states

very clearly — and I'm not going into all the details of why

costs are escalating — on November 6, that'

"Most of the money that is being spent and is being budgeted

in the future is going to be channelled through the hospital system, which is

being reshaped by the emergence of the B.C. Medical Centre."

When you read the acceleration of costs now and you listen

to what the proposed accelerations are going to be, Mr.

Minister, this B.C. Medical Centre is indeed going to be a

very expensive situation.

What concerns me is that right in the

article it says that

Vancouver General, for example, and St. Paul's will probably

end this year with deficits of about $750,000 and $400,000

respectively. But both expect no problem getting the money. In

the previous

article someone made it very clear that a great

deal of money has to be spent, but they are not really too

concerned about that.

I suggest, Mr. Minister, that one of the things you must be

greatly concerned about is not penny-pinching, but indeed

knowing where your money is going to go, knowing in terms of

capital construction, in terms of operating costs, because many

of the programmes that are being initiated have very heavy,

ongoing, in-built costs. It is not simply a matter of those

costs as you see them in the next three to five years. It's

what's going to happen to those costs over the next 10 to 20

years, and how the demands of such powerful machinery that

you're setting up are going to affect the priorities of health

care in this province.

I think the Minister will agree with me — and he has said

publicly in the east and, I believe, in the States — that

British Columbia has enjoyed one of the highest standards of

medical care and health service in the world for the greatest

number of people. We have

[ Page 4539 ]

the highest standard in nursing education; we have the

highest standard in practical nursing education. We have the

highest standards in medical education. We have the quality

hospitals in nearly every area of this province. And that is

not to be sneezed at.

Certainly some things have had to be sacrificed, just as

the Minister will have to sacrifice in the future. One of the

questions that must be answered is: where are those priorities

going to lie? We must strive to keep up the local and regional

health care and their facilities, and we must strive to see

that the health-delivery programmes in British Columbia are

such that they continue to attract quality people, whether they

are trained in British Columbia or not, and that we don't do

whose basic qualification is that they are willing to suffer

and serve and peddle pills under a very suppressive and

initiative-starved system, and where there is a system of

layering, which is absolutely stifling to anyone in any sector

of delivery of health care.

I would caution the Minister, when one examines the

potential of administrative distribution and the potential for

great bureaucratic development in this bill, and in some of the

other bills that are under

section 6 of his administration,

that in British Columbia we have had a high standard of medical

care. We have attracted quality people to deliver this service.

We have among the highest quality for all paramedical services

in Canada and, I might add, the seventh-lowest — or among the

highest qualified — physicians in Canada on an overall standard

of training.

I suggest the reason those physicians have come here was

because the system itself that was practised here has been a

very attractive system to both patient and doctor, and also to

the paramedical services. There has been a degree in the

patient and doctor relationship which is not enjoyed

everywhere, and there certainly has been a degree of

cooperation in the B.C. Medical Plan, because it was worked

out between the doctors and the government. It has probably

been the most successful, in terms of patient service and

meeting the needs of the doctors and being financially

responsible, of any plan in the world. I'm sure the

Minister realizes this.

But is the Minister aware, when he talks in terms of growing

costs, of the cost squeeze that is going on out there within

the medical profession, for example — I won't talk about the

hospitals because someone else has — where they're built into a

payment system on fee for service, which should be continued,

which hasn't taken into account their rising costs of

operation?

There's the fact that nurses have received increases, the minimum wage has

gone up, office help price has gone up and will have to go up more. The costs

of operating any services within the clinic, Mr. Speaker, have gone up. The

operation of these clinics in forms of taxes, Hydro power, heating, have all

gone up, and we are having growing in British Columbia something we have never

had before.

I'm certainly not speaking for all, but the majority of

medical clinics in this province which have been functioning on

the concept of close relationship between varieties of

physicians in their specialties in order to give the patients

the best possible service, and even many doctors operating on

their own, simply are not going to be able to continue to give

the service that they have in the past or that they want,

because they are not going to be able to afford to operate

their clinics.

Their own remunerative position and the fact that they are,

by and large, such dedicated people is the reason there hasn't

been a lot of public talk about it. Their hourly income runs

around $5.50 for the average physician on a greatly extended

hourly basis — not by their own choosing but by the nature of

the practices they are involved in.

They are in the position now of not having guarantees of

holidays, time off, regular hours, weekends. Yet they are

earning less than perhaps the local plumber or electrician and,

in many instances, other jobs which don't require any major

training.

I'm not championing any particular cause, but I point this

out to the Minister as one of the cost squeezes, one of the

accelerating cost problems that must be faced if you are to

plug in to this plan the way you want to all these services.

The success of this plan to a large degree depends upon the

nurses and the physicians. You cannot do it without them and

you cannot do it without their cooperation. It is a matter

which should be recognized in your early budgeting stages, and

I fear that it hasn't.

In saying this I would again caution the Minister, when one

looks at this blueprint he's designing for medicine — and

that's what it is — that not only is the challenge going to be

in implementing it in an effective manner for the patient and

those involved in the delivery of care, but that we are not

moving towards the implementation of the programme that went in

in Manitoba, which is gorgeous in design and disastrous in

patient care, because the patient is absolutely lost in the

shuffle; that we don't develop in Canada the same system that

has developed in England where you have a two-tier system of

medical care, one for the wealthy and those who can afford it,

and the other for the poor; that we maintain the freedom of

physicians and nurses to move about as their ability and needs

direct to maintain flexibility and ability for the professions

in all sectors of interest to respond rapidly to medical

changes; and that we don't get into a system where one centre

of the province is favoured over another in providing

facilities so that we have again what they have in England — just years of waiting lists and inadequate

[ Page 4540 ]

facilities.

We have to see in British Columbia that our regional and

local hospital facilities for acute care maintain and expand

the service that they are, so that people who don't live in the

lower mainland and who aren't near to highly specialized

centres where this service could be given just as well out in

their own region, have to face the extra cost of coming down,

the extra emotional problems, and sometimes very serious health

problems.

I'm sure I'll have more to say about that under the

Minister's estimates. I would just remind him, in this grand

design that is evolving, of the recommendation of quality care

and service of the British Columbia Medical Association of

July, 1973, where they say:

"The British Columbia Medical Association therefore believes

it essential that the family physician should not only have

free access to hospitals within his community but should have

appropriate use of their services. Only in this way will

high-quality, concerned and informed primary care medicine

continue to be available throughout the communities."

I would suggest that that is a very vital recommendation for

the Minister to bear in mind as he delegates more and more

authority to see that the qualified practising physician has

his input and has a good deal of responsible freedom to

practise his profession and doesn't become locked into a

hierarchy where nothing short of death of a senior will see any

change.

I would recommend just on this point that the Minister

consider, in incorporating any heavy medical structure — perhaps such as the B.C. Medical Centre — that appointments be

considered on a term basis, perhaps 5-year review and 10-year

maximum, so that an individual can come in, be chosen for

various reasons, can exercise those reasons to the very best of

their ability with their enthusiasm, with their freshness, with

their open minds, and they can do a good job and they can move

on to other areas with grace and in the best interest of the

patients and patient care in the province.

I am a little concerned in addressing this bill because it

was mentioned somewhere in an

article by Tim Padmore on

November 6 in the Sun that health care in British Columbia was

the second biggest business to MacMillan Bloedel. I just hope,

when one reads through the terms of care and levels of care — and I hope even more after listening to the Minister a few

minutes ago when he talked about this level of care and that

level of care (I can't even recall all the different pinpoints

he had) — that we're not going to start turning out health care

like we do plywood and whether intentioned or not, end up a

system of health care in British Columbia that is marked like

plywood.

You're good on one side or you're sanded on the other side. This is marked

for sheeting, if you'll pardon the expression, or this is a utility health care,

or this is D-grade health care. I think this is what has happened in England

and I'm sure the Minister would agree that this is something we don't want to

happen in British Columbia.

It's all very well to talk in terms of big business, and we

may be second only to MacMillan Bloedel But, for goodness'

sakes, let's not run health care like you run MacMillan

Bloedel. It's people we're dealing with — human beings, not

trees.

Listening to the Minister talk about his levels of care and

talking about finances, I would ask him one question and

perhaps he would elaborate on it. In the

article in the Sun on

November 6 it defines various levels of care and who will pay

for what. I draw your attention to primary care, which refers

to the patient's initial contact with the medical professional — an ambulance driver or general practitioner, for example.

This is to be paid for at the local level.

Now, is it the Minister's intention to shift some of the

cost-sharing and some of the cost responsibility of the

programmes that he is developing or that this director may

develop onto the local level? Is it the Minister's intention

that all ambulance services should be paid for at the local

level? Perhaps you can clear that up for me.

I'd like to speak for a minute on continuing education.

Others have mentioned some of the gaps in medical service in

British Columbia at this time This is a gap, Mr. Minister,

where you yourself have compounded the problem and compounded

some ill feeling. It's in this whole area of continuing

education.

Your speech today was predicated on the expansion of

facilities, expansion of care, expansion of services. But who

is going to carry out all of these? I know that the B.C.

Medical Centre has a good design or a blueprint for long-term

training, and I know they have a design sometime for continuing

education programmes. But the need, Mr. Speaker, is now, and

this need is growing every day.

Traditionally there is a concern in this area. Right now we

find that universities and higher education institutions are

being very heavily funded in the training of health personnel

and in health programmes. But there's an irregular system of

funding for continuing education. It's been traditional to this

point, and it may well mean changing, but continuing education

is the area under which continuing education for health

programmes for nurses has been done, and this has been through

the extension departments.

What has happened now is that there is such heavy funding in

the universities themselves, which are not interested in

carrying on these programmes of a clinical nature in continuing

education because

[ Page 4541 ]

they're concentrating on their programmes,. that the

extension departments have been literally told to paddle their

own canoes. And there just are not funds available today for

this type of education. Their own overall budgets are very

marginal.

I believe it's high time — I think the nurses believe that

it's high time — that continuing education was recognized and

funded. The Minister has offered funding for forms of

continuing medical education to the physicians in this

province. He pays for….

Interjections.

Mrs. Jordan: Well, I checked yesterday, Mr. Minister,

and I'm told, "Not so."

Interjection.

Mrs. Jordan: Perhaps there's a breakdown in liaison

because my understanding is that certainly the registered

nurses don't know about this.

Interjection.

Mrs. Jordan: Well, then, I'm not getting across to

you. Is this a long-term programme? Is this a short-term

programme?

Interjection.

Mrs. Jordan: Well, is this going to allow for

planning and development money for training programmes?

Deputy Speaker: Order, please! I would ask the Hon.

Member to relate her remarks more directly to the principle of

the bill and not get in too detailed a discussion at this

time.

Mrs. Jordan: Thank you, Mr. Speaker. This is under

the Minister's administration. We are passing a bill delegating

more powers from him and we're concerned about the fact that

this delegation may interrupt a continuity of service to the

patient, which health care is all about. We're concerned about

bureaucracies building that have no relationship to the

patient.

One of the most vital areas of concern in nursing today is

the lack of funds for continuing education. It takes anywhere

from two months to 16 weeks to develop a proper programme for

continuing education in various areas of health.

Nurses in British Columbia are deeply concerned that more and more demands

are being made on them in their nursing practice, and more and more changes

are coming along for which they haven't the opportunities to upgrade their knowledge

and their abilities. It's always been a changing situation but it has accelerated

greatly. To their knowledge, there are not these moneys available, and they

would like to see them made available.

I suggest to the Minister, in the interest of carrying out

some of the changes in medicine or the continuation of some of

these medical programmes, that this money must be made

available, If it's there and they don't know about it, why not?

Why don't they know about it?

I hope that this sort of funding for nurses is not going to

be incorporated in the wage-and-working-conditions negotiation.

I hope it will be made free so that the responsible groups

within nursing education can design the plans as they see them

needed in the delivery of health care, not as some contract

suggests that they should be made. That freedom and flexibility

must be there.

Interjection.

Mrs. Jordan: Mr. Minister, I have tried to be

constructive and kind. You, in this bill, have another stupid,

massive NDP bureaucracy. We've tried to give you the benefit of

the doubt; we've tried to praise you where praise is due. We

have not unduly criticized you. But I suggest the day is

coming, if your administration doesn't change, when the people

of this province will condemn you most seriously. And you turn

around and giggle.

Speaking of bureaucracies, Mr. Speaker, I'd like to mention

something that's going on in the province. We've had one case

right now where there has been a breakdown of liaison. I ask

the Minister and point out to him that this is another

danger.

In the hospitals around British Columbia there has been a

large increase in administrative staff. One of these problems

is that there is, intentionally or unintentionally, a breakdown

of communication. I have had letters and met with some people

around the province where we have positions available in the

hospitals but not being advertised and where we have young

people taking special training in order to practise in our

hospitals in British Columbia — such as licensed practical

nurses and orderlies — going back to their home towns or going

to a community and going to the hospital to apply for a job.

When they apply for that job. they're told that there isn't one

available and that they should call back every once in a

while.

This has happened in many places. I have a specific case

here where a young lady was financed by her family at over

$2,000 to take a practical nursing course. She graduated with

top marks or very good marks. She wasn't eligible for financial

assistance under Canada Manpower because she had done the very

sinful thing of going from high school right into training

without taking a year off to go on welfare. So she didn't

qualify for any training mone